Powerpoint questions
Cholestyramine has been prescribed for a patient. Which instruction should the nurse include in patient teaching? a. Cholestyramine can impair absorption of fat-soluble vitamins. b. Stop taking the drug if you develop constipation. c. Take cholestyramine with other drugs you are prescribed to enhance absorption. d. Do not take the medication if the formula is cloudy after mixing with water.
Answer: A Rationale: Cholestyramine is a bile acid sequestrant. Cholestyramine can impair absorption of fat-soluble vitamins (A, D, E, and K); vitamin supplements may be required. Cholestyramine causes constipation; patients should be informed that constipation can be minimized by increasing dietary fiber and fluids. A mild laxative may be used if needed. Instruct patients taking cholestyramine or colestipol to notify the prescriber if constipation becomes bothersome, in which case a switch to colesevelam should be considered. Cholestyramine can bind with other drugs and prevent their absorption. Advise patients to administer other medications 1 hour before or 4 hours after cholestyramine. Cholestyramine powder should be mixed with water, fruit juice, soup, or pulpy fruit (for example, applesauce, crushed pineapple) to reduce the risk of esophageal irritation and impaction. Inform patients that the sequestrants are not water soluble, therefore the mixtures will be cloudy suspensions, not clear solutions.
A patient is receiving an intravenous infusion of heparin to treat a pulmonary embolism. What laboratory value will the nurse monitor to evaluate treatment with this medication? a. Activated partial thromboplastin time (aPTT) b. Prothrombin time (PT) c. Platelet count d. Hemoglobin and hematocrit
Answer: A Rationale: The most commonly used laboratory value that monitors the effect of heparin is the activated partial thromboplastin time (aPTT).
The nurse will teach a patient who is prescribed niacin [Niacor] to prevent flushing of the face by doing what? a. Drinking a full glass of water after taking the medication b. Taking 325 mg of aspirin 30 minutes before each dose c. Ingesting a meal before taking the medication d. Increasing dietary fiber before and after each dose
Answer: B Rationale: Aspirin reduces flushing by preventing the synthesis of prostaglandins, which mediate the flushing response.
During administration of alteplase [Activase], the patient's IV site starts to ooze blood around the catheter. Which action by the nurse is most appropriate? a. Discontinue the infusion of alteplase. b. Assess the patient's vital signs. c. Apply direct pressure over the puncture site. d. Administer aminocaproic acid [Amicar].
Answer: C Rationale: Alteplase may cause bleeding, and the management of bleeding depends on its severity. Oozing at sites of cutaneous puncture can be controlled with direct pressure or a pressure dressing. If severe bleeding occurs, alteplase should be discontinued. Excessive fibrinolysis can be reversed with IV aminocaproic acid [Amicar], a compound that prevents activation of plasminogen and directly inhibits plasmin.
Which patient does the nurse identify as most likely needing an increased dose of warfarin [Coumadin] to have the same anticoagulant effect? a. Patient taking acetaminophen [Tylenol] for back pain b. Patient taking cimetidine [Tagamet] to prevent gastric ulcers c. Patient taking oral contraceptives to prevent pregnancy d. Patient taking prednisone [Deltasone] for rheumatoid arthritis
Answer: C Rationale: Oral contraceptives decrease the effects of warfarin; therefore, warfarin doses may need to be increased. Acetaminophen and cimetidine increase the effects of warfarin. Prednisone increases the risk of bleeding.
What is the antidote for heparin? a. Ferrous sulfate b. Atropine sulfate c. Protamine sulfate d. Magnesium sulfate
Answer: C Rationale: Protamine sulfate is an antidote to severe heparin overdose.
A patient diagnosed with heart failure has stage 1 hypertension. Which medication, if ordered by the health care provider, should the nurse question? a. Angiotensin-converting enzyme inhibitor b. Calcium channel blocker c. Thiazide diuretic d. Beta blocker
B
A patient is prescribed a medication that causes venous dilation. It is most important for the nurse to teach the patient about what? a. B-natriuretic peptide b. Postural hypotension c. Increased urination d. Intermittent claudication
B
A patient is prescribed hydralazine. What is most important for the nurse to teach the patient? a. Precautions for postural hypotension b. Prevention of reflex tachycardia c. High initial dose for slow acetylators d. Recognition of hypertrichosis
B
A patient with severe hypertension is prescribed minoxidil. Which medications will the nurse expect to be administered to reduce adverse responses to minoxidil? a. Adenosine [Adenocard] and ticlopidine [Ticlid] b. Furosemide [Lasix] and propranolol [Inderal] c. Digoxin [Lanoxin] and captopril [Capoten] d. Donepezil [Aricept] and clonidine [Catapres]
B
A patient with stage 2 hypertension has been prescribed a thiazide diuretic and an angiotensin-converting enzyme inhibitor. It is most appropriate for the nurse to do what? a. Contact the health care provider. b. Administer both drugs to the patient. c. Administer the thiazide diuretic at bedtime. d. Hold the medications if the blood pressure is normal.
B
A patient's cardiac output is 8 liters per minute. Which hemodynamic effect would the nurse expect? a. Decreased contractility b. Increased stroke volume c. Decreased preload d. Increased arterial pressure
B
A patient is prescribed lovastatin [Mevacor]. The nurse will teach the patient to take the medication at which time? a. With any meal b. With the evening meal c. 1 hour before breakfast d. 2 hours after a meal
B Rationale: Lovastatin should be taken with the evening meal to increase absorption. Cholesterol synthesis normally increases during the night; statins are most effective when given in the evening.
A patient has hypertension, type 2 diabetes, and chronic kidney disease. Which blood pressure goal would be most beneficial for this patient? a. Blood pressure less than 140/90 mm Hg b. Diastolic blood pressure less than 100 mm Hg c. Blood pressure less than 130/80 mm Hg d. Systolic blood pressure less than 160 mm Hg
C
A patient is prescribed a medication that lowers the arterial blood pressure. The nurse should assess for which response by the body to restore the blood pressure? a. Orthostatic hypotension b. Fluid retention c. Reflex tachycardia d. Increased natriuresis
C
Which patient is the most appropriate candidate for both lifestyle changes and drug therapy with an antihypertensive medication? a. A 47-year-old patient with blood pressure of 110/78 mm Hg and with type 2 diabetes mellitus b. A 76-year-old patient with blood pressure of 128/88 mm Hg and a history of dyslipidemia c. A 52-year-old patient with blood pressure of 136/89 mm Hg who smokes 1 pack of cigarettes per day d. A 32-year-old patient with blood pressure of 142/94 mm Hg who is sedentary
D
Which patient would most likely be prescribed sodium nitroprusside [Nitropress]? a. A patient with a recent diagnosis of essential hypertension b. A patient with heart failure who receives weekly home visits c. A patient who is hypotensive after a myocardial infarction d. A patient with a hypertensive crisis in the intensive care unit
D
Which patient would the nurse expect to have the highest risk for postural hypotension? a. A patient who is prescribed a drug that acts primarily on the arterioles b. A patient who is prescribed a drug that blocks the renin-angiotensin-aldosterone system c. A patient who is prescribed a drug that triggers the baroreceptor reflex d. A patient who is prescribed a drug that promotes venous vasodilation
D
