Cardiology HW Qs Flashcards by Katie White

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.

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

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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

A. Difficulty feeding with vomiting

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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

A. 70 beats/min

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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.’

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

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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

B. Vomiting

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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.

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.

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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

A. Digoxin

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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

B. Yellow vision

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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

C. Cardiac dysrhythmias

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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

A. Digoxin

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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

A. Vomiting

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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

A. Digoxin

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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.

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

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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.’

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

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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

C. Increased contractile force of the myocardium

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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

A. Maintaining potassium levels

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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

C. Signs and symptoms of digoxin toxicity

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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.

B. Monitor the client for cardiac dysrhythmias.

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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

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

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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

B. Bradycardia

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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

A. Resolution of heart failure

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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.’

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

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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.

D. Report increasing fatigue.

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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

D. Slows and strengthens cardiac contractions

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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

D. Slows and strengthens cardiac contractions

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

A. Apical heart rate

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

A. Nausea B. Yellow vision C. Irregular pulse

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.'

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

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.

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

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

A. Digoxin

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

A. Potassium level of 3.1 mEq/L

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.

D. Vomiting.

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.

B. Assess the serum potassium level.

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

B. Consult the pharmacist regarding the error

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.

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

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

C. Low potassium level

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

A. Increased heart rate

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

D. Clarify the prescription with the healthcare provider

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

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

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

D. Cardiac dysrhythmias

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

B. Measure apical pulse prior to administration

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

B. Nausea, vomiting, fatigue

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

C. Bradycardia

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

A. Muscle weakness or cramping

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.

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

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

B. Digoxin C. Theophylline

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

A. Potassium levels

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

C. Digoxin (Lanoxin)

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

C. Blood pressure of 94/60

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

B. Serum potassium 3.1 mEq/L

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

C. Tomato juice

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

C. Improved respiratory status with increased urinary output

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

D. Assess the apical pulse for a full minute

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."

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

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

A. 70 beats/min

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

D. Cardiac glycoside/digoxin

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

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

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

B. Cardiac arrest

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

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

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.

A. Oliguria is an indication for withholding IV potassium.

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

B. Potassium chloride

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

D. Discontinue the IV catheter

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

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

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.

B. Take the medication with food.

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

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

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

D. Prevent electrolyte imbalance

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

A. To report any abdominal distress

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.'

A. 'I will report any abdominal distress.'

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.

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

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."

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

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

A. Broccoli

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

B. QRS duration of 0.28 seconds

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)

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

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

D. Relieved by sublingual nitroglycerin

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.'

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

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.

C. Decreased cardiac preload reduces cardiac workload.

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.'

C. 'It decreases cardiac oxygen demand.'

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.

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

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.'

A. 'I may experience a headache.'

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.

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

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

B. Hypotension

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.'

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

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.

B. The tablets are more than 3 months old.

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.'

B. 'Remove a previous patch before applying the next one.'

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.

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

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.'

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

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

A. Nitroglycerin

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%.

A. Client states chest pain is relieved.

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

B. Orthostatic hypotension

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.

C. The client reports a decrease in chest pressure.

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."

C. "Take one tablet immediately when you experience chest pain."

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

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

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

D. Blood pressure

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."

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

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

A. Headache

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

C. Carry the nitroglycerin with you at all times

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."

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

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

D. Blood pressure

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."

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

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

A. 1 to 3 minutes

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.'

C. 'Common side effects include headache and low blood pressure.'

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

D. Hypotension

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.

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

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

B. Sublingual spray

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.

A. Swallow the capsule whole.

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

A. Relief of anginal pain

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

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

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

D. Relaxing venous and arterial smooth muscles

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.

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

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.

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

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

B. Auscultating breath sounds

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

D. Loop of Henle

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

A. Weight loss D. Excessive loss of potassium ions

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

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

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

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

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

D. Absence of peripheral edema

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

B. Muscle cramps

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.

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

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.

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

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

D. Decreased appetite

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

B. Muscle weakness

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

A. Furosemide

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

B. Furosemide

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

D. Furosemide

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

D. Bananas

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

B. Buzzing ears

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.'

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

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

C. Hypokalemia

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

A. Osmosis

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.'

A. 'This can decrease my vitamin K level.'

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

A. Hypokalemia

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.

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

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."

D. "Increase the intake of potassium-rich foods."

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

D. Generalized weakness

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

A. Blood pressure

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.

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

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.'

A. 'HCTZ has fewer side effects.'

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

A. Increases the excretion of sodium

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.'

D. 'Increase the intake of potassium-rich foods.'

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."

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

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.

C. They reduce the circulating blood volume.

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.

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

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

B. Tinnitus C. Weakness D. Leg cramps

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

B. Hypokalemia

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

C. Hyperkalemia

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.

A. Verify both prescriptions with the healthcare provider.

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.

B. Refrain for eating foods high in potassium.

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

A. Review the drug formulary for side effects

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

C. Potassium

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

C. Promotes sodium and chloride excretion

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

C. Spironolactone

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

A. Potatoes C. Cantaloupe

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

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

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

A. Clarify the prescription with the healthcare provider

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

D. Dizziness

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

B. Most recent heart rate

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."

C. "I'm experiencing decreased sex drive."

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

C. Monitor the client's blood pressure

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."

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

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."

C. "This drug will decrease the workload on your heart."

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

B. Slow, irregular heart rate

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

A. Asthma

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

A. Heart rate decreases

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.

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

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

D. Hypotension

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.

B. Avoid abruptly discontinuing the medication.

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

A. Dizziness with strenuous activity

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.'

A. 'I must take the medication before going to bed.'

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

A. Paroxysmal nocturnal dyspnea

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.

A. Do not abruptly discontinue the medication.

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

C. Blocking the adrenergic response

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.

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

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.

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

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.

B. Wheezing, hypotension, and AV block.

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.

C. Blood pressure.

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

C. Decreased heart rate

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

C. Timolol maleate

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.

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.

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).

A. Assess for dizziness.

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

D. Captopril E. Lisinopril

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.'

A. 'Change to a standing position slowly.'

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

D. Decreased blood pressure

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.

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

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

C. Captopril

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.

B. Dizziness.

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

B. Clarify the prescription with the healthcare provider

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.

B. Avoid using salt substitutes.

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

C. Naproxen

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

D. Angiotensin-converting enzyme (ACE) inhibitors

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.

D. Check the blood pressure.

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

B. Hyperkalemia

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.

A. Withhold the scheduled dose.

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.

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

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.

C. Risk for injury.

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

C. Blood pressure of 125/79 mmHg

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

A. Renal stenosis

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.'

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.'

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

D. Facial flushing

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

C. Difficulty breathing

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.

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

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

B. Grapefruit juice

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

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

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

A. Schedule for taking medication

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.

D. Change slowly from sitting to standing.

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

C. Heart rate of 98 beats/minute

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

B. Grapefruit juice

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

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

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)

B. Triglycerides

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.

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

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.

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

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.

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

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."

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."

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)

A. Retinol (Vitamin A)

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.'

A. 'Increase your intake of fiber and fluid.'

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)

B. Calciferol (vitamin D)

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

A. At least 1 to 2 hours after other medications

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.

A. Expected duration of flushing.

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

B. Decrease in cardiac dysrhythmias

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

C. Amiodarone

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

A. Amiodarone

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

C. Amiodarone

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

A. Xerostomia

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.

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

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

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

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

A. Tremors

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

B. Pulse rate of 48 beats per minute

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

A. Dry mouth C. Constipation

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

D. Sodium bicarbonate

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

A. Refer to an IV compatibility chart

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.

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

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.

D. Heart failure.

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.

D. Notify the healthcare provider of the urinary output.

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

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

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

A. Compare the packaging of the medication to the prescription

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.

C. Apply continuous cardiac monitoring.

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

B. Monitor for shortness of breath

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.

A. Every 6 hours.

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

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

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

C. Continuous ECG readings

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."

C. "Take your medicine exactly as prescribed."

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

C. Sympathomimetic

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.

C. Heart failure.

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

D. Development of a rash

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

B. Methyldopa