N117 Exam 4

Taking ferrous sulfate with food can

reduce the GI symptoms associated with it taking the medication between meals maximizes absorption

Flaxseed can

reduce the absorption of conventional medication and the client should take flaxseed 1 hr before or 2 hr after taking conventional medications

Creatinine is monitored to identify

renal impairment and indicate the glomerular filtration rate

The return of color to the nail beds should occur within

3 seconds

Dependent edema is a manifestation of

right-sided heart failure

Captopril can cause

tachycardia

Foods that don't contain cholesterol

Any food that does not contain animal products does not contain cholesterol

Hydrochlorothiazide should be taken when

in the morning to avoid nocturia

Intermittent claudication

ischemic pain that is precipitated by exercise, resolves with rest, and is reproducible Early sign of PAD

Foot ulcers are a manifestation that occurs in

later stages of PAD

Nitroglycerin should be taken with

no food (empty stomach) 1 hour before or 2 hours after a meal with 8 oz of water

Furosemide can cause

potassium loss and increase the risk for digoxin toxicity when used concurrently with digoxin

Hydrochlorothiazide can cause hypokalemia. The client should increase intake of

potassium-rich foods, such as spinach and bananas

Spironolactone is a

potassium-sparing diuretic

Jugular distention indicates

right-sided heart failure

Nocturnal polyuria indicates

right-sided heart failure

Grapefruit juice can interfere with the metabolism of

statins

Someone with heart failure is likely to have

tachycardia decreased urine output weight gain orthopnea

A nurse is teaching a client who has a new prescription for captopril. Which of the following instructions should the nurse include in the teaching? A.) Monitor for a cough. B.) Hold medication for heart rate less than 60/min. C.) Take this medication with food. D.) Avoid grapefruit juice.

A.) Captopril is an ACE inhibitor used to treat hypertension. The client should monitor and report a cough and dyspnea.

A nurse is providing discharge teaching to a client who has a new diagnosis of heart failure. Which of the following instructions should the nurse include in the teaching? A.) Exercise at least three times per week. B.) Take diuretics early in the morning and before bedtime. C.) Notify the provider of a weight gain of 0.5 kg (1 lb) in a week. D.) Take naproxen for generalized discomfort.

A.) Clients who have heart failure who remain active appear to have improved outcomes. Regular exercise strengthens the heart and cardiovascular system, thereby improving circulation and lowering blood pressure. The nurse should instruct the client to avoid the use of NSAIDs as these contribute to sodium and fluid retention, worsening the client's condition.

A nurse is planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication? A.) Potassium B.) Hemoglobin C.) Creatinine D.) Blood urea nitrogen

A.) Digoxin is a cardiac glycoside medication used to improve myocardial contractility, increasing stroke volume and cardiac output in a client who has heart failure. During therapy, the nurse should closely monitor the client's potassium level as hypokalemia increases the risk of digitalis toxicity and cardiac arrhythmias.

When checking a client's capillary refill, the nurse finds that the color returns in 10 seconds. The nurse should understand that this finding indicates which of the following? A.) Arterial insufficiency B.) Venous insufficiency C.) Within the expected range D.) Thrombus formation in the vein

A.) To test capillary refill, a nurse presses on the client's nail beds to produce blanching and then measures the time it takes for the color to return. With adequate arterial capillary perfusion, the color should return within 3 seconds. If the skin color takes longer than 3 seconds to return to normal, this indicates impaired arterial blood flow to the extremity.

A nurse is teaching a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include? A.) "You should expect brown-colored urine." B.) "You should avoid grapefruit juice." C.) "You should monitor for ringing in the ears." D.) "You should take the medication in the morning."

B.) Grapefruit inhibits the drug-metabolizing enzyme CYP3A4 which slows the metabolism of simvastatin. This can cause an increase in serum simvastatin. Potential adverse effects include elevated liver enzymes, and rhabdomyolysis. The nurse should instruct the client to take the medication in the evening to increase efficacy.

A nurse is teaching a client about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following client food choices reflects the client's understanding of these dietary instructions? A.) Liver B.) Milk C.) Beans D.) Eggs

C.) Myopathy is an adverse effect of this medication. Signs of myopathy include muscle aches, tenderness, and muscle weakness.

A nurse is teaching a client who has a new prescription for aspirin to prevent cardiovascular disease. Which of the following instructions should the nurse include in the teaching? A.) Take the tablets on an empty stomach B.) Expect stools to turn black C.) Anticipate the tablets to smell like vinegar D.) Monitor for tinnitus

D.) Tinnitus is a manifestation of salicylism, or aspirin toxicity. Other manifestations include sweating, headache, and dizziness. The client should take aspirin with a full glass of water or with food to reduce gastric distress. The client should monitor for black, tarry stools and other manifestations of bleeding, such as bruising. Discard aspirin tablets that smell like vinegar because these tablets are decomposing and are ineffective.

A nurse is teaching a client who is taking atorvastatin daily. Which of the following statements by the client indicates an understanding of the teaching? A.) "I will avoid drinking grapefruit juice." B.) "I should take this medication without food." C.) "I should expect my stools to turn clay-colored." D.) "It is not necessary to have routine lab tests done."

A.) Grapefruits and grapefruit juice can reduce metabolism of atorvastatin, which increases the risk for toxicity. The client can take atorvastatin with or without food.

The expected reference range for HDL is

>45 mg/dL in men and >55 mg/dL in women

A nurse is providing instructions to a client who has a new prescription for sublingual nitroglycerin (Nitrostat) to treat angina pectoris. Which of the following instructions should the nurse include? A.) "Place the tablet under your tongue, and then take a small sip of water." B.) "The medication can take up to 15 minutes to take effect." C.) "Avoid taking the medication prior to exercising." D.) "Stop taking the medication and notify your provider if you develop a headache."

A.) A client who takes a sublingual medication should place it under his tongue. A sip of water can help the medication dissolve. The nurse should tell the client that the medication takes effect rapidly in 1-3 min.. The nurse should tell the client that the medication can be used to terminate an ongoing anginal attack as well as to prevent anginal pain prior to exertion. Therefore the client might need the medication prior to exercising. Headache is a common adverse effect of this medication that often dissipates with prolonged use. The client should continue to take the medication and take aspirin or acetaminophen for headache.

A nurse is teaching a client who has hypertension and a new prescription for atenolol. Which of the following findings should the nurse include as adverse effects of this medication? A.) Bradycardia B.) Tremor C.) Cough D.) Constipation

A.) Atenolol is a beta-blocker, which slows the heart rate. The nurse should instruct the client to monitor his pulse rate and report bradycardia.

A nurse is assessing a client who has chronic venous insufficiency. which of the following findings should the nurse expect? A.) Dependent rubor B.) Edema C.) Hair loss D.) Thick, deformed toenails

B.) An increase in venous hydrostatic pressure, which develops when fluid accumulates in the veins, causes fluid to leak out into the tissues resulting in edema

A client who has a history of myocardial infarction (MI) is prescribed aspirin 325 mg. The nurse recognizes that the aspirin is given due to which of the following actions of the medication A.) analgesic B.) anti-inflammatory C.) antiplatelet aggregate D.) antipyretic

C.) Aspirin is used to decrease the likelihood of blood clotting. It also is used to reduce the risk of a second heart attack or stroke by inhibiting platelet aggregation and reducing thrombus formation in an artery, a vein, or the heart.

A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect? A.) Jugular venous distention B.) Abdominal distension C.) Dependent edema D.) Hacking cough

D.) A hacking cough is a manifestation of left-sided heart failure that occurs due to pulmonary congestion.

At the start of warfarin therapy, the prescriber should monitor the client's

INR every day

Atenolol is a beta-blocker, which

Slows the heart rate

electrolytes impacting blood pressure include

alcium and magnesium, both of which can result in hypertension if dietary consumption is low

Metolazone is a

thiazide diuretic that increases the risk of hyponatremia and hypokalemia, not hyperkalemia

Nitroglycerin is a

vasodilator medication to treat angina

garlic can potentiate the action of

warfarin

Reclining immediately after taking ferrous sulfate may lead to

esophageal corrosion Clients should remain upright for 15-30 min following administering

manifestations of hypokalemia

fatigue, tachycardia, leg cramps, and muscle weakness

Aloe vera has potential adverse interactions with

furosemide and loop diuretics.

Medications that can cause secondary hypertension

glucocorticoids, mineralocorticoids, and sympathomimetics

Clients who take statins, such as atorvastatin, should avoid

grapefruit juice because it can reduce the metabolism of the medication and cause toxicity

A nurse is providing teaching to a client who is taking warfarin about monitoring its therapeutic effects. Which of the following explanations should the nurse provide about the international normalized ratio (INR) test? A.) "The INR also monitors heparin therapy if the provider switches the medication prescription." B.) "The INR is the only test available for anticoagulant therapy monitoring." C.) "You will only need the test twice per month." D.) "The INR is a standardized test that eliminates the variations between laboratories reports in prothrombin times."

D.) The INR is a standardized test, which means that the result will be the same, no matter which laboratory performs it.

ow dietary potassium intake has been associated with

an elevation in blood pressure and an increased risk of stroke

Benazepril is an

angiotensin-converting-enzyme (ACE) inhibitor that is used in the treatment of hypertension

Bronchospasms and wheezing are adverse effects of

atenolol

Lethargy and drowsiness are adverse effects of

atenolol

Nausea, vomiting, and diarrhea are adverse effects of

atenolol

Flumazenil is a

benzodiazepine antagonist (reverses the effects of benzodiazepines)

Metoprolol is a

beta-blocker that slows the heart rate and improves contractility of the heart muscle

Cranberry juice potentially increases the risk of

bleeding in clients who take warfarin

Digoxin is a

cardiac glycoside used to increase cardiac output in a client who has heart failure

Dependent rubor

dark red color to the feet and lower legs when the leg is in a dependent position It is the result of dilation of the arteries as a compensatory response to poor arterial blood flow and is a manifestation that occurs in later stages of PAD

a diet high in potassium has been found to

decrease blood pressure

Anorexia, nausea, vomiting, and abdominal discomfort are early signs of

digoxin toxicity.

A nurse is providing teaching to a client who has stable angina and a new prescription for nitroglycerin oral, sustained-release capsules. Which of the following instructions should the nurse include? A.) Take 1 capsule at the onset of anginal pain. B.) Take 1 capsule at the onset of anginal pain. C.) Take the medication with meals. D.) Swallow the capsules whole.

D.) Do not crush or chew either

A nurse is providing teaching to a client who has hypertension and a new prescription for captopril. Which of the following instructions should the nurse provide? A.) Do not use salt substitutes while taking this medication B.) Take the medication with food C.) Count your pulse rate before taking the medication D.) Expect to gain weight while taking this medication

** A.) Captopril, an ACE inhibitor, can cause hyperkalemia due to potassium retention by the kidney. The client should avoid salt substitutes, as most of them are high in potassium. The client should take captopril on an empty stomach, 1 hr before or 2 hr after a meal, in order to not reduce the medication's absorption. It is not necessary to count a pulse before taking captopril. Weight gain is not an adverse effect of captopril.

Captopril is an

ACE inhibitor used to treat hypertension

Coughing is an adverse effect of

ACE inhibitors

A nurse is providing discharge teaching to a client who has peripheral arterial disease (PAD). Which of the following instructions should the nurse include in the teaching? A.) Apply a heating pad on a low setting to help relieve leg pain. B.) Adjust the thermostat so that the environment is warm. C.) Wear antiembolic stockings during the day. D.) Rest with the legs above heart level.

B.) The client's instructions should include keeping the environment warm to prevent vasoconstriction. Wearing gloves, warm clothes, and socks will help prevent vasoconstriction. Clients who have PAD should not wear any constrictive clothing. Extreme elevation of the legs can slow the flow of arterial blood to the feet.

A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia? A.) Furosemide B.) Hydrochlorothiazide C.) Spironolactone D.) Spironolactone

D.) Spironolactone is a potassium-sparing diuretic. It blocks the effects of aldosterone in the renal tubules, causing a loss of sodium and water and the retention of potassium. The possible adverse reactions include hyperkalemia and hyponatremia.

The client who has PAD will have thickened or thinned toenails?

Thick

Abdominal distension is a manifestation of

right-sided heart failure

Diuretics are used in the treatment of

heart failure to remove excess extracellular fluid from the body

The activated partial thromboplastin time (aPTT) monitors

heparin therapy

Fab antibody fragments

AKA Digibind or digoxin immune Fab binds to digoxin and block its action (Used for Digoxin OD)

A nurse is reviewing discharge instructions with a client who has Raynaud's disease. Which of the following client statements indicates an understanding of the teaching? A.) "I plan to use nicotine gum to help me quit smoking." B.) "I am going to take a stress management class." C.) "I will limit myself to only two cups of coffee in the morning." D.) "I should not drive in the winter months."

B.) The nurse should instruct the client that stress can elicit attacks. The client should learn to avoid stressful situations when possible and learn to manage stress to limit the occurrence of attacks. The nurse should instruct the client to avoid all forms of nicotine, including nicotine patches and gums used to assist in smoking cessation, as these products can induce an attack. The nurse should instruct the client to avoid caffeine intake, as this can induce an attack. The nurse should instruct the client that she can drive in the winter, but she should first warm up their vehicle prior to getting in. In this way, the client can avoid touching a cold steering wheel or door handle, both of which can induce an attack

A nurse is reviewing the medication list for a client who has a new prescription for warfarin. The nurse should recognize that which of the following medications is incompatible with warfarin? A.) Furosemide B.) Alprazolam C.) Vitamin K D.) Vitamin A

C.) Vitamin K antagonizes the action of warfarin and is the antidote for warfarin toxicity.

A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication, which of the following actions should the nurse take? A.) Offer the client a light snack. B.) Measure the client's blood pressure. C.) Measure the client's apical pulse. D.) Weigh the client.

C.) Digoxin decreases the heart rate, so the nurse should count the apical pulse for at least 1 min before administering. The nurse should hold the medication and notify the provider if the client's heart rate is below 60/min or if a change in heart rhythm is detected.

A nurse is educating a group of clients about the contraindications of warfarin therapy. Which of the following statements should the nurse include in the teaching? A.) "Clients who have glaucoma should not take warfarin." B.) "Clients who have rheumatoid arthritis should not take warfarin." C.) "Clients who are pregnant should not take warfarin." D.) "Clients who have hyperthyroidism should not take warfarin."

C.) Warfarin therapy is contraindicated in the pregnant client because it crosses the placenta and places the fetus at risk for bleeding.

A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of the following statements by the client indicates an understanding of the teaching? A.) "It's okay to have a couple of glasses of wine with dinner each evening." B.) "I'll be sure to eat more foods with vitamin K." C.) "I'll take aspirin for my headaches." D.) "I'll use my electric razor for shaving."

D.) Because this medication prolongs clotting times, the client should avoid situations that put him at high risk for bleeding, such as shaving with a straight razor or a razor blade. Alcohol can alter the medication's effects. Excessive intake can increase its effects, while chronic intake can decrease its effects. Clients taking warfarin should keep their intake of vitamin K consistent. Aspirin could compound the effects of warfarin and put the client at a higher risk for bleeding.

A nurse is completing a medical interview with a client who has elevated cholesterol levels and takes warfarin. The nurse should recognize that which of the following actions by the client can potentiate the effects of warfarin? A.) The client follows a low-fat diet to reduce cholesterol. B.) The client drinks a glass of grapefruit juice every day.C.) The client sprinkles flax seeds on food 1 hr before taking the anticoagulant. D.) The client uses garlic to lower cholesterol levels.

D.) The nurse should recognize that garlic can potentiate the action of the warfarin.

Clients who are taking atorvastatin should

have their liver enzymes assessed before treatment and 1 to 2 months initially, then in 6 to 12 weeks, and periodically during therapy have their cholesterol levels monitored to evaluate the effects of treatment Avoid grapefruits because Grapefruits and grapefruit juice can reduce metabolism of atorvastatin, which increases the risk for toxicity

Acetylcysteine reduces the risk oF

hepatotoxicity after acetaminophen overdose

Clay-colored stools are a manifestation of

hepatotoxicity, an adverse effect to atorvastatin

Hydrochlorothiazide is a

hiazide diuretic that increases the risk of hypokalemia, not hyperkalemia

Furosemide is a

high-ceiling (loop) diuretic that increases the risk of hyponatremia and hypokalemia, not hyperkalemia

low HDL level is a risk factor in the development of

hypertension

Hydrochlorothiazide can cause

hypokalemia

Rest pain, or a numbness or burning sensation to various areas of the foot, is a manifestation that occurs in

later stages of PAD

atorvastatin can cause

liver damage impotence in male clients

A nurse is assessing a male client who has advanced peripheral artery disease (PAD). Which of the following findings should the nurse expect? A.) Thin, pliable toe nails B.) Leg pain at rest C.) Hairy legs D.) Flushed, warm legs

B.) In the initial stages of PAD, clients might experience intermittent claudication. As the disease progresses, the client will experience pain even at rest due to ischemia of the distal extremities. The client might describe this pain as a persistent burning or aching pain that often awakens the client at night.

A nurse is assessing a client who has hypercholesterolemia and is receiving simvastatin. Which of the following findings should the nurse recognize as a potential adverse effect? A.) Urinary retention B.) Muscle weakness C.) Orthostatic hypotension D.) Blurred vision

B.) Myopathy is an adverse effect of this medication. Signs of myopathy include muscle aches, tenderness, and muscle weakness.

A nurse is assessing a toddler who has heart failure. Which of the following findings should the nurse expect? A.) Weight loss B.) Increased urine output C.) Bradycardia D.) Orthopnea

D.) A toddler who has heart failure has increased venous return to the heart and lungs, which leads to pulmonary congestion. The congestion causes orthopnea, or difficulty breathing, while lying down. Having the toddler sit up decreases venous return, as well as pressure the abdominal organs have on the diaphragm. This decrease in pressure improves breathing and oxygenation.

The client should take atorvastatin with or without food?

Either is fine

Because of the decreased perfusion to the lower extremities, the client who has PAD will have

shiny, dry skin on the legs with sparse hair growth

Brown-colored urine is a manifestation of

liver dysfunction, an adverse effect of simvastatin

Bumetanide is a

loop diuretic

The client should take captopril with

no food (on empty stomach) This will increase absorption

Naloxone reverses the effects of

opioid analgesics

Dependent rubor is a manifestation of

peripheral arterial disease

Hair loss is a manifestation of

peripheral arterial disease

Thick, deformed toenails is a manifestation of

peripheral arterial disease

BUN and creatinine levels are monitored together when caring for a client who has

renal insufficiency or failure

Simvastatin can cause

rhabdomyolysis and myopathy

ACE inhibitors cause an increase in

serum potassium Clients should avoid foods high in potassium if on ACE inhibitors

A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as the cause of the client's low potassium level? A.) Furosemide B.) Nitroglycerin C.) Metoprolol D.) Spironolactone

A.) Furosemide is a loop (high-ceiling) diuretic that inhibits the reabsorption of sodium and chloride and results in diuresis, which decreases potassium through excretion in the distal nephrons. Hypokalemia is an adverse effect of furosemide.

A nurse is caring for an older adult who has left-sided heart failure. Which of the following assessment findings should the nurse expect? A.) Frothy sputum B.) Dependent edema C.) Nocturnal polyuria D.) Jugular distention

A.) Left-sided heart failure reduces cardiac output and raises pulmonary venous pressure. Manifestations include hacking cough, frothy sputum, wheezing, fatigue, and weakness.

A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication? A.) Decreased blood pressure B.) Increase of HDL cholesterol C.) Prevention of bipolar manic episodes D.) Improved sexual function

A.)Lisinopril, an ACE inhibitor, may be used alone or in combination with other antihypertensives in the management of hypertension and congestive heart failure. A therapeutic effect of the medication is a decrease in blood pressure. Lisinopril may cause sexual dysfunction and impotence

A nurse is creating a dietary plan for an adult female client who has a hemoglobin level of 9.8 g/dL. Which of the following foods should the nurse recommend? A.) Carrots B.) Raisins C.) Maple Syrup D.) Orange Juice

B.) Foods high in iron are recommended to improve a low hemoglobin level. Raisins are a high source of iron.

A client is teaching a client who has a new prescription for hydrochlorothiazide for management of hypertension. Which of the following instructions should the nurse include? A.) "Take this medication before bedtime." B.) "Monitor for leg cramps." C.) "Avoid grapefruit juice.' D.) "Reduce intake of potassium-rich foods."

B.) Hydrochlorothiazide can cause hypokalemia. The client should monitor for manifestations of hypokalemia, such as fatigue, tachycardia, leg cramps, and muscle weakness.

A nurse is providing teaching for a client who has hypertension and a prescription change from metoprolol to metoprolol/hydrochlorothiazide. A.) "Now I will not have to diet to lose weight." B.) "With the new medication, I should experience fewer side effects." C.) "I will not have to do anything different because it is the same medication." D.) "The extra letters after the name of medication means it is a stronger dose."

B.) The client has stated an understanding of the purpose of the addition of the hydrochlorothiazide (HCTZ) to the metoprolol dosage. When used in combination with thiazide diuretics, a lower dose of the beta-blocker can be used. The benefit is there are fewer side effects when beta-blockers (and other antihypertensives) are used in lower dosages.

A nurse is providing discharge instructions for a client who has congestive heart failure. Which of the following client statements indicates to the nurse that the teaching was effective? A.) "I will read food labels and limit my sodium to 4 grams per day." B.) "I should use naproxen to manage discomfort." C.) "I plan to slow down if I am tired the day after exercising." D.) "I will take my diuretic before sleep and drink fluids during the day."

C.) Clients who experience chest pain or dyspnea while exercising or experience fatigue the next day are probably advancing the activity too quickly and should slow down. The nurse should instruct the client to consume no more than 2 g of sodium per day. Excessive sodium intake increases fluid retention and the workload on the heart. A client who has heart failure should avoid the use of NSAIDs as these medications can cause sodium retention. The nurse should recommend the use of acetaminophen for the treatment of discomfort. Clients should be advised to take diuretics in the morning to avoid waking during the night for voiding.

A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? A.) "I can walk a mile a day." B.) "I've had a backache for several days." C.) "I am urinating more frequently." D.) "I feel nauseated and have no appetite."

D.) Anorexia, nausea, vomiting, and abdominal discomfort are early signs of digoxin toxicity.

A nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following beverages should the nurse tell the client to avoid while taking this medication? A.) Milk B.) Orange juice C.) Coffee D.) Grapefruit juice

D.) Grapefruit juice increases blood levels of verapamil, a calcium channel blocker, by inhibiting its metabolism. The excess amount of medication can intensify the medication's hypotensive effects, putting the client at risk for syncope and dizziness. Although coffee consumption should be limited while taking verapamil, it does not have to be avoided.

contraindications for warfarin therapy

Liver disease Thrombocytopenia Pregnancy Peptic Ulcer disease

simvastatin should be taken when

in the evening to increase efficacy

A nurse is providing teaching to a client who has a new prescription for transdermal nitroglycerin paste. Which of the following statements by the client indicates the need for further teaching? A.) "I should measure the dosage on the supplied paper." B.) "I should leave the patch in place until it is time for the next dose." C.) "I should get up slowly when I stand." D.) "I might have a headache when I first start taking this medication."

B.) Clients should have a period of 10 to 12 hr without the patch on to reduce the risk for nitrate tolerance. Nitroglycerin patches can cause orthostatic hypotension. Instruct clients to rise slowly, and rest their feet on the floor for a few minutes before standing. Headaches caused by the vasodilation of cranial blood vessels can occur when using a topical nitroglycerin. The headaches should diminish as the client adjusts to the vasodilation effects of nitroglycerin.

A nurse is teaching a client who takes aspirin daily for coronary artery disease about herbal supplements. The nurse should instruct the client that which of the following herbal supplements may interact adversely with aspirin? A.) Cranberry juice B.) Aloe vera C.) Feverfew D.) Flaxseed

C.) The nurse should instruct the client to avoid taking feverfew with aspirin because it suppresses platelet aggregation and places the client at risk for bleeding when taken with aspirin.

A nurse is reviewing blood pressure classifications with a group of nurses at an inservice meeting. Which of the following should the nurse include as a risk factor for the development of hypertension? A.) High-density lipoprotein (HDL) level of 70 mg/dL B.) A diet high in potassium C.) Obstructive sleep apnea (OSA) D.) Taking benazepril

C.) The obstructed airway results in surges in the both the systolic and diastolic pressure during sleep and, in some clients, through the waking hours even when breathing is normal.

A nurse is providing teaching to a client who has a new prescription for lisinopril. Which of the following statements by the nurse indicates an understanding of the teaching? A.) "I should increase my intake of potassium-rich foods." B.) "I should expect to have facial swelling when taking this medication." C.) "I should take this medication with food." D.) "I should report a cough to my provider."

D.) Food does not alter absorption of lisinopril. Lisinopril can be administered with or without food. Clients can develop angioedema when on ACE inhibitors. The client should immediately call 911 if shortness of breath, swelling of the tongue or lips, or facial edema develops. ACE inhibitors can cause an increase in serum potassium. Clients should avoid foods high in potassium.

A nurse is teaching a client who has a new prescription for bumetanide. Which of the following instructions should the nurse include in the teaching? A.) "Report changes in hearing." B.) "Avoid foods high in potassium." C.) "Take the prescribed second dose at nighttime." D.) "Limit your fluid intake to no more than 1.5 L a day."

A.) Bumetanide is a high-ceiling loop diuretic. It promotes diuresis by inhibiting sodium and chloride reabsorption in the thick ascending limb of the loop of Henle. High-ceiling loop diuretics can cause ototoxicity. Concurrent use of aminoglycosides, such as gentamycin, increases the risk of ototoxicity. Inform clients about possible hearing loss, and instruct clients to notify the prescriber if a hearing deficit or tinnitus develops. The client should consume foods high in potassium content (such as dried fruits, nuts, bananas, and potatoes) to minimize the risk for hypokalemia. Inform the client to expect increased urine volume and frequency of voiding. The client should take diuretics early in the morning when prescribed daily. When prescribed twice per day, the client should take the medication at 0800 and 1400 to avoid frequent diuresis during the night. The client should consume 2-3 L of fluid per day to prevent dehydration due to loss of sodium, chloride, and water.

A nurse is caring for a client who is taking digoxin for heart failure and develops indications of severe digoxin toxicity. Which of the following medications should the nurse prepare to administer? A.) Fab antibody fragments B.) Flumazenil C.) Acetylcysteine D.) Naloxone

A.) Fab antibody fragments, also called digoxin immune Fab, bind to digoxin and block its action. The nurse should prepare to administer this antidote IV to clients who have severe digoxin toxicity.

A nurse is providing teaching to a client who has a stable angina and a new prescription for transdermal nitroglycerin. Which of the following instructions should the nurse include? (Select all that apply.) A.) Apply the patch to a hairless area and rotate sites. B.) Apply a new patch each morning. C.) Remove the patch for 10 to 12 hr daily. D.) Apply the patch to dry skin and cover the area with plastic wrap. E.) Apply a new patch at the onset of anginal pain.

A.) Hair can interfere with the adhesion of the patch. Rotating sites helps prevent skin irritation B.) Therapeutic preventive effects of transdermal nitroglycerin patches begin 30 to 60 min after application and last up to 14 hr C.) Removing the patches for 10 to 12 hr each day helps prevent tolerance to the medication.

A nurse is caring for a client who has peripheral vascular disease and reports difficulty sleeping because of cold feet. Which of the following nursing actions should the nurse take to promote the client's comfort? A.) Obtain a pair of slipper-socks for the client. B.) Rub the client's feet briskly for several minutes. C.) Increase the client's oral fluid intake. D.) Place a moist heating pad under the client's feet.

A.) In cold weather or when the client's feet are cold, he should wear extra socks or slipper socks to help provide warmth and increase his level of comfort.

A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? A.) Check the client's vital signs. B.) Request a dietitian consult. C.) Suggest that the client rests before eating the meal. D.) Request an order for an antiemetic.

A.) It is possible that the client's nausea is secondary to digoxin toxicity. By obtaining vital signs, the nurse can assess for bradycardia, which is a symptom of digoxin toxicity. The nurse should withhold the medication and call the provider if the client's heart rate is less than 60 bpm. Requesting an order for an antiemetic might relieve the client's nausea, but this is not the first action the nurse should take.

A nurse is providing teaching about a heart healthy diet to a group of clients with hypertension. Which of the following statements by one of the clients indicates a need for further teaching? A.) "I may eat 10 ounces of lean protein each day." B.) "Fresh fruits make a good snack option." C.) "I will replace table salt with dried herbs." D.) "I may thicken gravies with cornstarch as I cook."

A.) Lean meats should be limited to 5 to 6 oz per day. This statement by a client requires additional teaching.

A nurse is teaching about necessary baseline examinations with a female client who is to start taking atorvastatin. Which of the following baseline examinations should the nurse include in the teaching? A.) Liver function tests B.) Hearing test C.) Papanicolaou test D.) Dental examination

A.) The nurse should inform the client that statins such as atorvastatin can cause liver damage and should not be taken by clients who have a history of liver disease. The client should undergo baseline liver function testing before beginning therapy, and every 6 to 12 months thereafter.

A nurse is caring for a client who has a new diagnosis of essential hypertension. The nurse should monitor the client for which of the following findings that is consistent with the diagnosis? A.) Vertigo B.) Uremia C.) Blurred vision D.) Dyspnea

A.) The nurse should monitor the client for findings such as vertigo, headache, facial flushing, and fainting. These manifestations are consistent with a new diagnosis of essential hypertension. A client who has malignant hypertension might manifest uremia. A client who has malignant hypertension might manifest blurred vision. A client who has malignant hypertension might manifest dyspnea.

A nurse is caring for a client who has peripheral arterial disease (PAD). Which of the following symptoms should the nurse expect to find in the early stage of the disease? A.) Intermittent claudication B.) Dependent rubor C.) Rest pain D.) Foot Ulcers

A.) The pain associated with claudication arises when cellular oxygen demand exceeds supply. It occurs early in the disease course, and is typically the initial reason clients who have PAD seek medical attention

While performing an admission assessment for a client, the nurse notes that the client has varicose veins with ulcerations and lower extremity edema with a report of a feeling of heaviness. Which of the following nursing diagnoses should the nurse identify as being the priority in the client's care? A.) Impaired tissue perfusion B.) Alteration in body image C.) Alteration in activity tolerance D.) Impaired skin integrity

A.) When using the airway, breathing, and circulation (ABC) priority-setting framework, the nurse should identify impaired perfusion of tissues as the priority finding. The presence of varicose veins indicates venous reflux is present which inhibits perfusion to all the tissues. The nurse should note the client has signs of chronic venous insufficiency as well which include edema, a feeling of heaviness in the legs, and the presence of venous stasis ulcers. The nurse should address the client's alteration in body image because the client can consider the appearance of varicose veins, edema, and the ulcerations unattractive. However, another diagnosis is the priority. The nurse should assess the client for decreased ability to tolerate activity because the presence of varicose veins and edema can be painful and present a feeling of fullness in the legs. However, another diagnosis is the priority. The nurse should address the presence of venous stasis ulcers and edema because these factors can lead to infection, increased tissue breakdown, and delayed healing. However, another diagnosis is the priority.

A nurse is caring for a client who has a new prescription for ferrous sulfate tablets twice daily for iron-deficiency anemia. The client asks the nurse why the provider instructed that she take the ferrous sulfate between meals. Which of the following responses should the nurse make? A.) "Taking the medication between meals will help you avoid becoming constipated." B.) "Taking the medication with food increases the risk of esophagitis." C.) "Taking the medication between meals will help you absorb the medication more efficiently." D.) "The medication can cause nausea if taken with food."

C.) Ferrous sulfate provides the iron needed by the body to produce red blood cells. Taking iron supplements between meals helps to increase the bioavailability of the iron.

A nurse in a provider's clinic is assessing a client who takes sublingual nitroglycerin for stable angina. The client reports getting a headache each time he takes the medication. Which of the following statements should the nurse make? A.) "Take only one dose of nitroglycerin to reduce the risk of getting a headache." B.) "There's nothing that can be done to relieve the headaches that nitroglycerin causes." C.) "Try taking a mild analgesic to relieve the headache." D.) "We will ask the provider to prescribe a different medication for you."

C.) Headache is a common side effect of nitroglycerin. The nurse should suggest conservative measures, such as taking aspirin, acetaminophen, or some other mild analgesic, to manage the headache. Generally, headaches that are a side effect of nitroglycerin are transient.