Pharm Quiz week 6

A patient is taking a vasodilator that relaxes smooth muscles in veins. To help minimize drug side effects, the nurse caring for this patient will: A) caution the patient not to get up without assistance. B) encourage the patient to increase fluid intake. C) tell the patient to report shortness of breath D) warn the patient about the possibility of bradycardia

A) caution the patient not to get up without assistance.

A patient with diabetes develops hypertension. The nurse will anticipate administering which type of medication to treat in this patient? A. ACE inhibitors B. Beta blockers C. Direct-acting vasodilators D. Thiazide diuretics

A. ACE inhibitors

A patient with a recent onset of nephrosclerosis has been taking an ACE inhibitor and a thiazide diuretic. The patient's initial blood pressure was 148/100 mm Hg. After 1 month of drug therapy, the patient's blood pressure is 120/90 mm Hg. The nurse will contact to provider to discuss: A. Adding a calcium channel blocker to this patient's drug regimen. B. Lowering doses of the antihypertensive medications. C. Ordering a high potassium diet. D. Adding spironolactone to the drug regimen.

A. Adding a calcium channel blocker to this patient's drug regimen.

A patient is taking clonidine for hypertension and reports having dry mouth and drowsiness. What will the nurse tell the patient? A. Drink extra fluids and avoid driving when drowsy. B. Beta blockers can reverse these side effects. C. Discontinue the medication immediately and notify the provider. D. Notify the provider if symptoms persist after several weeks.

A. Drink extra fluids and avoid driving when drowsy.

A patient has three separate blood pressure (BP) readings of 120/100 mm Hg, 138/92 mm Hg, and 126/96 mm Hg. Which category describes this patient's BP? A. Hypertension B. Isolated systolic hypertension C. Normal D. Prehypertension

A. hypertension

A five year old patient is seen in an outpatient clinic is noted to have hypertension on three separate visits. Ambulatory blood pressure monitoring confirms that the child has hypertension. As an initial intervention with the child's parents, the nurse will expect to: A. perform a detailed health history on the child. B. provide teaching about antihypertensive medications. C. reassure the parents that their child may outgrow this condition. D. teach the parents about lifestyle changes and a special diet.

A. perform a detailed health history on the child.

A patient with heart failure who has been given digoxin [lanoxin] daily for a week complains of nausea. Before giving the next dose, the nurse will: A.assess the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute. B.contact the provider to report digoxin toxicity. C.request an order for a decreased dose of digoxin. D.review the serum electrolyte values and withhold the dose if the potassium level is greater than 3.5 mEq/L

A.assess the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute.

An 88-year-old patient with heart failure has progressed to Stage D and is hospitalized for the third time in a month. The nurse will expect to discuss which topic with the patient's family? A) Antidysrhythmic medications B) End-of-life care C) Heart transplantation D) Implantable mechanical assist devices

B) End-of-life care

A nurse is reviewing the phenomenon of reflex tachycardia with a group of nursing students. Which statement by a student indicates understanding of this phenomenon? A. "Baroreceptors in the aortic arch stimulate the heart to beat faster." B. "Reflex tachycardia can negate the desired effects of vasodilators." C. "Reflex tachycardia is more likely to occur when beta blockers are given." D. "Venous dilation must occur for reflex tachycardia to occur."

B. "Reflex tachycardia can negate the desired effects of vasodilators."

A patient newly diagnosed with heart failure is admitted to the hospital. The nurse notes a pulse of 90 beats per minute. The nurse will observe this patient closely for: A. Increased blood pressure. B. Decreased urine output C. Jugular vein distension. D. Shortness of breath.

B. Decreased urine output

A patient takes an ACE inhibitor to treat hypertension and tells the nurse that she wants to become pregnant. She asks whether she should continue taking the medication while she is pregnant. What will the nurse tell her? A. Controlling her blood pressure will decrease her risk of preeclampsia. B. Discuss using methyldopa instead while she is pregnant. C. Ask the provider about changing to an ARB during pregnancy. D. Continue taking the ACE inhibitor during her pregnancy.

B. Discuss using methyldopa instead while she is pregnant.

A nurse is obtaining a medication history on a newly admitted patient, who reports taking minoxidil for hypertension. Admission vital signs reveal a heart rate of 78 beats per minute and a blood pressure of 120/80 mm Hg. What is an important part of the initial assessment for this patient? A. Monitoring for nausea and vomiting B. Evaluating ankle edema C. Noting the presence of hypertrichosifs D. Obtaining a blood glucose

B. Evaluating ankle edema

A patient who does not consume alcohol or nicotine products reports a strong family history of hypertension and cardiovascular disease. The patient has a blood pressure of 126/82 and a normal weight and body mass index for height and age. The nurse will expect to teach this patient about A. ACE inhibitors and calcium channel blocker medications. B. the DASH diet, sodium restriction, and exercise. C. increased calcium and potassium supplements. D. thiazide diuretics and lifestyle changes.

B. the DASH diet, sodium restriction, and exercise.

A patient with heart failure who takes a thiazide diuretic and digoxin [lanoxin] is admitted for shortness of breath. The patient's heart rate is 66 beats per minute, and the blood pressure is 130/88 mm Hg. The serum potassium level is 3.8 mEq/mL and the digoxin level is 0.8 ng/mL. The nurse admitting this patient understands that the patient: A) has digoxin toxicity. B) is showing signs of renal failure. C) is experiencing worsening of the disease. D) needs a potassium-sparing diuretic.

C) is experiencing worsening of the disease.

A nurse is administering a vasodilator that dilates resistance vessels. The nurse understands that the drug will have which effect on the patient? A. Decreased cardiac preload B. Decreased cardiac output C. Increased tissue perfusion D. Increased ventricular contraction

C. Increased tissue perfusion

A patient with hypertension will begin taking an alpha1 blocker. What will the nurse teach this patient? A. A persistent cough is a known side effect of this drug. B. Eat foods rich in potassium while taking this drug. C. Move slowly from sitting to standing when taking this drug D. Report shortness of breath while taking this drug.

C. Move slowly from sitting to standing when taking this drug

A patient has had blood pressures of 150/95 mm Hg and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient's diagnostic tests are all normal. The nurse will expect this patient's provider to order: A. a beta blocker. B. a loop diuretic and spironolactone. C. a thiazide diuretic. D. counseling on lifestyle changes.

C. a thiazide diuretic.

The potassium-sparing diuretic spironolactone [Aldactone] prolongs survival and improves heart failure symptoms by which mechanism? A. Increasing diuresis B. Reducing after load C. Reducing venous pressure D. Blocking aldosterone receptors

D. Blocking aldosterone receptors

A nurse prepares to administer a scheduled dose of digoxin. The nurse finds a new laboratory report showing a plasma digoxin level of 0.7 ng/ml. What action should the nurse take? A. Withhold the drug for an hour and reassess the level. B. Withhold the drug and notify the prescriber immediately. C. Administer Digibind to counteract the toxicity. D. Check the patient's apical pulse, and if it is within a safe range, administer the digoxin

D. Check the patient's apical pulse, and if it is within a safe range, administer the digoxin

A patient asks the nurse why he cannot use digoxin [lanoxin] for his heart failure, because both his parents used it for heart failure. The nurse will explain it is not the first-line therapy for which reason? A. It causes tachycardia and increases the cardiac workload. B. It has a wide therapeutic range that makes dosing difficult. C. It may actually shorten the patient's life expectancy. D. It does not correct the underlying pathology of heart failure

D. It does not correct the underlying pathology of heart failure

A hospitalized patient has a blood pressure of 145/96 mm Hg. The nurse caring for this patient notes that the blood pressure the day before was 132/98 mm Hg. The patient reports ambulatory blood pressure readings of 136/98 and 138/92 mm Hg. The patient has a history of a previous myocardial infarction and has adopted a lifestyle that includes use of the DASH diet and regular exercise. What will the nurse do? A. Notify the provider and suggest a thiazide diuretic as initial therapy. B. Order a diet low in sodium and high in potassium for this patient. C. Recheck the patient's blood pressure in 4 hours to verify the result. D. Notify the provider and discuss ordering a beta blocker for this patient

D. Notify the provider and discuss ordering a beta blocker for this patient

A patient with stage C heart failure (HF) who has been taking an ACE inhibitor, a beta blocker, and a diuretic begins to have increased dyspnea, weight gain, and decreased urine output. The provider orders spironolactone (Aldactone). The nurse will instruct the patient to: A. use a salt substitute instead of salt B. take extra fluids. C. monitor for a decreased heart rate D. Avoid potassium supplements

D. avoid potassium supplements

A patient with heart failure who has been taking an ACE inhibitor, a thiazide diuretic, and a beta blocker for several months comes to the clinic for evaluation. As part of the ongoing assessment of this patient, the nurse will expect the provider to evaluate: A. complete blood count. B. ejection fraction. C. maximal exercise capacity. D. serum electrolyte levels.

D. serum electrolyte levels.

A nurse is caring for a patient who will be getting taking hydralazine to treat hypertension. Which statement by patient indicates understanding of the nurses teaching about this drug?

I will also need to take a beta blocker medication with this drug to prevent rapid heart rate

A patient is admitted with severe hypertensive crisis. The nurse will anticipate administering which medication? A. Captopril PO B. Hydralazine (Apresoline) 25 mg PO C. Minoxidil 20 mg PO D. Sodium nitroprusside [nitropress] IV

Sodium nitroprusside [nitropress] IV

A nurse is preparing to administer digoxin [Lanoxin] to a patient. The patient's heart rate is 62 beats per minute, and the blood pressure is 120/60 mm Hg. The last serum electrolyte value showed a potassium level of 5.2 mEq/L. What will the nurse do? a.Contact the provider to request an increased dose of digoxin. b.Give the dose of digoxin and notify the provider of the potassium level. c.Request an order for a diuretic. d.Withhold the dose and notify the provider of the heart rate.

b.Give the dose of digoxin and notify the provider of the potassium level.

A 60-year-old African American patient has a blood pressure of 120/80 mm Hg and reports a family history of hypertension. The patient has a body mass index of 22.3. The patient reports consuming alcohol occasionally. Which therapeutic lifestyle change will the nurse expect to teach this patient? a. Alcohol cessation b. Potassium supplementation c. Sodium restriction d. Weight loss

c. Sodium Restriction