ATI Pharmacology Proctored 2019 Retake 3 Exam

1. When a patient has been receiving sodium nitroprusside for 1 week, the nurse should be alert for: - thiocyanate accumulation, evidenced by disorientation and delirium 2. Your patient is taking lisinopril for hypertension. His blood pressure still remains slightly elevated and the physician would like to order a diuretic. Which of the following diuretics would be inappropriate to prescribe? - triamterene 3. How would the nurse expect calcium channel blockers to physiologically affect the function of the heart? - Decrease AV node conduction 4. The patient takes insulin for diabetes mellitus. The physician orders atenolol for his hypertension. After medication teaching, the nurse determines that learning has been effective when the patient makes which statement? - "This medication can enhance the effects of my insulin." 5. Your patient is receiving 40 mg of furosemide every day, enteric-coated aspirin 325 mg every day and digoxin 0.25 mg every day. Your patient suddenly begins complaining of muscle weakness and seeing yellow halos around lights. What are your suspicions? - digitalis toxicity due to hypokalemia 6. Your patient is experiencing an emergent hypertensive crisis. The provider has ordered nitroprusside. Before administration, you should take action to: - protect the solution from sunlight/bright light by covering it up 7. Your patient is receiving a beta-blocker for his high blood pressure. He arrives in the ER with complaints of severe dizziness and shortness of breath. As you obtain his apical rate, you notive it is 40 bpm and realize the patient has taken too much of the drug. What antidote should be administered? - atropine 8. A direct vasodilator that relaxes capacitance vessels (veins) has what beneficial effect in the body? - Decreases preload 9. Your patient has been diagnosed with unstable angina. What is the anticipated treatment? ("select all that apply") – Morphine Supplemental Oxygen Nitroglycerin Aspirin 10. In addition to hypertension, alpha-1 blockers, such as doxazosin, may be useful in the treatment of: - Benign Prostatic Hypertrophy (BPH) 11. hydralazine and isosorbide are used in combination for heart failure patients because they cause synergistic effects and can avoid the tolerance that occurs with using isosorbide alone. What other beneficial fact is related to this combination agent? - First drug labeled for use in a specific race (African Americans) 12. Which of the following diuretics is the drug of choice in the treatment of cerebral edema? - mannitol 13. Prior to the administration of furosemide, the nurse should check the medication record for other drugs that may cause _________________ such as _________________________. - ototoxicity; aminoglycosides 14. The patient with a plasma cholesterol level of 360 mg/dL is taking the medication ezetimibe to reduce this value. Which statement made by the patient indicates a need for further education concerning about this medication? - "I cannot take this medication with any other lipid-lower agents." 15. Your patient has been experiencing tolerance to transdermal nitroglycerin. Whichof the following suggestions would be appropriate? 16. "You should: - take the patch off at bedtime and put a new one on in the morning." 17. Your patient is admitted with a diagnosis of angina pectoris. He has an order for nitroglycerin 0.4mg SL as needed for chest pain. When he complains of chest pain, you should administer: - one tablet under his tongue, if not relief, repeat in 5 minutes up to 3 doses. 18. A nurse prepares to administer a scheduled dose of digoxin. The nurse finds the morning laboratory report showing a plasma digoxin level of 0.7 ng/mL. What action should the nurse take next? - Check the apical rate for 1 minute and withhold the digoxin if <60 bpm 19. The goal of pharmacotherapy for patients with heart failure is using a drug that has what specific characteristics? ("select all that apply") – Negative Chronotropic Effects Positive Inotropic Effects Negative Dromotropic Effects 20. You are providing discharge instructions to a 72-year-old client who has been discharged home on a diuretic. What would the patient's instructions regarding the use of a diuretic at home include? - Weight yourself daily at the same time each day using the same scale 21. A nurse is providing patient education to a 35-year-old man who has been prescribed transdermal clonidine. The nurse will instruct the patient to apply the dosage patch: - to a hairless area on the upper arm every 7 days. 22. A patient taking a potassium-sparing diuretic, such as tramterene, should be educated about: - avoiding salt substitutes. 23. An important teaching point to be made to a patient taking cholestyramine, a bile acid sequestrant, is to: - increase fluid and fiber intake secondary to potential constipation. 24. Which of the following are true statements in regards to diuretic therapy? ("select all that apply") – Manages edematous conditions by reducing plasma volume which facilitates the mobilization of fluid from the tissues The amount of diuresis is directly related to the amount of sodium chloride (NaCl) reabsorption blockade Those drugs who work early in the nephron will produce the greatest diuresis Diuretics lower blood pressure through sodium depletion which is also accompanied by vasodilating effects on arterioles 25. Abrupt discontinuation of the use of clonidine may result in: - rebound hypertension. 26. A nurse has an order to apply nitroglycerin topically twice a day. The nurse's initial action will be to: - put on a pair of nonsterile gloves. 27. Your patient has hyperlipidemia despite the aggressive lifestyle changes that have been made. The healthcare provider has prescribed lovastatin to help decrease the patient's LDL levels. Patient teaching should include instructions to: - take the medication at bedtime so the drug is peaking when cholesterol is being synthesized. 28. The nurse checks a patient's medication record and discovers these medications in addition to furosemide. Which medication order would most concern the nurse? - Nonsteroidal Antiinflammatory Drugs (NSAIDS) 29. Which classification of drug inhibits the conversion of angiotensinogen to angiotenin I? - Direct Renin Inhibitors