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pharm test
pharm test 6
| Question | Answer |
|---|---|
| A nurse is teaching a class on the cardiovascular system to nurses from the unit. The nurse asks the class what factors largely determine stroke volume. Which response from a member of the class demonstrates a need for further teaching? | Viscosity of the blood |
| A nurse is performing a physical assessment on a patient with heart failure. If Starling’s law were to break down, what is the most significant clinical manifestation the patient could display? | Shortness of breath |
| A patient with a history of hypertension is admitted for a procedure. If the patient’s arterial pressure decreases, which clinical manifestation would the nurse expect to see? | Increased heart rate |
| In an effort by the body to compensate for a low arterial pressure, the kidneys retain which electrolyte? | Sodium |
| A nurse assesses a patient with severe venous incompetence. When the patient stands, blood pressure decreases. Which compensatory change should the nurse expect? | Tachycardia |
| A patient has decreased cardiac output. Which physiological process in the kidneys would be most affected by this disease process? | Tubular reabsorption |
| A nurse is assessing the appropriateness of her patient’s medications. The nurse understands that it would be most dangerous for the patient taking an angiotensin-converting enzyme (ACE) inhibitor if the patient had which of the following comorbidities? | Renal artery stenosis |
| A nurse just administered the first dose of an ACE inhibitor to the patient 1 hour ago. The patient, who is resting supine, urgently asks to go to the bathroom. The nurse’s best action would be which of the following interventions? | Provide a bed pan. |
| A patient who has been taking lisinopril (Zestril) for 2 weeks complains of a dry cough. What patient education should the nurse provide regarding this complaint? | The cough is a common side effect of the medication. |
| A patient is being discharged from the hospital on enalapril (Vasotec), taken orally. A nurse is providing patient education about the medication. Which statement made by the patient demonstrates a need for further teaching? | “My cough will subside within 3 days of being on this medication.” |
| A patient with type II diabetes is admitted with complications and nephropathy. A nurse is providing patient education about losartan (Cozaar). When the patient asks how the medication will help his nephropathy, the nurse should explain, “Losartan | slows the progression of renal disease.” |
| A nurse is reviewing a patient’s medications prior to administration. Which drug-to-drug interactions should most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L? | Eplerenone (Inspra) and spironolactone (Aldactone) |
| A patient comes to the clinic for a follow-up appointment. As the nurse reviews the patient’s medications, the person states, “I don’t think my lisinopril (Zestril) is as effective as it once was.” Which medication would the nurse be most concerned about | Ibuprofen (Motrin) |
| A patient admitted to the intensive care unit (ICU) is being treated with both verapamil (Calan) and digoxin (Lanoxin). A nurse is aware that the patient should be monitored for which of the following effects from concurrent use of these medications? | Digoxin toxicity |
| A patient is started on nifedipine (Procardia) concurrently with a beta blocker for hypertension. The rationale for concurrent use of a beta blocker is to produce which of the following effects? | Prevention of reflex tachycardia |
| A nurse counsels an elderly patient who is just beginning verapamil (Calan) therapy. The nurse should include which pertinent and important side effect in the patient’s education? | Dizziness may occur; therefore, caution must be used when walking or rising from a sitting position. |
| The nurse is aware that a major difference between verapamil (Calan) and nifedipine (Procardia) is which of the following effects? | Nifedipine causes fewer effects on the heart. |
| A patient is taking verapamil (Calan) and is being taught the various side effects and drug-to-drug interactions. Which statement made by the patient demonstrates a need for further teaching? | “I will experience an increase in my heart rate.” |
| A patient is receiving vasodilator therapy for hypertension. To counter the increase in blood volume caused by prolonged vasodilator therapy, the patient should be concurrently receiving what drug? | A diuretic to prevent sodium and water retention |
| The nurse is caring for a patient with hypertension who takes a thiazide diuretic. In addition, the patient recently was prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse knows that the patient is knowledgeable about the two drugs whe | should bring my blood pressure down further, because it is acting as a vasodilator.” |
| A patient taking a vasodilator complains of dizziness when getting out of bed to go to the bathroom. Which intervention is a priority for this patient? | Moving slowly from one position to another |
| A patient is being treated with an angiotensin-converting enzyme (ACE) inhibitor. The nurse should advise the patient that ACE inhibitors should not be taken concurrently with which of the following drugs? | Potassium-sparing diuretics |
| When providing education for a patient taking clonidine (Catapres), an alpha2 agonist, the nurse should inform the patient to anticipate which likely side effect? | Dry mouth |
| The nurse is teaching a group of patients about hypertension. A patient who has been diagnosed with uncomplicated primary hypertension asks the nurse what the preferred initial antihypertensive drug regimen is. Which of the following is the nurse’s best r | Thiazide diuretics, as long as renal disease is not a factor |
| A patient with essential hypertension has been placed on hydralazine (Apresoline). A week later, the patient complains that her heart rate goes up and down. To counteract this reflex tachycardia, the nurse anticipates that the prescriber will order | a beta blocker. |
| A nurse is teaching a class on hypertension to a group of African American patients. The nurse is correct to explain that African Americans with type I diabetes and proteinuria respond best to which combination of medications? | Angiotensin-converting enzyme (ACE) inhibitors and diuretics |
| An elderly patient has hypertension, and the prescriber has ordered a combination of medications that have been shown to reduce mortality and morbidity in the elderly. Which combination of medications would the nurse anticipate being prescribed? | A beta blocker and a diuretic |
| During patient education, the nurse discusses the major side effects of thiazide diuretics, because the patient has just begun therapy. The nurse should review the laboratory results for the patient and should be concerned about a finding of a | potassium level of 3 mEq/L. |
| A patient is taking enalapril (Vasotec). The nurse understands that patients taking this type of drug for heart failure need to be monitored carefully for | hyperkalemia |
| A patient is taking carvedilol (Coreg) for heart failure. The nurse should monitor the patient carefully for which of the following, which would indicate an adverse effect? | Dizziness |
| A patient in heart failure shows a decrease in the glomerular filtration rate. The patient has been taking digoxin (Lanoxin) and hydrochlorothiazide (HydroDIURIL). Considering the change in the patient’s status, what change in the medication regimen would | A change from hydrochlorothiazide (HydroDIURIL) to furosemide (Lasix) |
| The neurohormonal systems, including the sympathetic nervous system (SNS) and the renin-angiotensin-aldosterone system (RAAS), greatly affect cardiac remodeling with declining cardiac performance. What is the ultimate effect of this pathology? | A progressive decline in cardiac output |
| The potassium-sparing diuretic spironolactone (Aldactone) has been demonstrated to prolong survival and improve heart failure (HF) symptoms by | blocking receptors for aldosterone. |
| A nurse prepares to administer a scheduled dose of digoxin. The nurse finds a new laboratory report showing a plasma digoxin level of 0.7 ng/mL. What action should the nurse take? | Check the patient’s apical pulse, and if it is within a safe range, administer the digoxin. |
| The nurse is caring for a patient recently admitted to the ICU with heart disease. Which symptom is a life-threatening adverse effect of digoxin toxicity? | Dysrhythmias |
| The nurse is reviewing medications for heart failure. The nurse is correct to assume that the front-line therapy for heart failure currently consists of which regimen? | Diuretic, ACE inhibitor, and beta blocker |
| The nurse is preparing to administer digoxin IV to treat a patient’s heart failure. Which action is essential for the nurse to perform? | Use a cardiac monitor during administration of the drug and for at least 2 hours afterward. |
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