NUR 203 Quiz 2

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For which clinical manifestation should the nurse assess in a client with heart​ failure? (Select all that​ apply.) A. Peripheral edema B. Hypotension C. Pulmonary congestion D. Fatigue E. Dyspnea on exertion

A,C,D,E

A client continues to have chest pain after the first dose of sublingual​ (SL) nitroglycerin. Which standard protocol should the nurse​ follow? A. Administer another sublingual tablet in 5 minutes B. Wait 15 minutes and administer two more sublingual tablets C. Wait 3 minutes and reevaluate pain using a pain scale D. Administer atropine at 10 minutes if pain has not subsided

A

A client is prescribed an​ angiotensin-converting enzyme​ (ACE) inhibitor immediately following an acute myocardial infarction​ (MI). For which reason should the nurse realize that this dose was​ prescribed? A. Reduce risk of mortality. B. Increase arterial pressure. C. Lower cardiac output. D. Increase preload to the heart.

A

An older client with a dysrhythmia asks why the first dose of an antidysrhythmic medication is being given at bedtime. Which reason should the nurse​ provide? A. Risk of hypotension as a​ first-dose effect B. Metabolizes better when in the supine position C. Sedative properties D. Causes confusion

A

Which adverse effect of lisinopril​ (Prinivil) should be reported to the healthcare​ provider? A: cough B: increase urine output C: facial flushing D: fever

A

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

A

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

A

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

A

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

Which statements should the nurse include in the teaching for a client prescribed warfarin​ (Coumadin) therapy? 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 and C- Warfarin increases the risk of bleeding from dental procedures. Strenuous or risky activities place the patient at risk for injury and bleeding

A client with​ Parkinson's disease is experiencing an increase in bradykinesia. Which assessment findings should the nurse​anticipate?A: slow speech B: difficulty chewing C: shuffling feet when walking D: stooped posture E: lack of facial expression

A, B, C

Which conditions contribute to heart​ failure? A: uncontrolled hypertension B: coronary artery disease C: diabetes D: HIV E: mitral stenosis

A, B, C, E

Which findings should the nurse anticipate when assessing a client developing​ right-sided heart​ failure?A: ankle edema B: enlarged liver C: displaced apical heart rate D: shortness of breath E: coughing

A, B, C- Shortness of breath and coughing are symptoms associated with​ left-sided heart failure.

Which statements by the client are specifically associated with unstable​ angina? A: My chest has started hurting even if I am just watching​ television." B: ​"My chest starts hurting if I climb one set of​ stairs." C: ​"My attacks of chest pain are more frequent D: the pain occurs after I eat a meal E: the pain is worse than it use to be

A, C, E- pain that is predictable is usually stable angina

Which statements made by the client indicate an understanding of the compensatory mechanisms associated with 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." 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,B,C

Which information should the nurse include the teaching for a client prescribed​ heparin? 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,B,C,D

Which information should the nurse include when educating a client about coronary artery​ disease? A: Plaque causes narrowing of artery B: Plaque begins to accrue early in life C: Plaque causes narrowing of the veins D: Plaque affects the elasticity of the artery E: Plaque builds up in the myocardial tissue

A,B,D

Which prescriptions does the nurse anticipate to be included in the goal to reduce the​ post-MI mortality of a ​client? A: aspirin B: beta blockers C: narcotic analgesics D: ACE inhibitors E: antidysrhythmics

A,B,D

The nurse is explaining the action of an antianginal medication to a client. Which information should the nurse​ include? (Select all that​ apply.) A. Dilates veins so the heart receives more blood B. Blocks myocardial receptors to prevent increased afterload C. Lowers blood pressure D. Slows heart rate E. Causes the heart to contract with less force

A,C,D,E

Which lifestyle behaviors should the nurse discuss with a client to help reduce their risk of coronary artery​disease? A: abstinence from smoking B: decrease stress C: limit alcohol consumption D: maintain optimal weight E: limit sodium intake

A,C,E

A client is demonstrating signs of heart failure. Which disorders should the nurse suspect as a possible​ etiology? (Select all that​ apply.) A. Mitral stenosis B. Chronic hypotension C. Chronic renal failure D. Diabetes mellitus E. Coronary artery disease

A,D,E

Which adverse effect is shared among all antidysrhythmic​ drugs? A. Prodysrhythmic effects B. Impotence C. Photosensitivity D. Edema

A- All antidysrhythmic agents can worsen existing dysrhythmias or create new ones.

Depolarization occurs when which two electrolytes rush into the​ cell? A: calcium and sodium B: chloride and potassium C: calcium and magnesium D: sodium and potassium

A- An action potential begins when sodium and calcium flow into the​ cell, resulting in depolarization

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? A: Antidysrhythmic prescriptions have many side​ effects; cardioversion is considered​ safer." B: Special diets are necessary with antidysrhythmic​ prescriptions, and they are hard to​ follow. C: Antidysrhythmic prescriptions​ don't really work very well for most​ dysrhythmias D: There is a high risk of seizures when you take antidysrhythmic​ prescriptions

A- Antidysrhythmic medications can cause serious side effects and are normally reserved for patients with overt symptoms or for patients whose condition cannot be controlled by other​ means, such as cardioversion.

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

A- Beta blockers decrease contractions of the myocardium and decrease the speed of conduction through the atrioventricular​ (AV) node. This can result in a significant decrease in heart​ rate, and the client should notify the healthcare provider if their heart rate falls below 60.

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 eat a lot of garlic B: are u restricting ur fluids C: have u been eating a lot of salads and veggies D: do you drink a lot of milk

A- Garlic has been shown to decrease the aggregation of​ platelets, thus producing an anticoagulant effect.

Which food should the nurse instruct the client prescribed warfarin​ (Coumadin) to​ avoid? A: tomato salad w kale and basil B: fettuccine alfredo C: salt substitute D: whole wheat bread w margarine

A- Kale is high in vitamin K and must be avoided when a client receives warfarin.

Which is the most serious adverse effect associated with milrinone​ (Primacor)? A: ventricular dysrhythmia B: nausea C: headache D: atrial dysrhythmia

A- Milrinone is a phosphodiesterase inhibitor that can cause ventricular dysrhythmias

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

A- Propranolol should be used cautiously in clients with type 1 diabetes mellitus due to the hypoglycemic effects

Which is a priority assessment for the client receiving reteplase​ (Retavase) intravenously? A: abnormal bleeding B: fluid balance C: respiratory rate D: blood glucose

A- Reteplase is used to dissolve blood clots. The most serious adverse effect of reteplase is abnormal bleeding

Which is the purpose of the AV​ node? A: delay impulse from SA node B: enhance impulse from SA node C: pace the heart at 40-60 bpm D: pace heart at 60-100

A- The AV node delays the impulse as it travels from the atria to the ventricle

Which information about the primary therapeutic action of an antianginal prescription should the nurse include in client​ teaching? A: ​"The prescription decreases how much oxygen your heart​ needs." B: ​"This prescription will thin your blood so your heart receives more​ oxygen." C: ​"This prescription increases the oxygen to your heart by increasing nitric oxide​ production." D: ​"This prescription increases the amount of oxygen your heart​ receives."

A- decrease the frequency of angina​ episodes by reducing the myocardial demand for oxygen.

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

A- ​"Enhancing potassium and sodium is how our prescriptions will work to prevent​ dysrhythmias."

Which laboratory study is used to evaluate the proper dosage for heparin​ therapy? A: aPtt B: serum heparin levels C: sedimentation rate D: complete blood count

A-: aPtt is used to help identify the correct dosage of heparin therapy for the client

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 less insulin when I take metoprolol​ (Lopressor)." B: "I might be able to change from insulin to a pill with metoprolol​ (Lopressor)." C: "I might need more insulin when I take metoprolol​ (Lopressor)." D: "I might not need to check my blood sugars as often with metoprolol​ (Lopressor).

A: Metoprolol may enhance the hypoglycemic effects of insulin and oral hypoglycemic​ agents, so the client might require less insulin.

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: Decreased effectiveness of digoxin​ (Lanoxin) B: Increased effectiveness of furosemide​ (Lanoxin) C: Hypermagnesemia D: Hyponatremia

A: antacids may decrease digoxin

Which prescription should the nurse anticipate will most likely prescribed for a client with​ Alzheimer's disease? A.Donepezil hydrochloride​ (Aricept) B.Levodopa​ (Larodopa) C. Benztropine mesylate​ (Cogentin) D.Haloperidol​ (Haldol

ALevodopa/Benztropine is used for Parkinsons

A client who is taking sublingual nitroglycerin asks how the medication works so quickly. Which response should the nurse​ provide? A. "Vasodilation occurs, relaxing both arteries and​ veins." B. "Coronary arteries​ dilate, which relaxes​ spasms, allowing more blood to flow to the​ myocardium." C. ​"Receptors are blocked in the​ heart, slowing the heart​ rate." D. ​"Dysrhythmias are quickly​ suppressed, while oxygen saturation in the heart is​ increased."

B

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 not disturb the intravenous infusion. D.The client will keep the right leg elevated on two pillows.

B

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

B

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: internal bleeding C: dehydration D: decreased activated partial thromboplastin time (aPTT

B

Which additional prescribed treatment should the nurse anticipate for the client prescribed heparin​ therapy? A: Advil prn for headaches B: obtaining aPTT C: weekly weights D: low vitamin K diet

B

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

B

Which describes the primary action of anticoagulant​ therapy? A: decrease prothrombin time B: prevent formation of blood clots C: increase number of platelets D: dissolve blood clots

B

Which should the nurse anticipate to be included in the treatment plan for a client with stage A heart​ failure? A: beta blocker B: lifestyle modifications C: cardiac glycoside D: angiotensin converting enzyme inhibitor

B

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? A: ​"This condition is best treated with what we call antidysrhythmic​ drugs." B: ​"This is very​ common; your doctor will discuss the best treatment with​ you." C: ​"Depending on your​ symptoms, your healthcare provider may use an electrical​ shock." D: ​"This is quite​ serious; did your healthcare provider discuss a heart​ transplant?" E: ​"It is very​ serious, even more serious than a ventricular​ dysrhythmia."

B and C- atrial fibrillation is the most common dysrhythmia

Which classifications of prescriptions are used to increase cardiac output by increasing the force of myocardial​ contractions? A: Angiotensin receptor blockers B: Cardiac glycosides C: Adrenergic blockers D: Phosphodiesterase inhibitors E: ACE inhibitor

B and D- ARBs and ACEIs increase cardiac output by lowering BP and BV, adrenergic blockers decrease cardiac workload

Which are the goals of antianginal​ therapy? A: Increased blood flow to the peripheral blood vessels. B: Decreased myocardial oxygen demand C: Decreased oxygen consumption of brain D: Increased blood flow to the myocardium E: Increased myocardial contractility.

B and D- Angina is a mismatch between myocardial oxygen supply and oxygen demand. Basic antianginal strategies are to increase oxygen supply by increasing blood flow to the coronary arteries or to decrease myocardial oxygen demand.

Which conditions is the use of thrombolytic therapy contraindicated​ in? A: venous emboli B: history of intracranial hemorrhage C: hemophilia D: liver disease E: peptic ulcer disease

B, C, D, E

The patient tells 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?" What are the nurse's best responses? A: "Conduction through the bundle of His is the slowest in the​ heart." B: "Conduction begins in the sinoatrial​ (SA) node and travels to the atrioventricular​ (AV) node." C: "Conduction continues through the bundle branches to the Purkinje​ fibers." D: "Conduction travels from the atrioventricular​ (AV) node through the bundle of​ His." E: The sinoatrial​ (SA) node is located in the left​ atrium."

B, C, D- conduction through AV node is slowest and SA node is in the RA

Which information should the nurse include in the education for a client prescribed antianginal​ therapy? A: The prescriptions increase heart rate B: The prescriptions dilate the veins so the heart receives less blood C: The prescriptions cause heart to contract with less force D: The prescriptions increase BPE: The prescriptions increase ability of body to produce RBCs

B,C

A client is recovering from myocardial infarction​ (MI). Which laboratory value should the nurse monitor for​ changes? (Select all that​ apply.) A. Partial prothrombin time​ (PPT) B. Creatinine​ kinase-MB (CK-MB) C. Total creatinine kinase​ (CK) D. Troponin E. High-density lipoprotein​ (HDL)

B,C,D

Which should the client be instructed to avoid when prescribed an​ anticoagulant? A: citrus fruits B: alcohol C: contact sports D: prolonged sitting E: hard toothbrush

B,C,D,E

The nurse is preparing to administer a medication to a client with a dysrhythmia. Which should the nurse recall as the function of cardiac medications in the treatment of​ dysrhythmias? (Select all that​ apply.) A. Increase the amount of sodium B. Alter autonomic activity C. Reduce the amount of calcium D. Alter conduction E. Change the level of potassium

B,D

Which current prescription should the nurse be concerned with for the client newly prescribed amiodarone​ (Cordarone)? A: oxycodone B: warfarin C: omeprazole D: fluoxetine

B- Amiodarone can block the metabolism of warfarin.

Which is the most sensitive and effective biomarker of a myocardial​ infarction? A. Creatine kinase B. Troponin C: White blood cells D: Myoglobin

B- Troponin is a​ cardiac-specific and the most sensitive and effective biomarker after a myocardial infarction.

Which prescription should the nurse anticipate to increase the myocardial contractility for a client with heart​failure? A: lisinopril B: digoxin C: carvedilol D: furosemide

B- cardiac glycosides increase cardiac output by increasing contractionLisinopril (ACE inhibitor) lowers peripheral resistance and blood volume; carvedilol (beta blocker) lowers HR; furosemide (diuretic) lowers blood volume

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

B- digoxin may result in depression

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

B- heart walls thicken/enlarge w HF this is referred to as cardiac remodeling

The nurse is preparing to provide education for a client prescribed carbidopa​ (Sinemet). Which information should the nurse ​include? A: avoid caffeinated drinks B: take on empty stomach C: take w meals D: take w protein food

B: for better absorption

Which assessment finding in an older adult prescribed levodopa​ (Stalevo) should the nurse be most concerned​ with? A: Diarrhea B: Muscle twitching C: hypertension D: dark urine

B: may indicate toxicity

Which client should the nurse anticipate a prescription for reteplase​ (Retavase) therapy post myocardia l​infarction? A: A​ 45-year-old female with a​ 2-week-old cranial artery repair B: A​ 70-year-old male with active GI bleed C: A​ 54-year-old female with type 2 diabetes D: A​ 62-year-old with a recent hemorrhagic stroke

C- Contraindications for reteplase therapy include a history of CVA​ (stroke), recent surgical​ procedure, and active bleeding.

A client experiences​ steady, intense, crushing chest pain. Which health problem should the nurse​ suspect? A. Coronary artery disease B. Myocardial infarction C. Angina pectoris D. Myocardial ischemia

C

A client is diagnosed with stage C heart failure​ (HF). Which medications should the nurse recognize as most effective in treating this stage of the​ disease? A. IV nitrogen B. Phosphodiesterase inhibitor C. IV diuretic D. Anticoagulant

C

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? A.​"Diltiazem (Cardizem) increases prostaglandin​ synthesis, giving you the​ headache." B.​"Diltiazem (Cardizem) causes the blood vessels in your brain to​ narrow, giving you the​ headache." C.​"Diltiazem (Cardizem) causes the blood vessels in your brain to​ widen, giving you the​ headache." D.​"Diltiazem (Cardizem) releases Substance​ P, activating pain receptors in your brain and giving you the​headache."

C

A client with coronary artery disease​ (CAD) asks what causes the health problem. Which explanation should the nurse​ provide? A. "Your peripheral arteries are blocked so your heart is receiving little blood​ supply." B."Your heart muscle is too weak to pump an adequate supply of​ blood." C."A build-up of plaque in your coronary arteries is preventing an adequate blood supply to your​ heart." D. ​"Your coronary arteries are​ overdilated, which is causing your​ symptoms."

C

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? A.​"I should take a tablet as soon as chest pain​ occurs. "B.​"If my pain is not reduced 5 minutes after taking one tablet I should call​ EMS." C.​"I can take up to 5 tablets to resolve the chest​ pain." D.​"I can take three​ tablets, one every 5​ minutes."

C

The nurse is providing a client education about dysrhythmias. Which statement should the nurse include in the​teaching? A: ​"Dysrhythmias cause serious electrolyte​ imbalances; this results in heart​ block." B: ​"Dysrhythmias are the result of​ long-standing, uncontrolled​ hypertension." C: ​"Dysrhythmias interrupt the normal electrical pathways in the heart so it​ can't beat​ properly." D: ​"Dysrhythmias alter the blood flow through the heart and cause it to stop​ beating."

C

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

C

Which information should the nurse include in the education for a client prescribed an​ antidysrhythmic? A: Elevate your extremities if you notice any​ swelling." B: Weigh yourself every other​ day." C: Take the first dose of your prescription before​ bed." D: Take your medication while you are lying​ down."

C

Which should the nurse include in the plan of care for the patient with​ Parkinson's disease? A.Limit exercise to decrease the possibility of fractures. B.Check peripheral circulation for thrombophlebitis. C.Monitor the client for the ability to chew and swallow. D.Monitor the client for psychotic symptoms.

C

The nurse is reviewing the prescription history for a client receiving levodopa​ (Stalevo). Which routine prescription is most​concerning? A: Synthroid B: Metformin C: Ca anatacid D: Aspirin

C: calcium antacid can decrease levodopa therapeutic effect

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? 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 and E- left HF aka congestive HF is associated w pulmonary congestion. Right HF results in peripheral edemaHF results from inability of left ventricle to pump blood

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

C- ACE inhibitor is first line treatment for chronic HF-Beta are standard for stage 3 HFCardiac glycosides (digoxin) reserved for advanced HFDiuretics treat HF symptoms like fluid V overload, edema, pulmonary congestion

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

C- Anticoagulants are used to prolong bleeding time and thereby prevent thrombi from forming or enlarging.

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

C- Beta-adrenergic blockers are rarely used to treat heart failure alone. They are commonly used in combination with ACE inhibitors.

Which occurs initially in the cardiac conduction​ pathway? A: The action potential moves over the bundle branches B: The action potential moves through the AV node C: The SA node generates an action potentiaL D: The action potential travels across the bundle of His

C- Once an AP is generated in the SA​ node, it moves to the AV​ node, across the bundle of​ His, across the bundle​ branches, and through the Purkinje fibers. It is at this point that the action potential reaches the​ ventricles, causing the muscle to contract.

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

C- hypotension could occur but not tachycardia (would be bradycardia), diarrhea is more likely

Which factor increases cardiac​ output? A: reduced cardiac B: peripheral vascular resistance C: increase in preload D: hypovolemia

C- increased preload results in more forceful contraction and increases cardiac output

A client asks the nurse how hypertension can lead to heart failure. Which response should the nurse provide the​ client? A: 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." B: Hypertension causes resistance in the venous system requiring the heart to work harder to pump the blood​ forward." C: 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 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- peripheral resistance that occurs in hypertension causes the heart to work harder to pump the blood out into the arterial system

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? A: The prescription will increase the strength of the muscles in the heart during each​ beat." B: "The prescription thins your blood so more clots will not​ develop." C: "The prescription is dissolving the clot that has caused your heart​ attack." D: "The prescription dilates the arteries in the heart so it can get more​ oxygen."

C- thrombolytic therapy is administered to dissolve clots obstructing the coronary​ arteries, thus restoring circulation to the myocardium.

Which assessment finding warrants the nurse to hold the dosage of benztropine​ (Cogentin) and notify the healthcare​ provider? A: BP 142/80 B: respiratory rate of 14 C: pulse of 112 D: Temp of 100.2

C: Benztropine can cause tachycardia

The nurse is providing education for a client about the characteristics of​ Alzheimer's disease. Which information should the nurse​ include? A: More women than men are effected B: The disease is characterized by the degeneration of the neurons. C: Chronic inflammation of the brain may be a cause of the disease. D: The disease mainly affects people over 50 years of age.

C: Chronic inflammation and excess free radicals may cause neuron damage and contribute to​ Alzheimer'sParkinson's disease is characterized by the degeneration of the neurons.

Which adverse effect should the nurse instruct the client to monitor for while receiving warfarin​ sodium? A: headache B: rash C: pain D: bleeding

D

Which is the primary desired outcome for a client that has experienced several episodes of​ angina? A: The client will experience relief of chest pain with anticoagulant therapy. B: The client will experience relief of chest pain with aspirin therapy. C: The client will experience relief of chest pain with therapeutic lifestyle changes. D: The client will experience relief of chest pain with nitrate therapy.

D

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

D

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 hypertension C: Monitor for symptoms of atrial fibrillation D: Continuous ECG monitoring

D

A client with a history of gastrointestinal​ (GI) bleeding caused by aspirin requires an antiplatelet medication. Which medication should the nurse anticipate as an alternative to​ aspirin? A. Abciximab​ (ReoPro), a glycoprotein​ IIb/IIIa inhibitor B. Atenolol​ (Tenormin), a​ beta-adrenergic agonist C. Amiodarone​ (Cordarone), a vasopressor D. Clopidogrel​ (Plavix), an adenosine diphosphate receptor blocker

D

A client with heart failure asks what caused the health problem. Which response should the nurse make to the​ client? A. The heart has a limited ability to increase​ contractility, and in a diseased​ heart, the increased preload leads to volume overload and pulmonary​ congestion." B. "Cardiac output is​ normal, but the increased pressure in the ventricle creates higher pressure in the pulmonary​ capillaries, resulting in pulmonary​ edema." C. ​"The left ventricle is forced to work harder due to the increased preload or​ afterload, which results in thickening of the heart​ walls." D. "The left side of the heart has​ weakened, causing fluid to build up in the capillaries in the​ lung, which ultimately decreases oxygen in the​ heart."

D

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

D

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

D

Which laboratory test is used to measure the effectiveness of warfarin sodium​ therapy? A: complete blood count B: platelet count C: aPTT D: international normalized ratio (INR)

D

Which statement describes the purpose for the use of acetylcholinesterase inhibitors prescribed to treat​ Alzheimer's disease? A:Reverse the structural damage within the brain. B: Increase synthesis of acetylcholine. C:Increase enzymatic breakdown leading to increased neuronal production. D:Intensify the effect of acetylcholine at the receptor.

D

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

Which prescription is indicated for the prevention of blood​ clots? A: captopril B: reteplase C: morphine D: abciximab

D -Abciximab is a glycoprotein​ IIb/IIIa inhibitor​ (antiplatelet agent) used to prevent blood clots. Captopril is an ACE​ inhibitor, morphine is used for​ analgesia, and reteplase is used to break up blood clots.

Which statements made by a client indicates an understanding of the education provided by the nurse regarding digoxin​ (Lanoxin) toxicity? 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 and E- OJ is a source of K which will minimize toxicity

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

D- A patient with erectile dysfunction is likely to use sildenafil​ (Viagra). Concurrent use of sildenafil​(Viagra) and nitroglycerine​ (Nitrostat) may cause​ life-threatening hypotension and cardiovascular collapse.

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

D- ACE inhibitors decrease aldosterone secretion from the adrenal cortex resulting in a lowering of the blood volume

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? A: ​"The literature is not always​ accurate, but if you have concerns I recommend discussing them with your healthcare​ provider." B: ​"Your prescription is not the​ problem; it is when you mix it with​ over-the-counter (OTC) drugs that you develop irregular​ beats." C: ​"The aspirin that you take every day will help you avoid experiencing the irregular​ heartbeats." D: ​"Your medication blocks the flow of the electrolytes in your​ heart, and this can cause irregular​beats."

D- Most antidysrhythmic drugs act by interfering with myocardial action​ potentials, blocking the action of​ sodium, potassium, and calcium channels and causing some irregular beats.

Which prescriptions reduce the​ heart's demand for oxygen by lowering heart​ rate? A.Anticoagulants and​ beta-adrenergic blockers B.Organic nitrates and calcium channel blockers C.Calcium channel blockers and anticoagulants D.​Beta-adrenergic blockers and calcium channel blockers

D-Organic nitrates dilate​ vessels, and anticoagulants prevent blood clots from forming.


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