Download NCLEX PHARMACOLOGY PROCTORED 2019 EXAM - STUDY GUIDE / Correct Questions & Answers and more Study notes Nursing in PDF only on Docsity! 1. The nursing student needs to administer potassium chloride intravenously as prescribed to a client with hypokalemia. The nursing instructor determines that the student is unprepared for this procedure if the student states that which action is part of the plan for preparation and administration of the potassium? 1. Obtaining an intravenous (IV) infusion pump 2. Monitoring urine output during administration 3. Preparing the medication for bolus administration 4. Ensuring that the medication is diluted in the appropriate amount of normal saline 3. Preparing the medication for bolus administration 2. A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hour. The nurse determines that the client is receiving the therapeutic effect based on which results? 1. Prothrombin time of 12.5 seconds 2. Activated partial thromboplastin time of 60 seconds 3. Activated partial thromboplastin time of 28 seconds 4. Activated partial thromboplastin time longer than 120 seconds 2. Activated partial thromboplastin time of 60 seconds 3. The nurse provides discharge instructions to a client who is taking warfarin sodium (Coumadin). Which statement, by the client, reflects the need for further teaching? 1. "I will avoid alcohol consumption." 2. "I will take my pills every day at the same time." 3. "I have already called my family to pick up a Medic-Alert bracelet." 4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated." 4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated." 4. A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3 mEq/L and is complaining of anorexia. The health care provider prescribes determination of the serum digoxin level to rule out digoxin toxicity. The nurse checks the results, knowing that which value is the therapeutic serum level (range) for digoxin? 1. 0.5 to 2 ng/mL 2. 1.2 to 2.8 ng/mL 3. 3.0 to 5.0 ng/mL 4. 3.5 to 5.5 ng/mL 1. 0.5 to 2 ng/mL 5. A client is being treated with procainamide for a cardiac dysrhythmia. Following intravenous administration of the medication, the client complains of dizziness. What intervention should the nurse take first? 1. Measure the heart rate on the rhythm strip. 2. Administer prescribed nitroglycerin tablets. 3. Obtain a 12-lead electrocardiogram immediately. 4. Auscultate the client's apical pulse and obtain a blood pressure. 4. Auscultate the client's apical pulse and obtain a blood pressure. 6. The nurse is monitoring a client who is taking propranolol (Inderal LA). Which assessment data indicates a potential serious complication associated with this medication? 1. The development of complaints of insomnia 2. The development of audible expiratory wheezes 3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication 4. A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of 72 beats/minute after two doses of the medication 2. The development of audible expiratory wheezes 7. A client with atrial fibrillation secondary to mitral stenosis is receiving a heparin sodium infusion at 1000 units/hour and warfarin sodium (Coumadin) 7.5 mg at 5:00 pm daily. The morning laboratory results are as follows: activated partial thromboplastin time (aPTT) = 32 seconds; internationalized normalized ratio (INR) = 1.3. The nurse should plan to take which action based on the client's laboratory results? 1. Collaborate with the health care provider (HCP) to discontinue the heparin infusion and administer the warfarin sodium as prescribed. 2. Collaborate with the HCP to obtain a prescription to increase the heparin infusion and administer the warfarin sodium as prescribed. 3. Collaborate with the HCP to withhold the warfarin sodium since the client is receiving a heparin infusion and the aPTT is within the therapeutic range. 4. Collaborate with the HCP to continue the heparin infusion at the same rate and to discuss use of dabigatran etexilate (Pradaxa) in place of warfarin sodium. 2. Collaborate with the HCP to obtain a prescription to increase the heparin infusion and administer the warfarin sodium as prescribed. 8. A client is diagnosed with an ST-segment elevation myocardial infarction (STEMI) and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention? 1. Monitor for kidney failure. 2. Monitor psychosocial status. 3. Monitor for signs of bleeding. 4. Have heparin sodium available. 3. Monitor for signs of bleeding. 3. "A syringe that has a small ⅝-inch needle is used to administer the injection." 18. A client is scheduled for a dose of ramipril (Altace). The nurse should check which measurement before administering the medication? 1. Weight 2. Apical pulse 3. Blood pressure 4. Potassium level 3. Blood pressure 19. The clinic nurse is providing instructions to a client with hypertension who will be taking captopril (Capoten). Which statement by the client indicates a need for further instruction? 1. "I need to change positions slowly." 2. "I need to avoid taking hot baths or showers." 3. "I need to drink at least 4 quarts of water daily." 4. "I need to sit down and rest if dizziness or lightheadedness occurs." 3. "I need to drink at least 4 quarts of water daily." 20. A thrombolytic is administered in the hospital emergency department to a client who has had a myocardial infarction. The client's spouse asks the nurse about the purpose of the medication. The nurse bases the response on which fact regarding this medication? 1. Thrombolytics suppress the production of fibrin. 2. Thrombolytics act to prevent thrombus formation. 3. Thrombolytics act to dissolve thrombi that have already formed. 4. Thrombolytics have been proved to reverse all detrimental effects of heart attacks. 3. Thrombolytics act to dissolve thrombi that have already formed. 21. A client who had surgery 3 days earlier is receiving heparin sulfate by subcutaneous injection every 12 hours. In planning for the client's morning care, the priority nursing intervention is which action? 1. Allow the client to sit only at the bedside. 2. Assist the client to shave using an electric razor. 3. Monitor the prothrombin time (PT) every 4 hours. 4. Tell the client that brushing the teeth is not allowed. 2. Assist the client to shave using an electric razor. 22. A client scheduled to take a subcutaneous anticoagulant at home says to the nurse, "I'm not sure I will be able to take this medication at home." Which statement by the nurse is most appropriate? 1. "Maybe your spouse can give you your shots." 2. "You'll be fine once you get used to giving your own shots." 3. "What are your concerns about taking this medication at home?" 4. "Don't worry. Your health care provider knows what's best for you." 3. "What are your concerns about taking this medication at home?" 23. A client is being discharged on warfarin sodium (Coumadin), and the nurse provides instructions to the client regarding the medication. Which statement, if made by the client, indicates to the nurse that the client understands the teaching provided? 1. "I'll stop my medication if I see bruising." 2. "Stiff joints are common while taking warfarin." 3. "This medication will prevent me from having a stroke." 4. "If I notice blood-tinged urine, I will call the health care provider." 4. "If I notice blood-tinged urine, I will call the health care provider." 24. A client receives education regarding self-administration of enoxaparin (Lovenox) on discharge to home. The client complains, "I feel as if the health care provider is discharging me too soon if I still have to take injections at home." What is the best nursing response? 1. "Are you not happy about going home?" 2. "Do you want to stay in the hospital forever?" 3. "You'll have to take that up with the health care provider." 4. "Research shows that it is best for clients to administer this medication at home rather than stay in the hospital." 4. "Research shows that it is best for clients to administer this medication at home rather than stay in the hospital." 25. The nurse is caring for a client who is taking warfarin (Coumadin), an oral anticoagulant. The nurse notes the presence of gross hematuria and large areas of bruising on the client's body. The nurse notifies the health care provider and ensures that which prescribed medication is available? 1. Heparin sulfate 2. Protamine sulfate 3. Phytonadione (vitamin K) 4. Oral potassium supplements 3. Phytonadione (vitamin K) 26. The home care nurse has given instructions to a client who is beginning therapy with digoxin (Lanoxin). The nurse determines a need for further teaching of the instructions if the client makes which statement? 1. "If I miss a dose, I should just take two the next day." 2. "I shouldn't change brands without asking the health care provider first." 3. "I should call the health care provider if my daily pulse rate is under 60 or over 100." 4. "The pills should be kept in their original container so they don't get mixed up with my other medicines." 1. "If I miss a dose, I should just take two the next day." 27. A client who began medication therapy with prazosin hydrochloride (Minipress) 1 week earlier arrives at the health care clinic for follow-up evaluation and care. The nurse interprets that the client is experiencing the expected benefit of therapy if which is noted? 1. Increased pulse 2. Increased platelet count 3. Decreased blood pressure 4. Decreased blood glucose level 3. Decreased blood pressure 28. A hypertensive client has been prescribed clonidine hydrochloride (Catapres-TTS), a transdermal patch. The nurse provides written instructions to the client on the use of the patch. Which statement by the client indicates the need for further instruction? 1. "I need to change the patch every 24 hours." 2. "I need to apply the patch to a hairless body site." 3. "I need to apply the patch to skin areas that are not broken." 4. "I need to apply the patch to the skin on the upper arm or body." 1. "I need to change the patch every 24 hours." 29. A client with hypertension has begun taking spironolactone (Aldactone). The nurse teaches the client to limit intake of which food? 1. Rice 2. Salad 3. Oatmeal 4. Citrus fruits 4. Citrus fruits 30. A client with hypertension has a new prescription for a medication called moexipril (Univasc). The nurse plans to provide written directions that tell the client to take the medication at which time? 1. At bedtime 2. With meals 3. 1 hour before meals 4. With a snack in late afternoon 3. 1 hour before meals 31. A health care provider (HCP) prescribes warfarin sodium (Coumadin) for a client. The home care nurse visits the client at home and teaches the client about the medication and 1. Hypokalemia 40. A client is taking amiloride (Midamor) 10 mg orally daily. What medication instruction should the nurse provide to the client? 1. Take the dose without food. 2. Eat foods with extra sodium. 3. Take the dose in the morning. 4. Withhold the dose if the blood pressure is high. 3. Take the dose in the morning. 41. Lisinopril (Prinivil) has been prescribed for a client. What should the nurse instruct the client to do? 1. Take the medication with food only. 2. Discontinue the medication if nausea occurs. 3. Rise slowly from a reclining to a sitting position. 4. Expect to note a full therapeutic effect immediately. 3. Rise slowly from a reclining to a sitting position. 42. A health care provider (HCP) prescribes quinidine gluconate for a client. The nurse decides to withhold the medication and contact the HCP if which assessment finding is documented in the client's medical record? 1. Muscle weakness 2. History of asthma 3. Presence of infection 4. Complete atrioventricular (AV) block 4. Complete atrioventricular (AV) block 43. A client is to be discharged from the hospital on quinidine gluconate to control ventricular ectopy. The nurse provides instructions to the client about the medication. Which statement by the client indicates a need for further instruction? 1. "The best time to schedule this medication is with meals." 2. "I need to avoid alcohol, caffeine, and cigarettes while I am on this medication." 3. "I need to stop the medication immediately if diarrhea, nausea, or vomiting occurs." 4. "I need to take this medication regularly, even if the heartbeat feels strong and regular." 3. "I need to stop the medication immediately if diarrhea, nausea, or vomiting occurs." 44. A client has been prescribed pindolol (Visken) for hypertension. The nurse provides anticipatory guidance, knowing that which common side effect of this medication may decrease client compliance? 1. Impotence 2. Mood swings 3. Increased appetite 4. Difficulty swallowing 1. Impotence 45. A client receiving total parenteral nutrition (TPN) has a history of heart failure. The health care provider has prescribed furosemide (Lasix) 40 mg by mouth daily to prevent fluid overload. Which laboratory value should the nurse monitor to identify the presence of an adverse effect from this medication? 1. Sodium 2. Glucose 3. Potassium 4. Magnesium 3. Potassium 46. A client with heart failure is scheduled to be discharged to home with digoxin (Lanoxin) and furosemide (Lasix) as daily prescribed medications. The nurse tells the client to report which finding as an indication that the medications are not having the intended effect? 1. Sudden increase in appetite 2. Weight gain of 2 to 3 lb in a few days 3. Increased urine output during the day 4. Cough accompanied by other signs of respiratory infection 2. Weight gain of 2 to 3 lb in a few days 47. A client with pulmonary edema has a prescription to receive morphine sulfate intravenously. The nurse should determine that the client is experiencing an intended effect of the medication as indicated by which assessment finding? 1. Increased pulse rate 2. Relief of apprehension 3. Decreased urine output 4. Increased blood pressure 2. Relief of apprehension 48. The nurse has provided instructions to a client receiving enalapril maleate (Vasotec). Which statement by the client indicates a need for further instruction? 1. "I need to rise slowly from a lying to sitting position." 2. "I need to notify the health care provider if fatigue occurs." 3. "I need to notify the health care provider (HCP) if a sore throat occurs." 4. "I know that several weeks of therapy may be required for the full therapeutic effect." 2. "I need to notify the health care provider if fatigue occurs." 49. A health care provider writes a prescription for lisinopril (Zestril) for a hospitalized client. The nurse caring for the client determines that the medication has been prescribed to treat which disorder? 1. Hypertension 2. Immune disorder 3. Venous insufficiency 4. Gastroesophageal reflux disorder 1. Hypertension 50. A client taking an angiotensin-converting enzyme (ACE) inhibitor to treat hypertension calls the clinic nurse and reports that he has a dry, nonproductive cough that is very bothersome. The nurse should respond by making which statement? 1. The medication may need to be changed. 2. The cough must be the start of a respiratory infection. 3. The medication needs to be taken with large amounts of water to prevent the cough. 4. This sometimes happens, and the client will need to take a cough medication with each dose of medication. 1. The medication may need to be changed. 51. The home care nurse visits a client with a diagnosis of unstable angina. The client is taking acetylsalicylic acid (aspirin) on a daily basis to reduce the risk of myocardial infarction (MI). Which medication dose would the nurse expect the client to be taking? 1. 300 to 325 mg daily 2. 650 to 700 mg daily 3. 1.3 g daily 4. 3 g daily 1. 300 to 325 mg daily 52. The nurse prepares to teach a client with subarachnoid hemorrhage about the effects of nimodipine. The nurse plans to explain which information about the purpose of this medication? 1. β-Adrenergic blocker that will decrease blood pressure 2. Vasodilator that has an affinity for cerebral blood vessels 3. Diuretic that will decrease blood pressure by decreasing fluid volume 4. Calcium channel blocker that will decrease spasm in cerebral blood vessels 4. Calcium channel blocker that will decrease spasm in cerebral blood vessels 53. A client is being treated for moderate hypertension and has been taking diltiazem (Cardizem) for several months. The client schedules an appointment with the health care provider because of episodes of chest pain, and Prinzmetal's angina is diagnosed. The nurse understands that this medication will provide which therapeutic effect for this new diagnosis? 3. Hypotension 4. Tachycardia 3. Hypotension 63. Atenolol (Tenormin) has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching? 1. "I need to rise slowly from a lying to a sitting position." 2. "If I feel that my heart rate is too low, I should stop the medication." 3. "It will take 1 to 2 weeks before my blood pressure becomes controlled." 4. "I should avoid tasks that require alertness until I know how the medication will affect my body." 2. "If I feel that my heart rate is too low, I should stop the medication." 64. A nurse is collecting subjective and objective data from a client and notes that the client is taking atorvastatin (Lipitor). What should the nurse determine that this medication has been prescribed to specifically treat? 1. Heart failure 2. Hypertension 3. Angina pectoris 4. Hypercholesterolemia 4. Hypercholesterolemia 65. Atorvastatin (Lipitor) has been prescribed for a client, and the client asks the nurse about the action of the medication. How should nurse respond about the action of this medication? 1. Increases plasma cholesterol 2. Increases plasma triglycerides 3. Decreases low-density lipoproteins (LDLs) 4. Decreases high-density lipoproteins (HDLs) 3. Decreases low-density lipoproteins (LDLs) 66. The health care provider (HCP) writes a prescription for atorvastatin (Lipitor) for a client who was admitted to the hospital. The nurse contacts the HCP to verify the prescription if which finding is noted in the assessment data? 1. Renal calculi 2. Chronic heart failure 3. Cirrhosis of the liver 4. Coronary artery disease 3. Cirrhosis of the liver 67. Atorvastatin (Lipitor) has been prescribed for a client. The nurse tells the client that which blood test will be done periodically while the client is taking this medication? 1. Neutrophil count 2. Liver function studies 3. White blood cell count 4. Complete blood cell (CBC) count 2. Liver function studies 68. Atorvastatin (Lipitor) has been prescribed for a client, and the client asks the nurse about the side effects of the medication. What should the nurse tell the client is a frequent side effect of this medication? 1. Tremors 2. Lethargy 3. Headache 4. Tiredness 3. Headache 69. A client seen in the health care clinic for follow-up care is taking atorvastatin (Lipitor). The nurse should assess the client for which adverse effect of the medication? 1. Earache 2. Hearing loss 3. Photosensitivity 4. Lung congestion 3. Photosensitivity 70. Atorvastatin (Lipitor) has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching? 1. "This medication will lower my cholesterol level." 2. "I will need to have blood tests drawn while I am taking this medication." 3. "I won't need to adhere to a low-fat diet as long as I take this medication faithfully." 4. "I need to talk to the health care provider (HCP) before taking any over-the-counter medications." 3. "I won't need to adhere to a low-fat diet as long as I take this medication faithfully." 71. Diltiazem (Cardizem) is prescribed for a client with Prinzmetal's variant angina. The nurse should plan care, knowing that this medication works by which method? 1. Increasing the heart rate 2. Constricting peripheral arteries 3. Increasing sinoatrial (SA) and atrioventricular (AV) conduction 4. Inhibiting calcium movement across cell membranes of cardiac and smooth muscle 4. Inhibiting calcium movement across cell membranes of cardiac and smooth muscle 72. A client with cardiac disease has begun taking propranolol (Inderal LA), and the nurse provides information to the client about the medication. The nurse should tell the client to contact the health care provider (HCP) if which symptoms develop? 1. Insomnia and headache 2. Nausea and constipation 3. Night cough and dyspnea 4. Drowsiness and nightmares 3. Night cough and dyspnea 73. Hydrochlorothiazide (HydroDIURIL) has been prescribed for a client. The nurse contacts the health care provider to verify the prescription if which condition is noted in the assessment data? 1. Hypertension 2. Allergy to eggs 3. Nephrotic syndrome 4. Allergy to sulfonamides 4. Allergy to sulfonamides 74. A client is seen in the clinic complaining of anorexia and nausea. The health care provider suspects that the client may be experiencing digoxin toxicity. While waiting for test results to become available, the nurse should assess the client for which sign or symptom that would support a diagnosis of digoxin toxicity? 1. Edema 2. Chest pain 3. Constipation 4. Photophobia 4. Photophobia 75. The nurse is administering a dose of intravenous hydralazine (Apresoline) to a client. The nurse should ensure that which item is in place before injecting the medication? 1. Central line 2. Foley catheter 3. Pulse oximeter 4. Blood pressure cuff 4. Blood pressure cuff 76. The nurse is performing an assessment on a client with a diagnosis of chronic angina pectoris. The client is receiving sotalol (Betapace) orally daily. Which assessment finding indicates to the nurse that the client is experiencing a side/adverse effect related to the medication? 2. An increased dosage of warfarin 3. A decreased dosage of levothyroxine 4. An increased dosage of levothyroxine 1. A decreased dosage of warfarin 86. A nurse prepares to administer sodium polystyrene sulfonate (Kayexalate) to a client. Before administering the medication, the nurse reviews the action of the medication and understands that which is released by this medication? 1. Bicarbonate in exchange for primarily sodium ions 2. Potassium ions in exchange for primarily sodium ions 3. Sodium ions in exchange for primarily potassium ions 4. Sodium ions in exchange for primarily bicarbonate ions 3. Sodium ions in exchange for primarily potassium ions 87. A home health nurse instructs a client about the use of a nitrate patch. The nurse should make which statement to the client to prevent client tolerance to nitrates? 1. "Do not remove the patches." 2. "Have a 12-hour ‘no-nitrate' time." 3. "Ensure a 24-hour ‘no-nitrate' time." 4. "Keep nitrates on 24 hours, then off 24 hours." 2. "Have a 12-hour ‘no-nitrate' time." 88. A client with nausea and bradycardia is admitted to a medical unit. The family hands a nurse a small white envelope labeled "heart pill." The envelope is sent to the pharmacy and it is found to be digoxin (Lanoxin). A family member states, "That health care provider doesn't know how to take care of my family." Which statement would convey a therapeutic response by the nurse? 1. "Don't worry about this. I'll take care of everything." 2. "You are concerned your loved one receives the best care." 3. "You're right! I've never seen them put pills in an envelope." 4. "I think you're wrong. That health care provider (HCP) has been in practice more than 30 years." 2. "You are concerned your loved one receives the best care." 89. A male client is on enalapril (Vasotec) for the treatment of hypertension. The nurse teaches the client that he should seek emergent care if he experiences which adverse effect? 1. Nausea 2. Insomnia 3. Dry cough 4. Swelling of the tongue 4. Swelling of the tongue 90. What should the nurse teach a client about an expected outcome of nesiritide (Natrecor) administration? 1. The client will have an increase in urine output. 2. The client will have an absence of dysrhythmias. 3. The client will have an increase in blood pressure. 4. The client will have an increase in pulmonary capillary wedge pressure. 1. The client will have an increase in urine output. 91. A client is admitted to a hospital with acute myocardial infarction and is started on tissue plasminogen activator (tPA, Activase) by infusion. Of the following parameters, which one should a nurse determine requires the least frequent assessment to detect complications of therapy with tPA? 1. Neurological signs 2. Blood pressure and pulse 3. Presence of bowel sounds 4. Complaints of abdominal and back pain 3. Presence of bowel sounds 92. A hospitalized client with coronary artery disease complains of substernal chest pain. After assessing the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes the client states, "My chest still hurts." Which actions should the nurse take? Select all that apply. 1. Call a Code Blue. 2. Contact the client's family. 3. Assess the client's pain level. 4. Check the client's blood pressure. 5. Contact the health care provider (HCP). 6. Administer a second nitroglycerin, 0.4 mg, sublingually. o 3. Assess the client's pain level. o 4. Check the client's blood pressure. o 6. Administer a second nitroglycerin, 0.4 mg, sublingually. 93. A client has developed paroxysmal nocturnal dyspnea. Which medication should the nurse anticipate will be prescribed by the health care provider? 1. Bumetanide 2. Lidocaine (Xylocaine) 3. Propranolol (Inderal LA) 4. Streptokinase (Streptase) 1. Bumetanide 94. A home health care nurse is visiting an older client at home. Furosemide (Lasix) is prescribed for the client and the nurse teaches the client about the medication. Which statement, if made by the client, indicates the need for further teaching? 1. "I will sit up slowly before standing each morning." 2. "I will take my medication every morning with breakfast." 3. "I need to drink lots of coffee and tea to keep myself healthy." 4. "I will call my health care provider (HCP) if my ankles swell or my rings get tight." 3. "I need to drink lots of coffee and tea to keep myself healthy." 95. In reviewing the medication records of the following group of clients, the nurse determines that which client would be at greatest risk for developing hyperkalemia? 1. Client receiving bumetanide 2. Client receiving furosemide (Lasix) 3. Client receiving spironolactone (Aldactone) 4. Client receiving hydrochlorothiazide (HCTZ) 3. Client receiving spironolactone (Aldactone) 96. The nurse is caring for a client who is receiving dopamine. Which potential problem is a priority concern for this client? 1. Fluid overload 2. Peripheral vasoconstriction 3. Inability to perform self-care 4. Inability to discriminate hot or cold sensations 2. Peripheral vasoconstriction 97. The health care provider has prescribed clonidine (Catapres) for a client with hypertension. The nurse should inform the client that which is a side effect of this medication? 1. Diarrhea 2. Constipation 3. Hypertension 4. Increased salivation 2. Constipation 98. Gemfibrozil (Lopid) is prescribed for a client. Which laboratory finding should alert the nurse about the need to withhold the medication and contact the health care provider? 1. Elevated glucose 2. Elevated triglycerides 3. Elevated liver function tests 4. Elevated blood urea nitrogen (BUN) 2. Check the client's blood pressure. 108. A man who has developed atrial fibrillation and has been placed on warfarin (Coumadin). The nurse is doing discharge dietary teaching with the client and determines that the client needs additional education if he stated he would choose which foods while taking this medication? 1. Cherries 2. Potatoes 3. Broccoli 4. Spaghetti 3. Broccoli 109. A client with heart disease is taking digoxin (Lanoxin) and complains of having no appetite, and experiencing diarrhea and blurry vision. The nurse notes that the client's serum potassium (K) level is 3.0 mEq/L. Based on analysis of the data, what might the nurse expect to note when reviewing the digoxin level results? 1. Digoxin level of 1.8 ng/mL 2. Digoxin level higher than 2 ng/mL 3. Digoxin level lower than 0.5 ng/mL 4. Digoxin level of 0 ng/mL because of diarrhea 2. Digoxin level higher than 2 ng/mL 110. The nurse is providing medication information to a client who is beginning medication therapy with enalapril (Vasotec). The nurse should tell the client that which is an anticipated, although unpleasant, side effect of this medication? 1. Rapid pulse 2. Persistent dry cough 3. Increased blood pressure 4. Metallic taste in the mouth 2. Persistent dry cough 111. A client has recently begun medication therapy with propranolol (Inderal LA). The long-term care nurse should plan to notify the health care provider (HCP) if which assessment finding is noted? 1. Complaints of insomnia 2. Audible expiratory wheezes 3. Decrease in heart rate from 86 to 78 beats/min 4. Decrease in blood pressure from 162/90 to 136/84 mm Hg 2. Audible expiratory wheezes 112. A client is receiving scheduled doses of lovastatin (Mevacor). The nurse determines that the medication is having the intended effect if which is noted? 1. Weight loss 2. Increased pulse rate 3. Lowered blood pressure 4. Decreased cholesterol level 4. Decreased cholesterol level 113. A client taking verapamil (Calan) has been given information about side effects of this medication. The nurse determines that the client understands the information if the client states to watch for which most common side effect of this medication? 1. Weight loss 2. Constipation 3. Nasal stuffiness 4. Abdominal cramping 2. Constipation 114. The nurse has a prescription to give a first dose of hydrochlorothiazide (HydroDIURIL) to an assigned client. The nurse would question the prescription if the client has a history of allergy to which item? 1. Iodine 2. Shellfish 3. Penicillin 4. Sulfa drugs 4. Sulfa drugs 115. The nurse has a prescription to give a client a scheduled dose of digoxin (Lanoxin). Prior to administering the medication, the nurse should assess for which manifestations that could indicate digoxin toxicity? 1. Dyspnea, edema, and palpitations 2. Chest pain, hypotension, and paresthesias 3. Constipation, dry mouth, and sleep disorder 4. Double vision, loss of appetite, and nausea 4. Double vision, loss of appetite, and nausea 116. A hospitalized client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin, gr 1/4 sublingually. Five minutes later, the client is still experiencing chest pain. If the blood pressure remains stable, the nurse should take which action next? 1. Administer another nitroglycerin tablet. 2. Administer 10 L of oxygen via nasal cannula. 3. Call for a 12-lead electrocardiogram (ECG) to be performed. 4. Wait an additional 5 minutes, and then give a second nitroglycerin tablet. 1. Administer another nitroglycerin tablet. 117. The long-term care client with a history of heart failure has developed paroxysmal nocturnal dyspnea (PND). The nurse reviews the client's medication record and determines that which medication has been prescribed to treat the PND? 1. Bumetanide 2. Warfarin (Coumadin) 3. Propranolol (Inderal LA) 4. Acetylsalicylic acid (aspirin) 1. Bumetanide 118. The nurse is working with a client receiving an intravenous heparin sodium drip. The nurse should review which laboratory study to determine the therapeutic effect of heparin for the client? 1. Bleeding time 2. Thrombin time 3. Prothrombin time (PT) 4. Partial thromboplastin time (PTT) 4. Partial thromboplastin time (PTT) 119. The nurse is caring for a child with heart failure (HF). The nurse provides instructions to the mother regarding the procedure for administration of the prescribed digoxin (Lanoxin). Which statement by the mother indicates a need for further teaching? 1. "I will make sure to mix the medication with food." 2. "I need to take the child's pulse before administering the medication." 3. "If more than one dose is missed, I need to call the health care provider." 4. "If the child vomits after being given the medication, I should not repeat the dose." 1. "I will make sure to mix the medication with food."