Pharmacology Week 4 Perfusion
Select the values from the drop down menus that accurately complete the sentence. Blood pressure control is achieved when the systolic pressure is (100-119, 120-139, less than 150) millimeters of mercury (mm Hg) with a diastolic pressure of (less than 60, 70-79, 80-89) mm Hg, or at lowest level tolerated by the individual.
120-139 80-89
Which statement by the patient reflects the need for additional patient education about the calcium channel blocker diltiazem? "I can take this drug to stop an attack of angina." "This drug may cause my blood pressure to drop, so I need to be careful when getting up." "I understand that food and antacids alter the absorption of this oral drug." "When the long-acting forms are taken, the drug cannot be crushed."
"I can take this drug to stop an attack of angina."
Which statement by an individual taking prescribed captopril indicates further teaching is required? "The soluble fiber I take before bedtime really keeps me regular." "My pharmacy sends email reminders so I don't forget to refill me prescriptions. Takes a load off my mind." "I take the first dose each day with breakfast, then space them out evenly until bedtime." "Sitting in bed for a couple of minutes before getting up has helped with my morning dizziness."
"I take the first dose each day with breakfast, then space them out evenly until bedtime."
An individual taking three doses of isosorbide dinitrate asks the health professional why this medication is taken once every six hours, rather than in the morning, with lunch, and before going to bed like another medication they take. What is the best response by the health professional? "This timing assures the medication levels are highest during the day when you are most active and likely to have angina." "That is how your health care provider prescribes it for all their patients." "That is just how this medication is given." "A nitrate free period allows your cells to be responsive to the medication."
"A nitrate free period allows your cells to be responsive to the medication."
The nurse volunteering at a community picnic on a hot, humid day is treating an older adult experiencing dizziness and hypotension. After the patient is feeling better and their blood pressure has returned to normal, what information will the nurse provide to help the patient avoid a recurrence? "Hot weather can increase the effects of your medication. Try to limit your time outside on days like this." "You should drink a lot more water on days that are this hot." "Perhaps you are too old and should stop attending these outdoor events." "This happens to a lot of people. Just make sure stay near the first aid tent in the future."
"Hot weather can increase the effects of your medication. Try to limit your time outside on days like this."
While attending a community picnic on a hot day, and older adult with stable angina had an episode of chest pain and took a sublingual nitroglycerine tablet, which relieved the pain. Thirty minutes later, the individual experienced dizziness and hypotension and was brought to the first aid tent for care. After the patient is feeling better and their blood pressure has returned to normal, what information will the nurse provide to help the patient avoid a recurrence? "This happens to a lot of people. Just make sure to stay near the first aid tent in the future." "Perhaps you are too old and should stop attending these outdoor events." "You should drink a lot more water on days that are this hot." "Hot weather can increase the effects of your medication. Try to limit your time outside on days like this."
"Hot weather can increase the effects of your medication. Try to limit your time outside on days like this."
An individual diagnosed with hypertension six months ago is frustrated that their blood pressure is still elevated despite having tried several medications. When asked what is taking so long, what is the best response by the health care provider? "There are so many medications, we just need to find the right one for you." "Hypertension is the type of illness that develops over time, so it is expected that finding the right treatment will also take time. We just need to be patient and keep trying." "Trial and error is the best way to determine how your body will respond, unfortunately. But there are a lot more drugs we can try." "Hypertension is a complex disease with multiple causes, so it can take time to discover which medication, or combination of medications, works best for each person."
"Hypertension is a complex disease with multiple causes, so it can take time to discover which medication, or combination of medications, works best for each person."
While caring for a client with hypertension who has recently started taking carvedilol, the client reports, "This medication seems to give me a rash." Which of the following statements by the health care provider is best? "That is common with your new medication. You should continue to take the medication to help control your blood pressure." "That's too bad. You could try taking half a pill twice a day." "I am glad you mentioned this. Does this rash itch or hurt?" "That is unusual with this medication. Have you noticed any muscle twitching or facial numbness?"
"I am glad you mentioned this. Does this rash itch or hurt?"
The nurse is providing discharge instructions to a patient who will be taking an adrenergic antihypertensive at home. Which statements by the patient demonstrate they understood your discharge instructions? Select all that apply. "I will make sure I incorporate a high amount of potatoes, bananas, oranges, and tomatoes into my diet while taking this medication." "If I feel unwell, it is okay that I miss a dose." "I will avoid using salt substitutes that contain potassium." "I will regularly check my blood pressure and pulse rate while taking this medication and report any significant changes to my doctor." "I have been walking every day and no longer smoke cigars. I am starting to enjoy exercise, but really do miss the cigars, though."
"I will avoid using salt substitutes that contain potassium." "I will regularly check my blood pressure and pulse rate while taking this medication and report any significant changes to my doctor." "I have been walking every day and no longer smoke cigars. I am starting to enjoy exercise, but really do miss the cigars, though."
After the nurse has finished teaching a patient about the use of sublingual nitroglycerin, which patient statement indicates that the teaching has been effective? "I can expect some nausea as a side effect of nitroglycerin." "I will call an ambulance if I still have pain after taking 3 nitroglycerin 5 minutes apart." "Nitroglycerin helps prevent a clot from forming and blocking blood flow to my heart." "I should only take the nitroglycerin if I start to have chest pain."
"I will call an ambulance if I still have pain after taking 3 nitroglycerin 5 minutes apart."
In preparation for discharge, the nurse teaches a patient with chronic stable angina how to use the prescribed short-acting and long-acting nitrates. Which patient statement indicates that the teaching has been effective? "I will stop what I am doing and sit down before I put the nitroglycerin under my tongue." "I will put the nitroglycerin patch on as soon as I get any chest pain." "I will be sure to remove the nitroglycerin patch before taking any sublingual nitroglycerin." "I will check my pulse rate before I take any nitroglycerin tablets."
"I will stop what I am doing and sit down before I put the nitroglycerin under my tongue."
Mr. James, an older adult with hypertension and chronic kidney disease, is talking with a group of young men newly diagnosed with hypertension about coping with the diagnosis of a lifelong alteration in health. When a participant asks Mr. James what he would do differently if he had the chance, which statement from Mr. James reinforces the importance of medication compliance? "I would not have ignored my wife nagging me to take my medicines." "I would have improved my diet and taken herbal supplements when I was still healthy." "I would have started taking antihypertensives when my doctor first said I needed them." "I would have talked to my health care provider about how the medications made me feel."
"I would have started taking antihypertensives when my doctor first said I needed them."
A patient is prescribed metoprolol. Which statement by the patient requires the nurse to re-educate the patient on how to take the medication properly? "If I stop taking this medication, I will let my physician know." "I will change positions slowly while I'm taking this medication." "I take this medication with my breakfast every morning." "I am getting pretty good with monitoring my heart rate."
"If I stop taking this medication, I will let my physician know."
An individual asks how their diltiazem works to help their angina. What is the best response by the health professional? "It prevents cardiac dysrhythmias." "It increases excretion of sodium and water through the kidneys." "It blocks calcium channels allowing the arteries to dilate." "It blocks the renin-angiotensin-aldosterone cycle."
"It blocks calcium channels allowing the arteries to dilate."
The nurse is counseling a client who is to start taking amlodipine for hypertension. Which statement by the client indicates that further teaching is needed? "It is important that I take this medication on an empty stomach." "I'll get up slowly since I may be a little dizzy if I get up too fast." "I need to call the doctor if my pulse is less than 50 beats in a minute." "I need to check with the doctor before taking any new over-the-counter cold medicines."
"It is important that I take this medication on an empty stomach."
A hypertensive client who has been prescribed captopril states, "The doctor keeps changing my pills and none are working. I feel like a guinea pig." Which response by the nurse would be most appropriate? "The doctor is just trying to help you control your blood pressure." "It often takes a while before the right medication is found." "The action of this drug is to work on both the arteries and to remove excess fluids." "This drug is used when all other drugs have failed."
"It often takes a while before the right medication is found."
Which statement provides subjective data that the recently prescribed isosorbide dinitrate is having the desired therapeutic effect on the individual speaking? Select all that apply. "Last night I realized I had not taken any sublingual nitroglycerin through the day, instead of the 2-3 times I'd been averaging." "My angina is about the same as it has been. Not better. Not worse." "I have been sleeping so well these past few nights." "I was able to walk around the block twice last night with my partner. First time in years we've done that."
"Last night I realized I had not taken any sublingual nitroglycerin through the day, instead of the 2-3 times I'd been averaging." "I was able to walk around the block twice last night with my partner. First time in years we've done that."
A patient who has a prescription for methyldopa is being tapered off the medication. The nurse includes which statement in the patient teaching? "Stopping this medication suddenly can be very dangerous, so it is important that you follow the taper schedule carefully." "Patients usually only take this drug for 1-2 weeks before switching to another medication." "I bet you're glad to be getting off this medication since it is so expensive." "By slowly weaning you from this drug, the risk of rebound headaches is reduced."
"Stopping this medication suddenly can be very dangerous, so it is important that you follow the taper schedule carefully."
A client calls the health care provider at 2 p.m. stating, "I forgot to take my daily blood pressure pill at 8 a.m. like I usually do. Should I take it now?" Which of response by the healthcare provider is best? "It would be best to simply take 2 pills tomorrow." "Yes, it is important to take the medication each day." "Why did you forget to take it today?" "No, too much time has gone by so just skip that dose."
"Yes, it is important to take the medication each day."
Increase Angiotensin Converting Enzyme (ACE) Inhibitors Effectiveness Decrease Angiotensin Converting Enzyme (ACE) Inhibitors Effectiveness Tricyclic antidepressant Diuretics Nitrates Monoamine oxidase inhibitors (MAOIs) Appetite suppressants
Increase: Diuretics, Nitrates Decrease: Tricyclic antidepressants, Monoamine oxidase inhibitors (MAOIs), Appetite suppressants
Which individual would benefit most from an ACE inhibitor? 54-year-old male with hypovolemic shock 35-year-old female with chronic hepatitis 48-year-old male with severe renal failure 50-year-old female with systolic dysfunction heart failure
50-year-old female with systolic dysfunction heart failure
In which individual should clonidine be used with caution? 26-year-old with hypertension in the 27th week of gestation 58-year-old with essential hypertension 87-year-old with heart failure and hypertension 14-year-old with ADHD
87-year old with heart failure and hypertension
In which individuals should caution be used when administering isosorbide dinitrate? Select all that apply. A middle-aged adult who is dehydrated A diabetic with chronic heart failure An individual having a heart attack involving the right ventricular muscle An individual with glaucoma An older adult experiencing chest pain for the first time
A middle-aged adult who is dehydrated An individual having a heart attack involving the right ventricular muscle An older adult experiencing chest pain for the first time
A patient taking diltiazem to treat an irregular heart rhythm should not take their medication and notify the prescribing health care provider if which conditions are present when checking his pulse and blood pressure? Select all that apply. Heart rate is 1366 beats per minute Blood pressure 198/102 Last bowel movement was two days ago Heart rhythm is irregular A new rash has developed
A new rash has developed
Which statements about hypertension in the United States are supported by facts? Select all that apply. About 30 million adults with known hypertension are not being treated All individuals with hypertension require prescription medication to reduce risk of complications An estimated 31 million adults taking medication for high blood pressure are not taking the right dose Most adults with hypertension do not have their hypertension under control Nearly 1 in 10 adults have hypertension
About 30 million adults with known hypertension are not being treated An estimated 31 million adults taking medication for high blood pressure are not taking the right dose Most adults with hypertension do not have their hypertension under control
Which individuals may require a lower dose of amlodipine? Select all that apply. An emaciated 49-year-old A 79-year-old with vasospastic angina A person with chronic cirrhosis An individual with renal insufficiency A 54-year-old with a yeast infection
An emaciated 49-year-old A 79-year-old with vasospastic angina A person with chronic cirrhosis
When giving antihypertensive drugs, the nurse will consider giving the first dose at bedtime for which class of drugs? Vasodilators, such as hydralazine Antilipemics, such as simvastatin Angiotensin converting enzyme (ACE) inhibitors, such as captopril Diuretics, such as furosemide
Angiotensin converting enzyme (ACE) inhibitors, such as captopril
What precautions does the nurse take to protect themselves when preparing and administering nitroglycerin ointment? Document vital signs prior to applying the ointment Carefully measure the dose Adhere to the rights of medication administration Apply gloves
Apply gloves
While obtaining subjective assessment data from a patient with rheumatoid arthritis and angina whose episodes of chest pain have decreased only marginally after three months of treatment with sublingual nitroglycerin, the nurse asks the patient if they are having any difficulty placing the small tablet beneath the tongue. What is the rationale for this question? Select all that apply. Assess for physical limitations that may affect medication use Evaluate the patient's understanding of how and when to take the medication Determine if the person really wants to be healthier Understand what motivates the patient Shame the patient to comply with the treatment plan
Assess for physical limitations that may affect medication use Evaluate the patient's understanding of how and when to take the medication
While obtaining subjective assessment data from a patient with hypertension whose blood pressure has not reached goal after three months of therapy, the nurse asks the patient about changes they have made to their diet and exercise. What is the rationale for this question? Assess patient's adherence to recommended lifestyle changes Determine if the person really wants to be healthier Shame the patient to comply with the treatment plan Understand what motivates the patient
Assess patient's adherence to recommended lifestyle changes
An hour after administering the daily dose of an antihypertensive to a 64-year-old patient the nurse is asked to help them to the bathroom. What priority action will the nurse take before completing the request? Assist the patient to put on slippers Ask for assistance Listen to breath sounds Assess the orthostatic blood pressure
Assess the orthostatic blood pressure
The nurse prepares discharge teaching for a client receiving isosorbide dinitrate for treatment of angina. What information to lower potential side effects of the medication will the nurse include? Monitor intake and output Report skin flushing to the prescribing health care provider Limit exercise to 30 minutes twice per week Avoid alcohol consumption
Avoid alcohol consumption
When counseling a 68-year-old male who is taking doxazosin and denies any history of hypertension, the health care provider asks if he has history of which other condition? Benign prostatic hypertrophy Gout Psoriasis Lymphoma
Benign prostatic hypertrophy
How does captopril impact the vasoconstriction, aldosterone secretion, and renin release that occur as a result of the renin-angiotensin-aldosterone system? Select all that apply. Promotes renin release Binds to renin and bradykinins Destroys angiotensin I Blocks aldosterone secretion Inhibits vasoconstriction
Blocks aldosterone secretion inhibits vasoconstriction
Which of the angiotensin converting enzyme (ACE) inhibitors have been shown to reduce the risk of death or development of heart failure (HF) following a myocardial infarction (MI)? Select all that apply. trandolapril enalapril quinapril lisinopril captopril
Captopril, lisinopril, and trandolapril
Many individuals who are aware they have hypertension are not being treated. The nurse understands that which factors can impact how well a patient adheres to the prescribed treatment plan? Select all that apply. Cost of medications They tried medications and did not like how they felt They may not feel sick Challenges getting to a health care provider Do not care about their health
Cost of medications They tried medications and did not like how they felt They may not feel sick Challenges getting to a health care provider
What are the goals of antianginal therapy? Select all that apply. Decrease intensity of anginal pain Protect the brain Prevent myocardial infarction Reverse coronary artery disease Minimize frequency of angina
Decrease intensity of anginal pain Prevent myocardial infarction Minimize frequency of angina
A person is prescribed an Angiotensin Converting Enzyme (ACE) Inhibitors after experiencing a myocardial infarction. What effects on the body will this medication achieve? Select all that apply. Decreases SVR (systemic vascular resistance) and blood pressure Constriction of the venous blood vessels Kidneys will excrete water and sodium Increases SVR and blood pressure Kidneys will retain potassium
Decreases SVR (systemic vascular resistance) and blood pressure Kidneys will excrete water and sodium Kidneys will retain potassium
The teaching plan for a client being started on long-acting nitroglycerin includes the drug's mechanism of action. The nurse teaches that this drug relieves chest pain by which action? Increasing contractility of the heart Dilating arteries and veins Decreasing the blood pressure Dilating just the coronary arteries
Dilating just the coronary arteries
When teaching an individual with angina to administer translingual nitroglycerin, which information regarding safety should be included? Stay standing when using this medication Direct the spray carefully Wash your hands before taking the cap off the medication Measure their heart rate for a full minute
Direct the spray carefully
Which effects of angiotensin II do angiotensin II blocking medications (ARBs) stop in order to decrease blood pressure? Select all that apply. Direct vasoconstriction Increase peripheral catecholamine release Hypertrophy vascular cells Release of aldosterone Remodeling cardiac cells
Direct vasoconstriction Release of aldosterone
A client with newly discovered hypertension has an average blood pressure (BP) reading of 158/98 millimeters of mercury (mm Hg) after 3 months of exercise and diet modifications. Which management strategy will be a priority for this patient? More changes in the patient's lifestyle are needed for a longer time before starting drug therapy BP monitoring should continue for 3 months to confirm a diagnosis of hypertension Drug therapy will be needed because the BP is still not at goal Lifestyle changes can be stopped since they were not effective, and drugs will be started
Drug therapy will be needed because the BP is still not at goal
Which action is the first priority of care for a client exhibiting signs and symptoms of angina? Decrease anxiety Educate the client about their symptoms Administer sublingual nitroglycerin Enhance myocardial oxygenation
Enhance myocardial oxygenation
A patient states they are experiencing an annoying, persistent dry cough that started once they begin taking an ACE inhibitor. The patient is not experiencing any other signs and symptoms. What is the best response by the health care provider? Tell the patient to immediately stop taking the medication and seek medical treatment Recommend the patient start taking the medication at night to decrease the coughing Explain that this is a known, harmless side effect of the medication Reassure the patient that the cough will disappear within 6 months of taking the medication
Explain that this is a known, harmless side effect of the medication
Routine oral hygiene is necessary to prevent which adverse effect associated with calcium channel blocker therapy? Gingival hyperplasia Dental caries Bad breath Oral candidiasis
Gingival hyperplasia
Which signs and symptoms would demonstrate a person is experiencing an overdose of a beta blocker medication? Select all that apply. Heart rate 35 beats per minute Patient is very drowsy Blood pressure 200/110 Patient is hyperactive Dyspnea
Heart rate 35 beats per minute Patient is very drowsy
The initial nursing assessment of a patient diagnosed with angina should including questions about which underlying causes? Select all that apply. High blood pressure Depression Tobacco use Allergies to medications Diabetes mellitus
High blood pressure Tobacco use Diabetes mellitus
In addition to angina, for what conditions are calcium channel blocker medications indicated? Select all that apply. Heart failure Hypertension Renal insufficiency Arrhythmia Diabetes mellitus
Hypertension Arrhythmia
Which pathophysiological conditions can lead to coronary artery disease? (Select all that apply.) Atrial Fibrillation Heart Failure Pneumonia Gastroenteritis Hypertension Diabetes
Hypertension Diabetes
Adam's chest pain is not changed after taking their antianginal medication to the maximum dose prescribed. What action should he take next? Call 911 to request assistance Wait 15 minutes and take another dose of his medication Drive himself to the closest hospital Call his partner to pick them up
call 911 to request assistance
Which medications are included in the adrenergic antihypertensives class? Select all that apply. carvedilol acetaminophen clonidine methyldopa diphenhydramine
carvedilol clonidine methyldopa
The nurse is administering antihypertensive drugs to older adult patients. The nurse knows that which adverse effect is of most concern for these patients? Dry mouth Restlessness Constipation Hypotension
Hypotension
Which medical conditions are considered contraindications to antianginal therapy? Select all that apply. Hypotension Acute myocardial infarction Presence of a pacemaker Low dose aspirin therapy Second degree atrioventricular (AV) block
Hypotension Acute myocardial infarction Second degree atrioventricular (AV) block
The initial nursing assessment of a patient diagnosed with hypertension should including questions about which underlying causes? Select all that apply. Kidney disease Pheochromocytoma Pneumonia Lactose intolerance Hepatic dysfunction
Kidney disease Pheochromocytoma Hepatic dysfunction
What teaching point is a priority when the nurse is teaching a client who is taking an angiotensin converting enzyme (ACE) inhibitor? Avoid consuming alcoholic beverages Limit foods high in potassium Take the medications with food Decrease salt intake
Limit foods high in potassium
While reviewing the health history of an individual taking an antihypertensive, the health care provider is concerned that which over-the-counter product may interfere with blood pressure medicine? Select all that apply. Nonsteroidal anti-inflammatory drugs (NSAIDs) Calcium supplement Appetite suppressant Multivitamin with iron Nasal decongestant
Nonsteroidal anti-inflammatory drugs (NSAIDs) Appetite suppressant Nasal decongestant
A patient has a new prescription for an angiotensin converting enzyme (ACE) inhibitor. During a review of the patient's list of current medications, which would cause concern for a possible interaction with this new prescription? Select all that apply. Nonsteroidal anti-inflammatory drugs (NSAIDs) taken as needed for headaches Opioid used for occasional severe pain Antihistamines taken as needed for allergies Oral anticoagulant taken daily Potassium supplement taken daily
Nonsteroidal anti-inflammatory drugs (NSAIDs) taken as needed for headaches Opioid used for occasional severe pain Potassium supplement taken daily
What are the goals of antihypertensive therapy? Select all that apply. Protect the kidneys Normalization of blood pressure Prevent stroke Alleviate early symptoms Reduce organ damage
Protect the kidneys prevent stroke normalization of blood pressure reduce organ damage
A nurse is monitoring a patient with angina for therapeutic effects of a rapid-acting nitrate given for chest pain. Which assessment finding indicates that the medication has been effective? ECG without evidence of ST changes Blood pressure 120/80 mm Hg Heart rate 70 beats per minute Client stating that pain is 0 out of 10
client stating that pain is 0 out of 10
Metoprolol is available for administration by which routes? Select all that apply. Transdermal Oral Rectal suppository Subcutaneous Intravenous
Oral IV
By what routes can isosorbide dinitrate be administered? Select all that apply. Oral Sublingual Intravenous Buccal Rectal
Oral Sublingual
Extracellular calcium is required for the (contraction, relaxation) of cardiac and (smooth, striated) muscle cells.
contraction, smooth
During a follow up visit with the health care provider a person taking carvedilol reports the following information. Which indicates a possible complication due to the medicine? Heart rate in the morning averaging 64 bpm Experiencing insomnia Blood pressure readings averaging 120/66 Shortness of breath with mild exertion
Shortness of breath with mild exertion
During his walk, Adam experiences chest pain similar to past anginal episodes. Which actions should he take now? Select all that apply. Sit down right away Take the antianginal as directed Call 911 Return to the car and rest Keep walking at a slower pace
Sit down right away Take the antianginal as directed
Which over-the-counter item should not be consumed by an individual taking ranolazine for unstable angina? Select all that apply. Dark chocolate Cured pork (bacon or ham) Kiwi St. John's Wort Grapefruit juice
St. John's Wort Grapefruit juice
By which mechanisms do ACE inhibitors cause systemic vasodilation and lower blood pressure? Select all that apply. Increase aldosterone levels Decrease plasma renin levels Stop the conversion of angiotensin I to angiotensin II Prevent the breakdown of bradykinin Directly cause the excretion of sodium and water through the kidneys
Stop the conversion of angiotensin I to angiotensin II Prevent the breakdown of bradykinin
The nurse is preparing to administer a morning dose of atenolol to a patient with hypertension and angina. The nurse withholds the medication and notifies the prescribing health care provider based on which cues discovered during the focused assessment? Select all that apply. Swelling in bilateral lower extremities Dyspnea Crackles in lung fields Headache with a pain level of 4/10 Blood pressure 102/76 mmHg Heart rate 120 beats per minute
Swelling in bilateral lower extremities Dyspnea Crackles in lung fields
Which calcium channel blockers below are known as the dihydropyridines and are known to be more vascular selective? Select all that apply. amlodipine verapamil diltiazem nifedipine felodipine
amlodipine, nifedipine, felodipine
Which assessment data collected by the nurse who is admitting a patient with chest pain suggests that the pain is caused by angina? The pain is reproducible when the patient raises the arms The pain increases with deep breathing The pain is relieved after the patient takes nitroglycerin The pain has lasted longer than 30 minutes
The pain is relieved after the patient takes nitroglycerin
An individual with a history of angina takes sublingual nitroglycerine to relieve chest pain ranked 6/10. Five minutes later, the chest pain is 4/10. What action should be taken next? The person should take another sublingual nitroglycerine tablet Have a family member call 911 Wait an additional 10 minutes before taking any action The individual should take a warm shower
The person should take another sublingual nitroglycerine tablet
While reviewing the medication list for a newly admitted patient the nurse notes they are taking a calcium channel blocker. Based on knowledge of the medication, the nurse inquires if the patient has a history of which conditions? Select all that apply. Left ventricular hypertrophy Myocardial infarction Angina pectoris Hypertension Cardiac dysrhythmia
angina pectoris cardiac dysrhythmias hypertension
Which antihypertensive medications are contraindicated during pregnancy and lactation? Select all that apply. clonidine methyldopa angiotensin II receptor blockers (ARBs) angiotensin converting enzyme (ACE) inhibitors hyralazine
angiotensin II receptor blockers (ARBs) angiotensin converting enzyme (ACE) inhibitors
The nurse cautions the client receiving isosorbide dinitrate for treatment of angina that long-term use can lead to the development of which condition? Tachycardia Urinary retention Hypertension Tolerance
Tolerance
A patient with angina has been given a prescription for a calcium channel blocker. The nurse knows that this class of drugs is used to treat which type of angina? Crescendo Vasospastic Unstable Prinzmetal
Vasospastic
An individual taking carvedilol for the last three weeks is reporting an increasingly dry mouth, unusual issues with constipation, and becoming extremely dizzy within five minutes of jogging for exercise. When asked, the person confirms that these symptoms started after the medication was prescribed and have been increasing since. The health care provider suspects (a genetic enzyme disorder, a hereditary allergy to carvedilol, lack of adherence to dosing schedule) as the reason for the current symptoms and recommends the individual (stop the medication immediately, discontinue the dose of carvedilol slowly.)
a genetic enzyme disorder discontinue the dose of carvedilol slowly
By (decreasing, increasing) the systemic vascular resistance, calcium channel blockers decrease the (workload of the heart, dilation of the ventricles) and myocardial demand for (oxygen, potassium, sodium.)
decreasing workload of the heart oxygen
Which antihypertensive medication is contraindicated for an older adult with an esophageal stricture? minoxidil losartan terazosin doxazosin
doxazosin
In addition to angina, for what condition is isosorbide dinitrate indicated? Select all that apply. Diabetes mellitus Hypertension Heart failure Renal insufficiency
heart failure
In addition to hypertension, carvedilol is also prescribed to treat (heart failure, coronary artery disease, inflammation) and impaired left ventricular function after a (cerebrovascular accident (CVA), myocardial infarction (MI), living donor liver transplant.)
heart failure myocardial infarction (MI)
Which antianginal medications are used to prevent future episodes of angina? Select all that apply. isosorbide mononitrate nitroglycerin biguanides isosorbide dinitrate nonsteroidal anti-inflammatory drugs (NSAIDs)
isosorbide mononitrate nitroglycerin isosorbide dinitrate
An individual with diabetes and hypertension is seen in urgent care with severe hypoglycemia. She is concerned that her usual symptoms of low blood sugar were not present, allowing her levels to drop to the point she became faint. Which of her current medications may contribute to the masking of her hypoglycemia? losartan clonidine labetalol doxazosin
labetalol
In addition to hypertension, ACE Inhibitors are also prescribed to prevent (left ventricular hypertrophy, right ventricular enlargement, atrial fibrillation) after a myocardial infarction and decrease the morbidity and mortality associated with (arterial vascular disease, hepatic dysfunction, heart failure.)
left ventricular hypertrophy heart failure
Which ACE inhibitor is not metabolized by the liver and is eliminated unchanged in urine? enalapril ramipril moexipril lisinopril
lisinopril
Which of the oral ACE inhibitor medications are ready to be used by the body as soon as they are absorbed? Select all that apply. fosinopril lisinopril ramipril benazepril captopril
lisinopril captopril
ACE inhibitors should be used cautiously in individuals with (liver disease, diabetes mellitus, angina) and those with a family history of (spontaneous abortions, peptic ulcers, angioedema.)
liver disease angioedema
Which medication is used to treat hypertension? losartan gabapentin prednisone acyclovir
losartan
When providing hypertension screening and education a health care professional shares that which medications are in the ARB class? Select all that apply. propranolol losartan eprosartan doxazosin atenolol valsartan
losartan eprosartan valsartan
An individual taking nifedipine for blood pressure regulation has a new prescription for digoxin. The health care provider anticipates that this combination of medications may have which effects? Select all that apply. Low heart rate Increased elimination of digoxin Increased digoxin levels Hypertension Renal toxicity Heart failure
low heart rate increased digoxin levels heart failure
Which antianginal medications belong to the classification of beta-adrenergic blockers? metoprolol atenolol pyrogallol nadolol propranolol
metoprolol atenolol nadolol propranolol
By what routes can diltiazem be administered? Select all that apply. Oral Intravenous Rectal Sublingual Buccal
oral Intravenous
Which condition may result from stopping clonidine therapy abruptly? Cardiomyopathy Rebound hypertension Severe bronchospasms Stevens-Johnson syndrome
rebound hypertension
Control of angina is achieved when the (severity, force, crippling effects) and (length, frequency, duration) of episodes decreases and the patient's (tolerance of, interest in) increased activity occurs.
severity frequency tolerance of
A male patient admitted to the emergency department with intermittent chest pain provides a list of prescription medications to the nurse. Concurrent use of which medications has the most immediate implications for the patient's care? Select all that apply. sildenafil aspirin warfarin furosemide captopril
sildenafil captopril
Some medications used to treat angina work by (slowing, maintaining, increasing) the heart rate to allow the myocardial cells to (rest, receive oxygen, produce energy.)
slowing receive oxygen
An individual taking an ACE inhibitor for the last three weeks reports swelling of the lips, eyes, and tongue that started about 30 minutes before they called the prescribing health care provider. The health care provider suspects these symptoms are related to (a genetic enzyme disorder, the onset of angioedema, taking the medication with an antacid) and recommends the individual (call 911 immediately, skip the next scheduled dose of the medication, make an appointment to be seen in the office tomorrow.)
the onset of angioedema call 911 immediately
A patient with angina has been given a prescription for a calcium channel blocker. The nurse knows that this class of drugs is used to treat which type of angina? Unstable Effort Vasospastic Crescendo
vasospastic
Which calcium channel blockers are indicated for cardiac dysrhythmias? isradipine verapamil diltiazem amlodipine nifedipine
verapamil diltiazem
Scheduling a (daily, weekly, monthly) nitrate free period allows plasma and tissue nitrate levels to (fall, remain consistent, rise), allowing cells to recover to a responsive state when the next dose is administered. These nitrate free periods are used to (offset allergic reactions, dependence, tolerance) that can develop with long-term continuous administration of nitrates.
weekly fall tolerance