Chapter 22-25 Test Answers – Flashcards
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A pt has been taking dig at home but took an accidental overdose and has developed toxicity. HE has been admitted to the telemetry unit where the physician had ordered Digibind. The pt asks the nurse why the medication is ordered. What is the nurse's best response? a. "It works faster than Dig." b. "It is safer than Dig and can be taken orally." c. "It helps to convert the irregular heart rhythm to a more normal rhythm." d. "This drug is an antidote to dig and will help to lower the blood levels."
answer
D
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A patient has been placed on a milrinone infusion as part of the therapy for end-stage heart failure. What risks involved with this drug will the nurse keep in mind while assessing this patient during the infusion? a. HTN b. Hyperkalemia c. N/V d. Caridac dysrhythmias
answer
D
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When reviewing the list of medications taken by a patient who will be receiving a new prescription for digoxin, the nurse would be concerned about which medication that may interact with the digoxin? Choose one answer. a. aspirin b. acetaminophen (Tylenol) c. furosemide (Lasix) d. vitamin K
answer
C
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In assessing a pt before administration of cardiac glycoside, the nurse knows that which lab result can increase the toxicity of the drug? ** a. K+ level of 2.8 b. K+ level 4.9 c. Na+ level 140 d. Ca++ level 10
answer
A
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The nurse administering the phosphodiesterase inhibitor inamrinone & recognize that this drug should have a positive inotropic effect. This effect will result in increased: a. Heart rate b. Blood vessel dilation c. Force of cardiac contraction d. Conduction of electrical impulses across the heart
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C
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As part of tx for early HF, a pt is started on an ACE inhibitor. The nurse will monitor the patient's lab work for which potential effect? a. Agranulocytosis b. Proteinuria c. Hyperkalemia d. Hypoglycemia
answer
D
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When starting a pt on antidysrhythimic therapy, the nurse should remember that which problem is a potential adverse effect of any antidysrhythmic drug? a. Deficiency of fat- soluble vits b. Hyperkalemia c. Heart failure d. Dysrhythmias
answer
D
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A pt is experiencing a rapid dysrhythmias and the nurse is preparing to administer adrenocard. Which is the correct administration procedure?
answer
It should be given fast IV push
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ACE inhibitors and other vasodilators are used in the early treatment of CHF. They act to: a. Cause loss of volume b. Increase arterial pressure and perfusion c. Cause pooling blood and decreased venous return to the heart, decreasing ht workload of the heart d. Increase the release of aldosterone and improve fluid balance
answer
C
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A pt is taking a beta- blocker as part of the tx plan for HF. The nurse knows that the purpose of the beta blocker is to: a. Increase urine output b. Prevent stimulation of the heart by catecholamines c. Increase contractility of heart muscle d. Cause peripheral vasodilation
answer
B
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A CCB is RX for a pt, and the nurse provides instructions to the pt about the meds. What does the nurse tell the pt? a. The tab should be chewed for faster release of the med b. To increase the effect of the drug, take it with grapefruit juice c. If the A/E of chest pain, fainting, or dyspnea occurs, discontinue the med and call doc immediately d. A high fiber diet with plenty of fluids will help prevent the constipation that may occur
answer
D
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A 74 yo professional golfer has chest pain that occurs toward the end of his golf games. He says the pain usually goes away after 1-2 sL nitroglycerin tabs and rest. What type of angina does he have? ** a. Classic b. Variant c. Unstable d. Printzmals
answer
A
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When applying transdermal nitroglycerin patches, how will the nurse instruct the pt? a. Use any nonhairy are on the body b. Use only the chest are for application sites c. Temporarily remove the patch if you go swimming d. Apply the patch to the same site consistently
answer
A
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A pt has been taking a beta- blocker for 4 weeks as part of his antianginal therapy. He also has type II DM and hyperthydoidism. When discussing possible A/Es the nurse should include which info? a. Watch for unusual weight loss b. Monitor your pulse for increased heart rate c. Use the hot tub and sauna at the gym as long as time is limited to 15 min d. Monitor your BS levels for possible hypoglycemia or hyper glycemia
answer
D
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What action is recommended to help reduce the tolerance to transdermal nitroglycerin therapy that commonly develops? a. Omit a dose once a week b. Leave the patch on for 2 days at a time c. Cut the patch in half for a week until the tolerance subsides d. Remove the patch at bedtime, and then apply a new one in the morning
answer
D
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While assessing a pt who is taking a beta- blocker for angina, the nurse knows to monitor for which a/e? a. Nervousness b. HTN c. Bradycardia d. Dry cough
answer
C
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Sodium channel blockers: a. Reduce automaticity b. Slow the impulse conduction c. Prolong the refractory period d. Increase the impulse conduction
answer
B
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Common side effects of antidysrhythmic meds include: a. Hypotension b. Hypertension c. Dizziness d. Weakness e. Panic attacks
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A C D
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ACE inhibitor on the renin-angiotensin system to prevent the conversion of angiotensin 1 to angiotension II. Because this blocking occurs in the cells in the lung, which is usually the site of this conversion, use of ACE inhibitor often results in: a. Spontaneous pneumothorax b. Pneumonia c. Unrelenting cough d. Resp depression
answer
C
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A patient with severe liver disease is receiving the angiotensin converting enzyme (ACE) inhibitor, captopril (Capoten). The nurse is aware that the advantage of this drug for this patient is that captopril Choose one answer. a. is a prodrug and is metabolized by the liver before becoming active. b. is not a prodrug and does not need to be metabolized by the liver before becoming active. c. rarely causes first-dose hypotensive effects. d. has little effect on electrolyte levels.
answer
Is not a prodrug and doesn't need to be metabolized by the liver before becoming active
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pain associated with lack of O2 to the heart muscles
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Angina
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Nitrates are commonly used antianginal drugs that work to:
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Dilate coronary vessels to increase the delivery of O2 through the vessels
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Calcium channel blockers are effective in treating angina because they:
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Block strong muscle contractions and cause vasodilation, decreasing work of the heart
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A spasm of a coronary vessel:
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Printzmals Angina
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Which of the following parameters determine the regulation of arterial blood pressure? **
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Cardiac output and vascular resistance
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Nurse is creating a plan of care for a pt with a new diagnosis of HTN. Which is a potential nursing diagnosis for the pt taking antihypertensive meds?
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Sexual dysfunction
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Pt taking antihypertensive drugs for a few months complaining of having persistent dry cough. Nurse knows that this cough is adverse effect of what drug? **
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ACE inhibitors
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Which drug is commonly used for a pregnant pt who is experiencing HTN?
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Methyldopa (Aldomet)
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Pt diagnosed with pre-HTN has BP reading of _____mm HG systolic and _____mm HG diastolic **
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120 and 139; over 80 and 89
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Pt has HTN along with T1DM and proteinuria. Nurse anticipates that a drug from which class will be order for its renal-protective effects? **
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ACE inhibitors
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Nurse is reviewing orders for pt and notes new order for ACE inhibitor. Nurse checks current med orders, knowing that this drug class may have serious interaction with what other drug class:
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Nonsteroidal anti-inflammatory drugs (NSAIDs)
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Calcium channel blockers are effective in treating angina because:
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Block strong muscle contractions and cause vasodilation, decreasing work of the heart
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Antidysrhythmic drugs alter the action potential of the cardiac cells. Because they alter the action potential, antidysrhythmic drugs often:
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Cause new dysrhythmias
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Pts with CHF present clinically with:
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Congestion of blood vessels with slowing in delivery of nutrients and removal of waste products
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A nurse is about to administer Digoxin to a pt whose apical pulse is 48 beats/min. She should:
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Withhold the drug and notify prescriber
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When administering topical nitroglycerin ointment, the nurse should use which technique? Choose one answer. a. The ointment should be applied on the chest over the heart. b. The ointment should be used only in the case of a mild angina episode. c. The old ointment should be removed before new ointment is applied. d. The ointment should be massaged gently into the skin, then covered with plastic wrap.
answer
c. The old ointment should be removed before new ointment is applied.
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The nurse is giving intravenous nitroglycerin to a patient who has just been admitted because of an acute myocardial infarction. Which statement is true regarding the administration of the intravenous form of this medication? Choose one answer. a. Specific nonpolyvinylchloride (non-PVC) plastic intravenous bags and tubing must be used. b. It is stable for only 24 hours after preparation. c. It can be given in infusions with other medications. d. The solution will be slightly colored green or blue.
answer
A
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The physician orders states: "Digoxin elixir 0.25mg PO daily and hold for apical heart rate below 60/min. The bottle is labeled 0.05mg/ml. How many ml(s) are needed for the ordered dose? Choose one answer. a. 5 ml b. 10 ml c. 15 ml d. 20 ml
answer
A
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The physician orders 500mg of Ancef I.M. The pharmacy supplies a vial powder with the following instructions: "Add 2.5ml of sterile water for injection. This will provide a yield of 330mg/ml." How many ml of this antibiotic preparation should be administered to the patient? Choose one answer. a. 0.125 ml b. 0.9 ml c. 1.5 ml d. 2.6 ml
answer
C
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A patient has been taking digoxin at home but has taken an accidental overdose and has developed toxicity. He has been admitted to the telemetry unit where the physician has ordered digoxin immune Fab (Digibind). The patient asks the nurse why the medication is ordered. What is the nurse's best response? Choose one answer. a. "It works faster than digoxin." b. "It is safer than digoxin and can be taken orally." c. "It helps to convert the irregular heart rhythm to a more normal rhythm." d. "This drug is an antidote to digoxin and will help to lower the blood levels."
answer
D
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A 53-year-old man 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 patient how to use sublingual nitroglycerin, what instruction should the nurse include? Choose one answer. 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 1 minute between doses of sublingual tablets, up to three doses.
answer
C
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A patient about to receive his morning dose of digoxin has an apical pulse of 70 beats per minute. What will the nurse do? Choose one answer. a. Administer the dose. b. Administer the dose and notify the physician. c. Check the radial pulse for 1 full minute. d. Withhold the dose and notify the physician.
answer
A
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A patient arrives in the emergency department with severe chest pain. She says 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? Choose one answer. a. Blood pressure of 98/68 mm Hg b. History of liver disease c. History of heart failure d. History of a myocardial infarction 2 years ago
answer
A
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While assessing a patient who is receiving intravenous digitalis, the nurse recognizes that the drug has a negative chronotropic effect. How would this drug effect be evident in the patient? Choose one answer. a. Increased heart rate b. Decreased heart rate c. Decreased conduction d. Increased ectopic beats
answer
B
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A patient is taking procainamide for cardiac dysrhythmia. The nurse will monitor the patient for which possible adverse effect? Choose one answer. a. Tinnitus b. Shortened QT interval c. Constipation d. Nausea and diarrhea
answer
B (????????????????? or A?)
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The nurse needs to administer adenosine (Adenocard) to a patient who is experiencing an acute episode of paroxysmal supraventricular tachycardia. When giving this medication, which is important to remember? Choose one answer. a. The onset of action occurs in 5 minutes. b. The medication must be given as a slow intravenous (IV) push. c. Asystole may occur for a few seconds after administration. d. The medication has a long half-life, and therefore duration of action is very long.
answer
C
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When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse should discuss which potential problem? Choose one answer. a. Impotence b. Bradycardia c. Increased libido d. Increased weight
answer
A
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Order: You want to give 5mg/kg of ampicillin to a child weighing 65 pounds. How many kilograms does the child weigh? (Keep answer at nearest 10th of a point). Choose one answer. a. 29 kg b. 30 kg c. 29.5 kg d. 29.6 kg
answer
C
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Order: You want to give 5mg/kg of ampicillin Q8HR to a child weighing 65 pounds. If there is 25mg/ml on hand, how many mls will you give per dose? Choose one answer. a. 6 mls b. 5.9 mls c. 5.92 mls d. 5.8 mls
answer
B
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Order: You want to give 5mg/kg of ampicillin Q8HR to a child weighing 65 pounds. If there is 25mg/ml on hand, how many total mls will you give in 24 hours? Choose one answer. a. 18 mls b. 17.7 mls c. 17.76 mls d. 17.4 mls
answer
B
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A 73-year-old man is asking for a prescription for sildenafil (Viagra). He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate? Choose one answer. a. Significant increase in blood pressure b. Significant decrease in blood pressure c. Significant increase in bleeding tendencies d. Reduction in the effectiveness of the sildenafil
answer
B
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Order: You want to give 5mg/kg of ampicillin to a child weighing 65 pounds. How many milligrams would you give? Choose one answer. a. 147.5 mg b. 145 mg c. 148 mg d. 150 mg
answer
A
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When teaching the pt about the S/Sx of cardiac glycoside toxicity, the nurse should alert the pt to watch for: a. visual changes such as photophobia b. flickering lights or halos around lights c. dizziness when standing up d. increased urine output
answer
B
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During assessment of a pt who is receiving digoxin, the nurse monitors for findings that would indicate an increased possibility of toxicity, such as: a. apical pulse rate of 62 beats/min b. Digoxin level of 1.5 ng/mL c. Serum potassium level of 2.0 mEq/L d. Serum potassium level of 4.8 mEq/L
answer
C
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When monitoring a pt who is receiving an IV infusion of inamrinone, the nurse will look for which adverse effect? a. thrombocytopenia b. proteinuria c. anemia d. decreased BUN and creatine levels
answer
A
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The nurse is assessing a pt who is receiving a milrinone infusion and checks the pt's cardiac rhythm on the heart monitor. What adverse cardiac effect is most likely to occur in a pt who is receiving IV milrinone? a. tachycardia b. bradycardia c. atrial fibrillation d. ventricular dysrhythmia
answer
D
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The nurse is administering an IV infusion of a phospho-diesterase inhibitor to a pt who has heart failure. The nurse will evaluate the patient for which therapeutic effect? (Select all that apply) a. positive inotropic effects b. vasodilation c. decreased heart rate d. increased blood pressure e. positive chronotropic effects
answer
A B E
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A pt with a rapid, irregular heart rhythm is being treated in the emergency department with adenosine. During administration of this drug, the nurse should be be prepared to monitor the pt for which effect? a. N/V b. transitory asystole c. muscle tetany d. HTN
answer
B
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When assessing a pt who has been taking amiodarone for 6 months, the nurse monitors for which potential adverse effect? a. Glycosuria b. Dysphagia c. Photophobia d. Urticaria
answer
C
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The nurse is assessing a pt who has been taking quinidine and asks about adverse effects. Adverse effects associated with the use of this drug include: a. muscle pain b. tinnitus c. chest pain d. excessive thirst
answer
B
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A patient calls the family practice office to report that he has seen his pills in his stools when he has BM. What should be the nurse's response? a. "The pills are not being digested properly. You should be taking them on an empty stomach." b. "The pills are not being digested properly. You should be taking them with food." c. "What you are seeing is the waxy matrix that contained the medication, but the drug has been absorbed." d. "This indicates that you are not tolerating this medication and will need to switch to a different form."
answer
C
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The nurse is administering a class I antidysrhythmic and considers which condition, if present in the patient, a causation for the use of this drug? a. tachycardia b. hypertension c. Ventricular dysrhytmias d. renal dysfunction
answer
D
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When the nurse is teaching a pt about taking an antidysrhythmic drug, which statements by the nurse are correct? (Select all that apply) a. "Take the medication with an antacid if stomach upset occurs." b. "Do not chew sustained- release capsules." c. "If weight gain of 5 pounds within 1 week occurs, notify your physician at the next office visit." d. "If you experience severe adverse effects, stop the drug and notify your physician." e. "You may take the medication with food if stomach upset occurs."
answer
B E
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A patient has a new prescription for transdermal nitroglycerin patches. The nurse teaches the pt that these patches are most appropriately used: a. to relieve exertional angina b. to prevent palpitations c. to prevent the occurrence of angina d. to reduce the severity of anginal episodes
answer
C
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A nurse with adequate knowledge about the administration of IV nitroglycerin will recognize that which statement is correct? a. the IV form is given by bolus injection b. because the IV forms are short-lived, the dosing must be q2h c. IV nitroglycerin must be protected from exposure to light through use of special tubing d. IV nitroglycerin can be given via gravity drip infusions
answer
C
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Which statement by the patient reflects the need for additional pt education about the calcium channel blocker diltiazem (Cardizem)? a. "I can take this drug to stop acute anginal attacks." b. "I understand that food and antacids alter the absorption of this PO drug." c. "When the long-acting forms are taken, the drug cannot be crushed." d. "This drug may cause my BP to drop, so I should be careful when getting up."
answer
A
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While assessing a pt with angina who is to start beta-blocker therapy, the nurse is aware that the presence of which condition may be a problem if these drugs are used? a. HTN b. Essential Tremors c. Exertional angina d. Asthma
answer
D
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A 68-yo man has been taking the nitrate isorbide dinitrate for 2 years for angina. He recently has been experiencing erectile dysfunction and wants a Rx for sildenafil (Viagra). Which response would the nurse most likely hear from the prescriber? a. "He will have to be switched to isorbide mononitrate if he wants to take sildenafil." b. "Taking sildenafil with the nitrate may result in severe hypotension, so a contraindication exists." c. "I'll write a Rx, but if he uses it, he needs to stop taking the isosorbide for one dose." d. "These drugs are compatible with each other, and so I'll write a Rx."
answer
B
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The nurse is reviewing drug interactions w/ a male pt who has a Rx for isosorbide dinitrate (Isordil) as tx for angina symptoms. Which substances listed below could potentially result in a drug interaction? (Select all that apply) a. a glass of wine b. thyroid replacement hormone c. Viagra, an erectile dysfunction drug d. Glucophage, an antidiabetic drug e. Coreg, a beta- blocker
answer
A C E
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The nurse is administering anti-HTN drugs to older adult pts. The nurse knows that which adverse effect is of most concern for these pts? a. dry mouth b. hypotension c. restlessness d. constipation
answer
B
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When giving anti-HTN drugs, the nurse must consider giving the first dose at bedtime for which class of drugs? a. alpha- blockers such as Cardura b. Diuretics such as Lasix c. Ace inhibitors such as Capoten d. vasodilators such as Apresoline
answer
A
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A 56 yo man started anti-HTN drug therapy 3 mnths earlier and is in the office for a follow-up visit. While the nurse is taking his BP, he informs the nurse that he has had some problems with sexual intercourse. Which would be the most appropriate response by the nurse? a. "Not to worry. Eventually, tolerance will develop." b." The physician an work with you on changing the dose and/or drugs." c. "Sexual dysfunction happens with this therapy, and yo must learn to accept it." d. "This is an unusual occurrence, but it is important to stay on your medications."
answer
B
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When a pt is being taught about the potential adverse effects of an ACE inhibitor, which of the following should the nurse mention as possibly occurring when this drug is taken to treat HTN? a. hypokalemia b. nausea c. Dry, non-productive cough d. sedation
answer
C
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A patient is in the intensive care unit because of an acute myocardial infarction. He is experiencing severe ventricular dysrhythmias. The nurse should prepare to give which drug of choice for this dysrhythmia? Choose one answer. a. diltiazem (Cardizem) b. verapamil (Calan) c. lidocaine d. adenosine (Adenocard)
answer
C
question
The nurse is reviewing the orders for a pt and notes a new order for an ACE inhibitor. The nurse checks the current med orders, knowing that this drug class may have a serious interaction with what other drug class?
answer
NSAIDS
