Nurs 306 Module 2
A 37-year-old client presents with a blood pressure of 128/78 mm Hg. What lifestyle change should the nurse suggest related to this assessment finding?
"Be aware of your salt intake and limit hidden salt."
After teaching a client about prescribed statin therapy, the nurse determines that additional teaching is needed when the client makes which statement?
"I can take the drug with grapefruit juice."
A nurse is giving discharge instructions to a client receiving nitroglycerin for angina. The nurse recognizes the client needs additional information when the client makes what statement?
"I will take a pill every 15 minutes until the pain subsides."
A 52-year-old client who experienced a myocardial infarction has an order for discharge. Part of the discharge teaching includes prior administration of nitroglycerin for chest pain. Which statement by the client indicates understanding of the teaching provided
"I will take three nitroglycerin tablets 5 minutes apart, and if I do not have any relief I will seek emergency care immediately."
The nurse is providing education to a client who has been prescribed digoxin for symptomatic heart failure. What teaching point would the nurse convey to this client?
"Make sure to take your pulse for a minute before taking your digoxin."
A male client who is prescribed digoxin asks the nurse how he should take the drug. Which instruction would be most appropriate?
"Take the drug on an empty stomach at the same time each day."
A client is diagnosed with angina pectoris. What would the nurse include when explaining this condition to the client?
"The heart muscle isn't getting enough oxygen."
9s Report this Question The nurse is providing education to an older adult client who has been prescribed atorvastatin. How should the nurse describe the common adverse effects of the drug?
"The most common side effects of atorvastatin include some mild gastrointestinal upset."
A client prescribed nitroglycerin reports to the nurse that he is having headaches. How should the nurse best respond?
"You may experience headaches as an adverse reaction to nitroglycerin."
Which individual is most likely to be experiencing vasodilation?
A 51-year-old man with a history of hypertension who is taking a medication that blocks the effect of the renin-angiotensin-aldosterone system
A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which action should the nurse do first when he reports chest pain?
Administer a tablet under the tongue and repeat the action in 5 and 10 minutes if the pain has not subsided.
A staff nurse on a renal unit knows that most patients require treatment for hypertensive disease. What would the nurse expect to assess prior to the beginning of antihypertensive treatment?
Baseline renal function
Which heart valve controls the flow of blood between the left atria and the left ventricle?
Bicuspid valve
After teaching a group of students about angina, the instructor determines that the teaching was successful when the students describe stable angina as:
Chest pain that is relieved by rest
Ms. Quinn is admitted to the surgical intensive care unit after open heart surgery. The health care provider prescribes IV nitroglycerin, according to a hospital protocol for titration of the drug. Which factor would be most important when determining increases or decreases in the dose?
Current blood pressure
Key behavioral determinants of blood pressure are related to what factor?
Dietary consumption of calories and salt
A nurse is planning an in-service program for a group of staff nurses about heart failure and its treatment. The nurse would identify which agent as the most commonly used drug for treatment?
Digoxin
A client with a history of severe renal failure has been placed on digoxin for atrial dysrhythmia. Based on the client's history, the nurse anticipates which action?
Digoxin dose will need to be reduced.
What is given to treat a massive digoxin overdose?
Digoxin immune Fab (Digibind)
A client is experiencing nausea and visual disturbances when taking digoxin. Which medication will be administered?
Digoxin immune fab
A client's most recent digoxin level is reported to be 2.2 ng/mL. What conclusion should the nurse draw?
Digoxin toxicity is a possibility. The normal digoxin level is 0.5 to 2.0 ng/mL. Toxic serum levels are greater than 2 ng/mL; however, toxicity may occur at any serum level. None of the other options would result in a digoxin level above normal serum levels
A 35-year-old female client controls the symptoms of her cardiovascular disease with ACE inhibitors. She discovers that she is pregnant and contacts her primary care provider regarding her medication regimen. What would the nurse expect the provider to do?
Discontinue the drug
As part of a routine physical examination, a 60-year-old client's primary care provider has ordered blood work that includes cholesterol levels. What result would strongly suggest the need for an antihyperlipidemic drug?
Elevated LDL levels
The nurse instructs a patient to take his prescribed simvastatin at bedtime to promote:
Enhanced drug effectiveness
The pharmacology instructor is discussing medications used in the treatment of dyslipidemia. Which drug class would the instructor identify as the most widely used dyslipidemia drug
HMG-CoA reductase inhibitors
A male client who has been receiving verapamil for several months comes to the clinic reporting significant dizziness, light-headedness, and fatigue. He also reports frequent episodes of nausea and swelling of his ankles. Drug toxicity is suspected. Which question would be critical to ask the client?
Have you been drinking any grapefruit juice lately?"
A nurse is providing care to a client who has elevated levels of low-density lipoprotein (LDL). A review of the client's history reveals a sedentary lifestyle and a history of being overweight. The nurse understands that this combination of factors places the client at risk for which condition?
Heart disease
What is the most common reason for an elevated cholesterol level in a client who does not have a genetic disorder of lipid metabolism?
His dietary intake of saturated fat
Fluid moves into the arterial end of a capillary due to:
Hydrostatic pressure
A client is admitted to the intensive care unit with an electrolyte imbalance. Which imbalance will contraindicate the administration of digoxin?
Hypokalemia
A patient, aged 78 years, is receiving nitroprusside for hypertensive emergency. For which condition should the patient be assessed?
Hypotensive crisis
The nurse knows that nitroglycerin can be administered in what ways? (
IV Transdermal Transmucosal
The nurse is administering a beta blocker to a patient with hypertension. Which would the nurse expect this drug to do? (Select all that apply.)
Increase renal blood flow Decrease heart rate Decrease cardiac muscle contraction
Which would be considered a therapeutic effect of digoxin?
Increased force of contraction
The pharmacology instructor is discussing cardiac glycosides with a class of pre-nursing students. According to the instructor, what physiologic effect do cardiac glycosides trigger?
Increased force of heart attraction
An electrocardiogram (ECG) is prescribed for a client experiencing signs and symptoms associated with a cardiac dysfunction. Which function of the heart will this diagnostic tool help evaluate?
Ineffective pumping
A group of students are reviewing the drugs used to treat heart failure. The students demonstrate understanding of the information when they identify which agent as a phosphodiesterase inhibitor?
Milrinone
A backflow of blood is noted in the left ventricle from the left atrium. The patient is suffering from a defect in which valve?
Mitral valve
A 59-year-old female client has been prescribed digoxin. The nurse assigned to the client will instruct her to avoid:
OTC cold remedies
A patient has been admitted to a health care center with reports of dyspnea. Which signs should the nurse monitor for when assessing the patient for left ventricular dysfunction?
Orthopnea
A nurse is explaining blood flow through the heart to a patient who has experienced a myocardial infarction. How would the nurse explain flow from the lungs to the heart?
Oxygenated blood from the lungs enters the left atrium through the pulmonary veins.
A client, newly diagnosed with hypertension is started on captopril (or Enalopril/Lisinopril), , an ACE inhibitor. The client should be informed of the possibility of what adverse effect?
Persistent cough
Which of the following drugs should be avoided by a client taking nitrates?
Phosphodiesterase 5 inhibitors
A client is prescribed aliskiren. The nurse would monitor the laboratory test results of which electrolyte closely?
Potassium
Which client diagnosis is related to left-sided heart failure?
Pulmonary edema
A nurse is caring for a client who has been diagnosed with primary hypertension. What nursing interventions should be included in the teaching plan? Select all that apply.
Regular aerobic exercise Diet with more fruits and vegetables Decreased alcohol consumption Smoking cessation
Which condition would least likely contribute to the development of heart failure?
Renal failure
Which is released initially when blood flow to the kidneys is decreased?
Renin
What should the nurse suggest to assist a client to improve his cholesterol levels?
Smoking cessation
A male client who is prescribed digoxin asks the nurse how he should take the drug. Which instruction would be most appropriate?
Take the drug on an empty stomach at the same time each day."
A client has severe aortic valve disease. When educating the client about anatomy, what would the nurse include?
The aortic valve separates the left ventricle and aorta.
A client has an elevated BUN. The client has been prescribed digoxin for heart failure. What aspect of care is the priority regarding this client?
The dose should be decreased in this client.
After teaching a group of students about metabolic syndrome, the instructor determines that the teaching was successful when the students identify which characteristic?
Triglyceride level above 150 mg/dL
Vasodilators used to treat heart failure include nitrates and ACE inhibitors.
True
A cardiovascular clinical nurse specialist describes the dysfunctional endothelium in relation to cardiovascular disease. What is the major factor in the development of the dysfunctional endothelium?
atheroclerosis
A patient with class-IV CHF has a medication regimen consisting of metoprolol (Lopressor), enalapril (Vasotec), and furosemide (Lasix). In addition to regularly assessing the patient's heart rate, the nurse should prioritize assessment of the patient's
blood pressure
When considering vital signs, which assessment is focused on the functioning of the body's resistance system
blood pressure
Which category of blood lipids is involved in the formation of atherosclerotic plaques?
cholesterol
Which property is related to the ability of the heart cells to transmit an action potential of electrical impulse?
conductivity
The chest pain and pressure a client experiences during an anginal attack is caused by which of the following?
decreased oxygen supply to the heart.
In addition to being synthesized in the liver and intestine, from where are blood lipids derived?
diet
Which would the nurse identify as a cardiac glycoside?
digoxin
What antihypertensive agent is the most likely initial drug of choice for a black client?
diuretic
The client is taking a calcium-channel blocker. What adverse effects might the client experience?
headaches and dizziness
The patient has been placed on a nitroprusside drip for the treatment of a hypertensive crisis. Which mechanism of action does the nurse know is true for nitroprusside?
it directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins
A client presents to the ED with wheezing and blood-tinged sputum. The nurse suspects the client is experiencing pulmonary edema. The nurse should suspect the cause of the pulmonary edema is most likely:
left ventricular failure
The nurse is providing education to a client who has been prescribed atorvastatin. In what way will the nurse describe how the drug achieves its desired therapeutic effect?
reduces the amount of cholesterol synthesized by the liver
What should the nurse suggest to assist a client to improve his cholesterol levels?
smoking cessation