Nursing 6521 QUIZ 3 Latest Updated Questions with Answers Tested and Verified Exam Prepara, Exams of Nursing

Download Nursing 6521 QUIZ 3 Latest Updated Questions with Answers Tested and Verified Exam Prepara and more Exams Nursing in PDF only on Docsity!

Nursing 6521 QUIZ 3 Latest Updated Questions with Answers

Tested and Verified Exam Preparations 100% Correct

- Question 1 0 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 Respons e 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 (^2) 1 out of 1 points A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.) Respons e Feedbac k: Because of its effects on blocking beta-1 receptors, metoprolol slows the heart rate, the speed of conduction, and decreases the force of contraction, thus cardiac output is decreased, decreasing blood pressure. Consequently, it is necessary to assess the patient's heart rate in addition to his or her blood pressure. Neither beta blockers nor thiazide diuretics create a direct need for the assessment of temperature, respiratory rate, or oxygen saturation level. - Question 3 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

Respons e 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 (^4) 1 out of 1 points A nurse is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The nurse should anticipate that the drug will be administered Respons e Feedbac k: Clonidine may be administered orally or parenterally but is most frequently administered transdermally. - Question (^5) 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? Respons e 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 (^6) 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 (^7) 1 out of 1 points A patient has recently been prescribed a drug that treats his

hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of Respons e Feedbac k: Those drugs that stimulate sympathetic receptors are referred to as adrenergic or dopaminergic agonists (stimulators) and those that block are referred to as adrenergic antagonists (blockers). Adrenergic antagonism is not synonymous with the

action of a cardiotonic drug.

- Question 8 Which of the following patients is most likely to benefit from the administration of an adrenergic agonist? 1 out of 1 points Respons e Feedbac k: One of the most frequent indications for adrenergic agonist drugs is shock. Their use is contraindicated in labor, and they would exacerbate hypertension. - Question 9 A nurse is caring for a patient who is taking digoxin and a loop diuretic. 1 out of 1 points Which of the following would be most important for the nurse to monitor? Respons e Feedbac k: Although it is important to monitor the patient's ECG, it is more important to closely monitor potassium levels when the patient is taking a drug that promotes the loss of potassium, such as thiazide or loop diuretics. Hypokalemia increases the effect of digoxin and increases the risk for digoxin toxicity. The patient's sodium levels and liver enzyme levels may need to be monitored periodically, but not as closely as potassium levels. - Question 10 A 62-year-old man is admitted to the hospital with a diagnosis of chest 1 out of 1 points pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain? Respons e Feedbac k: The initial action by the nurse should be sublingual administration of the drug by placing one tablet under the patient's tongue and repeating the action in 5 and 10 minutes if necessary. Asking the patient to relax is important and should be done, but administering the tablets would need to be done first. The nurse would not call the physician if the pain has subsided by the third tablet. If the pain has not subsided, the patient is considered to be having an acute MI, and it would be urgent to call the physician. Nitroglycerin does not come in oral form; therefore, it would not be swallowed. - Question (^11) 0 out of 1 points A patient is diagnosed with heart failure and is started on digoxin.

On the second day of therapy, lab values, the ECG results, and the patient's symptoms indicate that the medication is not producing a therapeutic effect. An appropriate nursing action would be to

Respons e Feedbac k: The nurse should continue regular administration of the drug because digoxin requires a loading dose before the drug's therapeutic effect is present. It may take several days for optimal clinical effects to appear. Therefore, seeking an order to increase the dosage, seeking orders to discontinue digoxin and start another drug, or insisting that another drug be ordered would not be necessary at this time.

- Question 12 A nurse has been following a male patient who is taking hydralazine, clonidine, and a diuretic for hypertension. After 2 weeks of medication therapy, the patient begins to complain of numbness and tingling in his hands and feet. The nurse suspects that these signs or symptoms are 1 out of 1 points Respons e Feedbac k: The nurse will evaluate the numbness and tingling in the patient's hands and feet as signs of peripheral neuritis, which is an adverse effect of the hydralazine. If a diagnosis is made to confirm the nurse's suspicion, pyridoxine should be administered because the neuritis may be caused by the antipyridoxine effect of the drug therapy. The numbness and tingling are not associated with clonidine and a diuretic. An increased risk of diabetes has not been identified as being related to this combination of medications. - Question 13 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 0 out of 1 points Respons e 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 diluent. Add the entire contents of the reconstituted vial back to the 250-mL plastic IV bag and invert the bag several times to ensure complete mixing. Use the reconstituted nesiritide solution within 24 hours. The initial IV bolus must be drawn from the prepared infusion bag and administered over approximately 60 seconds through an IV port. - Question (^14) 0 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

Respons e Feedbac k: Since the patient works outdoors most of the time, the nurse should advise him to avoid prolonged exposure to sunlight by wearing protective gear. Advising the patient regarding the use of OTC drugs and drug changes would be better handled by the prescriber. The patient should not drink moderate amounts of alcohol, but should avoid alcohol altogether while taking lovastatin.

- Question 15 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? Respons e 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 (^16) 0 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 Respons e 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 (^17) 0 out of 1 points A patient is brought to the emergency department in hypertensive crisis. Nitroprusside is administered intravenously. The patient

experiences diaphoresis and dizziness. Which of the following is the appropriate action by the nurse? Respons e Feedbac k: Administering nitroprusside too quickly can result in abdominal

pain, apprehension, diaphoresis, dizziness, headache, muscle twitching, nausea, palpitations, restlessness, retching, and retrosternal discomfort. The nurse should quickly inform the prescriber and slow the infusion. Symptoms quickly subside when the nitroprusside infusion is slowed or stopped, and usually do not return when the infusion resumes at a slower rate. Consulting the prescriber for a dose change would not help; the rate of drug administration is the issue. Continuing to give the nitroprusside at the ordered rate could be fatal.

- Question 18 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 (^19) 1 out of 1 points A priority nursing assessment for a patient who is to receive an alpha- or beta-adrenergic antagonist would be to Respons e Feedbac k: The patient's heart rate must be assessed prior to administration of alpha- and beta-adrenergic antagonists. These drugs are contraindicated in a patient who has bradycardia; both these drugs could further decrease the heart rate and cause serious conduction complications. Caution should also be exercised in patients with bronchospasms and diabetes mellitus because the combination could worsen both conditions. Because these drugs are mostly excreted in the urine, it would be important for the nurse to be aware of the patient's output. However, the most serious adverse effect would be severe bradycardia, so the nurse's priority would be assessment of the heart rate. - Question 20 A patient with class-IV CHF has a medication regimen consisting of metoprolol (Lopressor), enalapril (Vasotec), and furosemide (Lasix). In 1 out of 1 points addition to regularly assessing the patient s heart rate, the nurse should prioritize assessment of the patient's

Respons e Feedbac k: Fluid balance, cognition, and exercise tolerance are all affected by CHF and should be regularly assessed as part of thorough nursing care. However, the combination of an ACE inhibitor, a beta blocker, and a diuretic constitutes a significant risk for hypotension and indicates a need for frequent blood pressure monitoring.

- Question 21 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? Respons e Feedbac k: Adverse effects of lovastatin are usually mild and 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 indications. - Question 22 A nurse is caring for a patient who is diabetic and has been diagnosed 1 out of 1 points with hypertension. An angiotensin-converting enzyme inhibitor, captopril, has been prescribed for her. Which of the following should the nurse assess before beginning drug therapy? Respons e Feedbac k: Captopril inhibits the angiotensin-converting enzyme that is needed to change the inactive angiotensin I to the active form, angiotensin II. This reduction of angiotensin II decreases the secretion of aldosterone, preventing sodium and water retention. This action decreases peripheral vascular resistance and lowers blood pressure. Serum potassium may increase as a result of decreased aldosterone levels. It would be helpful to have a baseline level at the beginning of the drug therapy to monitor the possible effect of hyperkalemia. There is no need to monitor calcium and magnesium levels. While it is important to always know a diabetic's blood glucose level, captopril does not alter the level during therapy. - Question 23

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 (^24) 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 Respons e 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 synthesis 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 25 Question 1 1 out of 1 points 0 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 Respons e 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 2

1 out of 1 points A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that

apply.) Respons e Feedbac k: Because of its effects on blocking beta-1 receptors, metoprolol slows the heart rate, the speed of conduction, and decreases the force of contraction, thus cardiac output is decreased, decreasing blood pressure. Consequently, it is necessary to assess the patient's heart rate in addition to his or her blood pressure. Neither beta blockers nor thiazide diuretics create a direct need for the assessment of temperature, respiratory rate, or oxygen saturation level. Question 3 A resident of a long-term care facility receives 12.5 mg metoprolol 1 out of 1 points (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessments? Respons e 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 (^4) 1 out of 1 points A nurse is providing patient education to a 35-year-old man who has been prescribed clonidine (Catapres) as part of step 2 antihypertensive therapy. The nurse should anticipate that the drug will be administered Respons e Feedbac k: Clonidine may be administered orally or parenterally but is most frequently administered transdermally. Question (^5) 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? Respons e 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

p a t ient. 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 6

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 7 A patient has recently been prescribed a drug that treats his 1 out of 1 points hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of Respons e Feedbac k: Those drugs that stimulate sympathetic receptors are referred to as adrenergic or dopaminergic agonists (stimulators) and those that block are referred to as adrenergic antagonists (blockers). Adrenergic antagonism is not synonymous with the action of a cardiotonic drug. Question 8 Which of the following patients is most likely to benefit from the administration of an adrenergic agonist? 1 out of 1 points Respons e Feedbac k: One of the most frequent indications for adrenergic agonist drugs is shock. Their use is contraindicated in labor, and they would exacerbate hypertension. Question (^9) 1 out of 1 points A nurse is caring for a patient who is taking digoxin and a loop diuretic. Which of the following would be most important for the nurse to monitor? Respons e Feedbac k: Although it is important to monitor the patient's ECG, it is more important to closely monitor potassium levels when the patient is taking a drug that promotes the loss of potassium, such as thiazide or loop diuretics. Hypokalemia increases the effect of digoxin and increases the risk for digoxin toxicity. The patient's sodium levels and liver enzyme levels may need to be monitored periodically, but not as closely as potassium levels.

Question (^10) 1 out of 1 points A 62-year-old man is admitted to the hospital with a diagnosis of chest

pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain? Respons e Feedbac k: The initial action by the nurse should be sublingual administration of the drug by placing one tablet under the patient's tongue and repeating the action in 5 and 10 minutes if necessary. Asking the patient to relax is important and should be done, but administering the tablets would need to be done first. The nurse would not call the physician if the pain has subsided by the third tablet. If the pain has not subsided, the patient is considered to be having an acute MI, and it would be urgent to call the physician. Nitroglycerin does not come in oral form; therefore, it would not be swallowed. Question (^11) 0 out of 1 points A patient is diagnosed with heart failure and is started on digoxin. On the second day of therapy, lab values, the ECG results, and the patient's symptoms indicate that the medication is not producing a therapeutic effect. An appropriate nursing action would be to Respons e Feedbac k: The nurse should continue regular administration of the drug because digoxin requires a loading dose before the drug's therapeutic effect is present. It may take several days for optimal clinical effects to appear. Therefore, seeking an order to increase the dosage, seeking orders to discontinue digoxin and start another drug, or insisting that another drug be ordered would not be necessary at this time. Question (^12) 1 out of 1 points A nurse has been following a male patient who is taking hydralazine, clonidine, and a diuretic for hypertension. After 2 weeks of medication therapy, the patient begins to complain of numbness and tingling in his hands and feet. The nurse suspects that these signs or symptoms are Respons e Feedbac k: The nurse will evaluate the numbness and tingling in the patient's hands and feet as signs of peripheral neuritis, which is an adverse effect of the hydralazine. If a diagnosis is made to confirm the nurse's suspicion, pyridoxine should be administered because the neuritis may be caused by the antipyridoxine effect of the drug therapy. The numbness and tingling are not associated with clonidine and a diuretic. An increased risk of diabetes has not been identified as being related to this combination of medications.

Question (^13) 0 out of 1 points

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 Respons e 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 diluent. Add the entire contents of the reconstituted vial back to the 250-mL plastic IV bag and invert the bag several times to ensure complete mixing. Use the reconstituted nesiritide solution within 24 hours. The initial IV bolus must be drawn from the prepared infusion bag and administered over approximately 60 seconds through an IV port. Question (^14) 0 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 Respons e Feedbac k: Since the patient works outdoors most of the time, the nurse should advise him to avoid prolonged exposure to sunlight by wearing protective gear. Advising the patient regarding the use of OTC drugs and drug changes would be better handled by the prescriber. The patient should not drink moderate amounts of alcohol, but should avoid alcohol altogether while taking lovastatin. Question (^15) 1 out of 1 points A patient is admitted to the emergency department with severe chest pain. The emergency department physician orders intravenous 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? Respons e 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 (^16) 0 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 Respons e 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 (^17) 0 out of 1 points A patient is brought to the emergency department in hypertensive crisis. Nitroprusside is administered intravenously. The patient experiences diaphoresis and dizziness. Which of the following is the appropriate action by the nurse? Respons e Feedbac k: Administering nitroprusside too quickly can result in abdominal pain, apprehension, diaphoresis, dizziness, headache, muscle twitching, nausea, palpitations, restlessness, retching, and retrosternal discomfort. The nurse should quickly inform the prescriber and slow the infusion. Symptoms quickly subside when the nitroprusside infusion is slowed or stopped, and usually do not return when the infusion resumes at a slower rate. Consulting the prescriber for a dose change would not help; the rate of drug administration is the issue. Continuing to give the nitroprusside at the ordered rate could be fatal. Question (^18) 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 (^19) 1 out of 1 points A priority nursing assessment for a patient who is to receive an

alpha- or beta-adrenergic antagonist would be to