PHARM - Cardiovascular Exam 2025–2026
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The nurse has completed client teaching about heart failure and prescribed medications
that include digoxin and furosemide. The nurse documents that the teaching goals have
been met if the client states knowing to report which symptom?
Weight gain of 2 to 3 pounds in a few days
Rationale: Clients with heart failure should immediately report weight gain, loss of
appetite, shortness of breath with activity, edema, persistent cough, and nocturia. A high
urine output is expected with these medications. A cough that accompanies a cold is
normal. A sudden increase in appetite is insignificant.
The nurse is preparing to administer digoxin to an adult client. The nurse checks which
important item before administering the medication?
Apical pulse rate
Rationale:Digoxin is a cardiac glycoside that is used to manage and treat heart failure and
to control ventricular rates in clients with atrial fibrillation. Before administering the
medication, the nurse needs to assess the apical heart rate for 60 seconds. If the pulse
rate is less than 60 beats per minute in an adult client, the nurse would withhold the
medication and contact the health care provider because a low pulse rate may be an
indication of toxicity. Blood pressure, Neurological signs, and level of consciousness may
be a component of the assessment depending on the client's diagnosis. However, these
assessments are not specifically associated with the use of digoxin.
Vasopressin is prescribed for the client with diabetes insipidus. During data collection,
the nurse is particularly cautious in checking the client for which preexisting condition?
,Coronary artery disease
Rationale: Because of its powerful vasoconstrictive actions, vasopressin can cause adverse
cardiovascular effects. By constricting arteries of the heart, vasopressin can cause angina
pectoris and even myocardial infarction, especially if administered to clients with coronary
artery disease. In addition, vasopressin may cause gangrene by decreasing blood flow in
the periphery.
A client has taken his first dose of lisinopril about 2 hours ago and begins to develop
fullness in his face and hoarseness. Which action should the nurse take first?
Determine the client's ability to breathe effectively.
Rationale: The client is experiencing angioedema, an adverse effect of the medication,
which involves facial swelling and hoarseness. Assessing the ability to breathe effectively
takes priority over assessing the blood pressure, preventing dizziness, or determining how
long the client has been hoarse.
A client takes digoxin 0.25 mg by prescription every day. When the nurse enters the
client's room with the medication, the client's meal tray is untouched and the client says
he has no appetite. Which action is the most appropriate?
Listen to the client's apical pulse. If it is less than 60 beats per minute, withhold the
medication.
Rationale: Anorexia is a common early sign of digoxin toxicity. Another sign of digoxin
toxicity is an apical pulse rate of less than 60 beats per minute. If the apical pulse rate is
less than 60 beats per minute, the dose should be withheld and the health care provider
notified. The remaining options are incorrect actions and would harm the client
(administer one half the prescribed amount to avoid digoxin toxicity.) or delay needed
intervention (check the client's temperature, radial pulse rate, and respiratory rate. and
,offer to bring back the digoxin to the client when his appetite improves.). Additionally, a
radial pulse is not as accurate as an apical pulse and should not be used to determine the
possibility of digoxin toxicity.
A 1-year-old child has been prescribed digoxin to treat heart failure (HF). When should
the nurse plan on withholding the prescribed dose of the medication?
The child's pulse is less than 80 beats per minute.
Rationale: The normal pulse rate for a 1-year-old child is about 100 beats per minute. A
missed dose is withheld if 4 hours have elapsed. Fever is not a contraindication to giving
the medication. Knowing that a sign of digoxin toxicity is a decreased heart rate, the most
likely choice is pulse less than 80 bpm, which indicates a relative bradycardia.
Thrombolytic therapy was administered to a client following an acute inferior
myocardial infarction. The nurse giving discharge instructions to the client evaluates
a need for further teaching when the client makes which statement?
"I will apply pressure for 10 minutes for minor bleeding."
Rationale: Thrombolytic medication causes lysis of blood clots. Client teaching includes
reporting a temperature over 104° F (40° C), which can be an indicator of internal
bleeding. Other instructions include avoiding venous or arterial punctures and rectal
temperatures. Fevers can be treated with acetaminophen or aspirin. Pressure should be
applied for 30 seconds to a minor bleeding site. Inform the primary health care provider if
this does not attain hemostasis.
The nurse is caring for a client who is receiving hydralazine. The nurse evaluates
the effectiveness of the medication by monitoring which client parameters?
Blood pressure
, Rationale: Hydralazine is an antihypertensive medication used in the management of
moderate to severe hypertension. It is a vasodilator medication that decreases afterload,
so it is important that the blood pressure be monitored. The remaining options are not
specifically related to determining the effectiveness of this medication.
A client has received atropine sulfate intravenously during a surgical procedure. The
nurse monitors the client for which side effect of the atropine sulfate in the
postoperative period?
Urinary retention
Rationale: Atropine sulfate is an anticholinergic medication that causes tachycardia,
drowsiness, blurred vision, dry mouth, constipation, and urinary retention. The nurse
monitors the client for any of these effects in the postoperative period.
A client receiving total parenteral nutrition (PN) has a history of heart failure. The health
care provider has prescribed furosemide 40 mg orally daily to prevent fluid overload.
The nurse is giving instructions about taking furosemide in relation to the client's health
plan. Which statement by the client indicates a need for further teaching?
"I need to talk to my doctor about increasing my digoxin."
Rationale: Furosemide is a potassium-losing diuretic. Instructions include a need for a
high-potassium diet or potassium replacement, rising slowly from a lying or sitting
position because orthostatic hypotension may occur, and taking the medication early in
the day to prevent sleeplessness and nocturia. Furosemide can increase the risk of toxicity
of lithium, nondepolarizing skeletal muscle relaxants, digoxin, salicylates,
aminoglycosides, and cisplatin.
A client is receiving heparin sodium by continuous intravenous (IV) infusion. The
licensed practical nurse (LPN) is concerned that the client received a bolus of medication
Accurate Real Exam Questions and Verified
Correct Answers JUST RELEASED
The nurse has completed client teaching about heart failure and prescribed medications
that include digoxin and furosemide. The nurse documents that the teaching goals have
been met if the client states knowing to report which symptom?
Weight gain of 2 to 3 pounds in a few days
Rationale: Clients with heart failure should immediately report weight gain, loss of
appetite, shortness of breath with activity, edema, persistent cough, and nocturia. A high
urine output is expected with these medications. A cough that accompanies a cold is
normal. A sudden increase in appetite is insignificant.
The nurse is preparing to administer digoxin to an adult client. The nurse checks which
important item before administering the medication?
Apical pulse rate
Rationale:Digoxin is a cardiac glycoside that is used to manage and treat heart failure and
to control ventricular rates in clients with atrial fibrillation. Before administering the
medication, the nurse needs to assess the apical heart rate for 60 seconds. If the pulse
rate is less than 60 beats per minute in an adult client, the nurse would withhold the
medication and contact the health care provider because a low pulse rate may be an
indication of toxicity. Blood pressure, Neurological signs, and level of consciousness may
be a component of the assessment depending on the client's diagnosis. However, these
assessments are not specifically associated with the use of digoxin.
Vasopressin is prescribed for the client with diabetes insipidus. During data collection,
the nurse is particularly cautious in checking the client for which preexisting condition?
,Coronary artery disease
Rationale: Because of its powerful vasoconstrictive actions, vasopressin can cause adverse
cardiovascular effects. By constricting arteries of the heart, vasopressin can cause angina
pectoris and even myocardial infarction, especially if administered to clients with coronary
artery disease. In addition, vasopressin may cause gangrene by decreasing blood flow in
the periphery.
A client has taken his first dose of lisinopril about 2 hours ago and begins to develop
fullness in his face and hoarseness. Which action should the nurse take first?
Determine the client's ability to breathe effectively.
Rationale: The client is experiencing angioedema, an adverse effect of the medication,
which involves facial swelling and hoarseness. Assessing the ability to breathe effectively
takes priority over assessing the blood pressure, preventing dizziness, or determining how
long the client has been hoarse.
A client takes digoxin 0.25 mg by prescription every day. When the nurse enters the
client's room with the medication, the client's meal tray is untouched and the client says
he has no appetite. Which action is the most appropriate?
Listen to the client's apical pulse. If it is less than 60 beats per minute, withhold the
medication.
Rationale: Anorexia is a common early sign of digoxin toxicity. Another sign of digoxin
toxicity is an apical pulse rate of less than 60 beats per minute. If the apical pulse rate is
less than 60 beats per minute, the dose should be withheld and the health care provider
notified. The remaining options are incorrect actions and would harm the client
(administer one half the prescribed amount to avoid digoxin toxicity.) or delay needed
intervention (check the client's temperature, radial pulse rate, and respiratory rate. and
,offer to bring back the digoxin to the client when his appetite improves.). Additionally, a
radial pulse is not as accurate as an apical pulse and should not be used to determine the
possibility of digoxin toxicity.
A 1-year-old child has been prescribed digoxin to treat heart failure (HF). When should
the nurse plan on withholding the prescribed dose of the medication?
The child's pulse is less than 80 beats per minute.
Rationale: The normal pulse rate for a 1-year-old child is about 100 beats per minute. A
missed dose is withheld if 4 hours have elapsed. Fever is not a contraindication to giving
the medication. Knowing that a sign of digoxin toxicity is a decreased heart rate, the most
likely choice is pulse less than 80 bpm, which indicates a relative bradycardia.
Thrombolytic therapy was administered to a client following an acute inferior
myocardial infarction. The nurse giving discharge instructions to the client evaluates
a need for further teaching when the client makes which statement?
"I will apply pressure for 10 minutes for minor bleeding."
Rationale: Thrombolytic medication causes lysis of blood clots. Client teaching includes
reporting a temperature over 104° F (40° C), which can be an indicator of internal
bleeding. Other instructions include avoiding venous or arterial punctures and rectal
temperatures. Fevers can be treated with acetaminophen or aspirin. Pressure should be
applied for 30 seconds to a minor bleeding site. Inform the primary health care provider if
this does not attain hemostasis.
The nurse is caring for a client who is receiving hydralazine. The nurse evaluates
the effectiveness of the medication by monitoring which client parameters?
Blood pressure
, Rationale: Hydralazine is an antihypertensive medication used in the management of
moderate to severe hypertension. It is a vasodilator medication that decreases afterload,
so it is important that the blood pressure be monitored. The remaining options are not
specifically related to determining the effectiveness of this medication.
A client has received atropine sulfate intravenously during a surgical procedure. The
nurse monitors the client for which side effect of the atropine sulfate in the
postoperative period?
Urinary retention
Rationale: Atropine sulfate is an anticholinergic medication that causes tachycardia,
drowsiness, blurred vision, dry mouth, constipation, and urinary retention. The nurse
monitors the client for any of these effects in the postoperative period.
A client receiving total parenteral nutrition (PN) has a history of heart failure. The health
care provider has prescribed furosemide 40 mg orally daily to prevent fluid overload.
The nurse is giving instructions about taking furosemide in relation to the client's health
plan. Which statement by the client indicates a need for further teaching?
"I need to talk to my doctor about increasing my digoxin."
Rationale: Furosemide is a potassium-losing diuretic. Instructions include a need for a
high-potassium diet or potassium replacement, rising slowly from a lying or sitting
position because orthostatic hypotension may occur, and taking the medication early in
the day to prevent sleeplessness and nocturia. Furosemide can increase the risk of toxicity
of lithium, nondepolarizing skeletal muscle relaxants, digoxin, salicylates,
aminoglycosides, and cisplatin.
A client is receiving heparin sodium by continuous intravenous (IV) infusion. The
licensed practical nurse (LPN) is concerned that the client received a bolus of medication
