Pharm 2: Exam 2 PRACTICE Q

A patient with a history of heart failure will be started on spironolactone (Aldactone). Which drug group should not be used, or used with extreme caution in patients taking potassium-sparing diuretics? A. Nonsteroidal anti-inflammatory drugs B. Corticosteroids C. Loop diuretics D. Angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers

4

Which action by the nurse is most important when caring for a patient with chronic kidney disease who has an order for furosemide (Lasix)? A. Assess urine output and renal laboratory values for signs of nephrotoxicity. B. Check the specific gravity of the urine daily. C. Eliminate potassium-rich foods from the diet. D. Encourage the patient to void every 4 hours.

A

What health teaching should the nurse provide for a patient receiving diltiazem (Cardizem)? Select all that apply. A. Avoid driving or performing other activities requiring mental alertness until the effects of the drug are known. B. Maintain adequate fluid and fiber intake to facilitate stool passage. C. Report weight gain of 2 kg (5 lb) per week. D. Rise slowly from prolonged periods of sitting or lying down. E. Immediately stop taking the medication if sexual dysfunction is noted.

A, B, C, D

Which assessment findings in a patient who is receiving atenolol (Tenormin) for angina would be cause for the nurse to hold the drug and contact the provider? (Select all that apply.) A. Heart rate of 50 beats/minute B. Heart rate of 124 beats/minute C. Blood pressure 86/56 D. Blood pressure 156/88 E. Tinnitus and vertigo

A, C

A patient with significant hypertension unresponsive to other medications is given a prescription for hydralazine. An additional prescription of propranolol (Inderal) is also given to the patient. The patient inquires why two drugs are needed. What is the nurse's best response? A.Giving the two drugs together will lower the blood pressure even more than just one alone. B. The hydralazine may cause tachycardia and the propranolol will help keep the heart rate within normal limits. C. The propranolol is to prevent lupus erythematosus from developing. D. Direct-acting vasodilators such as hydralazine cause fluid retention, and the propranolol will prevent excessive fluid buildup.

B

Erectile dysfunction drugs such as sildenafil (Viagra) are contraindicated in patients taking nitrates for angina. What is the primary concern with concurrent administration of these drugs? A. They contain nitrates, resulting in an overdose. B. They also decrease blood pressure through vasodilation and may result in prolonged and severe hypotension when combined with nitrates. C. They will adequately treat the patient's angina as well as erectile dysfunction. D. They will increase the possibility of nitrate tolerance developing and should be avoided unless other drugs can be used.

B

Nifedipine (Procardia XL) has been ordered for a patient with hypertension. In the care plan, the nurse includes the need to monitor for which adverse effect? A. Rash and chills B. Reflex tachycardia C. Increased urinary output D. Weight loss

B

The nurse is providing teaching to a patient who has been prescribed furosemide (Lasix). Which of the following should the nurse teach the patient? A. Avoid consuming large amounts of kale, cauliflower, or cabbage. B. Rise slowly from a lying or sitting position to standing. C. Count the pulse for one full minute before taking this medication. D. Restrict fluid intake to no more than 1 L per 24-hour period.

B

The patient is being discharged with nitroglycerin (Nitrostat) for sublingual use. While planning patient education, what instruction will the nurse include? A. "Swallow three tablets immediately for pain and call 911." B. "Put one tablet under your tongue for chest pain. If pain does not subside, call 911." C. "Call your healthcare provider when you have chest pain. She will tell you how many tablets to take." D. "Place three tablets under your tongue and call 911."

B

The patient is taking atenolol (Tenormin) and doxazosin (Cardura). What is the rationale for combining two antihypertensive drugs? A. The blood pressure will decrease faster. B. Lower doses of both drugs may be given with fewer adverse effects. C. There is less daily medication dosing. D. Combination therapy will treat the patient's other medical conditions.

B

The nurse is caring for a patient with chronic hypertension. The patient is receiving losartan (Cozaar) daily. Which patient manifestations would the nurse conclude is an adverse effect of this medication? (Select all that apply.) A. Tremors B. Dizziness C. Drowsiness D. Hypoglycemia E. Angioedema

B, D, E

Nitroglycerin patches have been ordered for a patient with a history of angina. What teaching will the nurse give to this patient? A. Keep the patches in the refrigerator. B. Use the patches only if the chest pain is severe. C. Remove the old patch and wait 6-12 hours before applying a new one. D. Apply the patch only to the upper arm or thigh areas.

C

The patient has been given a prescription of hydrochlorothiazide (Microzide) as an adjunct to treatment of hypertension and returns for a follow-up check. Which is the most objective data for determining the therapeutic effectiveness of the furosemide? A. Absence of edema in lower extremities B. Weight loss of 13 kg (6 lb) C. Blood pressure log notes blood pressure 120/70 mmHg to 134/88 mmHg since discharge D. Frequency of voiding of at least 6 times per day

C

Which of the following clinical manifestations may indicate that the patient taking metolazone (Zaroxolyn) is experiencing hypokalemia? A. Hypertension B. Polydipsia C. Cardiac dysrhythmias D. Skin rash

C

While planning for a patient's discharge from the hospital, which teaching points would be included for a patient going home with a prescription for chlorothiazide (Diuril)? A. Increase fluid and salt intake to make up for the losses caused by the drug. B. Increase intake of vitamin-C rich foods, such as grapefruit and oranges. C. Report muscle cramping or weakness to the healthcare provider. D. Take the drug at night because it may cause drowsiness.

C

The patient admitted for heart failure has been receiving hydrochlorothiazide (Microzide). Which laboratory levels should the nurse carefully monitor? (Select all that apply.) A. Platelet count B. White blood cell count C. Potassium D. Sodium E. Uric acid

C, D, E

The nurse is caring for a patient with chronic stable angina who is receiving isosorbide dinitrate (Isordil). Which of the following are common adverse effects of isosorbide? A. Flushing and headache B. Tremors and anxiety C. Sleepiness and lethargy D. Light-headedness and dizziness

D

What health teaching should the nurse provide for the patient receiving nadolol (Corgard)? A. Increase fluids and fiber to prevent constipation. B. Report a weight gain of 1 kg per month or more. C. Immediately stop taking the medication if sexual dysfunction occurs. D. Rise slowly after prolonged periods of sitting or lying down.

D