Exam 2 Flashcards
- A client with hypertension has been prescribed losartan. After 6 weeks of therapy, the primary health care provider decides the losartan alone is not controlling the client’s hypertension. What does the nurse anticipate will be added to the losartan regimen for better control of this client’s hypertension?
A.candesartan
B.hydrochlorothiazide
C.olmesartan
D. antidiuretic hormone (ADH)
B
The nurse is administering a beta blocker to a client with hypertension. Which would the nurse expect this drug to do? SELECT ALL THAT APPLY.
A. Increase renal blood flow
B.Decrease heart rate
C.Decrease cardiac muscle contraction
d)
Increase renin release
e)
Block vasodilation
ABC
A client is admitted to the intensive care unit in shock with hypotension. What is an appropriate nursing conclusion for this client?
a) impaired gas exchange
b)deficient fluid volume
C) risk for falls
D)ineffective peripheral tissue perfusion
D
After teaching a group of nursing students on the mechanism of action of angiotensin-converting enzyme inhibitor (ACEl) drugs, the instructor determines the session is successful after the students correctly choose which action as the result of aldosterone?
a)Inhibits renin secretion
B)Causes sodium and water retention
C)Causes excess potassium retention
D) Promotes angiotensin I conversion
B
A client with hypertension has had their ACE inhibitor discontinued and an angiotensin Il receptor blocker prescribed. What factor may have contributed to this change in medication?
Rebound hypertension
Persistent cough
Transient ischemic attack
Non-adherence to ACE inhibitor treatment
Persistent cough
- A nurse is caring for a client who has been diagnosed with primary hypertension.
What nursing interventions should be included in the teaching plan? Select all that apply.
e,
Regular aerobic exercise
Diet with more fruits and vegetables
Decreased alcohol consumption
Smoking cessation
Focus on finding a different job
All but focus
A client has been taking citalopram for several years to treat depression but has now consulted with the health care provider and has decided to stop taking the medication.
The nurse will ensure the client is following which recommendation?
Gradually reduce the daily dose over a period of several weeks.
Gradually introduce a tricyclic antidepressant while the client is reducing the SSRI dose.
Taper down the medication dose over 6 to 8 months, with medical supervision.
Ensure the client has a PRN lorazepam order to mitigate antidepressant discontinuation syndrome.
Gradually reduce the daily dose over a period of several weeks.
The nurse is caring for a 12-year-old client diagnosed with depression. Which category of medication would the nurse question before giving to this client?
tricyclic antidepressant (TCA)
monoamine oxidase inhibitor (MAOI)
serotonin norepinephrine inhibitor (SNRI)
selective serotonin reuptake inhibitor (SSRI)
monoamine oxidase inhibitor (MAOI)
. A client has been taking a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which represents the action of the medication?
SSRIs block GABA function.
SSRIs prevent serotonin from being reabsorbed.
SSRIs increase serotonin synthesis.
SSRIs increase the number of serotonin binding sites.
SSRIs prevent serotonin from being reabsorbed.
An older adult was diagnosed with depression several decades ago and has been taking tricyclic antidepressants (TCAs) ever since, with good effect. The nurse should recognize what therapeutic action of this client’s medication?
inhibiting monoamine oxidase inhibitors that break down norepinephrine
inhibiting generalized neuron activity, preventing overexcitability or stimulation
blocking the reuptake of serotonin, which increases the levels of norepinephrine
inhibiting reuptake of 5HT and NE
inhibiting reuptake of 5HT and NE
The female client states that her father has had high blood pressure all of his life and he is healthy. She does not understand why the care provider has prescribed medication for her blood pressure. What is the nurse’s best response?
“Maybe you do not need medication with your history.”
“With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease.”
“The effects of high blood pressure are different for different people.
“We always treat high blood pressure with medicine to prevent further damage to your body.”
“With high blood pressure, blood vessels may be damaged and that can cause heart and kidney disease.”
nurse is educating a group of nursing students on the mechanisms of action of angiotensin-converting enzyme inhibitors (ACEl). What should the nurse explain is the hormone produced by the adrenal cortex?
Angiotensin
Aldosterone
Renin
Enalapril
Aldosterone
The stimulation of beta adrenergic receptors in the heart by epinephrine would cause what result?
increased heart rate
decreased heart muscle contractions
decreased oxygen demand by the myocardium
vasoconstriction of the coronary arteries
Increased heart rate
Barbiturates are considered the sedative and hypnotic drugs of choice.
True
False
False
- Alpha and beta-specific adrenergic agonists are primarily used to treat obstren pulmonary conditions.
True
False
False
Which would be important to perform for a client who has received an anticholinergic agent? SELECT ALL THAT APPLY
Auscultating bowel sounds
Monitoring urine output
Monitoring heart rate
Administering an antidiarrheal agent
Assessing deep tendon reflexes
Auscultating bowel sounds
Monitoring urine output
Monitoring heart rate
Which would contraindicate the use of a topical nasal decongestant?
Nasal ulceration
Hypertension
Diabetes
Glaucoma
Nasal ulceration
Which of the following adrenergic receptors is responsible for the vasoconstriction of peripheral blood vessels?
a1 receptors
a2 receptors
B1 receptors
B2 receptors
A1 receptors
Which of the following adrenergic receptors is responsible for increased heart rate land increased force of myocardial contraction?
B1 receptors
a1 receptors
a2 receptors
B2 receptors
B1 receptors
Expectorants elicit their effect by which mechanism?
Thinning respiratory secretions
Breaking down thick mucus in the lower lungs
Depressing the cough center in the brain
Anesthetizing stretch receptors in the respiratory passages
Thinning respiratory secretions
The nurse is preparing to administer a sympathomimetic drug to a client. How does this drug achieve a therapeutic effect?
a) stimulating beta-receptors and blocking alpha-receptors
b)
stimulating alpha-receptors and blocking beta-receptors
c)
blocking adrenergic receptors
d)
stimulating alpha- and beta-receptors
Stimulating alpha and beta receptors
Anticholinergics have varied effects on the body. What is one of those effects?
Preventing vagal stimulation
Stimulating the release of acetylcholine
Increasing respiratory tract secretions
Increasing secretion of sweat glands
Preventing vagal stimulation
A client newly diagnosed with chronic obstructive pulmonary disease (COPD) asks the nurse to explain what the newly prescribed medications are for. What would be the most appropriate response by the nurse?
“The medications that have been prescribed for you are what the primary health care provider thinks will help your breathing the most.”
“The medications that have been prescribed for you are to help you breathe with less resistance from your diaphragm.”
“The medications that have been prescribed for you are designed to work together to reduce your oxygen requirements.”
‘The medications that have been prescribed for you are to help relieve the inflammation and open your airways.”
‘The medications that have been prescribed for you are to help relieve the inflammation and open your airways.”
The nurse is caring for a client who is taking a bronchodilator. In what disease process should bronchodilators be used cautiously?
liver failure
renal failure
respiratory failure heart failure
Heart failure
Heart failure
When the nurse administers a beta-adrenergic blocker to a client with angina, the nurse expects the drug will help to control angina. What other effect does a beta-adrenergic blocker have?
increased heart rate
increased oxygen consumption
decreased strength of heart muscle contraction
decreased urinary output
decreased strength of heart muscle contraction
For which adverse reactions should the nurse monitor the patient who has been administered antipsychotic drugs?
Hypertension
Skin eruptions
Dry mouth
Bradycardia
Dry mouth
patient admitted to the health care facility for alcohol withdrawal has been prescribed an antianxiety medication. Why should the nurse suggest the patient stop consuming alcohol while therapy is ongoing?
Increased risk for digitalis toxicity
Increased risk for respiratory depression
Increased risk for sedation
Increased risk for central nervous system depression
Increased risk for central nervous system depression
nurse is caring for an elderly patient undergoing antianxiety treatment. The patient is to be administered antianxiety drugs parenterally. What precautions should be taken by the nurse?
Arrange for a blood transfusion.
Provide fiber-rich food.
Provide plenty of fluids.
Have resuscitative equipment ready.
Have resuscitative equipment ready.
What are sedatives and hypnotics used to treat? (Select all that apply.)
Headache
Status epileptic
Preoperative sedation
Insomnia
Hypertension
Hypertension
Status epileptic
Preoperative sedation
Insomnia
client is administered atropine to increase the heart rate. What is the action of
atropine?
It blocks the parasympathetic vagal stimulation.
It exacerbates the parasympathetic vagal stimulation.
It provides long-acting antihistamine blockage.
It blocks cell wall synthesis of gram-negative bacilli.
It blocks the parasympathetic vagal stimulation.
Which symptom should the nurse monitor for when caring for a client whose sinus bradycardia has been treated with large doses of atropine?
Pallor
Flushing
Edema
Incontinence
Flushing
What is the most common first line therapy for relief of an acute asthma attack?
Inhaled steroid
Leukotriene modifier
Beta2-adrenergic agonist
Xanthine
Beta 2
A 28-year-old woman has been diagnosed with schizophrenia. The health care provider has prescribed a typical antipsychotic, haloperidol. Which will the nurse include in the teaching related to the most common adverse effects?
Neuroleptic malignant syndrome
Agranulocytosis
Extrapyramidal symptoms
Gastrointestinal problems
Extrapyramidal symptoms
A patient taking olanzapine (Zyprexa) reports a new onset of excessive sedation.
The nurse reviews the patient’s medication history and notes that the patient has recently started taking St. John’s Wort for depression. Which of the following is the most likely cause of the patient’s symptoms?
St. John’s Wort increases the metabolism of olanzapine, reducing its efficacy.
St. John’s Wort decreases the metabolism of olanzapine, leading to increased sedation.
St. John’s Wort has no known interaction with olanzapine.
The patient’s symptoms are unrelated to the new herbal supplement and are likely due to disease progression.
St. John’s Wort decreases the metabolism of olanzapine, leading to increased sedation.
client presents with chronic renal failure with dialysis. The clients blood pressure is
180/110 mm Hg. The prescriber orders an intravenous line to be placed and administration of sodium nitroprusside (a vasodilator). Which statement is included in the instructions to the client about this medication?
“The medication will assist to bring down your blood pressure.”
“You should feel less pain with this medication.”
“Be prepared to feel more relaxed and have a sense of relief.”
“The medication will decrease your oxygen demand and decrease coronary spasm.”
“The medication will assist to bring down your blood pressure.”
- An adolescent client is diagnosed with mild persistent asthma and is prescribed a low-dose inhaled glucocorticoid to be taken daily. The client’s parents express concern about receiving a daily glucocorticoid and how that will affect their child. Which
“Inhaled glucocorticoids slow how fast my child grows, m but they will still be as tall as they would have been without the medication as an adult.”
“Our child needs to take supplements of calcium and vitamin D and perform regular exercise to ensure the bones remain strong. Loss of bone mass will occur when inhaled corticosteroids are used over long periods of time.”
“We understand that long-term use of inhaled glucocorticoids may increase the risk of eye problems such as cataracts and glaucoma.”
“Oral thrush and a hoars voice are unavoidable side effects when using inhaled glucocorticoids.”
“Oral thrush and a hoars voice are unavoidable side effects when using inhaled glucocorticoid
. The nurse is providing client education regarding the use of medications to treat seasonal allergies. Which statement by the client shows a need for further teaching?
I should avoid driving after taking a first-generation antihistamine like diphenhydramine.
Diphenhydramine and loratadine can cause side effects like dry mouth, constipation, and urinary retention.”
Second generation antihistamines such as loratadine do not cause sedation.”
“It doesn’t matter which second generation antihistamine I take; they all work equally as well.”
Diphenhydramine and loratadine can cause side effects like dry mouth, constipation, and urinary retention.”
A nurse is reviewing the medications of a patient with hypertension and notices the patient is taking Norasc. Which of the following correctly identifies the genetic hame and classification of this medication?
Generic Name: Diltiazem; Classification:
Calcium Channel Blocker
Generic Name: Amlodipine; Classification: Calcium Channel Blocker
Generic Name: Lisinopril; Classification: ACE Inhibitor
Generic Name: Losartan; Classification: Angiotensin Il Receptor Blocker
Generic Name: Amlodipine; Classification: Calcium Channel Blocker
patient with depression is prescribed Zoloft. Which of the following correctly identifies the generic name and classification of this medication?
Generic Name: Fluoxetine; Classification: SSRI
Generic Name: Sertraline; Classification: SSRI
Generic Name: Lorazepam; Classification: Benzodiazepine
Generic Name: Diltiazem; Classification: Calcium Channel Blocker
Generic Name: Sertraline; Classification: SSRI
A patient is prescribed Cozaar for hypertension. Which of the following correctly matches the brand name, generic name, and classification of this medication?
Brand Name: Cozaar; Generic Name: Losartan; Classification: Angiotensin lI
Receptor Blocker
Brand Name: Zestril; Generic Name: Lisinopril; Classification: ACE Inhibitor
Brand Name: Toprol; Generic Name: Metoprolol; Classification: Beta Blocker
Brand Name: Inderal; Generic Name: Propranolol; Classification: Beta Blocker
Brand Name: Cozaar; Generic Name: Losartan; Classification: Angiotensin lI
Receptor Blocker
nurse is teaching a 45-year-old client about the sublingual nitroglycerin that the health care provider has prescribed for management of stable angina. Which statement by the client indicates that the client understands the teaching session?
“I will take the nitroglycerin twice a day.”
“I will use the nitroglycerin if I experience chest pain.”
“I will take the nitroglycerin whenever I eat, to help with the absorption of the medication.”
“I will take the nitroglycerin once a week to improve my ability to exercise.”
“I will use the nitroglycerin if I experience chest pain.”
-An asthmatic client on a beta blocker should be observed for which adverse Veaction?
Bronchospasm
Hypoglycemia
Pleural effusion
Pneumonia
Bronchospasm
The chest pain and pressure a client experiences during an anginal attack is caused by which of the following?
decreased oxygen supply to the heart. increased oxygen supply to the heart.
vasodilation of the arteries around the heart. decreased workload on the heart.
Decreased oxygen supply to the heart
A client may administer a maximum of how many doses of sublingual nitroglycerin in a 15-minute period?
3
4
1
2
3
- A client has just been admitted for an overdose of pseudoephedrine. The nurse’s assessment of the client should prioritize what system?
cardiovascular
neurological
gastrointestinal
renal
Cardiovascular
When instructing a client in how to use a topical nasal spray, what would the nurse emphasize to do first?
Clear the nasal passages.
Spray the medication with the bottle upright.
Lie down to tilt the head back.
Close the opposite nares.
Clear the nasal passages
A male college student has presented to the campus medical clinic reporting cold symptoms that he has been experiencing for the past 2 weeks. He tells the nurse that he has been taking OTC decongestants twice daily since the onset of the cold. What teaching point should the nurse provide to this student?
“‘s best to take small doses of decongestants several times daily rather than two larger doses each day.”
“You can probably expect to get relief within the next few days or a week at the
longest.”
“Over-the-counter decongestants don’t normally work; you’l likely need to get a prescription for something more effective.”
“You might find yourself more congested than ever as your body compensates for your use of these drugs.”
“You might find yourself more congested than ever as your body compensates for your use of these drugs.”
- An older adult client has been prescribed ipratropium by metered-dose inhaler and the nurse has provided education on using the device. When demonstrating the technique back to the nurse, the client is unable to coordinate pressing down on the inhaler and maintaining a seal with their lips. What is the nurse’s best action?
Obtain a spacer and educate the client on its use.
Advocate for a change to a medication available by the oral route.
Identify a trusted family member to be responsible for administration.
Request an increased dose from the health care provider to offset the client’s incorrect technique.
Obtain a spacer and educate the client on its use.
- A client has been admitted to the emergency department (ED) in status asthmaticus.
The ED nurse should anticipate administering which medication?
inhaled corticosteroids
intravenous theophylline
high doses of montelukast
beta2 agonists in high doses
Beta 2
A nurse is preparing to administer clonidine to a patient with hypertension. The nurse knows that clonidine belongs to which drug class, and what is its primary mechanism of action?
Class: Beta-Blocker; Mechanism of Action: Blocks beta-adrenergic receptors, decreasing heart rate and contractility.
Class: Calcium Channel Blocker; Mechanism of Action: Inhibits calcium ions from entering cardiac and vascular smooth muscle, leading to vasodilation.
Class: Alpha-2 Adrenergic Agonist; Mechanism of Action: Stimulates alpha-2 adrenergic receptors in the brain, reducing sympathetic outflow and lowering blood pressure.
Dio angieni, Mincha an of cin hire the conversion of aradensin
Class alpha 2
