Exam 3 Answers

A client is started on antiarrhythmic therapy to treat atrial fibrillation. The nurse caring for this client knows which occurrence is a potential side effect of this medication? Malignant hyperthermia Shortness of breath Other arrhythmias Angina

Other arrhythmias

What is a contraindication for class II antiarrhythmics? Asthma Colitis Migraine headache Antidiarrheals

asthma

A female patient diagnosed with chronic atrial flutter has been prescribed verapamil in conjunction with digoxin to control ventricular rate. To enhance the therapeutic effect of the drug, the nurse will instruct the patient to: take the medication with meals. avoid grapefruit and grapefruit juice take an aspirin every day. avoid fresh fruit.

avoid grapefruit and grapefruit juice

Which property is related to the ability of the heart cells to transmit an action potential of electrical impulse? Contractility Automaticity Afterload Conductivity

conductivity

To help liquefy cold-related secretions, the nurse should encourage the client to implement which measure? reducing salt intake deep breathing and exercises gargling with normal saline increasing fluid intake

increasing fluid intake

A group of students are reviewing the common conditions associated with the upper respiratory tract. The students demonstrate understanding of the material when they identify what as a response to a specific antigen? Asthma Seasonal rhinitis Sinusitis Pharyngitis

seasonal rhinitis

When the use of antihistamines result in dryness of the mouth, the nurse should recommend which to relieve the dryness? Select all that apply. Suck on sugarless hard candy. Administer intravenous fluid bolus. Offer ice chips. Take frequent sips of water. Use a dehumidifier in the home.

suck on sugarless hard candy, offer ice chips, take frequent sips of water

A nurse caring for a patient with atrial fibrillation who is started on digitalis is required to monitor plasma digitalis levels in the patient's blood. Which plasma level of digitalis indicates that the nurse should report to the practitioner? 1.6 nanograms (ng)/ml 1.8 ng/ml 2 ng/ml 2.2 ng/ml

2.2

A client reports a hacking cough. The client asks if taking an antihistamine would be helpful. The nurse's best response is: Antihistamines are not used for this issue. Antihistamines are recommended for extended use, as long as you monitor for adverse effects. Antihistamines are not recommended for this issue; only antibiotics are useful. Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.

Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.

A client has been prescribed an antihistamine for the treatment of seasonal allergies. What dietary guidelines should the nurse provide to the client? Avoid drinking alcohol while taking antihistamines Avoid grapefruit juice until at least 48 hours after treatment is complete Increase intake of foods that are high in vitamin C Eat several small meals instead of three larger meals in case of GI upset

Avoid drinking alcohol while taking antihistamines

A nurse is caring for a patient who has been prescribed a nasal decongestant. Which of the following factors should the nurse assess before administering the drug? Motor coordination Blood pressure Vision Auditory tests

BP

When instructing a client in how to use a topical nasal spray, what would the nurse emphasize to do first? Clear the nasal passages. Spray the medication with the bottle upright. Lie down to tilt the head back. Close the opposite nares.

Clear the nasal passages.

A 45-year-old female client is being seen in the health care provider's office for a dry, hacking cough that is keeping her up at night. The provider prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan? Dextromethorphan works in the medulla to suppress the cough reflex. Dextromethorphan works on the receptors in the throat to prevent a cough. Dextromethorphan works by inhibiting allergen response. Dextromethorphan works by relaxing the smooth muscles in the bronchioles.

Dextromethorphan works in the medulla to suppress the cough reflex.

T/F Second generation antihistamines are associated with a higher risk of sedation than first generation antihistamines

False

There are several classes of antiarrhythmic drugs. What class of antiarrhythmics drugs block potassium channels, prolonging phase 3 of the action potential, and slowing the rate and conduction of the heart? I II III IV

III

The nurse prepares to administer a phosphodiesterase inhibitor by what route? Oral IV Subcutaneous Intramuscular

IV

The client has a diagnosis of atherosclerosis. When a branch of the coronary artery becomes completely blocked, what event will the nurse expect to occur? Heart failure Arrhythmia Myocardial infarction Hypertension

MI

Which drug is in the class of drugs called human B-type natriuretic peptides? Bosentan (Tracleer) Milrinone (Primacor) Digoxin (Lanoxin) Nesiritide (Natrecor)

Nesiritide

The student nurses are studying the conduction system of the heart. The instructor explains that the electrical conduction of the heart usually originates in the SA node. What sequence completes the conduction? SA node to bundle of HIS to AV node to Purkinjie fibers SA node to AV node to Purkinjie fibers to bundle of HIS SA node to bundle of HIS to Purkinjie fibers to AV node SA node to AV node to bundle of HIS to Purkinjie fibers

SA node to AV node to bundle of HIS to Purkinjie fibers

When heart failure occurs, one of the results is increased preload. What is this? The amount of blood returning to the heart The resistance the heart must overcome The amount of blood pooled in the extremities The pulse rate caused by venous distention

The amount of blood returning to the heart

A patient, diagnosed with congestive heart failure, would like the nurse to explain what it means. What would the nurse explain about congestive heart failure? The heart muscle fails, the blood backs up, and the system becomes congested The hydrostatic pressure pushing fluid out of the capillaries is lower than the oncotic pressure The decrease in venous pressure from the back up of blood increases hydrostatic pressure on the venous end of the capillaries Increase protein can lead to a fall in oncotic pressure and the inability to pull fluid back into the vascular system

The heart muscle fails, the blood backs up, and the system becomes congested

The nurse is reviewing with the client the three major layers of the heart wall and how they relate to the pericardium. What is the best description by the nurse to the client about the myocardium layer of the heart? Thick, strong muscles making up the middle layer Thin outer layer of the cardiac wall A membrane lining the heart's interior wall Outermost layer anchoring the heart

Thick, strong muscles making up the middle layer

Expectorants elicit their effect by which mechanism? Thinning respiratory secretions Breaking down thick mucus in the lower lungs Depressing the cough center in the brain Anesthetizing stretch receptors in the respiratory passages

Thinning respiratory secretions

T/F Nesiritide is a human B-type natriuretic peptide.

True

What type of cough is best treated with dextromethorphan? an occasional, productive cough a cough that is associated with an allergy to ragweed a cough that occurs when the client is exposed to airborne irritants a dry, nonproductive cough

a dry, nonproductive cough

When describing the benefits of second-generation H1 receptor antagonists to those of first-generation H1 receptor antagonists, the nurse should cite what advantage? lower cost decreased sedation absence of adverse effects once-weekly dosing

decreased sedation

A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients? Drowsiness Dry mouth Nasal burning Nonproductive cough

drowsiness

The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects? Dry mouth Blurred vision Excessive salivation Drowsiness

excessive salivation

What is the chemical mediator released in immune and inflammatory response to allergic reactions? norepinephrine mast cells epinephrine histamine

histamine

Propranolol is ordered for a client who has a cardiac arrhythmia. It will be important for the nurse to determine if the person has a history of: chronic heart failure secondary to a tachyarrhythmia. idiosyncratic reaction to cinchona derivatives. hypersensitivity to beta blockers. hypersensitivity to sulfonylureas.

hypersensitivity to beta blockers

When administering milrinone (Primacor), the nurse should observe the client for which adverse effect? Hypoglycemia Confusion Hypotension Seizures

hypotension

What would the nurse recognize as increased signs and symptoms of heart failure? Decreased pedal edema Dry, hacking cough Increased crackles in lung fields Increased pulse rate

increased crackles in lung fields

A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by: blocking adrenergic receptors and producing antisympathetic effects. inhibiting the movement of calcium ions across the cardiac muscle cell membrane. decreasing sodium and potassium conduction. weakening diastolic depolarization and the action potential duration.

inhibiting the movement of calcium ions across the cardiac muscle cell membrane.

Pseudoephedrine (Sudafed) is prescribed for a client suffering from nasal and sinus congestion. What is the most important assessment the nurse should complete before the client leaves the clinic to purchase the medication? Observe for swelling in nasal passages. Ask about history of hay fever. Obtain the client's blood pressure. Ask about nausea and vomiting.

obtain the client's BP

A client with a history of heart failure is being treated with digoxin. The nurse knows that this medication increases the force of contractions of the heart. What effect improves the contractility of the heart? positive chronotropic effect positive inotropic effect negative inotropic effect negative dromotropic effect

positive inotropic effect

A 25-year-old woman comes to the clinic because of a chronic, nonproductive cough. Assessment reveals that she has a history of asthma, and dextromethorphan (Robitussin) is prescribed for her. The nurse will question this order because serotonin syndrome may result. persistent coughing may develop. respiratory secretions may be thickened. secretions may be retained.

respiratory secretions may be thickened.

An older client diagnosed with hypertension is requesting an oral nasal decongestant for cold symptoms. Which statement by the nurse best describes the effect of decongestants on blood pressure? "The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels." "The administration of a nasal decongestant will cause bradycardia and increase peripheral blood pressuregastric reflux." "The administration of a nasal decongestant will decrease the thyroid production and increase rebound congestion." "The administration of nasal decongestant will act on the central nervous system to cause vasodilation of blood vessels."

"The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels."

A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon? Antitussives suppress coughing while expectorants loosen bronchial secretions. Both drug types loosen bronchial secretions for ease of removal. Antitussives liquefy bronchial secretions while expectorants assist in the expectoration of those secretions. Antitussives kill cold viruses while expectorants liquefy bronchial secretions.

Antitussives suppress coughing while expectorants loosen bronchial secretions.

An adult client has asked the nurse to recommend an OTC cold remedy. Before making a recommendation, the nurse should implement which intervention? Consult with a pharmacist or pharmacy technician. Assess the client's understanding of the epidemiology of the common cold and upper respiratory infections. Assess the client for health problems that may contraindicate the use of a particular remedy. Ensure that the client has tried some of the more common herbal and natural remedies.

Assess the client for health problems that may contraindicate the use of a particular remedy.

The nurse is preparing discharge teaching for a client prescribed chronic antiarrhythmic medication therapy. Which signs/symptoms should be reported to the health care provider immediately? (Select all that apply.) Chest pain Dyspnea Nausea Heart palpations Diarrhea

chest pain, dyspnea, heart palpations

A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow? Antitussives Decongestants Expectorants Mucolytics

decongestants

A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example? Guaifenesin Acetylcysteine Dextromethorphan Benzonatate

guaifenesin

A patient with cardiac arrhythmia is prescribed verapamil. Which of the following possible adverse effects should the nurse inform the patient about? Diarrhea Hyperactivity Peripheral edema Hypertension

peripheral edema

A female client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that she will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client? Codeine Guaifenesin Dextromethophan Aspirin

guaifenesin

A client presents to the Emergency Department (ED) with rales, wheezing, and blood-tinged sputum. The nurse suspects that the client is in congestive heart failure (CHF). What would the nurse suspect the client is experiencing? Cardiomyopathy Cardiomegaly Valvular heart disease Pulmonary edema

pulmonary edema

When administering digoxin (Lanoxin), the nurse would monitor the apical pulse for 1 full minute. The nurse should withhold digoxin (Lanoxin) and notify the health care provider if: respiratory rate falls below 14. history reveals liver failure. pulse is 54 beats per minute. blood pressure is 72/40 mm Hg.

pulse is 54 bpm

The nurse is teaching a group of clients with allergic rhinitis about the use of their medications. What would be the most essential information to give these clients about preventing possible drug interactions? OTC medications are safe to use. Use only one pharmacy so the pharmacist can check drug interactions for you. Read drug labels before taking OTC medications. Ask the pharmacy tech to assist you in selecting an OTC medication.

read drug labels before taking OTC medications

A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition? Drink ample water before taking the tablet. Take an antacid before the tablet. Take the tablet with food. Take the tablet one hour before food.

take the tablet with food

A new nurse on the cardiac unit is taking a class in the anatomy and physiology of the heart. What does the nurse learn is the cardiac action potential? The cycle of depolarization and repolarization The time it takes from the firing of the SA node to the contraction of the ventricles The time between the contraction of the atria and the contraction of the ventricles The cycle of the firing of the AV node and the contraction of the myocardium

the cycle of depolarization and repolarization

A nurse assessing a client on digoxin suspects toxicity. Which visual disturbances would the nurse expect to assess? Complete loss of vision Double vision Yellow or green vision Difficulty of near vision

yellow or green vision