NURS 6521-Week 3 quiz-with 100% verified answers-2024-2025 .docx, Exams of Nursing

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NURS 6521-Week 3 quiz-with 100% verified answers-

- Question (^1) 1 out of 1 points A clinic nurse has been assigned a 49-year-old female patient who has a history of diabetes. A recent diagnosis of hypertension has been made, and the patient has been prescribed a thiazide diuretic and labetalol. The patient will be scheduled to return to the clinic once a month for the next 6 months. A priority action by the nurse will be to Respons e Feedbac k: Monitoring of blood pressure would be the priority assessment in the care of this patient. Questioning the patient about her dietary intake and weighing her would be appropriate, but secondary in importance. It is unnecessary to monitor the patient's respiratory rate. - Question 2 A 55-year-old man's hypertension has not responded adequately to his 1 out of 1 points current medication regimen consisting or an ACE inhibitor, a beta- blocker and a thiazide diuretic. As a result, he will soon begin taking hydralazine (Apresoline) in addition to his existing antihypertensives. The addition of this medication to his regimen means that the nurse must prioritize which of the following nursing actions? Respon se Feedbac k : Hydralazine is associated with an increase in cardiac output that can precipitate palpitations, tachycardia, and angina. As a result, there is a need for astute cardiac assessment. The use of hydralazine does not directly necessitate close monitoring of electrolytes or blood sugars, even though these are prudent assessment measures. There is a risk of dizziness and possibly falls with the use of any antihypertensive, but it is unnecessary to supervise all of the patient's ADLs. - Question 3 A 39-year-old African-American male is 25 pounds overweight and has 1 out of 1 points been diagnosed with hypertension after three consecutive above- normal blood pressure readings. The most likely initial drug therapy for this patient will be

Respon se Feedbac k : The patient would most likely be prescribed a diuretic in combination with diet and other lifestyle changes. African- American men are at increased risk for developing hypertension and tend to respond differently to antihypertensive therapy. The research shows that African-American men are most responsive to single-drug therapy and diuretics. The use of a calcium channel blocker and/or alpha-adrenergic blocker would follow if he is unresponsive to the diuretic in combination with diet and other lifestyle changes. African Americans tend to be less

- Question 7 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 assessments? 1 out of 1 points

Respon se Feedbac k : Metoprolol has a profound effect on both blood pressure and heart rate. Consequently, the nurse should assess these parameters prior to administering the drug. Assessments related to pain, respiratory status, cognition, and temperature are not central to the administration of a beta blocker.

- Question (^8) 1 out of 1 points A nurse who provides care in a busy clinic is aware of the high incidence and prevalence of hyperlipidemia and the consequent need for antihyperlipidemics in many patients. Treatment of high cholesterol using statins would be contraindicated in which of the following patients? Respons e Feedbac k: Active liver disease is a contraindication to the use of statins. As well, heavy alcohol use increases the risk of liver dysfunction. Respiratory disease, recent surgery, and organic cognitive deficits do not preclude the use of statins for high cholesterol. - Question (^9) 1 out of 1 points A nurse is caring for a male patient who has a diagnosis of coronary artery disease (CAD). His drug therapy includes lovastatin. Because the patient has a history of severe renal disease, the nurse will assess for which of the following? Respons e Feedbac k: Patients with severe renal disease may have an increased plasma concentration of lovastatin because 10% of the drug is eliminated in the urine. Patients with renal disorders are not likely to experience a decrease in LDL or an increase in the statin tolerance level. - Question 10 A nurse is caring for a patient who is admitted into the cardiac care unit with acute, decompensated heart failure. Nesiritide (Natrecor) has been ordered. When preparing for administration of the drug, the nurse will 1 out of 1 points Respon se Feedbac k : Nesiritide must be reconstituted and then further diluted for infusion. Reconstitute one vial by adding 5 mL of diluent that has been removed from a 250-mL plastic IV bag. Do not shake the vial. Rock the vial gently so that all surfaces, including the stopper, are in contact with the

- Question (^11) 1 out of 1 points A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by Respon se Feedbac k : Verapamil acts by inhibiting the movement of calcium ions across the cardiac and arterial muscle cell membrane. It works preferentially in “slow response” myocardial tissue, such as the SA and AV nodes. Beta blockers inhibit adrenergic receptors and Class IB antiarrhythmics are among the drugs that decrease sodium and potassium conduction. Lidocaine weakens phase 4 diastolic depolarization and decreases the action potential duration and the effective refractory period of Purkinje fibers and ventricular muscle. - Question 12 A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous 1 out of 1 points nitroglycerin 5 mcg/min, titrate dose by 5 mcg/min every 3 to 5 minutes per infusion pump as needed. Before administering the nitroglycerin, the nurse should prioritize which of the following assessments? Respon se Feedbac k : Before administering IV nitroglycerin, the nurse should first assess blood pressure to make sure that the patient does not have hypotension and to establish a baseline blood pressure. It is also important to assess the heart rate and urinary function (urinary output and BUN). However, in the case of administering intravenous nitroglycerin, the nurse would first assess the blood pressure. - Question 13 The nurse is performing patient education for a woman who will soon begin treatment of hyperlipidemia with simvastatin (Zocor). The patient 1 out of 1 points has asked the nurse if there are any “bad side effects” that she should be aware of. Which of the following statements should underlie the nurse's response? Respon se Feedbac k :

A d v e r s e e f f e c t s o f l o v a s t a t i n a r e u s u a l l y m i l d a nd transient; the drug is generally well tolerated. A fairly common complaint with all statins, including lovastatin, is nonspecific muscle aches or joint aches, weakness, and/or cramps (myalgias), which are not associated with any signs of muscle damage. GI upset and cough are not associated with the use of statins. Renal disease may contraindicate the use of statins, but frequent analysis of kidney function is not necessary for patients with no preexisting

t his time.

- Question (^17) 1 out of 1 points A nurse is caring for a patient with chronic angina. The patient is receiving ranolazine (Ranexa) 500 mg PO bid. Which of the following signs or

symptoms would the nurse attribute to being a common adverse effect of this medication? Respon se Feedbac k : The most common adverse effects from ranolazine are dizziness, headache, constipation (not diarrhea), and nausea. Bradycardia is not an identified adverse effect of ranolazine therapy. Perspiring skin that is cold to the touch is a manifestation usually associated with a nitroglycerin overdose.

- Question (^18) 1 out of 1 points A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit she reports that since she has been on the drug, she can breathe better and her heart rate has been around 74 beats per minute. The nurse weighs the patient and notices that she has gained 10 pounds since the digoxin therapy was started. The patient is concerned that the additional weight will necessitate an increase in the medication. Which of the following is an appropriate response by the nurse? Respon se Feedbac k : Serum digoxin levels are not affected significantly by changes in fat tissue weight and are best calculated on ideal body weight rather than actual weight of the patient. Therefore, the nurse will advise the patient that the dosage will not be changed. The nurse should know this, and there should be no need to ask the prescriber. - Question 19 An expected outcome for a patient who has just taken sublingual nitroglycerin should be 1 out of 1 points Respon se Feedbac k : Nitroglycerin relaxes vascular smooth muscle and dilates both arterial and venous vessels. Dilation of veins is more predominant than dilation of arteries, resulting in peripheral pooling of blood and decreased preload. Blood pressure will usually decrease as a result of the venous dilation. Reflex tachycardia usually follows the drop in blood pressure. - Question (^20) 1 out of 1 points A 45-year-old man who is a construction worker has been diagnosed with hyperlipidemia and has been prescribed lovastatin. The nurse will advise the patient to

alcohol, but should avoid alcohol altogether while taking lovastatin.

- Question 21 1 out of 1 points A nurse explains to a patient that nitroglycerin patches should be applied in the morning and removed in the evening. This medication schedule reduces the potential for Respon se Feedbac k : The nurse will stress that it is important to remove the patch for 10 to 12 hours every 24 hours to prevent nitrate tolerance from developing. If anginal symptoms develop at night, the use of a beta blocker or calcium channel blocker should be considered. Patients who normally have angina only during daytime hours are not at substantial risk for developing nighttime angina with a nightly nitrate-free period. Applying the nitroglycerin patch in the morning and removing it in the evening would not significantly limit the adverse effects from the drug. Dependency does not occur with nitroglycerin, and prescribed dosages should not cause toxic effects. - Question (^22) 1 out of 1 points A 77-year-old man's chronic heart failure is being treated with a regimen of quinapril (Accupril) and furosemide (Lasix). Which of the following assessment findings would suggest that the loop diuretic is contributing to a therapeutic effect? Respons e Feedbac k: Appropriate diuretic therapy leads to the resolution of pulmonary and peripheral edema. Healthy kidney function, cardiac rhythm, and electrolyte levels are all desirable outcomes, but they are not directly indicative of the therapeutic action of diuretics in the treatment of CHF. - Question (^23) 1 out of 1 points A 62-year-old man has been prescribed extended-release lovastatin. The nurse will instruct the patient to take the medication Respon se Feedbac k : Patients who are prescribed extended-release lovastatin should take the medication at bedtime, without food, to be most effective. This is because most cholesterol

s y n t hesis occurs during this time. Immediate-release lovastatin should be taken after the evening meal. It would not be appropriate to take lovastatin in the afternoon or the early morning.

- Question 24 A nurse has been following a male patient who is taking hydralazine, 1 out of 1 points