Pharm Prep-U Module 3 practice questions
A nurse is providing medication teaching to a client prescribed captopril. Which statements should be included to describe potential adverse effects? Select all that apply.
"A decrease of blood pressure is expected." "A persistent cough may develop."
A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administration of a diuretic such as hydrochlorothiazide may improve the patient's urine output. How should the colleague bestrespond to this suggestion?
"Actually, patients with renal failure usually can't take hydrochlorothiazide."
A 37-year-old client presents with a blood pressure of 128/78 mm Hg. What lifestyle change should the nurse suggest related to this assessment finding?
"Be aware of your salt intake and limit hidden salt."
After teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states:
"I need to make sure I don't eat too many high potassium foods."
The nurse is teaching a 62-year-old client about hydrochlorothiazide, which the health care provider has prescribed for treatment of hypertension. What statement, made by the client, suggests that the client understands the teaching?
"I will need to stand slowly."
A 58-year-old man has recently been prescribed atorvastatin (Lipitor) in an effort to reduce his cholesterol levels. The man has acknowledged the potentially harmful effects of hyperlipidemia and is motivated to make changes to resolve this health problem. What advice should the nurse give to this client?
"It's a good idea to keep your intake of saturated fat to a bare minimum."
A 39-year-old nulliparous woman has been taking atorvastatin for 2 years and has now decided that she would like to become pregnant. What health education should the nurse provide to this client?
"It's important that you stop taking atorvastatin before you stop using contraception."
Which instruction would be most appropriate for a client who is taking a diuretic?
"It's okay to take it with food."
Which question would be most important for a nurse to ask a female client who is starting on an angiotensin II receptor blocker for hypertension?
"When was your last menstrual period?"
A client who is taking an ACE inhibitor informs the nurse that she is considering having a child. What information should the nurse provide to the client related to this new information?
ACE inhibitors are contraindicated during pregnancy because they are teratogenic.
A nurse is caring for a client with acute renal failure. The health care provider has prescribed a diuretic therapy for the client to promote dieresis. What intervention should the nurse perform to prevent the inconvenience caused by increased urination?
Administer the drug early in the day.
A nurse is educating a group of nursing students on the mechanisms of action of angiotensin-converting enzyme inhibitors (ACEI). What should the nurse explain is the hormone produced by the adrenal cortex?
Aldosterone
A nurse is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics. Treatment of high cholesterol using statins would be contraindicated in which client?
An obese male client who is a heavy alcohol user and who has cirrhosis of the liver
The ICU nurse is caring for a patient in neurogenic shock. What would the nurse know is a characteristic of neurogenic shock?
Bradycardia
A nurse is educating a patient with hypertension who is prescribed losartan on the mechanism of action of the drug. Which mode of action helps losartan to bring about its antihypertensive effect?
By blocking the angiotensin II receptors
A client who has been taking a statin has seen an improvement in his cholesterol laboratory values; however, the low-density lipoprotein remains elevated. What medication will be added to the medical regime?
Cholestyramine
Which would be classified as a bile acid sequestrant?
Cholestyramine
When circulatory shock occurs, there is massive vasodilation causing pooling of the blood in the periphery of the body. An ICU nurse caring for a patient in circulatory shock knows that the pooling of blood in the periphery leads to:
Decreased venous return
Elevated blood lipids are a major risk factor for atherosclerosis and vascular disorders. From where are blood lipids derived?
Diet
A client is taking cholestyramine to reduce LDL cholesterol. Cholestyramine will cause a decrease in absorption of which medication?
Digoxin
Which drug is most effective in reducing most major types of dyslipidemia in patients at risk or who have already developed CAD?
HMG-CoA reductase inhibitors
What is the most common reason for an elevated cholesterol level in a client who does not have a genetic disorder of lipid metabolism?
His dietary intake of saturated fat
A client is receiving a diuretic as the first-line treatment of mild hypertension. The nurse monitors the client for signs and symptoms of hypokalemia with which agent?
Hydrochlorothiazide
The nurse assesses a client receiving furosemide for:
Hypotension
A client is admitted to the emergency department with pulmonary edema. What diuretic does the nurse expect the health care provider to prescribe to achieve rapid therapeutic effect?
Loop diuretic
When describing where bumetanide acts, what would the nurse include?
Loop of henle
What would contraindicate the use of indapamide?
Renal disease
A client has not responded normally to rescue inhaler therapy. When subcutaneous epinephrine is prescribed, the nurse should anticipate what reaction to occur?
instant bronchodilation
A client with primary hypertension asks the nurse why the prescriber added another medication to assist with lowering the blood pressure. What is the nurse's best response?
"Many clients require two or more drugs for high blood pressure."
The client receives a prescription for niacin. The nurse is providing education about the medication and possible adverse effects. Which adverse affect would the nurse include?
"Some people get very flushed skin when they take this medication."
The client wants information about triglycerides and cholesterol. Which response by the nurse would be correct?
"Triglycerides and cholesterol are fatlike substances found in your blood."
What information should the nurse discuss with the client considering pregnancy regarding the use of a diuretic during pregnancy?
"Typically, women on diuretics prior to becoming pregnant can remain on the medication during their pregnancy."
A client has been prescribed furosemide. What medication education should the nurse provide this client? (Select all that apply.)
-The medication will cause you to urinate larger amounts of urine than you are accustom to. -You should try to avoid excessive intake of salt. -Be aware that standing up quickly can cause you to be dizzy. -Notify your health care provider if you have more than a 3-pound weight change in one day.
A client with diabetes also has hypertension. The nurse would expect that the blood pressure goal for the client would be which of the following?
130/80 mm Hg
What health problems contraindicate the use of fibrates for the treatment of dyslipidemia? Select all that apply.
Chronic renal failure Liver disease
What type of diet should a patient taking diuretics have?
Eat potassium-rich or low-potassium diet as appropriate
A patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment?
Frequently monitor blood cholesterol.
After teaching a group of nursing students about diuretics, the instructor determines that the teaching was successful when the group identifies which as a loop diuretic?
Furosemide
After teaching a group of students about fats and biotransformation, the instructor determines that the teaching was successful when the students identify what as the storage location of bile acids?
Gallbladder
After reviewing information about antihyperlipidemic drugs, a group of nursing students demonstrate understanding when they identify which medication as a fibric acid derivative (fibrate)?
Gemfibrozil
The three major classes of drugs used to control blood lipids are statins, bile acid resins (or sequestrants), and fibrates. Which is a fibrate?
Gemfibrozil
The nurse instructs a client to take the prescribed pravastatin at bedtime based on understanding that:
Greater drug effectiveness is achieved at this time.
After reviewing information about lipoproteins, a group of students demonstrate understanding of the information when they identify which of the following as being loosely packed?
HDLs
The nurse is providing education to a client with diabetes mellitus who has been prescribed captopril. What potential adverse effect will the nurse include in the teaching?
Hyperkalemia
A patient, aged 78 years, is receiving nitroprusside for hypertensive emergency. For which condition should the patient be assessed?
Hypotensive Crisis
A health care provider has prescribed a loop diuretic for a client with hypertension. The client also has diabetes mellitus. What condition should the nurse monitor for in this client after administering the prescribed drug?
Increased blood glucose levels
The health care provider prescribes fibrate for a client with elevated triglycerides. The client begins to self-administer niacin approximately 3 mg daily. What would the nurse expect the provider to order?
LFTs
After teaching a group of students about the cardiovascular system and pressures, the students demonstrate understanding of the information when they identify which area as having the highest pressure?
Left ventricle
A group of students are reviewing the various antihypertensive agents. The students demonstrate understanding of the information when they identify what as an example of an angiotensin II receptor blocker?
Losartan
A client who is malnourished and hypertensive client is being treated with losartan. Considering the client's nutritional status, how should the dose of the medication be adjusted in this client?
Lowered
The nurse is caring for a client who is experiencing elevated intracranial pressure following neurosurgery. The health care provider orders an osmotic diuretic to reduce pressure. Which medication would the nurse expect to be ordered?
Mannitol
Which adverse effect would a nurse expect to assess in a client taking ezetimibe?
Mild abdominal pain
The ICU nurse is caring for a patient in shock. What is one of the most important functions of the nursing role in caring for this patient?
Monitoring for complications and side effects of treatment
A client is unconscious and experiencing increasing intracranial pressure. What type of diuretic will the client most likely be prescribed?
Osmotic diuretic
What is the term for the action of a diuretic in a patient with glaucoma?
Osmotic pull
A client, newly diagnosed with hypertension is started on captopril, an ACE inhibitor. The client should be informed of the possibility of what adverse effect?
Persistent cough
A client is prescribed aliskiren. The nurse would monitor the laboratory test results of which electrolyte closely?
Potassium
HMG-CoA reductase inhibitors (statins) are classified as which pregnancy category?
Pregnancy Category X
A client has been largely unsuccessful in achieving adequate control of dyslipidemia through lifestyle changes and the use of a statin. As a result, the client has been prescribed cholestyramine. What change in this client's lipid profile will the nurse identify as the most likely goal of therapy?
Reduction in LDL cholesterol levels
During a routine check up of a 45-year-old patient with renal disease, the nurse observes an increase in the patient's blood pressure. Which is the most likely consequence of renal impairment?
Secondary hypertension
A nurse is caring for a client who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed. Which should the nurse assess before beginning drug therapy?
Serum potassium levels
What substance is reabsorbed in the ascending limb of the loop of Henle?
Sodium
A male client has cirrhosis and is receiving diuretic therapy. The nurse knows that what drug will help prevent metabolic alkalosis or hypokalemia in this client?
Spironolactone
Which single class drug is known to be most effective in reducing the major types of dyslipidemia?
Statins
The nurse is administering norepinephrine intravenous (IV) to an adult client diagnosed with septic shock. The client suddenly develops redness and edema at the right forearm IV site. The client's systolic blood pressure (SBP) is 88 mm Hg. Which action would the nurse implement first?
Stop the infusion and administer diluted phentolamine
A client with a long history of hypertension has just been prescribed an alpha1-adrenergic receptor blocker. To reduce this client's risk of orthostatic hypotension and falls, the nurse should encourage the client to implement what intervention?
Take the medication at bedtime
The pharmacology instructor is discussing hypertension in children and adolescents. What should the instructor tell the class is the reason for the cautious management of childhood hypertension?
The long-term effects of the antihypertensive agents are not known.
What information would be included in a lipoprotein profile? Select all that apply:
Total cholesterol Triglycerides LDL
After teaching a group of students about metabolic syndrome, the instructor determines that the teaching was successful when the students identify which characteristic?
Triglyceride level above 150 mg/dL
A patient with metabolic syndrome usually has increased plasminogen activator levels.
True
The nurse is preparing to administer norepinephrine IV to a client. What intervention can the nurse take to minimize the risk for extravasation?
Use a central line to administer the medication.
A nurse is caring for several clients. Which client would have the greatest chance of developing CAD as determined by total cholesterol?
a 62-year-old White client with total cholesterol of 260 mg/dl
Which category of blood lipids is involved in the formation of atherosclerotic plaques?
cholesterol
The nurse is caring for an older adult client who receives furosemide on a regular basis. The nurse should prioritize assessments related to what health problem?
dehydration
An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident's medication regimen make create a risk for:
falls
The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin?
headache and flatulence.
A health care provider prescribes spironolactone, a potassium-sparing diuretic, for a client with cirrhosis. For which category of clients is the use of potassium-sparing diuretics contraindicated?
hyperkalemia
The nurse should be cognizant that niacin therapy is the most effective method of achieving which cardiac-related goal?
increased concentration of HDL cholesterol
A physician has prescribed triamterene to a client with renal disease. The client informs the nurse that they are taking potassium supplements to address some heart problems. The nurse would be alert for which of the following?
increased risk of hyperkalemia.
A client has been prescribed lovastatin for high cholesterol. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels in which manner?
inhibits cholesterol syntheses.
A client diagnosed with hyperlipidemia is prescribed a statin. The nurse is reviewing the client's history and would notify the client's health care provider if which condition was noted in the client's history?
liver disease
Losartan focuses on what aspect of the cardiac process to address the pathophysiology of heart failure?
lowering blood pressure
When the cardiac workload is increased from secondary hypertension, the client is at risk for developing what associated condition?
myocardial hypertrophy
The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness and states barely being able to move the extremities. The nurse suspects the client has which?
rhabdomyolysis.