exam 2

After teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states

"I need to make sure I don't eat too many high potassium foods."

The nurse is teaching a 62-year-old client about hydrochlorothiazide, which the health care provider has prescribed for treatment of hypertension. What statement, made by the client, suggests that the client understands the teaching?

"I will need to stand slowly."

Which instruction would be most appropriate for a client who is taking a diuretic?

"It's okay to take it with food."

A client is receiving low-molecular-weight heparin to prevent thromboembolic complications. The nursing student asks the instructor the reason why this treatment is given instead of heparin. What is the instructor's best explanation of the rationale for LMWH over heparin?

"LMWH is associated with less thrombocytopenia than standard heparin."

A client asks, "Why is my prescription is being switched from furosemide to spironolactone?" What is the nurse's best response?

"You will lose less potassium with spironolactone than with furosemide."

The nurse is preparing to administer a thrombolytic drug to a client. The nurse understands that this class of drugs would be contraindicated in clients with which conditions? Select all that apply.

Active bleeding History of aneurysm History of stroke

A 55-year-old man has been diagnosed with coronary artery disease and begun antiplatelet therapy. The man has asked the nurse why he is not taking a "blood thinner like warfarin." What is the most likely rationale for the clinician's use of an antiplatelet agent rather than an anticoagulant?

Antiplatelet agents are more effective against arterial thrombosis; anticoagulants are more effective against venous thrombosis.

Which would be important to do when administering nitroglycerin transbuccally?

Check the inside of the cheeks for ulcers or breakdown.

The nurse is caring for a 53-year-old man with a 30-year history of alcohol dependency. He presents with ascites, secondary to cirrhosis. Which mechanism is involved in his fluid shift?

Decreased plasma oncotic pressure Decreased plasma oncotic pressure may occur with decreased synthesis of plasma proteins caused by liver disease.

What is the basis for a nurse's recommendation to avoid a stringent fat-restricted diet when planning interventions to treat a client's dyslipidemia?

Diets with more stringent fat restrictions raise serum triglyceride levels.

A nurse is caring for a patient with edema due to congestive heart failure (CHF). The physician has prescribed indapamide to the patient. The patient is also undergoing treatment with digitalis glycoside. Which intervention should the nurse perform when caring for this patient?

Frequently monitor the patient's pulse rate and rhythm.

The pharmacology instructor is discussing medications used in the treatment of dyslipidemia. Which drug class would the instructor identify as the most widely used dyslipidemia drugs?

HMG-CoA reductase inhibitors

A nurse is providing care to a client who has elevated levels of low-density lipoprotein (LDL). A review of the client's history reveals a sedentary lifestyle and a history of being overweight. The nurse understands that this combination of factors places the client at risk for which condition?

Heart disease

A patient with diabetes is prescribed propranolol (Inderal). For what should the patient be assessed?

Hypoglycemia

During a cardiac catheterization and concurrent GP IIb/IIIa receptor antagonist administration, a client begins to bleed from the arterial access site of the catheterization. In what, if any, specific circumstance can the infusion continue?

It can continue when bleeding can be controlled by pressure application.

A health care provider has prescribed sublingual nitroglycerin and the nitroglycerin patch for a client. When the nurse explains the medications to the client, what advantage of the patch might the nurse mention?

It has a longer duration of action than sublingual tablets.

After teaching a group of students about the cardiovascular system and pressures, the students demonstrate understanding of the information when they identify which area as having the highest pressure?

Left ventricle

A client develops primary hypertension and asks the nurse, "How long will I need to receive therapy?" The nurse responds based on the understanding that therapy would be required for how long?

Lifelong

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?

NSAIDs

For relief of acute angina and for prophylaxis before events that cause acute angina, what is the primary drug of choice?

Nitroglycerin

A client with a history of angina has sustained a mild head injury in a motor vehicle accident. When the client reports chest pain, what explanation should the nurse provide to support the decision not to treat the angina-related pain with nitroglycerin tablets?

Nitroglycerin will increase intracranial pressure.

An ED nurse is caring for a patient who is receiving furosemide for treatment of pulmonary edema. What will the nurse monitor to observe for adverse effects of the drug?

Potassium levels

The pharmacology instructor is discussing the differences among the various diuretic agents. Which would the instructor cite as a difference between spironolactone and hydrochlorothiazide?

Potassium losses are greater with hydrochlorothiazide than with spironolactone.

The health care provider discovers a clot in the client's left lower leg. Anticoagulant drugs are prescribed to prevent formation of new clots and to achieve which other effect?

Prevent extension of clots already present

A student asks the instructor what the goal of drug therapy is in hypotension and shock. What would the instructor respond?

Restore and maintain adequate tissue perfusion.

Antianginal drugs are most often used to manage what conditions? (Select all that apply.)

Severe hypertension Severe angina Serious cardiac dysrhythmias

The nurse is reviewing a patient's ECG and notes that the ECG is normal, but the rate is 110 beats/minute. The nurse would identify this as

Sinus tachycardia

The nurse is administering norepinephrine intravenous (IV) to an adult client diagnosed with septic shock. The client suddenly develops redness and edema at the right forearm IV site. The client's SBP is 88 mm. Which action would the nurse implement first?

Stop the infusion and administer diluted phentolamine.

A stable daily dose of warfarin is reached when which parameter is achieved?

The PT and INR are within their therapeutic ranges, and the dose does not cause bleeding.

What primary event has occurred when a client experiences an ectopic focus?

The location of the heart's functioning pacemaker is no longer the sinoatrial (SA) node

A nurse obtains an allergy history from a client based on the understanding that which class is associated with a cross-sensitivity reaction with sulfonamides?

Thiazide diuretics

Which medication exerts its effects by depressing the reabsorption of sodium in the kidney tubules, thereby increasing sodium and water excretion?

Triamterene

An elderly client with a history of heart failure has presented to the emergency department in respiratory distress. Assessment reveals the presence of pulmonary edema, and an infusion of IV furosemide has been prescribed. For the duration of treatment, the nurse should prioritize assessments related to which expected age-related dysfunctions? Select all that apply.

cardiac function renal function hepatic function

The chest pain and pressure a client experiences during an anginal attack is caused by which of the following?

decreased oxygen supply to the heart.

A 49-year-old client reports frequent muscle cramps while on hydrochlorothiazide therapy. The nurse would advise the client to do which?

eat potassium-rich foods.

A health care provider prescribes spironolactone, a potassium-sparing diuretic, for a client with cirrhosis. For which category of clients is the use of potassium-sparing diuretics contraindicated?

hyperkalemia

Epinephrine promotes oxygenation of the heart and brain by what means?

redirecting blood flow away from the peripheral circulation

A patient with metabolic syndrome usually has increased plasminogen activator levels.

true