NU440 Pharm Quiz 6

NU440 Pharm Quiz 6 1. Potassium chloride 10 mEq intravenously has been ordered for a client whose potassium is 2.9 following diuretics. How will the nurse administer the potassium dose? Dilute the dose in a 50 ml IV rider and infused over a minimum of 30 minutes Push the dose as a rapid IV push because of the patient’s dangerously low potassium level Push the dose in increments over 10 minutes Ask to give the dose in a large muscle since the intravenously route is too dangerous Q U ESTIO N 2 1. A client, who has been taking Lisinopril (an ACE inhibitor), complains of a dry cough. How should the nurse respond to this complaint? The cough will subside within 5 to 7 days when the body becomes accustomed to the medicine. The cough is a sign of impending angioedema. The client should stop the medicine immediately. The cough is a result of immune suppression. The client should stop the medicine immediately. The cough is a common side effect of ACE inhibitors (prils). ARBs (sartans) may be prescribed as an alternative, if the cough becomes disruptive. Q U ESTIO N 3 1. A client is experiencing edema. Which over-the-counter medication might be reducing the diuretic effects of her lisinopril? St John's Wort Glucosamine Vitamin C Ibuprofen Q U ESTIO N 4 1. A client, who has been seeing multiple doctors, reports that she is taking Lisinopril and another antihypertensive medication, the name of which she can’t recall. What type of antihypertensive is contraindicated when people are taking ACE inhibitors due to risk of compound effects? Thiazide diuretics Beta blockers Potassium-sparing diuretics Calcium channel blockers Q U ESTIO N 5 1. In preparing discharge education for a client who has just begun hydrochlorothiazide therapy, a nurse reviews the client's lab results. Which finding should the nurse be concerned about in relationship to the discharge prescription? blood sugar level of 80 mg/dL potassium level of 3.1 mEq/L hemoglobin of 15 g/dL potassium level of 4.8 mEq/L Q U ESTIO N 6 1. A client has had hypertension for approximately 7 years and now is interested in becoming pregnant. What is the safest anti-hypertensive for a women in the early stages of pregnancy? Amlodipine Lisinopril Methyldopa Valsartan Q U ESTIO N 7 1. If a client is taking carvedilol, a beta blocker, which adverse effect should the nurse watch for? Hypoventilation Sinus tachycardia Hyperglycemia Dizziness Q U ESTIO N 8 1. While preparing to administer a scheduled dose of digoxin, the nurse finds a new lab result showing a digoxin level of 0.7 ng/mL. What action should the nurse take? Hold the drug for an hour and reassess the level. Withhold the drug and notify the prescriber immediately. Administer Digibind to counteract the toxicity. Check the patient’s apical pulse, and if it is within a safe range, administer the digoxin. Q U ESTIO N 9 1. A client has been taking digoxin 0.25 mg, and furosemide 40 mg, daily. Upon routine assessment by the nurse, the client states, “I see yellow halos around the lights.” The nurse should perform which of the following actions based on this assessment? Consult the provider then request a digoxin and potassium level check. Withhold the next dose of furosemide. Continue to monitor the patient for heart failure. Document the findings and reassess in 1 hour. Q U ESTIO N 10 1. A client with angina is preparing to go home with a prescription for Nifedipine, a calcium channel blocker. What should the client be taught? Elevate your feet when you are sitting to avoid edema side effects Drink grapefruit juice with breakfast to reduce you risk of plaque. Eat cheese regularly to restore calcium and manage loose stools. Use salt substitute to replenish you potassium losses due to diuretic effects Q U ESTIO N 11 1. A client with stable angina asks why the physician told her to put her nitro patch on at 8am and take it off at 8pm. What explanation should he be given? The doctor is trying to reduce your risk of night falls. Patch-free intervals are needed to sustain medication effectiveness. The patch should be replaced, not removed at bedtime. You should follow this advice for any patch medications you use. Q U ESTIO N 12 1. A client with stable angina as starting treatment with nifedipine a calcium channel blocker. The client’s spouse asks how nifedipine alleviates chest pain. How should the nurse respond? “They reduce platelet aggregation.” “They help the heart propel blood forward by reducing aortic blood pressure.” “They increase the heart rate and contractility.” “They improve cardiac circulation through vasoconstriction.” Q U ESTIO N 13 1. The nurse is providing patient education to a patient who has just been given a new prescription for sublingual nitroglycerin tablets. Which statement by the client would indicate a need for additional teaching? “I should take the nitro every 2 to 3 minutes until my pain goes away.” “I can take one tablet every 5 minutes, up to three times unless I get dizzy.” “I should store my nitroglycerin in its original dark bottle to protect it from light.” “I should dissolve the tablet under my tongue and be careful not to swallow it.” Q U ESTIO N 14 1. A client presents to the emergency department with chest pain. On a scale of 1:10 he rates the pain as a 6. His respiratory rate is 22. His blood pressure is 156/92. His heart rate is 110. He is afebrile. What other information should the nurse obtain before administering nitroglycerin? Has the patient experienced any dizziness or nausea within the last two weeks? Has the patient used any alcohol or drugs for erectile dysfunction recently? Has the patient taken any drugs within the past 12 hours? Has the patient had a previous heart attack? Q U ESTIO N 15 1. A client is being discharged to his home on enoxaparin (Lovenox) injections for treatment of deep vein thrombosis (DVT). Which of the following statements made by the client indicates a need for further discharge teaching by the nurse? “I will inject the enoxaparin into the fatty tissue of my abdomen.” “I hate needles, but I know enoxaparin doesn’t come in pill form.” “I will go to the clinic every day to have my PTT drawn." “I will call my physician if I pass black tarry stools or pink urine.” Q U ESTIO N 16 1. A client is brought to the emergency department for accidental warfarin (Coumadin) overdose. The nurse determines that the client has no apparent signs of bleeding. Which action should the nurse take next? Obtain a stat PTT level. Administer protamine sulfate. Type and cross-match the patient’s blood. Draw a stat blood level for PT or INR. Q U ESTIO N 17 1. In which of the following situations should the nurse prepare to administer of protamine sulfate? A patient on warfarin with an INR of 4 and tarry stools A patient on warfarin with a PT of 12 seconds and bleeding from a laceration A patient on a heparin drip with a PTT 120 seconds and active GI bleeding A patient on a heparin drip with a PTT of 60 seconds and pink-tinged urine Q U ESTIO N 18 1. A client presents in the clinic with concerns of having taken his dabigitran (Pradaxa) twice this morning. Realizing that this is a new oral anticoagulant (NOAC), what should the nurse do next? (Select all that apply.) Seek advice from the physician Ask the client to share how the overdose happened Have the client eat a spinach salad Have the lab check a stat INR Insist that the client receive fresh frozen plasma immediately. Assess for signs of active bleeding Q U ESTIO N 19 1. Atenolol (Tenormin) has been prescribed for a client who is recovering from a recent heart attack. The nurse would consult the provider before giving the medicine in which of these situations? (Select all that apply.) Pulse 52 BP 110/86 Respirations 32 with wheezes Blood glucose 50 Tension headache Parkinsonian tremors Q U ESTIO N 20 1. A client is starting sildenafil (Viagra) for the treatment of pulmonary hypertension. Which of these medications could cause a serious reaction if they are taken with sildenafil? (select all that apply) Nitroglycerin, an antianginal clopidigrel, and antiplatelet simvastatin, an antilipemic CoEnzyme Q, an herbal remedy doxazosin, an alpha blocker