Pharm: assignment 13-19
Which of the following classes is the most effective in their ability to lower low-density lipoproteins (LDLs)? a. Bild acid sequestrants b. statins
b
Which of the following is a dihydropyridine calcium channel blocker? a. lisinopril b. amlodipine
b
Which of the following pairing of drug with adverse effect is a significant unwanted effect to be monitored for? a. tachycardia with verapamil b. fetal damage with losartan
b
Which prescription should the nurse prepare to administer for a client experiencing a warfarin sodium overdose? a. heparin b. vitamin K
b
Which prescriptions reduce the heart's demand for oxygen by lowering heart rate? a. anticoagulants and beta blockers b. beta blockers and non-dihydropyridine calcium channel blockers
b
Which statement is accurate in regard to secondary hypertension? a. known as idiopathic b. results from chronic renal impairment
b
Which substance may decrease the side effects of flushing and pruritus when taken with niacin? a. alcohol b. aspirin
b
A nurse evaluates the effectiveness of dopamine therapy for a patient in shock. Which of the following may indicate treatment is successful? (Select all that apply) a. diminished breath sounds b. improved urine output c. increased BP
b, c
Which assessment findings in a patient who is receiving atenolol (Tenormin) for angina would be cause for the nurse to hold the drug and contact the provider? (Select all that apply) a. BP 156/88 b. BP 86/56 c. HR of 50 beats/minute
b, c
Common adverse effects of antidysrhythmic medications include which of the following? (Select all three that apply) a. hypertension b. weakness c. dizziness d. hypotension
b, c, d
Which prescriptions does the nurse anticipate being included in the goal to reduce the post-MI mortality of a client? (Select all three that apply) a. antidysrhythmics b. ACE inhibitors c. aspirin d. beta blockers
b, c, d
Which describes the mechanism of action for Clopidogrel (Plavix)? a. stimulates platelet production b. Prevents platelets from sticking to each other
B
A patient has been ordered gemfibrozil (Lopid) for hyperlipidemia. The nurse will first validate the order with the healthcare provider if the patient reports a history of which disorder? a. gallbladder disease b. angina
a
A patient is receiving a thrombolytic drug, alteplase (Activase), following an acute myocardial infarction. Which effect is most likely attributed to this drug? a. bruising and epistaxis b. skin rash with urticaria
a
3. Which route of administration should the nurse anticipate to use for a client's prescribed enoxaparin (Lovenox)? a. administer the prescription into abdomen, sub Q b. administer orally
a
A client asks the nurse how hypertension can lead to heart failure. Which response should the nurse provide the client? a. hypertension increases the resistance in the blood vessels causing the heart to work harder to pump blood out against resistance of arteries b. hypertension causes resistance in the venous system requiring the heart to work harder to pump the blood forward
a
A client is to receive intravenous (IV) dopamine (Intropin). Which should the nurse have immediately available prior to initiating the dopamine? a. phentolamine b. naltrexone
a
A client prescribed doxazosin (Cardura) asks how the medication works. Which information should the nurse provide the client? a. helps dilate blood vessels b. helps heart work more efficiently
a
A client with a history of mild congestive heart failure (CHF) is receiving diltiazem for hypertension. The nurse should give priority to which of the following assessments? a. bradycardia and peripheral edema b. improved ability to perform activities of daily living
a
A patient was admitted from the emergency department after receiving treatment for dysrhythmias. He will be started on amiodarone (Pacerone) due to the lack of therapeutic effects from his other antidysrhythmic therapy. When the nurse checks with him in the afternoon, he complains of feeling lightheaded and dizzy. What will the nurse assess first? a. whether the patients pulse and BP are within normal limits b. whether an allergic reaction is occurring with anticholinergic like symptoms
a
A patient with deep vein thrombosis is receiving an infusion of heparin and will be started on warfarin (Coumadin) soon. While the patient is receiving heparin, what laboratory test will provide the nurse with information about its therapeutic effects? a. aPTT b. INR
a
Of the following agents, which is considered to have the strongest negative inotropic effect? a. verapamil b. lisinopril
a
The patient is prescribed digoxin (Lanoxin) for treatment of heart failure. Which statement by the patient indicates the need for further teaching? a. this drug should cure my HF b. I may notice my HR decrease
a
The patient is to begin taking atorvastatin (Lipitor) and the nurse is providing education about the drug. Which symptom related to this drug should be reported to the healthcare provider? a. increasing muscle or joint pain b. constipation
a
The teaching plan for a patient receiving hydralazine (Apresoline) should include which point? a. rising slowly to standing from a lying or sitting position b. decreasing potassium rich food in diet
a
Which action of Lisinopril (Prinivil) results in a decrease in the blood volume? a. decrease in aldosterone secretion b. agonistic effect on angiotensin converting enzyme
a
Which classification of drug is used to treat ventricular tachycardia? a. potassium channel blockers b. calcium channel blockers
a
Which client has the greatest risk for developing heart disease? a. a 68 year old with stage 2 hypertension and recent MI b. 52 year old with osteoporosis and stage 1 hypertension
a
Which effect should the nurse anticipate for a client receiving a low-dose dopamine (Intropin)? a. urinary output of at least 50 mL/h b. stabilization of fluid loss
a
Which factors are responsible for blood pressure? a. cardiac output, blood volume, and peripheral vascular resistance b. age, weight, and race
a
Which information should the nurse include when discussing cardiogenic shock with a client? a. occurs due to pump failure b. occurs in relation to blood loss
a
Which is a priority assessment for the client receiving reteplase (Retavase) intravenously? a. abnormal bleeding b. fluid balance
a
Which is the nurse's priority assessment for a client treated with intravenous hydralazine (Apresoline)? a. hypotension and tachycardia b. hypotension and bradycardia
a
Which laboratory test is used to measure the effectiveness of warfarin sodium therapy? a. INR b. aPTT
a
Which type of lipoprotein is often referred to as "the good type?" a. HDL b. LDL
a
patient with heart failure has an order for lisinopril (Prinivil, Zestril). Which condition in the patient's history would lead the nurse to confirm the order with the provider? a. hx of angioedema after taking enalapril b. hx of alcoholism
a
Which are the goals of antianginal therapy? (Select two that apply) a. decreased myocardial oxygen demand b. increased blood flow to the myocardium c. increased myocardial contractility
a, b
Lisinopril (Prinivil) is part of the treatment regimen for a patient with heart failure. The nurse monitors the patient for the development of which adverse effects of this drug? (Select all that apply) a. hyperkelmia b. dizziness c. cough d. heartburn
a, b, c
Select all of the ions that regulate heart activity. (Select all that apply) a. K b. Na c. Mg d. Ca
a, b, d
For which conditions is a client with hypertension at risk? (Select all that apply) a. blindness b. HF c. liver failure d. kidney damage e. stroke
a, b, d, e
The nurse is preparing to administer clevidipine (Cleviprex) to a client experiencing a hypertensive crisis. Which interventions should the nurse implement? (Select all that apply) a. continually monitor BP b. monitor bowel sounds c. administer the drug IV
a, c
The nurse is preparing to discuss the use of primary hypertensive agents with a client. Which prescriptions should the nurse include? (Select all that apply) a. ARBs b. beta blockers c. thiazide diuretics
a, c
The patient in hypovolemic shock is prescribed an infusion of lactated Ringer's. What is the purpose for infusing this solution in shock? (Select all that apply) a. solution will help to maintain vascular volume b. solution will draw water into cells c. solution will help to replace fluid and promote urine output
a, c
A client with cirrhosis of the liver asks the nurse why they are at risk for bleeding. Which response should the nurse provide the client? a. the liver thickens your blood so it is less likely to clot b. the liver is injured and cannot make clotting factors
b
A patient has started clopidogrel (Plavix) after experiencing a transient ischemic attack. What is the desired therapeutic effect of this drug? a. to stop clots from becoming emboli b. to reduce the risk of a stroke from a blood clot
b
A patient is given a prescription for propranolol (Inderal) 40 mg bid. What is the most important instruction the nurse should give to this patient? a. take this med on an empty stomach, as food interferes with its absorption b. do not stop taking this med abruptly, the dosage must be decreased gradually if it is discontinued
b
A patient is receiving cholestyramine (Questran) for elevated low-density lipoprotein (LDL) levels. As the nurse completes the nursing care plan, which adverse effects will be included for continued monitoring? a. sore throat and fever b. abdominal fever
b
A 22-year-old runner has an anaphylactic reaction after having been stung by a wasp. Which of the following is the preferred initial treatment? a. dopamine b. epinephrine
b
A 45-year-old man was started on therapy for hypertension and developed a persistent, dry cough. Which is most likely responsible for this side effect? a. atenolol b. lisinopril
b
A client is prescribed an intravenous infusion of milrinone (Primacor) for acute heart failure. Which is a priority nursing assessment during the infusion? a. vital signs every shift b. continuous EKG monitoring
b
A client post-acute myocardial infarction asks the nurse why they are prescribed reteplase (Retavase) intravenously (IV). Which response should the nurse provide the client? a. thins your blood so more clots will not develop b. is dissolving the clot that has caused your heart attack
b
A client receiving diltiazem (Cardizem) asks the nurse why they get a headache after taking the prescription. Which response should the nurse provide the client? a. causes blood vessels in brain to narrow, giving you a headache b. causes blood vessels in brain to widen, giving you a headache
b
A patient with significant hypertension unresponsive to other medications is given a prescription for hydralazine. An additional prescription of metoprolol (Lopressor) is also given to the patient. The patient inquires why two drugs are needed. What is the nurse's best response? a. metoprolol is to prevent lupus from developing b. hydralazine may cause tachycardia and metoprolol will help keep the heart rate within normal limits
b
Abnormal liver function tests (LFTs), pulmonary fibrosis, skin discoloration, and thyroid disturbances are potential adverse effects of a. metoprolol b. amiodarone
b
Before a client receives carvedilol as treatment for heart failure, the nurse should ask the client about a history of which health problem? a. seizures b. asthma
b
Erectile dysfunction drugs such as sildenafil (Viagra) are contraindicated in patients taking nitrates for angina. What is the primary concern with concurrent administration of these drugs? a. they will adequately treat the patients angina as well as erectile dysfunction b. they also decrease BP through vasodilation and may result in prolonged and severe hypotension when combined with nitrates
b
Nifedipine (Procardia XL) has been ordered for a patient with hypertension. In the care plan, the nurse includes the need to monitor for which adverse effect? a. rash and chills b. reflex tachycardia
b
Nursing assessment of a patient receiving normal serum albumin for treatment of shock should include which of the following? a. potassium level b. breath sounds
b
The nurse has reinforced the treatment plan for the administration of normal human serum albumin (Albutein) for a client recovering from hypovolemic shock. Which statement made by the client indicates an understanding of the information? a. prescription is a liquid that has electrolytes in it to pull water into my blood vessels b. prescription is a protein that pulls water into my blood vessels
b
The nurse is caring for a patient with chronic stable angina who is receiving isosorbide dinitrate (Isordil). Which of the following are common adverse effects of isosorbide? a. nausea/vomiting b. light headedness and dizziness
b
The nurse notes that the intravenous (IV) norepinephrine (Levophed) has been accidentally abruptly discontinued. Which is the nurse's priority action? a. obtain an oxygen saturation reading b. assess the clients BP
b
The nurse notes the blood pressure and red blood cell (RBC) count of a client receiving heparin is low. Which should the nurse suspect has occurred? a. clot formation b. internal bleeding
b
The patient is being discharged with nitroglycerin (Nitrostat) for sublingual use. While planning patient education, what instruction will the nurse include? a. place 3 tablets under tongue and call 911 b. put one tablet under tongue for chest pain. if pain does not subside call 911.
b
The patient receiving heparin therapy asks how the "blood thinner" works. What is the best response by the nurse? a. heparin dissolves the clot b. heparin does not thin the blood but prevents clots from forming as easily in the blood vessels
b
The use of procainamide (Pronestyl) is limited to the treatment of life-threatening dysrhythmias because of what potential adverse effect? a. it can cause rebound hypertension in patients with HF b. it causes antinuclear antibodies (ANA) when given long term, resulting in blood dycrasias
b
Verapamil (Calan, Covera-HS, Verelan) should be used with extra caution or is contraindicated in patients with which cardiovascular condition? a. angina b. HF
b
What is the mechanism by which irbesartan lowers blood pressure? a. inhibiting renin b. blocking angiotensin AT 1 receptors
b
What is the mechanism of action of cholestyramine in reducing cholesterol levels? a. it prevents the synthesis of cholesterol b. it binds bile acids salts and cholesterol
b
When monitoring for therapeutic effect of any antidysrhythmic drug, the nurse would be sure to assess which essential parameter? a. drug level b. pulse
b
Which adverse effect is most common for clients prescribed topical nitroglycerin paste? a. rash b. headache
b
Which adverse effect is shared among all antidysrhythmic drugs? a. edema b. prodysrhythmic effects
b
Which antihypertensive medication can cause the rare side effect of angioedema? a. prazosin b. fosinopril
b
Which describes a characteristic of colloids? a. contain electrolytes b. too large to cross membrane
b
Which describes the mechanism of atorvastatin's (Lipitor) ability to lower blood cholesterol levels? a. prevents dietary absorption within the GI tract b. inhibits enzyme that is essential for cholesterol synthesis
b
Which describes the primary action of anticoagulant therapy? a. dissolve blood clots b. prevent the formation of blood clots
b
Which is a priority nursing intervention for a client who is newly prescribed enalapril (Vasotec)? a. review clients lab b. take clients BP
b
Which is the priority action of the nurse when caring for a client receiving a statin with elevated creatine kinase (CK) levels? a. administer the prescription and continue to assess for muscle pain b. hold the prescription and notify the healthcare provider
b
Which mechanism of action does beta-adrenergic agonists have on the cardiovascular system? a. dilate venous system b. decrease the contractility of the heart
b
Which medication, if given concomitantly, may reduce the bioavailability and effectiveness of statins and other drugs given orally? a. niacin b. cholestyramine
b
Which of the following class of drugs is considered the cornerstone in the treatment of chronic heart failure? a. loop diuretics b. ACE inhibitors
b
A patient is starting to receive dobutamine by intravenous infusion for treatment of shock. This drug is particularly useful for which type of shock? a. hypovolemic b. septic c. cardiogenic
c
The patient is receiving hydralazine with isosorbide (BiDil) for heart failure. The nurse should monitor this patient for: a. bleeding b. tingling c. dizziness and rapid HR
c
Which describes the mechanism of action of norepinephrine? a. increase HR b. increase blood flow c. vasoconstriction
c
