NUR 117 Exam 3 Questions With Complete Solutions
A patient admitted 4 days ago with a pulmonary embolism has
been prescribed oral warfarin (Coumadin) and IV heparin. What
is the reason for the patient receiving two anticoagulants?
The oral and injectable forms must be administered together for
effective anticoagulation.
The combination of drugs results in fewer adverse effects than
when using heparin alone.
Oral anticoagulants are used to reach an adequate level of
anticoagulation when heparin alone is unable to do so.
Heparin is often used to initiate therapy, then oral anticoagulants
are prescribed and adjusted until laboratory tests indicate an
adequate therapeutic response. Correct Answers D
A patient has been placed on a loop diuretic to reduce the fluid
that has been accumulating in the lungs. Which statement made
by the patient indicates a need for further teaching about the
medication by the nurse?
"I'll be sure to take my medication with supper."
"I'll have a banana with my breakfast every morning."
"I'll weigh myself each day before breakfast."
"If my shortness of breath returns, I'll contact my physician."
Correct Answers A
A patient has been recently diagnosed with heart failure due to
systolic dysfunction. She asks the nurse to explain the disease
process to family members. The best explanation is:
"The heart rate is failing to keep up with the body's needs."
"The patient has developed dysrhythmias that have failed to
respond to medication."
,"The heart does not have adequate force to pump all needed
blood."
"The left ventricle fails to relax enough between beats to fill
with blood." Correct Answers C
A patient has presented to the emergency department reporting
feeling short of breath. What other symptom alerts the nurse that
the patient may be in heart failure?
Lungs clear to auscultation
2+ ankle edema
BP 118/74 mm Hg
Stable weight Correct Answers B
A patient who regularly takes digoxin for a heart condition is
newly diagnosed with hypothyroidism and started on thyroid
replacement hormones. What effect will this new diagnosis and
the initiation of thyroid replacement have on the patient's
digoxin dosage?
It will be increased.
It will remain the same.
It will be decreased.
It will be discontinued. Correct Answers A because you have to
increase digoxin
A patient who was admitted with a deep vein thrombosis in the
calf is being discharged on low-molecular-weight heparin
enoxaparin (Lovenox), which is administered by injection. The
patient successfully demonstrates the injection technique, but
which statement by the patient indicates a need for further
instruction by the nurse?
,"I will inject the medication into the side of my abdomen into
the fatty tissue."
"I'll change the site from side to side each day."
"I'll be sure to massage the spot I inject so the drug will absorb."
"I'll be careful not to bump myself." Correct Answers C. Do not
massage
ACE Inhibitor Correct Answers Actions
Blocks ACE from converting angiotensin I to angiotensin II,
leading to a decrease in blood pressure, a decrease in
aldosterone production, and a small increase in serum potassium
levels along with sodium and fluid loss
Indications
Treatment of hypertension, congestive heart failure (CHF),
diabetic nephropathy, left ventricular dysfunction following an
MI
Pharmacokinetics
Well absorbed, widely distributed, metabolized in the liver, and
excreted in the urine and feces
Blocks the conversion of angiotensin I to angiotensin II;
blocking effects of angiotensin on blood vessels
Promotes vasodilation
Helps prevent MI
Contraindications
Allergic to it
Impaired renal function
Pregnant/lactating
Caution
CHF
Adverse Effects
Chronic Cough
, GI irritation
Renal insufficiency
Administering medication method Correct Answers 30mL flush
medication
10mL flush
medication
10mL flush
medication
30mL flush
Once you crush a medication and give it you need to give time
before giving another med
Stomach holds 500mL
Administration of a Disposable Enema Correct Answers The
dose form will be a prepackaged, disposable-type enema
solution
Technique begins with the seven rights
Explain procedure and check pertinent parameters
Time of last defecation
Position patient on left side
Apply lubricant to rectal tube
Insert lubricated tube and insert solution
Educate
Document
Administration of Medications
by Nasogastric Tube Correct Answers Flush the tube with 10-
30 ml of water before and after medication administration for an
ng tube
A patient admitted 4 days ago with a pulmonary embolism has
been prescribed oral warfarin (Coumadin) and IV heparin. What
is the reason for the patient receiving two anticoagulants?
The oral and injectable forms must be administered together for
effective anticoagulation.
The combination of drugs results in fewer adverse effects than
when using heparin alone.
Oral anticoagulants are used to reach an adequate level of
anticoagulation when heparin alone is unable to do so.
Heparin is often used to initiate therapy, then oral anticoagulants
are prescribed and adjusted until laboratory tests indicate an
adequate therapeutic response. Correct Answers D
A patient has been placed on a loop diuretic to reduce the fluid
that has been accumulating in the lungs. Which statement made
by the patient indicates a need for further teaching about the
medication by the nurse?
"I'll be sure to take my medication with supper."
"I'll have a banana with my breakfast every morning."
"I'll weigh myself each day before breakfast."
"If my shortness of breath returns, I'll contact my physician."
Correct Answers A
A patient has been recently diagnosed with heart failure due to
systolic dysfunction. She asks the nurse to explain the disease
process to family members. The best explanation is:
"The heart rate is failing to keep up with the body's needs."
"The patient has developed dysrhythmias that have failed to
respond to medication."
,"The heart does not have adequate force to pump all needed
blood."
"The left ventricle fails to relax enough between beats to fill
with blood." Correct Answers C
A patient has presented to the emergency department reporting
feeling short of breath. What other symptom alerts the nurse that
the patient may be in heart failure?
Lungs clear to auscultation
2+ ankle edema
BP 118/74 mm Hg
Stable weight Correct Answers B
A patient who regularly takes digoxin for a heart condition is
newly diagnosed with hypothyroidism and started on thyroid
replacement hormones. What effect will this new diagnosis and
the initiation of thyroid replacement have on the patient's
digoxin dosage?
It will be increased.
It will remain the same.
It will be decreased.
It will be discontinued. Correct Answers A because you have to
increase digoxin
A patient who was admitted with a deep vein thrombosis in the
calf is being discharged on low-molecular-weight heparin
enoxaparin (Lovenox), which is administered by injection. The
patient successfully demonstrates the injection technique, but
which statement by the patient indicates a need for further
instruction by the nurse?
,"I will inject the medication into the side of my abdomen into
the fatty tissue."
"I'll change the site from side to side each day."
"I'll be sure to massage the spot I inject so the drug will absorb."
"I'll be careful not to bump myself." Correct Answers C. Do not
massage
ACE Inhibitor Correct Answers Actions
Blocks ACE from converting angiotensin I to angiotensin II,
leading to a decrease in blood pressure, a decrease in
aldosterone production, and a small increase in serum potassium
levels along with sodium and fluid loss
Indications
Treatment of hypertension, congestive heart failure (CHF),
diabetic nephropathy, left ventricular dysfunction following an
MI
Pharmacokinetics
Well absorbed, widely distributed, metabolized in the liver, and
excreted in the urine and feces
Blocks the conversion of angiotensin I to angiotensin II;
blocking effects of angiotensin on blood vessels
Promotes vasodilation
Helps prevent MI
Contraindications
Allergic to it
Impaired renal function
Pregnant/lactating
Caution
CHF
Adverse Effects
Chronic Cough
, GI irritation
Renal insufficiency
Administering medication method Correct Answers 30mL flush
medication
10mL flush
medication
10mL flush
medication
30mL flush
Once you crush a medication and give it you need to give time
before giving another med
Stomach holds 500mL
Administration of a Disposable Enema Correct Answers The
dose form will be a prepackaged, disposable-type enema
solution
Technique begins with the seven rights
Explain procedure and check pertinent parameters
Time of last defecation
Position patient on left side
Apply lubricant to rectal tube
Insert lubricated tube and insert solution
Educate
Document
Administration of Medications
by Nasogastric Tube Correct Answers Flush the tube with 10-
30 ml of water before and after medication administration for an
ng tube
