Cardiology HW Qs

Question 1

Which nursing intervention is important when caring for clients receiving intravenous (IV) digoxin? Select all that apply. One, some, or all responses may be correct.
A. Monitor the heart rate closely.
B. Check the blood levels of digoxin.
C. Administer the dose over 1 minute.
D. Monitor the serum potassium level.
E. Give the medication with other infusing medications.

Answer 1

A. Monitor the heart rate closely.
B. Check the blood levels of digoxin.
D. Monitor the serum potassium level.

Question 2

An infant with congenital heart disease is prescribed digoxin and furosemide upon discharge. Which sign would the nurse instruct the parents to be alert for?
A. Difficulty feeding with vomiting
B. Cyanosis during periods of crying
C. Daily naps lasting more than 3 hours
D. A pulse rate faster than 100 beats/min

Answer 2

A. Difficulty feeding with vomiting

Question 3

According to developmental norms for a 5-year-old child, the nurse would hold digoxin if an apical heart rate falls below which number?
A. 70 beats/min
B. 80 beats/min
C. 90 beats/min
D. 100 beats/min

Answer 3

A. 70 beats/min

Question 4

The clinic nurse receives a call from the mother of an infant prescribed digoxin. The mother reports she forgot whether she gave the morning dose of digoxin. Which response by the nurse is most appropriate?
A. ‘Give the next dose immediately.’
B. ‘Wait 2 hours before giving the medication.’
C. ‘Skip this dose and give it at the next prescribed time.’
D. ‘Take the baby’s pulse and give the medication if it’s more than 90 beats/min.’

Answer 4

C. ‘Skip this dose and give it at the next prescribed time.’

Question 5

The nurse is monitoring a 6-year-old child for toxicity precipitated by digoxin. Which sign of digoxin toxicity would the nurse monitor for?
A. Oliguria
B. Vomiting
C. Tachypnea
D. Splenomegaly

Answer 5

B. Vomiting

Question 6

Which lifestyle advice does the nurse give to a client when oral digoxin therapy is initiated? Select all that apply. One, some, or all responses may be correct.
A. Bran can decrease digoxin absorption.
B. Digoxin should not be taken with hawthorn supplements.
C. Ginseng may cause a dangerous increase in digoxin levels in the blood.
D. St. John’s Wort can increase digoxin levels in the blood.
E. Medications that lower serum potassium or magnesium can cause digoxin toxicity.

Answer 6

A. Bran can decrease digoxin absorption.
B. Digoxin should not be taken with hawthorn supplements.
C. Ginseng may cause a dangerous increase in digoxin levels in the blood.
E. Medications that lower serum potassium or magnesium can cause digoxin toxicity.

Question 7

The client with hypokalemia reports nausea, vomiting, and seeing a yellow light around objects. Which of the client’s medications is the likely cause of the client’s symptoms?
A. Digoxin
B. Furosemide
C. Propranolol
D. Spironolactone

Answer 7

A. Digoxin

Question 8

When teaching a client about digoxin, which symptom will the nurse include as a reason to withhold the digoxin?
A. Fatigue
B. Yellow vision
C. Persistent hiccups
D. Increased urinary output

Answer 8

B. Yellow vision

Question 9

Which clinical finding indicates that a client taking digoxin may have developed digoxin toxicity?
A. Constipation
B. Decreased urination
C. Cardiac dysrhythmias
D. Metallic taste in the mouth

Answer 9

C. Cardiac dysrhythmias

Question 10

A client who takes multiple medications complains of severe nausea, and the client’s heartbeat is irregular and slow. The nurse determines that these signs and symptoms are toxic effects of which medication?
A. Digoxin
B. Captopril
C. Furosemide
D. Morphine sulfate

Answer 10

A. Digoxin

Question 11

A health care provider prescribes digoxin for a client. The nurse teaches the client to be alert for which common early indication of acute digoxin toxicity?
A. Vomiting
B. Urticaria
C. Photophobia
D. Respiratory distress

Answer 11

A. Vomiting

Question 12

One week after being hospitalized for an acute myocardial infarction, a client reports nausea and loss of appetite. Which of the client’s prescribed medications would be withheld and the health care provider notified?
A. Digoxin
B. Propranolol
C. Furosemide
D. Spironolactone

Answer 12

A. Digoxin

Question 13

A client has been given a prescription for furosemide 40 mg every day in conjunction with digoxin. Which concern would prompt the nurse to ask the health care provider about potassium supplements?
A. Digoxin causes significant potassium depletion.
B. The liver destroys potassium as digoxin is detoxified.
C. Lasix requires adequate serum potassium to promote diuresis.
D. Digoxin toxicity occurs rapidly in the presence of hypokalemia.

Answer 13

D. Digoxin toxicity occurs rapidly in the presence of hypokalemia.

Question 14

A client has been receiving digoxin. The client calls the clinic and complains of ‘yellow vision.’ Which response would the nurse provide?
A. ‘This is related to your illness rather than to your medication.’
B. ‘This is an expected side effect; you will become accustomed to it over time.’
C. ‘This side effect is only temporary. You should continue the medication.’
D. ‘The medication may need to be discontinued. Come to the clinic this afternoon.’

Answer 14

D. ‘The medication may need to be discontinued. Come to the clinic this afternoon.’

Question 15

Digoxin is prescribed for a client. Which therapeutic effect of digoxin would the nurse expect?
A. Decreased cardiac output
B. Decreased stroke volume of the heart
C. Increased contractile force of the myocardium
D. Increased electrical conduction through the atrioventricular (AV) node

Answer 15

C. Increased contractile force of the myocardium

Question 16

A client takes furosemide and digoxin for heart failure. Why would the nurse advise the client to drink a glass of orange juice every day?
A. Maintaining potassium levels
B. Preventing increased sodium levels
C. Limiting the medications’ synergistic effects
D. Correcting the associated dehydration

Answer 16

A. Maintaining potassium levels

Question 17

The nurse is providing discharge medication teaching to a client who will be taking furosemide and digoxin after discharge from the hospital. Which information is important for the nurse to include in the teaching plan?
A. Maintenance of a low-potassium diet
B. Avoidance of foods high in cholesterol
C. Signs and symptoms of digoxin toxicity
D. Importance of monitoring output

Answer 17

C. Signs and symptoms of digoxin toxicity

Question 18

When a client with type 1 diabetes develops heart failure, digoxin is prescribed. Which nursing action is important to include when planning care?
A. Administer the digoxin 1 hour after the client’s morning insulin.
B. Monitor the client for cardiac dysrhythmias.
C. Monitor for increased risk of hyperglycemia.
D. Increase digoxin dosage if insulin requirements are increased.

Answer 18

B. Monitor the client for cardiac dysrhythmias.

Question 19

A client with left ventricular heart failure and supraventricular tachycardia is prescribed digoxin 0.25 mg daily. Which changes would the nurse expect to find if this medication is therapeutically effective? Select all that apply. One, some, or all responses may be correct.
A. Diuresis
B. Tachycardia
C. Decreased edema
D. Decreased pulse rate
E. Reduced heart murmur
F. Jugular vein distention

Answer 19

A. Diuresis
C. Decreased edema
D. Decreased pulse rate

Question 20

A client with hypertensive heart disease who had an acute episode of heart failure is to be discharged on a regimen of metoprolol and digoxin. Which outcome would the nurse anticipate when metoprolol is administered with digoxin?
A. Headaches
B. Bradycardia
C. Hypertension
D. Junctional tachycardia

Answer 20

B. Bradycardia

Question 21

A client is given a loading dose of digoxin and placed on a maintenance dose of digoxin 0.25 mg by mouth daily. Which responses would the nurse expect the client to exhibit when a therapeutic effect of digoxin is achieved?
A. Resolution of heart failure
B. Decreased anginal episodes
C. Conversion of atrial fibrillation
D. Decreased blood pressure

Answer 21

A. Resolution of heart failure

Question 22

The nurse provides medication discharge instructions to a client who received a prescription for digoxin. Which statement by the client leads the nurse to conclude that the teaching was effective?
A. ‘I will avoid foods high in potassium.’
B. ‘I must increase my intake of vitamin K.’
C. ‘I should adjust the dosage according to my activities.’
D. ‘It will be important to check my pulse rate daily.’

Answer 22

D. ‘It will be important to check my pulse rate daily.’

Question 23

Which advice will the nurse include when teaching a client about digoxin for left ventricular failure?
A. Sleep flat in bed.
B. Follow a low-potassium diet.
C. Take the pulse three times a day.
D. Report increasing fatigue.

Answer 23

D. Report increasing fatigue.

Question 24

A client with heart failure is to receive digoxin. Which therapeutic effect is associated with this medication?
A. Reduces edema
B. Increases cardiac conduction
C. Increases rate of ventricular contractions
D. Slows and strengthens cardiac contractions

Answer 24

D. Slows and strengthens cardiac contractions

Question 25

A client with heart failure is to receive digoxin. Which therapeutic effect is associated with this medication?
A. Reduces edema
B. Increases cardiac conduction
C. Increases rate of ventricular contractions
D. Slows and strengthens cardiac contractions

Answer 25

D. Slows and strengthens cardiac contractions

Question 26

Which assessment will the nurse conduct before administering digoxin to a client?
A. Apical heart rate
B. Radial pulse
C. Difference between carotid and radial pulses
D. Difference between apical and radial pulses

Answer 26

A. Apical heart rate

Question 27

Digoxin is prescribed for a client with heart failure. The nurse will assess for which signs and symptoms that indicate digoxin toxicity? Select all that apply. One, some, or all responses may be correct.
A. Nausea
B. Yellow vision
C. Irregular pulse
D. Increased urine output
E. Heart rate of 64 beats/minute

Answer 27

A. Nausea
B. Yellow vision
C. Irregular pulse

Question 28

A client who takes furosemide and digoxin reports to the nurse that everything looks yellow. Which response by the nurse is most appropriate?
A. ‘This is related to your heart problems, not to the medication.’
B. ‘I will hold the medication until I consult with your health care provider.’
C. ‘It is a medication that is necessary, and that side effect is only temporary.’
D. ‘Take this dose, and when I see your health care provider, I will ask about it.’

Answer 28

B. ‘I will hold the medication until I consult with your health care provider.’

Question 29

The nurse is reviewing medication instructions with parents of an infant receiving digoxin and spironolactone. Which parental response indicates instructions have been understood?
A. Activity should be restricted.
B. Orange juice should be given daily.
C. Vomiting should be reported to the health care provider.
D. Anti-inflammatory medications should be avoided.

Answer 29

C. Vomiting should be reported to the health care provider.

Question 30

A child being treated with cardiac medications developed vomiting, bradycardia, anorexia, and dysrhythmias. The nurse understands which medication toxicity is responsible for these symptoms?
A. Digoxin
B. Nesiritide
C. Dobutamine
D. Spironolactone

Answer 30

A. Digoxin

Question 31

A client is admitted to the hospital for a new onset of supraventricular tachycardia (SVT) and is prescribed digoxin. For which laboratory finding should the nurse notify the healthcare provider immediately?
A. Potassium level of 3.1 mEq/L
B. Sodium level of 132 mEq/L
C. Calcium level of 8.6 mg/dL
D. Magnesium level of 1.2 mEq/L

Answer 31

A. Potassium level of 3.1 mEq/L

Question 32

A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the client. Which finding requires the most immediate intervention?
A. Heartburn.
B. Headache.
C. Constipation.
D. Vomiting.

Answer 32

D. Vomiting.

Question 33

The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which intervention should the nurse implement prior to administering the digoxin?
A. Observe respiratory rate and depth.
B. Assess the serum potassium level.
C. Obtain the client’s blood pressure.
D. Monitor the serum glucose level.

Answer 33

B. Assess the serum potassium level.

Question 34

The nurse is preparing to administer prescribed digoxin to client with atrial fibrillation. The nurse notes the packaging for the medication is provided in a different route than prescribed. Which action should the nurse take?
A. Administer the medication as ordered
B. Consult the pharmacist regarding the error
C. Alert the charge nurse to the medication error
D. Contact the health care provider

Answer 34

B. Consult the pharmacist regarding the error

Question 35

A charge nurse is observing a staff nurse prepare 1 ml of intravenous digoxin for a client with heart failure. After the staff nurse prepares the medication, the nurse notices precipitate in the syringe. Which action by the staff nurse likely caused this reaction?
A. D5W was used as the diluent.
B. The medication was not allowed to reach room temperature.
C. The medication was added to 1 mL of diluent.
D. Air was not inserted into the vial.

Answer 35

C. The medication was added to 1 mL of diluent.

Question 36

The nurse is caring for a client prescribed furosemide and digoxin for the treatment of heart failure. The client reports seeing halos and bright lights. Which laboratory result would be anticipated?
A. Low sodium level
B. Low digitalis level
C. Low potassium level
D. Low serum osmolality

Answer 36

C. Low potassium level

Question 37

The nurse is caring for a client who received digoxin-specific immune fab. Which finding indicates the treatment is having the intended effect?
A. Increased heart rate
B. Decreased potassium levels
C. Decreased blood pressure
D. Increased serum digoxin levels

Answer 37

A. Increased heart rate

Question 38

A nurse is providing care to an older adult client with newly diagnosed heart failure. The nurse receives a prescription for digoxin PO 1.5 mg daily. Which action does the nurse perform next?
A. Instruct the client to take the heart rate before administration
B. Educate the client on the purpose of digoxin
C. Administer the medication to the client
D. Clarify the prescription with the healthcare provider

Answer 38

D. Clarify the prescription with the healthcare provider

Question 39

A nurse is preparing to administer prescribed maintenance dose of digoxin to a client who has heart failure. Which action should the nurse to take?
A. Withhold the medication if the heart rate is above 100/min
B. Instruct the client to eat foods that are low in potassium
C. Measure apical pulse rate for 30 seconds before administration
D. Evaluate the client for nausea, vomiting, and anorexia

Answer 39

D. Evaluate the client for nausea, vomiting, and anorexia

Question 40

A client is prescribed furosemide and digoxin for heart failure. The nurse should monitor the client for which potential adverse drug effect?
A. Pulmonary hypertension
B. Acute arterial occlusion
C. Acute kidney injury
D. Cardiac dysrhythmias

Answer 40

D. Cardiac dysrhythmias

Question 41

The client diagnosed with heart failure is prescribed oral digoxin. What is the priority nursing assessment for this medication?
A. Monitor serum electrolytes and creatinine
B. Measure apical pulse prior to administration
C. Maintain accurate intake and output ratios
D. Monitor blood pressure every 4 hours

Answer 41

B. Measure apical pulse prior to administration

Question 42

The nurse is reviewing medication instructions with a client who is taking digoxin. The nurse should reinforce to the client to report which of the following side effects?
A. Rash, dyspnea, edema
B. Nausea, vomiting, fatigue
C. Hunger, dizziness, diaphoresis
D. Polyuria, thirst, dry skin

Answer 42

B. Nausea, vomiting, fatigue

Question 43

The nurse is monitoring a 4-month-old infant who is prescribed digoxin. The infant’s blood pressure is 92/78 mmHg; resting pulse is 78 beats per minute; respirations are 28 breaths per minute; and serum potassium level is 4.8 mEq/L. The infant is irritable and has vomited twice since receiving the morning dose of digoxin. Which finding is most indicative of digoxin toxicity?
A. Irritability
B. Vomiting
C. Bradycardia
D. Dyspnea

Answer 43

C. Bradycardia

Question 44

The nurse is providing care for a client admitted to the hospital with a diagnosis of digoxin toxicity. The client reports more than usual urine output over the previous 48 hours, because of the prescribed diuretic. Which assessment finding does the nurse anticipate?
A. Muscle weakness or cramping
B. Blood in the urine
C. Hypertension
D. Tinnitus

Answer 44

A. Muscle weakness or cramping

Question 45

A hospitalized 8-month-old infant is receiving digoxin to treat Tetralogy of Fallot. Prior to administering the next dose of the medication, the parent reports that the baby vomited one time, just after breakfast. The infant’s heart rate is 92 bpm. What action should the nurse take?
A. Give the scheduled dose after the client is done eating lunch.
B. Hold the medication and notify the primary health care provider.
C. Reduce the next dose by half and then resume the normal medication schedule.
D. Double the next dose to make up for the medication lost from vomiting.

Answer 45

B. Hold the medication and notify the primary health care provider.

Question 46

The home care nurse is reviewing the medical record of a new client with a history of chronic obstructive pulmonary disease, atrial fibrillation, and gout. After reviewing the client’s medication list, for which medications should the nurse arrange to monitor blood levels? Select all that apply.
A. Beclomethasone
B. Digoxin
C. Theophylline
D. Allopurinol
E. Montelukast

Answer 46

B. Digoxin
C. Theophylline

Question 47

An 80-year-old client who is taking digoxin reports nausea, vomiting, abdominal cramps, and halo vision. Which laboratory result should the nurse evaluate first?
A. Potassium levels
B. Blood pH
C. Magnesium levels
D. Blood urea nitrogen

Answer 47

A. Potassium levels

Question 48

A nurse is preparing to administer morning medications to a client with heart failure. The morning lab values are: sodium 142 mEq/L (142 mmol/L), potassium 2.9 mEq/L (2.9 mmol/L), digoxin level 1.4 ng/mL. Which of the following medications should the nurse not administer until after speaking with the health care provider?
A. Spironolactone
B. Carvedilol (Coreg)
C. Digoxin (Lanoxin)
D. Ferrous sulfate

Answer 48

C. Digoxin (Lanoxin)

Question 49

A client is prescribed digoxin 0.25 mg by mouth daily. The health care provider has written a new order to give metoprolol tartrate 25 mg twice a day by mouth. In assessing the client prior to administering the medications, which finding should the nurse report to the health care provider?
A. Urine output of 50 mL/hour
B. Respiratory rate of 16
C. Blood pressure of 94/60
D. Heart rate of 76 BPM

Answer 49

C. Blood pressure of 94/60

Question 50

The nurse is preparing to administer digoxin to a client with recurring atrial fibrillation. Which laboratory value should be of highest concern for the nurse?
A. Hemoglobin 9.4 g/dL
B. Serum potassium 3.1 mEq/L
C. Serum creatinine 1.9 mg/dL
D. B-type natriuretic peptide 140 pg/mL

Answer 50

B. Serum potassium 3.1 mEq/L

Question 51

A client recently diagnosed with heart failure has been prescribed digoxin and furosemide. Which of the following foods should the nurse teach the client to eat at least one serving a day?
A. Blueberries
B. Wheat cereal
C. Tomato juice
D. Pear nectar

Answer 51

C. Tomato juice

Question 52

The nurse is caring for a client diagnosed with heart failure who will begin treatment with digoxin. Which therapeutic effect would the nurse expect to find after administering this medication?
A. Decreased chest pain with decreased blood pressure
B. Increased heart rate with increased respirations
C. Improved respiratory status with increased urinary output
D. Diaphoresis with decreased urinary output

Answer 52

C. Improved respiratory status with increased urinary output

Question 53

The nurse is preparing to administer digoxin to a client admitted for acute decompensated heart failure. Which action is the priority before giving this drug?
A. Monitor oxygen saturation on room air
B. Assess the client’s weight and compare to the baseline
C. Auscultate the lungs for crackles in the bases
D. Assess the apical pulse for a full minute

Answer 53

D. Assess the apical pulse for a full minute

Question 54

Which response would a nurse give to a client who takes furosemide and digoxin and reports that everything looks yellow?
A. “This is related to your heart problems, not to the medication.”
B. “I will hold the medication until I consult with your health care provider.”
C. “It is a medication that is necessary, and that side effect is only temporary.”
D. “Take this dose, and when I see your health care provider, I will ask about it.”

Answer 54

B. “I will hold the medication until I consult with your health care provider.”

Question 55

According to developmental norms for a 5-year-old child, the nurse would hold digoxin if an apical heart rate falls below which number?
A. 70 beats/min
B. 80 beats/min
C. 90 beats/min
D. 100 beats/min

Answer 55

A. 70 beats/min

Question 56

A client receives a cardiac glycoside, a diuretic, an angiotensin-converting enzyme (ACE) inhibitor, and a vasodilator. The client’s apical pulse rate is 44 beats/minute. The nurse concludes that the decreased heart rate is caused by which medication?
A. Diuretic/furosemide
B. Vasodilator/nitroglycerin
C. ACE inhibitor/“ace” to -pril
D. Cardiac glycoside/digoxin

Answer 56

D. Cardiac glycoside/digoxin

Question 57

Which medications may be used to correct severe hyperkalemia resulting from intravenous (IV) administration? Select all that apply. One, some, or all responses may be correct.
A. Calcium chloride
B. Sodium chloride
C. Calcium gluconate
D. Sodium bicarbonate
E. Dextrose solution with insulin

Answer 57

A. Calcium chloride
C. Calcium gluconate
D. Sodium bicarbonate
E. Dextrose solution with insulin

Question 58

The nurse administers a parenteral preparation of potassium slowly to avoid which complication?
A. Metabolic acidosis
B. Cardiac arrest
C. Seizure activity
D. Respiratory depression

Answer 58

B. Cardiac arrest

Question 59

Which assessment would be brought to the health care provider’s attention before administration of intravenous potassium chloride?
A. Progressively worsening muscle weakness
B. Poor tissue turgor with tenting
C. Urinary output of 200 mL during the previous 8 hours
D. Oral fluid intake of 300 mL during the previous 12 hours

Answer 59

C. Urinary output of 200 mL during the previous 8 hours

Question 60

Intravenous (IV) potassium is prescribed for a client with a diagnosis of hypokalemia. Which statement about administration of IV potassium is accurate?
A. Oliguria is an indication for withholding IV potassium.
B. Rapid infusion of potassium prevents burning at the IV site.
C. Clients with severe deficits should be given IV push potassium.
D. Average IV dosage of potassium should not exceed 60 mEq in 1 hour.

Answer 60

A. Oliguria is an indication for withholding IV potassium.

Question 61

Which medication is unsafe to administer as an intravenous (IV) bolus?
A. Saline flush
B. Potassium chloride
C. Naloxone
D. Adenosine

Answer 61

B. Potassium chloride

Question 62

A nurse is assessing a client receiving intravenous potassium chloride. The client verbalizes pain to the IV site. The site appears swollen and is warm to touch. Which action does the nurse perform?
A. Decrease the rate of the infusion
B. Apply ice to the IV access site
C. Inform the client that this is an expected finding
D. Discontinue the IV catheter

Answer 62

D. Discontinue the IV catheter

Question 63

The inpatient hospital nurse is caring for a client with hypokalemia. The health care provider prescribed a potassium intravenous (IV) infusion of 40 mEq potassium chloride in 250 mL normal saline to be infused over 4 hours. The nurse receives the infusion from the pharmacy. Which action should the nurse take next?
A. Confirm patency of the peripheral venous access device and start the infusion
B. Notify the health care provider of the inappropriate dose of the prescribed IV potassium
C. Ask another nurse to verify the prescription, IV solution, and serum potassium level
D. Ask another nurse to witness the addition of the prescribed potassium to the IV solution

Answer 63

C. Ask another nurse to verify the prescription, IV solution, and serum potassium level

Question 64

Which information will the nurse include when teaching a client about potassium chloride effervescent tablets?
A. Chew the tablet completely.
B. Take the medication with food.
C. Take the medication at bedtime.
D. Use warm water to dissolve the tablet.

Answer 64

B. Take the medication with food.

Question 65

Which nursing assessment would be performed by a nurse before administering intravenous (IV) infusion of potassium chloride (KCl) 40 mEq in 100 mL of 5% dextrose and water to be infused over 2 hours? Select all that apply. One, some, or all responses may be correct.
A. Urinary output
B. Deep tendon reflexes
C. Last bowel movement
D. Arterial blood gas results
E. Last serum potassium level
F. Patency of the intravenous access

Answer 65

A. Urinary output
E. Last serum potassium level
F. Patency of the intravenous access

Question 66

Which reason would an intravenous infusion of 5% dextrose with 0.45% sodium chloride and 20 mEq of potassium be prescribed for a client with a nasogastric (NG) tube set to low intermittent suction?
A. Prevent constipation
B. Prevent dehydration
C. Prevent vomiting
D. Prevent electrolyte imbalance

Answer 66

D. Prevent electrolyte imbalance

Question 67

Which teaching would a nurse give to a client with a prescription for potassium supplements?
A. To report any abdominal distress
B. To use salt substitutes to season food
C. To take the medication on an empty stomach
D. To increase the dosage if muscle cramps occur

Answer 67

A. To report any abdominal distress

Question 68

Potassium supplements are prescribed for a client receiving diuretic therapy. Which client statement indicates that the teaching about potassium supplements is understood?
A. ‘I will report any abdominal distress.’
B. ‘I should use salt substitutes with my food.’
C. ‘The medication must be taken on an empty stomach.’
D. ‘The dosage is correct if my urine output increases.’

Answer 68

A. ‘I will report any abdominal distress.’

Question 69

A client with an intravenous (IV) infusion containing 40 mEq of potassium reports a stinging pain at the IV site. Which actions will the nurse take? Select all that apply. One, some, or all responses may be correct.
A. Restart the IV in a different vein.
B. Assist the client through guided imagery.
C. Assess the IV site.
D. Ask the health care provider for pain medication.
E. Verify that the potassium is adequately diluted and not infusing too rapidly.

Answer 69

C. Assess the IV site.
E. Verify that the potassium is adequately diluted and not infusing too rapidly.

Question 70

The nurse is discharging a client on oral potassium replacement. Which of the following statements requires further teaching by the nurse?
A. “I can still take my nonsteroidal anti-inflammatory medications occasionally for my arthritis pain.”
B. “I will continue to use salt substitutes to flavor my food.”
C. “I will take my furosemide first thing in the morning.”
D. “I will read the food labels for added potassium.”

Answer 70

B. “I will continue to use salt substitutes to flavor my food.”

Question 71

Which food would the nurse encourage a client to eat while receiving treatment to prevent hypokalemia?
A. Broccoli
B. Oatmeal
C. Fried rice
D. Canned carrots

Answer 71

A. Broccoli

Question 72

When the nurse is administering intravenous potassium to a client with hypokalemia, which finding is most important to communicate to the health care provider?
A. U waves on cardiac monitor
B. QRS duration of 0.28 seconds
C. Decreased bowel sounds
D. Weakened grip strength

Answer 72

B. QRS duration of 0.28 seconds

Question 73

The nurse administers sodium polystyrene sulfonate to a client with chronic renal failure. Which finding provides evidence that the intervention is effective?
A. Pruritus decreases
B. Mental status improves
C. Sodium decreases to 137 mEq/L (137 mmol/L)
D. Potassium decreases to 4.2 mEq/L (4.2 mmol/L)

Answer 73

D. Potassium decreases to 4.2 mEq/L (4.2 mmol/L)

Question 74

Which pain characteristic would the nurse expect to observe when a client is experiencing anginal pain?
A. Unchanged by rest
B. Precipitated by light activity
C. Described as a knifelike sharpness
D. Relieved by sublingual nitroglycerin

Answer 74

D. Relieved by sublingual nitroglycerin

Question 75

Which instructions about the use of nitroglycerin to prevent angina will the nurse provide to a client?
A. ‘At the point when pain first occurs, place two tablets under the tongue.’
B. ‘Place one tablet under the tongue before activity, and swallow another if pain occurs.’
C. ‘Before physical activity, place one tablet under the tongue, and repeat the dose in 5 minutes if pain occurs.’
D. ‘Place one tablet under the tongue when pain occurs and use an additional tablet after the attack to prevent recurrence.’

Answer 75

C. ‘Before physical activity, place one tablet under the tongue, and repeat the dose in 5 minutes if pain occurs.’

Question 76

A client who had a myocardial infarction receives a prescription for a nitroglycerin patch. Which statement would the nurse identify as the purpose of the nitroglycerin patch?
A. Decreased heart rate lowers cardiac output.
B. Increased cardiac output increases oxygen demand.
C. Decreased cardiac preload reduces cardiac workload.
D. Peripheral venous and arterial constriction increases peripheral resistance.

Answer 76

C. Decreased cardiac preload reduces cardiac workload.

Question 77

The health care provider prescribes isosorbide dinitrate 10 mg for a client with chronic angina pectoris. The client asks the nurse why the isosorbide dinitrate is prescribed. How will the nurse respond?
A. ‘It prevents excessive blood clotting.’
B. ‘It suppresses irritability in the ventricles.’
C. ‘It decreases cardiac oxygen demand.’
D. ‘The inotropic action increases the force of contraction of the heart.’

Answer 77

C. ‘It decreases cardiac oxygen demand.’

Question 78

Sublingual nitroglycerin has been prescribed for a client with unstable angina. Which client response indicates that nitroglycerin is effective?
A. Pain subsides as a result of arteriole and venous dilation.
B. Pulse rate increases because the cardiac output has been stimulated.
C. Sublingual area tingles because sensory nerves are being triggered.
D. Capacity for activity improves as a response to increased collateral circulation.

Answer 78

A. Pain subsides as a result of arteriole and venous dilation.

Question 79

Which client statement indicates understanding of the side effects of nitroglycerin ointment?
A. ‘I may experience a headache.’
B. ‘Confusion is a common adverse effect.’
C. ‘A slow pulse rate in an expected side effect.’
D. ‘Increased blood pressure readings may occur initially.’

Answer 79

A. ‘I may experience a headache.’

Question 80

The nurse is preparing to apply nitroglycerin ointment. Before applying the ointment, which action will the nurse take?
A. Assess the client’s pulse rate.
B. Prepare the site with an alcohol swab.
C. Shave the client’s chest in the area for application.
D. Use the dose measuring application paper and spread the ointment in a thin layer to the prescribed amount.

Answer 80

D. Use the dose measuring application paper and spread the ointment in a thin layer to the prescribed amount.

Question 81

A client presents to the emergency department with chest pain. A myocardial infarction is suspected, and 500 mL of 5% dextrose in water (D 5W) with 50 mg of nitroglycerin intravenously (IV) has been prescribed. The nurse will monitor the client for which common side effect of nitroglycerin?
A. Bradycardia
B. Hypotension
C. Nausea and vomiting
D. Leg cramps

Answer 81

B. Hypotension

Question 82

Sublingual nitroglycerin is prescribed for a client with a history of a myocardial infarction and atrial tachycardia. The nurse instructs the client about the prophylactic use of these tablets. Which statement by the client indicates the teaching was effective?
A. ‘I should take the medicine three times a day.’
B. ‘I will be sure to take my pulse after I have exercised.’
C. ‘It will be important to avoid activities that can cause angina.’
D. ‘I should take one tablet before attempting activity that has caused angina.’

Answer 82

D. ‘I should take one tablet before attempting activity that has caused angina.’

Question 83

Which criterion is an indicator that the nitroglycerin sublingual tablets have lost their potency?
A. Sublingual tingling is experienced.
B. The tablets are more than 3 months old.
C. The headache is less severe.
D. Onset of relief is delayed.

Answer 83

B. The tablets are more than 3 months old.

Question 84

Which instruction would the nurse include in a teaching plan for nitroglycerin patches?
A. ‘Apply the patch on a distal extremity.’
B. ‘Remove a previous patch before applying the next one.’
C. ‘Massage the area gently after applying the patch to the skin.’
D. ‘Apply a warm compress to the site before attaching the patch.’

Answer 84

B. ‘Remove a previous patch before applying the next one.’

Question 85

A client has a prescription for a sublingual nitroglycerin tablet. Which technique will the nurse teach the client to use?
A. Place the pill inside the cheek and let it dissolve.
B. Place the pill under the tongue and let it dissolve.
C. Chew the pill thoroughly and then swallow it.
D. Swallow the pill with a full glass of water.

Answer 85

B. Place the pill under the tongue and let it dissolve.

Question 86

The nurse is preparing a teaching plan for a client prescribed nitroglycerin sublingual. Which would the nurse include in the teaching?
A. ‘Place the tablet under the tongue or between the cheek and gums.’
B. ‘It takes 30 to 45 minutes for the nitroglycerin to achieve its effect.’
C. ‘If dizziness occurs, take a few deep breaths and lean the head back.’
D. ‘To facilitate absorption, drink a large glass of water after taking the medication.’

Answer 86

A. ‘Place the tablet under the tongue or between the cheek and gums.’

Question 87

A client with acute myocardial infarction is admitted to the coronary care unit. Which medication should the nurse administer to lessen the workload of the heart by decreasing the cardiac preload and afterload?
A. Nitroglycerin
B. Propranolol
C. Morphine
D. Captopril

Answer 87

A. Nitroglycerin

Question 88

Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved?
A. Client states chest pain is relieved.
B. Client’s pulse decreases from 120 to 90.
C. Client’s systolic blood pressure decreases from 180 to 90.
D. Client’s SaO2 level increases from 92% to 96%.

Answer 88

A. Client states chest pain is relieved.

Question 89

A nurse has administered sublingual nitroglycerin to a client in the emergency department. Which clinical finding indicates an adverse response to the medication?
A. Persistent chest pain
B. Orthostatic hypotension
C. Decreased heart rate
D. Labored breathing

Answer 89

B. Orthostatic hypotension

Question 90

The nurse is monitoring a client who is taking prescribed nitroglycerin for angina. Which finding indicates the medication has a therapeutic effect?
A. The client blood pressure is 150/80 mmHg.
B. The client heart rate is 110.
C. The client reports a decrease in chest pressure.
D. The client reports a headache.

Answer 90

C. The client reports a decrease in chest pressure.

Question 91

A nurse is teaching a client with stable angina about newly prescribed SL nitroglycerin. Which statement should the nurse include in the teaching?
A. “Take this medication after each meal and at bedtime.”
B. “Take one tablet 30 minutes before any physical activity.”
C. “Take one tablet immediately when you experience chest pain.”
D. “Take this medication with 8 ounces of water.”

Answer 91

C. “Take one tablet immediately when you experience chest pain.”

Question 92

The nurse is teaching a client with stable angina about their new prescription for nitroglycerin transdermal patch. Which instructions should the nurse include? Select all that apply.
A. Remove the patch if ankle edema occurs
B. Apply the patch to a hairless area of the body
C. Notify your provider for persistent dizziness or any fainting episode
D. Apply a second patch with chest pain
E. Plan for patch-free time, usually overnight
F. Rotate the application area

Answer 92

B. Apply the patch to a hairless area of the body
C. Notify your provider for persistent dizziness or any fainting episode
E. Plan for patch-free time, usually overnight
F. Rotate the application area

Question 93

The nurse working in an intensive care unit is caring for a client diagnosed with acute angina. The client is receiving an intravenous infusion of nitroglycerin. What is the priority assessment for this client?
A. Heart rate
B. Neurologic status
C. Urine output
D. Blood pressure

Answer 93

D. Blood pressure

Question 94

A client with angina has been instructed about the use of sublingual nitroglycerin. Which statement by the client indicates the need for additional teaching?
A. “I’ll call the health care provider if pain continues after three tablets five minutes apart.”
B. “I will rest briefly right after taking one tablet.”
C. “I understand that the medication should be kept in the dark bottle.”
D. “I can swallow two or three tablets at once if I have severe pain.”

Answer 94

D. “I can swallow two or three tablets at once if I have severe pain.”

Question 95

The nurse is providing discharge instructions to a client with a prescription for sublingual nitroglycerin. The nurse should inform the client to prepare for this most common side effect?
A. Headache
B. Depression
C. Dry mouth
D. Anorexia

Answer 95

A. Headache

Question 96

The nurse is teaching a client who has a new prescription for sublingual nitroglycerin. Which point should the nurse emphasize?
A. Take the medication at the same time each day
B. Rest in bed for an hour after taking medication
C. Carry the nitroglycerin with you at all times
D. Keep the medication bottle in the refrigerator

Answer 96

C. Carry the nitroglycerin with you at all times

Question 97

The nurse is providing discharge education to a client diagnosed with coronary artery disease. The client is prescribed to use a nitroglycerin transdermal patch at home. Which statement by the client indicates a correct understanding of safe medication administration?
A. “I will remove the old patch and cleanse the area before applying a new patch.”
B. “This drug can lead to hypertension. So, I will monitor my blood pressure at home.”
C. “I will keep a record of chest pain occurrences now that I have this patch.”
D. “I can place this patch on broken skin. It will absorb better.”

Answer 97

A. “I will remove the old patch and cleanse the area before applying a new patch.”

Question 98

The nurse on a cardiac unit is caring for a client who is receiving nitroglycerin intravenously for unstable angina. During administration of the medication, which assessment is the priority?
A. Respiratory rate
B. Cardiac enzymes
C. Cardiac rhythm
D. Blood pressure

Answer 98

D. Blood pressure

Question 99

Which information would the nurse include when preparing a teaching plan for a client prescribed sublingual nitroglycerin?
A. “Place the tablet under the tongue or between the cheek and gums.”
B. “It takes 30 to 45 minutes for the nitroglycerin to achieve its effect.”
C. “If dizziness occurs, take a few deep breaths and lean the head back.”
D. “To facilitate absorption, drink a large glass of water after taking the medication.”

Answer 99

A. “Place the tablet under the tongue or between the cheek and gums.”

Question 100

Nitroglycerin sublingual tablets are prescribed for a client with the diagnosis of angina. The nurse advises the client to anticipate pain relief will begin within which period of time?
A. 1 to 3 minutes
B. 4 to 5 seconds
C. 30 to 45 seconds
D. 10 to 15 minutes

Answer 100

A. 1 to 3 minutes

Question 101

Which instruction would the nurse include when teaching the client about sublingual nitroglycerin?
A. ‘Once the tablet is dissolved, spit out the saliva.’
B. ‘Take tablets 3 minutes apart up to a maximum of five tablets.’
C. ‘Common side effects include headache and low blood pressure.’
D. ‘Once opened, the tablets should be refrigerated to prevent deterioration.’

Answer 101

C. ‘Common side effects include headache and low blood pressure.’

Question 102

A client with a myocardial infarction receives intravenous nitroglycerin to relieve pain. The nurse will assess for which medication side effect?
A. Nausea
B. Delirium
C. Bradycardia
D. Hypotension

Answer 102

D. Hypotension

Question 103

Which instructions will the nurse give a client for whom nitroglycerin tablets are prescribed?
A. Limit the number of tablets to four per day.
B. Discontinue the medication if a headache develops.
C. Increase the number of tablets if dizziness is experienced.
D. Ensure that the medication is stored in its original dark container.

Answer 103

D. Ensure that the medication is stored in its original dark container.

Question 104

A client with midsternal pain presents to the emergency department. Vital signs are stable. Which form of nitroglycerin would the nurse anticipate giving initially?
A. Oral capsule
B. Sublingual spray
C. Intravenous solution
D. Transdermal patch

Answer 104

B. Sublingual spray

Question 105

A client is discharged with a prescription for sustained-release nitroglycerin. Which information will the nurse provide to the client?
A. Swallow the capsule whole.
B. Take the medication with milk.
C. Place the capsule under the tongue.
D. Crush the capsule and mix with soft food.

Answer 105

A. Swallow the capsule whole.

Question 106

The nurse has administered sublingual nitroglycerin. Which outcome would the nurse use to determine the effectiveness of sublingual nitroglycerin?
A. Relief of anginal pain
B. Improved cardiac output
C. Decreased blood pressure
D. Ease in respiratory effort

Answer 106

A. Relief of anginal pain

Question 107

Which client response indicates to the nurse that a vasodilator medication is effective?
A. Absence of adventitious breath sounds
B. Increase in the daily amount of urine produced
C. Pulse rate decreases from 110 to 75 beats/minute
D. Blood pressure changes from 154/90 to 126/72 mmHg

Answer 107

D. Blood pressure changes from 154/90 to 126/72 mmHg

Question 108

Sodium nitroprusside is prescribed for a client with a blood pressure of 260/120 mmHg. The nurse recalls that sodium nitroprusside decreases blood pressure by which mechanism?
A. Decreasing the heart rate
B. Increasing cardiac output
C. Increasing peripheral resistance
D. Relaxing venous and arterial smooth muscles

Answer 108

D. Relaxing venous and arterial smooth muscles

Question 109

The nitrate isosorbide dinitrate is prescribed for a client with angina. Which instruction should the nurse include in this client’s discharge teaching plan?
A. Quit taking the medication if dizziness occurs.
B. Do not get up quickly. Always rise slowly.
C. Take the medication with food only.
D. Increase your intake of potassium-rich foods.

Answer 109

B. Do not get up quickly. Always rise slowly.

Question 110

A client’s dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO daily. When the client reports the onset of a headache prior to the next scheduled dose, which action should the nurse implement?
A. Hold the next scheduled dose of Imdur 60 mg and administer a PRN dose of acetaminophen (Tylenol).
B. Administer the 40 mg of Imdur and then contact the healthcare provider.
C. Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol).
D. Do not administer the next dose of Imdur or any acetaminophen until notifying the healthcare provider.

Answer 110

C. Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol).

Question 111

A client is admitted to the hospital with a diagnosis of heart failure and acute pulmonary edema. The health care provider prescribes furosemide 40 mg intravenous (IV) stat to be repeated in 1 hour. Which nursing action will best evaluate the effectiveness of the furosemide in managing the client’s condition?
A. Performing daily weights
B. Auscultating breath sounds
C. Monitoring intake and output
D. Assessing for dependent edema

Answer 111

B. Auscultating breath sounds

Question 112

A health care provider prescribes furosemide for a client with hypervolemia. The nurse recalls that furosemide exerts its effects in which part of the renal system?
A. Distal tubule
B. Collecting duct
C. Glomerulus of the nephron
D. Loop of Henle

Answer 112

D. Loop of Henle

Question 113

A client is receiving furosemide to relieve edema. The nurse will monitor the client for which responses? Select all that apply. One, some, or all responses may be correct.
A. Weight loss
B. Negative nitrogen balance
C. Increased urine specific gravity
D. Excessive loss of potassium ions
E. Pronounced retention of sodium ions

Answer 113

A. Weight loss
D. Excessive loss of potassium ions

Question 114

The nurse is caring for a child receiving furosemide for pulmonary edema. Which nursing intervention(s) would the nurse implement? Select all that apply. One, some, or all responses may be correct.
A. Checking the child’s weight every day
B. Administering the medication on an empty stomach
C. Calculating the dose of medication as carefully as possible
D. Exposing the child to sunlight for increasing periods
E. Assessing the child regularly to help prevent electrolyte loss

Answer 114

A. Checking the child’s weight every day
C. Calculating the dose of medication as carefully as possible
E. Assessing the child regularly to help prevent electrolyte loss

Question 115

The client with congestive heart failure is receiving furosemide 80 mg once daily. Which data collection assessment would be performed to evaluate medication effectiveness? Select all that apply. One, some, or all responses may be correct.
A. Daily weight
B. Intake and output
C. Monitor for edema
D. Daily pulse oximetry
E. Auscultate breath sounds

Answer 115

A. Daily weight
B. Intake and output
C. Monitor for edema
D. Daily pulse oximetry
E. Auscultate breath sounds

Question 116

A nurse is assessing a client with heart failure who is taking prescribed torsemide. Which clinical finding indicates effectiveness of the medication?
A. Symmetrical pulses bilaterally
B. Full strength to bilateral extremities
C. Intact whisper test
D. Absence of peripheral edema

Answer 116

D. Absence of peripheral edema

Question 117

The client is discharged from the hospital with a new prescription for furosemide. During a follow-up visit one week later, the nurse notes the following findings. Which finding is most important to report to the health care provider?
A. Constipation
B. Muscle cramps
C. Occasional lightheadedness
D. Increased urine production

Answer 117

B. Muscle cramps

Question 118

The nurse is providing discharge instructions to an older adult client with heart failure. The client asks, “What is the purpose for taking the furosemide?” How should the nurse respond?
A. It will help with decreasing fluid buildup in your lungs.
B. It will help with reducing the risk for an irregular heart rhythm.
C. It will protect your kidneys from chronic damage.
D. It will reverse the damage to your heart muscle.

Answer 118

A. It will help with decreasing fluid buildup in your lungs.

Question 119

A client received 40 mg of furosemide by mouth at 10 am. Which information is most important for the nurse to provide to the next nurse in the change-of-shift report?
A. The client lost two pounds in the last 24 hours.
B. The client is to receive another dose of furosemide at 10 pm.
C. The client’s potassium level was 4.0 mEq/L prior to administration.
D. The client’s urine output was 1500 mL over nine hours.

Answer 119

D. The client’s urine output was 1500 mL over nine hours.

Question 120

The nurse is caring for a client who has been taking furosemide for the past week. Which manifestation would indicate that the client may be experiencing a negative side effect?
A. Edema of the ankles
B. Gastric irritability
C. Weight gain of five pounds
D. Decreased appetite

Answer 120

D. Decreased appetite

Question 121

Which sign of hypokalemia will the nurse monitor for in a client receiving furosemide?
A. Chvostek sign
B. Muscle weakness
C. Anxious behavior
D. Abdominal cramping

Answer 121

B. Muscle weakness

Question 122

Which diuretic would the nurse anticipate administering to a client admitted with acute pulmonary edema?
A. Furosemide
B. Chlorothiazide
C. Spironolactone
D. Acetazolamide

Answer 122

A. Furosemide

Question 123

Hypertension develops in a school-age child with acute glomerulonephritis. Which medication would the nurse anticipate providing teaching for?
A. Digoxin
B. Furosemide
C. Diazepam
D. Phenytoin

Answer 123

B. Furosemide

Question 124

A school-age child is admitted with hypertensive acute glomerulonephritis. Which medication would the nurse anticipate being prescribed initially in addition to hydralazine?
A. Digoxin
B. Alprazolam
C. Phenytoin
D. Furosemide

Answer 124

D. Furosemide

Question 125

A client was prescribed furosemide. The nurse would instruct the client to include which food in the diet?
A. Liver
B. Apples
C. Cabbage
D. Bananas

Answer 125

D. Bananas

Question 126

The nurse is administering 40 mg of furosemide intravenously. Which sensation reported by the client would the nurse consider when determining that it is being administered too quickly?
A. Full bladder
B. Buzzing ears
C. Fast heartbeat
D. Numb arms and legs

Answer 126

B. Buzzing ears

Question 127

Which client statements indicate that the teaching about furosemide is understood? Select all that apply. One, some, or all responses may be correct.
A. ‘It may take 2 or 3 days for this medication to take effect.’
B. ‘I should wear dark glasses when outdoors during the day.’
C. ‘I should avoid lying flat in bed.’
D. ‘I need to change my position slowly.’
E. ‘I should eat more food that is high in potassium.’

Answer 127

D. ‘I need to change my position slowly.’
E. ‘I should eat more food that is high in potassium.’

Question 128

A client is receiving furosemide to relieve edema. The nurse will monitor the client for which adverse effect?
A. Hypernatremia
B. Elevated blood urea nitrogen
C. Hypokalemia
D. Increase in the urine specific gravity

Answer 128

C. Hypokalemia

Question 129

Which principle explains how loop diuretics promote diuresis?
A. Osmosis
B. Filtration
C. Diffusion
D. Active transport

Answer 129

A. Osmosis

Question 130

Furosemide has been prescribed as part of the medical regimen for a client with hypertension. Which client statement indicates a need for medication education?
A. ‘This can decrease my vitamin K level.’
B. ‘I will take the medication in the morning.’
C. ‘I will contact my health care provider if I notice muscle weakness.’
D. ‘I plan to take the medication even when my blood pressure is normal.’

Answer 130

A. ‘This can decrease my vitamin K level.’

Question 131

A client is given a prescription for bumetanide. The nurse will teach the client to watch for symptoms of which condition?
A. Hypokalemia
B. Hyperchloremia
C. Hypernatremia
D. Hypoglycemia

Answer 131

A. Hypokalemia

Question 132

The nurse is observing a new graduate nurse preparing to administer bumetanide 4 mg orally to a client with heart failure. Which client finding requires the nurse to intervene immediately?
A. The client’s most recent serum potassium level is 2.9 mEq or mmol/L.
B. The client has crackles in both lung bases.
C. The client has 4+ pitting edema in both lower legs.
D. The client’s most recent blood pressure is 96/60 mmHg.

Answer 132

A. The client’s most recent serum potassium level is 2.9 mEq or mmol/L.

Question 133

Which instruction would the nurse include when teaching about hydrochlorothiazide given to a client diagnosed with a transient ischemic attack (TIA) related to hypertension?
A. “Resume regular eating habits.”
B. “Drink a protein supplement daily.”
C. “Avoid eating foods high in insoluble fiber.”
D. “Increase the intake of potassium-rich foods.”

Answer 133

D. “Increase the intake of potassium-rich foods.”

Question 134

After the nurse provides education about hydrochlorothiazide, the client will agree to notify the health care provider regarding the development of which symptom?
A. Insomnia
B. Nasal congestion
C. Increased thirst
D. Generalized weakness

Answer 134

D. Generalized weakness

Question 135

A client is receiving hydrochlorothiazide. Which physiological alteration will the nurse monitor to best determine the effectiveness of the client’s hydrochlorothiazide therapy?
A. Blood pressure
B. Decreasing edema
C. Serum potassium level
D. Urine specific gravity

Answer 135

A. Blood pressure

Question 136

A client with the diagnosis of primary hypertension is started on a regimen of hydrochlorothiazide. Which information will the nurse include when providing instructions regarding this medication?
A. A common side effect is decreased sexual libido.
B. One dose should be omitted if dizziness occurs when standing up.
C. The client should adjust the dosage daily based on the client’s blood pressure.
D. An antihypertensive medication will likely be required for the remainder of life.

Answer 136

D. An antihypertensive medication will likely be required for the remainder of life.

Question 137

Hydrochlorothiazide (HCTZ) has been prescribed for a client with hypertension. The client reports hearing that furosemide is more effective and requests a prescription change. How will the nurse respond?
A. ‘HCTZ has fewer side effects.’
B. ‘HCTZ does not cause dizziness.’
C. ‘HCTZ is only taken when needed.’
D. ‘HCTZ does not cause dehydration.’

Answer 137

A. ‘HCTZ has fewer side effects.’

Question 138

Which mechanism of action explains how hydrochlorothiazide increases urine output?
A. Increases the excretion of sodium
B. Increases the glomerular filtration rate
C. Decreases the reabsorption of potassium
D. Increases renal perfusion

Answer 138

A. Increases the excretion of sodium

Question 139

A client diagnosed with a transient ischemic attack (TIA) related to hypertension is discharged with a prescription of hydrochlorothiazide. Which instruction would the nurse include when teaching about this medication?
A. ‘Resume regular eating habits.’
B. ‘Drink a protein supplement daily.’
C. ‘Avoid eating foods high in insoluble fiber.’
D. ‘Increase the intake of potassium-rich foods.’

Answer 139

D. ‘Increase the intake of potassium-rich foods.’

Question 140

Which instruction regarding nutrition will the nurse give a client discharged after a short hospitalization for an episode of a transient ischemic attack (TIA) related to hypertension who is on a regimen that includes chlorothiazide?
A. “Eat more dark green, leafy vegetables such as spinach.”
B. “Substitute a potassium-based salt substitute for table salt.”
C. “Return to previous eating habits.”
D. “Increase intake of dairy products.”

Answer 140

A. “Eat more dark green, leafy vegetables such as spinach.”

Question 141

A health care provider prescribes a diuretic for a client with hypertension. Which mechanism of action explains how diuretics reduce blood pressure?
A. They facilitate vasodilation.
B. They promotes smooth muscle relaxation.
C. They reduce the circulating blood volume.
D. They block the sympathetic nervous system.

Answer 141

C. They reduce the circulating blood volume.

Question 142

A client hospitalized for uncontrolled hypertension and chest pain was started on a daily diuretic 2 days ago upon admission, with prescriptions for a daily basic metabolic panel. The client’s potassium level this morning is 2.7 mEq/L (2.7 mmol/L). Which action will the nurse take next?
A. Send another blood sample to the laboratory to retest the serum potassium level.
B. Notify the health care provider that the potassium level is above normal.
C. Notify the health care provider that the potassium level is below normal.
D. No action is required because the potassium level is within normal limits.

Answer 142

C. Notify the health care provider that the potassium level is below normal.

Question 143

Intravenous furosemide has been prescribed for a client with severe edema and hypertension. Which subjective clinical manifestations lead the nurse to suspect that the furosemide is infusing too rapidly? Select all that apply. One, some, or all responses may be correct.
A. Hunger
B. Tinnitus
C. Weakness
D. Leg cramps
E. Excess salivation

Answer 143

B. Tinnitus
C. Weakness
D. Leg cramps

Question 144

A client with cirrhosis of the liver has been taking chlorothiazide. The provider adds spironolactone to the client’s medication regimen to prevent which condition?
A. Hyponatremia
B. Hypokalemia
C. Ascites
D. Peripheral neuropathy

Answer 144

B. Hypokalemia

Question 145

A client with cirrhosis of the liver develops ascites, and the health care provider prescribes spironolactone. The nurse will monitor the client for which adverse medication effect?
A. Bruising
B. Tachycardia
C. Hyperkalemia
D. Hypoglycemia

Answer 145

C. Hyperkalemia

Question 146

The nurse is transcribing a new prescription for spironolactone (Aldactone) for a client who receives an angiotensin-converting enzyme (ACE) inhibitor. Which action should the nurse implement?
A. Verify both prescriptions with the healthcare provider.
B. Report the medication interactions to the nurse manager.
C. Hold the ACE inhibitor and give the new prescription.
D. Transcribe and send the prescription to the pharmacy.

Answer 146

A. Verify both prescriptions with the healthcare provider.

Question 147

A client with heart failure is prescribed spironolactone (Aldactone). Which information is most important for the nurse to provide to the client about diet modifications?
A. Do not add salt to foods during preparation.
B. Refrain for eating foods high in potassium.
C. Restrict fluid intake to 1000 ml per day.
D. Increase intake of milk and milk products.

Answer 147

B. Refrain for eating foods high in potassium.

Question 148

The nurse is collecting the health history for a client who reports a sudden onset of generalized weakness and fatigue. The nurse notes the client has a new prescription for spironolactone. Which action should the nurse take first?
A. Review the drug formulary for side effects
B. Request the health care provider to stop the medication
C. Notify the pharmacist of the findings
D. Document the findings

Answer 148

A. Review the drug formulary for side effects

Question 149

The nurse is administering spironolactone for a client diagnosed with cirrhosis of the liver and ascites. Which electrolyte should the nurse anticipate to be spared when giving this medication?
A. Sodium
B. Phosphate
C. Potassium
D. Albumin

Answer 149

C. Potassium

Question 150

The nurse is admitting a client to the hospital with findings of liver failure and ascites. A health care provider (HCP) orders spironolactone. The nurse understands that the pharmacological effects of the medication are which of the following?
A. Combines safely with antihypertensives
B. Depletes potassium reserves
C. Promotes sodium and chloride excretion
D. Increases aldosterone levels

Answer 150

C. Promotes sodium and chloride excretion

Question 151

Which medication requires the nurse to monitor the client for signs of hyperkalemia?
A. Furosemide
B. Metolazone
C. Spironolactone
D. Hydrochlorothiazide

Answer 151

C. Spironolactone

Question 152

Which dietary choices will the nurse instruct the client taking spironolactone to avoid increasing? Select all that apply. One, some, or all responses may be correct.
A. Potatoes
B. Red meat
C. Cantaloupe
D. Wheat bread
E. Flavored yogurt

Answer 152

A. Potatoes
C. Cantaloupe

Question 153

A nurse is providing dietary instructions to a client who is taking prescribed amiloride. Which information will the nurse include in the teaching?
A. Avoid eating foods that are rich in potassium such as bananas
B. It is important to control high-sodium foods such as canned soups
C. Eat plenty of foods that contain calcium such as milk
D. Choose foods that are high in iron content such as shellfish

Answer 153

A. Avoid eating foods that are rich in potassium such as bananas

Question 154

During morning rounds, a healthcare provider informs a client with hypertension that a calcium channel blocker will be added to their treatment regimen. The nurse notes a new prescription for amiloride 10 mg PO daily. Which action does the nurse perform next?
A. Clarify the prescription with the healthcare provider
B. Educate the client on the new prescription
C. Administer the medication with food
D. Assess the client blood pressure

Answer 154

A. Clarify the prescription with the healthcare provider

Question 155

The nurse is assessing a postpartum client who is taking labetalol. Which client report should the nurse identify as a potential adverse effect of the medication?
A. Nausea
B. Ankle edema
C. Abdominal pain
D. Dizziness

Answer 155

D. Dizziness

Question 156

The nurse is preparing to administer metoprolol to a client with a history of hypertension. Which of the following data is the priority for the nurse to review prior to administration?
A. Potassium level
B. Most recent heart rate
C. Creatinine level
D. Respiratory rate

Answer 156

B. Most recent heart rate

Question 157

A 42-year-old male client diagnosed with hypertension tells the nurse he no longer wants to take the prescribed propranolol. Which client statement best explains the reason why he does not want to take this medication?
A. “I have difficulty falling asleep.”
B. “I’m having problems with my stomach.”
C. “I’m experiencing decreased sex drive.”
D. “I feel so tired all the time.”

Answer 157

C. “I’m experiencing decreased sex drive.”

Question 158

The nurse incorrectly administers carvedilol (Coreg) to a client with an order for benztropine (Cogentin). What is the priority nursing intervention after making this medication error?
A. Complete an incident report
B. Notify the nurse manager
C. Monitor the client’s blood pressure
D. Notify the health care provider

Answer 158

C. Monitor the client’s blood pressure

Question 159

The nurse is providing information to a client about propranolol. Which statement by the client indicates the teaching has been effective?
A. “I should expect to feel nervousness during the first few weeks.”
B. “I can have a heart attack if I stop this medication suddenly.”
C. “I could have an increase in my heart rate for a few weeks.”
D. “I may experience seizures if I stop the medication abruptly.”

Answer 159

B. “I can have a heart attack if I stop this medication suddenly.”

Question 160

The nurse is talking with a client who was admitted with an acute myocardial infarction due to coronary artery disease. The clients asks what the purpose for the prescribed carvedilol is. How should the nurse respond?
A. “A beta blocker will prevent postural hypotension.”
B. “Most people develop hypertension after a heart attack.”
C. “This drug will decrease the workload on your heart.”
D. “Beta blockers will help to increase your heart rate.”

Answer 160

C. “This drug will decrease the workload on your heart.”

Question 161

The nurse is providing discharge education to a client who will be starting daily atenolol for the treatment of hypertension. Which side effect is most important for the client to notify their health care provider about?
A. Decreased libido
B. Slow, irregular heart rate
C. Dizziness in the morning
D. Decreased exercise tolerance

Answer 161

B. Slow, irregular heart rate

Question 162

Propranolol is prescribed for a client with coronary artery disease (CAD). The nurse should consult with the health care provider (HCP) before giving this medication when the client reports a history of which condition?
A. Asthma
B. Deep vein thrombosis
C. Myocardial infarction
D. Peptic ulcer disease

Answer 162

A. Asthma

Question 163

Which action describes a therapeutic effect of atenolol?
A. Heart rate decreases
B. Cardiac output increases
C. Bronchospasm is relieved
D. Pulse oximetry improves

Answer 163

A. Heart rate decreases

Question 164

Atenolol is prescribed for a client with moderate hypertension. Which information would the nurse include when teaching the client about this medication? Select all that apply. One, some, or all responses may be correct.
A. Change to standing positions slowly.
B. Take the medication before going to bed.
C. Count the pulse before taking the medication.
D. Mild weakness and fatigue are common side effects.
E. It is safe to take over-the-counter (OTC) medications.

Answer 164

A. Change to standing positions slowly.
C. Count the pulse before taking the medication.
D. Mild weakness and fatigue are common side effects.

Question 165

The health care provider prescribes atenolol for a client with angina. Which potential side effect will the nurse mention when instructing the client about this medication?
A. Headache
B. Tachycardia
C. Constipation
D. Hypotension

Answer 165

D. Hypotension

Question 166

A primary health care provider prescribes atenolol 20 mg by mouth four times a day. Which information is important for the nurse to include in the discharge teaching plan for this client?
A. Drink alcoholic beverages in moderation.
B. Avoid abruptly discontinuing the medication.
C. Increase the medication if chest pain develops.
D. Report a pulse rate less than 70 beats/minute.

Answer 166

B. Avoid abruptly discontinuing the medication.

Question 167

A client is receiving metoprolol. Which potential effect will the nurse teach the client to expect?
A. Dizziness with strenuous activity
B. Acceleration of the heart rate after eating a heavy meal
C. Flushing sensations after taking the medication
D. Pounding of the heart

Answer 167

A. Dizziness with strenuous activity

Question 168

The nurse provides instruction when the beta-blocker (BB) atenolol is prescribed for a client with moderate hypertension. Which client statement indicates to the nurse that further teaching is needed?
A. ‘I must take the medication before going to bed.’
B. ‘This medication will make me feel drowsy.’
C. ‘I need to count my pulse before taking the medication.’
D. ‘I will move slowly when changing positions from sitting to standing.’

Answer 168

A. ‘I must take the medication before going to bed.’

Question 169

A client who has type 1 diabetes and chronic bronchitis is prescribed atenolol for the management of angina pectoris. Which clinical manifestation will alert the nurse to the fact that the client may be developing a life-threatening response to the medication?
A. Paroxysmal nocturnal dyspnea
B. Supraventricular tachycardia
C. Malignant hypertension
D. Hyperglycemia

Answer 169

A. Paroxysmal nocturnal dyspnea

Question 170

A client with hypertension has received a prescription for metoprolol. Which information will the nurse include when teaching this client about metoprolol?
A. Do not abruptly discontinue the medication.
B. Consume alcoholic beverages in moderation.
C. Report a heart rate of less than 70 beats per minute.
D. Increase the medication dosage if chest pain occurs.

Answer 170

A. Do not abruptly discontinue the medication.

Question 171

A client who is receiving atenolol for hypertension frequently reports feeling dizzy. Which effect of atenolol is responsible for this response?
A. Depleting acetylcholine
B. Stimulating histamine release
C. Blocking the adrenergic response
D. Decreasing adrenal release of epinephrine

Answer 171

C. Blocking the adrenergic response

Question 172

The nurse is caring for a client who has taken atenolol for 2 years. The healthcare provider recently changed the medication to enalapril to manage the client’s blood pressure. Which instruction should the nurse provide the client regarding the new medication?
A. Take the medication at bedtime.
B. Report presence of increased bruising.
C. Check pulse before taking medication.
D. Rise slowly when getting out of bed or chair.

Answer 172

D. Rise slowly when getting out of bed or chair.

Question 173

A client prescribed atenolol has a blood pressure of 120/68 mmHg, displaying a sinus bradycardia with a rate of 58 beats/minute, and a P-R interval of 0.24. Which action should the nurse take?
A. Lower the head of the bed and assess the client for orthostatic vital sign changes.
B. Give the medication as prescribed and continue to monitor the client.
C. Prepare to administer atropine sulfate IV push.
D. Hold the prescribed dose and contact the healthcare provider.

Answer 173

B. Give the medication as prescribed and continue to monitor the client.

Question 174

The nurse is providing care for a client prescribed propranolol. Which symptoms should the nurse report to the healthcare provider immediately?
A. Headache, hypertension, and blurred vision.
B. Wheezing, hypotension, and AV block.
C. Vomiting, dilated pupils, and papilledema.
D. Tinnitus, muscle weakness, and tachypnea.

Answer 174

B. Wheezing, hypotension, and AV block.

Question 175

The nurse administers a dose of metoprolol for a client. Which assessment is most important for the nurse to obtain?
A. Temperature.
B. Lung sounds.
C. Blood pressure.
D. Urinary output.

Answer 175

C. Blood pressure.

Question 176

A beta blocker is prescribed for the client with persistent ventricular tachycardia. Which response indicates that the beta blocker is working effectively?
A. Decreased anxiety
B. Reduced chest pain
C. Decreased heart rate
D. Increased blood pressure

Answer 176

C. Decreased heart rate

Question 177

A client has primary open-angle glaucoma. Which ophthalmic preparation is indicated to manage this condition?
A. Tetracaine
B. Fluorescein
C. Timolol maleate
D. Atropine sulfate

Answer 177

C. Timolol maleate

Question 178

Which instruction would the nurse give an unlicensed assistive personnel (UAP) to perform while caring for a client prescribed captopril? Select all that apply. One, some, or all responses may be correct.
A. Obtain blood pressure.
B. Measure intake and output.
C. Weigh the client every morning.
D. Notify the nurse if the client has a dry cough.
E. Assist the client to change positions slowly.

Answer 178

A. Obtain blood pressure.
B. Measure intake and output.
C. Weigh the client every morning.
D. Notify the nurse if the client has a dry cough.
E. Assist the client to change positions slowly.

Question 179

Which is an appropriate nursing action when caring for a client taking benazepril for hypertension?
A. Assess for dizziness.
B. Assess for dark, tarry stools.
C. Administer the medication after meals.
D. Monitor the electroencephalogram (EEG).

Answer 179

A. Assess for dizziness.

Question 180

Which angiotensin-converting enzyme inhibitors (ACE inhibitors) are appropriate for a client with liver dysfunction? Select all that apply. One, some, or all responses may be correct.
A. Ramipril
B. Enalapril
C. Quinapril
D. Captopril
E. Lisinopril

Answer 180

D. Captopril
E. Lisinopril

Question 181

The nurse prepares discharge instructions for a client who will take enalapril for hypertension. Which instruction would the nurse include in the client’s teaching?
A. ‘Change to a standing position slowly.’
B. ‘This may color your urine green.’
C. ‘The medication may cause a sore throat for the first few days.’
D. ‘Schedule blood tests weekly for the first 2 months.’

Answer 181

A. ‘Change to a standing position slowly.’

Question 182

Captopril is prescribed for a client. Which effect would the nurse anticipate?
A. Increased urine output
B. Decreased anxiety
C. Improved sleep
D. Decreased blood pressure

Answer 182

D. Decreased blood pressure

Question 183

A health care provider prescribes enalapril for a client. Which nursing action is important?
A. Assess the client for hypokalemia.
B. Monitor for adverse effects on renal function.
C. Monitor the client’s blood pressure during therapy.
D. Assess the client for hypoglycemia.

Answer 183

C. Monitor the client’s blood pressure during therapy.

Question 184

Which medication may be useful in managing hypertension in a child with acute glomerulonephritis?
A. Digoxin
B. Diazepam
C. Captopril
D. Phenytoin

Answer 184

C. Captopril

Question 185

A client with heart failure is being discharged with a new prescription for the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse’s discharge instructions should include reporting which problem to the healthcare provider?
A. Weight loss.
B. Dizziness.
C. Muscle cramps.
D. Dry mucous membranes.

Answer 185

B. Dizziness.

Question 186

A nurse is reviewing new prescriptions for a client diagnosed with heart failure. The nurse notes captopril 25mg PO. Which action does the nurse perform next?
A. Administer the medication before meals
B. Clarify the prescription with the healthcare provider
C. Take the client weight
D. Check the client latest creatinine level

Answer 186

B. Clarify the prescription with the healthcare provider

Question 187

The nurse is reviewing prescribed medications with a client. Which information should the nurse reinforce about captopril?
A. Take the medication with meals.
B. Avoid using salt substitutes.
C. Restrict fluids to 1000 mL/day.
D. Avoid green leafy vegetables.

Answer 187

B. Avoid using salt substitutes.

Question 188

The nurse is caring for a client who is being treated for heart failure. After completing the medication reconciliation process, the nurse notes that the prescriber has added lisinopril 5mg orally bid. Which medication from the list below should the nurse question due to possible drug-to-drug interaction with lisinopril?
A. Metoprolol
B. Glipizide
C. Naproxen
D. Enoxaparin

Answer 188

C. Naproxen

Question 189

A client taking multiple medications for hypertension develops a persistent, hacking cough. Which antihypertensive medication class would the nurse identify as the likely cause of the cough?
A. Thiazide diuretics
B. Calcium channel blockers
C. Direct renin inhibitors
D. Angiotensin-converting enzyme (ACE) inhibitors

Answer 189

D. Angiotensin-converting enzyme (ACE) inhibitors

Question 190

How would the nurse determine if a client is experiencing the therapeutic effect of valsartan?
A. Check a lipid profile.
B. Assess an apical pulse.
C. Measure urinary output.11
D. Check the blood pressure.

Answer 190

D. Check the blood pressure.

Question 191

Valsartan, an angiotensin II receptor antagonist, is prescribed for a client. The nurse will monitor the client for which adverse effect?
A. Constipation
B. Hyperkalemia
C. Hypertension
D. Change in visual acuity

Answer 191

B. Hyperkalemia

Question 192

The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker (ARB), for a client with hypertension and heart failure. The nurse reviews the client’s laboratory results and notes that the client’s serum potassium level is 5.9 mEq/L. Which action should the nurse take first?
A. Withhold the scheduled dose.
B. Check the client’s apical pulse.
C. Notify the healthcare provider.
D. Repeat the serum potassium level.

Answer 192

A. Withhold the scheduled dose.

Question 193

Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan has been achieved?
A. Dependent edema reduced from +3 to +1.
B. Serum HDL increased from 35 to 55 mg/dL.
C. Pulse rate reduced from 150 to 90 beats/minute.
D. Blood pressure reduced from 160/90 mmHg to 130/80 mmHg.

Answer 193

D. Blood pressure reduced from 160/90 mmHg to 130/80 mmHg.

Question 194

Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin-2 receptor antagonist irbesartan (Avapro)?
A. Fluid volume deficit.
B. Risk for infection.
C. Risk for injury.
D. Impaired sleep patterns.

Answer 194

C. Risk for injury.

Question 195

A nurse is assessing a client who started taking prescribed olmesartan 2 weeks ago. Which finding indicates an expected response to the medication?
A. Heart rate of 85 beats/min
B. Urinary output of 45 ml/hr
C. Blood pressure of 125/79 mmHg
D. Respiratory rate of 20 breaths/min

Answer 195

C. Blood pressure of 125/79 mmHg

Question 196

A nurse is reviewing a client’s medical history. The client has been newly diagnosed with hypertension and has been prescribed oral losartan as treatment. The nurse will clarify the use of losartan if which comorbidity is noted in the client’s medical record?
A. Renal stenosis
B. Hyperlipidemia
C. Atrial fibrillation
D. Diabetes

Answer 196

A. Renal stenosis

Question 197

A client with hypertension is prescribed an angiotensin II receptor blocker (ARB). Which instructions will the nurse provide about this medication? Select all that apply. One, some, or all responses may be correct.
A. ‘Monitor the blood pressure daily.’
B. ‘Stop treatment if a cough develops.’
C. ‘Stop the medication if swelling of the mouth, lips, or face develops.’
D. ‘Have blood drawn for potassium levels 2 weeks after starting the medication.’

Answer 197

C. ‘Stop the medication if swelling of the mouth, lips, or face develops.’
D. ‘Have blood drawn for potassium levels 2 weeks after starting the medication.’

Question 198

A client who has been diagnosed with Raynaud’s disease and hypertension is prescribed nifedipine. For which side effect should the nurse monitor the client?
A. Cyanosis of the lips
B. Decreased urine output
C. Increased pain in fingers
D. Facial flushing

Answer 198

D. Facial flushing

Question 199

Amlodipine is prescribed for a client with hypertension. Which response to the medication will the nurse instruct the client to report to the health care provider?
A. Blurred vision
B. Dizziness on rising
C. Difficulty breathing
D. Excessive urination

Answer 199

C. Difficulty breathing

Question 200

Which instruction will the nurse include in a teaching plan for a client taking a calcium channel blocker such as nifedipine? Select all that apply. One, some, or all responses may be correct.
A. Reduce calcium intake.
B. Report peripheral edema.
C. Expect temporary hair loss.
D. Avoid drinking grapefruit juice.
E. Change to a standing position slowly.

Answer 200

B. Report peripheral edema.
D. Avoid drinking grapefruit juice.
E. Change to a standing position slowly.

Question 201

The nurse is assisting a client who is taking amlodipine with meal planning. Which fluid selected by the client would require follow up by the nurse?
A. Black coffee
B. Grapefruit juice
C. Green tea
D. Chocolate Milk

Answer 201

B. Grapefruit juice

Question 202

A nurse is providing education to a client about newly prescribed diltiazem. Which statement will the nurse include in the teaching?
A. Skip the dose if your systolic blood pressure is less than 120 mmHg
B. Hold the dose if your heart rate is less than 50 beats/min
C. Call your healthcare provider if you experience any fever
D. Notify your healthcare provider if you notice any weight loss

Answer 202

B. Hold the dose if your heart rate is less than 50 beats/min

Question 203

The nurse is assessing a client with hypertension who reports experiencing dizziness after taking prescribed diltiazem. It is most important that the nurse assesses for which client characteristic?
A. Schedule for taking medication
B. Appearance of feet and ankles
C. Activity and rest patterns
D. Daily intake of potassium

Answer 203

A. Schedule for taking medication

Question 204

Which advice would the nurse include in a teaching plan to reduce the side effects of diltiazem?
A. Lie down after meals.
B. Avoid dairy products in diet.
C. Take the medication with an antacid.
D. Change slowly from sitting to standing.

Answer 204

D. Change slowly from sitting to standing.

Question 205

A client with supraventricular tachycardia (SVT) has a heart rate of 170 beats/minute. After treatment with diltiazem, which assessment indicates to the nurse that the diltiazem is effective?
A. Increased urine output
B. Blood pressure of 90/60 mm Hg
C. Heart rate of 98 beats/minute
D. No longer complaining of heart palpations

Answer 205

C. Heart rate of 98 beats/minute

Question 206

Which food would the nurse instruct a client taking diltiazem to avoid? Select all that apply. One, some, or all responses may be correct.
A. Alcohol
B. Grapefruit juice
C. Cheddar cheese
D. Summer sausage
E. Dark green vegetables

Answer 206

B. Grapefruit juice

Question 207

The nurse is preparing to administer diltiazem to a client with heart disease. Which action should the nurse take first?
A. Assess the client’s lung sounds and monitor for wheezing
B. Assess the client’s blood pressure and apical pulse
C. Assess the client’s urine output and potassium level
D. Auscultate the abdomen for bowel sounds

Answer 207

B. Assess the client’s blood pressure and apical pulse

Question 208

Which clinical indicator would the nurse monitor to determine if the client’s simvastatin is effective?
A. Heart rate
B. Triglycerides
C. Blood pressure
D. International normalized ratio (INR)

Answer 208

B. Triglycerides

Question 209

Which instructions will the nurse include in the teaching plan for a client who will be taking simvastatin? Select all that apply. One, some, or all responses may be correct.
A. Increase dietary intake of potassium.
B. Avoid prolonged exposure to the sun.
C. Schedule regular ophthalmic examinations.
D. Take the medication at least half an hour before meals.
E. Contact your health care provider if skin becomes gray-bronze.

Answer 209

B. Avoid prolonged exposure to the sun.
C. Schedule regular ophthalmic examinations.
E. Contact your health care provider if skin becomes gray-bronze.

Question 210

A health care provider prescribes simvastatin 20 mg daily for elevated cholesterol and triglyceride levels for a female client. Which advice is important for the nurse to teach when the client initially takes the medication?
A. Take the medication with breakfast.
B. Have liver function tests every 6 months.
C. Wear sunscreen to prevent photosensitivity reactions.
D. Inform the health care provider if you wish to become pregnant.

Answer 210

D. Inform the health care provider if you wish to become pregnant.

Question 211

A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-specific teaching the nurse should provide to this client?
A. Increase consumption of potassium-rich foods since low potassium levels can cause muscle spasms.
B. Have serum electrolytes checked at the next scheduled appointment to assess hyponatremia, a cause of cramping.
C. Make an appointment to see the healthcare provider because muscle pain may be an indication of a serious side effect.
D. Be sure to consume a low-cholesterol diet while taking the drug to enhance the effectiveness of the drug.

Answer 211

C. Make an appointment to see the healthcare provider because muscle pain may be an indication of a serious side effect.

Question 212

A client has been taking rosuvastatin for six weeks as part of a treatment plan to reduce hyperlipidemia. The clinic nurse is reviewing and reinforcing information about the medication with the client. Which statements by the client indicates an understanding about the medication? Select all that apply.
A. “I will need to call my doctor if I have any muscle weakness or pain, especially in my legs.”
B. “I will need to come back to have my liver and kidney labs checked.”
C. “I need to be careful when I get up because this medication can make my blood pressure drop.”
D. “I add some nuts and fresh fruit to my oatmeal in the morning and I can’t remember when I last ate a steak.”
E. “This medication has to be taken first thing in the morning before I eat breakfast.”

Answer 212

A. “I will need to call my doctor if I have any muscle weakness or pain, especially in my legs.”
B. “I will need to come back to have my liver and kidney labs checked.”
D. “I add some nuts and fresh fruit to my oatmeal in the morning and I can’t remember when I last ate a steak.”

Question 213

Which vitamin deficiency may occur if cholestyramine, an anion exchange resin, to treat a client’s persistent diarrhea is needed long-term?
A. Retinol (Vitamin A)
B. Riboflavin (Vitamin B 2)
C. Thiamine (Vitamin B 12)
D. Pyridoxine (Vitamin B 6)

Answer 213

A. Retinol (Vitamin A)

Question 214

Which instructions will the nurse include in the teaching plan for a client with hyperlipidemia who is being discharged with a prescription for cholestyramine?
A. ‘Increase your intake of fiber and fluid.’
B. ‘Take the medication before you go to bed.’
C. ‘Check your pulse before taking the medication.’
D. ‘Contact your health care provider if your skin turns yellow.’

Answer 214

A. ‘Increase your intake of fiber and fluid.’

Question 215

A client is prescribed cholestyramine for the treatment of type II hyperlipoproteinemia. Which vitamin would the nurse anticipate may become deficient because of this therapy?
A. Niacin (vitamin B 3)
B. Calciferol (vitamin D)
C. Ascorbic acid (vitamin C)
D. Cyanocobalamin (vitamin B 12)

Answer 215

B. Calciferol (vitamin D)

Question 216

A client has been prescribed cholestyramine (Questran) in addition to other medications for coronary artery disease and hyperlipidemia. When should the nurse instruct the client to take the cholestyramine?
A. At least 1 to 2 hours after other medications
B. At least 1 hour before meals
C. Anytime is acceptable
D. Early in the morning on an empty stomach

Answer 216

A. At least 1 to 2 hours after other medications

Question 217

A client with hyperlipidemia receives a prescription for niacin (Niaspan). Which client teaching is most important for the nurse to provide?
A. Expected duration of flushing.
B. Symptoms of hyperglycemia.
C. Diets that minimize GI irritation.
D. Comfort measures for pruritus.

Answer 217

A. Expected duration of flushing.

Question 218

Which client response must the nurse monitor to determine the effectiveness of amiodarone?
A. Absence of ischemic chest pain
B. Decrease in cardiac dysrhythmias
C. Improvement in fasting lipid profile
D. Maintenance of blood pressure control

Answer 218

B. Decrease in cardiac dysrhythmias

Question 219

A client who had a myocardial infarction has runs of ventricular tachycardia. Which medication will the nurse prepare to administer?
A. Digoxin
B. Furosemide
C. Amiodarone
D. Norepinephrine

Answer 219

C. Amiodarone

Question 220

A client’s cardiac monitor indicates multiple multifocal premature ventricular complexes (PVCs). Which medication is indicated for treatment of ventricular dysrhythmias?
A. Amiodarone
B. Epinephrine
C. Methyldopa
D. Hydrochlorothiazide

Answer 220

A. Amiodarone

Question 221

The cardiac monitor reveals several runs of ventricular tachycardia. Which medication is used to treat this dysrhythmia?
A. Atropine
B. Epinephrine
C. Amiodarone
D. Sodium bicarbonate

Answer 221

C. Amiodarone

Question 222

A client is receiving clonidine for hypertension. Which side effect of clonidine will the nurse include when providing medication education?
A. Xerostomia
B. Diarrhea
C. Euphoria
D. Photosensitivity

Answer 222

A. Xerostomia

Question 223

A client is receiving clonidine 0.1 mg/24 hr via transdermal patch. Which assessment finding indicates the desired effect of the medication has been achieved?
A. Absence of nausea and vomiting.
B. Change in peripheral edema from +3 to +1.
C. Denial of anginal pain and shortness of breath.
D. Blood pressure from 180/120 mmHg to 140/70 mmHg.

Answer 223

D. Blood pressure from 180/120 mmHg to 140/70 mmHg.

Question 224

The health care provider prescribes lidocaine to treat a ventricular dysrhythmia in a client with cirrhosis of the liver. Which alterations in the usual lidocaine dosage would the nurse anticipate for this client?
A. Higher than usual dosage to compensate for the impaired liver function
B. Lower than usual dosage because the medication is metabolized at a diminished rate
C. Reduced dosage because other organs will compensate for the sluggish liver
D. Equal dosage to that needed for other clients but used over a shorter duration

Answer 224

B. Lower than usual dosage because the medication is metabolized at a diminished rate

Question 225

Which assessment finding would the nurse identify as an adverse effect of a client’s lidocaine infusion?
A. Tremors
B. Tachypnea
C. Tachycardia
D. Hypertension

Answer 225

A. Tremors

Question 226

A nurse is administering lidocaine to a client with a myocardial infarction. Which assessment finding requires the nurse’s immediate action?
A. Respiratory rate of 22
B. Pulse rate of 48 beats per minute
C. Central venous pressure reading of 9 mm Hg
D. Blood pressure of 144/92

Answer 226

B. Pulse rate of 48 beats per minute

Question 227

A client is prescribed oral disopyramide to manage a ventricular dysrhythmia. Which side effects will the nurse include when teaching the client about this medication? Select all that apply. One, some, or all responses may be correct.
A. Dry mouth
B. Rhinorrhea
C. Constipation
D. Hyperglycemia
E. Stress incontinence

Answer 227

A. Dry mouth
C. Constipation

Question 228

When a client’s cells are deprived of oxygen during a cardiac arrest, which medication corrects for deleterious effects of anaerobic energy production?
A. Regular insulin
B. Calcium gluconate
C. Potassium chloride
D. Sodium bicarbonate

Answer 228

D. Sodium bicarbonate

Question 229

The nurse is caring for a client diagnosed with diabetic ketoacidosis who is receiving 50 mEq of sodium bicarbonate in 1 L of dextrose 5% in water via a central venous access device. The client has three new prescriptions for continuously infused medications. Which action is appropriate?
A. Refer to an IV compatibility chart
B. Request that an additional IV access be inserted
C. Use a Y-site connector to infuse two medications in the same port
D. Insert a peripheral intravenous access

Answer 229

A. Refer to an IV compatibility chart

Question 230

A health care provider prescribes milrinone for a client with congestive heart failure. Which action would the nurse perform first?
A. Administer the loading dose over 10 minutes.
B. Monitor the electrocardiogram (ECG) continuously for dysrhythmias during infusion.
C. Assess the heart rate and blood pressure continuously during infusion.
D. Have the prescription, dosage calculations, and pump settings checked by a second nurse.

Answer 230

D. Have the prescription, dosage calculations, and pump settings checked by a second nurse.

Question 231

A client is prescribed 1 mcg/kg/min of dobutamine hydrochloride via IV infusion. Which client’s condition would benefit the most from an administration of dobutamine hydrochloride?
A. Shock.
B. Asthma.
C. Hypotension.
D. Heart failure.

Answer 231

D. Heart failure.

Question 232

A client has a continuous IV infusion of dopamine (Intropin) and an IV of normal saline at 50 mL/hour. The nurse notes that the client’s urinary output has been 20 mL/hour for the last 2 hours. Which intervention should the nurse initiate?
A. Stop the infusion of dopamine.
B. Change the normal saline to a keep open rate.
C. Replace the urinary catheter.
D. Notify the healthcare provider of the urinary output.

Answer 232

D. Notify the healthcare provider of the urinary output.

Question 233

A nurse is providing care to a client in cardiogenic shock. The client is on a prescribed dopamine infusion at 10 mcg/kg/min with orders to titrate as needed. The latest blood pressure is 75/40 mmHg. Which action does the nurse perform next?
A. Recheck the client blood pressure
B. Increase the infusion rate to 12 mcg/kg/min
C. Report the findings to the healthcare provider
D. Decrease the infusion rate to 8 mcg/kg/min

Answer 233

B. Increase the infusion rate to 12 mcg/kg/min

Question 234

The nurse is caring for a client with a diagnosis of cardiogenic shock who has been prescribed dobutamine infusion. Which action should the nurse take first?
A. Compare the packaging of the medication to the prescription
B. Prime the IV tubing with the medication
C. Set the infusion pump for the correct infusion rate
D. Increase the frequency of blood pressure and heart rate monitoring on the bedside monitor

Answer 234

A. Compare the packaging of the medication to the prescription

Question 235

Which action is most important for the nurse to implement prior to the administration of the antiarrhythmic drug adenosine (Adenocard)?
A. Assess pupillary response to light.
B. Instruct the client that facial flushing may occur.
C. Apply continuous cardiac monitoring.
D. Request that family members leave the room.

Answer 235

C. Apply continuous cardiac monitoring.

Question 236

The nurse is planning care for a pediatric client with a new prescription for adenosine to treat symptomatic supraventricular tachycardia (SVT). Which action should the nurse include in the plan of care?
A. Monitor for ventricular dysrhythmias
B. Monitor for shortness of breath
C. Monitor for hypertension
D. Monitor for nausea

Answer 236

B. Monitor for shortness of breath

Question 237

A client with a dysrhythmia is prescribed procainamide (Pronestyl) in 4 divided doses over the next 24 hours. Which dosing schedule is best for the nurse to implement?
A. Every 6 hours.
B. QID.
C. AC and bedtime.
D. PC and bedtime.

Answer 237

A. Every 6 hours.

Question 238

A nurse is providing discharge education on the use of sustained-release procainamide to a client with newly diagnosed atrial flutter. What will the nurse include in the teaching?
A. You will need to have laboratory blood tests performed every 3 months
B. Hold the medication if your heart rate is below 70 beats/min
C. Notify your healthcare provider if you begin experiencing joint pain
D. Crush your medication and mix it with food to mask the taste

Answer 238

C. Notify your healthcare provider if you begin experiencing joint pain

Question 239

The nurse is caring for a client who is receiving procainamide intravenously. It is most important that the nurse monitors which parameter?
A. Serum potassium levels
B. Hourly urinary output
C. Continuous ECG readings
D. Neurological signs

Answer 239

C. Continuous ECG readings

Question 240

Which information is most important for the nurse to teach a client prescribed an antihypertensive medication to be taken once in the morning and a 2-gram sodium diet?
A. “Avoid adding salt to cooked foods.”
B. “Use less salt when preparing foods.”
C. “Take your medicine exactly as prescribed.”
D. “Measure your blood pressure every morning.”

Answer 240

C. “Take your medicine exactly as prescribed.”

Question 241

A health care provider in the emergency department identifies that a client is in cardiogenic shock. Which type of medication is indicated for management of this condition?
A. Loop diuretic
B. Cardiac glycoside
C. Sympathomimetic
D. Alpha-adrenergic blocker

Answer 241

C. Sympathomimetic

Question 242

The healthcare provider prescribes a beta-1 agonist medication to be administered. The nurse should anticipate the medication to be prescribed for a client diagnosed with which condition?
A. Glaucoma.
B. Hypertension.
C. Heart failure.
D. Asthma.

Answer 242

C. Heart failure.

Question 243

The nurse is monitoring the client who is taking newly prescribed antihypertensive medication. Which finding should indicate to the nurse that the client might be experiencing an allergic reaction to the medication?
A. Mild decrease in blood pressure
B. Increased urine output
C. Left-sided weakness
D. Development of a rash

Answer 243

D. Development of a rash

Question 244

A client develops hemolytic anemia. Which client medication can cause this adverse effect?
A. Famotidine
B. Methyldopa
C. Levothyroxine
D. Ferrous sulfate

Answer 244

B. Methyldopa