Pharm exam 4

Which one of the following are an adverse effect related to calcium channel blockers? Diarrhea Butterfly rash Weight loss Constipation

Constipation

A patient is prescribed verapamil. The nurse should assess the patient for which common adverse effects? -Atrial fibrillation, photosensitivity, and blurred vision -Tachycardia, stomatitis, and inflammation of the joints -Constipation, headache, and edema of the ankles and feet -Dry mouth, lymphadenopathy, and decreased appetite

Constipation, headache, and edema of the ankles and feet

Digoxin and other inotropic agents: Increase the force of myocardial contraction Decrease cardiac output Increase heart rate Decrease urine production

Increase the force of myocardial contraction

This is a potentially life-threatening reaction to ACE inhibitors. Angioedema Hyperglycemia Dyspepsia Cough

Angioedema

A nurse instructs a patient about signs and symptoms of digoxin toxicity. The nurse determines that teaching is successful if the patient states? .

"I should report any visual disturbances or muscle weakness"

The nurse teaches a patient about captopril. Which statement by the patient requires an intervention by the nurse? "I use NoSalt for seasoning foods instead of salt." "I eat sweet potatoes once or twice a week." "I drink 4 ounces of prune juice each morning." "I like asparagus because it is high in vitamin K."

"I use NoSalt for seasoning foods instead of salt."

The nurse instructs a patient about taking nifedipine SR. Which statement made by the patient indicates an understanding of medication teaching? "I will stop taking my beta blocker." "The pill should be swallowed whole." "The drug will cause constipation." "This drug treats heart rhythm problems."

"The pill should be swallowed whole"

Which patient would most likely be prescribed sodium nitroprusside? -A patient with a recent diagnosis of essential hypertension -A patient with heart failure who receives weekly home visits -A patient who is hypotensive after a myocardial infarction -A patient with a hypertensive crisis in the intensive care unit

-A patient with a hypertensive crisis in the intensive care unit

The most common reason for discontinuing ACE inhibitors is Excessive diuresis A cough First-dose hypertension Hypokalemia

A cough

What is the priority nursing diagnosis for a patient with a dysrhythmia? Ineffective breathing pattern Alteration in cardiac output Imbalance of fluid and electrolytes Inadequate peripheral tissue perfusion

Alteration is cardiac output

Which lifestyle modifications are strongly encouraged in patients with primary hypertension? Alcohol intake restriction Sodium restriction/ DASH eating plan Aerobic exercise Smoking cessation Weight loss

Alcohol intake restriction Sodium restriction/ DASH eating plan Aerobic exercise Smoking cessation Weight los

What baseline data should be collected before giving an alpha1-adrenergic antagonist? Fasting lipid panel Kidney function tests BP and HR Liver function study

BP and HR

Instructing a patient on the Valsalva maneuver is asking the patient to do what? Pant like a dog Breathe through pursed lips Tighten the pelvic floor muscles Bear down as if having a bowel movement

Bear down as if having a bowel movement

Beta blockers produce most of their beneficial effects by blocking which receptors in the heart? Alpha 1 receptors Beta 2 receptors Alpha 2 receptors Beta 1 receptors

Beta 1

A patient has hypertension, type II diabetes, and chronic kidney disease. Which medication would the nurse anticipate will be ordered to manage this patient's hypertension?

Captopril

Your patient is prescribed a calcium channel blocker. As the nurse you know that these medication works to block calcium channels in what areas of the body? Select all that apply: Peripheral nervous cells Cardiac myocytes SA and AV nodal tissue Vascular smooth muscle Vagal nerve cells

Cardiac myocytes SA and AV nodal tissue Vascular smooth muscle

A patient recently began taking a loop diuretic for hypertension related to heart failure. He is complaining about dizziness and lightheadedness when standing. What advice can the nurse give him to keep him safe? Change positions slowly Reduce the dosage of the medication Take the medication before going to bed Take the medication earlier in the day

Change positions slowly

Drugs that dilate capacitance vessels (veins) Increase cardiac afterload. Decrease cardiac preload. Decrease cardiac afterload. Increase cardiac preload.

Decrease cardiac preload

Postural (orthostatic) hypotension is caused by Water retention Vasoconstriction Increased cardiac output Decreased venous return

Decreased venous return

A patient with severe hypertension is prescribed minoxidil (vasodilator). Which medications will the nurse expect to be administered to reduce adverse responses to minoxidil? Adenosine and ticlopidine Furosemide and propranolol Digoxin and captopril Donepezil and clonidine

Furosemide and propranolol

The nurse prepares to administer metoprolol to a patient with chronic stable angina. What is a priority assessment to make before the administration of this medication? Temp Urinary Function Respiratory rate Heart rate

Heart rate

A patient with deep vein thrombosis receiving an intravenous (IV) heparin infusion asks the nurse how this medication works. What is the nurse's best response? Heparin prevents the activation of vitamin K and thus blocks synthesis of some clotting factors. Heparin works by converting plasminogen to plasmin, which in turn dissolves the clot matrix. Heparin suppresses coagulation by helping antithrombin perform its natural functions. Heparin inhibits the enzyme responsible for platelet activation and aggregation within vessels.

Heparin suppresses coagulation by helping antithrombin perform its natural functions.

The ___________________ is used to monitor warfarin therapy. Platelet count INR (international normalized ratio) No test is required for warfarin therapy. aPTT

INR

The nurse cares for a patient receiving digoxin. What indicates to the nurse that treatment with this medication is effective?

Improved cardiac output -If cardiac output is improved we can measure profusion of kidneys by the promotion of urine output

A patient with asthma requires a beta blocker. Which of the following drugs would be appropriate for this patient? Propanolol Metoprolol Carvedilol Terazosin

Metoprolol

A patient with diabetes requires a beta blocker. Which of the following drugs would be appropriate for this patient? Propanolol Metoprolol Carvedilol Terazosin

Metoprolol

The nurse is teaching a patient who has had an ST-segment elevation myocardial infarction (STEMI) about home medications. Which agent represents a drug category that should be taken by all post-MI patients? Diltiazem Atorvastatin Metoprolol Hydrochlorothiazide (HCTZ)

Metoprolol

Your type 1 diabetic patient is on a beta blocker. Which is the best way to determine if your patient is hypoglycemic? Monitor capillary blood glucose Check the blood glucose once a week Watch for symptoms of hypoglycemia

Monitor capillary blood glucose

The physician prescribes sustained-release verapamil to an 82-year-old patient who takes digoxin daily. Which action by the nurse is best? -Monitor the patient's cardiac rhythm continuously. -Assess the patient for tachycardia and hypertension. -Maintain the patient on bed rest for 8 to 10 hours. -Reduce dietary fiber to prevent loose, watery diarrhea.

Monitor the patient's cardiac rhythm continuously

Cardiac afterload is primarily determined by Stroke volume Systemic filling pressure Peripheral resistance Myocardial contractility

Peripheral resistance

In evaluating a patient's response to calcium channel blockers, the nurse recognizes that these drugs do not have a significant effect on what? Cardiac arteries Peripheral arterioles Cardiac contractility Peripheral veins

Peripheral veins

When caring for a patient who is prescribed a vasodilator, it is important to monitor for which adverse effects associated with vasodilation? Bradycardia Postural Hypotension Fluid volume overload Lowering of blood pressure to target levels Tachycardia

Postural hypotension Fluid volume overload Tachycardia

A patient is prescribed hydralazine. What concern is most important for the nurse to address? Precautions for postural hypotension Prevention of reflex tachycardia High initial dose for slow acetylators Recognition of hypertrichosis

Prevention of reflex tachycardia

Calcium channel blockers are useful in treating hypertension and angina pectoris because they: Cause vasoconstriction Promote excretion of sodium Increase myocardial contractility Promote vasodilation

Promote vasodilation

A patient with type 2 diabetes mellitus is diagnosed with stable angina. Which beta blocker, if prescribed by the physician, would the nurse question? Metoprolol Propanolol Bisoprolol Atenolol

Propanolol

In a healthy heart what is the pacemaker? AV node SA node Ventricle Bundle of His

SA node

The patient is prescribed digoxin and furosemide. It is most important for the nurse to assess which value before administration of these medications?

Serum Potassium

Which are beneficial effects that can be derived from atorvastatin and other drugs in this class? (Select all that apply.) Improvement in liver function Stabilization of the plaque in coronary arteries Reduction of LDLs Reduction of risk of cardiovascular events Elevation of HDLs

Stabilization of the plaque in coronary arteries Reduction of LDLs Reduction of risk of cardiovascular events Elevation of HDLs

The balance between the pulmonary and systemic circulations in a healthy heart is maintained in accordance with

Starling's Law of the Heart

A patient who is receiving intravenous nitroprusside is disoriented and unable to recognize family members. The nurse should take which action first? Perform a complete neurologic examination. Provide reality orientation as needed. Stop the intravenous nitroprusside. Review the patient's liver function tests.

Stop the intravenous nitroprusside.

Untreated hypertension can lead to Stroke. Type 1 diabetes mellitus. Kidney disease. Heart disease.

Stroke Kidney disease. Heart disease.

The nurse is aware that which nitroglycerin preparation has a rapid onset? Transdermal patch Sustained release capsule Topical ointment Sublingual tablets

Sublingual tablets

Aspirin and other antiplatelet drugs: Bind to plasma proteins. Prevent activation of vitamin K Dissolve existing thrombi. Suppress thrombus formation in arteries.

Suppress thrombus formation in arteries.

Your heart failure patient has been started on digoxin. What is the most important patient teaching consideration regarding this medication? Teach the patient to take the medication at the same time every day Teach the patient to keep their scheduled appointments with their health care provider Teach the patient to take their blood pressure before each dose Teach the patient the signs and symptoms of digoxin toxicity

Teach the patient the signs and symptoms of digoxin toxicity

A patient is to receive a scheduled dose of diltiazem. The nurse should hold the medication and contact the prescriber if what occurs? The patient's blood pressure is 112/64 mm Hg. The patient's cardiac rhythm is atrial fibrillation. The patient is complaining of chest pain. The patient is in second-degree heart block.

The patient is in second-degree heart block.

It is important for the nurse to discuss adverse effects of the antihypertensive drugs that are prescribed because the nurse knows what about the drugs' adverse effects? They affect adherence. They are necessary if the antihypertensive is at an effective dose. They reflect the cause of hypertension. They are life-threatening.

They affect adherence

Which drug classification is the first-line drug treatment for primary hypertension?

Thiazide diuretics

Therapy with cholesterol-lowering drugs must continue lifelong.

True

The nurse is caring for a patient receiving nitrates for relief of angina. What pharmacodynamic action is responsible for the relief of anginal pain with nitrates? Influx of calcium ions leads to relaxation of vascular smooth muscle. Vasoconstriction leads to improved cardiac output. Decreased force of contraction leads to decreased oxygen demand. Vasodilation leads to decreased preload, which decreases oxygen demand.

Vasodilation leads to decreased preloasd which decreases oxygen demand

The kidneys provide long-term control of arterial pressure by regulating Potassium Water Angiotensin II Peripheral resistance

Water

What drug/food interactions should the nurse teach the client about calcium channel blockers? Select all that apply. -smoked fish -insulin -grapefruit juice -beta blockers -digoxin

grapefruit juice beta blockers digoxin

ALL antidysrhythmic drugs are

prodysrhythmic

What is a major use of epinephrine?

treatment of anaphylaxis

The healthcare provider prescribes atorvastatin 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 one 325-mg aspirin 30 minutes before your dose to lessen the problem of flushing and itching that can occur with this drug." • "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains." • "Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes." • "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."

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