pharm chapter 22

The nurse is performing a head to toe assessment on a resident in a long term care facility with a history of angina pectoris. when assessing peripheral perfusion, the nurse will perform which interventions? (select all that apply) a. count heart rate and describe rhythm b. note any loss of hair on lower legs c. auscultate blood pressure d. check pedal pulses e. assess pupil reaction

. b. note any loss of hair on lower legs d. check pedal pulses

The nurse is assessing a patient who was recently admitted to the er with dysrhythmias and sob. which baseline nursing assessment should be the priority? (select all that apply) a. ECG monitoring b. medication history c. oxygen saturation d. presence of chest pain, dyspnea, and fatigue e. mental status f. sleep pattern

a. ECG monitoring b. medication history c. oxygen saturation d. presence of chest pain, dyspnea, and fatigue e. mental status

A patient has recently been prescribed cilostazol (Pletal), which statement by the patient indicates that this medication is effective? a. I have less leg cramping when I walk b. my pulse rate is more regular c. I have had fewer episodes of angina d. my blood pressure has decreased

a. I have less leg cramping when I walk

the nurse is caring for a 3-year-old girl who has a congenital heart anomaly. the patients current medications include digoxin and furosemide (Lasix). the apical pulse rate is 100 beats/min. which action will the nurse take? a. administer the medication b. contact the pediatric cardiologist for further orders c. hold the digoxin d. request that another unit nurse assess the child

a. administer the medication

which medication lowers blood pressure by directly inhibiting renin? a. aliskiren (Tekturna) b. eplierenone (Inspra) c. diltiazem (Cardizem) d. reserpine

a. aliskiren (Tekturna)

which complication is associated with uncontrolled hypertension? (select all that apply) a. angina b. stroke c. hyperglycemia d. renal failure e. heart failure

a. angina b. stroke d. renal failure e. heart failure

The nurse is preparing a teaching plan for a patient with Raynauds disease who is soon to be discharged. what info will be included to improve circulation and prevent complications of this disease? (select all that apply) a. begin a daily exercise program b. keep hands and feet warm c. surgery is often the most effective treatment d. elevate the lower extremities when reclining e smoking cessation will improve outcomes

a. begin a daily exercise program b. keep hands and feet warm e. smoking cessation will improve outcomes

which medication is often administered with hydralazine to reduce reflex physiologic response to the drug? a. beta blockers b. renin inhibitor c. ACE inhibitor d. angiotensin II receptor blocker

a. beta blockers

The nurse is preparing to administer niacin for the first time to a patient being treated for dyslipidemia. Before administering this med, the nurse will assess: (select all that apply) a. blood glucose levels b. blood pressure c. heart rate d. temperature e. oxygen saturation

a. blood glucose levels b. blood pressure c. heart rate

the nurse is assessing a patient who is being evaluated for hyperlipidemia. which assessment will most increase the risk of coronary artery disease (CAD)? a. bp, 168/90 mmHg b. hemoglobin A1c 6% c. walks 3 miles briskly, usually 4 days a week d. eats 5 servings of fruit or veggies daily

a. bp, 168/90 mm Hg

How do beta adrenergic blocking agents reduce myocardial oxygen demand? a. by inhibiting the stimulation of norepinepherine b. by increasing the production of dopamine and acetylcholine c. by delaying the destruction of acetylcholinesterase and cholinesterase d. by enhancing the sensitivity of alpha receptors and beta receptors.

a. by inhibiting the stimulation of norepinepherine

the nurse is preping to administer procainamide hydrochloride for the first time to a patient newly diagnosed with atrial fibrillation. before administering this med. the nurse will assess: (select all that apply) a. cardiac rhythm b. bp c. oxygen saturation d. blood glucose levels e. liver function tests

a. cardiac rhythm b. bp c. oxygen saturation

the nurse has provided info to a patient with diabetes who has been prescribed a beta adrenergic blocker. which statement by the patient indicates a need for further teaching? a. if I get dizzy, I will stop taking the medication b. I may not have my usual symptoms of low blood sugars c. my dosage may need adjustment if I start taking any NSAIDs d. I will need to be evaluated in a few weeks to see if my dosage is effective.

a. if I get dizzy, I will stop taking the medication

Which are necessary steps in the assessment of the patient preparing for treatment PVD with pentoxifylline (Trental)? (select all that apply) a. check for intolerance to caffiene b. obtain baseline data on pain that may be present c. obtain test results for PT and aPTT d. perform baseline GI assessment to determine if the patient has nausea, vomiting, or dyspepsia e. ask specifically if the patient has any cardiac symptoms or dizziness f. schedule the patient for an exercise stress test

a. check for intolerence to caffiene b. obtain baseline data on pain that may be present d. perform baseline GI assessment to determine if the patient has nausea, vomiting, or dyspepsia e. ask specifically if the patient has any cardiac symptoms or dizziness

the nurse is performing pain assessment on a patient admitted for evaluation of angina. which type of angina is precipitated by physical exertion and is relieved by rest? a. chronic stable b. nocturnal c. unstable d. variant

a. chronic stable

the nurse is preparing to administer adenosine to a patient with supraventricular tachycardia. which considerations should the nurse take into account before administration? (Select all that apply) a. constant ECG monitoring is necessary b. initial recommended dosage is 12mg IV bolus c rapid IV bolus administration is recommended d. saline flush following bolus is necessary e. long half life of adenosine may prolong adverse medication effects

a. constant ECG monitoring is necessary c. rapid IV bolus administration is recommended d. saline flush following bolus is necessary

which statements concerning the use of antihypertensive therapy for the treatment of hypertension would be considered true? (select all that apply) a. diuretics are the most commonly prescribed antihypertensive agent b. diuretics are not used for older adult patients c. diuretics are the most expensive of the antihypertensive agents d. diuretics are often prescribed in combination therapy with other antihypertensive agents e. loop diuretics are considered potassium sparing

a. diuretic are the most commonly prescribed antihypertensive agent d. diuretics are often prescribed in combination therapy with other antihypertensive agents

the nurse is preparing discharge education for a patient who will be recieving warfarin (Coumadin) at home. which important points will the nurse include? select all that apply a. do not make any major changes to your diet without discussing it with your doctor b. keep outpatient lab appointment for monitoring therapy c. take the medication after meals d. report s/s of bleeding to your doctor, including observing skin for bruising; petechiae; blood in emesis, urine, or stools' bleeding gums; cold, clammy skin; or altered sensorium e. avoid aspirin products

a. do not make any major changes to your diet without discussing it with your doctor b. keep outpatient lab appointment for monitoring therapy d. report s/s of bleeding to your doctor, including observing skin for bruising; petechiae; blood in emesis, urine, or stools; bleeding gums; cold, clammy skin; or altered sensorium e. avoid aspirin products

The nurse is educating a patient about niacin prescribed to treat his hyperlipidemia. which important teaching points should be included in the education plan? (select all that apply) a. effectiveness of niacin in lowering total cholesterol b. info on high cholesterol foods and food preperation using unsaturated fats. c. importance of smoking cessation and daily exercise d. alternative funding resource info because of the high cost of niacin e adverse effects to report

a. effectiveness of niacin in lowering total cholesterol b. info on high cholesterol foods and food preperation using unsaturated fats. e. adverse effects to report

the nurse transcribes a new order for ranolazine (Ranexa), for a patient with chronic stable angina. before initiating this medication, the nurse will ensure which lab results are available? (select all that apply) a. electrocardiography b. BUN c. creatinine d. electrolyte levels e CBC

a. electrocardiography b. BUN c. creatinine d. electorlyte levels e. CBC

a patient recently prescribed felodipine (Plendil) for treatment of hypertension is experiencing dizziness when rising to a standing postition. which action will the nurse take? a. encourage the patient to sit down if feeling faint b. advise the patient to increase dietary sodium c. inform the patient to discontinue the medication d. instruct the patient to monitor weight daily

a. encourage the patient to sit down if feeling faint

what will the nurse include in teaching plan for a patient with angina who is prescribed a beta adrenergic blocking agent? (select all that apply) a. goals include reduced frequency of attacks, reduced nitrate use, and improved exercise tolerance. b. only some beta blockers are effective in treating angina pectoris c. comorbidities, such as diabetes or COPD, influence the product selection of beat blockers to treat angina d. cardioselective agents minimize pulmonary and peripheral vascular adverse effects e. stress exercise is an effective way to determine the most appropriate dosage. f. Aceputolol, atenolol, and metoprolol must be taken in divided doses to be effective in treating angina.

a. goals include reduced frequency of attacks, reduced nitrate use, and improved exercise tolerance c. comorbities, such as diabetes or COPD, influence the product selection of beta blockers to treat angina d. cardioselective agents minimize pulmonary and peripheral vascular adverse effects e. stress exercise is an effective way to determine the most appropriate dosage.

the nurse is finished conducting nutritional education with a patient about the DASH diet. the patient would like to complete the breakfast menu for tomorrow. which foods offered for breakfast would be most appropriate for the patient to choose? (select all that apply) a. grapefruit b. bacon c. whole milk d. oj e. eggs f. oatmeal

a. grapefruit d. orange juice f. oatmeal

a teaching plan for a patient with hyperlipidemia would instruct the patient to avoid which foods? (Select all that apply) a. hard cheeses b. egg whites c. unsaturated vegggie oils d. green vegetables e. liver

a. hard cheese e. liver

Which are included in the baseline assessment of PVD? (select all that apply) a. history of heart disease b. smoking and dietary habits c. current medications d. weight e. limb pain f. mental status

a. history of heart disease b. smoking of heart disease c. current medications d. weight e. limb pain

which contributing factors to heart failure are modifiable? select all that apply a. hypertension b. addiction to smoking c. genetic history d. exercise tolerance e. age

a. hypertension b. addiction to smoking d. exercise tolerance

the nurse transcribes a new order for a daily diuretic on a patient diagnosed with congestive heart failure. the nurse will schedule this medication: a. in the morning b. after lunch c. with dinner d. at bedtime

a. in the morning

which agents stimulate the heart to increase the force of contractions, thereby increasing cardiac output? a. inotropic b. chonotropic c. isotonic d. isopropyl

a. inotropic

A patient asks the nurse how amlodipine (Norvasc) works to reduce the bp. which response will the nurse provide? a. it causes blood vessel dilation b. it helps you get rid of fluid c. it helps your heart beat stronger d. it slows your heart rate

a. it causes blood vessel dilation

The nurse transcribes a new order for Lovaza on a patient in a long term care facility. when providing education to the patient about this medication, the nurse will include which statements? Select all that apply a. liver function tests should be completed before initiating therapy b. Lovaza is available in tablet form c. triglyceride levels should increase with use d. Lovaza should be used with caution if the patient has an allergy to fish e. Lovaza does not cause myositis

a. liver function tests should by completed before initiating therapy d. Lovaza should be used with caution if the patient has an allergy to fish e. Lovaza does not cause myositis

the pharmacologic agents used to treat DVT may act in which ways? select all that apply a. prevent platelet aggregation b. prevent the extension of existing clots c. inhibit steps in the fibrin clot formation cascade d. prolong bleeding time e. lower serum triglycerides

a. prevent platelet aggregation b. prevent the extension of existing clots c. inhibit steps in the fibrin clot formation cascade d. prolong bleeding time

which instruction by the nurse will be included when teaching an adult patient about digoxin (Lanoxin) for management of heart failure? a. report nausea and vomiting to your doctor b. decrease the amount of high potassium foods you eat c. omit your dose of digoxin if your pulse is 60 beats/min d. visual disturbances are common adverse effects.

a. report nausea and vomiting to your doctor

before administering digoxin (Lanoxin), the nurse takes the adult patients apical pulse for 1 full min. what additional nursing considerations will be taken before adminstration of the medication? select all that apply a. review the digoxin blood level b. administration of the medication with pulse less than 60 beats/min c. review of serum electrolytes, liver, and kidney function tests d. administration of the medication with a pulse of 110 beat/min e obtaining baseline patient assessment data, including lung sounds, vital signs, and weight

a. review the digoxin blood level c. review of serum electrolytes, liver, and kidney function tests e obtaining baseline patient assessment data, including lung sounds, vital signs, and weight

A patient is taking a HMG CoA reductase inhibitor and reports muscle aches, soreness, and weakness. the nurse suspects these symptoms to indicate early signs of myopathy. when notifying the doctor of these symptoms, the nurse will also be sure to report the results of the patients: a. serum creatine phosphokinase levels b. red blood cell count c. uring culture d. echocardiogram.

a. serum creatine phosphokinase levels

what will the nurse review when teaching a patient about therapy with statins? (select all that apply) a. statins are the most potent antilipemic agents available b. statins should be taken with food c. statins replace dietary therapy for the control of hyperlipidemia d. statins cause mild increases in HDL levels e. statins are adminstered in the morning when cholesterol production is high f. statins reduce inflammation, platelet aggregation, and plasma viscosity

a. statins are the most potent antilipemic agents available b. statins should be taken with food d. statins cause mild increases in HDL levels f. statins reduce inflammation, platelet aggregation and plasma viscosity

which statements about vasodilators are true? select all that apply a. they reduce systemic vascular resistance b. they increase afterload c. they reduce preload d. they decrease pulmonary congestion e. they increase tissue perfusion to muscles and organs f. they increase the volume of blood returning to the heart

a. they reduce systemic vascular resistance c. they reduce preload d. they decrease pulmonary congestion e. they increase tissue perfusion to muscles and organs

which response will the nurse provide when a patient complains of a headache when using sublingual nitroglycerin? a. this is a common adverse effect that can be managed with acetaminophen b. discontinue taking this medication c. try taking this medication at night to minimize the possibility of headaches d. lie down after using nitroglycerin to avoid a headache

a. this is a common adverse effect that can be managed with acetaminophen

anticoagulant therapy may be used for which situation? select all that apply a. to prevent stroke in patients at high risk b. following a MI c.. following total hip or knee joint replacement surgery d. with DVT e. to prevent thrombosis in immobilized patients f. peptic ulcer disease

a. to prevent stroke in patients at high risk b. following a MI c. following total hip or knee joint replacement surgery d. with DVT e. to prevent thrombosis in immobilized patients

which lifestyle modifications will the nurse include when educating the patient with angina pectoris? (select all that apply) a. weight reduction therapy b. low potassium diest c. smoking cessation d. stress managment e independent exercise

a. weight reduction therapy c. smoking cessation d. stress management

the nurse is preparing to administer dalteparin (Fragmin) to a patient in order to prevent DVT following a hip replacement. when providing this medication to the patient, the nurse will: select all that apply a. administer intramuscularly b. inject slowly c. remove needle immediately after injection d. rub injection site following administration e. alternate injection sites every 24 hours

b inject slowly e. alternate injection sites every 24 hours

which drug is used to obtain vasodilation in the treatment of chronic heart failure? a. ACTH b. ACE inhibitors c. ARBs d. ANB agents

b. ACE inhibitors

which medication combinations may be beneficial in treating angina pectoris? a. antidysrhythmics and platelet active agents b. ACE inhibitors and statins c. vasoconstrictors and diuretics d. anagesics and thrombolytics

b. ACE inhibitors and statins

which antilipemic agent is most potent? a. niacin b. HMG CoA reductase inhibitor c. bile acidbinding resin d. fibric acid

b. HMG CoA reductase inhibitor

when assessing a client recently prescribed pentoxifylline (Trental), which medication will alert the nurse to monitor closely for adverse effect? a. antilipemic b. antihypertensive c. antibiotic d. antipsychotic

b. antihypertensive

which actions will the nurse take when caring for a patient with heart failure? select all that apply a. administer diuretics at bedtime b. assess electrolyte levels c. report daily weight flucturations d. encourage sodium intake e. maintain skin hygiene

b. assess electrolyte levels c. report daily weight flucturations e. maintain skin hygiene

a patient with heart failure has been prescribed nesiritide (Natrecor). which statements are true regarding this med? select all that apply a. it increases preload b. cardiac ventricles secrete this hormone in response to fluid overload c. it suppresses aldosterone d. it promotes norepinephrine secretion e. it causes vasodilation

b. cardiac ventricles secrete this hormone in response to fluid overload c. it suppresses aldosterone e. it causes vasodilation

The nurse is providing instruction to a patient who was recently prescribed an ACE inhibitor for hypertension. which is an adverse effect of this medication? a. constipation b. chronic cough c. hypokalemia d. nervousness

b. chronic cough

which therapies are used in the treatment of angina pectoris? (select all that apply) a. ECG b. coronary artery bypass c. coronary angioplasty d. avoidance of caffeine and emotional stress e. use of nitrates

b. coronary artery bypass c. coronary angioplasty d. avoidance of caffeine and emotional stress e. use of nitrates

the nurse advises a patient taking papaverine to consult the doctor or pharmacist before taking which over the counter medication? a. laxatives b. cough and cold remedies c. vitamin supplements d. acetaminophen

b. cough and cold remedies

which action by the nurse is most accurate when administering nitroglycerin ointment to a patient? a. spread the ointment on the patients legs in a thin, uniform layer b. cover the patch with a clear plastic wrap c. rub the ointment into the skin in a circular motion d. shave the skin prior to application

b. cover the patch with a clear plastic wrap

which nursing assessment is most important to determine fluid status for a patient with heart failure a.auscultation of lungs b. daily weights c. I and O d. measurement of abdominal girth

b. daily weights

the nurse is preparing to mix a lidocaine infusion for a patient. which considerations should the nurse take into account before administration? a. lidocaine with preservative should be used. b. dextrose 5% is the solution to mix with lidocaine c. therapeutic blood levels should be 1-5 mg/L d. the rate of adminstration is 1-4 mg/min e monitor for changes in neurologic status

b. dextrose 5% is the solution to mix with lidocaine c. therapeutic blood levels should be 1-5 mg/L d the rate of administration is 1-4 mg/min e monitor for changes in neurologic status

the patient recently prescribed quinidine is at highest risk for which common adverse effect? a. chills b. diarrhea c. nausea d. rash

b. diarrhea

which action will the nurse implement to decrease the risk of clot formation in an older patient on bed rest? a. assess peripheral pulses b. encourage passive leg exercises c.limit fluid intake d.position pillows behind the knees

b. encourage passive leg exercises

the nurse monitors a patient receiving digoxin closely for toxicity when which other medication is prescribed? a. potassium supplements b. furosemide (Lasix) c. acetylsalicylic acid (aspirin d. antibiotics

b. furosemide (Lasix)

which common adverse effect of an angiotensin II receptor antagonist will the nurse expect to assess in a patient? a. bradycardia b. headache c. hypokalemia d. insomnia

b. headache

a patient receiving IV heparin therapy for a deep vein thrombosis (DVT) in his right calf asks why his calf remains painful. edematous, and warm to touch after 2 days of anticoagulant therapy. which response by the nurse is most accurate? a. it takes at least 3 days for the symptoms to resolve once the clot dissolves b. heparin does not dissolve blood clots, but neutralizes clotting factors, preventing extension of the clot and the possibility of it traveling elsewhere in your body c. I will report this to your doctor because there may be a need to look at alternative treatments d. you appear anxious. the doctor will eventually put you on ticlopidine, which allows for an earlier discharge

b. heparin does not dissolve blood clots, but neutralizes clotting factors, preventing extension of the clot and the possibility of it traveling elsewhere in your body

the nurse is assessing a patient on papaverine therapy and notes tachycardia, which is a compensatory effect of which condition? a. hypoventilation b. hypotension c. excessive sympathetic stimulation d. adrenergic suppression

b. hypotension

The nurse has admitted a resident with the diagnosis of PVD to a long term care facility. when providing care to this patient, the nurse will: (select all that apply) a. initiate elevation of lower extremities b. implement plan management as ordered c. assess skin temp d. vigorously dry feet after washing e palpate pedal pulses

b. implement plan management as ordered c. assess skin temp e. palpate pedal pulses

which is true about postural hypotension during therapy with direct vasodilators? a. it indicates a therapeutic effect b. it gradually resolves with continued medication use c. it is a dose limiting complication of drug therapy d. it is a precursor to hypertensive crisis

b. it gradually resolves with continued medication use

which statement is true regarding the pain associated with angina? a. it does not subside until treatment is initiated b. it is highly variable in intensity and location c. it typically subsides after 1-3 minutes d. it is directly related to the degree of myocardial damage.

b. it is highly variable in intensity and location

which is an accurate nursing action when administering subcutaneous enoxaparin, a low-molecular-weight heparin product? a. expel the air bubble from the prefilled syringe b. leave the needle in place for 10 sec. after injection c. administer the medication into the deltoid muscle d. massage the site after injection to increase absorption

b. leave the needle in place for 10 sec. after injection

What is the rationale for administering fibrinolytic agents, such as streptokinase, within hours of the onset of myocardial infarction? a. enhances myocardial oxygenation b. lyses the blood clot c. promotes platelet aggregation d. inhibits clotting mechanisms

b. lyses the blood clot

The nurse is providing education to a patient who has recently been prescribed niacin. which information given by the nurse is accurate? a. weigh yourself weekly because of the risk of fluid retention. b. nausea can be decreased if you take this medication with food. c. because your bp may increase while taking this drug, have it checked monthly d. you should not take aspirin while on this medication

b. nausea can be decreased if you take this medication with food.

which symptom is indicative of bleeding in a patient taking warfarin (Coumadin)? a. bradycardia b. petechiae c. increased urinary output d. dry skin

b. petechiae

what will the nurse include in discharge teaching for patients on nitrate therapy? (select all that apply) a. increase caffeine in diet b. relaxation techniques c. proper storage of medications d. pain assessment e. isometric exercise program

b. relaxation techniques c. proper storage of medications d. pain assessment

patients who are on neuromuscular blocking agents and lidocaine must be closely observed for which complication? a. hyperkalemia b. respiratory depression c. neurotoxicity d. seizures

b. respiratory depression

A patient who has just begum taking an angiotensin converting enzyme (ACE) inhibitor calls the nurse and reports feeling dizzy when standing up, and asks if the medication should be discontinued. what is the nurses best response? a. stop taking the medication immediatelyh b. rise to a sitting or standing position slowly; your symptoms will resolve c. I will schedule you to visit the doctor today d. cut the pill in half and take a reduced dosage

b. rise to a sitting or standing postion slowly; you symptoms will resolve

Amiodarone is contraindicated for patient with which condition? a. pulmonary edema b. severe sinus node dysfunction causing bradycardia c. atrial fibrillation d. premature ventricular contractions (PVCs)

b. severe sinus node dysfunction causing bradycardia

which medication is a potassium sparing diuretic? a. acetazolamide (Diamox) b. spironolactone (Aldactone) c. furosemide (Lasix) d. bumetanide (Bumex)

b. spironolactone (Aldactone)

Which psysiologic response will the nurse expect to assess in patients taking hydralazine (Apresoline)? a. pale skin b. tachycardia c. increased urinary output d. cool extremities

b. tachycardia

what is the rationale behind administering calcium channel blockers to patients with angina? a. they decrease heart rate b. they dilate blood vessels c. they increase cardiac contractility d. they promote fluid excretion

b. they dilate blood vessels

The nurse is explaining to a patient how ACE inhibitors affect blood pressure. which statement accurately describes the action of these medications? a. they increase aldosterone secreation b. they inhibit vasoconstriction c. they lower heart rate d. they promote sodium retention

b. they inhibit vasoconstriction

which nutritional concept is necessary to provide to patients receiving colestipol? select all that apply a. take on an empty stomach to enhance absorption b. whole grains, raw fruits, and veggie will minimize constipation c. drink 8 to 10 eight oz glasses of water daily to eliminate dehydration that results from frequent loose stools. d. report signs of vitamin K deficiency, including bleeding gums, dark tarry stools, and coffee ground emesis. e. supplemental fat souluble vitamins may be necessary.

b. whole grains, raw fruits, and veggies will minimize constipation d. report signs of vitamin K deciency, including bleeding gums, dark tarry stools, and coffee ground emesis e. supplemental fat soluble vitamins may be necessary

how soon will diuresis be expected to occur after the nurse has administered 20 mg of furosemide (Lasix) intravenously(IV) to a patient with heart failure? a. as soon as injected b. within 10 min c. after 2 hours d. after 4 hours

b. within 10 min

how does propranolol (Inderal) control hypertension? a. blocks alpha receptors throughout the body b. increased the diuretic response in the renal tubules c. reduces the sympathetic stimulation in cardiac muscle d. inhibits the conversion of angiotensin I to angiotensin II

c reduces the sympathetic stimulation in cardiac muscle

the nurse is to administer digoxin to an 18 month old patient who weighs 16.5 lb. guidelines for administration read as follows: 0.0075-0.010 mg/kg/day. which is a safe medication dose? a. 0.05 mg b. 0.12 mg c. 0.074 mg d. 0.75 mg

c. 0.074 mg

which instruction will the nurse include when teaching a patient about the administration of translingual nitroglycerin spray? a. shake the container to disperse the medication evenly b. inhale the medication slowly over 1- 2 minutes c. administer the medication under the tongue d. close the mouth and swallow the spray

c. administer the medication under the tongue

what will the nurse advise the patient to do to avoid the development of tolerance to nitroglycerin? a. use the sublingual form only b. administer subsequent doses parenterally c. allow for a daily 8-12 hours nitrate free period d. store the drug in a dark container, free from light and moisture.

c. allow for a daily 8-12 hours nitrate free period

The nurse is assisting with a patient admission to the telemetry unit. the patient is diagnosed with angina pectoris. when obtaining info. for angina therapy in regard to the central nervous system (CNS), the nurse will document: a. history of smoking b. diet c. anxiety level d. heart rate

c. anxiety level

a patient is admitted to the acute care telemetry unit with a diagnosis of atrial fibrillation. the physician orders dofetilide (Tikosyn). before initiating this med. the nurse will: a. hold anticoagulant meds b. remove ECG leads c. assess potassium level d. ensure QTc interval is more than 440-500 msec

c. assess potassium level

which is the initial manifestation of digoxin toxicity in children? a. hallucinations b. weakness c. atrial dysrhythmia d. diuresis

c. atrial dysrhythmia

Dipyridamole (Persantine) has been used extensively in combination with warfarin to prevent the formation of thromboembolism after which type of event? a. MI b. transient ischemic attack c. cardiac valve replacement d. heart transplant

c. cardiac valve replacement

the nurse is teaching a patient about nitroglycerin prior to discharge to home. which instruction will the nurse provide the patient? a. report any headaches following self administration to your doctor b. carry the medication in a pocket directly next to the body c. carry the medication with you at all times d. store nitroglycerin in a clear glass container with a tight lid

c. carry the medication with you at all times

a patient is taking amiodarone (Cordarone) for hypertrophic cardiomyopathy and begins to complain of dizziness. what will the nurse instruct the patient to do? a. d/c the medication immediately b. lower the medication dosage for 1 week, and then resume the original order c. change positions slowly d. increase the dosage per doctors directions

c. change positions slowly

which drug will be administered to a patient being admitted with severe digoxin intoxication? a. Amidarone (Cordarone) b. Spironolactone (Aldactone) c. digoxin immune fab (Digibind) d. digitalis glycoside

c. digoxin immune fab (Digibind)

the nurse is assessing an er patient who was recently discharged following a MI. which symptoms would the nurse observed in this patient with left ventricular systolic failure? select all that apply a. reports of recent weight loss b. complaints of peripheral edema c. diminished exercise tolerance d. shortness of breath with activity e. blood pressure elevation

c. diminished exercise tolerance d. shortness of breath with activity

how frequently are nitroglycerin tablets discarded and prescriptions refilled? a. monthly b. every 3 months c. every 6 months d. yearly

c. every 6 months

Rivaroxaban (Xarelto) is ordered on a patient following knee replacement surgery. when providing education on this medication to the patient, the nurse conveys that treatment will continue: a. only while hospitalized b. for 35 days post surgically c.for 12 days postsurgerically d. as long as cratinine clearance is less than 30

c. for 12 days postsurgically

The nurse has completed teaching to a patient recently prescribed cilostazol (Pletal). which statement by the patient indicates a need for further teaching? a. I will sit down if I feel lightheaded or faint b. because this medication helps my circulation, I will try to quit smoking c. grapefruit juice will increase the effects of this medication d. diarrhea may occur but likely will stop with continued therapy

c. grapefruit juice will increase the effects of this medication

which assessment verifies increased blood perfusion to the lower extremities? a. toes cool to the touch b. decreased sensation below the knees c. increased amplitude of pedal pulses d. paleness of the foot

c. increased amplitude of pedal pulses

the nurse instructs the patient to avoid a sudden discontinuation of beta adrenergic blockers so as to avoid which symptom? a. postural hypotension b. edema c. increased angina d. confusion

c. increased angina

what would the nurse anticipate if a patient with a history of type 2 diabetes is prescribed a thiazide diuretic? a. no change in the antidiabetic regimen b. decreased need for antidiabetic medication c. increased blood sugar levels d. less frequent monitoring of blood sugar levels

c. increased blood sugar levels

what is the action of pentoxifylline (Trental), a hemorheologic agent used to treat chronic occlusive arteriole disease? a. vasodilates the peripheral arteries b. potentiates the blood clotting mechanism c. increases erythrocyte flexibility d. increases blood viscosity

c. increases erythrocyte flexibility

which statement about ranolazine (Ranexa), a fatty oxidase enzyme inhibitor, is true? a. it causes coronary artery vasodilation b. it causes no gastrointestinal (GI) side effects c. it causes QT interval prolongation d. it elevates LDL levels

c. it causes QT interval prolongation

A patient has been diagnosed with angina pectoris and an elevated LDL cholesterol level. The doctor has prescribed HMG CoA reductase inhibitor. what is the primary indication in using this medication? a. reduce coronary vessel spasm b. simplify oxygen requirements of the cardiac cells. c. lower cholesterol levels d. dilate the coronary arteries

c. lower cholesterol levels

when teaching a patient who is taking thiazide diuretics, the nurse will encourage the patient to increase the intake of which electrolyte? a. calcium b. sodium c. potassium d. magnesium

c. potassium

a trauma patient arrives in the er via ems. he is bleeding profusely. a medical alert bracelet indicates that he is on heparin therapy. the nurse will most likely administer which medication that counteracts the action of heparin? a. warfarin sodium (Coumadin) b. enoxaparing (Lovenox) c. protamine sulfate d. vitamin K

c. protamine sulfate

The nurse observes a patient taking papaverine hydrochloride to be flushing and diaphoretic following the initial dose. the nurses best response is to: a. hold the next dose b. assess blood glucose c. provide comfort measures d. immediately notify the physician

c. provide comfort measures

in addition to controlling hyperlipidemia, what are bile acidbinding resins prescribed to treat? a. constipation secondary to excess fecal bile acids b. constipation related to pseudomembranous colitis c. pruritus secondary to biliary stasis d. jaundice related to cholelithiasis

c. pruritus secondary to cholelithiasis

a patient is admitted to the telemetry unit with a diagnosis of cardiovascular disease. when performing the initial assessment, the nurse records bp in the left arem of 142/84, bp in the right arm of 138/80, temp of 98.8 f, and radial pulse of 80 and that is weak and irregular. the nurse should notify the doctor regarding: a. both bp and pulse b. bp only c. pulse only d. both bp and temp

c. pulse only

an older adult male patient with long term heart failure has presented for an office visit. the nurse obtains info. that he has recently begun taking st. johns wort. what results with the use of this herbal supplement? a. digoxin toxicity b. altered potassium electrolyte balance c. reduced therapeutic benefits of digoxin d. enhanced digoxin effectiveness without producing toxicity

c. reduced therapeutic benefits of digoxin

the nurse is providing education to a patient with altered cardiac function. when instructing this patient the nurse will encourage: select all that apply a. alcohol consumed in moderation b. use of salt substitute c. regular, mild exercise d. good skin care e. stress reducation

c. regular, mild exercise d. good skin care e. stress reducation

a patient is receiving IV heparin therapy. the aPTT is 90; the lab control is 30 sec. which nursing intervention is most accurate? a. document in the nursing notes that these results are within therapeutic range b. not the RBC count and wait for the doctor to make the next round to discuss all lab values c. stop the heparin drip d. assess the patient for s/s of decreased sensorium

c. stop the heparin drip

what will the nurse include in the discharge teaching plan for a patient with PVD? (select all that apply) a. intermittent cold applications to the extremities b. heat therapy c. stress reduction techniques d. an exercise program e. bed positioning techniques

c. stress reduction techniques d. an exercise program e. bed positioning techniques

which instruction will the nurse include for a patient prescribed sublingual nitrate PRN for angina? a. take a dose routinely at bedtime b. place the tablet under the tongue and swallow immediately c. take 1 tablet and then seek medical attention if the pain is not relieved within 5 minutes d. take one tablet every 2-3 minutes until relief is obtained.

c. take 1 tablet and then seek medical attention if the pain is not relieved within 5 minutes

What is the mean arterial pressure (MAP)? a. the difference between the systolic and diastolic pressures b. an indicator of the tone of the arterial blood vessel walls c. the average pressure throughout each cycle of the heartbeat d. the product of the cardiac output and the peripheral vascular resistence

c. the average pressure throughout each cycle of the heartbeat

Which agents are preferred for the initial treatment of hypertension? a. ACE inhibitors and angiotensin receptor antagonists b. calcium ion agonists and central acting alpha agonists c. thiazide diuretics and beta adrenergic blockers d. direct vasodilators and peripherally acting adrenergic antagonists

c. thiazide diuretics and beta adrenergic blockers

what risk is minimized when the smallest dose of nitroglycerin is used to provide satisfactory results? a. allergy b. dependence c. tolerance d. nausea

c. tolerance

a patients bp is 134/78 mm Hg. the nurse records teh pulse pressure as: a. 212 b. 134 c.78 d. 56

d. 56

how many milligrams of lidocaine will the nurse administer via IV bolus to a 30 year old patient with ventricular tachycardia who weighs 75 kg after a MI? a. 10 b. 25 c. 50 d. 75

d. 75

on admission a patient with a history of cardiac insufficiency complains of sob. the nurse auscultates the lungs and notes bilateral crackles throughout both fields. in addition, there is bilateral +2 edema of the lower extremities. which medication does the nurse anticipate that the doctor will prescribe? a. allopurinol (Syloprim) b. diphenhydramine (Benadryl;) c. mannitol d. Furosemide (Lasix)

d. Furosemide (Lasix)

The nurse has provided instruction to a patient recently prescribed warfarin (Coumadin). which statement by the patient indicates to the nurse the need for further teaching? a. i will always wear a medical alert bracelet b. i will check with my doctor before I take any OTC medications c. i will be careful when I use a knife or sharp objects d. I will rinse my mouth with mouthwash instead of brushing my teeth

d. I will rinse my mouth with mouthwash instead of brushing my teeth

which class of antihypertensive agents should be avoided by patients with asthma? a. ACE inhibitors b. diuretics c. aldosterone receptor antagonists d. beta adrenergic blocking agents

d. beta adrenergic blocking agents

which nursing assessment confirms that the angiotensin II receptor blocker (ARB) that a patient is taking is effective? a. weight loss of more than 2 lbs/week b. LDL cholesterol levels have decreased c. urinary output is increased d. blood pressure is decreased

d. bp is decereased

The nurse is preparing to provide personal care to a patient with peripheral vascular disease. when providing foot care, the nurse will: a. assist the patient to a supine position b. keep feet moistened with lotion c. trim toe nails daily d. change socks daily

d. change socks daily

A patient is receiving 1400 units of heparin/hour on an IV pump. the aPTT time is 54. the lab control is 25. which action by the nurse is accurate? a. bolus the patient with an additional 5000 units of heparin b. stop the heparin immediately and notify the doctor that the patients blood level is toxic c. administer protamine sulfate stat d. continue with the prescribed rate

d. continue with the prescribed rate

which patient statement indicates to the nurse that the patient has a good understanding of PVD? a. symptoms are warning signs of the increased potential to develop diseases b. pharmacologic treatments can reverse the disease process c. surgical interventions will cure the disease d. controlling contributing factors may affect the progression of the disease

d. controlling contributing factors may affect the progression of the disease

which nursing interventions would be accurate when administering heparin subcutaneouly? select all that apply a. assessment of recent aPTT levels b. massaging the site after injection of medication c. aspirating after needle insertion d. documenting ecchymotic areas e. monitoring of vital signs

d. documenting ecchymotic areas e. monitoring of vital signs

when sustained released nitroglycerin tablets administered? a. once a day b. at bedtime c. when symptoms of acute angina appear d. every 8-12 hours

d. every 8-12 hours

a patient with altered cardiac function is being assessed by the nurse. when auscultating lung sounds, the nurse will assist this patient into a _______ position? a. prone b. supine c. sims d.fowlers

d. fowlers

the nurse is teaching a patient about statin therapy. which statement by the patient indicates a need for further teaching? a. i will take this medication at night b. this medication will reduce blood clot formation c. I will avoid drinking grapefruit juice. d. if I get a headache, I will notify my health care provider.

d. if I get a headache, I will notify my health care provider.

the nurse is caring for a 27 year old woman on the postpartum unit one day following a Csection. to prevent clot formation, the nurse will: a. position the patient with knees flexed b. initiate use of fitted thromboembolic disease deterrent (TED) stockings c. maintain complete bed rest d. implement deep breathing and coughing exercises

d. implement deep breathing and coughing exercises

a patient who is started on phenytoin (Dilantin), who is also taking amiodarone (Cordarone), should be assessed for what possible effect? a. CNS depression and sedation b. decrease in effectivness of phenytoin c. respiratory depression d. increase in serum phenytoin levels

d. increase in serum phenytoin levels

which action of ACE inhibitors results in effective treatment of heart failure? a. increased afterload b. increased aldosterone c. increased preload d. increased cardiac output

d. increased cardiac output

which lidocaine preperation is appropriate for the treatment of cardiac dysrhythmias? a. 0.1% lidocaine with preservative b. 2% lidocaine for topical use c. lidocaine patch d. injectable lidocaine without preservative

d. injectable lidocaine without preservative

which statement is true regarding the antidysrhythmic agent adonosine (Adenocard)? a. it is synthesized from petroleum products b. it is created through recombinant DNA c. it is extracted from plants d. it is naturally occurring chemical in the body

d. it is naturally occuring chemical in the body

What is the action of amiodarone (Codarone), a class III agent used to treat cardiac dysrhythmias? a. it acts as a myocardial depressant by inhibiting sodium ion movement b. it prolongs the duration of the electrical stimulation on cells and the refractory time between electrical impulses c. it acts as a beta adrenergic agent d. it slows the rate of electrical conduction and prolongs the time between contractions.

d. it slows the rate of electrical conduction and prolongs the time between contractions

The nurse is assessing the patients leg for peripheral vascular disease (PVD) and is unable to palpate the pedal pulse in either foot. which action will the nurse take first? a. contact the doctor b. request x-ray studies of the lower extremities c. request that the patient lie flat d. obtain a doppler ultrasound device for auscultation

d. obtain a doppler ultrasound device for auscultation

what is the mechanism of action of drugs used to treat thromboembolic disease? a. dissolving clots and preventing formation of new clots b. making platelets more flexible and preventing formation of new clots c. causing vasodilation and increased blood flow d. preventing platelet aggregation and inhibiting clot formation

d. preventing platelet aggregation and inhibiting clot formation

Hydralazine, a direct vasodilator, is used to treat hypertension associated with which condition? a. stroke b. diabetes mellitus c. myocardial infarction d. renal diseaese

d. renal disease

The nurse is teaching a patient about dietary implications while on warfarin (Coumadin) therapy. which salad is highest in vitamin K? a. fruit b. pasta c. potato d. spinach

d. spinach

the nurse is providing teaching to a patient with heart failure who has been prescribed nifedipine, a calcium channel blocker. which statement by the nurse is accurate? a. this medication dilates your coronary arteries b. this medication will help your kidneys get rid of fluid c. this medication reduces volume returning to your heart so it doesn't overstretch d. this medication reduces the resistance your heart has to pump against

d. this medication reduces the resistance your heart has to pump against

which symptom will the nurse encourage the patient taking flecainide to report to the doctor? a. headache b. dizziness c. constipation d. weight gain

d. weight gain

when displayed by the patient, which symptom would be most indicative to the nurse to withhold a recently prescribed beta adrenergic blocker? a. dizziness b. peripheral edema c. hyperglycemia d. wheezing

d. wheezing

prior to the adminstration of a beta adrenergic blocker, the nurse notes the patient to have a heart rate of 52 beat/min, peripheral edema, crackles in the bases of the lungs, and mottled skin. which is the priority nursing action? a. administer the medication as ordered. b. re evaluate the patient in 20 min c. obtain a serum blood level d. withhold the medication and notify the doctor

d. withhold the medication and notify doctor