quiz 17

A patient with heart failure asks you why the antihypertensive drug enalapril (Vasotec) has been prescribed. What is your best response?

"Lowering your blood pressure will allow your heart to pump more easily."

The nurse is providing teaching to a patient who will be discharged with oral warfarin sodium (Coumadin). The nurse informs the patient that he will need to undergo which regular blood tests? (Select all that apply.)

-PT (prothrombin). -INR (international normalized ratio).

Before administering digoxin (Lanoxin), the nurse takes the adult patients apical pulse for 1 full minute. What additional nursing consideration(s) will be taken before administration of the medication? (Select all that apply.)

-Review of the digoxin blood level -Review of serum electrolytes, liver, and kidney function studies -Obtaining baseline patient assessment data, including lung sounds, vital signs, and weight

Which drug categories are used as preferred antihypertensive treatments in patients with metabolic syndrome? (Select all that apply.)

-Thiazide diuretics -ACE inhibitors -Beta blockers

A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client. What is the sequence of events the nurse should follow? (Move the steps of mixing insulin on the left into the box on the right, placing them in the selected order of performance. All steps must be used.)

1st. Inspect vials for contaminants. 2nd. Roll NPH vial between palms of hands. 3rd. Inject air into NPH insulin vial. ​ 4th. Inject air into regular insulin vial. 5th. Withdraw short-acting insulin into syringe. 6th. Add intermediate insulin to syringe.

Which drug is used to obtain vasodilation in the treatment of chronic heart failure?

ACE inhibitors

A nurse is administering heparin, subcutaneous twice daily, to a patient in cardiogenic shock. What is the expected action of this drug?

Anticoagulant to prevent blood clots.

The nurse recognizes that a medication error has been made. What is the nurse's highest priority initial action?

Assess the patient's condition.

A patient has diabetes with hypertension and is admitted for frequent bouts of hypoglycemia. Which prescription drug might be causing the hypoglycemia?

Atenolol (Tenormin)

A patient who has hypertension also has a history of asthma, and asks why a beta blocker is not prescribed to treat the hypertension. How should the nurse respond?

Beta blocker medications can cause bronchospasm, which can trigger an asthma attack.

Which medication is often administered with hydralazine to reduce reflex physiological responses to the drug

Beta blockers

A nurse is caring for a client who has hypertension and is to start taking atenolol. The nurse should instruct the client to monitor for which of the following findings as an adverse effect of this medication?

Bradycardia

A client presents with diaphoresis, palpitations, jitters, and tachycardia approximately 1 ½ hours after taking his regular morning insulin. Which of the following treatment is appropriate for this client?

Check blood glucose level, and administer carbohydrates.

The nurse is providing instruction to a patient who was recently prescribed an ACE inhibitor for hypertension. Which is an adverse effect of this medication?

Chronic cough others: -chronic cough -dizziness -headache -fatigue -angioedema -hyperkalemia -hypotension (FAHHHCD)

A nurse should anticipate that a patient taking Vasotec, an angiotensin-converting enzyme (ACE) inhibitor, should have which positive outcome to this drug?

Decreased blood pressure.

Which drug will be administered to a patient being admitted with severe digoxin intoxication?

Digoxin immune Fab (Digibind)

After a blood glucose reading, it is determined that the patient should receive 4 units of Lispro and 8 units of NPH. Which action will the nurse take to administer these medications?

Draw up the Lispro first and then the NPH using the same syringe.

A nurse is reinforcing teaching for a client who has Type 2 Diabetes Mellitus and is prescribed glipizide. The client should be taught that glipizide works in which of the following ways?

Glipizide stimulates the pancreas to release adequate insulin

A licensed practical nurse (LPN) is caring for a patient who is being treated with digoxin (Lanoxin). The nurse assesses the patient's apical pulse before administering a dose of the medication and finds that the rate is 58 beats per minute. What should be the INITIAL action by the nurse?

Hold the dose of the medication.

If you are giving diuretics to a pt, what adverse effect should you monitor?

Hypokalemia

Which action of ACE inhibitors results in effective treatment of heart failure?

Increased cardiac output

Which condition warrants the use of acetazolamide (Diamox) as a diuretic?

Increased intraocular pressure

A nurse preparing to administer insulin to a patient who has type 1 diabetes. The physician has prescribed two types of insulin, 10 U of regular insulin and 35 U of neutral protamine Hagedorn (NPH) insulin. Which is the proper procedure for the nurse to follow when preparing these medications?

Inject 35 U air into the NPH insulin, inject 10 U air into the regular insulin, withdraw 10 U of the regular insulin, and withdraw 35 U of the NPH insulin.

Which agents stimulate the heart to increase the force of contractions, thereby increasing cardiac output?

Inotropic

If your pt has high bp and complains of chest pain, what is administered?

Nitroglycerin (Nitrostat)

The nurse is instructing a patient about insulin administration. Which statement by the patient indicates a need for further teaching?

Once I open my insulin, I will store it in the refrigerator. Once insulin is opened and being used, it can be stored at room temperature for up to 1 month. (30 days) The patient may need more insulin if undergoing surgery, should date the insulin bottle after opening, and should keep a spare bottle of insulin on hand.

Hydralazine, a direct vasodilator, is used to treat hypertension associated with which condition?

Renal disease

The nurse administers a medication to the wrong client. The appropriate nursing action is to:

Report the error to the physician, document the medication in the client record, and complete an incident report.

Pt has type II diabetes who is obese. He has controlled condition by diet alone successfully. The provider orders sitagliptin (januvia). The nurse knows that this drug is commonly used for DM II because of what?

Stimulates the pancreas to secrete more insulin.

Which physiologic response will the nurse expect to assess in patients taking hydralazine (Apresoline)?

Tachycardia

Which agents are preferred for the initial treatment of hypertension?

Thiazide diuretics and beta adrenergic blockers

​​Which response will the nurse provide when a patient complains of a headache when using sublingual nitroglycerin?

This is a common adverse effect that can be managed with acetaminophen.

The nurse is providing teaching to a patient with heart failure who has been prescribed nifedipine, a calcium channel blocker. Which statement by the nurse is accurate?

This medication reduces the resistance your heart has to pump against.

A 32-year-old patient with diabetes is starting on intensive insulin therapy. Which type of insulin will the nurse discuss using for mealtime coverage?

lispro (Humalog) Rapid- or short-acting insulin is used for mealtime coverage for patients receiving intensive insulin therapy. NPH, glargine, or detemir will be used as the basal insulin.