Normal Sinus
The nurse caring for a 92-year-old patient with pneumonia who is receiving IV carefully monitors the flow rate of the IV infusion because rapid infusion can cause:
heart failure.
A patient is prescribed a bile acid resin. The nurse instructs the patient to report which adverse reaction related to vitamin K deficiency?
Coffee-ground emesis
A patient with a body mass index (BMI) of 25 would be considered to be in which weight category?
Overweight
Hydralazine, a direct vasodilator, is used to treat hypertension associated with which condition?
Renal disease
The nurse is preparing medications for a patient. When is the best time for the nurse to administer lovastatin (Mevacor)?
During the patient's dinner
The nurse is preparing to assess blood pressure on a patient who has had two prior readings of 160/100. Physician's notes from a prior visit indicate that the patient is suspected to have hypertension. When reassessing this patient for hypertension, the nurse will do what? (Select all that apply.)
Choose a cuff encircling at least 80% of the arm./Support patient's arm at heart level./Encourage patient to sit quietly for 5 minutes before assessing blood pressure.
Which is the mechanism of action demonstrated by exercise in managing blood glucose levels?
Increased muscle mass and less fat tends to normalize blood glucose levels because glucose is used by muscle cells when exercising.
Which nutritional concept(s) is/are necessary to provide to patients receiving colestipol? (Select all that apply.)
Adequate fluid and fiber in the diet will help prevent constipation, as well as additional expected GI adverse effects. High doses of resins may reduce absorption of fat-soluble vitamins; this interaction is not usually significant in normally nourished patients. If these severe symptoms appear, they should be reported to the healthcare provider. Patients who are taking bile acid-sequestering resins may require supplemental fat-soluble vitamin therapy (A, D, E, K). The recommended time of administration is with meals, but this may be modified to avoid interference with absorption of other medications. Constipation is a more likely adverse effect than loose stools.
The nurse identifies the "LUBB" sound of the "LUBB/DUBB" of the cardiac cycle as the sound of the:
AV valves closing.
A patient is taking a HMG-CoA reductase inhibitor and reports muscle aches, soreness, and weakness. The nurse suspects these symptoms to indicate early signs of myopathy. When notifying the physician of these symptoms, the nurse will also be sure to report the results of the patient's:
serum creatinine phosphokinase levels.
A patient's blood pressure is 134/78 mm Hg. The nurse records the pulse pressure as:
56.
If blood pressure is 120/70, what is the MAP?
86.66
The nurse is preparing to assess blood pressure on a patient who has had two prior readings of 160/100. Physician's notes from a prior visit indicate that the patient is suspected to have hypertension. When reassessing this patient for hypertension, the nurse will do what? (Select all that apply.)
Choose a cuff encircling at least 80% of the arm./Support patient's arm at heart level./Encourage patient to sit quietly for 5 minutes before assessing blood pressure.
The nurse is providing education to a patient who has recently been prescribed niacin. Which information given by the nurse is accurate?
"Nausea can be decreased if you take this medication with food."
Which is true about postural hypotension during therapy with direct vasodilators?
It gradually resolves with continued medication use.
Which physiologic response will the nurse expect to assess in patients taking hydralazine (Apresoline)?
Tachycardia
The nurse points out which of the following as modifiable risks for coronary artery disease (CAD)? (Select all that apply.)
Diabetes mellitus/Smoking/Hypertension/Hyperlipidemia
A patient recently prescribed felodipine (Plendil) for treatment of hypertension is experiencing dizziness when rising to a standing position. Which action will the nurse take?
Encourage the patient to sit down if feeling faint.
A teaching plan for a patient with hyperlipidemia would instruct the patient to avoid which food(s)? (Select all that apply.)
Hard cheeses/Liver
In addition to controlling hyperlipidemia, what are bile acid-binding resins prescribed to treat?
Pruritus secondary to biliary stasis
The nurse is assessing a patient who is being evaluated for hyperlipidemia. Which assessment will most increase the risk of coronary artery disease (CAD)?
Blood pressure, 168/90 mm Hg
The nurse is providing instruction to a patient who was recently prescribed an ACE inhibitor for hypertension. Which is an adverse effect of this medication?
Chronic cough
Which lipoprotein contributes to the development of atherosclerosis?
Low-density lipoprotein chylomicron (LDL C)
Which statement(s) concerning the use of antihypertensive therapy for the treatment of hypertension would be considered true? (Select all that apply.)
Diuretics are the most commonly prescribed antihypertensive agent./Diuretics are often prescribed in combination therapy with other antihypertensive agents.
A patient asks the nurse how amlodipine (Norvasc) works to reduce the blood pressure. Which response will the nurse provide?
"It causes blood vessel dilation."
A patient who has just begun taking an angiotensin converting enzyme (ACE) inhibitor calls the nurse and reports feeling very dizzy when standing up and asks if the medication should be discontinued. What is the nurse's best response?
"Rise to a sitting or standing position slowly; your symptoms will resolve."
Healthy diets should include no more than which percentage of saturated fat based on total calories?
A healthy diet should have no more than 7% of calories from saturated fat. A diet with 30% or 10% saturated fat would not be considered a healthy diet. A diet can have up to 7% saturated fat before it is considered unhealthy.
Prior to the administration of a beta-adrenergic blocker, the nurse notes the patient to have a heart rate of 52 beats/min, peripheral edema, crackles in the bases of the lungs, and mottled skin. Which is the priority nursing action?
Withhold the medication and notify the healthcare provider.
The nurse is explaining to a patient how ACE inhibitors affect blood pressure. Which statement accurately describes the action of these medications?
They inhibit vasoconstriction.
What lifestyle choice(s) may aggravate metabolic syndrome? (Select all that apply.)
Excessive tobacco smoking/Excessive consumption of alcohol
Which medication is often administered with hydralazine to reduce reflex physiologic responses to the drug?
Beta blockers
Which vitamin has antilipemic actions?
B3
a. Right atrium
b. Pulmonary artery
c. Tricuspid valve
d. Right ventricle
e. Superior and inferior vena cava
f. Pulmonary vein
g. Left atrium
h. Mitral valve
i. Left ventricle
j. Lungs
E, A, C, D, B, J, F, G, H, I
The blood travels through the vena cava to the right atrium, through the tricuspid valve to the right ventricle, through the pulmonary artery to the lungs. The pulmonary veins deliver the blood to the left atrium, then through the mitral valve to the left ventricle and out the aorta to the body.
Trace the impulse pattern of conduction in sequence through the heart. (Separate letters by a comma and space as follows: A, B, C, D)
a. Atrial wall
b. Atrial-ventricular (AV) node
c. Purkinje fibers
d. Sinoatrial (SA) node
e. Bundle branches
f. Bundle of His
B, A, D, F, E, C
The conduction begins with the impulse from the SA node that travels down the atrial wall to the AV node, to the Bundle of His, to the bundle branches, and finally to the Purkinje fibers.
How does propranolol (Inderal) control hypertension?
Reduces the sympathetic stimulation in cardiac muscle.
The nurse has completed an admitting patient history and notes the patient's current medications to be simvastatin (Zocor) and warfarin (Coumadin). What is the result of the interaction of these drugs?
Increased INR
The nurse is preparing medications for a patient. When is the best time for the nurse to administer lovastatin (Mevacor)?
During the patient's dinner
Which common adverse effect of an angiotensin II receptor antagonist will the nurse expect to assess in a patient?
Headache
Which nursing assessment confirms that the angiotensin II receptor blocker (ARB) that a patient is taking is effective?
Blood pressure has decreased.
Why are statins, or HMG-CoA reductase inhibitors, administered at bedtime?
Cholesterol production is at its peak.