NURS 3550 Test 2 Questions With Complete Solutions
3 basic functions pf diuretics? Correct Answer Three basic
functions of diuretics
Cleansing of extracellular fluid (ECF) and maintenance of ECF
volume and composition
Maintenance of acid-base balance
Excretion of metabolic wastes and foreign substances
A nurse instructs a patient about signs and symptoms of digoxin
toxicity. The nurse determines that teaching is successful if the
patient makes which statement?
A. "If my heart is racing, the dose may be too high."
B. "I should report any muscle weakness or nausea."
C. "My doctor should be notified if diarrhea occurs."
D. "The dose will be reduced if I develop memory loss."
Correct Answer Answer: B
Rationale: Digoxin toxicity manifests with dysrhythmias,
bradycardia, muscle weakness, anorexia, nausea, vomiting,
fatigue, and visual disturbances.
A patient is prescribed a nitroglycerin transdermal patch. The
nurse should include which statement when teaching the patient
how to use this medication?
A. "Apply the patch to the chest over the heart."
B. "Change the patch each week."
C. "Remove the patch at bedtime."
D. "Put on the patch before exercising." Correct Answer C.
Rationale: A transdermal nitroglycerin patch is applied once
daily to a hairless area of skin. The site should be rotated to
avoid local irritation. Tolerance develops if patches are used
,continuously. A patch-free interval of 10 to 12 hours is
recommended. Patches are suited for sustained prophylaxis and
will not abort an ongoing attack.
A patient is prescribed digoxin [Lanoxin] and furosemide
[Lasix]. It is most important for the nurse to assess which value
before administering these medications.
A. . Serum sodium
B. Blood urea nitrogen
C. Serum potassium
D. Plasma B-natriuretic peptide Correct Answer Answer: C
Rationale: Furosemide is a loop diuretic that promotes loss of
potassium and thereby increases the risk of digoxin-induced
dysrhythmias. When digoxin and furosemide are used
concurrently, serum potassium levels must be monitored and
maintained within a normal range (3.5 to 5 mEq/L).
A patient is prescribed spironolactone [Aldactone] for treatment
of hypertension. Which foods should the nurse teach the patient
to avoid?
- Baked fish
- Low-fat milk
- Salt substitutes
- Green beans Correct Answer Answer: C
Rationale: Spironolactone is a potassium-sparing diuretic.
Medications that are potassium sparing, potassium supplements,
and salt substitutes should be avoided. High-potassium foods
should also be avoided.
,A patient is prescribed sustained-release oral nitroglycerin
capsules for chronic stable angina. The nurse should include
which instruction?
A. "Avoid exercising to help prevent chest pain."
B. "Place the capsule under the tongue if chest pain occurs."
C. "Take the capsule as needed before exercise or exertion."
D. "Sit or lie down if dizziness or lightheadedness occurs."
Correct Answer D. Rationale: Patients taking nitroglycerin
should be instructed about symptoms of hypotension (eg,
dizziness, lightheadedness) and advised to sit or lie down if
these occur. Patients should be advised to avoid overexertion but
should be encouraged to establish a regular program of aerobic
exercise. Sustained-release nitroglycerin should be swallowed,
not placed under the tongue. Sustained-release nitroglycerin is
prescribed 1 to 4 times daily, not as needed.
A patient is prescribed verapamil [Calan]. The nurse should
assess the patient for which common adverse effects?
- Atrial fibrillation, photosensitivity, and blurred vision
- Tachycardia, stomatitis, and inflammation of the joints
- Constipation, headache, and edema of the ankles and feet
- Dry mouth, lymphadenopathy, and decreased appetite Correct
Answer Answer: C
Rationale: The adverse effects of verapamil occur secondary to
vasodilation. Common adverse effects include constipation,
dizziness, facial flushing, headache, and edema of the ankles and
feet.
A patient is receiving an intravenous infusion of heparin to treat
a pulmonary embolism. What laboratory value will the nurse
monitor to evaluate treatment with this medication?
, - Activated partial thromboplastin time (aPTT)
- Prothrombin time (PT)
- Platelet count
- Hemoglobin and hematocrit Correct Answer Answer: A
Rationale: The most commonly used laboratory value that
monitors the effect of heparin is the activated partial
thromboplastin time (aPTT).
A patient is to receive a scheduled dose of diltiazem [Cardizem].
The nurse should hold the medication and contact the prescriber
if which of the following is noted?
- The patient's blood pressure is 112/64 mm Hg.
- The patient's cardiac rhythm is atrial fibrillation.
- The patient is complaining of chest pain.
- The patient has a second-degree heart block. Correct Answer
Answer: D
Rationale: Diltiazem is contraindicated in patients with second-
degree or third-degree heart block; diltiazem can exacerbate
cardiac dysfunction.
A patient reports having taken morphine for the past 6 months.
Which medication, if ordered by the physician, should the nurse
question?
- Promethazine [Phenergan]
- Pentazocine [Talwin]
- Methylnaltrexone [Relistor]
- Dextromethorphan [Delsym] Correct Answer Answer: B
Rationale: Pentazocine is an agonist-antagonist opioid. If
pentazocine is given to a patient who is physically dependent on
a pure opioid agonist such as morphine, withdrawal or
abstinence syndrome will occur. Before an agonist-antagonist is
3 basic functions pf diuretics? Correct Answer Three basic
functions of diuretics
Cleansing of extracellular fluid (ECF) and maintenance of ECF
volume and composition
Maintenance of acid-base balance
Excretion of metabolic wastes and foreign substances
A nurse instructs a patient about signs and symptoms of digoxin
toxicity. The nurse determines that teaching is successful if the
patient makes which statement?
A. "If my heart is racing, the dose may be too high."
B. "I should report any muscle weakness or nausea."
C. "My doctor should be notified if diarrhea occurs."
D. "The dose will be reduced if I develop memory loss."
Correct Answer Answer: B
Rationale: Digoxin toxicity manifests with dysrhythmias,
bradycardia, muscle weakness, anorexia, nausea, vomiting,
fatigue, and visual disturbances.
A patient is prescribed a nitroglycerin transdermal patch. The
nurse should include which statement when teaching the patient
how to use this medication?
A. "Apply the patch to the chest over the heart."
B. "Change the patch each week."
C. "Remove the patch at bedtime."
D. "Put on the patch before exercising." Correct Answer C.
Rationale: A transdermal nitroglycerin patch is applied once
daily to a hairless area of skin. The site should be rotated to
avoid local irritation. Tolerance develops if patches are used
,continuously. A patch-free interval of 10 to 12 hours is
recommended. Patches are suited for sustained prophylaxis and
will not abort an ongoing attack.
A patient is prescribed digoxin [Lanoxin] and furosemide
[Lasix]. It is most important for the nurse to assess which value
before administering these medications.
A. . Serum sodium
B. Blood urea nitrogen
C. Serum potassium
D. Plasma B-natriuretic peptide Correct Answer Answer: C
Rationale: Furosemide is a loop diuretic that promotes loss of
potassium and thereby increases the risk of digoxin-induced
dysrhythmias. When digoxin and furosemide are used
concurrently, serum potassium levels must be monitored and
maintained within a normal range (3.5 to 5 mEq/L).
A patient is prescribed spironolactone [Aldactone] for treatment
of hypertension. Which foods should the nurse teach the patient
to avoid?
- Baked fish
- Low-fat milk
- Salt substitutes
- Green beans Correct Answer Answer: C
Rationale: Spironolactone is a potassium-sparing diuretic.
Medications that are potassium sparing, potassium supplements,
and salt substitutes should be avoided. High-potassium foods
should also be avoided.
,A patient is prescribed sustained-release oral nitroglycerin
capsules for chronic stable angina. The nurse should include
which instruction?
A. "Avoid exercising to help prevent chest pain."
B. "Place the capsule under the tongue if chest pain occurs."
C. "Take the capsule as needed before exercise or exertion."
D. "Sit or lie down if dizziness or lightheadedness occurs."
Correct Answer D. Rationale: Patients taking nitroglycerin
should be instructed about symptoms of hypotension (eg,
dizziness, lightheadedness) and advised to sit or lie down if
these occur. Patients should be advised to avoid overexertion but
should be encouraged to establish a regular program of aerobic
exercise. Sustained-release nitroglycerin should be swallowed,
not placed under the tongue. Sustained-release nitroglycerin is
prescribed 1 to 4 times daily, not as needed.
A patient is prescribed verapamil [Calan]. The nurse should
assess the patient for which common adverse effects?
- Atrial fibrillation, photosensitivity, and blurred vision
- Tachycardia, stomatitis, and inflammation of the joints
- Constipation, headache, and edema of the ankles and feet
- Dry mouth, lymphadenopathy, and decreased appetite Correct
Answer Answer: C
Rationale: The adverse effects of verapamil occur secondary to
vasodilation. Common adverse effects include constipation,
dizziness, facial flushing, headache, and edema of the ankles and
feet.
A patient is receiving an intravenous infusion of heparin to treat
a pulmonary embolism. What laboratory value will the nurse
monitor to evaluate treatment with this medication?
, - Activated partial thromboplastin time (aPTT)
- Prothrombin time (PT)
- Platelet count
- Hemoglobin and hematocrit Correct Answer Answer: A
Rationale: The most commonly used laboratory value that
monitors the effect of heparin is the activated partial
thromboplastin time (aPTT).
A patient is to receive a scheduled dose of diltiazem [Cardizem].
The nurse should hold the medication and contact the prescriber
if which of the following is noted?
- The patient's blood pressure is 112/64 mm Hg.
- The patient's cardiac rhythm is atrial fibrillation.
- The patient is complaining of chest pain.
- The patient has a second-degree heart block. Correct Answer
Answer: D
Rationale: Diltiazem is contraindicated in patients with second-
degree or third-degree heart block; diltiazem can exacerbate
cardiac dysfunction.
A patient reports having taken morphine for the past 6 months.
Which medication, if ordered by the physician, should the nurse
question?
- Promethazine [Phenergan]
- Pentazocine [Talwin]
- Methylnaltrexone [Relistor]
- Dextromethorphan [Delsym] Correct Answer Answer: B
Rationale: Pentazocine is an agonist-antagonist opioid. If
pentazocine is given to a patient who is physically dependent on
a pure opioid agonist such as morphine, withdrawal or
abstinence syndrome will occur. Before an agonist-antagonist is
