A patient with angina who uses sublingual nitroglycerin tells the nurse that the
episodes are increasing in frequency and usually occur when the patient walks the
dog. The patient reports needing almost daily doses of the nitroglycerin and states
that one tablet usually provides complete relief. What will the nurse do?
a.Contact the provider to suggest ordering a transdermal patch for this patient.
b.Question the patient about consumption of grapefruit juice.
c.Suggest that the patient limit walking the dog to shorter distances less frequently.
d.Suggest that the patient take two tablets of nitroglycerin each time, because the
symptoms are increasing in frequency.
Give this one a try later!
, a.Contact the provider to suggest ordering a transdermal patch for this
patient.
Transdermal patches are good for sustained prophylaxis for anginal attacks
and are especially useful when patients have a regular pattern of attacks.
Grapefruit juice does not affect the metabolism of nitroglycerin. Patients
with angina should be encouraged to increase, not decrease, exercise.
Taking two tablets is not recommended when one is effective.
A patient with malaise has been taking daptomycin (Cubicin) for an infection and is
concurrently taking simvastatin (Zocor). The nurse should be concerned if the patient
complains of:
a.nausea.
b.tiredness.
c.muscle pain.
d.headache.
Give this one a try later!
c.muscle pain.
Statins can injure muscle tissue, causing muscle aches and pain known as
myopathy/rhabdomyolysis. Daptomycin also can cause myopathy and
therefore should be used with caution in patients concurrently taking
simvastatin. Nausea, tiredness, and headache would not cause the nurse as
much concern as the likelihood of myopathy.
A patient has had blood pressures of 150/95 mm Hg and 148/90 mm Hg on two
separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in
an ambulatory setting. The patient's diagnostic tests are all normal. The nurse will
expect this patient's provider to order:
a.a beta blocker.
b.a loop diuretic and spironolactone.
,c.a thiazide diuretic.
d.counseling on lifestyle changes.
Give this one a try later!
c.a thiazide diuretic.
This patient has primary, or essential, hypertension as evidenced by systolic
pressure greater than 140 and diastolic pressure greater than 90, along with
normal tests ruling out another primary cause. Thiazide diuretics are first-
line drugs for hypertension. Beta blockers are effective, but are most often
used to counter reflex tachycardia associated with reduced blood pressure
caused by therapeutic agents. Loop diuretics cause greater diuresis than is
usually needed and so are not first-line drugs. This patient should be
counseled on lifestyle changes as an adjunct to drug therapy, but should
also begin drug therapy because hypertension already exists.
A prescriber has ordered rosuvastatin (Crestor) for a patient with non-alcoholic-
related cirrhosis. Which intervention would be most appropriate for the nurse before
administration of this drug?
a.Question the order, because rosuvastatin is contraindicated in patients with liver
disease.
b.No intervention is necessary
Give this one a try later!
, just administer the drug as ordered.
c.Review the baseline liver function test results.
d.Assess the patient for liver disease.
;
c.Review the baseline liver function test results.
Before administering rosuvastatin, the nurse should review the results of the
baseline liver function tests (LFTs). Statins can be used by patients with liver
disease but not by those with alcoholic or viral hepatitis. Administering the
drug before obtaining baseline LFT results would not allow for an accurate
baseline. The patient clearly already has liver disease.
During discharge instruction, a nurse wants to assess a patient's understanding of
treatment with cholestyramine (Questran). Which statement made by the patient best
demonstrates a need for additional teaching?
a."I will take cholestyramine (Questran) 1 hour before my other medications."
b."I will increase fluids and fiber in my diet."
c."I will weigh myself weekly."
d."I will have my blood pressure checked weekly."
Give this one a try later!
c."I will weigh myself weekly."
Patients need not weigh themselves weekly when taking cholestyramine.
Cholestyramine should be taken at least 1 hour before other medications.
When taken with other medications, cholestyramine can inhibit the
absorption of the other drugs. Constipation is the principal complaint with
cholestyramine. It can be minimized by increasing dietary fiber and fluids.
Regular blood pressure checks are a good idea. The patient is taking
cholestyramine because of high cholesterol, which contributes to
hypertension.
episodes are increasing in frequency and usually occur when the patient walks the
dog. The patient reports needing almost daily doses of the nitroglycerin and states
that one tablet usually provides complete relief. What will the nurse do?
a.Contact the provider to suggest ordering a transdermal patch for this patient.
b.Question the patient about consumption of grapefruit juice.
c.Suggest that the patient limit walking the dog to shorter distances less frequently.
d.Suggest that the patient take two tablets of nitroglycerin each time, because the
symptoms are increasing in frequency.
Give this one a try later!
, a.Contact the provider to suggest ordering a transdermal patch for this
patient.
Transdermal patches are good for sustained prophylaxis for anginal attacks
and are especially useful when patients have a regular pattern of attacks.
Grapefruit juice does not affect the metabolism of nitroglycerin. Patients
with angina should be encouraged to increase, not decrease, exercise.
Taking two tablets is not recommended when one is effective.
A patient with malaise has been taking daptomycin (Cubicin) for an infection and is
concurrently taking simvastatin (Zocor). The nurse should be concerned if the patient
complains of:
a.nausea.
b.tiredness.
c.muscle pain.
d.headache.
Give this one a try later!
c.muscle pain.
Statins can injure muscle tissue, causing muscle aches and pain known as
myopathy/rhabdomyolysis. Daptomycin also can cause myopathy and
therefore should be used with caution in patients concurrently taking
simvastatin. Nausea, tiredness, and headache would not cause the nurse as
much concern as the likelihood of myopathy.
A patient has had blood pressures of 150/95 mm Hg and 148/90 mm Hg on two
separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in
an ambulatory setting. The patient's diagnostic tests are all normal. The nurse will
expect this patient's provider to order:
a.a beta blocker.
b.a loop diuretic and spironolactone.
,c.a thiazide diuretic.
d.counseling on lifestyle changes.
Give this one a try later!
c.a thiazide diuretic.
This patient has primary, or essential, hypertension as evidenced by systolic
pressure greater than 140 and diastolic pressure greater than 90, along with
normal tests ruling out another primary cause. Thiazide diuretics are first-
line drugs for hypertension. Beta blockers are effective, but are most often
used to counter reflex tachycardia associated with reduced blood pressure
caused by therapeutic agents. Loop diuretics cause greater diuresis than is
usually needed and so are not first-line drugs. This patient should be
counseled on lifestyle changes as an adjunct to drug therapy, but should
also begin drug therapy because hypertension already exists.
A prescriber has ordered rosuvastatin (Crestor) for a patient with non-alcoholic-
related cirrhosis. Which intervention would be most appropriate for the nurse before
administration of this drug?
a.Question the order, because rosuvastatin is contraindicated in patients with liver
disease.
b.No intervention is necessary
Give this one a try later!
, just administer the drug as ordered.
c.Review the baseline liver function test results.
d.Assess the patient for liver disease.
;
c.Review the baseline liver function test results.
Before administering rosuvastatin, the nurse should review the results of the
baseline liver function tests (LFTs). Statins can be used by patients with liver
disease but not by those with alcoholic or viral hepatitis. Administering the
drug before obtaining baseline LFT results would not allow for an accurate
baseline. The patient clearly already has liver disease.
During discharge instruction, a nurse wants to assess a patient's understanding of
treatment with cholestyramine (Questran). Which statement made by the patient best
demonstrates a need for additional teaching?
a."I will take cholestyramine (Questran) 1 hour before my other medications."
b."I will increase fluids and fiber in my diet."
c."I will weigh myself weekly."
d."I will have my blood pressure checked weekly."
Give this one a try later!
c."I will weigh myself weekly."
Patients need not weigh themselves weekly when taking cholestyramine.
Cholestyramine should be taken at least 1 hour before other medications.
When taken with other medications, cholestyramine can inhibit the
absorption of the other drugs. Constipation is the principal complaint with
cholestyramine. It can be minimized by increasing dietary fiber and fluids.
Regular blood pressure checks are a good idea. The patient is taking
cholestyramine because of high cholesterol, which contributes to
hypertension.
