EXAM 2 Patho Pharm practice questions
A client who is taking lisinopril to treat hypertension calls the clinic nurse and reports that he has a dry, nonproductive cough that is very bothersome. The nurse should respond by making which statement? a. The medication may need to be changed b. The cough must be the start of a respiratory infection c. The medication needs to be taken with large amounts of water to prevent the cough d. This sometimes happens and you will need to take a cough medication with each dose of the medication
A
A nurse is administering hydrochlorothiazide to a client who has gouty arthritis. The nurse should monitor the client for which of the following findings that indicates an adverse effect of this drug? a. Hyperuricemia b. Hypernatremia c. Hyperkalemia d. Hypoglycemia
A
A nurse is assessing a client who is taking a loop diuretic and is experiencing a thready, irregular pulse, orthostatic hypotension, and confusion. The nurse should identify that these manifestations indicate which of the following adverse effects? a. Hypokalemia b. Hypoglycemia c. Hypouricemia d. Hyponatremia
A
A nurse is caring for a client who has a depressive disorder and required a prescription drug to treat hypertension. The nurse should recognize that which of the following antihypertensive drugs is contraindicated for this client? a. Reserpine b. Captopril c. Hydralazine d. Eplerenone
A
A nurse is caring for a client who is taking amiodarone to treat atrial fibrillation. Which of the following should the nurse instruct the client to avoid while taking this drug? a. Grapefruit juice b. Milk c. Foods high in vitamin K d. NSAIDs
A
A nurse is caring for a client who is taking atorvastatin and has a new prescription for gemfibrozil. The nurse should recognize that this drug combination places the client at an increased risk for which of the following adverse effects? a. Myopathy b. Hypoglycemia c. Irregular pulse d. Kidney failure
A
A nurse is caring for a client who is taking diuretic. The nurse should instruct the client to include which of the following foods in their diet to increase potassium intake? a. Raisins b. Cabbage c. Cheese d. Eggs
A
A nurse is caring for a client 2 hours after admission. The patient has an SpO2 of 91%, exhibits audible wheezing, and is using accessory muscles to create. Which of the following medications should the nurse expect to administer? a. Montelukast b. Labetalol c. Digoxin d. Albuterol
D
A nurse should recognize that milrinone is contraindicated for a client who has which of the following conditions? a. Acute myocardial infarction b. Peripheral vascular disease c. Ulcerative colitis d. Ventricular tachycardia
A
A nurse is providing teaching to a client who is taking simvastatin. The nurse should instruct the client to report which of the following manifestations as an indication of a serious adverse reaction that could require discontinuing drug therapy? a. bronchoconstriction b. muscle pain c. lip numbness d. somnolence
b
A nurse is reviewing new prescriptions with a client who has heart disease. The nurse should instruct the client that which of the following drugs is prescribed to treat hypercholesterolemia? a. Simvastatin b. Furosemide c. Losartan d. Nitroglycerin
A
A nurse is caring for a client who is about to begin captopril therapy. Which of the following adverse effects should the nurse instruct the client to report because it can indicate a need to discontinue drug therapy? SATA a. Rash b. Distorted taste c. Swelling of the tongue d. Photosensitivity e. Dry cough
A, B, C, E
Which characteristics are associated with HTN? (SATA) a. Glucose intolerance b. Obesity c. High dietary sodium d. Asian race e. Family history of HTN
A, B, C, E
A nurse is teaching a client about the adverse effects of pseudoephedrine. Which of the following should the nurse include? (Select all that apply.) a. Restlessness b. Bradycardia c. Insomnia d. Muscle pain e. Anxiety
A, C, E.
A nurse is administering a dopamine infusion at a low dose to a client who has severe heart failure. Which of the following medications places the client at risk for digoxin toxicity? a. Lowered heart rate b. Increased urine output c. Decreased conduction through the AV node d. Vasoconstriction of renal blood vessels
B
A nurse is caring for a client who has a new prescription for digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which medication places the client at risk for digoxin toxicity? a. Phenytoin b. Verapamil c. Warfarin d. Aluminum hydroxide
B
A nurse is caring for a client who is taking spironolactone to treat hypertension. The nurse should recognize that which of the following client laboratory values required immediate intervention? a. Sodium 140 mEq/L b. Potassium 5.2 mEq/L c. Chloride 100 mEq/L d. Magnesium 1.9 mEq/L
B
A nurse is developing a teaching plan for a client about preventing acute asthma attacks. Which of the following points should the nurse plan to discuss first? a. Eliminating environmental triggers that precipitate attacks b. Addressing the client's perception of the disease process and what might have triggered the attacks c. Reviewing the client's medication regimen d. Explaining manifestation of respiratory infections
B
A nurse in a provider's office is monitoring blood electrolytes for four clients who take digoxin. Which of the following electrolyte values increase a client's risk for digoxin toxicity? a. Calcium 9.2 mg/dL b. Calcium 10.3 mg/dL c. Potassium 3.4 mEq/L d. Potassium 4.8 mEq/L
C
A nurse is monitoring plasma drug levels in a client who is taking theophylline. Which of the following findings should the nurse expect to see if the client's drug level indicates toxicity? a. Seizures b. Constipation c. Normal sinus rythm d. Somnolence
a
A nurse is providing teaching to a client who has a new prescription for losartan to treat hypertension. The nurse should instruct the client that which of the following findings could indicate an adverse reaction to the drug and needs to be reported? a. facial edema b. sleepiness c. peripheral edema d. constipation
a
A patient has just received a prescription for fluticasone/salmeterol [Advair Diskus]. What will the nurse include as part of the teaching for this patient about the use of this device? a. "You will begin to inhale before activating the device." b. "You do not need good hand-lung coordination to use this device." c. "You will need to use a spacer to help control the medication." d. You will take 2 inhalations twice daily.
a
What are the results of using glucocorticoid drugs to treat asthma? a. Reduced bronchial hyperreactivity b. Increased synthesis of inflammatory mediators c. Increased responsiveness to beta 2-adrenergic agonists d. Reduces the number of beta 2-adrenergic receptors.
a
A nurse is teaching a client who has a prescription for albuterol via inhaler and fluticasone via inhaler for asthma management. For which of the following reasons should the nurse instruct the client to use the albuterol inhaler before using the fluticasone inhaler? a. Albuterol will increase the absorption of fluticasone b. Albuterol will decrease inflammation c. Albuterol will reduce nasal secretions d. Fluticasone will reduce the adverse effects of albuterol
a- because albuterol causes bronchodilation
A nurse is teaching a client who is taking prednisone for an acute asthma exacerbation. Which of the following instruction should the nurse include? a. "Avoid taking nonsteroidal anti-inflammatory drugs." b. "Rinse your mouth after taking the medication to prevent a yeast infection." c. "Stop taking the medication if you become nauseous." d. "Change position slowly when standing up."
a. Anti-inflammatory drugs can cause GI bleeding
A nurse is preparing to administer phenylephrine to a client. The nurse should identify that which of the following manifestations is an adverse effect of this drug? a. Headache b. Sleepiness c. Hypotension d. Constipation
a. Oral sympathomimetics stimulate the adrenergic receptors, causing blood vessel constriction, which can cause nervousness, headache, blurred vision, and tremors.
A nurse is administering a vasodilator that dilates resistance vessels. The nurse understands that this drug will have which effect on the patient? a. Increased ventricular contraction b. Increased cardiac output c. Decreased cardiac preload d. Decreased cardiac output
b
Legal restrictions apply to the purchase of pseudoephedrine because of which of the following risks? a. Respiratory depression b. Drug abuse c. Drug tolerance d. Rebound congestion
b. It is possible to alter pseudoephedrine into methamphetamine
A nurse is teaching a client about the use of antihistamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions? a. Decrease viscosity of nasal secretions b. Block H2 receptors c. Prevent histamine from binding to receptors. d. Reduce nasal congestion
c
A nurse is teaching a client about the use of beclomethasone to treat asthma. The nurse should explain that the drug has which of the following therapeutic effects? a. Thins mucus b. Relaxes bronchial smooth muscle c. Decreases inflammation d. Increases the cough threshold
c
A patient begins taking an ACE inhibitor and complains of a dry cough. What does the nurse correctly tell the patient about this symptom? a. It indicates that a serious side effect has occurred b. It occurs frequently in patients taking the drug but will subside over time. c. It may be uncomfortable enough that the drug will need to be discontinued. d. It is a common side effect that occurs in almost all patients taking the drug.
c
A nurse is caring for a client who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the nurse expect to administer to the client? a. Ipratropium b. Beclomethasone c. Acetylcysteine d. Azelastine
c. Acetylcysteine is a mucolytic that loosens thick respiratory secretions
A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is priority to make? a. Blood pressure b. Apical heart rate c. Respirations d. Level of consciousness
c. Can cause severe respiratory depression
A patient is taking a vasodilator that relaxes smooth muscles in veins. To help minimize drug side effects, the nurse caring for this patient will: a. Tell the patient to report shortness of breath. b. Warn the patient about the possibility of bradycardia c. Encourage the patient to increase fluid intake. d. Caution the patient not to get up abruptly.
d
A provider has ordered captopril [Capoten] for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril [Vasotec] in the past. Which action by the nurse is correct? a. Reassure the patient that this is not a serious side effect. b. Request an order to administer fosinopril instead of captopril. c. Administer the captopril and monitor for adverse effects d. Hold the dose and notify the provider.
d
A nurse is teaching a client about albuterol. The nurse should instruct the client to monitor for and report which of the following as an adverse effect of this drug? a. Fever b. Bruising c. Polyuria d. Palpitations
d. B2 agonists can cause cardiac stimulus, leading to chest pain, palpitations, hypertension and arrythmias
A nurse should recognize that using pseudoephedrine to treat allergic rhinitis required caution use with clients who have which of the following conditions? a. Peptic ulcer disease b. A seizure disorder c. Anemia d. Coronary artery disease
d. Because pseudoephedrine can cause systemic vasoconstriction
A nurse is teaching a client about the use of cromolyn sodium to prevent bronchospasm. The nurse should explain that the drug has which of the following therapeutic effects? a. Increases leukocyte activity b. Blocks muscarinic receptors c. Causes bronchodilation d. Reduces inflammation
d. Cromolyn is a mast cell stabilizer and reduces inflammation. It does not cause bronchodilation
A nurse is teaching a client who is beginning fluticasone propionate/salmeterol therapy. Which of the following instructions should the nurse include? a. Take the drug as needed for acute asthma b. Follow a low sodium diet c. Use an alternate-day dosing schedule d. Increase weight bearing activity
d. Increasing weight bearing activity can minimize bone less which is an adverse effect of salmeterol.
A nurse is teaching a client about montelukast. Which of the following instructions should the nurse include? a. Use a spacer to improve inhalation. b. Take the drug at the onset of bronchospasm c. Rinse mouth to prevent an oral fungal infection d. Take the drug once a day in the evening
d. Montelukast is an oral leukotriene modifier used for long-term therapy of asthma
A nurse is caring for a client who has a new prescription for aliskiren to treat hypertension. The nurse should monitor the client for which of the following findings as an adverse effect of the drug? SATA a. Hyperkalemia b. Throat swelling c. Constipation d. Cough e. Joint pain
A, B, D
A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation of digoxin toxicity? SATA a. Fatigue b. Constipation c. Anorexia d. Rash e. Blurred vision
A, C, E
A nurse is teaching a client who has a prescription for long-term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication? a. Weight gain b. Nervousness c. Bradycardia d. Constipation
A- steroid cause you to gain weight because of sodium and water retention. Nervousness is seen with albuterol
A nurse is teaching a client who has a new prescription for verapamil to control hypertension. Which of the following instructions should the nurse include? a. Increase the amount of fiber in the diet. b. Drink grapefruit juice daily to increase vitamin C intake. c. Decrease the amount of calcium in the diet. d. Withhold food for 1 hr after the medication is taken.
A. Constipation is a common side effect of verapamil, so increasing fiber would be appropriate.
A nurse is teaching a client about ipratropium. The nurse should include that this drug has which of the following adverse effects? a. Muscle tremors b. Urinary retention c. Dry mouth d. Insomnia e. Tachycardia
B, C
A nurse is preparing to administer IV altepase to a client. Which of the following interventions should the nurse plan to take? a. Administer IM enoxaparin along with the altepase dose. b. Obtain the client's weight c. Administer aminocaproic acid IC prior to alteplase infusion d. Prepare to administer alteplase within 8 hr of manifestation onset
B. An accurate weight is needed to calculate the dosage
A nurse is planning to administer subcutaneous enoxaparin 40 mg using a profiled syringe of enoxaparin at 40 mg/0.4 ml to an adult client following hip arthroplasty. Which of the following actions should the nurse plan to take? a. Expel the air bubble from the profiled syringe before injecting b. Insert the needle completely into the client's tissue c. Administer the injection in the client's thigh d. Aspirate carefully after inserting the needle into the client's skin
B. Deep subcutaneous injection
A nurse is teaching an adult client about diphenhydramine. The nurse should inform the client to expect which of the following adverse effects? a. Muscle tremors b. Drowsiness c. Excitation d. Insomnia
B. Diphenhydramine is a first generation antihistamine
A nurse is teaching a client about using intranasal glucocorticoids. Which of the following instructions should the nurse give? a. Start at a low dose and gradually increase it. b. Take the drugs as needed for nasal congestion. c. Allow at least 2 weeks for the full therapeutic effect d. Use the drug prior to exercise.
C
A client with atrial fibrillation is receiving heparin infusion at 1000 units/hour. The nurse determines that the client is receiving the therapeutic dose based on which results? A. Prothrombin time of 12.5 seconds B. Activated partial thromboplastin time of 60 seconds C. Activated partial thromboplastin time of 28 seconds D. Activated partial thromboplastin time longer than 120 seconds
B. Normal APTT value is 30-24 so therapeutic range is 45-60. Over 120 means blood is not clotting
A nurse is caring for a client who has a new prescription for captopril for hypertension. The nurse should monitor the client for which of the following as an adverse effect of this medication? a. Hypokalemia b. Hypernatremia c. Neutropenia d. Bradycardia
C
A nurse is caring for a client who has a new prescription for propranolol to treat tachydysrythmia. The nurse should instruct the client to avoid taking which of the following types of over the counter drugs while taking propranolol? a. Antihistamines b. Potassium supplements c. NSAIDs d. Vitamin C
C
A nurse is caring for a client who has a new prescription for verapamil. The nurse should clarify the prescription with the provider if the client has a history of which of the following conditions? a. Migrane headaches b. Pancreatitis c. Second degree AV block d. Angina pectoris
C
During administration of atleplase, the patient's IV site starts to ooze blood around the catheter. Which action by the nurse is most appropriate? a. Discontinue the infusion of alteplase b. Assess the patient's vital signs c. Apply direct pressure over the puncture site d. Administer aminocaproic acid
C
Which patient does the nurse identify as most likely needing an increase dose of paraffin (Coumadin) to have the same anticoagulant effect? a. Patient taking acetaminophen for back pain b. Patient taking cimetidine to prevent gastric ulcers c. Patient taking oral contraceptives to prevent pregnancy d. Patient taking prednisone for rheumatoid arthritis
C
A nurse is caring for a client who will begin using transdermal nitroglycerin to treat angina pectoris. When speaking to the client about the drug, which of the following instructions should the nurse include? (SATA) a. "Apply a new patch at the onset of anginal pain." b. "Apply the patch to dry skin and cover the area with plastic wrap." c. "Apply the patch to a hairless area and rotate sites." d. "Apply a new patch when you start your day." e. "Remove patches for 10 to 12 hours each day."
C, D, E
A nurse in an acute care facility is caring for a client who is receiving IV nitroprusside for hypertensive crisis. Which of the following conditions should the nurse monitor the client for as an adverse effect of this medication? a. Intestinal ileus b. Neutropenia c. Delirium d. Hyperthermia
C. Delirium is a sign of thiocynanate toxicity
A nurse is assessing a client who is taking digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity? a. Bruising b. Report of metallic taste c. Muscle pain d. Report of anorexia
D
A nurse is caring for a client who has a glomerular filtration rate of 10 mL/min and a reduced urine output. The nurse should clarify a prescription for hydrochlorothiazide for this client because of which of the following characteristics of the drug? a. The drug can cause hypoglycemia in clients who have a low urine output. b. The drug does not reduce blood pressure for clients who have a low urine output. c. The drug can increase the risk of pulmonary edema for clients who have renal insufficiency d. The drug does not promote diuresis for clients who have renal insufficiency
D
A patient with stable Asthma receives prescriptions for an inhaled glucocorticoid and a short-acting inhaled beta 2-adrenergic agonist. Which statement by the patient indicates understanding of this medication regimen? a. "The glucocorticoid is used as prophylaxis to prevent asthma attacks." b. "The beta 2-adrenergic agonist suppresses the synthesis of inflammatory mediators." c. "I will need to use the beta 2 adrenergic agonist daily." d. "I should use the glucocorticoid as needed when symptoms flare."
a
A young adult woman will begin using an inhaled glucocorticoid to treat asthma. The nurse will teach this patient about the importance of which action? a. Participating in weight-bearing exercises on a regular basis. b. Taking oral glucocorticoids during times of acute stress. c. Using two reliable forms of birth control to prevent pregnancy. d. Lowering her calcium intake and increasing her vitamin D intake.
a
For which of the following reasons should a client attach a spacer to a metered-dose inhaler? a. To increase the amount of drug delivered to the lungs b. To increase the amount of drug delivered to the oropharynx. c. To increase the amount of drug delivered on exhalation. d. To increase the speed of drug delivery into the mouth.
a
A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension. The nurse should recognize which of the following conditions as a contraindication for taking propranolol? a. Asthma b. Glaucoma c. Hypertension d. Tachycardia
a. Propranolol is a non-selective beta blocker that could block beta 2 receptors in the lungs
A nurse is teaching a client who has a new prescription for quinidine. Which of the following statements should the nurse include? a. "Monitor your pulse rate and report changes." b. "Remain upright for 30 minutes after taking this medication." c. "This medication can decrease digoxin levels." d. "This medication can cause urinary incontinence."
a. sodium channel blockers can worsen dysrhythmias or cause new ones
A nurse is teaching a client about ipratropium. Which of the following should the nurse include? a. Do not drink anything for 30 minutes after using the drug b. Wait 5 minutes between using the drug and another inhaled drug. c. This drug is used to thin respiratory secretions d. Check pulse rate after inhaling the drug
b
A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects?
b
A nurse is caring for a client who has a new prescription for verapamil to treat atrial fibrillation. The nurse should instruct the client to avoid drinking grapefruit juice while taking verapamil because it can cause the client to experience which of the following conditions? a. tachycardia b. dehydration c. diarrhea d. hypotension
d
A patient diagnosed with heart failure has a history of asthma and diabetes. Which medications if ordered by the health care provider, should the nurse question? a. Angiotensin-converting enzyme inhibitor b. Calcium channel blocker c. Thiazide diuretic d. Beta blockers
d
Which are therapeutic uses for verapamil? (SELECT ALL THAT APPLY) a. Suppression of preterm labor b. angina of effort c. Cardiac dysrhythmias d. Essential hypertension e. Sick sinus syndrome
B, C, D
A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching? a. Contact provider if heart rate is less than 60/min b. Check pulse rate for 30 seconds and multiply result by 2 c. Increase intake of sodium d. Take with food if nausea occurs
A
A nurse is teaching a client who has a new prescription for nitroglycerin. The nurse should instruct the client that which of the following manifestations is a potential adverse affect of this drug? a. headache b. constipation c. hypertension d. hyperglycemia
A
A patient is receiving an intravenous infusion of heparin to treat a pulmonary embolism. What laboratory value will the nurse monitor to evaluate treatment with this medication? a. Activated partial thromboplastin time (aPTT) b. Prothrombin time (PT) c. Platelet count d. Hemoglobin and hematocrit
A
The nurse is performing an assessment on a client with a diagnosis of left sided heart failure. Which assessment component would elicit specific information regarding the client's left sided heart function. A. Listening to lung sounds B. Palpating for organomegaly C. Assessing for jugular vein distention D. Assessing for peripheral and sacral edema
A
A nurse is providing instruction to a client who has a new prescription for albuterol, PO. Which of the following instructions should the nurse include? a. You can take the medication to abort an acute asthma attack b. Tremors are an adverse effect of this medication c. Prolonged use of this medication can cause hyperglycemia d. This medication can slow skeletal growth
B
A nurse is planning on administering a first dose of captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (SATA) a. Simvastatin b. Hydrochlorothiazide c. Phenytoin d. Clonidine e. Aliskiren
B, D, E. Hydrochlorothiazide is a diuretic. Clonidine is an alpha 2 agonist and aliskiren is a direct renin inhibitor
A nurse is caring for a client who has atrial fibrillation and a new prescription for dabigatran. Which of the following medications is prescribed concurrently to treat an adverse effect of dabigatran? a. Vitamin K b. Protamine c. Omeprazole d. Probenecid
C
A nurse is caring for a client who is receiving heparin by continuous IV infusion. The client begins vomiting blood. After the heparin has been stopped, which should the nurse prepare to administer? a. Vitamin K b. Atropine c. Protamine d. Calcium gluconate
C
A nurse is teaching a client about the use of a mucolytic to treat a cough. The nurse should include that a mucolytic has which of the following therapeutic effects? a. Suppresses the cough stimulus b. Reduces inflammation c. Thins and loosens mucus d. Dries secretions
C
A nurse is caring for a client who is experiencing thick oral secretions. Which of the following actions should the nurse take first? a. Provide chest physiotherapy b. Perform oropharyngeal suctioning c. Encourage deep breathing and coughing d. Assist the client with ambulation
C- start with least invasive action
A nurse is caring for a client who is taking carvedilol and has a prescription for an oral anti diabetic drug to manage their new diagnosis of type 2 diabetes mellitus. By taking both drugs concurrently, the nurse should identify that the client is at an increased risk for what condition? a. Hyperglycemia b. Bradycardia c. Hypotension d. Hypoglycemia
D
A patient with asthma will be using a metered-dose inhaler (MDI) for delivery of an inhaled medication. The provider has ordered 2 puffs to be given twice daily. It is important for the nurse to teach this patient that: a. The patient should wait 1 minute between doses. b. The patient should store the MDI in the refrigerator between doses. c. The patient should activate the device and then exhale. d. The patient should inhale suddenly to receive the maximum dose.
a
For which of the following reasons should a nurse instruct a client to avoid taking guaifenesin with combination over-the counter cold products? a. Over-the-counter cold products can also contain guaifenesin. b. Blood glucose levels are increased. c. Rebound congestion is likely. d. Drug tolerance is likely.
a. Over the counter cold products might also contain guaifenesin which can lead to taking excessive amounts
A nurse is teaching a client who has a prescription for zileuton. Which of the following instruction should the nurse include? a. Check apical pulse before taking the drug. b. Take the drug only as needed before exercising. c. Rinse mouth after using the drug. d. Have laboratory tests performed at regular intervals.
d. Zileuton is a leukotriene modifier and can cause liver injury, so the nurse should monitor liver function frequently
A nurse is caring for a client who has a new prescription for dobutamine. The nurse should clarify the prescription with the provider if the client is receiving which of the following types of drugs? (SATA) a. ACE inhibitor b. MAOI c. General anesthetic d. Tricyclic antidepressant e. Beta blocker
B, C, E
A nurse is monitoring a patient who takes aspirin daily. The nurse should identify which of the following manifestations as adverse effects of aspirin? (SATA) a. Hypertension b. Coffee-ground emesis c. Tinnitus d. Paresthesias of the extremities e. Nausea
B, C, E
A nurse is caring for a client who is taking digoxin and develops changes on their ECG tracing and other manifestations that indicate the client has severe digoxin toxicity. Which of the following drugs should the nurse expect to administer to treat this complications? a. Acetylcysteine b. Flumazenil c. Antigen binding fragments d. Deferoxamine
C
A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension. The nurse should recognize which of the following is a contraindication for taking propranolol? a. Asthma b. Glaucoma c. Hypertension d. Tachycardia
A
A nurse is teaching a new heart failure patient with prescriptions for furosemide and digoxin. Which of the following should the nurse include? SATA a. Weigh yourself daily, first thing each morning b. Decrease your potassium intake c. Expect muscle weakness while taking digoxin d. Hold digoxin if your heart rate is less than 70/min e. Decrease sodium intake
A and E
A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine? a. Reduced antitussive effect of dextromethorphan b. Potentiation of depression of CNS actions c. Increased renal reabsorption of the dextromethorphan d. Delayed analgesic effect of the opioid
B
A nurse is caring for a client who presents to the ER with a blood pressure of 266/147 mmHg. She complains of a headache and double vision. She reports that she ran out of her diltiazem 3 days ago. What is the nurse's first action? a. Administer acetaminophen for her headache b. Provide teaching about the importance of taking her blood pressure medications c. Obtain IV access and prepare an IV hypertensive d. Call social services for a referral for financial assistance in obtaining her prescriptions
C
A nurse is preparing to assist a nursing student to administer intravenous verapamil to a patient who also receives a beta blocker. The nurse asks the nursing student to discuss the plan of care for this patient. Which statement by the student indicates a need for further teaching? a. "I will monitor the heart rate frequently to assess for reflex tachycardia." b. "I will monitor vital signs closely to assess for hypotension." c. "I will prepare to administer intravenous norepinephrine if necessary." d. "I will check to see when the last dose of the beta blocker was given."
a
A parent asks a nurse about growth suppression resulting from the use of an inhaled glucocorticoid in children. What will the nurse tell the parent? a. Growth may be slowed, but eventual adult height will not be reduced. b. The growth rate is not impaired, but overall height will be reduced. c. The growth rate slows while the drug is used and only resumes when the drug is stopped. d. Long-term use of the drug results in a decrease in adult height
a
A patient begins taking long acting nifedipine [Procardia], and metoprolol (lopressor), to treat hypertension. The nurse understands that metoprolol is used to: a. prevent reflex tachycardia. b. reduce flushing. c. minimize gingival hyperplasia. d. prevent constipation
a
A patient who uses an inhaled glucocorticoid for chronic asthma calls the nurse to report hoarseness. What will the nurse do? a. Ask whether the patient is rinsing the mouth after each dose b. Tell the patient to discontinue the glucocorticoid c. Request an order for an antifungal medication d. Suggest the patient be tested for a bronchial infection.
a
A patient with asthma is admitted to an emergency department with a respiratory rate of 22 breaths per minute, a prolonged expiratory phase, tight wheezes, and an oxygen saturation of 90% on room air. The patient reports using fluticasone [Flovent HFA] 110 mcg twice daily and has used 2 puffs of albuterol [Proventil HFA], 90 mcg/puff, every 4 hours for 2 days. The nurse will expect to administer which drug? a. Intravenous glucocorticoids, nebulized albuterol and ipratropium, and oxygen b. Four puffs of albuterol, oxygen, and intravenous theophylline c. Intramuscular glucocorticoids and salmeterol by metered-dose inhaler d. Intravenous theophylline, oxygen, and fluticasone (Flovent HFA) 220 mcg
a
A patient with persistent, frequent asthma exacerbations asks a nurse about a long-acting beta 2-agonist medication. What will the nurse tell this patient? a. LABAs should be combined with an inhaled glucocorticoid. b. LABAs are safer than short-acting beta 2 agonists c. LABAs can be used on an as-needed basis to treat symptoms d. LABAs reduce the risk of asthma-related deaths
a
The nurse is caring for a patient who is taking a vasodilator that dilates capacitance vessels. The nurse will expect which effect in this patient? a. Increase in tissue perfusion b. Increase in venous return c. Increase in cardiac output d. Decrease in cardiac work
d
A nurse should identify that which of the following drugs is used only for the short-term treatment of a cardiac dysrhythmia because of the serious adverse effects associated with long-term use? a. Quinidine b. Procainamide c. Nitroglycerin d. Verapamil
B
A nurse is teaching a client who has a new prescription for gemfibrozil. Which of the following instructions should the nurse include? SATA a. Take the drug food b. Report any new intolerance to fried foods c. Report muscle tenderness d. Expect periodic liver function testing e. Take the drug once each day
B, C, D
A patient who has been taking an antihypertensive medication for several years is recovering from a myocardial infarction. The prescriber changes the patient's medication to an ACE inhibitor. The patient asks the nurse why a new drug is necessary. What is the nurse's response? a. "ACE inhibitors regulate electrolytes that affect the cardiac rhythm." b. "ACE inhibitors increase venous return to the heart, improving cardiac output." c. "ACE inhibitors can prevent or reverse pathologic changes in the heart's structure." d. "ACE inhibitors help lower LDL cholesterol and raise HDL cholesterol."
c
