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The Human Body in Health and Disease7th EditionGary A. Thibodeau, Kevin T. Patton 1,505 solutions The answers are B, D, E, F, and I. Histamine: INCREASES capillary permeability (not decreases) by shifting the intravascular fluid to the interstitial space...this causes swelling and lowers blood pressure, vasodilates vessels...this lower blood pressure and causes red skin, increases heart rate (not decreases), constricts the airway...this causes difficulty breathing and wheezes, stimulates contraction of GI smooth muscles and stimulates (not inhibits) the production of gastric secretions...this leads to vomiting, nausea, and pain, and there is also itching. The answers are B, C, E, F, and G. Patients who are in anaphylactic shock will have signs and symptoms associated with the effects of histamine. Remember histamine affects the respiratory, cardiac, GI and skin. The patient can have the following: Respiratory: dyspnea and wheezing (bronchoconstriction), swelling of upper airways due to edema "tightness"...can't speak, coughing, stuffy nose, watery eyes, Cardiac: tachycardia, hypotension (vasodilation)...loss of consciousness, dizzy, GI: vomiting, nausea, pain, Skin: vasodilation...red, swollen, itchy, hives The nurse is reviewing drugs on the emergency cart with regard to their therapeutic action. Which medications can help initiate heart contraction during a cardiac arrest? Topical phenylephrine Intravenous epinephrine Subcutaneous terbutaline Intravenous epinephrine Which statement is true regarding the EpiPen? The EpiPen auto-injector is a multiuse delivery system. The EpiPen is available over the counter at any retail pharmacy. The EpiPen is an epinephrine auto-injector indicated for emergency treatment of anaphylaxis. The EpiPen is an epinephrine auto-injector indicated for emergency treatment of anaphylaxis. Which drug is classified as an adrenergic antagonist? Propofol Milrinone Propranolol Epinephrine propranolol Which medication does the nurse classify as an alpha-adrenergic agonist? Terbutaline Dobutamine Isoproterenol Phenylephrine phenylephrine The nurse will administer norepinephrine for which condition? Asthma Anaphylaxis Hypertension Cardiogenic shock cardiogenic shock A nurse is preparing to administer a beta blocker to a patient. The nurse recognizes that beta blockers are used to treat which conditions? Select all that apply. Heart failure Hypertension Angina pectoris Sinus bradycardia Cardiogenic shock Chronic obstructive pulmonary disease heart
failure Why does the nurse anticipate administering metoprolol rather than propranolol for diabetic patients who need a beta-blocking agent? Propranolol causes both beta 1 and beta 2 blockade. Metoprolol is less likely to cause diabetic nephropathy. Propranolol is associated with a higher incidence of foot ulcers. Metoprolol helps prevent retinopathy in individuals with diabetes. Propranolol causes both beta 1 and beta 2 blockade. The patient is being treated with epinephrine during cardiopulmonary resuscitation. The nurse finds on the crash cart a solution marked "epinephrine 1:10,000." What does the nurse interpret the strength of the medication to mean? 1 gram of medication contained in 10,000 mL of solution 1 kilogram of medication contained in 10,000 mL of solution 1 milligram of medication contained in 10,000 mL of solution 1 microgram of medication contained in 10,000 mL of solution 1 gram of medication contained in 10,000 mL of solution Before administering an adrenergic agonist, what is the most important assessment for the nurse to complete? Temperature Skin integrity Blood pressure Respiratory rate blood pressure Which statement is true about dopamine? Dopamine is used to treat asthma. Dopamine is a catecholamine with dose dependent receptor sensitivity. Dopamine is a noncatecholamine that produces selective activation of beta 2 receptors. Dopamine deactivates alpha 1 receptors along with beta 1 receptors and dopamine receptors. Dopamine is a catecholamine with dose dependent receptor sensitivity. Which one of these statements is true regarding the effects of the drug dopamine? Select all that apply. At low therapeutic doses, dopamine acts on dopamine receptors only. MAO inhibitors decrease the effects of dopamine on the heart and blood vessels. Dopamine is a catecholamine whose receptor specificity is highly dose dependent. At moderate doses, dopamine activates beta 1 receptors in addition to dopamine receptors. At high doses, dopamine activates alpha 1 receptors along with beta 1 receptors and dopamine receptors. At low therapeutic doses, dopamine acts on dopamine receptors only. Dopamine is a catecholamine whose receptor specificity is highly dose dependent. At moderate doses, dopamine activates beta 1 receptors in addition to dopamine receptors. At high doses, dopamine activates alpha 1 receptors along with beta 1 receptors and dopamine receptors. The nurse reviews a patient's medical history and recognizes which conditions as contraindications to the use of adrenergic medications? Select all that apply. Migraines Pregnancy Drug allergy Diverticulitis Severe hypertension drug allergy and severe hypertension The nurse is preparing to administer a dose of clonidine. Which is the best description of the action of this drug? It depletes sympathetic neurons of norepinephrine. It directly blocks alpha and beta receptors in the periphery. It causes peripheral activation of alpha 1 and alpha 2 receptors. It selectively activates alpha 2 receptors in the central nervous system. It selectively activates alpha 2 receptors in the central nervous system. The nurse will administer norepinephrine for which condition? Asthma Anaphylaxis Hypertension Cardiogenic shock cardiogenic shock The nurse is caring for several patients prescribed propranolol. In which patient condition is propranolol used with caution? Angina Diabetes Hypertension Cardiac dysrhythmias diabetes The patient who takes insulin has just been prescribed a beta blocker drug. The nurse recognizes that the interaction of the beta blocker and the insulin may have which result? Masked signs of hypoglycemia Masked signs of hyperglycemia Enhanced activity of the beta blocker drug Decreased activity of the beta blocker drug masked signs of hypoglycemia What assessment finding indicates the patient is experiencing an adverse effect of adrenergic drug therapy for hypertension? Temperature 38° C Heart rate 40 beats/min Blood pressure 110/70 mm Hg Respiratory rate 20 breaths/min heart rate 40 beats/min The nurse is caring for a patient who is scheduled to receive a first dose of an alpha adrenergic antagonist drug. The nurse is prepared to monitor the patient for which effect? Rash Anorexia Syncope Vomiting syncope(insufficent blood flow to the brain The nurse assesses the peripheral intravenous infusion site of a patient receiving intravenous dopamine and suspects extravasation. What is the nurse's first action? Stop the infusion. Apply a cold pack to the site. Elevate the patient's extremity. Remove the intravenous (IV) line immediately. stop the infusion When the patient develops anaphylactic shock, which drug does the nurse expect to administer? Ephedrine Isoproterenol Epinephrine Norepinephrine epinepherine The patient who takes a monoamine oxidase inhibitor (MAOI) for mental illness is prescribed an adrenergic drug. Which action by the nurse is most appropriate? Administer the adrenergic drug as prescribed. Monitor the patient closely during treatment for evidence of side effects. Anticipate that the healthcare provider will decrease the dose of the MAOI. Hold the adrenergic drug and notify the healthcare provider of the use of the MAOI medication. Hold the adrenergic drug and notify the healthcare provider of the use of the MAOI medication. The nurse observes paleness and swelling on the forearm where epinephrine was administered intravenously. The nurse anticipates administration of which medication to counteract the effects on the surrounding tissue at the intravenous (IV) access site? Labetalol Doxazosin Phentolamine Norepinephrine phentolamine The nurse is caring for a patient who has been ordered an adrenergic drug to treat asthma. When assessing the patient before administering the first dose of the drug, the nurse finds that the patient's blood pressure is 180/90 mm Hg. What is the nurse's highest priority action? Notify the healthcare provider of the patient's elevated blood pressure reading. Hold the initial dose of the medication until the patient's blood pressure decreases. Administer the medication but monitor the blood pressure closely for the first hour. Administer the medication as usual because the patient's hypertension is not new onset. Notify the healthcare provider of the patient's elevated blood pressure reading. For his asthma, a patient is prescribed albuterol in the form of an inhalant. The patient tells the nurse that the medication causes shakes and hand tremors. What is the nurse's best response? "I will contact your provider about your problem." "The tremors are probably not related to the medication." "I will contact the respiratory therapist about your problem." "Tremors are the most common side effect of this inhalant and will usually fade over time." "Tremors are the most common side effect of this inhalant and will usually fade over time." A primary healthcare provider prescribes long-acting propranolol tablets for a patient. What instruction(s) should the nurse provide to the patient regarding administration of the drug? Select all that apply. Crush the tablet. Swallow the tablet. Take the tablet on a full stomach. Take the tablet with a glass of water. Avoid eating grapefruit while taking this drug. Swallow the tablet. Take the tablet on a full stomach. Take the tablet with a glass of water. Which patient with hypertension would benefit most from receiving an alpha 1 blocker? The patient with asthma The patient with an increased heart rate The patient with benign prostatic hyperplasia The patient with benign prostatic hyperplasia Before discharge, the nurse provides teaching related to adverse effects of terazosin to the patient and caregivers. Which adverse effects should the nurse include in the teaching about this drug? Select all that apply. Headache Hypoglycemia Nasal congestion Reflex tachycardia Orthostatic hypotension headache Reflex tachycardia Orthostatic hypotension Which outcome would be most appropriate to establish for a patient who is taking a selective alpha 1 receptor blocker? The patient's urine output is less than 240 mL in an 8-hour period. The patient's heart rate is greater than 80 beats/min when ambulating. The patient's systolic blood pressure is maintained between 140 mm Hg and 110 mm Hg. The patient's systolic blood pressure is maintained between 140 mm Hg and 110 mm Hg. Which outcome would be most appropriate to establish for patients taking beta 1 agonists? Relaxation of uterine smooth muscle Relaxation of bronchial smooth muscle Increased contractility of the myocardium Increased resistance of peripheral vessels Increased contractility of the myocardium The nurse is administering several different diuretics. Which drug will produce the most diuresis in a patient? Furosemide Triamterene Spironolactone Hydrochlorothiazide furosemide The nurse knows that which organ is primarily responsible for maintaining fluid volume and osmolality? Liver Heart Kidneys Blood vessels kidney A patient who has vomiting and diarrhea is ordered an isotonic intravenous fluid. Which intravenous fluid should the nurse prepare to administer? 0.9% sodium chloride 0.45% sodium chloride 0.25% sodium chloride 0.9% sodium chloride Which acid-base imbalance is caused by chronic renal failure, loss of bicarbonate during severe diarrhea, or metabolic disorders that result in overproduction of lactic acid? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis metabolic acidosis The nurse is working in the emergency department when a patient with a head injury develops increased intracranial
pressure. Which drug would the nurse anticipate administering? Metolazone Spironolactone Hydrochlorothiazide mannitol The nurse knows that diuretics mostly affect which function of the kidneys? Excretion of metabolic waste Elimination of foreign substances Maintenance of acid-base balance Maintenance of extracellular fluid volume maintenance of extracellular fluid volume Which action should the nurse take when caring for a patient receiving triamterene? Assess potassium levels Monitor for hypernatremia Monitor for effects of hypoglycemia Assess urinary output every other day assess potassium levels Which acid-base imbalance is caused by retention of carbon dioxide secondary to hypoventilation? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis respiratory acidosis Which acid-base imbalance is characterized by increases in both the pH and bicarbonate content of plasma? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis metabolic alkalosis Which acid-base imbalance is caused by hyperventilation? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis respiratory alkalosis What is the best information for the nurse to provide to a patient who is receiving spironolactone and furosemide therapy? "Using two drugs increases the osmolality of plasma and the glomerular filtration rate." "This combination prevents dehydration and loss of fluid volume." "Moderate doses of two different diuretics are more effective than a large dose of one." "This combination promotes urine output but decreases the risk of low potassium." "This combination promotes urine output but decreases the risk of low potassium." A patient is taking hydrochlorothiazide. On assessment, the nurse notes that the patient has muscle weakness, cramping, and leg discomfort. What should be the nurse's first intervention? Reduce salt in the patient's diet Administer calcium supplements Assess the serum potassium level Give a lower dose of the medication Assess the serum potassium level Which statement made to the patient will demonstrate the nurse's knowledge of calcium-channel blockers (CCBs) for management of hypertension? "CCBs promote excretion of water." "CCBs block reabsorption of sodium." "CCBs increase blood return to heart." "CCBs relax vascular smooth muscle." "CCBs relax vascular smooth muscle." The patient taking an alpha 1 blocker. Of which potentially dangerous side effect should the
patient be made aware? Orthostatic hypotension Increased urinary output Increased urinary flow rate Orthostatic hypotension The nurse is caring for a patient who is scheduled to begin treatment with carvedilol. While updating the history, the patient tells the nurse that he experiences frequent attacks of asthma. What is the nurse's highest priority action? Expect a decreased effect from the medication. Expect an increased effect from the medication. Notify the health care provider of this information. Monitor the patient for a toxic reaction to the drug Notify the health care provider of this information. Which medication will decrease vasoconstriction by blocking angiotensin II receptor sites? Enalapril Furosemide Metoprolol valsartan The community health nurse is providing education on an antihypertensive medication, clonidine, to an elderly patient during a home visit. The nurse stresses that the patient should not abruptly discontinue the medication because of which potential effect? Dry mouth Hypotension Restlessness Rebound hypertension rebound hypertension A patient has a prescription for hypertension that blocks both alpha and beta receptors. Which drug will the nurse administer? Carvedilol Methyldopa Propranolol carvedilol Which goal does the nurse document in the plan of care for a 63-year-old patient with hypertension? Maintain blood pressure below 140/90 mm Hg Maintain blood pressure below 140/50 mm Hg Maintain blood pressure below 150/90 mm Hg maintain blood pressure below 150/90 The nurse is instructing a patient about potential adverse effects of a prescribed angiotensin-converting enzyme inhibitor. The nurse would instruct the patient to immediately seek medical attention if which adverse effect occurs? Fatigue Diarrhea Angioedema Dry, nonproductive cough angioedema To understand pharmacologic therapy for hypertension, what will the nurse teach the patient? Urinary output determines blood pressure. Blood pressure is determined by heart contraction. Sympathetic stimulation causes blood pressure to decrease. Blood pressure is a product of cardiac output and vascular resistance. blood pressure is a product of cardiac output and vascular resistance A nurse is caring for an afebrile patient who is taking an angiotensin-converting enzyme (ACE) inhibitor and develops a dry, nonproductive cough. What is the nurse's priority action? Notify the health care provider. Tell the patient that the cough will subside in a few days. Assess the patient for other symptoms of upper respiratory infection. Instruct the patient to take antitussive medication until the symptoms subside. notify the healthcare provider The nurse is caring for several patients. Which patient will need teaching about treatment of hypertension? The patient with a diastolic pressure of 70 mm Hg and above The patient with a systolic pressure consistently above 140 mm Hg The patient with a diastolic blood pressure 80 mm Hg after exercise The patient with a blood pressure of 140/90 mm Hg after walking up two flights of stairs The patient with a systolic pressure consistently above 140 mm Hg Which statement will be included in the teaching about calcium channel blockers? "This medication will work to cause you to get rid of fluid." "This medication will help you to lose weight to lower your blood pressure." "This medication will enable vasodilation of your blood vessels to lower your blood pressure." "This medication will enable vasodilation of your blood vessels to lower your blood pressure." When teaching a patient about the drug clonidine, what information will the nurse include in the teaching plan? "Do not stop the medication abruptly." "Stop the medication if you feel tired." "If you have gastric upset, take the medication with an antacid." "Use a hot tub daily to help vasodilation so that the medication will work more effectively." "Do not stop the medication abruptly." Which class(es) of medications are prescribed as initial therapy for hypertension after myocardial infarction (MI)? Select all that apply. Diuretic Beta blocker Aldosterone antagonists Calcium channel blocker Angiotensin-converting enzyme (ACE) inhibitor beta blocker Which comment by the patient indicates understanding about the use of enalapril for treatment of hypertension? "I cannot go out in the sun while on this therapy." "I should stop the drug if I have ringing in my ears." "If I feel tired, I should call the health care provider." "If I develop a chronic cough, I need to notify my health care provider." "If I develop a chronic cough, I need to notify my health care provider." The community health nurse is providing education on an antihypertensive medication, clonidine, to an elderly patient during a home visit. The nurse stresses that the patient should not abruptly discontinue the medication because of which potential effect? Dry mouth Hypotension Restlessness Rebound hypertension Rebound hypertension When monitoring patients receiving antihypertensive agents, the nurse realizes which medication could have a side effect similar to those of systemic lupus erythematosus? Lisinopril Valsartan Aliskiren Hydralazine Hydralazine Which statement indicates to the nurse that the patient needs additional instruction about antihypertensive treatment? "I will change my position slowly to prevent feeling dizzy." "I will not mow my lawn until I see how this medication makes me feel." "I will check my blood pressure daily and take my medication when it is over 140/90." "I will include rest periods during the day to help me tolerate the fatigue my medicine may cause." "I will check my blood pressure daily and take my medication when it is over 140/90." A patient with hypertension will be started on a diuretic as first-line drug therapy after lifestyle changes have been ineffective. Which type of diuretics does the nurse anticipate will be used? A loop diuretic A thiazide diuretic An osmotic diuretic A potassium-sparing diuretic a thiazide diuretic The patient taking methyldopa has elevated liver function tests. What is the nurse's best action? Change the patient's diet. Notify the health care provider. Stop the medication immediately. Document the finding and continue care. Notify the health care provider. The nurse is reviewing a medication history on a patient taking an angiotensin-converting enzyme (ACE) inhibitor. The nurse will contact the health care provider if the patient is also taking which medication? Furosemide Spironolactone Morphine sulfate Docusate sodium spironolactone A patient with hypertension receives ramipril and consequently develops a potassium level of 5.6 mEq/L. Which medication will help to lower the patient's potassium level? Metoprolol Eplerenone Spironolactone Hydrochlorothiazide hctz The nurse administers clonidine. Which finding indicates the medication is therapeutic? There is increased urinary output. There is an absence of chest pain. The heart rate decreases from 100 beats/min to 40 beats/min. Blood pressure decreases from 150/100 mm Hg to 110/70 mm Hg. Blood pressure decreases from 150/100 mm Hg to 110/70 mm Hg. A calcium channel blocker has been ordered for a patient. Which condition in the patient's history is contraindicated with this medication? Hypotension Hypokalemia Dysrhythmias Increased intracranial pressure hypotension A patient receiving the adrenergic medication clonidine reports experiencing dry mouth. What will be included in the plan of care for this patient? Limit fluids to 1000 mL/day. Inform the patient that these are common adverse effects of the medication. Discuss incorporation of psyllium-based products in the plan of care with the health care provider. Inform the patient that these are common adverse effects of the medication. Which is an appropriate nursing intervention for the patient who is taking hydrochlorothiazide? Schedule the dose to be taken in the evening. Monitor serum calcium and sodium levels daily. Encourage the intake of foods rich in potassium. Take the radial pulse for 1 full minute before administering the drug. Encourage the intake of foods rich in potassium. The charge nurse is teaching a student nurse about antihypertensive drugs and the renin-angiotensin-aldosterone system. Which statement from the student nurse indicates a correct understanding of the teaching? "Aldosterone antagonists decrease release of renin." "Angiotensin-converting enzyme inhibitors block the actions of angiotensin II." "Direct renin inhibitors stop the changing of angiotensinogen into angiotensin I." "Angiotensin II receptor blockers block the formation of angiotensin II." "Direct renin inhibitors stop the changing of angiotensinogen into angiotensin I." The nurse is teaching the patient why hypertension must be treated. Which complications would be included in the teaching plan? Select all that apply. Stroke Diabetes Heart failure Emphysema Cardiovascular disease stroke The nurse determines that the patient is experiencing an adverse effect of enalapril if which effect is noted? Patient has a dry, hacking cough Patient's serum sodium is 140 mEq/L Patient's serum potassium is 4.2 mEq/L Patient complains of persistent dry mouth Patient has a dry, hacking cough A nurse is caring for a pregnant woman with severe preeclampsia. To lower blood pressure, which drug will the nurse prepare to administer? Aspirin Labetalol Magnesium sulfate Sodium nitroprusside labetalol Which prescription will the nurse administer to provide the most safe and effective care to patients with hypertension? An adrenergic neuron blocker to a 16-year-old with hypertension A beta blocker to an African American patient with hypertension A centrally acting alpha 2 agonist to a 16-year-old with hypertension A calcium channel blocker (CCB) to an African American patient with hypertension A calcium channel blocker (CCB) to an African American patient with hypertension Which medication does the nurse anticipate to be prescribed to a pregnant patient who developed hypertension at 28 weeks estimated gestational age? Captopril Valsartan Methyldopa Propranolol methyldopa The nurse administers candesartan to a patient. Which patient assessment finding would the nurse use as a clinical indicator of therapeutic effectiveness of the medication? Cool, dry, pale extremities Serum sodium 140 mEq/L Serum potassium 3.8 mEq/L Blood pressure 120/72 mm Hg blood pressure 120/72 mm Hg A patient with coronary artery disease and diabetes mellitus has resistant hypertension despite therapy with benazepril. Which antihypertensive agent does the nurse avoid administering to this
patient? Propranolol Candesartan Hydrochlorothiazide Propranolol What is a priority nursing diagnosis for a patient taking an antihypertensive medication? Fatigue related to side effects of medication Knowledge deficit related to medication regimen Alteration in comfort related to nonproductive cough Alteration in cardiac output related to effects on the sympathetic nervous system Alteration in cardiac output related to effects on the sympathetic nervous system A patient with hypertension receives ramipril and consequently develops a potassium level of 5.6 mEq/L. Which medication will help to lower the patient's potassium level? Metoprolol Eplerenone Spironolactone Hydrochlorothiazide Hydrochlorothiazide A calcium channel blocker has been ordered for a patient. Which condition in the patient's history is contraindicated with this medication? Hypotension Hypokalemia Dysrhythmias Increased intracranial pressure hypotension Which assessment finding is most important for the nurse to obtain before administering hydralazine? Capillary refill Homans' sign Blood pressure Peripheral pulses blood pressure The nurse is administering several medications at 8 a.m. Which medication will decrease blood pressure by blocking angiotensin II receptor sites? Enalapril Valsartan Eplerenone Furosemide valsartan Calcium channel blockers (CCBs) work by reducing calcium influx into the cells of the heart and blood vessels. Calcium channels are coupled to which type of autonomic nervous system receptors? Beta 1 Beta 2 Alpha 1 Alpha 2 beta1 When the nurse is monitoring patients receiving antihypertensive agents, which drugs should be identified as those that affect only the arterioles? Select all that apply. Losartan Minoxidil Enalapril Hydralazine Nitroprusside minoxifil A staff member asks how calcium channel blockers (CCBs) work. Which response should the nurse provide? CCBs increase arterial pressure. CCBs block reabsorption of sodium. CCBs relax vascular smooth muscle. CCBs have a positive inotropic effect. ccbs relax vascular smooth muscle Which statement is true regarding the renin-angiotensin-aldosterone system? Renin is the by-product of angiotensinogen catalysis. Angiotensinogen is catalyzed by renin into angiotensin I. Angiotensinogen catalyzes the conversion of angiotensin I to angiotensin II. Angiotensin-converting enzyme (ACE) converts angiotensinogen to angiotensin I. Angiotensinogen is catalyzed by renin into angiotensin I. The nurse is preparing to administer minoxidil 5 mg orally. What is the only cardiovascular indication for this medication? Heart failure Angina pectoris Myocardial infarction Severe hypertension severe hypertension The nurse is teaching the staff about the therapeutic effects of vasodilators. Which statements indicate a correct understanding of the teaching? Select all that apply. "Preload is decreased." "Vasodilators reduce afterload." "Vasodilators promote sodium and water retention." "Cardiac output and tissue perfusion are increased." "Some vasodilators dilate arteries or veins, whereas others dilate both" "Preload is decreased." "Vasodilators reduce afterload." The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure. Which compound in this system is most powerful at raising blood pressure? Renin Angiotensin I Angiotensin II Angiotensin III angiotensin II The nurse is caring for a patient prescribed aliskiren. How does
this medication lower blood pressure? It selectively blocks aldosterone receptors in the kidneys. It blocks the conversion of angiotensin I to angiotensin II. It inhibits the conversion of angiotensinogen to angiotensin I. It inhibits the conversion of angiotensinogen to angiotensin I. Which medication works by preventing angiotensin II from binding with its receptor sites? Quinapril Aliskiren Eplerenone Candesartan candesartan Which medication is most likely to cause constipation? Diltiazem Isradipine Nifedipine Amlodipine dilitazem The nurse is administering 8:00 a.m. medications for hypertension. Which drugs should the nurse identify as aldosterone antagonists? Select all that apply. Losartan Aliskiren Benazepril Eplerenone Spironolactone eplerenone and spironolactone The nurse is caring for a patient receiving hydralazine. The health care provider prescribes propranolol. A drug such as propranolol is often combined with hydralazine for which purpose? To prevent heart failure To reduce the risk of headache To improve hypotensive effects To protect against reflex tachycardia to protect against reflex tachycardia For which purpose should the nurse administer aliskiren to a patient with hypertension? To prevent stroke To reduce blood pressure To reduce diabetic nephropathy To prevent myocardial infarction to reduce blood pressure Which patient finding would cause the nurse to hold the 8 a.m. dose of verapamil? The patient has atrial flutter. The patient has tachycardia. The patient has hypotension. The patient has angina pectoris. the patient has hypotension The nurse is teaching the staff about the effects of calcium channel blockers (CCBs). Which responses describe actions of CCBs? Select all that apply. Increase the heart rate Reduce force of heart contraction Constrict peripheral venules and veins Dilate peripheral arterioles and arteries Suppress conduction through the atrioventricular (AV) node Reduce force of heart contraction A patient with angina pectoris has been prescribed nifedipine. Which possible adverse effects should the nurse expect with this medication? Select all that apply. Headache Constipation Nausea and vomiting Edema of ankles and feet Overgrowth of gum tissue headache The nurse is administering minoxidil to a patient. The nurse is caring for which patient? One with heart failure One with prehypertension One with cardiac tamponade One with severe hypertension one with severe hypertension A patient is receiving nifedipine. Which adverse effect should the nurse monitor for in this patient? Pallor Diarrhea Backache Ankle edema ankle edema Which patient assessment would assist the nurse in evaluating therapeutic effects of a calcium channel blocker (CCB)? Absence of dizziness Absence of chest pain Decreased swelling in the ankles Decreased eczematous eruptions absence of chest pain The nurse administers candesartan to a patient. Which assessment finding should the nurse use as a clinical indicator of the therapeutic effectiveness of the medication? Blood pressure reduction Serum potassium retention Peripheral perfusion reduction Pulmonary congestion retention blood pressure reduction A patient is prescribed lisinopril 40 mg by mouth once a day for hypertension. For which therapeutic effect should the nurse monitor? Slowing of the heart rate Decrease in blood pressure Symptoms such as dizziness and fainting Pulse oximetry oxygen saturation of 100% Decrease in blood pressure The nurse is instructing a patient about potential adverse effects of a prescribed angiotensin-converting enzyme (ACE) inhibitor. For which adverse effect should the patient seek immediate medical
attention? Diarrhea Angioedema Dry, nonproductive cough angioedema Which behavior by a patient indicates more teaching is needed about taking diltiazem? Takes with tea Takes with lemonade Takes with apple juice Takes with grapefruit juice takes with grapefruit juice A
patient is taking minoxidil and develops hypertrichosis. Which area should the nurse assess first? Heart Lungs Ankles face The nurse is caring for patients receiving vasodilators. Which instruction should the nurse give the patients to combat a common adverse effect? "Avoid taking with grapefruit juice." "Drink the oral solution through a straw." "Rise slowly from a sitting to standing position." "Rise slowly from a sitting to standing position." The patient is prescribed hydralazine and propranolol and asks the nurse why he must take both medications. Which response by the nurse is appropriate? "Propranolol prevents you from retaining too much fluid." "Propranolol prevents your heart rate from getting too high." "Propranolol keeps you from developing symptoms of lupus erythematosus." "Propranolol helps your body excrete excess sodium and water." "Propranolol prevents your heart rate from getting too high." The nurse is caring for a patient receiving a nitroprusside intravenous infusion. The patient's wife asks why furosemide is being prescribed along with this drug. The nurse's response should be based on which concept? Furosemide will help reduce reflex tachycardia. Vasodilators can cause serious orthostatic hypotension. Many vasodilators cause retention of sodium and water. Thiocyanate may accumulate in patients receiving nitroprusside. Many vasodilators cause retention of sodium and water. A patient with hypertension and left ventricular hypertrophy takes losartan 50 mg daily. What is a benefit of this therapy for a patient with hypertension? This medication has no side effects. This medication decreases the risk of stroke. This medication is less expensive than others. This medication decreases blood pressure more effectively than others. This medication decreases the risk of stroke. The nurse is caring for a patient who takes an angiotensin-converting enzyme (ACE) inhibitor. If the patient develops a persistent nonproductive cough, what should the nurse do? Notify the provider of the new development. Tell the patient that the cough will subside in a few days. Assess the patient for other symptoms of upper respiratory tract infection. Instruct the patient to take antitussive medication until the symptoms subside. Notify the provider of the new development. A patient with a hypertensive emergency is admitted to the hospital. Which medication should the nurse be prepared to administer to this patient? Minoxidil Hydralazine Sodium nitroprusside Hydralazine and isosorbide dinitrate sodium nitroprusside The nurse has just administered the initial dose of enalapril to a newly admitted patient. What is the priority nursing intervention related to this medication over the next several hours? Check the heart rate. Monitor blood pressure. Auscultate lung sounds. Draw a potassium level monitor blood pressure A patient is prescribed hydralazine for the treatment of essential hypertension. Which expected adverse effects should the nurse discuss with the patient? Select all that apply. Nausea Fatigue Dizziness Headache Joint pain Fatigue Dizziness Headache The nurse is teaching a patient about the reason for the administration of calcium channel blockers (CCBs). Which information should be included in the teaching plan? "This medication will help you get rid of sodium." "This medication will work to cause you to get rid of fluid." "This medication will enlarge the blood vessels to lower your blood pressure." "This medication will lower your blood pressure by promoting weight loss." "This medication will enlarge the blood vessels to lower your blood pressure." The patient is admitted for the management of a hypertensive emergency. The health care provider prescribes sodium nitroprusside drug therapy. What is the priority nursing action during this treatment? Observe for respiratory depression. Monitor the electrocardiogram for tachycardia. Initiate oxygen therapy via nasal cannula at 2 L/min. Adjust the intravenous infusion rate to the blood pressure response. Adjust the intravenous infusion rate to the blood pressure response. The nurse is caring for several patients. For which patient diagnosis would a prescription for nifedipine be least appropriate? Atrial fibrillation Angina pectoris Vasospastic angina Essential hypertension Atrial fibrillation Verapamil has been administered to a patient. The nurse should closely monitor for which adverse effects of this drug? Select all that apply.` Dizziness Headache Ankle edema Reflex tachycardia Heart block evidence on cardiac monitor dizziness The nurse is caring for a patient with bipolar disorder treated with lithium. The patient has a new prescription for captopril for hypertension. The combination of these two drugs makes which assessment particularly important? Lithium level Blood pressure Potassium level Creatinine level lithium level A patient develops hypotension after administration of verapamil. Which intervention is appropriate? Administer atropine. Perform gastric lavage. Assist with cardioversion. Place in modified Trendelenburg position. Place in modified Trendelenburg position. A patient is taking verapamil. Which instruction should the nurse give the patient to help prevent a common adverse effect of this drug? "Use sunscreen." "Increase calorie intake." "Use a skin barrier cream." "Increase fluid and fiber intake." "Increase fluid and fiber intake." The nurse is caring for a patient who has hyperlipidemia and who has been prescribed gemfibrozil. On reviewing the medical history of the patient, the nurse learns that the patient is taking warfarin. What does the nurse anticipate after reviewing the patient's medical history? The patient has an increased risk of infection. The patient has an increased risk of bleeding. The patient has an increased risk of vitamin K toxicity. The patient has an increased risk of bowel obstruction. The patient has an increased risk of bleeding. The nurse is caring for a patient who has coronary heart disease (CHD). The nurse tells the patient, "Your cholesterol levels are abnormal; you are at a high risk of having a heart attack." What did the nurse discover regarding the lipoprotein levels in the patient's blood report? High levels of low-density lipoproteins (LDLs) High levels of high-density lipoproteins (HDLs) Low levels of very-low-density lipoproteins (VLDLs) Low levels of intermediate-density lipoproteins (IDLs) high levels of low density lipoproteins Which statement made by the patient indicates to the nurse that understanding of the discharge instructions on antihyperlipidemic medications has occurred? "I will stop taking the medication if it causes nausea and vomiting." "It is important to double my dose if I miss one, to maintain therapeutic blood levels." "I will continue to modify my diet and keep exercising to help increase my high-density lipoprotein serum levels." "Antihyperlipidemic medications will replace the other interventions I have been doing to try to decrease my cholesterol." "I will continue to modify my diet and keep exercising to help increase my high-density lipoprotein serum levels." When teaching the nursing student about coronary heart disease, which statement will the nurse include in the session? "Coronary heart disease occurs because of the formation of atherosclerotic plaques." "Coronary heart disease is nonlethal and cannot be prevented by antilipemic medications." "Coronary heart disease cannot be prevented by changing lifestyle modifications." "Coronary heart disease is due to decreases in the cholesterol levels to below 200 mg/dL." "Coronary heart disease occurs because of the formation of atherosclerotic plaques." A patient is prescribed a therapeutic lifestyle change (TLC) diet. The patient understands the diet when he states which of the following? "The TLC diet was prescribed to help me reduce my low-density lipoproteins (LDL) cholesterol and maintain a healthy weight." "The TLC diet was prescribed to help me reduce my high-density lipoproteins (HDL) and gain weight." "The TLC diet was prescribed to help me lose weight and keep if off." "The TLC diet was prescribed for me to eat more trans fats (T), lean (L) meat, and have few carbohydrates (C) each day." "The TLC diet was prescribed to help me reduce my low-density lipoproteins (LDL) cholesterol and maintain a healthy weight." A patient receiving atorvastatin therapy to reduce high cholesterol levels calls the clinic and reports, "I am experiencing severe pain in both my legs." What is the nurse's best response? "Stop taking the drug and visit the clinic immediately." "Continue taking the drug; leg pain is a common side effect." "Stop taking the drug if the symptoms persist for another week." "Continue taking the drug along with niacin and a pain killer." "Stop taking the drug and visit the clinic immediately." The nurse understands that cholesterol is carried through the blood by lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis? Apolipoprotein B-100 Low-density lipoprotein (LDL) High-density lipoprotein (HDL) Very-low-density lipoprotein (VLDL) Low-density lipoprotein (LDL) A patient with cardiovascular disease is taking rosuvastatin. Which finding would indicate a potential adverse effect of this drug? Muscle pain and tenderness Platelet count of 100 × 10 3/mm 3 Blood pressure of 140/90 mm Hg Wheezing and shortness of breath Muscle pain and tenderness When will the nurse administer hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins)? In the evening With breakfast With an antacid On an empty stomach in the evening The nurse is teaching a group of patients about dietary approaches to reduce cholesterol levels. Which statement is most important to include in the teaching? "Eliminate red meat and pork from your diet." "Lower your cholesterol intake to 300 mg/day." "Read food labels and reduce your intake of saturated fats." "Reduce salt consumption to keep your sodium intake to 2400 mg/day." "Read food labels and reduce your intake of saturated fats." Laboratory reports indicate that a patient's serum cholesterol concentration is 250 mg/dL and triglyceride levels are 450 mg/dL. The health care provider prescribes gemfibrozil to lower cholesterol levels. What is the desired effect of the drug on the patient's lipoprotein levels? There would be an increase in low-density lipoprotein levels. There would be a decrease in low-density lipoprotein (LDL) levels. There would be an increase in very-low-density lipoprotein (VLDL) levels. There would be a decrease in high-density lipoprotein (HDL) levels. There would be a decrease in low-density lipoprotein (LDL) levels. Which drug is the most effective for lowering Which drug is the most effective for lowering low-density lipoprotein (LDL) cholesterol? Gemfibrozil Ezetimibe Atorvastatin Cholestyramine atrovastatin The nurse is caring for a patient who has hypercholesterolemia and newly prescribed atorvastatin. Which instruction will the nurse receive from the primary health care provider for the safe administration of the medication? "Administer 2 mg of atorvastatin orally." "Administer 10 mg of atorvastatin orally." "Administer 100 mg of atorvastatin orally." "Administer 120 mg of atorvastatin orally." "Administer 100 mg of atorvastatin orally." Which antilipemic medication reduces serum cholesterol by inhibiting its absorption in the small intestine? Niacin Ezetimibe Rosuvastatin Cholestyramine ezetimibe The nurse is caring for a patient with hypercholesterolemia who is taking 20 mg of simvastatin as prescribed. After a few days, the patient's urinalysis reports indicated the presence of myoglobin. What instruction would the nurse receive from the primary health care provider? "Give 10 mg of medication daily." "Give the medication before meals." "Discontinue administering the medication." "Give the medication with 250 mL of water." "Discontinue administering the medication." How does simvastatin exert its action? By inhibiting lipolysis in the adipose tissue By preventing the reabsorption of bile acids By activating the lipoprotein lipase enzyme By inhibiting the enzyme hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase By inhibiting the enzyme hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase The nurse is assessing a patient with diabetes who has hyperlipidemia. The patient asks the nurse to suggest either an herbal medication or a dietary modification to reduce cholesterol levels. Which suggestion given by the nurse would be most beneficial to the patient? "Include flax seeds in your food." "Eat foods rich in omega-3 fatty acids." "Consume excessive amounts of garlic." "Take 20 mg of St. John's wort regularly." "Eat foods rich in omega-3 fatty acids." The nurse is caring for a patient prescribed gemfibrozil. For which patient should the nurse question the use of this drug? A patient with history of gallstones A patient with elevated triglycerides A patient with cardiovascular disease A patient with elevated very-low-density lipoprotein (VLDL) levels A patient with history of gallstones The health care provider prescribes lovastatin for a patient discharged from the hospital after a myocardial infarction. Which instructions are most appropriate for the nurse to include in the patient's teaching plan? Select all that apply. "Take your medication in the morning, with a full glass of water, for best results." "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains." "Do not start any new medications without first talking to your health care provider." "Take one 325-mg aspirin 30 minutes before your dose to lessen the problem of flushing and itching that can occur with this drug." "Before starting this medication a blood test will be done to check your total cholesterol level and measure liver enzymes." "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains." "Do not start any new medications without first talking to your health care provider." The nurse is caring for a patient who takes multiple cholesterol-lowering drugs. Which drug is least likely to cause systemic side effects? Gemfibrozil Simvastatin Colesevelam Nicotinic acid colesevelam The nurse provides teaching to a patient who will take atorvastatin at home. Which patient teaching is most likely to help maintain the antilipemic medication dosage at the lowest level possible? Take atorvastatin at bedtime. Avoid all alcoholic beverages. Engage in moderate exercise. Adhere to the blood test schedule. engage in moderate exercise On assessment of a patient with hyperlipidemia, the nurse learns that the patient has recently undergone liver transplantation. Which antihyperlipidemic drug does the nurse expect to be excluded from the patient's prescription? Ezetimibe Gemfibrozil Atorvastatin Cholestyramine atrovastin Which assessment finding in a patient taking a hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor will the nurse act on immediately? Decreased hemoglobin Elevated liver function tests Elevated low-density lipoprotein (LDL) cholesterol Elevated high-density lipoprotein (HDL) cholesterol elevated liver function tests Which statement indicates the patient understands discharge instructions regarding cholestyramine? "I will weigh myself weekly." "I will have my blood pressure checked weekly." "I will take cholestyramine with water, fruit juice, or soup." "I will take cholestyramine 1 hour before my other medications." "I will take cholestyramine with water, fruit juice, or soup." A patient with hyperlipidemia has been prescribed simvastatin. While caring for the patient, the nurse unknowingly administers niacin along with simvastatin. Which complication may the patient have due to the drugs' interaction? Myopathy Blurred vision Bowel obstruction Hepatic dysfunction myopathy A patient with hyperlipidemia is treated with atorvastatin. On the follow-up visit, the nurse discovers that the patient has had no improvement in cholesterol levels. What could be the reason for this? The patient has a history of rhabdomyolysis. The patient took atorvastatin with gemfibrozil. The patient is taking the medication in the morning. The patient consumed more than 8 ounces of grapefruit juice per day. The patient is taking the medication in the morning. The nurse is caring for a patient who has undergone kidney transplantation. The patient's laboratory reports show hyperlipidemia. Which antihyperlipidemic drug would be most beneficial for the patient? Fluvastatin Cyclosporin Colesevelam Cholestyramine colesevelam Which drug is approved for hyperlipidemia and to help control hyperglycemia in patients with type 2 diabetes? Ezetimibe Colesevelam Cholestyramine Niacin (nicotinic acid) colesevelam The nurse is assessing a patient who has been prescribed cholestyramine. The nurse finds that the patient has decreased peristalsis and bloating. Which intervention should the nurse perform to relieve the symptoms? Select all that apply. Check the patient's weight. Increase the intake of fluid. Include milk in the patient's diet. Monitor the patient's blood pressure. provide a diet rich in fiber The nurse is caring for a patient who has elevated triglyceride levels and is unresponsive to HMG-CoA reductase inhibitors. What does the nurse expect the primary health care provider to prescribe to the patient? Gemfibrozil Simvastatin Cholestyramine gemfibrozil Which discharge instructions should the nurse include for a patient prescribed cholestyramine? "Take with all other morning medications." "Take 325 mg of aspirin 30 minutes before each dose." "Notify the health care provider if upper abdominal discomfort occurs." mix with water or juice Which antilipemic medication reduces serum cholesterol by inhibiting its absorption in the small intestine? Niacin Ezetimibe Rosuvastatin Cholestyramine ezetimibe The nurse reviews the history for a patient taking atorvastatin. What will the nurse act on immediately? The patient is on oral contraceptives. The patient takes medications with grape juice. The patient takes herbal therapy including kava kava. The patient was started on penicillin for a respiratory infection. The patient is on oral contraceptives. The nurse would question an order for colesevelam if the patient has which condition in the medical history? Glaucoma Constipation Renal disease Hepatic disease constipation A patient with hyperlipidemia has been prescribed simvastatin. The nurse instructs the patient to undergo a liver function test and a kidney function test every 3 to 6 months. Which drug therapy-related complication is the nurse trying to prevent? Cirrhosis Hepatitis Nephritis Rhabdomyolysis rhabdomyolusis Which are beneficial effects that can be derived from simvastatin and other drugs in this class? Select all that apply. Improvement of liver function Reduction of risk of cardiovascular events Reduction of low-density lipoproteins (LDLs) Elevation of high-density lipoproteins (HDLs) Stabilization of the plaque in coronary arteries Reduction of risk of cardiovascular events Reduction of low-density lipoproteins (LDLs) Elevation of high-density lipoproteins (HDLs) Stabilization of the plaque in coronary arteries A patient with hypercholesterolemia has been prescribed simvastatin. Which action should the nurse perform while caring for the patient? Instruct the patient to take aspirin for pain relief. Inform the patient that this drug may cause nausea. Inform the patient that allergies are a side effect of the drug. Instruct the patient to discontinue the drug in case of muscle pain. Inform the patient that this drug may cause nausea. Which instruction will be included in the discharge teaching for a patient with a transdermal nitroglycerin patch? "Apply the patch to a hairless, nonfatty area of the upper torso or arm." "Apply the patch to the same site each day to maintain consistent drug absorption." "If you get a headache, remove the patch for 4 hours and then reapply." "If you experience chest pain, apply a second patch right next to the first patch." "Apply the patch to a hairless, nonfatty area of the upper torso or arm." The nurse is caring for a patient receiving nitrates for relief of angina. Which pharmacodynamic action is responsible for the relief of anginal pain with nitrates? Vasoconstriction leads to improved cardiac output. Decreased force of contraction leads to decreased oxygen demand. Influx of calcium ions leads to relaxation of vascular smooth muscle. Vasodilation leads to decreased preload, which decreases oxygen demand. Vasodilation leads to decreased preload, which decreases oxygen demand. What does the nurse administer when a patient has a sudden attack of angina? Atenolol Nifedipine Nitroglycerin Transdermal nitroglycerin patch nitroglycerin Which patient assessment would assist the nurse in evaluating the therapeutic effects of a calcium channel blocker? Absence of chest pain Patient denies dizziness Patient states that she feels stronger Decreased swelling in the ankles and feet Absence of chest pain A patient taking sublingual nitroglycerin complains of flushing and headaches. What instruction does the nurse give the patient? "Stop taking the tablets immediately." "These effects will subside over time." "You should take a lower dose of the drug." "You should get diagnostic testing immediately." "These effects will subside over time."
Which classes of drugs are used in the treatment of angina pectoris? Select all that apply. Nitrates Diuretics Beta blockers Antihistamines Calcium channel blockers nitrates A patient who is prescribed sublingual nitroglycerin reports after 6 months that she left the bottle in her car for a few weeks. The nurse instructs the patient to obtain a new prescription from the primary health care provider. What is the purpose of obtaining a new prescription? The drug can cause toxicity. The drug has lost its potency. The patient needs a lower drug dose. The patient has developed drug tolerance. the drug has lost its potency Which assessment finding could indicate a myocardial infarction (MI) in a patient who is taking nitroglycerin for angina? The patient has a headache after taking the drug. There is sudden and severe hypotension in the patient. Chest pain is not relieved by administering nitroglycerin. The patient complains of feeling dizzy when trying to move. Chest pain is not relieved by administering nitroglycerin. What is the primary effect of calcium channel blockers (CCBs)? To treat acute myocardial infarction (MI) To reduce exercise-induced elevations in heart rate To prolong the QT interval on the electrocardiogram To decrease the afterload and reduce the workload of the heart To decrease the afterload and reduce the workload of the heart What is the most appropriate outcome criteria for a patient who has been prescribed a calcium channel blocker? Absence of chest pain Increased cardiac output Systolic blood pressure 140 mm Hg Weight gain in one week greater than or equal to 5 lb absence of chest pain What is the duration of action of a nitroglycerin transdermal patch? 3 to 5 minutes 0.5 to 1 hour Up to 24 hours 4 to 6 hours up to 24 hours The nurse is teaching a patient who has been prescribed hydrochlorothiazide. Which statement from the patient indicates a correct understanding of the teaching? "I will limit my intake of oats." "I will not eat melons or grapes." "I will take iron supplements every day." "I will take the dose only in the morning." i will take the dose only in the morning The nurse should monitor for which adverse effect after administering hydrochlorothiazide and digoxin to a patient? Dehydration Heart failure Digoxin toxicity Decreased diuretic effect digoxin toxicity |
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