More Cardiac
A nurse is caring for a client who is taking digoxin (Lanoxin) 0.25mcg tab once a day. The client suddenly complaints of anorexia, nausea, vomiting, and diarrhea. The physician is ruling a digoxin toxicity. As a nurse, you know the therapeutic digoxin rate is?
A. 0.25-0.5 ng/ml
B. 0.5-2 ng/ml
C. 1.5-3 ng/ml
D. 3.5-4.5 ng/ml
0.5-2 ng/ml
The therapeutic level of digoxin is 0.5-2 ng/ml. Levels of toxic concentrations are anything higher than 4.0 ng/mL. Signs and symptoms of digoxin toxicity include abdominal pain, anorexia, visual disturbances, nausea, vomiting, and arrhythmias.
Which of the following would be most concerning with the use of montelukast?
Ringing in the ears
Psychiatric changes
Excessive fatigue
Blood loss
Psychiatric changes
What class of anti-infectives are known to cause loss of hearing?
Aminoglycosides
Fluoroquinolones
Penicillins
Cephalosporins
Aminoglycosides
Which of the following deficiencies could result from the use of metformin?
Vitamin D
Vitamin C
B12
Niacin
B12
A client with bipolar disorder experiences extreme mania. Which medication should the nurse expect to be prescribed for this client?
Lithium
Lorazepam
Trazodone
Methylphenidate
Lithium
This answer is correct because lithium is an antimanic, mood-stabilizer medication used to control manic episodes associated with bipolar disorder..
A nurse is providing instructions to a client who is receiving warfarin sodium (Coumadin). Which statement made by the client indicates the need for further instruction?
A. "I will observe the color of my urine and stool".
B. "I will take Ecotrin (Enteric-coated aspirin) for my headaches".
C. "I will avoid drinking alcohol".
D. "I will use a hair removing cream on my legs".
“I will take Ecotrin (Enteric-coated aspirin) for my headaches”.
Ecotrin is an aspirin-containing product and should be avoided due to the risk of bleeding.
Which of the following would be least associated with theophylline toxicity?
Edema
Anxiety
Tachycardia
Tremor
Edema
A 44 year old female with a history of hypertension (on lisinopril) has developed a skin infection and has been prescribed Bactrim. Which electrolyte abnormality would you be concerned about with this combination of medications?
Hyponatremia
Hypernatremia
Hypokalemia
Hyperkalemia
Hyperkalemia
Which diabetes medication is most likely to cause hypoglycemia when used as monotherapy (by itself)?
Metformin
Empagliflozin
Semaglutide
Glipizide
Glipizide
Mr. Thomas was prescribed lamotrigine by their neurologist. They can't recall what side effects are associated with this medication. What adverse effect would be most important for the nurse to educate them about?
Edema
Rash
Hyperkalemia
Weight gain
Lamictal
Rash
As a knowledgeable nurse, you know that the action of nitrates is:
A. Smooth muscle contraction
B. Vasoconstriction
C. Smooth muscle relaxation
D. Increase preload
Smooth muscle relaxation
Nitrates cause smooth muscle relaxation, vasodilation, reduction of preload, and improved blood flow to the myocardium. Nitrates exert their pharmacological effect by being activated by mitochondrial or cytosolic aldehyde dehydrogenase (ALDH2) into nitric oxide (NO), an endothelium-derived relaxing factor (EDRF). NO is generally produced by the endothelium to dilate the blood vessels; however, endothelial dysfunction in diseases such as atherosclerosis can deplete NO levels. Other choices have the opposite effect of nitrates.
Your patient is taking budesonide (inhalation via nebulized formulation) for asthma. Which of the following education points is incorrect?
Budesonide can increase the risk for thrush
Budesonide is an appropriate choice for reducing asthma attacks
Rinsing the mouth after administration is recommended
It is long acting beta-agonist
Pulmicort
It is long acting beta-agonist
A 7-year-old boy is going to start amoxicillin/clavulanate for his ear infection. Which patient education point would be most appropriate to tell his mother?
Contact the clinic within 12-24 hours if there is no improvement in ear pain
Educate about the adverse effect of ringing in the ears
Recommend that the medication should not be taken with milk
Provide education about the potential for diarrhea as an adverse effect
Provide education about the potential for diarrhea as an adverse effect
You are meeting with a patient today and he describes significant nausea. He thinks it is his diabetes medications that are causing this. Which medication would you likely suspect is causing this?
Glipizide
Insulin glargine
Dapagliflozin
Liraglutide
Liraglutide
A client is prescribed a monoamine oxidase inhibitor (MAOI) for severe depression. Which teaching should the nurse include? Select all that apply.
It is important to get weekly medication levels drawn since MAOIs have a narrow therapeutic range.
Check with your health care provider (HCP) before taking any other prescription medications or OTC medications
Avoid salt substitutes while on this medication
This class of medication has a high propensity for addiction
Avoid foods that have high levels of tyramine such as aged meats, cheeses, and wine.
Check with your health care provider (HCP) before taking any other prescription medications or OTC medications
Avoid foods that have high levels of tyramine such as aged meats, cheeses, and wine.
This answer is correct because many interactions exist among MAOIs and other drugs including herbal remedies. The HCP must be informed of the complete list of medications the client is on prior to prescribing an MAOI for depression. A special diet must also be followed while on a MAOI.
A special diet must be followed while on a MAOI. Foods high in tyramine can cause a potential hypertensive crisis when combined with an MAOI medication. Examples of these foods include aged cheeses, smoked and processed meats and red wine.
ß blockers should be avoided in which of the following conditions?
A. Bronchoconstriction
B. Hypertension
C. Angina
D. Myocardial infarction
Bronchoconstriction
ß blockers should be avoided in bronchoconstrictive disease. Traditionally, beta-blockers have been contraindicated in asthmatic patients. However, recommendations have aligned for allowing cardio-selective beta-blockers, also known as beta-1 selective, in asthmatics but not non-selective beta-blockers.
Nurse Karen is reviewing the medical history of a patient with chronic obstructive pulmonary disease (COPD) who has been prescribed Ipratropium (Combivent). She becomes concerned about the prescription upon discovering which of the following in the patient's history?
A. An allergy to eggs.
B. A previous infection.
C. A history of smoking.
D. An allergy to peanuts.
D. An allergy to peanuts.
An allergy to peanuts. Ipratropium (Combivent) is a combination medication that contains both Ipratropium bromide and Albuterol, which are used to manage symptoms in patients with chronic obstructive pulmonary disease (COPD). Historically, some formulations of Ipratropium inhalers used soya lecithin as a propellant, which is related to peanuts. Patients with a peanut allergy could have a severe allergic reaction (anaphylaxis) if they used these inhalers. Although modern formulations may no longer contain this ingredient, the concern remains, and it is critical to confirm that the patient does not have a peanut allergy before administering the medication.
JZ is a 29 year old female presenting to the clinic with complaints of increased urination and pain while urinating. She is otherwise healthy and denies other symptoms. She is diagnosed with a UTI and prescribed Bactrim DS. However, you notice in her chart that she has a sulfa allergy. How should you proceed?
Educate the patient about the risk for a reaction and recommend they monitor when they begin the treatment
Taking Bactrim should not be a problem with a sulfa allergy
Contact the provider and recommend changing to a different medication
Recommend diphenhydramine (Benadryl) as needed if the patient has a skin reaction
Contact the provider and recommend changing to a different medication
A 2-year-old male is diagnosed with type 1 diabetes. Which of the following agents would be most appropriate to initiate to manage hyperglycemia?
Metformin
Insulin
Glipizide
Empagliflozin
Insulin
hile conducting routine assessments before medication administration on the psychiatric unit, the nurse prepares to administer risperidone and finds the client with an altered mental status, muscle rigidity and sweating profusely with a fever of 101.5 F (38.6 C). Which is the priority action by the nurse based on the current data?
Apply a cooling blanket and call the healthcare provider (HCP).
Give naproxen for fever and reassess every half hour.
Hold the risperidone and immediately call the healthcare provider (HCP).
Recheck the client's temperature and give the risperidone.
Hold the risperidone and immediately call the healthcare provider (HCP)
This client is experiencing symptoms indicative of neuroleptic malignant syndrome (NMS), a life-threatening adverse reaction to the prescribed medication. The priority is to hold the risperidone and immediately notify the HCP.
Which of the following effects of calcium channel blockers causes a reduction in blood pressure?
A. Increased cardiac output.
B. Decreased peripheral vascular resistance.
C. Decreased renal blood flow.
D. Calcium influx into cardiac muscles.
Decreased peripheral vascular resistance
Nurse Amy is caring for a patient with asthma who has been prescribed Montelukast (Singulair). To ensure safe medication therapy, which laboratory values should Nurse Amy prioritize monitoring?
A. ALT and AST levels.
B. Complete blood count (CBC).
C. Calcium levels and platelet count.
D. Sodium and potassium levels.
ALT and AST levels. Montelukast (Singulair) is a leukotriene receptor antagonist used for the maintenance treatment of asthma and to relieve symptoms of allergic rhinitis. Although Montelukast is generally well-tolerated, there is a potential risk of liver dysfunction, particularly in patients with pre-existing liver conditions or those taking other hepatotoxic medications. Therefore, Nurse Amy should prioritize monitoring liver function tests, specifically alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Elevated levels of ALT and AST can indicate liver inflammation or damage, which may necessitate adjusting the dosage or discontinuing the medication.
Which antibiotic class would be most likely to cause birth defects and should be avoided in pregnancy?
Penicillins
Cephalosporins
Tetracyclines
All of the above
Tetracyclines
Which of the following is true with regard to insulin glargine?
Hypoglycemia is more problematic with glargine versus insulin aspart
It is a rapid acting insulin
Weight loss is a common adverse effect
It is typically given once daily
It is typically given once daily
The nurse in a psychiatric unit receives the morning shift report on the following four clients. Which client should the nurse assess first?
Client with bipolar disorder with a lithium level of 1.0 mEq/L
Client with depression taking isocarboxazid with a blood pressure of 190/110 mm Hg
Client with anxiety and a respiratory rate of 12/mm requesting lorazepam
Client with psychosis and agitation due for a scheduled dose of haloperidol
Client with depression taking isocarboxazid with a blood pressure of 190/110 mm Hg
The client taking isocarboxazid has a severely elevated blood pressure. Isocarboxazid is a monoamine oxidase inhibitor (MAOI) that can cause severe hypertension if taken with specific foods. This client is the priority.