Med Chart 6 practice questions Flashcards
A patient is taking Digoxin, what are some adverse effects would the the nurse might see? SATA (select all that apply)
A. colored vision B. Anorexia C. N/V D. dysrhythmias E. Hypotension
A. colored vision
B. Anorexia
C. N/V
D. dysrhythmias
Which is true regarding Digoxins MOA:
A. Negative Inotropic, Positive Dromotropic, Negative Chemotropic
B. Positive Inotropic, Negative Dromotropic, Negative Chemotropic
C. Positive Inotropic, Positive Dromotropic, Negative Chemotropic
B. Positive Inotropic, Negative Dromotropic, Negative
True or false:
Digoxin does not affect Blood pressure
True
Which Beta Adrenergic Antagonist is noncardioselective and may exacerbate asthma?
A. Propranolol (Inderal)
B. Metoprolol (Lopressor/ Toprol)
C. Atenolol (Tenormin)
A. Propranolol (Inderal)
What are Calcium Channel Blockers Dihydropyridines used for? SATA
A. Hypotension
B.Hypertension
C. Angina Pectoris
D. COPD
B.Hypertension
C. Angina Pectoris
Which statements shows the nurse the patient is educated about calcium channel blockers?
A. I can still smoke while taking calcium channel blockers
B. If i have headaches i should be concerned
C. I can not eat grapefruits will taking calcium channel blockers
C. I can not eat grapefruits will taking calcium channel blockers
What are Calcium Channel Blockers Nondihydropyridines used for? SATA
A. Angina pectoris
B. hypertension
C. coronary artery disease
D. hypotension
A. Angina pectoris
B. hypertension
C. coronary artery disease
A patient has hypertension and a Potassium level of 5.7. Which drug would be given to this patient?
A. Enalapril
B .Losartan
C. Clonidine
B .Losartan
it wouldnt be Enalapril because patient already has a high potassium level and hyperkalemia is an adverse effect of that drug
A patient is given Nitroglycerin for her angina. What adverse effects would the nurse look out for? SATA (select all that apply)
A. Hypotension B. Hypertension C. Headache D. Blurred vision E. Syncope F. Tolerance
A. Hypotension C. Headache D. Blurred vision E. Syncope F. Tolerance
A patient was given Nitroglycerin sublingual. The patient says her under her tongue is burning. What would the nurse do?
A. Notfiy HCP
B. Stop medication
C. Normal side effect
C. Normal side effect
A patient is given the topical ointment of nitroglycerin. What statements indicates proper patient education.
A. I will apply it with my hand
B. I will wash previous application site
C. I will put it in the same spot everytime
B. I will wash previous application site
HCP tells nurse to give patient a calcium channel blocker. The patient has a Blood pressure of 80/100. What should the nurse do?
A. hold the drug and question the HCP
B. proceed to give med to patient
C. none of the above
A. hold the drug and question the HCP
you would hold the drug since the systolic BP is less than 90
A patient recently started taking Verpamil. What statements indicates the patient is educated about this med. SATA
A. I will avoid eating grapefruit
B. I can still smoke and drink with this med.
C. I cant breastfeed with this med.
D. Report if i have and palpitations or nausea
A. I will avoid eating grapefruit
C. I cant breastfeed with this med.
D. Report if i have and palpitations or nausea
What is an adverse effect that can happen while taking Enalapril? SATA
A. dysrhythmias
B. hyperkalemia
C. persistent cough
D. angioedema
B. hyperkalemia
C. persistent cough
D. angioedema
What antihypertension drug only blocks effects of Angiotensin 2
A. Enalapril
B. Clonidine
C. Losartan
D.Prazosin
C. Losartan
What Alpha 2 Agonists drug would a HCP prescribe for hypertension
A. prazosin
B.Clonidine
C. Losartan
B.Clonidine
What are some adverse effects for Hydralazine? SATA
A. bradycardia
B. reflex tachycardia
C. fluid retention
D. lethargy
B. reflex tachycardia
C. fluid retention
A patient is experiencing heparin overdose. Which medication would the nurse prepare to administer?
vitamin K
factor VIII
antihistamine
protamine sulfate
protamine sulfate
The nurse monitors the aPTT of a patient receiving heparin for a deep vein thrombosis. The nurse notes that the aPTT is 70. What is the most important action to be taken by the nurse?
Notify the physician
Document the result
Increase the infusion rate
Decrease the infusion rate
Document the result
The patient in this situation has an aPTT of 70, which is in the therapeutic range. It would be appropriate to continue the infusion at the same rate and document the results.
What does the nurse recognize as the major adverse effect of low-molecular-weight heparin?
thrombocytosis
anaphylaxis
infection
bleeding
bleeding
Low-molecular-weight heparin interferes with the normal clotting cascade and may lead to bleeding. Additionally, these drugs can cause thrombocytopenia.
A patient is taking warfarin. The nurse knows that this drug works by which mechanism?
- Decreased number of circulating clotting factors
- Blocking of vitamin K-dependent factors
- Decreased numbers of platelets
- Altered cellular permeability
Blocking of vitamin K-dependent factors
Coagulation is suppressed by warfarin because of its ability to interfere with synthesis of vitamin K. Four clotting factors require vitamin K for synthesis, and without them, coagulation
Which statement below BEST describes how Heparin works as an anticoagulant?*
A. “It inhibits clotting factors from synthesizing Vitamin K.”
B. “It inactivates the extrinsic pathways of coagulation.”
C. “It prevents Factor Xa from activating prothrombin to fibrinogen.”
D. “It enhances the activation of antihrombin III, which prevents the activation of thrombin and the conversion of fibrinogen to fibrin.
D. “It enhances the activation of antihrombin III, which prevents the activation of thrombin and the conversion of fibrinogen to fibrin.
A patient, who is receiving continuous IV Heparin, has an aPTT of 105 seconds. What is your next nursing action per protocol?
A. Continue with the infusion because no change is needed based on this aPTT.
B. Increase the drip rate per protocol because the aPTT is too low.
C. Re-draw the aPTT STAT.
D. Hold the infusion for 1 hour and decrease the rate per protocol because the aPTT is too high.
D. Hold the infusion for 1 hour and decrease the rate per protocol because the aPTT is too high.
A patient is receiving a thrombolytic agent, alteplase (Activase), follwing an acute myocardial infraction. Which condition is most likely attributed to thrombolytic therapy with this agent?
- Skin rash with urticaria
- Wheezing with labored respirations
- Brusing and epistaxis
- Temperature elevation of 100.8F
- Brusing and epistaxis
A patient is prescribed Lovastatin. This medication is known as a \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_? A. Fibric Acid Derivative B. Bile-acid Sequestrant C. HMG-CoA Reductase Inhibitor D. Cholesterol Absorption Inhibitor
C. HMG-CoA Reductase Inhibitor
A patient has been given Fureosemide (Lasix) a loop diuretic. What is an adverse effect
a. gout attacks
b. blood dyscrasis
c. otoxicity
c. otoxicity
The physician prescribes the patient a loop diuretic. As the nurse you know that this type of diuretic causes diuresis by MAINLY affecting what structure in the nephron?
A. Distal convoluted tubule
B. Descending limb of the loop of Henle
C. Proximal convoluted tubule
D. Ascending limb of the loop of Henle
D. Ascending limb of the loop of Henle
Loop diuretics are effective with inhibiting sodium reabsorption within the nephron because it inhibits?
A. the sodium-chloride transporter
B. the effects of aldosterone on the distal convoluted tubule
C. the sodium-potassium-chloride cotransporter
D. the transport of bicarbonate by the proximal convoluted tubule
C. the sodium-potassium-chloride cotransporter
Your patient is ordered a loop diuretic at 1000. Which finding below would require you to hold the dose and notify the physician for further orders?
A. Calcium level 9 mg/L
B. Potassium level 1.5 mEq/L
C. Blood pressure 102/78
D. Sodium level 144
B. Potassium level 1.5 mEq/L
You’re developing a plan of care for a patient with fluid volume overload related to heart failure exacerbation. The physician has prescribed an IV loop diuretic. What nursing interventions will you include in the patient’s plan of care? Select all that apply:
A. Perform and assess daily weights.
B. Educate the patient about consuming a low potassium diet.
C. Strict measuring of the patient’s daily intake and output.
D. Encourage the patient to drink 2 L of fluids per day.
E. Assess lung sounds every shift.
A. Perform and assess daily weights.
C. Strict measuring of the patient’s daily intake and output.
E. Assess lung sounds every shift
A patient with heart failure is prescribed Digoxin and a loop diuretic. The nurse knows that what finding below would increase a patient’s risk of developing Digoxin toxicity?
A. Magnesium level 1.8 mg/dL
B. Potassium 2 mEq/L
C. BUN 15
D. Albumin 5 g/dL
B. Potassium 2 mEq/L
You’re educating a group of new nurse graduates about loop diuretics. One topic you discuss is ototoxicity. You ask the new nurses to explain how to prevent this adverse side effect in a patient prescribed a loop diuretic. Which response by one of the new nurses is correct?
A. “Always administer intravenous loop diuretics slowly.”
B. “Monitor for signs and symptoms of low potassium levels because this increases the risk of inner ear damage while taking loop diuretics.”
C. “Administer the medication with meals.”
D. “Avoid administering loop diuretics with a tetracycline.”
A. “Always administer intravenous loop diuretics slowly.”
You’re providing discharge instructions to a patient who will be taking a loop diuretic at home. Which statement by the patient demonstrates they did NOT understand the teaching material and requires that you reinforce some of the teaching points?
A. “I will eat a diet rich in potatoes, bananas, avocadoes, strawberries, and spinach.”
B. “I will weight myself daily and report to my physician if I gain more than 3 lbs in 1 day.”
C. “I will change position slowly because I can become dizzy easily while taking this medication.”
D. “This medication can cause dehydration, so I will stay hydrated by consuming at least 2 L or more of fluid per day.”
D. “This medication can cause dehydration, so I will stay hydrated by consuming at least 2 L or more of fluid per day.”
The physician prescribes the patient a potassium-sparing diuretic. Which statement below best describes how this medication works to cause diuresis?
A. These medications work to inhibit the sodium-chloride cotransporter in the early part of the distal convoluted tubule.
B. These medications work to inhibit the sodium-potassium-chloride cotransporter in the thick ascending limb of the loop of Henle.
C. These medications work to inhibit the sodium and potassium exchange within the sodium channels in the distal tubule and collecting duct.
D. These medications work to inhibit the sodium channels within the proximal convoluted tubule by decreasing sodium reabsorption.
C. These medications work to inhibit the sodium and potassium exchange within the sodium channels in the distal tubule and collecting duct.
Potassium-sparing diuretics alter how sodium is reabsorbed in what part of the nephron? Select all that apply:
A. Loop of Henle B. Proximal Convoluted Tubule C. Distal Convoluted Tubule D. Collecting Duct E. Thick ascending limb of the loop of Henle
C. Distal Convoluted Tubule
D. Collecting Duct
TRUE or FALSE: Potassium-sparing diuretics are the most effective type of diuretic and are often combined with loop or thiazide diuretics.
True
False
false
For a patient prescribed hydrochlorothiazide (HydroDIURIL), the nurse should closely monitor which laboratory test value? A. Sodium B. Glucose C. Calcium D. Chloride
B. Glucose Correct
Thiazide and thiazide-like diuretics are associated with adverse metabolic effects of hyperglycemia; therefore, close monitoring of blood glucose levels are needed. Other metabolic disturbances include hyperlipidemia and hyperuricemia.
Which laboratory test result is a common adverse effect of furosemide (Lasix)? A. Hypokalemia B. Hypernatremia C. Hyperchloremia D. Hypophosphatemia
A. Hypokalemia Correct
Furosemide is a potent loop diuretic, and the most common adverse effect of loop diuretics is electrolyte imbalances. This results in major electrolyte losses of potassium and sodium and, to a lesser extent, calcium.
A patient asks the nurse about using potassium supplements while taking spironolactone (Aldactone). What is the nurse’s best response?
A. “I will call your health care provider and discuss your concern.”
B. “I would recommend that you take two multivitamins every day.”
C. “This diuretic is potassium sparing, so there is no need for extra potassium.”
D. “You will need to take potassium supplements for the medication to be effective.”
C. “This diuretic is potassium sparing, so there is no need for extra potassium.” Correct
Spironolactone is a potassium-sparing diuretic, and thus the patient does not need potassium supplementation. Intake of excess potassium may lead to hyperkalemia.
To treat a patient diagnosed with primary hyperaldosteronism, the nurse would expect to administer which diuretic? A. Furosemide (Lasix) B. Acetazolamide (Diamox) C. Spironolactone (Aldactone) D. Hydrochlorothiazide (HydroDIURIL)
C. Spironolactone (Aldactone) Correct
Spironolactone is the direct antagonist for aldosterone.
To treat a patient with pulmonary edema, the nurse prepares to administer which diuretic to this patient? A. Furosemide (Lasix) B. Amiloride (Midamor) C. Triamterene (Dyrenium) D. Spironolactone (Aldactone)
A. Furosemide (Lasix) Correct
Furosemide is a potent, rapid-acting diuretic that would be the drug of choice to treat pulmonary edema. The other medications are not potent enough to cause the diuresis necessary to treat this condition.
To evaluate the therapeutic effects of mannitol (Osmitrol), the nurse should monitor the patient for which clinical finding? A. Increase in urine osmolality B. Decrease in serum osmolality C. Decrease in intracranial pressure t D. Increase in cerebral blood volume
C. Decrease in intracranial pressure Correct
Mannitol is an osmotic diuretic that pulls fluid from extravascular spaces into the bloodstream to be excreted in urine. This decreases intracranial pressure and cerebral blood volume, increases excretion of medications, decreases urine osmolality, and increases serum osmolality.
Acetazolamide (Diamox) is used to treat which conditions?
A. Dry eye syndrome
B. Cardiac dysrhythmias
C. High-altitude sickness
D. Open-angle glaucoma
D. Open-angle glaucoma
What are some adverse effects a nurse might see in a patient taking lovastatin? SATA
a. diarrhea
b. belching
c. constipation
d. rhabdomyolysis
a. diarrhea
c. constipation
d. rhabdomyolysis
What are some nursing concerns with Fluvastatin? SATA
a. interactions with warfarin
b. interactions with digoxin and grapefruit
c. administer in the evening when cholesterol synthesis is at peak
b. interactions with digoxin and grapefruit
c. administer in the evening when cholesterol synthesis is at peak
Cholestyramine ….. SATA
a. Lowers LDL cholesterol levels by increasing LDL receptors on hepatocytes
b.Prevents absorption of cholesterol in the gut,
Binds to bile acids.
c. inhibit breakdown of stored fat (HDL)
a. Lowers LDL cholesterol levels by increasing LDL receptors on hepatocytes
b.Prevents absorption of cholesterol in the gut,
Binds to bile acids.
What adverse effects would the nurse look out for with a patient taking Cholestyramine.. SATA
a. contraindiction
b. constipation
c. abnormal liver function
d. bloating/belching
e. stearorrhea
a. contraindiction
b. constipation
d. bloating/belching
e. stearorrhea
A client was given a drug 20 minutes ago, the HCP tells nurse to administer Cholestyramine. What would the nurse do?
a. administer drug
b. hold drug and question order
c. none of the above
b. hold drug and question order
because other meds should be taken 1 hr before or 4 hrs after Cholestyramine.
What nursing concerns go along with Cholestyramine? SATA
- Interactions with digoxin and warfarin
- Exercise, Drink water, Eat fiber enriched food to prevent constipation
- Monitor for bruising and bleeding (low Vitamin K
- no breastfeeding
- Teaching plan for nutrition of fat soluble vitamins (A, K, E) supplement
-Interactions with digoxin and warfarin
-Exercise, Drink water, Eat fiber enriched food to
prevent constipation
- Monitor for bruising and bleeding (low Vitamin K
- Teaching plan for nutrition of fat soluble vitamins (A, K, E) supplement
Gemfibrozil (Lopid) ….
a. Lowers LDL cholesterol levels by increasing LDL receptors on hepatocytes
b. Inhibit breakdown of stored fat (HDL),
Decrease production of cholesterol.
c. binds to bile acids
b. Inhibit breakdown of stored fat (HDL),
Decrease production of cholesterol
What are the adverse effects of Gemfibrozil (Lopid) SATA
-Cholelithiasis (gall stones)
-Steatorrhea
-Rhabdomyolysis
abnormal liver function
- Cholelithiasis (gall stones)
- abnormal liver function
What are some nursing concerns the nurse should look out for in a patient taking Gemfibrozil?
- Report abnormal cramping
- Interactions with digoxin and warfarin
- NO breastfeeding
- Follow low-cholesterol diet
- Monitor for bruising and bleeding (low Vitamin K)
- Monitor blood glucose level if diabetic
- Report abnormal cramping
- NO breastfeeding
- Follow low-cholesterol diet
- Monitor blood glucose level if diabetic
