question

A patient has a new order for the betablocker metoprolol/Lopressor. When providing education about this drug, the nurse will include which instructions?

answer

-to educate to not go into hot saunas/ hot baths

question

During a follow-up visit, the health care provider examines the fundus of the patient's eye. Afterward, the patient asks the nurse, "Why is he looking at my eyes when I have high blood pressure? It does not make sense to me!" What is the best response by the nurse?

answer

-to see if treatment is affective over long term

question

When counseling a male patient about the possible adverse effects of antihypertensive drugs, the nurse will discuss which potential problem?

answer

-sexual dysfunction

question

A patient's blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is obvious. He is transferred to the intensive care unit and started on a sodium nitroprusside (Nipride) drip to be titrated per his response. With this medication, the nurse knows that the maximum dose of this drug should be infused for how long?

answer

-10 minutes

question

A patient who has been taking antihypertensive drugs for a few months complains of having a persistent dry cough. The nurse knows that this cough is an adverse effect of which class of antihypertensive drugs?

answer

-ACE inhibitor

question

A patient with type 2 diabetes mellitus has been found to have trace proteinuria in their urine. The prescriber writes an order for an angiotensin-converting enzyme (ACE) inhibitor. What is the main reason for prescribing this class of drug for this patient?

answer

-renal protective

question

The nurse is reviewing the orders for a patient and notes a new order for an angiotensin-converting enzyme (ACE) inhibitor. The nurse checks the current medication orders, knowing that this drug class may have a serious interaction with what other drug class?

answer

NSAIDs

question

An elderly patient will be taking a vasodilator for hypertension. Which adverse effect is of most concern for the older adult patient taking this class of drug?

answer

-orthostatic hypotension

question

When the nurse is administering topical nitroglycerin ointment, which technique is correct?

answer

-wipe off the old and put on the new and wear gloves

question

A patient has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. When teaching the patient how to use sublingual nitroglycerin, the nurse will include which instruction?

answer

-If chest pain isn't relieved then call emergency after first tablet

question

A calcium channel blocker (CCB) is prescribed for a patient, and the nurse provides instructions to the patient about the medication. Which instruction is correct?

answer

-high fiber diet with plenty of fluids

question

A patient has been taking a beta blocker for 4 weeks as part of his antianginal therapy. He also has type II diabetes and hyperthyroidism. When discussing possible adverse effects, the nurse will include which information?

answer

-it can mask the symptoms of hyperglycemia or hypoglycemia

question

What action is often recommended to help reduce tolerance to transdermal nitroglycerin therapy?

answer

-take off the patch at night, have 8 hours with a nitrate free period

question

While assessing a patient who is taking a beta blocker for angina, the nurse knows to monitor for which adverse effect?

answer

-bradycardia

question

When teaching a patient who has a new prescription for transdermal nitroglycerin patches, the nurse tells the patient that these patches are most appropriately used for which situation?

answer

-angina

question

A patient about to receive a morning dose of digoxin has an apical pulse of 53 beats/minute. What will the nurse do next?

answer

-not give and call the doctor

question

A patient is taking digoxin (Lanoxin) and a loop diuretic (furosemide/Lasix) daily. When the nurse enters the room with the morning medications, the patient states, "I am seeing a funny yellow color around the lights." What is the nurse's next action?

answer

-assess for dig. toxicity

question

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?

answer

-decreases heart rate

question

Positive inotropic effect

answer

increase the force of myocardial contraction

question

Positive chronotropic drugs

answer

-increase heart rate

question

Positive dromotropic drugs

answer

Accelerate cardiac conduction

question

A patient has been taking digoxin at home but took an accidental overdose and has developed toxicity. The patient has been admitted to the telemetry unit, where the physician has ordered digoxin immune Fab (Digifab). The patient asks the nurse why the medication is ordered. What is the nurse's best response?

answer

-antidote to digoxin and will help lower the drug levels

question

Appropriate serum level for digoxin

answer

0.5-2

question

A patient has been placed on a milrinone (Primacor) infusion as part of the therapy for end-stage heart failure. What adverse effect of this drug will the nurse watch for when assessing this patient during the infusion?

answer

-dysrhythmias

question

A patient has a digoxin level of 1.4 ng/mL. The nurse interprets that this level is

answer

within therapeutic range

question

The nurse is reviewing discharge teaching for a patient who will be taking digoxin (Lanoxin) therapy. The nurse will teach the patient to avoid which foods when taking the digoxin?

answer

-bran muffins (fiber)

question

In assessing a patient before administration of a cardiac glycoside, the nurse knows that which lab result can increase the toxicity of the drug?

answer

-potassium level 2.8 which is supposed to 3.5-5

question

The nurse administering the phosphodiesterase inhibitor milrinone (Primacor) recognizes that this drug will have a positive inotropic effect. Which result reflects this effect?

answer

-increase the force of myocardial contraction

question

A patient is taking procainamide (Pronestyl) for a cardiac dysrhythmia. The nurse will monitor the patient for which possible adverse effect

answer

-prolongs QT interval, and diarrhea

question

A 62-year-old man is to receive lidocaine as treatment for a symptomatic dysrhythmia. Upon assessment, the nurse notes that he has a history of alcoholism and has late-stage liver failure. The nurse will expect which adjustments to his drug therapy?

answer

-the doses will be reduced by 50%

question

A patient has been started on therapy of a continuous infusion of lidocaine after receiving a loading dose of the drug. The nurse will monitor the patient for which adverse effect?

answer

-convulsions

question

A patient is receiving an aluminum-containing antacid. The nurse will inform the patient to watch for which possible adverse effect?

answer

-constipation

question

A patient who has been taking cimetidine (Tagamet) for hyperacidity calls the clinic to say that the medication has not been effective. The nurse reviews his history and notes that which factor may be influencing the effectiveness of this drug?

answer

-smoking

question

A patient is complaining of excessive and painful gas. The nurse checks the patient's medication orders and prepares to administer which drug for this problem?

answer

-simethicone

question

A 75-year-old woman comes into the clinic with complaints of muscle twitching, nausea, and headache. She tells the nurse that she has been taking sodium bicarbonate 5 or 6 times a day for the past 3 weeks. The nurse will assess for which potential problem that may occur with overuse of sodium bicarbonate?

answer

-metabolic alkalosis

question

A patient is about to undergo a diagnostic bowel procedure. The nurse expects which drug to be used to induce total cleansing of the bowel?

answer

GOlytely (hyperosmotic)

question

A patient asks the nurse about the difference between diphenoxylate with atropine (Lomotil) and the over-the-counter drug loperamide (Imodium). Which response by the nurse is correct?

answer

Imodium does not cause physical dependence because lomotil is opiod and imodium is over the counter

question

A patient wants to prevent problems with constipation and asks the nurse for advice about which type of laxative is safe to use for this purpose. Which class of laxative is considered safe to use on a long-term basis?

answer

-bulk forming, metamucil and citrucel

question

A patient is severely constipated and needs immediate relief. The nurse knows that which class of laxative will provide the most rapid results?

answer

Magnesium hydroxide

question

A 22-year-old patient has been taking lithium for 1 year, and the most recent lithium level is 0.9 mEq/L. Which statement about the laboratory result is correct

answer

the lithium level is therapeutic -loop diuretic

question

A patient wants to take a ginseng dietary supplement. The nurse instructs the patient to look for which potential adverse effect?

answer

-palpations and anxiety

question

A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The patient asks the nurse why he has to be on two medications. The nurse's response is based on which rationale?

answer

Heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels

question

A patient is receiving thrombolytic therapy, and the nurse monitors the patient for adverse effects. What is the most common undesirable effect of thrombolytic therapy?

answer

-internal and superficial bleeding

question

A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive which antidote?

answer

-vitamin K

question

A patient will be receiving a thrombolytic drug as part of the treatment for acute myocardial infarction. The nurse explains to the patient that this drug is used for which purpose?

answer

To dissolve the clot in the coronary artery

question

A patient who is taking warfarin (Coumadin) therapy has a headache and calls the prescriber's office to ask about taking a pain reliever. The nurse expects to receive instructions for which type of medication?

answer

acetaminophen (Tylenol)

question

A patient has had recent prosthetic heart valve surgery and is receiving anticoagulant therapy. While monitoring the patient's laboratory work, the nurse interprets that the patient's international normalized ratio (INR) level of 2.5 indicates that

answer

Pt's warfarin dose is at therapeutic levels

question

A patient has received an overdose of intravenous heparin, and is showing signs of excessive bleeding. Which substance is the antidote for heparin overdose?

answer

-protamine sulfate

question

he nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics?

answer

Spironalactone

question

Mannitol (Osmitrol) has been ordered for a patient with acute renal failure. The nurse will administer this drug using which procedure

answer

Intravenously, through a filter; Osmotic diuretic; can crystalized in cold temperatures and IV only, and it is stored in a warmer in pharmacy. Pregnancy C drug

question

Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?

answer

be sure to change your position slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes

question

When monitoring a patient who is taking hydrochlorothiazide (HydroDIURIL), the nurse notes that which drug is most likely to cause a severe interaction with the diuretic?

answer

There is an increased risk for digitalis toxicity in the presence of hypokalemia, which may develop with hydrochlorothiazide therapy. Potassium supplements are often prescribed with hydrochlorothiazide therapy to prevent hypokalemia. The other options do not have interactions with hydrochlorothiazide.

question

When a patient is receiving diuretic therapy while in a hospital, which of these assessment measures would best reflect the patient's fluid volume status

answer

Intake, output, and daily weight

question

A patient is being discharged to home on a single daily dose of a diuretic. The nurse instructs the patient to take the dose at which time so it will be least disruptive to the patient's daily routine?

answer

-morning

question

A patient in the neurologic intensive care unit is being treated for cerebral edema. Which class of diuretic is used to reduce intracranial pressure?

answer

-Mannitol

question

When giving dextromethorphan, the nurse understands that this drug suppresses the cough reflex by which mechanism of action?

answer

Dextromethorphan suppresses the cough reflex through a direct action on the cough center. The other options are not correct

question

During a routine checkup, a patient states that she is unable to take the prescribed antihistamine because of one of its most common adverse effects. The nurse suspects that which adverse effect has been bothering this patient

answer

-drowsiness

question

A patient is taking guaifenesin (Humibid) as part of treatment for a sinus infection. Which instruction will the nurse include during patient teaching?

answer

Force fluids to help loosen and liquefy secretions.

question

A patient with a tracheostomy has difficulty removing excessive, thick mucus from the respiratory tract. The nurse expects that which drug will be ordered to aid in the removal of mucus?

answer

guaifenesin (Mucinex)

question

The nurse is reviewing the use of antitussive drugs. Antitussive drugs would be most appropriate for which patient?

answer

-nonproductive cough

question

A patient is taking intravenous aminophylline for a severe exacerbation of chronic obstructive pulmonary disease. The nurse will assess for which therapeutic response?

answer

-increased easy of breathing

question

A patient is taking a xanthine derivative as part of treatment for chronic obstructive pulmonary disease. The nurse will monitor for adverse effects associated with the use of xanthine derivatives, such as

answer

-palpitations

question

A patient is in an urgent-care center with an acute asthma attack. The nurse expects that which medication will be used for initial treatment?

answer

A beta2 agonist such as albuterol (Proventil)

question

The prescriber has changed the patient's medication regimen to include the leukotriene receptor antagonist montelukast (Singulair) to treat asthma. The nurse will emphasize which point about this medication?

answer

It should be taken every day on a continuous schedule, even if symptoms improve.

question

After receiving a nebulizer treatment with a beta agonist, the patient complains of feeling slightly nervous and wonders if her asthma is getting worse. What is the nurse's best response?

answer

This is an expected adverse effect. Let me take your pulse."

question

A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient?

answer

The bronchodilator should be taken first."

question

When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects?

answer

-oral candisis, dry mouth

question

When evaluating a patient's use of a metered-dose inhaler (MDI), the nurse notes that the patient is unable to coordinate the activation of the inhaler with her breathing. What intervention is most appropriate at this time?

answer

-use a spacer

question

The nurse is providing instructions about the Advair inhaler (fluticasone propionate and salmeterol). Which statement about this inhaler is accurate?

answer

It is used for prevention of bronchospasms.

question

Which drug classes are commonly used as over-the-counter (OTC) remedies? (Select ALL that apply)

answer

-Nonsteroidal antiinflammatory drugs -Cold remedies -Smoking deterrent systems -Histamine 2 (H2) blockers

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