Quiz - Cardiovascular Drugs

A patient with chronic congestive heart failure has repeated hospitalizations in spite of ongoing treatment with hydrochlorothiazide [HydroDIURIL] and digoxin. The prescriber has ordered spironolactone [Aldactone] to be added to this patient's drug regimen, and the nurse provides education about this medication. Which statement by the patient indicates understanding of the teaching? A. "I need to stop taking potassium supplements." B. "I should use salt substitutes to prevent toxic side effects." C. "I should watch closely for dehydration." D. "I can expect improvement within a few hours after taking this drug."

A. "I need to stop taking potassium supplements."

A patient with a history of elevated triglycerides and LDL cholesterol begins taking nicotinic acid [Niacin]. The patient reports uncomfortable flushing of the face, neck, and ears when taking the drug. What will the nurse advise the patient? A. "You should take 325 mg of aspirin a half hour before each dose of Niacin to prevent this effect." B. "Ask your provider about assessing your serum uric acid levels which may be elevated." C. "You should stop taking the Niacin immediately since this is a serious adverse effect." D. "You should stop taking the Niacin immediately since this is a serious adverse effect."

A. "You should take 325 mg of aspirin a half hour before each dose of Niacin to prevent this effect."

The potassium-sparing diuretic spironolactone [Aldactone] prolongs survival and improves heart failure symptoms by which mechanism? A. Blocking aldosterone receptors B. Reducing afterload C. Reducing venous pressure D. Increasing diuresis

A. Blocking aldosterone receptors

Which plasma lipoprotein level is most concerning when considering the risk of coronary atherosclerosis? A. Elevated low-density lipoprotein B. Elevated high density lipoprotein C. elevated triglycerides D. Elevated total cholesterol

A. Elevated low-density lipoprotein

A nurse checks a patient's vital signs in the hospital and notes a blood pressure of 146/98 mm Hg. What will the nurse do? A. Recheck the patient's blood pressure in the other arm. B. Prepare the patient for an electrocardiogram and blood tests. C. Instruct the patient to consume a low-sodium diet. D. Request an order for a thiazide diuretic.

A. Recheck the patient's blood pressure in the other arm.

A patient has 2+ pitting edema of the lower extremities bilaterally. Auscultation of the lungs reveals crackles bilaterally, and the serum potassium level is 6 mEq/L (elevated). Which diuretic agent ordered by the prescriber should the nurse question? A. Spironolactone [Aldactone] B. Bumetanide [Bumex] C. Furosemide [Lasix] D. Hydrochlorothiazide [HydroDIURIL]

A. Spironolactone [Aldactone]

A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient? A. The patient should stop taking the medication and contact her provider immediately. B. The patient's prescriber probably will change her medication to an ARB. C. The fetus must be monitored closely while the patient is taking this drug. D. The fetus most likely will have serious congenital defects.

A. The patient should stop taking the medication and contact her provider immediately.

A patient who is taking simvastatin [Zocor] develops an infection and the provider orders azithromycin [Zithromax] to treat the infection. The nurse should be concerned if the patient complains of: A. muscle pain B. headache C. tiredness D. nausea

A. muscle pain

A patient who was in a motor vehicle accident sustained a severe head injury and is brought into the emergency department. The provider orders intravenous mannitol [Osmitrol]. The nurse knows that this is given to: A. reduce intracranial pressure. B. restore extracellular fluid. C. reduce peripheral edema. D. reduce reduce renal perfusion.

A. reduce intracranial pressure.

A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug? A. Spironolactone [Aldactone] B. Furosemide [Lasix] C. Mannitol [Osmitrol] D. Hydrochlorothiazide [HydroDIURIL]

B. Furosemide [Lasix]

A patient is taking enalapril [Vasotec]. The nurse understands that patients taking this type of drug for heart failure need to be monitored carefully for: A. Hypokalemia B. Hyperkalemia C. Hypertension D. Hypernatremia

B. Hyperkalemia

A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do? A. Request an order for a diuretic to counter the side effects of the ACE inhibitor. B. Instruct the patient not to get up without assistance. C. Make sure the patient takes a potassium supplement. D. Report the presence of a dry cough to the prescriber.

B. Instruct the patient not to get up without assistance.

A patient with hypertension will begin taking an alpha1 blocker. What will the nurse teach this patient? A. A persistent cough is a known side effect of this drug. B. Move slowly from sitting to standing when taking this drug. C. Eat foods rich in potassium while taking this drug. D. Report shortness of breath while taking this drug.

B. Move slowly from sitting to standing when taking this drug.

A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart failure. The prescriber has ordered furosemide [Lasix]. The nurse notes an irregular heart rate of 86 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the nurse the most concern? A. Sodium level of 140 mEq/L (normal) B. Potassium level of 3.5 mEq/L (low) C. Oxygen saturation of 90% (low) D. Blood glucose level of 120 mg/dL (elevated)

B. Potassium level of 3.5 mEq/L (low)

A patient with heart failure who has been given digoxin [Lanoxin] daily for a week complains of nausea. Before giving the next dose, the nurse will: A. review the serum electrolyte values and withhold the dose if the potassium level is greater than 3.5 mEq/L. B. assess the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute. C. request an order for a decreased dose of digoxin. D. contact the provider to report digoxin toxicity.

B. assess the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute.

Lovastatin [Mevacor] is prescribed for a patient for the first time. The nurse should provide the patient with which instruction? A. "You may take lovastatin without regard to meals." B. "Take this medicine on an empty stomach." C. "Take lovastatin with your evening meal." D. "Take this medicine before breakfast."

C. "Take lovastatin with your evening meal."

A prescriber orders ramipril [Altace] for an obese patient with type 2 diabetes mellitus who has developed hypertension. The nurse provides teaching before dismissing the patient home. Which statement by the patient indicates understanding of the teaching? A. "I should check my blood sugar more often, because hyperglycemia is a side effect of this drug." B. "I am less likely to develop diabetic nephropathy when taking this medication." C. "Taking this medication helps reduce my risk of stroke and heart attack." D. "This medication will probably prevent the development of diabetic retinopathy."

C. "Taking this medication helps reduce my risk of stroke and heart attack."

A nurse preparing to administer morning medications notes that a patient with a history of hypertension has been prescribed spironolactone [Aldactone]. The nurse assesses the patient and notes dyspnea, bilateral crackles, and pitting edema in both feet. Which intervention is appropriate? A. Contact the provider to request an order for serum electrolytes. B. Administer the medications as ordered. C. Contact provider to discuss an order for furosemide [Lasix]. D. Ask the patient about the use of salt substitutes.

C. Contact provider to discuss an order for furosemide [Lasix].

A patient is admitted with severe hypertensive crisis. The nurse will anticipate administering which medication? A. Minoxidil 20 mg PO B. Captopril PO C. Sodium nitroprusside [Nitropress] IV D. Hydralazine [Apresoline] 25 mg PO

C. Sodium nitroprusside [Nitropress] IV

A nurse is discussing how beta blockers work to decrease blood pressure with a nursing student. Which statement by the student indicates a need for further teaching? A. "Beta blockers decrease heart rate and contractility." B. "Beta blockers decrease the release of renin." C. "Beta blockers decrease peripheral vascular resistance." D. "Beta blockers block the actions of angiotensin II."

D. "Beta blockers block the actions of angiotensin II."

A female patient who begins taking spironolactone [Aldactone] as an adjunct to furosemide [Lasix] complains that her voice is deepening. What will the nurse do? A. Report this side effect to the provider and request another medication for this patient. B. Contact the provider to obtain an order for a complete blood count (CBC) and liver function tests. C. Teach the patient to report any associated cough, which may indicate a more severe side effect. D. Explain that this drug binds with receptors for steroid hormones, causing this effect.

D. Explain that this drug binds with receptors for steroid hormones, causing this effect.

A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct? A. Request an order to administer fosinopril instead of captopril. B. Administer the captopril and monitor for adverse effects. C. Reassure the patient that this is not a serious side effect. D. Hold the dose and notify the provider.

D. Hold the dose and notify the provider.