week 6 sherpath Flashcards
A patient who is taking metoprolol questions the nurse regarding the need for liver function tests. Which nursing response is appropriate?
“The drug may not be effective if your liver function is abnormal.”
“Patients with decreased liver function may experience toxic effects from this drug.”
“This drug may damage the liver, so your health care provider needs to monitor liver function.”
“If your liver is not functioning well, the medication may not be absorbed properly.”
“Patients with decreased liver function may experience toxic effects from this drug.”
The nurse administers an oral dose of metoprolol at 0800 to a patient with hypertension. At which time will the nurse anticipate the peak effect?
0815
0830
1000
1400
1000
The charge nurse is teaching a group of new nurses about safe administration of beta blockers. Which statements indicate that further teaching is required?
Select all that apply.
“Metoprolol is commonly prescribed to treat hypertension.”
“Beta blockers increase the heart rate and force of cardiac contraction.”
“Metoprolol can cause liver failure, so laboratory values are required.”
“Beta blockers are only used to treat hypertension.”
“Beta blockers are also called beta-adrenergic antagonists”
“Beta blockers increase the heart rate and force of cardiac contraction.”
“Metoprolol can cause liver failure, so laboratory values are required.”
“Beta blockers are only used to treat hypertension.”
The nurse is teaching Ms. Jones about her new prescription for metoprolol. What teachings will the nurse include?
Select all that apply.
“Sit on the side of the bed for a few moments prior to standing up.”
“If you miss a dose, double your next dose.”
“Stop taking the medication if you experience side effects.”
“Inform all health care providers that you are taking metoprolol.”
“Notify your health care provider if dizziness becomes excessive.”
“Sit on the side of the bed for a few moments prior to standing up.”
“Inform all health care providers that you are taking metoprolol.”
“Notify your health care provider if dizziness becomes excessive.”
The nurse is conducting a health history on a patient who is taking a beta blocker. Which assessment data present contraindications or cautions to beta blocker therapy?
Select all that apply.
History of asthma
Second-degree atrioventricular (AV) block on telemetry monitor
Type 2 diabetes
Blood pressure 168/92 mm Hg
Difficulty with urination due to benign prostatic hypertrophy (BPH)
History of asthma
Second-degree atrioventricular (AV) block on telemetry monitor
Type 2 diabetes
The health care provider prescribes a maintenance dose of metoprolol 250 mg orally twice daily for hypertension. Which action would the nurse take upon receiving the prescription?
Ask the health care provider if the dose should be 500 mg once daily.
Administer the metoprolol as prescribed.
Hold the medication and ask the health care provider about the dose.
Discuss whether the medication should be given intravenously.
Hold the medication and ask the health care provider about the dose.
The charge nurse is teaching a new nurse about beta blockers. Which teaching would the nurse include?
First-generation beta blockers are nonselective and block beta1 and beta2 receptors.
Second-generation beta blockers include carvedilol and labetalol.
Beta blockers are divided into four categories or generations
Beta blockers stimulate beta receptors in the heart.
First-generation beta blockers are nonselective and block beta1 and beta2 receptors.
A patient is admitted to the emergency department with a blood pressure of 222/110 mm Hg. For which reason would the nurse anticipate intravenous (IV) beta blocker administration?
IV forms of beta blockers have immediate effects.
Administering a beta blocker intravenously prolongs the action of the drug.
There are fewer adverse systemic effects when giving IV beta blockers.
IV beta blockers have a slower peak time than other forms of these medications.
IV forms of beta blockers have immediate effects.
A 30-year-old female patient who is taking a beta blocker asks the nurse, “Can I take this drug if I am considering pregnancy?” Which nursing response is appropriate?
“The drug will affect your ability to become pregnant.”
“There is potential risk to the fetus because metoprolol crosses the placental barrier.”
“Being pregnant will alter the effectiveness of the medication.”
“Taking this drug while pregnant increases the risk for bradycardia.”
“There is potential risk to the fetus because metoprolol crosses the placental barrier.”
A patient who has hypertension and asthma asks, “Why can’t I take a beta blocker for my hypertension?” Which nursing response is appropriate?
“Taking a beta blocker with asthma medication increases the risk for toxicity.”
“Most asthma medications reduce the therapeutic effects of beta blocker medications.”
“Beta blocker medications can cause bronchospasm, which can trigger an asthma attack.”
“Asthma medications act to potentiate the effects of beta blockers, increasing the risk for toxicity.”
“Beta blocker medications can cause bronchospasm, which can trigger an asthma attack.”
A patient has been taking metoprolol IR for 6 weeks. Current assessment data includes a heart rate of 72 beats per minute and blood pressure of 126/74 mm Hg. The patient reports occasional dizziness, insomnia, and fatigue. Which recommendation will the nurse provide for this patient?
“You should stop the drug immediately.”
“It is important to discuss these symptoms with the health care provider.”
“You should go to an emergency department for evaluation.”
“These symptoms are common, harmless side effects.”
“It is important to discuss these symptoms with the health care provider.”
The nurse is caring for a patient with newly diagnosed hypertension who has been prescribed metoprolol. Which teaching would the nurse include?
Change positions slowly.
Avoid foods high in sugar.
Report a heart rate less than 80 beats per minute.
Stop taking the medication if the systolic blood pressure is less than 95 mm Hg.
Change positions slowly.
The nurse is teaching a patient who is being discharged with a prescription for metoprolol. Which patient statement indicates understanding of the teaching?
“I will take an antacid with the medication to prevent upset stomach.”
“I should begin to feel better right away.”
“I will not drive until I know how this medication affects me.”
“If I miss a dose of my medication, I will double the next dose.”
“I will not drive until I know how this medication affects me.”
When is atorvastatin expected to achieve its peak concentration?
0.25 to 0.5 hr
1 to 2 hr
3 to 6 hr
4 to 8 hr
1 to 2 hr
Which phrase accurately describes a statin’s mechanism of action?
Increase in apolipoprotein B-100 production
Reduction of cholesterol removal from circulation
Inhibition of the enzyme hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase
Reduction in the number of low-density lipoprotein (LDL) receptors on the hepatocytes
Inhibition of the enzyme hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase
Which statement regarding the pharmacokinetics of statins is accurate?
Statins have a bioavailability of 50%.
Statins are largely excreted in the urine.
Statins, except for pravastatin, are minimally protein bound.
Statins undergo first-pass metabolism through the liver, the primary site of statin activity.
Statins undergo first-pass metabolism through the liver, the primary site of statin activity.
Which medication that Mrs. Harrison is currently taking may cause a potential drug interaction with simvastatin?
Metformin
Ranitidine
Metoprolol
Amlodipine
Amlodipine
Which laboratory values will a nurse ensure are ordered for a patient before initiation of a statin?
Select all that apply.
Potassium
Lipid panel
Liver enzymes
Serum creatinine
Creatine kinase (CK)
Lipid panel
Liver enzymes
Creatine kinase (CK)
Which administration information will a nurse provide to a patient who is newly prescribed immediate-release lovastatin 20 mg?
Take it in the morning with a meal.
Take it in the evening with a meal.
Take it in the morning without a meal.
Take it in the evening without a meal.
Take it in the evening with a meal.
Which statins are significantly metabolized by CYP3A4?
Select all that apply.
Lovastatin
Fluvastatin
Pitavastatin
Simvastatin
Atorvastatin
Rosuvastatin
Lovastatin
Simvastatin
Atorvastatin
Which parameters are expected to decrease with statins?
Select all that apply.
Triglycerides
Total cholesterol
Apolipoprotein B-100
Low-density lipoprotein (LDL) cholesterol
High-density lipoprotein (HDL) cholesterol
Triglycerides
Total cholesterol
Apolipoprotein B-100
Low-density lipoprotein (LDL) cholesterol
Which statements regarding pharmacodynamics and pharmacokinetics of statins are accurate?
Select all that apply.
In general, statins undergo significant urinary excretion.
All statins except for simvastatin are highly protein bound.
Statins increase apolipoprotein B-100 production to decrease very low–density lipoprotein (VLDL) synthesis.
Statins reduce cholesterol production through inhibition of hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase.
Hepatocytes increase the number of low-density lipoprotein (LDL) receptors in response to decreased cholesterol synthesis by statins to remove cholesterol from circulation.
Statins reduce cholesterol production through inhibition of hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase.
Hepatocytes increase the number of low-density lipoprotein (LDL) receptors in response to decreased cholesterol synthesis by statins to remove cholesterol from circulation.
Which patients would a nurse determine can safely receive treatment with a statin in the absence of any other factors?
Select all that apply.
A 36-year-old pregnant patient
A 41-year-old breastfeeding patient
A 48-year-old patient with hyperthyroidism
A 69-year-old patient with alcoholic cirrhosis
A 55-year-old patient with type 2 diabetes mellitus
A 48-year-old patient with hyperthyroidism
A 55-year-old patient with type 2 diabetes mellitus
A 51-year-old male patient has been prescribed lovastatin 40 mg PO each evening to help lower his low-density lipoprotein (LDL) cholesterol. In addition to lovastatin, this patient also takes pantoprazole for gastroesophageal reflux disease (GERD), amiodarone for atrial fibrillation, tamsulosin for benign prostatic hyperplasia, and lisinopril for hypertension. Which medication could cause a potential drug interaction with lovastatin?
Lisinopril
Tamsulosin
Amiodarone
Pantoprazole
Amiodarone
