Pharm Test 2

A client is ordered to receive azelastine (Optivar) nasal spray. This antihistamine has a half-life of 22 hours. The nurse anticipates this medication to be ordered: 1. daily 2. bid 3. tid 4. qid

1

A client is ordered to receive digoxin (Lanoxin). Based on its half-life of 36 hours, the nurse will anticipate administering the maintenance dose: 1. once a day 2. twice a day 3. three times a day 4. once a week

1

A client is ordered to receive flecainide (Tambocor) and tocainide (Tonocard). They are effective in the treatment of: 1. life-threatening ventricular dysrhythmias 2. third-degree heart block 3. bundle branch block 4. asystole

1

The adrenergic receptor that causes the greatest increase in blood pressure is: 1. alpha1 2. alpha2 3. beta1 4. beta2

1

4. For lovastatin (Mevacor) to have the desired therapeutic effect, it can take: 1. 24 hours 2. 3 or 4 days 3. 3 weeks 4. 3 months

3

A client is receiving atorvastatin (Lipitor) for high blood cholesterol level. Which of the following warrants the client's immediate contacting of the health care provider? 1. muscle aches 2. GI distress 3. constipation 4. flushing of the skin

1

A client is receiving atorvastatin (Lipitor) for high blood cholesterol. Which of the following symptoms warrant the client's immediate contacting of the health care provider? 1. muscle aches 2. GI distress 3. constipation 4. flushing of the skin

1

A client is receiving epinephrine (Adrenalin) for treatment of bronchospasm. The nurse plans to monitor the client for which of the following? 1. increased serum blood glucose 2. decreased serum lactic acid 3. increased white blood cell count (WBC) 4. decreased platelet count

1

A client is treated with two inhalers, albuterol (Proventil) and a glucocorticoid (beclomethasone [Vanceril]). The nurse is planning the care and knows that the client should: 1. use the Proventil inhaler first and wait 5 minutes before following with Vanceril 2. use Vanceril first, wait 2 minutes, and then follow with Proventil 3. use Vanceril first, wait 10 minutes, and follow with Proventil 4. use the Proventil inhaler first and follow immediately with Vanceril

1

A client receiving warfarin (Coumadin) is noted to have significant bleeding from the gums while on therapy. The physician orders an antidote. If excess bleeding occurs because of warfarin accumulation in the body, the antidote is: 1. vitamin K 2. vitamin E 3. naloxone (Narcan) 4. protamine sulfate

1

A client who smokes is receiving theophylline products. Because of his history of smoking, the nurse would expect that the dose would be: 1. increased 2. decreased 3. the same 4. closely monitored

1

A client's serum cholesterol level is 268 mg/dl. Lovastatin (Mevacor) is prescribed. The nurse plans care based on the fact that the action of lovastatin is to: 1. inhibit hepatic synthesis of cholesterol 2. stimulate hepatic synthesis of cholesterol 3. increase renal excretion of cholesterol 4. increase fecal excretion of cholesterol

1

A nurse is teaching a client about bethanechol hydrochloride (Urecholine). The nurse informs the client that this drug warrants which of the following precautions: 1. Rise slowly from lying positions. 2. Count pulse rate frequently to assess for bradycardia. 3. Avoid diarrhea by eating binding foods. 4. Maintain aspiration precautions because of excess saliva.

1

A nurse receives an order to administer epinephrine (Adrenalin) to a client. Which of the following routes of administration would the nurse question? 1. oral 2. subcutaneous 3. intramuscular 4. intravenous

1

Adverse reactions to lidocaine (Xylocaine) include: 1. hypotension and bradycardia 2. hypertension and tachycardia 3. vomiting and diarrhea 4. abdominal cramps and tachycardia

1

An example of an A-II receptor antagonist is: 1. losartan potassium (Cozaar) 2. atenolol (Tenormin) 3. nifedipine (Procardia) 4. captopril (Capoten)

1

Antianginal drugs are prescribed for relief of anginal pain. Anginal pain is characterized by the following except: 1. pain that lasts for 24 hours 2. tightness and pressure in the center of the chest 3. pain that may radiate down the left arm 4. pain that lasts for a few minutes

1

Anticholinergics are contraindicated with glaucoma because they: 1. increase intraocular pressure 2. constrict the pupils 3. blur vision 4. cause opacities in the lens

1

Anticholinergics for parkinsonism are used during which stage of the disorder? 1. early 2. intermediate 3. late 4. They are not effective in treating this disorder.

1

Antiplatelet drug therapy suppresses platelet aggregation in the arteries. These agents are prescribed for the purpose of: 1. preventing myocardial infarction and stroke 2. enhancing blood flow 3. dissolving blood clots 4. preventing cardiac dysrhythmias

1

Bethanechol chloride (Urecholine) is contraindicated if a client has a history of: 1. severe bradycardia and hypotension 2. tachycardia and hypertension 3. urinary retention and abdominal distention 4. hypertension and urinary retention

1

Clients with nausea and vomiting are frequently prescribed antihistamines and anticholinergics. Side effects associated with antihistamines and anticholinergics include: 1. drowsiness and dry mouth 2. bradycardia and fatigue 3. tachycardia and dyspnea 4. abdominal cramps and nausea

1

Drugs that mimic the effect of norepinephrine are called: 1. sympathomimetics, or adrenergic drugs 2. sympatholytics, or adrenergic drugs 3. sympathomimetics, or adrenergic blockers 4. sympatholytics, or adrenergic blockers

1

In caring for a client with thrombophlebitis, the nurse notes that heparin is key to early therapy. The action of heparin is to: 1. prolong clotting time 2. decrease clotting time 3. dissolve the blood clot 4. inhibit bleeding time

1

Indirect-acting cholinergics act by: 1. inhibiting the action of the enzyme cholinesterase 2. promoting the action of the enzyme cholinesterase 3. inhibiting the action directly on the cholinergic receptors 4. promoting the action directly on the cholinergic receptors

1

Intranasal glucocorticoids (steroids) are effective for treating allergic rhinitis. The use of intranasal glucocorticoids: 1. could cause systemic effects when used longer than 30 days 2. should occur during symptoms, because most allergic rhinitis is seasonal 3. causes an increase in inflammatory action during allergic rhinitis 4. should not be done in combination with other intranasal rhinitis medications

1

Low-molecular-weight heparins are indicated for the prevention of: 1. venous thrombosis 2. arterial embolism 3. thrombocytopenia 4. leukopenia

1

Mucolytics are agents used in chronic lung disease to: 1. break down tenacious secretions 2. stimulate respiratory mucosal glands 3. suppress inflammation 4. inhibit release of histamine

1

Nonpharmacologic methods to decrease blood pressure include: 1. weight reduction and restricted salt intake 2. stress reduction techniques and high caloric intake 3. decreased exercise and decreased fat intake 4. decreased water intake and increased potassium intake

1

The health care provider suggests that a client with an upper respiratory tract infection use a nasal decongestant spray. Most decongestants are from which drug group? 1. sympathomimetics 2. sympatholytics 3. parasympathomimetics 4. parasympatholytics

1

The nurse administers lidocaine (Xylocaine) and monitors for adverse reactions. These include: 1. hypotension and bradycardia 2. hypertension and tachycardia 3. vomiting and diarrhea 4. abdominal cramps and tachycardia

1

The serum potassium level that determines hypokalemia is: 1. <3.5 mEq/L 2. <4.5 mEq/L 3. <5.3 mEq/L 4. >6 mEq/L

1

The slow calcium channel blocker that acts by decreasing excitability and contractility of the myocardium is: 1. verapamil (Calan) 2. nifedipine (Procardia) 3. diltiazem (Cardizem) 4. nicardipine (Cardene)

1

The sympathomimetic drugs that stimulate adrenergic receptors are classified into three categories: direct acting, indirect acting, and mixed acting. An example of a mixed-acting sympathomimetic is: 1. ephedrine (Ephedsol, Ectasule) 2. epinephrine (Adrenalin) 3. norepinephrine (Levophed) 4. dobutamine hydrochloride (Inotropin)

1

When a clot occludes a blood vessel, what occurs? 1. Tissue ischemia occurs. 2. Tissue perfusion occurs. 3. Blood flow is increased to the involved tissue area. 4. Blood flow is decreased to the tissue area.

1

Which of the following instructions will the nurse include in a teaching plan for a client taking metoprolol (Lopressor) for treatment of hypertension? 1. Rise slowly from a supine or sitting position. 2. Limit fluid intake while taking this drug. 3. Encourage frequent ophthalmic exams. 4. Use lozenges if a dry cough occurs.

1

Your client has myasthenia gravis. Client teaching should include: 1. instructing the client to take the drug on time to avoid respiratory muscle weakness 2. informing the client that if a dose of the drug is missed to double the drug dose when the next dose is scheduled 3. instructing the client that if muscle weakness occurs, to rest, and if it persists to call the health care provider the next day 4. informing the client that if respiratory distress occurs, rest, double the drug dose, and call the health care provider

1

A client is ordered to receive an antihypertensive medication. Select all of the following elements that should be included in teaching: 1. Warn client to rise slowly to avoid orthostatic hypotension. 2. Limit water intake. 3. Limit potassium intake. 4. Eat a high-sodium diet. 5. Discuss potential side effects of medication. 6. Tell client to stop medications if blood pressure is within normal limits.

1. Warn client to rise slowly to avoid orthostatic hypotension. 5. Discuss potential side effects of medication.

Adrenergic agents have specific effects on the body. Select the actions of adrenergic medications from the following: 1. dilate pupils 2. increase heart rate 3. stimulate gastric muscle 4. dilate blood vessels 5. dilate bronchioles 6. relax uterine muscles 7. contract the bladder

1. dilate pupils 2. increase heart rate 5. dilate bronchioles 6. relax uterine muscles

A client has had a sinus infection for 1 week. She was seen in the clinic 4 days ago and was instructed to take OTC decongestants and antipyretics. She returns to the clinic with continued symptoms and green nasal mucus. The medication the nurse anticipates will be ordered is a(n): 1. narcotic 2. antibiotic 3. antiviral agent 4. antifungal agent

2

A client is being assessed for signs and symptoms of digitalis toxicity that include which of the following? 1. abdominal cramping 2. bradycardia 3. polyuria 4. hearing disturbances

2

A client is demonstrating signs and symptoms of digoxin toxicity. The antidote for cardiac/digitalis glycoside toxicity is: 1. vitamin K 2. digoxin immune Fab (Digibind) 3. inamrinone lactate (Inocor) 4. naloxone (Narcan)

2

A client is ordered bethanechol chloride (Urecholine) for urinary retention. A nurse is adding up the client's intake and output for the 8-hour shift. The client's I = 850 ml, O = 350 ml. The nurse should: 1. administer an extra dose of bethanechol 2. palpate the client's bladder 3. increase the client's fluid intake 4. continue the plan of care

2

A client is ordered to receive clopidogrel (Plavix) after a stroke. The nurse instructs the patient that this medication is given to: 1. increase blood flow to the brain 2. decrease platelet aggregation 3. disintegrate clots 4. promote thrombolysis

2

A client is ordered to receive metaproterenol (Alupent) for asthma by inhaler, rather than orally. The nurse is aware that which of the following is true? 1. The inhaled dose is higher than the oral dose. 2. The onset of the inhaled dose is faster than that of the oral dose. 3. There are more side effects with the inhaled dose. 4. The oral dose has a shorter t1/2.

2

A client is ordered to receive propranolol (Inderal) for a blood pressure measurement of 140/90 mm Hg. The nurse is aware that propranolol is a: 1. selective beta blocker 2. nonselective beta blocker 3. nonselective alpha and beta blocker 4. nonselective alpha blocker

2

4. The nurse instructs the client to avoid which of the following herbal preparations while taking furosemide (Lasix)? 1. chamomile 2. feverfew 3. goldenseal 4. licorice

ANS: 4 Licorice can increase potassium loss, leading to hypokalemia.

A client is ordered to receive propranolol (Inderal). The nurse notes that the client has a history of asthma. The nurse calls the ordering physician with the knowledge that propranolol may cause: 1. no change in airway 2. bronchial constriction 3. bronchial dilation 4. bronchial enlargement

2

A client is to receive a heparin injection. Before administering the medication, what diagnostic test must the nurse check? 1. PT, INR 2. PTT, APTT 3. CBC 4. platelet count

2

A client is to receive a peripheral vasodilator. Side effects include which of the following? 1. bradycardia 2. dizziness, lightheadedness 3. headache 4. pallor

2

A client receiving warfarin (Coumadin) must have lab tests checked before the drug is administered. The laboratory test(s) that is/are monitored while a client receives warfarin is: 1. PTT and APTT 2. PT and INR 3. a CBC 4. a platelet count

2

A client sustains a myocardial infarction. Alteplase (tPA) is administered. The nurse is aware that when a thrombolytic is administered, the thrombus should disintegrate within: 1. 2 hours 2. 6 hours 3. 12 hours 4. 24 hours

2

A client was prescribed a transdermal nitroglycerin patch, 5 mg/24 hours. A health teaching point is: 1. to leave the old patch on when applying the new patch 2. to change to a new site when applying the new nitroglycerin patch 3. to apply the nitroglycerin patch only to the chest area 4. that the patch medication area may be touched while applying it

2

A client was stung by a bee. This is the third bee sting the client has received, and the client complains of shortness of breath. The adrenergic drug used in emergencies to combat a life-threatening allergic reaction is: 1. norepinephrine (Levophed) 2. epinephrine (Adrenalin) 3. terbutaline (Brethine) 4. propranolol (Inderal)

2

A client with asthma is given albuterol sulfate (Proventil), a selective adrenergic drug that stimulates the beta2-receptor site. The effect of this response is: 1. bronchoconstriction 2. bronchodilation 3. decreased heart rate 4. increased blood pressure

2

A client with asthma is receiving metoprolol (Lopressor), a beta blocker for hypertension. The client asks if metoprolol will affect her asthma. Your response could be: 1. "Metoprolol may cause bronchoconstriction, and is questionable if it will help decrease blood pressure." 2. "Metoprolol decreases pulse rate and thus blood pressure, but it should not have an effect on the bronchioles." 3. "Metoprolol causes bronchodilation and increased pulse rate, so refuse the drug." 4. "I'll inform the health care provider that you should not take metoprolol."

2

A nurse is infusing dopamine (Intropin) intravenously. The nurse is aware that infiltration of this medication may lead to tissue necrosis. An early sign of intravenous infiltration includes: 1. a red streak following the course of the vein 2. swelling at the IV site 3. warmth at the insertion site 4. bleeding at the insertion site

2

According to the new blood pressure guidelines from the Joint National Committee-7, treatment for hypertension should begin when the systolic blood pressure is ____ mm Hg over the client's goal systolic value. 1. 10 2. 20 3. 30 4. 40

2

According to the new blood pressure guidelines from the Joint National Committee-7, which of the following blood pressures represents pre-hypertension? 1. <120/80 mm Hg 2. 120-139/80-89 mm Hg 3. 140-159/90-99 mm Hg 4. >160/100 mm Hg

2

African Americans tend to develop hypertension more readily than whites. They do not respond to certain antihypertensive drugs, such as angiotensin-converting enzyme (ACE) inhibitors because of: 1. high-renin hypertensive response 2. low-renin hypertensive response 3. increased production of antidiuretic hormone (ADH) 4. decreased production of antidiuretic hormone (ADH)

2

Albuterol (Proventil), a beta2-adrenergic agonist and a sympathomimetic, is an effective drug to control asthma. The action of a beta2 adrenergic is to: 1. decrease mucus production 2. enhance bronchodilation 3. promote bronchoconstriction 4. promote bronchospasm

2

Alpha-adrenergic blockers promote vasodilation, causing: 1. increased blood pressure 2. decreased blood pressure 3. decreased pulse rate 4. rapid respiration

2

American Indians have a reduced or lower response to which antihypertensive as compared to Caucasians? 1. furosemide (Lasix) 2. metoprolol (Apo-Metoprolol, Toprol SR) 3. minoxidil (Loniten, Rogaine) 4. prazosin (Minipress)

2

Atropine and atropine-like drugs are anticholinergics. Atropine is usually prescribed as one of the preoperative drugs. The primary use for atropine as a preoperative drug is to: 1. increase heart rate 2. decrease salivation 3. decrease GI motility 4. decrease urination

2

Certain adrenergic drugs stimulate several receptor sites. The adrenergic drug that stimulates alpha1 and beta1 receptors to correct hypotension and spare renal function is: 1. epinephrine (Adrenalin) 2. dopamine hydrochloride (Inotropin) 3. dobutamine hydrochloride (Dobutrex) 4. terbutaline sulfate (Brethine)

2

Clients receiving warfarin therapy should maintain an International Normalized Ratio (INR) of: 1. 1-2 2. 2-3 3. 3-4 4. 4-5

2

Continual use of angiotensin-converting enzyme (ACE) inhibitors can cause: 1. fluid retention 2. hyperkalemia 3. hypernatremia 4. hypercalcemia

2

Direct-acting arterial vasodilators are potent antihypertensive drugs. The vasodilator effect decreases blood pressure, and peripheral edema may occur because of: 1. potassium loss 2. sodium and water retention 3. sodium and water excretion 4. orthostatic hypotension

2

Drugs that loosen bronchial secretions are from which of the following groups? 1. antitussives 2. expectorants 3. antihistamines 4. decongestants

2

During a cold, nasal congestion results from: 1. constriction of nasal blood vessels 2. dilation of nasal blood vessels 3. allergic reaction 4. increased bronchial secretions

2

Frequent use of a sympathomimetic inhaler may cause which of the following symptoms? 1. lethargy 2. nervousness 3. hyperthermia 4. decreased respirations

2

In planning care for a client receiving heparin, the nurse is aware that the dose is administered subcutaneously. Heparin is not administered orally because: 1. it is absorbed readily by the gastrointestinal mucosa and protected by the liver 2. it is poorly absorbed by the gastrointestinal mucosa and destroyed by liver enzymes 3. food can hamper its effectiveness 4. blood flow to the stomach is inadequate

2

Leukotriene is a chemical mediator that can cause: 1. infectious lung disease 2. inflammatory changes in the lungs 3. acute asthmatic attack 4. bronchodilation

2

Nifedipine (Procardia), the most potent calcium blocker, promotes vasodilation of the coronary and peripheral vessels. The nurse should assess for: 1. elevated blood pressure 2. decreased blood pressure 3. pulse rate <70 beats/minute 4. pulse rate >120 beats/minute

2

Peripheral vasodilators are more effective in disorders resulting from: 1. vessel occlusion 2. vasospasms 3. embolus 4. arteriosclerotic changes

2

Prazosin (Minipress) and minoxidil (Loniten) cause vasodilation to control hypertension and can cause sodium and water retention. The drugs that may be used with these antihypertensives are: 1. cardiac glycosides 2. diuretics 3. glucocorticoids 4. antihistamines

2

Rebound congestion may result if a client overuses a nasal decongestant spray. Rebound congestion is: 1. rebound vasoconstriction of the nasal mucosa 2. rebound vasodilation of the nasal mucosa 3. reduction in fluid secretion 4. reduction of nasal congestion

2

Sodium nitroprusside (Nipride) and diazoxide (Hyperstat) are two direct-acting antihypertensives prescribed for hypertensive crisis. These agents: 1. are potent vasoconstrictors 2. are potent vasodilators 3. are potent diuretics 4. increase peripheral vascular resistance

2

Some cholinesterase inhibitors are used to improve memory in mild to moderate Alzheimer's dementia. These agents act by: 1. decreasing cholinergic function 2. enhancing cholinergic function 3. increasing anticholinergic function 4. blocking cholinergic action

2

Teaching clients taking anticholinergic includes: 1. encouraging the use of alcohol and caffeine before bedtime for sleep disorders 2. suggesting hard candy, chewing gum, and oral hygiene for dry mouth 3. instructing the client to report dizziness and a slow pulse rate immediately 4. instructing the client to avoid lifting heavy objects

2

The action of indirect-acting parasympathomimetics is to: 1. act on the cholinergic receptors to stimulate a response 2. inhibit or inactivate the enzyme acetylcholinesterase, thus permitting the accumulation of acetylcholine at the receptors 3. inhibit the actions of acetylcholine by occupying the cholinergic receptors 4. block the action of norepinephrine

2

The advantage of using a glucocorticoid inhaler instead of an oral glucocorticoid is that it: 1. increases the risk for adrenal suppression 2. minimizes the risk for adrenal suppression 3. increases the need for more oral glucocorticoid 4. necessitates less glucocorticoid

2

The advantages of using nasal decongestants over systemic decongestants include that they: 1. take longer to take effect with a longer duration 2. have fewer side effects 3. have fewer tolerance effects 4. affect the entire body

2

The major complication of thrombolytic drugs is: 1. thrombus formation 2. hemorrhage 3. platelet aggregation 4. leukopenia

2

The mixed-acting sympathomimetics act by: 1. stimulating the adrenergic receptor sites and inhibiting the release of norepinephrine 2. stimulating the adrenergic receptor sites and stimulating the release of norepinephrine 3. inhibiting the adrenergic receptor sites and inhibiting the release of norepinephrine 4. inhibiting the adrenergic receptor sites and stimulating the release of norepinephrine

2

The nurse assesses a client for side effects of lovastatin (Mevacor). Which of the following is not associated with this medication? 1. headaches 2. tachycardia 3. GI disturbances 4. dizziness

2

The nurse assesses for signs of adequate blood flow. Impaired blood flow is manifested by: 1. capillary refill of 2 seconds, coolness 2. coolness of extremities and pallor 3. pitting edema and mottling 4. pain and warmth

2

The usefulness of cholinesterase inhibitors for controlling myasthenia gravis is: 1. for diagnostic purposes 2. to increase muscle strength 3. to decrease muscle strength 4. to promote urination

2

When alcohol is taken with some antihypertensives, what might occur? 1. The hypertensive state is intensified. 2. The hypotensive state is intensified. 3. Hypertensive crisis may occur. 4. Stimulation of the respiratory center may occur.

2

Which side effect frequently occurs with angiotensin-converting enzyme (ACE) inhibitors but does not occur with A-II receptor antagonists? 1. abdominal cramps 2. cough 3. headaches 4. dyspnea

2

A client with high cholesterol is ordered to take atorvastatin (Lipitor). Select all of the following that should be included in care: 1. You only need to take this medicine and no longer watch your diet. 2. Take the medication at night for greatest effectiveness. 3. Take the medicine with a full glass of water. 4. Watch for body aches or GI upset as side effects. 5. Have renal function tests frequently done. 6. Have liver function tests frequently done.

2. Take the medication at night for greatest effectiveness. 3. Take the medicine with a full glass of water. 4. Watch for body aches or GI upset as side effects. 6. Have liver function tests frequently done.

Cholinergic agents have specific effects on the body. Select the actions of cholinergic medications from the following: 1. dilate pupils 2. decrease heart rate 3. stimulate gastric muscle 4. dilate blood vessels 5. dilate bronchioles 6. increase salivation 7. constrict pupils

2. decrease heart rate 3. stimulate gastric muscle 4. dilate blood vessels 6. increase salivation 7. constrict pupils

A client has congestive heart failure and has been taking digoxin (Lanoxin) for 9 years. The client is admitted with signs and symptoms of digoxin toxicity. Select all of the following that are associated with digoxin toxicity: 1. scomata 2. vomiting 3. supraventricular tachycardia 4. yellow halos in the visual field 5. diarrhea 6. insomnia

2. vomiting 4. yellow halos in the visual field 5. diarrhea

A client diagnosed with hyperlipidemia has been prescribed cholestyramine (Questran). Which of the following instructions will the nurse include in the client's teaching plan? 1. Restrict fluids while taking this medication. 2. Eat a low-fiber diet. 3. Mix powder well with fluid. 4. Take an antidiarrheal agent if diarrhea occurs.

3

A client experiences premature ventricular contractions. The nurse prepares to administer lidocaine (Xylocaine), with the knowledge that it is administered intravenously to correct: 1. bradycardia 2. atrial dysrhythmias 3. ventricular dysrhythmias 4. heart block

3

A client experiencing shortness of breath associated with asthma is given epinephrine (Adrenalin). This medication is considered a nonselective adrenergic drug because it innervates: 1. alpha-adrenergic receptor sites 2. beta-adrenergic receptor sites 3. alpha-, beta1-, and beta2-adrenergic receptor sites 4. beta1- and beta2-adrenergic receptor sites

3

A client is discharged on beta blockers. Which of the following skills is essential for the client's family to learn? 1. how to prepare a low-sodium diet 2. assessments to detect fluid retention 3. how to monitor heart rate and blood pressure 4. early signs of changing level of consciousness

3

A client is ordered to receive diphenhydramine (Benadryl). This medication is from which group? 1. antitussives 2. expectorants 3. antihistamines 4. decongestants

3

A client is receiving bethanechol chloride (Urecholine) orally. What other route of administration can be used to give bethanechol? 1. intramuscular 2. intravenous 3. subcutaneous 4. intradermal

3

A client who is taking digoxin (Lanoxin) also has a history of gastroesophageal reflux disease. The client takes Mylanta II (magnesium and aluminum hydroxide) and Tums (calcium carbonate). The client needs to space the medications apart because antacids taken with digoxin cause: 1. anorexia and nausea 2. increased absorption of digoxin 3. decreased absorption of digoxin 4. diarrhea

3

A client who uses an inhaler is taught the strategies to prevent Candida infections. Which of the following would the nurse include in the instructions? 1. Soak the spacer in alcohol between uses. 2. Do not use a spacer. 3. Rinse the mouth with water after each use. 4. Use fluconazole (Diflucan) prophylactically.

3

A client with asthma is admitted to the hospital with shortness of breath. He was given theophylline via intravenous (IV) fluids. The agent the client received intravenously was: 1. theophylline (Theo-Dur) 2. oxtriphylline (Choledyl) 3. aminophylline (Somophyllin) 4. dyphylline (Dilor)

3

A factor contributing to hypertension is: 1. deficit of norepinephrine 2. deficit of aldosterone 3. retention of sodium and water 4. retention of potassium and calcium

3

A new nurse is listing the interventions he should employ when caring for a client on thrombolytic therapy. Which of the following nursing interventions is not warranted during thrombolytic therapy? 1. Monitor vital signs and report changes. 2. Check for active bleeding for 24 hours after therapy. 3. Inform the client that aspirin and NSAIDs may be taken for discomfort. 4. Monitor electrocardiogram strips for cardiac dysrhythmias.

3

A nurse is monitoring a client after the client has received pentoxifylline (Trental) for treatment of intermittent claudication. Which of the following indicates a positive response to the medication? 1. increased claudication 2. bradycardia 3. decrease in pain 4. orthostatic hypotension

3

A nurse is preparing to administer nitroglycerin (NTG) via the sublingual route. The nurse knows that nitroglycerin tablets are administered sublingually: 1. to avoid the bitter taste 2. to prevent nausea and vomiting 3. to absorb readily into the circulation 4. to undergo first-pass metabolism

3

A nurse is teaching a client about hypertension. Which statement by the client indicates a need for additional teaching? 1. "I'll call the physician when I want to take an over-the-counter medication." 2. "I need to have my blood pressure checked frequently." 3. "When my blood pressure is normal, I can decrease my dose." 4. "I will watch my sodium and cholesterol intake."

3

A nurse is teaching a client about the side effects/adverse reactions of theophylline (Theo-Dur). They include: 1. headache and an aura 2. hypertension and flushing 3. tachycardia and palpitations 4. diarrhea and dehydration

3

A nurse is teaching a client about the treatment of hyperlidemia and use of statin drugs. Instructions include: 1. "This treatment is only temporary." 2. "Diet and exercise are not important to treatment." 3. "Annual eye exams are recommended." 4. "Diarrhea is a common side effect."

3

A nurse is teaching a client how to use phenylephrine (Neo-Synephrine) nasal spray. To avoid systemic absorption, the nurse teaches the client to: 1. apply pressure to the nose after spraying 2. administer the spray while in the supine position 3. insert the spray while sitting up 4. exhale deeply while injecting the nasal spray

3

A positive inotropic action is one of the effects of digitalis drugs. Positive inotropic action means: 1. decreased conduction of the myocardium 2. decreased heart rate 3. increased myocardial contraction 4. decreased myocardial contraction

3

Albuterol sulfate (Proventil) has a short half-life and duration of action. Therefore the drug dosing for oral Proventil may be: 1. once a day 2. once every other day 3. 3 or 4 times a day 4. 6 to 8 times a day

3

Another name for sympatholytics is: 1. adrenergic agonists 2. beta agonists 3. adrenergic blockers 4. cholinergic blockers

3

Antacids taken with digoxin (Lanoxin) cause: 1. anorexia and nausea 2. increased absorption of digoxin 3. decreased absorption of digoxin 4. diarrhea

3

Antihistamines are divided into first and second generations. Second-generation antihistamines: 1. cause drowsiness and dry mouth 2. cause many anticholinergic symptoms 3. have fewer anticholinergic symptoms 4. can cause central nervous system depression with alcohol use

3

Asthma is treated according to severity. For quick relief of a single asthmatic symptom, a(n) ________ drug is recommended. 1. oral beta1 and beta2 2. inhaled glucocorticoid 3. short-acting inhaled beta2 agonist 4. theophylline preparation

3

Client teaching for people using a bronchodilator includes the following except: 1. to measure pulse rate and report irregular heartbeats (cardiac dysrhythmias) 2. to maintain or increase fluid intake, which can loosen secretions 3. that over-the-counter drugs should not affect the prescribed drug regimen 4. to stop smoking

3

Drug groups used to control cold symptoms include which of the following? 1. antivirals 2. antifungals 3. antitussives 4. antibiotics

3

Isoproterenol (Isuprel) was one of the first drugs used to control asthma. Isuprel is a: 1. selective beta2 adrenergic 2. selective alpha adrenergic 3. nonselective beta1 and beta2 4. nonselective alpha, beta1, and beta2

3

The action of angiotensin-converting enzyme (ACE) is to: 1. increase the release of aldosterone 2. promote the formation of angiotensin II 3. inhibit the formation of angiotensin II 4. increase the formation of angiotensin I

3

The action of cholinesterase inhibitors for glaucoma is to: 1. cause the eyeball to decrease in size 2. cause the aqueous humor of the eye to expand 3. produce pupillary constriction 4. produce pupillary dilation

3

The drug group that inhibits clot formation is: 1. antihyperlipidemics 2. thrombolytics 3. anticoagulants 4. antidysrhythmics

3

The drug used as a prophylactic agent in clients to prevent an asthmatic attack is: 1. aminophylline-theophylline ethylenediamine (Somophyllin) 2. ephedrine (Ephedsol) 3. cromolyn sodium (Intal) 4. guaifenesin (Organidin NR)

3

The general sympathetic responses to adrenergic drugs include: 1. constricting bronchioles and gastrointestinal smooth muscles 2. decreasing heart rate and dilating blood vessels 3. increasing heart rate and constricting blood vessels 4. dilating bronchioles and decreasing heart rate

3

The herbs that interfere with platelet aggregation are: 1. ephedra and dill 2. black cohosh and licorice 3. garlic and ginkgo 4. ginseng and green tea

3

The major responses to anticholinergic drugs include: 1. decreased heart rate and increased salivation 2. pupil constriction and increased bronchial secretions 3. increased heart rate and decreased salivation 4. increased urine output and pupil constriction

3

The nurse instructs a client taking digoxin (Lanoxin) for treatment of congestive heart failure (CHF) to eat which of the following? 1. cabbage 2. lima beans 3. potatoes 4. yogurt

3

The nurse is aware that which of the following herbal preparations decreases the absorption of digoxin? 1. garlic 2. ginger 3. St. John's wort 4. saw palmetto

3

The nurse is reviewing the history of a client who has been prescribed tolterodine tartrate (Detrol, Detrol LA) for treatment of incontinence. The nurse plans to contact the health care provider if the client has which of the following conditions? 1. cataracts 2. hyperthyroidism 3. narrow-angle glaucoma 4. parkinsonism

3

The nurse reviews a client's history before administering nadolol (Corgard) for treatment of angina. The nurse plans to contact the health care provider if the client has which of the following conditions? 1. cataracts 2. glaucoma 3. second-degree AV heart block 4. thrombocytopenia

3

Those taking angiotensin-converting enzyme (ACE) inhibitors who do not respond effectively to a reduction in blood pressure include: 1. Asian Americans 2. Hispanics 3. African Americans 4. Caucasians

3

What is the level of risk for coronary artery disease for a client with a serum cholesterol level of 270 mg/dl? 1. low risk 2. moderate risk 3. high risk 4. within the normal range

3

What laboratory tests should be monitored while a client receives treatment with the statin medications? 1. CBC 2. electrolytes 3. liver enzymes 4. urinalysis

3

When stimulating the beta1-adrenergic receptors, the response is: 1. increased blood pressure 2. decreased blood pressure 3. increased pulse rate 4. decreased pulse rate

3

Which of the following statements made by a client receiving (warfarin) Coumadin therapy indicates a need for further teaching? 1. "I shouldn't take aspirin." 2. "I will use a toothbrush with soft bristles." 3. "I will eat large quantities of green leafy vegetables, rich in vitamin K." 4. "I will use an electric razor to avoid shaving cuts."

3

A client experiences bradycardia as a result of vagal stimulation. The nurse will expect to administer: 1. bethanechol chloride (Urecholine) 2. benztropine (Cogentin) 3. metoclopramide (Reglan) 4. atropine sulfate (atropine)

4

A client is ordered to receive a nitrate to relieve stable angina. A common side effect to anticipate in a client receiving this medication includes: 1. nausea and vomiting 2. increased blood pressure 3. pruritus and skin rash 4. a pounding headache

4

A client is ordered to take inamrinone lactate (Inocor) for treatment of acute heart failure. The nurse anticipates that this drug will be administered intravenously for no longer than: 1. 12 hours 2. 24 hours 3. 36 hours 4. 72 hours

4

A client is to receive simvastatin (Zocor) to reduce serum cholesterol levels. The nurse recommends to the client that the best time to take this medication is: 1. before breakfast 2. with meals 3. mid-afternoon 4. in the evening

4

A client receiving clopidogrel (Plavix) has the following conditions as part of the health history. Which causes the greatest concern to the nurse? 1. asthma 2. glaucoma 3. allergy to shellfish 4. active peptic ulcer

4

A new drug category with U.S. Food and Drug Administration approval is leukotriene inhibitors/modifiers. Leukotriene inhibitors are prescribed: 1. to treat acute asthmatic attacks 2. to increase inflammatory response 3. to enhance bronchoconstriction 4. for exercise-induced asthma

4

A nurse is caring for a client with congestive heart failure. The client is ordered to receive nesiritide (Natrecor). The nurse evaluates the effectiveness of this medication in achieving the desired effect by noting: 1. vasoconstriction 2. oliguria 3. decreased diuresis 4. decreased shortness of breath

4

A nurse is providing health teaching for clients taking antihypertensives. One of the key teaching priorities to tell clients is that abrupt discontinuation of the drug may cause: 1. drowsiness 2. nasal stuffiness 3. rebound hypotension 4. rebound hypertension

4

An antidote to correct an overdose of thrombolytic drugs is: 1. naloxone (Narcan) 2. protamine sulfate 3. vitamin E 4. aminocaproic acid (Amicar)

4

An antidysrhythmic agent used during life-threatening situations to convert ventricular fibrillation to normal sinus rhythm when lidocaine (Xylocaine) and procainamide (Pronestyl) are ineffective is: 1. phenytoin (Dilantin) 2. tocainide (Tonocard) 3. atropine 4. bretylium (Bretylol)

4

An example of a cholinesterase inhibitor used for clients with early-stage Alzheimer's dementia is: 1. ambenonium chloride (Mytelase) 2. bethanechol chloride (Urecholine) 3. atropine sulfate 4. tacrine hydrochloride (Cognex)

4

Angiotensin II receptor antagonists (A-II blockers) are similar to angiotensin-converting enzyme (ACE) inhibitors, but differ by: 1. enhancing the release of aldosterone 2. inhibiting the angiotensin-converting enzyme 3. increasing peripheral resistance 4. blocking angiotensin II at the AT1 receptor

4

Antitussives act by: 1. decreasing nasal secretions 2. loosening bronchial secretions 3. blocking the effect of histamines 4. suppressing the cough reflex

4

Atropine-like drugs are contraindicated in clients with: 1. parkinsonism 2. a peptic ulcer 3. cirrhosis 4. glaucoma

4

Certain anticholinergics are used for parkinsonism. One of the purposes for their use is to: 1. increase salivation and drooling 2. increase muscle tone 3. increase urination 4. decrease tremors and rigidity

4

Client teaching for patients receiving beta blockers includes: 1. instructing the client to take the beta blocker when symptoms occur 2. instructing clients to have blood pressure and pulse rate checked monthly or quarterly 3. instructing a client that GI upset is a common problem and if it occurs to stop the drug 4. instructing a client not to abruptly stop taking the beta blocker because of the possible occurrence of rebound hypertension

4

Clients taking a theophylline drug need to be aware of herbal drug(s) that may cause drug interaction. An herb that can cause cardiac dysrhythmias and theophylline toxicity when taken with theophylline is: 1. ginkgo 2. ginseng 3. ginger 4. ephedra

4

Many of the beta-adrenergic blockers are nonselective, blocking both beta1 and beta2 receptors. The response would be: 1. increased pulse rate and bronchoconstriction 2. decreased pulse rate and bronchodilation 3. increased pulse rate and bronchodilation 4. decreased pulse rate and bronchoconstriction

4

One of the first beta-adrenergic blockers (beta blocker) was propranolol (Inderal). It blocks: 1. alpha1 receptors 2. beta1 receptors 3. beta2 receptors 4. beta1 and beta2 receptors

4

Parasympathomimetics affect the cardiovascular, gastrointestinal (GI), and urinary systems, as well as the eye, causing: 1. increased pulse rate 2. decreased GI motility 3. decreased bladder contraction 4. myosis (pupil constriction)

4

The action of thrombolytics is to: 1. prolong clotting time 2. inhibit clot formation 3. enhance fibrin formation in the blood clot 4. stimulate the fibrinolytic mechanism to dissolve blood clots

4

The adrenergic receptor that causes bronchodilation when stimulated is: 1. alpha1 2. alpha2 3. beta1 4. beta2

4

The new anticholinergic drug used to treat asthmatic conditions by dilating the bronchioles is: 1. tiotropium (Spiriva) 2. triamcinolone (Aristocort) 3. theophylline (Theo-Dur) 4. ipratropium bromide (Atrovent)

4

The nurse instructs a client to adminster montelukast (Singulair) at which time? 1. morning 2. noon 3. late afternoon 4. evening

4

When using a mucolytic drug and a bronchodilator in a nebulizer, the nurse should instruct the client that: 1. the mucolytic drug should be given 30 minutes before the bronchodilator 2. the bronchodilator should be given 30 minutes before the mucolytic drug 3. the mucolytic drug should be given 5 minutes before the bronchodilator 4. the bronchodilator should be given 5 minutes before the mucolytic drug

4

Which of the following is not included as a risk factor for coronary artery disease in the following laboratory test results? 1. cholesterol 2. triglyceride 3. low-density lipoprotein (LDL) 4. high-density lipoprotein (HDL)

4

16. A patient who is intubated develops bradycardia because of vagal stimulation. Which medication will the nurse anticipate administering to treat this symptom? a. Atropine sulfate (Atropine) b. Benztropine (Cogentin) c. Bethanechol chloride (Urecholine) d. Metoclopramide (Reglan)

A

A client is ordered to receive azelastine (Optivar) nasal spray. This antihistamine has a half-life of 22 hours. The nurse anticipates this medication to be ordered _____ per day. a. once b. twice c. three times d. four times

A

A client is ordered to receive digoxin (Lanoxin). Based on its half-life of 36 hours, the nurse will anticipate administering the maintenance dose: a. once a day. b. twice a day. c. three times a day. d. once a week.

A

A client is receiving atorvastatin (Lipitor) for high blood cholesterol level. Which sign warrants the client's immediate contacting of the healthcare provider? a. Muscle tenderness b. Gastrointestinal distress c. Constipation d. Flushing of the skin

A

A client receiving warfarin (Coumadin) is noted to have significant bleeding from the gums while on therapy. The physician orders an antidote. If excess bleeding occurs because of warfarin accumulation in the body, what is the antidote? a. Vitamin K b. Vitamin E c. Naloxone (Narcan) d. Protamine sulfate

A

A client who smokes is receiving theophylline products. Because of his history of smoking, the nurse would expect that the dose would be affected in which way? a. Increased b. Decreased c. The same d. Closely monitored

A

A client's serum cholesterol level is 268 mg/dl. Lovastatin (Mevacor) is prescribed. A positive outcome of treatment with the medication is ________ of cholesterol. a. inhibition of hepatic synthesis b. stimulation of hepatic synthesis c. an increase in renal excretion d. an increase in fecal excretion

A

A nurse receives an order to administer epinephrine (Adrenalin) orally to a client. What is the highest priority action on the part of the nurse? a. Call the physician to question the order. b. Administer the medication as ordered. c. Call the pharmacist for clarification of the order. d. Hold the order and continue to monitor the client.

A

A nursing student asks why a direct-acting cholinergic agonist drug that is selective to muscarinic receptors is described as being non-specific. The nurse will explain that this is because a. muscarinic receptors are present in many different tissues. b. the action of cholinesterase alters the bioavailability at different sites. c. these drugs can also affect nicotinic receptors. d. they vary in their reversible and irreversible effects.

A

A nursing student asks why the anticoagulant heparin is given to patients who have disseminated intravascular coagulation (DIC) and are at risk for excessive bleeding. The nurse will explain that heparin is used in this case for which reason? a. To decrease the risk of venous thrombosis b. To dissolve blood clots as they form c. To enhance the formation of fibrous clots d. To preserve platelet function

A

A patient begins taking cholestyramine (Questran) to treat hyperlipidemia. The patient reports abdominal discomfort and constipation. The nurse will provide which instruction to the patient? a. Increase fluid and slowly increase fiber intake. b. Stop taking the medication immediately. c. Take an over-the-counter laxative. d. Take the medication on an empty stomach.

A

A patient begins taking nicotinic acid (Niacin) and reports dizziness and flushing of the skin. The nurse will perform which action? a. Contact the provider to discuss decreasing the dose. b. Counsel the patient to increase fluid intake. c. Request an order for renal function tests. d. Schedule the medication to be taken with meals.

A

A patient experiences a blood clot in one leg, and the provider has ordered a thrombolytic medication. The patient learns that the medication is expensive and asks the nurse if it is necessary. Which response by the nurse is correct? a. "The drug will decrease the likelihood of permanent tissue damage." b. "This medication also acts to prevent future blood clots from forming." c. "You could take aspirin instead of this drug to achieve the same effect." d. "Your body will break down the clot, so the drug is not necessary."

A

A patient has a serum cholesterol level of 270 mg/dL. The patient asks the nurse what this level means. Which response by the nurse is correct? a. "You have a high risk for coronary artery disease." b. "You have a moderate risk for coronary artery disease." c. "You have a low risk for coronary artery disease." d. "You have no risk for coronary artery disease."

A

A patient has been taking cholestyramine (Questran) to treat hyperlipidemia type II. The patient reports abdominal cramping and constipation. The patient's serum low- density lipoprotein (LDL) has decreased from 170 mg/dL to 110 mg/dL, and triglycerides have not changed from 150 mg/dL since beginning the medication. The provider changes the medication to colesevelam HCl (Welchol).The patient asks the nurse why the medication was changed, and the nurse will explain that colesevelam HCl is ordered for which reason? a. It has fewer side effects. b. It has more convenient dosing. c. It provides greater LDL reduction. d. It provides greater triglyceride reduction.

A

A patient has been taking spironolactone (Aldactone) to treat heart failure. The nurse will monitor for a. hyperkalemia. b. hypermagnesemia. c. hypocalcemia. d. hypoglycemia.

A

A patient is brought to the emergency department and reports having taken "a lot" of acetaminophen extra-strength tablets 16 hours prior. The nurse will expect the provider to order a. acetylcysteine (Mucomyst). b. dornase alfa (Pulmozyme). c. gastric lavage. d. renal enzyme tests.

A

A patient is receiving a thrombolytic medication. The patient calls the nurse to report having bloody diarrhea. The nurse will anticipate administering which medication? a. Aminocaproic acid (Amicar) b. Enoxaparin sodium (Lovenox) c. Protamine sulfate d. Vitamin K

A

A patient is taking clopidogrel bisulfate (Plavix). When teaching this patient about dietary restrictions while taking this medication, the nurse will instruct the patient to avoid excessive consumption of which food? a. Garlic b. Grapefruit c. Green, leafy vegetables d. Red meats

A

A patient is taking doxazosin mesylate (Cardura) 1 mg per day to treat hypertension. The nurse notes a blood pressure of 110/72 mm Hg and a heart rate of 92 beats per minute. The nurse will contact the provider to discuss which change to the drug regimen? a. Changing to a beta-adrenergic blocker b. Decreasing the drug dose c. Increasing the drug dose d. Adding a diuretic

A

A patient who has been taking theophylline at home reports having palpitations and jitteriness. What action will the nurse take? a. Ask the patient if herbal medications are used. b. Notify the provider to report theophylline toxicity. c. Recommend that the patient increase fluid intake. d. Request an order for renal function studies.

A

A patient who has irritable bowel syndrome would most likely receive which type of drug to treat this condition? a. An anticholinergic b. A cholinergic esterase inhibitor c. A muscarinic agent d. A nicotinic agent

A

A patient who has narrow-angle glaucoma asks the nurse to recommend a medication to alleviate cold symptoms such as nasal congestion and runny nose. The nurse will suggest the patient talk to the provider about which medication? a. Azelastine (Astelin) b. Cetirizine (Zyrtec) c. Chlorpheniramine maleate (Chlor-Trimeton) d. Diphenhydramine (Benadryl)

A

A patient who has received heparin after previous surgeries will be given enoxaparin sodium (Lovenox) after knee-replacement surgery. The patient asks how this drug is different from heparin. The nurse will explain that enoxaparin a. decreases the need for laboratory tests. b. has a shorter half-life than heparin. c. increases the risk of hemorrhage. d. may be taken orally instead of subcutaneously.

A

A patient who has recently had a myocardial infarction (MI) will begin taking clopidogrel (Plavix) to prevent a second MI. Which medication will the nurse expect the provider to order as adjunctive therapy for this patient? a. Aspirin b. Enoxaparin sodium (Lovenox) c. Ticagrelor (Brilinta) d. Warfarin (Coumadin)

A

A patient who has stable angina pectoris is given nitroglycerin to use as needed. In addition to pharmacotherapy, the nurse will give the patient which instruction? a. Avoid extremes in weather. b. Begin a rigorous exercise program. c. Drink glass of red wine daily. d. Seek medical care at first sign of pain.

A

A patient who is using inhaled cromolyn sodium (Intal) daily calls the clinic to report experiencing cough and a bad taste. The nurse will instruct the patient to perform which action? a. Drink water before and after using the inhaler. b. Schedule an appointment to discuss these effects with the provider. c. Stop taking the medication immediately. d. Use the inhaler only as needed for acute bronchospasms.

A

A patient who takes digoxin to treat heart failure will begin taking a vasodilator. The patient asks the nurse why this new drug has been ordered. The nurse will explain that the vasodilator is used to a. decrease ventricular stretching. b. improve renal perfusion. c. increase cardiac output. d. promote peripheral fluid loss.

A

A patient will begin taking albuterol (Proventil) to treat asthma. When teaching the patient about this drug, the nurse will make which recommendation? a. Report rapid or irregular heart rate. b. Drink 8 to 16 extra ounces of fluid each day. c. Monitor serum glucose daily. d. Take a calcium supplement.

A

A patient will begin taking rosuvastatin calcium (Crestor) to treat hyperlipidemia. The patient asks the nurse how to take the medication for best effect. Which statement by the nurse is correct? a. "Increase your fluid intake while taking this medication." b. "Stop taking the medication if you develop muscle aches." c. "Take the medication with food to improve absorption." d. "You may increase dietary fat while taking this medication."

A

A patient will begin using an albuterol metered-dose inhaler to treat asthma symptoms. The patient asks the nurse about the difference between using an oral form of albuterol and the inhaled form. The nurse will explain that the inhaled form of albuterol a. has a more immediate onset than the oral form. b. may cause more side effects than the oral preparation. c. requires an increased dose in order to have therapeutic effects. d. will not lead to tolerance with increased doses.

A

A patient will begin using ipratropium bromide (Atrovent), albuterol (Proventil), and an inhaled glucocorticoid medication (steroid) to treat chronic bronchitis. When teaching this patient about disease and medication management, the nurse will instruct the patient to administer these medications in which order? a. Albuterol, ipratropium bromide, steroid b. Albuterol, steroid, ipratropium bromide c. Ipratropium bromide, albuterol, steroid d. Steroid, ipratropium bromide, albuterol

A

A patient with chronic obstructive pulmonary disease (COPD) who has a persistent nonproductive cough asks about a medication that will not cause sedation. The nurse will encourage the patient to discuss which medication with the provider? a. Benzonatate HCl (Tessalon Perles) b. Dextromethorphan hydrobromide (Benylin DM) c. Guaifenesin and codeine d. Promethazine with dextromethorphan

A

A patient, who has intermittent claudication, has been taking 400 mg of pentoxifylline (Trental) three times daily with meals for 2 weeks. The patient calls the clinic and reports mild flushing, occasional gastrointestinal upset, and continued pain in both legs. How will the nurse advise the patient? a. "Expect side effects to diminish as drug effects increase in several weeks." b. "Notify the provider of the continued pain and request increasing the dose." c. "Take a daily aspirin tablet to enhance the effects of pentoxifylline." d. "Take the medication 1 hour before or 2 hours after a meal."

A

An adult patient is brought to the emergency department for treatment of an asthma exacerbation. The patient uses inhaled albuterol as needed to control wheezing. The nurse notes expiratory wheezing, tremors, restlessness, and a heart rate of 120 beats per minute. The nurse suspects that the patient has a. over-used the albuterol. b. not been using albuterol. c. taken a beta-adrenergic blocker. d. taken a monoamine oxidase (MAO) inhibitor.

A

The client has been diagnosed as being borderline hypertensive. As part of client teaching, the nurse should emphasize that the client can potentially avoid being placed on medication if he will attempt which changes? a. Weight reduction and restricted salt intake b. Stress reduction techniques and higher caloric intake c. Decreased weight-bearing exercise and decreased fat intake d. Decreased fluid intake and increased potassium intake

A

The client has been ordered to be treated with Sectral. She is also being treated with a diuretic. The nurse anticipates that the interaction of the two drugs will result in a(n) _____ effect of the _____. a. increased; Sectral b. increased; diuretic c. decreased; Sectral d. decreased; diuretic

A

The client has been placed on a therapeutic regimen that includes Regitine. She tells the nurse that she routinely takes St. John's wort for depression. What should the nurse expect to see as a result of the client taking these medications? a. Worsening of the hypotensive effects of the Regitine b. Client experiencing bradycardia c. Worsening of the hypertensive effects of the Regitine d. Client experiencing of tachycardia

A

The client has been started on Zyflo. The nurse's highest priority intervention while the client is receiving this medication is to monitor: a. liver enzymes. b. serum glucose. c. calcium level. d. potassium level.

A

The client is being treated with Lanoxin and complains to the nurse of experiencing blurred vision. The highest priority nursing intervention is to recognize that this: a. is an expected side effect of the medication; notify the physician. b. is indicative of an anaphylactic reaction to the medication. c. is an adverse reaction to the medication; notify the physician. d. indicates an error in mixing the medication; notify the pharmacist.

A

The client is being treated with captopril (Capoten). The nurse teaches the client that while she is on the medication, she should avoid eating a diet that is rich in which: a. potassium. b. calcium. c. iron. d. folic acid.

A

The client is being treated with ergoloid mesylates (Hydergine). The nurse determines that the medication is producing a positive outcome for the client when the client is noted to be exhibiting a(n): a. improvement in mood. b. decrease in blood pressure. c. decrease in serum cholesterol. d. change in GI functioning.

A

The client is being treated with metoprolol. The nurse notes that the client has been experiencing sinus bradycardia. What is the highest priority nursing intervention? a. Call the physician; the medication is contraindicated if there is sinus bradycardia. b. Teach the client that the medication schedule must be strictly adhered to. c. Call the physician; the dosage should be increased when there is sinus bradycardia. d. Teach the client that he should notify the physician if he experiences rapid heart rate.

A

The client is being treated with sodium nitroprusside (Nipride, Nitropress). As the nurse is preparing to administer the medication, the most important thing to verify is that the container is: a. wrapped in aluminum foil. b. a glass bottle. c. a plastic bag. d. tinted a dark color.

A

The client is being treated with warfarin sodium as well as a diuretic. The nurse anticipates that the interaction of the two drugs will produce a(n) _____ effect from the _____. a. increased; warfarin sodium b. decreased; warfarin sodium c. increased; diuretic d. decreased; diuretic

A

The client is ordered to be treated with Singulair. The nurse anticipates the client will experience what type of change in her laboratory values? a. Abnormal liver function tests b. Hyperglycemia c. Increased potassium level d. Change in cardiac enzymes

A

The client requires a nasal decongestant and tells the nurse that she is very interested in using herbal remedies. She has been using peppermint as an herbal decongestant. The nurse's most accurate interpretation of this is that peppermint __________ nasal decongestant. a. can be effectively used as an herbal b. is usually ineffective when used as a c. can cause an anaphylactic reaction when used as a d. can cause fatality when used as a

A

The client who is most likely to be ordered low-molecular-weight heparin would be the client who is considered to be at high risk to develop: a. venous thrombosis. b. arterial embolism. c. thrombocytopenia. d. leukopenia.

A

The drugs that mimic the effect of norepinephrine are called: a. sympathomimetics, or adrenergic agonists. b. sympatholytics, or adrenergic drugs. c. sympathomimetics, or adrenergic blockers. d. sympatholytics, or adrenergic blockers.

A

The nurse administers a dose of digoxin (Lanoxin) to a patient who has heart failure and returns to the room later to reassess the patient. Which finding indicates that the medication is effective? a. Decreased dyspnea b. Decreased urine output c. Increased blood pressure d. Increased heart rate

A

The nurse has just begun administering intravenous streptokinase (Streptase). The nurse assesses vital signs and notes a temperature of 37° C, a heart rate of 70 beats per minute, and a blood pressure of 88/58 mm Hg. The nurse will contact the provider to a. request an adjustment of the streptokinase dose. b. request an order for aminocaproic acid (Amicar). c. request epinephrine to prevent anaphylaxis. d. report potential hemorrhage in this patient.

A

The nurse is admitting a patient who has been taking minoxidil (Loniten) to treat hypertension. Prior to beginning therapy with this medication, the patient had a blood pressure of 170/95 mm Hg and a heart rate of 72 beats per minute. The nurse assesses the patient and notes a blood pressure of 130/72 mm Hg and a heart rate of 78 beats per minute, and also notes a 2.2-kg weight gain since the previous hospitalization and edema of the hands and feet. The nurse will contact the provider to discuss which intervention? a. Adding hydrochlorothiazide to help increase urine output b. Adding metoprolol (Lopressor) to help decrease the heart rate c. Increasing the dose of minoxidil to lower the blood pressure d. Restricting fluids to help with weight reduction

A

The nurse is assessing a patient who takes warfarin (Coumadin). The nurse notes a heart rate of 92 beats per minute and a blood pressure of 88/78 mm Hg. To evaluate the reason for these vital signs, the nurse will assess the patient's a. gums, nose, and skin. b. lung sounds and respiratory effort. c. skin turgor and oral mucous membranes. d. urine output and level of consciousness.

A

The nurse is caring for a 70-year-old patient who has recently begun taking amlodipine (Norvasc) 5 mg/day to control hypertension. The nurse notes mild edema of the patient's ankles, a blood pressure of 130/70 mm Hg, and a heart rate of 80 beats per minute. The patient reports flushing and dizziness. The nurse will notify the provider and a. ask to decrease the dose to 2.5 mg/day. b. discuss twice daily dosing. c. request an order for a diuretic. d. suggest adding propranolol to the regimen.

A

The nurse is caring for a male patient with myasthenia gravis who will begin taking ambenonium chloride (Mytelase). When performing a health history, the nurse will be concerned about a history of which condition in this patient? a. Benign prostatic hypertrophy b. Chronic constipation c. Erectile dysfunction d. Upper respiratory infection

A

The nurse is caring for a patient recently diagnosed with mild emphysema and provides teaching about the disease and medications for treatment. Which statement by the patient indicates understanding of the medication regimen? a. "I should use albuterol when my symptoms worsen." b. "I will need to take oral prednisone on a daily basis." c. "My provider will prescribe prophylactic antibiotics." d. "My symptoms are reversible with proper medications."

A

The nurse is caring for a patient who has asthma and administers a selective beta2-adrenergic agonist to treat bronchospasm. The nurse will expect this drug to also cause which side effect? a. Increased blood glucose b. Increased blood pressure c. Increased heart rate d. Increased gastrointestinal (GI) motility

A

The nurse is caring for a patient who is receiving warfarin (Coumadin) and notes bruising and petechiae on the patient's extremities. The nurse will request an order for which laboratory test? a. International normalized ratio (INR) b. Platelet level c. Partial thromboplastin time (PTT) and activated partial thromboplastin time (aPTT) d. Vitamin K level

A

The nurse is caring for a patient whose provider has just ordered a switch from atenolol (Tenormin) to reserpine. When preparing the patient to take this medication, what will the nurse do? a. Ask about herbal supplements. b. Counsel that NSAIDs are safe to take with reserpine. c. Teach about potential side effects of mood elevation and euphoria. d. Tell the patient to expect immediate therapeutic effects.

A

The nurse is caring for a postoperative patient and notes that the patient received atropine sulfate preoperatively. Which assessment finding would prompt the nurse to notify the provider? a. Absent bowel sounds b. Drowsiness c. Dry mouth d. Heart rate of 78 beats per minute

A

The nurse is caring for an African-American patient who has been taking a beta blocker to treat hypertension for several weeks with only slight improvement in blood pressure. The nurse will contact the provider to discuss a. adding a diuretic medication. b. changing to an ACE inhibitor. c. decreasing the beta blocker dose. d. doubling the beta blocker dose.

A

The nurse is preparing a dose of Lanoxin for a pediatric client. The nurse recognizes that the pediatric medication takes which form? a. Elixir b. Tablet c. Lozenge d. Infusion

A

The nurse is preparing to administer a first dose of clopidogrel (Plavix) to a patient. As part of the history, the nurse learns that the patient has a previous history of peptic ulcers, diabetes, and hypertension. The nurse understands it will be necessary to notify the provider and obtain an order for a. a proton pump inhibitor (PPI) medication. b. frequent serum glucose monitoring. c. increased antihypertensive medications. d. nonsteroidal antiinflammatory medications.

A

The nurse is preparing to administer tolterodine tartrate (Detrol LA) to a patient who has incontinence. Which symptom would be a contraindication for this drug? a. Decreased bowel sounds b. Drooling c. Gastric upset d. Pain

A

The nurse is teaching a patient how to use phenylephrine HCl (Neo-Synephrine) nasal spray to treat congestion from a viral upper respiratory infection. What instruction will the nurse give the patient? a. Stop using the medication after 3 days. b. Spray the medication into the nose while lying supine. c. Use frequently since systemic side effects do not occur. d. Use the medication with any other over-the-counter medications.

A

The nurse is teaching a patient who will begin taking bethanechol (Urecholine). Which statement by the patient indicates a need for further teaching? a. "Excessive sweating is a normal reaction to this medication." b. "Excess salivation is a serious side effect." c. "I should get out of bed slowly while taking this drug." d. "I will not take the drug if my heart rate is less than 60 beats per minute."

A

The nurse notes a blood pressure of 160/90 mm Hg in a patient taking a thiazide diuretic. The patient reports taking an herbal medication that a friend recommended. Which herbal product is likely, given this patient's blood pressure? a. Ginkgo b. Hawthorne c. Licorice d. St. John's wort

A

The nurse notes that the client is ordered to receive flecainide (Tambocor) and tocainide (Tonocard). The nurse anticipates that the client has been diagnosed with: a. life-threatening ventricular dysrhythmias. b. third-degree heart block. c. bundle branch block. d. asystole.

A

The client is being treated with Atorvastatin (Lipitor). He tells the nurse that he has been self-medicating at home with antacids. The nurse anticipates that the interaction of the two drugs will produce a(n) _____ effect from the _____. a. increased; Atorvastatin (Lipitor) b. decreased; Atorvastatin (Lipitor) c. increased; antacids d. decrease; antacids

B

The client is being treated with eplerenone (Inspra). The nurse recognizes that which laboratory value must be monitored most closely while the client is on this medication regimen? a. Calcium b. Potassium c. Sodium d. Magnesium

B

Potassium-sparing diuretics are: 1. weaker than potassium-wasting diuretics 2. stronger than potassium-wasting diuretics 3. of equal strength to potassium-wasting diuretics 4. three times as weak as potassium-wasting diuretics

ANS: 1 By their nature, potassium-sparing diuretics are not as strong as potassium-wasting diuretics.

The two main reasons for use of diuretics are to: 1. decrease blood pressure and decrease edema 2. increase blood pressure and decrease edema 3. increase blood pressure and increase heart rate 4. decrease blood pressure and increase pulse rate

ANS: 1 Diuretics are given to decrease body fluid volume.

A client is ordered to receive triamterene (Dyrenium) to decrease his blood pressure. The nurse is evaluating the effectiveness of the medication in returning the blood chemistries to normal. Which of the following changes indicate a positive response to the medication? 1. increased K level, decreased Na level 2. increased K level, increased Na level 3. decreased K level, decreased Na level 4. decreased K level, increased Na level

ANS: 1 The serum potassium level would return to normal, and lower sodium levels would decrease the fluid volume.

The client is to receive hydrochlorothiazide (HCTZ). The nurse is aware that thiazide diuretics have a direct action on the arterioles, causing dilation and increasing: 1. body sodium and water loss 2. body sodium and water retention 3. potassium and sodium retention 4. metabolic alkalotic state

ANS: 1 Thiazide diuretics cause sodium and water loss.

Potassium-sparing diuretics interfere with the sodium-potassium pump that is controlled by the mineralocorticoid hormone: 1. cortisol 2. aldosterone 3. thyroxine 4. calcitonin

ANS: 2 Aldosterone is the hormone that regulates water retention.

Nursing interventions for a client taking furosemide (Lasix) include the following,EXCEPT to: 1. monitor urinary output 2. instruct the client to take furosemide before bedtime 3. instruct the client to rise slowly to prevent dizziness resulting from fluid loss 4. check serum potassium levels, especially if the client is taking digoxin (Lanoxin)

ANS: 2 Furosemide causes a rapid diuresis, which interrupts sleep.

A client's blood pressure is 165/90 mm Hg. Hydrochlorothiazide (HCTZ) daily is ordered. Thiazide diuretics are classified according to their duration of action. HCTZ is: 1. a thiazide-like diuretic 2. a short-acting thiazide 3. an intermediate-acting thiazide 4. a long-acting thiazide

ANS: 2 HCTZ has a short t.

Combination potassium-wasting and potassium-sparing diuretics are prescribed to control hypertension and edema, and to prevent: 1. hyperkalemia 2. hypokalemia 3. hypernatremia 4. hyponatremia

ANS: 2 The addition of a potassium-sparing diuretic to a potassium-wasting diuretic assists the body in conserving potassium.

A client is taking a thiazide diuretic. The nurse assesses the client's serum glucose level—the fasting blood glucose level is 150 mg/dl. An appropriate response for the nurse may be to: 1. inform the client to discontinue taking hydrochlorothiazide 2. inform the health care provider of the client's blood sugar level and the possible need for a different diuretic 3. instruct the client to take hydrochlorothiazide every other day 4. instruct the client that the fasting blood sugar level is elevated and to take an antidiabetic drug instead of the diuretic

ANS: 2 Thiazide diuretics can lead to impaired insulin function and hyperglycemia, warranting changing diuretic agents.

Thiazide diuretics are contraindicated if the client has which of the following disorders? 1. emphysema 2. arteriosclerotic cardiovascular disease 3. renal failure 4. viral infection

ANS: 3 Renal failure decreases the excretion of the drug, leading to accumulation and electrolyte imbalance.

Osmotic diuretics are primarily prescribed for: 1. lowering the blood pressure 2. lowering pulse rate 3. decreasing intracranial and intraocular pressures 4. maintaining serum potassium level

ANS: 3 These are the major uses of osmotic diuretics.

Client teaching for a client taking a thiazide diuretic includes which of the following? 1. Instruct the client to increase salt intake. 2. Instruct the client to decrease intake of potassium-rich foods (fruits, vegetables). 3. Instruct the client to check pulse rate if digoxin is taken with hydrochlorothiazide (HydroDIURIL) because rapid heart rate could result. 4. Advise the client to rise slowly from a sitting to a standing position to avoid dizziness.

ANS: 4 Diuretics can lead to orthostatic hypotension. The client should limit Na intake and ingest K-containing foods.

A nurse is teaching a client about lifestyle changes when taking a potassium-sparing diuretic. Which of the following statements indicates a need for more teaching? 1. "I need to have my blood drawn frequently." 2. "I need to call the clinic if I notice I am not urinating as much as usual." 3. "I need to be careful when out in the sun." 4. "I need to eat foods high in potassium, like bananas."

ANS: 4 Eating high-potassium foods with potassium-sparing diuretics can lead to hyperkalemia.

Client teaching for a client taking a thiazide diuretic includes the following: 1. Instruct the client to increase salt intake. 2. Instruct the client to decrease intake of potassium-rich foods (fruits, vegetables). 3. Instruct the client to check pulse rate if digoxin is taken with hydrocholorothiazide (HydroDIURIL) because rapid heart rate could result. 4. Advise the client to rise slowly from a sitting to a standing position to avoid dizziness.

ANS: 4 Volume depletion may lead to orthostatic hypotension, warranting certain activity restrictions.

The nurse is teaching a patient about taking hydrochlorothiazide. Which statement by the patient indicates a need for further teaching? a. "I may need extra sodium and calcium while taking this drug." b. "I should eat plenty of fruits and vegetables while taking this medication." c. "I should take care when rising from a bed or chair when I'm on this medication." d. "I will take the medication in the morning to minimize certain side effects."

ANS: A Patients do not need extra sodium or calcium while taking thiazide diuretics. Thiazide diuretics can lead to hypokalemia, so patients should be counseled to eat fruits and vegetables that are high in potassium. Patients can develop orthostatic hypotension and should be counseled to rise from sitting or lying down slowly. Taking the medication in the morning helps to prevent nocturia-induced insomnia.

The nurse is caring for a patient who develops marked edema and a low urine output as a result of heart failure. Which medication will the nurse expect the provider to order for this patient? a. Digoxin (Lanoxin) b. Furosemide (Lasix) c. Hydrochlorothiazide (HydroDIURIL) d. Spironolactone (Aldactone)

ANS: B Furosemide is a loop diuretic and is given when the patient's condition warrants immediate removal of body fluid, as in heart failure. Digoxin improves cardiac function but does not remove fluid quickly. The other diuretics may be used when immediate fluid removal is not necessary.

The nurse is preparing to administer the first dose of hydrochlorothiazide (HydroDIURIL) 50 mg to a patient who has a blood pressure of 160/95 mm Hg. The nurse notes that the patient had a urine output of 200 mL in the past 12 hours. The nurse will perform which action? a. Administer the medication as ordered. b. Encourage the patient to drink more fluids. c. Hold the medication and request an order for serum BUN and creatinine. d. Request an order for serum electrolytes and administer the medication.

ANS: C Thiazide diuretics are contraindicated in renal failure. This patient has oliguria and should be evaluated for renal failure prior to administration of the diuretic—especially in the absence of known renal failure for this patient. Drinking more fluids will not increase urine output in patients with renal failure.

The nurse is caring for a patient who is to begin receiving a thiazide diuretic to treat heart failure. When performing a health history on this patient, the nurse will be concerned about a history of which condition? a. Asthma b. Glaucoma c. Gout d. Hypertension

ANS: C Thiazides block uric acid secretion and elevated levels can contribute to gout. Patients with a history of gout should take thiazide diuretics with caution; they may need behavioral and/or pharmacologic changes to their gout treatment.

The nurse is preparing to administer doses of hydrochlorothiazide (HydroDIURIL) and digoxin (Lanoxin) to a patient who has heart failure. The patient reports having blurred vision. The nurse notes a heart rate of 60 beats per minute and a blood pressure of 140/78 mm Hg. Which action will the nurse take? a. Administer the medications and request an order for serum electrolytes. b. Give both medications and evaluate serum blood glucose frequently. c. Hold the digoxin and notify the provider. d. Hold the hydrochlorothiazide and notify the provider.

ANS: C When thiazide diuretics are taken with digoxin, patients are at risk of digoxin toxicity because thiazides can cause hypokalemia. The patient has bradycardia and blurred vision, which are both signs of digoxin toxicity. The nurse should hold the digoxin and notify the provider. Serum electrolytes may be ordered, but the digoxin should not be given.

The nurse is caring for a patient who is receiving furosemide (Lasix) and an aminoglycoside antibiotic. The nurse will be most concerned if the patient reports which symptom? a. Dizziness b. Dysuria c. Nausea d. Tinnitus

ANS: D The interaction of furosemide and an aminoglycoside can produce ototoxicity in the patient. Tinnitus is a sign of ototoxicity. Dizziness can occur as a result of diuretic therapy but not necessarily as a result of this combination. Dysuria and nausea are not common signs of these drugs interacting.

The client is being treated with heparin and also with nitroglycerin. The nurse anticipates that the interaction of the two drugs will produce which effect? a. Inadequate effect from the nitroglycerin b. Decreased effect from the heparin c. Toxic dose of the nitroglycerin d. Increased effect from the heparin

B

The client is ordered to receive Mucomyst after an overdose of acetaminophen. The nurse recognizes that the most effective time for the client to receive the drug is _____ hours after the overdose. a. 8 to 12 b. 12 to 24 c. 24 to 36 d. 36 to 48

B

A patient asks the nurse why nitroglycerin is given sublingually. The nurse will explain that nitroglycerin is administered by this route for which reason? a. To avoid hypotension b. To increase absorption c. To minimize gastrointestinal upset d. To prevent hepatotoxicity

B

A client has had a sinus infection for 1 week. She was seen in the clinic 4 days ago and was instructed to take over-the-counter decongestants and antipyretics. She returns to the clinic with continued symptoms and green nasal mucus. The nurse anticipates that which medication will be ordered? a. Narcotic b. Antibiotic c. Antiviral agent d. Antifungal agent

B

A client is being treated with warfarin (Coumadin). The highest priority nursing intervention before administration of the medication is to check the: a. PTT and APTT. b. PT and INR. c. most current CBC. d. most current platelet count.

B

A client is demonstrating signs and symptoms of digoxin toxicity. The nurse anticipates that the client will be treated with: a. vitamin K. b. digoxin immune Fab (Digibind). c. inamrinone lactate (Inocor). d. naloxone (Narcan).

B

A client is ordered to receive metaproterenol (Alupent) for asthma by inhaler, rather than orally. The nurse recognizes that when the medication is given by inhaler rather than orally: a. the inhaled dose is higher than the oral dose. b. the onset of the inhaled dose is faster than that of the oral dose. c. there are more side effects with the inhaled dose. d. the oral dose has a shorter half-life.

B

A client is ordered to receive propranolol (Inderal). The nurse notes that the client has a history of asthma. The nurse calls the ordering physician with the knowledge that propranolol may cause: a. no change in airway. b. bronchial constriction. c. bronchial dilation. d. bronchial enlargement.

B

A client is to receive a heparin injection. The highest priority nursing intervention before administration of the medication is to check the: a. PT and INR. b. PTT and APTT. c. CBC. d. platelet count.

B

A client was prescribed a transdermal nitroglycerin patch, 5 mg/24 hr. What is an important point of instruction for the client? a. Leave the old patch on when applying the new patch. b. Change to a new site when applying the new nitroglycerin patch. c. Apply the nitroglycerin patch only to the chest area. d. The patch medication area may be touched while applying it.

B

A client was stung by a bee. This is the third bee sting the client has received, and the client complains of shortness of breath. What is the adrenergic drug used in emergencies to combat a life-threatening allergic reaction? a. Norepinephrine (Levophed) b. Epinephrine (Adrenalin) c. Terbutaline (Brethine) d. Propranolol (Inderal)

B

A patient has been receiving intravenous heparin. When laboratory tests are drawn, the nurse has difficulty stopping bleeding at the puncture site. The patient has bloody stools and is reporting abdominal pain.The nurse notes elevated partial thromboplastin time (PTT) and activated partial thromboplastin time (aPTT). Which action will the nurse perform? a. Ask for an order for oral warfarin (Coumadin). b. Obtain an order for protamine sulfate. c. Request an order for vitamin K. d. Suggest that the patient receive subcutaneous heparin.

B

A patient has been taking atorvastatin (Lipitor) for several months to treat hyperlipidemia. The patient reports muscle weakness and tenderness. The nurse will counsel the patient to a. ask the provider about switching to simvastatin. b. contact the provider to report these symptoms. c. start taking ibuprofen to combat these effects. d. stop taking the medication immediately.

B

A patient who has a nonproductive cough will begin taking guaifenesin to help with secretions. When teaching this patient about the medication, the nurse will provide which instruction? a. "Avoid driving or using heavy machinery." b. "Drink extra water while taking the medication." c. "Monitor urine output closely." d. "Take with an oral antihistamine for better effects."

B

A patient who has asthma is diagnosed with hypertension. The nurse understands that which drug will be safe to give this patient? a. Pindolol (Visken) b. Metoprolol (Lopressor) c. Nadolol (Corgard) d. Propranolol (Inderal)

B

A patient with chronic obstructive pulmonary disease (COPD) has increasing dyspnea and is being evaluated for heart failure (HF). Which test will be ordered to help differentiate between dyspnea due to lung dysfunction and dyspnea due to HF? a. Atrial natriuretic hormone (ANH) level b. Brain natriuretic peptide (BNP) level c. Cardiac enzymes d. Electrocardiogram (ECG)

B

In planning care for a client receiving heparin, the nurse is aware that the dose is administered subcutaneously. What is the reason for using this route? a. Heparin is absorbed readily by the gastrointestinal mucosa and protected by the liver. b. Heparin is poorly absorbed by the gastrointestinal mucosa and destroyed by liver enzymes. c. The effective absorption of heparin can be hampered by food. d. The effective absorption of heparin is hampered by the stomach's inadequate blood flow.

B

Nifedipine (Procardia), the most potent calcium blocker, promotes vasodilation of the coronary and peripheral vessels. While the client is taking the drug, the nurse's highest priority intervention is to monitor for: a. elevated blood pressure. b. decreased blood pressure. c. pulse rate less than 70 beats/minute. d. pulse rate greater than 120 beats/minute.

B

The actions of the mixed-acting sympathomimetics are _____ the adrenergic receptor sites and _____ the release of norepinephrine. a. stimulating; inhibiting b. stimulating; stimulating c. inhibiting; inhibiting d. inhibiting; stimulating

B

The client comes to a health clinic asking for Sudafed. He tells the nurse that he has a history of diabetes mellitus. What is the most accurate response from the nurse? a. "Sudafed is a safe drug to give to a client who is a diabetic." b. "Sudafed should not be used by a client who is a diabetic." c. "You can use Sudafed, but you must monitor your blood sugar very closely." d. "You can use Sudafed, but you will probably experience hypoglycemia."

B

The client has been ordered to be treated with Losartan potassium. What effect should the nurse expect to see in the client's laboratory values? a. Decreased liver enzymes b. Increased BUN and creatinine c. Decreased serum glucose d. Increased calcium

B

The client has been ordered to be treated with Sectral. The nurse anticipates that the client will experience an increase in which laboratory value? a. Calcium b. Potassium c. Magnesium d. Glucose

B

The client has been ordered treatment with minoxidil (Loniten) to control her hypertension. In designing a client teaching session, the nurse anticipates that the primary health provider will likely order which drug to increase the effectiveness of the minoxidil (Loniten)? a. Cardiac glycosides b. Diuretics c. Glucocorticoids d. Antihistamines

B

The client has been started on a treatment regimen that includes albuterol. The nurse should anticipate seeing a decrease in the client's serum _____ level. a. calcium b. potassium c. magnesium d. glucose

B

The client has been started on an oral dosage of aminophylline. The nurse recognizes that the dosage of this medication is prepared based on the client's: a. remaining medication regimen. b. body weight in kilograms. c. breathing pattern and lung capacity. d. current pulmonary function test.

B

The client has symptoms of the common cold and is to be treated with a decongestant nasal spray. What is the nurse's highest priority instruction to the client? a. Use as many puffs as needed as often as necessary for up to 10 days. b. Use one to two puffs four to six times daily for up to 5 to 7 days. c. Use no more than one puff three times daily for up to 7 days. d. Use two puffs two times daily for no longer than 3 days.

B

The client is a Native American who has been diagnosed as having hypertensive disease. In conferring with the primary health provider, the nurse recognizes that which antihypertensive medication would not be effective with this client? a. Furosemide (Lasix) b. Metoprolol (Apo-Metoprolol, Toprol SR) c. Minoxidil (Loniten, Rogaine) d. Prazosin (Minipress)

B

The client is being ordered Robitussin DM. He complains of experiencing dizziness. What is the highest priority nursing intervention? a. Call the physician; this is indicative of an anaphylactic reaction to the medication. b. Call the physician; this is an expected side effect of the medication. c. Call the pharmacist; this is evidence that the drug was prepared incorrectly. d. Call the pharmacist; this is evidence that this is not the correct drug.

B

The client is being treated with Alupent. The nurse anticipates the client will experience what type of change in his laboratory values? a. Hypoglycemia b. Decreased serum potassium c. Increased calcium d. Decreased serum magnesium

B

A nurse is teaching a client about the side effects and adverse reactions of theophylline (Theo-Dur). The side effects include: a. headache and an aura. b. hypertension and flushing. c. tachycardia and palpitations. d. diarrhea and dehydration.

C

The nurse administers bethanechol (Urecholine) to a patient to treat urinary retention. After 30 minutes, the patient voids 800 mL of urine and reports having a loose stool but no cramping or gastrointestinal pain. The patient's blood pressure is 110/70 mm Hg. The nurse will perform which action? a. Notify the provider of bethanechol adverse effects. b. Record the urine output and the blood pressure and continue to monitor. c. Request an order for intravenous atropine sulfate. d. Suggest another dose of bethanechol to the provider.

B

The nurse administers subcutaneous epinephrine to a patient who is experiencing an anaphylactic reaction. The nurse should expect to monitor the patient for which symptom? a. Bradycardia b. Decreased urine output c. Hypotension d. Nausea and vomiting

B

The nurse assesses a client for side effects of lovastatin (Mevacor). Which symptom would be least likely to be associated with Mevacor? a. Headache b. Tachycardia c. Gastrointestinal (GI) disturbances d. Dizziness

B

The nurse is caring for a patient who experiences a rapid rise in blood pressure. The nurse will contact the provider to discuss administering which medication? a. Amlodipine (Norvasc) b. Nifedipine (Procardia) c. Nifedipine extended release (Procardia XL) d. Verapamil (Calan)

B

The nurse is caring for a patient who is hospitalized for an asthma exacerbation. The patient reports taking diphenhydramine at home at night to help with symptoms of allergic rhinitis and cough. The nurse will contact the patient's provider to request an order for which medication? a. Benzonatate (Tessalon Perles) b. Cetirizine (Zyrtec) c. Dextromethorphan hydrobromide (Benylin DM) d. Diphenhydramine (Benadryl)

B

The nurse is caring for a patient who is receiving clopidogrel (Plavix). The patient calls the nurse to report flulike symptoms. The nurse notes a heart rate of 76 beats per minute, a blood pressure of 110/76 mm Hg, and a respiratory rate of 20 breaths per minute. The nurse suspects that the patient is experiencing which condition? a. Anaphylaxis b. An expected drug side effect c. Hemorrhage d. Possible myocardial infarction

B

The nurse is caring for a patient who is receiving diphenhydramine. The nurse notes that the patient has not voided for 12 hours. What action will the nurse take? a. Encourage the patient to drink more fluids. b. Evaluate the bladder to check for distension. c. Request an order for an intravenous fluid bolus. d. Request an order for urinary catheterization.

B

The nurse is caring for a patient who is receiving intravenous theophylline. The patient complains of headache and nausea. The nurse will contact the provider to a. change the medication to an oral theophylline. b. obtain an order for a serum theophylline level. c. request an order for an analgesic medication. d. suggest an alternative methylxanthine medication.

B

The nurse is caring for a patient who will begin taking atenolol (Tenormin). What information will the nurse include when teaching the patient about taking this medication? a. The drug must be taken twice daily. b. The patient must rise slowly from a chair or bed. c. The medication is safe to take during pregnancy. d. Use NSAIDs as needed for mild to moderate pain.

B

The nurse is caring for a patient who will begin taking captopril (Capoten) for hypertension. The nurse reviews the patient's laboratory test results and notes increased BUN and creatinine. Which action will the nurse take? a. Administer the captopril and monitor vital signs. b. Contact the provider to discuss changing to fosinopril (Monopril). c. Obtain an order for intravenous fluids to improve urine output. d. Request an order to add hydrochlorothiazide (HydroDIURIL).

B

The nurse is caring for a patient who will begin taking theophylline at home. During the assessment, the nurse learns that the patient smokes. The nurse reports this to the provider and will expect the provider to a. decrease the dose of theophylline. b. increase the dose of theophylline. c. keep the theophylline dose as ordered. d. discontinue the theophylline.

B

The nurse is caring for a postoperative patient who is receiving alteplase tPA (Activase) after developing a blood clot. The nurse notes a heart rate of 110 beats per minute and a blood pressure of 90/60 mm Hg. The nurse will perform which action? a. Ask the patient about itching or shortness of breath. b. Assess the surgical dressing for bleeding. c. Evaluate the patient's urine output and fluid intake. d. Recheck the patient's vital signs in 15 minutes.

B

The nurse is designing a client teaching session for a hypertensive client who has just been placed on antihypertensive medication. He tells the nurse that he typically drinks two glasses of wine each night. The best reply by the nurse is "Alcohol should not be taken with antihypertensives because the combination may: a. increase the hypertensive state." b. increase the hypotensive state." c. lead to renal failure." d. lead to a toxic level of the medication."

B

The nurse is performing an admission assessment on a patient who has recently begun taking reserpine. The patient reports using St. John's wort. The nurse anticipates that the patient will have a. hypotension. b. hypertension. c. bradycardia. d. tachycardia.

B

The nurse is performing an assessment on a patient who will begin taking propranolol (Inderal) to treat hypertension. The nurse learns that the patient has a history of asthma and diabetes. The nurse will take which action? a. Administer the medication and monitor the patient's serum glucose. b. Contact the provider to discuss another type antihypertensive medication. c. Request an order for renal function tests prior to administering this drug. d. Teach the patient about the risks of combining herbal medications with this drug.

B

The nurse is preparing to administer an angiotensin-converting enzyme (ACE) inhibitor to a patient who has hypertension. The nurse notes peripheral edema and swelling of the patient's lips. The patient has a blood pressure of 160/80 mm Hg and a heart rate of 76 beats per minute. What is the nurse's next action? a. Administer the dose and observe carefully for hypotension. b. Hold the dose and notify the provider of a hypersensitivity reaction. c. Notify the provider and request an order for a diuretic medication. d. Request an order for serum electrolytes and renal function tests.

B

The nurse is preparing to administer benztropine (Cogentin) to a patient who has Parkinson's disease. When performing an assessment, which aspect of the patient's history would cause the nurse to hold the medication and notify the provider? a. Asthma b. Glaucoma c. Irritable bowel syndrome d. Motion sickness

B

The nurse is preparing to administer digoxin to a patient who has a serum digoxin level of 2.5 ng/mL. The patient takes 0.25 mg of digoxin per day. What action will the nurse take? a. Administer the next dose as ordered. b. Notify the provider of digoxin toxicity. c. Request an order to decrease the digoxin dose. d. Suggest that the patient may need an increased digoxin dose.

B

The nurse is preparing to administer digoxin to a patient who has heart failure. The patient reports nausea, vomiting, and a headache. The nurse notes a respiratory rate of 18 breaths per minute, a heart rate of 58 beats per minute, and a blood pressure of 120/78 mm Hg. What will the nurse do next? a. Administer the next dose as ordered since these are mild side effects. b. Hold the dose and notify the provider of possible digoxin toxicity. c. Reassure the patient that these are common, self-limiting side effects. d. Request an order for an antiemetic and an analgesic medication.

B

The nurse is preparing to care for a Native-American patient who has hypertension. The nurse understands that which antihypertensive medication would be most effective in this patient? a. Acebutolol (Sectral) b. Captopril (Capoten) c. Carteolol HCl (Cartrol) d. Metoprolol (Lopressor)

B

The nurse is providing teaching for a patient who will use intranasal dexamethasone (Decadron) after discharge home from the hospital. What information is important to include when teaching this patient about this drug? a. "Dexamethasone may be used for year-round symptoms." b. "Dexamethasone should be discontinued after 30 days." c. "Dexamethasone should not be taken with antihistamines." d. "Dexamethasone should not cause systemic steroid side effects."

B

The parents of a 3-year-old child tell the nurse that they are planning to give their child diphenhydramine (Benadryl) on a flight to visit the child's grandparents to help the child sleep during the flight. What will the nurse tell the parents about giving this drug? a. Administer 25 mg of diphenhydramine when using to induce sleep. b. Diphenhydramine may have the opposite effect and could cause agitation. c. Give the diphenhydramine about 5 minutes prior to takeoff. d. Loratadine should be used instead of diphenhydramine to minimize side effects.

B

Which symptom would be highest priority for the nurse to monitor while the client is being treated with peripheral vasodilators? a. Bradycardia b. Dizziness c. Headache d. Pallor

B

Which symptom would cause the nurse to suspect that the client is experiencing digitalis toxicity? a. Abdominal cramping b. Bradycardia c. Polyuria d. Hearing disturbances

B

A new nurse is listing the interventions he should employ when caring for a client on thrombolytic therapy. Which nursing intervention is inappropriate for the client during thrombolytic therapy? a. Monitor vital signs and reporting changes. b. Check for active bleeding for 24 hours after therapy. c. Inform the client that aspirin and NSAIDs may be taken for discomfort. d. Monitor electrocardiogram strips for cardiac dysrhythmias.

C

A nurse is monitoring a client after the client has received pentoxifylline (Trental) for treatment of intermittent claudication. Which effect indicates a positive response to the medication? a. Increased claudication b. Bradycardia c. Decrease in pain d. Orthostatic hypotension

C

A client diagnosed with hyperlipidemia has been prescribed cholestyramine (Questran). Which of the following instructions will the nurse include in the client's teaching plan? a. Mix powder sparingly with fluid. b. Eat a low-fiber diet. c. Mix powder well with fluid. d. Take an antidiarrheal agent if diarrhea occurs.

C

A client experiences premature ventricular contractions. The nurse prepares to administer lidocaine (Xylocaine), with the knowledge that it is administered intravenously to correct: a. bradycardia. b. atrial dysrhythmias. c. ventricular dysrhythmias. d. heart block.

C

A client experiencing shortness of breath associated with asthma is given epinephrine (Adrenalin). This medication is considered a nonselective adrenergic drug because it innervates ________ receptor sites. a. alpha-adrenergic b. beta-adrenergic c. alpha-, beta1-, and beta2-adrenergic d. beta1- and beta2-adrenergic

C

A client who uses an inhaler is taught strategies to prevent Candida infections. Which instruction would the nurse include in the teaching? a. Soak the spacer in alcohol between uses. b. Do not use a spacer. c. Rinse the mouth with water after each use. d. Use fluconazole (Diflucan) prophylactically.

C

A nurse is preparing to administer nitroglycerin (NTG) via the sublingual route. The nurse knows that nitroglycerin tablets are administered sublingually to: a. avoid the bitter taste. b. prevent nausea and vomiting. c. absorb readily into the circulation. d. undergo first-pass metabolism.

C

A nurse is teaching a client about the treatment of hyperlipidemia and use of statin drugs. What do the instructions include? a. "This treatment is only temporary." b. "Diet and exercise are secondary to treatment." c. "Annual eye examinations are recommended." d. "Diarrhea is a common side effect."

C

A patient has a blood pressure of 155/95 mm Hg. The nurse understands that this patient's risk of cardiovascular disease is _____ greater than normal. a. two times b. three times c. four times d. six times

C

A patient has begun taking spironolactone (Aldactone) in addition to a thiazide diuretic. With the addition of the spironolactone, the nurse will counsel this patient to a. continue taking a potassium supplement daily. b. recognize that abdominal cramping is a transient side effect. c. report decreased urine output to the provider. d. take these medications at bedtime.

C

A patient is admitted to the hospital after developing pneumonia. During the admission assessment, the patient reports having used a nasal decongestant spray for the past few weeks but thinks the nasal congestion is getting worse. The nurse will a. request an order for a systemic decongestant medication. b. request an order so the patient can continue to use the decongestant spray. c. tell the patient the congestion will clear up after stopping the spray. d. tell the patient to increase oral fluid intake.

C

A patient who has recently begun taking captopril (Capoten) to treat hypertension calls a clinic to report a persistent cough. The nurse will perform which action? a. Instruct the patient to go to an emergency department because this is a hypersensitivity reaction. b. Reassure the patient that this side effect is nothing to worry about and will diminish over time. c. Schedule an appointment with the provider to discuss changing to an angiotensin II receptor blocker (ARB). d. Tell the patient to stop taking the drug immediately since this is a serious side effect of this drug.

C

A patient who has seasonal allergies with a runny nose during the daytime reports increasing nighttime symptoms of coughing and sneezing that are interfering with sleep. The provider recommends diphenhydramine (Benadryl) at bedtime. What information will the nurse include when teaching the patient about this medication? a. "Avoid fluids at bedtime to prevent urinary retention." b. "This will help clear your daytime symptoms, too." c. "You should be able to sleep better when you take this medication." d. "You should take this medication on an empty stomach."

C

A patient who is taking warfarin has an international normalized ratio (INR) of 5.5. The nurse will anticipate giving a. fresh frozen plasma. b. intravenous iron. c. oral vitamin K. d. protamine sulfate.

C

A patient will begin taking simvastatin (Zocor) to decrease serum cholesterol. When teaching the patient about this medication, the nurse will counsel the patient to take which action? a. Return to the clinic annually for laboratory testing. b. Take care when rising from a sitting to standing position. c. Take the medication in the evening for best effect. d. Use ibuprofen as needed for muscle aches and pain.

C

A provider has prescribed ipratropium bromide/albuterol sulfate (Combivent) for a patient who has chronic obstructive pulmonary disease (COPD). The nurse explains that this combination product is prescribed primarily for which reason? a. To be more convenient for patients who require both medications b. To improve compliance in patients who may forget to take both drugs c. To increase forced expiratory volume, an indicator of symptom improvement d. To minimize the side effects that would occur if the drugs are given separately

C

The client has been ordered to be treated with Minipress. She complains to the nurse of experiencing rapid heart rate. The highest priority nursing intervention is to call the physician because a rapid heart rate: a. is an expected side effect of the medication. b. is evidence of an anaphylactic reaction. c. is evidence of an adverse reaction to the medication. d. shows that the medication was mixed incorrectly.

C

The client has been ordered treatment with warfarin. She tells the nurse that she self-medicates with herbal remedies as much as possible. The highest priority teaching point that the nurse should give the client is the avoid the use of _____ while taking warfarin. a. ephedra and dill b. black cohosh and licorice c. garlic and ginkgo d. ginseng and green tea

C

The client has been taking Robitussin DM in the home setting. The nurse suspects that she is taking an excessive amount of the medication when she complains of: a. nausea. b. drowsiness. c. hallucinations. d. bloody sputum.

C

The client is being treated with Alupent. The client is also being treated with a beta-blocker drug. The nurse anticipates that the interaction of the two drugs will result in: a. increased action of the Alupent. b. toxicity of the beta blocker. c. decreased action of the Alupent. d. anaphylactic reaction to the beta blocker.

C

The client is being treated with Lanoxin and is also self-medicating with antacids. The nurse expects the combination of these medications to result in _____ digoxin. a. anaphylactic reaction to the b. increased absorption of c. decreased absorption of d. toxicity of the

C

The client is being treated with Lanoxin. He is also being treated with quinidine. The nurse anticipates that the combination of the two drugs will result in a(n) _____ level. a. increased quinidine b. decreased digoxin c. increased digoxin d. decreased quinidine

C

The client is being treated with Plavix. He complains to the nurse of experiencing chest pain. The highest priority nursing intervention is to call the physician because the client is experiencing a(n): a. adverse reaction to the medication. b. myocardial infarction. c. expected side effect of the medication. d. anaphylactic reaction to the medication.

C

The client is being treated with digoxin. She tells the nurse that she frequently self-medicates her depression with St. John's wort. What is the nurse's highest priority instruction to the client? a. Take the St. John's wort; it will have no effect on the digoxin. b. Do not take St. John's wort; it will cause a toxic reaction to the digoxin. c. Do not take St. John's wort; it decreases the effectiveness of the digoxin. d. Take the St. John's wort; it will enhance the effect of the digoxin.

C

The client is being treated with metoprolol as well as digitalis. The nurse anticipates the interaction of these two drugs will result in an increased incidence of: a. tachycardia. b. heart block. c. bradycardia. d. cardiac pauses.

C

The client is being treated with sodium nitroprusside (Nipride, Nitropress). The nurse notes that the medication is tinted red. What is the highest priority nursing intervention in response to this observation? a. Administer the medication as ordered. b. Call the pharmacist since the medication should be tinted blue. c. Discard the medication; it should not be tinted red. d. Call the physician since this indicates that the dosage is wrong.

C

The client is experiencing cold symptoms. The nurse anticipates that the client will be ordered: a. antivirals. b. antifungals. c. antitussives. d. antibiotics.

C

The client is taking Flonase in the home setting. Once the client's symptoms have subsided; the nurse's highest priority instruction to the client should be to reduce the spray to: a. three times daily. b. two times daily. c. once daily. d. once every other day.

C

The client is taking fenofibrate (Tricor). The highest priority nursing intervention with this medication is to monitor serum: a. potassium. b. glucose. c. creatinine. d. sodium.

C

The level of risk for coronary artery disease for a client with a serum cholesterol level of 270 mg/dl is _____ risk. a. low b. moderate c. high d. no

C

The nurse instructs a client taking digoxin (Lanoxin) for treatment of congestive heart failure (CHF) to eat: a. cabbage. b. lima beans. c. potatoes. d. yogurt.

C

The nurse is assessing a patient prior to administering thrombolytic therapy. Which is an important assessment for this patient? a. Determining whether the patient has a history of diabetes b. Finding out about a history of renal disease c. Assessing which medications are taken for discomfort d. Assessing whether the patient eats green, leafy vegetables

C

The nurse is caring for a patient in the post-anesthesia recovery unit. The nurse notes that the patient received atropine sulfate 2 mg 30 minutes prior to anesthesia induction. The patient has received 1,000 mL of intravenous fluids and has 700 mL of urine in the urinary catheter bag. The patient reports having a dry mouth. The nurse notes a heart rate of 82 beats per minute. What action will the nurse perform? a. Administer a fluid bolus. b. Give the patient ice chips. c. Palpate the patient's bladder. d. Reassess the patient in 15 minutes.

C

The nurse is caring for a patient who has recently begun taking atenolol (Tenormin) to treat hypertension. The patient reports dizziness, nausea, vomiting, and decreased libido since beginning the medication. What will the nurse do? a. Hold the next dose until the provider can be notified of these side effects. b. Reassure the patient that these symptoms are common and not worrisome. c. Recommend that the patient discuss these effects with the provider. d. Suggest that the patient request a different beta-adrenergic blocker.

C

The nurse is caring for a patient who is taking digoxin to treat heart failure. The patient's electrocardiogram shows a ventricular dysrhythmia. The nurse will notify the provider and will anticipate an order for which medication? a. Digoxin immune Fab (Digibind) b. Furosemide (Lasix) c. Phenytoin (Dilantin) d. Potassium

C

The nurse is caring for an 80-year-old patient who has just begun taking a thiazide diuretic to treat hypertension. What is an important aspect of care for this patient? a. Encouraging increased fluid intake b. Increasing activity and exercise c. Initiating a fall risk protocol d. Providing a low potassium diet

C

The nurse is performing a medication history on a patient who reports long-term use of montelukast (Singulair) and an albuterol metered-dose inhaler (Proventil). The nurse will contact the provider to discuss an order for which laboratory tests? a. Cardiac enzymes and serum calcium b. Electrolytes and a complete blood count c. Liver function tests and serum glucose d. Urinalysis and serum magnesium

C

The nurse is preparing to administer a drug and learns that it is an indirect-acting cholinergic agonist. The nurse understands that this drug a. acts on muscarinic receptors. b. acts on nicotinic receptors. c. inhibits cholinesterase. d. inhibits cholinergic receptors.

C

The nurse is teaching a patient about the use of a transdermal nitroglycerin patch. Which statement by the patient indicates understanding of the teaching? a. "I will apply the patch as needed when I experience anginal pain." b. "I will remove the old patch and replace it with a new one at bedtime each day." c. "I should rotate sites when changing the patch to prevent skin irritation." d. "When I am symptom-free, I may stop using the patch on a regular basis."

C

The nurse is teaching a patient who is going on a cruise about the use of transdermal scopolamine . What information will the nurse include when teaching this patient? a. "Apply the patch as needed for nausea and vomiting." b. "Apply the patch to your upper arm." c. "Change the patch every 3 days." d. "Restrict fluids while using this patch."

C

The nurse is teaching a patient who will begin taking furosemide. The nurse learns that the patient has just begun a 2-week course of a steroid medication. What will the nurse recommend? a. Consume licorice to prevent excess potassium loss. b. Report a urine output greater than 600 mL/24 hours. c. Obtain an order for a potassium supplement. d. Take the furosemide at bedtime.

C

The nurse is teaching a patient who will begin taking oral theophylline (Theo-Dur) when discharged home from the hospital. What information will the nurse include when teaching the patient about this drug? a. An extra dose should be taken when symptoms worsen. b. Anorexia and gastrointestinal upset are unexpected side effects. c. Avoid caffeine while taking this medication. d. Food will decrease the amount of drug absorbed.

C

The nurse provides teaching to a patient who will begin taking simvastatin (Zocor) to treat hyperlipidemia. Which statement by the patient indicates understanding of the teaching? a. "I may have diarrhea as a result of taking this medication." b. "I may stop taking this medication when my lipid levels are normal." c. "I will need an annual eye examination while taking this medication." d. "I will increase my intake of vitamins A, D, and E while taking this medication.

C

The nurse understands that a medication such as carvedilol (Coreg) may not be effective in an African-American patient because of its effects on a. cardiac contractility. b. heart rate. c. renin release. d. vascular resistance.

C

The patient who has nasal congestion asks the nurse to recommend a decongestant medication. The nurse performs a medication history and learns that the patient takes a beta blocker to treat hypertension. Which over-the-counter product will the nurse recommend? a. Diphenhydramine (Benadryl) b. Ephedrine HCl (Pretz-D) c. Phenylephrine nasal (NeoSynephrine Nasal) d. Loratadine (Claritin)

C

Which cholinesterase inhibitor would be prescribed for a patient who has Alzheimer's disease? a. Ambenonium chloride (Myletase) b. Benztropine (Cogentin) c. Donepezil HCl (Aricept) d. Neostigmine methylsulfate (Prostigmin)

C

Which laboratory test would be highest priority for the nurse to monitor while a client receives treatment with the statin medications? a. CBC b. Electrolytes c. Liver enzymes d. Urinalysis

C

Which statement made by a client receiving (warfarin) Coumadin therapy indicates a need for further teaching? a. "I shouldn't take aspirin while I'm on Coumadin." b. "I will use a toothbrush with soft bristles." c. "I will eat large quantities of green leafy vegetables." d. "I will use an electric razor to avoid shaving cuts."

C

A client is ordered to receive a nitrate to relieve stable angina. What is(are) a common side effect(s) to anticipate in a client receiving this medication? a. Nausea and vomiting b. Increased blood pressure c. Pruritus and skin rash d. Pounding headache

D

A client is ordered to take inamrinone lactate (Inocor) for treatment of acute heart failure. The nurse anticipates that this drug will be administered intravenously for no longer than _____ hours. a. 12 b. 24 c. 36 d. 72

D

A client is to receive simvastatin (Zocor) to reduce serum cholesterol levels. The nurse recommends to the client that the best time to take this medication is: a. before breakfast. b. during meals. c. in the mid-afternoon. d. in the evening.

D

A client receiving clopidogrel (Plavix) has the following conditions as part of the health history. Which causes the greatest concern to the nurse? a. Asthma b. Glaucoma c. Allergy to shellfish d. Active peptic ulcer

D

A female patient has serum lipid levels performed, which reveal a total cholesterol of 285 mg/dL, triglycerides of 188 mg/dL, a low-density lipoprotein (LDL) of 175 mg/dL, and a high-density lipoprotein (HDL) of 40 mg/dL. The patient's blood pressure is 138/72 mm Hg. The nurse may expect the provider to order which medication for this patient? a. Amlodipine and atorvastatin (Caduet) b. Colestipol HCl (Colestid) c. Fenofibrate (TriCor) d. Niacin and lovastatin (Advicor)

D

A nurse is caring for a client with congestive heart failure. The client is ordered to receive nesiritide (Natrecor). The nurse evaluates the effectiveness of this medication by noting which desired effect? a. Vasoconstriction b. Oliguria c. Decreased diuresis d. Decreased shortness of breath

D

A nurse is providing health teaching for clients taking antihypertensives. The highest priority teaching point regarding discontinuation of the drug is that abrupt discontinuation of the drug may result in: a. drowsiness. b. nasal stuffiness. c. rebound hypotension. d. rebound hypertension.

D

A patient arrives in the emergency department after developing a rash, runny nose, and sneezing after eating strawberries. What action will the nurse expect to take first? a. Administer diphenhydramine. b. Administer epinephrine. c. Assess for urinary retention. d. Assess heart rate, respiratory rate, and lung sounds.

D

A patient asks the nurse about using dextromethorphan for cough. What information will the nurse include when teaching this patient about this drug? a. "It does not cause sedation except at high doses." b. "It may be used to treat cough for up to 2 weeks." c. "It is non-narcotic, and it is OK to consume alcohol while taking this drug." d. "It should not be taken by patients who have chronic obstructive pulmonary disease (COPD)."

D

A patient has a blood pressure of 135/85 mm Hg on three separate occasions. The nurse understands that this patient should be treated with a. a beta blocker. b. a diuretic and a beta blocker. c. a diuretic. d. lifestyle changes.

D

A patient is admitted to the hospital, and the provider orders gemfibrozil (Lopid) 600 mg twice daily, 30 minutes prior to meals. The nurse learns that the patient takes warfarin (Coumadin) once daily. The nurse will contact the provider to discuss a. decreasing the dose of gemfibrozil. b. giving the warfarin at noon. c. increasing the dose of warfarin. d. ordering frequent INR levels.

D

A patient is diagnosed with heart failure, and the prescriber has ordered digoxin. The patient asks what lifestyle changes will help in the management of this condition. The nurse will recommend which changes? a. Aerobic exercise and weight lifting 2 or 3 times weekly b. Changing from cigarette smoking to pipe smoking c. Consuming 2 teaspoons or less of salt every day d. Having no more than one alcoholic beverage per day

D

A patient is ordered to receive a nitrate to relieve stable angina. What side effect(s) will the nurse anticipate in a patient receiving this medication? a. Nausea and vomiting b. Increased blood pressure c. Pruritus and skin rash d. Pounding headache

D

A patient who has Parkinson's disease will begin treatment with benztropine (Cogentin). Which symptom of Parkinson's disease would be a contraindication for this drug? a. Drooling b. Muscle rigidity c. Muscle weakness d. Tardive dyskinesia

D

A patient who has Raynaud's disease will begin taking an alpha-adrenergic blocker. The patient asks the nurse how the drug works to treat symptoms. The nurse explains that alpha-adrenergic blockers treat Raynaud's disease by causing a. decreased peripheral vascular resistance. b. orthostatic hypotension. c. reflex tachycardia. d. vasodilation.

D

A patient who has Wolff-Parkinson-White syndrome is given intravenous adenosine (Adenocard). The nurse will explain that the medication is effective because it a. controls atrial flutter. b. deepens myocardial excitability. c. prevents multifocal ventricular contractions. d. prolongs repolarization.

D

A patient who has atrial fibrillation is taking digoxin. The nurse expects which medication to be given concurrently to treat this condition? a. Hydrochlorothiazide (HydroDIURIL) b. Inamrinone (Inocor) c. Milrinone (Primacore) d. Warfarin (Coumadin)

D

A patient who has been taking nitroglycerin for angina has developed variant angina, and the provider has added verapamil (Calan) to the patient's regimen. The nurse will explain that verapamil is given for which purpose? a. To facilitate oxygen use by the heart b. To improve renal perfusion c. To increase cardiac contractility d. To relax coronary arteries

D

A patient who has begun taking nifedipine (Procardia) to treat variant angina has had a recurrent blood pressure of 90/60 mm Hg or less. The nurse will anticipate that the provider will a. add digoxin to the drug regimen. b. change to a beta blocker. c. order serum liver enzymes. d. switch to diltiazem (Cardizem).

D

A patient who has heart failure receives digoxin (Lanoxin) and an angiotension-converting enzyme (ACE) inhibitor. The patient will begin taking spironolactone (Aldactone). The patient asks why the new drug is necessary. The nurse will tell the patient that spironolactone will be given for which reason? a. To enhance potassium excretion b. To increase cardiac contractility c. To minimize fluid losses d. To provide cardioprotective effects

D

A patient who is taking clopidogrel (Plavix) and aspirin is preparing for orthopedic surgery. The nurse will consult with the surgeon and provide which instruction to the patient? a. Continue taking aspirin and stop taking clopidogrel 2 weeks prior to surgery. b. Continue taking clopidogrel and stop taking aspirin 5 days prior to surgery. c. Continue both medications to prevent thromboembolic events during surgery. d. Stop taking both medications 7 days prior to surgery.

D

A patient who uses an inhaled glucocorticoid medication reports having a sore tongue. The nurse notes white spots on the patient's tongue and oral mucous membranes. After notifying the provider, the nurse will remind the patient to perform which action? a. Avoid using a spacer with the inhaled glucocorticoid medication. b. Clean the inhaler with hot, soapy water after each use. c. Consume yogurt daily while using this medication. d. Rinse the mouth thoroughly with water after each use.

D

A patient who uses transdermal nitroglycerin reports having headaches. The nurse will counsel the patient to perform which action? a. Call 911 when this occurs. b. Notify the provider. c. Reapply the patch three times daily. d. Take acetaminophen as needed.

D

A patient will be discharged home with albuterol (Proventil) to use for asthma symptoms. What information will the nurse include when teaching this patient about this medication? a. Failure to respond to the medication indicates a need for a higher dose. b. Monitor for hypoglycemia symptoms when using this medication. c. Palpitations are common with this drug even at normal, therapeutic doses. d. Overuse of this medication can result in airway narrowing and bronchospasm.

D

Clients taking a theophylline drug must be aware of herbal drug(s) that may cause drug interaction. Which is an herb that can cause cardiac dysrhythmias and theophylline toxicity when taken with theophylline? a. Ginkgo b. Ginseng c. Ginger d. Ephedra

D

The client has been ordered Nasonex. The highest priority instruction that the nurse should give the client is to direct the spray: a. upwards in the nasal passages. b. downwards in the nasal passages. c. towards the nasal septum. d. away from the nasal septum.

D

The client has been ordered to receive a beta-adrenergic blocker. The nurse should anticipate that the client will exhibit: a. increased pulse rate and bronchoconstriction. b. decreased pulse rate and bronchodilation. c. increased pulse rate and bronchodilation. d. decreased pulse rate and bronchoconstriction.

D

The client has been started on a treatment regimen that includes atenolol. She complains to the nurse of experiencing weakness. Which is the best response from the nurse? a. "I will hold your next dose of the medication. You are reaching a toxic level." b. "I will increase your next dose of the medication. Your level is too low." c. "This is an adverse reaction to the medication. I will stop the drug." d. "This is a side effect of the medication. I will notify your physician."

D

The client has been started on a treatment regimen that includes fosinopril (Monopril). The nurse realizes that the client has also been diagnosed with renal insufficiency. What is the most accurate nursing intervention? a. Call the physician; the medication is contraindicated. b. Teach the client that the side effects of the drug will be intensified. c. Call the physician; the dosage will need to be decreased. d. Give the medication as ordered.

D

The client has received an overdose of a thrombolytic drug. The nurse anticipates that he will be treated with: a. naloxone (Narcan). b. protamine sulfate. c. vitamin E. d. aminocaproic acid (Amicar).

D

The client is being treated with Nitro-stat. She is also being treated with heparin. The nurse anticipates that the combination of the two medications will result in a(n) _____ effect of the _____. a. increased; Nitro-stat b. increased; heparin c. decreased; Nitro-stat d. decreased; heparin

D

The client is being treated with warfarin sodium. She complains to the nurse of soreness in her mouth. The highest priority nursing intervention is to call the physician because the client is _____ the medication. a. beginning to hemorrhage from b. developing a clot from c. experiencing an expected side effect of d. experiencing an adverse reaction to

D

The client is scheduled to begin treatment with Isoxsuprine. In preparing the teaching plan for the client, the nurse anticipates that the client will be taking the drug _____ daily. a. once b. 1 to 2 times c. 2 to 3 times d. 3 to 4 times

D

The client tells the nurse that he has been taking Neo-Synephrine for the past month. What is the nurse's highest priority response to the client? a. Neo-Synephrine can be taken indefinitely while it is still effective. b. Neo-Synephrine should not be taken longer than 24 hours. c. Neo-Synephrine can be taken until symptoms decrease. d. Neo-Synephrine should not be taken for longer than 3 to 5 days.

D

The nurse instructs a client to administer montelukast (Singulair): a. in the morning. b. at noon. c. late in the afternoon. d. in the evening.

D

The nurse is caring for a patient who has metabolic alkalosis and is experiencing fluid overload. The provider orders acetazolamide (Diamox). The patient reports right-sided flank pain after taking this medication. The nurse suspects that this patient has developed which condition? a. Gout b. Hemolytic anemia c. Metabolic acidosis d. Renal calculi

D

The nurse is caring for a patient who is receiving intravenous dopamine (Intropin). The nurse notes erythema and swelling at the IV insertion site. What is the nurse's initial action? a. Apply warm soaks to the area. b. Monitor the patient closely for hypertension. c. Obtain an order for an electrocardiogram. d. Notify the provider of a need for phentolamine mesylate (Regitine).

D

The nurse is caring for a patient who is taking hydrochlorothiazide (HydroDIURIL) and digoxin (Lanoxin). Which potential electrolyte imbalance will the nurse monitor for in this patient? a. Hypermagnesemia b. Hypernatremia c. Hypocalcemia d. Hypokalemia

D

The nurse is caring for a postoperative patient. The nurse will anticipate administering which medication to this patient to help prevent thrombus formation caused by slow venous blood flow? a. Alteplase (Activase) b. Aspirin c. Clopidogrel (Plavix) d. Low-molecular-weight heparin

D

The nurse is preparing to administer bethanechol (Urecholine) to a patient who is experiencing urinary retention. The nurse notes that the patient has a blood pressure of 90/60 mm Hg and a heart rate of 98 beats per minute. The nurse will perform which action? a. Administer the drug and monitor urine output. b. Administer the medication and monitor vital signs frequently. c. Give the medication and notify the provider of the increased heart rate. d. Hold the medication and notify the provider of the decreased blood pressure.

D

The nurse is preparing to administer isoproterenol (Isuprel) to a patient who is experiencing an acute bronchospasm. The nurse understands that, because isoproterenol is a nonselective beta-adrenergic agonist, the patient will experience which effects? a. Alpha- and beta-adrenergic agonist effects b. Anticholinergic effects c. A shorter duration of therapeutic effects d. Cardiac and pulmonary effects

D

The nurse is preparing to administer the anticholinergic medication benztropine (Cogentin) to a patient who has Parkinson's disease. The nurse understands that this drug is used primarily for which purpose? a. To decrease drooling and excessive salivation b. To improve mobility and muscle strength c. To prevent urinary retention d. To suppress tremors and muscle rigidity

D

The nurse is teaching a patient about sublingual nitroglycerin administration. What information will the nurse include when teaching this patient? a. Call 911 if pain does not improve after three doses. b. If pain persists after one dose, administer a second dose. c. Swallow the tablet with small sips of water. d. Take the first tablet while sitting or lying down.

D

The nurse is teaching a patient about the use of an anticholinergic medication. What information will the nurse include when teaching this patient about this medication? a. "Check your heart rate frequently to monitor for bradycardia." b. "Drink extra fluids while you are taking this medication." c. "Rise from a chair slowly to avoid dizziness when taking this drug." d. "Use gum or lozenges to decrease dry mouth caused by this drug."

D

The nurse is teaching a patient who has hypertension about long-term management of the disease and a beta blocker. The patient reports typically consuming 1 to 2 glasses of wine each evening with meals. How will the nurse respond? a. "Beta blockers and wine cause a reflex hypertension." b. "Four to 6 ounces of wine is considered safe with these medications." c. "Wine in moderation helps you relax and get better blood pressure control." d. "Wine increases the hypotensive effects of the beta blocker."

D

The nurse is teaching a patient who will begin taking warfarin (Coumadin) for atrial fibrillation. Which statement by the patient indicates understanding of the teaching? a. "I should eat plenty of green, leafy vegetables while taking this drug." b. "I should take a nonsteroidal anti-inflammatory drug (NSAID) instead of acetaminophen for pain or fever." c. "I will take cimetidine (Tagamet) to prevent gastric irritation and bleeding." d. "I will tell my dentist that I am taking this medication."

D

The nurse performs a medication history and learns that the patient takes a thiazide diuretic and digoxin (Lanoxin). The nurse will question the patient to ensure that the patient is also taking which medication? a. Cortisone b. Lidocaine c. Nitroglycerin d. Potassium

D

The nurse provides teaching for a patient who has a ventricular dysrhythmia who is prescribed acebutolol (Spectral) 200 mg twice daily. Which statement by the patient indicates understanding of the teaching? a. "Diuretics may decrease the effectiveness of this drug." b. "Dizziness, nausea, and vomiting indicate a severe reaction." c. "I should eat fruits and vegetables to increase potassium intake." d. "I should not stop taking this drug abruptly to avoid palpitations."

D

The nurse provides teaching for patient who will begin taking montelukast sodium (Singulair). The patient reports sensitivity to aspirin. Which statement by the patient indicates a need for further teaching? a. "I will need to have periodic laboratory tests while taking this medication." b. "I will not take ibuprofen for pain or fever while taking this drug." c. "I will take one tablet daily at bedtime." d. "I will use this as needed for acute symptoms."

D

The patient has been ordered to receive Sudafed to treat nasal congestion. The nurse performing an admission assessment learns that the patient has diabetes mellitus. What action is appropriate for the nurse to take? a. Administer the medication as ordered. b. Contact the provider to discuss a lower dose. c. Give the medication and monitor serum glucose closely. d. Hold the medication and contact the provider.

D

The patient has been started on a treatment regimen that includes atenolol (Tenormin) and complains to the nurse of feeling weak. Which is the best response from the nurse? a. "I will hold your next dose of the medication." b. "You may need an increase in your next dose of the medication." c. "This is an adverse reaction to the medication. I will stop the drug." d. "This is a side effect of the medication. I will notify your physician."

D

To promote elimination of theophylline from the client's system, the client's diet should emphasize high _____ and low _____. a. fat; carbohydrate b. carbohydrate; fat c. fiber; protein d. protein; carbohydrate

D

When using a mucolytic drug and a bronchodilator in a nebulizer, the highest priority instruction that the nurse should give the client is that the _____ should be given _____ minutes before the _____. a. mucolytic drug; 30; bronchodilator b. bronchodilator; 30; mucolytic drug c. mucolytic drug; 5; bronchodilator d. bronchodilator; 5; mucolytic drug

D

The nurse teaches a patient about antihypertensive medication. Which statements by the patient indicate understanding of the teaching? (Select all that apply.) a. "I should be careful when I stand up from a chair." b. "I should not add extra salt to my foods." c. "If I have side effects, I should stop taking the drug immediately." d. "If my blood pressure returns to normal, I can stop taking this drug." e. "I may need to take a combination of drugs, including diuretics." f. "I will not need to make lifestyle changes since I am taking a medication."

abe

Cholinergic drugs have specific effects on the body. What are the actions of cholinergic medications? (Select all that apply.) a. Dilate pupils b. Decrease heart rate c. Stimulate gastric muscle d. Dilate blood vessels e. Dilate bronchioles f. Increase salivation g. Constrict pupils

b. Decrease heart rate c. Stimulate gastric muscle d. Dilate blood vessels f. Increase salivation g. Constrict pupils

A client has congestive heart failure and has been taking digoxin (Lanoxin) for 9 years. The client is admitted with signs and symptoms of digoxin toxicity. Which signs and symptoms are associated with digoxin toxicity? (Select all that apply.) a. Scomota b. Vomiting c. Supraventricular tachycardia d. Yellow halos in the visual field e. Diarrhea f. Insomnia

bde

A client with high cholesterol is ordered to take atorvastatin (Lipitor). What information should be included in the client teaching? (Select all that apply.) a. Dietary management is not a priority with this medication. b. The medication should be taken on an empty stomach. c. The medicine should be taken with a full glass of water. d. The client should watch for body aches or GI upset as side effects. e. The client should have renal function tests frequently. f. The client should have liver function tests frequently.

c. The medicine should be taken with a full glass of water. d. The client should watch for body aches or GI upset as side effects. f. The client should have liver function tests frequently.

A patient with high cholesterol is ordered to take atorvastatin (Lipitor). What information will be included in the patient teaching? (Select all that apply.) a. Dietary management is not a priority with this medication. b. The medication should be taken on an empty stomach. c. The medicine should be taken with a full glass of water. d. The patient should watch for body aches or gastrointestinal upset as side effects. e. The patient should have renal function tests frequently. f. The patient should have liver function tests frequently.

c. The medicine should be taken with a full glass of water. d. The patient should watch for body aches or gastrointestinal upset as side effects. f. The patient should have liver function tests frequently.