pharm 2 final pt1

a client is prescribed enalapril for hypertension. which adverse effect should the nurse instruct the client to report immediatley?

Swelling of the lips and tongue

a provider prescribes valproic acid 500mg PO. The available valproc acid oral solution is labeled 250mg per 5mL. using a dimensional0analysis approach. what volume should the nurse administer? Round to the nearest whole number and use a leading zero if it applies; do not use a trailing zero)

10mL

A client reports taking an excessive amount of acetiminophen. which finding most strongly indicates acute acetaminophen toxicity rather than other medication effects?

Vomitting with early risk of hepatic necrosis

A client teaching for verapamil: a nurse is reinforcing teaching with a client who has hypertension and a new prescription for verapamil. which food or beverage should the client avoid taking with this medication due to increased risk of hypotension and cardiotoxicity from inhibited drug metabolism?

Grapefruit juice with doses

a client taking spironolactone for heart failure reports muscle weakness and palpations. which laboratory result should the nurse review first?

Serum potassium

a nurse is preparing to administer potassium chloride to a client taking furosemide. which assessment finding would require the nurse to withhold the medication and notify the provider

serum potassium 5.5mEq/L

a nurse is preparing the administer metoprolol 100mg PO. the avilable tablets are 50mg each. how many tablets should the nurse give? round to the nearest whole tablet.

2 tablets

a client is prescribed metoprolol has an apical heart ate of 49/min. which medication should the nurse prepare to administer to treat the bradycardia?

atropine

a client with liver failure and ascites is taking spironolactone. which laboratory finding indicates an adverse effect of this medication?

Serum potassium 5.2 mEq/L suggesting hyperkalemia

a client is prescribed warfarin for atrial fibrillation. which food should the nurse instruct the client to consume consistently to avoid flucuations in anticoagulation

Spinach due to high vitamin K content

which needle size and length are most appropriate for a deep subcutaneous heparin injection?

25 gauge

a client is prescribed lisinopril for hypertension. which adverse effect should the nurse instruct the client to report immediatley?

Swelling of the lips and tongue

a client is starting amlodipine for blood pressure control. which instruction should the nurse include to minimize a common side effect?

rise slowly from lying positions to prevent dizziness

a nurse must administer digoxin 1mg PO. the supply is digoxin 0.5mg per tablet. and the stock bottle indicates 1 tablet contains 0.5mg. Using either ratio proportion or desired over have. what is the correct number of tablers to give? round to the nearest whole tablet.

2 tablets

a provider prescribes clonidone 0.2mg Po. The medication on hand is clonidine 0.1mg/tablet. using the desired over have method, how many tablets should the nurse administer? round to the nearest whole tablet.

2 tablets

a client taking warfarin asks about the importance of regular blood tests. which response by the nurse is most appropriate?

they help ensure your blood is not too thick and not too thin

a client with a new warfarin prescription asks for safety guidance. which instruction is appropriate?

use an electric razor to help reduce the risk of cuts

a provider prescribes celecoxib 400mg PO. The medication on hand is celecoxib 200mg per capsule. Using desired over have method, how many capsules should be administered for one dose? round to the nearest whole number

2 capsules

a client taking warfarin presents with an elevated PT/INR. Which medication should the nurse anticipate administering to reverse the anticoagulant effect?

vitamin K

when monitoring a client on furosemide, which complication is most consistent with the drugs mechanism of promoting potassium excretion?

hypokalemia causing disrhythmias

a clients prescription is digoxin 0.25mg PO. the available supply is digoxin 0.125mg per tablet. based on the dimensional analysis shown in the example, which number of tablets should be administered? round to the nearest whole tablet.

2 tablets

strategic selection: a client on chronic ibuprofen therapy asks what monitoring is important, which instruction reflects appropriate ongoing assessment to detect potential adverse effects of ibuprofen?

schedule regular eye examinations while taking ibuprofen

a client prescribed meotoprolol reports feeling dizzy when standing up quickly. what is the most appropriate nursing response?

instruct the client to rise slowly from sitting to standing position

a client with hypertension is beginning propranolol therapy, which action best demonstrates understanding of how to reduce dizziness related to hypotension when changing positions?

sit on the side of the bed before standing up

teaching is porvided to a client starting sublingual nitroglycerin for angina. which statement shows correct understanding of emergency actions

call 911 if 3 doses does not relieve pain

a nurse is caring for a client beginning warfarin therapy. which laboratory test is used to monitor the therapeutic effect to warfarin?

prothrombin time PT/INR

a client has started atenolol for hypertension. which adverse effect should the nurse priorize monitoring?

bradycardia due to beta 1 blockade

diuretic induced electrolyte effect: during a teaching session about diuretics, which medication should the nurse identidy as increasing the risk for hyperkalemia due to potassium-sparing action?

spironolactone

applying adverse effect reasoning: a client starting verapamil asks why grapefruit should be avoided. which rationale best explains the instruction?

grapefruit juice inhibits drug metabolism, increasing verpamil blood levels and risk of hypotension

a client is taking clopidogrel after cardiac stent placement. which finding is most consistent with an adverse effect of clopidogrel that warrants notifying the provider?

black tarry stools that indicate GI bleeding

a newly licensed nurse i administering enoxaparin subcutaneously using a prefilled syringe. which action demonstrates correct technique?

administer the injection at least 2 inches (5.08cm) from the umbillicus

a patients prescription is desmopressin 25mg PO. the medication available is scored tablets lebeled 50mg/tablet. using a standard nursing doage method. what amount should the nurse administer?

0.5 tablet

what is the primary action of alpha-1 adrenergic blockers?

appose the effects of the sympathetic nervous system

how do alpha 1 adrenergic blockers help treat hypertension?

by inducing vasodilation

which of the following is a common side effect of alpha 1 adrenergic blockers, especially after the first dose?

orthostatic hypotension

what is an important instruction for a client taking their first dose of an alpha 1 adrenergic blocker?

take the first dose at bedtime to minimize severe orthostatic hypotension and syncope

a nurse is reviewing discharge instructions for a client starting lisinopril. which adverse effect should the client be taught to report the provider immediately?

swelling of the lips and tongue

a nurse is reviewing medication for a client with heart failure. which medication combination increases the risk for hyperkalemia and should be monitored closely?

spironolactione and lisinprol

a nurse is caring for a client recieving furosemide. which finding requires immediate follow-up because it indicates an adverse e. ffect associated with this medication?

Potassium level 2.8 mEq/L with muscle weakness

a client is prescribed amlodipine for hypertension. which adverse effect should the nurse instruct the client to report immediatley?

swelling of the ankles and feet

teaching is reinforced for a client prescribed simvastatin. which instruction is appropriate to maximize therapeutic effect and safety?

take the medication in the evening to align with peak cholesterol production

a client taking digoxin develops nausea, blurred vision, and a heart rate of 48/bpm. which laboratory value should the nurse check first to assess for a common cause of digoxin toxicity

serum potassium

a client is prescribed transdermal nitroglycerin for chronic angina. which application instruction is correct?

apply a new patch at the same time each day after removing the old patch

a women with osteoarthritis is considering aspirin for pain control which history finding represents a potential contraindication to aspirin use and should be reported?

History to vitamin K deficiency

a client prescribed verapamil for angina asks about food interactions. which instruction is appropriate?

avoud grapejuice because it can increase drug toxicity

a client is prescribed enoxaparin for DVT prophylaxis. which laboratory value should the nurse monitor to assess for potential bleeding complications?

platelet count

a client taking digoxin reports seeing yellow halos around lights and experiencing nausea. which action should the nurse take first.

hold the next dose and verify the healthcare provider

a client is prescribed enoxaparin for DVT prohylaxis. which instruction should the nurse provide regarding self administration of this medication at home?

rotate injection sites within the abdomen

which of the following is NOT involved in detecting a decrease in blood pressure?

affarent artieoles

which enzyme is responsible for converting angiotensin 1 to angiotensin 2

ACE

How does Angiotension 1 primarily affect the efferent arteriole in the kidney?

it causes the efferent arteriole to constrict more than the afferent artierole, increasing glomerular filtration rate

which of the following is a direct effect of angiotensin 2

stimulation of the adrenal cortex to release aldosterone

during a teaching session about antihypertensive medications, which instruction should the nurse give to a client starting metoprolol to minimize the risk of orthostatic hypotension?

rise slowly from sitting and lying positions

what is the primary function of thrombolytics?

to breakdown existing blood clots

what is the process called when the body gradually degrades the fibrin mesh to dissolve a blood clot

fibrinylosis

which of the following thrombolytic medications is NOT derived from tissue plasminogen activator (TPA)

Streptokinase

in which of the following situations should thrombolytics generally not administered due to increased risk?

history of intracranial bleeding

a nurse is reviewing the mediation list of a client taking warfarin. which over the counter medication should the nurse advise the client to avoid due to increased bleeding risk?

Ibuprofen

a nurse is preparing to administer atenolol to a client with hypertension. which assessment finding would require the nurse to withhold the medication and notify the provider?

heart rate 48 beats per minute

indication recognition: a nurse reviews a history for a client prescribedcelecoxib daily. which condition in the history would support the need for celecoxib therapy.

osteoarthritis with chronic joint pain

a nurse must administer aspirin 650mg PO. the medication on hand is aspirin 325mg per tablet. using a standard a standard dosage calculation method, how many tablets should the nurse give? round to the nearest whole tablet

2 tablets

a client taking furosemide reports fatigue, abdominal distention and decreased bowel sounds. which adverse effect is the nurse most concerned about?

hyppkalema with increased distal secretions

a client receiving digoxin is also taking furosemide for chronic hypertension. based on common drug interactions and electrolyte effects, which risk should the nurse recognize?

increased risk of digoxin toxicity due ti hypokalemia from loop diuretics

a nurse is teaching a client about the safe administration of subcutaneous heparin. which instruction is correct?

rotayte injection sites within the abdomen

what laboratory value should be monitored most closely in a client taking both furosemide and digoxin

serum potassium

a clients prescription reads: hydrochlorothiazide 25mg PO every 8hr, Each available tablet contains hydrochlorothiazide 50mg. How many tablets shpould be administered per dose? Round to the nearest tenth/whole as appropriate

0.5 tablet

a client has a new prescription for clopidogrel. which nursing action is most appropriate to include in the plan of care?

monitor for black tarry stools and report to provider

a client asks if metoprolol would be appropriate for her. which client history indicates a contraindication to metoprolol that the nurse should identify?

a history of sinus bradycardia

a postop client is receiving fentanyl via patient controlled analgesia. the provider prescribes naloxone. what is the primary purpose naloxone in this situation

to block the effect of opioids on the CNS and reverse respiratory depression

a client asks which vital sign parameter would require withholding propranolol and nitifying the provider. Which insruction is most apporpriate?

withhold the dose is heart rate is less than 50beats/ min

a nurse is teaching a client about warfarin therapy. which statement by the client indicates a need for further teaching?

i can take aspirin for headaches while on warfarin

a nurse is preparing to administer enoxaparin to a client. which site is msot appropriate for a subcutaneous injection of this medication?

abdomen at leats 2 inches from umbillicus

a client taking warfarin is scheduled for a dental procedure. which instruction should the nurse provide regarding warfarin therapy?

Contiue taking warfarin as prescribed and inform the dentist

a nurse is preparing to administer heparin subcutaneously. which technique is appropriate for the site and post injection care?

Inject into the abdomen above the iliac crest and at least 2 inches from the umbillicus; apply firm pressure without massaging

what is the trade name for the medication digoxin?

lanoxin

Digoxin belongs to which medication class?

Cardiac glycosides

what is the therapeutic range for digoxin?

0.5-2.0ng?mL

which of the following is a key symptom of digoxin toxicity?

vision changes

a client taking spironolactone should be monitored for which electrolyte imbalance?

hyperkalemia

client education is provided for captopril therapy for hypertension. which instruction helps manage a common adverse effect?

tke the medication on an empty stomach to improve absorption

a client on warfarin presents with signs of overdose. which medication should be readily available to reverse warfarins effects?

Vitamin K

which monitoring instruction is most appropriate for a client starting verapamil?

Report bradycardia and tachycardia

a provider reviews medication for clients taking digoxin. which concurrent therapy increases the risk of digoxin toxicity and warrants close monitoring?

Furosemide for hypertension

a client is prescribed heparin for deep vein thrombosis. which laboratory value should the nurse monitor to assess the effectiveness of heparin therapy?

aPTT

what is the primary cause of angina pectoris?

an imbalance between the hearts oxygen supply and demand

how do nitrates primarily alleviate chest pain in angina?

by dilating veins which increases oxygen supply to the heart

which nitrate medication is typically used for immediate relief of acute angina?

Nitroglycerin

what is the recommended sublingual dosage for nitroglycerin (nitroSTAT) to treat acute angina?

0.3 - 0.6 every 5 mins

what is the recommended first step when experiencing angina and taking nitroglycerin?

sit down and dissolve the tablet under the tongue

what is the main reason for requiring a 12 hour nitrate free interval for chronic nitrate medications like isosorbide mononitrate?

to prevent development of tolerance to the medication

which of the following is a common side effect of nitrate medications, often attributed to vasodilation?

Headache

what adverse effect can occur if nitrates are used concurrently with PDE-5 inhibitors (ex: sildenafil, tadalafil)?

Severe hypotension

a client with pulmonary embolism is receiving IV heparin. which laboratory finding should the nurse report to the provider immediatley?

platelets 74,000

a client reports ingesting an excessive amount of aspirin. which manifestations is the nurse most likely to identify as an indication of salicylism?

tinnitus with ringing in ears

a nurse is teaching a client about safe use of nitroglycerin sublingual tablets for angina. which instruction should be included?

store tablets in tight sealed or original glass container

a prescription is for acetiminophen 650mg PO. Available tablets are 325mg each. using ratio and proportion, how many tablets should be administered? (round to the nearest whole tablet.)

2 tablets

a client receiving furosemide is at risk for which electrolyte imbalance that can cause muscle cramps and cardiac arrhythmias?

hypokalemia

a client on chronic aspirin therapy asks why vitamin K status matters. which statement best explains the relationship?

vitamin k is needed for clotting factor synthesis; deficiency increases bleeding risk when taking aspirin

a nurse is reviewing laboratory results for a client taking furosemide. which finding should prompt the nurse to notify the provider immediately?

serum potassium 2.9mEq/L

after administering morning medications, a nurse realizes nifedipine was given to the wrong client. what is the priority nursing action?

check the clients vital signs