A nurse is caring for a patient who is diabetic and has been diagnosed with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the nurse assess before beginning drug therapy?
A) Serum calcium levels
B) Serum potassium levels
C) Blood glucose levels
D) Serum magnesium levels
A normal maintenance dose for digoxin is 0.125 to 0.5 mg/day. In which of the following patients would the nurse most likely administer a lower-than-normal maintenance dose of digoxin?
A) A 25-year-old male with congestive heart failure and atrial fibrillation
B) A 32-year-old female with cardiomegaly
C) A 79-year-old male with cardiomegaly
D) A 42-year-old female with a third heart sound
A nurse is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a patient who has just been admitted. What is the most likely goal of this intervention?
A) To treat sinus bradycardia accompanied by hypotension
B) To resolve the patient's uncompensated heart failure
C) To treat the patient's ventricular tachycardia
D) To convert the patient's atrial fibrillation to normal sinus rhythm
A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which of the following drugs?
B) Digoxin immune fab
A nurse is caring for a patient who is admitted into the cardiac care unit with acute, decompensated heart failure. Nesiritide (Natrecor) has been ordered. When preparing for administration of the drug, the nurse will
A) add the reconstituted vial of medication to a 1,000 mL IV bag.
B) shake the vial vigorously to mix the medication for reconstitution.
C) administer the initial IV bolus over approximately 60 seconds.
D) use the reconstituted solution within a 36-hour period.
A 62-year-old man has been prescribed extended-release lovastatin. The nurse will instruct the patient to take the medication
A) at bedtime.
B) in the early morning.
C) in the evening.
D) in the afternoon.
A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by
A) blocking adrenergic receptors and producing antisympathetic effects.
B) inhibiting the movement of calcium ions across the cardiac muscle cell membrane.
C) decreasing sodium and potassium conduction.
D) weakening diastolic depolarization and the action potential duration.
A nurse is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for which of the following?
A) Decrease in plasma concentration of lovastatin
B) Increase in the statin tolerance level
C) Decrease in LDL
D) Increase in plasma concentration of lovastatin
A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is concerned that the additional weight will necessitate an increase in the medication. Which of the following is an appropriate response by the nurse?
A) "Yes, the drug dosage will probably have to be increased."
B) "No, the drug dosage will likely stay the same."
C) "No, the drug dosage will have to be decreased."
D) "I don't know; I will have to ask your physician."
A nurse has been following a male patient who is taking hydralazine, clonidine, and a diuretic for hypertension. After 2 weeks of medication therapy, the patient begins to complain of numbness and tingling in his hands and feet. The nurse suspects that these signs or symptoms are
A) a result of new onset diabetes.
B) an adverse effect of the diuretic.
C) signs of peripheral neuritis.
D) an idiosyncratic reaction to clonidine.
A nurse is responsible for patient education for a 48-year-old woman who has been prescribed colestipol. The nurse will instruct the patient to take the medication
A) at bedtime.
B) before a meal.
C) after a meal.
D) two hours before a meal.
A nurse is caring for a patient who is taking digoxin and a loop diuretic. Which of the following would be most important for the nurse to monitor?
A) Electrocardiogram results
B) Potassium levels
C) Sodium levels
D) Liver enzymes
A patient has been prescribed lovastatin for a high cholesterol level. The nurse's teaching plan will include a basic explanation of how the drug produces its therapeutic effect. The nurse will explain that lovastatin lowers cholesterol levels because it
A) is a hormone.
B) is a bile-acid resin.
C) inhibits cholesterol syntheses.
D) consists of a fibric acid derivative.
A patient is brought to the emergency department in hypertensive crisis. Nitroprusside is administered intravenously. The patient experiences diaphoresis and dizziness. Which of the following is the appropriate action by the nurse?
A) Obtain an order for naloxone
B) Ask the prescriber to reduce the dose
C) Slow the rate of the infusion
D) Give the nitroprusside at the ordered rate
A 39-year-old African-American male is 25 pounds overweight and has been diagnosed with hypertension after three consecutive above-normal blood pressure readings. The most likely initial drug therapy for this patient will be
A) an ACE inhibitor.
B) a beta blocker.
C) a calcium channel blocker.
D) a diuretic.
A 55-year-old man's hypertension has not responded adequately to his current medication regimen consisting or an ACE inhibitor, a beta-blocker and a thiazide diuretic. As a result, he will soon begin taking hydralazine (Apresoline) in addition to his existing antihypertensives. The addition of this medication to his regimen means that the nurse must prioritize which of the following nursing actions?
A) Close monitoring of the patient's electrolyte levels
B) Supervision of the patient when performing activities of daily living
C) Frequent assessment of the patient's cardiac status
D) Checking the patient's blood glucose levels before each meal and at bedtime
A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of
A) an adrenergic antagonist.
B) an adrenergic agonist.
C) a cardiotonic.
D) a neurotransmitter.
An expected outcome for a patient who has just taken sublingual nitroglycerin should be
A) increased heart rate and decreased blood pressure.
B) decreased heart rate and decreased blood pressure.
C) increased heart rate and increased blood pressure.
D) decreased heart rate and increased blood pressure.
A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous nitroglycerin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infusion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments?
A) Blood pressure
B) Urinary output
C) Heart rate
D) Blood urea nitrogen (BUN)
A nurse is caring for a patient with chronic angina. The patient is receiving ranolazine (Ranexa) 500 mg PO bid. Which of the following signs or symptoms would the nurse attribute to being a common adverse effect of this medication?
D) Perspiring skin that is cold to the touch
The nurse is performing patient education for a woman who will soon begin treatment of hyperlipidemia with simvastatin (Zocor). The patient has asked the nurse if there are any “bad side effects” that she should be aware of. Which of the following statements should underlie the nurse's response?
A) Many patients experience gastrointestinal upset with statins, which can be partially alleviated by taking the drug with food.
B) The patient may experience a dry cough, especially at night, for the first few weeks after starting to take the simvastatin.
C) The patient will have to schedule regular blood work to closely monitor her kidney function for the duration of treatment.
D) Most patients tolerate statins well, with minor muscle aches being among the most common adverse effects.
A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.)
A) Respiratory rate
B) Oxygen saturation
D) Heart rate
E) Blood pressure
A nurse who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients?
A) A 72-year-old man who has emphysema and a 55-pack-year history of cigarette smoking
B) An obese male client who is a heavy alcohol user and who has cirrhosis of the liver
C) A female client who had a laparoscopic cholecystectomy (gall bladder removal) earlier this year
D) A resident of a long-term care facility whose Alzheimer disease is being treated with donepezil (Aricept)
A nurse has administered a medication to a patient with hypertension. The prescribed drug is supposed to decrease cardiac output. A decrease in cardiac output would most likely
A) increase the serum creatinine level.
B) decrease drug absorption in the blood.
C) decrease the amount of circulating blood sent through the kidneys.
D) increase the synergistic effect of the drug.
A nurse is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The nurse should anticipate that the drug will be administered
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- Submitted On 16 Jun, 2018 03:48:56