Chapter 9, 26, 10, 28 pharmacology
The nurse is preparing to teach a client with hyperlipidemia about the prescribed cholestyramine. Which instruction should the nurse prioritize for the client? "Take the water-soluble form of vitamin D." "Eat foods high in dietary fiber." "Be sure to stay on complete bed rest." "Follow a complete liquid diet."
"Eat foods high in dietary fiber."
After teaching a client about prescribed statin therapy, the nurse determines that additional teaching is needed when the client makes which statement? "I should report any problems with muscle pain or weakness." "I should take the dose around bedtime." "I need to be careful when I'm out in the sun." "I can take the drug with grapefruit juice."
"I can take the drug with grapefruit juice."
A 54-year-old client has been prescribed sublingual nitroglycerin. After the nurse has finished teaching the client about the medication, what statement could the client make to suggest that the client understands proper self-administration? "I should only take the medication if the pain becomes severe." "I can take up to three tablets at five-minute intervals." "I should take as many tablets as I need to make the pain go away." "I should take three tablets as soon as I start to feel chest pain."
"I can take up to three tablets at five-minute intervals."
The nurse is assessing a client taking a beta blocker as treatment for angina. Which statement by the client indicates to the nurse that the client is experiencing an adverse effect of the medication? "I have not changed by diet." "My heart doesn't race anymore." "I sleep through the night better." "I feel so down about my life."
"I feel so down about my life."
The nurse provides drug teaching to the client prescribed captopril. What statement made by the client does the nurse interpret to mean teaching has been effective? "I'll take the drug in the morning so that I don't have to go to the bathroom often at night." "I will increase my intake of foods high in potassium, such as bananas." "I will monitor the effectiveness by watching for any symptoms of hypertension." "I will call my doctor if I bruise easily or become extremely tired."
"I will call my doctor if I bruise easily or become extremely tired."
A client who is receiving cholestyramine also takes digoxin. The nurse teaches the client about the drug and administration. The client demonstrates understanding of the teaching when stating: "I need to take both drugs at the same time of the day." "I'll take the digoxin about 15 minutes before the cholestyramine." "I'll take the cholestyramine at 8 AM and the digoxin at 9 AM." "I will take the digoxin about an hour before the cholestyramine."
"I will take the digoxin about an hour before the cholestyramine."
A 52-year-old client who experienced a myocardial infarction has an order for discharge. Part of the discharge teaching includes prior administration of nitroglycerin for chest pain. Which statement by the client indicates understanding of the teaching provided? "I will take two nitroglycerin tablets 15 minutes apart, and if I do not have any relief I will contact my health care provider." "I will take one tablet and lay down for an hour." "I will take three tables every 5 minutes until the chest pain subsides." "I will take three nitroglycerin tablets 5 minutes apart, and if I do not have any relief I will seek emergency care immediately."
"I will take three tables every 5 minutes until the chest pain subsides."
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 more serious side effects of atorvastatin involve a risk of bleeding." "The most common side effects of atorvastatin include some mild gastrointestinal upset." "Some clients experience mild chest pain initially." "Most people who experience side effects from atorvastatin report stiffness in their joints."
"The most common side effects of atorvastatin include some mild gastrointestinal upset."
The client wants information about triglycerides and cholesterol. Which response by the nurse would be correct? "Triglycerides are found in your blood. Cholesterol is how the fat is transported." "Triglycerides transport cholesterol throughout the body." "Triglycerides and cholesterol are fatlike substances found in your blood." "Triglycerides are found in your blood. Cholesterol is found in the gallbladder."
"Triglycerides and cholesterol are fatlike substances found in your blood."
Which question would be most important for a nurse to ask a female client who is starting on an angiotensin II receptor blocker for hypertension? "How much physical exercise do you get?" "Do you eat something when you take your medications?" "When was your last menstrual period?" "Have you always weighed 150 pounds?"
"When was your last menstrual period?"
A client who is prescribed a hypnotic asks the nurse, "About how long will I be taking this medication?" Which time frame would the nurse most likely include in the response? 8 weeks 6 weeks 2 weeks 4 weeks
2 weeks
When administering tirofiban, the nurse would administer the drug intravenously over which time frame? 30 minutes 45 minutes 60 minutes 15 minutes
30 minutes
A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which action should the nurse do first when he reports chest pain? Ask the client to lie back and try to relax. Have the client swallow a tablet every 5 minutes for 15 minutes. Call the health care provider. Administer a tablet under the tongue and repeat the action in 5 and 10 minutes if the pain has not subsided.
Administer a tablet under the tongue and repeat the action in 5 and 10 minutes if the pain has not subsided.
What is the nurse's best action when administering zaleplon to a client? Offer 4 oz. of grapefruit juice with this medication. Administer on an empty stomach. Administer with breakfast. Administer with small sips of water only.
Administer on an empty stomach.
A 75-year-old client is brought to the emergency department by the family. The family relates that the client has confusion, seizures, and abnormal perception of movement. When the nurse looks at the medication that the family has brought to the ED, the nurse discovers that twice the number of tablets are missing from the vial as there should be if the prescription orders were being followed. What should the nurse suspect is wrong with this client? Antihypertensive toxicity Sedative toxicity Benzodiazepine toxicity Analgesic toxicity
Benzodiazepine toxicity
The nurse is teaching a client with hypertension about losartan which the health care provider has prescribed. The nurse can explain that losartan exerts which action on the body? Prevents renin secretion Blocks angiotensin II receptors Blocks aldosterone receptors Prevents conversion of angiotensin I
Blocks angiotensin II receptors
A direct thrombin inhibitor (DTI) has been added to a client's medication regimen to treat the onset of acute coronary syndrome. The nurse should anticipate administration by what route? Select all that apply. a. intramuscular b. subcutaneous c. intravenous d. oral e. transdermal
C D
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? Nitroglycerin Triglycerides Phospholipids Cholesterol
Cholesterol
An older adult client is prescribed a sedative for the treatment of insomnia. The nurse would suspect that the client is experiencing an adverse reaction to the drug based on assessment of which of the following? Headache Confusion Stress Anxiety
Confusion
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 respiratory rate Current blood pressure Susceptibility of the client to renal insufficiency Susceptibility of the client to intracranial pressure
Current blood pressure
The nurse is providing education to a client regarding healthy sleeping habits. What statement most accurately describes an aspect of rapid eye movement (REM) sleep? a. Clients with decreased REM sleep cycles are clinically depressed. b. There is little benefit provided by REM sleep cycles. c. Older clients have increased periods of REM sleep cycles. d. REM deprivation can lead to serious psychological problems.
D
A client is prescribed warfarin. The client also takes a diuretic for the treatment of cardiac problems. The nurse will monitor the client for which potential interaction? a. Decreased effectiveness of the anticoagulant b. Increased effectiveness of the diuretic c. Increased absorption of the anticoagulant d. Increased absorption of the diuretic
Decreased effectiveness of the anticoagulant
A client is diagnosed with atherosclerosis. What would the nurse say is the most likely cause of his angina? Hypertension of the myocardium Decreased oxygenation to the myocardium Decreased musculature of the myocardium related to plaque A reduction in plaque secondary to atherosclerosis
Decreased oxygenation to the myocardium
Which of the following best reflects the action of ezetimibe? Binds with bile acids to form an insoluble complex for excretion Decreases the absorption of dietary cholesterol from the small intestine Blocks the enzyme involved in cholesterol synthesis Stimulates the breakdown of lipoproteins from tissues
Decreases the absorption of dietary cholesterol from the small intestine
Elevated blood lipids are a major risk factor for atherosclerosis and vascular disorders. From where are blood lipids derived? Exercise Kidneys Diet Medications
Diet
A client is admitted to the hospital with deep vein thrombosis (DVT). An infusion of heparin is established. What action best protects the client's safety? a. Have two nurses independently monitor the client's heparin infusion. b. Ensure that the client's call light is easily accessible. c. Ensure that protamine sulfate is readily available. d. Keep a preloaded syringe of vitamin K in the room.
Ensure that protamine sulfate is readily available.
A client is brought to the emergency department with suspected overdose of a benzodiazepine. Which drug should the nurse anticipate administering to counteract the effects of the overdose? Naloxone Flumazenil Diazepam Naltrexone
Flumazenil
A patient has been advised to use a transdermal patch of clonidine for hypertension. For which of the following time periods should the nurse ensure that the patch is intact? For three weeks For one week For two weeks For four weeks
For one week
A patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment? Take a dietary history of the patient. Frequently monitor blood cholesterol. Obtain reports of fasting blood sugar levels. Inspect skin and eyelids for evidence of xanthomas.
Frequently monitor blood cholesterol.
The nurse should instruct the client to take what action if nitroglycerin tablets taken sublingually are not effective in eliminating chest pain? Call the primary health care provider. Go to the emergency department. Lie down after taking an aspirin. Take more tablets until pain subsides, to a maximum of six tablets.
Go to the emergency department.
The client is taking a calcium-channel blocker. What adverse effects might the client experience? Headache and dizziness Hypertension and tachycardia Fever and bronchospasm Palpitations and tingling of extremities
Headache and dizziness
Which genetic clinical condition will likely, over the course of the client's lifetime, require the pharmaceutical introduction of clotting factors to assure the client's safety? Leukemia Diabetes Hemophilia Cystic fibrosis
Hemophilia
The nurse determines teaching about warfarin is successful when the client makes what statement? "I will check with my primary health care provider before taking any herbal supplements." "I will make sure to get the annual flu vaccine this fall." "I will minimize my physical activity so I don't start bleeding." "If I miss a dose one day, I will compensate by taking two pills the next day."
I will check with my primary care provider before taking any herbal supplements
A nurse is caring for a patient who is prescribed flurazepam. Which is an effect of flurazepam? Improves circulation Induces sleep Decreases stress Eases pain
Induces sleep
The patient has been placed on a nitroprusside drip for the treatment of a hypertensive crisis. Which mechanism of action does the nurse know is true for nitroprusside? a. It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins. b. It inhibits the movement of calcium ions across cell membranes. c. It binds selectively to the mineralocorticoid receptors. d. It blocks the action of angiotensin II from all the different pathways where it is formed, not just the single substrate altered by ACE inhibitors.
It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins.
The nurse is aware that there is some research that reveals that anxiety may be treated with nutritional and herbal supplements. Which nutritional and/or herbal supplement is used in this treatment? Whey Kava Melatonin Caffeine
Kava
A 75-year-old client presents to the health care provider's office with bleeding gums and multiple bruises. When the nurse reviews the client's drug history, the nurse finds that the client is prescribed aspirin 81 mg/d. What drug may cause increased bleeding when used in conjunction with the aspirin? Antiarrhythmics Antihypertensives NSAIDs Antibiotics
NSAIDs
After teaching a group of students about drugs used as antianginal agents, the instructor determines that the teaching was successful when the students identify which as a beta-blocker antianginal agent? Amlodipine Nadolol Verapamil Ranolazine
Nadolol
A patient is using propranolol for treatment of angina. The nurse understands that this drug is administered by which route? Intravenous Sublingual Transdermal Oral
Oral
A patient with very high serum triglyceride levels is prescribed the fibric acid derivative clofibrate. In which of the following categories of patients is the use of clofibrate contraindicated? Patients with primary biliary cirrhosis Patients with respiratory depression Patients with endocrine disorder Patients with arterial bleeding
Patients with primary biliary cirrhosis
After reviewing the various drugs that are classified as barbiturates, a student demonstrates understanding when identifying which as the prototype? Amobarbital Pentobarbital Phenobarbital Secobarbital
Phenobarbital
A nurse is conducting an assessment on a client who has recently undergone exploratory laparotomy. The nurse notes the continued order for enoxaparin. The nurse predicts this is to accomplish which goal? Prevent formation of a blood clot Repair damage to a blood vessel Prevent coagulation cascade Encourage cessation of bleeding
Prevent formation of a blood clot
The health care provider has prescribed fenofibrate for a client discovered to have very high serum triglyceride levels. The nurse should question this order if the client has a history of which additional disorder? Endocrine disorder Respiratory depression Arterial bleeding Primary biliary cirrhosis
Primary biliary cirrhosis
The pharmacology instructor is discussing heparin with the students. How would the instructor explain the action of heparin? Promotes the inactivation of factor VIII Binds to factor Xa Promotes the inactivation of clotting factors Binds to factor X
Promotes the inactivation of clotting factors
What drug is used for long-term management of angina pectoris caused by atherosclerosis? Diltiazem (Cardizem) Isosorbide dinitrate (Isordil) Propranolol (Inderal) Nifedipine (Procardia)
Propranolol (Inderal)
A nurse is caring for a 64-year-old female client who is receiving IV heparin and reports bleeding from her gums. The nurse checks the client's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which drug may be ordered?
Protamine sulfate
The nurse is aware that the use of ranolazine is contraindicated in clients who have what condition? QT-interval prolongation Sinus tachycardia Arterial claudication Congestive heart failure
QT-interval prolongation
The client presents for a routine clink visit to evaluate the long-term use of cholestyramine. The health care provider determines vitamin A and D should be prescribed at this time. The nurse determines which nursing diagnose is most appropriate at this time? Risk for impaired skin integrity Risk for imbalanced nutrition: less than body requirements Constipation Risk for injury
Risk for imbalanced nutrition: less than body requirements
The nurse would avoid administering nitrates to clients using which medication? Albuterol Lisinopril Simvastatin Sildenafil
Sildenafil
A client receiving antianxiety drug therapy reports constipation. The nurse explains this is the result of which factor? Oral administration of the drug Overdose of an antianxiety drug Excess fibrous food in the diet Slowed intestinal transit time
Slowed intestinal transit time
The client has been prescribed amlodipine for hypertension. The client's blood pressure upon a revisit remains elevated. The nurse inquiries about the use of which alternative therapy? St. John's Wort Prune juice Hawthorn Lavender
St. John's Wort
A client with a long history of hypertension has just been prescribed an alpha1-adrenergic receptor blocker. To reduce this client's risk of orthostatic hypotension and falls, the nurse should encourage the client to implement what intervention? Take the medication at bedtime. Increase fluid intake for 48 hours before taking the first dose. Take the medication with a high-fat meal. Start with a low dose and increase gradually over 2 to 3 weeks.
Take the medication at bedtime.
The nurse is teaching a 63-year-old client about sustained-release oral nitrates which has been prescribed for treatment of angina. Which instructions would the nurse offer to the client when teaching how to properly self-administer the medication? Take the medication immediately following a meal. Crush the medication and mix it with food. Crush the medication and dissolve it in water. Take the medication on an empty stomach.
Take the medication on an empty stomach.
A client is being sent home with subcutaneous heparin after a total hip replacement. The nurse understands what symptom would indicate a serious drug reaction? Hypotension Headache Stomach pain Tarry stools
Tarry stools
The nurse administers promethazine to the client before sending the client to the preoperative holding area. What outcome demonstrates therapeutic effects? The client is unresponsive to verbal and physical stimuli. The client is conscious but drowsy. The client is asleep. The client's blood pressure is below 130/80 mm Hg.
The client is conscious but drowsy.
The nurse is teaching a young female about the prescribed anticoagulant. The nurse determines the session is successful when the client correctly indicates they will apply which recommendation? Avoid caffeinated drinks. Take the drug with a glass of milk. Use a reliable contraceptive. Take the drug on an empty stomach.
Use a reliable contraceptive.
The nurse cautions the client taking nitroglycerin to avoid the use of which vitamin? Vitamin A Vitamin B Vitamin E Vitamin D
Vitamin E
A 73-year-old client receiving warfarin (Coumadin) has blood in the urinary drainage bag this morning. After reporting these observations to the health care provider, the nurse will expect to administer what substance? Aminocaproic acid (Amicar) Protamine sulfate Platelets Vitamin K
Vitamin K
A nurse emphasizes the need to avoid caffeine and caffeinated beverages with a client undergoing treatment for insomnia based on which known caffeine effect? Restlessness Depression Delirium Wakefulness
Wakefulness
The nurse is caring for a client who is taking a sustained-release (SR) oral nitrate. How should the nurse instruct this client to take the medication? With milk or milk products Sublingually until absorbed With water 1 hour after eating
With water
After teaching a group of nursing students about sedatives and hypnotics, the instructor determines that additional teaching is needed when the students conclude the absorption of which drug is affected by a high-fat meal? Ramelteon Zaleplon Zolpidem Eszopiclone
Zolpidem
Autoregulation of blood flow is directly connected to raising or lowering blood pressure via vasoactive substances. Which substances are examples of vasodilators? Select all that apply. a. Nitric oxide b. Prostacyclin c. Thromboxane A2 d. Angiotensin II e. Serotonin
a b
The nurse is preparing a teaching session for a client who is being discharged with a prescription for clopidogrel. Which potential adverse reaction(s) should the nurse point out is associated with this drug? Select all that apply. Dizziness Nausea Skin rash Bleeding Bruising
a b c d e
What should the nurse review about an antihyperlipidemic medication with the client when completing discharge counseling? (Select all that apply.) Dosage form Correct dose Reason for taking the prescribed drug Drug name Frequency of administration
a b c d e
The nurse is preparing to administer lorazepam to a client recently diagnosed with anxiety. The nurse will seek clarification from the health care provider if which condition is noted in the client's medical record? Select all that apply. a. Psychoses b. Acute narrow-angle glaucoma c. Hypotension d. Pregnancy e. Cataracts
a b d
Nitrate efficacy in lowering systolic blood pressure contraindicates when what contraindication exists? Select all that apply. a. severe anemia b. phosphodiesterase enzyme type 5 inhibitor c, variant angina d. hypervolemia e. cerebral hemorrhage
a b e
The nurse is caring for a client who received a new diagnosis of cancer. The client exhibits signs of a sympathetic stress reaction. What sign(s) and symptom(s) will the nurse assess in this client consistent with an acute reaction to stress? Select all that apply. a. tachycardia b. diaphoresis c. hypotension d. confusion e. tachypnea
a b e
Which tasks should a nurse assist a client with in the ambulatory setting in regards to hypertensive management? (Select all that apply.) a. Teaches client how to properly record weight and blood pressure b. Finds local resources in the community for taking blood pressure c. Schedules an appointment to see a nephrologist d. Schedules an appointment to see a cardiologist e. Schedules regular monitoring of weight and blood pressure
a b e
Clients suffering from frequent anginal attacks should be instructed to keep a record of each attack. What information should the client document in the record? Select all that apply. a. Drug used to relieve the acute pain b. Blood pressure c. Date of attack d. Dose of drug use to relieve the acute pain e. Time of attack
a c d e
The nurse is assessing the medication record of a client who is prescribed a nonbenzodiazepine. Which drug would the nurse expect to find? Select all that apply. a. Hydroxyzine b. Chlordiazepoxide c. Doxepin d. Alprazolam e. Buspirone
a c e
To effectively prevent or manage metabolic syndrome, what should the desired blood lipid profile include? (Select all that apply.) a. Low triglycerides b. High total cholesterol c. Low LDL cholesterol d. High HDL cholesterol e. High VLDL cholesterol
a d c
Which information should be included in the teaching plan of a client who is taking a sedative for a diagnosis of insomnia? Select all that apply. a. Do not drive or operate heavy machinery while taking the medication. b. Call the prescriber after 2 weeks if the medication appears to be ineffective. c. Avoid tea or coffee with meals and prior to sleep. d. Take the medication 2 hours before bedtime. e. Do not drink alcoholic beverages 2 hours before or within 8 hours after taking the drug.
a e
The nurse has completed a comprehensive assessment of a new client. What assessment findings would support a diagnosis of metabolic syndrome? Select all that apply. a. blood pressure 148/93 mmHg b. resting heart rate 77 beats/min c. waist measurement 107 cm (42 in) d. fasting blood glucose 7.2 mmol/L (121 mg/dL) e. high-density lipoprotein (HDL) 1.29 mmol/L (50 mg/dL)
a e c d
Which client should the nurse expect to receive a lower-than-usual dose of benzodiazepines? a client who is 6 months postgastrectomy a client whose anxiety is due to pain caused by gallstones a client who has irritable bowel syndrome a client with alcoholic liver disease
a client with alcoholic liver disease
A nursing instructor has finished teaching a group of students about sedatives and hypnotics. The instructor determines the session is successful when the students correctly choose which drugs as examples of barbiturates? Select all that apply. Pentobarbital Eszopiclone Secobarbital Triazolam Zolpidem
a. b
A nurse is caring for a client who has been diagnosed with primary hypertension. What nursing interventions should be included in the teaching plan? Select all that apply. a. Smoking cessation b. Regular aerobic exercise c. Focus on finding a different job d. Diet with more fruits and vegetables e. Decreased alcohol consumption
a. b. d e
A 46-year-old client with a high body-mass index and a sedentary lifestyle has been diagnosed with hypertension after serial blood pressure readings. The clinician has opted to begin the client on captopril (Capoten). The nurse should recognize that the therapeutic effect of this drug is achieved in what way? a. By inhibiting the transformation of angiotensin I to angiotensin II b. By blocking the movement of calcium ions into arterial smooth muscles c. By directly relaxing vascular smooth muscle d. By blocking aldosterone from binding to mineralocorticoid receptors
a. By inhibiting the transformation of angiotensin I to angiotensin II
A male client presents to the health care provider's office with symptoms of hyperglycemia. He is taking his oral antidiabetic medication and has not modified his diet or exercise program in any way. When the nurse interviews the client, he states that he now takes flax seed to reduce his cholesterol level. What may occur as a result of taking flax seed? a. Decreased absorption of his drugs b. Decreased excretion of the drug through the kidneys c. Increased absorption of his drugs d. Increased liver metabolism e. the kidneys
a. Decreased absorption of his drugs
A female client is started on warfarin therapy. The client asks the nurse why she is no longer on heparin therapy. What differentiates heparin from warfarin? a. Heparin is administered parenterally, while warfarin is administered orally. b. Heparin causes more serious adverse effects than warfarin. c. Heparin is used to treat thrombosis, while warfarin treats heart attacks. d. Heparin is an anticoagulant, while warfarin is a thrombolytic.
a. Heparin is administered parenterally, while warfarin is administered orally.
The nurse administers warfarin to a client. Which expected effect should the drug have on the body? a. decrease in production of vitamin K-dependent clotting factors b. increase in production of vitamin K-dependent factors in the liver c. increase in production of prothrombin d. increase in production of procoagulation factors
a. decrease in production of vitamin K-dependent clotting factors
A client has been prescribed intravenous heparin. What laboratory value will the nurse prioritize when providing care for this client? D-dimer factor XIII levels aPTT platelet count
aPTT
A patient in a health care facility is receiving the thrombolytic drug reteplase. What should the nursing diagnoses checklist for this patient include? Constipation Anxiety Ineffective tissue perfusion Disturbed sensory perception
anxiety
A male client is not only having difficulty falling asleep but wakes up frequently during the night. The health care provider prescribes zolpidem in the CR form. The client asks what makes this form of the drug different. What is the nurse's best response to this client? a. "Ambien CR contains a slow-releasing layer of medication, which aids a person in falling asleep, and a second layer, which is released even more slowly to promote sleep all night." b. "Ambien CR contains a rapid-releasing layer of medication, which aids a person in falling asleep, and a second layer, which is also released rapidly to promote sleep all night." c. "Ambien CR contains a slow-releasing layer of medication, which aids a person in falling asleep, and a second layer, which is released rapidly to promote sleep all night." d. "Ambien CR contains a rapid-releasing layer of medication, which aids a person in falling asleep, and a second layer, which is released more slowly to promote sleep all night."
b
A stable daily dose of warfarin is reached when which parameter is achieved? a. The INR is between 1 and 2, and the dose does not cause bleeding. b. The PT and INR are within their therapeutic ranges, and the dose does not cause bleeding. c. The PTT is within the therapeutic range. d. The INR is between 4 and 5.
b
Anxiolytic drugs can be used in the management of which conditions? (Select all that apply.) a. Hypertension b. Seizures c. Panic attacks d. Diabetic neuropathy e. Alcohol withdrawal
b c e
Which of the following should not be administered to a client taking pravastatin (Pravachol) due to increased risk of myopathy? Select all that apply: a. Albuterol (Proventil b. Niacin (Niaspan) c. Clarithromycin (Biaxin) d. Quinapril (Accupril) e. Verapamil (Calan)
b c e
Which would the nurse identify as the end of the intrinsic pathway? a. Release of factor XI b. Thrombin formation c. Platelet aggregation d. Vasoconstriction
b. Thrombin formation
A client who is experiencing acute alcohol withdrawal is being treated with intravenous lorazepam (Ativan). This drug achieves a therapeutic effect by: a. affecting the regulation of serotonin and norepinephrine in the brain. b. increasing the effects of the neurotransmitter GABA. c. inhibiting the action of monoamine oxidase. d. increasing the amount of serotonin available in the synapses.
b. increasing the effects of the neurotransmitter GABA.
A client has had an exacerbation of hemorrhoidal irritation. What drug should the nurse suspect as most likely to contribute to this adverse effect? bile acid sequestrants fibrates cholesterol absorption inhibitor hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors
bile acid sequestrants
A 70-year-old resident of a long-term care facility has experienced increasing pain, swelling, and redness to her lower leg over the past 12 hours, prompting the care providers at the facility to have the woman brought to the local emergency department. Diagnostic testing has confirmed deep vein thrombosis (DVT) and an IV infusion of alteplase (Activase) has been initiated. Unlike anticoagulants, a thrombolytic such as alteplase can: break down existing clots. inhibit platelet aggregation. potentiate the action of vitamin K. prevent the formation of new clots.
break down existing clots.
The nurse is caring for a 76-year-old client who is receiving IV heparin 5000 units q4h. At the initiation of therapy, the client's control activated thromboplastin time (aPTT) was found to be 35 seconds. One hour prior to the next scheduled dose, aPTT is determined to be 92 seconds. Based on this result, the nurse will: administer an increased dose at the scheduled time. a. administer the scheduled dose and b. monitor the client closely. c. hold the dose and contact the provider. d. administer the scheduled dose.
c
What should the nurse's pre-administration assessment for a client receiving a sedative or hypnotic include? (Select all that apply.) a. Temperature b. Respiratory rate c. Blood pressure d. Pulse e. Pulse ox
c d a b
The nurse determines a client has a nursing diagnosis of acute pain related to angina. When teaching the client about antianginal drugs, the nurse would point out which information about the pain? Select all that apply. a. Will worsen with continued use b. Will only occur during prolonged exercise c. May be less intense d. May be less frequent e. May not be completely relieved
c d e
The nurse is preparing to teach a client about an anxiolytic which was recently prescribed. When discussing potential adverse reactions which instructions should the nurse prioritize? a. Ask to have the drug given by injection. b. Take the drug on an empty stomach. c. Increase fiber intake. d. Stop taking the drug. e. Increase fluid intake.
c e
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? a. "I will clean the previous site where I remove an old patch with soap and water and dry it thoroughly." b. "I will remove the patch and fold it on itself to prevent my dog or grandchildren from touching it." c. "I will apply the patch for 24 hours and then remove it, and place another transdermal patch." d. "I will rotate placement of the transdermal patch on my chest, abdomen, and thighs
c. "I will apply the patch for 24 hours and then remove it, and place another transdermal patch."
Which client statement demonstrates an accurate understanding of the action of a prescribed anticoagulant? "a. Anticoagulants thin the blood so clots can't get as big." b. "If I have another stroke, this medication will bust up the clot before too much damage is done." c. "This medication will keep unnecessary clots from forming in my blood." d. "If a big clot starts to form, this medication will help break it up."
c. "This medication will keep unnecessary clots from forming in my blood."
When prescribed for angina, how does oral nifedipine achieve a therapeutic effect? a. binding extracellular sodium ions with chloride ions b. potentiating the effect of B-type natriuretic peptide c. inhibiting the influx of calcium through slow channels. d. preventing the outflow of intracellular potassium
c. inhibiting the influx of calcium through slow channels.
A client is receiving fosinopril. Which adverse effect would the nurse caution the client about to help to promote compliance?
cough
The nurse is caring for a client who has been diagnosed with high serum cholesterol and triglyceride levels. In teaching the client about therapeutic lifestyle changes and the use of medications, the nurse explains the desired goal for cholesterol levels is what? a. elevated blood lipids and fasting glucose less than 5.6 mmol/L (100 mg/dL) b. 1:1:1 ratio of low-density lipoprotein (LDL), HDL, and total cholesterol c. increased high-density lipoprotein (HDL) values and increased triglyceride values d. reduced LDL values and increased HDL values
d
The nurse is providing education to a client who has been prescribed nitroglycerin transdermal spray. What instruction should the nurse provide the client concerning how to administer the spray? a. Do not administer more than one dose. b. Administer the spray after consulting with the health care provider or a nurse. c. Administer the spray if the angina pain is unrelieved by 30 minutes of rest. d. Administer the spray as soon as chest pain develops.
d. Administer the spray as soon as chest pain develops.
The nurse is preparing to teach discharge instructions to a client with angina. Which instruction should the nurse prioritize giving the client when teaching about the prescribed oral nitroglycerin? a. Store the nitroglycerin capsules in a plastic container. b. Do not store nitroglycerin in a dark container. c. Place the nitroglycerin capsules along with other tablets. d. Recap the container tightly after taking out the capsules.
d. Recap the container tightly after taking out the capsules.
A client presents to the emergency department with a new onset of unilateral weakness and visual disturbances. The primary health care provider suspects that the client has had a cerebrovascular accident (CVA) and prescribes alteplase. What is the nurse's priority prior to administering alteplase? a. asking the client to state any medication allergies b. reviewing the medical record to find the client's blood type c. seeing if the client takes a beta-adrenergic blocker or aminoglycoside antibiotics d. assessing the client for a hemorrhagic stroke
d. assessing the client for a hemorrhagic stroke
The provider orders heparin for a 35-year-old female client. The nurse administers the drug only after confirming that the client: does not have asthma. does not have peptic ulcer disease. does not have a urinary tract infection. is not hypertensive.
does not have peptic ulcer disease.
What is the most likely reason a client has experienced a proliferation of atherosclerotic plaque in his/her coronary arteries? elevated blood cholesterol levels chronic epigastric pain variant angina diabetes mellitus
elevated blood cholesterol levels
A client taking an anticoagulant drug tells the nurse she is having bleeding in the gums and teeth. When reviewing client history, the client states she has decided to try an herbal remedy. Which of the following is most likely the cause of increased bleeding? Echinacea Lavender Vitamin D Ginger
ginger
A client taking atorvastatin presents to the clinic reporting acute muscle pain not associated with exercise or injury. The nurse asks questions to determine if this client has been taking what contraindicated substance? ginseng ibuprofen grapefruit juice saw palmetto
grapefruit juice
A postsurgical client possesses numerous risk factors for venous thromboembolism, including a previous deep vein thrombosis. What drug would the nurse anticipate administering while this client recovers in the hospital? cilostazol vitamin K clopidogrel heparin
heparin
The nurse is caring for a pediatric client who needs anticoagulation therapy. What drug will the nurse anticipate being prescribed for this client? dabigatran rivaroxaban heparin low molecular weight heparins
heparin
The nurse is preparing to administer protamine emergently to a client per instructions from the health care provider. The nurse concludes this is necessary due to an adverse reaction to which drug? Heparin Warfarin Alteplase Clopidogrel
heparin
Protamine is used to treat overdose of which medications? (Select all that apply.) Heparin Clopidogrel (Plavix) Enoxaparin (Lovenox) Warfarin (Coumadin) Alteplase (Activase)
heparin lovenox
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): decrease in LDL. increase in plasma concentration of lovastatin. increase in the statin tolerance level. decrease in plasma concentration of lovastatin.
increase in plasma concentration of lovastatin.
When prescribed for angina, how does oral nifedipine achieve a therapeutic effect? inhibiting the influx of calcium through slow channels. binding extracellular sodium ions with chloride ions potentiating the effect of B-type natriuretic peptide preventing the outflow of intracellular potassium
inhibiting the influx of calcium through slow channels.
A client is to receive abciximab. The nurse would expect to administer the drug by which route? Oral Intramuscular Intravenous Subcutaneous
intraveneous
A client is to receive eptifibatide. The nurse would expect to administer this drug by which route? Intravenous Intramuscular Oral Subcutaneous
intravenous
The nurse administers agents that control bleeding to clients with hemophilia and what other condition? a. pheochromocytoma b. disseminated intravascular coagulation (DIC) c. liver disease d. Lyme disease
liver disease
Losartan focuses on what aspect of the cardiac process to address the pathophysiology of heart failure? increasing heart rate reducing preload increasing stroke volume lowering blood pressure
lowering blood pressure
When the cardiac workload is increased from secondary hypertension, the client is at risk for developing what associated condition? hepatic damage myocardial hypertrophy arterial lumen dilation increased venous tone
myocardial hypertrophy
A male client is receiving heparin by continuous intravenous infusion. The nurse will instruct the client and family members to report what should it occur? Sudden occurrence of sleepiness and drowsiness Presence of blood in urine or stools A skin rash Dizziness
presence of blood in urine or stools
A client arrives at the urgent care center reporting chest pain. After diagnosis, the health care provider prescribes amlodipine for the client's condition. The nurse understands that this drug is indicated for which condition? Sick sinus syndrome Atrioventricular (AV) block Prinzmetal angina ith waterCardiogenic shock
prinzmetal angina
A client is to receive enoxaparin. The nurse would administer this drug by which route? Intramuscular injection Intravenous infusion Orally Subcutaneous injection
subcutaneous injection
The nurse explains to a client that angina can be caused by a thrombus forming in which anatomical location? the heart the lungs the brain the legs
the heart
The nurse is caring for an older adult client who is prescribed a benzodiazepine. When planning the client's assessment, the nurse should be aware of what possible adverse effect? acute renal failure dysuria unpredictable reactions epistaxis (nosebleed)
unpredictable reactions
