NURS 6521N Week 3 Quiz .Q&A

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NURS 6521N Week 3 Quiz .Q&A • Question 1 1 out of 1 points A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely adminis... ter a lower-than-normal maintenance dose of digoxin? Response Feedback: The nurse should continue regular administration of the drug because digoxin requires a loading dose before the drug's therapeutic effect is present. It may take several days for optimal clinical effects to appear. Therefore, seeking an order to increase the dosage, seeking orders to discontinue digoxin and start another drug, or insisting that another drug be ordered would not be necessary at this time. • Question 2 1 out of 1 points A nurse is caring for a patient who is taking digoxin and a loop diuretic. Which of the following would be most important for the nurse to monitor? Response Feedback: Although it is important to monitor the patient's ECG, it is more important to closely monitor potassium levels when the patient is taking a drug that promotes the loss of potassium, such as thiazide or loop diuretics. Hypokalemia increases the effect of digoxin and increases the risk for digoxin toxicity. The patient's sodium levels and liver enzyme levels may need to be monitored periodically, but not as closely as potassium levels. • Question 3 1 out of 1 points Which of the following patients is most likely to benefit from the administration of an adrenergic agonist? Response Feedback: One of the most frequent indications for adrenergic agonist drugs is shock. Their use is contraindicated in labor, and they would exacerbate hypertension. • Question 4 1 out of 1 points A nurse has been following a male patient who is taking hydralazine, clonidine, and a diuretic for hypertension. After 2 weeks of medication therapy, the patient begins to complain of numbness and tingling in his hands and feet. The nurse suspects that these signs or symptoms are Response Feedback: The nurse will evaluate the numbness and tingling in the patient's hands and feet as signs of peripheral neuritis, which is an adverse effect of the hydralazine. If a diagnosis is made to confirm the nurse's suspicion, pyridoxine should be administered because the neuritis may be caused by the antipyridoxine effect of the drug therapy. The numbness and tingling are not associated with clonidine and a diuretic. An increased risk of diabetes has not been identified as being related to this combination of medications. • Question 5 1 out of 1 points Several months of treatment with a statin accompanied by lifestyle modifications have failed to appreciably improve a patient's cholesterol levels. Consequently, the patient has been prescribed cholestyramine. The nurse should recognize that this drugs achieves its therapeutic effect by Response Feedback: Unlike statins, which work by decreasing the synthesis of cholesterol, the bile acid sequestrants such as cholestyramine promote the oxidation of cholesterol to bile acids. Bile acid sequestrants do not promote vasodilation or bind HDL to LDL. • Question 6 1 out of 1 points A nurse has administered a medication to a patient with hypertension. The prescribed drug is supposed to decrease cardiac output. A decrease in cardiac output would most likely Response Feedback: A drug-induced decrease in cardiac output would cause a decrease in the amount of circulating blood sent through the kidneys. If a patient has normal kidney function, a decrease in cardiac output would not result in an increased serum creatinine level. Further, the decrease in cardiac output would not cause an increased synergistic effect of the drug, nor would it decrease drug absorption in the blood. • Question 7 1 out of 1 points A nurse is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The nurse should anticipate that the drug will be administered Response Feedback: Clonidine may be administered orally or parenterally but is most frequently administered transdermally. • Question 8 1 out of 1 points A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by Response Feedback: Verapamil acts by inhibiting the movement of calcium ions across the cardiac and arterial muscle cell membrane. It works preferentially in “slow response” myocardial tissue, such as the SA and AV nodes. Beta blockers inhibit adrenergic receptors and Class IB antiarrhythmics are among the drugs that decrease sodium and potassium conduction. Lidocaine weakens phase 4 diastolic depolarization and decreases the action potential duration and the effective refractory period of Purkinje fibers and ventricular muscle. • Question 9 1 out of 1 points A 55-year-old man's hypertension has not responded adequately to his current medication regimen consisting or an ACE inhibitor, a beta-blocker and a thiazide diuretic. As a result, he will soon begin taking hydralazine (Apresoline) in addition to his existing antihypertensives. The addition of this medication to his regimen means that the nurse must prioritize which of the following nursing actions? Response Feedback: Hydralazine is associated with an increase in cardiac output that can precipitate palpitations, tachycardia, and angina. As a result, there is a need for astute cardiac assessment. The use of hydralazine does not directly necessitate close monitoring of electrolytes or blood sugars, even though these are prudent assessment measures. There is a risk of dizziness and possibly falls with the use of any antihypertensive, but it is unnecessary to supervise all of the patient's ADLs. • Question 10 1 out of 1 points A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.) Response Feedback: Because of its effects on blocking beta-1 receptors, metoprolol slows the heart rate, the speed of conduction, and decreases the force of contraction, thus cardiac output is decreased, decreasing blood pressure. Consequently, it is necessary to assess the patient's heart rate in addition to his or her blood pressure. Neither beta blockers nor thiazide diuretics create a direct need for the assessment of temperature, respiratory rate, or oxygen saturation level. ...........CONTINUED [Show More]

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