N352 Unit 4 Exit Exam Questions With All Complete & Verified Solution (graded a+)

Drug cards - correct answer Nitroglycerin Metoprolol Diltiazem Lisinopril Atorvastin Phenytoin Lithium Ativan Haloperiodol Fluoxetine The nurse is caring for a patient receiving glatiramer acetate (Copaxone) for a diagnosis of Multiple Sclerosis. Which finding, if present in this patient, could be considered a potential adverse effect of this drug? - correct answer Injection site pain and redness The nurse is assessing a patient receiving valproic acid (Depakote) for potential adverse effects associated with this drug. What is the most common problem with this drug? - correct answer Nausea, vomiting, and indigestion The nurse receives a laboratory report indicating that the phenytoin (Dilantin) level for the patient seen in the clinic yesterday is 16 mcg/mL. Which intervention is most appropriate? - correct answer Continue as planned, because the level is within normal limits. The therapeutic range for phenytoin is 10 to 20 mcg/mL. The nurse has just administered the first dose of haloperidol (Haldol) to a patient with schizophrenia. Which finding, if present, is the most important for the nurse to report to the healthcare provider prior to the next dose? - correct answer BP 88/52 Hypotension and changes in the ECG should be immediately reported to the health care provider The nurse is caring for a patient receiving clozapine (Clozaril). Which assessment finding is most indicative of an adverse effect of this drug? - correct answer White blood cell (WBC) count of 2000/mm3. Clozapine, an atypical antipsychotic, carries a risk of fatal agranulocytosis. For this reason, the WBC count should be monitored and should be greater than 3500/mm3 The nurse is seeing several patients in the outpatient clinic today. Which patient most requires the nurse's immediate attention? - correct answer A male patient takes lithium and who has a lithium level of 2.1 mEq/L. Lithium levels above 1.5 mEq/L should be reported, because this level may indicate impending serious toxicity. The nurse is monitoring a patient with depression in the early phase of treatment with amitriptyline (Elavil), a tricyclic antidepressant. Which question is most important for the nurse to ask the patient? - correct answer "Have you had any changes in your mood or anxiety level?" In the early phase of treatment for depression, suicide risk may increase. Patients should be monitored closely for worsening mood, unusual changes in behavior, and suicide risk. The other questions would be useful in assessing the patient for adverse effects of amitriptyline [Elavil], but assessing suicide risk is the most important intervention. The nurse is preparing to administer a daily dose of digoxin (Lanoxin) to a patient in heart failure. Which assessment receives priority at this time? - correct answer Assessing apical pulse for one minute. Before giving digoxin, the nurse will assess the heart rate and rhythm. The dosage will be held and the prescriber notified if the heart rate is below 60 beats per minute or if the cardiac rhythm has changed. Digoxin can cause bradycardia and electrical changes in the heart. The nurse is caring for a patient receiving amiodarone (Cordarone). What is the the most serious potential adverse effect of amiodarone? - correct answer Increased respiratory effort. Pulmonary toxicity is the most serious potential adverse effect of amiodarone. It may manifest as pneumonitis or pulmonary fibrosis, with symptoms such as dyspnea, cough, and chest pain. The nurse is caring for patient with atherosclerosis. Which agent is in the category of drugs considered most effective for lowering LDL cholesterol? - correct answer Atorvastatin (Lipitor) The statin drugs, such as atorvastatin, are the most effective drugs available for lowering LDL cholesterol. They are better tolerated, have fewer adverse effects, and produce better clinical outcomes than any other agents available for lowering LDL. Nitroglycerin - correct answer Do not take with other meds that lower BP- ED meds Metoprolol - correct answer Beta blocker action: Uses: lower BP and HR, depression, tachycardia, heart failure, acute MI, dysrhythmias Nursing implications -Less effective on african americans -relaxes, lower BP/HR Side effects: dizziness, fatigue, sexual dysfunction Anti-HTN - correct answer Check BP/pulse Wait 4 hours between doses Don't take with other anti-HTN Deltiazam - correct answer -Actions: slows HR, lowers BP -Uses: HTN, angina, ?? -Do not give if pulse is less than 60, systolic?? less than 90 -Monitor I/O, no grape fruit juice -Get better: chest pain, dysrhytmias, HTN -Labs: K, BUN/creatinine, liver enzymes -Side effects: brradycardia, low BP, heart block, headache, abdominal discomfort, peripheral edema??? -Adverse: heart block, bradycardia -Teach: get own bp/monitor, check heart rate, avoid grape fruit juice Drug name: cartizam?? IV - need to be on ECG Lisinopro - correct answer Class: ACE inhibitor Action: works on kidneys Concern: kidney problems - elevated BUN/creatinine, Slow HR, can help with diabetic and non-diabetic neuropathy, NTN, heart failure, prevention of a heart attack ??? Nursing Im: kidney issue - check labs before starting (Na, K, BUN/creatinine) Monitor: reason for taking it should get better Side effects: 1st dose - hypotension, cough, angiodema? Adverse: hypotension, hypercalemia/natermia, kidney failure, neutropenia Teaching: change positions slowly, report edema/cough, high K/low Na, mouth sores/sore throat - neutropenia, I/O Atorvastin - correct answer Class: Anti-lupemic (lower lipids) Action: lower lipids/cholesterol, promotes plque stability, reduce risk of cardiac event Teaching: liver failure, issues with this med before - do not take Monitor: labs after a while (lipid panel) Teaching: diet & exercise, avoid alcohol head rash, gi discomfort, muscle