Pharmacology Exam #2 Multiple Choice Questions
A nurse is caring for a client who is prescribed isosorbide mononitrate for chronic stable angina and develops reflex tachycardia. Which of the following medications should the nurse expect to administer? A. furosemide B. captopril C. ranolazine D. metoprolol
D. metoprolol
A nurse in a provider's office is monitoring blood electrolytes for four clients who take digoxin. Which of the following electrolyte values increases a client's risk for digoxin toxicity? A. calcium 9.2 mg/dl B. calcium 10.3 mg/dl C. potassium 3.4 mEq/L D. potassium 4.8 mEq/L
C. potassium 3.4 mEq/L
A nurse is assessing a client who is taking amiodarone to treat atrial fibrillation. Which of the following findings is a manifestation of amiodarone toxicity? A. light yellow urine B. report of tinnitus C. productive cough D. blue-gray skin discoloration
C. productive cough
A nurse is caring for a client who is receiving heparin by continuous IV infusion. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer? A. vitamin K B. atropine C. protamine D. calcium gluconate
C. protamine
The nurse has just administered the initial dose of enalapril [Vasotec] to a newly admitted patient with hypertension. What is the priority nursing intervention over the next several hours? A. check the heart rate B. auscultate lung sounds C. draw a potassium level D. monitor blood pressure
D. monitor blood pressure
A nurse is assessing a client who is taking digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity? A. bruising B. report of metallic taste C. muscle pain D. report of anorexia
D. report of anorexia
A patient with angina pectoris has been prescribed nifedipine [Procardia].Which possible adverse effects should the nurse expect with this medication? (Select all that apply.) A. Headache B. Constipation C. Nausea and vomiting D. Edema of ankles and feet E. Overgrowth of gum tissue
A. Headache D. Edema of ankles and feet E. Overgrowth of gum tissue
A patient is prescribed hydralazine [Apresoline] for the treatment of essential hypertension. Which expected adverse effects should the nurse discuss with the patient? (Select all that apply.) A. Nausea B. Fatigue C. Dizziness D. Headache E. Joint pain
B. Fatigue C. Dizziness D. Headache
The nurse is evaluating the teaching done with a patient who has a new prescription for fosinopril [Monopril]. Which statement by the patient indicates a need for further teaching? A. "I can take this medication with breakfast each morning" B. "I will cal if I develop a bothersome cough" C. "I will use a salt substitute to lower my sodium intake" D. "I will call if I notice a rash or wheals on my skin"
C. "I will use a salt substitute to lower my sodium intake"
The nurse is preparing to give epinephrine by the IV push route. Which actions are essential before giving this drug? (Select all that apply.) A. Check the blood urea nitrogen (BUN) and creatinine levels. B. Obtain insulin from the medication cart. C. Assess the patency of the IV line. D. Review the allergy history. E. Assess the vital signs
C. Assess the patency of the IV line. D. Review the allergy history. E. Assess the vital signs
The nurse is caring for several patients. For which patient diagnosis would a prescription for nifedipine [Adalat] be least appropriate? A. Angina pectoris B. Essential hypertension C. Atrial fibrillation D. Vasospastic angina
C. Atrial fibrillation
The nurse understands patients receiving nitroglycerin are at risk for which adverse effects? (Select all that apply.) A. Headache B. Wheezing C. Dizziness D. Tachycardia E. Bradycardia
A. Headache C. Dizziness D. Tachycardia
Calcium channel blockers work by reducing calcium influx into the cells of the heart and blood vessels. Calcium channels are coupled to which type of autonomic nervous system receptors? A. Alpha 1 B. Alpha 2 C. Beta 1 D. Beta 2
C. Beta 1
Which classes of medications are prescribed as initial therapy for hypertension after a myocardial infarction (MI)? A. Diuretic and beta blocker B. Diuretic and calcium channel blocker C. Beta blocker and ACE inhibitor D. ACE inhibitor and calcium channel blocker
C. Beta blocker and ACE inhibitor
The nurse is teaching a patient with essential hypertension who has a new prescription for verapamil [Calan]. Which statements by the patient indicate that the teaching was effective? (Select all that apply.) A. "I will increase my intake of fluid and foods high in fiber." B. "I should stay out of direct sunlight to prevent exposing my skin to the sun." C. "I will call my healthcare provider if I notice swelling in my ankles." D. "I need to avoid salt substitutes and potassium supplements." E. "I may notice easy bruising and bleeding with this drug."
A. "I will increase my intake of fluid and foods high in fiber." C. "I will call my healthcare provider if I notice swelling in my ankles."
A patient with angina is being discharged with a prescription for nitroglycerin sublingual tablets. Which instruction should the nurse include? A. "Store the tablets in the original container and tightly close it after use." B. "The tablets are only good for 1 month after the container is opened." C. "Sublingual nitroglycerin tablets are also effective when swallowed whole." D. "Effects of sublingual nitroglycerin begin in 5 to 10 minutes."
A. "Store the tablets in the original container and tightly close it after use."
An adult male patient is taking medication for blood pressure management. The patient states to the nurse, "I'm not going to take these drugs anymore, because they are interfering with my sex life." What is the most appropriate response by the nurse? A. "let's discuss this effect with your prescriber. There are other drugs available to manage your blood pressure that may not have the same adverse effect" B. "It is unfortunate these drugs can cause erectile dysfunction but managing your blood pressure is more important than your sexual performance C. "I understand how discouraging it must be to live with adverse effect, but you could have a stroke if you do not take your blood pressure medications D. "I am glad you told me about your experience with this common side effect. Sexual performance can be a difficult subject to discuss"
A. "let's discuss this effect with your prescriber. There are other drugs available to manage your blood pressure that may not have the same adverse effect"
A nurse is teaching a client who's angina how to use nitroglycerine transdermal ointment. The nurse should include which of the following instructions? A. "remove the prior doses before applying a new dose" B. "rub the ointment directly into your skin until it is no longer visible" C. "cover the applied ointment with a clean gauze pad" D. "apply the ointment to the same skin area each time"
A. "remove the prior doses before applying a new dose"
The healthcare provider orders furosemide [Lasix] 20 mg IV twice daily. The medication available is furosemide [Lasix] 10 mg/mL. How many mL will the nurse administer with each dose? A. 2 mL B. 4 mL C. 1 mL D. 0.5 mL
A. 2 mL
What is the primary benefit of spironolactone [Aldactone] in patients with heart failure? A. Blockage of aldosterone receptors B. Stimulation of the renin-angiotensin-aldosterone system C. Increase in diuresis and fluid loss D. Inhibition of beta activation by norepinephrine
A. Blockage of aldosterone receptors
The nurse in the cardiac care unit is caring for a patient receiving epinephrine. Which assessment criterion takes priority in the monitoring for adverse effects of this drug? A. Cardiac rhythm B. Blood urea nitrogen C. Central nervous system (CNS) tremor D. Lung sounds
A. Cardiac rhythm
Which patient symptoms should cause the nurse to be concerned about digoxin [Lanoxin] toxicity? (Select all that apply.) A. Fatigue B. Blurred vision C. Muscle weakness D. Vomiting E. Dizziness
A. Fatigue B. Blurred vision D. Vomiting
A patient in a hypertensive crisis is being started on a continuous sodium nitroprusside [Nipride] infusion. Which interventions are essential before the nurse administers nitroprusside [Nipride]? (Select all that apply.) A. Obtain a baseline weight and weigh daily. B. Prepare for arterial line insertion. C. Discontinue the infusion when blood pressure is controlled. D. Observe for signs of hypertrichosis during the infusion. E. Cover the solution with an opaque bag.
A. Obtain a baseline weight and weigh daily. B. Prepare for arterial line insertion. E. Cover the solution with an opaque bag.
A patient is admitted to the unit in a hypertensive emergency and examination reveals papilledema. The nurse should expect which IV medications to be administered to achieve rapid, controlled reduction of the patient's blood pressure? A. Sodium nitroprusside [Nitropress] B. Furosemide [Lasix] C. Metoprolol [Lopressor] D. Diltiazem [Cardizem]
A. Sodium nitroprusside [Nitropress]
The nurse is caring for a patient who has been receiving intravenous sodium nitroprusside [Nitropress] for 3 days. Which assessment data indicate the patient may be experiencing thiocyanate toxicity? A. Sudden confusion B. Difficulty breathing C. Erythematous rash D. Gastrointestinal bleeding
A. Sudden confusion
Which instructions should the nurse include when developing a teaching plan for a patient prescribed diltiazem [Cardizem] for atrial fibrillation? (Select all that apply.) A. Weigh yourself daily at the same time each day. B. The medication will not cause dizziness or headache. C. Notify the healthcare provider if a skin rash develops. D. Do not take daily oral calcium supplements. E. Rise slowly from a lying to a sitting position.
A. Weigh yourself daily at the same time each day. C. Notify the healthcare provider if a skin rash develops. E. Rise slowly from a lying to a sitting position.
A nurse is caring for a client who is receiving furosemide IV for peripheral edema. Which of the following interventions should the nurse include in the plan of care? (select all that apply). A. assess for tinnitus B. report urine output 50mL/hr C. monitor blood potassium levels D. elevate the head of the bed slowly before ambulation E. recommend eating a banana daily
A. assess for tinnitus C. monitor blood potassium levels D. elevate the head of the bed slowly before ambulation E. recommend eating a banana daily
A nurse is reviewing the health care record of a client who asks about using propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol? A. asthma B. glaucoma C. hypertension D. tachycardia
A. asthma
A nurse is caring for a client who received IV verapamil to treat supra ventricular tachycardia (SVT). The client's pulse rate is now 98/min and the blood pressure is 74/44 mm Hg. The nurse should expect a prescription for which of the following IV medications? A. calcium gluconate B. sodium bicarbonate C. potassium chloride D. magnesium sulfate
A. calcium gluconate
A patient is admitted to the hospital with a diagnosis of hypertension. The nurse understands that which medication works by preventing angiotensin II from binding with its receptor sites? A. candesartan B. aliskiren C. eplerenone D. quinapril
A. candesartan
A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching? A. contact provider if heart rate is less than 60/min B. check pulse rate for 30 seconds and multiply result by 2 C. increase intake of sodium D. take with food if nausea occurs
A. contact provider if heart rate is less than 60/min
A patient is prescribed lisinopril [Prinivil] 40 mg by mouth once a day for hypertension. For which therapeutic effect will the nurse monitor? A. decrease in blood pressure B. symptoms such as dizziness and faintng C. pulse oximetry oxygen saturation 100% D. slowing of the heart rate
A. decrease in blood pressure
A nurse is taking care of a medication history from a client who has angina and is to begin taking ranolazine. The nurse should report which of the following medications in the client's history that can interact with ranolazine? (select all that apply). A. digoxin B. simvastatin C. verapamil D. amlodipine E. nitroglycerin transdermal patch
A. digoxin B. simvastatin C. verapamil
A nurse is providing teaching to a client who has a new prescription for digoxin. the nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation of digoxin toxicity? (Select all that apply). A. fatigue B. constipation C. anorexia D. rash E. blurred vision
A. fatigue C. anorexia E. blurred vision
A nurse is teaching a client who has a new prescription for verapamil to control hypertension. Which of the following instructions should the nurse include? A. increase the amount of fiber in the diet B. drink grapefruit juice daily to increase vitamin C intake C. decrease the amount of calcium in the diet D. withhold food for 1 hr after the medication is taken
A. increase the amount of fiber in the diet
A nurse is teaching a client who has a new prescription for nitroglycerin transdermal patch for angina pectoris. Which of the following instructions should the nurse include? A. remove the patch each evening B. cut each patch in half if angina attacks are under control C. take off the nitroglycerin patch 30min if a headache occurs D. apply a new patch every 48hr
A. remove the patch each evening
A nurse is providing information to a client who has a new prescription for hydrochlorothiazide. Which of the following information should the nurse include? A. take the medication with food B. plan to take the medication at bedtime C. expect increased swelling of the ankles D. fluid intake should be limited in the morning
A. take the medication with food
A nurse is providing teaching to a client who is starting simvastatin. Which of the following information should the nurse include in the teaching? A. take this medication in the evening B. change position slowly when rising from a chair C. maintain a steady intake of green leafy vegetables D. consume no more than 1 L/day of fluid
A. take this medication in the evening
Which assessment finding is most important for the nurse to obtain before administering hydralazine [Apresoline]? A. Peripheral pulses B. Homans' sign C. Blood pressure D. Capillary refill
C. Blood pressure
The nurse is providing discharge teaching for a patient with a new prescription for a nitroglycerin transdermal patch. Which statement by the patient indicates a need for further teaching? A. "I will remove my patch at bedtime each evening." B. "I will limit my alcohol to one drink per day." C. "I will not use Viagra as long as I am on nitroglycerin." D. "I will move slowly when changing positions."
B. "I will limit my alcohol to one drink per day."
The nurse is teaching a patient who has just been prescribed a vasodilator. Which statement by the patient indicates that the teaching was effective? A. "I can take this medication in the morning to reduce nighttime urination." B. "I will rise slowly when changing from a sitting to a standing position." C. "My heart rate may slow down with this drug. I will call if my pulse is below 60." D. "I need to increase my intake of fluids and foods that are high in fiber."
B. "I will rise slowly when changing from a sitting to a standing position."
The nurse is teaching a patient about the side effects associated with doxazosin [Cardura]. Which statement by the patient indicates an understanding of the nurse's instructions? A. "I may experience an increase in hair growth as a side effect." B. "When getting out of bed in the morning, I will sit on the side of the bed for several minutes before standing." C. "I'll make sure I include extra sources of potassium in my diet, such as bananas and baked potatoes." D. "I'll notify the healthcare provider if I develop a persistent cough."
B. "When getting out of bed in the morning, I will sit on the side of the bed for several minutes before standing."
A nurse is teaching a client who has anginal pectoris and is learning how to treat acute anginal attacks. The client asks "what is my next step if I take one tablet, wait 5 minutes, but still have anginal pain?" Which of the following responses should the nurse make? A. "take 2 more sublingual tablets at the same time" B. "call the emergency response team" C. "take a sustained-release nitroglycerin capsule" D. "wait another 5 minutes then take a second sublingual tablet"
B. "call the emergency response team"
About which patient should the nurse notify the healthcare provider immediately? A. A patient who takes digoxin [Lanoxin] 0.25 mg orally daily with a serum potassium level of 4.0 mEq/L B. A patient who takes oral spironolactone [Aldactone] 25 mg daily and enalapril [Vasotec] 5 mg daily with a serum potassium level of 5.5 mEq/L C. A patient who takes oral lisinopril [Zestril] 5 mg daily and digoxin 0.125 mg daily with a serum digoxin level of 0.5 ng/mL D. A patient who takes digoxin [Lanoxin] 0.125 mg orally daily with a serum digoxin level of 0.8 ng/mL
B. A patient who takes oral spironolactone [Aldactone] 25 mg daily and enalapril [Vasotec] 5 mg daily with a serum potassium level of 5.5 mEq/L
A patient is receiving isosorbide dinitrate [Isordil] 20 mg 3 times/day for management of newly diagnosed stable angina. Which assessment finding would require an immediate nursing intervention? A. A change in blood pressure from 122/70 to 108/66 mm Hg B. An increase in the resting heart rate to 110 beats/min from baseline rates of 68 to 72 beats/min C. A headache the patient rates as a 5 on a pain scale of 0 to 10 D. Report of increased frequency of urination
B. An increase in the resting heart rate to 110 beats/min from baseline rates of 68 to 72 beats/min
Which are the main types of drugs used to prevent or relieve anginal pain? (Select all that apply.) A. Platelet inhibitors B. Beta blockers C. Nitrates D. Calcium channel blockers E. Statins
B. Beta blockers C. Nitrates D. Calcium channel blockers
A patient with heart failure has developed a cough while taking an angiotensin-converting enzyme (ACE) inhibitor. The health care provider discontinued the ACE inhibitor and prescribed an angiotensin II receptor blocker (ARB) as an alternative to the ACE inhibitor. The patient continues to have symptoms of heart failure despite using an ARB. Which medication should the nurse anticipate will be prescribed? A. Hydrochlorothiazide [Microzide] B. BiDil [Isosorbide Dinitrate and Hydralazine] C. Eplerenone [Inspra] D. Triamterene [Dyrenium]
B. BiDil [Isosorbide Dinitrate and Hydralazine]
The nurse is caring for a patient who is receiving enteral feedings because of dysphagia. The healthcare provider prescribes isosorbide mononitrate [Imdur] 60 mg SR daily via the enteral tube. What is the most appropriate action by the nurse? A. Have the patient swallow the pill, because it cannot be crushed. B. Call the healthcare provider about an alternate form of nitrate for administration. C. Crush the Imdur into a fine powder, dilute it with water, and administer it via the enteral tube. D. Place the nitrate under the patient's tongue and let it dissolve, because the person has dysphagia.
B. Call the healthcare provider about an alternate form of nitrate for administration.
The nurse is caring for a patient who has diabetes and hypertension. Which medication is most likely to be prescribed to treat this patient's hypertension? A. Hydrochlorothiazide [HCTZ] B. Enalapril [Vasotec] C. Propranolol [Inderal] D.Methyldopa [Aldomet]
B. Enalapril [Vasotec]
The nurse is caring for a patient receiving a nitroprusside [Nipride] intravenous infusion. The patient's wife asks why furosemide [Lasix] is being prescribed along with this drug. The nurse's response is based on which concept? A. Furosemide will help reduce reflex tachycardia. B. Many vasodilators cause retention of sodium and water. C. Thiocyanate may accumulate in patients receiving nitroprusside. D. Vasodilators can cause serious orthostatic hypotension.
B. Many vasodilators cause retention of sodium and water.
The nurse is caring for a pregnant patient experiencing a new episode of hypertension. Which medication does the nurse anticipate will be prescribed for this patient? A. Captopril [Capoten] B. Methyldopa [Aldomet] C. Valsartan [Diovan] D. Propranolol [Inderal]
B. Methyldopa [Aldomet]
Which medications should be used with caution in a hypertensive diabetic patient? (Select all that apply.) A. Furosemide [Lasix] B. Metoprolol [Lopressor] C. Hydrochlorothiazide [HCTZ] D. Diltiazem [Cardizem] E. Enalapril [Vasotec]
B. Metoprolol [Lopressor] D. Diltiazem [Cardizem] E. Enalapril [Vasotec]
The healthcare provider prescribes an intravenous dose of diltiazem [Cardizem] for treatment of a patient with atrial fibrillation. What is the priority nursing intervention? A. Assist with cardioversion. B. Monitor electrocardiogram. C. Obtain baseline coagulation studies. D. Assess for increased urinary output.
B. Monitor electrocardiogram.
The nurse reviews the medication treatment regimen for a patient with chronic hypertension. To promote optimal medication adherence, which frequency of drug dosing should the nurse advocate for this patient? A. Three times a day B. Once a day C. Four times a day D. Every 8 hours
B. Once a day
The nurse is preparing to give terbutaline [Brethine] to prevent preterm labor. Which concepts are important to keep in mind when working with this drug? (Select all that apply.) A. Terbutaline must be given by a parenteral route. B. The selectivity of terbutaline is dose dependent. C. The patient may experience tremor with terbutaline. D. Terbutaline is a sympathomimetic drug. E. Bronchoconstriction is a potential adverse effect of terbutaline.
B. The selectivity of terbutaline is dose dependent. C. The patient may experience tremor with terbutaline. D. Terbutaline is a sympathomimetic drug.
A nurse is monitoring a client who takes aspirin daily. The nurse should identify which of the following manifestations as adverse effects of aspirin? (select all that apply). A. hypertension B. coffee-ground emesis C. tinnitus D. paresthesias of the extremities E. nausea
B. coffee-ground emesis C. tinnitus E. nausea
A patient is prescribed lisinopril [Prinivil] as part of the treatment plan for heart failure. Which finding indicates the patient is experiencing the therapeutic effect of this drug? A. jugular vein distention B. crackles in the lungs are no longer heard C. + 2 edema of the lower extremities D. potassium level of 3.5 mEq/L
B. crackles in the lungs are no longer heard
A nurse is planning to administer a first dose of captopril to a client who has hypertension. Which of the following medications can intensify first-dose hypertension? (Select all that apply). A. simvastatin B. hydrochlorothiazide C. phenytoin D. clonidine E. aliskiren
B. hydrochlorothiazide D. clonidine E. aliskiren
The nurse is reviewing the home medication list with the patient. The nurse recognizes that hydrochlorothiazide is used primarily for which condition? A. edema B. hypertension C. diabetes insipidus D. protection against postmenopausal osteoporosis
B. hypertension
A nurse is planning care for a client who has a new prescription for torsemide. The nurse should plan to monitor for which of the following conditions as potential adverse reactions of this medication? (Select all that apply). A. respiratory acidosis B. hypokalemia C. hypotension D. ototoxicity E. ventricular dysrhythmias
B. hypokalemia C. hypotension D. ototoxicity E. ventricular dysrhythmias
A nurse is administering a dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication? A. lowered heart rate B. increased urine output C. decreased conduction through the AV node D. vasoconstriction of renal blood vessels
B. increased urine output
A nurse is planning to administer subcutaneous enoxaparin 40mg using a refilled syringe of enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the nurse plan to take? A. expel the air bubbles from the profiled syringe before injecting B. insert the needle completely into the client's tissue C. administer the injection in the client's thigh D. aspirate carefully after inserting the needle into the client's skin
B. insert the needle completely into the client's tissue
A nurse is planning to administer IV alteplase to a client. Which of the following interventions should the nurse plan to take? A. administer IM enoxaparin along with the alteplase dose B. obtain the client's weight C. administer aminocaproic acid IV prior to alteplase infusion D. prepare to administer alteplase within 8 hr of manifestation onset
B. obtain the client's weight
A nurse is caring for a client who has a new prescription for alirocumab to reduce cholesterol. The nurse should monitor for which of the following findings as an adverse effect of alirocumab? (select all that apply). A. muscle aches B. vasculitis C. hearing loss D. urticaria E. jaundice
B. vasculitis D. urticaria E. jaundice
A nurse is caring for a client who has a new prescription for digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for digoxin toxicity? A. phenytoin B. verapamil C. warfarin D. aluminium hydroxide
B. verapamil
A nurse is assessing a client who has taken procainamide to treat dysrhythmias for the last 12 months. The nurse should assess the client for which of the following manifestations as an adverse effect of this medication? (select all that apply). A. hypertension B. widened QRS complex C. narrow QT interval D. easy bruising E. swollen joints
B. widened QRS complex D. easy bruising E. swollen joints
A nurse is caring for a client who has atrial fibrillation and a new prescription for dabigatran. Which of the following medications is prescribed concurrently to treat an adverse effect of dabigatran? A. vitamin K B. protamine C. omeprazole D. probenecid
C. omeprazole
Which medication combination is useful in the treatment of variant angina? A. Metoprolol [Lopressor] and ranolazine [Ranexa] B. Isosorbide dinitrate [Isordil] and metoprolol [Lopressor] C. Diltiazem [Cardizem] and isosorbide mononitrate [Imdur] D. Propranolol [Inderal] and diltiazem [Cardizem]
C. Diltiazem [Cardizem] and isosorbide mononitrate [Imdur]
The nurse is reviewing drugs on the emergency cart with regard to their therapeutic action. Which medications can help initiate heart contraction during a cardiac arrest? A. Topical phenylephrine B. Subcutaneous terbutaline C. Intravenous epinephrine D. Inhaled albuterol
C. Intravenous epinephrine
What is the most appropriate nursing consideration for a patient who is prescribed verapamil [Calan] and digoxin [Lanoxin]? A. Restrict intake of oral fluids and high-fiber food. B. Take an apical pulse for 30 seconds before administration. C. Notify the healthcare provider of nausea, vomiting, and visual changes. D. Hold the medications if the heart rate is greater than 110 beats/min.
C. Notify the healthcare provider of nausea, vomiting, and visual changes.
The nurse is monitoring a patient receiving ranolazine [Ranexa] for angina. Which assessment finding indicates an adverse effect of this drug? A. Blood pressure of 90/50 mm Hg B. Frequent bloody stools C. QT prolongation on the electrocardiogram D. Respiratory rate of 11 breaths per minute
C. QT prolongation on the electrocardiogram
Which laboratory result may be a consequence of therapy with a thiazide diuretic? A. Serum sodium level of 135 mEq/L B. Serum glucose level of 58 mg/dL C. Serum uric acid level of 10.4 mg/dL D. Serum potassium level of 5.3 mEq/L
C. Serum uric acid level of 10.4 mg/dL
A patient with hypertensive emergency is admitted to the hospital. Which medication should the nurse be prepared to administer to this patient? A. Minoxidil [Loniten] B. Hydralazine [Apresoline] C. Sodium nitroprusside [Nipride] D. Hydralazine and isosorbide dinitrate [BiDil]
C. Sodium nitroprusside [Nipride]
The nurse is caring for a patient receiving nitrates for relief of angina. What pharmacodynamic action is responsible for the relief of anginal pain with nitrates? A. Vasoconstriction leads to improved cardiac output. B. Decreased force of contraction leads to decreased oxygen demand. C. Vasodilation leads to decreased preload, which decreases oxygen demand. D. Influx of calcium ions leads to relaxation of vascular smooth muscle.
C. Vasodilation leads to decreased preload, which decreases oxygen demand.
The nurse is teaching a patient prescribed captopril [Capoten] for the treatment of hypertension. Which instructions should the nurse include? (Select all that apply.) A. take the medication with food B. expect a sore throat and fever C. a persistent dry cough may occur D. avoid potassium salt substitutes E. report difficulty in breathing immediately
C. a persistent dry cough may occur D. avoid potassium salt substitutes E. report difficulty in breathing immediately
A nurse is completing a nursing history for a client who takes simvastatin. The nurse should identify which of the following disorders as a contraindication to adding ezetimibe to the client's medications? A. history of severe constipation B. history of hypertension C. active hepatitis C D. type 2 diabetes mellitus
C. active hepatitis C
The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure. Which compound in this system is most powerful at raising the blood pressure? A. renin B. angiotensin I C. angiotensin II D. angiotensin III
C. angiotensin II
A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider? A. blood sodium 144 mEq/L B. urine output 120mL in 4 hr C. blood potassium 5.2 mEq/L D. blood pressure 140/90 mm Hg
C. blood potassium 5.2 mEq/L
The nurse knows that diuretics mostly affect which function of the kidneys? A. elimination of foreign substances B. maintenance of acid-base balance C. cleansing and maintenance of extracellular fluid volume D. excretion of metabolic waste
C. cleansing and maintenance of extracellular fluid volume
The nurse plans to closely monitor for which clinical manifestation after administering furosemide [Lasix]? A. decreased respiratory rate B. decreased pulse C. decreased blood pressure D. decreased temperature
C. decreased blood pressure
A nurse is caring for a client who has increased intracranial pressure and is receiving mannitol. Which of the following findings should the nurse report to the provider? A. blood glucose 150 mg/dl B. urine output 40 mL/hr C. dyspnea D. bilateral equal pupil size
C. dyspnea
The nurse caring for a patient taking furosemide [Lasix] is reviewing the patient's most recent laboratory results, which are: sodium, 136 mEq/L; potassium, 3.2 mEq/L; chloride, 100 mEq/L; blood urea nitrogen, 15 mg/dL. What is the nurse's best action? A. begin a 24-hour urine collection B. place the patient on a cardiac monitor C. hold the lasix and notify the physician D. administer lasix as ordered
C. hold the lasix and notify the physician
The nurse is caring for a patient prescribed aliskiren [Tekturna]. How does this medication lower blood pressure? A. it selectively blocks aldosterone receptors in the kidneys B. it prevents angiotensin II from binding to its receptors C. it inhibits the conversion of angiotensinogen into angiotensin I D. it blocks the conversion of angiotensin I to angiotensin II
C. it inhibits the conversion of angiotensinogen into angiotensin I
A nurse is collecting data from a client who is taking gemfibrozil. Which of the following assessment finding should the nurse identify as as adverse effect of this medication? A. mental status changes B. tremor C. jaundice D. pneumonia
C. jaundice
Which of the following statements about mannitol [Osmitrol] are correct? (Select all that apply.) A. mannitol is a loop diuretic B. mannitol can cause renal failure C. mannitol cannot be given orally D. diuresis. begins 30-60 min after administration E. mannitol can cause edema
C. mannitol cannot be given orally D. diuresis. begins 30-60 min after administration E. mannitol can cause edema
A nurse is caring for a client who has a new prescription for captopril for hypertension. The nurse should monitor the client for which of the following as an adverse effect of this medication? A. hypokalemia B. hypernatremia C. neutropenia D. bradycardia
C. neutropenia
The nurse is caring for a patient with renal artery stenosis who has been prescribed benazepril [Lotensin]. Which laboratory result indicates an adverse effect of this drug? A. uric acid level of 10 mg/dl B. potassium level of 3.2 mEq/L C. blood glucose level of 180 mg/dl D. serum creatinine level of 2.3 mg/dl
D. serum creatinine level of 2.3 mg/dl
The nurse is caring for a patient with heart failure who needs a diuretic. Which agent is likely to be chosen, because it has been shown to greatly reduce mortality in patients with heart failure? A. furosemide B. hydrochlorothiazide C. mannitol D. spironolactone
D. spironolactone
The nurse is caring for a patient receiving hydralazine [Apresoline]. The healthcare provider prescribes propranolol [Inderal]. The nurse knows that a drug such as propranolol often is combined with hydralazine for what purpose? A. To reduce the risk of headache B. To improve hypotensive effects C. To prevent heart failure D. To protect against reflex tachycardia
D. To protect against reflex tachycardia
The nurse should monitor for which adverse effect after administering hydrochlorothiazide [HydroDIURIL] and digoxin [Lanoxin] to a patient? A. dehydration B. decreased diuretic effect C. heart failure D. digoxin toxicity
D. digoxin toxicity
The nurse is caring for a patient with bipolar disorder treated with lithium [Eskalith]. The patient has a new prescription for captopril [Capoten] for hypertension. The combination of these two drugs makes which assessment particularly important? A. Blood pressure B. creatinine level C. potassium level D. lithium level
D. lithium level
The nurse provides discharge instructions to a patient prescribed verapamil [Calan] SR 120 mg PO daily for essential hypertension. Which statement by the patient indicates understanding of the medication? A. "I will take the medication with grapefruit juice each morning." B. "I should expect occasional loose stools from this medication." C. "I'll need to reduce the amount of fiber in my diet." D. "I must make sure I swallow the pill whole."
D. "I must make sure I swallow the pill whole."
The nurse is teaching a patient who has a new prescription for spironolactone [Aldactone]. Which statement by the patient indicates that the teaching was effective? A. "I will take this medication at bedtime each evening" B. "I will increase my intake of foods that are high in potassium" C. "I will use salt substitutes to lower my sodium intake" D. "I will call my doctor if I begin having menstrual irregularities"
D. "I will call my doctor if I begin having menstrual irregularities"
The nurse is teaching a patient with a history of anaphylaxis how to use an EpiPen. Which statement made by the patient indicates that he understands the proper use of this drug? A. "I will keep my medication in the refrigerator when I'm not using it." B. "I should take this medication within 30 minutes of the onset of symptoms." C. "I must remove my pants before injecting the medication into the leg." D. "I will jab this medication firmly into my outer thigh if needed."
D. "I will jab this medication firmly into my outer thigh if needed."
A nurse is teaching a client who is taking digoxin and has a new prescription for colesevelam. Which of the following instructions should the nurse include in the teaching? A. "take digoxin with your morning dose of colesevelam" B. "your sodium and potassium levels will be monitored periodically while taking colesevelam" C. "watch for bleeding or bruising while taking colesevelam" D. "take colesevelam with food and at least one glass of water"
D. "take colesevelam with food and at least one glass of water"
The healthcare provider orders mannitol 72 gm infusion over 24 hours. The nurse plans to set the infusion pump for how many grams per hour? A. 1 gm B. 4 gm C. 2 gm D. 3gm
D. 3gm
The patient is admitted for the management of a hypertensive emergency. The healthcare provider prescribes sodium nitroprusside [Nipride] drug therapy. What is the priority nursing action during this treatment? A. Observe for respiratory depression. B. Monitor the electrocardiogram for tachycardia. C. Initiate oxygen therapy via nasal cannula at 2 L/min. D. Adjust the intravenous infusion rate to the blood pressure response.
D. Adjust the intravenous infusion rate to the blood pressure response.
The home health nurse observes the patient for proper use of topical nitroglycerin ointment. Which action by the patient indicates the need for further teaching? A. Rotates the application sites to minimize skin irritation. B. Uses the applicator paper to measure the prescribed dose. C. Removes ointment from a previous dose before applying the next dose. D. Applies the prescribed ribbon of ointment to the applicator paper and places it on the chest.
D. Applies the prescribed ribbon of ointment to the applicator paper and places it on the chest.
Which medication is most likely to cause the side effect of constipation? A. Nifedipine [Adalat] B. Amlodipine [Norvasc] C. Isradipine [DynaCirc] D. Diltiazem [Cardizem]
D. Diltiazem [Cardizem]
The nurse is preparing to administer minoxidil [Loniten] 5 mg orally. What is the only cardiovascular indication for this medication? A. Heart failure B. Myocardial infarction C. Angina pectoris D. Severe hypertension
D. Severe hypertension
