exam 4 mylabs

The nurse is educating a patient whose blood pressure is​ 140/90 mmHg on ways to lower blood pressure and avoid hypertension. Which lifestyle choices may eliminate the need for pharmacotherapy in this​ patient? ​ Select all that apply. A. ​"I have incorporated yoga into my exercise​ program." B. ​"I will monitor my daily sodium​ intake." C. ​"I will drink a glass of red wine daily to help lower my blood​ pressure." D. ​"I am receiving acupuncture to help me stop​ smoking."

***C: I will drink a glass of red wine daily to help lower my blood pressure. Increasing the intake of​ alcohol, including​ wine, is not a positive lifestyle change associated with the nonpharmacologic treatment of hypertension. The patient should be encouraged to decrease the intake of alcohol.

A client with a dysrhythmia asks the nurse why they cannot take a prescription instead of have cardioversion for treatment? Which response should the nurse provide the client? 1) "Antidysrhythmic prescriptions have many side effects; cardioversion is considered safer." 2) "Special diets are necessary with antidysrhythmic prescriptions, and they are hard to follow." 3) "Antidysrhythmic prescriptions don't really work very well for most dysrhythmias." 4) "There is a high risk of seizures when you take antidysrhythmic prescriptions."

1) "Antidysrhythmic prescriptions have many side effects; cardioversion is considered safer." p. 419

The nurse is assessing a male client prescribed propranolol (Inderal) for adherence to the treatment plan. Which is an important question for the nurse to ask the client? 1) "Have you noticed any changes in your sexual functioning?" 2) "Has your appetite increased or decreased?" 3) "Have you noticed any changes in your bowel function?" 4) "Have you noticed any difficulty in your ability to concentrate?"

1) "Have you noticed any changes in your sexual functioning?" p. 425

Which statement made by a client receiving amiodarone should the nurse be most concerned about? 1) "I have a cough that is getting worse." 2) "I often feel tired throughout the day." 3) "I have lost 5 pounds over the last 3 weeks." 4) "I have a rash on my skin that will not go away."

1) "I have a cough that is getting worse." p. 426

Which information should the nurse include in the education for a client is prescribed an additional once-daily amiodarone to control persistent atrial fibrillation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "I will avoid drinking grapefruit juice." 2) "I understand the effect of the prescription will last 4 to 8 weeks after I stop taking it." 3) "I will monitor my blood pressure and report any significant changes." 4) "I will avoid the use of St John's wort." 5) "I will follow a low sodium diet."

1) "I will avoid drinking grapefruit juice." 2) "I understand the effect of the prescription will last 4 to 8 weeks after I stop taking it." 3) "I will monitor my blood pressure and report any significant changes." 4) "I will avoid the use of St John's wort." p. 424, 426

The nurse has provided client education regarding therapeutic lifestyle changes to help control cholesterol levels. Which statement made by the client indicates an understanding of the information? (3) 1) "I will maintain an optimal weight." 2) "I will implement a medically supervised exercise plan." 3) "I will increase saturated fat in my diet." 4) "I will increase insoluble fiber in my diet." 5) "I will eliminate tobacco use."

1) "I will maintain an optimal weight." 2) "I will implement a medically supervised exercise plan." 5) "I will eliminate tobacco use."

The nurse has provided education for a client who will self-administer a twice-daily antidysrhythmic prescription. Which statements made by the client indicate further teaching is needed? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "If I get the flu, I should stop taking the medication until my fever goes down." 2) "I should take my doses as close to 12 hours apart as I can." 3) "If I forget a dose of the prescription I should take two pills for the next dose." 4) "If I can't take the prescription for a couple of days because I am sick, I should call the clinic for advice." 5) "I should get my prescription refilled before I am completely out of medicine."

1) "If I get the flu, I should stop taking the medication until my fever goes down." 3) "If I forget a dose of the prescription I should take two pills for the next dose." p. 424, 425

Which assessment data obtained from a client receiving a statin is a priority for the nurse to report to the healthcare provider? 1) "My calves hurt, and I had a hard time walking to the bathroom." 2) "I know I just started this medicine yesterday, but my stomach really is upset." 3) "Will you call my healthcare provider? I have a really bad headache." 4) "My heart rate really went up this morning."

1) "My calves hurt, and I had a hard time walking to the bathroom."

Which statements made by a client that has been receiving a prescription for an atrial dysrhythmia indicate the client requires further information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "Since I can't drink coffee anymore, I have started drinking diet cola in the mornings." 2) "I have found that a glass of wine after work and one with dinner helps me to relax from my stressful job." 3) "We have celebrated several birthdays since I saw you last. I love chocolate birthday cake." 4) "I have really worked at stopping my smoking since I was last here." 5) "My friends and I have found several restaurants in our area that offer good, low-fat meals."

1) "Since I can't drink coffee anymore, I have started drinking diet cola in the mornings." 2) "I have found that a glass of wine after work and one with dinner helps me to relax from my stressful job." 3) "We have celebrated several birthdays since I saw you last. I love chocolate birthday cake." p. 424

A client prescribed verapamil (Calan) asks the nurse if it is okay to take herbal supplements with the prescription. Which response should the nurse provide the client? 1) "Some herbal supplements may interact with your prescription." 2) "Using herbal supplements may increase your blood pressure too much." 3) "Herbal supplements are okay as long as you take calcium salts with them." 4) "Most herbal supplements are okay, but you should avoid St. John's wort."

1) "Some herbal supplements may interact with your prescription." p. 428

The client states to the nurse, "My healthcare provider says I have heart disease and I need to decrease the cholesterol in my diet. I don't understand how this happened." Which response should the nurse provide the client? 1) "The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them." 2) "Low density lipoprotein (LDL) cholesterol is converted to saturated fat, which is stored in your coronary arteries." 3) "It is a good idea to decrease low density lipoprotein (LDL) cholesterol in your diet, although current research has not proven a correlation yet." 4) "Too much low density lipoprotein (LDL) cholesterol narrows all the arteries in your body so your heart does not receive enough blood to be healthy."

1) "The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them."

The nurse has reinforced the treatment plan for the administration of normal human serum albumin (Albutein) for a client recovering from hypovolemic shock. Which statement made by the client indicates an understanding of the information? 1) "The prescription is a protein that pulls water into my blood vessels." 2) "The prescription is a protein that causes my kidneys to conserve fluid." 3) "The prescription is a super-concentrated salt solution that helps my body conserve fluid." 4) "The prescription is a liquid that has electrolytes in it to pull water into my blood vessels."

1) "The prescription is a protein that pulls water into my blood vessels." p. 407

A client tells the nurse they are nervous about taking prescribed verapamil (Calan). Which response should the nurse provide the client? 1) "This prescription is safe, and most patients do very well with it." 2) "This prescription increases your blood pressure, but we will be monitoring that." 3) "This prescription has many side effects, but you should be okay." 4) "This prescription is a potassium channel blocker and is considered safe."

1) "This prescription is safe, and most patients do very well with it." p. 428

A client states to the nurse, "I read that my antidysrhythmic drug can actually cause me to have irregular heartbeats. How can this be?" Which response should the nurse provide the client? 1) "Your medication blocks the flow of the electrolytes in your heart, and this can cause irregular beats." 2) "The literature is not always accurate, but if you have concerns I recommend discussing them with your healthcare provider." 3) "The aspirin that you take every day will help you avoid experiencing the irregular heartbeats." 4) "Your prescription is not the problem; it is when you mix it with over-the-counter (OTC) drugs that you develop irregular beats."

1) "Your medication blocks the flow of the electrolytes in your heart, and this can cause irregular beats." p. 421

For which conditions should the nurse anticipate norepinephrine to be prescribed? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Acute shock 2) Cardiac arrest 3) Septic shock 4) Hypovolemic shock 5) Cardiogenic shock

1) Acute shock 2) Cardiac arrest 3) Septic shock p. 409

A patient has been prescribed gemfibrozil (Lopid). Which laboratory tests should the nurse schedule for the client on the next clinic appointment? (3) 1) Blood glucose 2) Liver enzymes 3) Potassium 4) Hemoglobin and hematocrit 5) Urinalysis

1) Blood glucose 2) Liver enzymes 4) Hemoglobin and hematocrit

Which should the nurse prepare for the client experiencing shock? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Cardiac monitor 2) Pulse oximeter 3) Oxygen 4) Whole blood 5) Dextran 40

1) Cardiac monitor 2) Pulse oximeter 3) Oxygen p. 406

A client treated previously for a fractured leg and multiple abrasions returns to the emergency department experiencing anaphylactic shock. Which prescriptions should the nurse suspect have caused the reaction? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Cephalosporin antibiotic 2) Topical antibiotic for use on abrasions 3) NSAIDs 4) Opioid analgesic 5) Normal saline wash for abrasions

1) Cephalosporin antibiotic 3) NSAIDs 4) Opioid analgesic p. 413

Which symptoms should the nurse anticipate to treat with epinephrine (EpiPen) for a child allergic to bee stings that has been stung? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Cold clammy skin 2) Excessive thirst 3) Warm dry skin 4) Restlessness 5) Hyperactivity

1) Cold clammy skin 2) Excessive thirst 4) Restlessness p. 405

The nurse is providing education about lipids for a client with hyperlipidemia. Which information should the nurse include in the education? 1) High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver. 2) High density lipoprotein (HDL) is called good cholesterol because it increases the oxygen content in the arteries and reduces the amount of plaque buildup. 3) High density lipoprotein (HDL) decreases the bad cholesterol (low density lipoprotein [LDL]), and promotes excretion of it through the kidneys. 4) High density lipoprotein (HDL) decreases low density lipoprotein (LDL) and prevents it from converting to very low density lipoprotein (VDRL), which is the worst kind of cholesterol in the body.

1) High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver.

The educator is reviewing the mechanism of action of intravenous glucagon as a treatment for an overdose of propranolol (Inderol) with the nursing staff. Which information should the educator include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Improves AV node conduction 2) Dilates the coronary arteries 3) Increases the heart rate 4) Enhances myocardial contractility 5) Increases the fluid volume in the vascular system

1) Improves AV node conduction 3) Increases the heart rate 4) Enhances myocardial contractility p. 425

Which current prescriptions should the nurse be concerned with for a client requiring dopamine? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) MAO inhibitor 2) Phenytoin 3) Beta blocker 4) Digoxin 5) Aspirin

1) MAO inhibitor 2) Phenytoin 3) Beta blocker 4) Digoxin p.410

The nurse reviewing a client's serum cholesterol levels notes the following: Low density lipoprotein (LDL) = 105 mg/dl High density lipoprotein (HDL) = 37 mg/dl Low density lipoprotein (LDL)/high density lipoprotein (HDL) ratio = 4.1 Which should the nurse identify as the priority outcome in the client's plan of care? 1) Maintenance of normal lipid levels without the use of pharmacotherapy 2) Education about diet and exercise 3) Validate that the client understands the importance of lifestyle changes 4) The client's achievement of normal lipid levels through compliance with medications

1) Maintenance of normal lipid levels without the use of pharmacotherapy

Which immediate goals should the nurse focus on for a client experiencing an anaphylactic reaction to penicillin? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Normalization of blood pressure 2) Reduction of blood volume 3) Identification of other allergies 4) Reduction of inflammatory response 5) Provision of basic life support

1) Normalization of blood pressure 4) Reduction of inflammatory response 5) Provision of basic life support p. 411-413

Which assessment findings indicate a client receiving dobutamine (Dobutrex) is experiencing an adverse effect? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Palpitations 2) Drop in blood pressure 3) Cold extremities 4) Headache 5) Blurred vision

1) Palpitations 2) Drop in blood pressure 3) Cold extremities p. 408

A client is to receive intravenous (IV) dopamine (Intropin). Which should the nurse have immediately available prior to initiating the dopamine? 1) Phentolamine (Regitine) 2) Naltrexone (Revia) 3) Epinephrine (Adrenalin) 4) Flumazenil (Romazicon)

1) Phentolamine (Regitine) p. 410

Which classification of drug is used to treat ventricular tachycardia? 1) Potassium channel blocker 2) Calcium channel blocker 3) Beta-adrenergic antagonist 4) Sodium channel blocker

1) Potassium channel blocker p. 421

Which conditions should the nurse be concerned about prior to administering epinephrine for anaphylaxis? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Premature ventricular contractions 2) Hypertension 3) Hyperthyroidism 4) Pheochromocytoma 5) Hypotension

1) Premature ventricular contractions 2) Hypertension 3) Hyperthyroidism p.413

The nurse is discussing with a client, the dietary intake of omega-3 and CoQ10-rich foods to control lipid levels. Which foods should the nurse include in the discussion? (3) 1) Sardines 2) Shrimp 3) Almonds 4) Olive oil 5) Carrots

1) Sardines 3) Almonds 4) Olive oil

Which assessment findings indicate a client receiving verapamil (Calan) is experiencing adverse effects? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) The client tells the nurse they have frequent headaches. 2) The client has 3+ edema in the ankles and feet. 3) The client states, "Everything I eat tastes like metal." 4) The client states, "I got so dizzy yesterday that I had to lie down for a while." 5) The client's face is flushed.

1) The client tells the nurse they have frequent headaches. 2) The client has 3+ edema in the ankles and feet. 4) The client states, "I got so dizzy yesterday that I had to lie down for a while." p. 428

Which is the priority outcome for the client with type 1 diabetes mellitus prescribed propranolol (Inderal)? 1) The client will maintain blood glucose within normal limits. 2) The client will decrease the required number of calories/day. 3) The client will maintain adequate peripheral circulation. 4) The patient will perform activities of daily living.

1) The client will maintain blood glucose within normal limits p. 425

The educator is reviewing the classifications of prescriptions used to decrease blood cholesterol levels with a nurse. Which prescriptions should the educator include in the discussion of fibric acid agents? (2) 1) Tricor 2) Zetia 3) Lopid 4) Colestid 5) Zocor

1) Tricor 3) Lopid

The educator is preparing education about the different types of lipids for a nurse. Which should the educator include in the presentation? (3) 1) Triglycerides 2) Phospholipids 3) Steroids 4) Lecithins 5) Bile acids

1) Triglycerides 2) Phospholipids 3) Steroids

Which antidysrhythmic agent also dilates coronary arteries and is frequently used to treat angina? 1) Verapamil (Calan) 2) Amiodarone (Cordarone) 3) Procainamide (Pronestyl) 4) Lidocaine (Xylocaine)

1) Verapamil (Calan) p. 428

1) A client receiving diltiazem (Cardizem) asks the nurse why they get a headache after taking the prescription. Which response should the nurse provide the client? 1. "Diltiazem (Cardizem) causes the blood vessels in your brain to widen, giving you the headache." 2. "Diltiazem (Cardizem) increases prostaglandin synthesis, giving you the headache." 3. "Diltiazem (Cardizem) releases Substance P, activating pain receptors in your brain and giving you the headache." 4. "Diltiazem (Cardizem) causes the blood vessels in your brain to narrow, giving you the headache."

1. "Diltiazem (Cardizem) causes the blood vessels in your brain to widen, giving you the headache." Pg 392

1) The nurse has completed the education for a client with angina prescribed nitroglycerine (Nitrostat). Which statement made by the client indicates further teaching is required? 1. "I can take up to 5 tablets to resolve the chest pain." 2. "If my pain is not reduced 5 minutes after taking one tablet I should call EMS." 3. "I should take a tablet as soon as chest pain occurs." 4. "I can take three tablets, one every 5 minutes."

1. "I can take up to 5 tablets to resolve the chest pain." Pg 393

1) Which statement by the client receiving nitroglycerine (Nitrostat) should the nurse be concerned about? 1. "I'm getting married tomorrow; I hope my erectile dysfunction isn't a problem." 2. "I'm going water skiing tomorrow; I hope my angina isn't a problem." 3. "I really don't like taking those little pills, I would like to use a patch." 4. "My angina has been a little more frequent I would like something to take for the pain."

1. "I'm getting married tomorrow; I hope my erectile dysfunction isn't a problem." Pg 393

Which statements by the client are specifically associated with unstable angina? Select all that apply. 1. "My chest has started hurting even if I am just watching television." 2. "My chest starts hurting if I climb one set of stairs." 3. "My attacks of chest pain are coming more frequently now." 4. "The pain occurs most often after I eat a meal." 5. "The pain is worse than it used to be."

1. "My chest has started hurting even if I am just watching television." 3. "My attacks of chest pain are coming more frequently now." 5. "The pain is worse than it used to be." Pg 389

1) The nurse is reviewing the myocardial blood supply for a client with coronary artery disease (CAD). Which statements made by the client indicate an understanding of the information? Select all that apply. 1. "The heart has right and left arteries that arise from the aorta." 2. "The coronary arteries carry blood away from the heart to the right atrium." 3. "The heart receives its oxygen through the blood that fills it." 4. "Coronary arteries primarily carry blood to the left ventricle." 5. "The right and left arteries have smaller branches that go around the heart."

1. "The heart has right and left arteries that arise from the aorta." 5. "The right and left arteries have smaller branches that go around the heart. Pg 388, 391

1) Which information about the primary therapeutic action of an antianginal prescription should the nurse include in client teaching? 1. "The prescription decreases how much oxygen your heart needs." 2. "This prescription will thin your blood so your heart receives more oxygen." 3. "This prescription increases the amount of oxygen your heart receives." 4. "This prescription increases the oxygen to your heart by increasing nitric oxide production."

1. "The prescription decreases how much oxygen your heart needs."Pg 390,391

1) Which client should the nurse anticipate a prescription for reteplase (Retavase) therapy post myocardial infarction? 1. A 54-year-old female with type 2 diabetes 2. A 45-year-old female with a 2-week-old cranial artery repair 3. A 62-year-old with a recent hemorrhagic stroke 4. A 70-year-old male with active GI bleed

1. A 54-year-old female with type 2 diabetes Pg 399

1) Which lifestyle behaviors should the nurse discuss with a client to help reduce their risk of coronary artery disease? Select all that apply. 1. Abstinence from smoking 2. Decrease stress 3. Limit alcohol consumption 4. Maintain optimal weight 5. Limit sodium intake

1. Abstinence from smoking 3. Limit alcohol consumption 5. Limit sodium intake Pg 389

1) Which prescriptions does the nurse anticipate to be included in the goal to reduce the post-MI mortality of a client? Select all that apply. 1. Aspirin 2. Beta blockers 3. Narcotic analgesics 4. ACE inhibitors 5. Antidysrhythmics

1. Aspirin 2. Beta blockers 4. ACE inhibitors Pg 399-400

1) Which symptom is most likely to be related to angina as opposed to a myocardial infarction? 1. Chest pain relieved by one sublingual nitroglycerin 2. Chest pain that radiates to the patient's back 3. Chest pain that occurred while the patient was eating breakfast 4. Chest pain accompanied by shortness of breath

1. Chest pain relieved by one sublingual nitroglycerin Pg 388-389

1) For which conditions should the nurse instruct a client to hold the application of nitroglycerin ointment and contact the healthcare provider? Select all that apply. 1. Dyspnea 2. Productive cough 3. Headache 4. Fever 5. Confusion

1. Dyspnea 2. Productive cough 5. Confusion Pg 392-3

1) Which information should the nurse include when educating a client about coronary artery disease? Select all that apply. 1. Plaque causes narrowing of the artery. 2. Plaque begins to accrue early in life. 3. Plaque causes narrowing of the veins. 4. Plaque affects the elasticity of the artery. 5. Plaque builds up in the myocardial tissue.

1. Plaque causes narrowing of the artery. 2. Plaque begins to accrue early in life. 4. Plaque affects the elasticity of the artery. Pg 388

1) A client asks which conditions will cause the heart to need more oxygen. Which information should the nurse be prepared to discuss? 1. Sleep apnea 2. Hyperthyroidism 3. Asthma 4. Hepatitis B

1. Sleep apnea Pg 390

A client states to the nurse, "This educational video you gave me shows normal electrical conduction through the heart, but I still don't understand it. Can you explain it to me?" Which responses should the nurse include in the discussion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "Conduction through the bundle of His is the slowest in the heart." 2) "Conduction begins in the sinoatrial (SA) node and travels to the atrioventricular (AV) node." 3) "Conduction continues through the bundle branches to the Purkinje fibers." 4) "Conduction travels from the atrioventricular (AV) node through the bundle of His." 5) "The sinoatrial (SA) node is located in the left atrium."

2) "Conduction begins in the sinoatrial (SA) node and travels to the atrioventricular (AV) node." 3) "Conduction continues through the bundle branches to the Purkinje fibers." 4) "Conduction travels from the atrioventricular (AV) node through the bundle of His." p. 417, 418

A client asks the nurse how fat is carried in the blood. Which response should the nurse provide? 1) "Fats in your blood are carried inside small molecules called phospholipids." 2) "Fats travel in the blood on little proteins called lipoproteins." 3) "Fats are free floating in your circulatory system." 4) "Fats are encapsulated inside little bags known as lecithin."

2) "Fats travel in the blood on little proteins called lipoproteins."

The nurse has completed the education for a client prescribed gemfibrozil (Lopid). Which statement made by the client indicates an understanding of the information? 1) "I should take this medication on an empty stomach to help it absorb better." 2) "I must take this medication with food or I can have heartburn." 3) "My physician said it really doesn't matter how I take this medication." 4) "Taking this medication with yogurt will help it to absorb better."

2) "I must take this medication with food or I can have heartburn."

Which statements by a client treated with epinephrine should the nurse be concerned about? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "I feel jittery." 2) "My heart is skipping beats." 3) "I have a pounding headache." 4) "I am so dizzy." 5) "That really hurt when you gave me that med."

2) "My heart is skipping beats." 3) "I have a pounding headache." p. 413

Which information about the dietary intake of lipids should the nurse provide a client? (4) 1) "Phospholipids will help prevent Alzheimer's disease." 2) "Phospholipids are essential to building plasma membranes." 3) "Cholesterol is a building block for estrogen and testosterone." 4) "Triglycerides are the major form of fat in the body." 5) "Cholesterol in the diet is unnecessary as the liver synthesizes it."

2) "Phospholipids are essential to building plasma membranes." 3) "Cholesterol is a building block for estrogen and testosterone." 4) "Triglycerides are the major form of fat in the body." 5) "Cholesterol in the diet is unnecessary as the liver synthesizes it."

Which information should the nurse include in the education for a client prescribed niacin to lower lipid levels? 1) "Be sure to take your niacin on an empty stomach as soon as you arise." 2) "Take one aspirin 30 minutes before you take your niacin." 3) "Take your niacin tablet with food and at least one full glass of water." 4) "It may be time to ask your healthcare provider about switching to another drug."

2) "Take one aspirin 30 minutes before you take your niacin."

The client tells the nurse, "My healthcare provider says I have atrial fibrillation. Is this serious and how is it treated?" Which responses should the nurse provide the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "This condition is best treated with what we call antidysrhythmic drugs." 2) "This is very common; your doctor will discuss the best treatment with you." 3) "Depending on your symptoms, your healthcare provider may use an electrical shock." 4) "This is quite serious; did your healthcare provider discuss a heart transplant?" 5) "It is very serious, even more serious than a ventricular dysrhythmia."

2) "This is very common; your doctor will discuss the best treatment with you." 3) "Depending on your symptoms, your healthcare provider may use an electrical shock." p. 417, 418

Which prescription should the nurse anticipate administering to a client treated for an anaphylactic reaction with epinephrine? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Antibiotics 2) Antihistamines 3) Corticosteroids 4) Vasopressors 5) Vasodilators

2) Antihistamines 3) Corticosteroids p. 412, 413

Which assessment is a nursing priority for a client receiving cholestyramine (Questran)? 1) Auscultation of heart sounds 2) Auscultation of bowel sounds in all four abdominal quadrants 3) Assessment of 24-hour urine output 4) Palpation for peripheral edema in the lower extremities

2) Auscultation of bowel sounds in all four abdominal quadrants

Which laboratory results should the nurse understand are associated with the treatment of epinephrine? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Elevated digoxin 2) Decreased potassium 3) Increased calcium 4) Decreased sodium 5) Elevated blood glucose

2) Decreased potassium 5) Elevated blood glucose p. 413

Which is the purpose of the AV node? 1) Pace the heart at 40-60 bpm. 2) Delay the impulse from the SA node. 3) Pace the heart at 60-100 bpm. 4) Enhance the impulse from the SA node.

2) Delay the impulse from the SA node. p. 418

The patient is receiving cholestyramine (Questran) and complains of constipation. The physician orders bisacodyl (Dulcolax) tablets. When is the best time for the nurse to administer the bisacodyl (Dulcolax) tablets? 1) The drugs can be administered together. 2) Four hours after administration of cholestyramine (Questran). 3) Bisacodyl (Dulcolax) can be given any time but must be taken with food. 4) One hour after administration of cholestyramine (Questran).

2) Four hours after administration of cholestyramine (Questran).

Which type of lipoprotein is often referred to as "the good type?" 1) Triglycerides 2) HDL 3) LDL 4) VLDL

2) HDL

Which equipment should the nurse secure for use when administering dopamine (Intropin)? 1) Oxygen cannula 2) Intravenous (IV) pump 3) Pulse oximeter 4) Sequential compression devices

2) Intravenous (IV) pump p. 410

Which condition should the nurse review a client's records for prior to administering epinephrine (Adrenalin) for a client? 1) Type 1 diabetes mellitus 2) Narrow angle glaucoma 3) Hypothyroidism 4) Human immunodeficiency virus (HIV) infection

2) Narrow angle glaucoma p. 413

Which laboratory value should the nurse notify the healthcare provider prior to administering amiodarone (Cordarone)? 1) Sodium 140 mEq/L 2) Potassium 3.1 mEq/L 3) Potassium 4.9 mEq/L 4) International normalized ratio (INR) of 12 seconds

2) Potassium 3.1 mEq/L p. 426

Which is a client with a heart rate of 170 bpm and a normal QRS duration most likely experiencing? 1) Tachydysrhythmia originating from the bundle branches. 2) Tachydysrhythmia originating from the atria. 3) Tachydysrhythmia originating from the ventricles. 4) Tachydysrhythmia originating from the Purkinje fibers.

2) Tachydysrhythmia originating from the atria. p. 420

Which statement provides the best rationale for monitoring HDL and LDL as opposed to total cholesterol? 1) HDL and LDL monitoring is less expensive than measuring total cholesterol. 2) Total cholesterol does not differentiate the amounts of "good" cholesterol and "bad" cholesterol. 3) HDL and LDL measurements are more general and frequently used to assess clients that are not at risk for heart disease. 4) Total cholesterol measurements are often inaccurate and not as reliable as HDL and LDL.

2) Total cholesterol does not differentiate the amounts of "good" cholesterol and "bad" cholesterol.

Which type of lipid serves as fuel for the body when energy is needed? 1) Phospholipids 2) Triglycerides 3) Steroids 4) Lecithins

2) Triglycerides

A client asks the nurse if angina is the same thing as having a heart attack. Which response should the nurse provide? 1. "They have some things in common, for example, severe emotional distress and panic can accompany both angina and myocardial infarction." 2. "Angina means the heart muscle is not getting enough oxygen, while heart attack, or myocardial infarction, means part of your heart has died." 3. "Actually, it depends on what type of angina you mean; there are several types." 4. "They are basically the same."

2. "Angina means the heart muscle is not getting enough oxygen, while heart attack, or myocardial infarction, means part of your heart has died." Pg 389

1) A client post-acute myocardial infarction asks the nurse why they are prescribed reteplase (Retavase) intravenously (IV). Which response should the nurse provide the client? 1. "The prescription dilates the arteries in the heart so it can get more oxygen." 2. "The prescription is dissolving the clot that has caused your heart attack." 3. "The prescription thins your blood so more clots will not develop." 4. "The prescription will increase the strength of the muscles in the heart during each beat."

2. "The prescription is dissolving the clot that has caused your heart attack." Pg 399

1) Which is a priority assessment for the client receiving reteplase (Retavase) intravenously? 1. Fluid balance 2. Abnormal bleeding 3. Blood glucose 4. Respiratory rate

2. Abnormal bleeding Pg 399

1) A client experiencing bradycardia is suspected of overdosing on diltiazem (Cardizem). Which treatment should the nurse anticipate prescribed? 1. Dopamine 2. Atropine 3. Calcium chloride 4. Narcan

2. Atropine Pg 397

1) Which conditions is the use of thrombolytic therapy contraindicated in? Select all that apply. 1. Venous emboli 2. History of intracranial hemorrhage 3. Hemophilia 4. Liver disease 5. Peptic ulcer disease

2. History of intracranial hemorrhage 3. Hemophilia 4. Liver disease 5. Peptic ulcer disease pg 399

1) Which should the nurse assess a client for prior to administering atenolol (Tenormin)? 1. Temperature 2. Pulse 3. Respirations 4. Blood pressure 5. Oxygen saturation

2. Pulse 4. Blood pressure Pg 396

1) Which information should the nurse include in the education for a client prescribed a transdermal nitroglycerin patch? Select all that apply. 1. Place the patch on the upper arm or leg. 2. Rotate sites of application. 3. Remove the patch for an hour each day. 4. Cleanse the skin under the patch after removal. 5. Triple wrap the patch in plastic wrap for disposal.

2. Rotate sites of application. 4. Cleanse the skin under the patch after removal. Pg 391,394

1) Which is the primary desired outcome for a client that has experienced several episodes of angina? 1. The client will experience relief of chest pain with anticoagulant therapy. 2. The client will experience relief of chest pain with nitrate therapy. 3. The client will experience relief of chest pain with aspirin therapy. 4. The client will experience relief of chest pain with therapeutic lifestyle changes.

2. The client will experience relief of chest pain with nitrate therapy. Pg 391

1) Which information should the nurse include in the education for a client prescribed antianginal therapy? Select all that apply. 1. The prescriptions increase the heart rate. 2. The prescriptions dilate the veins so that the heart receives less blood. 3. The prescriptions cause the heart to contract with less force. 4. The prescriptions increase blood pressure. 5. The prescriptions increase the ability of the body to produce red blood cells.

2. The prescriptions dilate the veins so that the heart receives less blood. 3. The prescriptions cause the heart to contract with less force. Pg 390-1

1) Which is the most sensitive and effective biomarker of a myocardial infarction? 1. White blood cells 2. Troponin 3. Myoglobin Creatine kinase

2. Troponin Pg 396

The nurse is providing a client education about dysrhythmias. Which statement should the nurse include in the teaching? 1) "Dysrhythmias cause serious electrolyte imbalances; this results in heart block." 2) "Dysrhythmias are the result of longstanding, uncontrolled hypertension." 3) "Dysrhythmias interrupt the normal electrical pathways in the heart so it can't beat properly." 4) "Dysrhythmias alter the blood flow through the heart and cause it to stop beating."

3) "Dysrhythmias interrupt the normal electrical pathways in the heart so it can't beat properly." p. 417

The nurse has completed the education for a client prescribed propranolol (Inderal). Which statement by the client indicates an understanding of the information? 1) "I will take my pulse every day and call my healthcare provider if it is higher than 100." 2) "I will call my healthcare provider if my anxiety increases and I start worrying again." 3) "I will take my pulse every day and call my healthcare provider if it is less than 60." 4) "I will call my healthcare provider if I lose more than 3 pounds a week."

3) "I will take my pulse every day and call my healthcare provider if it is less than 60." p. 425

The nurse has provided education for a client prescribed procainamide hydrochloride (Pronestyl). Which statement made by the client indicates an understanding of the information? 1) "I will not take the prescription on an empty stomach." 2) "This prescription may make me feel confused." 3) "I will take this prescription even when I am feeling well." 4) "If my pulse is less than 60 I will not take my prescription."

3) "I will take this prescription even when I am feeling well." p. 423

Which information should the nurse include in the education for a client prescribed an antidysrhythmic? 1) "Elevate your extremities if you notice any swelling." 2) "Weigh yourself every other day." 3) "Take the first dose of your prescription before bed." 4) "Take your medication while you are lying down."

3) "Take the first dose of your prescription before bed." p. 424

A client tells the nurse they will need a prescription for high cholesterol but does not know which would be best. Which information should the nurse provide the client? (3) 1) "The best drugs to raise the high density lipoprotein (HDL) levels are the fibric acid drugs." 2) "The statin drugs are good but will cause a lot of flushing if you swallow them with warm fluids." 3) "The bile resins keep cholesterol from being absorbed but have some side effects." 4) "The statin drugs inhibit the making of cholesterol and are considered the best choice." 5) "Fibric acid drugs will decrease triglycerides, but your low density lipoprotein (LDL) will still be high."

3) "The bile resins keep cholesterol from being absorbed but have some side effects." 4) "The statin drugs inhibit the making of cholesterol and are considered the best choice." 5) "Fibric acid drugs will decrease triglycerides, but your low density lipoprotein (LDL) will still be high."

A family member of a client receiving dobutamine intravenously asks the nurse how that will help their blood pressure. Which response should the nurse provide? 1) "The prescription is a vasopressor and helps the heart beat more effectively, which will increase blood pressure." 2) "Vasopressor drugs act on the renin-angiotensin system which will increase the blood pressure." 3) "The prescription is a vasopressor and will help stabilize blood pressure by making the blood vessels smaller." 4) "The prescription is a vasopressor which will help increase blood flow to peripheral muscles."

3) "The prescription is a vasopressor and will help stabilize blood pressure by making the blood vessels smaller." p. 407

The nurse has provided education about dysrhythmias for a group of clients. Which statement made by a client indicates an understanding of the information? 1) "The sodium, potassium, and magnesium levels must be okay for the heart to have an electrical impulse." 2) "Potassium is the most important electrolyte when it comes to the electrical impulse in the heart." 3) "The sodium, potassium, and calcium levels must be okay for the heart to have an electrical impulse." 4) "Enhancing potassium and sodium is how our prescriptions will work to prevent dysrhythmias."

3) "The sodium, potassium, and calcium levels must be okay for the heart to have an electrical impulse." p. 420

A client asks the nurse about the different types of shock. Which response should the nurse provide? 1) "There are many kinds of shock: heart failure, nervous system damage, loss of blood, and respiratory failure." 2) "Allergic response is the most fatal type of shock; other types involve loss of blood, heart failure, and liver failure." 3) "There are many kinds of shock that also include infection, nervous system damage, and loss of blood." 4) "Heart failure is the most serious kind of shock; others include infection, kidney failure, and a significant loss of blood."

3) "There are many kinds of shock that also include infection, nervous system damage, and loss of blood." p. 405

A client experiencing a severe allergic reaction to peanuts tells the nurse they have a known hypersensitivity to epinephrine (Adrenalin). Which response should the nurse provide the client? 1) "I will let the healthcare provider know about this immediately; we will need to choose an alternative prescription." 2) "Do you know what has been used before with this allergic response?" 3) "This is a life-threatening situation; a prior hypersensitivity is not an absolute contraindication." 4) "You most likely will be prescribed IV diphenhydramine (Benadryl)."

3) "This is a life-threatening situation; a prior hypersensitivity is not an absolute contraindication." p. 413

The nurse notes that the intravenous (IV) norepinephrine (Levophed) has been accidentally abruptly discontinued. Which is the nurse's priority action? 1) Obtain an oxygen saturation reading. 2) Notify the healthcare provider. 3) Assess the client's blood pressure. 4) Administer oxygen via a rebreather mask.

3) Assess the client's blood pressure. p. 409

Which assessment finding should the nurse associate with shock? 1) B/P: 140/90 mmHg, P: 46, weak and irregular, R: 24, and shallow 2) B/P: 50/0 mmHg, P: 126, weak and thready, R: 14, and shallow 3) B/P: 80/20 mmHg, P: 122, weak and thready, R: 28, and shallow 4) B/P: 130/88 mmHg, P: 90, bounding, R: 32, and shallow

3) B/P: 80/20 mmHg, P: 122, weak and thready, R: 28, and shallow p. 405

Depolarization occurs when which two electrolytes rush into the cell? 1) Sodium and potassium 2) Calcium and magnesium 3) Calcium and sodium 4) Chloride and potassium

3) Calcium and sodium p. 421

Which information should the nurse include when discussing cardiogenic shock with a client? 1) Cardiogenic shock occurs due to a presence of bacteria and toxins in the blood. 2) Cardiogenic shock occurs in relation to blood loss. 3) Cardiogenic shock occurs due to pump failure. 4) Cardiogenic shock occurs due to loss of sympathetic nerve activity.

3) Cardiogenic shock occurs due to pump failure. p. 405

The nurse has completed nutritional teaching for a client with a high low density lipoprotein (LDL) level. Which menu choice made by the client indicates an understanding of the teaching? 1) Beef tenderloin with gravy and noodles, fruit salad with apples and grapefruit, slice of rye bread, and apple pie 2) Grilled chicken salad with strawberries and pecans, baked macaroni and cheese, and low-fat brownie 3) Grilled chicken with rice and broccoli, tossed salad with walnuts and sliced apples, slice of whole-wheat bread, and low-fat chocolate pudding 4) Low-fat hamburger with whole-wheat bun, tossed salad with walnuts and olive oil, and raisin-oatmeal cookie

3) Grilled chicken with rice and broccoli, tossed salad with walnuts and sliced apples, slice of whole-wheat bread, and low-fat chocolate pudding

The nurse is preparing to provide education for a client prescribed a statin. Which serious adverse effects should the nurse include in the teaching? (2) 1) Headache 2) Abdominal pain 3) Myopathy 4) Muscle or joint pain 5) Rhabdomyolysis

3) Myopathy 5) Rhabdomyolysis

Which statement is accurate regarding the use of nicotinic acid (Niacin) for lowering blood cholesterol levels? 1) Works primarily by lowering LDL and HDL levels. 2) Due to adverse effects, niacin should not be used with statins. 3) Niacin may also reduce triglyceride levels. 4) High doses of 25-30 mg per day are often necessary.

3) Niacin may also reduce triglyceride levels.

Which is the expected priority outcome for a client receiving normal serum albumin (Albuminar)? 1) Afebrile 2) Free of a rash 3) Normal breathing pattern 4) Alert and oriented

3) Normal breathing pattern p.408

Which is the nurse's priority action when monitoring a client receiving norepinephrine (Levophed) with a blood pressure of 230/120 mmHg? 1) Assess the patient for signs/symptoms of a stroke. 2) Notify the healthcare provider. 3) Slow the rate of the infusion 4) Discontinue the administration of the prescription.

3) Slow the rate of the infusion p. 409

Which lipid type is associated with the highest risk for the development of atherosclerosis? 1) Phospholipids 2) Lecithins 3) Steroids 4) Triglycerides

3) Steroids

Which occurs initially in the cardiac conduction pathway? 1) The action potential moves over the bundle branches. 2) The action potential moves through the AV node. 3) The SA node generates an action potential. 4) The action potential travels across the bundle of His.

3) The SA node generates an action potential. p. 419, 420

Which describes a characteristic of colloids? 1) Contain electrolytes 2) Readily leave the blood and enter cells 3) Too large to cross membranes 4) Promote urine output

3) Too large to cross membranes p. 407

The nurse reviewing records should determine that which client's lab values are associated with the highest risk of developing heart disease? 1) Total 200, LDL 104, HDL 30 2) Total 210, LDL 135, HDL 58 3) Total 220, LDL 162, HDL 20 4) Total 186, LDL 125, HDL 54

3) Total 220, LDL 162, HDL 20

Which effect should the nurse anticipate for a client receiving a low-dose dopamine (Intropin)? 1) Vasoconstriction and increased blood pressure 2) Stabilization of fluid loss 3) Urinary output of at least 50 mL/h 4) Increased cardiac output

3) Urinary output of at least 50 mL/h p. 410

Which assessment finding for a client receiving a statin is a priority for the nurse to report to the healthcare provider? 1) Bowel sounds markedly increased in all four quadrants of the abdomen 2) Urine output of 200 mL/hour 3) Urine output of 20 mL/hour 4) Moderate elevation in liver function tests (LFTs)

3) Urine output of 20 mL/hour

Which current prescription should the nurse be concerned with for the client newly prescribed amiodarone (Cordarone)? 1) Oxycodone (OxyContin) 2) Omeprazole (Prilosec) 3) Warfarin (Coumadin) 4) Fluoxetine (Prozac)

3) Warfarin (Coumadin) p. 426

1) The nurse is preparing to administer nitroglycerine via the intravenous route. Which should the nurse do prior to the administration of the prescription? 1. Use gloves to prevent self-administration. 2. Instruct the client to avoid moving the arm in which the prescription is infusing. 3. Cover the intravenous (IV) bottle to decrease light exposure. 4. Darken the room to decrease light exposure.

3. Cover the intravenous (IV) bottle to decrease light exposure. Pg 393

1) Which mechanism of action does beta-adrenergic agonists have on the cardiovascular system? 1. Increase cardiac output 2. Dilate arterial smooth muscle 3. Decrease the contractility of the heart Dilate venous system

3. Decrease the contractility of the heart Pg 391

1) Which adverse effect is common for clients prescribed topical nitroglycerin paste? 1. Rash 2. Shortness of breath 3. Headache 4. Ventricular tachycardia

3. Headache Pg 393

Which is the priority nursing assessment for the client receiving human serum albumin (Albuminar) as treatment for shock? 1) Auscultate breath sounds for hyper-resonance. 2) Auscultate for an absence of breath sounds in the lower lobes. 3) Auscultate breath sounds for inspiratory stridor. 4) Auscultate breath sounds for crackles.

4) Auscultate breath sounds for crackles. p. 408

Which classification of drug is used for the treatment of paroxysmal supraventricular tachycardia (PSVT)? 1) Sodium channel blocker 2) Beta-adrenergic antagonist 3) Potassium channel blocker 4) Calcium channel blocker

4) Calcium channel blocker p. 421

Which initial intervention should the nurse be prepared for in the treatment of shock? 1) Initiate an intravenous line 2) Assess the level of consciousness 3) Assess the blood pressure and pulse 4) Connect the client to a cardiac monitor

4) Connect the client to a cardiac monitor p. 406

Which is the priority action of the nurse when caring for a client receiving a statin with elevated creatine kinase (CK) levels? 1) Hold the prescription and obtain another creatine kinase (CK) level in 6 hours. 2) Administer the prescription and continue to assess for muscle pain. 3) Administer the prescription and obtain another creatine kinase (CK) level in 6 hours. 4) Hold the prescription and notify the healthcare provider.

4) Hold the prescription and notify the healthcare provider.

Which describes the mechanism of atorvastatin's (Lipitor) ability to lower blood cholesterol levels? 1) Binds exogenous cholesterol and excreting it in the feces 2) Increases excretion by activating enzymes within the hepatic system 3) Prevents dietary absorption within the GI tract 4) Inhibits an enzyme that is essential for cholesterol synthesis

4) Inhibits an enzyme that is essential for cholesterol synthesis

Which anatomical location is Ezetimibe (Zetia) effective in blocking the absorption of cholesterol? 1) Stomach 2) Gallbladder 3) Liver 4) Jejunum

4) Jejunum

Which adverse effect should the nurse monitor a client for that is prescribed an antidysrhythmic? 1) Depression, irritability, fatigue, and nausea 2) Anorexia, insomnia, confusion, and 2+ pitting peripheral edema 3) Low-grade fever, diaphoresis, weakness, and dry mucous membranes 4) Palpitations, chest pain, weakness, and fatigue

4) Palpitations, chest pain, weakness, and fatigue p. 421

Which adverse effect is shared among all antidysrhythmic drugs? 1) Edema 2) Impotence 3) Photosensitivity 4) Prodysrhythmic effects

4) Prodysrhythmic effects p. 421

Which symptom should the nurse anticipate for a client experiencing cardiogenic shock? 1) Bradycardia 2) Low temperature 3) Restlessness and anxiety 4) Tachycardia and low blood pressure

4) Tachycardia and low blood pressure p. 405

Which statement correctly identifies why restricting dietary intake of cholesterol generally will not result in a significant reduction of blood cholesterol? 1) Most clients are not compliant with the dietary restriction. 2) Cholesterol is found in nearly all foods, and it is not possible to eliminate it from the diet. 3) Cholesterol is made within the body and cannot be absorbed via external sources. 4) The liver reacts to a low-cholesterol diet by making more cholesterol.

4) The liver reacts to a low-cholesterol diet by making more cholesterol.

Which describes the mechanism of action of norepinephrine? 1) Increased blood flow 2) Increase heart rate 3) Decrease cardiac output 4) Vasoconstriction

4) Vasoconstriction p. 409

Which is a contributing factor to hypovolemic shock? 1) Infectious process 2) Brain or spinal cord trauma 3) Inadequate cardiac output 4) Volume depletion

4) Volume depletion p. 405

1) Which prescription is indicated for the prevention of blood clots? 1. Captopril (Capoten) 2. Reteplase (Retavase) 3. Morphine 4. Abciximab (ReoPro)

4. Abciximab (ReoPro) Pg 400

1) Which prescriptions reduce the heart's demand for oxygen by lowering heart rate? 1. Anticoagulants and beta-adrenergic blockers 2. Calcium channel blockers and anticoagulants 3. Organic nitrates and calcium channel blockers 4. Beta-adrenergic blockers and calcium channel blockers

4. Beta-adrenergic blockers and calcium channel blockers Pg 391

1) Which is the primary pharmacologic goal in the treatment of a client experiencing stable angina? 1. Increase venous blood flow to the right atrium. 2. Eliminate blockages by using thrombolytics. 3. Establish a regular exercise program and diet plan. 4. Increase cardiac oxygen supply and reduce cardiac oxygen demand.

4. Increase cardiac oxygen supply and reduce cardiac oxygen demand. Pg 390

1) Which are the goals of antianginal therapy? Select all that apply. 1. Decreased oxygen consumption of the brain 2. Increased myocardial contractility 3. Increased blood flow to the peripheral blood vessels 4. Increased blood flow to the myocardium 5. Decreased myocardial oxygen demand

4. Increased blood flow to the myocardium 5. Decreased myocardial oxygen demand Pg 390-1

Which action should the nurse take when initiating a prescription of intravenous dextran 40​ (Gentran 40)? ​ Select all that apply. A. Start the infusion no faster than 240​ mg/min. B. Monitor the​ patient's vital signs continuously during administration. C. Monitor for signs of anaphylaxis. D. Monitor the client for deep vein thrombosis. E. Discard any unused portion of the infusion.

A,B,C,E: Start the infusion no faster than 240mg/min. Monitor the patient's vital signs continuously during administration. Monitor for signs of anaphylaxis. Discard any unused portion of the infusion. Nonemergency infusion should not be faster than 240​ mg/min. In an emergency the rate is increased to 1.2 to 2.4​ g/min. Hypertension may​ occur, so vital signs must be continuously monitored. Some clients may have an anaphylactic reaction to the prescription. There is no preservative in the​ preparation, so unused portions must be discarded.

The nurse is caring for a client kidney failure experiencing severe electrolyte imbalances. For which conditions is the client most at​ risk? ​ Select all that apply. A. Fluid retention B. Muscle spasms C. Fractures D. High cholesterol E. Depression

A,B,C: Fluid retention, muscle spasms, fractures Electrolytes are responsible for membrane permeability and water balance. An electrolyte​ imbalance, especially too much​ sodium, can result in fluid retention. Electrolytes are essential for muscle contractions. An imbalance in electrolytes can result in muscle spasms. Electrolytes are essential for bone growth and remodeling and may place a patient at risk for​ fractures, especially when there is an imbalance of calcium

Which nursing actions are appropriate for a client prescribed oral polystyrene sulfonate​ (Kayexalate)? ​ Select all that apply. A. Monitor for onset of action of this drug in an hour B. Administer sorbitol concurrently C. Repeat the dose in 4 hours if needed D. Mix the dose with a liquid high in glucose E. Administer with sodium bicarbonate

A,B,C: Monitor for onset of action of this drug in an hour. Administer sorbitol concurrently. Repeat the dose in 4 hours if needed. Polystyrene sulfonate​ (Kayexalate) has an onset of action of 1 hour. Sorbitol or another laxative is administered concurrently to promote rapid evacuation of potassium. The dose may be repeated in 4 hours if indicated.

The nurse is providing education for nonpharmacological interventions to manage hypertension. Which information should then nurse​ include? ​ Select all that apply. A. Increase your dietary intake of fruits and vegetables B. Decrease the consumption of alcohol C. Reduce the dietary intake of potassium D. Increase physical activity E. Restrict your intake of sodium

A,B,D,E: Increase your dietary intake of fruits and vegetables. Decrease the consumption of alcohol. Increase physical activity. Restrict your intake of sodium. Increasing the intake of fruits and vegetables is recommended to help manage hypertension. Decrease the consumption of alcohol. Increased physical activity is recommended to help manage hypertension. Reduction of the intake of sodium is recommended to help manage hypertension.

For which conditions is a client with hypertension at​ risk? ​ Select all that apply. A. Kidney damage B. Stroke C. Liver failure D. Heart failure E. Blindness

A,B,D,E: Kidney damage, stroke, heart failure, blindness The kidneys are affected by hypertension. Stroke is a common effect of hypertension. The heart is affected by hypertension. The retina is affected by hypertension.

The nurse is preparing to discuss the use of primary hypertensive agents with a client. Which prescriptions should the nurse​ include? ​ Select all that apply. A. Thiazide diuretics. B. ​Angiotensin-II receptor blockers​ (ARBs). C. ​Beta-adrenergic antagonists. D. ​Direct-acting vasodilators. E. Peripheral adrenergic antagonists.

A,B: Thiazide diuretics, angiotensin-II receptor blockers (ARBs) Diuretics are considered a primary antihypertensive agent. ARBs are considered a primary antihypertensive agent.

Which prescriptions should the nurse anticipate to be included in the treatment of a client with a pH of​ 7.32? ​ Select all that apply. A. Oral bicarbonate B. Sodium chloride C. Sodium citrate D. Potassium chloride E. Ammonium chloride

A,C: Oral bicarbonate, sodium citrate Oral bicarbonate is an agent used to treat acidosis. Sodium citrate is an agent used to treat acidosis.

Which nursing interventions should the nurse implement when administering oral potassium chloride​ (KCl)? ​ Select all that apply. A. Instruct the client sit straight up to swallow the pill B. Crush the tablet and put it in a soft food C. Instruct the client chew the tablet D. Administer the prescription with an antacid E. Instruct the client to take the prescription prior to eating a meal

A,D,E: Instruct the client sit straight up to swallow the pill. Adminster the prescription with an antacid. Instruct the client to take the prescription prior to eating a meal. The client should sit straight up when swallowing this pill to prevent choking and to prevent esophagitis. Potassium chloride can be administered with an antacid to prevent gastrointestinal upset. Potassium chloride should be taken with food to prevent gastric upset.

Which information should the nurse provide a client with hyperkalemia experiencing​ constipation? ​ Select all that apply. A. Increase fluid intake B. Include prune juice in your daily fluids C. Add fruits and vegetables to the diet D. Increase activity such as walking E. Use salt substitutes to reduce the sodium level

A,D: Increase fluid intake, increase activity such as walking The client should be instructed to increase water intake to avoid drinking fluids that may contain potassium. ​Exercise, such as​ walking, may stimulate the bowels.

Which physiological systems should the nurse recognize are most at risk for a client in a hypertensive​ crisis? ​ Select all that apply. A. Cardiac B. Respiratory C. Integumentary D. Gastrointestinal E. Renal

A,E: Cardiac, renal The heart responds to hypertension by decreasing heart rate and stroke volume. The kidney responds to hypertension by increasing urine output to decrease blood volume.

A male client states to the​ nurse, "I am going to stop taking my metoprolol​ (Lopressor). I have been experiencing problems having​ sex." Which responses should the nurse include in the discussion with the​ client? ​ Select all that apply. A. ​"I understand sexual dysfunction can be a common problem with this​ drug." B. ​"Perhaps it would be better if you took atenolol​ (Tenormin)." C. ​"I cannot stop you from discontinuing the​ drug." D. ​"Stopping the prescription abruptly may cause your blood pressure to elevate even​ higher." E. ​"Try taking the drug early in the​ morning."

A,E: I understand sexual dysfunction can be a common problem with this drug. Try taking the drug early in the morning. One of the major causes of noncompliance is the effect beta blockers have on male sexual function. Acknowledging the​ client's concern promotes therapeutic communication. Abrupt cessation of​ beta-blocker therapy can result in rebound HTN.

Which causes should the nurse associate with respiratory​ alkalosis? ​ Select all that apply. A. Hyperventilation B. Severe diarrhea C. Severe vomiting D. High altitude E. Excess alcohol ingestion

A,E: hyperventilation, excess alcohol ingestion Hyperventilation can result in respiratory alkalosis. Excess alcohol ingestion is associated with metabolic acidosis.

Which findings should the nurse anticipate when assessing a client developing​ right-sided heart​ failure? Select all that apply. A. Ankle edema B. Enlarged liver C. Displaced apical heart rate D. Shortness of breath E. Coughing

A. Ankle edema B. Enlarged liver C. Displaced apical heart rate

Which vital sign is of the greatest concern to the nurse prior to administering digoxin​ (Lanoxin)? A. Apical pulse B. Respiratory rate C. Blood pressure D. Temperature

A. Apical pulse

Which is the most appropriate food for the nurse to recommend to a client to eat that is prescribed a loop​ diuretic? A. Bananas B. Cheese C. Meat D. Yogurt

A. Bananas

The nurse completes the dietary education for a client prescribed digoxin​ (Lanoxin). Which dietary choice indicates the client understood the​ teaching? A. Cottage​ cheese, peach​ salad, and blueberry pie B. ​Hamburger, French​ fries, and chocolate chip cookies C. Green bean​ soup, whole-wheat​ bread, and an apple D. Baked​ fish, sweet​ potatoes, and banana pudding

A. Cottage​ cheese, peach​ salad, and blueberry pie

Which should the nurse recognize a client with acute renal failure cannot effectively​ regulate? (4) A. Fluid balance B. Electrolyte balance C. The pH of body fluids D. Heart rate E. Blood pressure

A. Fluid balance B. Electrolyte balance C. The pH of body fluids E. Blood pressure

Which conditions should the nurse anticipate the healthcare provider to possibly prescribe a​ diuretic? (3) A. Heart failure B. Hypertension C. Ketoacidosis D. Acute kidney injury E. Cerebrovascular accident

A. Heart failure B. Hypertension D. Acute kidney injury

Which is the client at risk for that is receiving spironolactone​ (Aldactone)? A. Hyperkalemia B. Hyponatremia C. Pancytopenia D. Aplastic anemia

A. Hyperkalemia

Which should the nurse recognize is associated with chronic kidney disease​ (CKD)? (2) A. Hypertension B. Inflammation C. Diabetes D. Hypoperfusion E. Sepsis

A. Hypertension C. Diabetes

Which factor increases cardiac​ output? A. Increase in preload B. Peripheral vascular resistance C. Hypovolemia D. Reduced cardiac contractility

A. Increase in preload

Which describes the mechanism of action of anticoagulant​ prescriptions? A. Inhibition of thrombi formation. B. Conversion of plasminogen to plasmin C. Alteration of plasma membrane and platelets D. Prevention of fibrin from dissolving

A. Inhibition of thrombi formation.

Which anatomical area should the nurse display a client when providing education about the point of origin of a pulmonary​ embolism? A. Right atrium B. Left atrium C. Right ventricle D. Left ventricle

A. Right atrium

The nurse suspects a client receiving chlorothiazide​ (Diuril) is experiencing side effects from the prescription. Which assessment finding supports the​ nurse's suspicion? A. Serum potassium level of 3.0​ mEq/L and low blood pressure B. Mental confusion and dependent edema C. Ataxia and frequent diarrhea D. Serum sodium level of 160​ mEq/L and headaches

A. Serum potassium level of 3.0​ mEq/L and low blood pressure

Which should the nurse recognize are important safety precautions when administering a prescription to a client with renal​ failure? (3) A. The client will require lower dosages. B. Some prescriptions increase fluid retention. C. Measure hourly intake and output. D. Some prescriptions are nephrotoxic. E. Some prescriptions are bound to plasma proteins.

A. The client will require lower dosages. C. Measure hourly intake and output. D. Some prescriptions are nephrotoxic.

Which statement is accurate regarding the use of​ beta-adrenergic blockers for use in clients with heart​ failure? A. They are generally used in combination with other​ heart-failure drugs. B. This drug class does not have an effect on the bronchioles of the lungs. C. Dosage changes are done on a daily basis for the first 2 weeks. D. Higher doses are used initially until optimal vital signs are achieved.

A. They are generally used in combination with other​ heart-failure drugs.

Which food should the nurse instruct the client prescribed warfarin​ (Coumadin) to​ avoid? A. Tomato salad with kale and basil B. Fettuccine Alfredo C. ​Whole-wheat bread with margarine D. Salt substitute

A. Tomato salad with kale and basil

Which conditions contribute to heart​ failure? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Uncontrolled hypertension B. Coronary artery disease​ (CAD) C. Diabetes​ (DM) D. HIV E. Mitral stenosis

A. Uncontrolled hypertension B. Coronary artery disease D. Diabetes E. Mitral stenosis

The nurse is preparing to provide education on daily​ self-monitoring for a client with congestive heart failure prescribed a diuretic. Which information should the nurse plan to include in the​ teaching? (3) A. Weight B. Pulse C. Temperature D. Blood pressure E. Respiratory rate

A. Weight B. Pulse D. Blood pressure

The nurse has provided education for a client with diabetes type I prescribed hydrochlorothiazide​ (Microzide) Which statement made by the client indicates an understanding of the​ information? A. ​"I expect my blood glucose to be​ elevated." B. ​"I anticipate to monitor my blood glucose more​ frequently." C. ​"I can expect my hemoglobin A1C to be​ elevated." D. ​"I expect I will need more insulin to help control my​ glucose."

A. ​"I expect my blood glucose to be​ elevated."

The nurse has provided discharge education for a client prescribed an anticoagulant. Which statement made by the client indicates an understanding of the​information? A. ​"I should wear a medical alert bracelet that says​ I'm on an​ anticoagulant." B. ​"I can take​ enteric-coated aspirin but not plain aspirin for my​ arthritis." C. ​"I need to eat more protein while I am taking this​ medication." D. ​"I must limit my intake of vitamin C while​ I'm on warfarin​ (Coumadin)."

A. ​"I should wear a medical alert bracelet that says​ I'm on an​ anticoagulant."

The nurse has provided dietary education for a client prescribed furosemide​ (Lasix). Which statement made by the client indicates an understanding of the​ information? A. ​"I will increase my consumption of​ green, leafy​ vegetables." B. ​"I will increase my consumption of​ poultry." C. ​"I will try and eat an orange​ daily." D. ​"I will try and incorporate more grains in my​ diet."

A. ​"I will increase my consumption of​ green, leafy​ vegetables."

Which statements should the nurse include in the teaching for a client prescribed warfarin​ (Coumadin) therapy? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"Inform your dentist you are taking warfarin prior to any​ procedures." B. ​"Report to the lab for testing of activated partial thromboplastin time​ (APTT)." C. ​"Avoid strenuous​ activities." D. ​"Place ice at the injection site if stinging or burning​ occurs." E. ​"Take nonsteroidal​ anti-inflammatories (NSAIDs) for minor pain​ relief."

A. ​"Inform your dentist you are taking warfarin prior to any​ procedures." C. ​"Avoid strenuous​ activities."

The nurse has provided client education about the function of renal system. Which statements made by the client indicate an understanding of the​ teaching? (3) A. ​"Kidneys help the heart by balancing​ potassium." B. ​"Kidneys balance the fluid and electrolytes in my​ body." C. ​"Kidneys keep blood pressure from getting too​ low." D. ​"Kidneys help decrease infections by excreting​ bacteria." E. ​"Kidneys help regulate the oxygen levels in my​ blood."

A. ​"Kidneys help the heart by balancing​ potassium." B. ​"Kidneys balance the fluid and electrolytes in my​ body." C. ​"Kidneys keep blood pressure from getting too​ low."

Which statements made by the client indicate an understanding of the compensatory mechanisms associated with heart​ failure?. Select all that apply. A. ​"My heart enlarged in order to compensate for the effects of heart​ failure." B. ​"My nervous system kicks in to compensate for the effects of heart​ failure." C. ​"My body will decrease blood flow to other organs in order to compensate for heart​ failure." D. ​"My body will increase urine output in order to compensate for the effects of heart​ failure." E. ​"My body will produce​ anti-inflammatory agents to compensate for heart​ failure."

A. ​"My heart enlarged in order to compensate for the effects of heart​ failure." B. ​"My nervous system kicks in to compensate for the effects of heart​ failure." C. ​"My body will decrease blood flow to other organs in order to compensate for heart​ failure."

A client prescribed spironolactone​ (Aldactone) asks the nurse which fluids they should drink to prevent dehydration. Which response should the nurse​ provide? A. ​"Plain water is really the​ best." B. ​"Any kind of fluid is​ okay, but avoid​ alcohol." C. ​"Electrolyte-replacement drinks like sports​ drinks." D. ​"Citrus juices are very good for​ rehydration."

A. ​"Plain water is really the​ best."

The educator is reviewing the physiology of the renal system with a nurse. Which statement made by the nurse indicates further teaching is​ required? A. ​"The kidneys stimulate white blood cell​ production." B. ​"The kidneys produce the active form of vitamin​ D." C. ​"The kidneys regulate the acid-base balance of body​ fluids." D. ​"The kidneys help regulate blood​ pressure."

A. ​"The kidneys stimulate white blood cell​ production."

The nurse has provided education for a client prescribed pentoxifylline​ (Trental). Which statements made by the client indicate an understanding of the​ information? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected.. Select all that apply. A. ​"The prescription will soften the red blood cells​ (RBCs) so they can fit through the smaller blood​ vessels." B. ​"The prescription decreases the platelets so the blood is less likely to​ clot." C. ​"The prescription decreases the​ "stickiness" of the​ blood." D. ​"The prescription affects how the liver makes clotting​ factors." E. ​"The prescription destroys some of the clotting​ factors."

A. ​"The prescription will soften the red blood cells​ (RBCs) so they can fit through the smaller blood​ vessels." B. ​"The prescription decreases the platelets so the blood is less likely to​ clot." C. ​"The prescription decreases the​ "stickiness" of the​ blood."

Which information should the nurse include the teaching for a client prescribed​ heparin? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​Self-administration of subcutaneous injections. B. Symptoms of deep vein thrombosis. C. Required laboratory tests. D. Signs of abnormal bleeding. E. Scheduled administration times with meals.

A. ​Self-administration of subcutaneous injections. B. Symptoms of deep vein thrombosis. C. Required laboratory tests. D. Signs of abnormal bleeding.

Which accounts for the percentage of intracellular fluid compartment of body​ weight? A. ​60% B. ​20% C. ​40% D. ​80%

A: 60% The cells that make up the intracellular fluid compartment do not hold fluid equal to​60% of body weight.

A client has a serum sodium level of 125​ mEq/L. Which prescription should the nurse​ anticipate? A. Administer normal saline intravenous​ (IV) B. Encourage the patient to drink fluids C. Administer​ 0.45% NaCl D. Provide a diet high in NaCl

A: Administer normal saline intravenous (IV) Hyponatremia is a serum sodium level less the 135​ mEq/L. Hyponatremia caused by sodium loss may be treated with intravenous​ (IV) fluids containing​ salt, such as normal saline.

The nurse is providing education for a client about the replacement of sodium after strenuous exercise. Which information should the nurse​ include? A. After exercising drink plenty of water B. Take one salt tablet prior to strenuous exercise C. Increase salt in the meals prior to exercising D. Avoid exercising in the outdoor heat

A: After exercising drink plenty of water ​Heat-related problems can be best avoided by consuming adequate amounts of water.

Which primary buffers help maintain a normal body​ pH? A. Bicarbonate and phosphate ions B. Potassium and phosphate ions C. Sodium and bicarbonate ions D. Sodium and calcium ions

A: Bicarbonate and phosphate ions Bicarbonate and phosphate are the two primary buffers of pH balances.

Which should the nurse understand is a potential client outcome if potassium chloride​ (KCl) is administered intravenous​ (IV) push? A. Cardiac arrest B. Seizures C. Respiratory distress D. Hypernatremia

A: Cardiac arrest Potassium chloride must never be administered intravenous​ push, as bolus injections can overload the heart and cause cardiac arrest

A client with an NG tube is prescribed potassium chloride​ (KCl). Which intervention should the nurse anticipate to include in the administration of the​ prescription? A. Dilute the drug prior to administration through the nasogastric tube. B. Flush the nasogastric tube with normal saline before and after administration. C. Crush the tablet prior to administration through the nasogastric tube. D. Flush the nasogastric tube with​ Coca-Cola before and after administration.

A: Dilute the drug prior to administration through the nasogastric tube Liquid forms of potassium chloride must be diluted prior to administration through a nasogastric tube to decrease gastrointestinal distress.

Which statement made by a client newly prescribed a​ beta-adrenergic blocker should the nurse be concerned​ about? A. ​"I have always had problems with my​ asthma." B. ​"When I have a migraine​ headache, I need to have the room​ darkened." C. ​"My father died of a heart attack when he was​ 48-years-old." D. ​"I don't handle stress​ well; I have a lot of​ diarrhea."

A: I have always had problems with my asthma This prescription should be used with caution in clients with asthma. With increased​ doses, beta-adrenergic blockers can slow the heart rate and cause bronchoconstriction.

Which statement is accurate in regard to secondary​ hypertension? A. It can result from chronic renal impairment. B. There is no known cause. C. It is also known as idiopathic. D. It accounts for​ 90% of all hypertensive cases.

A: It can result from chronic renal impairment Secondary hypertension has an identifiable cause.

The nurse understands which is the primary purpose for intravenous fluid replacement for a client that has a burn​ injury? A. Maintain blood pressure B. Antibiotic administration C. Administration of pain prescriptions D. Electrolyte replacement

A: Maintain blood pressure Net loss of fluids from the body can result in dehydration and shock. Intravenous​(IV) fluid therapy is used to maintain blood pressure.

Which should the nurse understand the reason sodium bicarbonate is prescribed for a client that has overdosed on​ aspirin? A. Promotes renal excretion B. Promotes detoxification in the liver C. Prevention of bleeding D. Prevention of ulceration of the gastrointestinal tract

A: Promotes renal excretion Sodium bicarbonate provides a base which aids in the renal excretion of acidic drugs such as aspirin.

5) Which describes the primary actions of Filgrastim (Granix)? Increases neutrophil production Increases the production of basophils Enhances cytotoxic function of the neutrophil Enhances phagocytic activity of the neutrophil Enhances the action of the basophils

Answer: 1 Explanation: Filgrastim increases the neutrophil production in the bone marrow. Filgrastim does not increase the production of basophils. Filgrastim enhances the cytotoxic function of the neutrophil. Filgrastim enhances phagocytic activity of the neutrophil. Filgrastim does not enhance the action of basophils.

23) Which time frame in conjunction with chemotherapy should the nurse administer prescribed Filgrastim (Neupogen)? Twenty-four hours prior to the chemotherapy At the time of the chemotherapy infusion Immediately following the chemotherapy 4. Immediately before the chemotherapy

Answer: 1 Explanation: Neupogen should not be administered The effectiveness of the Neupogen will Neupogen should not be administered The effectiveness of the Neupogen will Neupogen should not be administered The effectiveness of the Neupogen will Neupogen should not be administered The effectiveness of the Neupogen will within 24 hours before or after chemotherapy. be diminished by the chemotherapy. within 24 hours before or after chemotherapy. be diminished by the chemotherapy. within 24 hours before or after chemotherapy. be diminished by the chemotherapy. within 24 hours before or after chemotherapy. be diminished by the chemotherapy.

10) Which should the nurse anticipate to be included in the client's treatment plan during the intravenous sargramostim (Leukine)? ECG monitoring Insertion of indwelling urinary catheter Administration of oxygen Administration of an antiemetic

Answer: 1 Explanation: Sargramostim (Leukine) may cause abnormal ST-segment depression. The insertion of an indwelling urinary catheter is not necessary. The administration of oxygen is not necessary. The administration of an antiemetic is not necessary.

9) Which is the priority nursing assessment for a client prescribed epoetin alfa (Epogen)? Blood pressure Temperature Oxygen saturation Apical pulse

Answer: 1 Explanation: The most serious adverse effect of epoetin alfa (Epogen) is hypertension, which can raise blood pressure to dangerous levels, and which occurs in as many as 30% of clients receiving the prescription. There is no indication to assess the client's temperature. There is no indication to assess the client's oxygen saturation. There is no indication to take an apical pulse.

14) The nurse is reviewing the medical history for a client prescribed oprelvekin (Neumega). Which condition should the nurse be concerned about? Liver disease Asthma Diabetes mellitus Renal disease

Answer: 1 Explanation: The primary adverse effect of oprelvekin is fluid​ retention, which occurs in about​ 60% of patients and can be a concern for patients with preexisting cardiovascular disease or CKD. Liver​ disease, asthma, and diabetes mellitus are not the most concerning medical condition.

16) A mother asks the nurse if her breastfed infant is at risk for a B12 deficiency due to her vegetarian dietary preference. Which statement should the nurse provide the mother? "Vitamin B12 is not secreted in the breast milk." "The baby is unable to store adequate amounts of vitamin B12." "The baby's digestive system is unable to absorb sufficient amounts of vitamin B12." "The baby is at risk if exclusively breastfed for 12 months."

Answer: 1 Explanation: Vitamin B12 is secreted in the breast milk. The infant can store adequate amounts of vitamin B12. The infant is able to absorb sufficient amounts of vitamin B12. If a mother consumes no animal products, exclusively breastfed infants can develop vitamin B12 deficiency within 12 months.

A client receiving cyanocobalamin (Nascobal) with a history of a gastrectomy tells the nurse that they have stopped taking the prescription months ago. Which assessment findings should the nurse anticipate? Memory loss, numbness in the limbs, and depression A gradual decrease in red blood cell counts Jaundice and tarry stools Low hemoglobin and hematocrit counts

Answer: 1 Explanation: Cyanocobalamin is a purified form of vitamin B12 that is indicated for patients with vitamin B12 deficiency anemia. The most common cause of vitamin B12 deficiency (pernicious anemia) is the absence of intrinsic factor, a protein secreted by stomach cells. This protein is required for vitamin B12 to be absorbed from the intestine. Symptoms of pernicious anemia involve the nervous system and include memory loss, confusion, tingling or numbness in the limbs, and mood disturbances. A decrease in red blood cells is not associated with pernicious anemia. Jaundice and tarry stools are not symptoms of pernicious anemia. Low hemoglobin and hematocrit counts do not occur with pernicious anemia.

24) After reviewing a client's blood work, the nurse suspects the client is experiencing iron- deficiency anemia. Which questions should the nurse ask the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. "Have you had a significant dietary change in the last 6 months?" "Do you handle chemicals in your new job?" "Have your stools changed in appearance?" "Have you been eating more carbohydrates than usual?" "Are your menstrual periods heavier than normal for you?"

Answer: 1, 2, 3, 5 Explanation: Dietary changes may significantly influence production of red blood cells. Chemicals can cause RBC destruction. Change to dark tarry stool, red stools, or much looser stools could indicate blood loss. There is no connection between carbohydrate ingestion and anemia. Heavy menstrual flow is a leading cause of blood loss anemia in women.

22) Which assessment findings indicate the treatment for a client prescribed an erythropoiesis- stimulating factor is successful? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. The client's hemoglobin is increased. The client reports less shortness of breath on exertion. The client has not had an episode of epistaxis in over 3 weeks. The client reports enjoying a light exercise. The client has not had a fever since treatment began.

Answer: 1, 2, 4 Explanation: The purpose of this therapy is to increase red blood cells, which would increase hemoglobin. Since the client has more RBCs, more oxygen can be carried to tissues. This drug supports RBC production, not platelet production. Increase in activity level indicates treatment success. This treatment supports red blood cell production, not white blood cell production. Page Ref: 455

19) Which describes the classification system for anemias? Based on the shape of erythrocytes Based on the size and color of the erythrocytes Based on the number of erythrocytes present Based on the amount of oxygen carried by the erythrocytes

Answer: 2 Explanation: Anemias are not classified by the shape of the erythrocytes. Anemias are classified based on the description of the size and color of the erythrocytes. Anemias are not classified based on the number of erythrocytes present. Hemoglobin is the protein in the red blood cells that carry the oxygen.

4) Which describes the nurse's understanding of the purpose for choosing the names for the colony-stimulating factors? Named according to the interleukins they stimulate Named according to the type of blood cells they stimulate Named according to the type of neurotransmitters that are stimulated Named according to the type of hormones they stimulate

Answer: 2 Explanation: Colony-stimulating factors (CSFs) are named according to the types of blood cells that they stimulate. Colony-stimulating factors (CSFs) are named according to the types of blood cells that they stimulate. Colony-stimulating factors (CSFs) are named according to the types of blood cells that they stimulate. Colony-stimulating factors (CSFs) are named according to the types of blood cells that they stimulate.

11) A pregnant client prescribed cyanocobalamin (Nascobal) asks if the prescription will hurt her baby. Which response should the nurse provide the client? "This prescription is safe if taken in the form of a pill during pregnancy." "This prescription is safe during pregnancy." "The prescription is safe in the third trimester of pregnancy." "The prescription is safe when administered as an injection."

Answer: 2 Explanation: Cyanocobalamin (Nascobal), oral formulation, is a Pregnancy Category A drug, but it is a Pregnancy Category C when used parenterally. Cyanocobalamin (Nascobal), oral formulation, is a Pregnancy Category A drug, but it is a Pregnancy Category C when used parenterally. There is no evidence to support that oral cyanocobalamin (Nascobal) is teratogenic during the first or second trimesters. Cyanocobalamin (Nascobal), oral formulation, is a Pregnancy Category A drug, but it is a Pregnancy Category C when used parenterally.

1) A client asks the nurse how epoetin alfa (Epogen) will help their anemia. Which response should the nurse provide the client? "This prescription prevents the destruction of the red blood cells." "The prescription stimulates your body to make red blood cells." "This prescription contains red blood cells." "This prescription increases the iron binding capacity of the red blood cells."

Answer: 2 Explanation: Epoetin alfa does not prevent the destruction of your red blood cells. Epoetin alfa stimulates red blood cell production. Epoetin alfa does not contain red blood cells. Epoetin alfa does not increase the iron binding capacity of the red blood cells. Page Ref: 454

13) The nurse has provided education for a client prescribed oprelvekin (Neumega). Which statement made by the client indicates an understanding of the information? "This prescription will help my chemotherapy work better." "This prescription will help increase my platelet count." "This prescription will help me regain the weight I have lost." "This prescription will help increase my red blood cell count."

Answer: 2 Explanation: Oprelvekin (Neumega) does not enhance the effectiveness of chemotherapy. Oprelvekin (Neumega) is used to stimulate the production of platelets in clients who are at risk for thrombocytopenia caused by cancer chemotherapy. Oprelvekin (Neumega) does not promote weight gain. Oprelvekin (Neumega) does not increase red blood cell count.

27) Which is the initial origin for the development of erythrocytes? Megakaryocyte Myeloid stem cell Lymphoid stem cell Colony-stimulating factors

Answer: 2 Explanation: Platelets are formed from megakaryocytes. Erythrocytes are formed from myeloid stem cells. B and T lymphocytes are formed from lymphoid stem cells. Colony-stimulating factors are responsible for the end formation of granular leucocytes and macrophages.

12) A client receiving ferrous sulfate (Feosol) tells the nurse they are experiencing constipation. Which intervention should the nurse recommend? Laxatives Increase fluids and high fiber foods in the diet Self-administer Fleet® enemas Increase exercise

Answer: 2 Explanation: The nurse should consult with the healthcare provider prior to instructing the client to take laxatives. Increasing fluids and high fiber foods in the diet is a nonpharmacological intervention that should be implemented first. The nurse should consult with the healthcare provider prior to instructing the client to self-administer an enema. Increasing exercise will help relieve constipation but is not as effective as increasing fluids and eating a high fiber diet.

26) Which affect does colony-stimulating factors have on the body? Stimulate platelet production Stimulate white blood cell production Stimulate red blood cell production Stimulate stem cells production

Answer: 2 Explanation: Thrombopoietin receptor agonists are a classification of prescription used to stimulate platelet production. Colony-stimulating factors stimulate white blood cell production. Erythropoiesis-stimulating drugs stimulate the production of red blood cells. Other classifications of prescriptions are used to stimulate stem cell production. Page Ref: 454

30) Which prescription should the nurse anticipate to administer to a client with acute iron intoxication? Folic acid Deferoxamine (Desferal) Blood transfusion Cyanocobalamin (Nascobal)

Answer: 2 Explanation: Folic acid is a vitamin supplement and is not used to treat acute iron toxicity. The antidote for iron overdose is deferoxamine (Desferal). A blood transfusion is not used to treat acute iron intoxication. Cyanocobalamin (Nascobal) is a vitamin supplement and is not used to treat acute iron intoxication.

20) The nurse reviewing a client's record notes the morphology of the client's erythrocytes is reported to be microcytic-hypochromic. Which anemia should the nurse associate with the morphology? Pernicious anemia Iron-deficiency anemia Sickle-cell anemia Hemolytic anemia

Answer: 2 Explanation: Macrocytic-normochromic erythrocytes are associated with pernicious and folate- deficiency anemia. Microcytic-hypochromic erythrocytes are associated with iron-deficiency anemia or thalassemia. Normocytic-normochromic erythrocytes are associated with aplastic, hemorrhagic, sickle-cell, and hemolytic anemia. Normocytic-normochromic erythrocytes are associated with aplastic, hemorrhagic, sickle-cell, and hemolytic anemia.

28) The nurse is preparing to teach a client how to self-administer an erythropoiesis-stimulating drug. Which instruction should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. "Shake the vial to mix the contents before use." "Draw up what is needed and discard the rest of the vial." "Place your stock of medication in your refrigerator." "Warm the vial in your hand a few minutes before drawing up the medication." "Give the medication deeply into a muscle."

Answer: 2, 3, 4 Explanation: The vial should not be shaken as this may deactivate the medication. Vials are single use, and any medication remaining should be discarded. Medication should be kept in the refrigerator. The vial should be warmed before use. The medication should be injected into the subcutaneous tissue.

7) A client with chronic alcoholism asks the nurse why they should take folic acid. Which response should the nurse provide the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. "The alcohol decreases your folic acid level." "The alcohol interferes with folate metabolism in the liver." "The folic acid will improve your vitamin B12 deficiency." "Your dietary intake of folic acid is decreased when you drink alcohol." "The folic acid can help reverse some of the liver damage that has occurred from the alcohol abuse."

Answer: 2, 4 Explanation: The alcohol does not directly decrease the level of folic acid. Alcohol interferes with folate metabolism in the liver. Folic acid and vitamin B12 are two different deficiencies. Insufficient folic acid can manifest itself as anemia. This is often observed in chronic alcoholism, since alcoholics consume alcohol instead of eating nutritious foods. Folic acid cannot reverse liver damage that has been caused by alcoholism. Page Ref: 461

18) Which information should the nurse include in the teaching for a client prescribed ferrous sulfate (Feosol) tablets? Take this prescription with milk. Take this prescription before bedtime. Take this prescription with orange juice. Take this prescription with meals.

Answer: 3 Explanation: Food, especially dairy products, will inhibit absorption of ferrous sulfate. The client should not take tablets or capsules 1 hour before bedtime. Foods high in vitamin C such as orange juice can increase the absorption of iron. Food, especially dairy products, will inhibit absorption of ferrous sulfate. Page Ref: 463

15) Which contributes to the regulation of hematopoiesis? White bone marrow Hematopoietic stem cells Hormones Essential vitamins and nutrients

Answer: 3 Explanation: Hematopoiesis occurs primarily in red bone marrow. The process of hematopoiesis begins with a stem cell. Hematopoiesis is regulated by a number of hormones and growth factors. Hematopoiesis occurs primarily in red bone marrow and requires B vitamins, vitamin C, copper, iron, and other nutrients.

21) A client asks the nurse why the healthcare provider has prescribed darbepoetin alfa (Aranesp) instead of epoetin alpha (Epogen). Which response should the nurse provide the client? "Darbepoetin alfa has less side effects." "Darbepoetin alfa is more effective." "Darbepoetin alfa has a longer duration of action." "Darbepoetin alfa is less expensive."

Answer: 3 Explanation: Darbepoetin alfa is closely related to epoetin alfa. It has the same action, effectiveness, and safety profile; however, it has a longer duration of action that allows it to be administered once weekly or once every 2 weeks. Darbepoetin alfa is closely related to epoetin alfa. It has the same action, effectiveness, and safety profile; however, it has a longer duration of action that allows it to be administered once weekly or once every 2 weeks. Darbepoetin alfa is closely related to epoetin alfa. It has the same action, effectiveness, and safety profile; however, it has a longer duration of action that allows it to be administered once weekly or once every 2 weeks. Darbepoetin alfa is closely related to epoetin alfa. It has the same action, effectiveness, and safety profile; however, it has a longer duration of action that allows it to be administered once weekly or once every 2 weeks.

29) Which route of administration should the nurse anticipate the prescribed vitamin B12 to be administered for the client with pernicious anemia? Intravenous Oral Intramuscular Nasal inhalation

Answer: 3 Explanation: Vitamin B12 must be given intramuscularly in cases of pernicious anemia until therapeutic levels are reached and then may be prescribed by nasal spray. Vitamin B12 must be given intramuscularly in cases of pernicious anemia until therapeutic levels are reached and then may be prescribed by nasal spray. Vitamin B12 must be given intramuscularly in cases of pernicious anemia until therapeutic levels are reached and then may be prescribed by nasal spray. Vitamin B12 must be given intramuscularly in cases of pernicious anemia until therapeutic levels are reached and then may be prescribed by nasal spray. Page Ref: 465

8) The nurse has provided education for a client with iron-deficiency anemia. Which statement made by the client indicates further teaching is required? "Most iron in our bodies is stored on hemoglobin in the red blood cell." "Transferrin is a protein that transports iron to places in our bodies where it is needed." "We need extra iron because when the red blood cells die, all their iron is excreted from the body." "The most common cause of nutritional anemia is iron deficiency."

Answer: 3 Explanation: Most iron in our bodies is stored on hemoglobin in the red blood cell. Transferrin is a protein that transports iron to places in our bodies where it is needed. After erythrocytes die, nearly all of the iron in their hemoglobin is incorporated into transferrin and recycled for later use. The most common cause of nutritional anemia is iron deficiency.

25) Which should the nurse consider when administering an injection of ferrous sulfate intramuscularly to a client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. Give the injection in the deltoid muscle. Iron is best absorbed if given subcutaneously. Iron is irritating to the tissues. The z-track method should be used. Iron preparations should be administered through a needle gauge 16 or larger.

Answer: 3, 4 Explanation: The injection should be given deep IM in a larger muscle. Iron should be given deep IM. Iron is irritating to tissues. Z-track injection reduces leakage into the tissues and is the preferred method of IM injection of iron. There is no indication of need to use a large diameter needle for injection.

17) Which is most important for the nurse to monitor a client receiving​ erythropoiesis-stimulating agents? Cerebral vascular accident Transient ischemic attack Myocardial infarction Thromboembolism

Answer: 4 Explanation: Clients are at greater risk for thrombolytic​ disease, which can result in a transient ischemic​ attack, myocardial​ infarction, and cerebral vascular accident.

2) The educator is reviewing red blood cell formation with a nurse. Which statement made by the nurse indicates an understanding? "Red blood cell formation is regulated through chemicals called colony-stimulating factors." "Red blood cell formation is regulated through messages from the hormone secretin, which is located in the kidney." "Red blood cell formation is regulated through specific liver enzymes and a process called hemochromatosis." "Red blood cell formation is regulated through messages from the hormone erythropoietin."

Answer: 4 Explanation: Colony-stimulating factors affect white blood cell production. Secretin stimulates the pancreas to release a fluid that neutralizes stomach acid and aids in digestion and is not involved with red blood cell formation. Hemochromatosis refers to excess iron accumulation in the body, not to red blood cell formation. Regulation of hematopoiesis occurs through messages from hormones such as erythropoietin.

3) A client asks the nurse how epoetin alfa (Procrit) is related to their chemotherapy. Which response should the nurse provide? "This prescription is administered to enhance the effectiveness of the chemotherapy." "This prescription helps to counteract the nausea and vomiting caused by chemotherapy." "This prescription will stimulate the immune system to help kill the cancer cells." "This prescription will help prevent anemia that can be caused by your chemotherapy."

Answer: 4 Explanation: Epoetin alfa (Procrit) is prescribed to treat anemia associated with chemotherapy; it does not enhance the effectiveness of the chemotherapy. Epoetin alfa (Procrit) is prescribed to treat anemia associated with chemotherapy; it does not counteract nausea and vomiting. Epoetin alfa (Procrit) is prescribed to treat anemia associated with chemotherapy; it does not stimulate the immune system. Epoetin alfa (Procrit) is given to clients undergoing cancer chemotherapy to counteract the anemia caused by antineoplastic agents.

Which conditions should the nurse anticipate the need for intravenous fluid therapy to correct a fluid​ imbalance? ​ Select all that apply. A. Constipation B. Postoperative nausea and vomiting C. Severe burn D. Congestive heart failure E. Diabetic ketoacidosis

B,C,E: Postoperative nausea and vomiting, severe burn, diabetic ketoacidosis A postoperative client with nausea and vomiting may require intravenous fluid to avoid dehydration. A client with a severe burn will require intravenous fluid due to correct the fluid depletion. A client with diabetic ketoacidosis requires intravenous fluid administration to correct the fluid depletion.

The nurse is preparing to administer clevidipine​ (Cleviprex) to client experiencing a hypertensive crisis. Which interventions should the nurse​ implement? ​ Select all that apply. A. Monitor bowel sounds B. Administer the drug intravenously C. Continually monitor blood pressure D. Crush caplets for administration E. Infuse prescription in normal saline at 125​ mL/h

B,C: Administer the drug intravenously, continually monitor blood pressure Clevidipine​ (Cleviprex) is administered intravenously. Clevidipine​ (Cleviprex) has an ultrashort​ half-life so blood pressure will be monitored continuously.

The nurse has provided education for a client prescribed nifedipine​ (Adalat CC). Which statement made by the client indicates an understanding of the​ teaching? ​ Select all that apply. A. ​"If I drink alcohol while taking this​ medication, I will get very sick to my​ stomach." B. ​"I should stop taking my melatonin sleep​ medication." C. ​"I should no longer drink grapefruit​ juice." D. ​"I should no longer drink sports drinks with caffeine in​ them." E. ​"I should stop taking my vitamin C​ supplement."

B,C: I should stop taking my melatonin sleep medication. I should no longer drink grapefruit juice. Concurrent use with melatonin may increase blood pressure and heart rate. Grapefruit juice may enhance absorption of nifedipine.

Which fluids should the nurse recognize are appropriate isotonic solutions to be prescribed for the treatment of fluid loss during​ surgery? ​ Select all that apply. A. ​5% dextrose in lactated​ Ringer's B. ​0.9% sodium chloride​ (NS) C. ​0.45% sodium chloride D. Lactated​ Ringer's E. ​5% dextrose in water

B,D,E: 0.9% sodium chloride (NS), lactated ringers, 5% dextrose in water ​0.9% sodium chloride​ (NS) is an isotonic solution and is appropriate for the treatment of fluid loss during surgery. Lactated​ Ringer's is an isotonic solution that is appropriate to treat fluid loss caused fluid loss during surgery. ​5% dextrose in water is an isotonic solution that is appropriate to treat fluid loss during surgery.

Which clients should the nurse anticipate will require a pharmacological intervention to manage their blood​ pressure? ​ Select all that apply. A. A​ 30-year-old female whose blood pressure is​ 138/88 mmHg who is otherwise healthy. B. A​ 61-year-old man whose blood pressure is​ 144/90 mmHg who also has type 2 diabetes. C. A​ 56-year-old woman whose blood pressure is​ 135/84 mmHg who also has​ Cushing's disease. D. A​ 65-year-old man whose blood pressure is​ 148/88 mmHg who is otherwise healthy. E. A​ 61-year-old woman whose blood pressure is​ 153/92 mmHg who is otherwise healthy.

B,E: A 61-year-old man whose blood pressure is 144/90 mmHg who also has type 2 diabetes. A 61-year-old woman whose blood pressure is 153/92 mmHg who its otherwise healthy. Since this​ 61-year-old has both hypertension and​ diabetes, pharmacotherapy is indicated. Blood pressure over​ 150/90 mmHg requires treatment in those over age 60.

Which should the client be instructed to avoid when prescribed an​ anticoagulant? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Citrus fruits B. Alcohol C. Contact sports D. Prolonged sitting E. Hard toothbrush

B. Alcohol C. Contact sports D. Prolonged sitting E. Hard toothbrush

Which should the nurse recognize are adverse effects associated with digoxin​ (Lanoxin)? A. Tachycardia and hypotension B. Anorexia and nausea C. Blurred vision and tachycardia D. Anorexia and constipation

B. Anorexia and nausea

Which client is at greatest risk for developing heart​ failure? A. A​ 50-year-old African American female who smokes B. A​ 69-year-old African American male with hypertension C. A​ 52-year-old Caucasian female with asthma D. A​ 75-year-old Caucasian male who is overweight

B. A​ 69-year-old African American male with hypertension

Which laboratory values should the nurse assess for the client receiving lisinopril​ (Prinivil)? Select all that apply. A. Uric acid B. Blood urea nitrogen​ (BUN) C. Serum bilirubin D. ​ALT/AST E. Serum drug levels

B. Blood urea nitrogen​ (BUN) C. Serum bilirubin D. ​ALT/AST

Which classifications of prescriptions are used to increase cardiac output by increasing the force of myocardial​ contractions? Select all that apply. A. Angiotensin receptor blockers B. Cardiac glycosides C. Adrenergic blockers D. Phosphodiesterase inhibitors E. ​Angiotensin-converting enzyme inhibitor

B. Cardiac glycosides D. Phosphodiesterase inhibitors

Which describes the action of vasodilators in the relief of symptoms of heart​ failure? A. Improve cardiac contractility B. Decrease afterload C. Reduce fluid overload D. Reduce preload

B. Decrease afterload

Which prescription is nephrotoxic if an overdose​ occurs? A. Lorazepam​ (Ativan) B. Ibuprofen​ (Advil) C. Amitriptyline​ (Elavil) D. Quetiapine​ (Seroquel)

B. Ibuprofen​ (Advil)

Which laboratory test is used to measure the effectiveness of warfarin sodium​ therapy? A. Platelet count B. International normalized ratio​ (INR) C. aPtt D. Complete blood count

B. International normalized ratio​ (INR)

Which describes the mechanism of action for Clopidogrel​ (Plavix)? A. Stimulates platelet production B. Prevents the platelets from sticking together C. Prevents platelets from adhering to the injured tissue D. Decreases platelet production

B. Prevents the platelets from sticking together

Which vital signs should the nurse assess prior to the administration of a​ diuretic? (2) A. Temperature B. Pulse C. Respirations D. Blood pressure E. Pain

B. Pulse D. Blood pressure

Which diuretic is most effective in reducing the mortality of a client with heart​ failure? A. Chlorothiazide​ (Diuril) B. Spironolactone​ (Aldactone) C. Acetazolamide​ (Diamox) D. Furosemide​ (Lasix)

B. Spironolactone​ (Aldactone)

The nurse is caring for a client with a DVT​ (deep vein​ thrombosis) receiving heparin intravenously​ (IV). Which is the priority outcome for the​ client? A. The client will comply with dietary restrictions. B. The client will not experience bleeding. C. The client will keep the right leg elevated on two pillows. D. The client will not disturb the intravenous infusion.

B. The client will not experience bleeding.

Which client prescribed metoprolol​ (Toprol-XL) is most risk for adverse​ effects? A. The client with compensated heart failure B. The client with chronic bronchitis C. The client with a history of migraines D. The client with an apical pulse rate of 100

B. The client with chronic bronchitis

The nurse is preparing to provide education for a client prescribed Clopidogrel​ (Plavix) after a myocardial infarction and stent placement. Which statements should the nurse use to explain the action of​ Clopidogrel? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. ​"Clopidogrel will dissolve any clots that might form in your​ stent." B. ​"Clopidogrel will make the platelets in your blood less​ sticky." C. ​"Clopidogrel will change the way your platelets​ work." D. ​"Clopidogrel decreases your​ blood's ability to​ clot." E. ​"Clopidogrel works just like the heparin you were prescribed when in the​ hospital."

B. ​"Clopidogrel will make the platelets in your blood less​ sticky." C. ​"Clopidogrel will change the way your platelets​ work." D. ​"Clopidogrel decreases your​ blood's ability to​ clot."

The nurse notes that a client receiving warfarin​ (Coumadin) has a high international normalized ratio​ (INR). Which question should the nurse include in the​assessment? A. ​"Do you drink a lot of​ milk?" B. ​"Do you eat a lot of​ garlic?" C. ​"Are you restricting your​ fluids?" D. ​"Have you been eating a lot of salads and​ vegetables?"

B. ​"Do you eat a lot of​ garlic?"

The nurse is preparing to assess a client with von​ Willebrand's disease​ (vWD). Which priority question should the nurse ask the​ client? A. ​"What are you currently using for birth​ control?" B. ​"Do you have heavy menstrual​ periods?" C. ​"Do you have any other medical​ conditions?" D. ​"Have you ever been​ pregnant?"

B. ​"Do you have heavy menstrual​ periods?"

The nurse has completed the dietary teaching for a client prescribed spironolactone​ (Aldactone). Which statement made by the client indicates further teaching is​ required? A. ​"I usually eat an apple a day to stay​ regular." B. ​"I can still have my orange juice and bananas for​ breakfast." C. ​"I love to eat eggs and toast in the​ morning." D. ​"I am really happy that I can have my cranberry​ juice."

B. ​"I can still have my orange juice and bananas for​ breakfast."

An older adult receiving ethacrynic acid​ (Edecrin) tells the nurse he or she​ doesn't hear as well as he or she used to. Which statement should the nurse include in the​ response? A. ​"You may be​ dehydrated; are you drinking enough​ fluid?" B. ​"I will let your healthcare provider know about​ this; it could be a side effect of your​ medication." C. ​"How long have you been having difficulty​ hearing?" D. ​"I will schedule a hearing​ exam; this could be a side effect of your​ medication."

B. ​"I will let your healthcare provider know about​ this; it could be a side effect of your​ medication."

The nurse has provided education for a client prescribed lisinopril​ (Prinivil). Which statement made by the client indicates further teaching is​ required? A. ​"I will avoid using salt substitutes for​ seasoning." B. ​"I will not need to worry about having additional blood tests​ done." C. ​"I will monitor my blood pressure until my next​ appointment." D. ​"It takes a while for this medication to take​ effect."

B. ​"I will not need to worry about having additional blood tests​ done." ​Rationale: The use of ACE inhibitors can lead to electrolyte disturbances so levels should be monitored. Potassium should be limited to avoid hyperkalemia. Blood pressure should be monitored to assess effectiveness of the medication. It takes a while for lisinopril​ (Prinivil) to become effective.

Which classification of prescription should the nurse anticipate to be prescribed to a client newly diagnosed with chronic heart​ failure? A. Diuretics B. ​Angiotensin-converting enzyme​ (ACE) inhibitor C. ​Beta-adrenergic blockers D. Cardiac glycosides

B. ​Angiotensin-converting enzyme​ (ACE) inhibitor

A client experiencing syncope is suspected of taking a losartan​ (Cozaar) overdose? Which intervention should the nurse​ anticipate? A. Administer a loop diuretic B. Administer an intravenous solution of normal saline C. Administer a vasopressor D. Administer a calcium infusion

B: Administer an intravenous solution of normal saline An overdose of losartan is treated with intravenous solution of normal saline.

Which medical condition should the nurse be concerned about for a client prescribed​ hydralazine? A. Hyperthyroidism B. Angina C. Diabetes D. Asthma

B: Angina The use of hydralazine is contraindicated with angina.

Which are the​ nurse's priority assessments of a client who has received normal serum​ albumin? A. Urinary output and pupil response B. Blood pressure and urinary output C. Urinary output and nausea or vomiting D. Blood pressure and level of pain

B: Blood pressure and urinary output During fluid replacement​ therapy, the nurse must assess for fluid volume deficit and fluid volume excess. This is commonly done by assessment of blood pressure and urinary output.

Which factors are responsible for blood​ pressure? A. Body mass​ index, diet, and genetics B. Cardiac​ output, blood​ volume, and peripheral vascular resistance C. Blood​ volume, heart​ rate, and stroke volume D. ​Age, weight, and race

B: Cardiac output, blood volume, and peripheral vascular resistance Although many factors can contribute to blood​ pressure, such as diet and​ weight, the cardiac​ output, blood​ volume, and peripheral vascular resistance are the factors responsible for blood pressure.

Which prescription should the nurse be concerned about a pregnant client​ receiving? A. Potassium supplement B. Enalapril​ (Vasotec) C. Hydrochlorothiazide​ (HCTZ) D. Doxazosin​ (Cardura)

B: Enalapril (Vasotec) Enalapril is a Pregnancy Category D drug that has a higher fetal risk than do the other drugs listed.

A client receiving hydrochlorothiazide​ (Microzide) asks the nurse why they are urinating so frequently. Which statement should the nurse provide the​ client? A. ​"Hydrochlorothiazide (Microzide) increases your heart​ rate; this pumps blood faster to your kidneys so you urinate more and your blood pressure​ decreases." B. ​"Hydrochlorothiazide (Microzide) decreases the fluid in your bloodstream and this lowers your blood​ pressure." C. ​"Hydrochlorothiazide (Microzide) dilates your blood vessels so you urinate more and your blood pressure​ decreases." D. ​"Hydrochlorothiazide (Microzide) enhances kidney function causing you to urinate more and that decreases your blood​ pressure."

B: Hydrochlorothiazide (Microzide) decreases the fluid in your bloodstream and this lowers your blood pressure. Blood volume is one of the three factors influencing blood pressure. Diuretics like hydrochlorothiazide​ (Microzide) decrease blood pressure by decreasing total blood volume.

The educator is discussing intravenous solutions with a nurse. Which should the educator include when discussing crystalloid isotonic​ solutions? A. ​5% albumin B. Lactated Ringers C. Dextran 70 in normal saline D. Dextran 70 in normal saline

B: Lactated Ringers Lactated​ Ringer's is a crystalloid isotonic solution.

The nurse reviewing the records of a client diagnosed with hypertension notes a weight of 200​ lb., height​ 5' 4", dietary intake includes primarily​ starches, an alcohol intake of three beers per​ week, and stressors include​ 60-hour work weeks. Based on this​ information, which should the nurse identify as a priority​ outcome? A. Patient will balance diet according to the food pyramid. B. Patient will achieve and maintain optimum weight. C. Patient will decrease stress by limiting work to 40​ hours/week. D. Patient will eliminate alcohol from the diet.

B: Patient will achieve and maintain optimum weight. Achieving and maintaining optimum weight is of greatest importance when a client has hypertension. For obese​ patients, a​ 10- to​ 20-pound weight loss can produce a measurable change in blood pressure.

Which adverse effect should the nurse instruct the client receiving dextran 40​ (Gentran 40) to​ report? A. Diarrhea B. Unexplained cough C. Ototoxicity D. Difficulty urinating

B: Unexplained cough An unexplained cough should be reported immediately as this could be related to a fluid overload.

For which assessment findings should the nurse hold enalapril​ (Vasotec)? ​ Select all that apply. A. Cough B. Lightheadedness on ambulation C. Periorbital edema D. Sneezing E. Difficulty swallowing

C,E: Periorbital edema, difficulty swallowing Periorbital edema may indicate​ angioedema, which is a serious adverse effect. Holding the prescription is indicated. Difficulty swallowing may indicate swelling in the throat related to angioedema. Holding the drug is indicated.

The educator is preparing to review the diuretics that do not require potassium supplements with a nurse. Which diuretics should the educator​ include? (2) A. Furosemide​ (Lasix) B. Chlorothiazide​ (Diuril) C. Amiloride​ (Midamor) D. Mannitol​ (Osmitrol) E. Spironolactone​ (Aldactone)

C. Amiloride​ (Midamor) E. Spironolactone​ (Aldactone)

Which classification of prescriptions does the nurse anticipate for the client being treated for a thromboembolic​ disorder? ​Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Hemostatics B. Thrombolytics C. Anticoagulants D. Antiplatelet agents E. Clotting factor concentrates

C. Anticoagulants D. Antiplatelet agents

Which client has the greatest risk for developing heart​ disease? A. A​ 52-year-old with osteoporosis and stage 1 hypertension B. A​ 35-year-old with diabetes mellitus and prehypertension C. A​ 68-year-old with stage 2 hypertension and recent myocardial infarction D. A ​75-year-old with​ Parkinson's disease and normal blood pressure

C. A​ 68-year-old with stage 2 hypertension and recent myocardial infarction

Which statement is accurate regarding the physiological changes associated with heart​ failure? A. Blood pressure​ increases, resulting in lowered afterload. B. The walls of the heart​ shrink, leading to lower cardiac output. C. Cardiac remodeling occurs after prolonged ventricular hypertrophy D. Blood backs up into the lungs due to right ventricular hypertrophy.

C. Cardiac remodeling occurs after prolonged ventricular hypertrophy

The nurse is preparing the education for a client prescribed chlorothiazide​ (Diuril). Which information should the nurse include in the​ teaching? A. Assessment of blood glucose daily B. Daily weights with a report of a gain of more than 1 pound in 24 hours C. Consumption of foods high in potassium D. Report change in hearing

C. Consumption of foods high in potassium

Which action of Lisinopril​ (Prinivil) results in a decrease in the blood​ volume? A. Antagonistic effect on​ angiotensin-converting enzyme. B. Causes hypernatremia and increased renal tubule permeability resulting in a diuretic effect. C. Decrease aldosterone secretion. D. Causes a diuretic effect by lowering the amount of sodium lost in the urine.

C. Decrease aldosterone secretion.

Which describes the action of thrombolytic​ prescriptions? A. Convert plasmin to plasminogen. B. Prevent the liver from making fibrin. C. Digest and remove preexisting clots. D. Prevent thrombus formation.

C. Digest and remove preexisting clots.

A patient receiving chlorothiazide​ (Diuril) has developed hypokalemia. Which assessment findings support the​ diagnosis? A. Hyperglycemia B. Diarrhea C. Heart palpitations D. Increased urine output

C. Heart palpitations

The nurse notes the blood pressure and red blood cell​ (RBC) count of a client receiving heparin is low. Which should the nurse suspect has​ occurred? A. Clot formation B. Dehydration C. Internal bleeding D. Decreased activated partial thromboplastin time​ (aPTT)

C. Internal bleeding

Which should the nurse anticipate to be included in the treatment plan for a client with stage A heart​ failure? A. ​Angiotensin-converting enzyme​ (ACE) inhibitor B. ​Beta-blocker C. Lifestyle modifications D. Cardiac glycoside

C. Lifestyle modifications

Which is the primary functional unit of the​ kidney? A. ​Bowman's capsule B. Distal tubule C. Nephron D. Loop of Henle

C. Nephron

Which additional prescribed treatment should the nurse anticipate for the client prescribed heparin​ therapy? A. Weekly weights B. Low vitamin K diet C. Obtaining an aPTT D. Advil as needed​ (PRN) for headaches

C. Obtaining an aPTT

Which general adverse effect is associated with the use of​ diuretics? A. Constipation B. Hypertension C. Orthostatic hypotension D. Weight gain

C. Orthostatic hypotension

Which prescription should the nurse anticipate for a client that has overdosed on Clopidogrel​ (Plavix)? A. Whole blood transfusion B. Vitamin K C. Platelet transfusion D. Protamine sulfate

C. Platelet transfusion

Which describes the purpose of​ fibrinolysis? A. Produce enzymes B. Stop blood flow C. Remove a blood clot D. Increase blood flow

C. Remove a blood clot

Which should the nurse suspect after reviewing noting the presence of protein on a routine​ analysis? A. Chronic kidney injury B. Acute kidney injury C. Structural damage D. Kidney infection

C. Structural damage

The nurse is reviewing the process of hemostasis after an injury with a client. Which should the nurse identify as the initial event in this​ process? A. Plasma proteins convert to active forms. B. Platelets become sticky. C. The vessel spasms. D. Von​ Willebrand's factor is activated.

C. The vessel spasms.

Which is the most serious adverse effect associated with milrinone​ (Primacor)? A. Atrial dysrhythmia B. Nausea C. Ventricular dysrhythmia D. Headache

C. Ventricular dysrhythmia

Which laboratory study is used to evaluate the proper dosage for heparin​ therapy? A. Serum heparin levels B. Sedimentation rate C. aPtt D. Complete blood count

C. aPtt

Which priority question should the nurse ask a client suspected of experiencing a stroke that is prescribed alteplase​ (Activase). A. ​"Are you currently being treated for​ hypertension?" B. ​"Do you have any other medical​ conditions?" C. ​"Do you know what time the stroke​ occurred?" D. ​"Do you take any other​ prescriptions?"

C. ​"Do you know what time the stroke​ occurred?"

The nurse has provided a client education about enoxaparin​ (Lovenox). Which statement made by a client indicates an understanding of the​ information? A. ​"Enoxaparin inhibits the synthesis of​ prostaglandins." B. ​"Enoxaparin increases the flexibility of my blood​ cells." C. ​"Enoxaparin increases the time it takes for me to form a​ clot." D. ​"Enoxaparin dissolves small clots so I​ won't have a​ stroke."

C. ​"Enoxaparin increases the time it takes for me to form a​ clot."

Which information should the nurse include in the discharge plan for a client prescribed digoxin​ (Lanoxin)? A. ​"Report the development of a metallic taste in the​ mouth." B. ​"If you miss a​ dose, take two​ doses." C. ​"Report mental changes such as feelings of​ depression." D. ​"Stop the prescription if your pulse is​ irregular."

C. ​"Report mental changes such as feelings of​ depression."

A client with cirrhosis of the liver asks the nurse why they are at risk for bleeding. Which response should the nurse provide the​ client? A. ​"The liver is injured and unable to manufacture​ platelets." B. ​"The liver is breaking down your clotting factors too​ quickly." C. ​"The liver is injured and cannot make clotting​ factors." D. ​"The liver thickens your blood so it is less likely to​ clot."

C. ​"The liver is injured and cannot make clotting​ factors."

A client in heart failure asks the nurse how difficulty breathing is related to a heart problem. Which information should the nurse provide the​ client? Select all that apply. A. ​"The right side of your heart has weakened and blood has entered your​ lungs." B. ​"The right side of your heart has enlarged and cannot effectively pump​ blood." C. ​"What you have is called congestive heart​ failure." D. ​"The left side of your heart is weak and pumps blood too​ quickly." E. ​"The left side of your heart has weakened and blood has entered your​ lungs."

C. ​"What you have is called congestive heart​ failure." E. ​"The left side of your heart has weakened and blood has entered your​ lungs."

Which intravenous solution should the nurse anticipate to be prescribed for the client who is dehydrated with a stable blood​ pressure? A. D5 ​0.45% NS B. ​0.9% NaCl C. ​0.45% NaCl D. ​5% dextrose in NS

C: 0.45% NaCl ​0.45% NaCl is a hypotonic solution. This will cause fluid to shift from plasma to the tissues and cells in the intravascular compartment. Hypotonic solutions are indicated for patients who are dehydrated with normal blood pressure.

The nurse notes that a client experiencing heart failure has been receiving nifedipine​ (Procardia). Which is a priority assessment for the​ nurse? A. Assess urinary output. B. Assess level of orientation. C. Auscultate breath sounds for crackles. D. Review recent lab results for hypokalemia.

C: Auscultate breath sounds for crackles Some calcium channel blockers can reduce myocardial contractility and can worsen heart failure. Crackles in the lungs can indicate pulmonary​ edema, which could indicate heart failure.

Which changes are sensed by the baroreceptors and relayed to the vasomotor​ center? A. Oxygenation B. Carbon dioxide C. Blood pressure D. Blood pH

C: Blood pressure Baroreceptors sense and relay changes in blood pressure.

A client prescribed doxazosin​ (Cardura) asks how the medication works. Which information should the nurse provide the​ client? A. ​"Doxazosin helps the heart work more​ efficiently." B. ​"Doxazosin causes the kidneys to excrete more​ urine." C. ​"Doxazosin helps dilate the blood​ vessels." D. ​"Doxazosin decreases the release of the stress​ hormones."

C: Doxazosin helps dilate the blood vessels Doxazosin​ (Cardura) is selective for blocking alpha1​-receptors in vascular smooth​muscle, which results in dilation of arteries and veins.

Which condition should the nurse anticipate the healthcare provider to prescribe intravenous fluid​ therapy? A. Fluid intake of 2500​ mL/day B. Orthostatic hypotension C. Fluid output exceeds intake D. Pulmonary edema

C: Fluid output exceeds intake Intake and output imbalance may require intravenous fluid therapy to correct the imbalance.

A client receiving dextran 40​ (Gentran 40) begins experiencing​ tachycardia, dyspnea, and a cough. Which should the nurse understand is the causative factor of the​ symptoms? A. Renal failure B. Pulmonary edema C. Fluid overload D. Allergic reaction

C: Fluid overload Fluid overload is caused by a rate of infusion that is too rapid. Signs of fluid overload include​ tachycardia, peripheral​ edema, distended neck​ veins, dyspnea, and cough.

The nurse reviewing a​ client's records notes the client has received polystyrene sulfonate​ (Kayexalate). Which condition should the nurse associate with the​ treatment? A. Hypercalcemia B. Hyperphosphatemia C. Hyperkalemia D. Hypernatremia

C: Hyperkalemia

Which should the nurse recognize are potential causes for respiratory​ alkalosis? A. Hypotension B. Hypertension C. Hyperventilation D. Hypoventilation

C: Hyperventilation Hyperventilation occurs with respiratory alkalosis.

The nurse has discussed lifestyle modifications to help manage the​ client's hypertension. Which statement made by the client indicates an understanding of the​ information? A. ​"I need to get started on my medications right​ away." B. ​"I won't be able to run in the marathon race​ anymore." C. ​"I know I need to give up my cigarettes and​ alcohol." D. ​"My father had​ hypertension, did​ nothing, and lived to be​ 90-years-old."

C: I know I need to give up my cigarettes and alcohol Limiting intake of alcohol and discontinuing tobacco products are important nonpharmacological methods for controlling hypertension.

Which condition is a symptom of​ hypokalemia? A. Hypertension B. Weight gain C. Muscle weakness D. Constipation

C: Muscle weakness Muscle weakness can​ occur, since muscle fibers are very sensitive to changes in potassium.

Which electrolytes should the nurse anticipate monitoring for a client prescribed losartan​ (Cozaar)? A. Chloride B. Calcium C. Potassium D. Magnesium E. Sodium

C: Potassium The electrolytes that will be monitored for a client prescribed losartan include potassium.

Which intervention is the highest priority for a​ 30-year-old female with a BMI of 20 who smokes and has a blood pressure of​ 137/88? A. Stress management B. ​Weight-loss program C. ​Smoking-cessation program D. Diuretic therapy

C: Smoking-cessation program Smoking cessation is the priority.

A client receiving sodium bicarbonate intravenously​ (IV) for correction of metabolic acidosis is experiencing​ cyanosis, decreased​ respirations, and an irregular pulse. Which is the​ nurse's priority​ action? A. Decrease the rate of the infusion B. Increase the rate of the infusion C. Stop the infusion and notify the healthcare provider D. Continue the infusion

C: Stop the infusion and notify the healthcare provider The patient receiving sodium bicarbonate is prone to​ alkalosis; monitor for​cyanosis, slow​ respirations, and irregular pulse. The​ patient's symptoms indicate alkalosis so infusion must be stopped and the healthcare provider notified.

Which is a priority nursing intervention for a client who is newly prescribed enalapril​ (Vasotec)? A. Order a​ sodium-restricted diet for the client. B. Review the​ client's lab results for hypokalemia. C. Take the​ client's blood pressure. D. Monitor the client for headaches.

C: Take the client's blood pressure Enalapril may produce a​ first-dose phenomenon resulting in profound​ hypotension, which may result in syncope.

The educator is preparing to review the movement of body fluids with a nurse. Which statement should the educator use when referring to​ tonicity? A. The measure of the number of dissolved​ particles, or solutes in 1 liter of water. B. A solution that contains a greater concentration of solutes than plasma. C. The ability to cause change in water movement across a membrane. D. Water moves from areas of low concentration to areas of high solute concentration.

C: The ability to cause change in water movement across the membrane The ability to cause change in water movement across a membrane refers to tonicity.

Which route of administration should the nurse anticipate to use for a​ client's prescribed enoxaparin​ (Lovenox)? A. Administer the prescription via slow intravenous​ (IV) push. B. Administer the prescription intramuscularly into the thigh. C. Administer the prescription orally. D. Administer the prescription into the​ abdomen, subcutaneously.

D. Administer the prescription into the​ abdomen, subcutaneously.

Which adverse effect should the nurse instruct the client to monitor for while receiving warfarin​ sodium? A. Headache B. Pain C. Rash D. Bleeding

D. Bleeding

A client is prescribed an intravenous infusion of milrinone​ (Primacor) for acute heart failure. Which is a priority nursing assessment during the​ infusion? A. Vital signs every 15 minutes B. Monitor for symptoms of atrial fibrillation C. Monitor for hypertension D. Continuous ECG monitoring

D. Continuous ECG monitoring

Which adverse effect of lisinopril​ (Prinivil) should be reported to the healthcare​ provider? A. Fever B. Increased urine output C. Facial flushing D. Cough

D. Cough

A client prescribed furosemide​ (Lasix) and digoxin​ (Lanoxin) reports using an​ over-the-counter antacid for recurrent heartburn. Based on this​ information, which effect should the nurse be concerned​ about? A. Hyponatremia B. Hypermagnesemia C. Increased effectiveness of furosemide​ (Lanoxin) D. Decreased effectiveness of digoxin​ (Lanoxin)

D. Decreased effectiveness of digoxin​ (Lanoxin)

Which prescription should the nurse anticipate to increase the myocardial contractility for a client with heart​ failure? A. Lisinopril​ (Prinivil) B. Carvedilol​ (Coreg) C. Furosemide​ (Lasix) D. Digoxin​ (Lanoxin)

D. Digoxin​ (Lanoxin)

The nurse is reviewing the laboratory reports for a client with chronic kidney failure. Which lab should then nurse understand reflects the progression of the kidney​ disease? A. Serum creatinine B. Urinalysis C. Blood urea nitrogen​ (BUN) D. Glomerular filtration rate​ (GFR)

D. Glomerular filtration rate​ (GFR)

The nurse notes a​ client's warfarin​ (Coumadin) level is 7​ mcg/mL. Which action should the nurse​ take? A. Continue the treatment and monitor the client. B. Administer protamine sulfate and hold the next dose of warfarin​ (Coumadin). C. Hold the next dose of warfarin​ (Coumadin) and contact the healthcare provider. D. Hold the next dose of warfarin​ (Coumadin) and request an international normalized ratio​ (INR).

D. Hold the next dose of warfarin​ (Coumadin) and request an international normalized ratio​ (INR).

The nurse is reviewing the medical history of a client prescribed hydrochlorothiazide​ (Microzide). Which condition should the nurse be concerned​ about? A. Hypothyroidism B. Asthma C. Gout D. Hypertension

D. Hypertension

Which describes the primary action of anticoagulant​ therapy? A. Dissolve blood clots B. Decrease the prothrombin time C. Increase the number of platelets D. Prevent the formation of blood clots

D. Prevent the formation of blood clots

Which initial treatment prescribed should the nurse anticipate for the client that has overdosed on​ hydrochlorothiazide? A. Intravenous normal saline B. Furosemide​ (Lasix) C. Electrolyte replacement D. Vasopressor

D. Vasopressor

Which prescription should the nurse prepare to administer for a client experiencing a warfarin sodium​ overdose? A. Protamine sulfate B. Heparin C. Aspirin D. Vitamin K

D. Vitamin K

The healthcare provider has prescribed hydrochlorothiazide​ (HCTZ) for a client with chronic renal failure. Which assessment finding indicates the treatment is​ ineffective? A. Hypotension B. Weak pulses C. Poor skin turgor D. Wheezing

D. Wheezing

A client asks the nurse how hypertension can lead to heart failure. Which response should the nurse provide the​ client? A. ​"Hypertension causes resistance in the venous system requiring the heart to work harder to pump the blood​ forward." B. ​"Hypertension limits the ability of the heart to stretch before emptying resulting in the heart working harder to pump the blood out into the arterial​ system." C. ​"Hypertension limits the amount of blood entering the left ventricle increasing the workload of the heart to pump an adequate amount of blood into the circulatory​ system." D. ​"Hypertension increases the resistance in the blood vessels causing the heart work harder to pump the blood out against the resistance of the​ arteries."

D. ​"Hypertension increases the resistance in the blood vessels causing the heart work harder to pump the blood out against the resistance of the​ arteries."

Which statements made by a client indicates an understanding of the education provided by the nurse regarding digoxin​ (Lanoxin) toxicity? Select all that apply. A. ​"I should limit my fluids while taking this​ medication." B. ​"It is okay to keep taking my​ ginseng." C. ​"If I have​ nausea, it means I must stop the​ medication." D. ​"I can drink orange juice every​ morning." E. ​"I must check my pulse and not take the medication if it is less than​ 60."

D. ​"I can drink orange juice every​ morning." E. ​"I must check my pulse and not take the medication if it is less than​ 60."

The nurse has provided education for a client with diabetes mellitus prescribed metoprolol​ (Lopressor) for hypertension. Which statement made by the client indicates an understanding of the​ information? A. ​"I might need more insulin when I take metoprolol​ (Lopressor)." B. ​"I might be able to change from insulin to a pill with metoprolol​ (Lopressor)." C. ​"I might not need to check my blood sugars as often with metoprolol​ (Lopressor)." D. ​"I might need less insulin when I take metoprolol​ (Lopressor)."

D. ​"I might need less insulin when I take metoprolol​ (Lopressor)." ​Rationale: Metoprolol may enhance the hypoglycemic effects of insulin and oral hypoglycemic​ agents, so the client might require less insulin

Which statement made by the client indicates an understanding of​ self-care while taking prescriptions to treat their heart​ failure? A. ​"I will cut back on my​ smoking." B. ​"I will check my pulse every few​ days." C. ​"I will schedule my lab work if I am not feeling​ well." D. ​"I will weigh myself every day in the morning after I wake​ up."

D. ​"I will weigh myself every day in the morning after I wake​ up.

Which information should the nurse include when providing education for an older client prescribed chlorothiazide​ (Diuril)? A. ​"Take the medication on an empty​ stomach." B. ​"Avoid foods that are high in​ potassium." C. ​"It is alright to have a glass of wine with this​ medication." D. ​"Take the medication early in the​ morning."

D. ​"Take the medication early in the​ morning."

A client prescribed bumetanide​ (Bumex) asks the nurse how the drug works. Which response should the nurse provide the​ client? A. ​"This prescription causes your kidneys to reabsorb​ sodium." B. ​"This prescription causes your kidneys to reabsorb​ potassium." C. ​"This prescription causes your kidneys to reabsorb​ chloride." D. ​"This prescription causes your kidneys to reabsorb​ calcium."

D. ​"This prescription causes your kidneys to reabsorb​ calcium."

Which serum sodium level should the nurse recognize as​ hyponatremia? A. 137​ mEq/mL B. 140​ mEq/mL C. 145​ mEq/mL D. 133​ mEq/mL

D: 133mEq/mL A serum sodium of 133​ mEq/mL reflects a hyponatremic state.

The nurse educator is reviewing the physiological regulation blood pressure. Which should the educator identify as initially​ involved? A. Production of angiotensin II B. Antidiuretic hormone C. Production of angiotensin I D. Action of renin

D: Action of renin Renin forms angiotensin I.

The nurse has prescribed dietary education for a client prescribed nifedipine​ (Procardia XL). Which dietary choice should the nurse recognize requires further​ education? A. ​Whole-wheat pancakes with​ syrup, and​ bacon, oatmeal, and orange juice B. Eggs and​ sausage, a biscuit with​ margarine, coffee with​ cream, and cranberry juice C. Egg and cheese​ omelet, tea with sugar and​ lemon, hash brown​ potatoes, and prune juice D. ​Eggs, whole-wheat toast with​ butter, cereal,​ milk, and grapefruit juice

D: Eggs, whole-wheat toast with butter, cereal, milk, and grapefruit juice Grapefruit juice in combination with a​ sustained-release calcium channel blocker could result in rapid toxic​ overdose, which is a medical emergency.

Which is the​ nurse's priority assessment for a client treated with intravenous hydralazine​ (Apresoline)? A. Hypotension and tachypnea B. Hypotension and hyperthermia C. Hypotension and bradycardia D. Hypotension and tachycardia

D: Hypotension and tachycardia Direct vasodilators produce reflex​ tachycardia, a compensatory response to the sudden decrease in blood pressure caused by the drug.

The nurse has completed the education for a client prescribed hydrochlorothiazide​ (Microzide). Which statement made by the client indicates an understanding of the​ teaching? A. ​"I need to avoid salt substitutes and​ potassium-rich foods." B. ​"I really need to avoid grapefruit juice when I take this​ medication." C. ​"If I develop a​ cough, I should call my​ physician." D. ​"I take my medication early in the​ morning."

D: I take my medication early in the morning Taking hydrochlorothiazide​ (Microzide) early in the day will help prevent nocturia.

A client with a potassium level of 5.9​ mEq/L is prescribed glucose and insulin. Which statement should the nurse include in the​ client's education? A. ​"Insulin is safer than giving laxatives such as​ Kayexalate." B. ​"Insulin lowers blood sugar levels and this is how the extra potassium is​ excreted." C. ​"Insulin will help kidneys excrete the extra​ potassium." D. ​"Insulin will cause extra potassium to go into cells and lower the blood​ level."

D: Insulin will cause potassium to go into cells and lower the blood level Serum potassium levels may be temporarily lowered by administering glucose and​insulin, which cause potassium to leave the extracellular fluid and enter cells.

Which electrolyte imbalance should the nurse be concerned about for the client that is prescribed a thiazide​ diuretic? A. Magnesium B. Chloride C. Calcium D. Potassium

D: Potassium The client prescribed a thiazide diuretic is at risk for a potassium and sodium imbalance. The client should be monitored for hypokalemia.​ Magnesium, calcium, and chloride are not a concern.