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79. A client prescribed nitroglycerin reports to the…
79. A client prescribed nitroglycerin reports to the nurse that he is having headaches. How should the nurse best respond?
“You may experience headaches as an adverse reaction to nitroglycerin.”
“Do not take any more nitroglycerin. It is increasing your blood pressure.”
“If you lie down when taking nitroglycerin you will not experience a headache.”
“Nitroglycerin is dropping your blood pressure and that is causing the headache.”
80. The nurse would avoid administering nitrates to clients using which medication?
Sildenafil
Lisinopril
Simvastatin
Albuterol
81. A client, diagnosed with erectile dysfunction, is taking nitroglycerin for chest pain. What is the best explanation for why a nitrate-like sildenafil would be contraindicated?
“Nitroglycerin and sildenafil cause a severe decrease in blood pressure.”
“Nitroglycerin and sildenafil can lead to prostate cancer.”
“Nitroglycerin decreases the effect of sildenafil for erectile dysfunction.”
“Nitroglycerin and sildenafil will diminish the effectiveness of chest pain relief.”
82. Beta-adrenergic blocking agents decrease the oxygen demands of the heart by what mechanism?
Increasing conduction to the atrioventricular node, thereby increasing cardiac output
Increasing cardiac output, thereby increasing the oxygen supplied to the heart
Increasing blood pressure, which increases the amount of blood returned to the heart
Decreasing the heart rate, allowing for longer filling time and increased blood to the heart
83. The nurse is caring for a client who is taking a sustained-release (SR) oral nitrate. How should the nurse instruct this client to take the medication?
With water
Sublingually until absorbed
With milk or milk products
1 hour after eating
84. While teaching a patient about sublingual nitroglycerin, the nurse explains proper use and storage. When the patient asks whether the medication ever expires, the nurse should respond that it:
has an indefinite shelf life.
should be replaced monthly.
should be replaced every six months.
should be replaced annually.
85. The nurse is teaching a 63-year-old client about sustained-release oral nitrates which has been prescribed for treatment of angina. Which instructions would the nurse offer to the client when teaching how to properly self-administer the medication?
Take the medication on an empty stomach.
Take the medication immediately following a meal.
Crush the medication and mix it with food.
Crush the medication and dissolve it in water.
86. A client was given a new prescription for a transdermal nitroglycerin patch. What client education should the nurse provide regarding this medication?
“If your patch loses its adhesion during the day, replace it with a new one.”
“Remove your old patch and put on a new one each morning.”
“Apply one additional patch if you experience a sudden onset of chest pain.”
“Put your patch on a part of your skin that doesn’t have too much hair on it.”
87. The nurse provides client teaching for a client diagnosed with angina about the prescribed nitroglycerin transdermal patch. Which client statement establishes the need for further teaching?
“I will rotate placement of the transdermal patch on my chest, abdomen, and thighs.”
“I will apply the patch for 24 hours and then remove it, and place another transdermal patch.”
“I will remove the patch and fold it on itself to prevent my dog or grandchildren from touching it.”
“I will clean the previous site where I remove an old patch with soap and water and dry it thoroughly.”
88. What should the nurse tell the client about storage of oral nitroglycerin products? (Select all that apply.)
Store oral nitroglycerin in the original container.
Store oral nitroglycerin with the container lid tightly sealed.
Store oral nitroglycerin and other medications in the container.
Store oral nitroglycerin in a plastic pill box so doses are not missed.
Store oral nitroglycerin away from light exposure.
89. A patient is being discharged after being treated with nitroglycerin for an acute anginal attack. Which of the following instructions should the nurse provide the patient regarding the administration of nitroglycerin ointment?
Apply a thick layer of the ointment.
Rub the ointment onto the skin.
Use an applicator for applying the ointment.
Apply on the same site during every application.
90. A client has been diagnosed with angina and prescribed nitroglycerin. What aspect of the client’s health history should prompt the nurse to monitor the client particularly closely after administration of the drug?
Orthostatic hypotension
Depression and use of a selective serotonin reuptake inhibitor
Reynaud syndrome
Gastroesophageal reflux disease (GERD)
91. The nurse would avoid administering nitrates to clients using which medication?
Sildenafil
Lisinopril
Simvastatin
Albuterol
92. The nurse is performing a history for a black client that is concerned about developing coronary artery disease since it “runs in the family.” What risk factor, that is modifiable, does the nurse identify when taking the history?
client ethnicity
age of 62
Father had a myocardial infarction at 48
obese 40% over total body weight
93. The nurse provides client teaching for a client diagnosed with angina about the prescribed nitroglycerin transdermal patch. Which client statement establishes the need for further teaching?
“I will rotate placement of the transdermal patch on my chest, abdomen, and thighs.”
“I will apply the patch for 24 hours and then remove it, and place another transdermal patch.”
“I will remove the patch and fold it on itself to prevent my dog or grandchildren from touching it.”
“I will clean the previous site where I remove an old patch with soap and water and dry it thoroughly.”
94. The client is started on a transdermal nitroglycerin patch system. The nurse teaches the client that the system relieves pain by which action?
Dilates the coronary arteries
Decreases the size of the artery
Increases the workload of the heart
95. When teaching the client to safely administer nitroglycerin ointment, the nurse should convey which instruction?
“The backs of your hands and the tops of your feet are ideal sites for applying the ointment.”
“Make sure you squeeze the ointment on to a paper measuring scale before applying it.”
“Massage the ointment into your skin for 10 to 15 seconds after applying it.”
“Don’t apply the ointment unless you’re experiencing chest pain at the time.”
96. You are assessing a 6-year-old girl in the emergency department (ED) who was brought in by her mother because she was stung by a bee and is allergic to bee venom. The child is now having trouble breathing; she is vasodilated, hypotensive and has broken out in hives. What do you suspect is wrong with this child?
She is having an allergic reaction and going into cardiogenic shock
She is having an allergic reaction and going into anaphylactic shock
She is having an allergic reaction and going into neurogenic shock
97. Which type of shock is caused by an infection?
Cardiogenic
Septic
Hypovolemic
Anaphylactic
98. Anaphylaxis kits for clients allergic to bee stings would contain which medication?
dopamine
aspirin
epinephrine
norepinephrine
99. A client with a history of allergies is prescribed an auto-injector for self-administration in case of an allergic reaction. The nurse understands that this device contains which drug?
Dobutamine
Dopamine
Isoproterenol
Epinephrine
100. Adrenergic drugs increase the potential risk for what adverse effect?
intestinal wall muscle spasm
cardiac dysrhythmias
hypoglycemia
stupor
101. A client experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The client’s right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve which of the client’s symptoms?
pain and swelling around the sting site.
discoloration in her hand.
acute anxiety.
acute bronchospasm.
102. An adrenergic drug would be prescribed to produce what physiological effect?
decreased respiratory rate
increased heart rate
urine concentration
decreased blood pH
103. Your 25-year-old patient presents to the ED status post-MVA with hypotension, tachycardia, diaphoresis, pallor, and oliguria. Reports from the accident site indicate significant blood loss from the vehicle’s only occupant. What type of shock is your patient demonstrating?
Hypovolemic
Anaphylactic
Cardiogenic
Distributive
104. A patient is being treated for hypovolemic shock. Which of the following assessments is most important in the patient with hypovolemic shock?
Monitor intake and weight
Assess lung and bowel sounds
Assess temperature and peripheral pulses
Assess blood pressure and pulse
105. You are admitting a patient with a diagnosis of a gastrointestinal bleed who is in the compensatory stage of shock. You know that an early sign that accompanies initial shock is what?
Increased urine output
Decreased heart rate
Hyperactive bowel sounds
Cool, clammy skin
106. The nursing instructor is discussing shock with the senior nursing students. The instructor tells the students that shock is a life-threatening condition. What else should the instructor tell the students about shock?
Occurs when arterial blood flow and oxygen delivery to tissues and cells are inadequate
Causes respiratory distress syndrome
Begins when peripheral blood flow is inadequate
Is a component of any trauma
107. Epinephrine causes relaxation of:
bronchioles.
smooth muscles in the intestinal wall.
superficial blood vessels.
sphincter muscles.
108. Which would the nurse identify as a naturally occurring catecholamine?
Dobutamine
Dopamine
Ephedrine
Metaraminol
109. Your 69-year-old patient is started on IV dopamine for management of hypotension following open-heart surgery. As you care for the patient, you monitor him for adverse effects of the drug, including
fever.
tachycardia.
bradycardia.
cyanosis.
110. A 50-year-old male patient has been admitted to the emergency department in cardiogenic shock. His wife, after hearing the nurse mention that the patient is receiving dobutamine, wants to know how the medication will help him. How would the nurse best answer her question?
“He’s in shock because his heart rate is too low. The drug will help by increasing his heart rate significantly.”
“He’s in shock because his blood vessels have dilated so severely. The drug will help by reversing that dilation.”
“He’s in shock because his heart can’t pump effectively. This drug will help by causing his heart to pump more strongly.”
“He’s in shock because his heart can’t pump effectively. This drug will help by increasing his heart rate significantly.”
111. You are caring for a patient in the compensation stage of shock. You know that in this stage of shock epinephrine and norepinephrine are released into the circulation. What positive effect does this have on your patient?
Increases myocardial contractility
Decreases blood return to the heart
Decreases carbon dioxide exchange
Contracts bronchioles
112. An adrenergic drug would be prescribed to produce what physiological effect?
increased heart rate
urine concentration
decreased blood pH
113. A student asks the instructor what the goal of drug therapy is in hypotension and shock. What would the instructor respond?
Restore life to the patient.
Replace fluids the patient has lost.
Restore and maintain adequate tissue perfusion.
Resuscitate the client.
114. A child who is allergic to bee stings is stung by a bee at school. The school nurse administers a EpiPen (epinephrine). Why is epinephrine the drug of choice for this patient?
It has a long half-life.
It has an effect on the adrenal gland.
It has an antihistamine effect.
It is inexpensive and affordable.
115. Adrenergic drugs mimic the effects of stimulating what part of the nervous system?
parasympathetic
sympathetic
autonomic
central
116. The nursing instructor is discussing shock with the senior nursing students. The instructor tells the students that shock is a life-threatening condition. What else should the instructor tell the students about shock?
Occurs when arterial blood flow and oxygen delivery to tissues and cells are inadequate
Causes respiratory distress syndrome
Begins when peripheral blood flow is inadequate
Is a component of any trauma
117. Clinical indications for the use of adrenergic drugs stem mainly from their effects on the heart, blood vessels, and bronchi. They are often used as emergency drugs. For which of the following conditions would these drugs be used? Choose all that apply.
Myocardial infarction
Asthma attack
Anaphylaxis
Chronic cirrhosis
Fractured hip
118. You are assessing your patient. When prioritizing the patient’s care, you recognize that your patient is at risk for hypovolemic shock when
fluid circulating in the blood vessels decreases
cardiac output is increased.
blood pressure increases.
pulse is fast and bounding
119. Epinephrine causes relaxation of:
bronchioles.
smooth muscles in the intestinal wall.
superficial blood vessels.
sphincter muscles.
120. Which would the nurse identify as a naturally occurring catecholamine?
Dobutamine
Dopamine
Ephedrine
Metaraminol
121. The nurse is serving a breakfast tray to the client receiving an alpha- and beta-adrenergic agonist medication. The nurse notifies dietary of a food preparation error with the client’s diet when finding what on the tray?
aged cheese
bacon
coffee
milk
122. An 80-year-old patient in the emergency department is receiving dopamine for treatment of shock. Which of the following adverse effects could the patient experience?
Blood dyscrasia
Dysrhythmia
Hepatic toxicity
Respiratory depression
123. When caring for a patient at risk for shock, what assessment finding would the nurse consider a potential sign of shock?
Elevated systolic blood pressure
Elevated mean arterial pressure
Shallow, rapid respirations
Bradycardia
124. A 50-year-old male patient has been admitted to the emergency department in cardiogenic shock. His wife, after hearing the nurse mention that the patient is receiving dobutamine, wants to know how the medication will help him. How would the nurse best answer her question?
“He’s in shock because his heart rate is too low. The drug will help by increasing his heart rate significantly.”
“He’s in shock because his blood vessels have dilated so severely. The drug will help by reversing that dilation.”
“He’s in shock because his heart can’t pump effectively. This drug will help by causing his heart to pump more strongly.”
“He’s in shock because his heart can’t pump effectively. This drug will help by increasing his heart rate significantly.”
125. A 50-year-old male patient has been admitted to the emergency department in cardiogenic shock. His wife, after hearing the nurse mention that the patient is receiving dobutamine, wants to know how the medication will help him. How would the nurse best answer her question?
“He’s in shock because his heart rate is too low. The drug will help by increasing his heart rate significantly.”
“He’s in shock because his blood vessels have dilated so severely. The drug will help by reversing that dilation.”
“He’s in shock because his heart can’t pump effectively. This drug will help by causing his heart to pump more strongly.”
He’s in shock because his heart can’t pump effectively. This drug will help by increasing his heart rate significantly.”
126. Effective treatment of septic shock, if caused by bacterial infection, includes draining an abscess (if present) and administration of appropriate medications. Which of the following would be considered an appropriate medication?
Antimicrobials
Atropine
Norepinephrine
Adrenalin
127. The client is given epinephrine for an exacerbation of asthma. What response to the medication would the nurse expect?
Increased heart rate and respiratory rate
Increased ease of breathing and increased heart rate
Bronchodilation and decreased heart rate
Decreased inflammation and increased heart rate
128. A patient is admitted to the intensive care unit after surgery from a gunshot wound. His family is very concerned about him and asks why the dobutamine (Dobutrex) is being administered. What is your best response?
“We are giving this drug to increase his blood pressure and heart rate.”
“The medication will improve his condition and stabilize him.”
“The medication will increase the force of the heart contraction and increase blood pressure.”
“The medication will increase his heart rate and decrease his blood pressure.”
129. Which is expected after the administration of an adrenergic medication such as epinephrine? (Select all that apply.)
Increased heart rate
Vasoconstriction
Decreased heart rate
Vasodilation
Hypotension
130. The usual goal of vasopressor drug therapy is to maintain tissue perfusion and a mean arterial pressure of at least what level?
40 to 60 mm Hg
20 to 40 mm Hg
60 to 89 mm Hg
80 to 100 mm Hg
131. A need for additional education on the administration of epinephrine is needed when a new nursing graduate indicates that epinephrine can be effectively administered by what route?
oral
topical
intravenous
subcutaneous
132. The nurse knows that which of the following clients is likely to have hypovolemic shock? Select all that apply.
An infant with severe diarrhea and vomiting
A man with a burn on his finger
A woman bleeding profusely after giving birth
A teenage girl who has been taking 80 mg/day of unprescribed Lasix for five days
An elderly man in congestive heart failure
133. Which medication is a synthetic catecholamine prescribed for the treatment of bradycardia?
isoproterenol
pseudoephedrine
ephedrine
epinephrine
134. A nurse may be asked to administer adrenergic drugs to clients with which conditions? (Select all that apply.)
Hypovolemic shock
Respiratory distress
Severe hypertension
Allergic reactions
Cardiac arrest
135. Why do clients with impaired renal function require cautious use of epinephrine?
Metabolites may accumulate and increase the risk of adverse effects.
Epinephrine increases the pH of urine and constitutes a risk for urosepsis.
Epinephrine can cause lysis of Bowman’s capsules, further reducing renal function.
Epinephrine is fully resorbed in the proximate tubules and can accumulate to toxic levels.
136. Epinephrine promotes oxygenation of the heart and brain by what means?
promoting the binding of oxygen to hemoglobin
redirecting blood flow away from the peripheral circulation
promoting vasodilation both in the myocardium and in the brain
simultaneously slowing the heart rate and increasing the force of contraction
137. A patient is receiving an infusion of norepinephrine for treatment of acute hypotension. The nurse caring for the patient discovers that extravasation has occurred. What drug should be administered?
Phenylephrine
Propranolol
Epinephrine
Phentolamine
138. Which of the following is an effect of systemic administration of phenylephrine?
Reflex bradycardia
Hypotension
Excessive sedation
Rebound nasal congestion
139. What sign/symptom would help confirm the possible diagnosis of hypovolemic shock in a client experiencing a significant loss of blood? Select all that apply.
weak pulse
clammy skin
nausea
chest pain
fever
140. The client has been prescribed norepinephrine. While the nurse is teaching the client about this medication, the client asks the nurse what is it for. What is the nurse’s best response?
“It is a medication used to treat severe bacterial infections.”
“It is a neurotransmitter that keeps the nerve message going from the brain to the organ.”
“It is a neurotransmitter that keeps the kidneys producing insulin during stress.”
“It is a substance that sends impulses from the heart to the lungs in order to facilitate breathing.”
141. Contraindications to adrenergic drugs include what conditions? (Select all that apply.)
Cardiac dysrhythmias
Hyperthyroidism
Hypersensitivity to sulfites
Hypersensitivity to penicillin
Hypotension
142. A patient suffers from bradycardia. Which of the following medications is a synthetic catecholamine for the treatment of bradycardia?
Isoproterenol (Isuprel)
Pseudoephedrine (Sudafed)
Ephedrine
Epinephrine
143. The client with a complex health history has been taking medication affecting both alpha- and beta-receptor sites in the past. What medications would the nurse include in this category? Select all that apply.
dobutamine
epinephrine
dopamine
clonidine
albuterol
144. The client with a complex health history has been taking medication affecting both alpha- and beta-receptor sites in the past. What medications would the nurse include in this category? Select all that apply.
dobutamine
epinephrine
dopamine
clonidine
albuterol
145. What second-line vasopressor is likely to be prescribed when norepinephrine proves ineffective at treating hypotension? Select all that apply.
phenylephrine
vasopressin
epinephrine
phentolamine
Dopamine
146. What assessment should the nurse make before administering beta-adrenergic blocking agents?
Pulse and blood pressure
Weight and caloric intake
Serum albumin level
Serum sodium level
147. A male client has called the clinic because he is taking digoxin and is concerned about his pulse rate. The nurse should tell the client to hold the medication if he reports a pulse rate of:
52 beats/minute.
84 beats/minute.
78 beats/minute.
66 beats/minute.
148. A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessment findings?
Oxygen saturation and respiratory rate
Heart rate and blood pressure
Level of consciousness and pain level
Temperature and respiratory rate
149. A male client has been admitted with digitalis toxicity. He has been taking the same dose for more than 20 years. His family is asking how common this problem is and how he developed a toxic level while taking the usual dose. The nurse’s best explanation would be:
Toxicity can occur even on low-dose therapy due to various factors including advanced age
Toxicity is usually due to incorrect prescription strength.
The client must have been taking the wrong dose.
The client probably has severe renal impairment.
150. A nurse is giving medication instruction to a client who is taking metoprolol (Lopressor). Which statement by the client would indicate that teaching has been effective?
“I may have a very dry mouth while taking this drug.”
“”I should never stop taking this drug abruptly.”
“I can stop walking a mile a day.”
“Since I am taking this drug, I no longer need to worry about my diet.”
151. What is given to treat a massive digoxin overdose?
Digoxin immune Fab (Digibind)
Milrinone (Primacor)
Activated charcoal
Syrup of ipecac
152. The pharmacology instructor is discussing effects on the heart of different medication. What is the term the instructor would use to describe the effect of a medication that increases the force of the contractions of the heart?
Positive chronotropic
Positive inotropic
Negative inotropic
Negative dromotropic
153. A client being treated for hypokalemia has a medication history that includes propranolol, digoxin, and warfarin. When the client reports nausea, abdominal discomfort, and visual changes, the nurse suspects what as the causative factor?
heart failure
myocardial infarction
digitalis toxicity
acute renal failure
154. The nursing students are learning about digoxin therapy in their pharmacology class. The students will learn that there is a higher risk of digoxin toxicity in clients with
low serum chloride levels.
low serum potassium levels.
low serum sodium levels.
low serum calcium levels.
155. A nurse is caring for a client who is taking digoxin and a loop diuretic. Which would be most important for the nurse to monitor?
Electrocardiogram results
Potassium levels
Sodium levels
Liver enzymes
156. When caring for a patient who has been digitalized for his heart failure, the nurse observes that the patient is experiencing bradycardia. Which drug should be administered to patients who develop bradycardia?
Atropine
Cholestyramine
Inamrinone
Milrinone
157. The nurse is teaching a female patient about newly prescribed digoxin. The patient tells the nurse that she occasionally uses herbal therapies. The nurse should caution the patient against using therapies that involve which herbs?
Black cohosh
Ginseng
Saw palmetto
Valerian
158. When describing the action of beta blockers to a client, the nurse would emphasize that the majority of drug action involve stimulation of the receptors in which organ?
Heart
Kidney
Brain
Liver
159. A 66-year-old woman has a complex medical history that includes poorly-controlled type 1 diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her care provider has recently added spironolactone (Aldactone) to the woman’s medication regimen. The nurse should consequently assess for signs and symptoms of
atrial fibrillation.
thrombophlebitis.
hyperkalemia.
leukocytosis.
160. What assessment should the nurse perform on a daily basis when a client is prescribed furosemide?
body weights
arterial blood gases
magnesium level
pupillary response
161. A patient with congestive heart failure has been digitalized. The patient requires long-term digoxin therapy. Which instructions should the nurse provide the patient on discharge?
Take the drug with high fiber meals.
Report to the center if the pulse is less than 70 bpm.
Take antacids promptly to avoid gastric problems.
Take the drug regularly without skipping a dose.
162. Digoxin has been prescribed for an outpatient client with symptomatic heart failure. What is the priority teaching point to convey to this client?
“Try to limit the number of high-potassium foods in your diet.”
“Make sure to take your pulse for a minute before taking your digoxin.”
“Plan to take your digoxin on an empty stomach to make sure it’s fully absorbed.”
“If the swelling in your feet gets worse, you can take up twice your normal dose for 1 day.”
163. Which drug is in the class of drugs called human B-type natriuretic peptides?
Bosentan
Milrinone
Digoxin
Nesiritide
164 You are teaching an obese client with compensated heart failure how to manage his condition with both prescribed drug therapy and nonpharmacologic measures. What modifications would you suggest that your client make to his diet?
Restrict sodium, eliminate fat, reduce calories
Maintain sodium, reduce fat, maintain calories
Eliminate sodium, reduce fat, maintain calories
Restrict sodium, reduce fat and calories
165. A client, newly diagnosed with heart failure, questions why the therapy with digoxin will begin with four doses of digoxin rather than the usual one dose, in a 24-hour period. What is the rationale for the nurse’s response?
to more accurately gauge the effect of digoxin on the client’s cardiac function
to rapidly bring the client’s serum digoxin levels up to therapeutic levels
to confirm that the client does not have a hypersensitivity to digoxin
to mitigate the potential for adverse effects
166. A client who has been prescribed digoxin (Lanoxin) is also taking furosemide (Lasix) 20 mg daily. Which electrolyte imbalances will precipitate the client to develop digoxin toxicity?
Hyperkalemia
Hypokalemia
Hypermagnesemia
Hyponatremia
167. The client’s digoxin level is 0.125. How does the nurse interpret this level?
Normal
Elevated
Toxic
Low
168. The nurse is providing medication education to a client prescribed an adrenergic blocker. Which nervous system is the specific focus of this classification of medications?
central
peripheral
sympathetic
parasympathetic
169. A client has been administered nesiritide to manage symptoms of acute heart failure. What is the primary action of this drug?
exhibits mild inotropic action and decreased platelet aggregation
compensates for cardiac deterioration by reducing preload and afterload
corrects hyperthyroidism by inhibiting synthesis of the thyroid hormone
increases the concentration of acetylcholine to potentiate the action of ACE
170. The nurse monitors which client for an increased risk of digoxin toxicity?
The client with liver dysfunction
The client with renal dysfunction
The client with an integumentary dysfunction
The client with a peripheral vascular dysfunction
171. In a discussion of heart failure, the nursing instructor is explaining preload and afterload. Which of the following statements regarding preload and afterload is accurate?
Afterload is related to the ejection of blood from the ventricle, and preload is related to the filling of the ventricle.
Preload is related to the ejection of blood from the ventricle, and afterload is related to the filling of the ventricle.
Preload is related to the filling of the left ventricle, and afterload is related to the filling of the right ventricle.
Preload is related to the filling of the right ventricle, and afterload is related to the filling of the left ventricle.
172. An instructor is describing positive inotropic activity. Which would the instructor include as a result of this activity?
Increased cardiac output
Decreased heart rate
Increased preload
Increased conduction velocity
173 After teaching a group of students about conditions that can lead to heart failure, the instructor determines that additional teaching is needed when the students identify:
renal failure.
valvular disease.
coronary artery disease.
hypertension.
174. What is the priority nursing assessment for a client who is about to begin digoxin therapy?
Blood glucose levels
Neurological function
Kidney function
Liver function
175. The nurse evaluates an improvement in the client’s heart failure (HF) status on the basis of what assessment finding?
Using fewer pillows to sleep
Increased skin turgor
Heart rate regular
Improved mental status
176. Which would be considered a therapeutic effect of digoxin?
Decreased cardiac output
Increased heart rate
Increased force of contraction
Decreased renal perfusion
177. The pharmacology instructor is discussing cardiac glycosides with a class of pre-nursing students. According to the instructor, what physiologic effect do cardiac glycosides trigger?
Decreased cardiac output
Decreased afterload
Increased ventricular rate
Increased force of heart contraction
178. What is the first drug of choice for treatment of a client with a history of a myocardial infarction (MI) 2 years ago?
beta-blockers
calcium channel blockers (CCBs)
cardiac glycosides
angiotensin II receptor blockers (ARBs)
179. After administering an IV dose of digoxin, the nurse would expect to see effects within what period of time?
30 to 120 minutes
5 to 30 minutes
1 hour
2 hours
180. The nurse reviews the laboratory results of a client taking digoxin. What finding creates a risk for digoxin toxicity?
Chloride 98 mmol/L (98 mEq/L)
Potassium 3.3 mmpl/L (3.3 mEq/L)
Sodium 144 mmol/L (144 mEq/L)
Hemoglobin 133 g/L (13.3 g/dL)
181. Which adverse effect might occur in a client receiving milrinone?
Hypoglycemia
Confusion
Hypotension
Hyperkalemia
182. What is a goal of spironolactone therapy for a client being treated for heart failure (HF)?
The client will experience a decrease in edema.
The client will not require inotropes or beta-block
