Pharm Exam 2 Questions
The nurse is reviewing the home medication list with the patient. The nurse recognizes that hydrochlorothiazide is used primarily for which condition? a. Hypertension b. Edema c. Diabetes insipidus d. Protection against postmenopausal osteoporosis
a. Hypertension
Prior to discharge, the nurse provides teaching related to adverse effects of terazosin [Hytrin] to the patient and caregivers. Which adverse effects should the nurse include in the teaching of this drug? (Select all that apply.) a. Headache b. Hypoglycemia c. Nasal congestion d. Erectile dysfunction e. Orthostatic hypotension
a. Headache c. Nasal congestion d. Erectile dysfunction e. Orthostatic hypotension
The healthcare provider prescribes lovastatin [Mevacor] for a patient discharged from the hospital post-myocardial infarction. Which instructions are most appropriate for the nurse to include in the patient's teaching plan? (Select all that apply.) a. "Do not start any new medications without first talking to your healthcare provider." b. "Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes." c. "Take your medication in the morning, with a full glass of water for best results." d. "Take one 325-mg aspirin 30 minutes before your dose to lessen the problem of flushing and itching that can occur with this drug." e. "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains."
a. "Do not start any new medications without first talking to your healthcare provider." b. "Before starting this medication a blood test will be done to check your total cholesterol level and to measure liver enzymes." e. "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains."
The nurse is evaluating the teaching done with a patient who has a new prescription for transdermal clonidine [Catapres-TTS]. Which statement by the patient indicates understanding of the nurse's teaching? a. "I will apply the patch to a hairless, intact skin area on my upper arm." b. "I need to apply the patch before my evening meal." c. "The patch will not cause any skin reaction." d. "I will need to apply a new patch once every 3 to 4 days."
a. "I will apply the patch to a hairless, intact skin area on my upper arm."
The nurse is teaching a patient with essential hypertension who has a new prescription for verapamil [Calan]. Which statements by the patient indicate that the teaching was effective? (Select all that apply.) a. "I will increase my intake of fluid and foods high in fiber." b. "I should stay out of direct sunlight to prevent exposing my skin to the sun." c. "I will call my healthcare provider if I notice swelling in my ankles." d. "I need to avoid salt substitutes and potassium supplements." e. "I may notice easy bruising and bleeding with this drug."
a. "I will increase my intake of fluid and foods high in fiber." c. "I will call my healthcare provider if I notice swelling in my ankles."
Which statement is most appropriate for the nurse to include in the discharge teaching plan for a 30-year-old woman beginning a new prescription of clonidine [Catapres]? a. "If you stop taking this drug abruptly, your blood pressure might go up very high." b. "You will need to have your blood drawn regularly to check for anemia." c. "Take this medication first thing in the morning to reduce nighttime wakefulness." d. "This medication often is used to manage hypertension during pregnancy."
a. "If you stop taking this drug abruptly, your blood pressure might go up very high."
Which intravenous (IV) fluid would be most appropriate for treating isotonic volume contraction? a. 0.9% sodium chloride b. 5% dextrose and water c. 0.225% sodium chloride d. 3% sodium chloride and water
a. 0.9% sodium chloride
The nurse is preparing to administer a daily dose of digoxin [Lanoxin]. What is the priority nursing intervention? a. Analyze heart rate and rhythm. b. Assess for Homans' sign. c. Check blood pressure. d. Palpate the pedal pulses.
a. Analyze heart rate and rhythm.
Which drug is the most effective for lowering LDL cholesterol? a. Atorvastatin [Lipitor] b. Cholestyramine [Questran] c. Gemfibrozil [Lopid] d. Ezetimibe [Zetia]
a. Atorvastatin [Lipitor]
The nurse in the cardiac care unit is caring for a patient receiving epinephrine. Which assessment criterion takes priority in the monitoring for adverse effects of this drug? a. Cardiac rhythm b. Blood urea nitrogen c. Central nervous system d. Lung sounds
a. Cardiac rhythm
The nurse knows that diuretics mostly affect which function of the kidneys? a. Cleansing and maintenance of extracellular fluid volume b. Maintenance of acid-base balance c. Excretion of metabolic waste d. Elimination of foreign substance
a. Cleansing and maintenance of extracellular fluid volume
The nurse should monitor for which adverse effect after administering hydrochlorothiazide [HydroDIURIL] and digoxin [Lanoxin] to a patient? a. Digoxin toxicity b. Decreased diuretic effect c. Dehydration d. Heart failure
a. Digoxin toxicity
Which patient symptoms should cause the nurse to be concerned about digoxin [Lanoxin] toxicity? (Select all that apply.) a. Fatigue b. Vomiting c. Dizziness d. Blurred vision e. Muscle weakness
a. Fatigue b. Vomiting d. Blurred vision
Which medications should be used with caution in a hypertensive diabetic patient? (Select all that apply.) a. Furosemide [Lasix] b. Metoprolol [Lopressor] c. Diltiazem [Cardizem] d. Hydrochlorothiazide [HCTZ] e. Enalapril [Vasotec]
a. Furosemide [Lasix] b. Metoprolol [Lopressor] d. Hydrochlorothiazide [HCTZ]
The nurse is preparing to administer an oral dose of digoxin [Lanoxin]. The apical pulse rate is 64. What nursing action is most appropriate? a. Give the medication. b. Obtain a serum digoxin level. c. Notify the healthcare provider. d. Assess for signs of digoxin toxicity.
a. Give the medication.
A patient with angina pectoris has been prescribed nifedipine [Procardia]. Which possible adverse effects should the nurse expect with this medication? (Select all that apply.) a. Headache b. Constipation c. Nausea and vomiting d. Edema of ankles and feet e. Overgrowth of gum tissue
a. Headache d. Edema of ankles and feet e. Overgrowth of gum tissue
The nurse is preparing to administer a dose of clonidine [Catapres]. Which is the best description of the action of this drug? a. It selectively activates alpha2 receptors in the central nervous system (CNS). b. It causes peripheral activation of alpha1 and alpha2 receptors. c. It depletes sympathetic neurons of norepinephrine. d. It directly blocks alpha and beta receptors in the periphery.
a. It selectively activates alpha2 receptors in the central nervous system (CNS).
Which of the following statements about mannitol [Osmitrol] are correct? (Select all that apply.) a. Mannitol cannot be given orally. b. Mannitol can cause edema. c. Mannitol can cause renal failure. d. Diuresis begins in 30 to 60 minutes after administration. e. Mannitol is a loop diuretic
a. Mannitol cannot be given orally. b. Mannitol can cause edema. d. Diuresis begins in 30 to 60 minutes after administration.
The nurse has just administered the initial dose of enalapril [Vasotec] to a newly admitted patient with hypertension. What is the priority nursing intervention over the next several hours? a. Monitor blood pressure. b. Check the heart rate. c. Auscultate lung sounds. d. Draw a potassium level.
a. Monitor blood pressure.
A patient in a hypertensive crisis is being started on a continuous sodium nitroprusside [Nipride] infusion. What interventions are essential before the nurse administers nitroprusside [Nipride]? (Select all that apply.) a. Obtain a baseline weight and weigh daily. b. Prepare for arterial line insertion. c. Discontinue the infusion when blood pressure is controlled. d. Observe for signs of hypertrichosis during the infusion. e. Cover the solution with an opaque bag.
a. Obtain a baseline weight and weigh daily. b. Prepare for arterial line insertion e. Cover the solution with an opaque bag.
The nurse reviews the medication treatment regimen for a patient with chronic hypertension. To promote optimal medication adherence, which frequency of drug dosing should the nurse advocate for this patient? a. Once a day b. Three times a day c. Four times a day d. Every 8 hours
a. Once a day
The nurse notices significant edema surrounding and proximal to the peripheral intravenous (IV) site where epinephrine is being infused. Which action would the nurse anticipate first? a. Prepare to administer phentolamine [Regitine]. b. Ensure that naloxone [Narcan] is available. c. Institute the protocol for congestive heart failure (CHF). d. Monitor the blood urea nitrogen (BUN), creatinine, and potassium levels.
a. Prepare to administer phentolamine [Regitine].
Which are beneficial effects that can be derived from simvastatin [Zocor] and other drugs in this class? (Select all that apply.) a. Reduction of LDLs b. Elevation of HDLs c. Stabilization of the plaque in coronary arteries d. Reduction of risk of cardiovascular events e. Improvement of liver function
a. Reduction of LDLs b. Elevation of HDLs c. Stabilization of the plaque in coronary arteries d. Reduction of risk of cardiovascular events
Which acid-base imbalance is caused by retention of CO2 secondary to hypoventilation? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis
a. Respiratory acidosis
The nurse is caring for a patient who has been receiving intravenous sodium nitroprusside [Nitropress] for 3 days. Which assessement data indicate the patient may be experiencing thiocyanate toxicity? a. Sudden confusion b. Difficulty breathing c. Erythematous rash d. Gastrointestinal bleeding
a. Sudden confusion
In the failing heart, arterial pressure falls, stimulating the baroreceptor reflex to increase sympathetic nervous system activity. The nurse understands increased sympathetic activity will produce which response? a. Tachycardia b. Bradypnea c. Hypotension d. Hypoglycemia
a. Tachycardia
Which instructions should the nurse include when developing a teaching plan for a patient prescribed diltiazem [Cardizem] for atrial fibrillation? (Select all that apply.) a. Weigh yourself daily at the same time each day. b. The medication will not cause dizziness or headache. c. Notify the healthcare provider if a skin rash develops. d. Do not take daily oral calcium supplements. e. Rise slowly from a lying to a sitting position.
a. Weigh yourself daily at the same time each day. c. Notify the healthcare provider if a skin rash develops. e. Rise slowly from a lying to a sitting position.
The nurse is caring for a patient who has diabetes and hypertension. Which medication is most likely to be prescribed to treat this patient's hypertension? a. Hydrochlorothiazide [HCTZ] b. Enalapril [Vasotec] c. Propranolol [Inderal] d. Methyldopa [Aldomet]
b. Enalapril [Vasotec]
Which statement made by the patient indicates understanding of teaching related to a new prescription for atenolol [Tenormin]? a. "I will increase my fluids to prevent constipation." b. "I will not stop taking this medication abruptly." c. "I will take the first dose of this medicine at night." d. "I will wear sunscreen and a hat when I work in the sun."
b. "I will not stop taking this medication abruptly."
The nurse is teaching a patient who has just been prescribed a vasodilator. Which statement by the patient indicates that the teaching was effective? a. "I can take this medication in the morning to reduce nighttime urination." b. "I will rise slowly when changing from a sitting to a standing position." c. "My heart rate may slow down with this drug. I will call if my pulse is below 60." d. "I need to increase my intake of fluids and foods that are high in fiber."
b. "I will rise slowly when changing from a sitting to a standing position."
A patient is to be discharged home with a new prescription for prazosin [Minipress]. Which statement is most important for the nurse to include in the teaching plan? a. "You should increase your intake of fresh fruits and vegetables." b. "You should move slowly from a sitting to a standing position." c. "Be sure to wear a Medic Alert bracelet while taking this medication." d. "Take your first dose of this medication first thing in the morning."
b. "You should move slowly from a sitting to a standing position."
About which patient should the nurse notify the healthcare provider immediately? a. A patient who takes digoxin [Lanoxin] 0.125 mg orally daily with a serum digoxin level of 0.8 ng/mL b. A patient who takes oral spironolactone [Aldactone] 25 mg daily and enalapril [Vasotec] 5 mg daily with a serum potassium level of 5.5 mEq/L c. A patient who takes digoxin [Lanoxin] 0.25 mg orally daily with a serum potassium level of 4.0 mEq/L d. A patient who takes oral lisinopril [Zestril] 5 mg daily and digoxin 0.125 mg daily with a serum digoxin level of 0.5 ng/mL
b. A patient who takes oral spironolactone [Aldactone] 25 mg daily and enalapril [Vasotec] 5 mg daily with a serum potassium level of 5.5 mEq/L
The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure. Which compound in this system is most powerful at raising the blood pressure? a. Angiotensin I b. Angiotensin II c. Angiotensin III d. Renin
b. Angiotensin II
Which classes of medications are prescribed as initial therapy for hypertension after a myocardial infarction (MI)? a. Diuretic and beta blocker b. Beta blocker and ACE inhibitor c. ACE inhibitor and calcium channel blocker d. Diuretic and calcium channel blocker
b. Beta blocker and ACE inhibitor
What is the primary benefit of spironolactone [Aldactone] in patients with heart failure? a. Increase in diuresis and fluid loss b. Blockage of aldosterone receptors c. Inhibition of beta activation by norepinephrine d. Stimulation of the renin-angiotensin-aldosterone system
b. Blockage of aldosterone receptors
The nurse is monitoring a patient prescribed reserpine for the treatment of hypertension. Which assessment parameter indicates that this medication is effective? a. Decrease in diarrhea b. Blood pressure of 118/72 mm Hg c. Absence of bladder distention d. Improved symptoms of depression
b. Blood pressure of 118/72 mm Hg
The nurse is caring for a patient prescribed a cholesterol-lowering drug. Which drug is least likely to cause systemic side effects? a. Simvastatin [Zocor] b. Colesevelam [Welchol] c. Nicotinic acid [Niaspan] d. Gemfibrozil [Lopid]
b. Colesevelam [Welchol]
A patient is prescribed lisinopril [Prinivil] 40 mg by mouth once a day for hypertension. For which therapeutic effect will the nurse monitor? a. Slowing of the heart rate b. Decrease in blood pressure c. Symptoms such as dizziness and fainting d. Pulse oximetry oxygen saturation of 100%
b. Decrease in blood pressure
A patient is prescribed hydralazine [Apresoline] for the treatment of essential hypertension. Which expected adverse effects should the nurse discuss with the patient? (Select all that apply.) a. Nausea b. Fatigue c. Dizziness d. Headache e. Joint pain
b. Fatigue c. Dizziness d. Headache
The nurse knows that which organ is primarily responsible for maintaining fluid volume and osmolality? a. Liver b. Kidneys c. Blood vessels d. Heart
b. Kidneys
The nurse is caring for a patient with bipolar disorder treated with lithium [Eskalith]. The patient has a new prescription for captopril [Capoten] for hypertension. The combination of these two drugs makes which assessment particularly important? a. Potassium level b. Lithium level c. Creatinine level d. Blood pressure
b. Lithium level
The nurse is caring for a patient receiving a nitroprusside [Nipride] intravenous infusion. The patient's wife asks why furosemide [Lasix] is being prescribed along with this drug. The nurse's response is based on which concept? a. Furosemide will help reduce reflex tachycardia. b. Many vasodilators cause retention of sodium and water. c. Thiocyanate may accumulate in patients receiving nitroprusside. d. Vasodilators can cause serious orthostatic hypotension.
b. Many vasodilators cause retention of sodium and water.
The healthcare provider prescribes an intravenous dose of diltiazem [Cardizem] for treatment of a patient with atrial fibrillation. What is the priority nursing intervention? a. Assist with cardioversion. b. Monitor electrocardiogram. c. Obtain baseline coagulation studies. d. Assess for increased urinary output.
b. Monitor electrocardiogram.
The nurse is caring for a patient with hypertension who is receiving verapamil [Calan]. The patient has a healthy heart. What pharmacodynamic effects does the nurse expect from this drug? (Select all that apply.) a. Peripheral vasoconstriction b. Peripheral vasodilation c. Coronary vasodilation d. Increased heart rate e. Increased force of contraction
b. Peripheral vasodilation c. Coronary vasodilation
Why does the nurse anticipate administering metoprolol [Lopressor] rather than propranolol [Inderal] for diabetic patients who need a beta-blocking agent? a. Metoprolol is less likely to cause diabetic nephropathy. b. Propranolol causes both beta1 and beta2 blockade. c. Metoprolol helps prevent retinopathy in individuals with diabetes. d. Propranolol is associated with a higher incidence of foot ulcers.
b. Propranolol causes both beta1 and beta2 blockade.
Which acid-base imbalance is caused by hyperventilation? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis
b. Respiratory alkalosis
A patient is admitted to the unit in a hypertensive emergency and examination reveals papilledema. The nurse should expect which IV medications to be administered to achieve rapid, controlled reduction of the patient's blood pressure? a. Furosemide [Lasix] b. Sodium nitroprusside [Nitropress] c. Metoprolol [Lopressor] d. Diltiazem [Cardizem]
b. Sodium nitroprusside [Nitropress]
The heart undergoes cardiac remodeling during the initial phase of heart failure. Which cardiac geometric change occurs during heart failure? a. Ventricular constriction b. Ventricular wall thickening c. Ventricular atrophy d. Ventricles become more cylindric
b. Ventricular wall thickening
The nurse is caring for a patient receiving propranolol [Inderal]. Which clinical finding is most indicative of an adverse effect of this drug? a. A heart rate of 100 beats per minute b. Wheezing c. A glucose level of 180 mg/dL d. Urinary urgency
b. Wheezing
The nurse is teaching a patient who has a new prescription for spironolactone [Aldactone]. Which statement by the patient indicates that the teaching was effective? a. "I will use salt substitutes to lower my sodium intake." b. "I will increase my intake of foods that are high in potassium." c. "I will call my doctor if I begin having menstrual irregularities." d. "I will take this medication at bedtime each evening."
c. "I will call my doctor if I begin having menstrual irregularities."
The nurse is caring for a patient receiving oral magnesium gluconate. Which symptom indicates a common adverse effect of this medication? a. Headache b. Wheezing c. Loose stools d. Urinary retention
c. Loose stools
The nurse is evaluating the teaching done with a patient who has a new prescription for fosinopril [Monopril]. Which statement by the patient indicates a need for further teaching? a. "I can take this medicine with breakfast each morning." b. "I will call if I notice a rash or wheals on my skin." c. "I will use a salt substitute to lower my sodium intake." d. "I will call if I develop a bothersome cough."
c. "I will use a salt substitute to lower my sodium intake."
An adult male patient is taking medication for blood pressure management. The patient states to the nurse, "I'm not going to take these drugs anymore, because they are interfering with my sex life." What is the most appropriate response by the nurse? a. "It is unfortunate these drugs can cause erectile dysfunction but managing your blood pressure is more important than your sexual performance." b. "I understand how discouraging it must be to live with this adverse effect, but you could have a stroke if you do not take your blood pressure medications." c. "Let's discuss this effect with your prescriber. There are other drugs available to manage your blood pressure that may not have the same adverse effect." d. "I am glad you told me about your experience with this common side effect. Sexual performance can be a difficult subject to discuss."
c. "Let's discuss this effect with your prescriber. There are other drugs available to manage your blood pressure that may not have the same adverse effect."
The nurse is teaching a group of patients about dietary approaches to reduce cholesterol levels. Which statement is most important to include in the teaching? a. "Lower your cholesterol to 300 mg/day." b. "Eliminate red meat and pork from your diet." c. "Read food labels and reduce your intake of saturated fats." d. "Reduce salt consumption to keep your sodium intake to 2400 mg/day."
c. "Read food labels and reduce your intake of saturated fats."
The nurse is preparing to administer diltiazem and atenolol. What is the priority nursing intervention before administering these two medications to the patient? a. Obtain blood glucose b. Observe for lower leg edema c. Assess the heart rate d. Apply a pulse oximeter
c. Assess the heart rate
The nurse is preparing to give epinephrine by the IV push route. Which actions are essential before giving this drug? (Select all that apply.) a. Check the blood urea nitrogen (BUN) and creatinine levels. b. Obtain insulin from the medication cart. c. Assess the patency of the IV line. d. Review the allergy history. e. Assess the vital signs.
c. Assess the patency of the IV line. d. Review the allergy history. e. Assess the vital signs.
The nurse is caring for several patients. For which patient diagnosis would a prescription for nifedipine [Adalat] be least appropriate? a. Angina pectoris b. Essential hypertension c. Atrial fibrillation d. Vasospastic angina
c. Atrial fibrillation
The nurse is teaching a patient prescribed captopril [Capoten] for the treatment of hypertension. Which instructions should the nurse include? (Select all that apply.) a. Take the medication with food. b. Expect a sore throat and fever. c. Avoid potassium salt substitutes. d. A persistent dry cough may occur. e. Report difficulty in breathing immediate
c. Avoid potassium salt substitutes. d. A persistent dry cough may occur. e. Report difficulty in breathing immediate
Calcium channel blockers work by reducing calcium influx into the cells of the heart and blood vessels. Calcium channels are coupled to which type of autonomic nervous system receptors? a. Alpha1 b. Alpha2 c. Beta1 d. Beta2
c. Beta1
Which assessment finding is most important for the nurse to obtain before administering hydralazine [Apresoline]? a. Peripheral pulses b. Homans' sign c. Blood pressure d. Capillary refill
c. Blood pressure
A patient is prescribed lisinopril [Prinvil] as part of the treatment plan for heart failure. Which finding indicates the patient is experiencing the therapeutic effect of this drug? a. + 2 edema of the lower extremities b. Potassium level of 3.5 mEq/L c. Crackles in the lungs are no longer heard d. Jugular vein distention
c. Crackles in the lungs are no longer heard
The nurse plans to closely monitor for which clinical manifestation after administering furosemide [Lasix]? a. Decreased pulse b. Decreased temperature c. Decreased blood pressure d. Decreased respiratory rate
c. Decreased blood pressure
The nurse is caring for several patients prescribed propranolol [Inderal]. In which patient condition is propranolol [Inderal] contraindicated? a. Cardiac dysrhythmias b. Hypertension c. Diabetes d. Angina
c. Diabetes
The nurse is caring for a patient receiving IV therapy with a 3% sodium chloride infusion at 75 mL/hr. The nurse should closely monitor for which adverse effect of treatment? a. Blood urea nitrogen of 22 mg/dL b. Tenting of the skin and dry mucous membranes c. Distended neck veins and ankle edema d. Sodium level of 140 mEq/L
c. Distended neck veins and ankle edema
The nurse is assessing a patient in a clinic who has been taking clonidine [Catapres] for hypertension. Which clinical findings are most indicative of an adverse effect of this drug? a. Cough and wheezing b. Epigastric pain and diarrhea c. Drowsiness and dry mouth d. Positive Coombs' test result and anemia
c. Drowsiness and dry mouth
A patient with heart failure has developed a cough while taking an angiotensin-converting enzyme (ACE) inhibitor. The health care provider discontinued the ACE inhibitor and prescribed an angiotensin II receptor blocker (ARB) as an alternative to the ACE inhibitor. The patient continues to have symptoms of heart failure despite using an ARB. Which medication should the nurse anticipate will be prescribed? a. Eplerenone [Inspra] b. Triamterene [Dyrenium] c. Hydrochlorothiazide [Microzide] d. BiDil [Isosorbide Dinitrate and Hydralazine]
c. Hydrochlorothiazide [Microzide]
The nurse is reviewing drugs on the emergency cart with regard to their therapeutic action. Which medications can help initiate heart contraction during a cardiac arrest? a. Topical phenylephrine b. Subcutaneous terbutaline c. Intravenous epinephrine d. Inhaled albuterol
c. Intravenous epinephrine
The nurse is caring for a patient prescribed aliskiren [Tekturna]. How does this medication lower blood pressure? a. It blocks the conversion of angiotensin I to angiotensin II. b. It prevents angiotensin II from binding to its receptors. c. It inhibits the conversion of angiotensinogen into angiotensin I. d. It selectively blocks aldosterone receptors in the kidneys.
c. It inhibits the conversion of angiotensinogen into angiotensin I.
The nurse understands that cholesterol is carried through the blood by lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis? a. Very-low-density lipoprotein (VLDL) b. Apolipoprotein B-100 c. Low-density lipoprotein (LDL) d. High-density lipoprotein (HDL)
c. Low-density lipoprotein (LDL)
Which acid-base imbalance is caused by chronic renal failure, loss of bicarbonate during severe diarrhea, or metabolic disorders that result in overproduction of lactic acid? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis
c. Metabolic acidosis
What is the most appropriate nursing consideration for a patient who is prescribed verapamil [Calan] and digoxin [Lanoxin]? a. Restrict intake of oral fluids and high-fiber food. b. Take an apical pulse for 30 seconds before administration. c. Notify the healthcare provider of nausea, vomiting, and visual changes. d. Hold the medications if the heart rate is greater than 110 beats per minute
c. Notify the healthcare provider of nausea, vomiting, and visual changes.
The nurse is preparing to administer IV potassium to a patient with hypokalemia. Which prescription is the most appropriate? a. Potassium chloride 30 mEq in 100 mL IV over 1 hour b. Potassium chloride 10 mEq in 100 mL IV over 30 minutes c. Potassium chloride 10 mEq in 100 mL IV over 1 hour d. Potassium chloride 10 mEq IV push over 1 minute
c. Potassium chloride 10 mEq in 100 mL IV over 1 hour
The nurse is caring for a patient who takes spironolactone [Aldactone] and quinapril [Accupril] for treatment of heart failure. What finding indicates a potential interaction between these two drugs? a. Elevated serum quinapril level b. Heart rate of 58 beats per minute c. Potassium level of 5.7 mEq/L d. Glucose level of 180 mg/dL
c. Potassium level of 5.7 mEq/L
The nurse is caring for a patient with renal artery stenosis who has been prescribed benazepril [Lotensin]. Which laboratory result indicates an adverse effect of this drug? a. Potassium level of 3.2 mEq/L b. Blood glucose level of 180 mg/dL c. Serum creatinine level of 2.3 mg/dL d. Uric acid level of 10 mg/dL
c. Serum creatinine level of 2.3 mg/dL
A patient with hypertensive emergency is admitted to the hospital. Which medication should the nurse be prepared to administer to this patient? a. Minoxidil [Loniten] b. Hydralazine [Apresoline] c. Sodium nitroprusside [Nipride] d. Hydralazine and isosorbide dinitrate [BiDil]
c. Sodium nitroprusside [Nipride]
The nurse is caring for a patient with heart failure who needs a diuretic. Which agent is likely to be chosen, because it has been shown to greatly reduce mortality in patients with heart failure? a. Furosemide [Lasix] b. Hydrochlorothiazide [HydroDIURIL] c. Spironolactone [Aldactone] d. Mannitol [Osmitrol]
c. Spironolactone [Aldactone]
The nurse is caring for a patient prescribed digoxin [Lanoxin] for heart failure. Which finding would require immediate attention by the nurse? a. Potassium level of 3.7 mEq/L b. Digoxin level of 0.7 ng/mL c. Vomiting and diarrhea d. Heart rate of 68 beats per minute
c. Vomiting and diarrhea
Which laboratory result may be a consequence of therapy with a thiazide diuretic? a. Serum glucose level of 58 mg/dL b. Serum potassium level of 5.3 mEq/L c. Serum sodium level of 135 mEq/L d. Serum uric acid level of 10.4 mg/dL
d. Serum uric acid level of 10.4 mg/dL
The nurse provides discharge instructions to a patient prescribed verapamil [Calan] SR 120 mg PO daily for essential hypertension. Which statement by the patient indicates understanding of the medication? a. "I will take the medication with grapefruit juice each morning." b. "I should expect occasional loose stools from this medication." c. "I'll need to reduce the amount of fiber in my diet." d. "I must make sure I swallow the pill whole."
d. "I must make sure I swallow the pill whole."
The nurse is teaching a patient with a history of anaphylaxis how to use an EpiPen. Which statement made by the patient indicates that he understands the proper use of this drug? a. "I will keep my medication in the refrigerator when I'm not using it." b. "I should take this medication within 30 minutes of the onset of symptoms." c. "I must remove my pants before injecting the medication into the leg." d. "I will jab this medication firmly into my outer thigh if needed."
d. "I will jab this medication firmly into my outer thigh if needed."
The nurse is teaching the patient about atenolol [Tenormin]. Which statement by the patient indicates a correct understanding of the nurse's instruction? a. "I will need to wait for 6 months and then stop this medication." b. "One missed dose will not affect my blood pressure." c. "I may experience occasional chest pain and discomfort." d. "I will not stop taking this drug without the approval of my healthcare provider."
d. "I will not stop taking this drug without the approval of my healthcare provider."
The nurse is teaching a patient about the side effects associated with doxazosin [Cardura]. Which statement by the patient indicates an understanding of the nurse's instructions? a. "I may experience an increase in hair growth as a side effect." b. "I'll notify the healthcare provider if I develop a persistent cough." c. "I'll make sure I include extra sources of potassium in my diet, such as bananas and baked potatoes." d. "When getting out of bed in the morning, I will sit on the side of the bed for several minutes before standing."
d. "When getting out of bed in the morning, I will sit on the side of the bed for several minutes before standing."
The nurse is caring for a patient prescribed gemfibrozil [Lopid]. For which patient should the nurse question the use of this drug? a. A patient with cardiovascular disease and elevated triglycerides b. A patient with elevated very-low-density lipoprotein (VLDL) levels c. A patient with elevated triglycerides who has not responded to dietary changes d. A patient with history of gallstones and elevated triglycerides
d. A patient with history of gallstones and elevated triglycerides
The patient is admitted for the management of a hypertensive emergency. The healthcare provider prescribes sodium nitroprusside [Nipride] drug therapy. What is the priority nursing action during this treatment? a. Observe for respiratory depression. b. Monitor the electrocardiogram for tachycardia. c. Initiate oxygen therapy via nasal cannula at 2 L/min. d. Adjust the intravenous infusion rate to the blood pressure response
d. Adjust the intravenous infusion rate to the blood pressure response
A patient is admitted to the hospital with a diagnosis of hypertension. The nurse understands that which medication works by preventing angiotensin II from binding with its receptor sites? a. Quinapril [Accupril] b. Aliskiren [Tekturna] c. Eplerenone [Inspra] d. Candesartan [Atacand]
d. Candesartan [Atacand]
A patient who abuses cocaine, opioids, and other drugs frequently abuses which drug? a. Guanfacine b. Reserpine c. Methyldopa d. Clonidine
d. Clonidine
Which medication is most likely to cause the side effect of constipation? a. Nifedipine [Adalat] b. Amlodipine [Norvasc] c. Isradipine [DynaCirc] d. Diltiazem [Cardizem]
d. Diltiazem [Cardizem]
The nurse caring for a patient taking furosemide [Lasix] is reviewing the patient's most recent laboratory results, which are: sodium, 136 mEq/L; potassium, 3.2 mEq/L; chloride, 100 mEq/L; blood urea nitrogen, 15 mg/dL. What is the nurse's best action? a. Administer Lasix as ordered. b. Place the patient on a cardiac monitor. c. Begin a 24-hour urine collection. d. Hold the Lasix and notify the physician
d. Hold the Lasix and notify the physician
Which acid-base imbalance is characterized by increases in both the pH and bicarbonate content of plasma? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis
d. Metabolic alkalosis
A patient with cardiovascular disease is taking rosuvastatin [Crestor]. The nurse is monitoring for potential adverse effects. Which finding indicates a potential adverse effect of this drug? a. Blood pressure of 140/90 mm Hg b. Wheezing and shortness of breath c. Platelet count of 100 × 103/mm3 d. Muscle pain and tenderness
d. Muscle pain and tenderness
A nurse is caring for a patient prescribed doxazosin [Cardura] for hypertension. Safety is a priority because of which associated adverse effect? a. Reflex tachycardia b. Heart palpitations c. Cardiac dysrhythmias d. Orthostatic hypotension
d. Orthostatic hypotension
The nurse is preparing to administer minoxidil [Loniten] 5 mg orally. What is the only cardiovascular indication for this mediacation? a. Heart failure b. Myocardial infarction c. Angina pectoris d. Severe hypertension
d. Severe hypertension
The nurse is caring for a patient receiving hydralazine [Apresoline]. The healthcare provider prescribes propranolol [Inderal]. The nurse knows that a drug such as propranolol often is combined with hydralazine for what purpose? a. To reduce the risk of headache b. To improve hypotensive effects c. To prevent heart failure d. To protect against reflex tachycardia
d. To protect against reflex tachycardia
