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Galen pharm 210 Exam 3 Questions with
Complete Solution
1. What is hydrochlorothiazide and what is it used for?: a thiazide diuretic used for HTN or edema from CHF
2. What is furosemide and what is it used for?: Lasix a loop diuretic used to treat fluid retention, renal dysfunction,
cirrhosis, HTN, pulmonary edema
3. diuretics caused lab abnormalities: low K (except spironolactone which causes high K)
low Mg low Cl low Na high blood sugar low Ca (loop) high Ca (thiazide)
4. What is mannitol and what is it used for?: an osmotic diuretic used to decrease ICP, IOP, excrete toxins, used in
emergent situations
5. What is spironolactone and what is it used for?: a potassium-sparing diuretic blocks aldosterone, used for heart
failure and hepatic cirrhosis
6. diuretic interventions: monitor I's & O's, daily weight notify HCP if urine
output does not increase monitor VS, watch BP administer Lasix slowly for K wasting watch for s/s of hypokalemia for K sparing watch for s/s of hyperkalemia monitor electrolyte levels monitor glucose periodically
7. diuretics teaching: take BP before dose
weigh self daily (report gain of 2# overnight or 5# in week) take medication in morning ok to take w/ food for GI upset avoid sunlight for photosensitivity teach to get up slowly reinforce need for medication and compliance diet - K wasting - increase potassium, supplement, esp if Pt on digoxin diet - K sparing - decrease potassium teach that drugs can increase glucose so HCP will monitor blood glucose
8. A PATIENT IS TAKING FUROSEMIDE (LASIX) 40 MG DAILY FOR HEART FAILURE AND
HYPERTENSION. IT IS MOST IMPORTANT FOR THE NURSE TO ASSESS THE PATIENT FOR THE
DEVELOPMENT OF
A. LOW SERUM POTASSIUM, SODIUM, AND MAGNESIUM, AND ELEVATED CALCIUM.
B. LOW SERUM POTASSIUM AND SODIUM AND ELEVATED MAGNESIUM AND CALCIUM.
C. LOW SERUM POTASSIUM, SODIUM, MAGNESIUM, AND CALCIUM.
D. LOW SERUM POTASSIUM AND SODIUM, WITH
MAGNESIUM AND CALCIUM REMAINING NORMAL.: ANSWER: C RATIONALE: LOOP
DIURETICS CAUSE A LOSS OF
POTASSIUM, SODIUM, MAGNESIUM, AND CALCIUM.
9. WHICH STATEMENT WILL THE NURSE INCLUDE
WHEN TEACHING A PATIENT ABOUT LOOP (HIGH-
CEILING) DIURETICS?
A. TAKE THE MEDICATION AT BEDTIME.
B. TAKE THE MEDICATION ON AN EMPTY STOMACH.
IS MOST IMPORTANT FOR THE
NURSE TO MONITOR THE PATIENT FOR THE
DEVELOPMENT OF
A. HYPERKALEMIA.
B. HYPOKALEMIA.
C. HYPONATREMIA.
D. HYPERNATREMIA.: • ANSWER: B
- RATIONALE: HYPOKALEMIA IS THE MOST COMMON ELECTROLYTE BALANCE ASSOCIATED WITH FUROSEMIDE (LASIX) THERAPY.
12. A PATIENT WITH CONGESTIVE HEART FAILURE
GAINS 5 POUNDS IN 1 WEEK. THIS MOST LIKELY
INDICATES A FLUID WEIGHT GAIN OF
A. ½ L.
B. 1 L.
C. 2 L.
D. 3 L.: • ANSWER: C
- RATIONALE: WEIGHT GAIN OF 2.2 POUNDS IS EQUIVALENT TO AN EXCESS LITER OF BODY FLUIDS.
13. BEFORE ADMINISTERING
SPIRONOLACTONE, IT IS MOST IMPORTANT
FOR THE NURSE TO DETERMINE IF THE
PATIENT IS ALSO RECEIVING
A. DIGOXIN (LANOXIN).
B. POTASSIUM CHLORIDE (K-DUR).
C. ACETAMINOPHEN (TYLENOL).
D. DOXAZOSIN (CARDURA).: • ANSWER: B
- RATIONALE: SPIRONOLACTONE IS A POTASSIUM-SPARING DIURETIC. POTASSIUM SUPPLEMENTATION IS NOT INDICATED UNLESS THE PATIENT'S SERUM POTASSIUM LEVEL IS VERY LOW.
14. WHICH STATEMENT ABOUT ALDOSTERONE DOES THE
NURSE IDENTIFY AS BEING
TRUE? ALDOSTERONE
A. PROMOTES SODIUM EXCRETION.
B. IS A MINERALOCORTICOID HORMONE.
C. PROMOTES POTASSIUM RETENTION.
D. IS SECRETED BY THE PANCREAS.: • ANSWER: B
- RATIONALE: ALDOSTERONE IS A MINERALOCORTICOID HORMONE THAT PROMOTES SODIUM RETENTION, AND POTASSIUM EXCRETION IS NOT SE- CRETED BY THE PANCREAS
15. An elderly patient will be taking a vasodilator for hypertension. Which adverse effect is of most concern for
the older adult patient taking this class of drug? Dry mouth Restlessness Hypotension
20. What does the nurse know to be correct concerning the use of mannitol in patients?
It increases intraocular pressure. It decreases intracranial pressure. It causes sodium and potassium retention. It causes diuresis in several days.: It decreases intracranial pressure.
21. The nurse is caring for a patient who is to begin receiving a thiazide diuretic to treat heart failure. When
performing a health history on this patient, the nurse will be concerned about a history of which condition? Hypertension Gout Glaucoma Asthma: gout
22. The nurse is caring for a patient who develops marked edema and a low urine output as a result of heart
failure. Which medication will the nurse expect the provider to order for this patient? Digoxin Spironolactone Furosemide Hydrochlorothiazide: furosemide Furosemide is a loop diuretic and is given when the patient's condition warrants immediate removal of body fluid, as in heart failure. Digoxin improves cardiac function but does not remove fluid quickly. The other diuretics may be used when immediate fluid removal is not necessary.
23. what medications have the ending OLOL?: beta blockers metoprolol, propranolol
24. what are beta blockers used for?: HTN antidysrhythmic
and antianginal can be used as dual therapy along with diuretic for African Americans
25. beta blocker adverse reactions: depression, decreased libido orthostatic hypotension
bradycardia, hypotension masking of hypoglycemia
26. beta blocker contraindications: heart block, bradycardia asthma (unless selective
beta 1 such as propranolol) caution in renal dysfunction and pregnancy
27. beta blocker interactions: decrease effect with NSAIDs increased effect with other
antihypertensives and antidysrhythmic increased risk of hypoglycemia with insulin and sulfonylureas and masks the symp- toms
28. beta blocker interventions: Monitor vital signs - report marked changes in blood pressure or pulse below 60
Report bothersome side effects that don't improve such as dizziness, lightheaded- ness, stuffy nose, or depression Provide for safety - orthostatic hypotension
29. beta blocker teaching: Take medication at the same time every day Therapeutic effect can take
several weeks Patient to monitor their blood pressure and pulse and record Get up slowly to help prevent orthostatic hypotension To side effects/adverse reactions to report Do not drive until response to drug is known
30. what is prazosin and what is it used for?: alpha-adrenergic blocker used for HTN
heart failure benign prostatic hypertrophy (BPH) can be used as monotherapy in African Americans
antidysrhythmic PVD can be used as monotherapy for African Americans
36. amlodipine side effects and adverse reactions: flushing HA
dizziness peripheral edema erectile dysfunction hypotension, orthostatic hypotension bradycardia
37. amlodipine contraindications: caution with hepatic impairment (liver failure)
38. amlodipine interactions: other drugs that lower BP cold medications
39. what medications end in PRIL?: angiotensin-converting enzyme (ACE) in- hibitors
lisinopril
40. what is lisinopril and what is it used for?: ACE inhibitor used for HTN
heart failure can be used as dual therapy along with a diuretic for African Americans
41. lisinopril side effects and adverse reactions: constant irritating non-produc- tive cough (dry cough)
HA
GI upset insomnia erectile dysfunction orthostatic hypotension, hypotension hyperkalemia
tachycardia angioedema nephrotoxic (kidney damage)
42. lisinopril contraindications: pregnancy potassium-sparing
diuretics (spironolactone) salt substitutes that contain potassium
43. lisinopril interactions: potassium containing medication other antihypertensives
OTC cold medications
44. what medications end in SARTAN or TAN?: angiotensin II receptor blockers (ARBs)
valsartan
45. what is valsartan and what is it used for?: ARB used for HTN
heart failure
46. valsartan contraindications: pregnancy lactating
47. valsartan interactions: other antihypertensives alcohol
NSAIDs can increase renal dysfunction/hyperkalemia OTC cold medication
48. valsartan side effects/adverse reactions: DOES NOT cause the cough of ACE inhibitors
dizzy, drowsy, fatigue insomnia, HA erectile dysfunction orthostatic hypotension hyperkalemia hypotension renal dysfunction
52. A patient is receiving an angiotensin II receptor blocker (ARB). Which does the nurse recognize as an ARB?
A. Valsartan (Diovan)
B. Amlodipine (Norvasc)
C. Captopril (Capoten)
D. Metoprolol (Lopressor): Answer: A
Rationale: ARBs have a suffix of -sartan. Valsartan (Diovan) is an ARB. Amlodipine is a calcium channel blocker captopril is an ACE inhibitor with a common suffix of -pril. Metoprolol is a beta blocker with a common suffix of -lol.
53. A patient is receiving an angiotensin II receptor blocker. It
is most important for the nurse to assess the patient for
A. constipation.
B. tremors.
C. asthmatic attacks.
D. dizziness.: Answer: D
Rationale: Side effects/adverse effects of ARBs include dizziness, diarrhea, insomnia, occasional cough, and upper respiratory infection.
54. An African-American patient is to be treated with initial monotherapy to control hypertension. The nurse
expects the patient to receive
A. diuretics.
B. angiotensin-converting enzyme inhibitors.
C. alpha-adrenergic blockers.
D. beta blockers.: Answer: C
Rationale: African Americans do not respond well to diuretics as the initial monotherapy for controlling hypertension. This group is susceptible to low-renin hypertension; therefore, they do not respond well to beta blockers and ACE in- hibitors. The antihypertensive drugs that are effective for African Americans are alpha1 blockers and calcium channel blockers.
55. The nurse should instruct a patient to not suddenly stop taking antihyper- tensives in order to avoid
A. rebound bradycardia.
B. rebound tachycardia.
C. rebound hypertension.
D. rebound hypotension.: Answer: C
Rationale: Abrupt discontinuation of antihypertensive drugs may cause rebound hypertension
56. A patient with hypertension is ordered to receive an ACE inhibitor. The nurse identifies a common
benign side effect of this class of medications as
A. hiccups.
B. flatulence.
C. abdominal distention.
D. a dry cough.: Answer: D
Native Americans have a reduced or lower response to beta blockers compared with whites. Monitoring blood pressure and drug dosing should be an ongoing assessment for these cultural groups.
59. what is diphenhydramine and what is it used for?: Benadryl, first-generation antihistamine used for
allergic rhinitis itching (allergic reaction) prevent motion sickness sleep aid antitussive
60. what is loratadine and what is it used for?: Claritin second generation nonse- dating antihistamine (without
drowsiness and anticholinergic effects) used for allergic rhinitis itching (allergic reaction)
61. diphenhydramine and loratadine side effects: anticholinergic - Drowsiness, dry mouth, decreased secretions,
dizziness, blurred vision, urinary retention, con- stipation photosensitivity excitability in children less drowsiness fewer anticholinergic side effects
62. diphenhydramine contraindications and cautions: acute asthma attack severe liver disease
caution with narrow-angle glaucoma BPH, urinary retention pregnancy
interactions other CNS depressants
63. diphenhydramine nursing interventions and teaching: administer in large muscle IM
dilute and IV push over several minutes as can cause burning Avoid operating motor vehicles if drowsiness occurs. Avoid alcohol and other CNS depressants. Take as prescribed Use sugarless candy or gum or ice chips for temporary relief of mouth dryness. Instruct to use caution when giving to children - can cause excitability Older adult can be more sensitive and can cause confusion
64. what is pseudoephedrine and what is it used for?: Sudafed an adrenergic agonist used for nasal congestion
(decongestant)
65. what is oxymetazoline and what is it used for?: decongestant nasal spray used for nasal congestion
66. pseudoephedrine and oxymetazoline side effects and adverse reactions: -
nervous, jittery, restless HTN hyperglycemia tachycardia frequent use may lead to tolerance may lead to rebound nasal congestion should not be used for more than 3 days
monitor for cough suppression & resp status with narcotics teach proper use of nasal spray increase fluids (esp with expectorant) don't drive until action is known decongestants can cause insomnia, take early in the day & rebound congestion for overuse read labels to know what medications are in multiple symptom control medications contact HCP if cough lasts longer than 1 week
75. A patient is receiving dextromethorphan (Benylin). The
nurse knows the drug is exerting its therapeutic effect when the patient experiences
A. thinning of secretions.
B. bronchodilation.
C. decreased coughing.
D. relief of nasal congestion.: Answer: C
Rationale: Dextromethorphan (Benylin) is an antitussive which acts on the cough-control center in the medulla to suppress the cough reflex.
76. The nurse is teaching an older adult patient about guaifenesin (Robi- tussin). Which information is
appropriate to include in this teaching? (Select all that apply.)
A. Take the drug with a glass of water.
B. Read labels on over-the-counter drugs and check with health care
provider before taking cold remedies.
C. Take the drug at bedtime.
D. Advise patient to contact health care provider if cough persists more
than 2 days.: Answer: A, B Rationale: Taking the drug with a glass of water can help loosen mucus. Labels should be read, and the health care provider should be checked with, to avoid conflict with other medications the patient is taking. Cold remedies should not be taken at bedtime. The health care provider should be notified if the cough lasts for 1 week.
77. A patient has been diagnosed with the common cold. The nurse should question if which drug is ordered
to treat this patient?
A. Antihistamines
B. Antitussives
C. Expectorants
D. Antibiotics: Answer: D
Rationale: The common cold is caused by the rhinovirus. Antibiotics would not be used to treat a virus. Groups of drugs used to manage cold symptoms include antihistamines (H1 blockers), decongestants (sympathomimetic amines), antitussives, and expectorants.
78. Which medication is a first-generation antihistamine?
A. Cetirizine (Zyrtec)
B. Fexofenadine (Allegra)
C. Diphenhydramine (Benadryl)
D. Loratadine (Claritin): Answer: C
Rationale: Diphenhydramine (Benadryl) is a first-generation antihistamine. Most first-generation antihistamines cause drowsiness, dry mouth, and other anticholin- ergic symptoms. The other options are drugs that are second-generation antihis- tamines. These drugs have fewer anticholinergic effects and a lower incidence of drowsiness.
79. When teaching a patient about use of nasal decongestant sprays, the nurse informs the patient that they are
