Unit 2 Pharmacology

The nurse calls the client to follow up. What should the nurse ask the client first?

"Are you having shortness of breath?"

A client asks the nurse why the healthcare provider has prescribed darbepoetin alfa (Aranesp) instead of epoetin alpha (Epogen). Which response should the nurse provide the client?

"Darbepoetin alfa has a longer duration of action."

A client asks the nurse how fat is carried in the blood. Which response should the nurse provide?

"Fats travel in the blood on little proteins called lipoproteins."

Which statement made by a client receiving amiodarone should the nurse be most concerned about?

"I have a cough that is getting worse."

The nurse has completed the education for a client prescribed gemfibrozil (Lopid). Which statement made by the client indicates an understanding of the information?

"I must take this medication with food or I can have heartburn."

The nurse has completed the education for a client prescribed hydrochlorothiazide (Microzide). Which statement made by the client indicates an understanding of the teaching?

"I take my medication early in the morning."

The nurse has provided education for a client prescribed procainamide hydrochloride (Pronestyl). Which statement made by the client indicates an understanding of the information?

"I will take this prescription even when I am feeling well."

The nurse has provided dietary education for a client prescribed furosemide (Lasix). Which statement made by the client indicates an understanding of the information?

"I will try and eat an orange daily."

Which statement made by the client indicates an understanding of self-care while taking prescriptions to treat their heart failure?

"I will weigh myself every day in the morning after I wake up."

A client diagnosed with primary (essential) hypertension is taking chlorothiazide. The nurse determines teaching about this medication is effective when the client makes which statement? Select all that apply.

"I'll weight myself at the same time each day." "I won't drink alcoholic beverages while on this medication." "Ill reduce salt intake in my diet" "If I have prolonged exposure to sunlight, I'll use sunscreen."

Which statement by the client receiving nitroglycerine (Nitrostat) should the nurse be concerned about?

"I'm getting married tomorrow; I hope my erectile dysfunction isn't a problem."

The nurse has provided education for a client prescribed nifedipine (Adalat CC). Which statement made by the client indicates an understanding of the teaching?

"If I drink alcohol while taking this medication, I will get very sick to my stomach."

1) The nurse has provided education for a client who will self-administer a twice-daily antidysrhythmic prescription. Which statements made by the client indicate further teaching is needed? Select all that apply.

"If I get the flu, I should stop taking the medication until my fever goes down." "If I forget a dose of the prescription I should take two pills for the next dose."

Which statements should the nurse include in the teaching for a client prescribed warfarin (Coumadin) therapy? Select all that apply.

"Inform your dentist you are taking warfarin prior to any procedures." "Avoid strenuous activities."

1) Which statements made by the client indicate an understanding of the compensatory mechanisms associated with heart failure? Select all that apply.

"My heart enlarged in order to compensate for the effects of heart failure." "My nervous system kicks in to compensate for the effects of heart failure." "My body will decrease blood flow to other organs in order to compensate for heart failure."

1) Which statements by a client treated with epinephrine should the nurse be concerned about? Select all that apply.

"My heart is skipping beats." "I have a pounding headache."

A client prescribed spironolactone (Aldactone) asks the nurse which fluids they should drink to prevent dehydration. Which response should the nurse provide?

"Plain water is really the best"

How should the nurse instruct the client with unstable angina to use sublingual nitroglycerin tablets when chest pain occurs?

"Sit down and then take one tablet if pain persists after 5 minutes call 911"

The client states to the nurse, "My healthcare provider says I have heart disease and I need to decrease the cholesterol in my diet. I don't understand how this happened." Which response should the nurse provide the client?

"The arteries around your heart are narrowed by low density lipoprotein (LDL) cholesterol buildup in them."

A client asks the nurse about the different types of shock. Which response should the nurse provide?

"There are many kinds of shock that also include infection, nervous system damage, and loss of blood."

The nurse notes the blood pressure and red blood cell (RBC) count of a client receiving heparin is low. Which should the nurse suspect has occurred?

Internal bleeding

Which laboratory test is used to measure the effectiveness of warfarin sodium therapy?

International normalized ratio (INR)

Which should the nurse consider when administering an injection of ferrous sulfate intramuscularly to a client? Select all that apply.

Iron is irritating to the tissues. The z-track method should be used.

The nurse reviewing a client's record notes the morphology of the client's erythrocytes is reported to be microcytic-hypochromic. Which anemia should the nurse associate with the morphology?

Iron-deficiency anemia

Which anatomical location is Ezetimibe (Zetia) effective in blocking the absorption of cholesterol?

Jejunum

For which conditions is a client with hypertension at risk? Select all that apply.

Kidney damage Stroke Heart failure Blindness

The nurse is preparing the client for discharge after mitral valve replacement surgery. Which activity should the client avoid until after the one month post discharge appointment with the surgeon?

Lifting anything heavier than 10 lb (4.5 kg)

During cardio pulmonary resuscitation (CPR) for an adult, the rescuer's hands should be placed two fingers' width above the lower end of the sternum. Which organ would be most likely at risk for laceration by forceful compressions over the xiphoid process?

Liver

1) Which current prescriptions should the nurse be concerned with for a client requiring dopamine? Select all that apply.

MAO inhibitor Phenytoin Beta blocker Digoxin

An older adult is admitted to the telemetry unit for placement of a permanent pacemaker because of sinus bradycardia. What is a priority goal for the client within 24 hours after insertion of a permanent pacemaker?

Maintain cardiac conduction stability

The nurse reviewing a client's serum cholesterol levels notes the following: Low density lipoprotein (LDL) = 105 mg/dl High density lipoprotein (HDL) = 37 mg/dl Low density lipoprotein (LDL)/high density lipoprotein (HDL) ratio = 4.1 Which should the nurse identify as the priority outcome in the client's plan of care?

Maintenance of normal lipid levels without the use of pharmacotherapy

The nurse is making a discharge plan with an obese client with hypertension who smokes. What is the most important long-term goal for this client?

Make a commitment to long-term lifestyle changes

A client receiving cyanocobalamin (Nascobal) with a history of a gastrectomy tells the nurse that they have stopped taking the prescription months ago. Which assessment findings should the nurse anticipate?

Memory loss, numbness in the limbs, and depression

Which is the expected priority outcome for a client receiving normal serum albumin (Albuminar)?

Normal breathing pattern

which is the most important initial post procedure nursing assessment for a client who has had a cardiac catheterization?

Observe the puncture site for swelling and bleeding.

During rescue breathing in cardiopulmonary resuscitation (CPR), how will the nurse evaluate that victim is exhaling?

Observing normal relaxation of the chest

A nurse hears an irregular heart rate of 110 bpm when listening to a client's chest. After assessing the client and nothing new onset shortness of breath, which action should the nurse take next?

Obtain a prescription for a stat electrocardiogram

The nurse teaches a client with heart failure to take oral furosemide in the morning. What is the expected outcome for taking this drug in the morning? The client will:

Obtain more sleep

What instructions should the nurse's discharge teaching plan for the client with heart failure include?

Obtaining daily weights at the same time each day

Which general adverse effect is associated with the use of diuretics?

Orthostatic hypotension

1) Which assessment findings indicate a client receiving dobutamine (Dobutrex) is experiencing an adverse effect? Select all that apply.

Palpitations Drop in blood pressure Cold extremities

Which adverse effect should the nurse monitor a client for that is prescribed an antidysrhythmic?

Palpitations, chest pain, weakness, and fatigue

The nurse reviewing the records of a client diagnosed with hypertension notes a weight of 200 lbs, height 5' 4", dietary intake includes primarily starches, an alcohol intake of three beers per week, and stressors include 60-hour workweeks. Based on this information, which should the nurse identify as a priority outcome?

Patient will achieve and maintain optimum weight.

The nurse is caring for a group of clients on a medical surgical nursing unit. Which tasks could the nurse delegate to the unlicensed assistive personnel? Select all that apply.

Perform vital signs and oxygen saturation on a client returning from the catheterization lab. Obtain intake and output on a client experiencing heart failure. The nurses caring for a group of clients. Which client should the nurse see first? A client with the placement of a coronary artery stent 30 minutes ago.

For which assessment findings should the nurse hold enalapril (Vasotec)? Select all that apply.

Periorbital edema Difficulty swallowing

A client is to receive intravenous (IV) dopamine (Intropin). Which should the nurse have immediately available prior to initiating the dopamine?

Phentolamine (Regitine)

Which information about the dietary intake of lipids should the nurse provide a client? Select all that apply.

Phospholipids are essential to building plasma membranes. Cholesterol is a building block for estrogen and testosterone. Triglycerides are the major form of fat in the body. Cholesterol is not needed in the diet as the liver synthesizes adequate amounts from other chemicals.

Upon assessment of third-degree heart block on the monitor, what should the nurse do first?

Place transcutaneous packing pads on the client

Which information should the nurse include when educating a client about coronary artery disease? Select all that apply.

Plaque causes narrowing of the artery. Plaque begins to accrue early in life. Plaque affects the elasticity of the artery.

Which prescription should the nurse anticipate for a client that has overdosed on Clopidogrel (Plavix)?

Platelet transfusion

The client is admitted to the telemetry unit due to chest pain. The client has polysubstance abuse. and the nurse assesses that the client is anxious and irritable and has moist skin. What should the nurse do in order of priority from first to last? All options are used

Position electrodes on the chest Take vital signs Administer the prescribed dose of morphine Obtain a history of which drugs the client has used recently

Which laboratory value should the nurse notify the healthcare provider prior to administering amiodarone (Cordarone)?

Potassium 3.1 mEq/L

Which classification of drug is used to treat ventricular tachycardia?

Potassium channel blocker

1) Which conditions should the nurse be concerned about prior to administering epinephrine for anaphylaxis? Select all that apply.

Premature ventricular contractions Hypertension Hyperthyroidism

A client suddenly develops paroxysmal supraventricular tachycardia (PSVT) at a rate of 180 bpm. Current vital signs: blood pressure 85/45 mm Hg, heart rate 180 bpm, respirations 30 breaths/min, O2 saturation 90% on room air. The client is diaphoretic and reports dizziness. What should the nurse do first?

Prepare defibrillator for synchronized cardioversion

A client has been admitted to the coronary care unit. The nurse observes third-degree heart block at a rate of 35 bpm on the client's cardiac monitor. The client has a blood pressure of 90/60 mm Hg. What should the nurse do?

Prepare for transcutaneous pacing.

Which describes the primary action of anticoagulant therapy?

Prevent the formation of blood clots

After a myocardial infarction, the hospitalized client is taught to move the legs while resting in bed. What is the expected outcome of this exercise?

Prevent throbophlebitis and blood cloth formation

Which describes the mechanism of action for Clopidogrel (Plavix)?

Prevents the platelets from sticking together

Which adverse effect is shared among all antidysrhythmic drugs?

Prodysrhythmic effects

Which should the nurse assess a client for prior to administering atenolol (Tenormin)? Select all that apply.

Pulse Blood pressure

Which vital signs should the nurse assess prior to the administration of a diuretic? Select all that apply.

Pulse Respiration

An older adult has chest pain and shortness of breath. The healthcare provider (HCP) prescribes nitroglycerin tablets. What should the nurse instruct the client to do?

Put the tablet under the tongue until it is all absorbed

A client with acute chest pain is receiving IV morphine sulfate. Which is an expected effect of morphine? Select all that apply.

Reduces myocardial oxygen consumption Reduces blood pressure and heart rate Reduces anxiety and fear

The nurse is reviewing the medical history for a client prescribed oprelvekin (Neumega). Which condition should the nurse be concerned about?

Renal disease

The nurse is caring for an older adult with mild dementia admitted with heart failure. What nursing care will be helpful for this client in reducing potential confusion related to hospitalization and change in routine? Select all that apply

Reorient frequently to time, place, and situation. Arrange for familiar pictures or special items at bedside. Spend time with client, establishing a trusting relationship

The nurse is evaluating a client who received tissue plasminogen activator (t-PA) following a myocardial infarction (MI). What is the expected outcome of this drug?

Revascularize the blocked coronary artery

Which anatomical area should the nurse display a client when providing education about the point of origin of a pulmonary embolism?

Right ventricle

Which information should the nurse include in the teaching for a client prescribed heparin? Select all that apply.

Self-administration of subcutaneous injections Symptoms of deep vein thrombosis Required laboratory tests Signs of abnormal bleeding

The nurse suspects a client receiving chlorothiazide (Diuril) is experiencing side effects from the prescription. Which assessment finding supports the nurse's suspicion?

Serum potassium level of 3.0 mEq/L and low blood pressure

The nurse is assessing a client who has had a myocardial infarction. The nurse notes the cardiac rhythm showing on the electrocardiogram strip. How should the nurse interpret the rhythm strip?

Sinus tachycardia

A client asks which conditions will cause the heart to need more oxygen. Which information should the nurse be prepared to discuss?

Sleep apnea

Which is the nurse's priority action when monitoring a client receiving norepinephrine (Levophed) with a blood pressure of 230/120 mmHg?

Slow the rate of the infusion

Which intervention is the highest priority for a 30-year-old female with a BMI of 20 who smokes and has a blood pressure of 137/88?

Smoking-cessation program

When caring for a client with a newly diagnosed cardiac dysrhythmia, which laboratory values are the priority for the nurse to monitor? Select all that apply.

Sodium of 124 mEq/L Potassium of 3.1 mEq/L Calcium of 8.5 mEq/L

The client who experiences angina has been told to follow a low cholesterol diet which meal would be best?

Spaghetti with tomato sauce, salad, and coffee

Which diuretic is most effective in reducing the mortality of a client with heart failure?

Spironolactone (Aldactone)

The nurse connects the client to cardiac monitor, which reveals 8 premature ventricular contractions per minute. What should the nurse do next?

Start an intravenous infusion

Which lipid type is associated with the highest risk for the development of atherosclerosis?

Steroids

Which affect does colony-stimulating factors have on the body?

Stimulate white blood cell production

When teach a client about self-care following placement of a new permanent pacemaker to the left upper chest, the nurse should include which information? Select all that apply.

Take and record daily pulse rate Avoid lifting anything heavier that 3 lb (1.36 kg)

The nurse notices that a client's heart rate decreases from 63 to 50 bpm on the monitor. What should the nurse do first?

Take the client's blood pressure

Which is a priority nursing intervention for a client who is newly prescribed enalapril (Vasotec)?

Take the client's blood pressure.

A client who has diabetes is taking metoprolol for hypertension. What should the nurse instruct the client to do? Select all that apply.

Take the tablets with food at same time each day. Do not crush or chew the tablets Have a blood glucose level drawn every 6 to 12 months during therapy Report any fainting spells to the HCP

Which information should the nurse include in the teaching for a client prescribed ferrous sulfate (Feosol) tablets?

Take this prescription with orange juice.

Following the diagnosis of angina pectoris, a client reports being unable to walk up two flights of stairs without pain. What should the nurse instruct the client to do?

Taking nitroglycerin tablet before climbing the stairs

Which is an expected outcome for a client on the second day of hospitalization after a myocardial infarction?

The client can perform personal self-care activities without pain

1) Which assessment findings indicate a client receiving verapamil (Calan) is experiencing adverse effects? Select all that apply.

The client tells the nurse they have frequent headaches. The client has 3+ edema in the ankles and feet. The client states, "I got so dizzy yesterday that I had to lie down for a while."

The client who had a permanent pacemaker implanted 2 days earlier is being discharged from the hospital. What evidence will indicate to the nurse that the client understands the discharge plan?

The client verbalizes safety precautions needed to prevent pacemaker malfunction

In preparing a client and the family for a postoperative stay in the intensive care unit (ICU) after open heart surgery, what should the nurse tell the family?

The client will receive medication to relieve pain

Which should the nurse recognize are important safety precautions when administering a prescription to a client with renal failure? Select all that apply

The client will require lower dosages. Measure hourly intake and output. Some prescriptions are nephrotoxic.

A client is scheduled for the insertion of an implantable cardioverter-defibrillator (ICD). The spouse expresses anxiety about what would happen if the device discharges during physical contact. What should the nurse tell the spouse?

The shock would feel like a "tingle," but it would not cause any harm

A nurse is helping a suspected choking victim. When should the nurse perform the Heimlich maneuver?

The victim cannot speak due to airway obstruction.

Which statement is accurate regarding the use of beta-adrenergic blockers for use in clients with heart failure?

They are generally used in combination with other heart-failure drugs.

The nurse is preparing to discuss the use of primary hypertensive agents with a client. Which prescriptions should the nurse include? Select all that apply.

Thiazide diuretics Angiotensin-II receptor blockers (ARBs)

Which is most important for the nurse to monitor a client receiving erythropoiesis-stimulating agents?

Thromboembolism

A client experiences initial indications of dizziness after having an IV infusion of Iidocaine hydrochloride started. The nurse should further assess the client for which symptoms?

Tinnitus

Which food should the nurse instruct the client prescribed warfarin (Coumadin) to avoid?

Tomato salad with kale and basil

Which describes a characteristic of colloids?

Too large to cross membranes

The nurse reviewing records should determine that which client's lab values are associated with the highest risk of developing heart disease?

Total 220, LDL 162, HDL 20

Which statement provides the best rationale for monitoring HDL and LDL as opposed to total cholesterol?

Total cholesterol does not differentiate the amounts of "good" cholesterol and "bad" cholesterol.

The educator is reviewing the classifications of prescriptions used to decrease blood cholesterol levels with a nurse. Which prescriptions should the educator include in the discussion of fibric acid agents? Select all that apply

Tricor Lipid

Which type of lipid serves as fuel for the body when energy is needed?

Triglicerides

Which is the most sensitive and effective biomarker of a myocardial infarction?

Troponin

A client was admitted with an exacerbation of heart failure breath at 0200. At 0700, which information is most important for the nurse who admitted he client to communicate during the hand-off of care report to the nurse who will next take care of the client?

Urinary output of 120mL

Which effect should the nurse anticipate for a client receiving a low-dose dopamine (Intropin)?

Urinary output of at least 50 mL/h

The nurse is monitoring a client admitted with a myocardial infarction (MI) who is at risk for cardiogenic shock. The nurse should report which changes noted from the clients chart to the healthcare provider?

Urine output

Which assessment finding for a client receiving a statin is a priority for the nurse to report to the healthcare provider?

Urine output of 20 mL/hour

The nurse in the intensive care unit is giving a report to the nurse in a cardiac step-down unit about a client who had coronary artery bypass surgery. Which is the most effective way to assure essential information about the client is reported?

Use a printed checklist with information individualized for the client.

The healthcare provider prescribes continuous IV nitroglycerin infusion for the client with myocardial infarction. What should the nurse do to ensure safe administration of this drug?

Use an infusion pump for the medication

Which describes the mechanism of action of norepinephrine?

Vasoconstriction

1) Which is the most serious adverse effect associated with milrinone (Primacor)?

Ventricular dysrhythmia

Which antidysrhythmic agent also dilates coronary arteries and is frequently used to treat angina?

Verapamil (Calan)

A client returns to the nursing unit following successful synchronized cardioversion using transthoracic chest wall patches. What should the nurse assess when the client returns to the room? Select all that apply.

Vital signs Skin of chest wall Level of consciousness Cardiac rhythm

The nurse is caring for a client who has just returned from having a percutaneous transluminal balloon angioplasty with femoral artery access. In which order from first to last should the nurse obtain information about the client? All options must be used

Vital signs and oxygen saturation pedal pulse catheterization site color and sensation of extremity

What measures should the nurse take that will be most helpful in preventing wound infection when changing a client's dressing after coronary artery bypass surgery?

Wash hands before changing the dressing

The nurse is preparing to provide education on daily self-monitoring for a client with congestive heart failure prescribed a diuretic. Which information should the nurse plan to include in the teaching? Select all that apply.

Weight Pulse Blood pressure

The healthcare provider has prescribed hydrochlorothiazide (HCTZ) for a client with chronic renal failure. Which assessment finding indicates the treatment is ineffective?

Wheezing

Three days after mitral valve replacement surgery, the client tells the nurse there is a clicking noise from the chest incision. The nurse response should reflect the understanding that the client may be experiencing:

anxiety related to altered body image

The nurse teaches a client who has recently been diagnosed with hypertension about following a low-calorie, low-fat, low-sodium diet. Which menus selection would best meet the client's needs?

backed chicken, an apple, and a slice of white baked bread

A client receiving a loop diuretic should be encouraged to eat which foods to prevent potassium loss? Select all that apply

banana dried fruit orange juice

A client is admitted with a myocardial infarction and atrial fibrillation. While auscultating the heart, the nurse notes an irregular heart rate and hears and extra heart sound at the apex after the S2 that remains constant throughout the respiratory cycle. How should the nurse document these findings?

heart rate irregular with S3

Which are indications that a client with a history of left sided heart failure is developing pulmonary edema? Select all that apply

hoarse crackles tachycardia

A client has had a pulmonary artery catheter inserted in performing hemodynamic monitoring with the catheter, the nurse wedges the catheter. What information will the nurse obtain from this procedure?

left end-diastolic pressure

A client admitted with normal sinus rhythm converts to the following rhythm on the cardiac monitor

light-headedness nausea shortness of breath

A client is to have a treadmill stress test. Prior to the stress test, the nurse reviews the results of the laboratory reports. The nurse should report which elevated laboratory value to the health care provider (HCP) prior to stress test?

troponin level

A client is scheduled for a cardiac catheterization the nurse should do which person preprocedure tasks? Select all that apply

verify the client has stopped taking anticoagulants if instructed by the health care provider check for iodine sensitivity verify that written consent has been obtained withhold food in oral fluids before the procedure

When performing external chest compressions on an adult during cardiopulmonary resuscitation, how deep should the rescuer depress the sternum?

2 inches (5cm)

A client receiving an IV infusion of heparin sodium at 1,200 units/h. The dilution is 25,000 unites/500mL. How many milliliters per house will this client receive? Round your answer to a whole number

24 mL/h

Furosemide 40 mg intravenous push is prescribed. Furosemide 10 mg/mL is available how much should the nurse administer round your answer to a whole number

4mL

Furosemide is administered intravenously to a client with heart failure. How soon after administration should the nurse begin to see evidence of the drugs desired effect?

5 to 10 minutes

Which client has the greatest risk for developing heart disease?

A 68-year-old with stage 2 hypertension and recent myocardial infarction

1) Which lifestyle behaviors should the nurse discuss with a client to help reduce their risk of coronary artery disease? Select all that apply.

Abstinence from smoking Limit alcohol consumption Limit sodium intake

For which conditions should the nurse anticipate norepinephrine to be prescribed? Select all that apply.

Acute shock Cardiac arrest Septic shock

A client admitted for a myocardial infarction (MI) develops cardiogenic shock. An arterial lines is inserted. Which prescription from the healthcare provider should the nurse verify before implementing?

Administer metoprolol 5 mg IV push

A client has atrial fibrillation and a heart rate of 165 bpm. In which order from first to last should the nurse implement these prescriptions? All options must be used.

Administer oxygen via nasal cannula Place client on a cardiac monitor Obtain vital signs including BP, P, R, T and O2.

During physical assessment, the nurse should further assess the client for signs of atrial fibrilation when the nurse palpates the radial pulse and notices which signs?

An irregular rhythm with pulse rate >100 bpm

Which should the nurse recognize are adverse effects associated with digoxin (Lanoxin)?

Anorexia and nausea

Which classification of prescriptions does the nurse anticipate for the client being treated for a thromboembolic disorder? Select all that apply.

Anticoagulants Antiplatelet agents

A client admitted to the telemetry unit with newly diagnosed atrial fibrilation has been started on warfarin. What should the nurse instruct the client to do when taking this medication? Select all that apply.

Avoid injury to prevent bruising Be careful using a razor or fingernail clippers Report any changes in color of urine or stool

Which assessment finding should the nurse associate with shock?

B/P: 80/20 mmHg, P: 122, weak and thready, R: 28, and shallow

The nurse completes the dietary education for a client prescribed digoxin (Lanoxin). Which dietary choice indicates the client understood the teaching?

Baked fish, sweet potatoes, and banana pudding

Which is the most appropriate food for the nurse to recommend to a client to eat that is prescribed a loop diuretic?

Bananas

When performing the Heimlich maneuver on a conscious adult victim, where should the nurse deliver the rescuer inward and upward thrusts?

Below the xiphoid process and above the umbilicus

When monitoring client who is receiving tissue plasminogen activator (t-PA), the nurse should assess the client for which changes?

Cardiac arrhythmia a middle-aged client with a history of hypertension reports having indigestion.

1) Which classifications of prescriptions are used to increase cardiac output by increasing the force of myocardial contractions? Select all that apply.

Cardiac glycosides Phosphodiesterase inhibitors

Which symptom is most likely to be related to angina as opposed to a myocardial infarction?

Chest pain relieved by one sublingual nitroglycerin

1) Which symptoms should the nurse anticipate to treat with epinephrine (EpiPen) for a child allergic to bee stings that has been stung? Select all that apply.

Cold clammy skin Excessive thirst Restlessness

Which initial intervention should the nurse be prepared for in the treatment of shock?

Connect the client to a cardiac monitor

Which action of Lisinopril (Prinivil) results in a decrease in the blood volume?

Decrease aldosterone secretion.

The client has been managing angina episodes with nitroglycerin. Which finding indicates that the therapeutic effect of the drug has been achieved?

Decrease chest pain

Which prescription should the nurse anticipate to administer to a client with acute iron intoxication?

Deferoxamine (Desferal)

Which should the nurse anticipate to be included in the client's treatment plan during the intravenous sargramostim (Leukine)?

ECG monitoring

Which would be most helpful when coaching a client to stop smoking?

Establish the client's daily smoking pattern

The nurse is reviewing the laboratory reports for a client with chronic kidney failure. Which lab should the nurse understand reflects the progression of the kidney disease?

Glomerular filtration rate (GFR)

Which adverse effect is common for clients prescribed topical nitroglycerin paste?

Headache

The client has risk factors for coronary artery disease, including smoking cigarettes, eating a diet high in saturated fat, and leading a sedentary lifestyle. Which coaching strategies from the nurse will be most effective in assisting the client improve his or her health?

Helping the client establish a wellness vision to reduce the health risks

1) Which conditions is the use of thrombolytic therapy contraindicated in? Select all that apply.

History of intracranial hemorrhage Hemophilia Liver disease Peptic ulcer disease

The nurse notes a client's warfarin (Coumadin) level is 7 mcg/mL. Which action should the nurse take?

Hold the next dose of warfarin (Coumadin) and request an international normalized ratio (INR).

A client with angina is taking nifedipine. Which instruction should the nurse give the client?

Inspect gums daily

What information should the nurse provide to the client who is receiving warfarin?

Internationalized normalized ratio (INR) is used to assess effectiveness

Which route of administration should the nurse anticipate the prescribed vitamin B12 to be administered for the client with pernicious anemia

Intramuscular

Which equipment should the nurse secure for use when administering dopamine (Intropin)?

Intravenous (IV) pump

Which should the nurse anticipate to be included in the treatment plan for a client with stage A heart failure?

Lifestyle modifications

A client has mitral stenosis and will have a valve replacement period the nurse is instructing the client about help maintenance prior to surgery. Inability to follow these prescriptions would pose the greatest health hazard to this client at this time?

Medication therapy

The nurse is preparing to provide education for a client prescribed a statin. Which serious adverse effects should the nurse include in the teaching? Select all that apply

Myopathy Rhabdomyolysis

Which condition should the nurse review a client's records for prior to administering epinephrine (Adrenalin) for a client?

Narrow angle glaucoma

Which statement is accurate regarding the use of nicotinic acid (Niacin) for lowering blood cholesterol levels?

Niacin may also reduce triglyceride levels.

1) Which immediate goals should the nurse focus on for a client experiencing an anaphylactic reaction to penicillin? Select all that apply.

Normalization of blood pressure Reduction of inflammatory response Provision of basic life support

An older adult had a myocardial infarction (MI) 4 days ago. At 0930, the client's blood pressure is 102/64 mm Hg. After reviewing the client's progress notes (see chart), what should the nurse do first?

Notify the health care provider (HCP)

When caring for a client who has sustained a myocardial infarction (MI), the nurse notes 8 premature ventricular contractions (PVCs) in one minute on the cardiac monitor. The client is receiving an IV infusion of 5% dextrose in water (D5W) at 125 mL/h in oxygen at 2L/min. What should the nurse do first?

Notify the health care provider (PCP)

Which additional prescribed treatment should the nurse anticipate for the client prescribed heparin therapy?

Obtaining an aPTT

Which electrolyte imbalance should the nurse be concerned about for the client who is prescribed a thiazide diuretic?

Potassium

Which electrolytes should the nurse anticipate monitoring for a client prescribed losartan (Cozaar)? Select all that apply.

Potassium Sodium

A client who has been given cardiopulmonary resuscitation is transported by ambulance to the hospital's emergency department. What is the most effective way for the nurse to determine if this client has adequate oxygenation?

Pupils are reacting to light

Which activity would be appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP) for a client diagnosed with a myocardial infraction who is stable?

Record the intake and output

A client has chest pain rated at 8 out on a 10-point visual analog scale. The 12-lead electrocardiogram reveals ST elevation in the inferior leads, and troponin levels are elevated. What should the nurse do first?

Reduce pain and myocardial oxygen demand

Which describes the purpose of fibrinolysis?

Remove a blood clot

If a client is receiving rescue breast, and the chest wall fails to rise during cardiopulmonary resuscitation, what should the rescuer do first?

Reposition the airway

1) Which information should the nurse include in the education for a client prescribed a transdermal nitroglycerin patch? Select all that apply.

Rotate sites of application. Cleanse the skin under the patch after removal.

The nurse is discussing with a client, the dietary intake of omega-3 and CoQ10-rich foods to control lipid levels. Which foods should the nurse include in the discussion? Select all that apply

Sardines Almonds Olive oil

Which position is best for client with heart failure who has orthopnea?

Sitting upright (high Fowler's position) with legs resting on the mattress.

Which should the nurse suspect after noting the presence of protein on a routine urinalysis?

Structural damage

Which set of postural vital signs in a client with hypertension should the nurse report to the health care provider (HCP)?

Supine 120/70, 88 bpm Sitting 102/64, 86 bpm Standing 100/60, 92 bpm

Which is a client with a heart rate of 170 bpm and a normal QRS duration most likely experiencing?

Tachydysrhythmia originating from the atria.

The nurse is teaching the client with hypertension about maintaining an exercise program. Which teaching strategy will be most helpful?

Tailor a program to meet the client's needs and abilities

A client has a throbbing headache when nitroglycerin is taken for angina. What should the nurse instruct the client to do?

Take acetaminophen or ibuprofen

Which occurs initially in the cardiac conduction pathway?

The SA node generates an action potential.

A client has returned from the cardiac catheterization laboratory after a balloon valvuloplasty or mitral stenosis. Which finding requires immediate nursing action?

The client has become more somnolent

The nurse is caring for a client who recently experienced a myocardial infarction and has been started on clopidogrel. The nurse should develop a teaching plan that includes which points? Select all that apply.

The client should report unexpected bleeding or bleeding that lasts a long time. The client may bruise more easily and may experience bleeding gums Clopidogrel works by preventing platelets from sticking together and forming a clot

Which is the priority outcome for the client with type 1 diabetes mellitus prescribed propranolol (Inderal)?

The client will maintain blood glucose within normal limits.

The nurse is caring for a client with a DVT (deep vein thrombosis) receiving heparin intravenously (IV). Which is the priority outcome for the client?

The client will not experience bleeding.

Which client prescribed metoprolol (Toprol-XL) is most at risk for adverse effects?

The client with chronic bronchitis

Which assessment findings indicate the treatment for a client prescribed an erythropoiesis-stimulating factor is successful? Select all that apply.

The client's hemoglobin is increased. The client reports less shortness of breath on exertion. The client reports enjoying a light exercise.

Which statement correctly identifies why restricting dietary intake of cholesterol generally will not result in a significant reduction of blood cholesterol?

The liver reacts to a low-cholesterol diet by making more cholesterol.

Which is the primary functional unit of the kidney?

The nephron is the functional unit, which initially receives blood through the large renal arteries.

A client is given amiodarone in the emergency department for a dysrhythmia. Which finding indicates the drug is having the desired effect?

The number of premature ventricular contractions is decreasing

The nurse has reinforced the treatment plan for the administration of normal human serum albumin (Albutein) for a client recovering from hypovolemic shock. Which statement made by the client indicates an understanding of the information?

The prescription is a protein that pulls water into my blood vessels."

Which information should the nurse include in the education for a client prescribed antianginal therapy? Select all that apply.

The prescriptions dilate the veins so that the heart receives less blood. The prescriptions cause the heart to contract with less force.

The nurse is reviewing the process of hemostasis after an injury with a client. Which should the nurse identify as the initial event in this process?

The vessel spasms.

The educator is preparing education about the different types of lipids for a nurse. Which should the educator include in the presentation? Select all that apply

Triglycerides Phospholipids Steroids

Which time frame in conjunction with chemotherapy should the nurse administer prescribed Filgrastim (Neupogen)?

Twenty-four hours prior to the chemotherapy

1) Which conditions contribute to heart failure? Select all that apply.

Uncontrolled hypertension Coronary artery disease (CAD) Diabetes (DM) Mitral stenosis

Which initial treatment prescribed should the nurse anticipate for the client that has overdosed on hydrochlorothiazide?

Vasopressor

Which prescription should the nurse prepare to administer for a client experiencing a warfarin sodium overdose?

Vitamin K

Which is a contributing factor to hypovolemic shock?

Volume depletion

Which current prescription should the nurse be concerned with for the client newly prescribed amiodarone (Cordarone)?

Warfarin (Coumadin)

Captopril, furosemide, and metoprolol are prescribed for a client with systolic heart failure. The client's blood pressure is 136 slash Prior to medication administration at oh 900, the nurse reviews the following lab test what should the nurse do 136/82 mm Hg, and the heart rate is 65 bpm. Prior to medication administration at 0900, the nurse reviews the following lab tests (see chart) what should the nurse do first?

Withhold the captopril

A client with diabetes who has been maintained on metformin has been scheduled for a cardiac catheterization. The nurse should verify that the health care provider has written which prescriptions for taking the metformin before the procedure?

Withhold the metformin

Which laboratory study is used to evaluate the proper dosage for heparin therapy?

aPTT

A client who has undergone a mitral valve replacement has had a mediastinal chest tube inserted. The client has persistent bleeding from the sternal incision during the early postoperative. What action should the nurse take? Select all that apply

check the post operative CBC INR PTT and platelet levels confirm availability for blood products monitor the mediastinal chest tube draining

the nurse is assessing a client with chronic heart failure who is demonstrating neurohormonal compensatory mechanisms. Which are expected findings on assessment? Select all that apply

decrease cardiac output increased heart rate vasoconstriction and skin, GI tract, and kidneys fluid overload

A client returns from a left heart catheterization. The right groin was used for catheter access. In which location should the nurse palpate the distal pulse on this client?

dorsal surface of the right foot

NEW A client is taking clonidine for treatment of hypertension. The nurse should teach the cleint about which common adverse effects of this drug? Select all that apply.

dry mouth impotence sleep disturbance

The nurse should assess the client with left sided heart failure for which findings? Select all that apply.

dyspnea crackles oliguria decreased oxygen saturation

Which is the most appropriate diet for a client during the acute phase of a myocardial infarction (MI)?

small, easily digested meals

The nurse should teach the client that signs of digoxin toxicity include:

visual disturbances such as seeing yellow spots

A client asks the nurse if angina is the same thing as having a heart attack. Which response should the nurse provide?

"Angina means the heart muscle is not getting enough oxygen, while heart attack, or myocardial infarction, means part of your heart has died."

A client with a dysrhythmia asks the nurse why they cannot take a prescription instead of have cardioversion for treatment? Which response should the nurse provide the client?

"Antidysrhythmic prescriptions have many side effects; cardioversion is considered safer."

The nurse is preparing to provide education for a client prescribed Clopidogrel (Plavix) after a myocardial infarction and stent placement. Which statements should the nurse use to explain the action of Clopidogrel? Select all that apply.

"Clopidogrel will make the platelets in your blood less sticky." "Clopidogrel will change the way your platelets work." "Clopidogrel decreases your blood's ability to clot."

1) A client states to the nurse, "This educational video you gave me shows normal electrical conduction through the heart, but I still don't understand it. Can you explain it to me?" Which responses should the nurse include in the discussion? Select all that apply.

"Conduction begins in the sinoatrial (SA) node and travels to the atrioventricular (AV) node." "Conduction continues through the bundle branches to the Purkinje fibers." "Conduction travels from the atrioventricular (AV) node through the bundle of His

A client receiving diltiazem (Cardizem) asks the nurse why they get a headache after taking the prescription. Which response should the nurse provide the client?

"Diltiazem (Cardizem) causes the blood vessels in your brain to widen, giving you the headache."

The nurse notes that a client receiving warfarin (Coumadin) has a high international normalized ratio (INR). Which question should the nurse include in the assessment?

"Do you eat a lot of garlic?"

The nurse is preparing to assess a client with von Willebrand's disease (vWD). Which priority question should the nurse ask the client?

"Do you have heavy menstrual periods?"

Which priority question should the nurse ask a client suspected of experiencing a stroke that is prescribed alteplase (Activase).

"Do you know what time the stroke occurred?".

The nurse is preparing to teach a client how to self-administer an erythropoiesis-stimulating drug. Which instruction should the nurse include? Select all that appply

"Draw up what is needed and discard the rest of the vial." "Place your stock of medication in your refrigerator." "Warm the vial in your hand a few minutes before drawing up the medication."

A client is admitted to the hospital for evaluation of recurrent episodes of ventricular tachycardia as observed on Holter monitoring. The client is scheduled for electrophysiology studies (EPS) the following morning. Which statement should the nurse include in a teaching plan for this client?

"During the procedure, the health care provider will insert a special wire to increase the heart rate and produce the irregular beats that caused your signs and symptoms"

The nurse is providing a client education about dysrhythmias. Which statement should the nurse include in the teaching?

"Dysrhythmias interrupt the normal electrical pathways in the heart so it can't beat properly."

The nurse has provided a client education about enoxaparin (Lovenox). Which statement made by a client indicates an understanding of the information?

"Enoxaparin increases the time it takes for me to form a clot."

After reviewing a client's blood work, the nurse suspects the client is experiencing iron-deficiency anemia. Which questions should the nurse ask the client? Select all that apply.

"Have you had a significant dietary change in the last 6 months?" "Do you handle chemicals in your new job?" "Have your stools changed in appearance?" "Are your menstrual periodsheavier than normal for you?"

The nurse is assessing a male client prescribed propranolol (Inderal) for adherence to the treatment plan. Which is an important question for the nurse to ask the client?

"Have you noticed any changes in your sexual functioning?"

A client receiving hydrochlorothiazide (Microzide) asks the nurse why they are urinating so frequently. Which statement should the nurse provide the client?

"Hydrochlorothiazide (Microzide) decreases the fluid in your bloodstream and this lowers your blood pressure."

A client asks the nurse how hypertension can lead to heart failure. Which response should the nurse provide the client?

"Hypertension increases the resistance in the blood vessels causing the heart to work harder to pump the blood out against the resistance of the arteries."

Which statements made by a client indicates an understanding of the education provided by the nurse regarding digoxin (Lanoxin) toxicity? Select all that apply.

"I can drink orange juice every morning." "I must check my pulse and not take the medication if it is less than 60."

The nurse has completed the education for a client with angina prescribed nitroglycerine (Nitrostat). Which statement made by the client indicates further teaching is required?

"I can take up to 5 tablets to resolve the chest pain."

The nurse has completed the dietary teaching for a client prescribed spironolactone (Aldactone). Which statement made by the client indicates further teaching is required?

"I cant still have my orange juice and bananas for breakfast"

The nurse has provided education for a client with diabetes type I prescribed hydrochlorothiazide (Microzide). Which statement made by the client indicates an understanding of the information?

"I expect my blood glucose to be elevated."

Which statement made by a client newly prescribed a beta-adrenergic blocker should the nurse be concerned about?

"I have always had problems with my asthma."

1) The nurse is educating a patient whose blood pressure is 140/90 mmHg on ways to lower blood pressure and avoid hypertension. Which lifestyle choices may eliminate the need for pharmacotherapy in this patient? Select all that apply.

"I have incorporated yoga into my exercise program. "I will monitor my daily sodium intake." "I am receiving acupuncture to help me stop smoking."

The nurse has discussed lifestyle modifications to help manage the client's hypertension. Which statement made by the client indicates an understanding of the information?

"I know I need to give up my cigarettes and alcohol."

The nurse is discussing medications with a client with hypertension who has a prescription for furosemide daily. Which comment by the client indicates the client needs further education?

"I know I shouldn't drive after taking my furosemide."

The nurse has provided education for a client with diabetes mellitus prescribed metoprolol (Lopressor) for hypertension. Which statement made by the client indicates an understanding of the information?

"I might need less insulin when I take metoprolol (Lopressor)."

The nurse has provided discharge education for a client prescribed an anticoagulant. Which statement made by the client indicates an understanding of the information?

"I should wear a medical alert bracelet that says I'm on an anticoagulant."

A male client states to the nurse, "I am going to stop taking my metoprolol (Lopressor). I have been experiencing problems having sex." Which responses should the nurse include in the discussion with the client? Select all that apply.

"I understand sexual dysfunction can be a common problem with this drug." "Try taking the drug early in the morning."

1) Which information should the nurse include in the education for a client is prescribed an additional once-daily amiodarone to control persistent atrial fibrillation? Select all that apply.

"I will avoid drinking grapefruit juice." "I understand the effect of the prescription will last 4 to 8 weeks after I stop taking it." "I will monitor my blood pressure and report any significant changes." "I will avoid the use of St John's wort."

An older adult receiving ethacrynic acid (Edecrin) tells the nurse he or she doesn't hear as well as he or she used to. Which statement should the nurse include in the response?

"I will let your healthcare provider know about this; it could be a side effect of your medication."

The nurse has provided client education regarding therapeutic lifestyle changes to help control cholesterol levels. Which statement made by the client indicates an understanding of the information? Select all that apply

"I will maintain an optimal weight." "I will implement a medically supervised exercise plan. "I will eliminate tobacco use."

The nurse has provided education for a client prescribed lisinopril (Prinivil). Which statement made by the client indicates further teaching is required?

"I will not need to worry about having additional blood tests done."

The nurse has provided education for a client prescribed fenofibrate (Lofibra). Which statement made by the client indicates further teaching is required?

"I will take my prescription on an empty stomach."

The nurse has completed the education for a client prescribed propranolol (Inderal). Which statement by the client indicates an understanding of the information?

"I will take my pulse every day and call my healthcare provider if it is less than 60."

A client is scheduled for insertion of a coronary stent with right groin access. Which teaching points should the nurse include in this client's preoperative teaching plan? Select all that apply

"If you have chest pain during this procedure, please tell the staff when or if this should occur." "You will need to remain flat during the procedure and for 3 to 6 hours after the procedure"

What instructions to the nurse give the client who will be starting a prescription for simvastatin 40 mg/day client? Select all that apply.

"If you miss a dose, take it when you remember." "Report muscle pain or tenderness to your health care provider." "Continue to follow a diet that is low in saturated fats."

The nurse has provided client education about the function of the renal system. Which statements made by the client indicate an understanding of the teaching? Select all that apply

"Kidneys help the heart by balancing potassium." "Kidneys balance the fluid and electrolytes in my body." "Kidneys keep blood pressure from getting too low."

Which assessment data obtained from a client receiving a statin is a priority for the nurse to report to the healthcare provider?

"My calves hurt, and I had a hard time walking to the bathroom."

1) Which statements by the client are specifically associated with unstable angina? Select all that apply.

"My chest has started hurting even if I am just watching television." "My attacks of chest pain are coming more frequently now." "The pain is worse than it used to be."

The educator is reviewing red blood cell formation with a nurse. Which statement made by the nurse indicates an understanding?

"Red blood cell formation is regulated through messages from the hormone erythropoietin."

Which statements made by a client that has been receiving a prescription for an atrial dysrhythmia indicate the client requires further information? Select all that apply.

"Since I can't drink coffee anymore, I have started drinking diet cola in the mornings." "I have found that a glass of wine after work and one with dinner helps me to relax from my stressful job." "We have celebrated several birthdays since I saw you last. I love chocolate birthday cake."

A client prescribed verapamil (Calan) asks the nurse if it is okay to take herbal supplements with the prescription. Which response should the nurse provide the client?

"Some herbal supplements may interact with your prescription."

The nurse is teaching a client who has had a myocardial infarction about using nitroglycerin spray. Which information should the nurse include in the teaching plan? Select all that apply

"Spray the medication under the tongue as soon as you have chest pain." "If the chest pain continues after 2 sprays of the medication, wait 5 minutes and use 1 more spray." "Call 911 if chest pain continues after 10 minutes of using the 3 spray."

Which information should the nurse include in the education for a client prescribed niacin to lower lipid levels?

"Take one aspirin 30 minutes before you take your niacin."

Which information should the nurse include in the education for a client prescribed an antidysrhythmic?

"Take the first dose of your prescription before bed."

Which information should the nurse include when providing education for an older client prescribed chlorothiazide (Diuril)?

"Take the medication early in the morning."

A client with chronic alcoholism asks the nurse why they should take folic acid. Which response should the nurse provide the client? Select all that apply.

"The alcohol interferes with folate metabolism in the liver." "Your dietary intake of folic acid is decreased when you drink alcohol."

A client tells the nurse they will need a prescription for high cholesterol but does not know which would be best. Which information should the nurse provide the client? Select all that apply

"The bile resins keep cholesterol from being absorbed but have some side effects." "The statin drugs inhibit the making of cholesterol and are considered the best choice." "Fibric acid drugs will decrease triglycerides, but your low density lipoprotein (LDL) will still be high."

1) The nurse is reviewing the myocardial blood supply for a client with coronary artery disease (CAD). Which statements made by the client indicate an understanding of the information? Select all that apply.

"The coronary arteries carry blood away from the heart to the right atrium." "The heart receives its oxygen through the blood that fills it." "Coronary arteries primarily carry blood to the left ventricle."

The educator is reviewing the physiology of the renal system with a nurse. Which statement made by the nurse indicates further teaching is required?

"The kidneys stimulate white blood cell production."

A client with cirrhosis of the liver asks the nurse why they are at risk for bleeding. Which response should the nurse provide the client?

"The liver is injured and cannot make clotting factors."

Which information about the primary therapeutic action of an antianginal prescription should the nurse include in client teaching?

"The prescription decreases how much oxygen your heart needs."

A family member of a client receiving dobutamine intravenously asks the nurse how that will help their blood pressure. Which response should the nurse provide?

"The prescription is a vasopressor and will help stabilize blood pressure by making the blood vessels smaller."

A client post-acute myocardial infarction asks the nurse why they are prescribed reteplase (Retavase) intravenously (IV). Which response should the nurse provide the client?

"The prescription is dissolving the clot that has caused your heart attack."

A client asks the nurse how epoetin alfa (Epogen) will help their anemia. Which response should the nurse provide the client?

"The prescription stimulates your body to make red blood cells."

1) The nurse has provided education for a client prescribed pentoxifylline (Trental). Which statements made by the client indicate an understanding of the information? Select all that apply.

"The prescription will soften the red blood cells (RBCs) so they can fit through the smaller blood vessels." "The prescription decreases the platelets so the blood is less likely to clot." "The prescription decreases the 'stickiness' of the blood."

The nurse has provided education about dysrhythmias for a group of clients. Which statement made by a client indicates an understanding of the information?

"The sodium, potassium, and calcium levels must be okay for the heart to have an electrical impulse."

A client experiencing a severe allergic reaction to peanuts tells the nurse they have a known hypersensitivity to epinephrine (Adrenalin). Which response should the nurse provide the client?

"This is a life-threatening situation; a prior hypersensitivity is not an absolute contraindication."

1) he client tells the nurse, "My healthcare provider says I have atrial fibrillation. Is this serious and how is it treated?" Which responses should the nurse provide the client? Select all that apply.

"This is very common; your doctor will discuss the best treatment with you." "Depending on your symptoms, your healthcare provider may use an electrical shock."

A client with chronic heart failure has atrial fibrillation and mistaken warfarin what should the nurse tell the client about the expected outcome of this drug?

"This medication will prevent a clot from forming."

A client prescribed bumetanide (Bumex) asks the nurse how the drug works. Which response should the nurse provide the client?

"This prescription causes your kidneys to reabsorb calcium."

A pregnant client prescribed cyanocobalamin (Nascobal) asks if the prescription will hurt her baby. Which response should the nurse provide the client?

"This prescription is safe during pregnancy."

A client tells the nurse they are nervous about taking prescribed verapamil (Calan). Which response should the nurse provide the client?

"This prescription is safe, and most patients do very well with it."

The nurse has provided education for a client prescribed oprelvekin (Neumega). Which statement made by the client indicates an understanding of the information?

"This prescription will help increase my platelet count."

A mother asks the nurse if her breastfed infant is at risk for a B12 deficiency due to her vegetarian dietary preference. Which statement should the nurse provide the mother?

"Vitamin B12 is not secreted in the breast milk."

The nurse has provided education for a client with iron-deficiency anemia. Which statement made by the client indicates further teaching is required?

"We need extra iron because when the red blood cells die, all their iron is excreted from the body."

A client in heart failure asks the nurse how difficulty breathing is related to a heart problem. Which information should the nurse provide the client? Select all that apply.

"What you have is called congestive heart failure." "The left side of your heart has weakened and blood has entered your lungs."

A client states to the nurse, "I read that my antidysrhythmic drug can actually cause me to have irregular heartbeats. How can this be?" Which response should the nurse provide the client?

"Your medication blocks the flow of the electrolytes in your heart, and this can cause irregular beats."

Which is the primary desired outcome for a client that has experienced several episodes of angina?

1The client will experience relief of chest pain with nitrate therapy.

A cleint with hypertensive emergency is being treated with sodium nitroprusside. In a dilution of 50 mg/250 mL, how many micrograms of sodium nitroprusside are in each milliliter? Round your answer to the nearest who number

200 mcg

A client with hypertensive emergency is being treated with sodium nitroprusside. In a dilution of 50mg/250mL, how many micrograms of sodium nitroprusside are in each milliliter? Round your answer to a whole number.

200 mcg

The rapid response team has been called to manage an unwitnessed cardiac arrest in a client's hospital room. How long should the nurse estimate the maximum time a person can be without cardiopulmonary function and still not experience permanent brain damage?

4 to 6 minutes

The nurses tracking data on a group of clients with heart failure who have been discharged from the hospital and are being followed at a clinic. Which data are the best indicators that nursing interventions of monitoring and teaching have been effective?

5% of the clients required hospitalizations in the last 90 days

Which client should the nurse anticipate a prescription for reteplase (Retavase) therapy post myocardial infarction?

A 54-year-old female with type 2 diabetes

Which clients should the nurse anticipate will require a pharmacological intervention to manage their blood pressure? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A 61-year-old man whose blood pressure is 144/90 mmHg who also has type 2 diabetes A 61-year-old woman whose blood pressure is 153/92 mmHg who is otherwise healthy

Which client is at greatest risk for coronary artery disease?

A 65-year-old female who is obese with an LDL of 188 (10.4 mmol/L)

Which client is at greatest risk for developing heart failure?

A 69-year-old African American male with hypertension

Which symptom should the nurse teach the client with unstable angina to report immediately to the health care provider?

A change in the pattern of chest pain

Which prescription is indicated for the prevention of blood clots?

Abciximab (ReoPro)

Which is a priority assessment for the client receiving reteplase (Retavase) intravenously?

Abnormal bleeding

The nurse educator is reviewing the physiological regulation blood pressure. Which should the educator identify as initially involved?

Action of renin

A client experiencing syncope is suspected of taking a losartan (Cozaar) overdose? Which intervention should the nurse anticipate?

Administer an intravenous solution of normal saline

The nurse is preparing to administer clevidipine (Cleviprex) to a client experiencing a hypertensive crisis. Which interventions should the nurse implement? Select all that apply.

Administer the drug intravenously Continually monitor blood pressure

An adult comes to the emergency department with crushing substernal chest pain that radiates to the shoulder and left arm. The admitting diagnosis is acute myocardial infarction. Prescriptions include oxygen by nasal cannula at 4L/min, complete blood count, a chest radiography, a 12-lead electrocardiogram (ECG), and 2 mg of morphine sulfate give IV. What should the nurse do first?

Administer the morphine

Which route of administration should the nurse anticipate to use for a client's prescribed enoxaparin (Lovenox)?

Administer the prescription into the abdomen, subcutaneously.

The nurse is preparing to defibrillate a client on a cardiac monitor who is in ventricular fibrillation. What should the nurse do?

After pressing the charge button and calling "all clear," push the shock button.

Which should the client be instructed to avoid when prescribed an anticoagulant? Select all that apply.

Alcohol Contact sports Prolonged sitting Hard toothbrush

The educator is preparing to review the diuretics that do not require potassium supplements with a nurse. Which diuretics should the educator include? Select all that apply.

Amiloride (Midamor) Spironolactone (Aldactone)

Which medical condition should the nurse be concerned about for a client prescribed hydralazine?

Angina

Which classification of prescription should the nurse anticipate to be prescribed to a client newly diagnosed with chronic heart failure?

Angiotensin-converting enzyme (ACE) inhibitor

1) Which findings should the nurse anticipate when assessing a client developing right-sided heart failure? Select all that apply.

Ankle edema Enlarged liver Displaced apical heart rate

1) Which prescription should the nurse anticipate administering to a client treated for an anaphylactic reaction with epinephrine? Select all that apply.

Antihistamines Corticosteroids

Which vital sign is of the greatest concern to the nurse prior to administering digoxin (Lanoxin)?

Apical pulse

An older adult is admitted to the emergency department (ED) at 2000 hours with syncope, shortness of breath, and reported palpitations. At 2015, the nurse places the client on the ECG monitor and identifies the following rhythm. What should the nurse do? Select all that apply

Apply oxygen Monitor vital signs Have the client sign consent for cardioversion as prescribed

When teaching the client with hypertension to avoid orthostatic hypotension, the nurse should provide which instructions? Select all that apply.

Arise slowly from bed Avoid standing still for long periods

1) Which prescriptions does the nurse anticipate to be included in the goal to reduce the post-MI mortality of a client? Select all that apply.

Aspirin Beta blockers ACE inhibitors

The nurse is caring for a client diagnosed with an anterior myocardial infarction 2 days ago. Upon assessment, the nurse identifies a systolic murmur at the apex. What should the nurse do first?

Assess for changes in vital signs

The nurse is admitting an older adult to the hospital. The echocardiogram report revealed left ventricular enlargement. The nurse notes 2+ pitting edema in the ankles when getting the client into bed based on this finding, what should the nurse do first?

Assess respiratory status

The nurse is assessing a client who has had a myocardial infarction (MI). The nurse notes that cardiac rhythm on the monitor (see the electrocardiogram strip). What should the nurse do first?

Assess the client for changes in the rhythm

The nurse notes that the intravenous (IV) norepinephrine (Levophed) has been accidentally abruptly discontinued. Which is the nurse's priority action?

Assess the client's blood pressure.

Six hours after pacemaker insertion, a client reports sudden onset of chest pain and shortness of breath with a drop in SpO2 from 98% on 2 LPM of oxygen to 90% on 2 LPM of oxygen. Which action should the nurse take first?

Assess the client's breath sounds and chest movement

Cardiac telemetry shows that a client who is up to the bathroom has converted from normal sinus rhythm wit a rate of 72 bpm to atrial fibrilation with a ventricular response rate of 100 bpm. In what order from first to last should the nurse perform these interventions? All options should be used

Assist the client to the bed Assist with vital signs Initiate intravenous access Obtain a stat 12-lead electrocardiogram

The nurse is planning care for a group of elderly clients who are affected by orthostatic hypotension what should the nurse do? Select all that apply.

Assist the clients to stand to help prevent falls. Teach clients how to gradually change their position. Conduct "fall risk" assessments. Consider the use of sequential compression devices (SADs) for high-risk clients.

A client experiencing bradycardia is suspected of overdosing on diltiazem (Cardizem). Which treatment should the nurse anticipate prescribed?

Atropine

The nurse notes that a client experiencing heart failure has been receiving nifedipine (Procardia). Which is a priority assessment for the nurse?

Auscultate breath sounds for crackles.

Which is the priority nursing assessment for the client receiving human serum albumin (Albuminar) as treatment for shock?

Auscultate breath sounds for crackles.

Which assessment is a nursing priority for a client receiving cholestyramine (Questran)?

Auscultation of bowel sounds in all four abdominal quadrants

The nurse is teaching a client with hypertension about taking atenolol. What should the nurse instruct the client to do?

Avoid sudden discontinuation of the drug.

Which describes the classification system for anemias?

Based on the size and color of erythrocytes

The nurses teaching a client with heart failure how to avoid complications in further hospitalizations. The client has understood the instruction when the client identifies which potential complications? Select all that apply

Becoming increasingly short of breath at rest Weight gain of 2lbs (0.9 kg) or more in 1 day Having to sleep sitting up in the reclining chair

Which prescriptions reduce the heart's demand for oxygen by lowering heart rate?

Beta-adrenergic blockers and calcium channel blockers

Which adverse effect should the nurse instruct the client to monitor for while receiving warfarin sodium?

Bleeding

A patient has been prescribed gemfibrozil (Lopid). Which laboratory tests should the nurse schedule for the client on the next clinic appointment? Select all that apply

Blood glucose Liver enzymes Hemoglobin and hematocrit

A pulmonary artery catheter is inserted in a client with severe mitral stenosis and regurgitation. The nursing administers furosemide and nitroprusside as prescribed. The nurse notices they sit and drop in the pulmonary artery systolic pressure in pulmonary artery wedge pressure. What should the nurse assess next?

Blood pressure

An older client with a history of heart failure is admitted to the emergency department with pulmonary edema. During admission, what should the nurse assess first?

Blood pressure

Which changes are sensed by the baroreceptors and relayed to the vasomotor center?

Blood pressure

Which is the priority nursing assessment for a client prescribed epoetin alfa (Epogen)?

Blood pressure

A client with chest pain is prescribed intravenous nitroglycerin. Which finding is the greatest concern for the nurse initiating the nitroglycerin drip?

Blood pressure 88/46 mm Hg

1) Which laboratory values should the nurse assess for the client receiving lisinopril (Prinivil)? Select all that apply.

Blood urea nitrogen (BUN) Serum bilirubin ALT/AST

Good dental care is an important measure in reducing the risk of endocarditis. What information about dental care should the nurse include in the teaching plan for a client with mitral stenosis? Select all that apply.

Brush their teeth at least twice a day Floss the teeth at least once daily Have regular dental checkups

Depolarization occurs when which two electrolytes rush into the cell?

Calcium and sodium

Which classification of drug is used for the treatment of paroxysmal supraventricular tachycardia (PSVT)?

Calcium channel blocker

The nurse is caring for a client who has become unresponsive. The blood pressure is 80/40 mm Hg, and SpO2 is 90% on 50% face mask. What should the nurse do next?

Call the rapid response team

which food should the nurse teach a client with heart failure to limit when following a 2 gram sodium diet?

Canned tomato juice whole wheat bread hamburger

1) Which physiological systems should the nurse recognize are most at risk for a client in a hypertensive crisis? Select all that apply.

Cardiac Renal

1) Which should the nurse prepare for the client experiencing shock ?Select all that apply.

Cardiac monitor Pulse oximeter Oxygen

Which factors are responsible for blood pressure?

Cardiac output, blood volume, and peripheral vascular resistance

Which statement is accurate regarding the physiological changes associated with heart failure?

Cardiac remodeling occurs after prolonged ventricular hypertrophy.

Which information should the nurse include when discussing cardiogenic shock with a client?

Cardiogenic shock occurs due to pump failure.

1) A client treated previously for a fractured leg and multiple abrasions returns to the emergency department experiencing anaphylactic shock. Which prescriptions should the nurse suspect have caused the reaction? Select all that apply.

Cephalosporin antibiotic NSAIDs Opioid analgesic

The nurse is working the day shift on a cardiac unit receives a following shift report At the conclusion of shift report, it is 0730. Put the clients in the order from first to last in which the nurse should plan to assess them. All options must be used

Client 2: experience chest pain at 0630. Pain resolved after two sublingual nitroglycerin tablets Client 4: Scheduled for coronary artery bypass surgery at 0800. The client's family is in the client's room Client 3: Scheduled for oral antihypertensive medications at 0900. Incontinent of urine during the day. Client 1: Admitted yesterday morning with hypokalemia. Awaiting repeat electrolyte lab results drawn at 0600.

Which describes the nurse's understanding of the purpose for choosing the names for the colony-stimulating factors?

Colony-stimulating factors (CSFs) are named according to the types of blood cells that they stimulate.

The unlicensed assistive personnel reports to the nurse that a client is "feeling short of breath". The client's blood pressure was 124/78 mm Hg 2 hours ago with a heart rate of 82 bpm; the unlicensed assistive personnel reports that blood pressure is now 84/44 mm Hg with a heart rate of 54 bpm, and the client stated, "I just don't feel good." What action should the nurse take? Select all that apply

Confirm the clients' vital signs, and complete a quick assessment. Inform the charge nurse of the change in condition, and initiate the hospital's rapid/emergency response team. Position the client in semi-Fowler's position. Stay with the client, and reassure the client. Call the health care provider, and report the situation using SBAR format

The nurse has completed an assessment on a client with a decreased cardiac output. Which findings should receive the highest priority?

Confusion, urine output 15 mL over the last 2 hours, orthopnea

The nurse is preparing the education for a client prescribed chlorothiazide (Diuril). Which information should the nurse include in the teaching?

Consumption of foods high in potassium

A client is prescribed an intravenous infusion of milrinone (Primacor) for acute heart failure. Which is a priority nursing assessment during the infusion?

Continuous ECG monitoring

The nurse is assessing a client with a known history for chronic heart failure. Which finding indicates poor perfusion to the tissue?

Cool, pale extremities

Which adverse effect of lisinopril (Prinivil) should be reported to the healthcare provider?

Cough

The nurse is preparing to administer nitroglycerine via the intravenous route. Which should the nurse do prior to the administration of the prescription?

Cover the intravenous (IV) bottle to decrease light exposure.

Metoprolol is added to the pharmacological therapy of a diabetic female diagnosed with stage two hypertension who has been initially treated with furosemide in ramipril. The nurse should evaluate the client for which expected therapeutic effect?

Decrease in heart rate

Which mechanism of action does beta-adrenergic agonists have on the cardiovascular system?

Decrease the contractility of the heart

A client prescribed furosemide (Lasix) and digoxin (Lanoxin) reports using an over-the-counter antacid for recurrent heartburn. Based on this information, which effect should the nurse be concerned about?

Decreased effectiveness of digoxin (Lanoxin)

1) Which laboratory results should the nurse understand are associated with the treatment of epinephrine? Select all that apply.

Decreased potassium Elevated blood glucose

Which is the purpose of the AV node?

Delay the impulse from the SA node.

When preparing a client for a cardiac angiogram, what action should the nurse take? Select all that apply

Determine if the client has an allergy to liquid contrast material Inform he client that an intravenous infusion will be started before the procedure Remind the client to have nothing to eat or drink 8 hours before the procedure Instruct the client to remain still during the procedure

Which describes the action of thrombolytic prescriptions?

Digest and remove preexisting clots.

Which prescription should the nurse anticipate to increase the myocardial contractility for a client with heart failure?

Digoxin (Lanoxin)

Which information should the nurse include in the discharge plan for a client prescribed digoxin (Lanoxin)?

Digoxin may result in depression.

A client with heart failure is taking furosemide, digoxin, and potassium chloride. The client has nausea, blurred vision, headache, and weakness. The nurse notes that the client is confused. The telemetry strip shows first degree atrioventricular block. What other sign should the nurse assess next?

Digoxin toxicity

When administering a thrombolytic drug to the client who is experiencing a myocardial infarction (MI) and who has premature ventricular contractions, which is the expected outcome of the drug?

Dissolve clots

The nurse is assessing a client who has had a stent inserted in a coronary artery via the right femoral artery. The client is receiving intravenous heparin sodium at 1,000 units per house. During the second post procedure check, the nurse notes that the puncture site at the groin has begun to steadily ooze blood. What should the nurse do first?

Don gloves and apply direct pressure over the site

A client prescribed doxazosin (Cardura) asks how the medication works. Which information should the nurse provide the client?

Doxazosin helps dilate the blood vessels."

A client is taking clonidine for treatment of hypertensive. The nurse should teach the client about which common adverse effects of this drug? Select all that apply:

Dry mouth Impotence Sleep disturbance

1) For which conditions should the nurse instruct a client to hold the application of nitroglycerin ointment and contact the healthcare provider? Select all that apply.

Dyspnea Productive cough Confusion

The nurse has prescribed dietary education for a client prescribed nifedipine (Procardia XL). Which dietary choice should the nurse recognize requires further education?

Eggs, whole-wheat toast with butter, cereal, milk, and grapefruit juice

Which prescription should the nurse be concerned about a pregnant client receiving?

Enalapril (Vasotec)

Which should the nurse recognize a client with acute renal failure cannot effectively regulate? Select all that apply

Fluid balance Electrolyte balance The pH of body fluids Blood pressure

The patient is receiving cholestyramine (Questran) and complains of constipation. The physician orders bisacodyl (Dulcolax) tablets. When is the best time for the nurse to administer the bisacodyl (Dulcolax) tablets?

Four hours after administration of cholestyramine (Questran).

The nurse has completed nutritional teaching for a client with a high low density lipoprotein (LDL) level. Which menu choice made by the client indicates an understanding of the teaching?

Grilled chicken with rice and broccoli, tossed salad with walnuts and sliced apples, slice of whole-wheat bread, and low-fat chocolate pudding

Which type of lipoprotein is often referred to as "the good type?"

HDL

Which conditions should the nurse anticipate the healthcare provider to possibly prescribe a diuretic? Select all that apply

Heart failure Hypertension Acute kidney injury

A patient receiving chlorothiazide (Diuril) has developed hypokalemia. Which assessment findings support the diagnosis?

Heart palpitations

The nurse is providing education about lipids for a client with hyperlipidemia. Which information should the nurse include in the education?

High density lipoprotein (HDL) is called good cholesterol because it removes cholesterol from the body and gets rid of it in the liver.

Which is the priority action of the nurse when caring for a client receiving a statin with elevated creatine kinase (CK) levels?

Hold the prescription and notify the healthcare provider

Which contributes to the regulation of hematopoiesis?

Hormones

Which is the client at risk for that is receiving spironolactone (Aldactone)?

Hyperkalemia

The nurse is reviewing the medical history of a client prescribed hydrochlorothiazide (Microzide). Which condition should the nurse be concerned about?

Hypertension

Which should the nurse recognize is associated with chronic kidney disease (CKD)? Select all that apply.

Hypertension Diabetes

Which is the nurse's priority assessment for a client treated with intravenous hydralazine (Apresoline)?

Hypotension and tachycardia

Which prescription is nephrotoxic if an overdose occurs?

Ibuprofen (Advil)

Which describes the action of vasodilators in the relief of symptoms of heart failure?

Improve cardiac contractility

1) The educator is reviewing the mechanism of action of intravenous glucagon as a treatment for an overdose of propranolol (Inderol) with the nursing staff. Which information should the educator include? Select all that apply.

Improves AV node conduction Increases the heart rate Enhances myocardial contractility

What is the major goal of nursing care for a client with heart failure in pulmonary edema?

Increase cardiac output

Which is the primary pharmacologic goal in the treatment of a client experiencing stable angina?

Increase cardiac oxygen supply and reduce cardiac oxygen demand.

A client receiving ferrous sulfate (Feosol) tells the nurse they are experiencing constipation. Which intervention should the nurse recommend?

Increase fluids and high fiber foods in the diet

Which factor increases cardiac output?

Increase in preload

The nurse is providing education for nonpharmacological interventions to manage hypertension. Which information should the nurse include? Select all that apply.

Increase your dietary intake of fruits and vegetables Decrease the consumption of alcohol. Increase physical activity Restrict your intake of sodium.

Which are the goals of antianginal therapy? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Increased blood flow to the myocardium Decreased myocardial oxygen demand

Which is an expected outcome when a client is receiving an IV administration of furosemide?

Increased urine output

Which describes the primary actions of Filgrastim (Granix)?

Increases neutrophil production

Which describes the mechanism of action of anticoagulant prescriptions?

Inhibition of thrombi formation.

Which describes the mechanism of atorvastatin's (Lipitor) ability to lower blood cholesterol levels?

Inhibits an enzyme that is essential for cholesterol synthesis