pharm exam 2 review
The nurse assesses the client before administering digoxin and withholds the drug and notifies the physician with what finding?
Pulse is 44 beats/minute
A nurse is instructing a client on the application of nitroglycerin in transdermal patches. Which of the following statements by the client indicates an understanding of the teaching?
"I will take the patch off right after my evening meal."
. A client was started on Losartan 100 mg PO daily for hypertension. Which of the following statements of the nurse are correct in educating the client regarding the medication? SELECT ALL THAT APPLY
1.Your provider will be monitoring your potassium levels. 2.It is an angiotensin receptor blocker ( ARB)."
What is the function of Angiotensin II Receptor Blocker?
Inhibits the receptors of Angiotensin II
The nurse is observing a co-worker who is about to give an injection of INSULIN. Which of the following actions by the co-worker would require the nurse to INTERVENE?
Injecting the insulin medication 15 degrees using an insulin syringe
A nurse is assessing a client who is taking levothyroxine. The nurse should recognize that which of the following findings is a manifestation of levothyroxine overdose?
Insomnia- A- Levothyroxine overdose will result in manifestations of hyperthyroidism, which include insomnia, tachycardia, and hyperthermia.
The nurse suspects digitalis toxicity select all that apply
Irregular heart beat Anorexia Nausea
What is the action of Angiotensin converting enzyme ?
It blocks or inhibits the formation of Angiotensin
The nurse is educating a group of clients with congestive heart failure regarding the medication digoxin. Which of the following is/are correct with regards to this medication?
It decreases the heart rate
How does glipizide work?
It lowers blood glucose acutely by stimulating the release of insulin from the pancreas
Which of the following is a clinical manifestation of hyperglycemia?
Itchy skin
A child is diagnosed with hypothyroidism.. The nurse anticipates an order of drug choice when treating children , which is what?
Levothyroxine
Depression intolerance bradycardio and hypothyroidism what drug is given
Levothyroxine
What is an example of an ARB?
Losartan Drugs that end with "Tan"
A nurse is taking care of a client with Diabetes Mellitus type . Which of the following medications can cause lactic acidosis and should be discontinued prior to performing a diagnostic procedure with contrast dye due to the risk of acute renal failure?
Metformin
A client presents at the clinic reporting weight loss of 12 Ibs. over the past 3 months despite an increased appetite and tachycardia. What medication would most likely benefit the client?
Methimazole
Hyperthyroidism what drug what are lab results/
Methimazole/ PTU Increase t3 and t4 and low tsh
A client's hypertension has not responded significantly to first-line therapies so the client has been prescribed aliskiren and spironolactone in addition to blood pressure monitoring, what assessment should the nurse prioritize?
Monitoring for hyperkalemia
Will you be able to give Beta-blocker like propranolol to a patient who is hypertensive and at the same time asthmatic?
NO (because stimulation of the Beta2 will produce Broncho-constriction. (You are treating the hypertension but exacerbating the asthma)
A nurse is teaching a client who has angina about nitroglycerin sublingual tablets. Which of the following statements should the nurse include in the teaching
Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart"
A client has an order to receive epinephrine IV from the provider. Which of the following conditions is a contraindication for its use?
Pheochromocytoma
What is a cause of secondary hypertension due to rise of catecholamines?
Pheochromocytomas
The patient diagnosed with angina tells the nurse he is having chest pain. There is an order for sublingual nitroglycerin as needed. What action should the nurse take? what is the expected adverse effect?
Place one tablet under the tongue every 5 mins to the patients pain is gone or relieved.
The nurse reviews the laboratory results of a client taking digoxin. What finding creates a risk for digoxin toxicity?
Potassium 3.3 mmol/L (3.3 mE/L)
A nurse is reviewing the laboratory results of a client who is taking digoxin for heart failure. Which of the following results should the nurse report to the provider?
Potassium level 2.8 mEq/L
What statements by the 54-year-old client indicates an understanding of the nurse's teaching about how to take sublingual nitroglycerin?
"I can take up to three tablets at 5-minute intervals."
Which of the following questions would be most important for a nurse to ask a female patient who is starting on an angiotensin Il receptor blocker for hypertension?
"When was your last menstrual period?"
A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect?
. Miosis
When providing care for a patient receiving alpha and beta adrenergic agonists, which of the following would be important to assess in order to prevent the systemic overload of catecholamine?
. Pheochromocytoma (tumor in adrenal gland that produces excess catecholamine)
A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingual for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make?
A headache is an expected adverse effect of the medication
Which of the following is a primary action of Glucagon?
Accelerate the breakdown of glycogen
A client in cardiogenic shock is receiving an infusion of dopamine when it is discovered that extravasation has occurred . What action is most appropriate?
Administer phentolamine to the site, as prescribed .
A nurse is educating a group of nursing students regarding the different medications used in the treatment of hypertension. Which of the following medications is considered a calcium channel blocker that can cause ankle edema in some clients?
Amlodipine
Question: The following patients are prescribed metformin.Which patient is likely at the greatest risk of having an adverse reaction to metformin?
An alcoholic patient
A nurse is assessing a client who is receiving dopamine IV to treat left ventricular heart failure. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect?
Apical heart rate is increased
A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions
Asthma
A nurse in an emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer?
Atropine
Angiotensin converting enzyme
Blocks or inhibit the formation of angiotensin 2
A nurse is teaching a client who has hypertension and a new prescription for atenolol. Which of the following findings should the nurse include as adverse effects of this medication ?
Bradycardia
. If you administer a Beta1 blocker, what happens to the heartrate?
Bradycardia, it decreases.
The nurse is caring for patient on a beta blocker. What is an important contraindication of a adrenergic blocking agent to notify the doctor about?
Brdycardia
If you block Beta 2, what happens?
Broncho-Constriction
What is the effect of albuterol
Bronchodilation of lungs
Beta Adrenergic (metoprolol) variety of uses except contraindications of Beta blockers ABC's (Asthma/Copd, brdycardia bronchospams
Bronchospasm
A nurse is taking care of a client diagnosed with hypertension. what is the medication for ankle edema
Calcium channel blocker amlodepine
Adrenergic agonists are usually used to increase the blood pressure of a client . Which of the following adrenergic agonists will cause a DECREASE pressure
Clonidine
What is a drug used to treat Hypertension? How does it it lower BP?
Clonidine It inhibits the release of NE
. A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following interventions should the nurse include in the plan of care?
Determine the apical pulse prior to administering.
The nurse suspects the diabetic patient maybe having a hypoglycemic reaction when what manifestation is assesed?
Diaphoresis
Drug sustained release or enteric coated: tend to preserve the medication until is time to be release because of the longer action in the body?
Do not crush the drug
A nurse is administering donepezil to as client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately
Dyspnea
A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspnea. Which of the following medications should the nurse administer first?
Epinephrine
What is an indication for use non-selective adrenergic blocking agents?
Essential hypertension
A nurse is providing teaching for a client who is newly diagnosed with type 2 diabetes mellitus and has a prescription for glipizide. Which of the following statements by the nurse best describes the action of glipizide?
Glipizide stimulates your pancreas to release insulin."
A client is brought to the emergency department with hypoglycemia blood glucose level of 19 mg/dL. What drug should the nurse prepare to administer intravenously?
Glucagon
A client is brought to the emergency department with hypoglycemia what drug should be given
Glucagon
A client noted with diaphoresis and decreased mentation, blood sugar was taken and noted at 50 mg d/L. The patient is currently on NPO (nothing per orem) and have no IV access. Which of the following is expected to be given to this client?
Glucagon
A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The client's BP is 144/86, heart rate is 55 bpm, and respiratory rate is20 cpm. The nurse should withhold the medication and contact the provider for which of the following finding?
Heart rate
Adverse effect of Adrenergic agonists is increase blood pressure
Hypertension
The emergency department nurse is asked to prepare a nitroprusside infusion for a client being brought to the hospital in an ambulance . What is the client's most likely diagnosis?
Hypertensive crisis
The nurse is reading the lab of a client taking Digoxin
Hypokalemia ( low potassium levels)
A 20 year old taking Nitroglycerin and Nifedipine client admitted complains of uncontrolled chest pain. The nurse should observe the client for what adverse effect?
Hypotension
A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication ?
I feel nauseated and have no appetite
A nurse is providing teaching to a client who has a new prescription for lisinopril. Which of following statements by the nurse indicates an understanding of the teaching?
I should report a cough to my provider
What is the purpose of the use of Nitroprusside? Causes cyanide toxicity
Increase BP
A nurse is caring for a patient taking Cardiac glycoside what is the expected result?
Increase force of the myocardial contraction
A nurse is caring for a client who has developed agranulocytosis as a result of taking propylthiouracil to treat hyperthyroidism . The nurse should understand that this client is at increased risk for which of the following conditions?
Infection
What is the function phenyphrine ? What type of drug is it? What are the adverse effects?
Relieves nasal pressure. It is alpha 1. It can not be given to patients with hypertension it raises blood pressure
What are two side effects of statins
Rhabdomyolsis and hepatotoxicty
A nurse is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the nurse assess before beginning drug therapy?
Serum potassium levels
Assesment find of methimazole
Sore Throat
A nurse is taking care of a client diagnosed with hyperthyroidism and is currently on methimazole treatment. Which of the following symptoms should the nurse report to the clinician ?
Sore throat and fever
An older adult client is taking a sustained-release antihypertensive drug. What is the nurse's priority teaching point about this medication?
Swallow the drug whole and do not to cut, crush or chew it
An 81 year old patient at a nursing home has hypothyroidism of the thyroid gland
TSH increase and t3 and t4 decrease
A nurse is caring for a client taking albuterol what are side effcts
Tachycardia
A nurse is teaching a client who has angina pectoris about starting therapy with nitroglycerin tablets. The nurse should include which of the following instructions regarding how to take the medication ?
Take one tablet at the first indication of chest pain
After administering propylthiouracil ( PTU) what effect would the nurse anticipate the drug will have in the client's body?
To inhibit the production of thyroid hormone in the thyroid gland
Please identify the following statement as true or false. Another name for an adrenergic agonist drug is a sympathomimetic drug
True
The nurse is caring for a 27-year-old African American woman who was just prescribed an ACE inhibitor for management of her hypertension. What should be advised related to contraception?
Use barrier contraceptives to prevent pregnancy while taking these drugs.
If you block alpha one, what is the expected effect?
Vasodilation
What is the function of Beta Blockers
When the nurse administers a beta-adrenergic blocker to the client with angina, the nurse expects the drug will help to control angina but it also has what other effect?
When the nurse administers a beta-adrenergic blocker to the client with angina, the nurse expects the drug will help to control angina but it also has what other effect?
When the nurse administers a beta-adrenergic blocker to the client with angina, the nurse expects the drug will help to control angina but it also has what other effect?
If you want to decrease the blood pressure of your patient, are you able to give Beta blocker?
Yes
A 26-year-old white male patient has been prescribed captopril for hypertension. A nurse has been assigned to the patient to provide education regarding the use of this drug. The nurse will advise the patient that
a persistent, dry cough may occur; however, it is not serious.
Which client is most likely to be diagnosed with secondary hypertension?
a. A client whose most recent blood pressure readings were 143/92.147/94, and 144/94 mmHg
In which of the following ways does the thyroid gland use iodine?
b. To produce the thyroid hormones
The nurse is caring for a patient on a beta blocker importance of notifying the physician contraindications of adrenergic blocking agent
bradycardia
Which assessment findings would indicate that the client might be experiencing a SERIOUS adverse effect from METHIMAZOLE?
complaints of sore throat
What is Agranulocytosis?
failure of bone marrow to make enough WBC causing neutropenia and lowering the body defenses against infection
What is Nitroprusside used for?
hypertensive crisis
Why is levothyroxine the drug of choice in children?
its predictable bioavailability and reliability.
Are we able to give specific beta blockers to someone who is hypertensive?
yes
A client was diagnosed with hypothyroidism and was started on levothyroxine (Synthroid) therapy . Which of the following laboratory results supports the diagnosis of hypothyroidism? SELECT ALL THAT APPLY.
● *Decreased free T3 ● * Decreased free T4 ● *Increased TSH
A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingual for chest pain. The client reports relief from chest pain but now he is experiencing headache. Which of the following statements should the nurse make
● A headache is an expected adverse effect of the medication n
A client was immediately rushed to the hospital after experiencing a severe allergic food reaction and was given epinephrine. The nurse is aware that this medication has the following effects on the client. SATA (3)
● Bronchodilation →easier to breathe ● Vasoconstriction → inc in BP ● Mydriasis → pupil dilation
After administering digoxin what assessment finding would indicate to the nurse that the drug was having a desired effect?
● Icn urinary output to 80 cc.hr
A nurse is taking care of a client diagnosed with congestive heart failure. What assessment finding would indicate the clients left sided heart failure is worsening?
● Increased crackles in the lung fields
. A client was immediately rushed to the hospital after experiencing a severe allergic food reaction and was given epinephrine. The nurse is aware that this medication have which of the following effects to the client? SELECT ALL THAT APPLY.
● Mydriasis ● Vasoconstriction ● Bronchodilatation
A nurse is caring for an adolescent who has a long history of diabetes mellitus and is being admitted to the emergency department confused, flushed, and with an acetone odor on the breath. Diabetic ketoacidosis is suspected, blood sugar is 450 mg/dL. The nurse should anticipate using which of the following types of insulin to treat his client?
● Regular insulin
A nurse is teaching a client who has angina pectoris about starting therapy with SL nitroglycerin tablets. The nurse should include which of the following instruction regarding how to take this medication?
● Take one tablet at the first indication of chest pain
While studying the antihypertensive drugs, the nursing students learn the pressure in the cardiovascular system is regulated by various elements. What are they? Select all that apply.
● Total peripheral resistance ● Stroke volume ● Heart rate
To inhibit the production of thyroid hormone in the thyroid gland
● lowering thyroid hormone levels by preventing the formation of thyroid hormone in the thyroid cells, which lowers the serum levels of thyroid hormone.
Digoxin
● may result in increased total urinary output of this glycoside.