Pharm Review Endocrine & Cardio Meds

Endocrine

100

The thyroid gland performs many functions related to which of the following? (Select all that apply)

A. Potassium balance
B. Calcium balance
C. Metabolic rate

Answers:

• B. Calcium balance
• C. Metabolic rate

200

Levothyroxine is used for which of the following conditions? (Select all that apply)

A. Hypothyroidism
B. Hyperthyroidism

Correct Answers:

• A. Hypothyroidism
  • Rationale: Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism by replacing the deficient hormones in the body.

300

What is the recommended time to take Levothyroxine?

A. In the morning on an empty stomach
B. Before bedtime

Recommended Time to Take Levothyroxine:

• A. In the morning on an empty stomach
  • Rationale: Levothyroxine should be taken in the morning on an empty stomach, ideally 30-60 minutes before breakfast, to enhance absorption.

400

What can happen if a client has been prescribed levothyroxine and an oral anticoagulant?
A. Prolonged bleeding
B. Decreased clotting factor production
C. Increased risk of thrombosis

• A. Prolonged bleeding

  • Rationale: Levothyroxine can enhance the effects of oral anticoagulants by increasing the metabolism of clotting factors, leading to a higher risk of bleeding.

500

What can happen if a client has been prescribed levothyroxine and an oral antidiabetic medication?
A. Increased risk of hyperglycemia
B. Decreased insulin sensitivity
C. Enhanced glycemic control

A. Increased risk of hyperglycemia

• Rationale: Levothyroxine may increase insulin resistance, which can lead to elevated blood glucose levels, especially in clients taking oral antidiabetic medications.

Endocrine 2

100

Methimazole and Propylthiouracil are used for which of the following conditions?

A. Hypothyroidism
B. Hyperthyroidism

Correct Answers:

• B. Hyperthyroidism

  • Rationale: Methimazole and propylthiouracil are antithyroid medications used to treat hyperthyroidism by inhibiting the production of thyroid hormones.

• 
  

200

What is a severe reaction associated with these medications Methimazole and Propylthiouracil?

A. Nausea and vomiting
B. Agranulocytosis

 

A. Agranulocytosis

• Rationale: A severe reaction associated with these medications is agranulocytosis, which is a potentially life-threatening decrease in white blood cell count, increasing the risk of infection.

300

Which of the following statements about agranulocytosis is true?

A. It is an increase in white blood cell count, indicating infection.
B. It is a life-threatening condition characterized by a severe decrease in white blood cell count.
C. It is commonly caused by viral infections.
D. It can be easily treated with antibiotics alone.

Which of the following statements about agranulocytosis is true?

A. It is an increase in white blood cell count, indicating infection.
B. It is a life-threatening condition characterized by a severe decrease in white blood cell count.
C. It is commonly caused by viral infections.
D. It can be easily treated with antibiotics alone.

Example:
A patient taking methimazole for hyperthyroidism presents with a sore throat and fever. Laboratory tests show a white blood cell count of 2,000 cells/mm³ (normal range: 4,500-11,000 cells/mm³).

What should the nurse suspect?

Correct Answers:

• B. It is a life-threatening condition characterized by a severe decrease in white blood cell count.
  • Rationale: Agranulocytosis is indeed a severe condition that leads to a critically low white blood cell count, increasing the risk of serious infections.

400

Newly Prescribed Thyroid Supplement: Onset of Effect

How long does it typically take for a newly prescribed thyroid supplement to take effect?

a. Immediately

b. Several weeks or longer

Answer:B. Several weeks or even longer for a therapeutic response.

500

Which of the following should the nurse include in patient teaching for someone taking thyroid supplements? (Select all that apply)

A. Monitor for signs of hyperthyroidism, such as increased heart rate and anxiety.
B. Take the medication with food to improve absorption.
C. Report any unusual symptoms or side effects to the healthcare provider.
D. Continue taking the medication even if you feel well.

Correct Answers:

• A. Monitor for signs of hyperthyroidism, such as increased heart rate and anxiety.

  • Rationale: Patients should be educated on potential side effects of excessive thyroid hormone levels.

• C. Report any unusual symptoms or side effects to the healthcare provider.

  • Rationale: Patients should be encouraged to communicate any concerning symptoms for proper management.

• D. Continue taking the medication even if you feel well.

  • Rationale: Consistent medication adherence is essential for maintaining stable hormone levels, even if the patient feels better.

Cardio

100

Nitroglycerin is prescribed to relieve which of the following? (Select all that apply)

A. Epigastric pain
B. Acute anginal attacks
C. Prevent angina attacks

Correct Answers:

• B. Acute anginal attacks

  • Rationale: Nitroglycerin is primarily used to provide rapid relief of acute anginal pain by dilating blood vessels and improving blood flow to the heart.

• C. Prevent angina attacks

  • Rationale: Nitroglycerin can also be used in a long-acting formulation to help prevent angina attacks, allowing patients to engage in activities that may otherwise trigger symptoms.

200

Teaching Patients About Antihypertensive Drugs

Do we tell patients to continue the medication or discontinue it if their blood pressure improves due to medication use?  

A. Continue the medication

B. Discontinue the medication regimen

• Answer: Continue the medication.

300

True or False

Antihypertensive drug therapy is often a lifelong commitment for patients with hypertension.

True

• Rationale: Most patients with hypertension require long-term medication to maintain blood pressure control and reduce the risk of complications.

400

Which of the following statements about antihypertensive medications is correct?

A. Patients should stop taking their antihypertensive medication if their blood pressure readings are consistently normal.
B. It is essential for patients to take their antihypertensive medications as prescribed, even if they feel well.
C. Antihypertensive medications are only necessary during times of high blood pressure.
D. All patients can discontinue antihypertensive medication after six months of treatment.

orrect Answer:

B. It is essential for patients to take their antihypertensive medications as prescribed, even if they feel well.

• Rationale: Consistent adherence to medication is crucial for maintaining blood pressure control and preventing complications, regardless of how the patient feels.

500

Priority Assessment for Antianginal Drugs: Pain Assessment

Which of the following should be the nurse's priority assessment when caring for a client with anginal pain?

A. Determine the client's ideas regarding the cause of the pain and remedies they have used.
B. Immediately administer nitroglycerin without further assessment.
C. Assess the client's vital signs and perform an ECG.
D. Instruct the client to rest and avoid any activity

Correct Answer:

• A. Determine the client's ideas regarding the cause of the pain and remedies they have used.
  • Rationale: Prioritizing the client's perspective on their pain is essential for understanding its underlying causes and tailoring effective treatment. This assessment helps identify potential triggers and remedies the client has already tried, guiding the development of an individualized care plan.

Cardio 2

100

What interventions can the nurse implement to reduce the risk of falls in patients on antihypertensive medications?

A. Encourage patients to get up quickly after sitting or lying down.
B. Educate patients on the importance of slowly changing positions.
C. Advise patients to avoid taking their medications to prevent dizziness.
D. Recommend that patients do not engage in any physical activity.

Correct Answer:

• B. Educate patients on the importance of slowly changing positions.
  • Rationale: Educating patients on slowly changing positions helps minimize the risk of orthostatic hypotension and associated falls. Quick movements can exacerbate dizziness and increase fall risk.

200

How can the nurse assess a patient for orthostatic hypotension when they are taking antihypertensive medications?

A. Measure blood pressure and heart rate while the patient is lying, sitting, and standing.
B. Rely solely on the patient's verbal report of dizziness.
C. Check the patient’s blood pressure only when they feel faint.
D. Assess blood pressure at the same time each day without position changes.

Correct Answer:

• A. Measure blood pressure and heart rate while the patient is lying, sitting, and standing.
  • Rationale: Assessing blood pressure and heart rate in different positions helps identify orthostatic hypotension and determine if the patient is at risk for falls due to antihypertensive medications.

300

Nursing Diagnosis for Patients on Antihypertensive Medication Select all that apply- Think Priority 

a. Risk for Falls

b. Risk for trauma

c. Risk for injury

Nursing Diagnosis for Patients on Antihypertensive Medication

Nursing Diagnosis:
Risk for Falls & Risk for Trauma & risk for injury 

Why?
Patients on antihypertensive medications are at risk for falls, trauma, injury due to potential side effects such as dizziness, lightheadedness, and orthostatic hypotension (a significant drop in blood pressure when standing). This risk increases if patients do not adequately adjust to changes in position or if they experience fluctuations in blood pressure

400

Questions about Lisinopril Use and Patient Teaching

1. What dietary teaching should the nurse provide to a client prescribed lisinopril?

   A. The client can use any salt substitute without restrictions.
   B. The client should avoid salt substitutes unless a specific brand is approved by their healthcare provider.
   C. The client can increase sodium intake to counteract medication effects.
   D. The client should follow a strict vegetarian diet.

Correct Answer:

• B. The client should avoid salt substitutes unless a specific brand is approved by their healthcare provider.
  • Rationale: Some salt substitutes contain potassium, which can be dangerous for patients on lisinopril, as this medication can increase potassium levels. It's important for clients to consult with their healthcare provider before using any substitutes.

500

Which safety methods should the nurse teach a client at risk for orthostatic hypotension while taking lisinopril?

A. Encourage the client to rise quickly from a sitting or lying position.
B. Advise the client to stay hydrated and change positions slowly.
C. Instruct the client to avoid all physical activity to prevent falls.
D. Suggest that the client should only take their medication if they feel faint.

B. Advise the client to stay hydrated and change positions slowly.

• Rationale: Educating the client about staying hydrated and changing positions slowly helps prevent orthostatic hypotension, which can cause dizziness and increase the risk of falls.

Cardio 3

100

Multiple Choice Questions on Warfarin Therapy

1. Which of the following statements about warfarin therapy in pregnant women is correct?

   A. Warfarin is safe for all pregnant women.
   B. Warfarin is contraindicated in pregnant women, except for those with mechanical heart valves.
   C. Warfarin can be used during the first trimester without risk.
   D. Warfarin has no effects on fetal development.

Correct Answer:

• B. Warfarin is contraindicated in pregnant women, except for those with mechanical heart valves.
  • Rationale: Warfarin poses a significant risk of fetal harm during pregnancy; however, it may be prescribed to pregnant women with mechanical heart valves due to the increased risk of thromboembolic events.

200

What is the primary reversal agent for warfarin, and when might fresh frozen plasma be considered?

A. Vitamin K; for urgent reversal of warfarin effects.
B. Fresh frozen plasma; to prevent bleeding complications.
C. Prothrombin complex concentrate; only if the INR is above 4.0.
D. Vitamin K; when the INR is within the therapeutic range.

Correct Answer:

• A. Vitamin K; for urgent reversal of warfarin effects.
  • Rationale: Vitamin K is the primary reversal agent for warfarin. Fresh frozen plasma may be used if there is an urgent need to reverse the anticoagulant effects, especially in cases of life-threatening bleeding.

300

In which of the following conditions is warfarin contraindicated?

A. Patients with stable cardiovascular conditions.
B. Patients with mechanical heart valves.
C. Patients with recent or planned surgery of the central nervous system or eye.
D. Patients with a history of hypertension.

Correct Answer:

• C. Patients with recent or planned surgery of the central nervous system or eye.
  • Rationale: Warfarin is contraindicated in patients who have undergone or are planning surgery in sensitive areas such as the central nervous system or eye due to the increased risk of significant bleeding.

400

Which of the following statements regarding atorvastatin is correct?

A. Muscle pain is a common side effect, and liver enzyme elevation is a potential complication of atorvastatin therapy.
B. Atorvastatin can be safely taken with grapefruit juice, as it enhances the medication's effectiveness.
C. Rhabdomyolysis is a benign condition that rarely occurs with atorvastatin use.
D. Hepatotoxicity is a common side effect that requires no monitoring of liver enzymes.

Correct Answer:

• A. Muscle pain is a common side effect, and liver enzyme elevation is a potential complication of atorvastatin therapy.
  • Rationale: Muscle pain is a known side effect of atorvastatin, and liver enzyme elevation can occur as a complication. These side effects need to be monitored regularly to prevent serious complications.
  • 
    
  • Incorrect Answers:

  • B. Atorvastatin can be safely taken with grapefruit juice, as it enhances the medication's effectiveness.

    • Rationale: Grapefruit juice should be avoided with atorvastatin because it can increase drug levels in the body, leading to a higher risk of side effects and complications.

  • C. Rhabdomyolysis is a benign condition that rarely occurs with atorvastatin use.

    • Rationale: Rhabdomyolysis is a serious condition that can occur as a result of atorvastatin therapy, characterized by muscle breakdown that can lead to kidney damage.

  • D. Hepatotoxicity is a common side effect that requires no monitoring of liver enzymes.

    • Rationale: Hepatotoxicity can occur with atorvastatin use, so it is important to monitor liver enzymes regularly to catch any signs of liver damage early.

500

Which of the following statements should patients taking warfarin be advised to follow? (Select all that apply)

A. Tell all healthcare professionals and dentists that they are taking warfarin, especially before surgery or dental procedures.
B. Use electric razors instead of straight razors.
C. Carry identification stating that they are taking warfarin.
D. Notify their provider immediately if any unusual bleeding or symptoms occur, such as pain, swelling or discomfort, prolonged bleeding from cuts, increased menstrual flow or vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or dark brown urine, red or tar black stools, headache, dizziness, or weakness.
E. Discontinue warfarin if they experience any side effects without consulting their healthcare provider.

Correct Answers:

• Rationale:
  • A. Informing healthcare providers and dentists about warfarin use is crucial to prevent potential interactions or complications during procedures.
  • B. Using electric razors reduces the risk of cuts and bleeding, which is important for patients on anticoagulant therapy.
  • C. Carrying identification helps emergency personnel recognize the patient’s anticoagulation status, which is vital during emergencies.
  • D. Prompt reporting of unusual bleeding or other concerning symptoms allows for timely evaluation and management, reducing the risk of serious complications.