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7/4/23, 5:33 PM Answers Nclex-RN® Excel, Second Edition Test Success Throu... - (Chapter …
452 NCLEX-RN® Excel
eRESOURCE
To review the monitoring required for this medication, refer to Epocrates Online. [Pathway: http://
online.epocrates.com ➔ under the “Drugs” tab, enter “Gentamicin” in the search field ➔ select
“Gentamicin” ➔ select “Safety/Monitoring” and review content.]
Joyce reports feeling nauseous. The health care provider prescribes prochlorperazine
10 mg IV, one dose now.
EXERCISE 6.99 Multiple-choice:
Twenty minutes after administering prochlorperazine, the nurse enters Joyce’s room and finds that she is
anxious, restless, and agitated. The nurse should prepare to administer an intravenous (IV) dose of:
A. Naloxone
B. Flumazenil
C. Diphenhydramine
D. Protamine sulfate
The answer can be found on page 476
One week later, the wound infection is improved and a euthyroid state has been
achieved with the levothyroxine. Joyce manages her thyroid levels at home with the
effective use of pharmacological agents and a healthy lifestyle.
Answers
EXERCISE 6.1 Matching:
Match the antihypertensive classes in Column A with the mechanisms in Column B:
Column A Column B
Antihypertensive Class Mechanism by Which It Decreases Blood
Copyright © 2016. Springer Publishing Company. All rights reserved.
Pressure (BP)
A. Diuretics G Decreases sympathetic stimulation
B. Beta blockers from the central nervous system (CNS),
resulting in decreased heart rate,
C. Calcium channel blockers decreased vasoconstriction, and decreased
vascular resistance within the kidneys.
D Causes vasodilation by blocking the receptor
sites of alpha-1 adrenergic receptors.
I Blocks the receptor sites of angiotensin
II, thus preventing the vasoconstricting
effects. Prevents the release of
aldosterone, which causes increased
sodium and water reabsorption.
( continued )
Wittmann-Price, R. A., Cornelius, F. H., & Reap, T. B. (Eds.). (2016). Nclex-rn® excel, second edition : Test success through unfolding case study review. Retrieved from http://ebookcentral.proquest.com
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7/4/23, 5:33 PM Answers Nclex-RN® Excel, Second Edition Test Success Throu... - (Chapter …
CHAPTER 6 | Pharmacology 453
Column A Column B
D. Angiotensin-converting enzyme inhibitors F Decreases heart rate, resulting in
(ACE inhibitors) decreased cardiac output.
E. Angiotensin II receptor antagonists C Causes direct relaxation to arterioles,
F. Centrally acting alpha-2 stimulators resulting in decreased peripheral
resistance.
G. Peripherally acting alpha-1 blockers
A Inhibits the conversion of angiotensin I
H. Alpha-1 beta blockers
to angiotensin II, thereby preventing the
I. Direct vasodilators vasoconstrictive actions of angiotensin
II. Prevents the release of aldosterone,
which causes increased sodium and water
reabsorption.
B Decreases reabsorption of water in the
kidneys, resulting in decreased circulating
volume and decreased peripheral
resistance.
H Decreases heart rate, resulting in
decreased cardiac output, and causes
dilation of peripheral vessels resulting in
decreased vascular resistance.
E Decreases the mechanical contraction
of the heart by inhibiting the movement
of calcium across cell membranes. Also
dilates coronary vessels and peripheral
arteries.
EXERCISE 6.2 List:
The health care provider prescribes labetalol 10 mg intravenous (IV) push as a stat, one-time prescription.
Copyright © 2016. Springer Publishing Company. All rights reserved.
After preparing the medication using aseptic technique, the nurse enters Robert’s room and prepares
to administer the medication. On entering the room the nurse first pauses to check the “six rights” of
medication administration. List these rights, which the nurse must check before medication administration.
1. Right patient
2. Right medication
3. Right dose
4. Right time
5. Right route
6. Right documentation
Wittmann-Price, R. A., Cornelius, F. H., & Reap, T. B. (Eds.). (2016). Nclex-rn® excel, second edition : Test success through unfolding case study review. Retrieved from http://ebookcentral.proquest.com
Created from jmu on 2020-03-23 19:12:59.
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7/4/23, 5:33 PM Answers Nclex-RN® Excel, Second Edition Test Success Throu... - (Chapter …
454 NCLEX-RN® Excel
EXERCISE 6.3 Multiple-choice:
After identifying the six rights, the nurse notes Robert’s blood pressure (BP), heart rate (HR), and cardiac
rhythm. Robert’s BP is 218/108 mmHg, and his cardiac rhythm is sinus bradycardia at a rate of 50 beats
per minute (bpm). What action should the nurse take?
A. Administer the medication as prescribed—NO; labetalol blocks beta-1 adrenergic receptors, causing a
decrease in heart rate, and should not be administered to a patient with bradycardia.
B. Ask the physician to change the prescription to PO (oral) labetalol—NO; PO labetalol also blocks
beta-1 adrenergic receptors, causing a decrease in heart rate and should not be administered to a
patient with bradycardia.
C. Obtain a 12-lead electrocardiogram (EKG) before administering the medication—NO; a 12-lead EKG
is not required to administer intravenous (IV) labetalol.
D. Hold the medication and request a different antihypertension medication—YES; labetalol should
be held because of the bradycardia and an alternate antihypertensive medication should
be prescribed.
EXERCISE 6.4 Select all that apply:
The nurse understands that labetalol was discontinued for this patient because of the adverse effect of:
A. Agranulocytosis—NO; the medication decreases white blood cells, but this is not a concern for this
patient.
B. Heart block—YES; the patient’s heart rate is 50 beats per minute (bpm) and decreasing
the heart rate could cause atrioventricular (AV) block.
C. Bradycardia—YES; bradycardia is an adverse effect and the patient’s heart rate is 50 bpm.
D. Hypotension—NO; hypotension can occur, but this is not the concern with this patient.
EXERCISE 6.5 Calculation:
Hydralazine is available in a concentration of 20 mg/mL. How many milliliters of medication must be
withdrawn from the vial to administer 10 mg?
Copyright © 2016. Springer Publishing Company. All rights reserved.
0.5 mL
10 mg/20 mg × 1 mL = 0.5 mL
EXERCISE 6.6 Ordering:
In what order should the following be done? Place a number next to each.
4 Administer the medication over a 1-minute period
2 Clean the hub of the intravenous (IV) port using an alcohol pad
3 Flush the IV with 3 mL of normal saline to assess its patency
1 Identify the patient per hospital policy
5 Flush the IV with 3 mL of normal saline to clear site of medication
Wittmann-Price, R. A., Cornelius, F. H., & Reap, T. B. (Eds.). (2016). Nclex-rn® excel, second edition : Test success through unfolding case study review. Retrieved from http://ebookcentral.proquest.com
Created from jmu on 2020-03-23 19:12:59.
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7/4/23, 5:33 PM Answers Nclex-RN® Excel, Second Edition Test Success Throu... - (Chapter …
452 NCLEX-RN® Excel
eRESOURCE
To review the monitoring required for this medication, refer to Epocrates Online. [Pathway: http://
online.epocrates.com ➔ under the “Drugs” tab, enter “Gentamicin” in the search field ➔ select
“Gentamicin” ➔ select “Safety/Monitoring” and review content.]
Joyce reports feeling nauseous. The health care provider prescribes prochlorperazine
10 mg IV, one dose now.
EXERCISE 6.99 Multiple-choice:
Twenty minutes after administering prochlorperazine, the nurse enters Joyce’s room and finds that she is
anxious, restless, and agitated. The nurse should prepare to administer an intravenous (IV) dose of:
A. Naloxone
B. Flumazenil
C. Diphenhydramine
D. Protamine sulfate
The answer can be found on page 476
One week later, the wound infection is improved and a euthyroid state has been
achieved with the levothyroxine. Joyce manages her thyroid levels at home with the
effective use of pharmacological agents and a healthy lifestyle.
Answers
EXERCISE 6.1 Matching:
Match the antihypertensive classes in Column A with the mechanisms in Column B:
Column A Column B
Antihypertensive Class Mechanism by Which It Decreases Blood
Copyright © 2016. Springer Publishing Company. All rights reserved.
Pressure (BP)
A. Diuretics G Decreases sympathetic stimulation
B. Beta blockers from the central nervous system (CNS),
resulting in decreased heart rate,
C. Calcium channel blockers decreased vasoconstriction, and decreased
vascular resistance within the kidneys.
D Causes vasodilation by blocking the receptor
sites of alpha-1 adrenergic receptors.
I Blocks the receptor sites of angiotensin
II, thus preventing the vasoconstricting
effects. Prevents the release of
aldosterone, which causes increased
sodium and water reabsorption.
( continued )
Wittmann-Price, R. A., Cornelius, F. H., & Reap, T. B. (Eds.). (2016). Nclex-rn® excel, second edition : Test success through unfolding case study review. Retrieved from http://ebookcentral.proquest.com
Created from jmu on 2020-03-23 19:12:59.
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7/4/23, 5:33 PM Answers Nclex-RN® Excel, Second Edition Test Success Throu... - (Chapter …
CHAPTER 6 | Pharmacology 453
Column A Column B
D. Angiotensin-converting enzyme inhibitors F Decreases heart rate, resulting in
(ACE inhibitors) decreased cardiac output.
E. Angiotensin II receptor antagonists C Causes direct relaxation to arterioles,
F. Centrally acting alpha-2 stimulators resulting in decreased peripheral
resistance.
G. Peripherally acting alpha-1 blockers
A Inhibits the conversion of angiotensin I
H. Alpha-1 beta blockers
to angiotensin II, thereby preventing the
I. Direct vasodilators vasoconstrictive actions of angiotensin
II. Prevents the release of aldosterone,
which causes increased sodium and water
reabsorption.
B Decreases reabsorption of water in the
kidneys, resulting in decreased circulating
volume and decreased peripheral
resistance.
H Decreases heart rate, resulting in
decreased cardiac output, and causes
dilation of peripheral vessels resulting in
decreased vascular resistance.
E Decreases the mechanical contraction
of the heart by inhibiting the movement
of calcium across cell membranes. Also
dilates coronary vessels and peripheral
arteries.
EXERCISE 6.2 List:
The health care provider prescribes labetalol 10 mg intravenous (IV) push as a stat, one-time prescription.
Copyright © 2016. Springer Publishing Company. All rights reserved.
After preparing the medication using aseptic technique, the nurse enters Robert’s room and prepares
to administer the medication. On entering the room the nurse first pauses to check the “six rights” of
medication administration. List these rights, which the nurse must check before medication administration.
1. Right patient
2. Right medication
3. Right dose
4. Right time
5. Right route
6. Right documentation
Wittmann-Price, R. A., Cornelius, F. H., & Reap, T. B. (Eds.). (2016). Nclex-rn® excel, second edition : Test success through unfolding case study review. Retrieved from http://ebookcentral.proquest.com
Created from jmu on 2020-03-23 19:12:59.
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,second
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rnAnswers
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nclex
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edition
rn excel
throu
test
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7/4/23, 5:33 PM Answers Nclex-RN® Excel, Second Edition Test Success Throu... - (Chapter …
454 NCLEX-RN® Excel
EXERCISE 6.3 Multiple-choice:
After identifying the six rights, the nurse notes Robert’s blood pressure (BP), heart rate (HR), and cardiac
rhythm. Robert’s BP is 218/108 mmHg, and his cardiac rhythm is sinus bradycardia at a rate of 50 beats
per minute (bpm). What action should the nurse take?
A. Administer the medication as prescribed—NO; labetalol blocks beta-1 adrenergic receptors, causing a
decrease in heart rate, and should not be administered to a patient with bradycardia.
B. Ask the physician to change the prescription to PO (oral) labetalol—NO; PO labetalol also blocks
beta-1 adrenergic receptors, causing a decrease in heart rate and should not be administered to a
patient with bradycardia.
C. Obtain a 12-lead electrocardiogram (EKG) before administering the medication—NO; a 12-lead EKG
is not required to administer intravenous (IV) labetalol.
D. Hold the medication and request a different antihypertension medication—YES; labetalol should
be held because of the bradycardia and an alternate antihypertensive medication should
be prescribed.
EXERCISE 6.4 Select all that apply:
The nurse understands that labetalol was discontinued for this patient because of the adverse effect of:
A. Agranulocytosis—NO; the medication decreases white blood cells, but this is not a concern for this
patient.
B. Heart block—YES; the patient’s heart rate is 50 beats per minute (bpm) and decreasing
the heart rate could cause atrioventricular (AV) block.
C. Bradycardia—YES; bradycardia is an adverse effect and the patient’s heart rate is 50 bpm.
D. Hypotension—NO; hypotension can occur, but this is not the concern with this patient.
EXERCISE 6.5 Calculation:
Hydralazine is available in a concentration of 20 mg/mL. How many milliliters of medication must be
withdrawn from the vial to administer 10 mg?
Copyright © 2016. Springer Publishing Company. All rights reserved.
0.5 mL
10 mg/20 mg × 1 mL = 0.5 mL
EXERCISE 6.6 Ordering:
In what order should the following be done? Place a number next to each.
4 Administer the medication over a 1-minute period
2 Clean the hub of the intravenous (IV) port using an alcohol pad
3 Flush the IV with 3 mL of normal saline to assess its patency
1 Identify the patient per hospital policy
5 Flush the IV with 3 mL of normal saline to clear site of medication
Wittmann-Price, R. A., Cornelius, F. H., & Reap, T. B. (Eds.). (2016). Nclex-rn® excel, second edition : Test success through unfolding case study review. Retrieved from http://ebookcentral.proquest.com
Created from jmu on 2020-03-23 19:12:59.
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