NURS 215 Test 2 Pharmacology | Contains 60 Questions and Answers with Feedabck. 100% Correct

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NURS 215 Test 2 Pharmacology | Contains 60 Questions and Answers with Feedabck. 100% Correct A nurse is preparing to administer propranolol to a client who has a dysrhythmia. Which of the following a... ctions should the nurse plan to take? : C. Assist the client when she sits up or stands after taking this medication. Answers: A. Hold propranolol for an apical pulse greater than 100/min. B. . Administer propranolol to increase the client’s blood pressure. C. Assist the client when she sits up or stands after taking this medication. D. Check for hypokalemia frequently due to the risk for propranolol toxicity. : A. Propranolol is a beta-adrenergic blocker that is used to slow tachydysrhythmias. The nurse should not hold the medication for a pulse greater than 100/min, but should hold it for a very low pulse rate, such as less than 50/min. B. Propranolol is used to treat hypertension and is not administered to increase the client’s blood pressure. C. : Propranolol can cause orthostatic hypotension, so it is important assess for dizziness during ambulation or when moving to a sitting position. D. Propranolol can increase potassium level. The client is at risk for toxicity with digoxin, rather than propranolol, when the serum potassium is low. Question 2 2 out of 2 points A client is placed on aspirin. A toxic reaction to this medication that the nurse will teach the client to report is : C. tinnitus. Answers: A. blurred vision. B. muscle cramps. C. tinnitus. D. joint pain. Tinnitus, or ringing in the ears, is a common early sign of aspirin toxicity. Blurred vision, muscle cramps, and joint pain are not signs of aspirin toxicity. Question 3 2 out of 2 points A nurse is teaching a client who is taking digoxin and has a new prescription for colesevelam. Which of the following instructions should the nurse include in the teaching? : A. “Take digoxin with your morning dose of colesevelam.” Answers: A. “Take digoxin with your morning dose of colesevelam.” B. “Your sodium and potassium levels will be monitored periodically while taking colesevelam.” C. “Watch for bleeding or bruising while taking colesevelam.” D. “Take colesevelam with food and at least one glass of water.” : A. Many medications, including digoxin, should be taken 4 hr before colesevelam to prevent decreased absorption of the other medications. B. Serum electrolytes are not checked periodically while taking colesevelam. However, total cholesterol, LDL, HDL, and triglycerides are checked, as well as blood glucose and HbA1C levels for clients who have diabetes mellitus. C. Bleeding and bruising are not expected effects caused by colesevelam. D. : Colesevelam should be taken with food and at least 8 oz of water Question 4 2 out of 2 points The client in the emergency department experienced an acute myocardial infarction (MI) 8 hours ago. The nurse is administering reteplase intravenously (IV). The patient asks the nurse what is being done. What is the best response by the nurse? : B. "This medication is dissolving the clot that is causing your heart attack." Answers: A. "This medicine is widening the arteries in your heart so they can get more oxygen." B. "This medication is dissolving the clot that is causing your heart attack." C. "This medicine is thinning your blood so more clots will not develop." D. “This medication is preparing you for further heart testing to determine the amount of damage that has occurred.” : When treating myocardial infarction (MI), thrombolytic therapy is administered to dissolve clots obstructing the coronary arteries, thus restoring circulation to the myocardium. Thrombolytics dissolve clots in coronary arteries; they are not vasodilators. Thrombolytics are most effective when administered from 20 minutes to 12 hours after the onset of myocardial infarction (MI) symptoms; this patient is within the time frame. Thrombolytics dissolve clots in coronary arteries; they are not anticoagulants Question 5 0 out of 2 points A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia? : A. Furosemide Answers: A. Furosemide B. Hydrochlorothiazide C. Metolazone D. Spironolactone Question 6 2 out of 2 points The nurse is providing information for a patient who will self-administer a twice-daily antidysrhythmic medication at home. The nurse would provide additional education if the client makes which statement? Select all that apply. s: A. "If I get the flu, I should stop taking the medication until my fever goes down." C. "If I forget a dose of medication I should take two pills for the next dose." Answers: A. "If I get the flu, I should stop taking the medication until my fever goes down." B. "I should take my doses as close to 12 hours apart as I can." C. "If I forget a dose of medication I should take two pills for the next dose." D. "If I can't take the medication for a couple of days because I am sick, I should call the clinic for advice." E. "I should get my prescription refilled before I am completely out of medicine." : Doses of antidysrhythmic medications should be evenly spaced. The health care provider should be consulted if the patient is going to miss medication for more than 1 day. Abrupt discontinuation of antidysrhythmic medications can have serious side effects, so an adequate supply of the medication should be available. Antidysrhythmic medications should not be stopped abruptly. Antidysrhythmic medications should not be double-dosed to make up for missed doses. Question 7 2 out of 2 points A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? : A. Check the client's vital signs. Answers: A. Check the client's vital signs. B. Request a dietitian consult. C. Suggest that the client rests before eating the meal. D. Request an order for an antiemetic. : Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. By obtaining vital signs, the nurse can assess for bradycardia, which is a symptom of digoxin toxicity. The nurse shouldwithhold the medication and call the provider if the client's heart rate is less than 60 bpm. Question 8 2 out of 2 points A client with chronic angina is ordered to receive nitroglycerin via a patch. Which of the following would the nurse does in applying this transdermal medication? : C. Remove the old patch in the evening and apply a new one in the morning. Answers: A. Cut the patch to provide the dose of medication. B. Use sterile technique in applying the patch C. Remove the old patch in the evening and apply a new one in the morning. D. Apply the patch and cover with an airtight dressing. : Remove the old patch in the evening and applying the new patch in the morning Question 9 0 out of 2 points A nurse is assessing a client who has taken procainamide to treat dysrhythmias for the last 12 months. The nurse should assess the client for which of the following adverse effects of this medication? (Select all that apply.) s: A. Hypertension B. Widened QRS complex Answers: A. Hypertension B. Widened QRS complex C. Narrowed QT interval D. Easy bruising E. Swollen joints : A. Hypotension, rather than hypertension, is an adverse effect of procainamide. B. : On the ECG, procainamide can cause a widened QRS complex, which is a manifestation of cardiotoxicity if the QRS complex becomes widened by more than 50% of the expected reference range. C. On the ECG, procainamide can cause a prolonged QT interval, a manifestation of cardiotoxicity. D. : Procainamide can cause bone marrow depression, with neutropenia (infection) and thrombocytopenia (easy bruising, bleeding). E. : Systemic lupus erythematosus-like syndrome can occur as an adverse effect of procainamide. Manifestations include swollen, painful joints. Clients who take procainamide in large doses or for more than 1 year are at risk. Question 10 2 out of 2 points The client is being treated for angina. He asks the nurse if angina is the same thing as having a heart attack. Which of the following statements made by the nurse indicate understanding of the difference between angina and heart attack? : B. "Angina means heart muscle is not getting enough oxygen, while heart attack, or myocardial infarction, means part of your heart has died." Answers: A. "They have some things in common, for example, severe emotional distress and panic can accompany both angina and myocardial infarction." B. "Angina means heart muscle is not getting enough oxygen, while heart attack, or myocardial infarction, means part of your heart has died." C. "Actually, it depends on what type of angina you mean; there are several types." D. "They are basically the same." : Angina pectoris is acute chest pain caused by insufficient oxygen reaching a portion of the myocardium. Accompanying the discomfort is severe emotional distress, a feeling of panic with fear of impending death. A myocardial infarction indicates ischemia and necrosis have occurred to the affected part of the myocardium. Angina and myocardial infarction are different in that with myocardial infarction ischemia and necrosis occur to a portion of the myocardium. There are several types of angina; however, this response does not answer the patient's question. Question 11 0 out of 2 points A patient has been prescribed nitroglycerin ointment for transdermal application. The nurse should teach the client to hold the medication and contact the prescriber if which situations occur? Select all that apply. s: A. Dyspnea B. Cough with frothy sputum D. Fever E. Confusion Answers: A. Dyspnea B. Cough with frothy sputum C. Headache D. Fever E. Confusion : Nitroglycerin may worsen pre-existing respiratory conditions. This type of lung congestion may signal an impending heart failure. Confusion may indicate that cerebral perfusion is not adequate. Headache is a common adverse reaction and can be treated. The medication should not be held. Fever is not an adverse effect of nitroglycerin. Question 12 2 out of 2 points A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication? : A. Decreased blood pressure Answers: A. Decreased blood pressure B. Increase of HDL cholesterol C. Prevention of bipolar manic episodes D. Improved sexual function : Rationale: Lisinopril, an ACE inhibitor, may be used alone or in combination with other antihypertensives in the management of hypertension and congestive heart failure. A therapeutic effect of the medication is a decrease in blood pressure. Question 13 0 out of 2 points A nurse is taking a medication history from a client who has angina and is to begin taking ranolazine. The nurse should report which of the following medications in the client’s history that can interact with ranolazine? (Select all that apply.) s: A. Digoxin C. Verapamil D. Amlodipine nswers: A. Digoxin B. Simvastatin C. Verapamil D. Amlodipine E. Nitroglycerin transdermal patch : A. : Concurrent use with ranolazine increases serum levels of digoxin, so digoxin toxicity can result. B. : Concurrent use with ranolazine increases serum levels of simvastatin, so liver toxicity can result. C. : Verapamil is an inhibitor of CYP3A4, which can increase levels of ranolazine and lead to the dysrhythmia torsades de pointes. D. Amlodipine, a calcium channel blocker, is used for hypertension and stable angina. It is prescribed along with ranolazine to treat angina. E. Nitroglycerin transdermal patches are prescribed along with ranolazine to treat angina. Question 14 0 out of 2 points A nurse is assessing an older adult client who is receiving digoxin. The nurse should recognize that which of thefollowing findings is a manifestation of digoxin toxicity? : A. Ataxia Answers: A. Ataxia B. Anorexia C. Photosensitivity D. Jaundice Question 15 2 out of 2 points The nurse teaches the patient about digoxin (Lanoxin) toxicity and determines that learning has occurred when the patient makes which statements? s: C. "I can drink orange juice every morning." E. "I must check my pulse and not take the medication if it is less than 60." Answers: A. "I should limit my fluids while taking this medication." B. "It is okay to keep taking my ginseng." C. "I can drink orange juice every morning." D. "If I have nausea, it means I must stop the medication." E. "I must check my pulse and not take the medication if it is less than 60." : Orange juice is a source of potassium, which will minimize the risk for digoxin (Lanoxin) toxicity. Sixty beats per minute is the generally accepted limit for withholding digoxin (Lanoxin). Nausea, by itself, may be a side effect, but it is not necessarily indicative of digoxin (Lanoxin) toxicity. Ginseng may increase the risk of digoxin (Lanoxin) toxicity. Dehydration can increase the risk for digoxin (Lanoxin) toxicity; the patient must not limit fluids. Question 16 2 out of 2 points The client says to the nurse, "My doctor said I can't have fried chicken anymore because I have heart disease. I've eaten it all my life and am fine except for some indigestion lately." Which of the following is the best response by the nurse? : D. "Your indigestion could actually be chest pain caused by narrowed coronary arteries; you will need a low-fat diet." Answers: A. Did your doctor mention exercise? That is the most important lifestyle change to slow the progression of your heart disease." B. "Your indigestion is an indication that your body cannot tolerate fatty foods; this causes an increased workload for your heart." C. "Fried chicken is actually okay, but you must be very careful with the type of fat that you fry the chicken in." D. "Your indigestion could actually be chest pain caused by narrowed coronary arteries; you will need a low-fat diet." : The most common etiology of coronary artery disease (CAD) in adults is atherosclerosis, the presence of plaque within coronary artery walls. To decrease this, patients should eliminate foods high in cholesterol or saturated fats. Some patients experience angina pain in the midepigastrium, which is an indication of coronary artery disease (CAD), not an intolerance of fatty foods. Exercise is only one of several important healthy lifestyle habits to prevent or slow the progression of coronary artery disease (CAD). The patient should not consume chicken fried in any type of fat since foods that are high in saturated fats should be avoided. Question 17 2 out of 2 points A patient has been prescribed potassium chloride (KCl). The patient states, “This is sure a big pill.” What nursing actions are indicated? : C. Consult with the prescriber about an alternative drug form. Answers: A. Crush the tablet and put it in a soft food for the patient to swallow. B. Have the patient chew the tablet. C. Consult with the prescriber about an alternative drug form. D. Have the client skip the pills as they are too big to swallow. : The patient should sit straight up when swallowing this pill to prevent choking and to prevent esophagitis. Alternative forms of potassium are available and may be better for this patient. KCl should be taken with food to prevent gastric upset. The pill should not be crushed. The patient should not chew the tablet. Question 18 0 out of 2 points The nurse has completed medication education with the patient who is receiving atenolol. The nurse determines that teaching is effective when the patient makes which statement? : D. "I must take this medicine with food so it will be properly absorbed." Answers: A. "I must avoid grapefruit juice when I take this medicine." B. "I must call my doctor if I want to stop this medicine." C. "I must check my pulse before taking the medicine and call the doctor if it is less than 50." D. "I must take this medicine with food so it will be properly absorbed." : When beta blockers are abruptly discontinued, adrenergic receptors are stimulated causing excitation. This could result in tachycardia or myocardial infarction (MI). Atenolol (Tenormin) may be taken with or without food. Atenolol (Tenormin) is not metabolized through the CYP 450 chromosome system, so grapefruit juice is not contraindicated. Patients should check their pulse prior to taking atenolol (Tenormin), but they should call the physician if the pulse is less than 60, not 50. Question 19 2 out of 2 points The nurse has completed medication education with the client who is receiving nitroglycerine as therapy for angina. The nurse determines that additional teaching is necessary when the patient makes which statement? : A. "I can keep taking tablets until the pain is gone, but I should not use more than five tablets." Answers: A. "I can keep taking tablets until the pain is gone, but I should not use more than five tablets." B. "If my pain is not reduced 5 minutes after taking one tablet I should call EMS." C. "I should take a tablet as soon as chest pain occurs.." D. "I can take three tablets, one every 5 minutes." : When directed to do so, patients should follow the time frame of taking a nitroglycerine (Nitrostat) tablet every 5 minutes and not exceed three tablets. If pain is not gone 5 minutes after taking one tablet, EMS should be notified. The patient should not take additional NTG until directed to do so. The patient should not delay when chest pain occurs and should take a tablet immediately. When directed to do so, nitroglycerine (Nitrostat) tablets should be taken every 5 minutes. Question 20 2 out of 2 points The nurse ly understands the important baseline assessment prior to administration of nitroglycerin when she assesses which of the following? : D. Blood pressure Answers: A. Weight B. Resporation C. Urine output D. Blood pressure : Answer: D Blood pressure Use of organic nitrates place a patient at risk for severe hypotension related to vasodilation. Question 21 2 out of 2 points A nurse is caring for a client who is taking digoxin for heart failure and develops indications of severe digoxin toxicity. Which of the following medications should the nurse prepare to administer? : A. Fab antibody fragments Answers: A. Fab antibody fragments B. Flumazenil C. Acetylcysteine D. Naloxone : Rationale: Fab antibody fragments, also called digoxin immune Fab, bind to digoxin and block its action.The nurse should prepare to administer this antidote IV to clients who have severe digoxin toxicity. Question 22 2 out of 2 points A nurse is providing teaching to a client who is starting simvastatin. Which of the following information should the nurse include in the teaching? : A. Take this medication in the evening. Answers: A. Take this medication in the evening. B. Change position slowly when rising from a chair. C. Maintain a steady intake of green leafy vegetables. D. Consume no more than 1 L/day of fluid. : A. : The client should take simvastatin in the evening because nighttime is when the most cholesterol is synthesized in the body. Taking statin medications in the evening increases medication effectiveness. B. Changing position slowly might be necessary when taking an antihypertensive medication, but it is not necessary after taking simvastatin. C. Consuming a steady intake of green vegetables is important for clients taking warfarin, but does not help lower cholesterol when taking simvastatin. D. There is no indication for taking less than 1 L/day of fluid when taking simvastatin. Question 23 2 out of 2 points A nurse is caring for four clients. After administering morning medications, she realizes that the nifedipine prescribed for one client was inadvertently administered to another client. Which of the following actions should the nurse take first? : B. Check the client's vital signs. Answers: A. Notify the client's provider. B. Check the client's vital signs. C. Fill out an occurrence form. D. Administer the medication to the client. : Rationale: The first action the nurse should take using the nursing process is to assess the client. The nurse should know that the action of nifedipine is to lower blood pressure. Immediately upon realizing the error, the nurse should check the client's vital signs (especially the client's blood pressure) to ensure that the client is not hypotensive as a result. Only after ensuring that the client is safe and has stable vital signs should the nurse take other actions. Question 24 2 out of 2 points The nurse is caring for a patient who is being treated pharmacologically for the symptoms of heart failure. What would be included in the nurse's role of pharmacologic management of this patient? s: A. Teaching the patient how to space medications to decrease adverse effects with multiple medications. B. Teaching the patient the long-term benefits of beta blockers C. Continually monitoring the patient when on IV infusions Answers: A. Teaching the patient how to space medications to decrease adverse effects with multiple medications. B. Teaching the patient the long-term benefits of beta blockers C. Continually monitoring the patient when on IV infusions D. Decreasing medication dosages when the patient complains of adverse effects E. Changing a medication that is no longer working to decrease the patient's symptoms : One role of the nurse is patient teaching. The nurse should teach the patient how to space medications to decrease the hypotensive effects that can occur during treatment for heart failure. Beta blockers can have many adverse effects that can affect adherence. The nurse should teach the patient the long-term benefits in order to increase medication adherence. Patients who are receiving medications used to treat heart failure by IV require continual monitoring by the nurse. The nurse cannot change a dose of a medication without a health care provider's order. This is outside the nurse's scope of practice. The nurse cannot prescribe medications; it is outside the nurse's scope of practice to change a medication without a health care provider's order. Question 25 2 out of 2 points A nurse is caring for a client who has a new prescription for niacin to reduce cholesterol. The nurse should monitor for which of the following findings as an adverse effect of niacin? : D. Flushing of the skin Answers: A. Muscle aches B. Hypoglycemia C. Hearing loss D. Flushing of the skin : Hyperglycemia can occur as an adverse effect of niacin, not hypoglycemia. The nurse should plan to monitor blood glucose periodically. Hearing loss is not an adverse effect of taking niacin. D. : Flushing of the skin, along with tingling of the extremities, occurs soon after taking niacin. The effect should decrease in a few weeks, and can be minimized by taking an aspirin tablet 30 min before the niacin. Question 26 2 out of 2 points Four clients arrive at the emergency department. All have attempted suicide by overdosing on medication. Which client will the nurse plan to transfer to the renal failure unit? : C. The patient who overdosed on ibuprofen Answers: A. The patient who overdosed on lorazepam (Ativan) B. The patient who overdosed on amitriptyline C. The patient who overdosed on ibuprofen D. The patient who overdosed on quetiapine : NSAIDs, such as ibuprofen, are nephrotoxic drugs. Amitriptyline (Elavil) is cardiotoxic, not nephrotoxic. An overdose of lorazepam (Ativan) will result in CNS depression, not nephrotoxicity. An overdose of quetiapine (Seroquel) will result in CNS depression, not nephrotoxicity. Question 27 0 out of 2 points A nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of thefollowing beverages should the nurse tell the client to avoid while taking this medication? : C. Coffee Answers: A. Milk B. Orange juice C. Coffee D. Grapefruit juice Question 28 0 out of 2 points A nurse is caring for a client who has a new prescription for propranolol. The nurse should monitor the client for which of the following adverse reactions to this medication? : A. Ototoxicity Answers: A. Ototoxicity B. Tachycardia C. Postural hypotension D. Hypokalemia Question 29 2 out of 2 points A patient has been prescribed transdermal nitroglycerin patches. What medication education should the nurse provide? Select all that apply. s: B. Rotate sites of application. D. Cleanse the skin under the patch after removal. Answers: A. Place the patch on the upper arm or leg. B. Rotate sites of application. C. Remove the patch for an hour each day. D. Cleanse the skin under the patch after removal. E. Triple wrap the patch in plastic wrap for disposal. : Sites of application should be rotated to prevent irritation. After removing the patch, it is important to cleanse the skin to remove any residual medication. The patch should not be applied to the arm or leg as increased muscle activity may increase drug absorption. The patch should be removed for a period of 6–12 hours as directed, typically at night or when the patient is sleeping. While it is important to dispose of these patches carefully, triple wrapping in plastic wrap is not necessary. Question 30 2 out of 2 points The patient is started on a medication to treat a neuromuscular disorder. What does the nurse teach as the primary therapeutic goal of the medication? : D. To allow the patient increased independence Answers: A. To stop the patient's muscle spasms B. To improve the patient's appearance C. To promote exercise in the patient D. To allow the patient increased independence : The therapeutic goals of pharmacotherapy include minimizing pain and discomfort, increasing range of motion, and improving the patient's ability to function independently. Stopping muscle spasms can be achieved, but this is not the primary goal. Promoting exercise is not a goal. Improving the patient's appearance is not a goal. Question 31 0 out of 2 points A nurse in the emergency room is taking care of several clients. Which client with myocardial infarction would be a candidate for reteplase therapy? : C. 62-year-old with a recent hemorrhagic stroke Answers: A. 54-year-old female with type 2 diabetes B. 45-year-old female with a 2-week-old cranial artery repair C. 62-year-old with a recent hemorrhagic stroke D. 70-year-old male with active GI bleed : Contraindications for reteplase therapy include a history of CVA (stroke), recent surgical procedure, and active bleeding. Question 32 2 out of 2 points A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering thismedication, which of the following actions should the nurse take? : C. Measure the client's apical pulse. Answers: A. Offer the client a light snack B. Measure the client's oxygen level. C. Measure the client's apical pulse. D. Weigh the client. : Rationale: Digoxin decreases the heart rate, so the nurse should count the apical pulse for at least 1 minbefore administering. The nurse should hold the medication and notify the provider if theclient's heart rate is below 60/min or if a change in heart rhythm is detected. Question 33 0 out of 2 points A nurse is caring for a client who received IV verapamil to treat supraventricular tachycardia (SVT). The client’s pulse rate is now 98/min and his blood pressure is 74/44 mg Hg. The nurse should anticipate a prescription for which of the following IV medications? : B. Sodium bicarbonate Answers: A. Calcium gluconate B. Sodium bicarbonate C. Potassium chloride D. Magnesium sulfate : A. : Reverse severe hypotension caused by verapamil with calcium gluconate, given slowly IV. The calcium counteracts vasodilation caused by verapamil. Other measures to increase blood pressure can include IV fluid therapy and placing the client in a modified Trendelenburg position. B. IV sodium bicarbonate is used to treat metabolic acidosis. It is not used to increase blood pressure in clients who have received verapamil. C. IV potassium chloride is used to treat hypokalemia. It is not used to increase blood pressure in clients who have received verapamil. D. IV magnesium sulfate is used to treat ventricular dysrhythmias, such as torsades de pointe. It is not used to increase blood pressure in clients who have received verapamil. Question 34 0 out of 2 points A nurse is collecting data from a client who is taking gemfibrozil. Which of the following assessment findings should the nurse identify as an adverse reaction to the medication? : A. Mental status changes Answers: A. Mental status changes B. Tremor C. Jaundice D. Pneumonia : C. : Jaundice, anorexia, and upper abdominal discomfort can be findings in liver impairment, which can occur in clients taking gemfibrozil. Question 35 0 out of 2 points The patient has been started on morphine sulfate (MS Contin) for chronic back pain resulting from inoperable disk degeneration. What nursing actions are indicated? s: A. Use the prn order of MiraLax B. Ask the dietary department to add bran cereal to the patient's breakfast trays. E. Check the medical record for a prn order for an antiemetic. Answers: A. Use the prn order of MiraLax B. Ask the dietary department to add bran cereal to the patient's breakfast trays. C. Ask the health care provider to write an order for an indwelling urinary catheter. D. Review the trending of the patient's daily weights E. Check the medical record for a prn order for an antiemetic. Question 36 0 out of 2 points A nurse is caring for a client who is prescribed isosorbide mononitrate for chronic stable angina and develops reflex tachycardia. Which of the following medications should the nurse expect to administer? : B. Captopril Answers: A. Furosemide B. Captopril C. Ranolazine D. Metoprolol : Answer: D A. Furosemide, a loop diuretic, treats hypertension and edema associated with heart failure. It is not used to treat tachycardia. B. Captopril, an ACE inhibitor, treats hypertension or heart failure. It is not used to treat tachycardia. C. Ranolazine, an antianginal medication, treats stable angina pectoris. It is not used to treat tachycardia. to treat hypertension and stable angina pectoris, and is often prescribed to decrease heart rate in clients who have tachycardia.
Metoprolol, a beta adrenergic blocker, is used: D. Question 37 0 out of 2 points For the last 3 months, the nurse has been working with a group of clients who have been using nonpharmacological methods to try to manage their hypertension. The nurse anticipates that which patients will require the addition of a pharmacological intervention? Select all that apply. s: B. A 61-year-old man whose blood pressure is 144/90 mmHg who also has type 2 diabetes. Answers: A. 30-year-old female whose blood pressure is 138/88 mmHg who is otherwise healthy. B. A 61-year-old man whose blood pressure is 144/90 mmHg who also has type 2 diabetes. C. A 56-year-old woman whose blood pressure is 129/74 who also has Cushing’s disease. D. A 65-year-old man whose blood pressure is 138/88 mmHg who is otherwise healthy. E. A 61-year-old woman whose blood pressure is 153/92 mmHg who is otherwise healthy. : Answer: B, E Rationale A: Hypertension in this age group of healthy adults is considered to be 140/90 mmHg. Rationale B: Since this 61-year-old has both hypertension and diabetes, pharmacotherapy is indicated. Rationale C: This patient’s blood pressure is no longer in the range of hypertension. Rationale D: Since there are no other compelling illnesses, this patient’s hypertension does not need pharmacological intervention. Rationale E: Blood pressure over 150/90 mmHg requires treatment in those over age 60. Global Rationale: HTN is defined as blood pressure over 140/90 mmHg. Patients over age 60 who do not have chronic kidney disease or diabetes do not need pharmacotherapy until the 150/90 mmHg threshold has been reached. Question 38 2 out of 2 points The nurse is taking the initial history of a patient admitted to the hospital for hypertension. The physician has ordered a beta2 blocker. Which statement by the patient does the nurse recognize as most significant? : D. "I have always had problems with my asthma." Answers: A. "I don't handle stress well; I have a lot of diarrhea." B. "When I have a migraine headache, I need to have the room darkened." C. "My father died of a heart attack when he was 48-years-old." D. "I have always had problems with my asthma." : With increased doses, beta-adrenergic blockers can slow the heart rate and cause bronchoconstriction. They should not be used in patients with asthma. Beta-adrenergic blockers do not affect migraine headaches. Having a father who died of a heart attack when he was young is significant but has no correlation to this patient and use of beta-adrenergic blockers. There is no correlation between increased stress, diarrhea, and beta-adrenergic blockers. Question 39 2 out of 2 points The patient is receiving hydrochlorothiazide (Microzide) as well as digoxin (Lanoxin). Which lab result would the nurse recognize as most significant? : C. Potassium level of 2.9 mEq/L Answers: A. ALT level of 35 units/L B. Sodium level of 140 mEq/L C. Potassium level of 2.9 mEq/L D. BUN level of 20 mg/dl : Hypokalemia caused by hydrochlorothiazide (Microzide) may increase digoxin (Lanoxin) toxicity. The normal range for potassium is 3.5 to 5.2 mEq/L. The concern is hypokalemia, not sodium levels; this sodium level is within normal range. The concern is hypokalemia, not liver damage, and this ALT level is within normal range. The concern is hypokalemia, not kidney function, and this BUN is within normal range. Question 40 2 out of 2 points The nurse teaches the patient about lisinopril (Prinivil) and evaluates that additional teaching is required when the patient makes which statement? : D. "I don't need to worry about having blood tests done." Answers: A. "I will monitor my blood pressure until my next appointment." B. "I will avoid using salt substitutes for seasoning." C. "It takes a while for this medication to take effect." D. "I don't need to worry about having blood tests done." : The use of ACE inhibitors can lead to electrolyte disturbances so levels should be monitored. Potassium should be limited to avoid hyperkalemia. Blood pressure should be monitored to assess effectiveness of the medication. It takes a while for lisinopril (Prinivil) to become effective. Question 41 2 out of 2 points A nurse is assessing a client who is taking amiodarone to treat atrial fibrillation. Which of the following findings is a manifestation of amiodarone toxicity? : C. Productive cough Answers: A. Light yellow urine B. Report of tinnitus C. Productive cough D. Blue-gray skin discoloration : A. Light yellow urine is an expected finding and does not indicate toxicity. B. Ototoxicity can occur with aminoglycoside antibiotics, but does not indicate amiodarone toxicity. C. : Productive cough can indicate pulmonary toxicity or heart failure. The nurse should assess for cough, chest pain, and shortness of breath. D. A blue-gray skin discoloration can occur in clients who are taking amiodarone with sun exposure and should resolve. Question 42 0 out of 2 points A patient states, “My ankles swell at the end of the day. My neighbor takes furosemide (Lasix) for her swelling. Would that work for me?” Which information is important for the nurse to consider when formulating a response to this question? Select all that apply. s: B. The patient takes lithium to control bipolar disorder. C. The patient is allergic to sulfa drugs. D. The patient gets a rash if given penicillin. E. The patient uses salt substitutes. Answers: A. The patient is 55-years-old. B. The patient takes lithium to control bipolar disorder. C. The patient is allergic to sulfa drugs. D. The patient gets a rash if given penicillin. E. The patient uses salt substitutes. Question 43 0 out of 2 points A nurse is teaching a client who has a new prescription for captopril. Which of the following instructions should the nurse include in the teaching? : B. Take this medication with food. Answers: A. Avoid grape juice. B. Take this medication with food. C. Hold medication for heart rate less than 70/min. D. Monitor for a cough. Question 44 0 out of 2 points A nurse is completing a nursing history for a client who takes simvastatin. The nurse should identify which of the following disorders as a contraindication to adding ezetimibe to the client’s medications? : D. Type 2 diabetes mellitus Answers: A. History of severe constipation B. History of hypertension C. Active hepatitis C D. Type 2 diabetes mellitus : A. Unlike the bile-acid sequestrants, ezetimibe does not cause constipation and is not contraindicated in clients who have a history of constipation. B. A history of hypertension is not a contraindication to taking ezetimibe along with simvastatin. C. : Ezetimibe is contraindicated in clients who have an active moderate-to-severe liver disorder, especially if the client is already taking a statin, such as simvastatin. D. Type 2 diabetes mellitus is not a contraindication to taking ezetimibe along with simvastatin. Question 45 2 out of 2 points The client asks the nurse, "My doctor said I need cardioversion for my dysrhythmia. Why can't I just take medication?" What is the nurse's best response? : A. "Antidysrhythmic medications have many side effects; cardioversion is considered safer." Answers: A. "Antidysrhythmic medications have many side effects; cardioversion is considered safer." B. "Special diets are necessary with antidysrhythmic medications, and they are hard to follow." C. "Antidysrhythmic medications don't really work very well for most dysrhythmias." D. "There is a high risk of seizures when you take antidysrhythmic medications." : Antidysrhythmic medications can cause serious side effects and are normally reserved for patients with overt symptoms or for patients whose condition cannot be controlled by other means, such as cardioversion. Medications are effective for dysrhythmias; however, they have many side effects. There is no indication for a special diet when a patient is taking an antidysrhythmic drug. Antidysrhythmic drugs do not commonly cause seizures. Question 46 2 out of 2 points The patient comes to the emergency department with a blood pressure of 200/120 mmHg. The physician orders hydralazine (Apresoline) IV. What will the nurse's priority assessment include? : C. Hypotension and tachycardia Answers: A. Hypotension and bradycardia B. Hypotension and hyperthermia C. Hypotension and tachycardia D. Hypotension and tachypnea : Direct vasodilators produce reflex tachycardia, a compensatory response to the sudden decrease in blood pressure caused by the drug. Direct vasodilators produce hypotension and tachycardia, not bradycardia. Direct vasodilators do not affect body temperature. Direct vasodilators do not affect respiratory rate Question 47 0 out of 2 points The nurse is caring for a client on the Med-Surg unit who is complaining of chest pain. He categorizes his pain as a 6 (on a 1 to 10 scale). His BP is 108/72, The nurse gives the patient nitroglycerin 1/150 sublingual. After 5 minutes, the patient states that his chest pain is now a 2. What should the nurse do next? : D. Obtain EKG Answers: A. Administer another dose of nitroglycerine B. Check the WBC C. Check the pulse D. Obtain EKG : Answer: A Administer another nitroglycerin tablet. The client is in a controlled environment, the patient’s SBP is greater than 100 and he is still having chest pain. The ½ life of NTG SL is only a couple of minutes. Question 48 2 out of 2 points The nurse is managing care for a group of clients receiving antidysrhythmic medication. Which assessment data will the nurse discuss with the prescriber as adverse effects of these medications? : D. Palpitations, chest pain, weakness, and fatigue Answers: A. Depression, irritability, fatigue, and nausea B. Anorexia, insomnia, confusion, and 2+ pitting peripheral edema C. Low-grade fever, diaphoresis, weakness, and dry mucous membranes D. Palpitations, chest pain, weakness, and fatigue : Side effects of antidysrhythmic medications include palpitations, chest pain, weakness, and fatigue. Low-grade fever, diaphoresis, weakness, and dry mucous membranes are not side effects of antidysrhythmic medications. Anorexia, insomnia, confusion, and 2+ pitting peripheral edema are not side effects of antidysrhythmic medications. Depression, irritability, fatigue, and nausea are not side effects of antidysrhythmic medications. Question 49 2 out of 2 points A nurse is providing discharge teaching for a client who has pulmonary edema and is about to start taking furosemide. Which of the following instructions should the nurse include? : C. Eat foods that contain plenty of potassium. Answers: A. Take aspirin if headaches develop B. Expect some swelling in the hands and feet. C. Eat foods that contain plenty of potassium. D. Take the medication at bedtime. : Rationale: Furosemide, a high-ceiling (loop) diuretic, can cause potassium loss. The client should addpotassium-rich foods to his diet, such as nuts, dried fruits, bananas, and citrus fruits. Question 50 2 out of 2 points A nurse is providing teaching for a client who has hypertension and a prescription change from metoprolol to metoprolol/hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching? : B. "With the new medication, I should experience fewer side effects." Answers: A. "Now I will not have to diet to lose weight." B. "With the new medication, I should experience fewer side effects." C. "The extra letters after the name of medication means it is a stronger dose." D. "I will not have to do anything different because it is the same medication." : Rationale: The client has stated an understanding of the purpose of the addition of the hydrochlorothiazide(HCTZ) to the metoprolol dosage. When used in combination with thiazide diuretics, a lowerdose of the beta-blocker can be used. The benefit is there are fewer side effects when beta-blockers (and other antihypertensives) are used in lower dosages. Question 51 2 out of 2 points A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? : D. "I feel nauseated and have no appetite." Answers: A. "I can walk a mile a day." B. "I've had a backache for several days." C. "I am urinating more frequently." D. "I feel nauseated and have no appetite." : Rationale: Anorexia, nausea, vomiting, and abdominal discomfort are early signs of digoxin toxicity. Question 52 0 out of 2 points A patient has had great difficulty controlling hypertension with standard drug therapy. She says, “My neighbor couldn’t get her blood pressure down until the doctor started her on hydralazine (Apresoline). Which response, by the nurse, is indicated? s: A. “Because you had rheumatic fever that damaged your heart, this is not a good drug for you.” E. “We try to avoid using hydralazine (Apresoline) because it causes constant coughing.” Answers: A. “Because you had rheumatic fever that damaged your heart, this is not a good drug for you.” B. “Your neighbor must be over age 70.” C. “Your lupus diagnosis keeps us from using that drug.” D. “You should not use that drug because you have rheumatoid arthritis.” E. “We try to avoid using hydralazine (Apresoline) because it causes constant coughing.” Question 53 2 out of 2 points The client is receiving cholestryamine. When assessing for side effects, a primary focus of the nurse would be? : B. Auscultation of bowel sounds Answers: A. Assessment for peripheral neuropathy B. Auscultation of bowel sounds C. Palpation for peripheral edema in the lower extremities D. Assessment of 24-hour urine : Assessment of bowel sounds is a priority because this drug commonly causes constipation and has potential for obstruction of the intestines. It does not affect nervous system (A); does not result in fluid retention (C); and does not cause rhabdomyolysis so there is no need to assess 24 hour urine output (D). Question 54 2 out of 2 points The male client has been receiving propranolol (Inderal) for treatment of a dysrhythmia for 6 weeks. What is an important question for the nurse to ask the client when assessing medication compliance? : A. "Have you noticed any changes in your sexual functioning?" Answers: A. "Have you noticed any changes in your sexual functioning?" B. "Has your appetite increased or decreased?" C. "Have you noticed any changes in your bowel function?" D. "Have you noticed any difficulty in your ability to concentrate?" : Side effects such as diminished libido and impotence may result in noncompliance in male patients. Change in bowel function is not an adverse effect of propranolol (Inderal). Appetite is not affected by propranolol (Inderal). Inability to concentrate is not an adverse effect of propranolol (Inderal) except in the elderly who are receiving high doses. Question 55 2 out of 2 points A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions? : A. “Remove the prior dose before applying a new dose.” Answers: A. “Remove the prior dose before applying a new dose.” B. “Rub the ointment directly into your skin until it is no longer visible.” C. “Cover the applied ointment with a clean gauze pad.” D. “Apply the ointment to the same skin area each time.” : . : The client should remove the prior dose before applying a new dose to prevent toxicity. B. The ointment should not be rubbed directly onto the skin. It is also important to tell the client not to touch the ointment with the fingers. The client should use the applicator that comes with the ointment to measure the dose and then spread the ointment onto the pre-marked paper, before applying the ointment-covered paper to the skin. C. The client should cover the applied ointment with a transparent dressing and tape securely to the skin. Do not cover the medication with gauze. D. The client should rotate application sites each time the ointment is applied. The client should select a clean, hairless area of the body. Question 56 2 out of 2 points A nurse is teaching a client who has a new prescription for hydrochlorothiazide for management of hypertension.Which of the following instructions should the nurse include? : B. "Monitor for leg cramps." Answers: A. "Take this medication before bedtime." B. "Monitor for leg cramps." C. "Avoid orange juice.' D. "Reduce intake of potassium-rich foods." : Rationale: Hydrochlorothiazide can cause hypokalemia. The client should monitor for manifestations ofhypokalemia, such as fatigue, tachycardia, leg cramps, and muscle weakness. Question 57 0 out of 2 points A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of thefollowing prescribed medications places the client at risk for orthostatic hypotension? (Select all that apply.) s: A. Furosemide D. Clopidogrel E. Atorvastatin Answers: A. Furosemide B. Telmisartan C. Irbesartan D. Clopidogrel E. Atorvastatin : Furosemide is . This medication is used to reduce edema and hypertension, and an adverse effect is orthostatic hypotension.Telmisartan and Irbesartan are . These medication are Angiotensin II blockers used to control hypertension, and an adverse effect is orthostatic hypotension. Question 58 2 out of 2 points The nurse plans care for an older adult receiving nonsteroidal anti-inflammatory drug (NSAID) therapy. What is the best outcome for this client as it relates to side effects of nonsteroidal anti-inflammatory drugs (NSAIDs)? : C. The client will report any bleeding or bruising while taking the nonsteroidal anti-inflammatory drug (NSAID). Answers: A. The client will refrain from taking other medications with the nonsteroidal anti-inflammatory drug (NSAID). B. The client will avoid the use of caffeine while taking the nonsteroidal anti-inflammatory drug (NSAID). C. The client will report any bleeding or bruising while taking the nonsteroidal anti-inflammatory drug (NSAID). D. The client will report any mood changes while taking the nonsteroidal anti-inflammatory drug (NSAID). : Older adults are at risk for increased bleeding with nonsteroidal anti-inflammatory drug (NSAID) therapy. Older adults are often on several medications, and refraining from taking them with nonsteroidal anti-inflammatory drugs (NSAIDs) is an unrealistic outcome. There is no reason for avoiding use of caffeine while using a nonsteroidal anti-inflammatory drug (NSAID). Mood changes are not a side effect of nonsteroidal anti-inflammatory drug (NSAID) therapy. Question 59 0 out of 2 points Mrs. Smith has been prescribed atorvastatin To monitor for potential adverse effects of this drug, the nurse instructs her to return to the clinic in 12 weeks for which of the following? : D. Liver enzymes Answers: A. Complete Blood Count B. Urinalysis C. Complete Metabolic Panel D. Liver enzymes : Statin drugs interfere with cholesterol synthesis in the liver. Liver enzyme monitoring is done to detect hepatotoxic effects. Question 60 0 out of 2 points A nurse is providing teaching to a client who has hypertension and a new prescription for captopril. Which of the following instructions should the nurse provide? : B. Take the medication with food. Answers: A. Do not use salt substitutes while taking this medication B. Take the medication with food. C. Count your pulse rate for 30 seconds before taking the medication. D. Expect to gain weight while taking this medication. [Show More]

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