PHARM 3

Nurse educates a patient to hold their betablocker if

HR < 60 and/or SBP <100

A nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following beverages should the nurse tell the client to avoid while taking this medication? Grapefruit juice Coffee Orange juice Milk

Grapefruit juice

How would the nurse theoretically expect calcium channel blockers to affect the function of the heart? increase in force of contraction increase rate decreased AV nodal conduction decrease in coronary perfusion

decreased AV nodal conduction

A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? "I can walk a mile a day." "I've had a backache for several days." "I am urinating more frequently." "I feel nauseated and have no appetite."

"I feel nauseated and have no appetite."

A nurse is providing discharge teaching to a client who has a new prescription for verapamil for angina. Which of the following instructions should the nurse include? "Increase your daily intake of dietary fiber." "Limit your fluid intake to meal times." "You can expect swelling of the ankles while taking this medication." "Do not take this medication on an empty stomach."

"Increase your daily intake of dietary fiber."

A patient with angina pectoris is prescribed sublingual nitroglycerin. Which of the statements made by the patient indicates understanding of the medication teaching? A. "I may experience a headache as a side effect." B. "The chest pain should be relieved within 20 minutes." C. "I should swallow the tablet." D. "I should take this medication in the morning before breakfast."

A. "I may experience a headache as a side effect."

Which patient would the nurse be most concerned about developing hyperkalemia? A. A patient who is prescribed captopril B.A patient who is prescribed losartan C. A patient who is prescribed an angiotensin II receptor blocker. D. A patient who has type II diabetes mellitus with hypertension.

A. A patient who is prescribed captopril

A patient is receiving an intravenous infusion of heparin to treat a pulmonary embolism (PE). What laboratory value will the nurse monitor to evaluate the treatment with this medication? A. Activated partial thromboplastin time (aPTT) B. Prothrombin time (PT) C. Platelets D. Hemoglobin and hematocrit

A. Activated partial thromboplastin time (aPTT)

A patient who is taking eplerenone (Inspra) is newly prescribed losartan (Cozaar). The nurse should: A. assess for signs of hyperkalemia. B. observe for a hypertensive crisis. C. administer the medications as scheduled. D. evaluate for first-dose hypotension.

A. assess for signs of hyperkalemia.

A patient with heart failure is prescribed furosemide (Lasix). The nurse should instruct the patient to consume: A. oranges, spinach, and potatoes. B. baked fish, chicken, and cauliflower. C. tomato juice, skim milk, and cottage cheese. D. oatmeal, cabbage, and bran flakes.

A. oranges, spinach, and potatoes.

A patient has a serum potassium level of 3.1 mEq/L. The nurse plans to administer: A. sustained-release potassium tablets (K-Dur). B. foods that are deficient in potassium. C. furosemide (Lasix). D. sodium polystyrene sulfonate (Kayexalate).

A. sustained-release potassium tablets (K-Dur).

Class of medication used in heart failure that is associated with cough

ACE inhibitor

When using drugs that act on the renin-angiotensin-aldosterone system, which of the following is the target polypeptide? Angiotensin I Angiotensin II Renin Aldosterone

Angiotensin II

Which of the following is a true statement regarding antianginal drugs? Antianginal drugs can decrease the risk of infarction. Antianginal drugs must be used in conjunction with antihypertensive agents. Antianginal drugs alone can prolong the lives of patients with coronary heart disease. Antianginal drugs only provide symptomatic relief.

Antianginal drugs can decrease the risk of infarction.

The nurse is caring for a client who is diagnosed with hypertension and is treated with combination therapy, aliskiren and enalapril. Which is the priority nursing action? Assess a serum thyroid-stimulating hormone level Assess the serum potassium level Assess the complete blood count levels Assess the serum magnesium level

Assess the serum potassium level

The nurse provides education regarding a new prescription for lisinopril to a client diagnosed with hypertension and bipolar disorder. Which two instructions will the nurse give the client? Avoid Salt substitutes Rise slowly out of bed when you get up Closely monitoring the electrolyte chloride is important Take this medication without food

Avoid Salt substitutes Rise slowly out of bed when you get up

A patient is prescribed hydralazine (Apresoline). Which of the following is most important to include in medication teaching? A. Precautions for postural hypotension. B.A beta blocker will be added to prevent tachycardia. C.High dosages will be initiated then tapered. D.Common adverse effects include hypertrichosis.

B. A beta blocker will be added to prevent tachycardia.

The nurse assesses a client who is taking spironolactone (potassiumsparing diuretic) daily. The health care provider has just ordered captopril. Which action is most important for the nurse to implement? A. Asses the Clients Heartrate B. Educate the client to take the first dose at bedtime. C. Assess the client for any history of GI bleeding. D. Auscultate the clients lung sounds

B. Educate the client to take the first dose at bedtime

A patient receives a dose of epoetin alfa (Epogen) 3 times per week. What laboratory value will the nurse monitor to determine the therapeutic benefit of this medication? A. White blood cell count B. Hemoglobin C. Serum potassium D.Platelet count

B. Hemoglobin

A patient is prescribed amlodipine (Norvasc XL). Which statement made by the patient indicates an understanding of medication teaching? A."I will stop taking my beta blocker." B."I must swallow the pill whole." C."The medication will cause constipation." D."This medication will treat my heart rhythm problems."

B."I must swallow the pill whole."

A patient is prescribed a medication that causes venous dilation. The nurse should teach the patient about: A.peripheral vascular disease. B.postural hypotension. C.renal diuresis. D.retention of water.

B.postural hypotension.

A client who is taking propranolol asks the nurse, "Why am I having a hard time reaching my target pulse rate while exercising?" Which response by the nurse is correct? "You should just exert yourself as much as possible until you reach your target pulse rate." "It means you are out of condition and need to build back up to reach your target pulse rate." "Your medication can raise your pulse rate too much, so you shouldn't exercise too hard." Beta-blockers slow your pulse rate and prevents it from increasing during exercise."

Beta-blockers slow your pulse rate and prevents it from increasing during exercise."

A client is prescribed spironolactone (Aldactone) for treatment of hypertension. Which foods should the patient be taught to avoid? A. Baked fish B. Low-fat milk C. Salt substitutes D. Green beans

C. Salt substitutes

A patient is prescribed a nitroglycerin transdermal patch. The nurse will teach the patient to: A. apply the patch to the chest over the heart. B. change the patch each week. C. remove the patch at night. D. use the patch to prevent exercise-induced chest pain.

C. remove the patch at night.

A patient is prescribed a medication that lowers the arterial blood pressure. The nurse will observe for tachycardia because: A. the renin-angiotensin-aldosterone system is activated. B.atrial natriuretic peptide is produced. C. the baroreceptor reflex is triggered. D.contractility and preload are decreased.

C. the baroreceptor reflex is triggered.

A patient has hypertension, type 2 diabetes, and renal insufficiency. The nurse should set the blood pressure target goal for: A.less than 140/90 mm Hg. B.a diastolic pressure less than 100 mm Hg. C.less than 130/80 mm Hg. D.a systolic pressure less than 160 mm Hg.

C.less than 130/80 mm Hg.

A patient is to receive prescribed doses of digoxin (Lanoxin) and furosemide (Lasix). Before these drugs are administered the nurse should check the: A. serum sodium level. B.respiratory rate and depth. C.serum potassium level. D.blood pressure.

C.serum potassium level.

Class of medication that is used in treatment for chronic stable angina that dilate arterioles and decreases heart contractility

CCB

Three classes of medication used to treat chronic stable angina

Calcium channel blockers, Beta blockers, and vasodilator

A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of the following prescribed medications places the client at risk for orthostatic hypotension? (Select two that apply.) Atorvastatin Captopril Furosemide Clopidogrel

Captopril Furosemide

A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? Request an order for an antiemetic. Suggest that the client rests before eating the meal. Check the client's vital signs. Request a dietitian consult.

Check the client's vital signs.

Which of the following patients would be a candidate for both lifestyle changes and drug therapy with an antihypertensive medication? A. A 47-year-old patient with blood pressure of 110/78 mm Hg and with type 2 diabetes mellitus B. A 76-year-old patient with blood pressure of 128/88 mm Hg and a history of dyslipidemia C.A 52-year-old patient with blood pressure of 136/89 mm Hg who smokes 1 pack of cigarettes per day D. A 32-year-old patient with blood pressure of 142/94 mm Hg who is overweight and sedentary

D. A 32-year-old patient with blood pressure of 142/94 mm Hg who is overweight and sedentary

Which of the following patients would most likely be started on nitroprusside (Nitropress)? A. A patient with a recent diagnosis of essential hypertension B. A patient with heart failure managed in an outpatient setting C. A patient with a hypotensive episode following a myocardial infarction D. A patient with a hypertensive crisis in the intensive care unit

D. A patient with a hypertensive crisis in the intensive care unit

A patient is to receive a scheduled dose of diltiazem (Cardizem). The nurse should hold the medication and contact the prescriber if: A.blood pressure is at or above 190/88 mm Hg. B. cardiac rhythm is in atrial fibrillation. C. the patient is complaining of chest pain. D. the patient is in second-degree heart block.

D. the patient is in second-degree heart block.

A nurse is teaching a patient about the symptoms associated with digoxin toxicity. The nurse will teach the patient to report: A.cough, arthralgia, and rigidity. B.dizziness, ataxia, and diarrhea. C.tachycardia, dyspnea, and edema. D.muscle weakness, nausea, and fatigue.

D.muscle weakness, nausea, and fatigue.

A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication? Increase of HDL cholesterol Decreased blood pressure Improved sexual function Prevention of bipolar manic episodes

Decreased blood pressure

A nurse is providing teaching to a client who has hypertension and a new prescription for captopril. Which of the following instructions should the nurse provide? Take the medication with food. Count your pulse rate before taking the medication. Expect to gain weight while taking this medication. Do not use salt substitutes while taking this medication

Do not use salt substitutes while taking this medication (BC they are high in potassium)

Which of the following signs would the nurse most likely notice first if a patient started developing digoxin toxicity? Slow respiratory rate A significant drop in blood pressure without pulse changes Heart murmur Dysrhythmias

Dysrhythmias

A nurse is preparing to administer digoxin to a client who has heart failure. Which of the following actions is appropriate? Instructing the client to eat foods that are low in potassium Evaluating the client for nausea, vomiting, and anorexia Withholding the medication if the heart rate is above 100/min Measuring apical pulse rate for 30 seconds before administration

Evaluating the client for nausea, vomiting, and anorexia

Which of the following drugs would be most effective to prevent venous thrombosis? Aspirin Tirofibran Streptokinase Heparin

Heparin

Maintenance of fluid volume and osmolality is primarily the job of the ___________? Which Organ?

Kidneys

A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication, which of the following actions should the nurse take? Offer the client a light snack. Measure the client's blood pressure. Weigh the client. Measure the client's apical pulse.

Measure the client's apical pulse.

Two classes of anti-dysrhythmics that decrease myocardial contractility and decrease the automaticity of sinoatrial (SA) node

calcium channel blockers and beta blockers

A nurse is teaching a client who has a new prescription for captopril. Which of the following instructions should the nurse include in the teaching? Monitor for a cough. Take this medication with food. Avoid grapefruit juice. Hold medication for heart rate less than 60/min.

Monitor for a cough.

The nurse is teaching a client diagnosed with coronary artery disease and hypertension about the prescribed propranolol. Which client teaching does the nurse include? Select two that apply. This medication can cause low blood pressure and a higher heart rate Monitor your blood pressure and pulse daily Stop the medication immediately if you feel dizzy If you experience insomnia, stop the drug and restart it when you can sleep through the night Get up slowly from a lying or sitting position to a standing position

Monitor your blood pressure and pulse daily, Get up slowly from a lying or sitting position to a standing position

Increases when the heart rate (HR) and stroke volume increase

cardiac output (CO)

A nurse is caring for a client who has a new prescription for propranolol. The nurse should monitor the client for which of the following adverse reactions to this medication? Hypokalemia Postural hypotension Tachycardia Ototoxicity

Postural hypotension

Which of the following statements regarding secondary hypertension as compared with primary (essential) hypertension is true? More younger adults have primary hypertension, whereas older adults have secondary hypertension. Secondary hypertension is potentially curable where as primary hypertension is not. Primary hypertension may lead to significant morbidity, where as secondary hypertension usually does not. The cause of primary hypertension is known whereas the cause of secondary hypertension is unknown.

Secondary hypertension is potentially curable where as primary hypertension is not.

Which of the following statements are true regarding warfarin (Coumadin) A. Warfarin is an oral anticoagulant B. The antidote to warfarin is protamine sulfate C. The lab values used to monitor therapeutic lab levels is PT/INR (Prothrombin Time / International Ratio) D. My daily dietary choices can include a green leafy salad high in Vitamin K.

TFTF

A patient is being treated with sodium nitroprusside for a hypertensive emergency. When this drug is used, the nurse must monitor for: respiratory depression. cyanide poisoning. flaccid paralysis. pulmonary hypertension.

cyanide poisoning.

When treating an elderly patient with systolic hypertension, a good antihypertensive with which to start is: a calcium channel blocker. an adrenergic antagonist. a diuretic. an ACE inhibitor.

a diuretic.

The nurse is starting a patient on procainamide. When discussing possible adverse events, it is important to include the development of: a lupus-like syndrome. bronchospasm. pulmonary fibrosis. hypertension.

a lupus-like syndrome.

Heparin requires monitoring of what lab

aPTT

Anti-dysrhythmic that can terminate paroxysmal supraventricular tachycardia

adenosine

The nurse is caring for a patient on warfarin therapy. Which of the following laboratory values is a goal for most patients receiving this form of anticoagulation? an INR of 2-3 a PT of 4 seconds an aPPT of 3 times normal a PT of 20 seconds

an INR of 2-3

Selectively blocks the vasoconstriction effects of angiotensin II by blocking their access to receptors

angiotensin II receptor blockers (ARBs)

A patient is placed on a calcium channel blocker. Why should the nurse educate the patient to increase their activity level and to include fiber in their diet.

avoid constipation

Located in the carotid sinus and in the arch of the aorta that help regulate blood pressure

baroreceptors

What medication that is indicated in treatment of stable chronic angina is not needed for treatment of variant angina

beta blocker

Heart failure class of medication that reduces cardiac output (CO) through reduced myocardial contractility and reduced sinoatrial (SA) node automaticity that can cause bronchospasm

beta blockers

These 2 medications can be used to treat patients with heart failure and can also be used in patients with dysrhythmias

beta blockers bs and digoxin

When using a diuretic containing regimen to treat heart failure, efficacy is best assessed by: skin turgor. LV function. body weight. serum sodium.

body weight.

The client has been started on enalapril for hypertension. The nurse will monitor for the serious side effect of: hypokalemia. first dose hypotension. anuria. Tinnitus.

first dose hypotension.

What electrolyte imbalance is can cause digoxin toxicity

hypokalemia

Which of the following adverse events should the nurse monitor for in the patient treated with bretylium? hypotension. diarrhea shortening of action potential. facilitation of repolarization.

hypotension.

3 factors that effect systemic vascular resistance

length and diameter of the blood vessel and blood viscosity

Diuretic that is used in heart failure that promotes the greatest fluid loss

loop diuretic (furosemide)

What selective beta blocker is recommended to treat a person with COPD that has heart failure

metoprolol

What medication class that is used for angina that can have a potent, life-threatening vasodilatory effect if taken with a phosphodiesterase type 5 inhibitor like sildenafil

nitroglycerin

Nurse teaches patient to dangle feet on side of bed before rising to avoid

orthostatic hypotension

A patient is prescribed clopidogrel after a coronary artery bypass graft surgery. Nurse replies that this medication MOA is to inhibit

platelet aggregation

A patient being treated with an ACE inhibitor should probably not be taking: diuretics. beta blockers. potassium. calcium.

potassium.

An advantage of the synthetic form of the natriuretic-peptide, nesiritide, is that it: reduces both preload and afterload. it has an oral dose formulation. it has no adverse events associated with its use. it does not cause hypotension.

reduces both preload and afterload.

Dilating capacitance vessels results in a(n): reduction of cardiac afterload. reduction of cardiac preload. increase in cardiac preload. reduction in the number of vessels involved.

reduction of cardiac preload.

System that increases blood pressure by causing vasoconstriction of arterioles and through retention of water

renin-angiotensin-aldosterone-system (RAAS)

The best response from thrombolytic therapy occurs when it is: used subsequent to PTCA. started 12 hours after the onset of symptoms. started within 4-6 hours of onset of symptoms. given with warfarin.

started within 4-6 hours of onset of symptoms.

What form of nitroglycerin would you teach not to apply for 10-12 hours to avoid tolerance

transdermal path

Type of angina not caused by obstructed or narrowed arteries

variant angina

Vitamin K is an antidote for what anticoagulant

warfarin