Test 4 MC Questions 43-51

A patient with angina pectoris is prescribed sublingual nitroglycerin. Which statement made by the patient indicates understanding of the medication teaching? "I may experience a headache as a side effect." "The chest pain should be relieved within 20 minutes." "I should swallow the tablet and drink a glass of water." "I should take this medication in the morning before breakfast."

"I may experience a headache as a side effect."

The nurse instructs a patient about taking nifedipine [Procardia XL]. Which statement made by the patient indicates an understanding of medication teaching? "I'll 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 the nurse expect to have the highest risk for postural hypotension? A patient who is prescribed a drug that acts primarily on the arterioles A patient who is prescribed a drug that blocks the renin-angiotensin-aldosterone system A patient who is prescribed a drug that triggers the baroreceptor reflex A patient who is prescribed a drug that promotes venous vasodilation

A patient who is prescribed a drug that promotes venous vasodilation

The nurse is preparing discharge instructions for a client who was prescribed enalapril for treatment of hypertension. Which instruction is appropriate for the nurse to include in the client's teaching? A. Do not change to a standing position suddenly B. Lightheadedness is a common adverse effect that need not be reported C. The medication may cause a sore throat for the first few days D. Schedule blood tests weekly for the first two months

A. Do not change to a standing position suddenly

A patient with stage 2 hypertension has been prescribed a thiazide diuretic and an angiotensin-converting enzyme inhibitor. It is most appropriate for the nurse to do what? Contact the healthcare provider. Administer both drugs to the patient. Administer the thiazide diuretic at bedtime. Hold the medications if the blood pressure is normal.

Administer both drugs to the patient.

The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure. Which compound in this system is most powerful at raising the blood pressure? A. Angiotensin I B. Angiotensin II C. Angiotensin III D. Renin

Angiotensin II

A patient has hypertension, type 2 diabetes, and chronic kidney disease. Which blood pressure goal would be most beneficial for this patient? Blood pressure less than 140/90 mm Hg Diastolic blood pressure less than 100 mm Hg Blood pressure less than 130/80 mm Hg Systolic blood pressure less than 160 mm Hg

Blood pressure less than 130/80 mm Hg

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

C. Avoid potassium salt substitutes. D. A persistent dry cough may occur. E. Report difficulty in breathing immediately.

A patient diagnosed with heart failure has stage 1 hypertension. Which medication, if ordered by the healthcare provider, should the nurse question? Angiotensin-converting enzyme inhibitor Calcium channel blocker Thiazide diuretic Beta blocker

Calcium channel blocker

Cholestyramine has been prescribed for a patient. Which instruction should the nurse include in patient teaching? Cholestyramine can impair absorption of fat-soluble vitamins. Stop taking the drug if you develop constipation. Take cholestyramine with other drugs you are prescribed to enhance absorption. Do not take the medication if the formula is cloudy after mixing with water.

Cholestyramine can impair absorption of fat-soluble vitamins.

A patient is prescribed verapamil [Calan]. 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

A patient is prescribed lisinopril [Prinivil] 40 mg by mouth once a day for hypertension. For which therapeutic effect will the nurse monitor? A. Slowing of the heart rate B. Decrease in blood pressure C. Symptoms such as dizziness and fainting D. Pulse oximetry oxygen saturation of 100%

Decrease in blood pressure

A patient's cardiac output is 8 L/min. Which hemodynamic effect would the nurse expect? Decreased contractility Increased stroke volume Decreased preload Increased arterial pressure

Increased stroke volume

A patient who is hospitalized for an infection takes eplerenone [Inspra] for heart failure. Which medication, if ordered by the physician, should the nurse question?

Itraconazole [Sporanox]

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? A. Monitor blood pressure. B. Check the heart rate. C. Auscultate lung sounds. D. Draw a potassium level.

Monitor blood pressure.

A patient diagnosed with systemic lupus erythematosus (SLE) develops a dysrhythmia. Which medication, if ordered by the physician, should the nurse question? Lidocaine [Xylocaine] Procainamide [Procanbid] Disopyramide [Norpace] Amiodarone [Cordarone]

Procainamide [Procanbid]

A nurse administers quinidine sulfate to a patient with atrial fibrillation. The nurse should assess the electrocardiogram (ECG) tracing knowing that quinidine sulfate has what effect on the ECG? Prolongation of the QT interval Prolongation of the PR interval Narrowing of the QRS complex Tall, peaked T waves

Prolongation of the QT interval

A patient who is receiving intravenous nitroprusside (Nitropress) is disoriented and unable to recognize family members. The nurse should take which action first?

Stop the infusion

The nurse will teach a patient who is prescribed niacin [Niacor] to prevent flushing of the face by doing what? Drinking a full glass of water after taking the medication Taking 325 mg of aspirin 30 minutes before each dose Ingesting a meal before taking the medication Increasing dietary fiber before and after each dose

Taking 325 mg of aspirin 30 minutes before each dose

A patient is to receive a scheduled dose of diltiazem [Cardizem]. The nurse should hold the medication and contact the prescriber if which of the following is noted? 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.

A patient with stable exertional angina has been receiving a beta blocker. Before giving the drug, the nurse notes a resting heart rate of 55. Which is an appropriate nursing action? a. administer the drug as ordered, because this is a desired effect. b. hold the dose and notify the provider of the heart rate. c. request an order for a lower dose of the medication d. request an order to change to another antianginal medication.

administer the drug as ordered, because this is a desired effect.

A patient has begun using transdermal nitro for angina reports occasional periods of tachycardia. The nurse will expect the prescriber to order: a. digoxin to slow the heart rate b. immediate discontinuation of the nitroglycerin. c. periods of rest when the heart rate increases d. verapamil as an adjunct to nitroglycerin therapy.

verapamil as an adjunct to nitroglycerin therapy.

A nurse instructs a patient about signs and symptoms of digoxin toxicity. The nurse determines that teaching is successful if the patient makes which statement? "If my heart is racing, the dose may be too high." "I should report any muscle weakness or nausea." "My doctor should be notified if diarrhea occurs." "The dose will be reduced if I develop memory loss."

"I should report any muscle weakness or nausea."

The nurse teaches a patient about benazepril [Lotensin]. Which statement by the patient requires an intervention by the nurse?

"I use NoSalt instead of salt to season foods."

The nurse is evaluating the teaching done with a patient who has a new prescription for fosinopril [Monopril]. Which statement by the patient indicates a need for further teaching? A. "I can take this medicine with breakfast each morning." B. "I will call if I notice a rash or wheals on my skin." C. "I will use a salt substitute to lower my sodium intake." D. "I will call if I develop a bothersome cough."

"I will use a salt substitute to lower my sodium intake."

The nurse teaches a patient diagnosed with chronic stable angina about the mechanism of action of nitroglycerin. The nurse should include which instruction? "Nitroglycerin reduces vasospasms of the heart's arteries, which improves blood supply." "Nitroglycerin opens the arteries to allow more oxygen to be delivered to the heart muscle." "Nitroglycerin dilates veins, which decreases the amount of oxygen needed by the heart." "Nitroglycerin improves blood flow to the heart muscle by increasing blood pressure."

"Nitroglycerin dilates veins, which decreases the amount of oxygen needed by the heart."

A patient is prescribed a nitroglycerin transdermal patch. The nurse should include which statement when teaching the patient how to use this medication? "Apply the patch to the chest over the heart." "Change the patch each week." "Remove the patch at bedtime." "Put on the patch before exercising."

"Remove the patch at bedtime."

A patient is prescribed sustained-release oral nitroglycerin capsules for chronic stable angina. The nurse should include which instruction? "Avoid exercising to help prevent chest pain." "Place the capsule under the tongue if chest pain occurs." "Take the capsule as needed before exercise or exertion." "Sit or lie down if dizziness or lightheadedness occurs."

"Sit or lie down if dizziness or lightheadedness occurs."

A nurse is discussing the difference between stable and variant angina with a group of nursing students. Which statement by a student indicates the need for further teaching? A. "Beta blockers are effective in stable angina but not in variant angina" B. "in both types of angina, prophylactic treatment is possible" C. "Variant angina is primarily treated with vasodilators to increase oxygen supply." D. "Variant angina is the result of increased oxygen demand by the heart."

"Variant angina is the result of increased oxygen demand by the heart."

A nurse provides teaching to a patient with angina who also has T2D, asthma, and hypertension. Which statement by the patient indicates a need for further teaching? a. "an ACE inhibitor, in addition to nitroglycerin, will lower my risk of cardiovascular death." b. "beta blockers can help me control hypertension" c. "i should begin regular aerobic exercise." d. "Long-acting, slow release CCBs can help with anginal pain."

"beta blockers can help me control hypertension"

A patient with variant angina wants to know why a beta blocker cannot be used to treat the angina. Which response by the nurse is correct? a. "a beta1-selective beta blocker could be used for variant angina" b. "beta blockers do not help relax coronary artery spasm." c. "Beta blockers do not help to improve the cardiac oxygen supply." d. "beta blockers promote constriction of arterial smooth muscle."

"beta blockers do not help relax coronary artery spasm."

A nursing student is helping to care for a patient who takes verapamil for stable angina. The nurse asks the student to explain the purpose of verapamil in the treatment of this patient. Which statement by the student indicates a need for further teaching? a. "it relaxes coronary artery spasms." b. "it reduces peripheral resistance to reduce oxygen demands." c. "it reduces the heart rate, AV conduction, and contractility." d. "it relaxes the peripheral arterioles to reduce afterload."

"it relaxes coronary artery spasms."

Which patient is the most appropriate candidate for both lifestyle changes and drug therapy with an antihypertensive medication? A 47-year-old patient with blood pressure of 110/78 mm Hg and with type 2 diabetes mellitus A 76-year-old patient with blood pressure of 128/88 mm Hg and a history of dyslipidemia A 52-year-old patient with blood pressure of 136/89 mm Hg who smokes 1 pack of cigarettes per day A 32-year-old patient with blood pressure of 142/94 mm Hg who is sedentary

A 32-year-old patient with blood pressure of 142/94 mm Hg who is sedentary

Which patient would most likely be prescribed sodium nitroprusside [Nitropress]? 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

A patient with asthma and depression develops stable angina. In addition to organic nitrites, which other medications will be used to treat this condition? (Select all that apply) a. ACE inhibitors. b. Antiplatelet drugs c. Beta blockers d. CCBs e. Cholesterol-lowering agents.

ACE inhibitors. Antiplatelet drugs CCBs Cholesterol-lowering agents.

A patient has a serum potassium level of 3.1 mEq/L. It is appropriate for the nurse to take which action? A. Administer the ordered sustained-release potassium tablets [K-Dur]. B. Immediately stop the infusion of the maintenance IV, which has 30 mEq of potassium in it. C. Prepare to administer the ordered intravenous dose of furosemide [Lasix]. D. Administer the prescribed dose of sodium polystyrene sulfonate [Kayexalate].

Administer the ordered sustained-release potassium tablets [K-Dur].

A patient who is taking spironolactone [Aldactone] is prescribed losartan [Cozaar]. The nurse should take which action?

Assess for symptoms of hyperkalemia

A client is admitted to the hospital and benazepril is prescribed for hypertension. Which is an appropriate nursing action for clients taking this medication? A. Monitor the electroencephalogram (EEG) B. Assess for dizziness C. Administer the drug after meals D. Assess for dark, tarry stools

B. Assess for dizziness

A patient is admitted to the hospital with a diagnosis of hypertension. The nurse understands that which medication works by preventing angiotensin II from binding with its receptor sites? A. Quinapril [Accupril] B. Aliskiren [Tekturna] C. Eplerenone [Inspra] D. Candesartan [Atacand]

Candesartan [Atacand]

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

Crackles in the lungs are no longer heard

A patient with severe hypertension is prescribed minoxidil. Which medications will the nurse expect to be administered to reduce adverse responses to minoxidil? Adenosine [Adenocard] and ticlopidine [Ticlid] Furosemide [Lasix] and propranolol [Inderal] Digoxin [Lanoxin] and captopril [Capoten] Donepezil [Aricept] and clonidine [Catapres]

Furosemide [Lasix] and propranolol [Inderal]

The nurse is preparing to administer adenosine [Adenocard] to a patient to treat paroxysmal supraventricular tachycardia (SVT). Which action by the nurse is most appropriate? Inject the medication into the peripheral intravenous (IV) line. Infuse the dose by diluting the drug in 100 mL of saline. Administer a small test dose to determine hypersensitivity. Give the medication through the central line catheter.

Give the medication through the central line catheter.

The nurse administers an intravenous infusion of amiodarone [Coredarone] to a patient to prevent recurrent episodes of ventricular fibrillation. It is most important for the nurse to assess the patient for which condition? Urinary retention Hypercalcemia Hypotension Metallic taste

Hypotension

A patient with new-onset exertional angina has taken three nitro sublingual tabs at 5-minute intervals, but the pain has intensified. The nurse notes that the patient has a heart rate of 76 and a BP of 120/82. The ECG is normal. The patient's lips and nail beds are pink, and there is no respiratory distress. The nurse will anticipate providing: A. an ACE inhibitor B. IV nitro with a beta-blocker C. Ranolazine and quinidine D. supplemental O2 and IV morphine

IV nitro with a beta-blocker

The nurse cares for a patient receiving digoxin [Lanoxin]. What indicates to the nurse that treatment with this medication is effective? Improved cardiac output Reduced exercise tolerance Increased body weight Decreased cardiac contractility

Improved cardiac output

The nurse is caring for a patient with bipolar disorder treated with lithium [Eskalith]. The patient has a new prescription for captopril [Capoten] for hypertension. The combination of these two drugs makes which assessment particularly important? A. Potassium level B. Lithium level C. Creatinine level D. Blood pressure

Lithium level

The healthcare provider prescribes sustained-release verapamil [Calan SR] to an 82-year-old patient who takes digoxin [Lanoxin] daily. Which action is most appropriate for the nurse to take? 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.

A patient is prescribed a medication that causes venous dilation. It is most important for the nurse to teach the patient about what? B-natriuretic peptide Postural hypotension Increased urination Intermittent claudication

Postural hypotension

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

Prevention of reflex tachycardia

A patient is prescribed a medication that lowers the arterial blood pressure. The nurse should assess for which response by the body to restore the blood pressure? Orthostatic hypotension Fluid retention Reflex tachycardia Increased natriuresis

Reflex tachycardia

A patient with a serum magnesium level of 0.5 mEq/L receives an intravenous infusion of 10% magnesium at 1.5 mL/min. The nurse should assess the patient for which adverse effects? A. Skeletal muscle paralysis, bloating, and ileus B. Respiratory paralysis, hypotension, and lethargy C. Muscle twitching, disorientation, and seizures D. Peaked T wave, tingling of the lips, and anxiety

Respiratory paralysis, hypotension, and lethargy

The nurse is caring for a patient with renal artery stenosis who has been prescribed benazepril [Lotensin]. Which laboratory result indicates an adverse effect of this drug? A. Potassium level of 3.2 mEq/L B. Blood glucose level of 180 mg/dL C. Serum creatinine level of 2.3 mg/dL D. Uric acid level of 10 mg/dL

Serum creatinine level of 2.3 mg/dL

A patient is prescribed digoxin [Lanoxin] and furosemide [Lasix]. It is most important for the nurse to assess which value before administering these medications? Serum sodium Blood urea nitrogen Serum potassium Plasma B-natriuretic peptide

Serum potassium

A patient has a serum potassium level of 6.4 mEq/L and an arterial pH of 7.22. Which medication, if ordered by the physician, should the nurse question? A. Sodium bicarbonate infusion B. Glucose and insulin infusion C. Spironolactone D. [Aldactone] by mouthCalcium gluconate infusion

Spironolactone

The nurse cares for a patient with a digoxin level of 1.9 ng/mL. Which action would be most appropriate for the nurse to take initially? Start continuous heart monitoring. Check the patient's serum creatinine. Administer digoxin as prescribed. Give Fab antibody fragments [Digibind].

Start continuous heart monitoring.

A patient is prescribed lovastatin [Mevacor]. The nurse will teach the patient to take the medication at which time? With any meal With the evening meal 1 hour before breakfast 2 hours after a meal

With the evening meal

A nurse is providing teaching for a patient with stable angina who will begin taking nitroglycerin. Which statement by the pt indicates understanding of the teaching? a. "I should not participate in aerobic exercise while taking this drug." b. "i should take aspirin daily to reduce my need for nitro." c. "if I take nitro before exertion, I can reduce the chance of an anginal attack." d. "I take nitro to increase the amount of oxygen to my heart."

c. "if I take nitro before exertion, I can reduce the chance of an anginal attack."

A patient with angina who uses sublingual nitro tells the nurse that the episodes are increasing in frequency and usually occur when the patient walks the dog. The patient reports needing almost daily doses of nitro and states the one tablet usually provides complete relief. What will the nurse do? a. contact the provider to suggest ordering a transdermal patch for this patient b. question the patient about consumption of grapefruit juice. c. suggest that the patient limit walking the dog to shorter distances less frequently. d. suggest that the patient take two tablets of nitro each time, because the symptoms are increasing in frequency.

contact the provider to suggest ordering a transdermal patch for this patient

A hospitalized patient complains of acute chest pain. The nurse administers a 0.3mg sublingual nitro tablet, but the patient continues to complain of pain. Vital signs remain stable. Whats the nurses next step? a. apply a nitro transdermal patch b. continue dosing at 10 minute intervals c. give a second dose of nitro in 5 minutes d. request an order for IV nitro.

give a second dose of nitro in 5 minutes

A patient is taking a CCB for stable angina. The patient's spouse asks how CCBs relieve pain. The nurse will explain that CCBs: a. help relax peripheral arterioles to reduce afterload b. improve coronary artery perfusion c. increase the heart rate to improve myocardial contractility d. increase the QT interval.

help relax peripheral arterioles to reduce afterload

A patient who takes nitro to treat stable angina reports having ED and states he plans to ask his primary provider for a prescription for tadalafil [cialis]. What will the nurse tell this patient? a. you may take these two drugs together safely as long as you take them as directed. b. you should not take tadalafil and nitro within 30 to 60 minutes of each other. c. you should discuss another anti-angina medication with your provider. d. you should avoid sexual activity since this increases oxygen demand on the heart.

you should discuss another anti-angina medication with your provider.

A patient who has renal impairment will begin taking ranolazine as an adjunct to nitro to treat angina. What will the nurse include when teaching this patient? a. you will need to monitor your BP closely while taking this drug b. you should take this drug 1 hour before or 2 hours after a meal. c. you may experince rapid heart rate while taking this medicaiton d. you do not need to worry about drug interactions with this medication.

you will need to monitor your BP closely while taking this drug