Quiz #2

Chapters 20, 27 28, 30, and 31

Which lifestyle behaviors should the nurse discuss with a client to help reduce their risk of coronary artery disease?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Abstinence from smoking
2. Decrease stress
3. Limit alcohol consumption
4. Maintain optimal weight
5. Limit sodium intake

1. Abstinence from smoking
3. Limit alcohol consumption
5. Limit sodium intake

The nurse is reviewing the myocardial blood supply for a client with coronary artery disease (CAD). Which statements made by the client indicate an understanding of the information?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "The heart has right and left arteries that arise from the aorta."
2. "The coronary arteries carry blood away from the heart to the right atrium."
3. "The heart receives its oxygen through the blood that fills it."
4. "Coronary arteries primarily carry blood to the left ventricle."
5. "The right and left arteries have smaller branches that go around the heart."

1. "The heart has right and left arteries that arise from the aorta."
5. "The right and left arteries have smaller branches that go around the heart."

A client asks the nurse if angina is the same thing as having a heart attack. Which response should the nurse provide?
1. "They have some things in common, for example, severe emotional distress and panic can accompany both angina and myocardial infarction."
2. "Angina means the heart muscle is not getting enough oxygen, while heart attack, or myocardial infarction, means part of your heart has died."
3. "Actually, it depends on what type of angina you mean; there are several types."
4. "They are basically the same."

2. "Angina means the heart muscle is not getting enough oxygen, while heart attack, or myocardial infarction, means part of your heart has died."

Which is the primary desired outcome for a client that has experienced several episodes of angina?
1. The client will experience relief of chest pain with anticoagulant therapy.
2. The client will experience relief of chest pain with nitrate therapy.
3. The client will experience relief of chest pain with aspirin therapy.
4. The client will experience relief of chest pain with therapeutic lifestyle changes.

2. The client will experience relief of chest pain with nitrate therapy.

Which statement by the client receiving nitroglycerine (Nitrostat) should the nurse be concerned about?
1. "I'm getting married tomorrow; I hope my erectile dysfunction isn't a problem."
2. "I'm going water skiing tomorrow; I hope my angina isn't a problem."
3. "I really don't like taking those little pills, I would like to use a patch."
4. "My angina has been a little more frequent I would like something to take for the pain."

1. "I'm getting married tomorrow; I hope my erectile dysfunction isn't a problem."

The nurse is preparing to administer nitroglycerine via the intravenous route. Which should the nurse do prior to the administration of the prescription?
1. Use gloves to prevent self-administration.
2. Instruct the client to avoid moving the arm in which the prescription is infusing.
3. Cover the intravenous (IV) bottle to decrease light exposure.
4. Darken the room to decrease light exposure.

3. Cover the intravenous (IV) bottle to decrease light exposure.

Which mechanism of action does beta-adrenergic agonists have on the cardiovascular system?
1. Increase cardiac output
2. Dilate arterial smooth muscle
3. Decrease the contractility of the heart
4. Dilate venous system

3. Decrease the contractility of the heart

A client receiving diltiazem (Cardizem) asks the nurse why they get a headache after taking the prescription. Which response should the nurse provide the client?
1. "Diltiazem (Cardizem) causes the blood vessels in your brain to widen, giving you the headache."
2. "Diltiazem (Cardizem) increases prostaglandin synthesis, giving you the headache."
3. "Diltiazem (Cardizem) releases Substance P, activating pain receptors in your brain and giving you the headache."
4. "Diltiazem (Cardizem) causes the blood vessels in your brain to narrow, giving you the headache."

1. "Diltiazem (Cardizem) causes the blood vessels in your brain to widen, giving you the headache."

A client post-acute myocardial infarction asks the nurse why they are prescribed reteplase (Retavase) intravenously (IV). Which response should the nurse provide the client?
1. "The prescription dilates the arteries in the heart so it can get more oxygen."
2. "The prescription is dissolving the clot that has caused your heart attack."
3. "The prescription thins your blood so more clots will not develop."
4. "The prescription will increase the strength of the muscles in the heart during each beat."

2. "The prescription is dissolving the clot that has caused your heart attack."

Which is a priority assessment for the client receiving reteplase (Retavase) intravenously?
1. Fluid balance
2. Abnormal bleeding
3. Blood glucose
4. Respiratory rate

2. Abnormal bleeding

The nurse has completed the education for a client with angina prescribed nitroglycerine (Nitrostat). Which statement made by the client indicates further teaching is required?
1. "I can take up to 5 tablets to resolve the chest pain."
2. "If my pain is not reduced 5 minutes after taking one tablet I should call EMS."
3. "I should take a tablet as soon as chest pain occurs."
4. "I can take three tablets, one every 5 minutes."

1. "I can take up to 5 tablets to resolve the chest pain."

Which information about the primary therapeutic action of an antianginal prescription should the nurse include in client teaching?
1. "The prescription decreases how much oxygen your heart needs."
2. "This prescription will thin your blood so your heart receives more oxygen."
3. "This prescription increases the amount of oxygen your heart receives."
4. "This prescription increases the oxygen to your heart by increasing nitric oxide production."

1. "The prescription decreases how much oxygen your heart needs."

Which statements by the client are specifically associated with unstable angina?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "My chest has started hurting even if I am just watching television."
2. "My chest starts hurting if I climb one set of stairs."
3. "My attacks of chest pain are coming more frequently now."
4. "The pain occurs most often after I eat a meal."
5. "The pain is worse than it used to be."

1. "My chest has started hurting even if I am just watching television."
3. "My attacks of chest pain are coming more frequently now."
5. "The pain is worse than it used to be."

Which information should the nurse include in the education for a client prescribed a transdermal nitroglycerin patch?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Place the patch on the upper arm or leg.
2. Rotate sites of application.
3. Remove the patch for an hour each day.
4. Cleanse the skin under the patch after removal.
5. Triple wrap the patch in plastic wrap for disposal.

2. Rotate sites of application.
4. Cleanse the skin under the patch after removal.

Which should the nurse assess a client for prior to administering atenolol (Tenormin)?
1. Temperature
2. Pulse
3. Respirations
4. Blood pressure
5. Oxygen saturation

2. Pulse
4. Blood pressure

Which information should the nurse include when educating a client about coronary artery disease?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Plaque causes narrowing of the artery.
2. Plaque begins to accrue early in life.
3. Plaque causes narrowing of the veins.
4. Plaque affects the elasticity of the artery.
5. Plaque builds up in the myocardial tissue.

1. Plaque causes narrowing of the artery.
2. Plaque begins to accrue early in life.
4. Plaque affects the elasticity of the artery.

Which symptom is most likely to be related to angina as opposed to a myocardial infarction?
1. Chest pain relieved by one sublingual nitroglycerin
2. Chest pain that radiates to the patient's back
3. Chest pain that occurred while the patient was eating breakfast
4. Chest pain accompanied by shortness of breath

1. Chest pain relieved by one sublingual nitroglycerin

Which is the primary pharmacologic goal in the treatment of a client experiencing stable angina?
1. Increase venous blood flow to the right atrium.
2. Eliminate blockages by using thrombolytics.
3. Establish a regular exercise program and diet plan.
4. Increase cardiac oxygen supply and reduce cardiac oxygen demand.

4. Increase cardiac oxygen supply and reduce cardiac oxygen demand.

Which prescriptions reduce the heart's demand for oxygen by lowering heart rate?
1. Anticoagulants and beta-adrenergic blockers
2. Calcium channel blockers and anticoagulants
3. Organic nitrates and calcium channel blockers
4. Beta-adrenergic blockers and calcium channel blockers

4. Beta-adrenergic blockers and calcium channel blockers

Which adverse effect is common for clients prescribed topical nitroglycerin paste?
1. Rash
2. Shortness of breath
3. Headache
4. Ventricular tachycardia

3. Headache

Which is the most sensitive and effective biomarker of a myocardial infarction?
1. White blood cells
2. Troponin
3. Myoglobin
4. Creatine kinase

2. Troponin

Which client should the nurse anticipate a prescription for reteplase (Retavase) therapy post myocardial infarction?
1. A 54-year-old female with type 2 diabetes
2. A 45-year-old female with a 2-week-old cranial artery repair
3. A 62-year-old with a recent hemorrhagic stroke
4. A 70-year-old male with active GI bleed

1. A 54-year-old female with type 2 diabetes

Which prescription is indicated for the prevention of blood clots?
1. Captopril (Capoten)
2. Reteplase (Retavase)
3. Morphine
4. Abciximab (ReoPro)

4. Abciximab (ReoPro)

A client asks which conditions will cause the heart to need more oxygen. Which information should the nurse be prepared to discuss?
1. Sleep apnea
2. Hyperthyroidism
3. Asthma
4. Hepatitis B

1. Sleep apnea

A client experiencing bradycardia is suspected of overdosing on diltiazem (Cardizem). Which treatment should the nurse anticipate prescribed?
1. Dopamine
2. Atropine
3. Calcium chloride
4. Narcan

2. Atropine

Which are the goals of antianginal therapy?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Decreased oxygen consumption of the brain
2. Increased myocardial contractility
3. Increased blood flow to the peripheral blood vessels
4. Increased blood flow to the myocardium
5. Decreased myocardial oxygen demand

4. Increased blood flow to the myocardium
5. Decreased myocardial oxygen demand

Which information should the nurse include in the education for a client prescribed antianginal therapy?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. The prescriptions increase the heart rate.
2. The prescriptions dilate the veins so that the heart receives less blood.
3. The prescriptions cause the heart to contract with less force.
4. The prescriptions increase blood pressure.
5. The prescriptions increase the ability of the body to produce red blood cells.

2. The prescriptions dilate the veins so that the heart receives less blood.
3. The prescriptions cause the heart to contract with less force.

Which prescriptions does the nurse anticipate to be included in the goal to reduce the post-MI mortality of a client?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Aspirin
2. Beta blockers
3. Narcotic analgesics
4. ACE inhibitors
5. Antidysrhythmics

1. Aspirin
2. Beta blockers
4. ACE inhibitors

Which conditions is the use of thrombolytic therapy contraindicated in?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Venous emboli
2. History of intracranial hemorrhage
3. Hemophilia
4. Liver disease
5. Peptic ulcer disease

2. History of intracranial hemorrhage
3. Hemophilia
4. Liver disease
5. Peptic ulcer disease

For which conditions should the nurse instruct a client to hold the application of nitroglycerin ointment and contact the healthcare provider?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Dyspnea
2. Productive cough
3. Headache
4. Fever
5. Confusion

1. Dyspnea
2. Productive cough
5. Confusion

The nurse is providing a client education about dysrhythmias. Which statement should the nurse include in the teaching?
1. "Dysrhythmias cause serious electrolyte imbalances; this results in heart block."
2. "Dysrhythmias are the result of longstanding, uncontrolled hypertension."
3. "Dysrhythmias interrupt the normal electrical pathways in the heart so it can't beat properly."
4. "Dysrhythmias alter the blood flow through the heart and cause it to stop beating."

3. "Dysrhythmias interrupt the normal electrical pathways in the heart so it can't beat properly."

A client states to the nurse, "This educational video you gave me shows normal electrical conduction through the heart, but I still don't understand it. Can you explain it to me?" Which responses should the nurse include in the discussion?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "Conduction through the bundle of His is the slowest in the heart."
2. "Conduction begins in the sinoatrial (SA) node and travels to the atrioventricular (AV) node."
3. "Conduction continues through the bundle branches to the Purkinje fibers."
4. "Conduction travels from the atrioventricular (AV) node through the bundle of His."
5. "The sinoatrial (SA) node is located in the left atrium."

2. "Conduction begins in the sinoatrial (SA) node and travels to the atrioventricular (AV) node."
3. "Conduction continues through the bundle branches to the Purkinje fibers."
4. "Conduction travels from the atrioventricular (AV) node through the bundle of His."

The client tells the nurse, "My healthcare provider says I have atrial fibrillation. Is this serious and how is it treated?" Which responses should the nurse provide the client?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "This condition is best treated with what we call antidysrhythmic drugs."
2. "This is very common; your doctor will discuss the best treatment with you."
3. "Depending on your symptoms, your healthcare provider may use an electrical shock."
4. "This is quite serious; did your healthcare provider discuss a heart transplant?"
5. "It is very serious, even more serious than a ventricular dysrhythmia."

2. "This is very common; your doctor will discuss the best treatment with you."
3. "Depending on your symptoms, your healthcare provider may use an electrical shock."

The nurse has provided education about dysrhythmias for a group of clients. Which statement made by a client indicates an understanding of the information?
1. "The sodium, potassium, and magnesium levels must be okay for the heart to have an electrical impulse."
2. "Potassium is the most important electrolyte when it comes to the electrical impulse in the heart."
3. "The sodium, potassium, and calcium levels must be okay for the heart to have an electrical impulse."
4. "Enhancing potassium and sodium is how our prescriptions will work to prevent dysrhythmias."

3. "The sodium, potassium, and calcium levels must be okay for the heart to have an electrical impulse."

A client with a dysrhythmia asks the nurse why they cannot take a prescription instead of have cardioversion for treatment? Which response should the nurse provide the client?
1. "Antidysrhythmic prescriptions have many side effects; cardioversion is considered safer."
2. "Special diets are necessary with antidysrhythmic prescriptions, and they are hard to follow."
3. "Antidysrhythmic prescriptions don't really work very well for most dysrhythmias."
4. "There is a high risk of seizures when you take antidysrhythmic prescriptions."

1. "Antidysrhythmic prescriptions have many side effects; cardioversion is considered safer."

A client states to the nurse, "I read that my antidysrhythmic drug can actually cause me to have irregular heartbeats. How can this be?" Which response should the nurse provide the client?
1. "Your medication blocks the flow of the electrolytes in your heart, and this can cause irregular beats."
2. "The literature is not always accurate, but if you have concerns I recommend discussing them with your healthcare provider."
3. "The aspirin that you take every day will help you avoid experiencing the irregular heartbeats."
4. "Your prescription is not the problem; it is when you mix it with over-the-counter (OTC) drugs that you develop irregular beats."

1. "Your medication blocks the flow of the electrolytes in your heart, and this can cause irregular beats."

Which adverse effect should the nurse monitor a client for that is prescribed an antidysrhythmic?
1. Depression, irritability, fatigue, and nausea
2. Anorexia, insomnia, confusion, and 2+ pitting peripheral edema
3. Low-grade fever, diaphoresis, weakness, and dry mucous membranes
4. Palpitations, chest pain, weakness, and fatigue

4. Palpitations, chest pain, weakness, and fatigue

The nurse has provided education for a client prescribed procainamide hydrochloride (Pronestyl). Which statement made by the client indicates an understanding of the information?
1. "I will not take the prescription on an empty stomach."
2. "This prescription may make me feel confused."
3. "I will take this prescription even when I am feeling well."
4. "If my pulse is less than 60 I will not take my prescription."

3. "I will take this prescription even when I am feeling well."

The nurse is assessing a male client prescribed propranolol (Inderal) for adherence to the treatment plan. Which is an important question for the nurse to ask the client?
1. "Have you noticed any changes in your sexual functioning?"
2. "Has your appetite increased or decreased?"
3. "Have you noticed any changes in your bowel function?"
4. "Have you noticed any difficulty in your ability to concentrate?"

1. "Have you noticed any changes in your sexual functioning?"

Which is the priority outcome for the client with type 1 diabetes mellitus prescribed propranolol (Inderal)?
1. The client will maintain blood glucose within normal limits.
2. The client will decrease the required number of calories/day.
3. The client will maintain adequate peripheral circulation.
4. The patient will perform activities of daily living.

1. The client will maintain blood glucose within normal limits.

The nurse has completed the education for a client prescribed propranolol (Inderal). Which statement by the client indicates an understanding of the information?
1. "I will take my pulse every day and call my healthcare provider if it is higher than 100."
2. "I will call my healthcare provider if my anxiety increases and I start worrying again."
3. "I will take my pulse every day and call my healthcare provider if it is less than 60."
4. "I will call my healthcare provider if I lose more than 3 pounds a week."

3. "I will take my pulse every day and call my healthcare provider if it is less than 60."

Which current prescription should the nurse be concerned with for the client newly prescribed amiodarone (Cordarone)?
1. Oxycodone (OxyContin)
2. Omeprazole (Prilosec)
3. Warfarin (Coumadin)
4. Fluoxetine (Prozac)

3. Warfarin (Coumadin)

Which laboratory value should the nurse notify the healthcare provider prior to administering amiodarone (Cordarone)?
1. Sodium 140 mEq/L
2. Potassium 3.1 mEq/L
3. Potassium 4.9 mEq/L
4. International normalized ratio (INR) of 12 seconds

2. Potassium 3.1 mEq/L

A client tells the nurse they are nervous about taking prescribed verapamil (Calan). Which response should the nurse provide the client?
1. "This prescription is safe, and most patients do very well with it."
2. "This prescription increases your blood pressure, but we will be monitoring that."
3. "This prescription has many side effects, but you should be okay."
4. "This prescription is a potassium channel blocker and is considered safe."

1. "This prescription is safe, and most patients do very well with it."

A client prescribed verapamil (Calan) asks the nurse if it is okay to take herbal supplements with the prescription. Which response should the nurse provide the client?
1. "Some herbal supplements may interact with your prescription."
2. "Using herbal supplements may increase your blood pressure too much."
3. "Herbal supplements are okay as long as you take calcium salts with them."
4. "Most herbal supplements are okay, but you should avoid St. John's wort."

1. "Some herbal supplements may interact with your prescription."

The educator is reviewing the mechanism of action of intravenous glucagon as a treatment for an overdose of propranolol (Inderol) with the nursing staff. Which information should the educator include?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Improves AV node conduction
2. Dilates the coronary arteries
3. Increases the heart rate
4. Enhances myocardial contractility
5. Increases the fluid volume in the vascular system

1. Improves AV node conduction
3. Increases the heart rate
4. Enhances myocardial contractility

Which is the purpose of the AV node?
1. Pace the heart at 40-60 bpm.
2. Delay the impulse from the SA node.
3. Pace the heart at 60-100 bpm.
4. Enhance the impulse from the SA node.

2. Delay the impulse from the SA node.

Which is a client with a heart rate of 170 bpm and a normal QRS duration most likely experiencing?
1. Tachydysrhythmia originating from the bundle branches.
2. Tachydysrhythmia originating from the atria.
3. Tachydysrhythmia originating from the ventricles.
4. Tachydysrhythmia originating from the Purkinje fibers.

2. Tachydysrhythmia originating from the atria.

Depolarization occurs when which two electrolytes rush into the cell?
1. Sodium and potassium
2. Calcium and magnesium
3. Calcium and sodium
4. Chloride and potassium

3. Calcium and sodium

Which adverse effect is shared among all antidysrhythmic drugs?
1. Edema
2. Impotence
3. Photosensitivity
4. Prodysrhythmic effects

4. Prodysrhythmic effects

Which classification of drug is used for the treatment of paroxysmal supraventricular tachycardia (PSVT)?
1. Sodium channel blocker
2. Beta-adrenergic antagonist
3. Potassium channel blocker
4. Calcium channel blocker

4. Calcium channel blocker

Which antidysrhythmic agent also dilates coronary arteries and is frequently used to treat angina?
1. Verapamil (Calan)
2. Amiodarone (Cordarone)
3. Procainamide (Pronestyl)
4. Lidocaine (Xylocaine)

1. Verapamil (Calan)

Which classification of drug is used to treat ventricular tachycardia?
1. Potassium channel blocker
2. Calcium channel blocker
3. Beta-adrenergic antagonist
4. Sodium channel blocker

1. Potassium channel blocker

Which information should the nurse include in the education for a client prescribed an antidysrhythmic?
1. "Elevate your extremities if you notice any swelling."
2. "Weigh yourself every other day."
3. "Take the first dose of your prescription before bed."
4. "Take your medication while you are lying down."

3. "Take the first dose of your prescription before bed."

Which assessment findings indicate a client receiving verapamil (Calan) is experiencing adverse effects?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. The client tells the nurse they have frequent headaches.
2. The client has 3+ edema in the ankles and feet.
3. The client states, "Everything I eat tastes like metal."
4. The client states, "I got so dizzy yesterday that I had to lie down for a while."
5. The client's face is flushed.

1. The client tells the nurse they have frequent headaches.
2. The client has 3+ edema in the ankles and feet.
4. The client states, "I got so dizzy yesterday that I had to lie down for a while."

Which information should the nurse include in the education for a client is prescribed an additional once-daily amiodarone to control persistent atrial fibrillation?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "I will avoid drinking grapefruit juice."
2. "I understand the effect of the prescription will last 4 to 8 weeks after I stop taking it."
3. "I will monitor my blood pressure and report any significant changes."
4. "I will avoid the use of St John's wort."
5. "I will follow a low sodium diet."

1. "I will avoid drinking grapefruit juice."
2. "I understand the effect of the prescription will last 4 to 8 weeks after I stop taking it."
3. "I will monitor my blood pressure and report any significant changes."
4. "I will avoid the use of St John's wort."

Which statement made by a client receiving amiodarone should the nurse be most concerned about?
1. "I have a cough that is getting worse."
2. "I often feel tired throughout the day."
3. "I have lost 5 pounds over the last 3 weeks."
4. "I have a rash on my skin that will not go away."

"I have a cough that is getting worse."

The nurse has provided education for a client who will self-administer a twice-daily antidysrhythmic prescription. Which statements made by the client indicate further teaching is needed?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "If I get the flu, I should stop taking the medication until my fever goes down."
2. "I should take my doses as close to 12 hours apart as I can."
3. "If I forget a dose of the prescription I should take two pills for the next dose."
4. "If I can't take the prescription for a couple of days because I am sick, I should call the clinic for advice."
5. "I should get my prescription refilled before I am completely out of medicine."

1. "If I get the flu, I should stop taking the medication until my fever goes down."
3. "If I forget a dose of the prescription I should take two pills for the next dose."

Which statements made by a client that has been receiving a prescription for an atrial dysrhythmia indicate the client requires further information?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "Since I can't drink coffee anymore, I have started drinking diet cola in the mornings."
2. "I have found that a glass of wine after work and one with dinner helps me to relax from my stressful job."
3. "We have celebrated several birthdays since I saw you last. I love chocolate birthday cake."
4. "I have really worked at stopping my smoking since I was last here."
5. "My friends and I have found several restaurants in our area that offer good, low-fat meals."

1. "Since I can't drink coffee anymore, I have started drinking diet cola in the mornings."
2. "I have found that a glass of wine after work and one with dinner helps me to relax from my stressful job."
3. "We have celebrated several birthdays since I saw you last. I love chocolate birthday cake."

Which occurs initially in the cardiac conduction pathway?
1. The action potential moves over the bundle branches.
2. The action potential moves through the AV node.
3. The SA node generates an action potential.
4. The action potential travels across the bundle of His.

3. The SA node generates an action potential.

The nurse is preparing to provide client education on degenerative diseases of the nervous system. Which information should the nurse include?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. Amyotrophic lateral sclerosis
2. Multiple sclerosis
3. Alzheimer's disease
4. Myasthenia Gravis
5. Parkinson's disease

1. Amyotrophic lateral sclerosis
2. Multiple sclerosis
3. Alzheimer's disease
5. Parkinson's disease

A client with Parkinson's disease asks the nurse how his or her prescriptions will help him or
her. Which response should the nurse provide?
1. "The prescriptions will help prevent muscle wasting."
2. "The prescriptions will increase your appetite and energy."
3. "The prescriptions will balance serotonin and acetylcholine in your brain."
4. "The prescriptions will help you to eat and walk."

4. "The prescriptions will help you to eat and walk."

The nurse is providing education for a client about the characteristics of Alzheimer's disease. Which information should the nurse include?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. More women than men have Alzheimer's disease.
2. The disease is characterized by the degeneration of the neurons.
3. Chronic inflammation of the brain may be a cause of the disease.
4. The disease mainly affects people over 50 years of age.

3. Chronic inflammation of the brain may be a cause of the disease.

Which should the nurse include in the plan of care for the patient with Parkinson's disease?
1. Monitor the client for the ability to chew and swallow.
2. Check peripheral circulation for thrombophlebitis.
3. Monitor the client for psychotic symptoms.
4. Limit exercise to decrease the possibility of fractures.

1. Monitor the client for the ability to chew and swallow.

The nurse is caring for an older adult prescribed benztropine (Cogentin). For which adverse effect should the nurse monitor the patient?


1. Confusion
2. Bradycardia
3. Diarrhea
4. Agitation

1. Confusion

Which assessment finding warrants the nurse to hold the dosage of benztropine (Cogentin) and notify the healthcare provider?
1. A respiratory rate of 14
2. A pulse of 112
3. Blood pressure of 142/80 mmHg
4. A temperature of 100.2°F

2. A pulse of 112

The nurse is reviewing the prescription history for a client receiving levodopa (Stalevo). Which routine prescription is most concerning?
1. Aspirin
2. Metformin
3. Calcium antacid
4. Synthroid

3. Calcium antacid

Which assessment finding in an older adult prescribed levodopa (Stalevo) should the nurse be most concerned with?
1. Hypertension
2. Diarrhea
3. Muscle twitching
4. Dark urine

3. Muscle twitching

The nurse is preparing to provide education for a client prescribed carbidopa (Sinemet). Which information should the nurse include?
1. Avoid drinking caffeinated beverages.
2. Take the medication with meals.
3. Take the medication on an empty stomach.
4. Take the medication with a protein food.

3. Take the medication on an empty stomach.

The nurse is providing education to the family member of a client with Alzheimer's disease. Which information should the nurse include in the discussion?
1. "The prescription may help with the symptoms for a little while."
2. "The prescription may have serious side effects if used for a long time."
3. "Symptoms will improve as long as the prescription is taken regularly."
4. "Symptoms should begin improving within a few days."

1. "The prescription may help with the symptoms for a little while."

The nurse is preparing to assess a client with multiple sclerosis. Which assessment finding should the nurse anticipate?
1. Skeletal muscle atrophy
2. Tremors
3. Visual disturbances
4. Muscle rigidity

3. Visual disturbances

The nurse has completed the education for a client prescribed levodopa (Stalevo). Which statement made by the client indicates an understanding of the information?
1. "I will increase the intake of vitamin B6 in my diet."
2. "I will weigh myself weekly."
3. "I will increase the protein in my diet."
4. "I will notify my healthcare provider if my urine darkens."

2. "I will weigh myself weekly."

A client is prescribed trihexyphenidyl (Artane). Which assessment finding should the nurse report to the healthcare provider?
1. Dry mouth
2. Anorexia
3. Hypertension
4. Urinary retention

4. Urinary retention

The nurse is caring for a client suspected of overdosing on donepezil (Aricept). Which prescription should the nurse prepare to administer?
1. Physostigmine
2. Epinephrine
3. Atropine
4. Gastric lavage with charcoal

3. Atropine

Which best describes the action of Glatiramer (Copaxone)?
1. Stimulates the production of neurons
2. Stimulates the growth of myelin
3. Inhibits the destruction of myelin
4. Reduces the creation of new brain lesions

4. Reduces the creation of new brain lesions

A client with multiple sclerosis asks the nurse how Dalfampridine (Ampyra) will help them. Which response should the nurse provide?
1. "Dalfampridine will lessen the cognitive deficits that occur with MS."
2. "Dalfampridine will decrease the number of mood alterations."
3. "The prescription will disrupt the visual disturbances that occur with MS."
4. "The prescription will improve your ability to walk."

4. "The prescription will improve your ability to walk."

Which should the nurse understand is the action of the pharmacotherapy used to treat Parkinson's disease?
1. Increase the amount of dopamine and reduce the amount of acetylcholine.
2. Increase the amount of dopamine and acetylcholine.
3. Reduce the amount of dopamine and increase the amount of acetylcholine.
4. Reduce the amount of dopamine and acetylcholine.

1. Increase the amount of dopamine and reduce the amount of acetylcholine.

Which should the nurse recognize is the benefit of a prescription for levodopa for a client with Parkinson's disease?
1. Crosses the blood-brain barrier
2. Has fewer adverse effects
3. Less risk for addiction
4. Can be administered intravenously

1. Crosses the blood-brain barrier

Which statement best describes the contributing factor to the structural change that occurs in the brain of a patient with Alzheimer's disease?
1. Increased acetylcholine levels
2. Increases in blood pressure and cholesterol levels
3. Chronic inflammation and oxidative cellular damage
4. Cerebral bleeding and associated hypoxia

3. Chronic inflammation and oxidative cellular damage

Which prescription should the nurse anticipate will most likely be prescribed for a client with Alzheimer's disease?
1. Levodopa (Larodopa)
2. Haloperidol (Haldol)
3. Benztropine mesylate (Cogentin)
4. Donepezil hydrochloride (Aricept)

4. Donepezil hydrochloride (Aricept)

Which statement describes the purpose for the use of acetylcholinesterase inhibitors prescribed to treat Alzheimer's disease?
1. Reverse the structural damage within the brain
2. Increase synthesis of acetylcholine
3. Increase enzymatic breakdown leading to increased neuronal production
4. Intensify the effect of acetylcholine at the receptor

4. Intensify the effect of acetylcholine at the receptor

The nurse is preparing education for a caregiver of a patient with Alzheimer's disease. Which information should the nurse include in the teaching?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Glutamergic inhibitors are the most common class of drugs for treating Alzheimer's
disease.
2. Depression and aggressive behavior are common with the disease.
3. Memory difficulties are an early symptom of the disease.
4. Chronic inflammation of the brain can be a causative actor in the condition.
5. Pharmacologic therapies are given to help improve memory in Alzheimer's disease.

2. Depression and aggressive behavior are common with the disease.
3. Memory difficulties are an early symptom of the disease.
4. Chronic inflammation of the brain can be a causative actor in the condition.
5. Pharmacologic therapies are given to help improve memory in Alzheimer's disease.

The nurse is preparing to assess a client with amyotrophic lateral sclerosis (Lou Gehrig's disease). Which assessment findings should the nurse anticipate?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. Muscle weakness
2. Muscle atrophy
3. Mood alterations
4. Slow shuffling gait
5. Abnormal posture

1. Muscle weakness
2. Muscle atrophy

The nurse is preparing to assess a client with Parkinson's disease. Which finding should the nurse recognize interferes with the client's ability to control their hand movements?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. Pill rolling
2. Tremor
3. Stooped posture
4. Lack of arm swing
5. Difficulty bending the arms

1. Pill rolling
2. Tremor

A client with Parkinson's disease is experiencing an increase in bradykinesia. Which assessment findings should the nurse anticipate?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. Slow speech
2. Difficulty chewing
3. Shuffling the feet when walking
4. Stooped posture
5. Lack of facial expression

1. Slow speech
2. Difficulty chewing
3. Shuffling the feet when walking

The nurse is preparing the education for a client with progressive multiple sclerosis prescribed alemtuzumab (Lemtrada). Which information should the nurse plan to include in
the education?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. Monitoring for hypertension
2. Evaluation of a complete blood count (CBC)
3. Requirement of two doses of treatment 12 months apart
4. Dietary decrease of protein and vitamin B6
5. Intravenous administration of prescription

2. Evaluation of a complete blood count (CBC)
3. Requirement of two doses of treatment 12 months apart
5. Intravenous administration of prescription

Which should the nurse understand are the primary goals for the pharmacological treatment of multiple sclerosis?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. Modifying the progression of the disease
2. Treating acute exacerbations
3. Managing symptoms
4. Curing the disease
5. Remyelinating nerve fibers

1. Modifying the progression of the disease
2. Treating acute exacerbations
3. Managing symptoms

A client receiving pharmacotherapy for the treatment of Parkinson's disease has experienced increased eye twitching tremors. Which treatment interventions should the nurse anticipate?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. Increase in the dosage of the prescription
2. Changing the interval between the doses of prescriptions
3. Changing the route of administration of the prescription
4. A scheduled drug holiday
5. Implementing an adjunctive prescription

1. Increase in the dosage of the prescription
2. Changing the interval between the doses of prescriptions
5. Implementing an adjunctive prescription

The nurse has provided education for a client who received a new prescription for the treatment of Parkinson's disease. Which statements made by the client indicate an understanding of the information?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. "I guess I will have to give up eating my wife's banana pudding."
2. "I should add some wheat germ to my breakfast cereal."
3. "I should add olive oil to the salads I eat at noon each day."
4. "I will most likely have to become a vegetarian."
5. "I will take my medication on an empty stomach."

1. "I guess I will have to give up eating my wife's banana pudding."
5. "I will take my medication on an empty stomach."

A client who takes benztropine (Cogentin) has developed constipation. Which interventions should the nurse implement?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. Instruct the client to administer an enema.
2. Encourage the client to take docusate (Colace) daily.
3. Instruct the client to increase their fluid intake.
4. Encourage the client to walk daily
5. Instruct the client to discontinue their prescription until their bowel function returns to
normal.

3. Instruct the client to increase their fluid intake.
4. Encourage the client to walk daily

1) A client asks the nurse how hypertension can lead to heart failure. Which response should the nurse provide the client?
1. "Hypertension increases the resistance in the blood vessels causing the heart to work harder to pump the blood out against the resistance of the arteries."
2. "Hypertension limits the ability of the heart to stretch before emptying resulting in the heart working harder to pump the blood out into the arterial system."
3. "Hypertension causes resistance in the venous system requiring the heart to work harder to pump the blood forward."
4. "Hypertension limits the amount of blood entering the left ventricle increasing the workload of the heart to pump an adequate amount of blood into the circulatory system."

1. "Hypertension increases the resistance in the blood vessels causing the heart to work harder to pump the blood out against the resistance of the arteries."
Pg 373

1) A client in heart failure asks the nurse how difficulty breathing is related to a heart problem. Which information should the nurse provide the client?
Select all that apply.
1. "The right side of your heart has weakened and blood has entered your lungs."
2. "The right side of your heart has enlarged and cannot effectively pump blood."
3. "What you have is called congestive heart failure."
4. "The left side of your heart is weak and pumps blood too quickly."
5. "The left side of your heart has weakened and blood has entered your lungs."

3. "What you have is called congestive heart failure."
4. "The left side of your heart has weakened and blood has entered your lungs."

1. Which statements made by a client indicates an understanding of the education provided by the nurse
Select all that apply.


1. "I should limit my fluids while taking this medication."
2. "It is okay to keep taking my ginseng."
3. "If I have nausea, it means I must stop the medication."
4. "I can drink orange juice every morning."
5. "I must check my pulse and not take the medication if it is less than 60."

4. "I can drink orange juice every morning."
5. "I must check my pulse and not take the medication if it is less than 60."

1) The nurse has provided education for a client prescribed lisinopril (Prinivil). Which statement made by the client indicates further teaching is required?
1. "I will monitor my blood pressure until my next appointment."
2. "I will avoid using salt substitutes for seasoning."
3. "It takes a while for this medication to take effect."
4. "I will not need to worry about having additional blood tests done."

4. "I will not need to worry about having additional blood tests done."

1) A client is prescribed an intravenous infusion of milrinone (Primacor) for acute heart failure. Which is a priority nursing assessment during the infusion?
1. Monitor for symptoms of atrial fibrillation
2. Continuous ECG monitoring
3. Vital signs every 15 minutes
4. Monitor for hypertension

2. Continuous ECG monitoring

1) Which client prescribed metoprolol (Toprol-XL) is most at risk for adverse effects?
1. The client with an apical pulse rate of 100
2. The client with compensated heart failure
3. The client with chronic bronchitis
4. The client with a history of migraines

3. The client with chronic bronchitis

1) Which should the nurse recognize are adverse effects associated with digoxin (Lanoxin)?
1. Tachycardia and hypotension
2. Blurred vision and tachycardia
3. Anorexia and nausea
4. Anorexia and constipation

3. Anorexia and nausea

1) Which client is at greatest risk for developing heart failure?
1. A 50-year-old African American female who smokes
2. A 75-year-old Caucasian male who is overweight
3. A 69-year-old African American male with hypertension
4. A 52-year-old Caucasian female with asthma

3. A 69-year-old African American male with hypertension

1) A client prescribed furosemide (Lasix) and digoxin (Lanoxin) reports using an over-the-counter antacid for recurrent heartburn. Based on this information, which effect should the nurse be concerned about?
1. Hyponatremia
2. Hypermagnesemia
3. Increased effectiveness of furosemide (Lanoxin)
4. Decreased effectiveness of digoxin (Lanoxin)

4. Decreased effectiveness of digoxin (Lanoxin)

1) Which adverse effect of lisinopril (Prinivil) should be reported to the healthcare provider?
1. Cough
2. Fever
3. Increased urine output
4. Facial flushing

1. Cough