Pharm Final

Which instruction should be included in the teaching for a patient for whom fluticasone propionate (Flovent) MDI has been ordered?

"Gargle after using your inhaler."

Which statement by a patient indicates understanding of a nurse's teaching about fluticasone nasal spray (Flonase)?

"This drug will help prevent the inflammation and irritation from my allergies."

A patient develops supraventricular tachycardia (SVT) and is hypotensive. The nurse anticipates that which medication will be administered?

Adenosine (Adenocard)

Which agent is in the category of drugs considered most effective for lowering LDL cholesterol?

Atorvastatin (Lipitor)

Which medication is indicated for suppression of cough?

Benzonatate (Tessalon)

Before amiodarone therapy for atrial fibrillation is initiated, what should take place?

Blood should be drawn for baseline serum thyroid and liver function studies.

Which medication is not associated with prolongation of the QT interval?

Diltiazem (Cardizem)

A nurse instructs a patient that which nonprescription medication requires patient identification and a signature for purchase?

Ephedrine

Which class of drugs is most effective in preventing and treating seasonal and perennial rhinitis?

Intranasal glucocorticoids

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?

Peripheral vasodilation Coronary vasodilation

Which component of the electrocardiogram (ECG) represents the depolarization of the ventricles?

QRS complex

A nurse is planning care for a patient who takes fexofenadine (Allegra) for allergic rhinitis. Which outcome should the nurse anticipate?

Relief of sneezing and itching

Which laboratory abnormality may be a consequence of therapy with a thiazide diuretic?

Serum uric acid level of 10.4 mg/dL

A patient is receiving dronedarone (Multaq) for treatment of atrial fibrillation. When previous and present ECGs are compared, which change indicates an adverse effect?

The QT-interval measurement changes from 400 msec to 520 msec.

The nurse is teaching an older adult patient with hypertension who has a new prescription for verapamil (Calan). Which statement or statements by the patient indicate that the teaching was effective?

"I will increase my intake of fluid and foods high in fiber." "I will call my physician if I notice swelling in my ankles."

The nurse is teaching a patient who has just been prescribed a vasodilator. Which statement by the patient indicates that the teaching was effective?

"I will rise slowly when changing from a sitting to a standing position."

A patient is prescribed Calan SR 120 mg daily. Which statement by the patient indicates understanding of the medication?

"I will swallow the pill whole."

he 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?

"I will use a salt substitute to lower my sodium intake."

A nurse is teaching a patient who is to start taking an expectorant. The nurse provides the patient with which of these instructions?

"Increase your fluid intake to reduce the viscosity of secretions."

An adult male patient has taken medication for management of hypertension for 3 years. He says to the nurse, "I'm not going to take these drugs anymore, because they are interfering with my sex life." Which response by the nurse would be most helpful?

"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?

"Read food labels and reduce your intake of saturated fats."

Which instruction by the nurse should be the priority for a patient scheduled to start intranasal cromolyn (NasalCrom)?

"Relief may take a week or two."

Which instruction should the nurse include in the teaching for a patient prescribed cetirizine (Zyrtec) for seasonal allergic rhinitis?

"Take the medication daily throughout the allergy season."

A patient with asthma is scheduled to start taking a glucocorticoid medication with a metered-dose inhaler (MDI). The nurse should give the patient which instruction about correct use of the inhaler?

"Use a spacer with the inhaler and rinse your mouth after each dose administration."

Discharge teaching about amiodarone should include which statements?

"Wear sunblock and protective clothing when you are outdoors." "Check your pulse daily and report excessive slowing to your prescriber immediately." "Report new onset of dyspnea, cough, and chest pain immediately to your prescriber."

Which statement by a patient indicates understanding of treatment with doxazosin?

"When getting out of bed in the morning, I will sit on the side of the bed for several minutes before standing."

A nurse is teaching a patient about montelukast (Singulair). Which statement by the patient would indicate that the nurse's teaching was effective?

"While taking this medicine, I may be able to reduce my steroid medication."

The nurse is caring for patients who have been prescribed gemfibrozil (Lopid). For which patient should the nurse question the use of this drug?

A 58-year-old woman with history of gallstones and elevated triglycerides

The nurse is caring for several patients. For which patient would a prescription for nifedipine (Adalat) be least appropriate?

A 78-year-old man with atrial fibrillation

The parent of a pediatric patient with nasal stuffiness and congestion asks a nurse about cold remedies. Which additional information is the priority for the nurse to obtain?

Age

A 60-year-old man with an elevated triglyceride level is prescribed a pharmacologic dose of an extended-release form of nicotinic acid (Slo-Niacin). Which laboratory value takes priority for assessment when this patient is seen in the clinic?

Alanine aminotransferase (ALT)

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?

Angiotensin II Angiotensin II is a potent vasoconstrictor. It participates in all the pathways regulated by the renin-angiotensin-aldosterone system. Angiotensin I is a precursor to angiotensin II; angiotensin III is formed by degradation of angiotensin II and is less potent. Renin catalyzes the conversion of angiotensinogen to angiotensin I.

Which sustained dysrhythmia is the most common among the U.S. population?

Atrial fibrillation

Initial therapy for hypertension after a myocardial infarction (MI) includes drugs from which classes?

Beta blocker and ACE inhibitor

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?

Beta1

Before administering hydralazine (Apresoline), it is most important for the nurse to obtain which assessment?

Blood pressure

A patient is taking oral theophylline for maintenance therapy of stable asthma. A nurse instructs the patient to avoid using which substance to prevent a complication?

Caffeine

The nurse knows that diuretics mostly affect which function of the kidneys?

Cleansing and maintenance of extracellular fluid volume Most diuretics block sodium and chloride reabsorption, thus affecting the maintenance of extracellular fluid volume.

The nurse is caring for a group of patients who take cholesterol-lowering drugs. Which agent is least likely to cause systemic side effects and is considered safer than other lipid-lowering drugs?

Colesevelam (Welchol)

In which situation is dronedarone (Multaq) contraindicated?

Concomitant administration of amitriptyline (Elavil)

Which finding in a patient taking oxymetazoline (Afrin) nasal spray every 2 hours would indicate that the patient has developed an adverse effect?

Congestion and stuffiness

A patient is prescribed lisinopril (Prinvil) as part of the treatment plan for heart failure. Which finding indicates that the patient is experiencing the therapeutic effect of the drug?

Crackles in the lungs are no longer heard

The nurse is caring for a patient who takes quinidine (Quinaglute) for a supraventricular dysrhythmia. What is a common adverse effect of this drug?

Diarrhea

The nurse should monitor for which adverse effect after administering hydrochlorothiazide (HydroDIURIL) and digoxin (Lanoxin) to a patient?

Digoxin toxicity Digoxin levels have an inverse relationship with potassium levels. Because hydrochlorothiazide can lower potassium levels, combined use of hydrochlorothiazide and digoxin poses a risk for elevated digoxin levels and ensuing digoxin toxicity.

The nurse is planning care for a group of patients with cardiac problems who are at risk for dysrhythmias. The nurse understands that the Cardiac Arrhythmia Suppression Trial (CAST) confirmed which finding?

Dysrhythmias should be treated only when they are symptomatically significant.

The nurse is caring for a patient who has diabetes and hypertension. Which agent is most likely to be prescribed to treat this patient's hypertension?

Enalapril (Vasotec)

A nurse should recognize that recent research has shown which statement is true about the use of zinc in children with colds?

Evidence has been inconclusive, and more research is needed

Which medication or medications should be used with caution in a hypertensive diabetic patient?

Furosemide (Lasix) Metoprolol (Lopressor) Hydrochlorothiazide (HCTZ)

A patient is admitted to the emergency department with acute severe exacerbation of asthma. Which drug should the nurse anticipate will be included in the treatment plan?

High-dose albuterol (Proventil) via nebulizer treatment

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, 100mEq/L; blood urea nitrogen, 15 mg/dL. What is the nurse's best action?

Hold the Lasix and notify the physician The nurse's best action is to hold the Lasix and notify the physician. Loop diuretics, such as furosemide, can cause significant potassium loss. The normal potassium level is 3.5 to 5 mEq/L.

The nurse is caring for a patient prescribed aliskiren (Tekturna). In which way does this medication act to lower blood pressure?

It inhibits the conversion of angiotensinogen into angiotensin I

A patient who takes cromolyn (Intal) for exercise-induced bronchospasm should follow which approach for maximum therapeutic effectiveness?

It should be administered by inhalation 15 minutes before anticipated exertion.

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?

Lithium level

The nurse understands that cholesterol is carried through the blood by means of lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis?

Low-density lipoprotein (LDL)

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?

Many vasodilators cause retention of sodium and water

The nurse is caring for a pregnant patient who is experiencing a new episode of hypertension. Which agent does the nurse anticipate will be prescribed for this patient?

Methyldopa (Aldomet)

A 79-year-old man with cardiovascular disease is taking rosuvastatin (Crestor). The nurse is monitoring for potential adverse effects. Which symptom, if found, indicates a potential adverse effect of this drug?

Muscle pain and tenderness

A patient in a hypertensive crisis is being started on a continuous sodium nitroprusside (Nipride) infusion. Which activities should the nurse implement?

Obtain a baseline weight and weigh daily Collaborate with the physician on insertion of an arterial line Cover the IV bottle containing the medication with an opaque bag

To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule?

On a continuing, daily basis

A history of allergy to which substance is a contraindication to the use of ipratropium/albuterol (Combivent)?

Peanuts

A nurse should monitor more frequently the blood pressure of a patient with a history of hypertension who takes which medication for allergic rhinitis?

Pseudoephedrine (Sudafed)

Which are beneficial effects that can be derived from simvastatin (Zocor) and other agents in this class?

Reduction of LDLs Elevation of HDLs Stabilization of the plaque in coronary arteries Reduction of risk of cardiovascular events

Which outcome would be most appropriate for a nurse to establish for a patient with a cough who takes an antitussive with codeine?

Respiratory rate of 12 to 24 breaths per minute

The nurse is caring for a patient receiving amiodarone (Cordarone). Which parameter takes priority when this patient is assessed for serious adverse effects of this drug?

Respiratory symptoms

The nurse is caring for an adult male with renal artery stenosis who has been prescribed benazepril (Lotensin). Which symptom, if found, indicates an adverse effect of this drug?

Serum creatinine level of 2.3 mg/dL

Which is the only cardiovascular indication for minoxidil (Rogaine)?

Severe hypertension

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?

Spironolactone (Aldactone) Spironolactone is a potassium-sparing diuretic used to treat both hypertension and edema. It is a preferred drug in heart failure, because it has been shown to have a cardioprotective effect, reducing mortality in patients with heart failure.

A nurse teaches a patient with chronic obstructive pulmonary disease (COPD) about the adverse effects of tiotropium (Spiriva). Which behavior by the patient would indicate that the teaching has been effective?

Sucks on sugarless hard candy

The nurse is caring for a patient receiving hydralazine (Apresoline). The primary care provider prescribes propranolol (Inderal). The nurse knows that a drug such as propranolol often is combined with hydralazine for what purpose?

To protect against reflex tachycardia

Which statement should the nurse include in the teaching for a patient who is to be started on zileuton (Zyflo)?

"Have your blood drawn once a month for the next 3 months so that your liver function can be checked."

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?

"I will call my doctor if I begin having menstrual irregularities." Spironolactone is a potassium-sparing, aldosterone-blocking diuretic. As such, it can cause endocrine effects, such as gynecomastia, menstrual irregularities, impotence, hirsutism, and deepening of the voice. Patients taking spironolactone should avoid salt substitutes because they contain potassium, and high-potassium foods should be avoided with this drug. Ideally, all diuretics should be taken in the morning to prevent nocturia.

Which instruction should be included in the teaching for a patient being started on the antihistamine azelastine (Astelin)?

"You may experience an unpleasant taste in your mouth when using azelastine."

The nurse is working with a group of patients with hypertension. The nurse understands that which agent works by preventing angiotensin II from binding with its receptors?

andesartan (Atacand)

n which area of the healthy heart is the electrical impulse delayed to provide time for the blood to fill the ventricles?

AV node

The nurse plans to closely monitor for which clinical manifestation after administering Furosemide (Lasix)?

Decreased blood pressure High-ceiling loop diuretics, such as furosemide, are the most effective diuretic agents. They produce more loss of fluid and electrolytes than any others. A sudden loss of fluid can result in decreased blood pressure. When blood pressure drops, the pulse probably will increase rather than decrease.

Which agent is most likely to cause the side effect of constipation?

Diltiazem (Cardizem)

The nurse is administering lidocaine (Xylocaine) to a patient with a ventricular dysrhythmia. What action should the nurse take to prevent a complication with this drug?

Monitor the ECG

The nurse has just administered the initial dose of enalapril (Vasotec) to a newly admitted patient. Which nursing intervention takes priority over the next several hours?

Monitoring the blood pressure

A patient is admitted to the emergency department in hypertensive crisis, and examination reveals papilledema. The nurse would expect which IV medications to be administered to achieve rapid, controlled reduction of the patient's blood pressure?

Sodium nitroprusside (Nitropress)

Which complaint indicates that a patient is experiencing an adverse effect of beclomethasone (Beconase AQ) nasal spray?

Sore throat

Which outcome should a nurse establish as a priority for a patient taking an oral glucocorticoid for long-term treatment of asthma?

Supplements additional doses at times of stress.

Using a stepwise approach to managing asthma, a nurse teaches a patient who is at step 1 to use albuterol MDI (Proventil) at which of these times?

Whenever needed (PRN) as a quick-relief agent