Week 13: Chapter 17

Question 1

Which drug produces more venous vasodilation than arterial vasodilation?

Answer 1

Isosorbide

Question 2

Before administering a dose of digoxin, which action is essential?

Answer 2

Listen to then apical heart rate for a full minute

Question 3

What must you teach a patient about how to take sublingual nitroglycerine?

Answer 3

A tingling sensation tells you that the drug is potent.

Question 4

When you administer a vasodilator drug to an older adult, what is the primary risk?

Answer 4

Increased risk for falls

Question 5

Which foods will you teach patients are good sources of magnesium?

Answer 5

1. Almonds
2. Black beans
3. Soybeans

Question 6

A pt who has just been prescribed enalapril (Vasotec) for heart failure asks you how the drug will work? What is your best response?

Answer 6

It will decrease the fluid and sodium in your blood and tissues

Question 7

Which sx will you likely see in a pt with left heart failure?

Answer 7

+ Weak peripheral pulses
+ Pulmonary congestion
+ Hacking cough that is worse at night
+ Crackles in the lungs

Question 8

A pt was recently started on a nitroglycerin ointment, 1 inch every 6 hours. The patient asks you why the patch is removed at night. What is your best response?

Answer 8

The drug loses its effectiveness when it is used continuously

Question 9

Older adults are more sensitive to the effects of many heart failure drugs. Which drug is more likely to cause toxicity in older adults?

Answer 9

digoxin (Lanoxin)

Question 10

An adult patient prescribed magnesium (Max-Oxide) 400 mg PO daily tells you he has nausea after taking this drug. What should you teach the pt about taking this drug?

Answer 10

1. Take your magnesium with a full glass of water
2. You can take your magnesium right after a meal to decrease nausea
3. Always take your magnesium with food or a snack to avoid GI sx
4. Good food sources of magnesium include green leafy vegetables and almonds

Question 11

A pt is receiving dobutamine (Dobutrex) 0.5 mcg/ kg/ min by IV. Which manifestations indicate an infection at the IV site?

Answer 11

1. Pain at the IV site
2. Redness at the site
3. Warmth at the site
4. Swelling at the site

Question 12

What are the most important teaching points for a pt who will go home with sublingual nitroglycerin to be used as needed for chest pain?

Answer 12

1. Keep the tablet in place under your tongue until it dissolves
2. You should experience a tingling sensation, which indicates the drug is potent
3. If you experience a headache, acetaminophen can be taken for relief
4. A decrease in BP can be a S/E of this drug

Question 13

What should you teach a pt who has recently been prescribed nesirtide by IV infusion?

Answer 13

Monitoring your intake and output is important while you are receiving this drug

Question 14

A patient is being discharged with a prescription for nitroglycerin ointment. Which actions are important for the nurse to teach the patient about this medication? (select all that apply)

Answer 14

1. Wear gloves.
2. Use a special ruled paper.
3. Tape the special ruled paper in place.

Question 15

A patient who has been taking a nitroglycerin patch for several days reports a headache. What is the best advice the nurse should give to this patient?

Answer 15

“Take a mild headache pain reliever such as acetaminophen (Tylenol).”

Question 16

A patient is concerned about forgetting to take the morning dose of digoxin (Lanoxin) and it is now lunchtime. What should you tell the patient?

Answer 16

“Take the dose now.”

Question 17

The nurse is giving a patient with heart failure a vasodilator. What is the reason why this medication is being given?

Answer 17

They are given when ACE inhibitors cannot be given.

Question 18

How does the cardiac glycoside digoxin (Lanoxin) work to improve cardiac output? (select all that apply)

Answer 18

1. It slows down a heart rate that is too fast.

2. It increases the force of contraction of each heartbeat.

Question 19

The nurse is giving digoxin to a newly admitted telemetry patient with heart failure. What are possible side effects of digoxin? (select all that apply)

Answer 19

1. Fatigue
2. Decreased appetite, or anorexia
3. Nausea/vomiting

Question 20

Which foods are good sources of the electrolyte potassium? (select all that apply)

Answer 20

Baked potato
Tomato puree
Winter squash
Lima beans

Question 21

The nurse is assessing a patient’s cardiac output. What factors can increase cardiac output (CO)? (select all that apply)

Answer 21

Increased heart rate (HR)

Increased stroke volume (SV)

Question 22

A heart failure patient with shortness of breath and edema is prescribed a naturally occurring hormone. What hormone medication is most often given?

Answer 22

Nesiritide (Natrecor)

Question 23

The nurse is administering nesiritide (Natrecor) to a patient. What life-threatening adverse effect must the nurse watch for after administering this drug?

Answer 23

Apnea

Question 24

The nurse is discharging a patient with a prescription for a potassium supplement. What points are important for the nurse to teach this patient? (select all that apply)

Answer 24

Take with food.
Avoid salt substitutes.
Call the prescriber if muscle twitching or weakness occurs.

Question 25

The nurse is caring for a patient with heart failure who has a problem with increased afterload. What medication would the nurse expect the prescriber to order? (select all that apply)

Answer 25

Angiotensin-converting enzyme (ACE) inhibitors
Vasodilators
Angiotensin II receptor blockers

Question 26

A nurse is administering digoxin to a patient recently admitted with heart failure. What action best describes how this drug works in the body?

Answer 26

It allows more time for the ventricle to fill.

Question 27

A nurse is administering a beta blocker to a patient admitted with heart failure. What is the primary action of this drug?

Answer 27

It blocks the effects of adrenaline on the heart.

Question 28

Before administering a patient’s dose of digoxin (Lanoxin), you assess an apical heart rate of 56. What should you do next?

Answer 28

Hold the medication.

Question 29

The nurse is performing an assessment on a patient admitted with left heart failure. What symptoms the nurse most likely to find?

Answer 29

Dyspnea, breathlessness

Question 30

A patient with heart failure asks the nurse what treatment would cure the failure. What comment by the nurse is correct?

Answer 30

“A heart transplant.”