Pharm 2 Chapters 27, 30, 37, and 38

The nurse is caring for a client who is prescribed a nonselective adrenergic blocking agent. For which condition would labetalol be prescribed for this client? heart failure pheochromocytoma ventricular arrhythmias left ventricular dysfunction

pheochromocytoma

The health care provider has prescribed sucralfate for a client with a gastric ulcer. The client asks how long he must take this medication. What is the nurse's best response to this client? "You will take it for 5 days, then skip 5 days, then take it for another 5 days and you will be done with it." "You will need to take this medication for the rest of your life." "You must take this medication for the full 10 days." "You will need to take this medication for 4 to 8 weeks to ensure healing has occurred."

"You will need to take this medication for 4 to 8 weeks to ensure healing has occurred."

Which is true about digoxin? Digoxin decreases the mortality associated with heart failure. Digoxin is used to treat paroxysmal atrial fibrillation. The therapeutic range for digoxin is 0.5 to 2 ng/mL. Digoxin improves the quality of life for patients with heart failure in the absence of atrial fibrillation.

0.5 to 2 ng/mL.

A nurse is teaching a client about prescribed lansoprazole. The nurse instructs the client to take the drug at which time? 2 hours after a meal at bedtime first thing on arising 1 hour before eating

1 hour before eating

A nurse is assessing the serum digoxin level of a client who is receiving treatment for atrial fibrillation. Which result should the nurse prioritize and report to the primary health care provider? 1.8 ng/mL 1.6 ng/mL 2.0 ng/mL 2.2 ng/mL

2.2 ng/mL

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 2 ng/ml 2.2 ng/ml 1.8 ng/ml

2.2 ng/ml

A nurse is assessing a 78-year-old client in the emergency department. The nurse determines the client is experiencing severe digoxin toxicity. What is the nurse's priority action? Auscultate the client's apical heart rate for a minimum of 90 seconds. Give intravenous acetylcysteine immediately. Identify the client's troponin levels. Administer digoxin immune fab as prescribed.

Administer digoxin immune fab as prescribed.

A nurse is preparing to administer ivabradine to a client with heart failure. Which preadministration assessment should the nurse prioritize for this client? Inspect joints for swelling. Inspect skin for rash. Obtain blood glucose levels. Check for jugular vein distention.

Check for jugular vein distention.

Quinidine is prescribed to a patient with cardiac arrhythmia. When documenting the patient's drug history, the nurse inquires about the concomitant use of any other drug. Which drug when given concomitantly may cause an increase in serum Quinidine levels? Hydantoins Nifedipine Cimetidine Barbiturates

Cimetidine

A nurse is preparing to administer flecainide. The nurse identifies this drug as being classified as which type of antiarrhythmic? Class IA Class IC Class II Class IB

Class IC

he nurse should warn a client taking aluminum- and calcium-containing antacids about which adverse effects? Diarrhea Dehydration Flatulence Constipation

Constipation

A client who is receiving a beta blocker tells the nurse about also taking ibuprofen for arthritis pain. The nurse would be alert for which reaction? Increased risk of hypotension Increased risk of bradycardia Decreased effect of the b blocker Increased risk of paradoxical hypertensive effect

Decreased effect of the b blocker

A group of nursing students are analyzing the various categories of upper gastrointestinal system drugs. The instructor determines the session is successful when the students correctly choose which drug(s) as an example of a proton pump inhibitor? Nizatidine Esomeprazole Omeprazole Misoprostol Sucralfate

Esomeprazole Omeprazole

The nurse is administering an intravenous dose of amiodarone to a client in distress. What action should the nurse prioritize? Establish cardiac monitoring and maintain it until full recovery. Document resuscitation efforts in detail. Provide reassurance and support to the client. Perform medication reconciliation.

Establish cardiac monitoring and maintain it until full recovery.

Which adverse effect is more likely to be caused by cimetidine than by other H2RAs? Seizures Hypertension Hypoxia Gynecomastia

Gynecomastia

The health care provider has prescribed ranitidine for a hospitalized client on a unit. Prior to administering the drug for the first time, which adverse effects should the nurse mention to the client? Anxiety Headache Visual disturbances Tremor

Headache

Which adverse effect might occur in a client receiving milrinone? Hypotension Hypoglycemia Hyperkalemia Confusion

Hypotension

The nurse is providing education to clients on antiarrhythmic drug classes. What class of antiarrhythmics drug will the nurse indicate blocks potassium channels, prolonging phase 3 of the action potential and slowing the rate and conduction of the heart? IV III I II

III

A client has been prescribed IV amiodarone for emergency treatment of a serious ventricular arrhythmia. The nurse monitors the client's ECG anticipating a noted change how long after the medication is delivered? Immediately 90 minutes 2-3 days 10 minutes

Immediately

The nurse is administering quinidine to a client who is also taking digoxin. The nurse will assess this client for which important adverse effect? Increased anticoagulant effects Increased digoxin level Decreased red blood cell count Decreased white blood cell count

Increased digoxin level

The pharmacology instructor is discussing cardiac glycosides with a class of pre-nursing students. According to the instructor, what physiologic effect do cardiac glycosides trigger? Decreased afterload Increased ventricular rate Decreased cardiac output Increased force of heart contraction

Increased force of heart contraction

The pharmacology instructor is discussing cardiac glycosides with a class of pre-nursing students. According to the instructor, what physiologic effect do cardiac glycosides trigger? Decreased cardiac output Increased force of heart contraction Decreased afterload Increased ventricular rate

Increased force of heart contraction

A male client is receiving morphine sulfate for pain after an accident. The health care provider has also ordered cimetidine IV to assist in preventing a stress ulcer. The nurse will monitor for what effect that is caused by the interaction of these two drugs? Increased reports of pain Increased symptoms of GERD Increased nausea and vomiting Increased incidence of respiratory depression

Increased incidence of respiratory depression

The nursing instructor explains to students that positive inotropic action affects the heart in which way? Increased myocardial contraction Decreased venous return Increased heart rate Decreased ventricular pressures

Increased myocardial contraction

A patient is prescribed esmolol for treatment of supraventricular tachycardia. The nurse would expect to administer this drug by which route? Intravenous Subcutaneous Oral Intramuscular

Intravenous

Milrinone is a miscellaneous inotropic drug used in the short-term management of heart failure. What is the only way this drug is approved to be administered? Subcutaneously Orally Intramuscularly Intravenously

Intravenously

A nurse is conducting an ongoing assessment after administering an antacid to a client. The nurse should question the effectiveness of which drug(s) if noted in the client's record? Select all that apply. Isoniazid Enalapril Phenytoin Digoxin Simvastatin

Isoniazid Phenytoin Digoxin

A critical care nurse is caring for a client after open-heart surgery. What nursing intervention would the nurse initiate to help detect life-threatening arrhythmias and manage and minimize any that occur? Monitor cardiac rhythm continuously. Provide supplemental oxygen. Palpate the client's pulse and observe the client's response. Monitor blood pressure continuously.

Monitor cardiac rhythm continuously.

A client is prescribed misoprostol. The nurse would expect to administer this drug by which route? Intravenous Transdermal Oral Subcutaneous

Oral

The nurse is preparing to administer a prescribed medication to a client diagnosed with GERD. If the nurse discovers the client has a history of vitamin B12, which medication(s) will the nurse administer cautiously? Select all that apply. Sucralfate Metoclopramide Rabeprazole Pantoprazole Promethazine

Pantoprazole Rabeprazole

The pharmacology instructor is describing medications that increase the contractile force of the heart. Which term describes this effect? Negative inotropic Positive inotropic Positive chronotropic Negative dromotropic

Positive inotropic

After a cardiac muscle contracts, what chemical reaction is needed to prepare the muscle cells for the next contraction? Potassium ions return to the intracellular space. Calcium ions return to the extracellular space. Potassium ions return to the extracellular space. Sodium ions return to the intracellular space.

Potassium ions return to the intracellular space.

A patient is admitted to the cardiology unit of a health care facility for ventricular arrhythmia. In which condition can an anti-arrhythmic drug be safely administered? Third-degree heart block Premature ventricular contraction Aortic stenosis Severe congestive heart failure

Premature ventricular contraction

A client on antiarrhythmic drug therapy reports nausea, vomiting, abdominal pain, diarrhea, and a ringing sensation in the ears. Which drug should the nurse investigate first to determine possible cause? Quinidine Procainamide Flecainide Lidocaine

Quinidine

A female client presents to the health care provider's office with increasing stomach acidity. She self-administers calcium antacids. She notes that she seems to be having more issues with stomach acid, so she has been taking the calcium antacids more frequently. The nurse suspects that this may have caused what to occur in this client? Hyperactive gastric mucosa Hypocalcemia Rebound acidity Gastric reflux

Rebound acidity

A nurse is caring for a patient who is prescribed omeprazole for a duodenal ulcer. The patient is also taking benzodiazepines for the management of a seizure disorder. Which of the following should be the effect of the interaction between these two drugs? Decreased absorption of the proton pump inhibitor Increased risk of respiratory depression Increased risk of bleeding Risk for toxic level of benzodiazepines

Risk for toxic level of benzodiazepines

The critical care nurse is caring for a client with bradycardia after cardiovascular surgery. The nurse knows that the heart rate is determined by myocardial cells with the fastest depolarizing rate. Under normal circumstances, where are these cells located? Bundle of HIS SA node Purkinje cells AV node

SA node

The nurse administering a Class I antiarrhythmic drug understands that the action of this drug is to: Indirectly block calcium channels Prolong repolarization Stabilize or anesthetize the membranes of cardiac cells Depress depolarization and lengthen repolarization

Stabilize or anesthetize the membranes of cardiac cells

A nurse is preparing a teaching plan for a client with an acute peptic ulcer who is prescribed aluminum carbonate gel. Which instructions should the nurse prioritize for this client? The drug should be taken early in the morning before breakfast. Take the drug hourly for the first 2 weeks. Take the drug before meals and at bedtime. Dissolve the drug in 40 mL of apple juice.

Take the drug hourly for the first 2 weeks.

What primary event has occurred when a client experiences an ectopic focus? Fluid is no longer being pulled back int the venous system effectively The location of the heart's functioning pacemaker is no longer the sinoatrial (SA) node The arterial resistance has been increased significantly The contractibility of the heart has been diminished greatly.

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

A 77-year-old man's chronic heart failure is being treated with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect? The man's heart rate is between 60 and 70 beats per minute with a regular rhythm. The man's glomerular filtration rate and creatinine levels are within reference ranges. The man's chest sounds are clear and his ankle edema is lessened. The man's potassium and sodium levels remain with reference ranges.

The man's chest sounds are clear and his ankle edema is lessened.

A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAs more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract? The parietal cells of the stomach have H2 receptors but not H1 receptors. H2RAs may be administered orally and in an outpatient environment but H1RAs require intravenous administration. H2 receptors in the upper GI tract outnumber H1 receptors by a factor of 2:1. H2RAs have a longer duration of action and fewer adverse effects than H1RAs.

The parietal cells of the stomach have H2 receptors but not H1 receptors.

Tikosyn or dofetilide

To convert the client's atrial fibrillation to normal sinus rhythm

A 35-year-old female has been recently diagnosed with hyperthyroidism. Her health care provider has prescribed propranolol (Inderal) for what effect? To decrease systolic blood pressure To prevent respiratory depression To promote bronchodilation To decrease heart rate

To decrease heart rate

client diagnosed with an H. pylori-associated ulcer has been prescribed treatment that includes two antimicrobials. What does the nurse identify as the reason for using multiple antimicrobials? A single antimicrobial is generally not strong enough to eradicate the infection. Two antimicrobials help prevent the emergence of drug-resistant H. pylori organisms. One antimicrobial tends to alter the action of the adjunct medications. Two different microbes are involved, requiring two different antimicrobials.

Two antimicrobials help prevent the emergence of drug-resistant H. pylori organisms.

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: a. inhibiting the movement of calcium ions across the cardiac muscle cell membrane. b. weakening diastolic depolarization and the action potential duration. c. decreasing sodium and potassium conduction. d. blocking adrenergic receptors and producing antisympathetic effects.

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

The nurse is caring for a client admitted to the telemetry unit with atrial fibrillation on the electrocardiogram (ECG) monitor. The nurse should perform which assessment(s) for safe administration of the first dose of quinidine? Select all that apply. a. Check baseline renal and hepatic function before administering drug. b. Assess if the client has systemic lupus erythematosus or myasthenia gravis. c. Obtain a history of allergies to medications and specific reactions. d. After administration, assess for tinnitus, hearing loss, headache, and vertigo. e. Determine if the client has had grapefruit or grapefruit juice recently.

a b c d

Which would be a contraindication for using a class IV antiarrhythmic? (Select all that apply.) a. Heart block b. Sick sinus syndrome c. Renal dysfunction d. Idiopathic hypertrophic subaortic stenosis e. Heart failure f. Hypotension

a b e f

After reviewing antiarrhythmic drugs, a group of nursing students demonstrate understanding of the drugs when they identify which as a class II antiarrhythmic? Select all that apply. a. Acebutolol b. Verapamil c. Ibutilide d. Propranolol e. Amiodarone

a d

The nurse suggests which dietary habits for the client with heart failure? (Select all that apply.) a. Decrease calories to lose weight if needed. b. Only salt food once with every meal. c. Avoid unsaturated fats and include saturated fats in every meal. d. Use canned soups to decrease the work of cooking. e. Try to include vegetables, protein, and carbohydrates in each meal.

a e

Which drugs treat heartburn by neutralizing the acidity of the stomach by combining with hydrochloric acid (HCl) and increasing the pH of the stomach acid? metoclopramide omeprazole aluminum hydroxide famotidine

aluminum hydroxide

A nurse must recognize which class of medication a drug is part of in order to help in planning ongoing assessment and patient education. Which is an example of a drug in the class of beta-adrenergic blockers? (Select all that apply.) a. Carvedilol (Coreg) b. Metoprolol (Lopressor) c. Atenolol (Tenormin) d. Labetalol (Trandate) e. Propranolol (Inderal)

b c e

A nursing instructor is teaching a group of students about cardiotonics. The instructor determines the session is successful when the students correctly identify which as an action(s) of the cardiotonics? Select all that apply. a. Increases blood pressure b. Increases myocardial efficiency c. Improves profusion to all body tissues d. Increases peripheral edema e. Improves myocardial contractility

b c e

The nurse is administering milrinone to a client with heart failure. The nurse should prioritize what assessment when monitoring the client for common adverse effects? orientation to person, place, and time capillary blood glucose respiratory rate blood pressure

blood pressure

The nurse notes that a client's current medications include both diltiazem for a dysrhythmia and atazanavir. The nurse should recognize the need to closely monitor which client assessment datum? oxygen saturation levels level of consciousness blood pressure peripheral pulses

blood pressure

An older adult client has been on long-term proton pump inhibitor (PPI) therapy. The nurse practitioner should focus on what assessment related to adverse effects? joint mobility dental health integumentary system bone density

bone density

After teaching a group of nursing students about sympatholytic drugs, the instructor determines that the teaching was successful when the students correctly choose which groups as an example? Select all that apply. a. Angiotensin receptor blockers b. Angiotensin-converting enzyme inhibitors c. Alpha-adrenergic blockers d. Loop diuretics e. Beta-adrenergic blockers

c e

The nurse is providing education to a client who has been newly prescribed chlorpromazine to prevent motion sickness while traveling. The nurse would instruct the client to take the medication 30 minutes before travel and again at what interval? up to twice daily every 3 to 4 hours every 4 to 6 hours as often as needed

every 4 to 6 hours

The nurse is caring for a client who is receiving ondansetron for nausea associated with chemotherapy. The nurse would teach the client that what adverse effects may occur with this medication? urinary incontinence and photosensitivity weakness and rash fever and diarrhea headache and dizziness

headache and dizziness

While reviewing the medication history of a client newly prescribed omeprazole, the nurse sees that the client is also taking warfarin. What potential interaction should the nurse account for when developing the plan of care for this client? fluid volume excess venous thromboembolism rebound gastroesophageal reflux disease (GERD) hemorrhage

hemorrhage

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.

The nurse is administering lidocaine to a client with ventricular tachycardia. The nurse will need to observe for adverse effects, including hyperthermia. hypertension. hypotension. dysphagia.

hypotension.

anitidine and cimetidine are both H2RAs used in the treatment of peptic ulcer disease. Of the two, ranitidine is preferred in critically ill clients because it is less likely to: cause diarrhea. result in hypotension. cause macular rash and cough. interfere with the metabolism of other drugs.

interfere with the metabolism of other drugs.

The nurse prepares to administer a phosphodiesterase inhibitor to a client. Which route will the nurse use to administer the medication? intramuscular intravenous subcutaneous oral

intravenous

The nurse prepares to administer a phosphodiesterase inhibitor to a client. Which route will the nurse use to administer the medication? subcutaneous intramuscular intravenous oral

intravenous

The primary health care provider prescribes a class I sodium channel blocker to be given intravenously. Which drug would the nurse most likely administer? mexiletine lidocaine flecainide disopyramide

lidocaine

The nurse is providing medication education to a client prescribed an adrenergic blocker. Which nervous system is the specific focus of this classification of medications? sympathetic parasympathetic peripheral central

sympathetic