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Unit 1 Set 1
Terms in this set (175)
An APRN works in a urology clinic under the supervision of a physician who does not restrict the types of medications the APRN is allowed to prescribe. State law does not require the APRN to practice under physician supervision. How would the APRN's prescriptive authority be described?
Which factors increase the need for APRNs to have full prescriptive authority?
More patients will have access to health care.
Which factors could be attributed to limited prescriptive authority for APRNs? SATA
Inaccessibility of patient care
Higher health care costs
Which aspects support the APRN's provision for full prescriptive authority? SATA
-Clinical education includes prescription of medications and disease processes
-National examinations provide validation of the APRN's ability to provide safecare
-Licensure ensures compliance with health care and safety standards.
A family nurse practitioner practicing in Maine is hired at a practice across state lines in Virginia. Which aspect of practice may change for the APRN?
The APRN will have less prescriptive authority in the new position.
How can collaboration with a pharmacist improve positive outcomes for patients? Select all that apply
-Pharmacists have additional information on drug interactions.
- The pharmacist can suggest adequate medication dosing.
- Pharmacists have firsthand knowledge of the facility formulary
A patient presents with deliriumtremens requiring Ativan administration. The provider of care is not in the facility. Which action by the nurse is most appropriate?
obtain a telephone order
A patient with chronic pain calls the provider's office to request a refill on their oxycontin. Which action is most appropriate?
Schedule an appointment with the patient.
A patient prescribed amoxicillin for streptococcal pharyngitis reports new onset of a flat, itchy red rash on the chest and neck. Which action is most important?
discontinue the medication
A patient taking three medications for hypertension is diagnosed with COPD. Which action should be taken prior to prescribing medications to treat COPD?
Obtain a complete medication history.
A patient with diabetes reports losing their job and an inability to purchase required medications. Which action is most appropriate?
Contact a different pharmacy
A patient recently prescribed hydrocodone calls to report they are unable to fill the prescription. Which factors could contribute to the inability to fill the prescription? Select all that apply.
a. DEA number missing from prescription
b. Prescription sent via electronic messenger
d. Prescriber license number not included
A patient reports that a medication prescribed for recurrent migraine headaches is not working. Which action should be taken first?
Ask the patient about the number and frequency of tablets taken
A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding would be most concerning?
Drinks two glasses of wine every night
A patient is using a metered-dose inhaler containing albuterol for asthma. The medication label instructs the patient to administer "two puffs every 4 hours as needed for coughing or wheezing." The patient reports feeling jittery sometimes when taking the medication, and she doesn't feel that the medication is always effective. Which action is most appropriate?
Auscultating lung sounds and obtaining vital signs
A patient newly diagnosed with diabetes is to be discharged from the hospital. Which action should be taken first during medication education?
Asking the patient to demonstrate how to measure and administer insulin
The drug manual states that older adult patients are at increased risk for hepatic side effects. Which action is most important when prescribing this medication to an 80-year-old patient?
Obtain pretreatment laboratory work.
A patient recently diagnosed with HIV is prescribed several medications to treat the condition. Which factors could impact the patient's adherence to the treatment regimen? Select all that apply
a. The patient is uninsured
b. The patient works three part-time jobs
c. The medication regimen includes six different pills
e. Medication regimen requires medication be taken at regular 4-hour intervals.
A patient diagnosed with bipolar disorder is prescribed daily lithium. Which action is most important to determine if the therapeutic level is maintained?
Ensure periodic laboratory testing is completed
The nurse administers naloxone [Narcan] to a patient who has received a toxic dose of morphine sulfate. The nurse understands that the naloxone is effective because of which action?
Preventing activation of opioid receptors through antagonist actions
A patient is taking drug X and receives a new prescription for drug Y, which is listed as an inducing agent. The nurse caring for this patient understands that this patient may require doses of drug ?
The nurse is preparing to administer penicillin G intramuscularly to a child. The child's parents ask why the drug cannot be given in an oral liquid form. What is the nurse's reply?
This drug would be inactivated by enzymes in the stomach
Which statement about food and drug interactions is true?
Some foods can inhibit CYP isoenzymes and alter drug metabolism.
A nurse is teaching a patient about a drug that induces P-glycoprotein. The nurse will explain that this drug may cause which effect on other drugs?
Decreased elimination through the kidneys
A patient claims to get better effects with a tablet of Brand X of a drug than with a tablet of Brand Y of the same drug. Both brands contain the same amount of the active ingredient. What does the nurse know to be most likely?
Tablets can differ in composition and can have differing rates of disintegration and dissolution, which can alter the drug's effects in the body
Two nurses are discussing theories of drug-receptor interaction. Which statements are true regarding the affinity of a drug and its receptor? Select all that apply.
b. Affinity refers to the strength of the attraction between a drug and its receptor.
c. Drugs with high affinity are strongly attracted to their receptors.
e. The affinity of a drug for its receptors is reflected in its potency.
A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what?
Monitor Plasma Levels
What occurs when a drug binds to a receptor in the body?
It increases or decreases the activity of that receptor
A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels. The dosing is correct, and this medication has been tolerated by this patient in the past. Which could be a probable cause of the test result?
The patient is taking another medication that binds to serum albumin
A patient reports becoming "immune" to a medication because it no longer works to alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely caused by?
desensitization of receptor sites by continual exposure to the drug.
A patient who is taking morphine for pain asks the nurse how a pain medication can also cause constipation. What does the nurse know about morphine?
It is selective to receptors that regulate more than one body process.
The nurse is administering morning medications. The nurse gives a patient multiple medications, two of which compete for plasma albumin receptor sites. As a result of this concurrent administration, the nurse can anticipate that what might occur?Select all that apply.
a. Binding of one or both agents will be reduced.
b. Plasma levels of free drug will rise.
d. The increase in free drug will intensify effects
When administering medications to infants, it is important to remember which of the following? Select all that apply.
b. Immaturity of renal function in infancy causes infants to excrete drugs less efficiently.
c. Infants have immature livers, which slows drug metabolism.
d. Infants are more sensitive to medications that act on the central nervous system (CNS).
A nursing student is preparing to give a medication that has a boxed warning. The student asks?
They alert prescribers to measures to mitigate potential harm from side effects
A nurse is preparing to administer a drug. Upon reading the medication guide, the nurse notes that the drug has been linked to symptoms of Parkinson disease in some patients. What will the nurse do?
Observe the patient closely for such symptoms and prepare to treat them if needed
Which patients are at increased risk for adverse drug events? Select all that apply
a. A 2-month-old infant taking a medication for gastroesophageal reflux disease
c. A 40-year-old male who is intubated in the intensive care unit and taking antibiotics and cardiac medications
e. An 80-year-old male taking medications for COPD
A nurse provides teaching to a patient who will begin taking a drug with a known risk of hepatotoxicity. Which statement by the patient indicates a need for further teaching?
Routine testing and early detection of problems will prevent liver failure.
A nurse is reviewing a medication administration record before administering medications. Which order will the nurse implement?
Furosemide [Lasix] 20 mg PO daily
A patient is given a new medication and reports nausea within an hour after taking the drug. The nurse consults the drug information manual and learns that nausea is not an expected adverse effect of this drug. When the next dose is due, what will the nurse do?
Administer the drug and tell the patient to report further nausea
A nurse is preparing to give an antibiotic to a patient who reports being allergic to antibiotics. Before giving the medication, what will the nurse do first?
Ask whether the patient has taken this antibiotic for other infections
A patient is taking sertraline [Zoloft] for depression, and the provider orders azithromycin [Zithromax] to treat an infection. What will the nurse do?
Contact the provider to discuss an alternative to azithromycin
A patient is given a drug for the first time and develops shortness of breath. The patient's heart rate is 76 beats/minute, the respiratory rate is 20 breaths/minute, and the blood pressure is 120/70 mm Hg. The nurse checks a drug administration manual to make sure the correct dose was given and learns that some patients taking the drug experience shortness of breath. The nurse will contact the provider to report what?
A side effect
Which are effective ways to help prevent medication errors? Select all that apply
a. Developing non-punitive approaches to track errors
c. Helping patients to be active, informed members of the healthcare team
e. Using electronic medical order entry systems
A patient is taking a drug that has known toxic side effects. What will the nurse do?
Monitor the function of all organs potentially affected by the drug
A patient is being discharged after surgery. During the admission history, the nurse learned that the patient normally consumes two or three glasses of wine each day. The prescriber has ordered hydrocodone with acetaminophen [Lortab] for pain. What will the nurse do?
Tell the patient not to drink wine while taking Lortab
Which actions occur in 90% of fatal medication errors? Select all that apply.
b. Giving a drug intravenously instead of intramuscularly
c. Giving Nasarel instead of Nizoral
e. Writing a prescription illegibly
A nurse is caring for a woman with breast cancer who is receiving tamoxifen. A review of this
patient's chart reveals a deficiency of the CYP2D6 gene. The nurse will contact the provider to suggest?
A different medication
Which groups of people are especially sensitive to medication effects? Select all that apply.
A post-operative patient who is worried about pain control will be discharged several days after surgery. The nurse providing discharge teaching tells the patient that the prescribed Lortab is not as strong as the morphine the patient was given in the immediate post-operative period. Which response is the patient likely to experience?
A negative placebo effect when taking the medication
A patient has been taking narcotic analgesics for chronic pain for several months. The nurse caring for this patient notes that the prescribed dose is higher than the recommended dose. The patient has normal vital signs, is awake and alert, and reports mild pain. What does the nurse recognize about this patient?
This patient has developed pharmacodynamic tolerance, which has increased the minimal effective concentration (MEC) needed for analgesic effect.
A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient's?
This patient has developed pharmacodynamic tolerance, which has increased the minimal effective concentration (MEC) needed for analgesic effect.
A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient's:
metabolism of drugs
The nurse is assessing a newly admitted older patient who has recently lost 15 pounds. The nurse notes that the patient ist aking warfarin (Coumadin). Which laboratory tests will the nurse discuss with this patient's provider?
Serum albumin and coagulation studies
A nurse is preparing to care for a patient who is receiving digoxin. When screening for potential adverse effects from this drug, the nurse will review which of this patient's laboratory results?
A nurse administers the same medication in the same preparation in the same dose to several patients and notes that some patients have a better response to the drug than others. What is the most likely explanation for this phenomenon?
Pharmacogenomic differences among individuals
A nurse is teaching a group of women about medications. The women want to know why so many drugs have unpredictable effects in women. The nurse will tell them that?
most known drug effects are based on drug trials in men
The U.S. Food and Drug Administration (FDA) recommends genetic testing of patients receiving certain medications. Genetic testing helps prescribers?
determine whether a patient is a rapid or slow metabolizer of the drug
Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?
A 50-year-old man with cirrhosis of the liver
A patient presents to the emergency department with a drug level of 50 units/mL. The half-life of this drug is 1 hour. With this drug, concentrations above 25 units/mL are considered toxic and no more drug is given. How long will it take for the blood level to reach the non-toxic range?
A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of dizzy spells and weakness. While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
The impact of the warmer environment on the patients physical status
An important concept taught by the nurse when providing medication teaching is the need to provide a complete list of medications taken to health care?
Drug drug interactions
A pharmacology student asks the instructor what an accurate description of a drug agonistis. What is the instructors best response?
A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site
A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose?
A nurse is working as a member of a research team involved in exploring the unique response to drugs each individual displays based on genetic make-up. What is this area of study is called?
The nurse uses what term to describe the drug level required to have a therapeutic effect?
A nurse is caring for a patient who is supposed to receive two drugs at the same time. What is the nurses priority action?
Consult a drug guide for compatibility
The nurse is talking with a group of nursing students who are doing clinical hours on the unit. A student asks if all intramuscular (IM) drugs are absorbed the same. What factor would the floor nurse tell the students to affect absorption of the IM administration of drugs?
The patient is taking a drug that affects the body by increasing cellular activity. Where does this drug work on the cell?
Several processes enable a drug to reach a specific concentration in the body. Together they are called dynamic equilibrium. What are these processes? (Select all that apply.)
A) Distribution to the active site
A nurse is administering digoxin to a patient. To administer medications so that the drug isas effective as possible, the nurse needs to consider what?
Which types of drugs taken by a pregnant patient are more likely to have effects on a fetus?
A patient in her second trimester of pregnancy tells the nurse she is worried that a medication she took before knowing she was pregnant might have harmed the fetus. What will the nurse do?
Ask the patient what she took and when she learned she was pregnant
A patient who has just learned she is pregnant has stopped using a prescription medication that she takes for asthma because she does not want to harm her baby. What will the nurse tell her?
That her baby's health is dependent on hers
A pregnant patient in active labor is admitted to the emergency department. A toxicology screen and a physical assessment reveal that the patient is an active heroin addict. The nurse who cares for the neonate after delivery should anticipate which clinical manifestations?
A shrill cry and irritability
A pregnant patient asks the nurse about the safe use of medications during the third trimester. What will the nurse tell her about drugs taken at this stage?
They may need to be given in higher doses if they undergo renal clearance.
A patient has just given birth to a baby boy with a cleft palate. The nurse will review the patient's medication history with special emphasis on drugs taken during which period?
During the first trimester
A nurse is caring for a patient and her newborn immediately after delivery. The patient's medication history includes prenatal vitamins throughout pregnancy, one or two glasses of wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last trimester, and intravenous morphine during labor. What will the nurse expect to do?
Monitor the infant's respirations and prepare to administer naloxone if needed
A woman who is breastfeeding her infant must take a prescription medication for 2 weeks. The medication is safe, but the patient wants to make sure her baby receives as little of the drug as possible. What will the nurse tell the patient to do?
Take the medication immediately after breastfeeding
A nursing student asks the nurse why more is not known about the teratogenic effects of maternal medication ingestion during pregnancy. Which response by the nurse is correct?
Clinical trials to assess this risk would put the fetus at risk.
A nurse is teaching a class to a group of pregnant patients. The nurse correctly teaches that the highest risk of teratogen-induced gross malformations exists during which time?
During the first trimester
A nurse is caring for an infant after a surgical procedure. After ensuring that the ordered dose is appropriate for the infant's age and weight, the nurse administers a narcotic analgesic intravenously. When assessing the infant 15 minutes later, the nurse notes respirations of 22 breaths/minute and a heart rate of 110 beats/minute. The infant is asleep in the parent's arms and does not awaken when vital signs are assessed. The nurse understands that these findings are the result of?
immaturity of the blood-brain barrier in the infant
A child will receive 750 mg of an antibiotic for 10 days. The child attends day care. The drug may be dosed in several ways and is available in two concentrations. Which dosing regimen will the nurse discuss with the child's provider?
500 mg/5 mL to 375 mg PO twice daily
Parents ask the nurse why an over-the-counter cough suppressant with sedative side effects is not recommended for infants. Which response by the nurse is correct?
Infants are more susceptible to central nervous system effects than are adults
A nurse caring for a 5-year-old child notes that the child has discoloration of several teeth. When taking a medication history, the nurse will ask about which group of medications?
An infant has allergies and often develops a pruritic rash when exposed to allergens. The infant's parents ask the nurse about using a topical antihistamine. What should the nurse tell them?
Applying an antihistamine to the skin can cause toxicity in this age group
An infant is receiving a medication that has a narrow therapeutic range. The nurse reviews the medication information and learns that the drug is excreted by the kidneys. When giving the medication, the nurse will assess the infant for?
signs of drug toxicity
A pediatric nurse is teaching nursing students to calculate medication doses for children using a formula based on body surface area. Which statement by a nursing student indicates understanding of the teaching?
This formula helps approximate the first dose; other doses should be based on clinical observations
A pediatric nurse is teaching nursing students about medication administration in children. Which statement by a student indicates an understanding of the teaching?
Drugs effective in adults may not work in children, even if the dose is proportional for weight and size
A nurse is teaching nursing students about pediatric medication administration. What will the nurse include when discussing pediatric drug research?
Studies showed a significant percentage of unanticipated and potentially lethal side effects in children
A prescriber has ordered medication for a newborn. The medication is eliminated primarily by hepatic metabolism. The nurse expects the prescriber to?
order a dose that is lower than an adult dose
The parents of a child with asthma ask the nurse why their child cannot use oral corticosteroids more often, because they are so effective. The nurse will offer which information that is true for children?
Chronic steroid use can inhibit growth
A nurse is obtaining a drug history from an older adult patient who is taking multiple medications prescribed by different providers. Which two medications taken together create a reason for concern?
Amitriptyline [Elavil] and diphenhydramine [Benadryl]
A nurse is teaching a group of nursing students about administering medications to older adult patients. Which statement by a student indicates a need for further teaching?
Alteration in hepatic function requires more frequent drug dosing
A nurse is preparing to give medications to four older patients who are all taking multiple medications. Which patient is most likely to have an adverse drug reaction related to increased drug effects?
Thin patient with a chronically low appetite
A nurse is concerned about renal function in an 84-year-old patient who is taking several medications. What will the nurse assess?
A nurse is preparing to teach a forgetful older adult patient about a multiple drug regimen to follow after discharge from the hospital. To help promote adherence, what will the nurse do?
Cluster medication administration times as much as possible.
Based on changes in hepatic function in older adult patients, which adjustment should the nurse expect for oral medications that undergo extensive first pass metabolism?
The interval between doses should be increased
A thin older adult woman is admitted to the hospital after several days of vomiting, diarrhea, and poor intake of foods and fluids. She has not voided since admission. In preparing to care for this patient, the nurse will look for what laboratory values to help guide medication administration? Select all that apply.
a. Creatinine clearance
c. Plasma drug levels
d. Serum albumin
A nurse is reviewing an older adult patient's chart before giving medications. Which patient information is of most concern?
Low serum albumin
A nurse is caring for an older adult patient during the immediate postoperative period after a total hip replacement. The surgeon has ordered meperidine [Demerol] for severe pain. What will the nurse do?
Request an order for morphine instead of meperidine [Demerol]
The nurse is teaching a group of nursing students about adherence to medication in older adults. Which statement by a student indicates understanding of the teaching?
A majority of older patients who do not adhere to drug regimens do so intentionally
A nurse is making a home visit to an older adult woman who was recently discharged home from the hospital with a new prescription. The nurse notes that a serum drug level drawn the day before was subtherapeutic. What will the nurse do next?
Count the pills in the prescription bottle
An older adult patient is admitted to the hospital for treatment of an exacerbation of a chronic illness. Admission laboratory work reveals an extremely low serum drug level of the drug used to treat this condition. The patient has brought the medication to the hospital, along with other medications taken. The patient's renal and hepatic function tests are normal. What might the nurse suspect as a likely cause of this finding?
A nursing student asks about drugs that interfere with the termination of transmitter action. Which statement by the nurse is correct?
These drugs reduce either reuptake or degradation of the transmitter, causing an increase in receptor activation
A nurse is teaching a group of nursing students about neuropharmacology. Which statement by a student about peripheral nervous system (PNS) drugs indicates a need for further teaching?
Drugs affecting axonal conduction have a variety of uses
A nurse is preparing to administer a medication and learns that it is a nonselective agonist drug. What does the nurse understand about this drug?
It directly activates receptors to affect many physiologic processes
A patient has allergies and takes an antihistamine. The patient wants to know how the drug works. The nurse understands that antihistamines work because they are what?
A patient receiving botulinum toxin injections to control muscle spasticity asks how the drug works. The nurse knows that this drug affects the transmitter acetylcholine by?
inhibiting its release
A nurse is administering drug X to a patient. The drug information states that the drug acts by activating receptors in the peripheral nervous system by increasing transmitter synthesis. The nurse understands that the effect of this drug is to?
increase receptor activation
A patient receives morphine and shows signs of toxicity. The prescriber orders naloxone [Narcan] to reverse the effects of the morphine. The nurse understands that the naloxone reverses morphine toxicity by which action on morphine receptor sites?
Preventing activation of receptors
A nurse learns about a drug that interferes with transmitter storage in the PNS. The transmitter affected by this drug causes an increased heart rate. What response will the nurse expect to see when this drug is administered?
What is the target organ when a beta1 agonist is administered?
A nurse is teaching a group of nursing students about neurotransmitters. Which statement by a student about acetylcholine indicates a need for further teaching?
Its transmission is terminated by reuptake into the cholinergic nerve terminal
A nurse is administering an agonist drug that acts on postganglionic neurons of the sympathetic nervous system. Which response will the nurse expect to see?
Increased cardiac output
A nurse is teaching a patient about a medication that alters sympathetic nervous system functions. To evaluate understanding, the nurse asks the patient to describe which functions the sympathetic nervous system regulates. Which answer indicates the need for further teaching?
The digestive functions of the body
A patient is wheezing and short of breath. The nurse assesses a heart rate of 88 beats/minute, a respiratory rate of 24 breaths/minute, and a blood pressure of 124/78 mm Hg. The prescriber orders a nonspecific beta agonist medication. Besides evaluating the patient for a reduction in respiratory distress, the nurse will monitor for which side effect?
Many medications list side effects that include dry mouth, constipation, and urinary retention. What kinds of effects are these?
A patient is to receive a beta agonist. Before administration of this medication,which assessment finding would most concern the nurse?
Heart rate of 110 beats/minute
A nurse is explaining activation of beta2 receptors to nursing students during a clinical rotation at the hospital. Which statement by a student demonstrates a need for further teaching?
Beta2 activation results in contraction of uterine muscle
A pregnant patient is in premature labor. Which class of drug will she be given?
A prescriber has ordered bethanechol l[Urecholine] for a postoperative patient who has urinary retention. The nurse reviews the patient's chart before giving the drug. Which part of the patient's history would be a contraindication to using this drug?
An older adult patient who lives alone and is somewhat forgetful has an overactive bladder (OAB) and reports occasional constipation. The patient has tried behavioral therapy to treat the OAB without adequate results. Which treatment will the nurse anticipate for this patient?
Oxybutynin [Oxytrol] transdermal patch
A nurse is helping a nursing student who is administering a medication to a patient with myasthenia gravis. Which statement by the student indicates the need for further teaching?
I will let the patient sleep after giving the medication, because rest is important.
A patient is experiencing toxic side effects from atropine, including delirium and hallucinations. Which medication will the nurse expect to administer?
A prescriber has ordered pilocarpine [Pilocar]. A nurse understands that the drug stimulates muscarinic receptors and would expect the drug to have which action?
Lowering of intraocular pressure in patients with glaucoma
A nurse is caring for a patient who has myasthenia gravis. The prescriber has ordered neostigmine [Prostigmin]. An important initial nursing action before administration of the medication includes assessing?
A patient who has myasthenia gravis will be taking neostigmine [Prostigmin]. What will the nurse emphasize when teaching this patient about the medication?
Take a supplementary dose before exercise
A patient who has esophageal cancer is experiencing dry mouth and the provider orders oral pilocarpine to treat this symptom. What will the nurse expect to teach this patient about this medication?
You will begin taking 5 mg three times daily and may increase the dose to 10 mg
The nurse administers an adrenergic blocking agent in order to prevent release of what neurotransmitter?
What medication, if ordered for an 8-year-old patient, should the nurse question? (Select all that apply.)
- Amiodarone (Cordarone) 400 mg orally per 24 hours
- Labetalol (Normodyne) 100 mg orally b.i.d.
- Carvedilol (Coreg) 6.25 mg orally b.i.d.
A nurse is working with a patient who is taking an adrenergic blocking agent. While assessing the patients medication history, the nurse discovers that the patient takes several alternative therapies. What herb is the nurse concerned may interact with the adrenergic blocking agent and affect the patients blood glucose level?
A priority nursing assessment for a patient who is to receive an alpha- or beta adrenergic blocking agent would be what?
Assessing heart rate
Bisoprolol (Zebeta) would be the drug of choice for which patient with a diagnosis of hypertension?
A 69-year-old patient
What would be the teaching priority for a diabetic patient being treated with a nonselective beta-blocker?
To understand signs and symptoms of hypo- or hyperglycemic reaction
The nurse is caring for a patient who is receiving an adrenergic blocking agent. While writing the care plan for this patient what nursing diagnoses would be most appropriate concerning comfort?
Acute pain related to cardiovascular and systemic effects
A nurse is providing discharge instructions to a patient who is taking atenolol (Tenormin) to treat hypertension. What would the nurse teach the patient regarding a possible drug drug interaction?
Nonsteroidal anti-inflammatory drugs (NSAIDs)
A busy patient with many responsibilities is to have a medication ordered to treat her hypertension. To increase compliance with drug therapy, what drug would be a good choice for this patient?
The nurse provides patient teaching for a patient who has a new order for nadolol(Corgard) to treat hypertension. What statement by the patient concerning nadolol (Corgard) would indicate that the teaching has been effective?
I will not stop taking this drug abruptly and will talk to my doctor before discontinuing
A nursing student asks the nurse about receptor specificity of adrenergic agonist medications. What will the nurse say?
Specificity is relative and is dose dependent.
A nurse is teaching parents how to use an Epi-Pen for their child, who has a peanut allergy. Which statement by the parents indicates understanding of the teaching?
After using the Epi-Pen, we must go to the emergency department
A nursing student asks the nurse why epinephrine, and not other adrenergic agonists, is used to treat anaphylactic shock. What will the nurse tell the student?
Epinephrine has the ability to activate multiple types of adrenergic receptors
Dopamine is administered to a patient who has been experiencing hypotensive episodes. Other than an increase in blood pressure, which indicator would the nurse use to evaluate a successful response?
Increase in urine output
A nursing student asks why albuterol, which is selective for beta2 receptors, causes an increased heart rate in some patients. How should the nurse respond?
Adrenergic agonists can lose their selectivity when given at higher doses
Because they cause vasoconstriction, alpha1-adrenergic agonists are especially useful for?
causing hemostasis in skin and mucous membranes
A nurse is teaching a nursing student about the two classes of adrenergic agonist drugs. Which statement by the nursing student indicates understanding of the teaching?
Catecholamines often require continuous infusion to be effective
A patient with asthma uses albuterol [Ventolin] for wheezing. The nurse assesses the patient and notes vital signs of HR, 96 beats/minute; RR, 18 breaths/minute; and BP, 116/78 mmHg. The patient has clear breath sounds and hand tremors. What will the nurse do?
Ask the patient how often the inhaler is used
A nurse is administering intravenous dopamine [Intropin] to a patient inthe intensive care unit. Which assessment finding would cause the most concern?
Edema at the IV insertion site
A patient is receiving dobutamine [Dobutrex] as a continuous infusion in the immediate postoperative period. The patient also is receiving a diuretic. What adverse drug reactions are possible in this patient? Select all that apply?
A patient brought to the emergency department requires sutures. The prescriber orders a local anesthetic with epinephrine. The nurse understands that epinephrine is ordered to?
allow a reduced dose of the anesthetic
A patient is admitted to the intensive care unit for treatment of shock. The prescriber orders isoproterenol [Isuprel]. The nurse expects this drug to increase tissue perfusion in this patient by activating:
beta1 receptors to cause a positive inotropic effect
A patient with pheochromocytoma is admitted for surgery. The surgeon has ordered analpha blocking agent to be given preoperatively. What does the nurse understand about this agent?
It is ordered to prevent perioperative hypertensive crisis
A patient with type 1 diabetes is taking NPH insulin, 30 units every day. A nurse notes that the patient is also taking metoprolol [Lopressor]. What education should the nurse provide to the patient?
Metoprolol may mask signs of hypoglycemia, so you need to monitor your blood glucose closely."
A nurse is caring for a newborn 1 day after delivery. The infant's mother used betaxolol during pregnancy. The nurse will expect to monitor this infant for which condition?
A patient with migraines is started on a beta blocker. The nurse explains the benefits of taking the medication for migraines. Which statement by the patient indicates an understanding of the medication's effects?
I need to take it every day to reduce the frequency of migraines
A nurse is discussing phentolamine [OraVerse] with a nursing student. Which statement by the student indicates the need for further teaching?
Phentolamine is a competitive adrenergic agonist that acts selectively on alpha1 receptors
Which are conditions that may be treated using beta blockers? Select all that apply
a. Cardiac dysrhythmias
b. Heart failure
e. Stage fright
Which are adverse effects of alpha blockade? Select all that apply
b. Reflex tachycardia
c. Nasal congestion
The nurse is discussing home management with a patient who will begin taking an alpha adrenergic antagonist for hypertension. Which statement by the patient indicates understanding of the teaching?
I should take the first dose at bedtime
A nurse is teaching nursing students about the use of alpha-adrenergic antagonists. Which statement by a student indicates the need for further teaching?
Dilation of veins by alpha-adrenergic antagonists improves cardiac output
A patient taking a beta blocker complains of shortness of breath. The patient has respirations of 28 breaths/minute, a blood pressure of 162/90 mm Hg, and a pulse of 88 beats/minute. The nurse auscultates crackles in all lung fields. The nurse understands that these assessments are consistent with?
left-sided heart failure
A male patient is being treated for benign prostatic hyperplasia and has stopped taking his alpha-adrenergic antagonist medication because of ejaculatory difficulties. Which medication does the nurse expect the provider to prescribe?
A patient is taking a beta-adrenergic antagonist medication for angina pectoris and asks the nurse how the drug works to relieve the discomfort associated with this condition. Which statement by the patient after the nurse's teaching indicates understanding of the drug's effects?
It helps reduce the heart's oxygen needs
A patient will begin taking propranolol [Inderal] for hypertension. Which statement by the nurse is important when teaching this patient about the medication?
Check your hands and feet for swelling and report that to your provider
A patient who has been taking clonidine [Catapres] for several weeks complains of drowsiness and constipation. What will the nurse do?
Recommend that the patient take most of the daily dose at bedtime.
A prescriber has ordered methyldopa for a patient with hypertension. The nurse teaches the patient about drug actions, adverse effects, and the ongoing blood tests necessary with this drug. The nurse is correct to tell the patient what?
You will need to contact the provider and stop taking the medication if your eyes look yellow.
A prescriber has ordered clonidine [Catapres] for a patient who has hypertension. The nurse teaches the patient about side effects of this drug. Which statement by the patient indicates understanding of the teaching?
I should chew sugar-free gum or drink water to reduce dry mouth
A prescriber has ordered methyldopa for a female patient with hypertension. The nurse understands that which laboratory tests are important before beginning therapy with this drug? Select all that apply
b. Hemoglobin and hematocrit (H&H)
c. Liver function tests
A nurse is teaching nursing students about the pharmacology of methyldopa. Which statement by a student indicates the need for further teaching?
Methyldopa reduces blood pressure by reducing cardiac output
A patient complains to the nurse that the clonidine [Catapres] recently prescribed for hypertension is causing drowsiness. Which response by the nurse to this concern is appropriate?
Drowsiness is a common side effect initially, but it will lessen with time
A prescriber orders clonidine [Kapvay] ER tablets for a 12-year-old child. The nurse understands that this drug is being given to treat which condition?
A patient with hypertension has a previous history of opioid dependence. Which medication would the nurse question?
Clonidine is approved for the treatment of which conditions? Select all that apply
d. Severe pain
A prescriber orders transdermal clonidine [Catapres TTS] for a patient with hypertension. What will the nurse teach this patient?
To change the patch every week
A nurse is teaching a patient about a new prescription for reserpine [Serpasil] for hypertension. Which statement by the patient indicates the need for further teaching?
Depressive side effects are common and will improve over time
A nurse prepares to administer propranolol [Inderal] to a patient recovering from acute myocardial infarction. The patient's heart rate is 52 beats/minute, and the rhythm is regular. What action should the nurse take next?
Withhold the dose and notify the prescriber
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