Units 4 & 5

5.A patient arrives in the emergency department with severe chest pain. She says she has had pain off and on for a week now. Which assessment finding would indicate the need for cautious use of nitrates and nitrites? A. Blood pressure of 98/68 mm Hg B. History of liver disease C. History of heart failure D. History of a myocardial infarction 2 years ago

A. Blood pressure of 98/68 mm Hg

4. Which of the following parameters determine the regulation of arterial blood pressure? A. Cardiac output and vascular resistance B. Heart rate and peripheral resistance C. Blood volume and renal blood flow D. Myocardial contractility and arteriolar constriction

A. Cardiac output and vascular resistance

1. When teaching a patient about antihypertensive drug therapy, which statement by the nurse is correct? Select all that apply. A. "You should try to have your blood pressure checked once a week and keep track of the readings." B. "If you notice that the symptoms have gone away, you should be able to stop taking the drug." C. "An exercise program may be helpful in treating hypertension, but let's check with your doctor first." D. "If you experience severe side effects, stop the medicine and let us know at your next office visit." E. "Most over-the-counter decongestants are compatible with antihypertensive drugs." f. "please continue the medication, even if you are feeling better"

"You should try to have your blood pressure checked once a week and keep track of the readings." C. "An exercise program may be helpful in treating hypertension, but let's check with your doctor first." D. "If you experience severe side effects, stop the medicine and let us know at your next office visit."f. "please continue the medication, even if you are feeling better"

A patient about to receive his morning dose of digoxin has an apical pulse of 70 beats per minute. What will the nurse do? A. Administer the dose. B. Administer the dose and notify the physician. C. Check the radial pulse for 1 full minute. D. Withhold the dose and notify the

A. Administer the dose.

7. A patient's medication order indicates that he is to receive a dose of cosyntropin. The nurse is aware that this drug is used for what problem? A. Adrenocortical insufficiency B. Diabetes insipidus C. Myasthenia gravis D. Pituitary dwarfism

A. Adrenocortical insufficiency; life threatening state requiring immediate medical management. Glucocorticoid deficiency, a drop in extracellular fluid volume, hyponatremia, and hyperkalemia. "Addisonian crisis"

7.When applying transdermal nitroglycerin patches, how will the nurse instruct the patient? A. "Use any nonhairy area on the body." B. "Use only the chest area for application sites." C. "Temporarily remove the patch if you go swimming." D. "Apply the patch to the same site consistently."

A. "Use any nonhairy area on the body.

8. A patient's blood pressure elevates to 210/150 mm Hg, and a hypertensive emergency is obvious. He is transferred to the intensive care unit and started on a sodium nitroprusside (Nipride) drip to be titrated per his response. With this medication, the nurse knows that the maximum dose of this drug should be infused for how long? A. 10 minutes B. 30 minutes C. 1 hour D. 24 hours

A. 10 minutes

4.A 74-year-old professional golfer has chest pain that occurs toward the end of his golfing games. He says the pain usually goes away after 1 or 2 sublingual nitroglycerin tablets and rest. What type of angina does he have? A. Classic B. Variant C. Unstable D. Prinzmetal's

A. Classic also called (Chronic stable angina); chest pain that has as its primary cause arteriosclerosis, which results in a long-term but relatively stable level of obstruction in one or more coronary arteries.

6. When teaching about hydrochlorothiazide, the nurse should be sure the patient knows to be cautious in taking which medications with hydrochlorothiazide? A. Digitalis B. Penicillin C. Potassium supplements D. Over-the-counter vitamins

A. Digitalis, corticosteriods, diazoxide, and oral hypoglycemics

In assessing a patient before administration of a cardiac glycoside, the nurse knows that what condition can predispose a patient to digitalis toxicity? A. Hypokalemia B. Hyperkalemia C. Hypocalcemia D. Hypernatremia

A. Hypokalemia; control ventricular response to atrial fibrillation and a derived from foxglove. Digoxin is the only available cardiac glycoside---positive inotropic---inhibits sodium potassium pump (adenosine tripphophatase) Sodium and calcium rise. Cholinergic stimulation via the vagus nerve of Parasympathetic nervous system. ---Negative chronotropic---Negative Dromotropic effect

5. When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse should discuss which potential problem? A. Impotence B. Bradycardia C. Increased libido D. Increased weight

A. Impotence

8. A patient is being discharged to home on a single daily dose of a diuretic. The health care provider instructs the patient to take the dose at which time so it will be least disruptive to the patient's daily routine? A. In the morning B. At noon C. With supper D. At bedtime

A. In the morning

5. An 8-year-old girl has been diagnosed with true pituitary dwarfism. She is being treated with somatropin. In follow-up visits, the nurse will monitor for which expected outcome? A. Increased growth B. Decreased urinary output C. Increased muscle strength D. Increased height when she reaches puberty

A. Increased growth

Mannitol (Osmitrol) has been ordered for a patient with acute renal failure. The nurse knows to administer this drug using which procedure? A. Intravenously, through a filter B. By rapid intravenous bolus C. By mouth in a single morning dose D. Through a gravity intravenous drip with standard tubing

A. Intravenously, through a filter; Osmotic diuretic; can crystalized in cold temperatures and IV only, and it is stored in a warmer in pharmacy. Pregnancy C drug

9. In assessing a patient before administration of a cardiac glycoside, the nurse knows that which lab result can increase the toxicity of the drug? A. Potassium level 2.8 mEq/L B. Potassium level 4.9 mEq/L C. Sodium level 140 mEq/L D. Calcium level 10 mg/dL

A. Potassium level 2.8 mEq/L (low potassium normal is 3.5 to 5.0)

2.The nurse is giving intravenous nitroglycerin to a patient who has just been admitted because of an acute myocardial infarction. Which statement is true regarding the administration of the intravenous form of this medication? A. Specific nonpolyvinylchloride (non-PVC) plastic intravenous bags and tubing must be used. B. It is stable for only 24 hours after preparation. C. It can be given in infusions with other medications. D. The solution will be slightly colored green or blue.

A. Specific nonpolyvinylchloride (non-PVC) plastic intravenous bags and tubing must be used.

Select all that apply: 1.A patient is experiencing chest pain while playing tennis. He has a bottle of sublingual nitroglycerin with him. Which of the actions are appropriate for the patient to take at this time? Select all that apply. A. Stop the activity and lie down or sit down. B. Call 911 immediately. C. Call 911 if the pain is not relieved after taking 1 sublingual tablet. D. Call 911 if the pain is not relieved after taking 3 sublingual tablets in 15 minutes. E. Place a tablet under the tongue. F. Place a tablet in the space between the gum and cheek. G. Take another sublingual tablet if chest pain is not relieved after 5 minutes, up to three, total.

A. Stop the activity and lie down or sit down C. Call 911 if the pain is not relieved after taking 1 sublingual tablet. E. Place a tablet under the tongue. F. Place a tablet in the space between the gum and cheek. G. Take another sublingual tablet if chest pain is not relieved after 5 minutes, up to three, total.

9. The nurse notes in the patient's medication history that the patient will be starting anticoagulant therapy. Based on this finding, the nurse recognizes that the primary goal of anticoagulant therapy is to A. prevent thrombus formation. B. dissolve an existing thrombus. C. stabilize an existing thrombus. D. prevent the thrombus from becoming an embolus.

A. prevent thrombus formation.

2. Which drug classes are considered first-line treatment for heart failure? Select all that apply. A. Angiotensin converting enzyme (ACE) inhibitors B. Angiotensin II receptor blockers (ARBs) C. Digoxin (cardiac glycoside) D. Beta-blockers E. Nesiritide (Natrecor), the B-type natriuretic peptide

ACE ARBS Beta-blockers loop diuretics

9. A patient who has recently started therapy on a statin drug asks the nurse how long it will take until he sees an effect on his serum cholesterol. Which of the following would be the nurse's best response? A. "Blood levels return to normal within a week of beginning therapy." B. "It takes several weeks to see a change in cholesterol levels." C. "It takes at least 6 months to see a change in cholesterol levels." D. "You will need to take this medication for almost a year to see significant results."

B. "It takes several weeks to see a change in cholesterol levels."

6. A patient with atrial fibrillation was started on digoxin, and 1 week later a digoxin level was drawn. Which result is within normal therapeutic levels for digoxin? A. 0.4 ng/mL B. 0.7 ng/mL C. 2.1 ng/mL D. 2.6 ng/mL or higher

B. 0.7 ng/mL (normal 0.5 to 2.0 ng/mL

The nurse is preparing to transfuse a patient with a unit of packed red blood cells (PRBCs). Which intravenous solution should be used along with the PRBC transfusion? A. 5% dextrose in water (D5W) B. 0.9% sodium chloride (NS) C. 5% dextrose in 0.9% sodium chloride (D5NS) D. 5% dextrose in lactated Ringer's (D5LR)

B. 0.9% sodium chloride (NS)

12. A patient diagnosed with prehypertension has a blood pressure reading of _____ mm Hg systolic _____ mm Hg diatolic. A. less than 120; and less than 80 B. 120 and 139; or 80 and 89 C. 140 and 159; or 90 and 99 D. 160 and 179; or 100 and 109

B. 120 and 139; or 80 and 89

6. When reviewing patients' histories, the nurse recognizes that which of the following patients would be likely candidates for drug therapy for cholesterol reduction? A. A patient who has two risk factors and a low-density lipoprotein (LDL) level of 100 mg/dL, without coronary heart disease B. A patient who has coronary heart disease and an LDL level of 100 mg/dL C. A patient who has one risk factor, an LDL level of 170 mg/dL, and no history of coronary heart disease D. A patient who has coronary heart disease and an LDL level of 165 mg/dL

B. A patient who has coronary heart disease and an LDL level of 100 mg/dL

The nurse is planning to transfuse a patient with a unit of packed red blood cells (PRBCs). Which patient would be best treated with this transfusion? A. A patient with a coagulation disorder B. A patient with severe anemia C. A patient who has lost a massive amount of blood after emergency surgery D. A patient who has a clotting-factor deficiency

B. A patient with severe anemia

13. A patient has hypertension along with type I diabetes mellitus and proteinuria. The nurse anticipates that a drug from which drug class will be ordered for its renal-protective effects? A. Beta-blockers B. ACE inhibitors C. Diuretics D. Calcium channel blockers

B. ACE inhibitors (non-prodrugs captopril and lisinpril) doesn't need to be turn into an active form in the liver. (protect the kidneys by reducing the GFR pressure and the number one choice with cardiovascular and diabetes)

A patient is receiving an intravenous infusion of heparin. The nurse will monitor which laboratory studies to adjust and monitor the dose of the heparin? A. Bleeding times B. Activated partial thromboplastin time (aPTT) C. Prothrombin time-international normalized ratio (PT-INR) D. Vitamin K levels

B. Activated partial thromboplastin time (aPTT)

11. The nurse notes in a patient's medical record that nesiritide has been ordered. Based on this order, the nurse interprets that the patient has which disorder? A. Atrial fibrillation B. Acutely decompensated heart failure with dyspnea at rest C. Systolic heart failure D. Long-term treatment of heart failure.

B. Acutely decompensated heart failure with dyspnea at rest

10. A patient who has been taking antihypertensive drugs for a few months complains of having a persistent dry cough. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs? A. Beta-blockers B. Angiotensin-converting enzyme (ACE) inhibitors C. Angiotensin-receptor blockers (ARBs) D. Calcium channel blockers

B. Angiotensin-converting enzyme (ACE) inhibitors other adverse effects are: fatigue, dizziness, mood changes, and headaches. Dry non productive cough which is reversible when stopping ACE therapy. has a first dose hypotension effect

4. During a teaching session for a patient on antithyroid drugs, the nurse should discuss which dietary instructions? A. Using iodized salt when cooking B. Avoiding foods containing iodine C. Increasing fluid intake to 2500 mL per day D. Increasing intake of sodium- and potassium-containing foods

B. Avoiding foods containing iodine

While assessing a patient who is receiving intravenous digitalis, the nurse recognizes that the drug has a negative chronotropic effect. How would this drug effect be evident in the patient? A. Increased heart rate B. Decreased heart rate C. Decreased conduction D. Increased ectopic beats

B. Decreased heart rate

1. The nurse notes in a patient's medication history that the patient will be taking desmopressin. Based on this finding, the nurse interprets that the patient has which disorder? A. Diabetes mellitus B. Diabetes insipidus C. Adrenocortical insufficiency D. Carcinoid tumor

B. Diabetes insipidus (ADH hyposecretion disables the water-conserving capability of the kidneys; a condition of chronic polyuria without glucose) Insipidus means without taste.

4. A patient is concerned about the adverse effects of the medication she is taking to lower her cholesterol level, a fibric acid derivative. The adverse effects of this class of medication include which of the following? A. Constipation B. Diarrhea C. Joint pain D. Dry mouth

B. Diarrhea

1. When monitoring a patient who has diabetes and is receiving a carbonic anhydrase inhibitor for edema, the nurse monitors for which possible adverse effect? A. Metabolic alkalosis B. Elevated blood glucose C. Hyperkalemia D. Drowsiness

B. Elevated Blood glucose and glycosuria in diabetics

1. A patient has a deficiency in clotting factors. The nurse will prepare to administer which blood product? A. Cryoprecipitate B. Fresh frozen plasma C. Packed red blood cells (PRBCs) D. Plasma protein fractions

B. Fresh frozen plasma

10. A patient is being discharged on anticoagulant therapy. The nurse will include in the patient-education conversation that it is important to avoid herbal products that contain which substance? A. Valerian B. Ginkgo C. St. John's wort D. Saw palmetto

B. Ginkgo

11. When teaching a patient who is beginning antilipemic therapy about possible drug-food interactions, the nurse should discuss which food? A. Oatmeal B. Grapefruit juice C. Licorice D. Dairy products

B. Grapefruit juice

10. The nurse should monitor for muscle pain and possible myopathy when a patient is taking which class of antilipemic drugs? A. Bile acid sequestrants B. HMG-CoA reductase inhibitors C. Fibric acid derivatives D. Niacin

B. HMG-CoA reductase inhibitors

Select all that apply: 1. During diuretic therapy, the nurse monitors the fluid and electrolyte status of the patient. Which are symptoms of hyponatremia? Select all that apply. A. Red, flushed skin B. Lethargy C. Decreased urination D. Hypotension E. Stomach cramps F. Elevated temperature

B. Lethargy D. Hypotension E. Stomach cramps

10. A patient in the neurologic intensive care unit is being treated for cerebral edema and is given which type of drug to reduce intracranial pressure? A. Loop diuretics B. Osmotic diuretics C. Thiazide diuretics D. Vasodilators

B. Osmotic diuretics

7. The nurse is creating a plan of care for a patient with a new diagnosis of hypertension. Which is a potential nursing diagnosis for the patient taking antihypertensive medications? A. Diarrhea B. Sexual dysfunction C. Stress urinary incontinence D. Impaired memory

B. Sexual dysfunction

SELECT ALL THAT APPLY: 1. When a patient is experiencing digoxin toxicity, which clinical situation would necessitate the use of digoxin immune Fab (Digibind)? Select all that apply. A. The patient reports seeing colorful halos around lights. B. The patient's serum potassium level is above 5 mEq/L. C. The patient is experiencing nausea and anorexia. D. The patient is experiencing severe sinus bradycardia that does not respond to cardiac pacing. E. The patient has taken an overdose of greater than 10 mg of digoxin.

B. The patient's serum potassium level is above 5 mEq/L. D. The patient is experiencing severe sinus bradycardia that does not respond to cardiac pacing. (E) might be right as well a person taking 10mg of digoxin is a indication of toxicity...page 340 states life threatening digoxin overdose in adults and 4 mg in children)

2. A patient with severe liver disease is receiving the angiotensin converting enzyme (ACE) inhibitor, captopril (Capoten). The nurse is aware that the advantage of this drug for this patient is that captopril A. is a prodrug and is metabolized by the liver before becoming active. B. is not a prodrug and does not need to be metabolized by the liver before becoming active. C. rarely causes first-dose hypotensive effects. D. has little effect on electrolyte levels.

B. is not a prodrug and does not need to be metabolized by the liver before becoming active.

4. A patient has received too much warfarin. The nurse will prepare to give which antidote for warfarin toxicity? A. vitamin E B. vitamin K C. protamine sulfate D. potassium phosphate

B. vitamin K

A patient tells the nurse that he likes to eat large amounts of garlic for its cardiovascular benefits. The nurse reviews his medication history, and notes that which drug would have a potential interaction with the garlic? A. acetaminophen (Tylenol) B. warfarin (Coumadin) C. digoxin (Lanoxin) D. phenytoin (Dilantin)

B. warfarin (Coumadin)

10.While assessing a patient who is taking a beta-blocker for angina, the nurse knows to monitor for which adverse effect? A. Nervousness B. Hypertension C. Bradycardia D. Dry cough

C. Bradycardia (blocks beta 1 and beta 2 receptors) other adverse effects: negative chronotropic, decrease cardiac output, and negative dromotropic effect, beta 2: bronchoconstriction, increased airway resistence (asthma and COPD), cardiac rhytm, decrease renin release.

6. Antihypertensive drug therapy for a newly diagnosed, stage 1 hypertensive African American patient would most likely include which drug or drug classes? A. Vasodilators alone B. ACE inhibitors alone C. Calcium channel blockers with thiazide diuretic D. Beta-blockers with thiazide diuretic

C. Calcium channel blockers with thiazide diuretic

8. A patient is receiving an infusion of fresh frozen plasma. The nurse interprets that this patient has which disorder? A. Hypovolemic shock B. Anemia C. Coagulation disorder D. Previous transfusion reaction

C. Coagulation disorder

During a blood transfusion, a patient begins to have chills and back pain. What action will the nurse take first? A. Observe for other symptoms. B. Slow the infusion rate and monitor vital signs. C. Discontinue the infusion immediately and notify the physician. D. Tell the patient that her symptoms are a normal reaction to the blood product.

C. Discontinue the infusion immediately and notify the physician.

. During the infusion of albumin, the nurse monitors the patient closely for the development of which adverse effect? A. Hypernatremia B. Fluid volume deficit C. Fluid volume overload D. Transfusion reaction

C. Fluid volume overload

8. A patient with risk factors for coronary artery disease asks the nurse about the "good cholesterol" laboratory values. The nurse knows that this term refers to which of the following? A. Chylomicrons B. Low-density lipoproteins (LDLs) C. High-density lipoproteins (HDLs) D. Very-low-density lipoproteins (VLDLs)

C. High-density lipoproteins (HDLs)

3.A 53-year-old man has been admitted for evaluation of chest pain. He has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. When teaching the patient how to use sublingual nitroglycerin, what instruction should the nurse include? A. Take up to five doses at 15-minute intervals for an angina attack. B. If the tablet does not dissolve quickly, chew the tablet for maximal effect. C. If the chest pain is not relieved after one tablet, call 911 immediately to activate emergency medical services. D. Wait 1 minute between doses of sublingual tablets, up to three doses.

C. If the chest pain is not relieved after one tablet, call 911 immediately to activate emergency medical services.

7. When a patient is receiving diuretic therapy, which of the following would best reflect the patient's fluid volume status? A. Blood pressure and pulse B. Serum potassium and sodium levels C. Intake, output, and daily weight D. Measurements of abdominal girth and calf circumference

C. Intake, output, and daily weight

6. A patient has been instructed to take one low-dose aspirin a day as part of therapy to prevent strokes. The nurse will provide which instruction when providing patient teaching about this medication? A. Aspirin should be taken on an empty stomach to ensure maximal absorption. B. Low-dose aspirin therapy rarely causes problems with bleeding. C. Laboratory studies should be done to monitor liver, renal, and clotting functions. D. Coated tablets may be crushed if necessary.

C. Laboratory studies should be done to monitor liver, renal, and clotting functions.

6. When reviewing the medication profile of a patient with a new order for desmopressin, the nurse is aware that which drugs may have an interaction with desmopressin? A. Aspirin B. Digoxin C. Lithium D. Penicillin

C. Lithium

3. A patient calls the clinic office saying that the cholestyramine powder he started yesterday clumps and sticks to the glass when he tries to mix it. The nurse should suggest what method for mixing this medication for administration? A. The powder dissolves faster in a carbonated soda drink. B. Add it to any liquid and stir vigorously to dissolve it quickly. C. Mix it with food or fruit such as crushed pineapple, or at least 4 to 6 ounces of fluid. D. Sprinkle the powder into a spoon and take it dry, followed by a glass of water.

C. Mix it with food or fruit such as crushed pineapple, or at least 4 to 6 ounces of fluid.

14. The nurse is reviewing the orders for a patient and notes a new order for an ACE inhibitor. The nurse checks the current medication orders, knowing that this drug class may have a serious interaction with what other drug class? A. Calcium channel blockers B. Diuretics C. Nonsteroidal antiinflammatory drugs (NSAIDs) D. Nitrates

C. Nonsteroidal antiinflammatory drugs (NSAIDs) (iburprohen can reduce the effect of ACE and predispose the pt. with acute renal failure); other adverse effects: potassium levels above 5 mEq/L because they promote hyperkalemia, lactating women, children, bilateral renal disease); rash, pruritus, anemia, neutropenia, thrombocytosis, and agranulocytosis.

12. A patient who is severely anemic also has acute heart failure with severe edema due to fluid overload. The physician wants to improve the patient's anemia. The nurse anticipates that the patient will receive which blood product? A. Fresh frozen plasma B. Albumin C. Packed red blood cells (PRBCs) D. Whole blood

C. Packed red blood cells (PRBCs)

3. Levothyroxine has been prescribed for a patient with hypothyroidism. The nurse provides information to the patient about the medication and tells the patient to contact the prescriber if which potential adverse effect occurs? A. Fatigue B. Constipation C. Palpitations D. Drowsiness

C. Palpitations

2. When reviewing the health history of a patient, the nurse recalls that potassium supplements are contraindicated in patients with a history of which problem? A. Burns B. Diarrhea C. Renal disease D. Cardiac tachydysrhythmias

C. Renal disease

2. A patient reports having adverse effects with nicotinic acid. The nurse can suggest that the patient do which of the following to minimize these undesirable effects? A. Take the drug on an empty stomach. B. Take the medication every other day until these effects subside. C. Take small doses of aspirin 30 minutes before taking the nicotinic acid. D. Take the drug with large amounts of fiber.

C. Take small doses of aspirin 30 minutes before taking the nicotinic acid.

1.When administering topical nitroglycerin ointment, the nurse should use which technique? A. The ointment should be applied on the chest over the heart. B. The ointment should be used only in the case of a mild angina episode. C. The old ointment should be removed before new ointment is applied. D. The ointment should be massaged gently into the skin, then covered with plastic wrap.

C. The old ointment should be removed before new ointment is applied.

2. A 16-year-old boy who is taking somatropin comes into the office because he has had an asthma attack during a race at school. Because of this new development, the nurse expects which intervention to occur next? A. He should stop participation in school physical education classes. B. The somatropin must be discontinued immediately. C. The somatropin dosage may be adjusted. D. His growth should be documented and monitored for changes.

C. The somatropin dosage may be adjusted

5. When reviewing the mechanisms of action of diuretics, the nurse knows that which statement is true about the loop diuretics? A. They work by inhibiting aldosterone. B. They are very potent, having a diuretic effect that lasts at least 6 hours. C. They are particularly useful when rapid diuresis is desired because their onset of action is rapid. D. They have the disadvantage of ceasing to be effective when the creatinine clearance decreases below 25 mL/min.

C. They are particularly useful when rapid diuresis is desired because their onset of action is rapid.

9. A patient is started on a diuretic for antihypertensive therapy. The nurse expects that a drug in which of the following classes is likely to be used initially? A. Loop diuretics B. Osmotic diuretics C. Thiazide diuretics D. Vasodilators

C. Thiazide diuretics (chlorohiazide,hydrochlorohiazide, and bendroflumthiazide, chlorthalidone, indapamide, and metolazone)

SELECT ALL THAT APPLY 1. A patient is about to receive a dose of octreotide. The nurse should assess for which of the following contraindications or cautions? Select all that apply. A. Carcinoid crisis B. Diarrhea C. Type 1 diabetes mellitus D. Type 2 diabetes mellitus E. Chronic renal failure F. Esophageal varices

C. Type 1 diabetes mellitus D. Type 2 diabetes mellitus E. Chronic renal failure

11. A patient who is taking warfarin (Coumadin) therapy has a headache and calls the prescriber's office to ask about taking a pain reliever. The nurse expects to receive an order for which type of medication? A. aspirin tablets B. ibuprofen (Advil) C. acetaminophen (Tylenol) D. An opioid

C. acetaminophen (Tylenol)

7. A patient will be receiving a thrombolytic drug as part of his treatment for acute myocardial infarction. The nurse explains to him that this drug is used to A. relieve chest pain. B. prevent further clot formation. C. dissolve the clot in his coronary artery. D. control bleeding in the coronary microcirculation.

C. dissolve the clot in his coronary artery

10. The nurse administering the phosphodiesterase inhibitor inamrinone recognizes that this drug should have a positive inotropic effect. This effect will result in increased A. heart rate. B. blood vessel dilation. C. force of cardiac contraction. D. conduction of electrical impulses across the heart.

C. force of cardiac contraction. (increase cAMP) positive inotropic (by more calcium available in SR)effect and vasodilation, (inodilators)---positive chornotropic effect); USED IN ICU; ADVERSE EFFECT...thrombocytopenia, dysrhythmia, ventricular, hypotension and angina, hypokalemia, tremor.

7. When reviewing the list of medications taken by a patient who will be receiving a new prescription for digoxin, the nurse would be concerned about which medication that may interact with the digoxin? A. aspirin B. acetaminophen (Tylenol) C. furosemide (Lasix) D. vitamin K

C. furosemide (Lasix); (loop Diuretics); numerous ones on page 341

Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct? A. "Keep a weekly journal or log of your weight." B. "Avoid foods high in potassium, such as bananas, oranges, fresh vegetables, and dates." C. "If you experience weight gain, such as five or more pounds a week, be sure to tell your physician during your next routine visit." D. "Be sure to change your position slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes."

D. "Be sure to change your position slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes."

4. A pituitary drug is prescribed for a patient with a hormone deficiency, and the nurse provides instructions about the medication. Which statement by the patient indicates a need for further instructions? A. "I will not stop the drug unless my doctor tells me to stop it." B. "I will call my doctor if I have a fever or sore throat." C. "I will have to stop drinking my nightly glass of wine." D. "I am looking forward to a cure for my condition with this hormone replacement."

D. "I am looking forward to a cure for my condition with this hormone replacement."

8.A patient has been taking a beta-blocker for 4 weeks as part of his antianginal therapy. He also has type II diabetes and hyperthyroidism. When discussing possible adverse effects, the nurse should include which information? A. "Watch for unusual weight loss." B. "Monitor your pulse for increased heart rate." C. "Use the hot tub and sauna at the gym as long as time is limited to 15 minutes." D. "Monitor your blood glucose levels for possible hypoglycemia or hyperglycemia."

D. "Monitor your blood glucose levels for possible hypoglycemia or hyperglycemia."...BBs (-LOL), atenolol, metoprolol, nadolol, and propranolol.

12. A patient on diuretic therapy calls the clinic because he's had the flu, with "terrible vomiting and diarrhea," and he has not kept anything down for 2 days. He feels weak and extremely tired. What will the nurse advise this patient? A. "It's important to try to stay on your prescribed medication. Try to take it with sips of water." B. "Stop taking the diuretic for a few days, then restart it when you feel better." C. "You will need an increased dosage of the diuretic because of your illness. Let me speak to the physician." D. "Please come into the clinic for an evaluation to make sure there are no complications."

D. "Please come into the clinic for an evaluation to make sure there are no complications."

3. During a follow-up visit, the physician examines the fundus of the patient's eye. Afterward, the patient asks the nurse, "Why is he looking at my eyes when I have high blood pressure? It does not make sense to me!" What is the best response by the nurse? A. "We need to monitor for drug toxicity." B. "We must watch for increased intraocular pressure." C. "The physician is assessing for visual changes that may occur with drug therapy." D. "The physician is making sure the treatment is effective over the long-term."

D. "The physician is making sure the treatment is effective over the long-term.

9. A patient with primary hypertension is prescribed drug therapy for the first time. The patient asks how long drug therapy will be needed. Which answer by the nurse is the most correct response? A. "This therapy should take about 3 months." B. "This therapy should take about a year." C. "This therapy should go on until your symptoms disappear." D. "Therapy for high blood pressure is usually life-long."

D. "Therapy for high blood pressure is usually life-long."

A patient has been taking digoxin at home but has taken an accidental overdose and has developed toxicity. He has been admitted to the telemetry unit where the physician has ordered digoxin immune Fab (Digibind). The patient asks the nurse why the medication is ordered. What is the nurse's best response? A. "It works faster than digoxin." B. "It is safer than digoxin and can be taken orally." C. "It helps to convert the irregular heart rhythm to a more normal rhythm." D. "This drug is an antidote to digoxin and will help to lower the blood levels."

D. "This drug is an antidote to digoxin and will help to lower the blood levels." (severe bradycardia, advanced heart block, ventricularr tachycardia, fibrillation, and hyperkalemia); available in parental form. Clinical signs and symptoms are monitored NOT serum levels----used for systolic heart failure and atrial fibrillation.

6.A calcium channel blocker (CCB) is prescribed for a patient, and the nurse provides instructions to the patient about the medication. What does the nurse tell the patient? A. The tablet should be chewed for faster release of the medication. B. To increase the effect of the drug, take it with grapefruit juice. C. If the adverse effects of chest pain, fainting, or dyspnea occur, discontinue the medication immediately. D. A high-fiber diet with plenty of fluids will help prevent the constipation that may occur.

D. A high-fiber diet with plenty of fluids will help prevent the constipation that may occur.........CCBs: phenylalkylamins, benzothiazepines, and dihydroridines (verapril, dilitiazem, amlodipine)

8. The nurse is reviewing discharge teaching for a patient who will be taking digoxin (Lanoxin) therapy. The patient should be taught to avoid which foods when taking the digoxin? A. Leafy green vegetables B. Dairy products C. Grapefruit juice D. Bran muffins

D. Bran muffins

5. A patient has been placed on a milrinone infusion as part of the therapy for end-stage heart failure. What risks involved with this drug will the nurse keep in mind while assessing this patient during the infusion? A. Hypertension B. Hyperkalemia C. Nausea and vomiting D. Cardiac dysrhythmias

D. Cardiac dysrhythmias (contraindictated with ventricular tachycardia, and fibrillation) used for treatment of atrial fibrillation. Available in Oral and injection form.

3. When a patient is receiving vasopressin, which therapeutic responses would the nurse expect to see? A. Improved appetite B. Increased serum albumin levels C. Increased serum potassium levels D. Decreased urinary output

D. Decreased urinary output

11. A 79-year-old patient is taking a diuretic for treatment of hypertension. This patient is very independent and wants to continue to live at home, despite his diagnosis of mild heart failure. The nurse will know that which teaching point is important for this patient? A. He should take the diuretic with his evening meal. B. He should skip the diuretic dose if he plans to leave the house. C. If he feels dizzy while on this medication, he should stop taking it and take potassium supplements instead. D. He should take extra precautions when standing up because of possible orthostatic hypotension and resulting injury from falls.

D. He should take extra precautions when standing up because of possible orthostatic hypotension and resulting injury from falls.

1. A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The nurse recognizes that the reason for the two anticoagulants is which of the following? A. The oral and injection forms work synergistically. B. The combination of heparin and an oral anticoagulant results in fewer adverse effects than heparin used alone. C. Oral anticoagulants are used to reach an adequate level of anticoagulation when heparin alone is unable to do so. D. Heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels.

D. Heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels

12. The nurse is conducting a class about antilipemic drugs. The newer antilipemic drug ezetimibe (Zetia) works by which mechanism? A. Preventing resorption of bile acids from the small intestines B. Inhibiting HMG-CoA reductase C. Activating lipase, which breaks down cholesterol D. Inhibiting cholesterol absorption in the small intestine

D. Inhibiting cholesterol absorption in the small intestine

3. During thrombolytic therapy, the nurse monitors the patient for adverse effects. What is the most common undesirable effect of thrombolytic therapy? A. Dysrhythmias B. Nausea and vomiting C. Anaphylactic reactions D. Internal and superficial bleeding

D. Internal and superficial bleeding

2. The nurse is preparing to administer dipyridamole (Persantine). Which statement about this drug is true? A. It has antiinflammatory and antipyretic properties. B. It has analgesic properties as well as antithrombotic effects. C. It is useful in reducing the risk for fatal and nonfatal thrombotic stroke. D. It is used with warfarin to prevent postoperative thromboembolic complications.

D. It is used with warfarin to prevent postoperative thromboembolic complications

While a patient is receiving antilipemic therapy, the nurse knows to monitor the patient closely for the development of which problem? A. Photosensitivity B. Pulmonary problems C. Vitamin C deficiency D. Liver dysfunction

D. Liver dysfunction

6. When monitoring a patient for signs of hypokalemia, the nurse looks for what early sign? A. Seizures B. Cardiac dysrhythmias C. Stomach cramps D. Muscle weakness

D. Muscle weakness

Select all that apply: 1. When assessing a patient who is receiving a loop diuretic, the nurse looks for the manifestations of potassium deficiency, which would include which symptoms? Select all that apply. A. Dyspnea B. Constipation C. Tinnitus D. Muscle weakness E. Leg cramps F. Lethargy

D. Muscle weakness E. Leg cramps F. Lethargy

A patient is in an urgent care center and is receiving treatment for mild hyponatremia after spending a long time doing gardening work in the heat of the day. The nurse expects which drug therapy will be used to treat her condition? A. Oral supplementation of fluids B. Intravenous bolus of lactated Ringer's solution C. Normal saline infusion, administered slowly D. Oral administration of sodium chloride tablets

D. Oral administration of sodium chloride tablets

1. A patient, newly diagnosed with hypothyroidism, received a prescription for a thyroid hormone replacement drug. The nurse assesses for which potential contraindication to this drug? A. Infections B. Diabetes mellitus C. Lupus erythematosus D. Recent myocardial infarction

D. Recent myocardial infarction

9.What action is recommended to help reduce the tolerance to transdermal nitroglycerin therapy that commonly develops? A. Omit a dose once a week. B. Leave the patch on for 2 days at a time. C. Cut the patch in half for a week until the tolerance subsides. D. Remove the patch at bedtime, then apply a new one in the morning.

D. Remove the patch at bedtime, then apply a new one in the morning.

2. A patient with hypothyroidism is given a prescription for levothyroxine. When the nurse explains that this is a synthetic form of the thyroid hormone, he states that he prefers to receive more "natural" forms of drugs. What will the nurse explain to him about the advantages of levothyroxine? A. It has a stronger effect than the natural forms. B. Levothyroxine is less expensive than the natural forms. C. The synthetic form has fewer adverse effects on the gastrointestinal tract. D. The half-life of levothyroxine is long enough to permit once-daily dosing.

D. The half-life of levothyroxine is long enough to permit once-daily dosing.

The physician has ordered the adrenergic drug doxazosin (Cardura) for a patient. When providing education about this drug, the nurse should include which instructions? A. The patient should weigh herself daily and report any weight loss to the physician. B. The patient should increase her potassium intake by eating more bananas and apricots. C. The impaired taste associated with the medication usually goes away in 2 to 3 weeks. D. The patient should take her first dose while lying down because there is a first-dose effect with prazosin.

D. The patient should take her first dose while lying down because there is a first-dose effect with prazosin.

5. When administering heparin subcutaneously, the nurse should follow which procedure? A. Aspirating before injecting the medication B. Massaging the site after injection C. Applying heat to the injection site D. Using a 1/2 to 5/8 inch 25- to 28-gauge needle

D. Using a -1/2 to 5/8-inch 25- to 28-gauge needle

4. The nurse is preparing to administer intravenous potassium. Which administration technique is correct? A. The intravenous rate should not exceed 30 mEq/hr. B. Oral forms should be given on an empty stomach to maximize absorption. C. Intravenous solutions should not contain more than 60 mEq/L of potassium. D. When given intravenously, potassium must always be given in diluted form.

D. When given intravenously, potassium must always be given in diluted form.

11. After a severe auto accident, a patient has been taken to the trauma unit and has an estimated blood loss of more than 30% of his blood volume. The nurse prepares to administer which product? A. Fresh frozen plasma B. Albumin C. Packed red blood cells D. Whole blood

D. Whole blood

11. Which drug is commonly used for a pregnant patient who is experiencing hypertension? A. mannitol (Osmitrol) B. enalapril (Vasotec) C. hydrochlorothiazide (HydroDIURIL) D. methyldopa (Aldomet)

D. methyldopa (Aldomet); alpha 2-adrenergic receptor stimulators (agonist); has high incidence of adverse effects: orthostatic hypotension, fatigue, and dizziness. (clondine) is another drug but not used in pregnancy

The nurse should monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of the following diuretics? A. hydrochlorothiazide (HydroDIURIL) B. furosemide (Lasix) C. metolazone (Zaroxolyn) D. spironolactone (Aldactone)

D. spironolactone (Aldactone); synthetic steriod blocks aldosterone receptors...hyperkalemia common complication, it is a potassium sparing diuretic. Most commonly prescribed for children. only oral form and a pregnancy D drug.

. Nicotinic acid is prescribed for a patient with elevated lipid levels. The nurse informs the patient that which adverse effects may occur with this medication? A. Pruritus, cutaneous flushing B. Tinnitus, urine with a burnt odor C. Myalgia, fatigue D. Blurred vision, headaches

Pruritus, cutaneous flushing