Pharmacology PrepU for Exam 3
Which instruction would be most appropriate for a client who is taking a diuretic? "It's okay to take it with food." "Lie down after taking the drug." "Limit the amount of fluids you drink." "Take the daily dose around dinnertime."
"It's okay to take it with food."
After teaching a patient who is receiving ferrous sulfate about the drug therapy regimen, which patient statement indicates that the teaching was successful? "I must take the drug on an empty stomach." "My stools might turn dark or green." "I need to eat three large meals every day." "I need to watch the amount of fiber I eat."
"My stools might turn dark or green."
The client wants information about triglycerides and cholesterol. Which response by the nurse would be correct? "Triglycerides are found in your blood. Cholesterol is how the fat is transported." "Triglycerides transport cholesterol throughout the body." "Triglycerides are found in your blood. Cholesterol is found in the gallbladder." "Triglycerides and cholesterol are fatlike substances found in your blood."
"Triglycerides and cholesterol are fatlike substances found in your blood."
client asks, "Why is my prescription being switched from furosemide to spironolactone?" What is the nurse's best response? "You will have greater water losses with spironolactone than with furosemide." "You will have greater potassium losses with spironolactone than with furosemide." "You will lose less potassium with spironolactone than with furosemide." "You will have greater sodium losses with spironolactone than with furosemide."
"You will lose less potassium with spironolactone than with furosemide."
For which client would epoetin alfa NOT be indicated? A client with a hemoglobin of 12, with shortness of breath. A client with a hemoglobin of 8, who is asymptomatic. A client with a hemoglobin of 11, with shortness of breath. A client with a hemoglobin of 10, who is asymptomatic.
A client with a hemoglobin of 12, with shortness of breath.
A client who is taking an ACE inhibitor informs the nurse that she is considering having a child. What information should the nurse provide to the client related to this new information? Since ACE inhibitors cross the placenta, dosage during pregnancy should be reduced. ACE inhibitors are contraindicated during pregnancy because they are teratogenic. ACE inhibitors will exacerbate the fluid overload that commonly accompanies pregnancy. ACE inhibitor therapy can continue during pregnancy.
ACE inhibitors are contraindicated during pregnancy because they are teratogenic.
When educating a group of nursing students on the mechanism of the action of various anti-arrhythmic drugs, the nurse identifies which drugs as inhibiting the beta-adrenergic receptors of the heart and the kidney? Propafenone Amiodarone Disopyramide Acebutolol
Acebutolol
After reviewing antiarrhythmic drugs, a group of nursing students demonstrate understanding of the drugs when they identify which as a class II antiarrhythmic? Select all that apply. Ibutilide Acebutolol Verapamil Amiodarone Propranolol
Acebutolol Propranolol
After teaching a group of students about anemias, the instructor determines that the teaching was effective when the students identify what as the critical issue? Decreased levels of platelets A deficiency of vitamin B12 A defect in white blood cell function Altered red blood cell production or deficient functioning of red blood cells
Altered red blood cell production or deficient functioning of red blood cells
A patient with chronic renal failure receiving epoetin alfa will be having a total left hip arthroplasty. What supplementation should the patient receive prior to surgery? An iron supplement A blood transfusion A folic acid supplement A protein supplement
An iron supplement
A client, being treated in the hospital for a femoral fracture, is scheduled to receive a daily dose of prescribed metoprolol. Prior to administering this drug, the nurse should assess and document which client data? Select all that apply. Capillary refill Potassium level Oxygen saturation level Blood pressure Heart rate
Blood pressure Heart rate
The client is taking a calcium channel blocker. Which assessment findings would the nurse expect? Restlessness Palpitations Vomiting Bradycardia
Bradycardia
When caring for a patient with angina, the nurse instructs the patient to place the nitroglycerin tablet between the cheek and the gums. Which route of administration is the nurse referring to? Translingual Buccal Sublingual Transdermal
Buccal
A client is receiving captopril. Which would be most important for the nurse to monitor? Liver function studies Electrocardiogram Complete blood count Nutritional status
Complete blood count
An adult client with no known history of cardiovascular disease presents with atrial flutter. The client is prescribed propafenone PO 150 mg every 8 hours for 24 hours. What is the cardiac care nurse's priority assessment during this period? Every 1-hour monitoring of potassium levels Continuous ECG monitoring Blood pressure monitoring every 10 minutes Echocardiography
Continuous ECG monitoring
A client with angina is prescribed atenolol. Following absorption of the drug, the nurse should monitor the client for what desired effect? Relief of fatigue Mild to moderate drowsiness Decreased heart rate Increased oxygen saturation levels
Decreased heart rate
Diuretics increase the production and output of urine. Which statement helps explain how diuretics achieve these effects? Diuretics increase the reabsorption of electrolytes in the kidneys. Diuretics have no effect on reabsorption. Diuretics reduce the reabsorption of water in the kidneys. Diuretics increase production of nephrons.
Diuretics reduce the reabsorption of water in the kidneys.
There are two pathways that can be activated by the coagulation process. One pathway begins when factor XII is activated. The other pathway begins when there is trauma to a blood vessel. What are these pathways? Factor and trauma pathways Extrinsic and intrinsic pathways Clotting and bleeding pathways Inner and outer pathways
Extrinsic and intrinsic pathways
Which agent would a nurse expect to administer to a patient with Christmas disease? Aminocaproic acid Vitamin K Factor IX complex Antihemophilic factor
Factor IX complex
A 69-year-old client has been diagnosed with malignant melanoma. The care team has collaborated with the client and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the client may develop which adverse effect? Flulike symptoms Profound diaphoresis Decreased level of consciousness Cyanosis and pallor
Flulike symptoms
A nurse is caring for a client prescribed nicotinic acid for hyperlipidemia. The nurse would assess the client for which findings as a possibility? Weakness Dyspnea Flushing of the skin Tachycardia
Flushing of the skin
A patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment? Obtain reports of fasting blood sugar levels. Inspect skin and eyelids for evidence of xanthomas. Take a dietary history of the patient. Frequently monitor blood cholesterol.
Frequently monitor blood cholesterol.
The nurse is preparing discharge teaching for a client prescribed chronic antiarrhythmic medication therapy. Which signs/symptoms should be reported to the health care provider immediately? (Select all that apply.) Heart palpations Diarrhea Nausea Dyspnea Chest pain
Heart palpations Dyspnea Chest pain
What is the most common reason for an elevated cholesterol level in a client who does not have a genetic disorder of lipid metabolism? His waist size His alcohol intake His sedentary lifestyle His dietary intake of saturated fat
His dietary intake of saturated fat
A client is receiving a diuretic as the first-line treatment of mild hypertension. The nurse monitors the client for signs and symptoms of hypokalemia with which agent? Hydrochlorothiazide Amiloride Triamterene Spironolactone
Hydrochlorothiazide
Mr. Hon has been admitted to the hospital and placed on anticoagulant therapy. For what blood-related disorder is this therapy used? Hypercoagulation Hemophilia Hemostasis Blood cancer
Hypercoagulation
A 91-year-old client, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching the client about the drug, what major adverse effect should the nurse be sure to mention? Hypokalemia Hyperkalemia Angina Hypertension
Hyperkalemia
A client with diabetes is prescribed propranolol. For what should the client be assessed? Hypermagnesemia Hypoglycemia Hypocalcemia Hypercholesterolemia
Hypoglycemia
A client taking amlodipine (Norvasc) is having chest pain and is ordered sublingual nitroglycerin. The nurse evaluates the client for: Hypertension Hypotension Hyperkalemia Hypokalemia
Hypotension
A nurse is caring for a 59-year-old client who has been prescribed nitroglycerin to control angina. Which adverse effect might the nurse observe in this client? Renal insufficiency Hypotension Sedation Hypokalemia
Hypotension
An ED patient presents with dyspnea, tachycardia, and chest pain. The patient has a history of cardiomyopathy. The nursing assessment reveals hypotension with an apical pulse of 134 bpm. What would the nurse conclude might be causing the symptoms? Inadequate cardiac output Asthma attack Hypokalemia Adequate cardiac output
Inadequate cardiac output
The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome? Increased RBC count Decreased RBC count Decreased WBC count Increased WBC count
Increased RBC count
A health care provider has prescribed a loop diuretic for a client with hypertension. The client also has diabetes mellitus. What condition should the nurse monitor for in this client after administering the prescribed drug? Sudden pain in the joints Sudden increase in weight Increased blood glucose levels Occurrence of gout attacks
Increased blood glucose levels
A client has not responded normally to rescue inhaler therapy. When subcutaneous epinephrine is prescribed, the nurse should anticipate what reaction to occur? Increased level of consciousness within 2 to 5 minutes An immediate increase in respiratory rate Immediate reduction of anxiety Instant bronchodilation
Instant bronchodilation
A patient is prescribed esmolol for treatment of supraventricular tachycardia. The nurse would expect to administer this drug by which route? Oral Subcutaneous Intramuscular Intravenous
Intravenous
A group of students are reviewing the various antianginal agents. The students demonstrate a need for additional review when they identify what as a beta blocker? Metoprolol Isosorbide Nadolol Propranolol
Isosorbide
The patient has been placed on a nitroprusside drip for the treatment of a hypertensive crisis. Which mechanism of action does the nurse know is true for nitroprusside? It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins. It inhibits the movement of calcium ions across cell membranes. It binds selectively to the mineralocorticoid receptors. It blocks the action of angiotensin II from all the different pathways where it is formed, not just the single substrate altered by ACE inhibitors.
It directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins.
A health care provider has prescribed sublingual nitroglycerin and the nitroglycerin patch for a client. When the nurse explains the medications to the client, what advantage of the patch might the nurse mention? It is more effective than sublingual tablets in treating acute angina. It only has to be administered once a week. It acts more quickly than sublingual tablets. It has a longer duration of action than sublingual tablets.
It has a longer duration of action than sublingual tablets.
When describing where bumetanide acts, what would the nurse include? Loop of Henle Proximal convoluted tubule Collecting tubule Glomerulus
Loop of Henle
A group of students are reviewing the various antihypertensive agents. The students demonstrate understanding of the information when they identify what as an example of an angiotensin II receptor blocker? Amlodipine Moexipril Losartan Minoxidil
Losartan
A critical care nurse is caring for a client after open-heart surgery. What nursing intervention would the nurse initiate to help detect life-threatening arrhythmias and manage and minimize any that occur? Monitor blood pressure continuously. Monitor cardiac rhythm continuously. Palpate the client's pulse and observe the client's response. Provide supplemental oxygen.
Monitor cardiac rhythm continuously.
A 75-year-old client presents to the health care provider's office with bleeding gums and multiple bruises. When the nurse reviews the client's drug history, the nurse finds that the client is prescribed aspirin 81 mg/d. What drug may cause increased bleeding when used in conjunction with the aspirin? Antibiotics NSAIDs Antihypertensives Antiarrhythmics
NSAIDs
A client is taking lovastatin. Which are noted as the most common adverse effects? Hiccups, nasal congestion, and dizziness Fatigue and mental disorientation Increased appetite and blood pressure Nausea, flatulence, and constipation
Nausea, flatulence, and constipation
A client is unconscious and experiencing increasing intracranial pressure. What type of diuretic will the client most likely be prescribed? Potassium-sparing diuretic Osmotic diuretic Loop diuretic Thiazide diuretic
Osmotic diuretic
What is the term for the action of a diuretic in a patient with glaucoma? Diuresis IOP Potassium sparing Osmotic pull
Osmotic pull
A client is taking warfarin to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin monitored? aPTT RBC Platelet count PT and INR
PT and INR
A client, newly diagnosed with hypertension is started on captopril, an ACE inhibitor. The client should be informed of the possibility of what adverse effect? Hypokalemia Persistent cough Sedation Sweating
Persistent cough
A client experiences an overdose of warfarin. Which would the nurse expect to administer? Phytonadione Alteplase Urokinase Protamine
Phytonadione
After a cardiac muscle contracts, what chemical reaction is needed to prepare the muscle cells for the next contraction? Calcium ions return to the extracellular space. Potassium ions return to the extracellular space. Potassium ions return to the intracellular space. Sodium ions return to the intracellular space.
Potassium ions return to the intracellular space.
An ED nurse is caring for a patient who is receiving furosemide for treatment of pulmonary edema. What will the nurse monitor to observe for adverse effects of the drug? Potassium levels Blood oxygen saturation Temperature Bone marrow function
Potassium levels
The anemia that occurs with chronic renal failure is caused by the kidneys themselves. What inability of the kidneys causes anemia in chronic renal failure? Produce erythropoietin Produce rennin Produce angiotensin Inactivate vitamin D
Produce erythropoietin
The pharmacology instructor is discussing heparin with the students. How would the instructor explain the action of heparin? Promotes the inactivation of clotting factors Binds to factor X Promotes the inactivation of factor VIII Binds to factor Xa
Promotes the inactivation of clotting factors
A nurse is caring for a 64-year-old female client who is receiving IV heparin and reports bleeding from her gums. The nurse checks the client's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which drug may be ordered? Protamine sulfate Coumadin Alteplase Ticlopidine
Protamine sulfate
A patient, admitted to a health care facility with cardiac arrhythmia, is prescribed propranolol. Which factor should the nurse closely monitor as a part of the ongoing assessment during the therapy? Pulse rate Hydration Tendon reflexes Visual acuity
Pulse rate
A patient is being discharged after being treated with nitroglycerin for angina. Which instructions should the nurse include in the teaching plan for the patient? Place the nitroglycerin capsules along with other tablets. Recap the container tightly after taking the capsules. Do not store nitroglycerin in a dark container. Store the nitroglycerin capsules in a plastic container.
Recap the container tightly after taking the capsules.
What would contraindicate the use of indapamide? Systemic lupus erythematosus Diabetes Gout Renal disease
Renal disease
A patient has been prescribed epoetin alfa. The nurse recognizes that this medication is indicated for treatment of anemia associated with which disease process? Renal failure Lung failure Heart failure Liver failure
Renal failure
During a routine check up of a 45-year-old patient with renal disease, the nurse observes an increase in the patient's blood pressure. Which is the most likely consequence of renal impairment? Essential hypertension Rebound hypertension Hypertensive emergency Secondary hypertension
Secondary hypertension
A patient is receiving hydroxyurea. The nurse understands that this drug is used to treat: Anemia of renal failure Anemia secondary to cancer chemotherapy Sickle cell anemia Iron deficiency anemia
Sickle cell anemia
The nurse would avoid administering nitrates to clients using which medication? Simvastatin Albuterol Sildenafil Lisinopril
Sildenafil
What should the nurse suggest to assist a client to improve his cholesterol levels? Smoking cessation Weight lifting Limit exercise to the weekends Diet high in polysaturated fats
Smoking cessation
A male client has cirrhosis and is receiving diuretic therapy. The nurse knows that what drug will help prevent metabolic alkalosis or hypokalemia in this client? Bumetanide Dyazide Spironolactone Hydrochlorothiazide
Spironolactone
A student nurse is caring for a client who is receiving a hematopoietic agent. To test the student's understanding, the nursing instructor states that the drug could be administered by what route? Oral only Subcutaneous or Oral Oral or Intravenous Subcutaneous or Intravenous
Subcutaneous or Intravenous
A client with a long history of hypertension has just been prescribed an alpha1-adrenergic receptor blocker. To reduce this client's risk of orthostatic hypotension and falls, the nurse should encourage the client to implement what intervention? Take the medication with a high-fat meal. Take the medication at bedtime. Start with a low dose and increase gradually over 2 to 3 weeks. Increase fluid intake for 48 hours before taking the first dose.
Take the medication at bedtime.
A client is being sent home with subcutaneous heparin after a total hip replacement. The nurse understands what symptom would indicate a serious drug reaction? Hypotension Stomach pain Headache Tarry stools
Tarry stools
A stable daily dose of warfarin is reached when which parameter is achieved? The INR is between 4 and 5. The INR is between 1 and 2, and the dose does not cause bleeding. The PT and INR are within their therapeutic ranges, and the dose does not cause bleeding. The PTT is within the therapeutic range.
The PT and INR are within their therapeutic ranges, and the dose does not cause bleeding.
A client has been prescribed furosemide. What medication education should the nurse provide this client? (Select all that apply.) The medication will cause you to urinate larger amounts of urine than you are accustom to. Limit the amount of potassium-rich foods you eat. You should try to avoid excessive intake of salt. Notify your health care provider if you have more than a 3-pound weight change in one day. Be aware that standing up quickly can cause you to be dizzy.
The medication will cause you to urinate larger amounts of urine than you are accustom to. You should try to avoid excessive intake of salt. Notify your health care provider if you have more than a 3-pound weight change in one day. Be aware that standing up quickly can cause you to be dizzy.
What is the basis for a nurse's recommendation of a period of intensive diet therapy and lifestyle modification before initiation of drug therapy for a client newly diagnosed with dyslipidemia? Continued therapeutic lifestyle changes during drug therapy will guarantee success. Therapeutic lifestyle changes are easier to comply with than medication therapies. Therapeutic lifestyle changes are the preferred method for lowering blood lipids. Nonpharmacologic interventions are cheaper than using medications.
Therapeutic lifestyle changes are the preferred method for lowering blood lipids.
The health care provider indicates that a client experiencing renal failure is not a candidate for therapy with potassium-sparing diuretics. How will the nurse respond when the client's family member asks why this is the case? They may cause hyperkalemia. They promote excretion of potassium. They may cause rebound edema. They are the strongest form of diuretics.
They may cause hyperkalemia.
A client experiences pain in the chest that radiates to the jaw, occurring when the client is at rest. The nurse would interpret this as: Unstable angina Stable angina Myocardial infarction Prinzmetal angina
Unstable angina
A client who has been treated with warfarin after cardiac surgery is found to have an INR of 9.0. Which medication will be administered to assist in the development of clotting factors? Protamine sulfate Vitamin K Vitamin E Acetylsalicylic acid (aspirin)
Vitamin K
The nurse is caring for a 73-year-old client receiving warfarin. When the nurse performs the initial shift assessment, the nurse observes blood in the client's urinary drainage bag. After reporting the observation to the physician, which substance will the nurse likely administer? Aminocaproic acid Platelets Protamine sulfate Vitamin K
Vitamin K
When administering iron injections, which method would the nurse use? Z-track intramuscular This medication is not to be given as an injection. Intradermal Subcutaneous
Z-track intramuscular
A nurse has an order to administer heparin. Before initiating this therapy, a priority nursing assessment will be the client's: blood glucose level. heart rate and pulse. aPTT. sodium and potassium levels.
aPTT.
A client, diagnosed with chronic renal failure, has begun experiencing increasing shortness of breath. The nurse suspects that the client is experiencing symptoms associated with which resulting condition? thrombocytopenia hypoglycemia hypertension anemia
anemia
A female patient diagnosed with chronic atrial flutter has been prescribed verapamil in conjunction with digoxin to control ventricular rate. To enhance the therapeutic effect of the drug, the nurse will instruct the patient to: take the medication with meals. avoid fresh fruit. take an aspirin every day. avoid grapefruit and grapefruit juice.
avoid grapefruit and grapefruit juice.
How does captopril contribute to a reduction of a client's blood pressure? dilating peripheral arteries and relaxing vascular smooth muscle increasing rebel excretion of sodium and water blocking the blood pressure-raising effects of angiotensin II blocking the conversion of angiotensin I to angiotensin II
blocking the conversion of angiotensin I to angiotensin II
When describing the drugs classified as class IV antiarrhythmics, the nurse would identify these as: cardiac glycosides. vasodilators. beta blockers. calcium channel blockers.
calcium channel blockers.
A 49-year-old client reports frequent muscle cramps while on hydrochlorothiazide therapy. The nurse would advise the client to do which? drink plenty of fluids. take calcium supplements. include high-sodium foods in her diet. eat potassium-rich foods.
eat potassium-rich foods.
The client is diagnosed with hyperlipidemia and prescribed lovastatin. Which is the most common adverse effects of lovastatin? increased appetite and blood pressure. headache and flatulence. fatigue and mental disorientation. hiccups, sinus congestion, and dizziness.
headache and flatulence.
A health care provider has prescribed triamterene to a male client with renal disease. The client informs the nurse that he is taking potassium supplements to address some heart problems. The nurse would be alert for: decreased diuretic effectiveness. increased risk of bleeding. increased risk of arrhythmias. increased risk of hyperkalemia.
increased risk of hyperkalemia.
What is the primary goal of antidysrhythmic drug therapy for a client who has been successfully cardioverted? suppression of original dysrhythmia increase in blood pressure maintenance of normal sinus rhythm (NSR) proof of increased cardiac contractility
maintenance of normal sinus rhythm (NSR)
The nurse is caring for a client who is experiencing elevated intracranial pressure following neurosurgery. The health care provider orders an osmotic diuretic to reduce pressure. Which medication would the nurse expect to be ordered?
mannitol
A client will begin taking atorvastatin, and the nurse is conducting relevant health education. The nurse should emphasize the need to report any new onset of: dry mouth. pruritus (itching) increased thirst. muscle pain.
muscle pain.
A client is receiving hydrochlorothiazide. The nurse would expect to administer this drug by which route? Intravenous Oral Subcutaneous Intramuscular
oral
A client is receiving warfarin. The nurse would expect to administer this drug by which route? Intravenous Intramuscular Oral Subcutaneous
oral
A client, diagnosed with left-sided heart failure, should be taught to recognize the signs and symptoms of the onset of what classic manifestation of this condition? venous ulcers chest pain pulmonary edema palpitations
pulmonary edema
What effect, if any, would extensive facial and oral trauma have on a client's sublingual nitroglycerin therapy prescribed to manage the angina? route changed to transdermal increase in prescribed dosage temporary discontinuation of medication therapy no effect
route changed to transdermal
A 35-year-old female client controls the symptoms of her cardiovascular disease with ACE inhibitors. She discovers that she is pregnant and contacts her primary care provider regarding her medication regimen. What would the nurse expect the provider to do? Maintain the current dosage of the drug Increase the dosage of the drug Discontinue the drug Decrease the dosage of the drug
Discontinue the drug
A nurse is caring for a client receiving warfarin drug therapy. The client informs the nurse that he is also taking chamomile, which is an herbal remedy. The nurse would alert the client to which adverse effects? Decreased effectiveness of chamomile Increased risk for bleeding Increased absorption of warfarin Increased risk for hypertension
Increased risk for bleeding
Which would a nurse identify as the primary issue associated with anemias? Defective white blood cells Ineffective red blood cells Increased plasma proteins Lack of vitamin B12
Ineffective red blood cells
A 54-year-old client has been prescribed sublingual nitroglycerin. After the nurse has finished teaching the client about the medication, what statement could the client make to suggest that the client understands proper self-administration? "I should take three tablets as soon as I start to feel chest pain." "I should take as many tablets as I need to make the pain go away." "I can take up to three tablets at five-minute intervals." "I should only take the medication if the pain becomes severe."
"I can take up to three tablets at five-minute intervals."
After teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states: "I need to take the drug on an empty stomach." "I can still use my salt substitute if I want to." "I should take the medicine around dinnertime for the best effect." "I need to make sure I don't eat too many high potassium foods."
"I need to make sure I don't eat too many high potassium foods."
A patient has been receiving intramuscular injections of hydroxocobalamin as treatment for pernicious anemia. Which statement by the patient indicates that he understands the therapy? "I will need these injections monthly for the rest of my life." "Once my levels are up, I won't need the drug anymore." "I need the injections now, but then I can switch to a pill." "I will get the injection for a week and then stop."
"I will need these injections monthly for the rest of my life."
The nurse educates a client diagnosed with atrial fibrillation about the prescribed warfarin. Which client statements establish the need for further clarification? "I will take the warfarin at the same time each day." "I will not drink alcohol unless it is all right with my primary care provider." "I will keep my lab appointments for prothrombin and INR levels." "I will stop eating green leafy vegetables, broccoli, yogurt, or cheese."
"I will stop eating green leafy vegetables, broccoli, yogurt, or cheese."
The nurse is caring for a patient who is on thrombolytic therapy. The patient has a co-morbidity of renal insufficiency. What does the nurse know about the amount of heparin required to treat this patient? Lower doses are required. Higher doses are required. It is not possible to use heparin to treat this patient. It is not necessary to use an infusion pump for this patient.
Lower doses are required.
A client has been prescribed disopyramide (Norpace) to treat a tachyarrhythmia. Which factor would necessitate that the dose be reduced? Hypertension Renal impairment Immobility Chronic diarrhea
Renal impairment
A client with a diagnosis of renal failure is being treated for anemia with epoetin alfa. Frequent assessment of which laboratory values should be prioritized before and during treatment? C-reactive protein AST ALT CBC
CBC
Which process is cytokine-induced? Select all that apply. antibody production tissue repair inflammation oxygen binding to hemoglobin cellular differentiation
antibody production tissue repair inflammation cellular differentiation
A patient comes to the clinic reporting fatigue and pica. Laboratory findings reveal a low serum iron level and a low ferritin level. Upon evaluation of this assessment and laboratory data, the nurse suspects that the patient will be diagnosed with: sickle cell anemia. iron deficiency anemia. pernicious anemia. hemolytic anemia.
iron deficiency anemia.
A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administration of a diuretic such as hydrochlorothiazide may improve the patient's urine output. How should the colleague best respond to this suggestion? "That would only work if he could come in twice a day to get it intravenously." "Actually, patients with renal failure usually can't take hydrochlorothiazide." "Maybe, but hydrochlorothiazide affects the bladder more than the kidneys." "That would probably help, but we'd have to do blood work first."
"Actually, patients with renal failure usually can't take hydrochlorothiazide."
The nurse is teaching a nursing student about anemia and knows that it is important to start by explaining the causes of anemia. Which statement is true about the cause of anemia? "Anemia is a condition caused by reduced amounts of platelets, causing less oxygen to be delivered to the tissues." "Anemia is a condition caused by reduced amounts of protein, causing less oxygen to be delivered to the tissues." "Anemia is a condition caused by reduced amounts of hemoglobin, causing less oxygen to be delivered to the tissues." "Anemia is a condition caused by reduced amounts of hematocrit, causing less oxygen to be delivered to the tissues."
"Anemia is a condition caused by reduced amounts of hemoglobin, causing less oxygen to be delivered to the tissues."
A client prescribed ramipril earlier in the week states, "Now I have a nagging, dry cough." How should the nurse best follow-up the client's statement? "We need to obtain a sputum sample to see whether you have developed a respiratory infection." "Drugs like ramipril often cause a cough in clients; we should speak to the health care provider." "Coughing is an adverse effect of the medication that may lead to pneumonitis." "We should speak to the health care provider about immediately discontinuing the medication."
"Drugs like ramipril often cause a cough in clients; we should speak to the health care provider."
A client diagnosed with heart disease is prescribed an antiarrhythmic drug. Further teaching is needed when the client makes which statement? "I will take my medication at the prescribed time." "I know I must take my medication every day for my heartbeat to be fixed." "I can check the drug label about taking the medicine with food." "I need to call my primary care provider before taking any herbal supplements."
"I know I must take my medication every day for my heartbeat to be fixed."
What indicates that a client understands how to use sublingual nitroglycerin? "I should feel a fizzing or burning sensation." "I need to avoid taking any sips of water before using the drug." "I can chew the tablet once it starts dissolving." "I should put the pill between my tongue and cheek."
"I should feel a fizzing or burning sensation."
While preparing a client for discharge, the nurse teaches about the proper use of warfarin, which has been prescribed by the physician. Which statement by the client indicates that additional teaching is required? "I'll need to return periodically for blood tests." "I should use aspirin to control my arthritis pain." "I should carry a MedicAlert card that indicates I'm taking the medication." "I need to control my intake of foods containing vitamin K."
"I should use aspirin to control my arthritis pain."
A 39-year-old nulliparous woman has been taking atorvastatin for 2 years and has now decided that she would like to become pregnant. What health education should the nurse provide to this client? "Atorvastatin can be taken safely throughout your pregnancy since it does not cross through the placenta." "It's important that you stop taking atorvastatin before you stop using contraception." "Atorvastatin is approved to be taken during pregnancy, but you would have to stop taking it if you chose to breastfeed." "There's no evidence that atorvastatin is either safe or unsafe during pregnancy, so it's best to err on the side of caution."
"It's important that you stop taking atorvastatin before you stop using contraception."
A client with primary hypertension asks the nurse why the prescriber added another medication to assist with lowering the blood pressure. What is the nurse's best response? "Many clients require two or more drugs for high blood pressure." "You should talk to the prescriber for clarification about the medications. " "The prescriber has not read the current guidelines and needs an update." "Your diet and exercise are not effective and adding another drug is ideal."
"Many clients require two or more drugs for high blood pressure."
The client receives a prescription for niacin. The nurse is providing education about the medication and possible adverse effects. Which adverse affect would the nurse include? "It's important to avoid eating shellfish and to tell your care provider before having any diagnostic imaging tests." "Some people get very flushed skin when they take this medication." "You're likely to have some nausea when you begin taking the drug, but this will dissipate with time." "Sometimes this causes a full body rash when you first take it, but that doesn't necessarily mean you're allergic to it."
"Some people get very flushed skin when they take this medication."
A client is diagnosed with erectile dysfunction. He asks what effect sildenafil (Viagra) has because he is taking nitroglycerin for chest pain. What is the best explanation for why nitrates are contraindicated with sildenafil? "Taking the drugs together can lead to prostate cancer." "Nitroglycerine and sildenafil will diminish the effectiveness of chest pain relief." "The combination can cause a severe decrease in blood pressure." "Nitroglycerine decreases the effect of sildenafil for erectile dysfunction."
"The combination can cause a severe decrease in blood pressure."
A client is diagnosed with angina pectoris. What would the nurse include when explaining this condition to the client? "The arteries are narrowed due to fatty deposits." "The heart muscle has grown larger to compensate." "The heart muscle isn't getting enough oxygen." "The heart muscle has become damaged due to blocked blood flow."
"The heart muscle isn't getting enough oxygen."
An 86-year-old male client who was admitted earlier in the week with thrombophlebitis is being sent home on enoxaparin. Which statement by the client suggests that he understands proper management of his condition and proper use of the drug? "The only thing I need to do to manage my condition is to take this medication." "The medication will increase my risk of bleeding." "I should take the medication with grapefruit juice." "I should call the health care provider to report severe bleeding, but I should just take care of less serious bleeding by myself."
"The medication will increase my risk of bleeding."
The nurse is providing education to an older adult client who has been prescribed atorvastatin. How should the nurse describe the common adverse effects of the drug? "The most common side effects of atorvastatin include some mild gastrointestinal upset." "Most people who experience side effects from atorvastatin report stiffness in their joints." "Some clients experience mild chest pain initially." "The more serious side effects of atorvastatin involve a risk of bleeding."
"The most common side effects of atorvastatin include some mild gastrointestinal upset."
Which client statement demonstrates an accurate understanding of the action of a prescribed anticoagulant? "Anticoagulants thin the blood so clots can't get as big." "If I have another stroke, this medication will bust up the clot before too much damage is done." "This medication will keep unnecessary clots from forming in my blood." "If a big clot starts to form, this medication will help break it up."
"This medication will keep unnecessary clots from forming in my blood."
ACE inhibitors
-pril Blocks ACE in lungs from converting angiotensin I to angiotensin II Decreases BP, Decreased Aldosterone secretions, Sodium and fluid loss. Check BP before giving (hypotension) *DRY COUGH
A client experiencing a ventricular arrhythmia has received a bolus of lidocaine. What is the recommended rate for continuous infusion of lidocaine IV now prescribed for this client? 1 to 4 mg/min 10 to 20 mg/min 6 to 8 mg/min 0.25 to 0.75 mg/min
1 to 4 mg/min
A client reports substernal chest pain that radiates to the neck. The pain lasts 5 minutes and then subsides with relaxation. What is the most likely cause of the chest pain? Intermittent claudication Myocardial infarction Hypertension Angina pectoris
Angina pectoris
The client is a woman 65 years of age being treated for anemia secondary to chronic kidney disease. The nurse explains to the client that she will be getting a prescription for Epogen. Which of the following additional information would the nurse provide? Chronic kidney disease has no affect on the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia. Chronic kidney disease has an affect on the production of red blood cells causing anemia. Epogen minimizes the effect on the production of red blood cells to cause anemia. Chronic kidney disease stimulates the production of red blood cells causing anemia. Epogen slows the production of red blood cells to cause anemia. Chronic kidney disease slows the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia.
Chronic kidney disease slows the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia.
Beta-adrenergic blocking agents decrease the oxygen demands of the heart by what mechanism? Decreasing the heart rate, allowing for longer filling time and increased blood to the heart Increasing conduction to the atrioventricular node, thereby increasing cardiac output Increasing blood pressure, which increases the amount of blood returned to the heart Increasing cardiac output, thereby increasing the oxygen supplied to the heart
Decreasing the heart rate, allowing for longer filling time and increased blood to the heart
A 71-year-old male client is being treated for hypertension. Which measurement is a partial indication of effective treatment and management? Diastolic blood pressure below 90 mm Hg Systolic blood pressure above 140 mm Hg Systolic blood pressure below 160 mm Hg Diastolic blood pressure below 100 mm Hg
Diastolic blood pressure below 90 mm Hg
Elevated blood lipids are a major risk factor for atherosclerosis and vascular disorders. From where are blood lipids derived? Exercise Kidneys Medications Diet
Diet
A nurse is conducting a presentation for a local community group about hyperlipidemia. When discussing the modifiable factors that individuals can work on to reduce their risk, which information would the nurse include? Select all that apply. Gender Diet Family history Age Weight
Diet Weight
Key behavioral determinants of blood pressure are related to what factor? Dietary consumption of calories and salt Comorbidities Dietary consumption of sugars and fat Minimal body mass
Dietary consumption of calories and salt
A client is taking cholestyramine to reduce LDL cholesterol. Cholestyramine will cause a decrease in absorption of which medication? Aspirin Digoxin Acetaminophen Ibuprofen
Digoxin
After teaching a group of nursing students about diuretics, the instructor determines that the teaching was successful when the group identifies which as a loop diuretic? Furosemide Spironolactone Acetazolamide Hydrochlorothiazide
Furosemide
After reviewing information about antihyperlipidemic drugs, a group of nursing students demonstrate understanding when they identify which medication as a fibric acid derivative (fibrate)? Niacin Colesevelam Ezetimibe Gemfibrozil
Gemfibrozil
The three major classes of drugs used to control blood lipids are statins, bile acid resins (or sequestrants), and fibrates. Which is a fibrate? Colestipol Gemfibrozil Cholestyramine Colesevelam
Gemfibrozil
A 54-year-old client has a cholesterol level of 240 mg/dL (6.2064 mmol/L). What serum concentration of cholesterol would this client have? Very high Desirable High Optimal
H
The pharmacology instructor is discussing medications used in the treatment of dyslipidemia. Which drug class would the instructor identify as the most widely used dyslipidemia drugs? Bile acid sequestrants HMG-CoA reductase inhibitors Fibrates Niacin
HMG-CoA reductase inhibitors
A client is receiving IV norepinephrine for treatment of shock. What is the goal of administration? Increased blood pressure Increased cardiac contractibility Increased heart rate Increased cardiac output
Increased blood pressure
Because of the action of methazolamide, the nurse would assess a patient closely for signs and symptoms of which acid-base imbalance? Metabolic acidosis Respiratory alkalosis Respiratory acidosis Metabolic alkalosis
Metabolic acidosis
A client with renal impairment is in need of a diuretic. Because of the renal problem, potassium-sparing diuretics are contraindicated but may be used if there is no other option. If they are used at all, what nursing intervention would be most important for this client? Monitoring of CBC and serum albumin Monitoring of serum electrolytes, creatinine, and BUN Administration of concurrent potassium Administration of a thiazide diuretic
Monitoring of serum electrolytes, creatinine, and BUN
A client with a history of angina has sustained a mild head injury in a motor vehicle accident. When the client reports chest pain, what explanation should the nurse provide to support the decision not to treat the angina-related pain with nitroglycerin tablets? Nitroglycerin will decrease blood glucose. Nitroglycerin will increase intracranial pressure. Nitroglycerin will raise the client's blood pressure. Nitroglycerin will cause decreased cerebral edema.
Nitroglycerin will increase intracranial pressure.
A client has a complex cardiac history that includes recurrent ventricular fibrillation. After the failure of more conservative treatments, the care team has introduced oral amiodarone. What assessments should be prioritized by the nurse who is providing care for this client? Orientation and cognition Active and passive range of motion Respiratory assessment Neurological assessment
Respiratory assessment
A student asks the instructor what the goal of drug therapy is in hypotension and shock. What would the instructor respond? Resuscitate the client. Replace fluids the patient has lost. Restore and maintain adequate tissue perfusion. Restore life to the patient.
Restore and maintain adequate tissue perfusion.
The nurse notes that a client's current medications include both diltiazem for a dysrhythmia and atazanavir. The nurse should recognize the need to closely monitor which client assessment datum? peripheral pulses level of consciousness blood pressure oxygen saturation levels
blood pressure
A patient is admitted to the unit with problems controlling their serum glucose levels. The patient has hypertension as a co-morbidity, and the physician has ordered hydralazine for this patient. The nurse caring for this patient knows that hydralazine is a(n): direct vasoconstrictor. indirect vasoconstrictor. indirect vasodilator. direct vasodilator.
direct vasodilator.
Which diuretic will most likely be the initial drug of choice when a client demonstrates dyspnea related to pulmonary edema? mannitol spironolactone furosemide hydrochlorothiazide
furosemide
A health care provider prescribes spironolactone, a potassium-sparing diuretic, for a client with cirrhosis. For which category of clients is the use of potassium-sparing diuretics contraindicated? liver disease diabetes hyperkalemia gout
hyperkalemia
Propranolol is ordered for a client who has a cardiac arrhythmia. It will be important for the nurse to determine if the person has a history of: hypersensitivity to beta blockers. idiosyncratic reaction to cinchona derivatives. chronic heart failure secondary to a tachyarrhythmia. hypersensitivity to sulfonylureas.
hypersensitivity to beta blockers.
When prescribed for angina, how does oral nifedipine achieve a therapeutic effect? binding extracellular sodium ions with chloride ions inhibiting the influx of calcium through slow channels. preventing the outflow of intracellular potassium potentiating the effect of B-type natriuretic peptide
inhibiting the influx of calcium through slow channels.
A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by: blocking adrenergic receptors and producing antisympathetic effects. decreasing sodium and potassium conduction. inhibiting the movement of calcium ions across the cardiac muscle cell membrane. weakening diastolic depolarization and the action potential duration.
inhibiting the movement of calcium ions across the cardiac muscle cell membrane.
A client with a diagnosis of cardiovascular disease is taking atorvastatin calcium to reduce serum cholesterol. What is the goal of therapy for LDL cholesterol for a client taking atorvastatin calcium? 75 to 85 mg/dL (1.94 to 2.20 mmol/L) less than 60 mg/dL (1.55 mmol/L) 100 to 115 mg/dL (2.59 to 2.98 mmol/L) less than 130 mg/dL (3.37 mmol/L)
less than 130 mg/dL (3.37 mmol/L)
