Blood
A patient is newly diagnosed with hypertension. After several months of diet and exercise changes, the patient’s blood pressure has not improved. Which of the following antihypertensive medications would the nurse expect to be prescribed first?
A. Diuretic
B. Calcium channel blockers
C. Vasodilator
D. Angiotensin II receptor blocker
A. Diuretic
Your patient has been taking benazepril for 30 days. Which of the following lab values reflective of the patient’s health status may require a change in medication?
A. BUN: 17
B. Creatinine: 107
C. AST: 12
D. Potassium: 4.2
E. Magnesium: 1.8
B. Creatinine: 107
What do cardiac glycosides do? SATA
a. Make heart contract more forcefully
b. Make heart beat slower
c. Make heart beat faster
d. Make heart contract less forcefully
a. Make heart contract more forcefully
b. Make heart beat slower
A nurse has just given a patient an antiarrhythmic drug, after he presented to the ER with afib. What is the next best action by the nurse?
Place the patient on a cardiac monitor.
Nancy has been prescribed amlodipine (calcium channel blocker) three months ago and is returning for a check-up appointment. Which adverse effect should the nurse assess for?
A. Tachycardia
B. Edema in the lower legs
C. Shortness of breath
D. Frequent episodes of nausea
B. Edema in the lower legs
Fill in the blanks: Angiotensin II causes ___________ of the vessels and triggers the release of ____________.
A. vasodilation; anti-diuretic hormone (ADH)
B. vasodilation; aldosterone
C. vasoconstriction; aldosterone
D. vasoconstriction; anti-diuretic hormone (ADH)
C. vasoconstriction; aldosterone
A nurse is examining charts for several patients that have been newly prescribed mild diuretics and RAAS antihypertensive medications. Which of the following patient symptamology would cause the nurse to recommend a different therapeutic regime? Select all that apply
A. Patient A has frequent episodes of diarrhea
B. Patient B works in a hot factory that causes him to excessively sweat
C. Patient C has suffered from alcoholism for three years
D. Patient D has two large meals a day
E. Patient E’s favorite drink is grapefruit juice
A. Patient A has frequent episodes of diarrhea
B. Patient B works in a hot factory that causes him to excessively sweat
C. Patient C has suffered from alcoholism for three years
Before administering digoxin, what is the nurse's priority assessment?
Take the apical pulse for a full 60 seconds.
What should the HR be above?
What is the class III antiarrhythmic medication (amiodarone) indicated for?
a. SVT
b. PVC’s
c. Afib
d. Hypotension
c. Afib
A nurse is preparing to administer a cardiotonic agent. Which of the following assessment findings would require the nurse to hold the medication and contact the physician?
a. Temperature 98.5°F
b. 18 breaths/min
c. BP 95/50
d. HR 85bpm
e. A/O x3
c. BP 95/50
Which patient below would MOST benefit from an ACE Inhibitor?
A. A 50-year-old female with systolic dysfunction heart failure.
B. A 48-year-old male with severe renal failure.
C. A 35-year-old female with chronic hepatitis.
D. A 54-year-old male with hypovolemic shock.
A. A 50-year-old female with systolic dysfunction heart failure.
Your patient has been prescribed losartan for treatment of his stage II hypertension. Which of the following nursing diagnoses are appropriate for patient’s taking losartan?
A. Poor gas exchange due to unrelenting cough
B. Poor perfusion due to decreased cardiac output
C. Impaired mental state due to dizziness and syncope
D. Sillyness as evidenced by silly
B. Poor perfusion due to decreased cardiac output
Which of the following cardiotonic agents improve contractility by increasing cellular calcium levels in the heart? SATA
a. Phosphodiesterase inhibitors
b. ACE Inhibitors
c. Hyperpolarization-Activated Cyclic Nucleotide-Gated Channel Blockers (HCN)
d. Cardiac glycosides
a. Phosphodiesterase inhibitors
d. Cardiac glycosides
Procainamide can not be taken with (SATA):
a. A full glass of grapefruit juice
b. A full glass of water
c. A full glass of milk
d. A full glass of nursing student’s tears
a. A full glass of grapefruit juice
c. A full glass of milk
Sodium channel blockers are considered which class of antidysrhythmic drugs?
A. Class III
B. Class II
C. Class IV
D. Class I
D. Class I
A patient states they are experiencing an annoying, persistent dry cough that started once they begin taking an ACE Inhibitor. The patient is not experiencing any other signs and symptoms. As the nurse, your response is?
A. Tell the patient to immediately stop taking the medication and seek medical treatment.
B. Reassure the patient this is a harmless side effect of this medication and to not abruptly stop taking the medication.
C. Recommend the patient start taking the medication at night to decrease the coughing.
D. Reassure the patient that the cough will disappear within 6 months of taking the medication.
B. Reassure the patient this is a harmless side effect of this medication and to not abruptly stop taking the medication.
A patient calls your office to discuss some concerning symptoms they have had since beginning ARB therapy for their stage 1 hypertension. Which of the following symptoms would cause the nurse to advise the patient to contact their PCP? Select all that apply
A. fever
B. persistent cough
C. dry skin
D. abdominal pain
E. decreased urine output
A. fever
B. persistent cough
E. decreased urine output
True or false?
A patient who was placed on digoxin for heart failure is complaining of increased urinary frequency. This is an abnormal finding for a patient on this medication.
False
A nurse finds Mr. Johnson very upset in his room. He says he is irritated by all of the tubes and medications he has been taking. The nurse begins explaining what all of the medications are for. When she gets to his digoxin IV drip, she explains he is getting it for his:
a. Bradycardia
b. Sustained hypertension
c. Recurrent PVC’s
d. Loudness
c. Recurrent PVC’s
You are preparing to teach a client about their new BP medication therapy. Which of the following is important to include in your teaching?
A. “Now that you have these medications, you can return to your poor lifestyle and diet choices”
B. “If you experience adverse reactions, stop taking the medication and call your provider”
C. “It is important you take your medication every day at the same time”
D. “I hope you operate heavy machinery because this medication will have no effect on you”
C. “It is important you take your medication every day at the same time”
You’re providing discharge instructions to a patient that will be taking aliskiren and spironolatone at home. Which statements by the patient demonstrate they understood your discharge instructions? Select all that apply:
A. “If I feel unwell, it is okay that I miss a dose.”
B. “I will avoid using salt substitutes that contain potassium.”
C. “I will ensure to get my potassium levels periodically examined”.
D. “I will regularly check my blood pressure and pulse rate while taking this medication and report any significant changes to my doctor.”
B. “I will avoid using salt substitutes that contain potassium.”
C. “I will ensure to get my potassium levels periodically examined”.
D. “I will regularly check my blood pressure and pulse rate while taking this medication and report any significant changes to my doctor.”
You are caring for a patient that has recently been prescribed combination therapy (RAAS drug and a diuretic) for their treatment of diabetes and hypertension. Your patient is confused and asks you why they have to take so many medications. What benefits do would this patient receive with combination therapy? Select all that apply
A. Reduction in fluid volume leading to decreased workload for their heart
B. Fewer adverse effects
C. Slowed progression of damage to the arteries in the kidneys and eyes
D. Improved electrolyte and acid-base balance
E. Early combination therapy may reverse diabetes diagnosis
A. Reduction in fluid volume leading to decreased workload for their heart
C. Slowed progression of damage to the arteries in the kidneys and eyes
A nurse is assessing a patient who has been taking a cardiac glycoside. Which of the following symptoms indicate the patient has toxic levels of this drug in their bloodstream?
a. Depression
b. Nausea
c. Heart arrhythmias
d. Anorexia
e. Blurred vision
a. Depression
b. Nausea
c. Heart arrhythmias
d. Anorexia
What are these combination of symptoms called?
Before administering a dose of an antidysrhythmic drug to a patient, what is the priority nursing assessment?
A. Measure urine output and specific gravity.
B. Check apical pulse and blood pressure.
C. Evaluate peripheral pulses and level of consciousness.
D. Obtain temperature and pulse oximetry on room air.
B. Check apical pulse and blood pressure.
Select all the pharmacodynamic effects of angiotensin II receptor blockers (ARBs):
A. Vasodilation
B. Vasoconstriction
C. Sodium conservation
D. Sodium excretion
E. Water conservation
F. Water excretion
A. Vasodilation
D. Sodium excretion
F. Water excretion