Pnm 300 Test 2 | Questions And Answers | Complete With Detailed Rationales - Seneca College

PNM 300 TEST 2 | QUESTIONS AND ANSWERS | COMPLETE WITH DETAILED RATIONALES - SENECA COLLEGE 1. A patient with heart failure is prescribed digoxin. Which assessment finding indicates potential digoxin toxicity? A. Heart rate of 72 beats per minute B. Serum potassium level of 4.2 mEq/L C. Visual disturbances such as yellow halos around lights D. Blood pressure of 130/80 mmHg Answer: C. Visual disturbances such as yellow halos around lights Rationale: Visual disturbances, including yellow or green halos around lights, blurred vision, and photophobia, are classic signs of digoxin toxicity. A normal heart rate and potassium level do not indicate toxicity, and the blood pressure is within acceptable range. ________________________________________ 2. A patient is prescribed furosemide (Lasix) for heart failure. Which laboratory value should the nurse monitor most closely? A. Serum sodium B. Serum potassium C. Serum calcium D. Serum magnesium Answer: B. Serum potassium Rationale: Furosemide is a loop diuretic that causes significant potassium wasting. Hypokalemia is a common and potentially dangerous adverse effect that can lead to cardiac arrhythmias, especially in patients also taking digoxin. ________________________________________ 3. A patient with atrial fibrillation is prescribed amiodarone. Which adverse effect requires immediate nursing intervention? A. Blue-gray skin discoloration B. Pulmonary toxicity with crackles and dyspnea C. Corneal microdeposits D. Photosensitivity Answer: B. Pulmonary toxicity with crackles and dyspnea Rationale: Pulmonary toxicity is a serious and potentially fatal adverse effect of amiodarone. Signs include crackles, dyspnea, cough, and decreased oxygen saturation. This requires immediate discontinuation and medical evaluation. The other options are also adverse effects but are less immediately life-threatening. ________________________________________ 4. A patient is receiving heparin infusion for deep vein thrombosis. Which laboratory test is used to monitor therapeutic effectiveness? A. PT (Prothrombin Time) B. INR (International Normalized Ratio) C. aPTT (Activated Partial Thromboplastin Time) D. Platelet count Answer: C. aPTT (Activated Partial Thromboplastin Time) Rationale: aPTT is the primary laboratory test used to monitor heparin therapy. The therapeutic range is typically 1.5 to 2.5 times the normal control value. PT and INR are used to monitor warfarin therapy, while platelet count monitors for heparin-induced thrombocytopenia. ________________________________________ 5. A patient with heart failure is prescribed carvedilol. Which statement indicates the patient understands the medication teaching? A. "I can stop this medication if I feel dizzy." B. "I should take this medication with food to avoid stomach upset." C. "I will monitor my blood pressure and pulse daily." D. "This medication will increase my heart rate." Answer: C. "I will monitor my blood pressure and pulse daily." Rationale: Carvedilol is a beta-blocker that decreases heart rate and blood pressure. Patients should monitor these parameters daily and report significant changes. The medication should not be stopped abruptly due to rebound tachycardia and hypertension. It can be taken without regard to meals. ________________________________________ 6. A patient on warfarin (Coumadin) has an INR of 5.8. Which medication should the nurse anticipate administering? A. Protamine sulfate B. Vitamin K C. Aminocaproic acid D. Desmopressin Answer: B. Vitamin K Rationale: Vitamin K is the antidote for warfarin. An INR of 5.8 indicates excessive anticoagulation and increased bleeding risk. Protamine sulfate is the antidote for heparin. The therapeutic INR range for most indications is 2.0-3.0. ________________________________________ 7. A patient is prescribed an ACE inhibitor for heart failure. Which adverse effect should the nurse teach the patient to report immediately? A. Dry cough B. Angioedema C. Hyperkalemia D. Hypotension Answer: B. Angioedema Rationale: Angioedema is a rare but life-threatening adverse effect of ACE inhibitors characterized by swelling of the face, lips, tongue, and airways. This requires immediate medical attention. While dry cough, hyperkalemia, and hypotension are also adverse effects, they are not immediately life-threatening. ________________________________________ 8. Which medication is classified as an angiotensin II receptor blocker (ARB)? A. Lisinopril B. Losartan C. Enalapril D. Captopril Answer: B. Losartan Rationale: Losartan is an ARB. Lisinopril, enalapril, and captopril are all ACE inhibitors. ARBs work by blocking the angiotensin II receptor, while ACE inhibitors prevent the conversion of angiotensin I to angiotensin II. ________________________________________ 9. A patient with heart failure is prescribed spironolactone. Which food should the patient avoid? A. Bananas B. Grapefruit juice C. Dairy products D. Green leafy vegetables Answer: A. Bananas Rationale: Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia. Patients should avoid foods high in potassium, such as bananas, oranges, tomatoes, and salt substitutes containing potassium. Grapefruit juice affects metabolism of many drugs but is less specific to spironolactone. ________________________________________ 10. A patient prescribed digoxin reports nausea, vomiting, and seeing yellow halos. What is the priority nursing action? A. Administer the next scheduled dose B. Hold the digoxin and assess apical pulse C. Increase the digoxin dose D. Administer an antiemetic Answer: B. Hold the digoxin and assess apical pulse