Pharm test 4
therapeutic range for the INR
2-3
The nurse notes in a pts med history that the pt is taking benzonatate (Tessalon Perles) as needed. Based on this finding, the nurse interprets that the pt has which problem? A. Cough B. Seasonal allergies C. Chronic rhinitis D. Motion sickness
A
When giving antihypertensive drugs, the nurse will consider giving the first dose at bedtime for which class of drugs? a. Alpha blockers such as doxazosin (Cardura) b. Diuretics such as furosemide (Lasix) c. ACE inhibitors such as captopril (Capoten) d. Vasodilators such as hydralazine (Apresoline)
A
When monitoring a patient who is recieving an intravenous infusion of nesiritide (Natrecor) the nurse will look for which adverse effect? A. Dysrhythmia B. Protineuria C. Hyperglycemia D. Hypertension
A
Which statement by the pt reflects the need for additional pt edu about the calcium channel blocker diltiazem (Cardizem)? A. I can take this drug to stop an attack of angina B. I understand that food and antacids alter the absorption of this oral drug C. When the long acting forms are taken the drug cannot be crushed D. This drug may cause my bp to drop so I need to be careful when getting up
A
When teaching the patient about the signs and symptoms of cardiac glycoside toxicity, the nurse should alert the pt to watch for which of these? sata A. Dizziness B. Visual changes like halos C. Headaches D. Increased urine output E. Dark stools
A b c
The nurse is administering an IVinfusion of a phosphodiesterase inhibitor to a pt who has heart failure. The nurse will evaluate the pt for which therapeutic effects? Sata A. Positive inotropic effects B. Vasodilation C. Decreased heart rate D. Increased blood pressure E. Positive chronotropic effects
A b e
The nurse is assessing a pt who has a new prescription for vorapaxar (Zontivity). Which of these conditions are considered contraindications to the use of vorapaxar? Sata A. Impaired renal function B. Impaired liver function C. History of myocardial infarction D. Peripheral artery disease E. History of intracranial hemorrhage
A b e
A patient is recieving instructions regarding warfarin therapy and asks the nurse about what meds she can take for headaches. The nurse will tell her to avoid which type of meds? Sata A. Aspirin B. Acetaminophen C. NSAIDs D. Gingko E. Caffine
A c d
The nurse is reviewing drug interactions with a male pt who has a prescription for isosorbide dinitrate (Isordil) as treatment for angina. WHich substances listed could potentially result in a drug interaction? ( sata) A. A glass of wine B. Thyroid replacement horomone C. Tadalafil (cialist), erectile dysfunction drug D. Metformin (Glucophage) an antidiabetic drug E. Carvedilol (coreg) a beta blocker
A c e
When a patient is being taught about the potential adverse effects of an ACE inhibitor, which of these effects should the nurse mention as possibly occuring when this drug is taken to treat hypertension? (Sata) A. Fatigue B. Nausea C. Dry, nonproductive cough D. Diarrhea E. Dizziness
A c e
In administering niacin the nurse must monitor for which adverse effects? Sata A. Flushing of skin B. Muscle pain C. Prutitus D. Headache E. Constipation F. GI upset
A c f
While assessing a patient with angina who is to start a beta blocker therapy, the nurse is aware that the presence of which condition may be a problem if these drugs are used? (Sata) A. Diabetes B. Essential tremors C. Excertional angina D. Asthma E. Hypertension
A d
When assessing a pt who is to recieve a decongestant the nurse will recognize that a potential contraindication to this drug would be which condition? SATA A. Glaucoma B. Fever C. Hypotension D. Peptic ulcer disease E. Allergic rhinitis
A, c
A 46-year-old man started antihypertensive drug therapy 3 months earlier and is in the office for a follow-up visit. While the nurse is taking his blood pressure, he informs the nurse that he has had some problems with sexual intercourse. Which is the most appropriate response by the nurse? a. "Not to worry. Eventually, tolerance will develop." b. "The physician can work with you on changing the dose and/or drugs." c. "Sexual dysfunction happens with this therapy, and you will learn to accept it." d. "This is an unusual occurrence, but it is important to stay on your medications."
B
A 68 year old male patient has been taking the nitrate isosorbide dinitrate (Isordil) for 2 years for angina. He recently has been experiencing erectile dysfunction and wants a prescription for viagra. Which response would the nurse most likely hear from the doctor? A. He will have to be switched to isosorbide mononitrate if he wants to take viagra B taking viagra with a nitrate may result in severe hypotension so a contraindication exists C ill write a prescription but if he uses it he needs to stop the isosorbide for one dose D these drugs are compatable with each other and so I will write the prescription
B
A nurse is administering niacin would implement which action to help to reduce adverse effects? A. Give meds with grapefruit juice B. Administer a small sode of aspirin or NSAID 30 mins before the dose C. Administer the meds on an empty stomach D. Have the pt increase dietary fiber intake
B
A patient is taking a beta blocker as part of the treatment plan for heart failure. The nurse knows that the purpose of the beta blocker for this patient is to a. increase urine output. b. prevent stimulation of the heart by catecholamines. c. increase the contractility of the heart muscle. d. cause peripheral vasodilation.
B
A pt is currently taking a statin. The nurse considers that the pt may have a higher risk for developing rhabdomyolysis when also taking which produce? A. NAIDs B. A fibric acid derivative C. Orange jouce D. Fat soluble vitamine
B
A pt recieved a double dose of heparin during surgery and is bleeding thorugh the incision site. While the surgeons are working to stop the bleeding at the site, the nurses will prepare to take what action? A. Give IV vitamin K as an antidote B. Give IV protamine sulfate as an antidote C. Call the blood bank for an immediate platelet transfusion D. Obtain an order for packed red blood cells
B
A pt with a rapid, irregular heart rhythm is being treated in the ER with adenosine. During administration of the drug the nurse will be prepared to monitor the pt for which effect? A nausea and vomitting B a brief period of systole C muscle tetany D hypertension
B
The nurse is administering hypertensive drugs to older adult pts. The nurse knows that which adverse effect is of most concern for these pts? A. Dry mouth B. Hypotension C. Restlessness D. Constipation
B
The nurse is reviewing a patient's med orders for prn meds that can be given to a pt who has bronchitis with a productive cough. Which drug will the nurse choose? A. An antitussive B. An expectorant C. An antihistamine D. A decongestant
B
The nurse is teaching a pt about the self administration of enoxaparin (Lovenox). Which statement will be included in this teaching session? A. We will need to teach a family member how to give this drug in your arm B. This drug is given in the folds of your abdomen but atleast 2 inches away from your navel C. This drug needs to be taken at the same time every day with a full glass of water D. Be sure to massage the injection site thoroughly after administering the drug.
B
A pt is starting warfarin (coumadin) therapy as part of treatment for atrial fibrilation. The nurse will follow which prinicples of warfairn therapy? Sata A. Teach proper subcutaneous administration B. Administer the oral dose at the same time every day C. Assess carefully for excessive bruising or unusual bleeding D. Monitor lab results for a target INR of 2-3 E. Monitor lab results for aPTT value of 1.5-2.5
B c d
A pt has been taking simvastatin for 6 mths. Today he recieved a call that he needs to come to the office for a lab check. The nurse expects which lab tests will be ordered? Sata A. OT/INR B. Total cholesterol C. Triglycerides D. Liver function studies E. CBC F. HDL and LDL levels
B c d f
The nurse is giving an antihistamine and will observe the pt for which side effects? A. Hypertension B. Dizziness C. Hangover effect D. Drowsiness E. Tachycardia F. Dry mouth
B c d f
The nurse is assessing a pt who has been taking quinidine who asks about adverse effects. Which of these are potential adverse effects of quinidine? Sata A. Muscle pain B. Tinnitus C. Dyspnea D. Diarrhea E. Anorexia
B d e
THe nurse is adminitering cholestyra bile acid sequestrant. Which nursing interventions are appropriate? Sata A. Administering the drug on an empty stomach B. Administering the drug with meals C. Instructing the pt to follow a low fiber diet while taking this drug D. Instructing the pt to take a fiber supplement while taking this drug E. Increasing fluid intake F. Not administering this drug at the same time as other drugs
B d e f
A pt has a new prescription for an ACE inhibiutor. During a review of the pt list of current meds, which would cause concern for a possible interaction with this new prescription? (Sata) A. A benzodiazepine taken as needed for allergies B. A potassium supplement taken daily C. An oral anticoagulant taken daily D. An opiod used for occasional severe pain E. An NSAID taken as needed for headaches
B e
WHen the nurse is teaching a pt about taking an antidysrhythmic drug, which statements by the nurse are correct? Sata A. Take the meds with an antacid if stomach upset occurs B. Do not chew sustained- release capsules C. If a weight gain of 5 pounds occurs within 1 week notify your physician at the next office visit D. If you experience severe adverse effects, stop the drug and notify your physician E. If stomach upset occurs you may take the medication with food
B e
A nurse with adequate knowledge about the administration of intravenous nitroglycerin will recognize that which statement is correct? a) The intravenous form is given by IV push injection. b) Because the intravenous forms are short-lived, the dosing must be every 2 hours. c) Intravenous nitroglycerin must be protected from exposure to light through use of special tubing. d) Intravenous nitroglycerin can be given via gravity drip infusions.
C
A patient calls the family practice office to report that he has seen his pills in his stools when he has a bowel movement. How will the nurse respond? A. The pills are not being digested properly. You need to take them on an empty stomach B. The pills are not being digested properly. You need to take them with food C. What you are seeing is the wax matrix that contained the medication but the drug has been absorbed D. This indicates that you are not tolerating this medication and will need to switch to a different form
C
A patient is receiving dabigatran (Pradaxa) 150 mg twice daily as part of treatment for atrial defibrillation. Which condition would be a concern if the pt were to recieve this dose? A. Asthma B. Elevated liver enzymes C. Renal impairment D. History of myocardial infarction
C
A pt has a new prescription from transdermal nitroglycerin patches. The nurse teaches the pt that these patches are most appropriately used for which of the following? A. to relieve exertional angina B. to prevent palpatations C. to prevent the occurrence of angina D. to reduce the severity of anginal episodes
C
A pt is being assessed before a newly ordered antilipemic med is started. Which condition would be a possible contraindication? A. Diabetes insipidus B. Pulmonary fibrsis C. Liver cirrhosis D. Myocardial infarction
C
A pt is in the clinic for a follow up. He has been taking amiodarone (Cordarone) for almost 1 year, and today he tells the nurse, "I am noticing some blue color around my face, neck, and upper arms. Is that normal?" Which is the nurse's correct response? A. This is an expected side effect and should go away soon B. This is a harmless effect. As long as medication is working, we will just monitor your skin. C. This can happen with amiodarone. I will let your doctor know about it right away D. How much sun exposure have you had recently?
C
During assessment of a pt who is recieving digoxin, the nurse monitors for findings that would indicate an increased possibility of toxicity such as? A. Apical pulse rate of 62 beats/min B. Digoxin level of 1.5 ng/mL C. Serum potassium level of 2.0 D. Serum calcium level or 9.9
C
In assessing a pt who has been taking amiodarone for 6 mths the nurse monitors for which potential adverse effect? A. Hyperglycemia B. Dysphagia C. Photophobia D. Urticaria
C
The nurse knows tha an antitussive cough medication would be the best choice for which pt? A. A pt with a productive cough B. A pt with chronic paranasal sinusitis C. A pt who had a recent abdominal surgery D. A pt who has influenza
C
WHich point will the nurse emphasize to a pt who is taking an antilimpic med in the statin class? A. The drug must be taken on an empty stomach before meals B. A low fat diet is not necesary whole taking these meds C. It is important to report mucle pain immediately D. Imrpoved cholesterol levels will be evident in 2 weeks
C
When giving decongestants, the nurse must remember that these drugs have alpha-adrenergic-stimulating effects that may result in which effect? a. Fever b. Bradycardia c. Hypertension d. CNS depression
C
A patient with heart failure will be starting the beta blocker metoprolol (Lopressor). The nurse will monitor for which expected cardiovascular effects? Sata A. Increased heart rate B. Increased myocardial contratility C. Delayed AV node conduction D. Reduced heart rate E. Decreased myocardial automatitcity
C d e
A pt is taking a decongestant to help reduce symptoms of a cold. The nurse will instruct the pt to observe for which possible symptom, which may indicate an adverse effect of this drug? A. increased cough B. dry mouth C. slower heart rate D. heart palpitations
D
A pt with angina has been given a prescription for a calcium channel blocker. The nurse knows that this class of drugs is used to treat which type of angina? A. Effort B. Unstable C. Crecendo D. Vasospastic
D
The nurse is administering lidocaine and considers which condition is a caution for the use of this drug? A. Tachycardia B. Hypertension C. Ventricular dysrhythmias D. Renal dysfunction
D
The nurse is assessing a pt who is recieving a milrinone infusion and checks the pts cardiac rhythm on the heart monitor. What adverse cardiac effect is most likely to occur? A. Tachycardia B. Bradycardia C. Atrial fibrillation D. Ventricular dysrhythmia
D
The nurse is assessing a pt who will be starting antihypertensive therapy with an ACE inhibitor. Which condition if present would be a reason for cautious use? A. Asthma B. Rheumatoid arthritis C. Hyperthyroidism D. Renal insufficiency
D
The nurse is monitoring a pt who is recieving antithrombolytic therapy in the ER because of a possible MI. Which adverse effect would be at the greatest concern at this time? A. Dizziness B. Bp of 130/98 C. Slight bloody oozing from the IV insertion site D. Irregular heart rhythm
D
What is the antidote for Heparin toxicity? Why would the antidote not be given immediately to the client?
IV protamine sulfate; due to the drugs short 1/2 life the reversal of the toxic effects may occur simply by stopping the heparin, but in severe cases or large doses the antidote will need to be given
The nurse is assisting a nursing student who is about to administer eardrops. Which technique by the nursing student indicates a need for further instruction? (select all that apply) a warm the solution to 100F (37.7C) before using b position the client so that the affected ear is accessible c massage the tragus before administering the eardrops d gently insert a cotton ball into the outer ear canal after the drops are given e have the client lie in the same position for 5 minutes after the drops are given
a c
When the nurse is providing teaching about eye medications for glaucoma, the nurse tells the client that miotics help glaucoma by which mechanism of action? (select all that apply) a decreasing intraocular pressure b decreasing intracranial pressure c enhancing aqueous humor drainage d increasing tear production e causing pupillary dilation
a c
The nurse is assessing the client who is on Heparin therapy via intravenous route. Which of the following clinical manifestations would be a toxic effect of Heparin therapy? (select all that apply) hematuria melena petechiae stuffy nose flatulence ecchymoses
all but stuffy nose and flatulence
What is one of the most important standards to follow during instillation of drops or ointment in the eye?
avoid touching the eye with the tip of the dropper or container to prevention contamination of the product
The client diagnosed with coronary artery disease is prescribed atorvastatin (Lipitor), an HMG-CoA reductase inhibitor. Which statement by the client would warrant the nurse notifying the health-care provider? a "I really haven't changed my diet, but I am taking my medication every day." b "I am feeling pretty good, expect I am having muscle pain all over my body." c "I am swimming at the local pool about three times a week for 30 minutes." d "I am taking this medication first think int he morning with a bowl of oatmeal."
b
The nurse is preparing to administer warfarin (Coumadin), an anticoagulant. The client's current laboratory values are as follows: PT 38, PTT 39, INR 5.9 Which action should the nurse implement? a discontinue the intravenous bag immediately b prepare to administer AquaMEPHYTON (vitamin K) c notify the healthcare provider to increase the dose d administer the medication as ordered
b
The nurse is discharging the female client diagnosed with deep vein thrombosis (DVT) who is prescribed the anticoagulant warfarin (Coumadin). Which statement indicates the client needs more teaching concerning this medication? a I should wear a MedicAlert bracelet in case of an emergency" b "If I get cut, I will apply pressure for at least 5 mintues" c "I will increase the amount of green, leafy vegetables I eat" d "I will have to see my HCP regularly while taking this medication"
c
Otitis media is the second most common infection in [.].
children
The client with coronary artery disease is prescribed nicotinic acid (Niacin). The client complains of flushing of the face, neck, and ears. Which priority action should the nurse implement? a instruct the client to stop taking the medication immediately b encourage the client to take the medication wit meals only c discuss tat this is a normal side effect and will decrease with time d tell the client to take 325mg of aspirin 30 minutes before taking medication
d
The elderly client diagnosed with coronary artery disease has been taking aspirin daily for more than a year. Which data would warrant notifying the health care provider? a the client has lost 5 pounds in the last month b the client has trouble hearing low tones c the client reports having a funny taste in the mouth d the client has hard, dark, tarry stools
d
The nurse is preparing to administer eardrops and fins that the bottle has been stored in the medication room refrigerator. Which his the nurse's best action at this time? a remove the bottle from the refrigerator, and administer the drops b heat the bottle for 5 seconds int eh microwave oven before administering the drops c let the bottle sit in a cup of hot water for 15 minutes before administering the drops d remove the bottle from the refrigerator one hour before the drops are due to be given
d
A significant adverse effect of antidysrhythmics is [.]
dysrhythmias
[.] is a disorder of the eye caused by inhibition of the normal flow and drainage of aqueous humor, and treatment helps reduce intraocular pressure either by increasing the drainage of aqueous humor or by decreasing its production.
glaucoma
Caffeine may affect my heart rate or contribute to the development of more serious dysrhythmias if I drink it with my antidysrhythmic medications. t or f
t
