Unit 7: Chapter 03 (Karch 7th Ed) - Toxic Effects of Drugs

Question 1

1. A nurse is planning patient teaching about a newly prescribed drug. What is a priority teaching point
   included by the nurse to improve compliance and safety?
   A) List of pharmacies where the drug can be obtained
   B) Measures to alleviate any discomfort associated with adverse effects
   C) The cost of the brand name drug compared with the generic form
   D) Statistics related to Phase III testing for the prescribed drug

Answer 1

Ans: B
Feedback:
If a patient is aware of certain adverse effects and how to alleviate or decrease the discomfort, he or she
is more likely to continue taking the medication. A list of pharmacies can be useful information but will
not improve safety or compliance. Knowing the cost of the brand name versus the generic form could
also be helpful to the patient. However, a substitution may not be allowable and the cost of a drug does
not improve patient safety. Most patients are not concerned with the statistics related to drug testing
and it would not improve compliance or safety even if the patient was interested in the information.

Question 2

2. A patient presents at the clinic complaining of vaginal itching and a clear discharge. The patient reports
   to the nurse that she has been taking an oral antibiotic for 10 days. The nurse is aware that the patient is
   experiencing what?
   A) An adverse reaction from the antibiotic
   B) A drug toxicity effect of the antibiotic
   C) An overdose of the drug that is damaging to more than one body system
   D) A superinfection caused by the antibiotic, which has destroyed normal flora

Answer 2

Ans: D
Feedback:
Superinfections often occur with antibiotic use because the drug kills normal bacterial flora. This is not
a result of toxic levels of the antibiotic, but rather an effect of the medication that has killed normal
flora, which it is designed to do. Vaginal itching and a clear discharge are not considered adverse
effects of an antibiotic. An overdose of a drug that damages more than one body systems is considered drug poisoning.

Question 3

3. A 42-year-old male patient is brought to the emergency department by ambulance. The patient is in
   distress. The nurse suspects an anaphylactic reaction resulting from taking oral penicillin. What
   assessment findings are important in making this diagnosis?
   A) Blood pressure (BP): 186/100, difficulty breathing
   B) Hematocrit (Hct): 32%, decreased urine output
   C) Temperature: 102º, swollen joints
   D) Profuse sweating, Blood Pressure: 92/58

Answer 3

Ans: A
Feedback:
An anaphylactic reaction is an immune reaction that causes a massive release of histamine, which
results in edema and swelling that can lead to respiratory distress and increased blood pressure. A
decreased hematocrit and decreased urine output suggests a cytotoxic reaction. An increased
temperature and swollen joints could suggest serum sickness. Profuse sweating and decreased blood
pressure may indicate cardiac-related issues.

Question 4

4. A patient with seasonal allergies is taking an antihistamine to relieve itchy, watery eyes, and a runny
   nose. When planning teaching for this patient, the nurse would include what teaching point?
   A) Advise the patient to limit fluid intake to dry out mucous membranes.
   B) Advise the patient to avoid driving or operating machinery.
   C) Advise the patient to report strange dreams or nightmares.
   D) Advise the patient to decrease dietary fat.

Answer 4

Ans: B
Feedback:
An adverse effect of antihistamines is drowsiness, so that injury to the patient or others can occur if
driving or operating machinery. An increase in fluids would be indicated to help keep nasal membranes
moist. It is common for dreams to occur when taking medication and it is not necessary to report them.
Dietary fat should not interfere with the drug metabolism of antihistamines.

Question 5

5. A nurse is providing teaching to a group of patients who are beginning drug therapy for acquired
   immunodeficiency syndrome (AIDS). What should be included in her instructions to the group?
   A) Take your medications as directed. Poisoning occurs with overdosage causing damage to more
   than one body system.
   B) Renal injury results from first-pass effect when the drug is excreted from the system.
   C) A blood dyscrasia due to drug therapy can be serious. Call us if your skin looks yellowish or you
   experience itching.
   D) Most drugs are metabolized in the liver and the first indication of damage is dark red papules,
   which should be reported immediately

Answer 5

Ans: A
Feedback:
Poisoning resulting from overdosage can lead to the potential for fatal reactions when more than one
body system is affected. Liver, not kidney, injury can be caused by the first-pass effect and can cause
the skin to have a yellow appearance. Most drugs are metabolized in the liver but liver damage causes
jaundice, manifested as a yellow tinge to the skin and sclera. Dark red papules appearing on limbs are
characteristic of Stevens-Johnson syndrome, a potentially fatal erythema multiforme exudativum,
which should be reported but is not due to liver damage

Question 6

6. The pharmacology instructor is talking to the nursing students about potassium-sparing diuretics and
   how they can lead to hyperkalemia, indicated by what assessment finding?
   A) Urine output of 1,500 mL/24 hours
   B) Blood pressure of 98/60
   C) Potassium level of 5.9 mEq/L
   D) Calcium level of 11.4 mg/dL

Answer 6

Ans: C
Feedback:
The normal range of serum potassium for an adult is 3.5 to 5.0 mEq/L. A level higher than 5.0 mEq/L
can indicate hyperkalemia. Normal urinary output is between 1,500 and 2,000 cc per day. Urinary
output below 1,000 mL per day would include oliguria and would indicate hyperkalemia. A decrease in
blood pressure and pulse can indicate hypokalemia. Hyperkalemia refers to an elevated potassium level
and not an elevated calcium level.

Question 7

7. An 80-year-old patient presents at the clinic for a follow-up appointment. She is taking a macrolide
   antibiotic and is experiencing tinnitus. The nurse is talking with family members about home care for
   the patient. What should the nurse include in her instructions regarding home care?
   A) Keep the patient in a prone position when in bed.
   B) Eliminate salt from the patient’s diet.
   C) Provide protective measures to prevent falling or injury.
   D) Monitor exposure to sunlight.

Answer 7

Ans: C
Feedback:
Macrolide antibiotics can cause severe auditory nerve damage, which can cause dizziness, ringing in
the ears (tinnitus), and loss of balance and hearing. The patient would be at high risk for injury due to
falls. Usually a person who is dizzy is unable to lie flat and needs to recline with the head elevated. Salt
and sunlight are not a component of this patient’s presenting complaint.

Question 8

8. Oral antidiabetic drugs can cause alterations in glucose metabolism. Patients who are taking these drugs
would need to be observed for what?
A) Increased urination
B) Deep Kussmaul’s respirations
C) Thirst and hot or flushed skin
D) Confusion and lack of coordination

Answer 8

Ans: D
Feedback:
Antidiabetic medications decrease blood glucose levels. If levels fall too low, symptoms of
hypoglycemia would include confusion and lack of coordination. Elevated blood glucose levels can
occur when the patient does not take the medications. With inadequate dosage, hyperglycemia can
occur, resulting in increased urination in an attempt to eliminate serum glucose, deep Kussmaul’s
respirations to reduce blood pH by eliminating carbon dioxide, thirst, and hot or flushed skin.

Question 9

9. A patient is taking chloroquine (Aralen) for rheumatoid arthritis. What problem reported by the patient
   would the nurse suspect may be an adverse reaction of the medication?
   A) I have to urinate all the time.
   B) Sometimes I have blurred vision.
   C) I have tingling in my arms and legs.
   D) Sometimes I feel like I am off balance.

Answer 9

Ans: B
Feedback:
Chloroquine (Aralen) can cause ocular toxicity with blurring of vision, color vision changes, corneal
damage, and blindness. Increased urination, tingling, and numbness are signs of hyperkalemia and
hypokalemia. Loss of balance can be caused by auditory damage due to drug toxicity.

Question 10

10. A 68-year-old patient who must take antihistamines for severe allergies is planning a vacation to
    Mexico. The nurse will encourage the patient to do what?
    A) Avoid sightseeing during the hottest part of the day.
    B) Discontinue the antihistamines if he becomes extremely restless.
    C) Decrease the dosage of the drugs if he experiences excessive thirst.
    D) Continue taking the antihistamines even if he begins to hallucinate.

Answer 10

Ans: A
Feedback:
Antihistamines can cause anticholinergic effects, which would result in decreased sweating and place
the patient at high risk for heat stroke. Avoiding the hottest part of the day will help prevent
dehydration and heat prostration. Extreme restlessness could indicate Parkinson-like syndrome not
usually associated with antihistamines. Excessive thirst is characteristic of hyperglycemia.
Hallucinations are associated with drugs that affect neurologic functioning. Further, nurses should
never tell patients to decrease or discontinue a drug unless the prescriber has instructed them to do so.

Question 11

11. A 77-year-old man is brought to the clinic by his daughter for a routine follow-up appointment. The
    daughter tells the nurse that her father is only taking half the prescribed dosage of several of his
    medications. What effect would the nurse explain could result from this behavior?
    A) Increased risk of primary actions
    B) Dermatologic reaction
    C) Superinfection
    D) Reduced therapeutic effect

Answer 11

Ans: D
Feedback:
Taking too little of the medication would mean that therapeutic levels are not being reached and the
drugs will be less effective at lower dosages. Primary actions are the result of overdose, which is not
the case in this patient who is taking too little of the drug. Dermatologic reactions are not likely if the
patient is taking too little of the drug unless the drug is treating a dermatologic problem, which is not
indicated by the question. Superinfection would only result if the patient was taking an antibiotic,
which is not indicated by the question.

Question 12

12. A patient with Parkinson’s disease is taking an anticholinergic drug to decrease the tremors and
    drooling caused by the disease process. The patient complains that he is having trouble voiding. The
    nurse would explain that this is what?
    A) A hypersensitive action of the drug
    B) A primary action of the drug
    C) An allergic action of the drug
    D) A secondary action of the drug

Answer 12

Ans: D
Feedback:
Sometimes the drug dosage can be adjusted so that the desired effect is achieved without producing
undesired secondary reactions. But sometimes this is not possible, and the adverse effects are almost
inevitable. In such cases, the patient needs to be informed that these effects may occur and counseled
about ways to cope with the undesired effects. The situation described is not a hypersensitivity reaction
that would indicate an allergic reaction, a primary reaction that would be excessive therapeutic
response, or an allergic reaction to the drug.

Question 13

13. The nurse is assessing a patient new to the clinic. The patient says she is allergic to penicillin. What
    would be the nurse’s appropriate next action?
    A) Ascertain the exact nature of the patient’s response to the drug.
    B) Document the patient is allergic to penicillin.
    C) Mark the patient’s chart in red that she has a penicillin allergy.
    D) Continue to assess the patient for other allergies.

Answer 13

Ans: A
Feedback:
Ask additional questions of patients who state that they have a drug allergy to ascertain the exact nature
of the response and whether it is a true drug allergy. Patients may confuse secondary actions of the drug
with an allergy. Only after it was determined the action was truly an allergy would the nurse document
the allergy, mark the patient’s chart, and continue to assess for other allergies.

Question 14

14. The pharmacology instructor is discussing the adrenergic drug ephedrine with the nursing students and
    lists an adverse reaction of this drug as what?
    A) Bronchoconstriction
    B) Hyperglycemia
    C) Cardiac arrhythmias
    D) Severe constipation

Answer 14

Ans: B
Feedback:
Ephedrine (generic), a drug used as a bronchodilator to treat asthma and relieve nasal congestion, can
break down stored glycogen and cause an elevation of blood glucose by its effects on the sympathetic
nervous system. Ephedrine does not cause bronchoconstriction, cardiac arrhythmias, or severe
constipation.

Question 15

15. The nurse needs to consider teratogenic effects of medications when caring for what population of
patients?
A) Older adults
B) Patients with a history of cancer
C) Children
D) Young adult women

Answer 15

Ans: D
Feedback:
A teratogen is a drug that can harm the fetus or embryo so the nurse would consider the teratogenic properties of medications when caring for woman of child-bearing age including adolescents and
young adult women. Teratogens have no impact on older adults or children. Carcinogens are chemicals
that cause cancer.

Question 16

16. The nurse is caring for a patient receiving an antineoplastic medication who reports fever, chills, sore
    throat, weakness, and back pain. What type of adverse effect does the nurse suspect this patient is
    experiencing?
    A) Dermatologic reaction
    B) Blood dyscrasia
    C) Electrolyte imbalance
    D) Superinfection

Answer 16

Ans: B
Feedback:
Symptoms of blood dyscrasias include fever, chills, sore throat, weakness, back pain, dark urine,
decreased hematocrit (anemia), low platelet count (thrombocytopenia), low white blood cell count
(leukopenia), and a reduction of all cellular elements of the complete blood count (pancytopenia).
Dermatologic reactions would be reflected in skin alterations, electrolyte imbalances would result in
differing symptoms depending on the electrolyte involved but would not cause chills and fever, and a
superinfection could cause a fever but would not cause a sore throat, weakness, or back pain unless the
infection involved those body parts.

Question 17

17. The pharmacology instructor explains to students that adverse effects can be extensions of what?
A) Primary action of a drug
B) Anaphylaxis
C) Secondary action of a drug
D) Anticholinergic responses to the drug

Answer 17

Ans: A
Feedback:
Primary action adverse effects are extensions of the therapeutic action and are usually the result of
overdosage, essentially too much of the therapeutic effect. Anaphylaxis is not an extension of the
therapeutic action of the drug but a histamine reaction to an allergen. Secondary actions of a drug are
negative effects of the drug that occur even when the drug is in the therapeutic range. Anticholinergic
responses occur in response to drugs that block the parasympathetic nervous system.

Question 18

18. A student nurse asks her study group how to define a drug allergy. What would be the peer group’s best
    response?
    A) A second effect of the body to a specific drug
    B) The formation of antibodies to a drug protein causing an immune response when the person is next
    exposed to that drug.
    C) A serum sickness caused by a reaction to a drug
    D) Immediate systemic reaction to the drug when exposed to the drug the first time.

Answer 18

Ans: B
Feedback:
A drug allergy is the formation of antibodies to a drug or drug protein; causes an immune response
when the person is next exposed to that drug. A drug allergy does not occur at the first exposure to a
drug. A second action of a specific drug is an adverse response that the drug causes in addition to the
therapeutic effect. Serum sickness is one type of allergic reaction but does not define allergic reaction.
An immediate systemic reaction to a drug, usually not on first exposure, is an anaphylactic reaction.

Question 19

19. The home health nurse is caring for an elderly patient with benign prostatic hypertrophy. An
    anticholinergic drug has been prescribed. What would be the nurse’s priority teaching point for this
    patient?
    A) Urinary incontinence may develop.
    B) Bladder hypertonia may develop.
    C) An increased dosage may be required.
    D) Empty the bladder before taking the drug.

Answer 19

Ans: D
Feedback:
A patient with an enlarged prostate who takes an anticholinergic drug may develop urinary retention or
even bladder paralysis when the drug’s effects block the urinary sphincters, so anticholinergic drugs are
avoided whenever possible. However, if the medication is needed, the patient must be taught to empty
the bladder before taking the drug. A reduced dosage also may be required to avoid potentially serious
effects on the urinary system but this would not be a teaching point for the patient because the provider
will make that decision. Hypotonia, not hypertonia, is more likely to occur. Urinary incontinence is not
a likely effect in this case.

Question 20

20.
The Kardex record of a male patient who is prescribed antihistamines for treating an allergy reads as
follows:
Age: 32; Profession: Carpenter; Lifestyle & diet: Lives alone, average smoker, nonalcoholic, no food
preferences, practices yoga; Medical history: Suffers from hay fever, recent urinary tract infection that
has been treated successfully. What information from the Kardex is likely to have the greatest
implication in educating the patient about antihistamine administration?

A) The patient’s age
B) The patient’s smoking habit
C) The patient’s profession
D) The patient’s medical history

Answer 20

Ans: C
Feedback:
Most antihistamines cause drowsiness, so the nurse should advise the patient not to operate machinery
or perform tasks that require alertness when taking antihistamines (e.g., climbing ladders, working on
rooftops, standing on iron supports at the top of a building). Because the patient is not an older adult,
his age has no implications on the therapy. Although encouraging the patient to make better lifestyle
choices is an important part of the patient’s plan of care, this information is not related to
administration of antihistamines. There is nothing in the documented medical history that is significant
to antihistamine use.

Question 21

21. The nurse is caring for a patient who experienced a severe headache. When the prescribed number of
    over-the-counter pain relievers did not work the patient said she took double the dosage an hour later.
    The nurse recognizes this patient is at greatest risk for what?
    A) An allergic reaction
    B) Anaphylactic reaction
    C) Poisoning
    D) Sedative effects

Answer 21

Ans: C
Feedback:
This patient has taken an overdosage of the medication. Poisoning occurs when an overdose of a drug
damages multiple body systems, leading to the potential for fatal reactions. Allergic and anaphylactic
reactions can occur with any drug administration but this is not the patient’s greatest risk. More information about the exact type of medication would be needed to determine whether sedative effects
are likely.

Question 22

22. What classification of drug allergy would be described as an immune system reaction to injected
    proteins used to treat immune conditions?
    A) A cytotoxic reaction
    B) Serum sickness
    C) A delayed reaction
    D) An anaphylactic reaction

Answer 22

Ans: B
Feedback:
Serum sickness is an immune system reaction to certain medications, injected proteins used to treat
immune conditions, or antiserum, the liquid part of blood that contains antibodies that help protect
against infectious or poisonous substances. An allergic reaction can occur with any drug, not just those
containing protein. Anaphylaxis is an acute, systemic, life-threatening allergic reaction. A cytotoxic
reaction is one in which antibodies circulate and attack antigens on cell sites, causing death of that cell

Question 23

23. Why does the nurse need to be alert for any indication of an allergic reaction in patients?
    A) To obtain early warning of noncompliance in drug therapy
    B) To increase the effectiveness of a specific medication
    C) To maintain the patient’s safety during drug therapy
    D) To reduce the risk of adverse effects during drug therapy

Answer 23

Ans: C
Feedback:
Being alert to adverse effects what to assess and how to intervene appropriately can increase the
effectiveness of a drug regimen, provide for patient safety, and improve patient compliance. Indications
of allergic reactions would not indicate noncompliance or improve effectiveness of a specific
medication. Indications of allergic reaction would indicate an adverse effect and would not reduce the
risk.

Question 24

24. The nurse administers erythromycin, a drug that is known to irritate mucosa in the stomach lining.
    When the patient reports abdominal discomfort after taking the medication, the nurse would classify this discomfort as what type of adverse effect?
    A) Primary action
    B) Secondary action
    C) Hypersensitivity reaction
    D) Allergic reaction

Answer 24

Ans: B
Feedback:
Secondary actions are those actions that occur as a result of taking a medication but do not fall under
the category of therapeutic action and are often negative. This patient is experiencing a secondary
action of erythromycin. Primary actions would be extensions of therapeutic action. Hypersensitivity
reaction would be an excessive response to either the primary or secondary effects of a drug. An
allergic reaction would be an immune response to the drug.

Question 25

25. The nurse administers antipsychotic medications to the patient who has taken these same drugs for
    many years. What signs and symptoms would the nurse attribute to secondary actions of the drug?
    (Select all that apply.)
    A) Muscular tremors
    B) Drooling
    C) Changes in gait
    D) Yellow discoloration of skin and sclera
    E) Fine red rash on the trunk

Answer 25

Ans:
A, B, C
Feedback:
Drugs that affect the dopamine levels in the brain (e.g., antipsychotic drugs), cause a syndrome that
resembles Parkinson’s disease including lack of activity, akinesia, muscular tremors, drooling, changes
in gait, rigidity, extreme restlessness or jitters (akathisia), or spasms (dyskinesia). Yellow discoloration
of the skin and sclera indicate jaundice and would suggest liver damage. A fine red rash on the trunk
would be a dermatologic reaction unrelated to an antipsychotic agent’s secondary effects.

Question 26

26. The nurse is acting as the triage nurse in the emergency department when a 16-year-old boy is brought
    in by his friends. The patient is in respiratory distress, he is vomiting, and blood is noted in the vomitus. He is somnolent and his electrocardiogram shows an arrhythmia. The boy’s friends tell you he was
    taking a bunch of little green pills he got from the cupboard at his grandparent’s house. The nurse
    suspects what?
    A) Overdose of sleeping pills
    B) Poisoning
    C) Anaphylactic shock
    D) Allergic reaction to Dyazide

Answer 26

Ans: B
Feedback:
Poisoning occurs when an overdose of a drug damages multiple body systems, leading to the potential
for fatal reactions. The situation described does not indicate what was contained in the little green pills
so it is not possible to say whether the drugs were sedatives or triamterene and hydrochlorothiazide
(Dyazide). The symptoms do not indicate an anaphylactic reaction, which would not normally include
bloody vomitus.

Question 27

27. The patient with diabetes is also taking ephedrine to treat asthma that causes her blood sugar to
    increase. The patient asks the nurse, Why does this medication make my blood sugar go up? What is
    the nurse’s best response?
    A) The active ingredient in ephedrine is mixed with sugar.
    B) Ephedrine is a placebo containing only sugar.
    C) Stored glycogen is broken down by ephedrine, which is causing higher blood sugar levels.
    D) Insulin is inactivated by ephedrine so it cannot work to control sugar levels.

Answer 27

Ans: C
Feedback:
Ephedrine breaks down stored glycogen, which then enters the bloodstream as glucose and causes an
increase in serum blood glucose, or blood sugar, levels. Ephedrine is not mixed with sugar and is not a
placebo. Ephedrine has no effect on insulin.

Question 28

28. The nurse is writing a plan of care for a patient who is exhibiting Parkinson-like syndrome. What
    would be an appropriate intervention if, on assessing the patient, the nurse finds the patient is having
    difficulty swallowing?
    A) Thicken all liquids.
    B) Keep the patient NPO (not taking anything orally).
    C) Give only soft or pureed foods.
    D) Provide small, frequent meals.

Answer 28

Ans: D
Feedback:
Provide small, frequent meals if swallowing becomes difficult. Keeping the patient NPO would be
inappropriate because these effects often result from medications that will be taken throughout the
patient’s life. Soft or pureed foods are often more difficult to swallow than more rigid foods.
Thickening liquids would only be necessary if the dysphagia, or difficulty swallowing, continued to
progress

Question 29

29. The post-anesthesia care unit nurse is serving a patient after a right knee arthroscopy. As the patient
    begins to wake up from anesthesia, the nurse assesses rigidity, involuntary movements, hyperthermia,
    and tachycardia. What would the nurse suspect is causing these effects?
    A) Neuroleptic malignant syndrome
    B) Parkinson-like syndrome
    C) Malignant tachycardia
    D) Anaphylactic shock

Answer 29

Ans: A
Feedback:
Neuroleptic malignant syndrome is a generalized syndrome that includes extrapyramidal symptoms
such as slowed reflexes, rigidity, involuntary movements; hyperthermia; autonomic disturbances (e.g.,
hypertension, fast heart rate); fever may be noted as well. This is most often seen after administering
general anesthesia or drugs with central nervous system (CNS) effects. This syndrome was once known
as malignant hyperthermia. These symptoms are not consistent with Parkinson-like syndrome or
anaphylactic shock. Malignant tachycardia is a distracter.

Question 30

30. A patient is admitted to the intensive care unit with hyperkalemia. The nurse caring for the patient
    knows that the most severe adverse effect of hyperkalemia is what?
    A) Renal failure
    B) Cardiac emergency
    C) Liver failure
    D) Respiratory distress

Answer 30

Ans: B
Feedback:
Monitor for cardiac irregularities because potassium is an important electrolyte in the action potential,
needed for cell membrane stability. When potassium levels are too high, the cells of the heart become
very irritable and rhythm disturbances can occur. Be prepared for a possible cardiac emergency.
Hyperkalemia is often found in the patient with renal failure. Liver failure and respiratory distress are
not generally caused by hyperkalemia.

Question 31

31. The nurse administers an anticholinergic medication to the patient. When assessing this patient, what
    finding will the nurse consider a secondary effect of the drug?
    A) Nasal congestion
    B) Tachycardia
    C) Hyperthermia
    D) Profuse sweating

Answer 31

Ans: A
Feedback:
Anticholinergic secondary effects include dry mouth, altered taste perception, dysphagia, heartburn,
constipation, bloating, paralytic ileus, urinary hesitancy and retention, impotence, blurred vision,
cycloplegia, photophobia, headache, mental confusion, nasal congestion, palpitations, decreased
sweating, and dry skin. Tachycardia, hyperthermia, and profuse sweating would not be expected
findings or consistent with anticholinergic effects and would require further assessment.

Question 32

32. Before administering a macrolide antibiotic the nurse would question the order for what patient?
    A) An 82-year-old woman with hypertension
    B) A 12-year-old boy with hearing loss
    C) A 30-year-old pregnant patient
    D) A 51-year-old man after myocardial infarction

Answer 32

Ans: B
Feedback:
Macrolide antibiotics can cause severe auditory nerve damage so the nurse would question
administration of this drug to the child with hearing loss because another antibiotic may be indicated to
preserve remaining hearing. This drug is not contraindicated in older adults, although a lower dosage
may be indicated. It may safely be given in pregnancy and after myocardial infarction

Question 33

33. What cardiac effect would the nurse be prepared to see in the patient with an extremely high potassium
level?
A) Arrhythmia
B) Tachycardia
C) Sudden death
D) Bradycardia

Answer 33

Ans: A
Feedback:
Elevated potassium levels irritate cardiac cells and increase the likelihood of a cardiac arrhythmia.
Tachycardia, sudden death, and bradycardia would be the result of an arrhythmia if they were to occur.

Question 34

34. The nurse administers a loop diuretic to the patient. In addition to sodium and water, what other
    electrolyte would the nurse expect to be excreted in significant amounts?
    A) Calcium
    B) Magnesium
    C) Potassium
    D) Zinc

Answer 34

Ans: C
Feedback: Loop diuretics increase excretion of sodium, water, and potassium most significantly. Although other
electrolytes may be excreted, loss of magnesium, calcium, and zinc are usually not significant.

Question 35

35. The nurse administers a medication to the patient that induces the secondary action of hypoglycemia.
    What organ will be most acutely impacted by inadequate circulating glucose?
    A) Brain
    B) Heart
    C) Lungs
    D) Skin

Answer 35

Ans: A
Feedback:
While all cells require glucose to function, the brain uses the greatest amount. As a result,
hypoglycemia has the greatest impact on the brain, which explains why hypoglycemia has so many
neurological signs and symptoms including fatigue, drowsiness, anxiety, headache, shaking, lack of
coordination, numbness and tingling of the mouth, tongue, and /or lips; confusion, and in severe cases,
seizures or coma may occur because the brain cannot function without adequate supplies of glucose.