Prep U Exam
A client calls the clinic and talks to the nurse. The client tells the nurse the client has been taking colesevelam (Welchol) for six months and that the client is having small amounts of bright red rectal bleeding and is concerned. What would an appropriate response from the nurse be?
"The bleeding may be coming from hemorrhoids. We should check this out."
A client recovering from joint replacement surgery is prescribed subcutaneous heparin injections. Which response will the nurse make when the client asks if the medication can be taken orally?
"The gastrointestinal tract does not absorb the drug, so it cannot be given by mouth."
Which agent would the nurse expect to administer for a client with Prinzmetal angina?
Amlodipine
A 55-year-old client has been diagnosed with coronary artery disease and begun antiplatelet therapy. The client has asked the nurse why a "blood thinner like warfarin" hasn't been prescribed. What is the most likely rationale for the clinician's use of an antiplatelet agent rather than an anticoagulant?
Antiplatelet agents are more effective against arterial thrombosis; anticoagulants are more effective against venous thrombosis.
A patient receives propranolol orally at 9:00 AM. The nurse would expect the drug to begin its action at which time?
Between 9:20 to 9:30 AM
Which statement would be true about the mechanism of action of class II antiarrhythmic agents?
Block the stimulation of the adrenergic receptors
When describing the action of class II antiarrhythmics, which would the nurse include?
Blockage of beta receptors in the heart and kidneys
After teaching a group of students about angina, the instructor determines that the teaching was successful when the students describe stable angina as:
Chest pain that is relieved by rest
Quinidine is prescribed to a patient with cardiac arrhythmia. When documenting the patient's drug history, the nurse inquires about the concomitant use of any other drug. Which drug when given concomitantly may cause an increase in serum Quinidine levels?
Cimetidine
A male client does not respond to traditional treatment for his chronic angina. The health care provider orders ranolazine (Ranexa) and orders a baseline ECG prior to medication administration. Three months later, the health care provider orders a repeat ECG. For what reason is the provider monitoring the client?
Dose-dependent QT prolongation
The nurse is preparing to administer adenosine to a client. What is the rationale for administering adenosine as a bolus?
It has an exceptionally short half-life.
A client has been largely unsuccessful in achieving adequate control of dyslipidemia through lifestyle changes and the use of a statin. As a result, the client has been prescribed cholestyramine. What change in this client's lipid profile will the nurse identify as the most likely goal of therapy?
Reduction in LDL cholesterol levels
Which would the nurse identify as the end of the intrinsic pathway?
Thrombin formation
A patient with metabolic syndrome usually has increased plasminogen activator levels.
true
An older adult client's most recent physical assessment and diagnostic workup reveal the presence of dyslipidemia. The client is a candidate for monotherapy with a statin, and she will soon begin treatment with atorvastatin. The nurse should anticipate what prescription from the health care provider?
"Atorvastatin 10 mg PO daily"
The nurse provides client teaching for a client diagnosed with angina about the prescribed nitroglycerin transdermal patch. Which client statement establishes the need for further teaching?
"I will apply the patch for 24 hours and then remove it, and place another transdermal patch."
A 39-year-old nulliparous woman has been taking atorvastatin for 2 years and has now decided that she would like to become pregnant. What health education should the nurse provide to this client?
"It's important that you stop taking atorvastatin before you stop using contraception."
Which client statement demonstrates an accurate understanding of the action of a prescribed anticoagulant?
"This medication will keep unnecessary clots from forming in my blood."
The client wants information about triglycerides and cholesterol. Which response by the nurse would be correct?
"Triglycerides and cholesterol are fatlike substances found in your blood."
When administering tirofiban, the nurse would administer the drug intravenously over which time frame?
30 minutes
A client is started on enoxaparin immediately after hip surgery. The nurse would explain to the client that this drug will be continued for how long?
7 to 10 days
A 75-year-old client is being treated for type 2 diabetes, hypertension, gout, angina, coronary artery disease, and peptic ulcer disease. The nurse is concerned because the client is taking a traditional antianginal drug in combination with seven other medications. The nurse understands that what could be the consequence?
A greater incidence of adverse drug effects
When describing the action of atorvastatin, which would the nurse include?
Blocking the enzyme that is involved in cholesterol synthesis
A nurse is caring for a patient who is receiving lovastatin. Which assessment by the nurse would indicate that there is possible damage to the patient's skeletal muscle as a result of the drug therapy?
Brownish colored urine
A 60-year-old client experienced a sudden onset of chest pain and shortness of breath and was subsequently diagnosed with a pulmonary embolism in the emergency department. The client has been started on an intravenous heparin infusion. How does this drug achieve therapeutic effect?
By inactivating clotting factors and thus stopping the coagulation cascade
Ms. Quinn is admitted to the surgical intensive care unit after open heart surgery. The health care provider prescribes IV nitroglycerin, according to a hospital protocol for titration of the drug. Which factor would be most important when determining increases or decreases in the dose?
Current blood pressure
A client is diagnosed with atherosclerosis. What would the nurse say is the most likely cause of his angina?
Decreased oxygenation to the myocardium
When describing the action of ranolazine, which would be most appropriate?
Decreases myocardial workload
The nurse is providing education to a client who has been prescribed bisoprolol. During teaching, the nurse explains that the drug achieves a therapeutic effect in what way?
Decreasing heart rate
A client with a history of clot formation is scheduled for bowel resection due to colorectal cancer. What anticoagulant agent will be administered prophylactically?
Heparin
A client is administered diltiazem IV, followed by propranolol IV. The nurse should assess for what potential side effect of this medication combination?
Impaired myocardial contractility
When prescribed for angina, how does oral nifedipine achieve a therapeutic effect?
Inhibiting the influx of calcium through slow channels.
The nurse is caring for a client whose chest pain has not been relieved with sublingual organic nitrate. What medication does the nurse suspect will most likely be prescribed by the health care provider?
Intravenous nitroglycerine
The nurse is caring for a client who has been prescribed quinidine. The nurse should advocate for a lower-than-normal dose if the client has a history of what medical diagnosis?
Liver disease
A nurse at a long-term care facility is conducting a medication reconciliation for a client who has just moved into the facility. The client is currently taking clopidogrel. The nurse is most justified suspecting that this client has a history of what condition?
Myocardial infarction
A client is prescribed disopyramide. The nurse would expect to administer this drug by which route?
Oral
A client is started on antiarrhythmic therapy to treat atrial fibrillation. The nurse caring for this client knows which occurrence is a potential side effect of this medication?
Other arrhythmias
A client is receiving heparin. Which would the nurse use to monitor the effects of the drug?
Partial thromboplastin time
A patient with cardiac arrhythmia is prescribed verapamil. Which of the following possible adverse effects should the nurse inform the patient about?
Peripheral edema
Which of the following drugs should be avoided by a client taking nitrates?
Phosphodiesterase 5 inhibitors
The health care provider discovers a clot in the client's left lower leg. Anticoagulant drugs are prescribed to prevent formation of new clots and to achieve which other effect?
Prevent extension of clots already present
A patient on anti-arrhythmic drug therapy reports nausea, vomiting, abdominal pain, diarrhea, and a ringing sensation in the ears. Which drug should the nurse consider as the cause for these adverse effects?
Quinidine
Which statement correctly distinguishes between the therapeutic effects of sublingual isosorbide and sublingual nitroglycerin?
Sublingual isosorbide has a slower onset and a longer duration of action than sublingual nitroglycerin.
A client diagnosed with a dysrhythmia has not responded appreciably to treatment with oral propranolol. When the medication is discontinued, what instruction should the nurse provide the client to maximize safety?
Taper down the propranolol dose over a period of 2 weeks.
Frequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient's age will have what effect on her use of nitroglycerin?
The woman will be more susceptible to hypotension than a younger patient.
A nurse is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a client who has just been admitted. What is the most likely goal of this intervention?
To convert the client's atrial fibrillation to normal sinus rhythm
When describing the clotting process, which step would the nurse identify as the first reaction to occur with injury to a blood vessel?
Vasoconstriction
A 68-year-old client is treated with lidocaine for frequent premature ventricular contractions after a myocardial infarction. The nurse needs to assess this client frequently for adverse reactions that are dose related. What is the most common mild adverse effect of lidocaine therapy?
apprehension
A client receiving warfarin is prescribed disopyramide. The nurse would monitor for signs and symptoms of what as most important?
bleeding
A client has had cholestyramine added to his or her treatment plan for dyslipidemia. What effect will cholestyramine have on the pharmacokinetics of the thiazide diuretic that the client is currently prescribed?
decreased absorption
A nurse is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for a(n):
increase in plasma concentration of lovastatin.
An elderly client with dyslipidemia has had fenofibrate added to the existing medication regimen. In addition to having the lipid profile drawn on a regular basis, the nurse should educate the client about the need for what ongoing laboratory testing during therapy?
liver panel
The nurse's subsequent cardiac assessments and monitoring of a client prescribed disopyramide should be planned in the knowledge that this drug increases the client's risk for developing what health problem?
new arrhythmias
A 92-year-old male client is being sent home on disopyramide for a ventricular arrhythmia. The client asks why he must continue to take this drug. The nurse's best response would be that a ventricular arrhythmia may:
result in death
The nurse is providing education to an older adult client who has been prescribed atorvastatin. How should the nurse describe the common adverse effects of the drug?
"The most common side effects of atorvastatin include some mild gastrointestinal upset."
To effectively prevent or manage metabolic syndrome, what should the desired blood lipid profile include? (Select all that apply.)
-Low triglycerides -High HDL cholesterol -Low LDL cholesterol
What should the nurse review about an antihyperlipidemic medication with the client when completing discharge counseling? (Select all that apply.)
-Reason for taking the prescribed drug -Drug name -Correct dose -Frequency of administration -Dosage form
The nurse knows that what are the goals of antianginal drug therapy? (Select all that apply.)
-To relieve acute anginal pain -To improve exercise tolerance and quality of life -To prevent MI and sudden cardiac death
During ongoing assessment of a client receiving an antihyperlipidemic drug, what should the nurse collect? (Select all that apply.)
-Vital signs -Assessment of bowel function
The health care provider has prescribed quinidine. The nurse knows this drug is used for what physiologic effects on the heart? (Select all that apply.)
-reduces automaticity -prolongs the refractory period
A client is experiencing chest pain and self-administers nitroglycerine sublingually. When should the client expect to notice relief of the chest pain?
1 to 3 minutes
A client who had a total cholesterol-to-HDL cholesterol ratio of 5.3 has been losing weight and participating in an exercise program. His total cholesterol-to-HDL ratio is now 3.9. What LDL reading is also important to further decrease his risk of coronary artery disease?
95 mg/dL
A current client, an overweight 61-year-old with a history of diabetes mellitus, is status post-MI 1 month and has returned for a cardiology follow-up. Along with dietary changes, the nurse will discuss which nonpharmacologic lifestyle modification to reduce microvascular changes?
Glucose control
A patient receives lidocaine IV. The nurse would expect the drug to exert its effects for how long?
10 to 20 minutes
Blood lipids are a category of fatty acids, which are substances used within the body to perform essential functions. Which category of blood lipids is involved in the formation of atherosclerotic plaques?
Cholesterol
The nurse would anticipate administering fondaparinux to a client with which condition?
DVT prophylaxis