Pharm exam 2 cont.

Which prescription will the nurse administer to provide the most safe and effective care to patients with hypertension? An adrenergic neuron blocker to a 16-year-old with hypertension A beta blocker to an African American patient with hypertension A centrally acting alpha2 agonist to a 16 year old with hypertension A calcium channel blocker (CCB) to an African American patient with hypertension

A calcium channel blocker (CCB) to an African American patient with hypertension CCBs and alpha and beta blockers are also effective in African American patients.

In which patient would a low-dose aspirin be contraindicated? A patient with thrombosis A patient with a heart problem A patient with a hemorrhagic stroke A patient with a deep vein thrombosis

A patient with a hemorrhagic stroke

A Pt. presents to the emergency department with dilated pupils, flushed face, heart rate of 124 beats/min, temperature of 102.6 degrees, and urinary retention. The Pts. significant other reports that the Pt. has been taking diphenhydramine for hay fever but is unaware of any other medications taken. What does the nurse suspect? A. Acute toxicity B. Adverse reaction C. Paradoxical effect D. Reaction from unknown drug

A. Acute toxicity

Which adverse effects will the nurse monitor for in a Pt receiving chemotherapy? Select all that apply. A. Alopecia B. Stomatitis C. Neutropenia D. Hypertension E. Urinary retention

A. Alopecia B. Stomatitis C. Neutropenia

What should the nurse teach the Pt. to help minimize adverse effects of antihistamine administration? Select all that apply. A. Avoid alcohol B. Take with orange juice C. Keep hard candy nearby D. Take frequent sips of fluid E. Take on an empty stomach

A. Avoid alcohol C. Keep hard candy nearby D. Take frequent sips of fluid

A Pt. is prescribed diphenhydramine following a mild blood transfusion reaction. What adverse reaction(s) should the nurse teach the Pt. about this drug? Select all that apply. A. Dry mouth B. Insomnia C. Constipation D. Urinary retention E. Increased salivation

A. Dry mouth C. Constipatation D. Urinary retention

Which patient assessment would assist the nurse in evaluating therapeutic effects of a calcium channel blocker (CCB)? Absence of dizziness Absence of chest pain Decreased swelling in the ankles Decreased eczematous eruptions

Absence of chest pain. CCBs are given for angina, so an absence of chest pain is a therapeutic effects as is decreased blood pressure and dysrhythmias

A patient's serum digoxin level is noted to be 0.5 ng/mL. Which action by the nurse is appropriate? Notify the provider Administer an antidote Hold the ordered dose of digoxin Administer the ordered dose of digoxin

Administer the ordered dose of digoxin Therapeutic serum digoxin levels are 0.5 to 0.8 ng/mL. The patient should receive the next dose to keep the level in therapeutic range.

A bleeding patient receiving warfarin (Coumadin) has an international normalized ration (INR) of 6. What is the nurse's best course of action? Stop the IV drip Wait for the INR to decrease. Administer protamine sulfate. Administer vitamin K1 (phytonadione)

Administer vitamin K1 (phytonadione)

The nurse is preparing to administer a daily dose of digoxin (Lanoxin). What is the priority nursing intervention? Check blood pressure Palpate the pedal pulses Assess for Homan's sign Analyze heart rate and rhythm

Analyze heart rate and rhythm Before giving digoxin (Lanoxin), the nurse should assess heart rate and rhythm. The dosage will be held and the prescriber notified if the heart rate is below 60 beats/min or if the cardiac rhythm has changed. Digoxin can cause bradycardia and electrical changes in the heart

The nurse is instructing a patient about potential adverse effects of a prescribed angitotensin-converting enzyme (ACE) inhibitor. The nurse should instruct the patient to immediately seek medical attention if which adverse effect occurs? Fatigue Diarrhea Angioedema Dry, nonproductive cough

Angioedema Angioedema is a strong vascular reaction involving inflammation of submucosal tissue and can result in anaphylaxis.

A patient is receiving nifedipine (Adalat CC). Which adverse effect should the nurse monitor for in this patient? Pallor Diarrhea Backache Ankle edema

Ankle edema Peripheral edema is an adverse effect of nifedipine

The nurse is monitoring a patient with suspected digoxin toxicity. Which assessment findings would be consistent with digoxin toxicity? Select all that apply. Diarrhea Anorexia Vomiting Dry cough Visual disturbances

Anorexia Vomiting Visual disturbances Anorexia, vomiting, visual disturbances (blurred or yellow vision or appearance of halos around dark objects) fatigue, and nausea frequently foreshadow more serious toxicity (dysrhythmias) and should be reported immediately

The nurse is teaching a patient about therapy with anticoagulants. What is essential information to include in the teaching plan? Anticoagulants dissolve clots. Anticoagulants alter platelet function. Anticoagulants prevent clots from forming. Anticoagulants interfere with drug metabolism.

Anticoagulants prevent clots from forming. The patient needs to understand that anticoagulants will prevent new clots from forming but will not dissolve clots that are already formed. Anticoagulants inhibit clotting by acting on clotting factors and do not alter platelets or drug metabolism.

The healthcare provider orders promethazine. What intervention is essential during intravenous (IV) administration of this medication? A. Use a small bore needle. B. Administer at a rate of 50 mg/min C. Remain with the patient continuously D. Assess IV site frequently for extravastion

Assess IV site frequently for extravasation Promethazine should be administered with a large bore needle at a rate of 25 mg/min or less. The medication can cause severe local tissue injury if it extravasates, including gangrene that requires amputation

A patient with warfarin (Coumadin) toxicity is prescribed vitamin K (phytonadione). Which nursing assessment ensures patient safety? Assess the prothrombin time. Assess the amount of blood lost. Assess the white blood cell count. Assess the partial thromboplastin time.

Assess the prothrombin time. Warfarin can cause blood loss in the patient; thus, it is important to assess the duration of clotting. The duration of clotting can be assessed by finding the prothrombin time.

A patient with a serum cholesterol level of 275 mg/dL is prescribed simvastatin (Zocor). What instructions should the nurse provide the patient? Select all that apply. Avoid taking the drug with grapefruit juice Notify your healthcare provider if your urine becomes discolored Notify your healthcare provider if muscle pain occurs within 1 day Notify your healthcare provider if muscle pain occurs after 3 days Take aspirin (Ecotrin) 30 minutes before taking simvastatin (Zocor)

Avoid taking the drug with grapefruit juice. Notify your healthcare provider if your urine becomes discolored Notify your healthcare provider if muscle pain occurs after 3 days Simvastatin (Zocor) is a HMG Co-A reductase inhibitor that causes rhabdomyolysis as an adverse effect. Grapefruit juice inhibits the enzyme CYP3A4 that is required for the metabolism of simvastatin. This will increase levels of the drug in the body, resulting in rhabdomyolysis. Rhabdomyolysis is associated with the breakdown of muscle proteins that are excreted in the urine, changing the color of the urine. Simvastatin starts acting after 3 days of administration and can cause muscle pains. These should be reported tot he healthcare provider as it may progress to rhabdomyolysis

A Pt. is receiving cancer chemotherapy. Which type of drug is the nurse administering? A. Targeted drugs B. Cytotoxic agents C. Biologic response modifiers D. Hormones and hormone antagonists

B. Cytotoxic agents The term cancer chemotherapy applies only to cytotoxic drugs

When planning care for a patient who is receiving cyclophosphamide (Cytoxan), which intervention is most important for the nurse to include to prevent complications of cyclophosphamide (Cytotoxan) therapy? A. Give an antidiarrheal medication B. Increase the IV and oral fluid intake C. Palpate for pedal pulses every 2 hours D. Monitor for laryngeal stridor and tetany

B. Increase the IV and oral fluid intake

The nurse is reviewing the actions of histamine1 release in the allergic response. The nurse recalls that which of the following effects can be caused by histamine1 release? Select all that apply? A. Bronchodilation B. Itching and pain C. Vasoconstriction D. Secretion of mucus E. Secretion of gastric acid F. Increased capillary permeability

B. Itching and pain D. Secretion of mucus F. Increased capillary permeability

A Pr. is receiving vincristine (Oncovin) for cancer. Which assessment is priority? A. Presence of pulmonary fibrosis B. Presence of peripheral neuropathy C. Presence of bone marrow suppression D. Presence of severe nausea and/or vomiting

B. Presence of peripheral neuropathy Peripheral neuropathy is the major dose-limiting toxicity from vincristine.

Which assessment finding is most important for the nurse to obtain before administering hydralazine (Apresoline)? Capillary refill Homans' sign Blood pressure Peripheral pulses

Blood Pressure Monitoring the blood pressure and heart rate is the highest assessment priority

The nurse is administering an antihypertensive medication. What assessment finding requires immediate action? Calcium level of 8 mEq/dL Potassium level of 5 mEq/dL Apical pulse of 100 beats/min Blood pressure of 80/60mm Hg

Blood pressure of 80/60 mm Hg Blood pressure that goes below 100 mm Hg should immediately be reported to the healthcare provider, and the medication should be held.

The nurse administers candesartan (Atacand) to a patient. Which assessment finding should the nurse use as a clinical indicator of the therapeutic effectiveness of the medication? Blood pressure reduction Serum potassium retention Peripheral perfusion reduction Pulmonary congestion retention

Blood pressure reduction

A cancer Pt. who is on chemotherapy reports severe nausea and vomiting. Which action would be most beneficial to the Pt.? A. Wash hands often B. Administer allopurinol (Zyloprim) C. Administer ondansetron (Zofran) D. Wash lettuce before serving

C. Administer ondansetron (Zofran) Ondansetron (Zofran) will be most beneficial Anticancer medications stimulate the chemoreceptor trigger zone and induce nausea and vomiting in chemotherapy patients. Ondansetron is a serotonin antagonist that prevents nausea and vomiting

What does the nurse assess for in a Pt. who is receiving doxorubicin (Doxil)? Select all that apply. A. Blood in urine B. Thyroid function C. Cardiac function D. Pancreas function E. Infusion site for infiltration

C. Cardiac function E. Infusion site for infiltration Doxorubicin is cardiotoxic so cardiac function must be assessed regularly

A patient is on chemotherapy. Following periodic lab work, the nurse instructs the patient to use a soft-bristled toothbrush and to avoid activities that may increase risk of injury. What is the rationale for the nurse's instructions? A. The patient has developed anemia. B. The patient has developed neutropenia C. The patient has developed thrombocytopenia D. The patient has developed sores in the oral cavity

C. The patient has developed thrombocytopenia

A patient has a prescription for hypertension that blocks both alpha and beta receptors. Which drug will the nurse administer? Carvedilol Reserpine Methyldopa Propranolol

Carvedilol Carveilol is unusual in that it can block alpha1 receptors as well as beta receptors.

A Pt is prescribed lisinopril (Prinvil) as part of the treatment plan for heart failure. Which finding indicates that Pt. is experiencing the therapeutic effect of this drug? Jugular vein distention Potassium level of 3.5 mEq/L +2 edema of the lower extremities Crackles in the lungs are no longer heard

Crackles in the lungs are no longer heard. Because ACE inhibitors promote venous dilation, they provide the therapeutic effect of reducing pulmonary congestion and peripheral edema.

A cancer Pt. wants to know what the word nadir means. What is the nurse's best response? A. it is the Pts tolerance to the chemotherapy's bone marrow suppressant effect. B. It is the time it take the bone marrow to completely recover from a dose of chemotherapy. C. It is the maximum dose for a chemotherapy drug in reference to bone marrow suppression effects. D. It is the average number of days it takes for chemotherapy to decrease the neutrophil count to its lowest level

D. It is the average number of days it takes for chemotherapy to decrease the neutrophil count to its lowest level. Neutropenia begins to develop a few days after dosing, and the lowest neutrophil count, called the nadir, occurs between days 10 and 14

A Pt. presents to the clinic with a runny nose, itchy throat, and mild inflammation after being exposed to sumac on a hiking trip. After assessing the Pt., the nurse recognizes the symptoms as a result of what response? A. Anaphylaxis B. Drug suppression C. Drug adverse effect D. Mild allergic reaction

D. Mild allergic reaction

A cancer Pt is receiving a combination of cancer drugs. How should the nurse interpret this finding? A. The patient is terminal B. The patient has an infection C. This activates P-glycoprotein D. This prevents drug resistance

D. This prevents drug resistance

Which patient symptoms should alert the nurse to be concerned about digoxin (Lanoxin) toxicity? Select all that apply. Fatigue Vomiting Constipation Blurred vision Muscle weakness

Fatigue Vomiting Blurred vision Fatigue, vomiting, and blurred vision are common noncardiac symptoms that can provide advance warning of digoxin toxicity.

The nurse reviews a patient's laboratory values and observes a digoxin level of 2.5 ng/mL and a potassium level of 5.9 mEq/L. Upon physical assessment, the patient begins to experience changes in heart rate and rhythm (dysrhythmias). Which drug should the nurse be prepared to administer? Digoxin Quinidine Potassium supplements Digoxin immune Fab antibody fragments

Digoxin immune Fab antibody fragments When digoxin overdose is especially severe digoxin levels can be lowered using digoxin immune Fab antibody fragments.

The nurse is caring for a patient with hypercholestrolemia who is taking 20 mg of simvastatin (Zocor) as prescribed. After a few days, the patient's urinalysis reports indicated the presence of myoglobin. What instruction would the nurse receive from the primary healthcare provider? Give 10 mg of medication daily. Give the medication before. Discontinue administering the medication Give the medication with 250 mL of water

Discontinue administering the medication The presence of myoglobin in the urine indicates that the patient has rhabdomyolysis, and adverse effect of statins such as simvastatin (Zocor). Rhabdomyolysis is characterized by the breakdown of muscle proteins and can be fatal.

The healthcare provider prescribes lovastatin (Mevacor) for a patient discharged from the hospital post-myocardial infarction. Which instructions are most appropriate for the nurse to include in the patient's teaching plan? Select all that apply. Take your medication in the morning, with a full glass of water, for best results Do not start any new medications without first talking to your healthcare provider Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains. Take one 325-mg aspirin 30 minutes before your dose to lessen the problem of flushing and itching that can occur with this drug

Do not start any new medications without first talking to your HCP. Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains

When teaching a patient about the drug metoprolol, what information will the nurse include in the teaching plan? Do not stop the medication abruptly Stop the medication if you feel tired. If you have gastric upset, take the medication with an antacid. Use a hot tub daily to help vasodilation so that the medication will work more effectively

Do not stop the medication abruptly. The medication cannot be stopped abruptly as this can cause rebound hypertension.

The patient is being treated with a continuous intravenous infusion of heparin. What is the nurse's highest priority? Ensure that protamine sulfate is readily available at all times. Ensure that the patient's laboratory values are monitored correctly. Ensure that a loading dose was initially administered when treatment began. Ensure that the patient is taught dietary restrictions while on the medication.

Ensure that protamine sulfate is readily available at all times Protamine sulfate must be kept readily available because it is the antidote for an overdose of heparin.

The nurse is teaching a patient prescribed captopril (Capoten) for the treatment of hypertension. Which instructions should the nurse include? Select all that apply. Expect a persistent dry cough. Take the medication with food Expect a sore throat and fever Avoid potassium salt substitutes Report difficulty in breathing immediately

Expect a persistent dry cough Avoid potassium salt substitutes Report difficulty in breathing immediately Salt substitutes contain potassium and may increase the risk of hyperkalemia with ACE inhibitors. A persistent, dry, nonproductive cough may develop. Angioedema includes edema of the tongue, glottis, and pharynx that may cause difficulty breathing, which requires immediate medical attention. Captopril must be taken at least 1 hr before meals.

The nurse is teaching a group of coworkers the process of the allergic release of histamine. In which order will the nurse present the steps of this process? Reexposure to the allergen Production of immunoglobulin E Histamine is released Antibody binds with allergen Exposure to allergen Antibodies attach to mast cells and basophils

Exposure to allergen --> Production of immunoglobulin E-->Antibodies attach to mast cells and basophils-->Reexposure to the allergen --> Antibody binds with allergen -->Histamine is released

A patient is prescribed hydralazine (Apresoline) for the treatment of essential hypertension. Which expected adverse effects should the nurse discuss with the patient? Select all that apply. Nausea Fatigue Dizziness Headache Joint Pain

Fatigue Dizziness Headache

The nurse is preparing to administer an oral dose of digoxin (Lanoxin). The apical pulse rate is 64. Which nursing action is most appropriate? Give the medication Obtain a serum digoxin level Notify the healthcare provider Assess for signs of digoxin toxicity

Give the medication. Determine heart rate and rhythm prior to administration. If heart rate is less than 60 beats/min or if a change in rhythm is detected, whithhold digoxin and notify the healthcare provider

The nurse is caring for a patient who has coronary heart disease (CHD). The nurse tells the patient, "Your cholesterol levels are abnormal; you are at a high risk of having a heart attack." What did the nurse discover regarding the lipoprotein levels in the patient's blood report? High levels of low-density lipoproteins (LDL) High levels of hight-density lipoproteins (HDL) Low levels of very-low-density lipoproteins (VLDL) Low levels of intermediate density lipoproteins (IDL)

High levels of low-density lipoproteins (LDL) High level of low-density lipoproteins (LDL) refers to high cholesterol levels in the blood, as LDL is almost entirely composed of cholesterol. This cholesterol is bad cholesterol, which promotes the formation of atherosclerotic plaque resulting in CHD.

The nurse is teaching the patient why hypertension must be treated. What information should be included in the teaching plan? Select all that apply. Hypertension is a risk factor for stroke Hypertension is a risk factor for diabetes Hypertension is a risk factor for heart failure Hypertension is a risk factor for emphysema Hypertension is a risk factor for cardiovascular disease

Hypertension is a risk factor for stroke Hypertension is a risk factor for heart failure Hypertension is a risk factor for cardiovascular disease

Which information from the patient will most likely promote adherence to the medication regimen? I feel good even without my medication I will need to take this for the rest of my life I can take these drugs to cure my hypertension I hope this will prevent complications in the future

I will need to take this for the rest of my life For treatment to be effective, medication must be taken lifelong.

The nurse is teaching a patient who has just been prescribed a vasodilator. Which statement by the patient indicates that the teaching was effective? I will rise slowly when changing from a sitting to a standing position I need to increase my intake of fluids and foods that are high in fiber I can take this medication in the morning to reduce nighttime urination My heart rate may slow down with this drug. I will call if my pulse is below 60

I will rise slowly when changing from a sitting to a standing position. Vasodilators may cause postural hypotension and reflex tachycardia.

Which comment by a patient indicates correct understanding about the use of enalapril? If I feel tired, I should double the dose. I cannot go out in the sun while on this therapy I should stop the drug if I have ringing in my ears If I develop a chronic cough, I need to notify my provider.

If I develop a chronic cough, I need to notify my provider A patient on therapy with an ACE inhibitor such as enalapril should report a nonproductive chronic cough, as this is a potential side effect. there is no treatment other than to change the medication therapy

When will the nurse administer hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins)? In the evening With breakfast With an antacid On an empty stomach

In the evening The liver produces the majority of cholesterol during the night. This, it is best to give HMG-CoA reductase inhibitors (statins), which work to decrease this synthesis, during the evening so that blood levels are highest coinciding with this production.

The nurse understands that cholesterol is carried through the blood by lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis? Apolipoprotein B-100 Low-density lipoprotein (LDL) High-density lipoprotein (HDL) Very-low-density lipoprotein (VLDL)

Low-density lipoprotein (LDL) Cholesterol is the primary core lipid of low-density lipoproteins (LDLs), which are responsible for carrying cholesterol to tissues outside the liver. Of all the lipoproteins, LDLs are the most significant contributors to coronary atherosclerosis. When pharmacologic agents are used to lower cholesterol, the primary goal is to reduce elevated LDL levels

The nurse has just administered the initial dose of enalapril (Vasotec) to a newly admitted patient with hypertension. What is the priority nursing intervention over the next several hours? Check the heart rate Monitor blood pressure Auscultate lung sounds Draw a potassium level

Monitor blood pressure

A patient with cardiovascular disease is taking rosuvastatin (Crestor). Which finding would indicate a potential adverse effect of this drug? Muscle pain and tenderness Platelet count of 100 x 10^3/mm3 Blood pressure of 140/90 mmHg Wheezing and shortness of breath

Muscle pain and tenderness The statins, such as rosuvastatin typically are well tolerated; however, in rare cases they can cause the serious adverse effect of myopathy and rhabdomyolysis. If unexplained muscle pain and tenderness develop, the prescriber should be notified. The other effect would not likely be caused by rosuvastatin

The nurse is caring for a patient who is scheduled to being treatment with carvedilol (Coreg). While updating the history, the patient tells the nurse that he experiences frequent attacks of asthma. what is the highest priority action? Expect a decreased effect from the medication Expect an increased effect from the medication Notify the healthcare provider of this information Monitor the patient for a toxic reaction of the drug

Notify the healthcare provider of this information Carvedilol should be used with caution with a history of asthma.

The nurse is caring for a patient who takes angiotensin-converting enzyme (ACE) inhibitor. If the patient develops a persistent nonproductive cough, what should the nurse do? Notify the provider of the new development Tell the patient that the cough will subside in a few days Assess the patient for other symptoms of upper respiratory infection Instruct the patient to take antitussive medication until the symptoms subside.

Notify the provider of the new development ACE inhibitors prevent the breakdown of bradykinins, frequently causing a nonproductive cough. The patient should be switched to a different medication if the side effect cannot be tolerated.

The nurse is caring for a newly admitted patient who will begin heparin therapy. While documenting the patient's history, the nurse notes that the patient is currently undergoing treatment with enoxaparin. What is the nurse's highest priority? Notify the provider that the patient is at risk for an allergic reaction. Notify the provider that the patient should not be started on heparin. Notify the provider that the dosage of heparin will need to be increased. Notify the provider that the dosage of heparin will need to be decreased.

Notify the provider that the patient should not be started on heparin.

The nurse reviews the medication treatment regimen for a patient with chronic hypertension. To promote optimal medication adherence, which frequency of drug dosing should the nurse advocate for this patient? Once a day Every 8 hrs Four times a day Three times a day

Once a day

A patient develops hypotension after administration of verapamil. Which intervention is appropriate? Administer atropine. Perform gastric lavage. Assist with cardioversion Place in modified Trendelenburg's position.

Place in modified Trendelenburg's position. Placing the Pt. in modified Trendelenburg's position (legs elevated) and administering IV fluids may help with treatment of hypotension

The nurse is reviewing laboratory data before initiating a patient's heparin infusion. Which finding requires immediate action? Platelets 95,000/mm3 Potassium 3.5 mEq/L International normalized ratio (INR) of 1 Activated partial throboplastin time (aPTT) of 37 seconds

Platelets 95,000/mm3 A platelet count of less than 100,000/mm3 indicates thrombocytopenia. This significantly increases the patient's risk of bleeding.

Which assessment is most important for the nurse to obtain prior to administering digoxin to a patient with heart failure? Pulse Blood pressure Respiratory rate Weight in kilograms

Pulse It is crucial to measure the patient's pulse before administering digoxin because digoxin causes a decrease in heart rate. In fact, if the heart rate is below 60, digoxin cannot be given.

The nurse is reviewing the chart for a patient who has been receiving an angiotensin-converting enzyme (ACE) inhibitor for 4 days. Which finding would cause the nurse to hold the ACE inhibitor until evaluated by the patient's primary care provider? Reports sore throat Has bronchial asthma Diabetic with nephropathy No history of renal artery stenosis

Reports sore throat Sore throat is a sign of neutropenia in a patient receiving an ACE inhibitor. Neutropenia, with its associated risk of infection, is rare but serious complication.

The nurse is caring for patients receiving vasodilators. Which instruction should the nurse give the patients to combat a common adverse effect? Wear a hat when outdoors Avoid taking with grapefruit juice Drink the oral solution through a straw Rise slowly from a sitting to standing position

Rise slowly from a sitting to standing position. Vasodilators place patients at increased risk of falls.

A patient is prescribed digoxin to treat heart failure. Which biochemical parameter should be assessed by the nurse to ensure safe drug administration? Liver enzyme concentration Blood glucose concentration Serum calcium concentration Serum potassium concentration

Serum potassium concentration Hypokalemia, usually diuretic induced, is the most frequent underlying cause of dysrhythmias. The nurse should monitor serum potassium concentrations. Because potassium competes with digoxin

When administering phase-specific anticancer medications, which schedule is used to achieve maximum therapeutic effectiveness? A. At the end of treatment B. One day every 12 weeks C. Short intervals over time D. The first day of the month

Short intervals over time

A patient who has been receiving an infusion of heparin has an activated partial thromboplastin time (aPTT) of 120 seconds. What is the nurse's first action? Assess for bleeding. Shut off the heparin drip. Call the healthcare provider. Keep the patient on bed rest.

Shut off the heparin drip The nurse's first action is the case of an a PTT of 120 seconds is to shut off the infusion of heparin. The aPTT is too high, and the patient can have spontaneous bleeding. After shutting off the drip, the nurse should instruct the patient to stay on bed rest because a fall can be fatal. The healthcare provider would need to be notified and the nurse would continue care by assessing for bleeding.

A patient receiving atorvastatin (Lipitor) therapy to reduce high cholesterol levels calls the clinic and reports, "I am experiencing severe pain in both my legs." What is the nurse's best response? Stop taking the drug and visit the clinic immediately. Continue taking the drug; leg pain is a common side effect. Stop taking the drug if the symptoms persist for another week. Continue taking the drug along with niacin (Niaspan) and a pain killer.

Stop taking the drug and visit the clinic immediately The patient may have pain in both legs due to the myopathy, an adverse effect of atorvastatin (Lipitor). It progresses to a life-threatening condition called rhabdomyolysis, which involves the breakdown of muscle proteins leading to renal failure and death.

The nurse is assessing a patient who has been prescribed atorvastatin (Lipitor). What instruction should the nurse provider for the patient to ensure proper administration of the medication? Take the drug after breakfast Take the drug in the evening Take the drug with an antacid Take the drug on an empty stomach

Take the drug in the evening Cholesterol production by the liver usually occurs at night; thus, statin drugs such as atrovastatin work by decreasing the cholesterol synthesis and are generally administered in the evening to reduce cholesterol production.

Which behavior by a patient indicates more teaching is needed about taking diltiazem (Cardizem)? Takes with tea Takes with lemonade Takes with apple juice Takes with grapefruit juice

Takes with grapefruit juice. If the Pt. consumes grapefruit juice, it can raise the levels of diltiazem and verapamin.

The nurse is preparing to administer an anticoagulant to a patient. Which action, if observed, is in error? The nurse administers heparin subcutaneously to a patient. The nurse administers warfarin (Coumadin) orally to a patient. The nurse administers dabigaran (Pradaxa) orally to a patient. The nurse administers enoxaparin (Lovenox) intramuscularly to a patient.

The nurse administers enoxaparin (Lovenox) intramuscularly to a patient. The nurse should not administer an anticoagulant intramuscularly as this would cause a high risk of bleeding into the muscle and a large hematoma to form at the injection site.

A patient with hypercholesterolemia is prescribed lovastatin (Mevacor). After reviewing the patient's medical history, the nurse discovers that the medication is not safe to prescribe for the patient and reports this finding to the healthcare provider. What did the nurse find in the patient's medical history? The patient has leukemia The patient has renal disease The patient has hepatic disease The patient has chronic pulmonary disease

The patient has hepatic disease Lovastatin (Mevacor) can cause an increase in liver enzymes and should not be prescribed to patients with preexisting liver disease.

Which 90patient receiving losartan (Cozaar) should be monitored closely while receiving this therapy? The patient with constipation The patient with an elevated creatinine level The patient with a heart rate of 90 beats/min The patient with a potassium level of 3.4 mEq/L

The patient with an elevated creatinine level Losartan has been shown to be beneficial in patients with hypertension and heart failure. Patients with renal or hepatic dysfunction should be assessed carefully due to the potential for toxicity and increased side effects.

The nurse is administering tenecteplase (TNKase) therapy to a patient experiencing an acute myocardial infarction. What will the nurse teach the patient about this therapy? This therapy will quickly decrease your pain. This therapy will prevent new clots from forming. This therapy will reverse damage from the infarction This therapy will dissolve the clot that caused the heart attack.

This therapy will dissolve the clot that caused the heart attack.

The nurse is administering several medications at 8 AM. Which medication will decrease blood pressure by blocking angiotensin II receptor sites? Enalapril Furosemide Eplerenone (Inspra) Valsartan (Exforge)

Valsartan (Exforge) Sartan = angiotensin II receptor blocker (ARB)

A patient has overdosed on warfarin (Coumadin). Which substance will the nurse administer to reverse the effect of warfarin? Aspirin Calcium Vitamin K Potassium

Vitamin K

The nurse is caring for a patient prescribed digoxin (Lanoxin) for heart failure. Which finding would require immediate attention by the nurse? Vomiting and diarrhea Heart rate of 68 beats/min Digoxin level of 0.7 ng/mL Potassium level of 3.7 mEq/L

Vomiting and diarrhea Vomiting and diarrhea can lead to hypokalemia, which increases the risk of digoxin toxicity. These symptoms, along with nausea, fatigue, and visual disturbances, warrant further attention.

The nurse assesses a patient's pulse before administering digoxin and notes a rate of 55 beats/min. What is the priority intervention by the nurse? Withhold the dose Administer the drug Check potassium level before giving Reduce the dose to half the prescribed dose

Withhold the dose If heart rate is less than 60 beats/min or if a change in rhythm is detected, digoxin should be whithheld and the prescriber notified