NURSING 3210 Cardiovascular NCLEX Type Questions

1 NURSING 3210 2020 Cardiovascular NCLEX Type Questions 1. The client is to begin taking atorvastatin (Lipitor) and the nurse is providing education about the drug. Which symptom related to this drug should be report ...

1 NURSING 3210 2020 Cardiovascular NCLEX Type Questions 1. The client is to begin taking atorvastatin (Lipitor) and the nurse is providing education about the drug. Which symptom related to this drug should be reported to the health care provider? A. Constipation B. Increasing muscle or joint pain C. Hemorrhoids D. Flushing or “hot flash” Answer: B . Statins, HMG-CoA reductase inhibitors, include drugs such as atorvastatin(Lipitor) and lead to a rare serious effect known as rhabdomyolysis (death of muscle fibers), leading to increasing pain in the muscles and joints. 2. A client is receiving cholestyramine (Questran) for elevated low-density lipoprotein (LDL) levels. As the nurse completes the nursing care plan, which of the following adverse effects will be included for continued monitoring? A. Abdominal pain B. Orange-red urine and saliva C. Decreased capillary refill time D. Sore throat and fever Answer: A . The nurse should focus on caring plan for abdominal pain. Obstruction of the gastrointestinal tract is the most serious complications in this case and abdominal pain signals the presence of an obstruction. 3. The nurse is instructing a client on home use of niacin and will include important instructions on how to take the drug and about its possible adverse effects. Which of the following may be expected adverse effects of this drug? (Select all that apply.) A. Fever and chills B. Intense flushing and hot flashes C. Tingling of the fingers and toes D. Hypoglycemia E. Dry mucous membranes 4. The community health nurse is working with a client taking simvastatin (Zocor). Which client statement may indicate the need for further teaching about this drug? A. “I’m trying to reach my ideal body weight by increasing my exercise.” B. “I didn’t have any symptoms even though I had high lipid levels. I hear that’s common.” C. “I’ve been taking my pill before my dinner.” D. “I take my pill with grapefruit juice. I’ve always taken my medications that way.” 5. A client has been on long-term therapy with colestipol (Colestid). To prevent adverse effects related to the length of therapy and lack of nutrients, which of the following supplements may be required? (Select all that apply.) A. Folic acid B. Vitamins A, D, E, and K C. Potassium, iodine, and chloride D. Protein E. B vitamins2 6. A client has been ordered gemfibrozil (Lopid) for hyperlipidemia. The nurse will first validate the order with the health care provider if the client reports a history of which disorder? A. Hypertension B. Angina C. Gallbladder disease D. Tuberculosis 7. Which of the following actions by the nurse is most important when caring for a client with renal disease who has an order for furosemide (Lasix)? A. Assess urine output and renal laboratory values for signs of nephrotoxicity. B. Check the specific gravity of the urine daily. C. Eliminate potassium-rich foods from the diet. D. Encourage the client to void every 4 hours. 8. The client admitted for heart failure (HF) has been receiving hydrochlorothiazide (Microzide). Which of the following laboratory levels should the nurse carefully monitor? (Select all that apply.) A. Platelet count B. WBC count C. Potassium D. Sodium E. Uric acid 9. Which of the following clinical manifestations may indicate that the client taking metolazone (Zaroxolyn) is experiencing hypokalemia? A. Hypertension B. Polydipsia C. Cardiac dysrhythmias D. Skin rash 10. The nurse is providing teaching to a client who has been prescribed furosemide (Lasix). Which of the following should the nurse teach the client? A. Avoid consuming large amounts of kale, cauliflower, or cabbage. B. Rise slowly from a lying or sitting position to standing. C. Count the pulse for one full minute before taking this medication. D. Restrict fluid intake to no more than 1 L per 24-hour period. 11. While planning for a client’s discharge from the hospital, which of the following teaching points would be included for a client going home with a prescription for chlorothiazide (Diuril)? A. Increase fluid and salt intake to make up for the losses caused by the drug. B. Increase intake of vitamin-C rich foods such as grapefruit and oranges. C. Report muscle cramping or weakness to the health care provider. D. Take the drug at night because it may cause drowsiness. 12. A client with a history of HF will be started on spironolactone (Aldactone). Which of the following drug groups should not be used, or used with extreme caution in patients taking potassium-sparing diuretics? A. NSAIDs B. Corticosteroids C. Loop diuretics D. ACE inhibitors or ARBs 13. The client has been given a prescription of furosemide (Lasix) as an adjunct to treatment of hypertension and returns for a follow-up check. Which of the following is the most objective data for determining the therapeutic effectiveness of the furosemide? A. Absence of edema in lower extremities3 B. Weight loss of 6 lb C. Blood pressure log notes blood pressure 120/70 mmHg to 134/88 mmHg since discharge D. Frequency of voiding of at least six times per day 14. Nifedipine (Procardia) has been ordered for a client with hypertension. In the care plan, the nurse includes the need to monitor for which adverse effect? A. Rash and chills B. Reflex tachycardia C. Increased urinary output D. Weight loss 15. The client is taking atenolol (Tenormin) and doxazosin (Cardura). What is the rationale for combining two antihypertensive drugs? A. The blood pressure will decrease faster. B. Lower doses of both drugs may be given with fewer adverse effects. C. There is less daily medication dosing. D. Combination therapy will treat the patient’s other medical conditions. 16. What health teaching should the nurse provide for the client receiving nadolol (Corgard)? A. Increase fluids and fiber to prevent constipation. B. Report a weight gain of 1 kg per month or more. C. Immediately stop taking the medication if sexual dysfunction occurs. D. Rise slowly after prolonged periods of sitting or lying down. 17. The nurse is preparing to administer the first dose of enalapril (Vasotec). Identify the potential adverse effects of this medication. (Select all that apply.) A. Reflex hypertension B. Hyperkalemia C. Persistent cough D. Angioedema E. Hypotension 18. A client with significant hypertension unresponsive to other medications is given a prescription for hydralazine (Apresoline). An additional prescription of propranolol (Inderal) is also given to the client. The client inquires why two drugs are needed. What is the nurse’s best response? A. Giving the two drugs together will lower the blood pressure even more than just one alone. B. The hydralazine may cause tachycardia and the propranolol will help keep the heart rate within normal limits. C. The propranolol is to prevent lupus erythematosus from developing. D. Direct-acting vasodilators such as hydralazine cause fluid retention and the propranolol will prevent excessive fluid buildup. 19. The client is prescribed digoxin (Lanoxin) for treatment of HF. Which of the following statements by the client indicates the need for further teaching? A. “I may notice my heart rate decrease.” B. “I may feel tired during early treatment.” C. “This drug should cure my heart failure.” D. “My energy level should gradually improve.” 20. The nurse reviews laboratory studies of a client receiving digoxin (Lanoxin). Intervention by the nurse is required if the results include which of the following laboratory values? A. Serum digoxin level of 1.2 ng/dL B. Serum potassium level of 3 mEq/L4 C. Hemoglobin of 14.4 g/dL D. Serum sodium level of 140 mEq/L 21. A client with heart failure has an order for lisinopril (Prinivil, Zestril). Which of the following conditions in the client’s history would lead the nurse to confirm the order with the provider? A. A history of hypertension previously treated with diuretic therapy B. A history of seasonal allergies currently treated with antihistamines C. A history of angioedema after taking enalapril (Vasotec) D. A history of alcoholism, currently abstaining 22. The teaching plan for a client receiving hydralazine (Apresoline) should include which of the following points? A. Returning for monthly urinalysis testing B. Including citrus fruits, melons, and vegetables in the diet C. Decreasing potassium-rich food in the diet D. Rising slowly to standing from a lying or sitting position 23. Lisinopril (Prinivil) is part of the treatment regimen for a client with HF. The nurse monitors the client for the development of which of the following adverse effects of this drug? (Select all that apply.) A. Hyperkalemia B. Hypocalcemia C. Cough D. Dizziness E. Heartburn 24. The client who has not responded well to other therapies has been prescribed milrinone (Primacor) for treatment of his heart failure. What essential assessment must the nurse make before starting this drug? A. Weight and presence of edema B. Dietary intake of sodium C. Electrolytes, especially potassium D. History of sleep patterns and presence of sleep apnea 25. The client is being discharged with nitroglycerin (Nitrostat) for sublingual use. While planning client education, what instruction will the nurse include? A. “Swallow three tablets immediately for pain and call 911.” B. “Put one tablet under your tongue for chest pain. If pain does not subside, you may repeat in 5 minutes, taking no more than three tablets.” C. “Call your health care provider when you have chest pain. He will tell you how many tablets to take.” D. “Place three tablets under your tongue and call 911.” 26. Nitroglycerin patches have been ordered for a client with a history of angina. What teaching will the nurse give to this client? A. Keep the patches in the refrigerator. B. Use the patches only if the chest pain is severe. C. Remove the old patch before applying a new one. D. Apply the patch only to the upper arm or thigh areas. 27. Which of the following assessment findings in a client who is receiving atenolol (Tenormin) for angina would be cause for the nurse to hold the drug and contact the provider? (Select all that apply.) A. Heart rate of 50 beats/minute B. Heart rate of 124 beats/minute C. Blood pressure 86/565 D. Blood pressure 156/88 E. Tinnitus and vertigo 28. The nurse is caring for a client with chronic stable angina who is receiving isosorbide dinitrate (Isordil). Which of the following are common adverse effects of isosorbide? A. Flushing and headache B. Tremors and anxiety C. Sleepiness and lethargy D. Light-headedness and dizziness 29. Place the following nursing interventions in order for a client who is experiencing chest pain. A. Administer nitroglycerin sublingually. B. Assess heart rate and blood pressure. C. Assess the location, quality, and intensity of pain. D. Document interventions and outcomes. E. Evaluate the location, quality, and intensity of pain. 30. Erectile dysfunction drugs such as sildenafil (Viagra) are contraindicated in clients taking nitrates for angina. What is the primary concern with concurrent administration of these drugs? A. They contain nitrates, resulting in an overdose. B. They decrease blood pressure and may result in prolonged and severe hypotension when combined with nitrates. C. They will adequately treat the patient’s angina as well as erectile dysfunction. D. They will increase the possibility of nitrate tolerance developing and should be avoided unless other drugs can be used.