A patient about to receive his morning dose of digoxin has an apical pulse of 70. What should the nurse do? Show In
assessing the patient before administration of a cardiac glycoside, the nurse knows that what condition can predispose a patient to digitalis toxicity? While assessing a patient who is receiving digitalis, you recognize that the drug has a negative chronotropic effect. How would this negative chronotropic effect be evident in the patient? While preparing a patient for discharge, which of the following statements should be included in your instructions regarding his new prescription for furosemide (Lasix)? D. Be sure to change your position slowly and rise slowly after sitting or lying to prevent dizziness and possible fainting. When a
patient is receiving diuretic therapy, which of the following would BEST reflect the patient's fluid volume status? C. Intake, output and daily weight. An elderly patient is being discharged to home on a daily dose of a
diuretic. The nurse instructs the patient to take the dose at which of the following times to be least disruptive to the patient's daily routine? Which of the following commonly ocurs in male patients who are taking antihypertensives? A. Impotence B. Bradycardia C. Increased libido D. Increase Weight A persistent, dry, non-productive cough is an adverse effect of which of the following classes of antihypertensive drugs? B. Angiotensin Converting Enzyme ( ACE) inhibitor A 53-year old male has been
admitted for evaluation of chest pain. He has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. What patient teaching should be included for this patient? D. Once a dose is taken, lie down and be sure to change positions slowly to avoid falling or fainting When applying transdermal nitroglycerin patches, the patient should be instructed to: A. Use on non-hairy area on the upper torso of body. What action is recommended to help reduce the tolerance that often develops with transdermal nitroglycerin therapy? D. Remove the patch at bedtime then apply a new one 12 hours later in the morning. A patient with bronchial asthma would not be given which medication? D. A beta blocker, propranolol ( Inderal) Which of the following adverse effects should the nurse monitor for patients taking a calcium channel blocker such as verapamil (Calan)? Your patient is taking spirnolactone (Aldactone). He requests assistance with his diet. Which of the following foods would you NOT recommend? Diuretics as the first line of antihypertensive drugs are generally ordered for clients with systolic pressures greater than: Anticoagulants will : C. Prevent new clot formation Your patient was given heparin for early treatment of DVT. The effects of heparin are monitored by which lab
test(s)? In the event of hemorrhage when your patient is receiving heparin, which medication is most likely to be administered intravenously? Low molecular weight heparins (LMWH) are frequently being prescribed today to prevent DVT following knee
or hip replacement. Which one of the following is true regarding LMWHs use? A. Can be administered by the patient at home. The presence of which condition is a
contraindication to the use of antilipemic therapy, specifically when taking "statin" medications? Antacids that contain aluminum salts may result in: Antacids containing magnesium should be used cautiously with which condition? A patient who has been taking a histamine 2 blocker, such as cimetidine for hyperacidity calls to say that the medication has not been effective. What factor may be influencing the effectiveness of this drug? B. He smokes two packs a day. A patient is taking omeprazole (Prilosec) for the treatment of GERD. Which intervention is appropriate when teching about this medication? D. The entire capsule should be taken whole, not crushed or chewed. Which agent is used for the management of conditions associated with excessive gas production?
Calcium carbonate is not often used as an antacid because: A. Its use may result in kidney stones Methylcellulose, a bulk-forming laxative, should be administered
with at least how much water to avoid possible obstruction? Your patient asks you for a recommendation of a safe way to avoid constipation. Your recommend the avoidance of what laxative to decrease the potential for laxative dependence. While recovering from surgery, your patient started taking senna (Senokot) to relieve constipation caused by the pain medications. She tells you she likes how "regular" her bowels move now that she is taking the laxative.Which of the following teaching principles are appropriate for this patient? A. Use of a stimulant laxative will not affect the absorption of her other medications C. Long term use of laxatives often results in decreased bowel tone and may lead to dependency Mineral oil can interfere with the absorption of which vitamin(s)? Which medication is administered via a transdermal patch to prevent motion sickness? Which antiemetic agent works by blocking dopamine in the chemoreceptor trigger zone, causing the zone to be densensitized to impulses received from the GI tract? Which of the following interventions is correct regarding the managment of nausea and vomiting? A. Give antiemetics immediately after chemotherapy is administered B. Antiemetics are often administered 30 minutes to 3 hours before a chemotherapy agent is given C. Taking antiemetics at night may cause restlessness and interfere with sleep D. Antiemetics may be taken with a glass of wine to help settle the stomach B. Antiemetrics ae often administered 30 mins to 3 hrs before a chemo agent is given Which antiemetic agents have proven effective in preventing chemotherapy-induced and postoperative nausea and vomiting? Your patient is taking cimetidine (Tagomet), a histamine H2 receptor antagonists. He asks if he can take an antacid too. You respond by saying: C. Do not take antacids within 1-2 hours of taking cimetidine Your patient is admitted to the ED with severe abdominal pain and diarrhea. What would you expect to be appropriate treatment? D. No drug therapy is indicated until further evaluation is done What is a concern with taking drugs like Proton Pump Inhibitors or Histamine 2 Blockers long term? D. Less absorption of nutrients such as calcium and vitamins into the body Which Histamine H2 receptor antagonist has been known to produce antiandrogenic effects (impotence and gynecomastia)? Metoclopramide (Reglan) may be ordered for the following indications: Which medication has been used successfully to eradicate Helicobactoer pylori, an organism associated with the development of peptic ulcer
disease? D. metronidazole (Flagyl) Which adverse effect is associated with the use of ACE inhibitors? Which laboratory value may indicate an adverse effect to hydrochlorothiazide, a thiazide diuretic? A.sodium levels B. chloride levels C. glucose levels D. calcium levels What is appropriate teaching information for the client who is taking a potassium-sparing diuretic? A. Call your doctor if you have a weight gain or loss of 5 pounds per week. Which laboratory value reflects an adverse effect of furosemide, a loop diuretic? A.Hyperkalemia B.Hyperchloremia C. Hypokalemia D.Hypophosphatemia When teaching a beta blocker, such as metoprolol, it is important to teach the client that: A. it is important to watch for unusual weight loss B. hot baths and showers are encouraged to promote the therapeutic effects of this drug C.alcohol use may provide additive therapeutic vasodilation effects D.stopping the drug abruptly may result in rebound hypertension D. Stopping the drug abruptly may result in rebound hypertension Which statement by the client would reflect deficient knowledge when taking warfarin. A. I will call the doctor about excessive bruising. B. I will increase my diet of dark green leafy vegetables. C.I will avoid contact sports. D.I will need to obtain lab tests to monitor therapeutic effects. B. I will increase leafy greens A client is receiving a statin drug. Which assessment data would be a priority for the nurse to report of the doctor? A.Increased AST and ALT B.Pruritis and flushing C.Yellow vision, nausea and vomiting D.Hypokalemia Which client teaching information is appropriate for the client who is taking alpha adrenergic blockers? A.This medication is indicated for your asthma because it causes bronchodilation. B.This medication is indicated for your hypertension because it decreases heart rate and contraction. C.This medication is indicated for heart failure because it prevents remodeling of the heart muscle. D.This medication is indicated for hypertension becasue it causes vasodilation D.This medication is indicated for hypertension becasue it causes vasodilation The nurse teaching a client home administration of digoxin, a cardiac glycoside, will include which of the following in the teaching plan: A.Report pulse less than 60 bpm to the doctor. B.Check blood pressure weekly. C.This medication is indicated for people who have hypertension. D.You should avoid the use of salt substitutes A.Report pulse less than 60 bpm to the doctor. The nurse would question the administration of which drug for a client with a history of COPD. A.Epinephrine, an adrenergic agonist B. Propranolol, a beta-blocker C. Atropine, an anticholinergic D. Robinul, a cholinergic antagonist B. Propranolol, a beta-blocker The nurse is evaluating the effects of digoxin, a cardiac glycoside, and could anticipate the following therapeutic effect... A.Decreased contraction B. Increased heart rate C. Positive dromotropic effects D. Positive inotropic effect D. Positive inotropic effect A client has a new prescription for a thiazide diuretic. Which statement should the nurse include when teaching the client about the thiazide drug? A.Check your pulse prior to taking this medication and hold if less than 50 beats per minute. B.Avoid salt substitutes and high potassium foods with this medication. C.You should take the thiazide at night to avoid interactions with the diabetes medicine. D.Change position slowly. D. Change positions slowly The nurse assess the client, and finds the apical pulse to be 48 beats per minute. Based on this assessment, the nurse would hold the following medication... A.Loop diuretic B. Warfarin C.Beta-blocker D.Potassium-sparing diuretic A 53-year-old client has been admitted for evaluation of chest pain. He has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. When teaching the client how to use sublingual nitroglycerin, what instruction should the nurse include? A. Take up to five doses at 15-minute intervals for an angina attack. B. If the tablet does not dissolve quickly, chew the tablet for maximal effect. C. If the chest pain is not relieved after one tablet, call 911 immediately to activate emergency medical services. D. Wait 10 minutes between doses of sublingual tablets, up to three doses. C. If the chest pain is not relieved after one tablet, call 911 immediately to activate emergency medical services. A nurse can anticipate potential toxicity when the client takes diuretics and which of the following drugs? A. Aminoglycoside antibiotics B. Potassium supplements C.Thiazide diuretics D.Tetracycline antibiotic A. Aminoglycoside Antibiotics Your client is taking Nicotinic acid, Niacin, for hyperlipidemia. Appropriate client teaching for this medication includes: A.This medication will decrease triglyceride levels. B. Take with an antihistamine, such as Benadryl to prevent flushing. C. This medication will increase HDL levels. D. You will need to monitor BUN and creatinine levels before and during therapy. C. This medication will increase HDL levels. A client is taking a statin drug. Which assessment data would be a priority for the nurse to report immediately to the provider? A. Weight gain of 2-3 pounds per day. B. Pulse less than 50 beats per minute. C. My muscles hurt all over. D. My heart rate went up this morning after cutting the lawn C. My muscles hurt all over. A nurse is preparing to administer an Angiotensin Receptor blocker to a 58 year old man. His blood pressure is 120/68 mm HG. He says, "I don't need to take that medication anymore. My blood pressure is normal". What would be the nurse's best answer? A.Yes. Your blood pressure is within the normal range so you can stop taking the blood pressure medication. B.Yes. Your blood pressure is within the normal range but the doctor must confirm that you can stop taking the blood pressure medication. C.No. Your blood pressure is within the normal range, but you need to continue your blood pressure medication. D.No. Your blood pressure indicates that you are in the pre-hypertension range so you must continue your blood pressure medication C.No. Your blood pressure is within the normal range, but you need to continue your blood pressure medication. When teaching a client about antihypertensive drug therapy, which statement by the nurse is correct? Select ALL that apply. 1."You should try to have your blood pressure checked once a week and keep track of the readings." 2."If you notice that the symptoms have gone away, you should be able to stop taking the drug." 3."An exercise program may be helpful in treating hypertension, but let's check with your doctor first." 4."A low cholesterol, low salt diet will be helpful." 5."Please continue the medication, even if you are feeling better. 6."If you experience side effects, call the doctor before stopping the medication." 1."You should try to have your blood pressure checked once a week and keep track of the readings." 3."An exercise program may be helpful in treating hypertension, but let's check with your doctor first." 4."A low cholesterol, low salt diet will be helpful." 5."Please continue the medication, even if you are feeling better. 6."If you experience side effects, call the doctor before stopping the medication." Which drug classes are considered FIRST-line treatment for heart failure? Select ALL that apply. 1.Angiotensin converting enzyme (ACE) inhibitors 2.Bile Acid Sequestrants 3.Nitroglycerin 4.Diuretics 5.Calcium Channel Blockers A client comes to the clinic for an annual physical exam. The nurse would anticipate the client to start on two different antihypertensive medications to control elevated blood pressure after obtaining the following blood pressure reading on two
consecutive visits... A. BP 100/60 B. BP 128/82 C. BP 136/85 D. BP 164/92 Which client teaching is important for the client who is taking warfarin? A. Avoid the use of acetaminophen B. Taking ibuprofen is okay to treat mild to moderate pain C. Alcohol in moderation is important to avoid adverse effects D. Eat consistent amounts of Vitamin K foods each week D. Eat consistent amounts of Vitamin K foods each week. The nurse is administering an beta-1 adrenergic agonist. She can anticipate the following response: A. Increased heart rate and strength of contraction B. Decreased blood pressure C. Vasoconstriction of the peripheral blood vessels D. Decreased pulse A. Increased heart rate and strength of contraction The client is complaining of anorexia, nausea, and abnormal vision. The nurse recognizes these symptoms as potential toxicity of the following medication: A 58-year-old man
has had heart failure, has begun rehabilitation, and is ready for discharge. He is given a prescription for metoprolol (Lopressor), a beta-blocker and he becomes upset. "I don't have high blood pressure-why did my doctor give me this medicine?" The nurse explains to him that A.This medication prevents emboli that may lead to a heart attack. B..It is being prescribed to prevent the hypertension that often after heart failiure. C.Beta-blockers will improve blood flow to the kidneys. D. Studies
have shown that this medication has helped the heart muscle remain strong after heart failure. D. Studies have shown that this medication has helped the heart muscle remain strong after heart failure. A client arrives in the emergency department with severe chest pain, and state she has had pain off and on for a week now. Which assessment finding would indicate the need for cautious use of nitrates and nitrites? A. Blood pressure of 98/68 mm Hg B. History of liver disease C. History of heart failure D. History of kidney disease A. Blood pressure of 98/68 mm Hg The nurse is administering an ace inhibitor, lisinopril. The nurse would hold the medication upon the following
assessment. C. Blood pressure less than 100/60 During therapy with a beta-blocker, a client notices that she has swollen feet, has gained 3 pounds within 2 days, feels short of breath even when walking
around the house, and has been dizzy. The nurse suspects that which of the following is occurring? A. The client may need to increase the dose of the beta blocker. D. The client may be developing heart failure.
The provider has ordered the adrenergic alpha-blocking drug doxazosin (Cardura) for a client. When providing education about this drug, the nurse should include which instructions? A. The client should weigh herself daily and report any weight loss to the physician. B.The client should increase her potassium intake by eating more bananas and apricots. C. The impaired taste associated with the medication usually goes away in 2 to 3 weeks. D. The client should monitor blood pressure occasionally and keep a log of results D The client should monitor blood pressure occasionally and keep a log of results A client being started on an anticoagulant would be told that the primary goal of drug therapy is to: A. Prevent thrombus formation B. Dissolve an existing thrombus C. Stabilize an existing
thrombus D. Prevent the thrombus from becoming an embolus A. Prevent thrombus formation Which of the following adverse effects should the nurse monitor for clients taking Verapamil (Calan), a calcium channel blocker? The
usual protocol for acute anginal attacks is: D. One nitroglycerin tablet sublingual every 5 minutes; may take a total of three tablets; call 911 after first tablet if pain does not subside Which of the following is true regarding acute myocardial infarction? A. Acute myocardial infarction occurs when an area of heart muscle dies as a result of insufficient oxygen B. Signs and symptoms of a myocardial infarction are unique so patients seek medical attention promptly C.The goal for the care of the client with an acute myocardial infarction is to restore life to the dead heart tissue D. Among the first drugs given for an acute myocardial infarction is a calcium channel blocker. A. Acute myocardial infarction occurs when an area of heart muscle dies as a result of insufficient oxygen Your client takes calcium channel blockers for hypertension. What assessment would be important to assess for potential side effects? The client is taking a bile acid sequestrant. Important teaching for this client would include: A.Increase fluid and fiber in your diet to prevent constipation B. You will need to monitor your liver enzymes routinely C. Take the medication in the evening D. Take this medication one hour prior to other medications A.Increase fluid and fiber in your diet to prevent constipation A client was prescribed both heparin and warfarin (Coumadin). What is the rationale for using both these anticoagulants? A. It takes a period of time before the action of oral anticoagulants is evident B. Heparin is more effective when used with warfarin sodium C. By administering an oral anticoagulant with heparin, the client needs less frequent administration of heparin D. The client is less likely to experience adverse effects A. It takes a period of time before the action of oral anticoagulants is evident The nurse evaluates the client who is receiving Heparin for adverse effects and discovers blood in the urine, stools and sputum. The nurse anticipates that this will be treated by administering the following: A.Vitamin K B. Protamine sulfate C. Potassium sulfate D. Warfarin A nurse is evaluating the therapeutic effect of heparin, and would anticipate the following lab results... A. Decreased PT B. Increased aPTT C. Decreased aPTT D. Increased INR Which of the following is true about headaches in clients using nitroglycerin products? A. Headaches are an indication of excessive dosage of nitroglycerin B. Transient headache is the most common side effect experienced by clients beginning to use nitroglycerin products C. Mild analgesics, such as acetaminophen (Tylenol) are usually ineffective to relieve the headaches D. The frequency and duration of headaches usually remain unchanged with continued use of nitroglycerin products B. Transient headache is the most common side effect experienced by clients beginning to use nitroglycerin products. Which of the following is true about the site chosen for application of a transdermal nitroglycerin system? A. The transdermal patch should be placed on a location on the torso that is clean and hairless B. The transdermal patch should be placed directly over the heart for best effect C. The transdermal patch should be placed on the extremities D. The transdermal patch should be placed near the same location for consistent absorption A. The transdermal patch should be placed on a location on the torso that is clean and hairless Home teaching for a client who is taking ACE inhibitors would include the following: A.Increase potassium rich foods in your diet B. Avoid salt substitutes C. Your appetite may increase with this medication; weight yourself weekly D. Take an expectorant medication for a productive cough B. Avoid Salt substitutes Nitrates, such as
nitroglycerin are most often used to treat: A. Hyperlipidemia B. Arrhythmias C. Angina D. Pulmonary embolus The nurse anticipates that aspirin should not be given to a client who: A. Has peptic ulcers B. Is using codeine as an analgesic C. Has decreased BUN and creatinine values D. Who has a history of stroke The client asks for a recommendation of a
safe way to avoid constipation. The nurse recognizes client teaching as effective when the client states he could take... A. Saline laxatives B. Bulk-forming laxatives C. Cathartics D. Stimulating laxatives B. Bulk-forming laxatives The nurse is teaching the client who is taking cimetidine (Tagomet), a histamine H2 receptor antagonist, about
increased potential side effects of this drug compared to other histamine H2 receptor antagonists. The nurse states the side effects that may be related to this drug are... A. Increased confusion,. hallucinations The nurse teaches the client to observe for the following
when taking a calcium carbonate antacid: A. Kidney stones B. Diarrhea C. Renal failure D. Abdominal cramping The nurse would avoid the use of magnesium antacids in a patient who has the following medical condition: A. diarrhea B. heart failure C. hypertension D. hyperkalemia The nurses assess for the following when the client begins taking cimetidine, a H2 receptor antagonist...
A. Appetite B. Pregnancy C. Smoking D. Blood pressure The nurse encourages the client to increase fluid intake in order to decrease incidence of obstruction when taking which of the following medications? A. Bulk-forming B. Stool softeners C. Stimulants D. Cathartics The client has a peptic ulcer. When administering sucralfate (Carafate), a GI
protectant, which action by the nurse is most correct? A. Give the drug with meals B. Give the medication on an empty stomach C. Instruct the patient to restrict fluids D. Waiting 30 minutes before administering other drugs B. give medication on an empty stomach A client is taking lansoprazole (Previcid), a proton pump inhibitor, for the treatment of peptic ulcer disease. Which intervention is appropriate when teaching about this medication? A.The drug will neutralize the gastric acid in your stomach B. Smoking or taking with antacids will decrease the effectiveness of this medication C. The capsule should be taken whole, not crushed or chewed D. The medication will be prescribed for long-term therapy (more than 16 weeks) C. The capsule should be taken whole, not crushed or chewed Which of the following interventions is correct regarding the management of nausea and vomiting? A. Give antiemetics immediately after chemotherapy is admininistered B. Taking antiemetics with food may enhance absorption C. Antiemetics may be taken with a glass of wine to help settle the stomach D. Antiemetics are administered post-operatively to manage nausea and vomiting D. Antiemetics are administered post-operatively to manage nausea and vomiting Which antiemetic agents have proven effective in preventing opioid induced nausea and vomiting? A. meclizine (Antivert), an antihistamine B. ondansetron (zofran), a serotonin blocker C. scopolamine, an anticholinergic D. diphenhydramine (Benadryl), an antihistamine
The client is admitted the the ED with severe abdominal pain and diarrhea. Which of the following is the most appropriate treatment? A. Administer meoclopramide, (Reglan) to increase gastric emptying B. Administer an anticholinergic (atropine) to reduce intestinal motility C. Administer loperaminde HCl (Imodium) to reduce the motility of the GI tract D. No drug therapy is indicated until further evaluation is done D. No drug therapy is indicated until further evaluation When reviewing the various types of antinausea medications, the nurse recognizes that prokinetic drugs are also used for: A.Motion sickness B. Vertigo C. GI obstruction D. Delayed gastric emptying D. Delayed Gastric emptying A client is experiencing nausea related to motion sickness. The nurse would choose which drug class of antiemetic? A. A phenothiazene, such as Compazine (prochlorperazine) B. A corticosteroid, such as Decadron (dexamethasone) C. A serotinin blocker, such as Zofran (Ondansetron) D. A antihistamine, such as Benadryl (Diphenhydramine) D. A antihistamine, such as Benadryl (Diphenhydramine) The client is planning an ocean cruise. She exhibits her understanding of the use of scopalamine transdermal patches, an anticholinergic, when she states: A. I will apply the patch 72 hours before traveling. B. I may have a dry mouth and increased heart rate when using this drug. C. The patch should be applied to a clean, hairless area on the upper torso D. The patch should be applied to the temple just above the ear. B. I may have a dry mouth and increased heart rate when using this drug. A nurse selects Zofran (ondansetron), a serotonin blocker from the MAR to administer to the client. Which statements about ondansetron are true? Select all that apply. 1. It may cause more sedation than other antiemetics 2. It may cause extrapyramidal symptoms. 3. It may be used for prevention and treatment of motion sickness 4. It may be used to prevent nausea and vomitng associated with chemotherapy 5. It is used most effectively to prevent vomiting rather than used when the patient is vomiting. 2. It may cause extrapyramidal symptoms 4. It may be used to prevent nausea and vomitng associated with chemotherapy 5. It is used most effectively to prevent vomiting rather than used when the patient is vomiting. A client requests non-pharmacological methods to treat post-op nausea. Which choice below may help decrease this patient's nausea? A. Lavendar B. Peppermint C. Garlic D. St. John's Wort What would you instruct your patient about when using nitroglycerin?Nitroglycerin sublingual tablets should not be chewed, crushed, or swallowed. They work much faster when absorbed through the lining of the mouth. Place the tablet under the tongue or between the cheek and gum, and let it dissolve. Do not eat, drink, smoke, or use chewing tobacco while a tablet is dissolving.
What the nurse should instruct when teaching the patient with angina about taking nitroglycerin tablets?Adults—1 tablet placed under the tongue or between the cheek and gum at the first sign of an angina attack. 1 tablet may be used every 5 minutes as needed, for up to 15 minutes. Do not take more than 3 tablets in 15 minutes. To prevent angina from exercise or stress, use 1 tablet 5 to 10 minutes before the activity.
What should you monitor with nitroglycerin?Check blood pressure and pulse before each administration of NTG–blood pressure can drop precipitously after a single dose. Hold dose if systolic BP < 90 mm Hg or more than 30 mm Hg below baseline.
What is a common side effect to nitroglycerin that patients should know about?Dizziness, lightheadedness, or fainting may occur, especially when you get up quickly from a lying or sitting position. Getting up slowly may help. Also, lying down for a while may relieve dizziness or lightheadedness.
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What would the nurse teach the client about the safe and effective use of nitroglycerin?
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