Chapter Questions

Question 1

The client is started on propranolol (Inderal). Which is the most important action to be included in the plan of care for this client related to this medication?

1. Monitor apical pulse and BP
2. Elevate the head of the bed during meals
3. Take the medication after meals.
4. consume foods high in potassium.

Answer 1

1. Monitor apical pulse and BP

Question 2

Which of the following should the nurse instruct a client with diabetes who is prescribed a beta-adrenergic blocker for the treatment of hypertension to do?

1. Increase insulin intake by 2 to 3 unit daily each morning.
2. Decrease the intake of carbohydrates while on the antihypertensive medications
3. Elevate the lower extremities to promote venous drainage
4. Monitor blood glucose levels frequently and report hypoglycemia.

Answer 2

4. Monitor blood glucose levels frequently and report hypoglycemia.

Question 3

To avoid the first-dose phenomenon, the nurse knows that the initial dose of prazosin (Minipress) should be:

1. Very low and given at bedtime
2. Doubled and given before breakfast
3. The usual dose and given before breakfast
4. Doubled and given immedicately after breakfast

Answer 3

1. Very low and given at bedtime

Question 4

A client who is taking an adrenergic antagonist for hypertension reports being dizzy when first getting out of bed in the morning. The nurse should advise the client to

1. Move slowly from the recumbent to the upright position.
2. Drink a full glass of water before riising to increase vascular circulatory volume.
3. avoid sleeping in a prone position
4. stop taking the medication

Answer 4

1. Move slowly from the recumbent to the upright position.

Question 5

A health care provider has ordered an alpha-adrenergic antagonist for each of these clients. A nurse should question the order for the client with which disorder?

1. Benign prostatic hyperplasia
2. Phenochromocytoma
3. Raynaud’s disease
4. Tachycardia

Answer 5

4. Tachycardia

Question 6

The client taking atorvastatin (Lipitor) reports weakness and fatigue, pain in the shoulders, and aching joints. The nurse initially assesses the client for which condition?

1. Rhabdomyolysis
2. Renal failure
3. Rheumatoid arthritis
4. Hepatic insuffciency

Answer 6

1. Rhabdomyolysis

Question 7

A client is receiving chilestyramine (questran) for elevated low-density lipoprotein levels. Which adverse effect should the nurse include in the nurse plan to monitor the client?

1. Orange-colored urine
2. Abdominal pain
3. Sore throat and fever
4. Decreased capillary refill

Answer 7

2. Abdominal pain

Question 8

The provider order colestipol (colestid) n combination with atorvastatin (lipitor) for a client with elevated low-density lipoprotein lvels. The nurse collabrorates with the prescriber about which data related to the client?

1. Past history of peptic ulcer disease
2. Recent MI
3. laboratory value for serum sodium of 136 mEq/L
4. allergies to food high in tyramine

Answer 8

1. Past history of peptic ulcer disease

Question 9

The community health nurse visits a client who has been prescribed loastatin (Mevacor). Which statement, if made by the client, indicated that further teaching is necessary concerning this drug therapy?

1. “I should try to maintain my body weight at an optimal level.”
2. “Most clients with lipid disorders don’t have any symptoms.”
3. ” The best time for me to take this medication is before I go to bed.”
4. ” I will take my drug with beverages that contain grapefruit juice.”

Answer 9

4. ” I will take my drug with beverages that contain grapefruit juice.”

Question 10

nifedipine (Procarda) is being initiated for a client with elevated blood pressure. What health teaching would be most approiate? The client should:

1. weigh daily at the same time each day.
2. avoid crowds while taking this medication
3. increase intake of calcium-containing foods.
4. take this medication only when feeling that blood pressure is elevated.

Answer 10

1. weigh daily at the same time each day.

Question 11

A client is receiving felodipine (plendil) fr hypertension. In the care plan the nurse includes the need to monitor the client for which adverse effect?

1. rash and chills
2. increased urinary output
3. weight loss
4. reflex tachycardia

Answer 11

4. reflex tachycardia

Question 12

a client with primary hypertension has started therapy with verapamil (calan). The nurse performs what important intervention during the initial course of this treatment?

1. uses an electric razor to shave the client
2. monitors the client for increased thrombocyte levels
3. administers the meciation only during waking hours
4. measures intake and output ratio and daily weight

Answer 12

4. measures intake and output ratio and daily weight

Question 13

The nurse determines that the client understands an important principle in self-administration of nifedipine (procardia) when the client makes which statement?

1. “The use of antacids when taking the medications will enhance absorbtion.”
2. “grapefruit juice may enhance the absorbtion of nifedipine.”
3. ” If i miss a dose, i should take two nifedipine capsules when i remember.”
4. “This drug will make my birth control pills ineffective.”

Answer 13

2. “grapefruit juice may enhance the absorbtion of nifedipine.”

Question 14

a health care provider has ordered nifedipine (procardia XL) for each of these clients. A nurse will most closely monitor which client for drug-related problems?

1. a client who is admitted for an appendetomy in the morning.
2. a client is receiving renal dialysis three times per week.
3. A client who develops pulmonary edema in the intensive care unit
4. a client who receives psychotropic drugs for bipolar disease.

Answer 14

3. A client who develops pulmonary edema in the intensive care unit

Question 15

the community health nurse teaches a client at home. lisinopril (prinivil) has been prescribed for the client. which statesment, if made by the client, indicates that further teaching is necessary?

1. “I should notify my health care provider of symtoms of hypotension such as dizziness or fainting.”
2. ” I should avoid the use of salt substitue containing potassium.”
3. ” If a dose is missed, I will take it as soon as possible not too close to the next dose.”
4. ” Too much calcium in my diet will elevate my blood pressure.”

Answer 15

4. ” Too much calcium in my diet will elevate my blood pressure.”

Question 16

The client states, “ I always keep my lisinopril (prinivil) on my kitchen window sill. it helps me to remember to take it.” The nurse’s response would be based on whuch pharmacologic concept about heat and moisture?

1. They cause the medicine to break down.
2. They enhance the strenght of the drug.
3. They crystallize the medication
4. They convert the medicine to toxic metabolites.

Answer 16

1. They cause the medicine to break down.

Question 17

A client is hospitalized or uncontrolled hypertension and is receiving enalapril (vasotec). The nurse should notify the health care provider if the client exhibits:

1. dry mucous membranes
2. a decline in systolic blood pressure
3. nonproductive cough.
4. a reduction of diastolic blood pressure.

Answer 17

3. nonproductive cough.

Question 18

the nurse is caring for a client with chronic hypertension. the client is receiving losatan( Cozaar) daily. which client manifestations would the nurse conclude is an adverse effect of this medication?

1. Irritability and tremors
2. headache and dizziness
3. sleepiness and slurred speech
4. pruritus and rash

Answer 18

2. headache and dizziness

Question 19

Irbesartan (Avapro) is prescribed for each of the following clients. A nurse should question the order for which client? A client who has:

1. severe dehydration from diuretic therapy
2. long-term diabetes mellitus
3. a systolic blood pressure of 162
4. a 5-year history of heart failure

Answer 19

1. severe dehydration from diuretic therapy

Question 20

The nurse determines that the client does not understand an important principle in self-administration of benazepril (lotensin) when the client makes which statement?

1. “I will learn to monitor my own blood pressure and write down all my daily measurments.”
2. ” While taking this medication, I should avoid over-the-counter medications for colds, sinus, or appetite control.”
3. “This drug will not impair thinking and reaction time. I dont need to wait to start driving my car.”
4. “Drinking alcohol while on this medication can lower my blood pressure and lead to dizziness and faintness.”

Answer 20

3. “This drug will not impair thinking and reaction time. I dont need to wait to start driving my car.”

Question 21

The nurse is teaching a group of clients with cardiac conditions who are taking diuretic therapy. the nurse explains that individuals prescribed furosemide (lasix) should:

1. Avoid consuming large amounts of cabbage, cauliflower, and kale.
2. rise slowly from sitting and lying positions.
3. count their pulse for 1 full minute before taking the medications.
4. restrict fluid intake to no more than 1000 ml in a 24-hr period.

Answer 21

2. rise slowly from sitting and lying positions.

Question 22

The client is receiving bumetanide (bumex) is instructed to watch for symptoms associated with electrolyte imbalances. Which condition would the client most likely experience?

1. hyponatremia
2. hypokalemia
3. hyperkalemia
4. hypocalcemia

Answer 22

2.hypokalemia

Question 23

While preparing a client for dicharge, which of the following statements should the nurse include in the instructions regarding the client’s new prescription of hydrochlorothiazide (microzide)?

1. “There is no limitations on the amount of salt and fluid intake.”
2. ” ingest vitamin k-rich foods daily, such as green leafy vegetables and brocilli.”
3. “Report muscle cramps or weakness to te health care provider.”
4. ” antihypertensive drugs taken concurrently may produce sleepiness.”

Answer 23

3.”Report muscle cramps or weakness to te health care provider.”

Question 24

clients prescribed spironolactone (Aldactone) are often at rsk for electrolyte imbalance. The nurse assesses for this adverse effect because this drug may cause the body to:

1. retain potassium
2. release magnesium
3. excrete potassium
4. bind calcium

Answer 24

1. retain potassium

Question 25

Which nursing measures should be a nursing priority for a client when beginning mannitol(osmitrol)?

1. keep the urinal or bedpan available for clients with limited mobility.
2. assess for hypokalemia and encourage foods high in potassium
3. monitor intake and output ratio, and weigh the client daily.
4. monitor blood pressure and asses for level of consciousness.

Answer 25

4. monitor blood pressure and asses for level of consciousness.

Question 26

The nurse is monitoring a client receiving acetazolamide (Diamox). Which acid-base imbalance is a potential risk for this client?

1. metabolic acidosis
2. metabolic alkalosis
3. respiratory acidosis
4. respiratory alkalosis

Answer 26

1. metabolic acidosis

Question 27

Methyldopa (Aldomet) is being initiated for a client with hypertension. which health teaching would be most approiate for this drug?

1. avoid hot baths and showers, and prolonged standing in one position.
2. this drug may discolor the urine a pinkish-brown color.
3. you may experience bloating and weight gain.
4. the tablet should be taken only with food or milk.

Answer 27

1. avoid hot baths and showers, and prolonged standing in one position.

Question 28

A client receiving hydralazine (apresoline) for elevated blood pressure levels The nurse would include in the care plan to monitor the clinet for which adverse effects/

1. atelectasis
2. crystalluria
3. photosensitivity
4. orthostatic hypotension

Answer 28

4. orthostatic hypotension

Question 29

the nurse determines that the client understands an important principle in self-administration of hydralazine (Apresoline) when the client mkes which statement?

1. ” I should not drive until the response to drug therapy is determined.”
2. ” I can stop taking this medication once I begin to feel better.”
3. “If I experience dizziness, I should take only half the dose. “
4. “I should avoid air travel while taking this medication.”

Answer 29

1. ” I should not drive until the response to drug therapy is determined.”

Question 30

A client with hypertension crisis is started on nitroprusside (Nipride) therapy. The nurse would perform what priority intervention during the course of this treatment?

1. monitor for the presense or absense of bowel sounds.
2. obtain urine samples for specific gravity measurements and glucose levels.
3. observe skin pressure points for turgor and integrity.
4. tritrate intravenous infusion rate according to the blood pressure response.

Answer 30

4. tritrate intravenous infusion rate according to the blood pressure response.

Question 31

Methylodopa (Aldomet) has been associated with the development of antibodies (positive coombs’ test) in a significant number of clients. To determine if a client is developing further complications associated with these antibodies, what will the nurse also monitor?

1. red blood cell count
2. cardiac output
3. development of urticaria
4. plasma drug levels.

Answer 31

1. red blood cell count

Question 32

the client with deep vien thrombosis is being treated with a heparin infusion. The nurse would monitor for therapeutic effectiveness by noting which of the following?

1. activated partial thromboplastin time (aPTT)
2. prothrombin time (PT)
3. platelet counts
4. international normalized ratio (INR)

Answer 32

1. activated partial thromboplastin time (aPTT)

Question 33

A client who is taking warfarin (Coumadin) states, “ I wake up every morning with arthritis painand I always take aspirin or ibuprofen.” The nurse’s response would be ased on which physiological concept?

1. aspirin and ibuprofen (motrin) will counteract the therapeutic effect of many anticoagulants.
2. antioagulants will reduce the half-life of drugs such as aspirin and ibuprofen.
3. many substances such as aspirin and ibuprofen will increase the risk of bleeding
4. the combination of aspirin products with anticoagulants will worsen arthritis pain.

Answer 33

3. many substances such as aspirin and ibuprofen will increase the risk of bleeding

Question 34

What should the nurse teach the client who is to receive alteplase (activase) as a part of the treatment for myocardial infarction?

1. the drug will be given IV, and the client should be able to go home later today.
2. the client should remain quiet and lying down durin drug administration and for up to 8 hours after infusion.
3. the risk of bleeding returns to normal within 24 hours after the drug has been infused.
4. an increase n vitamin-k rich foods or a supplement will be needed for the week following the treatment.

Answer 34

2. the client should remain quiet and lying down durin drug administration and for up to 8 hours after infusion.

Question 35

A client who is taking clopidogel (plavix) to prevent another stroke asks the nurse how the medication works. the nurse response should be based on an understanding that plavis:

1. inhibits platelet aggregation to prevent clot formation
2. activates antithrombin III and subsequently inhibits thrombin.
3. inhibits enzymes involved in the formation of vitamin K.
4. converts plasminogen to plasma to dissolve fibrin clots.

Answer 35

1. inhibits platelet aggregation to prevent clot formation

Question 36

an adult client has been receiving testosterone (testoderm) for the treatment of prmary hypogonadism. Which labatory test would the nurse monitor to determine that this drug thereapy is effective?

1. red blood cell count
2. sperm count
3. FSH
4. LH

Answer 36

2. sperm count

Question 37

The client with erectile dysfunction s beng evaluated for pharmacotherapy. which question should the nurse ask prior to initiating therapy with sildenafil (viagra)?

1. “are you currently taking medication for angina?”
2. “Do you have history of diabetes/”
3. ” have you ever had an allergic reaction to pencillin products?”
4. ” Have you ever been treated for gastic ulcers?”

Answer 37

1. “are you currently taking medication for angina?”

Question 38

the nurse is counseling a client about the goal of therapy with sildenafil (viagra). what will the nurse teach the client about the drugs effects?

1. it should always result in a penile erection within 10 mins.
2. it is not effective if sexual dysfunction is psychological in nature
3. it will result in less intense feelings with prolonged use
4. it may heighten sexual response in female partners.

Answer 38

2. it is not effective if sexual dysfunction is psychological in nature

Question 39

a client who has takn finasteride (proscar) for the past 8 months reports sudden increase in urinary hestitancy, urinary retention, and slowing of the urinary stream.what will the nurse teach this client to do?

1. continue to take the drug to achieve full effects.
2. decrease the intake of coffee, tea and alcohol
3. discuss the use of a low-dose diuretic with the health care provider.
4. return to the health care provifer for PSA laboratory studies and a prostate exam.

Answer 39

4. return to the health care provifer for PSA laboratory studies and a prostate exam.