NURS 305 Exam 2 | Questions and Answers (Complete Solutions)

NURS 305 Exam 2 | Questions and Answers (Complete Solutions) Which statement by the nurse about beta blockers is accurate? 1) "Beta blockers increase myocardial contractility." 2) "Beta blockers increase the patient's urine output." 3) "Beta blockers increase dilation of the peripheral vessels." 4) "Beta blockers decrease sympathetic stimulation of the heart." *blocks actions of epinephrine and norepinephrine Which serum digoxin concentration is suggestive of digitalis toxicity? 1) 1.6 ng/mL 2) 1.8 ng/mL 3) 2.0 ng/mL 4) 2.2 ng/mL *greater than 2 ng/mL is toxic Which chamber of the heart will have to work harder to pump blood as a result of aortic valve dysfunction? 1) Left atrium 2) Right atrium 3) Left ventricle 4) right ventricle Which class of drugs is used in the treatment of angina pectoris? Select all that apply. One, some, or all responses may be correct. 1) Diuretics 2) Beta blockers 3) Antihistamines 4) Nitrates and nitrites 5) Calcium channel blockers (CCBs Which drug may cause bronchoconstriction? 1) Atenolol 2) Propranolol 3) Verapamil HCl 4) Nicardipine HC *nonselective beta blocker Which mechanism of action describes how digoxin immune Fab works? 1) Binding to digoxin 2) Decreasing elimination 3) Inducing a heart block 4) speeds up metabolism Which class of drugs is used as the first line of therapy for reducing fluid volume in patients with heart failure (HF)? 1) Nitrates 2) Diuretics 3) Beta blockers 4) Calcium channel blockers Which condition indicates an excessive dose of digoxin? 1) Polyuria 2) Dizziness 3) Halo vision 4) Photophobia Which side effect is associated with the use of nitroglycerin? 1) Diplopia 2) Anorexia 3) Dry mouth 4) Abdominal pain Which statement regarding normal pulmonary circulation is correct? 1) Blood is pumped from the ventricles into the atria. 2) The aorta receives deoxygenated blood from the body. 3) Blood travels to the lungs to exchange CO2 for oxygen. 4) The pulmonary artery pumps oxygenated blood to the body. Which laboratory value would the nurse assess if a patient has a new-onset abnormal cardiac rhythm? Select all that apply. One, some, or all responses may be correct. 1) Sodium 2) Calcium 3) Chloride 4) Potassium 5) phosphorus Which information would a nurse include in discharge teaching to a patient prescribed digoxin and hydrochlorothiazide for the management of heart failure? Select all that apply. One, some, or all responses may be correct. 1) Obtain pulse before taking digoxin dose. 2) Do not take over-the-counter medications. 3) Include foods high in potassium in the diet. 4) Report signs of toxicity such as blurred vision. 5) Hold drug for heart rate less than 60 beats per minute. Which outcome is expected with calcium channel blockers (CCBs)? 1) To treat acute myocardial infarction (MI) 2) To reduce exercise-induced elevations in heart rate 3) To prolong the QT interval on the electrocardiogram (ECG) 4) To decrease the afterload and reduce the workload of the heart Which statement by a nurse about the use of medicinal nitrates indicates effective understanding? 1) Medicinal nitrates slow conduction. 2) Medicinal nitrates dilate all blood vessels. 3) Medicinal nitrates have no adverse effects. 4) Medicinal nitrates are used for atrial fibrillation. Which patient assessment would assist a nurse in evaluating therapeutic effects of a calcium channel blocker for angina? 1) Absence of chest pain 2) Patient denies dizziness 3) Reduced dyspnea 4) Decreased swelling in the ankles and feet *decreased workload on heart Which statement about calcium channel blockers (CCBs) is true? Select all that apply. One, some, or all responses may be correct. 1) Peripheral edema is a common side effect. 2) CCBs relax the coronary arteries. 3) CCBs increase cardiac contractility and afterload. 4) Nifedipine is the most potent CCB. 5) Diltiazem is indicated for paroxysmal supraventricular tachycardia (PSVT). Which drug will a nurse expect the primary health care provider to prescribe for a patient receiving digoxin who reports headache, dizziness, nausea, and blurred vision and also has a pulse rate of 48 beats per minute? 1) Milrinone 2) Nesiritide 3) Dobutamine 4) Digoxin-immune Fab *SIGNS OF DIGITALIS TOXICITY Which assessment will the nurse make before administering isosorbide dinitrate? 1) Assess blood pressure. 2) Assess serum electrolytes. 3) Monitor level of consciousness. 4) Measure blood urea nitrogen and creatinine. *isosorbide dinitrate is a vasodilator and can cause hypotension Which therapeutic effects are expected with digoxin? 1) Positive inotropic, positive chronotropic, and negative dromotropic 2) Positive inotropic, negative chronotropic, and positive dromotropic 3) Positive inotropic, negative chronotropic, and negative dromotropic 4) Negative inotropic, negative chronotropic, and negative dromotropic Which assessment would a nurse make before administering digoxin? 1) Apical pulse 2) Homans sign 3) Breath sounds 4) Weight in kilograms Which instruction does a nurse provide a patient who is prescribed nitroglycerin patches in order to prevent the development of tolerance to nitrates? 1) "Apply the nitroglycerin patch every other day." 2) "Use the nitroglycerin patch for acute episodes of angina only." 3) "Use sublingual nitroglycerin if your systolic blood pressure is 140 mm Hg." 4) "Apply the nitroglycerin patch each day, and remove it for 10 hours at night." *give a drug holiday Upon assessment of a patient taking digoxin for the management of heart failure, the nurse documents a heart rate of 52 beats per minute, nausea, and a yellowish hue in the patient's vision. What would the nurse expect to hear from the health care provider about the management of this patient? 1) Obtain the digoxin level. 2) Administer the antiemetic. 3) Initiate a clear liquid diet. 4) Measure the oxygen saturation Which parameter do chronotropic drugs affect? 1) Heart rate 2) Blood pressure 3) Conduction velocity 4) Myocardial contractility Which statement made by a patient demonstrates a need for further instruction regarding the use of sublingual nitroglycerin?y 1) "I should keep my nitroglycerin in a cool, dry place that is protected from light." 2) "I should change positions slowly to avoid getting dizzy." 3) "I can take up to five tablets at 3-minute intervals for chest pain if necessary." 4) "If I get a headache, I should keep taking nitroglycerin and use acetaminophen for pain relief. *can take up to 3 tablets, every 5 minutes Before administering the daily dose of digoxin to a patient, the nurse notes that the patient is experiencing nausea, headache, malaise, and blurred vision. The patient's pulse rate is 54 beats per minute, and the patient states that he sees yellow halos around objects. Which action would the nurse anticipate taking in this situation? Select all that apply. One, some, or all responses may be correct. 1) Hold the dose. 2) Draw a digoxin level. 3) Notify the health care provider. 4) Administer digoxin-immune Fab. 5) Place the patient on a cardiac monitor. Which symptom will a nurse monitor in a patient with suspected digoxin toxicity? Select all that apply. One, some, or all responses may be correct. 1) Anorexia 2) Vomiting 3) Dry cough 4) Visual disturbances 5) Cardiac dysrhythmias Which action will be the nurse's priority for a patient receiving an intravenous (IV) antidysrhythmic agent? 1) Evaluate the electroencephalogram (EEG). 2) Monitor the vital signs. 3) Assess electrolyte levels. 4) Elevate the head of the bed. Which intervention would the nurse implement immediately for a patient newly prescribed digoxin who is concurrently prescribed furosemide? 1) Assess the prothrombin time (PT) and partial thromboplastin time (PTT). 2) Monitor the potassium level. 3) Obtain a baseline hearing assessment. 4) Instruct the patient on a low-sodium, low-fat diet *furosemide is a loop diuretic The nurse reviews the history of a patient experiencing premature ventricular contractions who is prescribed propranolol. Which action will be the nurse's priority when noting that the patient has a history of asthma? 1) Seek a bronchodilator prescription. 2) Administer the drug as prescribed. 3) Administer half the prescribed dose of the drug. 4) Ask the health care provider to switch to another drug. *propranolol is a nonselective betablocker; causes bronchoconstriction Which class of drugs would be prescribed for a patient who experiences exertional angina? 1) Beta blockers 2) Class Ib antidysrhythmics 3) Calcium channel blockers 4) Nitroglycerin transdermal patch *b/c beta blockers decrease HR & contractility & oxygen consumption Which intervention would the nurse implement immediately when caring for a patient who receives a new prescription for an intravenous (IV) antidysrhythmic? 1) Draw arterial blood gasses. 2) Monitor the patient for tachycardia. 3) Start an IV infusion of Ringer's lactate solution. 4) Place the patient on continuous cardiac monitoring The nurse is planning care for a patient prescribed mannitol for increased intracranial pressure (ICP). Which laboratory value would the nurse assess? Select all that apply. One, some, or all responses may be correct. 1) Sodium 2) Calcium 3) Potassium 4) Creatinine 5) Magnesium Which class of diuretics is used to manage increased intracranial pressure? , 1) Carbonic anhydrase inhibitors 2) Loop diuretics 3) Osmotic diuretics 4) Potassium-sparing diuretics Which phrase describes how a diuretic lowers blood pressure? 1) Increases blood volume 2) Maintains calcium balance 3) Removes excess potassium 4) Blocks sodium reabsorption Which assessment would the nurse include when caring for a patient receiving mannitol for the treatment of cerebral edema? Select all that apply. One, some, or all responses may be correct. 1) Vision 2) Blood pressure 3) Heart rate 4) Serum sodium 5) Serum potassium Which is an appropriate nursing intervention for a patient who is taking hydrochlorothiazide? 1) Encourage intake of foods rich in potassium. 2) Schedule the dose to be taken in the evening. 3) Monitor serum calcium and sodium levels daily. 4) Take the radial pulse for 1 full minute before administering the drug. Which two functions are associated with diuretics? 1) Reducing edema and blood pressure 2) Reducing weight and edema 3) Reducing blood volume and edema 4) Reducing calcium and blood pressure The nurse is caring for a patient prescribed bumetanide for pulmonary edema. Which finding in the patient's history would be a contraindication for using this medication? 1) Gout 2) Arthritis 3) Hypertension 4) Angina pectoris *loop diuretics cause elevated uric acid levels Which diuretic is beneficial in treating absence or petit mal seizures and open-angle glaucoma? 1) Furosemide 2) Mannitol 3) Acetazolamide 4) Triamterene *carbonic anhydrase inhibitor On which portion of the renal tubule would the nurse expect the potassium-sparing diuretics to work? 1) Distal tubule 2) Loop of Henle 3) Proximal tubule 4) Collecting tubule Which adverse effect does a nurse anticipate occurring from the administration of furosemide? Select all that apply. One, some, or all responses may be correct. 1) Hyperchloremia 2) Hypernatremia 3) Hypokalemia 4) Hypophosphatemia 5) Hypomagnesemia A patient is taking hydrochlorothiazide (HydroDIURIL). On assessment, the nurse notices the patient has muscle weakness and hypotension. What is the nurse's first intervention? 1) Administer calcium supplements 2) Assess the serum potassium level 3) Reduce salt in the patient's food 4) Give a lower dose of the medication. Which diuretic class may cause hypercalcemia? 1) Osmotic diuretics 2) Potassium-sparing diuretics 3) Loop or high-ceiling diuretics 4) Thiazide and thiazide-like diuretics Which laboratory finding would a nurse anticipate observing in a patient who is receiving furosemide? One, some, or all responses may be correct. 1) Increased chloride levels 2) Decreased sodium levels 3) Decreased calcium levels 4) Decreased potassium levels 5) Increased magnesium levels Which patient information will a nurse obtain before administering furosemide? Select all that apply. One, some, or all responses may be correct. 1) Serum potassium level 2) Level of consciousness 3) Baseline weight 4) Fluid intake and urine output 5) Blood pressure Which nursing instruction is beneficial for a patient who is prescribed furosemide? Select all that apply. One, some, or all responses may be correct. 1) avoid taking the drug with food 2) take ginseng along with the drug 3) take this drug before eating dinner 4) take this drug along with breakfast 5) rise slowly from lying or sitting when taking this drug Which intervention would the nurse include in the plan of care for a patient taking spironolactone? Select all that apply. One, some, or all responses may be correct. 1) Assess renal function. 2) Weigh patient every day. 3) Obtain serum electrolytes. 4) Monitor intake and output. 5) Offer high-potassium foods Which time period does a nurse expect diuresis to occur following intravenous (IV) administration of furosemide? 1) 1 minute 2) 5 minutes 3) 30 minutes 4) 60 minutes Which rationale explains why a nurse would advise an older adult patient to take furosemide in the morning? 1) To prevent the patient from urinating at night 2) To prevent an increase in overall body weight 3) To prevent orthostatic hypotension changes 4) To prevent fluid and electrolyte imbalances Which antidote is used for warfarin overdose? 1) Vitamin A 2) Vitamin B 3) Vitamin D 4) Vitamin K Which clotting factor is affected by oral anticoagulants? Select all that apply. One, some, or all responses may be correct. 1) II 2) IV 3) VII 4) IX 5) X The patient asks the nurse to explain the difference between dalteparin and heparin. Which response by the nurse is accurate? 1) "Dalteparin can be given during spinal surgery but heparin cannot." 2) "The only difference is that heparin dosing is based on the patient's weight and dalteparin has a fixed dose." 3) "Dalteparin can be given orally, whereas heparin is given in an injection." 4) "Dalteparin does not require monitoring of the activated partial thromboplastin time (aPTT) like heparin does." Which instructions will a nurse include in the plan of care for a patient receiving warfarin? 1) "Do not take aspirin for pain." 2) "Do not eat foods with potassium." 3) "Avoid the use of acetaminophen." 4) "Increase your intake of green, leafy vegetables." *don't take NSAIDs because it increases risk of bleeding (antiplatelet) Which explanation describes how anticoagulants work? 1) Anticoagulants dissolve clots. 2) Anticoagulants alter platelet function. 3) Anticoagulants prevent clots from forming. 4) Anticoagulants interfere with drug metabolism. Which oral anticoagulant requires routine coagulation monitoring? 1) Apixaban 2) Warfarin 3) Dabigatran 4) Rivaroxaban *monitor PT and INR Which drugs are known as "clot busters"? 1) Antiplatelets 2) Thrombolytics 3) Anticoagulants 4) Antifibrinolytics Which contraindication would be considered when a patient is prescribed clopidogrel bisulfate? Select all that apply. One, some, or all responses may be correct. 1) Trauma 2) Gastrointestinal (GI) bleed 3) Renal disease 4) Hepatic disease 5) Intracranial hemorrhage