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The most common reason for discontinuing ACE inhibitors is:
A. hypokalemia. B. first-dose hypertension. C. excessive diuresis. D. a cough.
D. a cough.
What drug/food interactions should the nurse teach the client about calcium channel blockers? Select all that apply.
A. beta blockers B. insulin C. digoxin D. smoked fish
A. beta blockers C. digoxin
Beta blockers produce most of their beneficial effects by blocking which receptors in the heart?
A. Beta 1 receptors B. Beta 2 receptors C. Alpha 1 receptors D. Alpha 2 receptors
A. Beta 1 receptors
Epinephrine is used to treat which of the following? Select all that apply.
A. Control of superficial bleeding B. Management of hypertension. C. Delay of local anesthetic absorption D. Treatment of anaphylaxis.
A. Control of superficial bleeding C. Delay of local anesthetic absorption D. Treatment of anaphylaxis.
An abnormality in the rhythm of the heartbeat is called a __________________.
A. Cardiac cycle. B. Baroreceptor reflex. C. Bruit. D. Dysrhythmia.
D. Dysrhythmia.
What baseline data should be collected before giving an alpha1-adrenergic antagonist?
A. Liver function studies B. Fasting lipid panel C. Blood pressure and heart rate D. Kidney function studies
C. Blood pressure and heart rate
The balance between the pulmonary and systemic circulations in a healthy heart is maintained in accordance with.....
A. the amount of peripheral resistance present. B. the venous pump. C. Starling's Law of the Heart. D. the baroreceptor reflex.
C. Starling's Law of the Heart.
In evaluating a patient's response to calcium channel blockers, the nurse recognizes that these drugs do not have a significant effect on ____________________.
A. Peripheral veins B. Peripheral arterioles C. Cardiac contractility D. Cardiac arteries
A. Peripheral veins
Cardiac afterload is primarily determined by....
A. systemic filling pressure. B. myocardial contractility. C. peripheral resistance. D. stroke volume.
C. peripheral resistance.
Drugs that dilate capacitance vessels (veins):
A. Decrease cardiac preload. B. Decrease cardiac afterload. C. Increase cardiac preload. D. Increase cardiac afterload.
A. Decrease cardiac preload.
The kidneys provide long-term control of arterial pressure by regulating...
A. potassium. B. contractility. C. water. D. peripheral resistance.
C. water.
Postural (orthostatic) hypotension is caused by
A. Water retention. B. Increased cardiac output. C. Decreased venous return. D. Vasoconstriction.
C. Decreased venous return.
Drugs that dilate resistance vessels (arterioles):
A. Decrease cardiac afterload. B. Increase cardiac preload. C. Increase cardiac afterload. D. Decrease cardiac preload.
A. Decrease cardiac afterload.
__________________ is a common adverse effect of the calcium channel blocker verapamil.
A. weight loss B. constipation C. butterfly rash D. diarrhea
B. constipation
When caring for a patient who is prescribed a vasodilator, it is important to monitor for which adverse effects associated with vasodilation? Select all that apply.
A. Postural Hypotension B. Bradycardia C. Reflex tachycardia D. Lowering of blood pressure to target levels E. Expansion of blood volume.
A. Postural Hypotension C. Reflex tachycardia E. Expansion of blood volume.
Your patient is prescribed the calcium channel blocker diltiazem. As the nurse you know that this medication works to block calcium channels in what areas of the body? Select all that apply:
A. Peripheral nervous cells B. Myocardium C. SA and AV nodal tissue D. Vascular smooth muscle E. Vagal nerve cells
B. Myocardium C. SA and AV nodal tissue D. Vascular smooth muscle
Calcium channel blockers such as verapamil and diltiazem are useful in treating hypertension and angina pectoris because they:
A. cause vasoconstriction to improve circulation. B. promote vasodilation and decrease heart rate. C. promote excretion of sodium. D. increase myocardial contractility.
B. promote vasodilation and decrease heart rate.
Your type 1 diabetic patient is on a beta blocker. Which is the best way to determine if your patient is hypoglycemic?
A. Don't worry because a diabetic patient on a beta blocker will not become hypoglycemia B. Monitor capillary blood glucose C. Check the blood glucose once a week D. Watch for symptoms of hypoglycemia
B. Monitor capillary blood glucose
A potentially life-threatening reaction to ACE inhibitors is:
A. Dyspepsia B. Angioedema C. Cough D. Hyperglycemia
B. Angioedema
In a healthy heart, what is the pacemaker?
A. AV Node B. Bundle of His C. SA Node D. Ventricle
C. SA Node
The nurse sees that a patient's potassium level has increased from 4.8 to 5.3 mEq/L. The patient has been receiving diuretic drugs to treat hypertension. Which of the following diuretics likely caused the change in the potassium level?
A. Furosemide B. Triamterene C. Hydrochlorothiazide D. Mannitol
B. Triamterene
Which drug classification is the first-line drug treatment for primary hypertension?
A. Loop diuretics B. Beta blockers C. Thiazide diuretics D. Aldosterone antagonists
C. Thiazide diuretics
The most common types of dysrhythmias are:
A. Tachydysrhythmias. B. Bradysdysrhythmias. C. Sinus dysrhythmias. D. Sinus arrhythmia.
A. Tachydysrhythmias.
Untreated hypertension can lead to: Select all that apply.
A. Heart disease. B. Type 1 diabetes mellitus. C. Kidney disease. D. Stroke.
A. Heart disease. C. Kidney disease. D. Stroke.
Digoxin and other positive inotropic agents:
A. increase heart rate B. decrease cardiac output C. decrease urine production D. increase the force of myocardial contraction
D. increase the force of myocardial contraction
Your patient with peripheral edema, weight gain, shortness of breath, and crackles in their bilateral lung bases is given an IV dose of a loop diuretic. What would you observe that indicated the medication was effective?
A. The patient's weight would increase. B. The patient's lung fields would clear. C. The patient would complain of chest pain. D. The patient would become more short of breath.
B. The patient's lung fields would clear.
Furosemide can cause:
A. hypertension B. hyperkalemia C. edema D. hearing loss
D. hearing loss
A client with heart failure has been admitted to the medical-surgical unit. Which of the following medications might the provider include to treat this patient? Select all that apply.
A. digoxin B. spironolactone C. metoprolol D. captopril E. furosemide
A. digoxin B. spironolactone C. metoprolol D. captopril E. furosemide
All antidysrhythmic drugs:
A. Cause diarrhea. B. Are prodysrhythmic. C. Are given by mouth. D. Given parentally.
B. Are prodysrhythmic.
Which drug might be prescribed to counteract reflex tachycardia associated with vasodilation and lowered blood pressure?
A. Digoxin B. Metoprolol C. Furosemide D. Enalapril
B. Metoprolol
Your heart failure patient has been started on digoxin. What is the most important patient teaching consideration regarding this medication?
A. Teach the patient to take their blood pressure before each dose B. Teach the patient the signs and symptoms of digoxin toxicity C. Teach the patient to keep their scheduled appointments with their health care provider D. Teach the patient to take the medication at the same time every day
B. Teach the patient the signs and symptoms of digoxin toxicity
A client with hypertension is prescribed valsartan and hydrochlorothiazide. The client asks "Why am I on 2 medications for my blood pressure?" The nurse best response is
A. Higher dosages of the drugs can be used when more than one is prescribed. B. Using two drugs from the same class will improve blood pressure control while decreasing adverse effects. C. Using more than one drug eliminates adverse effects. D. Using a variety of medications with different mechanisms of action to control blood pressure is more effective.
D. Using a variety of medications with different mechanisms of action to control blood pressure is more effective.
Vasodilators lower arterial pressure, triggering the baroreceptors, which causes which adverse effect?
A. Postural hypotension. B. Reflex tachycardia. C. Thiocyanate toxicity. D. SLE-like syndrome.
B. Reflex tachycardia.
It is important for the nurse to discuss adverse effects of the antihypertensive drugs that are prescribed because the nurse knows that the drugs' adverse effects:
A. affect adherence. B. are necessary if the antihypertensive is at an effective dose. C. reflect the cause of hypertension. D. are important to successful drug therapy.
A. affect adherence.
Which assessment indicates a therapeutic effect of Mannitol?
A. Decreased intracranial pressure B. Increased ocular pressure C. Increased urine output D. Decreased potassium level
A. Decreased intracranial pressure
The prescriber has ordered digoxin 4 mcg/kg/day for your heart failure patient. The patient weighs 132 pounds. What is the dose of digoxin the patient will be prescribed?
A. 528 mcg B. 504 mcg C. 290 mcg D. 240 mcg
D. 240 mcg
A patient recently began taking a loop diuretic for hypertension related to heart failure. He is complaining about dizziness and lightheadedness when standing. What advice can the nurse give him to keep him safe?
A. Take the medication earlier in the day B. Reduce the dosage of the medication C. Take the medication before going to bed D. Change positions slowly
D. Change positions slowly
Which lifestyle modifications are strongly encouraged in patients with primary hypertension? Select all that apply.
A. Aerobic exercise B. Weight loss C. Smoking cessation D. Alcohol intake restriction E. Sodium restriction/ DASH eating plan
A. Aerobic exercise B. Weight loss C. Smoking cessation D. Alcohol intake restriction E. Sodium restriction/ DASH eating plan
A patient is admitted with hypertensive emergency. The nurse will anticipate administering ____________.
A. Captopril PO B. Sodium nitroprusside IV C. Minoxidil 20 mg IV D. Epinephrine IV
B. Sodium nitroprusside IV
Adrenergic Agonists:
A. prevent norepinephrine from activating receptors. B. activate adrenergic receptors, mimicking the endogenous compound norepinephrine. C. Substitute for norepinephrine to prevent receptor activation. D. Eliminate the need for the endogenous compounds such as norepinephrine.
B. activate adrenergic receptors, mimicking the endogenous compound norepinephrine.
Adrenergic Antagonists:
A. prevent endogenous transmitter from activating receptors. B. activate adrenergic receptors, mimicking the endogenous compound norepinephrine. C. Substitute for norepinephrine to promote receptor activation. D. Eliminate the need for the endogenous compounds such as norepinephrine.
A. prevent endogenous transmitter from activating receptors.
After an intramuscular injection of penicillin, the patient develops severe difficulty breathing and a swollen tongue.Which medication should the nurse prepare to administer? A. Dopamine B. Epinephrine C. Norepinephrine D. Pseudoephedrine
B. Epinephrine
A patient is receiving dopamine for treatment of shock.What would indicate to the nurse that the medication is effective?
A. Decreased mean arterial pressure B. Gain of 2 kg in 24 hours C. Increased heart rate D. Increased urine output
D. Increased urine output
A patient with diabetes requires a beta blocker. Which of the following drugs would be appropriate for this patient?
A. Propranolol B. Metoprolol C. Carvedilol D. Terazosin
B. Metoprolol
A patient with asthma requires a beta blocker.Which of the following drugs would be appropriate for this patient?
A. Propranolol B. Metoprolol C. Carvedilol D. Terazosin
B. Metoprolol
The nurse prepares to administer metoprolol to a patient with chronic stable angina. What is a priority assessment to make before the administration of this medication?
A. Temperature B. Urinary function C. Respiratory rate D. Heart rate
D. Heart rate
A patient with type 2 diabetes mellitus is diagnosed with stable angina. Which beta blocker, if prescribed by the physician, would the nurse question?
A. Metoprolol B. Propranolol C. Bisoprolol D. Atenolol
B. Propranolol
The nurse teaches a patient about captopril. Which statement by the patient requires an intervention by the nurse?
A. "I use NoSalt for seasoning foods instead of salt." B. "I eat sweet potatoes once or twice a week." C. "I drink 4 ounces of prune juice each morning." D. "I like asparagus because it is high in vitamin K."
A. "I use NoSalt for seasoning foods instead of salt."
A patient is to receive a scheduled dose of diltiazem. The nurse should hold the medication and contact the prescriber if what occurs?
A. The patient's blood pressure is 112/64 mm Hg. B. The patient's cardiac rhythm is atrial fibrillation. C. The patient is complaining of chest pain. D. The patient is in second-degree heart block.
D. The patient is in second-degree heart block.
The nurse instructs a patient about taking nifedipine XR. Which statement made by the patient indicates an understanding of medication teaching?
A. "I will stop taking my beta blocker." B. "The pill should be swallowed whole." C. "The drug will cause constipation." D. "This drug treats heart rhythm problems."
B. "The pill should be swallowed whole."
A patient is prescribed verapamil. The nurse should assess the patient for which common adverse effects?
A. Atrial fibrillation, photosensitivity, and blurred vision B. Tachycardia, stomatitis, and inflammation of the joints C. Constipation, headache, and edema of the ankles and feet D. Dry mouth, lymphadenopathy, and decreased appetite
C. Constipation, headache, and edema of the ankles and feet
A patient is prescribed hydralazine. What concern is most important for the nurse to address?
A. Precautions for postural hypotension B. Prevention of reflex tachycardia C. High initial dose for slow acetylators D. Recognition of hypertrichosis
B. Prevention of reflex tachycardia
Which patient would most likely be prescribed sodium nitroprusside?
A. A patient with a recent diagnosis of essential hypertension B. A patient with heart failure who receives weekly home visits C. A patient who is hypotensive after a myocardial infarction D. A patient with a hypertensive crisis in the intensive care unit
D. A patient with a hypertensive crisis in the intensive care unit
A patient who is receiving intravenous nitroprusside is disoriented and unable to recognize family members. The nurse should take which action first?
A. Perform a complete neurologic examination. B. Provide reality orientation as needed. C. Stop the intravenous nitroprusside. D. Review the patient's liver function tests.
C. Stop the intravenous nitroprusside.
When providing discharge teaching for a patient who has been prescribed furosemide, it is most important for the nurse to include which dietary items to prevent adverse effects of furosemide therapy?
A. Oranges, spinach, and potatoes B. Baked fish, chicken, and cauliflower C. Tomato juice, skim milk, and cottage cheese D. Oatmeal, cabbage, and bran flakes
A. Oranges, spinach, and potatoes
A patient is prescribed spironolactone for treatment of hypertension.Which foods should the nurse teach the patient to avoid?
A. Baked fish B. Low-fat milk C. Salt substitutes D. Green beans
C. Salt substitutes
Triamterene is an example of what type of diuretics?
A. Loop B. Thiazides C. Potassium sparing diuretic (Aldosterone antagonist) D. Potassium sparing diuretic (Non-aldosterone antagonist)
D. Potassium sparing diuretic (Non-aldosterone antagonist)
What drug class would be the primary treatment for hypertension?
A. Loop diuretics B. Thiazide diuretics C. Osmotic diuretics D. Potassium sparing diuretics
B. Thiazide diuretics
Which is not an endocrine effect related to spironolactone use?
A. Deeper voice B. Hirsutism C. Gynecomastia D. Menstrual regulation
D. Menstrual regulation
Which disease process might you expect to administer mannitol for?
A. Hypertension B. Traumatic brain injury C. Congestive heart failure D. Edema
B. Traumatic brain injury
The nurse would expect an order for furosemide (a loop diuretic) for treatment of what condition?
A. Hypertension B. Septic shock C. Pulmonary edema D. Fluid retention during pregnancy
C. Pulmonary edema
Which symptom should a nurse instruct a patient receiving furosemide(a loop diuretic) to report?
A. Yellow vision B. Weight loss of 1 pound per day C. Muscle cramping D. Increased urination
C. Muscle cramping
When providing education to a patient who was prescribed spironolactone and furosemide, what information does the nurse tell the patient?
A. This combination of drugs will improve the glomerular filtration rate B. This combination of drugs will promote diuresis while decreasing the risk of hypokalemia C. It is always necessary to administer two diuretics together D. This combination of drugs will prevent dehydration from occurring
B. This combination of drugs will promote diuresis while decreasing the risk of hypokalemia
A patient inquires whether they will need potassium supplements while taking spironolactone. What is the nurse's best response?
A. I will call your physician and discuss your concern B. I would recommend you take 2 multivitamins per day C. This diuretic is potassium sparing so you will not need extra potassium D. You will need to take potassium supplements to prevent low potassium levels
C. This diuretic is potassium sparing so you will not need extra potassium
A patient is being treated with hydrochlorothiazide for hypertension.Which complaint from your patient is of concern?
A. Thrombophlebitis B. Hyperactive reflexes C. Hypoglycemia D. Muscle weakness
D. Muscle weakness
The nurse is providing education to a patient on spironolactone. Which state indicates the patient understands the teaching?
A. I will increase my intake of potatoes and bananas B. I will use salt substitutes on my food C. I will watch for increased breast tissue growth D. I will drink as much water as I can
C. I will watch for increased breast tissue growth
A nurse is educating a patient who has been prescribed digoxin and furosemide to treat heart failure. Which statement indicates understanding of the teaching?
A. Blurred vision is common when taking digoxin B. I will measure my urine output daily and record it C. I will increase my intake of fruits and vegetables that have high potassium content D. I will hold my digoxin for a heart rate less than 74
C. I will increase my intake of fruits and vegetables that have high potassium content
Which adverse effect should the nurse monitor for in a patient receiving IV mannitol?
A. Weight loss B. Increased intraocular pressure C. Hallucinations D. Crackles in the lungs
D. Crackles in the lungs
{The next few questions are pulled from a case study}
Flip to see the Case
A 74-year-old man with a history of stable angina, asthma and hypertension is admitted to the hospital with substernal chest pain that was not relieved by three sublingual nitroglycerin tablets. In the emergency department, the patient is prescribed diltiazem and an IV nitroglycerin drip
What actions must the nurse take when administering IV nitroglycerin?
The nurse should continuously monitor the patient's blood pressure and pulse.
What teaching should the nurse provide about administration of the nitroglycerin patch?
The nurse should instruct the patient to apply the nitroglycerin patch to hairless areas of skin and to rotate sites; normally patches are removed overnight to prevent tolerance.
Based on knowledge of nitroglycerin sublingual tablets, what factors may have contributed to why the nitroglycerin tablets did not relieve angina pain for a patient?
The nitroglycerin tablets may have been outdated or exposed to light, causing them to lose potency.
The nurse asks the patient's spouse to bring the patient's supply of sublingual nitroglycerin tablets in to the hospital. The patient's spouse shows the nurse a small plastic pill container. "Heart pills" is handwritten on a masking-tape label.
What teaching does the nurse need to provide?
The nurse must stress the importance of keeping nitroglycerin in its original brown glass bottle to protect it from air and light.
The patient states that he guesses he will not need to get any more nitroglycerin sublingual tablets now that he is using the nitroglycerin patches.
How should the nurse respond?
The nurse should instruct the patient to discuss the use of nitroglycerin tablets with his prescriber.
The nurse is reconciling medications during discharge instructions. The patient admits to adherence issues with taking his antihypertensive drug therapy because of experiencing erectile dysfunction. He asks what the nurse thinks about sildenafil (Viagra).
What information should the nurse provide?
The patient should discuss erectile dysfunction with his physician. Viagra is contraindicated if a patient is taking nitroglycerin because it can cause a severe, potentially fatal, drop in blood pressure.
{End of Case Study 1 Questions}
{Start of Case Study 2 Questions}
Flip to see the Case
A farmer who lives in a remote area was admitted with chest pain. He has been diagnosed with angina and is being discharged with a prescription for sublingual nitroglycerin tablets.
What teaching should the nurse provide about administration and storage of this drug (nitroglycerin)?
The nurse should instruct the patient to keep the nitroglycerin in its original dark container and to discard it 24 months after opening the container. The patient should write the "date to discard" on the label when opening the bottle and store the nitroglycerin in a cool and dry place (not in the bathroom).
Should nitroglycerin be stored in the bathroom?
No, it needs to be in a cool dry place and bathrooms can become humid and wet due to showers
The prescriber has written instructions that this patient should take the nitroglycerin before participating in stressful activity. What teaching should the nurse provide, considering that farm work includes operation of potentially dangerous equipment?
The patient should be informed that the drug can cause orthostatic hypotension and that he should therefore change positions slowly. He also should maintain a way to call for help when out working in the fields and use caution when operating machinery.
The patient has been instructed to take one baby aspirin tablet per day. The patient verbalizes that this seems silly because one baby aspirin tablet will not do much to relieve his chest pain. How should the nurse respond?
Aspirin thins the blood, which improves the ability of the blood to carry oxygen to heart cells. Low doses of aspirin are the most effective for inhibiting platelet aggregation.
{End fo Case Study 2 Questions}
A patient in the emergency department is diagnosed with ST-elevation myocardial infarction (STEMI). The patient has been prescribed 325 mg of aspirin. Which action by the nurse is appropriate?
A.Administer the medication to the patient if a headache develops. B.Administer the medication with a full glass of water. C.Instruct the patient to let the tablet dissolve under the tongue. D.Tell the patient to chew the tablet thoroughly.
D.Tell the patient to chew the tablet thoroughly.
A patient with angina pectoris is prescribed sublingual nitroglycerin. Which statement made by the patient indicates understanding of the medication teaching?
A."I may experience a headache as a side effect." B."The chest pain should be relieved within 20 minutes." C."I should swallow the tablet and drink a glass of water." D."I should take this medication in the morning before breakfast."
A."I may experience a headache as a side effect."
A patient is prescribed a nitroglycerin transdermal patch. The nurse should include which statement when teaching the patient how to use this medication?
A."Apply the patch to the chest over the heart." B."Change the patch each week." C."Remove the patch at bedtime." D."Put on the patch before exercising."
C."Remove the patch at bedtime."
A patient is prescribed sustained-release oral nitroglycerin capsules for chronic stable angina. The nurse should include which instruction?
A."Avoid exercising to help prevent chest pain." B."Place the capsule under the tongue if chest pain occurs." C."Take the capsule as needed before exercise or exertion." D."Sit or lie down if dizziness or lightheadedness occurs."
D."Sit or lie down if dizziness or lightheadedness occurs."
The nurse teaches a patient diagnosed with chronic stable angina about the mechanism of action of nitroglycerin. The nurse should include which instruction?
A."Nitroglycerin reduces vasospasms of the heart's arteries, which improves blood supply." B."Nitroglycerin opens the arteries to allow more oxygen to be delivered to the heart muscle." C."Nitroglycerin dilates veins, which decreases the amount of oxygen needed by the heart." D."Nitroglycerin improves blood flow to the heart muscle by increasing blood pressure."
C."Nitroglycerin dilates veins, which decreases the amount of oxygen needed by the heart."
A patient has been diagnosed with a STEMI. Which medications does the nurse expect to be prescribed for this patient?
A.Beta blocker, angiotensin II receptor blocker, and oxygen B.Aspirin, angiotensin-converting enzyme inhibitor, and diuretics C.Aspirin, beta blocker, oxygen, morphine, and nitroglycerin D.Heparin, nitroprusside, morphine, and calcium channel blocker
C.Aspirin, beta blocker, oxygen, morphine, and nitroglycerin
A female patient who has diabetes sustained an ST-elevation myocardial infarction (STEMI). The nurse provides discharge teaching. Which statement, made by the patient, indicates that further teaching is required?
A."Medications are needed to prevent heart failure." B."I will take aspirin, atenolol, and captopril indefinitely." C."My blood pressure should be less than 130/80 mm Hg." D."Daily estrogen will prevent another heart attack."
D."Daily estrogen will prevent another heart attack."
A patient has hypertension, type 2 diabetes, and chronic kidney disease. Which medication would the nurse anticipate will be ordered to manage this patient's hypertension?
A.Captopril B.Furosemide C.Digoxin D.Propranolol
A.Captopril
A patient is receiving an intravenous infusion of heparin to treat a pulmonary embolism. What laboratory value will the nurse monitor to evaluate treatment with this medication?
A.Activated partial thromboplastin time (aPTT) B.Prothrombin time (PT) C.Platelet count D.Hemoglobin and hematocrit
A.Activated partial thromboplastin time (aPTT)
What is the antidote for heparin?
A.Ferrous sulfate B.Atropine sulfate C.Protamine sulfate D.Magnesium sulfate
C.Protamine sulfate
What is an antiplatelet drug?
Aspirin
What drug is an adrenergic agonists?
Epinephrine
What drug is a HMG Co-A reductase inhibitor?
Atorvastatin
What drugs is an Adrenergic antagonists (beta)?
Propranolol and metoprolol
What drugs is a Renin-angiotensin-aldosterone system drugs?
Captopril, valsartan, spironolactone
What drug is a calcium channel blocker?
Diltiazem
What drug is a vasodilator?
Hydralazine, nitroglycerin
What drug is a cardiac glycosides?
Digoxin
Note
Flashcard