Pharm Exam 2 NCLEX Questions
Terms in this set (94)
The nurse knows that which drug acts by suppressing axonal conduction?
A. Lidocaine (Xylocaine) - local anesthetic
B. Citalopram (Celexa) - antidepressant
C. Morphine (Duramorph) - pain reliever
D. Halothane (Fluothane) - general anesthetic
The nurse is administering diphenhydramine (Benadryl), a neuropharmacologic agent that works by doing what?
A. Preventing mast cells from releasing histamine
B. Preventing axonal conduction
C. Binding to histamine receptors, preventing receptor activation
D. Acting as an agonist to H1 histamine receptors
The nurse can best describe what is meant by activation of a receptor with which phrase?
A. An effect that causes the physiologic process to speed up
B. An effect that mimics the natural neurotransmitter for that receptor
C. An effect that improves the function of the receptor
D. An effect that causes the receptor to be more sensitive
The nurse knows that the advantage of patients having multiple types of receptors to regulate bodily functions is what?
A. Improved maximal efficacy
B. Reduction of side effects and toxicity
C. Higher degree of selectivity
D. Lower therapeutic index
The nurse is administering isoproterenol, a beta1 and beta2 agonist. The nurse expects the patient to show which effects of this drug? (Select all that apply.)
A. Increased heart rate
B. Excessive drowsiness
C. Increased force of heart contraction
D. Decreased cardiac output
E. Bronchial dilation
F. Decreased glucose levels
A, C, E
A nurse is preparing to give a drug that stimulates the parasympathetic nervous system. Which patient response is an expected outcome of this drug?
A. Wheezing decreases due to bronchodilation.
B. Heart rate decreases to 60 beats per minute.
C. Diarrhea stool count decreases.
D. Oxygenation improves because of bronchodilation.
A patient is experiencing symptoms of the fight-or-flight response. Which autonomic process orchestrates this response?
A. Stimulation of the sympathetic system
B. Stimulation of the predominant tone of the organs
C. Stimulation of the baroreceptor reflex
D. Stimulation of the parasympathetic system
The nurse knows that which neurotransmitter is most commonly found at the synapses of the peripheral nervous system?
A nurse is preparing to give a medication that stimulates the beta2 receptors. What response will the nurse expect from this drug?
A. Increased peristalsis
B. Constriction of the pupil
A nurse gives a medication that inhibits acetylcholinesterase. How would this drug affect autonomic activity?
A. Parasympathetic activity would increase.
B. Parasympathetic signals would be depressed.
C. Sympathetic activity would increase.
D. Respiratory centers would be depressed.
Which organs are controlled primarily by the parasympathetic system? (Select all that apply.)
A. Gastrointestinal tract
B. Respiratory tract
C. Cardiovascular system
E. Salivary glands
All except C
Which receptors below are considered adrenergic receptors? (Select all that apply.)
All except D
A nurse is preparing to give bethanechol (Urecholine). What is an expected outcome of this drug?
A. Nondistended bladder
B. Increased heart rate and blood pressure
C. Improved pulse oximetry reading
D. Relief of cardiac rhythm problems
A nurse prepares to administer a new prescription for bethanechol (Urecholine). Which information in the patient's history should prompt the nurse to consult with the prescriber before giving the drug?
Which symptom is the most indicative of muscarinic poisoning?
B. Heart rate of 140 beats per minute
C. Blood pressure of 180/110 mm Hg
D. Blurred vision
Which label most aptly describes the drug atropine (Sal-Tropine)?
C. Muscarinic agonist
The nurse is caring for a patient receiving atropine (Sal-Tropine). Which is a therapeutic indication for giving this drug?
A. Use as a preanesthesia medication
B. Treatment of tachycardias
C. Prevention of urinary retention
D. Reduction of intraocular pressure in glaucoma
The nurse is caring for a group of patients who are all receiving anticholinergic drugs. In which patient is an anticholinergic drug contraindicated?
A. A 60-year-old woman with an overactive bladder (OAB)
B. A 72-year-old man with glaucoma
C. A 45-year-old woman with peptic ulcer disease (PUD)
D. A 26-year-old man being prepared for surgery today
Antimuscarinic poisoning can result from overdose of antihistamines, phenothiazines, and tricyclic antidepressants. Differential diagnosis is important, because antimuscarinic poisoning resembles which other condition?
B. Diabetic coma
The nurse is preparing to give neostigmine (Prostigmin). What best describes the action of this drug?
A. It inhibits acetylcholine at all cholinergic synapses.
B. It prevents inactivation of acetylcholine.
C. It prevents activation of muscarinic receptors.
D. It stimulates activation of adrenergic receptors.
What best describes the rationale for using neostigmine (Prostigmin) in the treatment of myasthenia gravis?
A. It promotes neuromuscular blockade in the periphery.
B. It promotes emptying of the bladder and sphincter relaxation.
C. It reduces intraocular pressure and protects the optic nerve.
D. It increases the force of skeletal muscle contraction.
The nurse is caring for a patient with a suspected overdose of pancuronium, which was used during surgery. Which drug does the nurse anticipate will be used as a reversal agent?
A. Neostigmine (Prostigmin)
B. Atropine (Sal-Tropine)
C. Pralidoxime (DuoDote)
D. Dobutamine (Dobutrex)
The nurse is caring for a patient with myasthenia gravis who is beginning a new prescription of neostigmine (Prostigmin), 75 mg PO twice daily. What is the most important initial nursing action?
A. Obtain a measurement of the plasma level of neostigmine
B. Teach the patient to wear a Medic Alert bracelet
C. Assess the patient's ability to swallow
D. Check the patient's deep tendon reflexes (DTRs)
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?
A. Topical phenylephrine
B. Subcutaneous terbutaline
C. Intravenous epinephrine
D. Inhaled albuterol
The nurse in the cardiac care unit is caring for a patient receiving epinephrine. Which assessment criterion takes priority in the monitoring for adverse effects of this drug?
A. Cardiac rhythm
B. Blood urea nitrogen
C. Central nervous system (CNS) tremor
D. Lung sounds
The nurse is teaching a patient with a history of anaphylaxis how to use an EpiPen. Which statement made by the patient indicates that he understands the proper use of this drug?
A. "I will keep my medication in the refrigerator when I'm not using it."
B. "I should take this medication within 30 minutes of the onset of symptoms."
C. "I must remove my pants before injecting the medication into the leg."
D. "I will jab this medication firmly into my outer thigh if needed."
The nurse is preparing to give terbutaline (Brethine) to prevent preterm labor. Which concepts are important to keep in mind when working with this drug? (Select all that apply.)
A. Terbutaline must be given by a parenteral route.
B. The selectivity of terbutaline is dose dependent.
C. The patient may experience tremor with terbutaline.
D. Terbutaline is a sympathomimetic drug.
E. Bronchoconstriction is a potential adverse effect of terbutaline.
B, C, D
The nurse is preparing to give epinephrine by the IV push route. Which actions are essential before giving this drug? (Select all that apply.)
A. Check the blood urea nitrogen (BUN) and creatinine levels
B. Obtain insulin from the medication cart
C. Assess the patency of the IV line
D. Review the allergy history
E. Assess the vital signs
C, D, E
Which statement made by the nurse is most important to include in the teaching plan for a patient being discharged from the hospital with a new prescription for prazosin (Minipress)?
A. "You should increase your intake of fresh fruits and vegetables."
B. "You should move slowly from a sitting to a standing position."
C. "Be sure to wear a Medic Alert bracelet while taking this medication."
D. "Take your first dose of this medication first thing in the morning."
The nurse notices significant edema surrounding and proximal to the peripheral intravenous (IV) site where epinephrine is being infused. Which action would the nurse anticipate first?
A. Prepare to administer phentolamine (Regitine)
B. Ensure that naloxone (Narcan) is available
C. Institute the protocol for congestive heart failure (CHF)
D. Monitor the blood urea nitrogen (BUN), creatinine, and potassium levels
The nurse is caring for a patient receiving propranolol (Inderal). Which finding is most indicative of an adverse effect of this drug?
A. A heart rate of 100 beats per minute
C. A glucose level of 180 mg/dL
D. Urinary urgency
The nurse is caring for several patients. For which patient is propranolol (Inderal) most likely to be contraindicated?
A. A 30-year-old woman with cardiac dysrhythmias
B. A 48-year-old man with hypertension
C. A 60-year-old woman with diabetes
D. A 72-year-old man with angina
Why does the nurse anticipate administering metoprolol (Lopressor) rather than propranolol (Inderal) for diabetic patients who need a beta-blocking agent?
A. Metoprolol is less likely to cause diabetic nephropathy.
B. Propranolol causes both beta1 and beta2 blockade.
C. Metoprolol helps prevent retinopathy in individuals with diabetes.
D. Propranolol is associated with a higher incidence of foot ulcers.
The nurse is preparing to administer a dose of clonidine (Catapres). Which is the best description of the action of this drug?
A. It selectively activates alpha2 receptors in the central nervous system (CNS).
B. It causes peripheral activation of alpha1 and alpha2 receptors.
C. It depletes sympathetic neurons of norepinephrine.
D. It directly blocks alpha and beta receptors in the periphery.
The nurse is assessing a patient in a clinic who has been taking clonidine (Catapres) for hypertension. Which findings are most indicative of an adverse effect of this drug?
A. Cough and wheezing
B. Epigastric pain and diarrhea
C. Drowsiness and dry mouth
D. Positive Coombs' test result and anemia
Which statement is the most appropriate to include in the teaching plan for a 30-year-old woman beginning a new prescription of clonidine (Catapres)?
A. "If you stop taking this drug abruptly, your blood pressure might go up very high."
B. "You will need to have your blood drawn regularly to check for anemia."
C. "Take this medication first thing in the morning to reduce nighttime wakefulness."
D. "This medication often is used to manage hypertension during pregnancy."
Which hemodynamic system serves as a reservoir for circulating blood?
Complete the equation: Cardiac output = Volume of blood ejected at each heartbeat × ____.
A. Stroke volume
D. Heart rate
Which physiologic mechanism helps to ensure venous return despite low pressure in the venules?
A. Positive pressure in the right atrium
B. Negative pressure in the right atrium
C. Vasodilation in the periphery
D. Cardiac muscle relaxation
Natriuretic peptides serve to protect the cardiovascular system under which condition?
B. Volume overload
C. Myocardial infarction
Which statement or statements accurately reflect Starling's law as applied to a healthy heart? (Select all that apply.)
A. When venous return increases, stroke volume decreases.
B. The right and left ventricles pump the same amount of blood.
C. Cardiac output is equal to the volume of blood delivered by the veins.
D. When venous return increases, cardiac output increases.
E. As cardiac muscle fibers increase in length, their contractile force decreases.
B, C, D
Which systems are the primary regulators of arterial pressure? (Select all that apply.)
A. Autonomic nervous system
B. Renin-angiotensin-aldosterone system
C. Renal system
D. Pulmonary system
E. P450 enzyme system
A, B, C
The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure. Which compound in this system is most powerful at raising the blood pressure?
A. Angiotensin I
B. Angiotensin II
C. Angiotensin III
The nurse is caring for an adult male with renal artery stenosis who has been prescribed benazepril (Lotensin). Which symptom, if found, indicates an adverse effect of this drug?
A. Potassium level of 3.2 mEq/L
B. Blood glucose level of 180 mg/dL
C. Serum creatinine level of 2.3 mg/dL
D. Uric acid level of 10 mg/dL
The nurse is caring for a patient with bipolar disorder treated with lithium (Eskalith). The patient has a new prescription for captopril (Capoten) for hypertension. The combination of these two drugs makes which assessment particularly important?
A. Potassium level
B. Lithium level
C. Creatinine level
D. Blood pressure
The nurse has just administered the initial dose of enalapril (Vasotec) to a newly admitted patient. Which nursing intervention takes priority over the next several hours?
A. Monitoring the blood pressure
B. Measuring the heart rate
C. Auscultating the lungs
D. Drawing blood for potassium levels
The nurse is evaluating the teaching done with a patient who has a new prescription for fosinopril (Monopril). Which statement by the patient indicates a need for further teaching?
A. "I can take this medicine with breakfast each morning."
B. "I will call if I notice a rash or wheals on my skin."
C. "I will use a salt substitute to lower my sodium intake."
D. "I will call if I develop a bothersome cough."
The nurse is caring for a patient prescribed aliskiren (Tekturna). In which way does this medication act to lower blood pressure?
A. It blocks the conversion of angiotensin I to angiotensin II.
B. It prevents angiotensin II from binding to its receptors.
C. It inhibits the conversion of angiotensinogen into angiotensin I.
D. It selectively blocks aldosterone receptors in the kidneys.
A patient is prescribed lisinopril (Prinvil) as part of the treatment plan for heart failure. Which finding indicates that the patient is experiencing the therapeutic effect of the drug?
A. +2 edema of the lower extremities
B. Potassium level of 3.5 mEq/L
C. Crackles in the lungs are no longer heard
D. Jugular vein distention
Calcium channel blockers 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?
The nurse is caring for several patients. For which patient would a prescription for nifedipine (Adalat) be least appropriate?
A. A 60-year-old man with angina and hypertension
B. A 48-year-old woman with primary hypertension
C. A 78-year-old man with atrial fibrillation
D. A 55-year-old woman with vasospastic angina
A patient is prescribed verapamil (Calan) SR 120 mg daily. Which statement by the patient indicates understanding of the medication?
A. "I will take the medication with grapefruit juice each morning."
B. "I should expect occasional loose stools from this medication."
C. "I'll need to reduce the amount of fiber in my diet."
D. "I will swallow the pill whole."
The nurse is teaching an older adult patient with hypertension who has a new prescription for verapamil (Calan). Which statement or statements by the patient indicate that the teaching was effective? (Select all that apply.)
A. "I will increase my intake of fluid and foods high in fiber."
B. "I will avoid exposing my skin to the sun."
C. "I will call my physician if I notice swelling in my ankles."
D. "I will avoid salt substitutes and potassium supplements."
E. "I may notice easy bruising and bleeding with this drug."
The nurse is caring for a patient with hypertension who is receiving verapamil (Calan). The patient has a healthy heart. What pharmacodynamic effects does the nurse expect from this drug? (Select all that apply.)
A. Peripheral vasoconstriction
B. Peripheral vasodilation
C. Coronary vasodilation
D. Increased heart rate
E. Increased force of contraction
The nurse is teaching a patient who has just been prescribed a vasodilator. Which statement by the patient indicates that the teaching was effective?
A. "I will take this medication in the morning to reduce nighttime urination."
B. "I will rise slowly when changing from a sitting to a standing position."
C. "My heart rate may slow down with this drug. I will call if my pulse is below 60."
D. "I will increase my intake of fluids and foods that are high in fiber."
Before administering hydralazine (Apresoline), it is most important for the nurse to obtain which assessment?
A. Peripheral pulses
B. Homans' sign
C. Blood pressure
D. Capillary refill
Which is the only cardiovascular indication for minoxidil (Rogaine)?
A. Heart failure
B. Myocardial infarction
C. Mild hypertension
D. Severe hypertension
The nurse is caring for a patient receiving a nitroprusside (Nipride) intravenous infusion. The patient's wife asks why furosemide (Lasix) is being prescribed along with this drug. The nurse's response is based on which concept?
A. Furosemide will help reduce reflex tachycardia.
B. Many vasodilators cause retention of sodium and water.
C. Thiocyanate may accumulate in patients receiving nitroprusside.
D. Vasodilators can cause serious orthostatic hypotension.
The nurse is caring for a patient receiving hydralazine (Apresoline). The primary care provider prescribes propranolol (Inderal). The nurse knows that a drug such as propranolol often is combined with hydralazine for what purpose?
A. To reduce the risk of headache
B. To improve hypotensive effects
C. To prevent heart failure
D. To protect against reflex tachycardia
An adult male patient has taken medication for management of hypertension for 3 years. He says to the nurse, "I'm not going to take these drugs anymore, because they are interfering with my sex life." Which response by the nurse would be most helpful?
A. "It is unfortunate that these drugs can cause erectile dysfunction, but managing your blood pressure is more important than your sexual performance."
B. "I understand how discouraging it must be to live with this adverse effect, but you could have a stroke if you do not take your blood pressure medicines."
C. "Let's discuss this effect with your prescriber. There are other drugs available to manage your blood pressure that may not have the same adverse effect."
D. "I am glad you told me about your experience with this adverse effect. Sexual performance can be a difficult subject to discuss."
The nurse is caring for a pregnant patient who is experiencing a new episode of hypertension. Which agent does the nurse anticipate will be prescribed for this patient?
A. Methyldopa (Aldomet)
B. Propranolol (Inderal)
C. Captopril (Capoten)
D. Valsartan (Diovan)
The nurse is caring for a patient who has diabetes and hypertension. Which agent is most likely to be prescribed to treat this patient's hypertension?
A. Hydrochlorothiazide (HCTZ)
B. Enalapril (Vasotec)
C. Propranolol (Inderal)
D. Methyldopa (Aldomet)
A patient is admitted to the emergency department in hypertensive crisis, and examination reveals papilledema. The nurse would expect which IV medications to be administered to achieve rapid, controlled reduction of the patient's blood pressure?
A. Furosemide (Lasix)
B. Sodium nitroprusside (Nitropress)
C. Metoprolol (Lopressor)
D. Diltiazem (Cardizem)
Which laboratory abnormality may be a consequence of therapy with a thiazide diuretic?
A. Serum glucose level of 58 mg/dL
B. Serum potassium level of 5.3 mEq/L
C. Serum sodium level of 135 mEq/L
D. Serum uric acid level of 10.4 mg/dL
Which statement by a patient indicates understanding of treatment with doxazosin?
A. "I may experience an increase in hair growth as a side effect."
B. "I'll notify the healthcare provider if I develop a persistent cough."
C. "I'll make sure I include extra sources of potassium in my diet, such as bananas and baked potatoes."
D. "When getting out of bed in the morning, I will sit on the side of the bed for several minutes before standing."
Initial therapy for hypertension after a myocardial infarction (MI) includes drugs from which classes?
A. Diuretic and beta blocker
B. Beta blocker and ACE inhibitor
C. ACE inhibitor and calcium channel blocker
D. Diuretic and calcium channel blocker
The Seventh Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7 report), released in 2003, is the guiding document for treatment of hypertension in the United States. Which principles are included in these guidelines? (Select all that apply.)
A. People with blood pressure above 120 to 139 systolic and 80 to 89 diastolic should receive medication treatment.
B. In people older than 50 years, an elevated diastolic blood pressure is more dangerous than an elevated systolic pressure.
C. For most patients, thiazide diuretics should be used as the initial medication therapy.
D. Blood pressure should be measured twice at a clinic visit, with the patient seated in a chair with feet on the floor.
E. The diagnosis of hypertension typically is made after several elevated readings at more than one clinic visit.
C, D, E
Which medication or medications should be used with caution in a hypertensive diabetic patient? (Select all that apply.)
A. Furosemide (Lasix)
B. Metoprolol (Lopressor)
C. Diltiazem (Cardizem)
D. Hydrochlorothiazide (HCTZ)
E. Enalapril (Vasotec)
A, B, D
The nurse knows that diuretics mostly affect which function of the kidneys?
A. Cleansing and maintenance of extracellular fluid volume
B. Maintenance of acid-base balance
C. Excretion of metabolic waste
D. Elimination of foreign substances
The nurse plans to closely monitor for which clinical manifestation after administering Furosemide (Lasix)?
A. Decreased pulse
B. Decreased temperature
C. Decreased blood pressure
D. Decreased respiratory rate
The nurse caring for a patient taking furosemide (Lasix) is reviewing the patient's most recent laboratory results, which are: sodium, 136 mEq/L; potassium, 3.2 mEq/L; chloride, 100mEq/L; blood urea nitrogen, 15 mg/dL. What is the nurse's best action?
A. Administer Lasix as ordered
B. Place the patient on a cardiac monitor
C. Begin a 24-hour urine collection
D. Hold the Lasix and notify the physician
The nurse should monitor for which adverse effect after administering hydrochlorothiazide (HydroDIURIL) and digoxin (Lanoxin) to a patient?
A. Digoxin toxicity
B. Decreased diuretic effect
D. Heart failure
The nurse is caring for a patient with heart failure who needs a diuretic. Which agent is likely to be chosen, because it has been shown to greatly reduce mortality in patients with heart failure?
A. Furosemide (Lasix)
B. Hydrochlorothiazide (HydroDIURIL)
C. Spironolactone (Aldactone)
D. Mannitol (Osmitrol)
The nurse is teaching a patient who has a new prescription for spironolactone (Aldactone). Which statement by the patient indicates that the teaching was effective?
A. "I will use salt substitutes to lower my sodium intake."
B. "I will increase my intake of foods that are high in potassium."
C. "I will call my doctor if I begin having menstrual irregularities."
D. "I will take this medication at bedtime each evening."
The heart undergoes cardiac remodeling during the early phase of heart failure. Which finding describes the geometric changes that occur during heart failure?
A. Ventricular constriction
B. Ventricular wall thickening
C. Ventricular atrophy
D. Ventricles become more cylindric
In the failing heart, arterial pressure falls, stimulating the baroreceptor reflex to increase sympathetic nervous system activity. Which finding is an expected outcome of increased sympathetic activity?
What is the primary benefit of spironolactone (Aldactone) in patients with heart failure?
A. Profound diuresis and fluid loss
B. Blockage of aldosterone receptors
C. Inhibition of beta activation by norepinephrine
D. Stimulation of the renin-angiotensin-aldosterone system
The nurse is caring for a patient who takes spironolactone (Aldactone) and quinapril (Accupril) for treatment of heart failure. Which symptom, if found, would indicate a potential interaction between these two drugs?
A. Elevated serum quinapril level
B. Heart rate of 58 beats per minute
C. Potassium level of 5.7 mEq/L
D. Glucose level of 180 mg/dL
The nurse is preparing to administer a daily dose of digoxin (Lanoxin). Which assessment receives priority at this time?
A. Evaluating for a change in the heart rhythm
B. Assessing for Homans' sign
C. Checking the blood pressure
D. Palpating the pedal pulses
The nurse is caring for a patient with heart failure who takes digoxin (Lanoxin). Which finding would require immediate attention by the nurse?
A. Potassium level of 3.7 mEq/L
B. Digoxin level of 0.7 ng/mL
C. Vomiting and diarrhea
D. Heart rate of 68 beats per minute
Which scenario would warrant an immediate call to the physician by the nurse?
A. A patient who takes digoxin 0.125 mg orally daily presents with a serum digoxin level of 0.8 ng/mL.
B. A patient who takes oral spironolactone (Aldactone) 25 mg daily and enalapril (Vasotec) 5 mg daily presents with a serum potassium level of 5.5 mEq/L.
C. A patient who takes digoxin 0.25 mg orally daily presents with a serum potassium level of 4.0 mEq/L.
D. A patient who takes oral lisinopril (Zestril) 5 mg daily and digoxin 0.125 mg daily presents with a serum digoxin level of 0.5 ng/mL.
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?
A. "Lower your cholesterol to 300 mg/day."
B. "Eliminate red meat and pork from your diet."
C. "Read food labels and reduce your intake of saturated fats."
D. "Reduce salt consumption to keep your sodium intake to 2400 mg/day."
The nurse understands that cholesterol is carried through the blood by means of lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis?
A. Very-low-density lipoprotein (VLDL)
B. Apolipoprotein B-100
C. Low-density lipoprotein (LDL)
D. High-density lipoprotein (HDL)
Which agent is in the category of drugs considered most effective for lowering LDL cholesterol?
A. Atorvastatin (Lipitor)
B. Cholestyramine (Questran)
C. Gemfibrozil (Lopid)
D. Ezetimibe (Zetia)
Which are beneficial effects that can be derived from simvastatin (Zocor) and other agents in this class? (Select all that apply.)
A. Reduction of LDLs
B. Elevation of HDLs
C. Stabilization of the plaque in coronary arteries
D. Reduction of risk of cardiovascular events
E. Improvement of liver function
All except E
A 68-year-old woman with a history of myocardial infarction is beginning a new prescription for lovastatin (Mevacor). Which statements by the nurse are appropriate to include in the teaching plan? (Select all that apply.)
A. "Call if you get new prescriptions from other providers, because several medications can interact with lovastatin."
B. "Return to the clinic every 6 to 12 months so we can run blood tests for possible side effects."
C. "Take your medication once a day, first thing in the morning, with a full glass of water for best results."
D. "Take one 325-mg aspirin 30 minutes before your dose to lessen the problem of flushing and itching that can occur with this drug."
E. "Lower the total fat and saturated fat in your diet by increasing your intake of fresh fruits and vegetables and whole grains."
A, B, E
The nurse is caring for a patient receiving nitrates for relief of angina. What pharmacodynamic action is responsible for the relief of anginal pain with nitrates?
A. Vasoconstriction leads to improved cardiac output.
B. Decreased force of contraction leads to decreased oxygen demand.
C. Vasodilation leads to decreased preload, which decreases oxygen demand.
D. Influx of calcium ions leads to relaxation of vascular smooth muscle.
The nurse is conducting discharge teaching for a patient with a new prescription for transdermal nitroglycerin. Which statement by the patient indicates a need for further teaching?
A. "I will remove my patch at bedtime each evening."
B. "I will limit my alcohol to one drink per day."
C. "I will not use Viagra as long as I am on nitroglycerin."
D. "I will move slowly when changing positions."
Which medication combination is useful in the treatment of variant angina?
A. Metoprolol (Lopressor) and ranozaline (Ranexa)
B. Isosorbide dinitrate (Isordil) and metoprolol (Lopressor)
C. Diltiazem (Cardizem) and isosorbide mononitrate (Imdur)
D. Propranolol (Inderal) and diltiazem (Cardizem)
Teaching for a patient with angina who is being discharged with a prescription for nitroglycerin sublingual tablets should include which instruction?
A. "Store the tablets in their original dark container."
B. "The tablets are only good for 1 month after the container is opened."
C. "Sublingual nitroglycerin tablets are also effective when swallowed whole."
D. "Effects of sublingual nitroglycerin begin in 5 to 10 minutes."
Which activity noted by the home care nurse indicates that the patient needs further teaching about topical nitroglycerin ointment?
A. The patient rotates the application sites to minimize skin irritation.
B. The patient uses the applicator paper to measure the prescribed dose.
C. The patient removes ointment from a previous dose before applying the next dose.
D. The patient applies the prescribed ribbon of ointment to the applicator paper and places it on the chest.
Which finding suggests that a patient is experiencing an adverse effect of metoprolol (Lopressor)?
A. The patient complains of headaches.
B. The patient's potassium level is 3.3 mEq/L.
C. The patient's resting heart rate is 58 beats per minute on the cardiac monitor.
D. The PR interval on the patient's cardiac rhythm strip is 0.32 seconds.
Patients receiving nitroglycerin are at risk for which adverse effects? (Select all that apply.)
A, C, D
Which are the main families of drugs used to prevent or relieve anginal pain? (Select all that apply.)
A. Platelet inhibitors
B. Beta blockers
D. Calcium channel blockers
B, C, D
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