Cardiology Pharm

Triglycerides

Which clinical indicator would the nurse monitor to determine if the client's simvastatin is effective? Heart rate Triglycerides Blood pressure International normalized ratio (INR

Potassium chloride

1086) Which medication is unsafe to administer as an intravenous (IV) bolus? Saline flush Potassium chloride Naloxone Adenosine

The tablets are more than 3 months old.

1091) Which criterion is an indicator that the nitroglycerin sublingual tablets have lost their potency? Sublingual tingling is experienced. The tablets are more than 3 months old. The headache is less severe. Onset of relief is delayed.

Lower than usual dosage because the medication is metabolized at a diminished rate

The health care provider prescribes lidocaine to treat a ventricular dysrhythmia in a client with cirrhosis of the liver. Which alterations in the usual lidocaine dosage would the nurse anticipate for this client? Higher than usual dosage to compensate for the impaired liver function Lower than usual dosage because the medication is metabolized at a diminished rate Reduced dosage because other organs will compensate for the sluggish liver Equal dosage to that needed for other clients but used over a shorter duration

B. Yellow vision

When teaching a client about digoxin, which symptom will the nurse include as a reason to withhold the digoxin? A. Fatigue B. Yellow vision C. Persistent hiccups D. Increased urinary output

Daily weight Intake and output Monitor for edema Daily pulse oximetry Auscultate breath sounds

1546) The client with congestive heart failure is receiving furosemide 80 mg once daily. Which data collection assessment would be performed to evaluate medication effectiveness? Select all that apply. One, some, or all responses may be . Daily weight Intake and output Monitor for edema Daily pulse oximetry Auscultate breath sounds

Hypokalemia

1076) A client with cirrhosis of the liver has been taking chlorothiazide. The provider adds spironolactone to the client's medication regimen to prevent which condition? Hyponatremia Hypokalemia Ascites Peripheral neuropathy

Auscultating breath sounds

1079) A client is admitted to the hospital with a diagnosis of heart failure and acute pulmonary edema. The health care provider prescribes furosemide 40 mg intravenous (IV) stat to be repeated in 1 hour. Which nursing action will best evaluate the effectiveness of the furosemide in managing the client's condition? Performing daily weights Auscultating breath sounds Monitoring intake and output Assessing for dependent edema

Xerostomia

A client is receiving clonidine for hypertension. Which side effect of clonidine will the nurse include when providing medication education? Xerostomia Diarrhea Euphoria Photosensitivity

Captopril

1497) Which medication may be useful in managing hypertension in a child with acute glomerulonephritis? Digoxin Diazepam Captopril Phenytoin

Report increasing fatigue.

975) Which advice will the nurse include when teaching a client about digoxin for left ventricular failure? Sleep flat in bed. Follow a low-potassium diet. Take the pulse three times a day. Report increasing fatigue.

Decreased heart rate

976) A beta blocker is prescribed for the client with persistent ventricular tachycardia. Which response indicates that the beta blocker is working effectively? Decreased anxiety Reduced chest pain Decreased heart rate Increased blood pressure

Hypokalemia

A client is receiving furosemide to relieve edema. The nurse will monitor the client for which adverse effect? Hypernatremia Elevated blood urea nitrogen Hypokalemia Increase in the urine specific gravity

Morphine

A client who has been diagnosed with a myocardial infarction receives digoxin, fluoxetine, morphine, and docusate sodium. Which medication would the nurse identify as a risk factor for straining due to constipation? Digoxin Morphine Docusate Fluoxetine

They reduce the circulating blood volume.

A health care provider prescribes a diuretic for a client with hypertension. Which mechanism of action explains how diuretics reduce blood pressure? They facilitate vasodilation. They promotes smooth muscle relaxation. They reduce the circulating blood volume. They block the sympathetic nervous system.

Vomiting

A health care provider prescribes digoxin for a client. The nurse teaches the client to be alert for which common early indication of acute digoxin toxicity? Vomiting Urticaria Photophobia Respiratory distress

Weight loss Excessive loss of potassium ions

1184) A client is receiving furosemide to relieve edema. The nurse will monitor the client for which responses? Select all that apply. One, some, or all responses may be . Weight loss Negative nitrogen balance Increased urine specific gravity Excessive loss of potassium ions Pronounced retention of sodium ions

'I will hold the medication until I consult with your health care provider.'

1191) A client who takes furosemide and digoxin reports to the nurse that everything looks yellow. Which response by the nurse is most appropriate? 'This is related to your heart problems, not to the medication.' 'I will hold the medication until I consult with your health care provider.' 'It is a medication that is necessary, and that side effect is only temporary.' 'Take this dose, and when I see your health care provider, I will ask about it.'

'Stop the medication if swelling of the mouth, lips, or face develops.' 'Have blood drawn for potassium levels 2 weeks after starting the medication.'

1078) A client with hypertension is prescribed an angiotensin II receptor blocker (ARB). Which instructions will the nurse provide about this medication? Select all that apply. One, some, or all responses may be . 'Monitor the blood pressure daily.' 'Stop treatment if a cough develops.' 'Stop the medication if swelling of the mouth, lips, or face develops.' 'Have blood drawn for potassium levels 2 weeks after starting the medication.' 'Do not take nonsteroidal anti-inflammatory drugs (NSAIDs) concurrently with this medication.'

Increases the excretion of sodium

1102) Which mechanism of action explains how hydrochlorothiazide increases urine output? Increases the excretion of sodium Increases the glomerular filtration rate Decreases the reabsorption of potassium Increases renal perfusion

Nausea Yellow vision Irregular pulse

1104) Digoxin is prescribed for a client with heart failure. The nurse will assess for which signs and symptoms that indicate digoxin toxicity? Select all that apply. One, some, or all responses may be . Nausea Yellow vision Irregular pulse Increased urine output Heart rate of 64 beats/minute

Dizziness with strenuous activity

A client is receiving metoprolol. Which potential effect will the nurse teach the client to expect? Dizziness with strenuous activity Acceleration of the heart rate after eating a heavy meal Flushing sensations after taking the medication Pounding of the heart

Hypotension

A client with a myocardial infarction receives intravenous nitroglycerin to relieve pain. The nurse will assess for which medication side effect? Nausea Delirium Bradycardia Hypotension

D. Vomiting.

A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the client. Which finding requires the most immediate intervention? A. Heartburn. B. Headache. C. Constipation. D. Vomiting.

A. Heart rate decreases

Which action describes a therapeutic effect of atenolol? A. Heart rate decreases B. Cardiac output increases C. Bronchospasm is relieved D. Pulse oximetry improves

A. To report any abdominal distress

Which teaching would a nurse give to a client with a prescription for potassium supplements? A. To report any abdominal distress B. To use salt substitutes to season food C. To take the medication on an empty stomach D. To increase the dosage if muscle cramps occur

Oliguria is an indication for withholding IV potassium.

1020) Intravenous (IV) potassium is prescribed for a client with a diagnosis of hypokalemia. Which statement about administration of IV potassium is accurate? Oliguria is an indication for withholding IV potassium. Rapid infusion of potassium prevents burning at the IV site. Clients with severe deficits should be given IV push potassium. Average IV dosage of potassium should not exceed 60 mEq in 1 hour.

Use the dose measuring application paper and spread the ointment in a thin layer to the prescribed amount.

1065) The nurse is preparing to apply nitroglycerin ointment. Before applying the ointment, which action will the nurse take? Assess the client's pulse rate. Prepare the site with an alcohol swab. Shave the client's chest in the area for application. Use the dose measuring application paper and spread the ointment in a thin layer to the prescribed amount.

Blood pressure

887) A client is receiving hydrochlorothiazide. Which physiological alteration will the nurse monitor to best determine the effectiveness of the client's hydrochlorothiazide therapy? Blood pressure Decreasing edema Serum potassium level Urine specific gravity

Hyperkalemia

978) Valsartan, an angiotensin II receptor antagonist, is prescribed for a client. The nurse will monitor the client for which adverse effect? Constipation Hyperkalemia Hypertension Change in visual acuity

A. Digoxin

A client who takes multiple medications complains of severe nausea, and the client's heartbeat is irregular and slow. The nurse determines that these signs and symptoms are toxic effects of which medication? A. Digoxin B. Captopril C. Furosemide D. Morphine sulfate

Sublingual spray

A client with midsternal pain presents to the emergency department. Vital signs are stable. Which form of nitroglycerin would the nurse anticipate giving initially? Oral capsule Sublingual spray Intravenous solution Transdermal patch

Sympathomimetic

A health care provider in the emergency department identifies that a client is in cardiogenic shock. Which type of medication is indicated for management of this condition? Loop diuretic Cardiac glycoside Sympathomimetic Alpha-adrenergic blocker

'The medication may need to be discontinued. Come to the clinic this afternoon.

A client has been receiving digoxin. The client calls the clinic and complains of 'yellow vision.' Which response would the nurse provide? 'This is related to your illness rather than to your medication.' 'This is an expected side effect; you will become accustomed to it over time.' 'This side effect is only temporary. You should continue the medication.' 'The medication may need to be discontinued. Come to the clinic this afternoon.

Cardiac glycoside

A client receives a cardiac glycoside, a diuretic, an angiotensin-converting enzyme (ACE) inhibitor, and a vasodilator. The client's apical pulse rate is 44 beats/minute. The nurse concludes that the decreased heart rate is caused by which medication? Diuretic Vasodilator ACE inhibitor Cardiac glycoside

D. Angiotensin-converting enzyme (ACE) inhibitors

A client taking multiple medications for hypertension develops a persistent, hacking cough. Which antihypertensive medication class would the nurse identify as the likely cause of the cough? A. Thiazide diuretics B. Calcium channel blockers C. Direct renin inhibitors D. Angiotensin-converting enzyme (ACE) inhibitors

Amiodarone

A client who had a myocardial infarction has runs of ventricular tachycardia. Which medication will the nurse prepare to administer? Digoxin Furosemide Amiodarone Norepinephrine

D. Potassium decreases to 4.2 mEq/L (4.2 mmol/L).

The nurse administers sodium polystyrene sulfonate to a client with chronic renal failure. Which finding provides evidence that the intervention is effective? A. Pruritus decreases. B. Mental status improves. C. Sodium decreases to 137 mEq/L (137 mmol/L). D. Potassium decreases to 4.2 mEq/L (4.2 mmol/L).

'Remove a previous patch before applying the next one.'

1105) Which instruction would the nurse include in a teaching plan for nitroglycerin patches? 'Apply the patch on a distal extremity.' 'Remove a previous patch before applying the next one.' 'Massage the area gently after applying the patch to the skin.' 'Apply a warm compress to the site before attaching the patch.'

C. Cardiac dysrhythmias

Which clinical finding indicates that a client taking digoxin may have developed digoxin toxicity? A. Constipation B. Decreased urination C. Cardiac dysrhythmias D. Metallic taste in the mouth

'Increase your intake of fiber and fluid.'

872) Which instructions will the nurse include in the teaching plan for a client with hyperlipidemia who is being discharged with a prescription for cholestyramine? 'Increase your intake of fiber and fluid.' 'Take the medication before you go to bed.' 'Check your pulse before taking the medication.' 'Contact your health care provider if your skin turns yellow.'

An antihypertensive medication will likely be required for the remainder of life.

920) A client with the diagnosis of primary hypertension is started on a regimen of hydrochlorothiazide. Which information will the nurse include when providing instructions regarding this medication? A common side effect is decreased sexual libido. One dose should be omitted if dizziness occurs when standing up. The client should adjust the dosage daily based on the client's blood pressure. An antihypertensive medication will likely be required for the remainder of life.

Refrain for eating foods high in potassium.

A client with heart failure is prescribed spironolactone (Aldactone). Which information is most important for the nurse to provide to the client about diet modifications? A. Do not add salt to foods during preparation. B. Refrain for eating foods high in potassium. C. Restrict fluid intake to 1000 ml per day. D. Increase intake of milk and milk products.

Notify the health care provider that the potassium level is below normal.

895) A client hospitalized for uncontrolled hypertension and chest pain was started on a daily diuretic 2 days ago upon admission, with prescriptions for a daily basic metabolic panel. The client's potassium level this morning is 2.7 mEq/L (2.7 mmol/L). Which action will the nurse take next? Send another blood sample to the laboratory to retest the serum potassium level. Notify the health care provider that the potassium level is above normal. Notify the health care provider that the potassium level is below normal. No action is required because the potassium level is within normal limits.

A. Nitroglycerin.

A client with acute myocardial infarction is admitted to the coronary care unit. Which medication should the nurse administer to lessen the workload of the heart by decreasing the cardiac preload and afterload? A. Nitroglycerin. B. Propranolol (Inderal). C. Morphine. D. Captopril (Capoten).

Resolution of heart failure

922) A client is given a loading dose of digoxin and placed on a maintenance dose of digoxin 0.25 mg by mouth daily. Which responses would the nurse expect the client to exhibit when a therapeutic effect of digoxin is achieved? Resolution of heart failure Decreased anginal episodes Conversion of atrial fibrillation Decreased blood pressure

Monitor the client's blood pressure during therapy.

926) A health care provider prescribes enalapril for a client. Which nursing action is important? Assess the client for hypokalemia. Monitor for adverse effects on renal function. Monitor the client's blood pressure during therapy. Assess the client for hypoglycemia.

C. Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol).

A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO daily. When the client reports the onset of a headache prior to the next scheduled dose, which action should the nurse implement? A. Hold the next scheduled dose of Imdur 60 mg and administer a PRN dose of acetaminophen (Tylenol). B. Administer the 40 mg of Imdur and then contact the healthcare provider. C. Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol). D. Do not administer the next dose of Imdur or any acetaminophen until notifying the healthcare provider.

Hyperkalemia

1130) A client with cirrhosis of the liver develops ascites, and the health care provider prescribes spironolactone. The nurse will monitor the client for which adverse medication effect? Bruising Tachycardia Hyperkalemia Hypoglycemia

'Before physical activity, place one tablet under the tongue, and repeat the dose in 5 minutes if pain occurs.'

951) Which instructions about the use of nitroglycerin to prevent angina will the nurse provide to a client? 'At the point when pain first occurs, place two tablets under the tongue.' 'Place one tablet under the tongue before activity, and swallow another if pain occurs.' 'Before physical activity, place one tablet under the tongue, and repeat the dose in 5 minutes if pain occurs.' 'Place one tablet under the tongue when pain occurs and use an additional tablet after the attack to prevent recurrence.'

D. An activated partial thromboplastin time (aPTT) is twice the usual value.

A client who has atrial fibrillation with rapid ventricular response is started on a continuous heparin infusion. Which clinical finding enables the nurse to conclude that the heparin therapy is effective? A. Atrial fibrillation converts to a sinus rhythm. B. The heart rate is stabilized at 70 to 90 beats per minute. C. The international normalized ratio (INR) is within normal range. D. An activated partial thromboplastin time (aPTT) is twice the usual value.

'I should take one tablet before attempting activity that has caused angina.'

1089) Sublingual nitroglycerin is prescribed for a client with a history of a myocardial infarction and atrial tachycardia. The nurse instructs the client about the prophylactic use of these tablets. Which statement by the client indicates the teaching was effective? 'I should take the medicine three times a day.' 'I will be sure to take my pulse after I have exercised.' 'It will be important to avoid activities that can cause angina.' 'I should take one tablet before attempting activity that has caused angina.'

Avoid drinking grapefruit juice.

890) Which instruction will the nurse include in a teaching plan for a client taking a calcium channel blocker such as nifedipine? Select all that apply. One, some, or all responses may be . Reduce calcium intake. Report peripheral edema. Expect temporary hair loss. Avoid drinking grapefruit juice. Change to a standing position slowly.

Relaxing venous and arterial smooth muscles

899) The nurse provides instruction when the beta-blocker (BB) atenolol is prescribed for a client with moderate hypertension. Which client statement indicates to the nurse that further teaching is needed? 'I must take the medication before going to bed.' 'This medication will make me feel drowsy.' 'I need to count my pulse before taking the medication.' 'I will move slowly when changing positions from sitting to standing.'

Bradycardia

919) A client with hypertensive heart disease who had an acute episode of heart failure is to be discharged on a regimen of metoprolol and digoxin. Which outcome would the nurse anticipate when metoprolol is administered with digoxin? Headaches Bradycardia Hypertension Junctional tachycardia

Amiodarone

946) A client's cardiac monitor indicates multiple multifocal premature ventricular complexes (PVCs). Which medication is indicated for treatment of ventricular dysrhythmias? Amiodarone Epinephrine Methyldopa Hydrochlorothiazide

Do not abruptly discontinue the medication.

949) A client with hypertension has received a prescription for metoprolol. Which information will the nurse include when teaching this client about metoprolol? Do not abruptly discontinue the medication. Consume alcoholic beverages in moderation. Report a heart rate of less than 70 beats per minute. Increase the medication dosage if chest pain occurs.

'It decreases cardiac oxygen demand.'

953) The health care provider prescribes isosorbide dinitrate 10 mg for a client with chronic angina pectoris. The client asks the nurse why the isosorbide dinitrate is prescribed. How will the nurse respond? 'It prevents excessive blood clotting.' 'It suppresses irritability in the ventricles.' 'It decreases cardiac oxygen demand.' 'The inotropic action increases the force of contraction of the heart.'

Have the prescription, dosage calculations, and pump settings checked by a second nurse.

983) A health care provider prescribes milrinone for a client with congestive heart failure. Which action would the nurse perform first? Administer the loading dose over 10 minutes. Monitor the electrocardiogram (ECG) continuously for dysrhythmias during infusion. Assess the heart rate and blood pressure continuously during infusion. Have the prescription, dosage calculations, and pump settings checked by a second nurse.

Avoid prolonged exposure to the sun. Schedule regular ophthalmic examinations. Contact your health care provider if skin becomes gray-bronze.

987) Which instructions will the nurse include in the teaching plan for a client who will be taking simvastatin? Select all that apply. One, some, or all responses may be . Increase dietary intake of potassium. Avoid prolonged exposure to the sun. Schedule regular ophthalmic examinations. Take the medication at least half an hour before meals. Contact your health care provider if skin becomes gray-bronze.

D. Prevent electrolyte imbalance

Which reason would an intravenous infusion of 5% dextrose with 0.45% sodium chloride and 20 mEq of potassium be prescribed for a client with a nasogastric (NG) tube set to low intermittent suction? A. Prevent constipation B. Prevent dehydration C. Prevent vomiting D. Prevent electrolyte imbalance

Amiodarone

1066) The cardiac monitor reveals several runs of ventricular tachycardia. Which medication is used to treat this dysrhythmia? Atropine Epinephrine Amiodarone Sodium bicarbonate

A. Difficulty feeding with vomiting

An infant with congenital heart disease is prescribed digoxin and furosemide upon discharge. Which sign would the nurse instruct the parents to be alert for? A. Difficulty feeding with vomiting B. Cyanosis during periods of crying C. Daily naps lasting more than 3 hours D. A pulse rate faster than 100 beats/min

A. Change to standing positions slowly. C. Count the pulse before taking the medication. D. Mild weakness and fatigue are common side effects.

Atenolol is prescribed for a client with moderate hypertension. Which information would the nurse include when teaching the client about this medication? Select all that apply. One, some, or all responses may be . A. Change to standing positions slowly. B. Take the medication before going to bed. C. Count the pulse before taking the medication. D. Mild weakness and fatigue are common side effects. E. It is safe to take over-the-counter (OTC) medications

D. Decreased blood pressure

Captopril is prescribed for a client. Which effect would the nurse anticipate? A. Increased urine output B. Decreased anxiety C. Improved sleep D. Decreased blood pressure

Increased contractile force of the myocardium

Digoxin is prescribed for a client. Which therapeutic effect of digoxin would the nurse expect? Decreased cardiac output Decreased stroke volume of the heart Increased contractile force of the myocardium Increased electrical conduction through the atrioventricular (AV) node

B. Furosemide

Hypertension develops in a school-age child with acute glomerulonephritis. Which medication would the nurse anticipate providing teaching for? A. Digoxin B. Furosemide C. Diazepam D. Phenytoin

A. Digoxin

The client with hypokalemia reports nausea, vomiting, and seeing a yellow light around objects. Which of the client's medications is the likely cause of the client's symptoms? A. Digoxin B. Furosemide C. Propranolol D. Spironolactone

C. Skip this dose and give it at the next prescribed time.'

The clinic nurse receives a call from the mother of an infant prescribed digoxin. The mother reports she forgot whether she gave the morning dose of digoxin. Which response by the nurse is most appropriate? A. Give the next dose immediately.' B. Wait 2 hours before giving the medication.' C. Skip this dose and give it at the next prescribed time.' D. Take the baby's pulse and give the medication if it's more than 90 beats/min

C. Heart failure.

The healthcare provider prescribes a beta-1 agonist medication to be administered. The nurse should anticipate the medication to be prescribed for a client diagnosed with which condition? A. Glaucoma. B. Hypertension. C. Heart failure. D. Asthma.

B. Do not get up quickly. Always rise slowly.

The nitrate isosorbide dinitrate is prescribed for a client with angina. Which instruction should the nurse include in this client's discharge teaching plan? A. Quit taking the medication if dizziness occurs. B. Do not get up quickly. Always rise slowly. C. Take the medication with food only. D. Increase your intake of potassium-rich foods.

B. Cardiac arrest

The nurse administers a parenteral preparation of potassium slowly to avoid which complication? A. Metabolic acidosis B. Cardiac arrest C. Seizure activity D. Respiratory depression

D. Captopril E. Lisinopril

Which angiotensin-converting enzyme inhibitors (ACE inhibitors) are appropriate for a client with liver dysfunction? Select all that apply. One, some, or all responses may be . A. Ramipril B. Enalapril C. Quinapril D. Captopril E. Lisinopril

Urinary output of 200 mL during the previous 8 hours

Which assessment would be brought to the health care provider's attention before administration of intravenous potassium chloride? Progressively worsening muscle weakness Poor tissue turgor with tenting Urinary output of 200 mL during the previous 8 hours Oral fluid intake of 300 mL during the previous 12 hours

Blood pressure changes from 154/90 to 126/72 mm Hg

Which client response indicates to the nurse that a vasodilator medication is effective? Absence of adventitious breath sounds Increase in the daily amount of urine produced Pulse rate decreases from 110 to 75 beats/minute Blood pressure changes from 154/90 to 126/72 mm Hg

A. Bran can decrease digoxin absorption. B. Digoxin should not be taken with hawthorn supplements. C. Ginseng may cause a dangerous increase in digoxin levels in the blood. E. Medications that lower serum potassium or magnesium can cause digoxin toxicity.

Which lifestyle advice does the nurse give to a client when oral digoxin therapy is initiated? Select all that apply. One, some, or all responses may be . A. Bran can decrease digoxin absorption. B. Digoxin should not be taken with hawthorn supplements. C. Ginseng may cause a dangerous increase in digoxin levels in the blood. D. St. John's Wort can increase digoxin levels in the blood. E. Medications that lower serum potassium or magnesium can cause digoxin toxicity.

may experience a headache.'

1030) Which client statement indicates understanding of the side effects of nitroglycerin ointment? 'I may experience a headache.' 'Confusion is a common adverse effect.' 'A slow pulse rate in an expected side effect.' 'Increased blood pressure readings may occur initially.'

'This can decrease my vitamin K level.'

1033) Furosemide has been prescribed as part of the medical regimen for a client with hypertension. Which client statement indicates a need for medication education? 'This can decrease my vitamin K level.' 'I will take the medication in the morning.' 'I will contact my health care provider if I notice muscle weakness.' 'I plan to take the medication even when my blood pressure is normal.'

A. Broccoli

320) Which food would the nurse encourage a client to eat while receiving treatment to prevent hypokalemia? A. Broccoli B. Oatmeal C. Fried rice D.Canned carrots

B. Wheezing, hypotension, and AV block.

The nurse is providing care for a client prescribed propranolol. Which symptoms should the nurse report to the healthcare provider immediately? A. Headache, hypertension, and blurred vision. B. Wheezing, hypotension, and AV block. C. Vomiting, dilated pupils, and papilledema. D. Tinnitus, muscle weakness, and tachypnea.

A. Verify both prescriptions with the healthcare provider.

The nurse is transcribing a new prescription for spironolactone (Aldactone) for a client who receives an angiotensin-converting enzyme (ACE) inhibitor. Which action should the nurse implement? A. Verify both prescriptions with the healthcare provider. B. Report the medication interactions to the nurse manager. C. Hold the ACE inhibitor and give the new prescription. D. Transcribe and send the prescription to the pharmacy.

B. QRS duration of 0.28 seconds

When the nurse is administering intravenous potassium to a client with hypokalemia, which finding is most important to communicate to the health care provider? A. U waves on cardiac monitor B. QRS duration of 0.28 seconds C. Decreased bowel sounds D. Weakened grip strength

C. Hyperkalemia

Which adverse medication effect will a nurse monitor for in a client with cirrhosis of the liver who develops ascites and is prescribed spironolactone? A. Bruising B. Tachycardia C. Hyperkalemia D. Hypoglycemia

Checking the child's weight every day Calculating the dose of medication as carefully as possible Assessing the child regularly to help prevent electrolyte loss

1501) The nurse is caring for a child receiving furosemide for pulmonary edema. Which nursing intervention(s) would the nurse implement? Select all that apply. One, some, or all responses may be . Checking the child's weight every day Administering the medication on an empty stomach Calculating the dose of medication as carefully as possible Exposing the child to sunlight for increasing periods Assessing the child regularly to help prevent electrolyte loss

Digoxin

1537) A child being treated with cardiac medications developed vomiting, bradycardia, anorexia, and dysrhythmias. The nurse understands which medication toxicity is responsible for these symptoms? Digoxin Nesiritide Dobutamine Spironolactone

Eat more dark green, leafy vegetables such as spinach.

186) Which instruction regarding nutrition will the nurse give a client discharged after a short hospitalization for an episode of a transient ischemic attack (TIA) related to hypertension who is on a regimen that includes chlorothiazide? "Eat more dark green, leafy vegetables such as spinach." "Substitute a potassium-based salt substitute for table salt." "Return to previous eating habits." "Increase intake of dairy products."

A. Monitor the heart rate closely. B. Check the blood levels of digoxin. D. Monitor the serum potassium level.

386) Which nursing intervention is important when caring for clients receiving intravenous (IV) digoxin? Select all that apply. One, some, or all responses may be . A. Monitor the heart rate closely. B. Check the blood levels of digoxin. C. Administer the dose over 1 minute. D. Monitor the serum potassium level.

Pain subsides as a result of arteriole and venous dilation.

985) Sublingual nitroglycerin has been prescribed for a client with unstable angina. Which client response indicates that nitroglycerin is effective? Pain subsides as a result of arteriole and venous dilation. Pulse rate increases because the cardiac output has been stimulated. Sublingual area tingles because sensory nerves are being triggered. Capacity for activity improves as a response to increased collateral circulation.

A. Potassium level of 3.1 mEq/L.

A client is admitted to the hospital for a new onset of supraventricular tachycardia (SVT) and is prescribed digoxin. For which laboratory finding should the nurse notify the healthcare provider immediately? A. Potassium level of 3.1 mEq/L. B. Sodium level of 132 mEq/L. C. Calcium level of 8.6 mg/dL. D. Magnesium level of 1.2 mEq/L.

D. Heart failure.

A client is prescribed 1 mcg/kg/min of dobutamine hydrochloride via IV infusion. Which client's condition would benefit the most from an administration of dobutamine hydrochloride? A. Shock. B. Asthma. C. Hypotension. D. Heart failure.

D. Blood pressure from 180/120 mmHg to 140/70 mmHg.

A client is receiving clonidine 0.1 mg/24 hr via transdermal patch. Which assessment finding indicates the desired effect of the medication has been achieved? A. Absence of nausea and vomiting. B. Change in peripheral edema from +3 to +1. C. Denial of anginal pain and shortness of breath. D. Blood pressure from 180/120 mmHg to 140/70 mmHg

C. Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect.

A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in his legs. Which statement reflects the drug-specific teaching the nurse should provide to this client? A. Increase consumption of potassium-rich foods since low potassium levels can cause muscle spasms. B. Have serum electrolytes checked at the next scheduled appointment to assess hyponatremia, a cause of cramping. C. Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect. D. Be sure to consume a low-cholesterol diet while taking the drug to enhance the effectiveness of the drug.

A. 70 beats/min

According to developmental norms for a 5-year-old child, the nurse would hold digoxin if an apical heart rate falls below which number? A. 70 beats/min B. 80 beats/min C. 90 beats/min D. 100 beats/min

Difficulty breathing

Amlodipine is prescribed for a client with hypertension. Which response to the medication will the nurse instruct the client to report to the health care provider? Blurred vision Dizziness on rising Difficulty breathing Excessive urination

1 to 3 minutes

Nitroglycerin sublingual tablets are prescribed for a client with the diagnosis of angina. The nurse advises the client to anticipate pain relief will begin within which period of time? A. 1 to 3 minutes B. 4 to 5 seconds C. 30 to 45 seconds D. 10 to 15 minutes

Digoxin

One week after being hospitalized for an acute myocardial infarction, a client reports nausea and loss of appetite. Which of the client's prescribed medications would be withheld and the health care provider notified? Digoxin Propranolol Furosemide Spironolactone

Rise slowly when getting out of bed or chair.

The nurse is caring for a client who has taken atenolol for 2 years. The healthcare provider recently changed the medication to enalapril to manage the client's blood pressure. Which instruction should the nurse provide the client regarding the new medication? Take the medication at bedtime. Report presence of increased bruising. Check pulse before taking medication. Rise slowly when getting out of bed or chair.

B. Vomiting

The nurse is monitoring a 6-year-old child for toxicity precipitated by digoxin. Which sign of digoxin toxicity would the nurse monitor for? A. Oliguria B. Vomiting C. Tachypnea D. Splenomegaly

A. 'Change to a standing position slowly.'

The nurse prepares discharge instructions for a client who will take enalapril for hypertension. Which instruction would the nurse include in the client's teaching? A. 'Change to a standing position slowly.' B. This may color your urine green.' C. The medication may cause a sore throat for the first few days.' D. Schedule blood tests weekly for the first 2 months.'

Tremors

Which assessment finding would the nurse identify as an adverse effect of a client's lidocaine infusion? Tremors Tachypnea Tachycardia Hypertension

B. Decrease in cardiac dysrhythmias

Which client response must the nurse monitor to determine the effectiveness of amiodarone? A. Absence of ischemic chest pain B. Decrease in cardiac dysrhythmias C. Improvement in fasting lipid profile D. Maintenance of blood pressure control

'I need to change my position slowly.' 'I should eat more food that is high in potassium.'

Which client statements indicate that the teaching about furosemide is understood? Select all that apply. One, some, or all responses may be . 'It may take 2 or 3 days for this medication to take effect.' 'I should wear dark glasses when outdoors during the day.' 'I should avoid lying flat in bed.' 'I need to change my position slowly.' 'I should eat more food that is high in potassium.'

C. 'Common side effects include headache and low blood pressure.'

Which instruction would the nurse include when teaching the client about sublingual nitroglycerin? A. 'Once the tablet is dissolved, spit out the saliva.' B. Take tablets 3 minutes apart up to a maximum of five tablets.' C. 'Common side effects include headache and low blood pressure.' D. 'Once opened, the tablets should be refrigerated to prevent deterioration.'

A. Expected duration of flushing.

A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most important for the nurse to provide? A. Expected duration of flushing. B. Symptoms of hyperglycemia. C. Diets that minimize GI irritation. D. Comfort measures for pruritus.

Loop of Henle

1101) A health care provider prescribes furosemide for a client with hypervolemia. The nurse recalls that furosemide exerts its effects in which part of the renal system? Distal tubule Collecting duct Glomerulus of the nephron Loop of Henle

Slows and strengthens cardiac contractions

1062) A client with heart failure is to receive digoxin. Which therapeutic effect is associated with this medication? Reduces edema Increases cardiac conduction Increases rate of ventricular contractions Slows and strengthens cardiac contractions

Swallow the capsule whole.

878) A client is discharged with a prescription for sustained-release nitroglycerin. Which information will the nurse provide to the client? Swallow the capsule whole. Take the medication with milk. Place the capsule under the tongue. Crush the capsule and mix with soft food.

A. Hypokalemia

A client is given a prescription for bumetanide. The nurse will teach the client to watch for symptoms of which condition? A. Hypokalemia B. Hyperchloremia C. Hypernatremia D. Hypoglycemia

Inform the health care provider if you wish to become pregnant.

1067) A health care provider prescribes simvastatin 20 mg daily for elevated cholesterol and triglyceride levels for a female client. Which advice is important for the nurse to teach when the client initially takes the medication? Take the medication with breakfast. Have liver function tests every 6 months. Wear sunscreen to prevent photosensitivity reactions. Inform the health care provider if you wish to become pregnant.

Hypotension

1069) A client presents to the emergency department with chest pain. A myocardial infarction is suspected, and 500 mL of 5% dextrose in water (D 5W) with 50 mg of nitroglycerin intravenously (IV) has been prescribed. The nurse will monitor the client for which common side effect of nitroglycerin? Bradycardia Hypotension Nausea and vomiting Leg cramps

Apical heart rate

1080) Which assessment will the nurse conduct before administering digoxin to a client? Apical heart rate Radial pulse Difference between carotid and radial pulses Difference between apical and radial pulses

Dry mouth Constipation

865) A client is prescribed oral disopyramide to manage a ventricular dysrhythmia. Which side effects will the nurse include when teaching the client about this medication? Select all that apply. One, some, or all responses may be . Dry mouth Rhinorrhea Constipation Hyperglycemia Stress incontinence

Signs and symptoms of digoxin toxicity

869) The nurse is providing discharge medication teaching to a client who will be taking furosemide and digoxin after discharge from the hospital. Which information is important for the nurse to include in the teaching plan? Maintenance of a low-potassium diet Avoidance of foods high in cholesterol Signs and symptoms of digoxin toxicity Importance of monitoring output

Relief of anginal pain

The nurse has administered sublingual nitroglycerin. Which outcome would the nurse use to determine the effectiveness of sublingual nitroglycerin? Relief of anginal pain Improved cardiac output Decreased blood pressure Ease in respiratory effort

B. Buzzing ears

The nurse is administering 40 mg of furosemide intravenously. Which sensation reported by the client would the nurse consider when determining that it is being administered too quickly? A. Full bladder B. Buzzing ears C.Fast heartbeat D. Numb arms and legs

A. Assess for dizziness.

Which is an appropriate nursing action when caring for a client taking benazepril for hypertension? A. Assess for dizziness. B. Assess for dark, tarry stools. C. Administer the medication after meals. D. Monitor the electroencephalogram (EEG).

C. Risk for injury.

Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin-2 receptor antagonist irbesartan (Avapro)? A. Fluid volume deficit. B. Risk for infection. C. Risk for injury. D. Impaired sleep patterns.

B)"I will hold the medication until I consult with your health care provider."

Which response would a nurse give to a client who takes furosemide and digoxin and reports that everything looks yellow? A) "This is related to your heart problems, not to the medication." B)"I will hold the medication until I consult with your health care provider." C)"It is a medication that is necessary, and that side effect is only temporary." D)"Take this dose, and when I see your health care provider, I will ask about it."

Decreased cardiac preload reduces cardiac workload.

952) A client who had a myocardial infarction receives a prescription for a nitroglycerin patch. Which statement would the nurse identify as the purpose of the nitroglycerin patch? Decreased heart rate lowers cardiac output. Increased cardiac output increases oxygen demand. Decreased cardiac preload reduces cardiac workload. Peripheral venous and arterial constriction increases peripheral resistance.

Place the pill under the tongue and let it dissolve.

1108) A client has a prescription for a sublingual nitroglycerin tablet. Which technique will the nurse teach the client to use? Place the pill inside the cheek and let it dissolve. Place the pill under the tongue and let it dissolve. Chew the pill thoroughly and then swallow it. Swallow the pill with a full glass of water.

'Place the tablet under the tongue or between the cheek and gums.'

1145) The nurse is preparing a teaching plan for a client prescribed nitroglycerin sublingual. Which would the nurse include in the teaching? 'Place the tablet under the tongue or between the cheek and gums.' 'It takes 30 to 45 minutes for the nitroglycerin to achieve its effect.' 'If dizziness occurs, take a few deep breaths and lean the head back.' 'To facilitate absorption, drink a large glass of water after taking the medication.'

Calciferol (vitamin D)

1185) A client is prescribed cholestyramine for the treatment of type II hyperlipoproteinemia. Which vitamin would the nurse anticipate may become deficient because of this therapy? Niacin (vitamin B 3) Calciferol (vitamin D) Ascorbic acid (vitamin C) Cyanocobalamin (vitamin B 12)

'Increase the intake of potassium-rich foods.'

1194) A client diagnosed with a transient ischemic attack (TIA) related to hypertension is discharged with a prescription of hydrochlorothiazide. Which instruction would the nurse include when teaching about this medication? 'Resume regular eating habits.' 'Drink a protein supplement daily.' 'Avoid eating foods high in insoluble fiber.' 'Increase the intake of potassium-rich foods.'

Vomiting should be reported to the health care provider.

1486) The nurse is reviewing medication instructions with parents of an infant receiving digoxin and spironolactone. Which parental response indicates instructions have been understood? Activity should be restricted. Orange juice should be given daily. Vomiting should be reported to the health care provider. Anti-inflammatory medications should be avoided.

Obtain blood pressure. Measure intake and output. Weigh the client every morning. Notify the nurse if the client has a dry cough. Assist the client to change positions slowly.

43) Which instruction would the nurse give an unlicensed assistive personnel (UAP) to perform while caring for a client prescribed captopril? Select all that apply. One, some, or all responses may be . Obtain blood pressure. Measure intake and output. Weigh the client every morning. Notify the nurse if the client has a dry cough. Assist the client to change positions slowly.

Monitor the client for cardiac dysrhythmias.

871) When a client with type 1 diabetes develops heart failure, digoxin is prescribed. Which nursing action is important to include when planning care? Administer the digoxin 1 hour after the client's morning insulin. Monitor the client for cardiac dysrhythmias. Monitor for increased risk of hyperglycemia. Increase digoxin dosage if insulin requirements are increased.

Verify that the potassium is adequately diluted and not infusing too rapidly. Assess the IV site.

884) A client with an intravenous (IV) infusion containing 40 mEq of potassium reports a stinging pain at the IV site. Which actions will the nurse take? Select all that apply. One, some, or all responses may be . Restart the IV in a different vein. Assist the client through guided imagery. Assess the IV site. Ask the health care provider for pain medication. Verify that the potassium is adequately diluted and not infusing too rapidly

Decreased edema Decreased pulse rate Diuresis

886) A client with left ventricular heart failure and supraventricular tachycardia is prescribed digoxin 0.25 mg daily. Which changes would the nurse expect to find if this medication is therapeutically effective? Select all that apply. One, some, or all responses may be . Diuresis Tachycardia Decreased edema Decreased pulse rate Reduced heart murmur Jugular vein distention

Sodium bicarbonate

923) When a client's cells are deprived of oxygen during a cardiac arrest, which medication s for deleterious effects of anaerobic energy production? Regular insulin Calcium gluconate Potassium chloride Sodium bicarbonate

Potatoes Cantaloupe

941) Which dietary choices will the nurse instruct the client taking spironolactone to avoid increasing? Select all that apply. One, some, or all responses may be . Potatoes Red meat Cantaloupe Wheat bread Flavored yogurt

A. Withhold the scheduled dose.

The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker (ARB), for a client with hypertension and heart failure. The nurse reviews the client's laboratory results and notes that the client's serum potassium level is 5.9 mEq/L. Which action should the nurse take first? A. Withhold the scheduled dose. B. Check the client's apical pulse. C. Notify the healthcare provider. D. Repeat the serum potassium level.

B) Take the medication with food

Which information will the nurse include when teaching a client about potassium chloride effervescent tablets? A) Chew the tablet completely. B) Take the medication with food. C) Take the medication at bedtime D) Use warm water to dissolve the tablet.

A. Place the tablet under the tongue or between the cheek and gums."

Which information would the nurse include when preparing a teaching plan for a client prescribed sublingual nitroglycerin? A. Place the tablet under the tongue or between the cheek and gums." B. t takes 30 to 45 minutes for the nitroglycerin to achieve its effect." C. If dizziness occurs, take a few deep breaths and lean the head back." D. To facilitate absorption, drink a large glass of water after taking the medication."

it will be important to check my pulse rate daily.'

935) The nurse provides medication discharge instructions to a client who received a prescription for digoxin. Which statement by the client leads the nurse to conclude that the teaching was effective? 'I will avoid foods high in potassium.' 'I must increase my intake of vitamin K.' 'I should adjust the dosage according to my activities.' 'It will be important to check my pulse rate daily.'

D. Blood pressure reduced from 160/90 mmHg to 130/80 mmHg.

Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan has been achieved? A. Dependent edema reduced from +3 to +1. B. Serum HDL increased from 35 to 55 mg/dL. C. Pulse rate reduced from 150 to 90 beats/minute. D. Blood pressure reduced from 160/90 mmHg to 130/80 mmHg.

Relieved by sublingual nitroglycerin

945) Which pain characteristic would the nurse expect to observe when a client is experiencing anginal pain? Unchanged by rest Precipitated by light activity Described as a knifelike sharpness Relieved by sublingual nitroglycerin

Blocking the adrenergic response

979) A client who is receiving atenolol for hypertension frequently reports feeling dizzy. Which effect of atenolol is responsible for this response? Depleting acetylcholine Stimulating histamine release Blocking the adrenergic response Decreasing adrenal release of epinephrine

'HCTZ has fewer side effects.'

981) Hydrochlorothiazide (HCTZ) has been prescribed for a client with hypertension. The client reports hearing that furosemide is more effective and requests a prescription change. How will the nurse respond? 'HCTZ has fewer side effects.' 'HCTZ does not cause dizziness.' 'HCTZ is only taken when needed.' 'HCTZ does not cause dehydration.'

A. Furosemide

Which diuretic would the nurse anticipate administering to a client admitted with acute pulmonary edema? A. Furosemide B. Chlorothiazide C. Spironolactone D. Acetazolamide

C. Take your medicine exactly as prescribed.

Which information is most important for the nurse to teach a client prescribed an antihypertensive medication to be taken once in the morning and a 2-gram sodium diet? A. Avoid adding salt to cooked foods." B. Use less salt when preparing foods."" C. Take your medicine exactly as prescribed. D. Measure your blood pressure every morning."

A. Urinary output E. Last serum potassium level F. Patency of the intravenous access

Which nursing assessment would performed by a nurse before administering intravenous (IV) infusion of potassium chloride (KCl) 40 mEq in 100 mL of 5% dextrose and water to be infused over 2 hours? Select all that apply. One, some, or all responses may be . A. Urinary output B Deep tendon reflexes C. Last bowel movement D. Arterial blood gas results E. Last serum potassium level F. Patency of the intravenous access

A. Weight loss D. Excessive loss of potassium ions

Which response would a nurse monitor for when a client is receiving furosemide to relieve edema? Select all that apply. One, some, or all responses may be. A. Weight loss B. Negative nitrogen balance C. Increased urine specific gravity D. Excessive loss of potassium ions E. Pronounced retention of sodium ions

D. Check the blood pressure.

How would the nurse determine if a client is experiencing the therapeutic effect of valsartan? A. Check a lipid profile. B. Assess an apical pulse. C. Measure urinary output. D. Check the blood pressure.

D. Furosemide

A school-age child is admitted with hypertensive acute glomerulonephritis. Which medication would the nurse anticipate being prescribed initially in addition to hydralazine? A. Digoxin B. Alprazolam C. Phenytoin D. Furosemide

Paroxysmal nocturnal dyspnea

924) A client who has type 1 diabetes and chronic bronchitis is prescribed atenolol for the management of angina pectoris. Which clinical manifestation will alert the nurse to the fact that the client may be developing a life-threatening response to the medication? Paroxysmal nocturnal dyspnea Supraventricular tachycardia Malignant hypertension Hyperglycemia

Heart rate of 98 beats/minute

982) A client with supraventricular tachycardia (SVT) has a heart rate of 170 beats/minute. After treatment with diltiazem, which assessment indicates to the nurse that the diltiazem is effective? Increased urine output Blood pressure of 90/60 mm Hg Heart rate of 98 beats/minute No longer complaining of heart palpations

Digoxin toxicity occurs rapidly in the presence of hypokalemia.

A client has been given a prescription for furosemide 40 mg every day in conjunction with digoxin. Which concern would prompt the nurse to ask the health care provider about potassium supplements? Digoxin causes significant potassium depletion. The liver destroys potassium as digoxin is detoxified. Lasix requires adequate serum potassium to promote diuresis. Digoxin toxicity occurs rapidly in the presence of hypokalemia.

B. Give the medication as prescribed and continue to monitor the client.

A client prescribed atenolol has a blood pressure of 120/68 mmHg, displaying a sinus bradycardia with a rate of 58 beats/minute, and a P-R interval of 0.24. Which action should the nurse take? A. Lower the head of the bed and assess the client for orthostatic vital sign changes. B. Give the medication as prescribed and continue to monitor the client. C. Prepare to administer atropine sulfate IV push. D. Hold the prescribed dose and contact the healthcare provider.

Maintaining potassium levels

A client takes furosemide and digoxin for heart failure. Why would the nurse advise the client to drink a glass of orange juice every day? Maintaining potassium levels Preventing increased sodium levels Limiting the medications' synergistic effects ing the associated dehydration

Avoid abruptly discontinuing the medication.

A primary health care provider prescribes atenolol 20 mg by mouth four times a day. Which information is important for the nurse to include in the discharge teaching plan for this client? Drink alcoholic beverages in moderation. Avoid abruptly discontinuing the medication. Increase the medication if chest pain develops. Report a pulse rate less than 70 beats/minute.

Generalized weakness

After the nurse provides education about hydrochlorothiazide, the client will agree to notify the health care provider regarding the development of which symptom? Insomnia Nasal congestion Increased thirst Generalized weakness

Ensure that the medication is stored in its original dark container.

Which instructions will the nurse give a client for whom nitroglycerin tablets are prescribed? Limit the number of tablets to four per day. Discontinue the medication if a headache develops. Increase the number of tablets if dizziness is experienced. Ensure that the medication is stored in its original dark container.

Osmosis

Which principle explains how loop diuretics promote diuresis? Osmosis Filtration Diffusion Active transport

B.Muscle weakness

Which sign of hypokalemia will the nurse monitor for in a client receiving furosemide? A.Chvostek sign B.Muscle weakness C.Anxious behavior D.Abdominal cramping