Exam 2 Drugs Practice Questions

Question 1

1. Loop Diuretics (Furosemide)
   Which of the following is a priority nursing action before administering furosemide (Lasix)?
   A. Monitor blood glucose levels
   B. Check potassium levels
   C. Assess for signs of hypoglycemia
   D. Encourage the patient to take with food

Answer 1

Answer: B (Loop diuretics can cause hypokalemia, so potassium levels must be checked before administration.)

Question 2

2. Thiazide Diuretics (Hydrochlorothiazide)
   Which electrolyte imbalance is most common with hydrochlorothiazide? A. Hyperkalemia
   B. Hypercalcemia
   C. Hypermagnesemia
   D. Hyponatremia

Answer 2

Answer: B (Thiazides cause potassium and magnesium loss but increase calcium reabsorption.)

Question 3

3. Beta-Blockers (-lol drugs)
   A patient taking metoprolol complains of feeling lightheaded when standing up. What is the best nursing intervention?
   A. Discontinue the medication immediately
   B. Instruct the patient to rise slowly from a sitting or lying position
   C. Increase fluid intake
   D. Have the patient take the medication with grapefruit juice

Answer 3

Answer: B (Beta-blockers can cause orthostatic hypotension; rising slowly prevents dizziness and falls.)

Question 4

4. ACE Inhibitors (-pril drugs)
   A nurse is educating a patient about lisinopril. What common side effect should the patient be warned about?
   A. Increased blood sugar
   B. Persistent dry cough
   C. Constipation
   D. Increased heart rate

Answer 4

Answer: B (ACE inhibitors cause a persistent dry cough due to increased bradykinin levels.)

Question 5

5. Calcium Channel Blockers (Amlodipine, Verapamil)
   Which of the following side effects is most common with amlodipine? A. Peripheral edema
   B. Cough
   C. Hypoglycemia
   D. Hyperkalemia

Answer 5

Answer: A (Amlodipine, a calcium channel blocker, commonly causes peripheral edema.)

Question 6

6. Anticoagulants (Warfarin, Heparin)
   Which lab value should be monitored for a patient on warfarin?
   A. aPTT
   B. INR
   C. Platelet count
   D. D-dimer

Answer 6

Answer: B (Warfarin requires INR monitoring; therapeutic range is 2.0–3.0.)

Question 7

7. Heparin vs. Warfarin
   Which statement by the patient indicates understanding of warfarin therapy?
   A. “I should monitor my potassium intake.”
   B. “I need to avoid foods high in vitamin K.”
   C. “I need to check my aPTT levels weekly.”
   D. “I can stop the medication if I feel better.”

Answer 7

Answer: B (Vitamin K reduces warfarin’s effectiveness.)

Question 8

8. Albuterol (Short-Acting Beta-Agonist)
   Which of the following symptoms is a common side effect of albuterol?
   A. Bradycardia
   B. Tremors
   C. Hypotension
   D. Constipation

Answer 8

Answer: B (Albuterol can cause tremors, tachycardia, and nervousness.)

Question 9

9. Inhaled Corticosteroids (Fluticasone)
   What should a nurse teach a patient using an inhaled corticosteroid?
   A. “Use this medication for acute asthma attacks.”
   B. “Rinse your mouth after each use.”
   C. “Take the medication on an empty stomach.”
   D. “Take an extra dose if symptoms persist.”

Answer 9

Answer: B (Rinsing prevents oral candidiasis (thrush).)

Question 10

10. Montelukast (Leukotriene Receptor Antagonist)
    What is an important patient teaching point for montelukast?
    A. “Take this medication during an asthma attack.”
    B. “Take this medication in the evening.”
    C. “Avoid taking this medication with dairy.”
    D. “This medication should be taken with food.”

Answer 10

Answer: B (Montelukast is preventative and should be taken in the evening.)

Question 11

11. Statins (Atorvastatin)
    Which adverse effect of atorvastatin requires immediate medical attention?
    A. Headache
    B. Muscle pain and dark urine
    C. Nausea
    D. Mild abdominal pain

Answer 11

Answer: B (Rhabdomyolysis is a severe side effect of statins.)

Question 12

12. Beta-Blockers
    A nurse is teaching a patient about beta-blockers. Which statements are correct? (Select all that apply.)
    A. “This medication may cause fatigue and dizziness.”
    B. “Monitor your heart rate daily and report if it falls below 60 bpm.”
    C. “Stop taking this medication immediately if you feel better.”
    D. “This drug lowers blood pressure and slows the heart rate.”
    E. “This medication is safe to use in patients with asthma.”

Answer 12

✅ A. “This medication may cause fatigue and dizziness.”
✅ B. “Monitor your heart rate daily and report if it falls below 60 bpm.”
❌ C. “Stop taking this medication immediately if you feel better.”
✅ D. “This drug lowers blood pressure and slows the heart rate.”
❌ E. “This medication is safe to use in patients with asthma.”

Correct Answers: A, B, D (Beta-blockers can cause fatigue and dizziness, lower HR/BP, and should not be stopped suddenly.)

Question 13

13. Digoxin Toxicity
    A nurse is assessing a patient for digoxin toxicity. Which signs and symptoms indicate toxicity? (Select all that apply.)
    A. Nausea and vomiting
    B. Yellow-green vision changes
    C. Bradycardia
    D. Hypertension
    E. Confusion

Answer 13

✅ A. Nausea and vomiting
✅ B. Yellow-green vision changes
✅ C. Bradycardia
❌ D. Hypertension
✅ E. Confusion

Correct Answers: A, B, C, E (Digoxin toxicity causes GI symptoms, visual disturbances, bradycardia, and confusion.)

Question 14

14. Prioritization: Heparin Infusion
    A nurse is monitoring a patient on a heparin drip. Which finding requires immediate intervention?
    A. INR of 2.5
    B. aPTT of 90 seconds
    C. Mild bruising on the arms
    D. Hemoglobin of 14 g/dL

Answer 14

Answer: B (A high aPTT (>80 sec) increases bleeding risk.)

Question 15

15. Delegation
    Which task can be delegated to a licensed practical nurse (LPN)?
    A. Titrating a heparin drip
    B. Assessing for digoxin toxicity
    C. Administering a scheduled subcutaneous enoxaparin injection
    D. Educating a patient about warfarin therapy

Answer 15

Answer: C (LPNs can administer injections but cannot titrate IV meds or educate on new meds.)

Question 16

1. Mechanism of Action
   Which of the following best describes the mechanism of action of thiazide diuretics?
   A. They inhibit the Na⁺/K⁺/2Cl⁻ cotransporter in the loop of Henle.
   B. They block aldosterone receptors in the collecting duct.
   C. They inhibit sodium-chloride (Na⁺/Cl⁻) reabsorption in the distal convoluted tubule.
   D. They prevent the conversion of angiotensin I to angiotensin II.

Answer 16

Answer: C (Thiazide diuretics inhibit Na⁺/Cl⁻ symporters in the distal convoluted tubule, leading to increased sodium and water excretion.)

Question 17

2. Clinical Indications
   Which condition is a primary indication for thiazide diuretics?
   A. Acute pulmonary edema
   B. Hypertension
   C. Hyperkalemia
   D. Atrial fibrillation

Answer 17

Answer: B (Thiazide diuretics are first-line treatment for hypertension, especially in Black and elderly patients.)

Question 18

3. Electrolyte Imbalances
   A nurse is reviewing lab results for a patient taking hydrochlorothiazide. Which finding is most concerning?
   A. Sodium level of 137 mEq/L
   B. Calcium level of 11.2 mg/dL
   C. Potassium level of 4.0 mEq/L
   D. Blood glucose of 90 mg/dL

Answer 18

Answer: B (Thiazide diuretics increase calcium reabsorption, potentially leading to hypercalcemia.)

Question 19

4. Side Effects
   A nurse is educating a patient about common side effects of hydrochlorothiazide. Which of the following should be included?
   A. Dizziness and hypotension
   B. Bradycardia
   C. Hyperkalemia
   D. Cough

Answer 19

Answer: A (Thiazide diuretics can cause orthostatic hypotension, dizziness, and dehydration.)

Question 20

5. Drug Interactions
   Which of the following medications should be used cautiously with thiazide diuretics due to increased risk of toxicity?
   A. Insulin
   B. Digoxin
   C. Acetaminophen
   D. Antacids

Answer 20

Answer: B (Hypokalemia caused by thiazides increases the risk of digoxin toxicity.)

Question 21

6. Patient Teaching
   A patient newly prescribed hydrochlorothiazide asks how to take their medication. Which response by the nurse is correct?
   A. “Take it at night to prevent dizziness during the day.”
   B. “Take it in the morning to prevent nighttime urination.”
   C. “You can take it anytime as long as you’re consistent.”
   D. “Take it on an empty stomach for better absorption.”

Answer 21

Answer: B (Thiazide diuretics should be taken in the morning to prevent nocturia.)

Question 22

7. Adverse Reactions
   Which of the following are potential adverse effects of thiazide diuretics? (Select all that apply.)
   A. Hypokalemia
   B. Hypercalcemia
   C. Hyperglycemia
   D. Increased heart rate
   E. Hyponatremia

Answer 22

✅ A. Hypokalemia
✅ B. Hypercalcemia
✅ C. Hyperglycemia
❌ D. Increased heart rate
✅ E. Hyponatremia

Answer: A, B, C, E (Thiazides can cause hypokalemia, hypercalcemia, hyperglycemia, and hyponatremia.)

Question 23

8. Contraindications
   A patient with which condition should NOT receive hydrochlorothiazide?
   A. Hypertension
   B. Osteoporosis
   C. Severe renal failure
   D. Mild edema

Answer 23

Answer: C (Thiazides are ineffective in severe renal failure—Creatinine clearance <30 mL/min.)

Question 24

9. Nursing Responsibilities
   Which nursing action is a priority before administering a thiazide diuretic?
   A. Check the patient’s white blood cell count
   B. Assess potassium levels
   C. Monitor hemoglobin levels
   D. Measure blood ammonia levels

Answer 24

Answer: B (Hypokalemia is a common side effect of thiazides, so potassium must be monitored.)

Question 25

10. Thiazide vs. Loop Diuretics How do thiazide diuretics differ from loop diuretics? A. Thiazides cause greater diuresis than loop diuretics. B. Thiazides increase calcium excretion, while loop diuretics retain calcium. C. Thiazides promote calcium retention, while loop diuretics increase calcium excretion. D. Thiazides are only used in emergency settings.

Answer 25

Answer: C (Thiazides retain calcium, while loop diuretics cause calcium loss.)

Question 26

11. Gout & Hyperuricemia Risk A nurse is reviewing a patient's history before administering a thiazide diuretic. Which condition requires caution? A. Gout B. COPD C. Anemia D. Depression

Answer 26

Answer: A (Thiazides can increase uric acid levels, worsening gout.)

Question 27

12. Metabolic Effects A patient on hydrochlorothiazide is experiencing muscle cramps, fatigue, and palpitations. What is the most likely cause? A. Hypernatremia B. Hypocalcemia C. Hypokalemia D. Hypermagnesemia

Answer 27

Answer: C (Hypokalemia can cause muscle cramps, fatigue, and cardiac arrhythmias.)

Question 28

13. Nursing Interventions A patient taking hydrochlorothiazide reports dizziness when standing up. What is the best nursing intervention? A. Discontinue the medication immediately B. Advise the patient to change positions slowly C. Encourage the patient to drink more fluids at night D. Increase the dosage to improve effectiveness

Answer 28

Answer: B (Orthostatic hypotension is common with thiazides, so patients should rise slowly.)

Question 29

14. Monitoring for Dehydration A nurse is monitoring a patient on hydrochlorothiazide. Which finding suggests dehydration? A. Blood pressure of 118/76 mmHg B. Urine output of 600 mL in 8 hours C. Weak, thready pulse D. Sodium level of 137 mEq/L

Answer 29

Answer: C (A weak, thready pulse suggests dehydration or hypovolemia.)

Question 30

15. Dietary Considerations A nurse is educating a patient about diet while taking hydrochlorothiazide. Which foods should be encouraged? A. Bananas and oranges B. Cheese and milk C. Red meat and eggs D. White bread and rice

Answer 30

Answer: A (Bananas, oranges, and potatoes are high in potassium, which helps prevent hypokalemia.)

Question 31

16. Drug Interactions Which of the following medications can reduce the effectiveness of hydrochlorothiazide? A. NSAIDs B. Beta-blockers C. Calcium channel blockers D. Proton pump inhibitors

Answer 31

Answer: A (NSAIDs can reduce the antihypertensive effects of thiazides.)

Question 32

17. Expected Outcomes A patient has been taking hydrochlorothiazide for two weeks. Which finding indicates the medication is effective? A. Increased heart rate B. Decreased blood pressure C. Increased potassium levels D. Increased edema

Answer 32

Answer: B (Thiazides lower blood pressure and reduce fluid retention.)

Question 33

1. Mechanism of Action How do potassium-sparing diuretics (e.g., spironolactone) work? A. They block sodium and chloride reabsorption in the loop of Henle. B. They inhibit aldosterone in the distal tubule and collecting duct. C. They increase sodium and potassium reabsorption. D. They promote calcium excretion in the kidneys.

Answer 33

Answer: B (Potassium-sparing diuretics block aldosterone, leading to sodium and water excretion while retaining potassium.)

Question 34

2. Indications for Use A patient is prescribed spironolactone. The nurse knows this medication is commonly used to treat which condition? A. Pulmonary embolism B. Hypokalemia C. Heart failure D. Hypercalcemia

Answer 34

Answer: C (Spironolactone is often used in heart failure to reduce fluid overload and cardiac remodeling.)

Question 35

3. Nursing Considerations Before administering spironolactone, which lab value should the nurse assess? A. Serum sodium B. Serum potassium C. INR D. Serum calcium

Answer 35

Answer: B (Hyperkalemia is a risk with potassium-sparing diuretics, so potassium levels must be checked.)

Question 36

4. Side Effects Which of the following is a common side effect of potassium-sparing diuretics? A. Hyperkalemia B. Hypocalcemia C. Hypertension D. Hypoglycemia

Answer 36

Answer: A (Hyperkalemia is a major risk with potassium-sparing diuretics.)

Question 37

5. Patient Education Which patient statement indicates a need for further teaching about spironolactone? A. “I should avoid salt substitutes.” B. “I need to have my potassium levels checked regularly.” C. “I should increase my potassium-rich food intake.” D. “I may experience dizziness or headache.”

Answer 37

Answer: C (Potassium-rich foods should be avoided due to the risk of hyperkalemia.)

Question 38

6. Drug Interactions Which of the following medications increases the risk of hyperkalemia when taken with spironolactone? A. Lisinopril B. Furosemide C. Hydrochlorothiazide D. Warfarin

Answer 38

Answer: A (ACE inhibitors like lisinopril increase potassium retention, raising the risk of hyperkalemia.)

Question 39

7. Contraindications Spironolactone is contraindicated in patients with: A. Hypertension B. Chronic kidney disease C. Hypokalemia D. Osteoporosis

Answer 39

Answer: B (Spironolactone should not be used in severe renal failure, as it can worsen hyperkalemia.)

Question 40

8. Hyperkalemia Risk A nurse is caring for a patient on spironolactone. Which symptom suggests the patient may have hyperkalemia? A. Muscle cramps and palpitations B. Increased thirst and dry skin C. Constipation and bloating D. Bradycardia and hypertension

Answer 40

Answer: A (Muscle cramps, weakness, and cardiac arrhythmias are signs of hyperkalemia.)

Question 41

9. Adverse Reactions Which of the following is a rare but serious adverse effect of spironolactone? A. Ototoxicity B. Stevens-Johnson syndrome C. Gynecomastia D. Hypotension

Answer 41

Answer: C (Gynecomastia can occur due to spironolactone’s anti-androgenic effects.)

Question 42

10. Diuretic Comparison How do potassium-sparing diuretics differ from loop and thiazide diuretics? A. They cause increased calcium excretion. B. They promote potassium retention instead of loss. C. They work in the proximal tubule. D. They have a stronger diuretic effect.

Answer 42

Answer: B (Potassium-sparing diuretics prevent potassium loss, unlike loop and thiazide diuretics.)

Question 43

11. Select-All-That-Apply (SATA): Patient Education A nurse is teaching a patient about spironolactone. Which statements should be included? (Select all that apply.) A. "You should avoid potassium supplements." B. "Monitor for signs of hyperkalemia, such as muscle weakness." C. "Increase potassium-rich foods, such as bananas and oranges." D. "You may experience breast tenderness or menstrual changes." E. "Take this medication at night to prevent dizziness."

Answer 43

✅ A. "You should avoid potassium supplements." ✅ B. "Monitor for signs of hyperkalemia, such as muscle weakness." ❌ C. "Increase potassium-rich foods, such as bananas and oranges." ✅ D. "You may experience breast tenderness or menstrual changes." ❌ E. "Take this medication at night to prevent dizziness." Correct Answers: A, B, D (Patients should avoid potassium supplements, monitor for hyperkalemia, and be aware of hormonal side effects.)

Question 44

12. Hormonal Effects of Spironolactone Which statement by the patient taking spironolactone requires further education? A. “I might experience some breast swelling.” B. “I need to report any unusual menstrual changes.” C. “This medication could cause me to lose my voice permanently.” D. “I may notice decreased facial hair growth.”

Answer 44

Answer: C (Spironolactone can cause gynecomastia, menstrual irregularities, and reduced androgens, but does not cause permanent voice loss.)

Question 45

13. Nursing Prioritization A patient on spironolactone reports weakness and irregular heartbeats. What is the nurse’s priority action? A. Give a potassium supplement B. Check the patient’s potassium level C. Administer IV calcium gluconate D. Increase the medication dose

Answer 45

Answer: B (Weakness and irregular heartbeats may indicate hyperkalemia, so potassium levels must be checked.)

Question 46

14. Dietary Considerations Which of the following foods should a patient taking spironolactone avoid? A. Chicken B. Apples C. Bananas D. Rice

Answer 46

Answer: C (Bananas are high in potassium and should be avoided.)

Question 47

15. Spironolactone & Kidney Function A patient with a history of chronic kidney disease is prescribed spironolactone. What is the nurse’s priority action? A. Administer the medication as prescribed B. Monitor for dehydration C. Notify the provider before administration D. Increase the patient’s potassium intake

Answer 47

Answer: C (Patients with CKD are at high risk for hyperkalemia, so the provider should be notified before giving spironolactone.)

Question 48

16. Monitoring for Effectiveness A patient has been taking spironolactone for two weeks. Which finding indicates that the medication is effective? A. Increased potassium levels B. Reduced edema C. Increased blood pressure D. Hypernatremia

Answer 48

Answer: B (Reduced edema suggests the medication is working.)

Question 49

17. Expected Outcomes Which of the following are expected effects of spironolactone? (Select all that apply.) A. Reduced blood pressure B. Decreased fluid retention C. Increased potassium levels D. Rapid and significant diuresis E. Prevention of cardiac remodeling

Answer 49

✅ A. Reduced blood pressure ✅ B. Decreased fluid retention ✅ C. Increased potassium levels ❌ D. Rapid and significant diuresis ✅ E. Prevention of cardiac remodeling Correct Answers: A, B, C, E (Spironolactone lowers BP, reduces fluid retention, retains potassium, and prevents cardiac remodeling.)

Question 50

1. Mechanism of Action Loop diuretics primarily act on which part of the nephron? A. Proximal tubule B. Loop of Henle C. Distal convoluted tubule D. Collecting duct

Answer 50

Answer: B (Loop diuretics inhibit sodium-potassium-chloride (Na⁺/K⁺/2Cl⁻) transporters in the loop of Henle, leading to rapid diuresis.)

Question 51

2. Indications for Use Which of the following conditions is a primary indication for loop diuretics? A. Mild hypertension B. Pulmonary edema C. Hypokalemia D. Atrial fibrillation

Answer 51

Answer: B (Loop diuretics are used to treat acute pulmonary edema, heart failure, and renal impairment.)

Question 52

3. Nursing Considerations Which electrolyte imbalance is most commonly associated with loop diuretics? A. Hyperkalemia B. Hypocalcemia C. Hypokalemia D. Hypernatremia

Answer 52

Answer: C (Loop diuretics cause potassium loss, leading to hypokalemia.)

Question 53

4. Adverse Effects Which of the following is a potential adverse effect of furosemide (Lasix)? A. Ototoxicity B. Hyperkalemia C. Bradycardia D. Constipation

Answer 53

Answer: A (High-dose or rapid IV administration of furosemide can cause ototoxicity.)

Question 54

5. Patient Teaching A nurse is educating a patient about furosemide. Which statement by the patient indicates a need for further teaching? A. “I should take this medication in the morning.” B. “I should increase my potassium intake.” C. “I can stop taking this medication if I feel better.” D. “I should monitor my blood pressure regularly.”

Answer 54

Answer: C (Loop diuretics should not be stopped abruptly without consulting a provider.)

Question 55

6. Drug Interactions Which medication, when taken with furosemide, increases the risk of digoxin toxicity? A. Ibuprofen B. Potassium chloride C. Warfarin D. Digoxin

Answer 55

Answer: D (Hypokalemia caused by loop diuretics increases digoxin toxicity risk.)

Question 56

7. IV Administration Safety When administering IV furosemide, how should the nurse proceed? A. Administer rapidly to enhance diuretic effects B. Administer over 1-2 minutes to prevent ototoxicity C. Mix with dextrose 5% in water D. Give as a rapid IV push over 10 seconds

Answer 56

Answer: B (Rapid administration of IV furosemide can cause ototoxicity; it should be given slowly.)

Question 57

8. Loop vs. Thiazide Diuretics Which of the following differentiates loop diuretics from thiazide diuretics? A. Loop diuretics cause potassium retention B. Loop diuretics promote calcium loss C. Loop diuretics are weaker diuretics D. Loop diuretics have no effect on electrolytes

Answer 57

Answer: B (Loop diuretics promote calcium excretion, while thiazides promote calcium retention.)

Question 58

9. Monitoring for Dehydration A nurse is monitoring a patient on furosemide. Which finding suggests dehydration? A. Blood pressure of 118/78 mmHg B. Weak, thready pulse C. Urine output of 900 mL in 8 hours D. Sodium level of 138 mEq/L

Answer 58

Answer: B (A weak, thready pulse suggests hypovolemia/dehydration.)

Question 59

10. Contraindications Which patient should NOT receive furosemide? A. A patient with pulmonary edema B. A patient with chronic kidney disease and severe hypokalemia C. A patient with hypertension D. A patient with peripheral edema

Answer 59

Answer: B (Severe hypokalemia is a contraindication for loop diuretics.)

Question 60

11. Select-All-That-Apply (SATA): Side Effects Which of the following are common side effects of loop diuretics? (Select all that apply.) A. Hypokalemia B. Orthostatic hypotension C. Hypercalcemia D. Ototoxicity E. Hypomagnesemia

Answer 60

✅ A. Hypokalemia ✅ B. Orthostatic hypotension ❌ C. Hypercalcemia ✅ D. Ototoxicity ✅ E. Hypomagnesemia Correct Answers: A, B, D, E (Loop diuretics cause hypokalemia, orthostatic hypotension, ototoxicity, and hypomagnesemia.)

Question 61

2. Prioritization A nurse is caring for a patient receiving furosemide. Which finding requires immediate intervention? A. Blood glucose of 150 mg/dL B. Potassium level of 2.8 mEq/L C. Mild dizziness upon standing D. Sodium level of 140 mEq/L

Answer 61

Answer: B (Severe hypokalemia can lead to dangerous cardiac arrhythmias.)

Question 62

13. Nursing Responsibilities Before administering furosemide, the nurse should: A. Check blood glucose levels B. Monitor serum potassium levels C. Assess for muscle pain D. Monitor liver enzymes

Answer 62

Answer: B (Hypokalemia is a common side effect of loop diuretics.)

Question 63

14. Expected Outcomes A patient has been taking furosemide for one week. Which finding indicates that the medication is effective? A. Increased potassium levels B. Decreased blood pressure C. Increased heart rate D. Hypernatremia

Answer 63

Answer: B (Loop diuretics lower blood pressure and reduce fluid overload.)

Question 64

15. Loop Diuretics & Renal Function Which statement about loop diuretics and renal function is true? A. They are ineffective in patients with kidney failure B. They increase renal blood flow and remain effective in renal impairment C. They should never be used in patients with chronic kidney disease D. They promote sodium retention in renal tubules

Answer 64

Answer: B (Loop diuretics increase renal blood flow and are effective even in renal impairment.)

Question 65

16. Dietary Considerations A nurse is educating a patient on dietary recommendations while taking furosemide. Which foods should be encouraged? A. Bananas and oranges B. Processed meats and canned soup C. Cheese and milk D. White bread and pasta

Answer 65

Answer: A (Bananas and oranges are high in potassium, which helps prevent hypokalemia.)

Question 66

17. Fluid Balance Monitoring A patient receiving furosemide has lost 2.2 lbs in 24 hours. How much fluid has been lost? A. 500 mL B. 1,000 mL C. 2,000 mL D. 3,500 mL

Answer 66

Answer: B (A 2.2 lb weight loss equals approximately 1,000 mL (1 liter) of fluid loss.)

Question 67

1. Mechanism of Action How do beta blockers work? A. They block calcium channels, causing vasodilation B. They block beta-adrenergic receptors, reducing heart rate and contractility C. They stimulate the sympathetic nervous system to increase cardiac output D. They increase renin release to lower blood pressure

Answer 67

Answer: B (Beta blockers block beta-adrenergic receptors, leading to decreased heart rate, reduced myocardial contractility, and lower blood pressure.)

Question 68

2. Indications for Use Beta blockers are commonly prescribed for which of the following conditions? (Select all that apply.) A. Hypertension B. Angina C. Heart failure D. Acute asthma attack E. Post-myocardial infarction (MI)

Answer 68

✅ A. Hypertension ✅ B. Angina ✅ C. Heart failure ❌ D. Acute asthma attack ✅ E. Post-myocardial infarction (MI) Correct Answers: A, B, C, E (Beta blockers treat hypertension, angina, heart failure, and post-MI but should be avoided in acute asthma attacks due to bronchoconstriction.)

Question 69

3. Cardioselective vs. Non-Selective Beta Blockers Which beta blocker is cardioselective, meaning it primarily blocks beta-1 receptors? A. Propranolol B. Carvedilol C. Atenolol D. Nadolol

Answer 69

Answer: C (Atenolol is a selective beta-1 blocker, affecting only the heart and minimizing bronchoconstriction risk.)

Question 70

4. Side Effects Which of the following is a common side effect of beta blockers? A. Tachycardia B. Bradycardia C. Hypoglycemia D. Increased cardiac output

Answer 70

Answer: B (Beta blockers slow the heart rate, leading to bradycardia.)

Question 71

5. Non-Selective Beta Blockers & Respiratory Effects A nurse is caring for a patient with COPD who has been prescribed propranolol. What is the priority action? A. Monitor for wheezing or shortness of breath B. Encourage deep breathing exercises C. Monitor for signs of hyperglycemia D. Assess for orthostatic hypotension

Answer 71

Answer: A (Non-selective beta blockers like propranolol block beta-2 receptors in the lungs, leading to bronchoconstriction and potential breathing difficulties.)

Question 72

6. Nursing Considerations Which of the following should be assessed before administering a beta blocker? (Select all that apply.) A. Blood pressure B. Heart rate C. Respiratory rate D. History of asthma or COPD E. Potassium levels

Answer 72

✅ A. Blood pressure ✅ B. Heart rate ❌ C. Respiratory rate ✅ D. History of asthma or COPD ❌ E. Potassium levels Correct Answers: A, B, D (Beta blockers lower BP and HR, so both should be assessed. Asthma/COPD history is important because non-selective beta blockers can cause bronchospasm.)

Question 73

7. Patient Teaching Which statement by the patient indicates a need for further teaching about beta blockers? A. “I will check my pulse daily.” B. “I can stop taking this medication once my symptoms improve.” C. “I may feel tired when I first start this medication.” D. “I should not stop this medication suddenly.”

Answer 73

Answer: B (Beta blockers should never be stopped suddenly, as they can cause rebound hypertension or angina.)

Question 74

8. Beta Blockers & Blood Sugar A diabetic patient taking metoprolol should be educated about which potential effect? A. Increased risk of hyperglycemia B. Blurred vision C. Masking of hypoglycemia symptoms D. Increased insulin sensitivity

Answer 74

Answer: C (Beta blockers can mask signs of hypoglycemia, such as tachycardia, making it harder for diabetics to recognize low blood sugar episodes.)

Question 75

9. Contraindications Which patient should NOT receive a beta blocker? A. A patient with a history of myocardial infarction B. A patient with an ejection fraction of 40% C. A patient with a heart rate of 52 bpm D. A patient with hypertension and migraines

Answer 75

Answer: C (Beta blockers can further lower heart rate, making them dangerous for patients with bradycardia.)

Question 76

10. Adverse Reactions Which serious adverse reaction is associated with beta blockers? A. Pulmonary fibrosis B. Heart failure exacerbation C. Hyperkalemia D. Thrombocytopenia

Answer 76

Answer: B (Beta blockers can worsen heart failure if used incorrectly, especially in high doses.)

Question 77

11. Rebound Hypertension Why should beta blockers never be discontinued abruptly? A. They can cause severe bradycardia B. They can lead to rebound hypertension, angina, or MI C. They can increase the risk of hypoglycemia D. They can cause immediate respiratory distress

Answer 77

Answer: B (Abruptly stopping beta blockers can cause a sudden increase in heart rate and blood pressure, leading to serious complications like MI.)

Question 78

12. Select-All-That-Apply (SATA): Patient Teaching Which instructions should be given to a patient taking beta blockers? (Select all that apply.) A. "Monitor your heart rate daily." B. "Do not stop taking this medication suddenly." C. "You should take this medication if your pulse is below 50 bpm." D. "This medication may cause fatigue and dizziness." E. "This medication is a rescue drug for angina attacks."

Answer 78

✅ A. "Monitor your heart rate daily." ✅ B. "Do not stop taking this medication suddenly." ❌ C. "You should take this medication if your pulse is below 50 bpm." ✅ D. "This medication may cause fatigue and dizziness." ❌ E. "This medication is a rescue drug for angina attacks." Correct Answers: A, B, D (Patients should monitor HR, avoid stopping the medication suddenly, and expect some fatigue and dizziness.)

Question 79

13. Prioritization A patient taking atenolol reports dizziness and a heart rate of 48 bpm. What is the nurse’s priority action? A. Administer an additional dose of atenolol B. Reassess heart rate in 30 minutes C. Hold the medication and notify the provider D. Encourage the patient to drink fluids

Answer 79

Answer: C (Beta blockers should be held if HR is below 50 bpm, and the provider should be notified.)

Question 80

14. Drug Interactions Which medication, when taken with beta blockers, increases the risk of severe bradycardia? A. NSAIDs B. Digoxin C. Furosemide D. Warfarin

Answer 80

Answer: B (Beta blockers and digoxin both slow heart rate, increasing the risk of severe bradycardia.)

Question 81

15. Monitoring for Effectiveness A patient has been taking metoprolol for three weeks. Which finding indicates that the medication is effective? A. Increased heart rate B. Reduced blood pressure C. Worsening angina D. Elevated blood sugar

Answer 81

Answer: B (Beta blockers effectively reduce blood pressure and help with angina and heart failure.)

Question 82

16. Emergency Situations A nurse is monitoring a patient who accidentally took too much propranolol. Which symptom indicates beta blocker toxicity? A. Tachycardia and palpitations B. Hypotension and bradycardia C. Hypertension and diaphoresis D. Muscle cramps and hyperreflexia

Answer 82

Answer: B (Beta blocker overdose can cause severe hypotension and bradycardia, leading to cardiovascular collapse.)

Question 83

17. Expected Outcomes Which of the following are expected effects of beta blockers? (Select all that apply.) A. Decreased blood pressure B. Decreased heart rate C. Increased cardiac output D. Reduced myocardial oxygen demand E. Increased renin secretion

Answer 83

✅ A. Decreased blood pressure ✅ B. Decreased heart rate ❌ C. Increased cardiac output ✅ D. Reduced myocardial oxygen demand ❌ E. Increased renin secretion Correct Answers: A, B, D (Beta blockers lower BP and HR while reducing the heart’s oxygen demand.)

Question 84

1. Mechanism of Action How do calcium channel blockers lower blood pressure? A. By increasing sodium excretion in the kidneys B. By inhibiting calcium influx into vascular smooth muscle and cardiac cells C. By blocking beta-adrenergic receptors in the heart D. By increasing aldosterone secretion

Answer 84

Answer: B (CCBs prevent calcium from entering cardiac and smooth muscle cells, leading to vasodilation and decreased myocardial contractility.)

Question 85

2. Indications for Use Calcium channel blockers are primarily used to treat which conditions? (Select all that apply.) A. Hypertension B. Angina C. Atrial fibrillation D. Heart failure with reduced ejection fraction E. Raynaud’s disease

Answer 85

✅ A. Hypertension ✅ B. Angina ✅ C. Atrial fibrillation ❌ D. Heart failure with reduced ejection fraction ✅ E. Raynaud’s disease Correct Answers: A, B, C, E (CCBs treat hypertension, angina, atrial fibrillation, and Raynaud’s disease but are avoided in heart failure with reduced EF due to negative inotropic effects.)

Question 86

3. Dihydropyridines vs. Non-Dihydropyridines Which calcium channel blocker primarily affects the heart rather than the blood vessels? A. Amlodipine B. Nifedipine C. Diltiazem D. Felodipine

Answer 86

Answer: C (Diltiazem is a non-dihydropyridine, which affects cardiac conduction and is used for atrial fibrillation and rate control.)

Question 87

4. Common Side Effects A patient taking amlodipine reports swelling in the ankles. What is the most likely cause? A. Heart failure B. Peripheral edema from vasodilation C. Pulmonary embolism D. Acute kidney injury

Answer 87

Answer: B (Dihydropyridine CCBs like amlodipine commonly cause peripheral edema due to vasodilation.)

Question 88

5. Patient Teaching Which statement by a patient taking verapamil indicates a need for further teaching? A. “I should take this medication at the same time every day.” B. “I should avoid grapefruit juice while taking this medication.” C. “I can stop taking this medication as soon as my blood pressure is normal.” D. “I should monitor my heart rate regularly.”

Answer 88

Answer: C (CCBs should never be stopped abruptly, as this can cause rebound hypertension.)

Question 89

6. Drug Interactions Which of the following medications can increase the risk of bradycardia when taken with diltiazem? A. Digoxin B. Furosemide C. Ibuprofen D. Lisinopril

Answer 89

Answer: A (Both diltiazem and digoxin slow heart rate, increasing the risk of bradycardia and heart block.)

Question 90

7. Adverse Effects Which adverse effect is associated with verapamil but not amlodipine? A. Bradycardia B. Reflex tachycardia C. Peripheral edema D. Hypokalemia

Answer 90

Answer: A (Verapamil is a non-dihydropyridine that affects cardiac conduction and can cause bradycardia.)

Question 91

8. Nursing Considerations Before administering diltiazem, which assessment is most important? A. Serum potassium level B. Blood pressure and heart rate C. Respiratory rate D. Liver function tests

Answer 91

Answer: B (Diltiazem slows HR and lowers BP, so both must be assessed before administration.)

Question 92

9. Contraindications A patient with which condition should NOT receive verapamil? A. Hypertension B. Atrial fibrillation C. Heart failure with reduced ejection fraction D. Raynaud’s disease

Answer 92

Answer: C (Non-dihydropyridine CCBs like verapamil can worsen heart failure with reduced EF due to negative inotropic effects.)

Question 93

10. Select-All-That-Apply (SATA): Side Effects Which of the following are common side effects of calcium channel blockers? (Select all that apply.) A. Hypotension B. Bradycardia (with verapamil/diltiazem) C. Hyperkalemia D. Peripheral edema E. Constipation (with verapamil)

Answer 93

✅ A. Hypotension ✅ B. Bradycardia (with verapamil/diltiazem) ❌ C. Hyperkalemia ✅ D. Peripheral edema ✅ E. Constipation (with verapamil) Correct Answers: A, B, D, E (CCBs cause hypotension, bradycardia (with non-dihydropyridines), peripheral edema, and constipation (with verapamil).)

Question 94

11. Prioritization A patient taking nifedipine reports dizziness when standing up. What is the nurse’s priority action? A. Discontinue the medication immediately B. Instruct the patient to change positions slowly C. Give an additional dose to stabilize BP D. Increase dietary sodium intake

Answer 94

Answer: B (Nifedipine can cause orthostatic hypotension; patients should change positions slowly.)

Question 95

12. Monitoring for Effectiveness A patient has been taking amlodipine for three weeks. Which finding indicates the medication is effective? A. Increased blood pressure B. Reduced angina episodes C. Increased potassium levels D. Bradycardia

Answer 95

answer: B (CCBs effectively reduce angina and lower BP.)

Question 96

13. Rebound Hypertension Risk Why should calcium channel blockers never be discontinued abruptly? A. They can cause severe bradycardia B. They can lead to rebound hypertension C. They can cause increased calcium excretion D. They can cause severe hypoglycemia

Answer 96

Answer: B (Stopping CCBs suddenly can cause rebound hypertension due to sudden vasoconstriction.)

Question 97

14. Emergency Situations A nurse is monitoring a patient who took too much verapamil. Which symptom indicates calcium channel blocker toxicity? A. Hypertension and tachycardia B. Hypotension and bradycardia C. Muscle cramps and hyperreflexia D. Increased urinary output

Answer 97

Answer: B (CCB overdose can cause severe hypotension and bradycardia.)

Question 98

15. Drug-Food Interactions Which food should be avoided while taking calcium channel blockers? A. Dairy products B. Grapefruit C. Caffeine D. Leafy green vegetables

Answer 98

Answer: B (Grapefruit increases drug levels, raising the risk of hypotension and toxicity.)

Question 99

16. Expected Outcomes Which of the following are expected effects of calcium channel blockers? (Select all that apply.) A. Decreased blood pressure B. Reduced myocardial oxygen demand C. Increased coronary artery perfusion D. Increased heart rate E. Decreased frequency of angina episodes

Answer 99

✅ A. Decreased blood pressure ✅ B. Reduced myocardial oxygen demand ✅ C. Increased coronary artery perfusion ❌ D. Increased heart rate ✅ E. Decreased frequency of angina episodes Correct Answers: A, B, C, E (CCBs lower BP, reduce oxygen demand, increase coronary perfusion, and decrease angina episodes.)

Question 100

1. Mechanism of Action How do ACE inhibitors lower blood pressure? A. By blocking aldosterone release, leading to sodium retention B. By inhibiting angiotensin-converting enzyme, reducing vasoconstriction C. By directly blocking beta-adrenergic receptors D. By increasing renin production

Answer 100

Answer: B (ACE inhibitors block the conversion of angiotensin I to angiotensin II, preventing vasoconstriction and reducing blood pressure.)

Question 101

2. Indications for Use ACE inhibitors are commonly used to treat which of the following conditions? (Select all that apply.) A. Hypertension B. Heart failure C. Diabetic nephropathy D. Asthma E. Post-myocardial infarction (MI)

Answer 101

✅ A. Hypertension ✅ B. Heart failure ✅ C. Diabetic nephropathy ❌ D. Asthma ✅ E. Post-myocardial infarction (MI) Correct Answers: A, B, C, E (ACE inhibitors treat hypertension, heart failure, diabetic nephropathy, and are used post-MI to improve survival.)

Question 102

3. Common Side Effects A patient taking lisinopril reports a persistent dry cough. What is the best nursing response? A. “This is a common side effect of ACE inhibitors.” B. “This is a sign of an allergic reaction; stop taking the medication immediately.” C. “Increase your fluid intake to reduce the cough.” D. “This is a normal symptom of high blood pressure.”

Answer 102

Answer: A (ACE inhibitors increase bradykinin levels, leading to a persistent dry cough.)

Question 103

4. Life-Threatening Adverse Reaction A nurse is monitoring a patient on enalapril. Which symptom requires immediate intervention? A. Mild dizziness B. Facial swelling and difficulty breathing C. Dry mouth D. Headache

Answer 103

Answer: B (Angioedema is a rare but life-threatening adverse effect of ACE inhibitors.)

Question 104

5. Nursing Considerations Which lab value should the nurse monitor for a patient on an ACE inhibitor? A. Serum potassium B. Serum sodium C. INR D. Hemoglobin

Answer 104

Answer: A (ACE inhibitors can cause hyperkalemia, so potassium levels should be monitored.)

Question 105

6. Drug Interactions Which medication increases the risk of hyperkalemia when taken with an ACE inhibitor? A. Furosemide B. Potassium supplements C. Warfarin D. Metformin

Answer 105

Answer: B (ACE inhibitors reduce aldosterone, leading to potassium retention. Potassium supplements or potassium-sparing diuretics increase hyperkalemia risk.)

Question 106

7. Contraindications Which patient should NOT take an ACE inhibitor? A. A patient with hypertension B. A patient with heart failure C. A patient who is pregnant D. A patient with type 2 diabetes

Answer 106

Answer: C (ACE inhibitors are teratogenic and should not be used during pregnancy.)

Question 107

8. Monitoring for Effectiveness A patient has been taking lisinopril for two weeks. Which finding indicates the medication is effective? A. Increased heart rate B. Reduced blood pressure C. Hyperkalemia D. Increased urine output

Answer 107

Answer: B (ACE inhibitors effectively lower blood pressure.)

Question 108

9. First-Dose Hypotension Which statement by a patient taking captopril requires further teaching? A. “I will rise slowly from a sitting or lying position.” B. “I should take my first dose at bedtime.” C. “If I feel dizzy, I should stop taking the medication immediately.” D. “I should drink plenty of water to stay hydrated.”

Answer 108

Answer: C (First-dose hypotension is common, but patients should not stop the medication abruptly without consulting their provider.)

Question 109

10. Select-All-That-Apply (SATA): Side Effects Which of the following are common side effects of ACE inhibitors? (Select all that apply.) A. Dry cough B. Hyperkalemia C. Reflex tachycardia D. Hypotension E. Angioedema (rare but serious)

Answer 109

✅ A. Dry cough ✅ B. Hyperkalemia ❌ C. Reflex tachycardia ✅ D. Hypotension ✅ E. Angioedema (rare but serious) Correct Answers: A, B, D, E (ACE inhibitors commonly cause cough, hyperkalemia, hypotension, and in rare cases, angioedema.)

Question 110

11. ACE Inhibitors vs. ARBs How do ACE inhibitors differ from angiotensin II receptor blockers (ARBs)? A. ACE inhibitors do not affect potassium levels B. ACE inhibitors increase bradykinin levels, leading to a dry cough C. ACE inhibitors block angiotensin II at the receptor level D. ACE inhibitors cause more sodium retention than ARBs

Answer 110

Answer: B (ACE inhibitors increase bradykinin, leading to the characteristic dry cough. ARBs do not cause this effect.)

Question 111

12. Prioritization A patient taking an ACE inhibitor reports dizziness and a BP of 85/50 mmHg. What is the nurse’s priority action? A. Administer IV fluids B. Hold the medication and notify the provider C. Give an extra dose of the medication D. Encourage the patient to drink more water

Answer 111

Answer: B (ACE inhibitors can cause hypotension, especially after the first dose. The medication should be held, and the provider should be notified.)

Question 112

13. Patient Education Which instruction should a nurse give to a patient taking lisinopril? A. “Monitor your blood pressure regularly.” B. “Avoid salt substitutes containing potassium.” C. “Report swelling of the face, lips, or tongue immediately.” D. “All of the above.”

Answer 112

Answer: D (All of these instructions are critical for patients taking ACE inhibitors.)

Question 113

14. Rebound Hypertension Risk Why should ACE inhibitors never be discontinued abruptly? A. They can cause rebound hypertension B. They can cause sudden hyperkalemia C. They can lead to bradycardia D. They can increase renin secretion

Answer 113

Answer: A (Stopping ACE inhibitors suddenly can cause rebound hypertension and worsen cardiovascular outcomes.)

Question 114

15. Emergency Situations A nurse is monitoring a patient who developed angioedema after taking enalapril. What is the priority nursing action? A. Discontinue the medication and administer epinephrine B. Monitor the patient’s blood pressure every 30 minutes C. Encourage the patient to drink plenty of fluids D. Give an extra dose to counteract the reaction

Answer 114

Answer: A (Angioedema is a life-threatening reaction requiring immediate discontinuation of the drug and epinephrine administration.)

Question 115

16. Drug-Food Interactions Which food should a patient taking lisinopril avoid? A. Grapefruit B. Bananas C. Dairy products D. Leafy green vegetables

Answer 115

Answer: B (Bananas are high in potassium, which can worsen hyperkalemia.)

Question 116

17. Expected Outcomes Which of the following are expected effects of ACE inhibitors? (Select all that apply.) A. Lowered blood pressure B. Reduced heart failure symptoms C. Decreased progression of diabetic nephropathy D. Increased heart rate E. Reduced risk of stroke and MI

Answer 116

Correct Answers: A, B, C, E (ACE inhibitors lower BP, reduce HF symptoms, slow nephropathy progression, and lower stroke/MI risk.)

Question 117

1. Mechanism of Action How do ARBs lower blood pressure? A. By blocking the conversion of angiotensin I to angiotensin II B. By directly relaxing vascular smooth muscle C. By blocking angiotensin II receptors, preventing vasoconstriction D. By increasing aldosterone secretion

Answer 117

Answer: C (ARBs block angiotensin II at the AT1 receptor, preventing vasoconstriction and aldosterone release.)

Question 118

2. Indications for Use ARBs are commonly used to treat which of the following conditions? (Select all that apply.) A. Hypertension B. Heart failure C. Diabetic nephropathy D. Asthma E. Stroke prevention

Answer 118

Correct Answers: A, B, C, E (ARBs treat hypertension, heart failure, diabetic nephropathy, and help prevent strokes.)

Question 119

3. ARBs vs. ACE Inhibitors How do ARBs differ from ACE inhibitors? A. ARBs do not cause a dry cough B. ARBs increase bradykinin levels C. ARBs are more likely to cause angioedema D. ARBs block the renin-angiotensin system at an earlier stage

Answer 119

Answer: A (Unlike ACE inhibitors, ARBs do not increase bradykinin and do not cause a dry cough.)

Question 120

4. Common Side Effects A patient taking losartan reports dizziness. What is the most likely cause? A. Hyperkalemia B. Hypotension due to vasodilation C. Reflex tachycardia D. Increased sodium retention

Answer 120

Answer: B (ARBs lower blood pressure by blocking vasoconstriction, which can cause dizziness.)

Question 121

5. Life-Threatening Adverse Reaction A nurse is monitoring a patient on valsartan. Which symptom requires immediate intervention? A. Persistent dry cough B. Swelling of the face and lips C. Headache D. Nausea

Answer 121

Answer: B (Though less common than with ACE inhibitors, ARBs can still cause life-threatening angioedema.)

Question 122

6. Nursing Considerations Which lab value should the nurse monitor for a patient on an ARB? A. Serum potassium B. Serum sodium C. INR D. White blood cell count

Answer 122

Answer: A (ARBs can cause hyperkalemia, so potassium levels must be monitored.)

Question 123

7. Drug Interactions Which medication increases the risk of hyperkalemia when taken with an ARB? A. Furosemide B. Potassium supplements C. Warfarin D. Metformin

Answer 123

Answer: B (ARBs promote potassium retention, so potassium supplements increase the risk of hyperkalemia.)

Question 124

8. Contraindications Which patient should NOT take an ARB? A. A patient with hypertension B. A patient with heart failure C. A patient who is pregnant D. A patient with type 2 diabetes

Answer 124

Answer: C (ARBs are teratogenic and should not be used during pregnancy.)

Question 125

9. Monitoring for Effectiveness A patient has been taking valsartan for two weeks. Which finding indicates the medication is effective? A. Increased heart rate B. Reduced blood pressure C. Hyperkalemia D. Increased urine output

Answer 125

Answer: B (ARBs effectively lower blood pressure.)

Question 126

10. First-Dose Hypotension Which statement by a patient taking losartan requires further teaching? A. “I will rise slowly from a sitting or lying position.” B. “I should take my first dose at bedtime.” C. “If I feel dizzy, I should stop taking the medication immediately.” D. “I should drink plenty of water to stay hydrated.”

Answer 126

Answer: C (First-dose hypotension is common, but the medication should not be stopped abruptly without consulting the provider.)

Question 127

11. Select-All-That-Apply (SATA): Side Effects Which of the following are common side effects of ARBs? (Select all that apply.) A. Dizziness B. Hyperkalemia C. Dry cough D. Hypotension E. Angioedema (rare but serious)

Answer 127

✅ A. Dizziness ✅ B. Hyperkalemia ❌ C. Dry cough ✅ D. Hypotension ✅ E. Angioedema (rare but serious) Correct Answers: A, B, D, E (ARBs commonly cause dizziness, hyperkalemia, and hypotension, and in rare cases, angioedema.)

Question 128

12. Prioritization A patient taking an ARB reports dizziness and a BP of 85/50 mmHg. What is the nurse’s priority action? A. Administer IV fluids B. Hold the medication and notify the provider C. Give an extra dose of the medication D. Encourage the patient to drink more water

Answer 128

Answer: B (Hypotension is a potential side effect of ARBs; the medication should be held, and the provider should be notified.)

Question 129

13. Patient Education Which instruction should a nurse give to a patient taking losartan? A. “Monitor your blood pressure regularly.” B. “Avoid salt substitutes containing potassium.” C. “Report swelling of the face, lips, or tongue immediately.” D. “All of the above.”

Answer 129

Answer: D (All of these instructions are critical for patients taking ARBs.)

Question 130

14. Rebound Hypertension Risk Why should ARBs never be discontinued abruptly? A. They can cause rebound hypertension B. They can cause sudden hyperkalemia C. They can lead to bradycardia D. They can increase renin secretion

Answer 130

Answer: A (Stopping ARBs suddenly can cause rebound hypertension and worsen cardiovascular outcomes.)

Question 131

15. Emergency Situations A nurse is monitoring a patient who developed angioedema after taking irbesartan. What is the priority nursing action? A. Discontinue the medication and administer epinephrine B. Monitor the patient’s blood pressure every 30 minutes C. Encourage the patient to drink plenty of fluids D. Give an extra dose to counteract the reaction

Answer 131

Answer: A (Angioedema is a life-threatening reaction requiring immediate discontinuation of the drug and epinephrine administration.)

Question 132

16. Drug-Food Interactions Which food should a patient taking valsartan avoid? A. Grapefruit B. Bananas C. Dairy products D. Leafy green vegetables

Answer 132

Answer: B (Bananas are high in potassium, which can worsen hyperkalemia.)

Question 133

17. Expected Outcomes Which of the following are expected effects of ARBs? (Select all that apply.) A. Lowered blood pressure B. Reduced heart failure symptoms C. Decreased progression of diabetic nephropathy D. Increased heart rate E. Reduced risk of stroke and MI

Answer 133

✅ A. Lowered blood pressure ✅ B. Reduced heart failure symptoms ✅ C. Decreased progression of diabetic nephropathy ❌ D. Increased heart rate ✅ E. Reduced risk of stroke and MI Correct Answers: A, B, C, E (ARBs lower BP, reduce HF symptoms, slow nephropathy progression, and lower stroke/MI risk.)

Question 134

1. Mechanism of Action How do direct-acting vasodilators lower blood pressure? A. By blocking beta-adrenergic receptors B. By relaxing vascular smooth muscle, leading to arterial dilation C. By inhibiting the renin-angiotensin system D. By increasing sodium and water excretion

Answer 134

Answer: B (Direct-acting vasodilators relax vascular smooth muscle, causing arterial dilation and reducing blood pressure.)

Question 135

2. Indications for Use Which condition is a primary indication for direct-acting vasodilators like hydralazine? A. Hypertension crisis B. Atrial fibrillation C. Hypotension D. Diabetes mellitus

Answer 135

Answer: A (Direct-acting vasodilators like nitroprusside are used in hypertensive emergencies.)

Question 136

3. Adverse Effects A patient receiving hydralazine reports a pounding headache and heart palpitations. What is the most likely cause? A. Reflex tachycardia B. Hyperkalemia C. Hypoglycemia D. Increased cardiac output

Answer 136

Answer: A (Direct vasodilation can cause reflex tachycardia as the body compensates for a sudden drop in blood pressure.)

Question 137

4. Sodium Nitroprusside Toxicity A patient receiving sodium nitroprusside for hypertensive crisis is experiencing confusion, muscle weakness, and metabolic acidosis. What is the nurse’s priority action? A. Administer IV fluids B. Discontinue the medication immediately C. Increase the infusion rate D. Check blood glucose levels

Answer 137

Answer: B (These are signs of cyanide toxicity, a serious complication of nitroprusside, requiring immediate discontinuation.)

Question 138

5. Nursing Considerations Before administering hydralazine, the nurse should monitor which vital sign? A. Heart rate B. Respiratory rate C. Oxygen saturation D. Temperature

Answer 138

Answer: A (Hydralazine can cause reflex tachycardia, so heart rate should be monitored.)

Question 139

6. Drug Interactions Which medication can be given with hydralazine to reduce reflex tachycardia? A. Beta-blockers B. Calcium channel blockers C. Diuretics D. ACE inhibitors

Answer 139

Answer: A (Beta-blockers are often prescribed with direct vasodilators to counteract reflex tachycardia.)

Question 140

7. Contraindications A patient with which condition should NOT receive minoxidil? A. Hypertension B. Heart failure C. Severe coronary artery disease D. Chronic kidney disease

Answer 140

Answer: C (Minoxidil may increase myocardial oxygen demand and worsen coronary artery disease.)

Question 141

8. Monitoring for Effectiveness A patient has been taking hydralazine for two weeks. Which finding indicates the medication is effective? A. Increased urine output B. Reduced blood pressure C. Increased potassium levels D. Bradycardia

Answer 141

Answer: B (Direct vasodilators effectively lower blood pressure.)

Question 142

9. Select-All-That-Apply (SATA): Side Effects Which of the following are common side effects of direct-acting vasodilators? (Select all that apply.) A. Reflex tachycardia B. Hypotension C. Hyperkalemia D. Headache E. Fluid retention

Answer 142

✅ A. Reflex tachycardia ✅ B. Hypotension ❌ C. Hyperkalemia ✅ D. Headache ✅ E. Fluid retention Correct Answers: A, B, D, E (Direct vasodilators commonly cause reflex tachycardia, hypotension, headaches, and fluid retention.)

Question 143

10. Prioritization A patient receiving sodium nitroprusside has a blood pressure of 85/50 mmHg. What is the nurse’s priority action? A. Stop the infusion immediately B. Reduce the infusion rate C. Administer IV fluids D. Give an additional dose of medication

Answer 143

Answer: B (Nitroprusside infusion should be titrated carefully to prevent severe hypotension.)

Question 144

11. Patient Education Which instruction should a nurse give to a patient taking hydralazine? A. “Monitor your heart rate regularly.” B. “Take this medication at night to avoid dizziness.” C. “Avoid foods high in potassium.” D. “This medication does not affect your blood pressure.”

Answer 144

answer: A (Patients should monitor their heart rate due to the risk of reflex tachycardia.)

Question 145

12. Emergency Situations A nurse is monitoring a patient who developed cyanide toxicity from sodium nitroprusside. What is the priority nursing action? A. Administer sodium thiosulfate B. Increase IV fluid administration C. Lower the bed and elevate the legs D. Discontinue the medication and give atropine

Answer 145

Answer: A (Sodium thiosulfate is the antidote for cyanide toxicity caused by nitroprusside.)

Question 146

13. Drug-Food Interactions Which food should a patient taking minoxidil avoid? A. Grapefruit B. Bananas C. Caffeine D. Leafy green vegetables

Answer 146

Answer: C (Caffeine can worsen reflex tachycardia and should be limited.)

Question 147

14. Expected Outcomes Which of the following are expected effects of direct vasodilators? (Select all that apply.) A. Lowered blood pressure B. Increased cardiac output (in some cases) C. Reduced afterload D. Increased sodium retention E. Decreased myocardial oxygen demand

Answer 147

✅ A. Lowered blood pressure ✅ B. Increased cardiac output (in some cases) ✅ C. Reduced afterload ❌ D. Increased sodium retention ✅ E. Decreased myocardial oxygen demand Correct Answers: A, B, C, E (Direct vasodilators lower BP, reduce afterload, and can improve cardiac output in some cases.)

Question 148

1. Mechanism of Action How does digoxin help manage heart failure? A. It increases heart rate and cardiac workload B. It decreases myocardial contractility C. It increases cardiac contractility and decreases heart rate D. It blocks beta-adrenergic receptors to reduce blood pressure

Answer 148

Answer: C (Digoxin is a positive inotrope (increases contractility) and a negative chronotrope (decreases heart rate).)

Question 149

2. Indications for Use Digoxin is primarily used to treat which of the following conditions? (Select all that apply.) A. Heart failure B. Atrial fibrillation C. Hypertension D. Pulmonary embolism E. Atrial flutter

Answer 149

✅ A. Heart failure ✅ B. Atrial fibrillation ❌ C. Hypertension ❌ D. Pulmonary embolism ✅ E. Atrial flutter Correct Answers: A, B, E (Digoxin is used in heart failure and atrial arrhythmias to slow conduction through the AV node.)

Question 150

3. Digoxin Toxicity A patient taking digoxin reports nausea, vomiting, and seeing yellow halos around lights. What is the nurse’s priority action? A. Administer an antiemetic B. Hold the medication and check digoxin levels C. Encourage increased fluid intake D. Continue the medication as prescribed

Answer 150

Answer: B (Nausea, vomiting, and visual disturbances are signs of digoxin toxicity; the medication should be held, and levels checked.)

Question 151

4. Nursing Considerations Before administering digoxin, the nurse should assess which vital sign? A. Blood pressure B. Respiratory rate C. Heart rate D. Temperature

Answer 151

Answer: C (Digoxin lowers heart rate, so the apical pulse must be checked before administration.)

Question 152

5. Apical Pulse Check A patient’s apical pulse is 50 bpm before administering digoxin. What is the nurse’s best action? A. Administer the medication as prescribed B. Hold the medication and notify the provider C. Give half of the prescribed dose D. Encourage the patient to drink more fluids

Answer 152

Answer: B (If the pulse is below 60 bpm, digoxin should be held, and the provider should be notified.)

Question 153

6. Therapeutic Drug Levels Which digoxin level is considered therapeutic? A. 0.2–0.5 ng/mL B. 0.5–2.0 ng/mL C. 2.5–4.0 ng/mL D. 4.5–6.0 ng/mL

Answer 153

Answer: B (The therapeutic range for digoxin is 0.5–2.0 ng/mL. Levels above this indicate toxicity.)

Question 154

7. Drug Interactions Which medication increases the risk of digoxin toxicity? A. Furosemide B. Acetaminophen C. Lisinopril D. Warfarin

Answer 154

Answer: A (Furosemide can cause hypokalemia, which increases the risk of digoxin toxicity.)

Question 155

8. Electrolyte Imbalances & Digoxin Which electrolyte imbalance increases the risk of digoxin toxicity? A. Hyperkalemia B. Hypokalemia C. Hypernatremia D. Hypocalcemia

Answer 155

Answer: B (Low potassium increases digoxin’s effects, raising toxicity risk.)

Question 156

9. Signs of Digoxin Toxicity Which of the following symptoms indicate digoxin toxicity? (Select all that apply.) A. Nausea and vomiting B. Yellow-green vision changes C. Bradycardia D. Hypertension E. Confusion

Answer 156

✅ A. Nausea and vomiting ✅ B. Yellow-green vision changes ✅ C. Bradycardia ❌ D. Hypertension ✅ E. Confusion Correct Answers: A, B, C, E (Common signs of digoxin toxicity include nausea, vomiting, visual disturbances, bradycardia, and confusion.)

Question 157

10. Digoxin Antidote What is the antidote for severe digoxin toxicity? A. Sodium bicarbonate B. Atropine C. Digoxin immune Fab (Digibind) D. Protamine sulfate

Answer 157

Answer: C (Digoxin immune Fab (Digibind) binds to digoxin and inactivates it.)

Question 158

11. Patient Teaching Which statement by a patient taking digoxin indicates a need for further teaching? A. “I will check my pulse before taking my medication.” B. “I should eat foods high in potassium.” C. “If I miss a dose, I will take two doses the next time.” D. “I will notify my provider if I have nausea or visual changes.”

Answer 158

Answer: C (Patients should never double doses of digoxin; this increases the risk of toxicity.)

Question 159

12. Digoxin & Heart Failure Management Which finding indicates digoxin is effectively treating heart failure? A. Increased heart rate B. Reduced edema and dyspnea C. Decreased urine output D. Increased blood pressure

Answer 159

Answer: B (Improved heart failure symptoms, such as reduced edema and dyspnea, indicate effectiveness.)

Question 160

13. Contraindications A patient with which condition should NOT receive digoxin? A. Atrial fibrillation B. Heart failure with reduced ejection fraction C. Second-degree heart block D. Hypertension

Answer 160

Answer: C (Digoxin slows AV conduction and is contraindicated in patients with heart blocks.)

Question 161

14. Expected Outcomes Which of the following are expected effects of digoxin? (Select all that apply.) A. Increased cardiac output B. Decreased heart rate C. Increased blood pressure D. Reduced symptoms of heart failure E. Increased sodium retention

Answer 161

✅ A. Increased cardiac output ✅ B. Decreased heart rate ❌ C. Increased blood pressure ✅ D. Reduced symptoms of heart failure ❌ E. Increased sodium retention Correct Answers: A, B, D (Digoxin improves cardiac output, lowers heart rate, and reduces HF symptoms.)

Question 162

15. Digoxin & Renal Function A nurse is reviewing a patient’s labs before administering digoxin. Which finding is most concerning? A. Creatinine 2.5 mg/dL B. Potassium 4.2 mEq/L C. Digoxin level 1.2 ng/mL D. Sodium 138 mEq/L

Answer 162

Answer: A (Kidney dysfunction can impair digoxin excretion, increasing the risk of toxicity.)

Question 163

16. Select-All-That-Apply (SATA): Nursing Responsibilities What should the nurse do before administering digoxin? (Select all that apply.) A. Check the patient’s apical pulse B. Monitor potassium levels C. Assess for signs of digoxin toxicity D. Administer the medication if the HR is below 50 bpm E. Review the patient’s renal function

Answer 163

✅ A. Check the patient’s apical pulse ✅ B. Monitor potassium levels ✅ C. Assess for signs of digoxin toxicity ❌ D. Administer the medication if the HR is below 50 bpm ✅ E. Review the patient’s renal function Correct Answers: A, B, C, E (Checking HR, potassium, toxicity signs, and renal function is critical before giving digoxin.)

Question 164

17. Rebound Effect & Discontinuation Why should digoxin never be stopped abruptly? A. It can cause rebound hypertension B. It can worsen heart failure symptoms C. It can cause sudden hyperkalemia D. It can lead to bradycardia

Answer 164

Answer: B (Stopping digoxin suddenly can worsen heart failure symptoms.)

Question 165

1. Mechanism of Action How do alpha-adrenergic blockers lower blood pressure? A. By inhibiting aldosterone secretion B. By blocking alpha-1 receptors, causing vasodilation C. By stimulating beta-2 receptors in the lungs D. By increasing renin production

Answer 165

Answer: B (Alpha-adrenergic blockers block alpha-1 receptors, leading to vasodilation and decreased blood pressure.)

Question 166

2. Indications for Use Alpha-adrenergic blockers are commonly prescribed for which conditions? (Select all that apply.) A. Hypertension B. Benign prostatic hyperplasia (BPH) C. Heart failure D. Asthma E. Pheochromocytoma

Answer 166

Alpha-adrenergic blockers are commonly prescribed for which conditions? (Select all that apply.) ✅ A. Hypertension ✅ B. Benign prostatic hyperplasia (BPH) ❌ C. Heart failure ❌ D. Asthma ✅ E. Pheochromocytoma Correct Answers: A, B, E (Alpha blockers treat hypertension, BPH, and pheochromocytoma (adrenal gland tumor).)

Question 167

3. First-Dose Effect A patient taking prazosin for the first time experiences dizziness and faints after standing up. What is the most likely cause? A. Reflex tachycardia B. First-dose hypotension C. Hypoglycemia D. Hyperkalemia

Answer 167

Answer: B (Alpha blockers can cause severe first-dose hypotension, leading to syncope.)

Question 168

4. Nursing Considerations When should a patient take their first dose of doxazosin to reduce the risk of first-dose hypotension? A. In the morning before breakfast B. With lunch C. At bedtime D. Immediately before exercise

Answer 168

Answer: C (Taking the first dose at bedtime reduces the risk of fainting from first-dose hypotension.)

Question 169

5. Reflex Tachycardia Risk Why do alpha-adrenergic blockers sometimes cause reflex tachycardia? A. The heart compensates for the sudden drop in blood pressure B. They directly stimulate beta-1 receptors C. They increase sodium retention D. They increase epinephrine release

Answer 169

Answer: A (Reflex tachycardia occurs because the body compensates for vasodilation-induced hypotension.)

Question 170

6. Drug Interactions Which medication, when taken with prazosin, increases the risk of severe hypotension? A. NSAIDs B. Beta-blockers C. Acetaminophen D. Digoxin

Answer 170

Answer: B (Beta-blockers and alpha blockers both lower blood pressure, increasing the risk of severe hypotension.)

Question 171

7. Patient Education Which statement by a patient taking terazosin indicates a need for further teaching? A. “I should rise slowly when getting up from bed.” B. “I will take my first dose at bedtime.” C. “If I miss a dose, I should take two doses next time.” D. “This medication may cause dizziness or drowsiness.”

Answer 171

Answer: C (Patients should never double doses of alpha blockers; this increases the risk of hypotension.)

Question 172

8. Select-All-That-Apply (SATA): Side Effects Which of the following are common side effects of alpha blockers? (Select all that apply.) A. Dizziness B. Hypotension C. Hyperkalemia D. Reflex tachycardia E. Nasal congestion

Answer 172

✅ A. Dizziness ✅ B. Hypotension ❌ C. Hyperkalemia ✅ D. Reflex tachycardia ✅ E. Nasal congestion Correct Answers: A, B, D, E (Common side effects include dizziness, hypotension, reflex tachycardia, and nasal congestion.)

Question 173

9. Alpha Blockers & BPH How do alpha blockers help patients with benign prostatic hyperplasia (BPH)? A. By shrinking the prostate gland B. By increasing bladder contractility C. By relaxing smooth muscle in the bladder and prostate D. By increasing urine production

Answer 173

Answer: C (Alpha blockers relax smooth muscle in the bladder neck and prostate, improving urine flow in BPH.)

Question 174

10. Monitoring for Effectiveness A patient has been taking prazosin for two weeks. Which finding indicates the medication is effective? A. Decreased heart rate B. Reduced blood pressure C. Increased blood sugar D. Worsened BPH symptoms

Answer 174

Answer: B (Alpha blockers effectively lower blood pressure.)

Question 175

11. Contraindications Which patient should NOT receive an alpha blocker? A. A patient with hypertension B. A patient with BPH C. A patient with orthostatic hypotension D. A patient with pheochromocytoma

Answer 175

Answer: C (Alpha blockers can worsen orthostatic hypotension.)

Question 176

12. Prioritization A patient taking doxazosin reports dizziness when standing up. What is the nurse’s priority action? A. Discontinue the medication immediately B. Instruct the patient to change positions slowly C. Give an additional dose to stabilize BP D. Encourage the patient to drink more fluids

Answer 176

Answer: B (Patients should be advised to change positions slowly to reduce dizziness from hypotension.)

Question 177

13. Rebound Hypertension Risk Why should alpha blockers never be discontinued abruptly? A. They can cause rebound hypertension B. They can cause sudden hyperkalemia C. They can lead to bradycardia D. They can increase renin secretion

Answer 177

Answer: A (Stopping alpha blockers suddenly can cause rebound hypertension due to sudden vasoconstriction.)

Question 178

14. Emergency Situations A nurse is monitoring a patient who took too much prazosin. Which symptom indicates severe hypotension? A. Bradycardia and pallor B. Syncope and dizziness C. Increased urinary output D. Muscle cramps and hyperreflexia

Answer 178

Answer: B (Severe hypotension from alpha blockers can cause syncope and dizziness.)

Question 179

15. Drug-Food Interactions Which food should a patient taking an alpha blocker avoid? A. Grapefruit B. Alcohol C. Leafy greens D. Dairy products

Answer 179

Answer: B (Alcohol can worsen hypotension when taken with alpha blockers.)

Question 180

16. Expected Outcomes Which of the following are expected effects of alpha blockers? (Select all that apply.) A. Lowered blood pressure B. Improved urine flow in BPH C. Increased sodium retention D. Decreased afterload E. Increased cardiac contractility

Answer 180

✅ A. Lowered blood pressure ✅ B. Improved urine flow in BPH ❌ C. Increased sodium retention ✅ D. Decreased afterload ❌ E. Increased cardiac contractility Correct Answers: A, B, D (Alpha blockers lower BP, improve urine flow in BPH, and decrease afterload.)

Question 181

1. Mechanism of Action How do nitrates relieve angina? A. By blocking calcium channels to reduce heart rate B. By dilating coronary arteries and reducing myocardial oxygen demand C. By increasing myocardial contractility D. By stimulating the sympathetic nervous system

Answer 181

Answer: B (Nitrates cause vasodilation, reducing myocardial oxygen demand and increasing blood flow to the heart.)

Question 182

2. Indications for Use Which conditions are commonly treated with nitrates? (Select all that apply.) A. Angina B. Heart failure C. Acute myocardial infarction (MI) D. Hypertension crisis (except IV nitroglycerin) E. Atrial fibrillation

Answer 182

✅ A. Angina ✅ B. Heart failure ✅ C. Acute myocardial infarction (MI) ❌ D. Hypertension crisis (except IV nitroglycerin) ❌ E. Atrial fibrillation Correct Answers: A, B, C (Nitrates are used for angina, heart failure, and acute MI but are not first-line for hypertension or atrial fibrillation.)

Question 183

3. Sublingual Nitroglycerin Administration A patient with angina is prescribed sublingual nitroglycerin. What instructions should the nurse provide? A. “Take one tablet every 10 minutes until the pain goes away.” B. “Take one tablet, wait five minutes, and repeat up to three times if needed.” C. “Chew the tablet thoroughly for faster absorption.” D. “Take the medication with food for better absorption.”

Answer 183

Answer: B (Sublingual nitroglycerin should be taken every five minutes (up to three times) for chest pain. If pain persists, call 911.)

Question 184

4. Nitroglycerin Patch Instructions A patient is prescribed a nitroglycerin patch. Which instruction is correct? A. “Apply the patch to the same site every day.” B. “Remove the patch at night to prevent tolerance.” C. “Keep the patch on 24/7 for continuous protection.” D. “Cut the patch in half if a lower dose is needed.”

Answer 184

Answer: B (To prevent nitrate tolerance, patches should be removed for 10-12 hours at night.)

Question 185

5. Nitrate Side Effects Which of the following is a common side effect of nitrates? A. Hypertension B. Bradycardia C. Headache D. Hyperglycemia

Answer 185

Answer: C (Vasodilation from nitrates can cause headaches.)

Question 186

6. Drug Interactions Which medication is contraindicated for a patient taking nitrates? A. Warfarin B. Sildenafil (Viagra) C. Metformin D. Acetaminophen

Answer 186

Answer: B (Nitrates and sildenafil can cause life-threatening hypotension.)

Question 187

7. Reflex Tachycardia Why do nitrates sometimes cause reflex tachycardia? A. Due to increased cardiac contractility B. Due to sudden vasodilation and blood pressure drop C. Due to activation of beta-adrenergic receptors D. Due to increased sodium retention

Answer 187

Answer: B (Vasodilation leads to a drop in BP, triggering compensatory tachycardia.)

Question 188

8. IV Nitroglycerin Administration A nurse is administering IV nitroglycerin. What is the priority assessment? A. Heart rate B. Blood pressure C. Respiratory rate D. Serum potassium

Answer 188

Answer: B (IV nitroglycerin can cause severe hypotension and must be closely monitored.)

Question 189

9. Nitrate-Free Periods Why are nitrate-free periods necessary? A. To prevent reflex tachycardia B. To prevent hypotension C. To prevent nitrate tolerance D. To reduce the risk of blood clots

Answer 189

Answer: C (Continuous nitrate use leads to tolerance; a nitrate-free period is needed daily.)

Question 190

10. Select-All-That-Apply (SATA): Side Effects Which of the following are common side effects of nitrates? (Select all that apply.) A. Headache B. Dizziness C. Hypotension D. Hyperkalemia E. Reflex tachycardia

Answer 190

✅ A. Headache ✅ B. Dizziness ✅ C. Hypotension ❌ D. Hyperkalemia ✅ E. Reflex tachycardia Correct Answers: A, B, C, E (Common side effects include headache, dizziness, hypotension, and reflex tachycardia.)

Question 191

11. Contraindications Which patient should NOT receive nitroglycerin? A. A patient with angina B. A patient who recently took sildenafil C. A patient with congestive heart failure D. A patient with a history of headaches

Answer 191

Answer: B (Nitroglycerin should not be used with sildenafil due to the risk of severe hypotension.)

Question 192

12. Monitoring for Effectiveness A patient has been taking isosorbide mononitrate for one month. Which finding indicates the medication is effective? A. Increased blood pressure B. Reduced frequency of angina episodes C. Increased heart rate D. Increased shortness of breath

Answer 192

Answer: B (Nitrates effectively reduce the frequency of angina attacks.)

Question 193

3. Patient Teaching A nurse is educating a patient about sublingual nitroglycerin. Which statement indicates a need for further teaching? A. “I will sit down before taking nitroglycerin.” B. “I will keep my nitroglycerin in the bathroom cabinet for easy access.” C. “I should feel a tingling sensation under my tongue.” D. “I will replace my nitroglycerin every six months.”

Answer 193

Answer: B (Nitroglycerin should be stored in a cool, dark place, not in a humid bathroom.)

Question 194

14. Nitrate Overdose Symptoms A nurse is assessing a patient who accidentally took too much nitroglycerin. Which finding suggests overdose? A. Hypertension and palpitations B. Hypotension and dizziness C. Hyperglycemia and confusion D. Bradycardia and increased urine output

Answer 194

Answer: B (Excessive nitroglycerin can cause severe hypotension and dizziness.)

Question 195

15. Emergency Situations A patient with chest pain takes nitroglycerin but still has pain after three doses. What is the nurse’s priority action? A. Administer aspirin B. Call 911 immediately C. Give an additional dose of nitroglycerin D. Encourage deep breathing exercises

Answer 195

Answer: B (If chest pain persists after three doses of nitroglycerin, emergency medical help is needed.)

Question 196

16. Expected Outcomes Which of the following are expected effects of nitrates? (Select all that apply.) A. Relief of chest pain B. Increased blood flow to the myocardium C. Reduced myocardial oxygen demand D. Increased blood pressure E. Prevention of angina episodes

Answer 196

✅ A. Relief of chest pain ✅ B. Increased blood flow to the myocardium ✅ C. Reduced myocardial oxygen demand ❌ D. Increased blood pressure ✅ E. Prevention of angina episodes Correct Answers: A, B, C, E (Nitrates relieve angina by improving blood flow and reducing oxygen demand.)

Question 197

1. Mechanism of Action How does warfarin prevent clot formation? A. By inhibiting platelet aggregation B. By blocking vitamin K-dependent clotting factors C. By stimulating fibrinolysis D. By directly inhibiting thrombin

Answer 197

Answer: B (Warfarin inhibits vitamin K-dependent clotting factors (II, VII, IX, X), reducing clot formation.)

Question 198

2. Monitoring Warfarin Therapy Which lab test is used to monitor warfarin therapy? A. Activated partial thromboplastin time (aPTT) B. International normalized ratio (INR) C. D-dimer D. Platelet count

Answer 198

Answer: B (INR is used to monitor warfarin, with a therapeutic range of 2.0–3.0 for most patients.)

Question 199

3. Warfarin Patient Education Which patient statement indicates a need for further teaching about warfarin? A. “I should avoid foods high in vitamin K, like spinach and kale.” B. “I need to have my INR checked regularly.” C. “If I miss a dose, I will take two doses the next time.” D. “I should use a soft-bristled toothbrush to avoid bleeding.”

Answer 199

Answer: C (Missed doses should never be doubled due to bleeding risk.)

Question 200

4. Warfarin Antidote What is the antidote for warfarin overdose? A. Protamine sulfate B. Vitamin K C. Heparin D. Fresh frozen plasma

Answer 200

Answer: B (Vitamin K reverses warfarin-induced bleeding.)

Question 201

5. Direct Oral Anticoagulants (DOACs) Which of the following is a direct thrombin inhibitor? A. Apixaban B. Rivaroxaban C. Dabigatran D. Warfarin

Answer 201

Answer: C (Dabigatran directly inhibits thrombin, preventing clot formation.)

Question 202

6. Drug Interactions with Warfarin Which medication increases the risk of bleeding when taken with warfarin? A. Acetaminophen B. NSAIDs (e.g., ibuprofen, aspirin) C. Antacids D. Metformin

Answer 202

Answer: B (NSAIDs increase the risk of GI bleeding when taken with warfarin.)

Question 203

7. LMWH Administration How is LMWH (enoxaparin) administered? A. Intramuscular B. Intravenous C. Subcutaneous D. Oral

Answer 203

Answer: C (LMWH is given subcutaneously to prevent DVT and PE.)

Question 204

8. Advantage of LMWH Over Heparin What is an advantage of LMWH over unfractionated heparin? A. Requires frequent aPTT monitoring B. Has a shorter half-life C. Has more predictable anticoagulation effects D. Has a higher risk of bleeding

Answer 204

Answer: C (LMWH has a more predictable effect and does not require routine aPTT monitoring.)

Question 205

9. LMWH Patient Education A patient is prescribed enoxaparin after surgery. What should the nurse include in discharge instructions? A. “Rub the injection site to help absorption.” B. “Inject into the muscle for faster effects.” C. “Expect mild bruising at the injection site.” D. “Avoid taking this medication at home.”

Answer 205

Answer: C (Bruising is a common side effect of LMWH injections.)

Question 206

10. LMWH Contraindications Which patient should NOT receive LMWH? A. A patient with deep vein thrombosis (DVT) B. A patient with a creatinine clearance <30 mL/min C. A patient undergoing hip replacement surgery D. A patient at risk for clotting disorders

Answer 206

Answer: B (LMWH is renally excreted and should be used with caution in severe renal impairment.)

Question 207

11. Mechanism of Action How does unfractionated heparin prevent clot formation? A. By inhibiting thrombin and factor Xa B. By increasing platelet aggregation C. By breaking down existing clots D. By increasing fibrin production

Answer 207

Answer: A (Heparin inhibits thrombin and factor Xa, preventing clot formation.)

Question 208

12. Monitoring Heparin Therapy Which lab test is used to monitor IV heparin therapy? A. INR B. aPTT C. Platelet count D. D-dimer

Answer 208

Answer: B (aPTT is used to monitor IV heparin; therapeutic range is 1.5–2.5 times normal.)

Question 209

13. Heparin Antidote What is the antidote for heparin overdose? A. Vitamin K B. Protamine sulfate C. Fresh frozen plasma D. Dabigatran

Answer 209

Answer: B (Protamine sulfate reverses heparin’s effects.)

Question 210

14. Heparin-Induced Thrombocytopenia (HIT) A nurse is monitoring a patient on IV heparin and notices a sudden drop in platelet count. What is the most likely cause? A. Normal response to anticoagulation B. Vitamin K deficiency C. Heparin-induced thrombocytopenia (HIT) D. Hypovolemia

Answer 210

Answer: C (HIT is a serious immune-mediated reaction causing platelet destruction and increased clot risk.)

Question 211

15. Heparin Administration Which statement about subcutaneous heparin administration is correct? A. “Aspirate before injecting to ensure the needle is in the correct location.” B. “Massage the site after injection to enhance absorption.” C. “Administer in the abdomen, avoiding the umbilical area.” D. “Use a 21-gauge needle for administration.”

Answer 211

Answer: C (Subcutaneous heparin should be injected into the abdomen, at least 2 inches away from the umbilicus.)

Question 212

16. Select-All-That-Apply (SATA): Side Effects of Heparin Which of the following are common side effects of heparin? (Select all that apply.) A. Bleeding B. Thrombocytopenia C. Hyperkalemia D. Bruising at injection sites E. Hypertension

Answer 212

✅ A. Bleeding ✅ B. Thrombocytopenia ❌ C. Hyperkalemia ✅ D. Bruising at injection sites ❌ E. Hypertension Correct Answers: A, B, D (Heparin increases bleeding risk, can cause HIT, and may lead to bruising at injection sites.)

Question 213

17. Prioritization A patient receiving IV heparin has an aPTT of 120 seconds (normal: 25-35 sec). What is the nurse’s priority action? A. Increase the heparin infusion rate B. Stop the infusion and notify the provider C. Give an extra dose of heparin D. Administer vitamin K

Answer 213

Answer: B (An aPTT of 120 seconds is dangerously high, increasing bleeding risk. The infusion should be stopped immediately.)

Question 214

18. Expected Outcomes of Anticoagulation Therapy Which of the following indicate that anticoagulant therapy is effective? (Select all that apply.) A. No new clot formation B. INR within the therapeutic range C. No signs of excessive bleeding D. Increased clotting factor production E. Stable hemoglobin levels

Answer 214

✅ A. No new clot formation ✅ B. INR within the therapeutic range ✅ C. No signs of excessive bleeding ❌ D. Increased clotting factor production ✅ E. Stable hemoglobin levels Correct Answers: A, B, C, E (Therapeutic anticoagulation prevents new clots while maintaining safe bleeding parameters.)

Question 215

1. Mechanism of Action How do thrombolytic drugs work? A. By inhibiting platelet aggregation B. By dissolving existing blood clots through plasmin activation C. By preventing new clot formation D. By inhibiting thrombin production

Answer 215

Answer: B (Thrombolytics activate plasminogen, converting it to plasmin, which breaks down fibrin clots.)

Question 216

2. Indications for Use Thrombolytics are commonly used to treat which of the following conditions? (Select all that apply.) A. Acute ischemic stroke (within 3–4.5 hours of onset) B. Pulmonary embolism (PE) C. Myocardial infarction (STEMI) D. Deep vein thrombosis (DVT) in stable patients E. Hemorrhagic stroke

Answer 216

✅ A. Acute ischemic stroke (within 3–4.5 hours of onset) ✅ B. Pulmonary embolism (PE) ✅ C. Myocardial infarction (STEMI) ❌ D. Deep vein thrombosis (DVT) in stable patients ❌ E. Hemorrhagic stroke Correct Answers: A, B, C (Thrombolytics are used for acute ischemic stroke, PE, and STEMI but are contraindicated in hemorrhagic stroke.)

Question 217

3. Contraindications Which of the following patients should NOT receive alteplase (tPA)? A. A patient with an ischemic stroke that started 2 hours ago B. A patient with ST-elevation myocardial infarction (STEMI) C. A patient with active internal bleeding D. A patient with a massive pulmonary embolism

Answer 217

Answer: C (Active bleeding is an absolute contraindication to thrombolytic therapy.)

Question 218

4. Administration Timing in Stroke A patient with signs of acute ischemic stroke arrives at the ER. Within what time frame should thrombolytic therapy be administered for maximum benefit? A. Within 1 hour of symptom onset B. Within 3 to 4.5 hours of symptom onset C. Within 12 hours of symptom onset D. Within 24 hours of symptom onset

Answer 218

Answer: B (Thrombolytics are most effective when given within 3 to 4.5 hours of stroke symptom onset.)

Question 219

5. Monitoring for Effectiveness A patient receives alteplase for an acute ischemic stroke. Which finding indicates the medication is effective? A. Decreased level of consciousness B. Sudden severe headache C. Improved neurological function D. Increased blood pressure

Answer 219

Answer: C (Improvement in neurological symptoms suggests clot dissolution and restored blood flow.)

Question 220

6. Major Adverse Effect What is the most serious adverse effect of thrombolytic therapy? A. Hypertension B. Severe bleeding/hemorrhage C. Reflex tachycardia D. Hypokalemia

Answer 220

Answer: B (Thrombolytics significantly increase the risk of bleeding, including intracranial hemorrhage.)

Question 221

7. Nursing Considerations Before administering alteplase for a stroke, the nurse must confirm which diagnostic test result? A. Complete blood count (CBC) B. Electrocardiogram (ECG) C. CT scan of the brain D. Serum potassium level

Answer 221

Answer: C (A CT scan must be done first to rule out hemorrhagic stroke, which is a contraindication to thrombolytics.)

Question 222

8. Drug Interactions Which medication, when taken with thrombolytics, increases the risk of severe bleeding? A. Acetaminophen B. Clopidogrel (Plavix) C. Furosemide D. Metformin

Answer 222

Answer: B (Antiplatelet drugs like clopidogrel increase the risk of bleeding when combined with thrombolytics.)

Question 223

9. Prioritization A patient receiving thrombolytic therapy suddenly develops unilateral weakness and confusion. What is the nurse’s priority action? A. Stop the infusion immediately B. Administer protamine sulfate C. Check blood glucose levels D. Give an additional dose of alteplase

Answer 223

Answer: A (New neurological deficits may indicate intracranial hemorrhage, requiring immediate discontinuation of the drug.)

Question 224

10. Select-All-That-Apply (SATA): Contraindications Which conditions are absolute contraindications for thrombolytic therapy? (Select all that apply.) A. Active internal bleeding B. History of hemorrhagic stroke C. Recent major surgery or trauma (within 14 days) D. History of hypertension controlled with medication E. Severe uncontrolled hypertension (SBP >185 mmHg)

Answer 224

✅ A. Active internal bleeding ✅ B. History of hemorrhagic stroke ✅ C. Recent major surgery or trauma (within 14 days) ❌ D. History of hypertension controlled with medication ✅ E. Severe uncontrolled hypertension (SBP >185 mmHg) Correct Answers: A, B, C, E (Absolute contraindications include active bleeding, history of hemorrhagic stroke, recent major surgery, and severe uncontrolled hypertension.)

Question 225

11. Antidote for Thrombolytics What is the antidote for excessive bleeding caused by thrombolytics? A. Vitamin K B. Protamine sulfate C. Aminocaproic acid (Amicar) D. Heparin

Answer 225

Answer: C (Aminocaproic acid (Amicar) inhibits fibrinolysis and is used to reverse thrombolytic effects.)

Question 226

12. Expected Outcomes Which of the following are expected effects of thrombolytic therapy? (Select all that apply.) A. Restoration of blood flow in the affected artery B. Decreased chest pain in MI patients C. Reduced neurological deficits in ischemic stroke D. Increased clot formation E. Resolution of pulmonary embolism

Answer 226

✅ A. Restoration of blood flow in the affected artery ✅ B. Decreased chest pain in MI patients ✅ C. Reduced neurological deficits in ischemic stroke ❌ D. Increased clot formation ✅ E. Resolution of pulmonary embolism Correct Answers: A, B, C, E (Thrombolytics restore blood flow, reduce chest pain in MI, improve stroke symptoms, and dissolve pulmonary embolisms.)

Question 227

13. Heparin & Thrombolytics A patient receives thrombolytics for an acute MI. Why might heparin also be prescribed afterward? A. To dissolve residual clots B. To prevent new clot formation C. To reverse the effects of alteplase D. To reduce blood pressure

Answer 227

Answer: B (Heparin is used after thrombolytic therapy to prevent new clots from forming.)

Question 228

14. Patient Teaching Which instruction should a nurse give to a patient receiving thrombolytics? A. “Avoid invasive procedures for 24 hours.” B. “Take an extra dose if chest pain returns.” C. “Expect mild bruising and bleeding gums.” D. “You can receive this medication multiple times if needed.”

Answer 228

Answer: A (Minimizing invasive procedures reduces the risk of excessive bleeding.)

Question 229

15. Administration Route How are thrombolytics usually administered? A. Intramuscular injection B. Subcutaneous injection C. Intravenous infusion D. Oral tablets

Answer 229

Answer: C (Thrombolytics are given IV to ensure rapid systemic circulation.)

Question 230

16. Follow-Up Monitoring A patient received alteplase for a stroke. Which follow-up test is most important? A. CT scan of the brain B. Serum potassium C. ECG D. INR

Answer 230

Answer: A (A follow-up CT scan is necessary to assess for intracranial hemorrhage or stroke progression.)

Question 231

17. Prioritization in MI A patient with STEMI arrives at the ER. What is the priority intervention if PCI (percutaneous coronary intervention) is unavailable? A. Administer thrombolytics B. Give aspirin and nitroglycerin C. Start IV fluids D. Obtain a chest X-ray

Answer 231

Answer: A (If PCI is unavailable, thrombolytics should be given ASAP (within 30 minutes of hospital arrival).)

Question 232

18. Signs of Successful Thrombolysis Which finding indicates successful thrombolysis in an MI patient? A. Continued ST-segment elevation B. Sudden resolution of chest pain C. Worsening shortness of breath D. Increased blood pressure

Answer 232

Answer: B (Relief of chest pain and ST-segment resolution indicate successful reperfusion.)

Question 233

1. Mechanism of Action How do antiplatelet drugs help prevent clot formation? A. By dissolving existing blood clots B. By preventing platelet aggregation C. By inhibiting thrombin production D. By breaking down fibrin strands

Answer 233

Answer: B (Antiplatelet drugs prevent platelets from clumping together, reducing clot formation.)

Question 234

2. Indications for Use Antiplatelet drugs are commonly prescribed to prevent which conditions? (Select all that apply.) A. Myocardial infarction (MI) B. Stroke C. Transient ischemic attacks (TIAs) D. Deep vein thrombosis (DVT) E. Peripheral arterial disease (PAD)

Answer 234

✅ A. Myocardial infarction (MI) ✅ B. Stroke ✅ C. Transient ischemic attacks (TIAs) ❌ D. Deep vein thrombosis (DVT) ✅ E. Peripheral arterial disease (PAD) Correct Answers: A, B, C, E (Antiplatelets prevent arterial clot formation but are not the first-line treatment for DVT.)

Question 235

3. Aspirin Mechanism of Action How does aspirin work as an antiplatelet drug? A. By inhibiting vitamin K-dependent clotting factors B. By blocking thromboxane A2 production, preventing platelet aggregation C. By activating plasminogen to break down clots D. By inhibiting factor Xa

Answer 235

Answer: B (Aspirin inhibits thromboxane A2, a key factor in platelet aggregation.)

Question 236

4. Dual Antiplatelet Therapy (DAPT) Why might a patient be prescribed both aspirin and clopidogrel after a myocardial infarction? A. To enhance blood clot formation B. To provide stronger platelet inhibition C. To reduce blood pressure D. To prevent hypokalemia

Answer 236

Answer: B (Dual antiplatelet therapy (DAPT) provides stronger platelet inhibition and reduces the risk of clot formation after MI or stent placement.)

Question 237

5. Common Side Effects What is the most common side effect of aspirin and clopidogrel? A. Hypotension B. Bleeding C. Hyperkalemia D. Reflex tachycardia

Answer 237

Answer: B (Antiplatelet drugs increase the risk of bleeding.)

Question 238

6. Contraindications for Aspirin Use Which patient should NOT take aspirin? A. A patient with a history of myocardial infarction B. A patient with hypertension C. A patient with an active gastrointestinal ulcer D. A patient with peripheral artery disease

Answer 238

Answer: C (Aspirin increases the risk of GI bleeding and should be avoided in patients with active ulcers.)

Question 239

7. Clopidogrel (Plavix) Patient Teaching Which instruction should the nurse provide to a patient taking clopidogrel? A. "Take this medication on an empty stomach to enhance absorption." B. "Avoid grapefruit juice as it may affect the drug's effectiveness." C. "Stop taking the medication immediately if mild bruising occurs." D. "You do not need to report any unusual bleeding to your provider."

Answer 239

Answer: B (Grapefruit juice can interfere with clopidogrel metabolism and reduce its effectiveness.)

Question 240

8. Drug Interactions Which medication increases the risk of bleeding when taken with antiplatelet drugs? A. Acetaminophen B. Ibuprofen C. Furosemide D. Metformin

Answer 240

Answer: B (NSAIDs like ibuprofen increase the risk of GI bleeding when taken with antiplatelets.)

Question 241

9. Monitoring for Adverse Effects A patient taking ticagrelor reports black, tarry stools. What is the nurse’s priority action? A. Continue the medication as prescribed B. Administer activated charcoal C. Assess the patient for signs of gastrointestinal bleeding D. Check potassium levels

Answer 241

Answer: C (Black, tarry stools (melena) indicate possible GI bleeding, a serious adverse effect.)

Question 242

10. Antiplatelet Discontinuation Before Surgery How many days before surgery should clopidogrel typically be discontinued to reduce bleeding risk? A. 1 day B. 3 days C. 5–7 days D. 10 days

Answer 242

Answer: C (Clopidogrel should be stopped 5–7 days before surgery to prevent excessive bleeding.)

Question 243

11. Select-All-That-Apply (SATA): Signs of Bleeding Which symptoms should a patient on antiplatelet therapy report to their healthcare provider? (Select all that apply.) A. Unusual bruising B. Black, tarry stools C. Blood in urine D. Increased appetite E. Prolonged bleeding from cuts

Answer 243

✅ A. Unusual bruising ✅ B. Black, tarry stools ✅ C. Blood in urine ❌ D. Increased appetite ✅ E. Prolonged bleeding from cuts Correct Answers: A, B, C, E (Signs of bleeding include bruising, melena, hematuria, and prolonged bleeding.)

Question 244

12. Reversal Agent for Antiplatelet Drugs What is the reversal agent for excessive bleeding caused by clopidogrel or aspirin? A. Vitamin K B. Protamine sulfate C. Platelet transfusion D. Heparin

Answer 244

Answer: C (Platelet transfusion is used to reverse excessive bleeding caused by antiplatelet drugs.)

Question 245

13. Aspirin for Stroke Prevention A patient is prescribed low-dose aspirin for stroke prevention. What is the typical recommended daily dose? A. 81 mg B. 160 mg C. 325 mg D. 650 mg

Answer 245

Answer: A (Low-dose aspirin (81 mg) is commonly used for stroke prevention.)

Question 246

14. Prioritization A patient on dual antiplatelet therapy develops sudden confusion and weakness on one side. What is the nurse’s priority action? A. Perform a neurological assessment and notify the provider B. Hold the next dose of aspirin C. Administer vitamin K D. Check blood glucose levels

Answer 246

Answer: A (Sudden neurological changes may indicate a hemorrhagic stroke, requiring immediate evaluation.)

Question 247

15. Expected Outcomes Which of the following indicate that antiplatelet therapy is effective? (Select all that apply.) A. No new clot formation B. No signs of stroke or MI C. Improved blood flow in peripheral arteries D. Increased platelet aggregation E. Prevention of transient ischemic attacks (TIAs)

Answer 247

✅ A. No new clot formation ✅ B. No signs of stroke or MI ✅ C. Improved blood flow in peripheral arteries ❌ D. Increased platelet aggregation ✅ E. Prevention of transient ischemic attacks (TIAs) Correct Answers: A, B, C, E (Antiplatelets reduce clot risk and improve arterial circulation.)

Question 248

1. Mechanism of Action How do statins lower cholesterol? A. By inhibiting the enzyme HMG-CoA reductase, reducing cholesterol synthesis B. By increasing bile acid excretion C. By preventing cholesterol absorption in the intestine D. By stimulating the breakdown of LDL cholesterol

Answer 248

Answer: A (Statins inhibit HMG-CoA reductase, reducing hepatic cholesterol production.)

Question 249

2. Indications for Use Statins are prescribed to treat which of the following conditions? (Select all that apply.) A. Hyperlipidemia B. Prevention of cardiovascular disease C. Post-myocardial infarction (MI) therapy D. Hypertension E. Diabetes-related cardiovascular risk reduction

Answer 249

✅ A. Hyperlipidemia ✅ B. Prevention of cardiovascular disease ✅ C. Post-myocardial infarction (MI) therapy ❌ D. Hypertension ✅ E. Diabetes-related cardiovascular risk reduction Correct Answers: A, B, C, E (Statins lower cholesterol and reduce cardiovascular risks but are not used for hypertension.)

Question 250

3. Statin Side Effects A patient taking atorvastatin reports muscle pain and weakness. What is the nurse’s priority action? A. Discontinue the medication immediately B. Monitor the patient’s liver enzymes C. Assess for signs of rhabdomyolysis D. Encourage the patient to increase fluid intake

Answer 250

Answer: C (Muscle pain and weakness can indicate rhabdomyolysis, a severe adverse effect of statins.)

Question 251

4. Statin Contraindications Which patient should NOT take a statin? A. A patient with a history of myocardial infarction B. A patient with high LDL cholesterol C. A patient who is pregnant D. A patient with type 2 diabetes

Answer 251

Answer: C (Statins are contraindicated in pregnancy due to potential teratogenic effects.)

Question 252

5. Monitoring for Statin Therapy Which lab tests should be monitored in patients taking statins? (Select all that apply.) A. Liver function tests (AST, ALT) B. Creatine kinase (CK) C. White blood cell count D. Lipid profile E. Hemoglobin A1C

Answer 252

✅ A. Liver function tests (AST, ALT) ✅ B. Creatine kinase (CK) ❌ C. White blood cell count ✅ D. Lipid profile ❌ E. Hemoglobin A1C Correct Answers: A, B, D (Statins can cause hepatotoxicity and muscle damage, so liver enzymes, CK, and lipid levels should be monitored.)

Question 253

6. Drug Interactions Which food should a patient taking simvastatin avoid? A. Dairy products B. Bananas C. Grapefruit juice D. Leafy green vegetables

Answer 253

Answer: C (Grapefruit juice inhibits statin metabolism, increasing toxicity risk.)

Question 254

7. Mechanism of Action How do fibrates lower cholesterol? A. By inhibiting cholesterol absorption in the intestines B. By increasing lipoprotein lipase activity, reducing triglycerides C. By blocking bile acid reabsorption D. By inhibiting HMG-CoA reductase

Answer 254

Answer: B (Fibrates lower triglycerides by increasing lipoprotein lipase activity.)

Question 255

8. Fibrate Drug Interactions Which medication increases the risk of myopathy when taken with fibrates? A. Warfarin B. Metformin C. Statins D. ACE inhibitors

Answer 255

Answer: C (Fibrates combined with statins increase the risk of muscle toxicity.)

Question 256

9. Mechanism of Action How do bile acid sequestrants lower cholesterol? A. By binding to bile acids in the intestine, preventing cholesterol reabsorption B. By reducing LDL cholesterol synthesis in the liver C. By inhibiting lipoprotein lipase D. By directly breaking down cholesterol in the bloodstream

Answer 256

Answer: A (Bile acid sequestrants bind to bile acids, preventing cholesterol reabsorption.)

Question 257

10. Common Side Effects Which side effect is most commonly associated with bile acid sequestrants? A. Constipation B. Hypoglycemia C. Muscle pain D. Bradycardia

Answer 257

Answer: A (Bile acid sequestrants commonly cause constipation and GI discomfort.)

Question 258

11. Drug Interactions with Bile Acid Sequestrants When should other medications be taken in relation to bile acid sequestrants? A. At the same time B. 1 hour before or 4 hours after C. Only in the evening D. With high-fat meals

Answer 258

Answer: B (Bile acid sequestrants can interfere with the absorption of other drugs, so they should be taken 1 hour before or 4 hours after other medications.)

Question 259

Cholesterol Absorption Inhibitor (Ezetimibe - Zetia) 12. Ezetimibe Mechanism of Action How does ezetimibe lower cholesterol? A. By inhibiting cholesterol absorption in the small intestine B. By breaking down LDL cholesterol C. By increasing HDL levels D. By blocking HMG-CoA reductase

Answer 259

Answer: A (Ezetimibe prevents cholesterol absorption in the small intestine.)

Question 260

13. Expected Outcomes Which lab finding indicates that ezetimibe is effective? A. Increased LDL cholesterol B. Decreased LDL cholesterol C. Increased triglycerides D. Decreased WBC count

Answer 260

Answer: B (Ezetimibe lowers LDL cholesterol by reducing intestinal absorption.)

Question 261

14. Niacin’s Effect on Lipids Which lipid level does niacin primarily affect? A. Increases LDL cholesterol B. Decreases HDL cholesterol C. Increases HDL cholesterol D. Increases triglycerides

Answer 261

Answer: C (Niacin increases HDL cholesterol, the “good” cholesterol.)

Question 262

15. Niacin Side Effects Which of the following is a common side effect of niacin therapy? A. Flushing and itching B. Hypotension C. Bradycardia D. Hyperkalemia

Answer 262

Answer: A (Niacin commonly causes flushing and itching due to prostaglandin release.)

Question 263

16. Patient Education for Niacin How can a patient reduce flushing caused by niacin? A. Take niacin with a high-fat meal B. Drink a glass of grapefruit juice C. Take aspirin 30 minutes before niacin D. Take the medication at bedtime

Answer 263

Answer: C (Aspirin reduces niacin-induced flushing.)

Question 264

17. Select-All-That-Apply (SATA): Adverse Effects of Antihyperlipidemic Drugs Which adverse effects should the nurse monitor in a patient taking antihyperlipidemic medications? (Select all that apply.) A. Liver toxicity (with statins and fibrates) B. Muscle pain (with statins and fibrates) C. GI discomfort (with bile acid sequestrants) D. Hyperkalemia E. Flushing (with niacin)

Answer 264

✅ A. Liver toxicity (with statins and fibrates) ✅ B. Muscle pain (with statins and fibrates) ✅ C. GI discomfort (with bile acid sequestrants) ❌ D. Hyperkalemia ✅ E. Flushing (with niacin) Correct Answers: A, B, C, E (Statins and fibrates can cause liver toxicity and muscle pain; bile acid sequestrants cause GI discomfort, and niacin causes flushing.)

Question 265

18. Expected Outcomes of Antihyperlipidemic Therapy Which of the following indicate that antihyperlipidemic therapy is effective? (Select all that apply.) A. Decreased LDL cholesterol B. Increased HDL cholesterol C. Decreased total cholesterol D. Increased triglycerides E. Reduced cardiovascular risk

Answer 265

✅ A. Decreased LDL cholesterol ✅ B. Increased HDL cholesterol ✅ C. Decreased total cholesterol ❌ D. Increased triglycerides ✅ E. Reduced cardiovascular risk Correct Answers: A, B, C, E (Successful therapy lowers LDL and total cholesterol, increases HDL, and reduces cardiovascular risk.)

Question 266

1. Mechanism of Action How do peripheral vasodilators improve circulation? A. By blocking beta receptors to slow heart rate B. By dilating blood vessels to increase blood flow C. By increasing sodium and water excretion D. By stimulating platelet aggregation

Answer 266

Answer: B (Peripheral vasodilators relax blood vessel walls, improving circulation and reducing blood pressure.)

Question 267

2. Indications for Use Peripheral vasodilators are commonly used to treat which conditions? (Select all that apply.) A. Peripheral arterial disease (PAD) B. Hypertension C. Raynaud’s disease D. Deep vein thrombosis (DVT) E. Intermittent claudication

Answer 267

✅ A. Peripheral arterial disease (PAD) ✅ B. Hypertension ✅ C. Raynaud’s disease ❌ D. Deep vein thrombosis (DVT) ✅ E. Intermittent claudication Correct Answers: A, B, C, E (Peripheral vasodilators improve blood flow in PAD, Raynaud’s, and hypertension but are not used for DVT.)

Question 268

3. Hydralazine Adverse Effects A patient taking hydralazine reports dizziness and a pounding headache. What is the most likely cause? A. Hypokalemia B. Reflex tachycardia C. Hyperglycemia D. Blood clot formation

Answer 268

Answer: B (Sudden vasodilation from hydralazine can cause reflex tachycardia as the body compensates.)

Question 269

4. Monitoring Hydralazine Therapy Which vital sign should be closely monitored in patients receiving hydralazine? A. Blood pressure B. Oxygen saturation C. Blood glucose D. Respiratory rate

Answer 269

Answer: A (Hydralazine can cause significant hypotension, requiring BP monitoring.)

Question 270

5. Patient Education for Peripheral Vasodilators A patient taking cilostazol for intermittent claudication asks how the medication helps. What is the best response? A. "It increases blood flow to the legs by preventing blood clot formation." B. "It helps open blood vessels to improve walking distance." C. "It reduces blood pressure by slowing your heart rate." D. "It strengthens your leg muscles to improve circulation."

Answer 270

Answer: B (Cilostazol is a phosphodiesterase inhibitor that dilates blood vessels and improves walking ability in PAD.)

Question 271

6. Contraindications Which patient should NOT receive cilostazol? A. A patient with intermittent claudication B. A patient with heart failure C. A patient with Raynaud’s disease D. A patient with high cholesterol

Answer 271

Answer: B (Cilostazol is contraindicated in heart failure due to an increased risk of mortality.)

Question 272

7. Minoxidil Side Effects Which side effect is commonly associated with minoxidil? A. Hair growth (hypertrichosis) B. Bradycardia C. Hypercalcemia D. Sedation

Answer 272

Answer: A (Minoxidil can cause excessive hair growth (hypertrichosis) and is used topically for hair loss.)

Question 273

8. Cilostazol Administration How should cilostazol be taken for maximum effectiveness? A. With a high-fat meal B. On an empty stomach C. Only at bedtime D. With calcium supplements

Answer 273

Answer: B (Cilostazol should be taken on an empty stomach for better absorption.)

Question 274

9. Drug Interactions with Vasodilators Which medication increases the risk of severe hypotension when taken with hydralazine? A. NSAIDs B. Beta-blockers C. Nitrates D. Warfarin

Answer 274

Answer: C (Combining hydralazine with nitrates can cause severe hypotension.)

Question 275

10. Select-All-That-Apply (SATA): Common Side Effects of Peripheral Vasodilators Which of the following are common side effects of peripheral vasodilators? (Select all that apply.) A. Headache B. Dizziness C. Hypotension D. Hyperkalemia E. Reflex tachycardia

Answer 275

✅ A. Headache ✅ B. Dizziness ✅ C. Hypotension ❌ D. Hyperkalemia ✅ E. Reflex tachycardia Correct Answers: A, B, C, E (Vasodilators commonly cause headache, dizziness, hypotension, and reflex tachycardia.)

Question 276

11. Pentoxifylline (Trental) Action How does pentoxifylline improve circulation in patients with PAD? A. By increasing the flexibility of red blood cells B. By directly dilating arteries C. By blocking platelet aggregation D. By reducing cholesterol levels

Answer 276

Answer: A (Pentoxifylline increases RBC flexibility, improving blood flow in microcirculation.)

Question 277

12. Prioritization A patient receiving minoxidil for hypertension reports swelling in the ankles and shortness of breath. What is the nurse’s priority action? A. Continue the medication as prescribed B. Assess for signs of fluid retention and heart failure C. Increase the dose to improve effectiveness D. Encourage the patient to limit fluid intake

Answer 277

Answer: B (Minoxidil can cause fluid retention and heart failure, requiring close monitoring.)

Question 278

13. Expected Outcomes of Peripheral Vasodilators Which findings indicate that a peripheral vasodilator is effective? (Select all that apply.) A. Increased walking distance without pain B. Reduced symptoms of Raynaud’s disease C. Lower blood pressure in hypertensive patients D. Increased platelet aggregation E. Improved circulation to extremities

Answer 278

✅ A. Increased walking distance without pain ✅ B. Reduced symptoms of Raynaud’s disease ✅ C. Lower blood pressure in hypertensive patients ❌ D. Increased platelet aggregation ✅ E. Improved circulation to extremities Correct Answers: A, B, C, E (Peripheral vasodilators improve circulation, reduce symptoms of PAD and Raynaud’s, and lower BP.)

Question 279

14. Emergency Situations A patient taking hydralazine develops a sudden drop in blood pressure (80/50 mmHg). What is the nurse’s priority action? A. Stop the medication and notify the provider B. Administer IV fluids C. Place the patient in a supine position D. All of the above

Answer 279

Answer: D (Severe hypotension requires stopping the drug, fluid administration, and positioning to improve circulation.)

Question 280

15. Minoxidil & Hypertension Why is minoxidil typically reserved for severe hypertension? A. It has a short half-life and must be given frequently B. It can cause excessive hair growth C. It has potent vasodilating effects and can lead to fluid retention D. It increases blood pressure unpredictably

Answer 280

Answer: C (Minoxidil is a powerful vasodilator that can cause severe fluid retention and is used as a last-line treatment.)

Question 281

1. Immediate Treatment for Severe Hyperkalemia A patient has a serum potassium level of 7.0 mEq/L and peaked T waves on an ECG. What is the nurse’s priority action? A. Administer oral sodium polystyrene sulfonate B. Give IV calcium gluconate C. Encourage the patient to drink more water D. Provide a potassium supplement

Answer 281

Answer: B (IV calcium gluconate stabilizes the cardiac membrane and prevents life-threatening arrhythmias.)

Question 282

2. Causes of Hyperkalemia Which of the following conditions can cause hyperkalemia? (Select all that apply.) A. Chronic kidney disease B. Potassium-sparing diuretics (e.g., spironolactone) C. Addison’s disease D. Loop diuretics (e.g., furosemide) E. Acidosis

Answer 282

✅ A. Chronic kidney disease ✅ B. Potassium-sparing diuretics (e.g., spironolactone) ✅ C. Addison’s disease ❌ D. Loop diuretics (e.g., furosemide) ✅ E. Acidosis Correct Answers: A, B, C, E (Hyperkalemia occurs due to impaired excretion (CKD), medications, adrenal insufficiency (Addison’s), and acidosis.)

Question 283

3. ECG Changes in Hyperkalemia Which ECG finding is most characteristic of hyperkalemia? A. ST-segment elevation B. Peaked T waves C. Shortened PR interval D. Widened QRS with U waves

Answer 283

Answer: B (Peaked T waves are a hallmark ECG change in hyperkalemia.)

Question 284

4. Role of Insulin in Hyperkalemia Treatment Why is IV insulin given for severe hyperkalemia? A. It binds to potassium and removes it from circulation B. It shifts potassium from the blood into the cells C. It neutralizes excess potassium in the bloodstream D. It increases potassium excretion through the kidneys

Answer 284

Answer: B (Insulin shifts potassium into cells, temporarily lowering serum potassium.)

Question 285

5. Administering Insulin for Hyperkalemia When giving IV insulin to treat hyperkalemia, what additional medication must also be given? A. Magnesium sulfate B. IV dextrose C. Sodium bicarbonate D. Warfarin

Answer 285

Answer: B (Dextrose (D50) prevents hypoglycemia when insulin is used to treat hyperkalemia.)

Question 286

6. Potassium-Removing Agents Which medication removes potassium from the body rather than just shifting it into cells? A. Insulin and dextrose B. Sodium polystyrene sulfonate (Kayexalate) C. Sodium bicarbonate D. Albuterol

Answer 286

answer: B (Kayexalate removes potassium via the GI tract through fecal excretion.)

Question 287

7. Emergency Hyperkalemia Management A patient in renal failure has a potassium level of 6.8 mEq/L. Which treatment removes potassium from the body? A. Calcium gluconate B. Sodium bicarbonate C. Dialysis D. IV dextrose and insulin

Answer 287

Answer: C (Dialysis is the most effective way to remove potassium in renal failure patients.)

Question 288

8. Sodium Bicarbonate in Hyperkalemia How does sodium bicarbonate help lower potassium levels? A. By binding to potassium and excreting it in urine B. By shifting potassium into cells by correcting acidosis C. By increasing potassium excretion through feces D. By promoting aldosterone release

Answer 288

Answer: B (Sodium bicarbonate corrects metabolic acidosis, which helps shift potassium into cells.)

Question 289

9. Potassium-Sparing vs. Potassium-Wasting Diuretics Which diuretic is commonly used to treat hyperkalemia? A. Spironolactone B. Triamterene C. Furosemide D. Eplerenone

Answer 289

Answer: C (Furosemide is a loop diuretic that increases potassium excretion.)

Question 290

10. Kayexalate (Sodium Polystyrene Sulfonate) Administration Which statement is true regarding Kayexalate administration? A. "It should be given only via IV." B. "It works immediately to lower potassium levels." C. "It can cause diarrhea as it removes potassium through the GI tract." D. "It is the first-line treatment for hyperkalemia with ECG changes."

Answer 290

Answer: C (Kayexalate removes potassium through feces but works slowly.)

Question 291

11. Select-All-That-Apply (SATA): Treatments for Hyperkalemia Which of the following treatments are used to lower potassium levels? (Select all that apply.) A. Calcium gluconate B. Insulin with dextrose C. Sodium bicarbonate D. Potassium chloride E. Dialysis

Answer 291

✅ A. Calcium gluconate ✅ B. Insulin with dextrose ✅ C. Sodium bicarbonate ❌ D. Potassium chloride ✅ E. Dialysis Correct Answers: A, B, C, E (All these treatments lower potassium, but potassium chloride would worsen hyperkalemia.)

Question 292

12. Prioritization in Hyperkalemia A patient’s potassium level is 6.9 mEq/L, and they are experiencing muscle weakness and peaked T waves. What is the nurse’s first action? A. Prepare the patient for dialysis B. Give IV calcium gluconate C. Administer oral sodium polystyrene sulfonate D. Call the provider for a stat ECG

Answer 292

Answer: B (IV calcium gluconate stabilizes the heart and prevents fatal arrhythmias.)

Question 293

13. Chronic Hyperkalemia Management Which dietary restriction should a patient with chronic hyperkalemia follow? A. Increase dairy intake B. Limit high-potassium foods such as bananas and oranges C. Avoid all protein sources D. Increase fluid intake to remove potassium

Answer 293

Answer: B (Patients with chronic hyperkalemia should avoid potassium-rich foods.)

Question 294

14. Albuterol’s Role in Hyperkalemia How does albuterol help lower potassium levels? A. By increasing urine output B. By shifting potassium into cells through beta-agonist stimulation C. By promoting sodium excretion D. By binding to potassium and excreting it via stool

Answer 294

Answer: B (Albuterol shifts potassium into cells by stimulating beta-adrenergic receptors.)

Question 295

15. Expected Outcomes of Hyperkalemia Treatment Which of the following indicate that hyperkalemia treatment is effective? (Select all that apply.) A. Potassium level returns to normal (3.5–5.0 mEq/L) B. Resolution of peaked T waves on ECG C. Absence of muscle weakness or paralysis D. Increased serum potassium levels E. Normalization of heart rhythm

Answer 295

✅ A. Potassium level returns to normal (3.5–5.0 mEq/L) ✅ B. Resolution of peaked T waves on ECG ✅ C. Absence of muscle weakness or paralysis ❌ D. Increased serum potassium levels ✅ E. Normalization of heart rhythm Correct Answers: A, B, C, E (Successful hyperkalemia treatment normalizes potassium, ECG changes, muscle strength, and heart rhythm.)

Question 296

1. Mechanism of Action How do antihistamines work? A. By blocking the release of histamine from mast cells B. By increasing histamine production C. By directly inhibiting inflammatory cytokines D. By stimulating H1 receptors

Answer 296

Answer: A (Antihistamines block histamine receptors, preventing allergic symptoms.)

Question 297

2. First-Generation vs. Second-Generation Antihistamines What is a key difference between first-generation and second-generation antihistamines? A. First-generation antihistamines cause more sedation B. Second-generation antihistamines are more effective C. First-generation antihistamines have a longer duration of action D. Second-generation antihistamines are used only for anaphylaxis

Answer 297

Answer: A (First-generation antihistamines like diphenhydramine cause more sedation due to CNS penetration.)

Question 298

3. Indications for Antihistamines Which of the following conditions are commonly treated with antihistamines? (Select all that apply.) A. Allergic rhinitis B. Urticaria (hives) C. Motion sickness D. Hypertension E. Anaphylaxis (as adjunct therapy)

Answer 298

✅ A. Allergic rhinitis ✅ B. Urticaria (hives) ✅ C. Motion sickness ❌ D. Hypertension ✅ E. Anaphylaxis (as adjunct therapy) Correct Answers: A, B, C, E (Antihistamines treat allergies, hives, motion sickness, and anaphylaxis (adjunct to epinephrine).)

Question 299

4. First-Generation Antihistamine Side Effects Which side effect is most commonly associated with first-generation antihistamines like diphenhydramine? A. Hypertension B. Drowsiness C. Increased appetite D. Bradycardia

Answer 299

Answer: B (First-generation antihistamines cause drowsiness due to CNS effects.)

Question 300

5. Antihistamines for Motion Sickness Which antihistamine is most effective for preventing motion sickness? A. Loratadine B. Cetirizine C. Diphenhydramine D. Meclizine

Answer 300

Answer: D (Meclizine is commonly used for motion sickness and vertigo.)

Question 301

6. Contraindications for Antihistamines Which patient should avoid taking diphenhydramine? A. A patient with seasonal allergies B. A patient with glaucoma C. A patient with a runny nose D. A patient with mild urticaria

Answer 301

Answer: B (Diphenhydramine can increase intraocular pressure and should be avoided in glaucoma.)

Question 302

7. Non-Sedating Antihistamines Which of the following is a second-generation, non-sedating antihistamine? A. Diphenhydramine B. Loratadine C. Hydroxyzine D. Promethazine

Answer 302

Answer: B (Loratadine is a non-sedating second-generation antihistamine.)

Question 303

8. Drug Interactions Which medication should be avoided when taking diphenhydramine due to increased sedation? A. Acetaminophen B. Ibuprofen C. Alcohol D. Vitamin C

Answer 303

Answer: C (Alcohol increases sedation when combined with first-generation antihistamines.)

Question 304

9. Overdose Symptoms A patient overdoses on diphenhydramine. What symptoms would the nurse expect? A. CNS depression, dry mouth, urinary retention B. Diarrhea, muscle spasms, and bradycardia C. Increased appetite, dizziness, and flushing D. Nausea, vomiting, and hypotension

Answer 304

Answer: A (Diphenhydramine overdose can cause CNS depression, anticholinergic effects, and urinary retention.)

Question 305

10. Select-All-That-Apply (SATA): Side Effects of Antihistamines Which of the following are common side effects of antihistamines? (Select all that apply.) A. Drowsiness (first-generation) B. Dry mouth C. Blurred vision D. Hyperkalemia E. Urinary retention

Answer 305

✅ A. Drowsiness (first-generation) ✅ B. Dry mouth ✅ C. Blurred vision ❌ D. Hyperkalemia ✅ E. Urinary retention Correct Answers: A, B, C, E (Antihistamines cause drowsiness, dry mouth, blurred vision, and urinary retention due to anticholinergic effects.)

Question 306

11. Prioritization A patient experiencing anaphylaxis receives epinephrine. What is the nurse’s next priority intervention? A. Administer diphenhydramine B. Start IV fluids C. Monitor for hypertension D. Give loratadine

Answer 306

Answer: A (Diphenhydramine is given after epinephrine to block histamine effects.)

Question 307

12. Patient Teaching for Seasonal Allergies A patient taking cetirizine for allergies asks when to take the medication. What is the best response? A. “Take it only when you have symptoms.” B. “Take it daily for best results.” C. “Take it with a high-fat meal.” D. “Take it at bedtime due to drowsiness.”

Answer 307

Answer: B (Second-generation antihistamines work best when taken daily during allergy season.)

Question 308

13. Antihistamines & Older Adults Why should first-generation antihistamines be used cautiously in older adults? A. Increased risk of dehydration B. Risk of falls due to sedation C. Increased metabolism of the drug D. Increased risk of allergic reactions

Answer 308

Answer: B (First-generation antihistamines can cause excessive sedation and increase fall risk in elderly patients.)

Question 309

14. Antihistamines for Sleep Aid Which antihistamine is commonly used as an over-the-counter sleep aid? A. Fexofenadine B. Diphenhydramine C. Loratadine D. Cetirizine

Answer 309

Answer: B (Diphenhydramine is used in OTC sleep aids due to its sedative effects.)

Question 310

15. Expected Outcomes of Antihistamine Therapy Which of the following indicate that antihistamine therapy is effective? (Select all that apply.) ✅ A. Decreased nasal congestion and sneezing ✅ B. Reduced itching and rash ✅ C. Prevention of motion sickness ❌ D. Increased blood pressure ✅ E. Relief from allergic rhinitis symptoms

Answer 310

Correct Answers: A, B, C, E (Effective antihistamine therapy reduces allergy symptoms and prevents motion sickness.)

Question 311

1. Mechanism of Action How do antitussives help manage cough? A. By breaking down mucus in the airways B. By suppressing the cough reflex in the brain (medulla) C. By increasing respiratory secretions D. By stimulating beta-2 receptors in the lungs

Answer 311

Answer: B (Antitussives suppress the cough reflex by acting on the medulla.)

Question 312

2. Indications for Antitussives Which type of cough should be treated with an antitussive? A. Productive cough with mucus B. Dry, nonproductive cough C. Chronic cough due to asthma D. Cough with wheezing and fever

Answer 312

Answer: B (Antitussives are used for dry, nonproductive coughs to prevent irritation.)

Question 313

3. Opioid vs. Non-Opioid Antitussives Which antitussive is an opioid? A. Dextromethorphan B. Guaifenesin C. Codeine D. Benzonatate

Answer 313

Answer: C (Codeine is an opioid that suppresses cough centrally and can cause sedation.)

Question 314

4. Side Effects of Codeine Which side effect is most concerning in a patient taking codeine for cough? A. Dry mouth B. Drowsiness C. Respiratory depression D. Increased heart rate

Answer 314

Answer: C (Codeine can cause respiratory depression, especially in high doses.)

Question 315

5. Patient Teaching for Benzonatate (Tessalon Perles) A patient is prescribed benzonatate for cough. What should the nurse include in patient teaching? A. “Chew the capsules for faster relief.” B. “Swallow the capsules whole to avoid numbness in the mouth.” C. “Take this medication with a full meal.” D. “Expect drowsiness and avoid driving.”

Answer 315

Answer: B (Benzonatate should never be chewed, as it can cause local anesthesia and numbness in the mouth.)

Question 316

6. Contraindications for Antitussives Which patient should NOT take an opioid antitussive like codeine? A. A patient with a dry, persistent cough B. A patient with COPD and respiratory depression C. A patient with seasonal allergies D. A patient with a postnasal drip cough

Answer 316

Answer: B (Opioid antitussives can worsen respiratory depression in COPD patients.)

Question 317

7. Drug Interactions Which medication should be avoided when taking dextromethorphan? A. Acetaminophen B. MAO inhibitors (e.g., phenelzine) C. Beta-blockers D. Vitamin C

Answer 317

Answer: B (Dextromethorphan with MAO inhibitors can cause serotonin syndrome.)

Question 318

8. Mechanism of Action How does guaifenesin help relieve cough? A. By thinning and loosening mucus for easier expectoration B. By suppressing the cough reflex C. By drying out respiratory secretions D. By reducing lung inflammation

Answer 318

Answer: A (Expectorants like guaifenesin thin mucus, making it easier to cough up.)

Question 319

9. Indications for Expectorants Which type of cough should be treated with an expectorant? A. Dry, nonproductive cough B. Productive cough with thick mucus C. Cough due to an allergic reaction D. Cough caused by GERD

Answer 319

Answer: B (Expectorants are used for productive coughs to loosen mucus.)

Question 320

10. Patient Teaching for Guaifenesin Which instruction should the nurse give a patient taking guaifenesin? A. “Drink plenty of fluids to help loosen mucus.” B. “Limit fluid intake to prevent overhydration.” C. “This medication will stop your cough immediately.” D. “Take an extra dose if mucus does not clear after the first dose.”

Answer 320

Answer: A (Increased fluid intake enhances the effectiveness of expectorants.)

Question 321

11. Guaifenesin Side Effects Which side effect is most commonly associated with guaifenesin? A. Drowsiness B. Nausea and vomiting C. Constipation D. Increased blood pressure

Answer 321

Answer: B (Guaifenesin can cause mild GI upset, including nausea.)

Question 322

2. Select-All-That-Apply (SATA): Differences Between Antitussives and Expectorants Which of the following correctly describe antitussives and expectorants? (Select all that apply.) A. Antitussives suppress cough, while expectorants promote mucus clearance B. Opioid antitussives can cause drowsiness and respiratory depression C. Expectorants should be taken with limited fluids D. Guaifenesin is the most common expectorant E. Benzonatate should never be chewed

Answer 322

✅ A. Antitussives suppress cough, while expectorants promote mucus clearance ✅ B. Opioid antitussives can cause drowsiness and respiratory depression ❌ C. Expectorants should be taken with limited fluids ✅ D. Guaifenesin is the most common expectorant ✅ E. Benzonatate should never be chewed Correct Answers: A, B, D, E (Antitussives suppress cough, expectorants clear mucus, opioids cause drowsiness, and benzonatate should not be chewed.)

Question 323

13. Prioritization A patient taking codeine for a cough reports difficulty breathing. What is the nurse’s priority action? A. Administer naloxone B. Encourage the patient to take deep breaths C. Increase fluid intake D. Discontinue the medication and monitor

Answer 323

Answer: A (Naloxone is given for opioid-induced respiratory depression.)

Question 324

14. Special Considerations for Pediatric Patients Why are opioid antitussives like codeine avoided in children? A. Risk of sedation and respiratory depression B. They are ineffective in children C. They cause excessive mucus production D. They interfere with immune system function

Answer 324

Answer: A (Codeine can cause fatal respiratory depression in children.)

Question 325

1. Mechanism of Action How do short-acting beta-agonists (SABAs) improve breathing? A. By blocking histamine release in the lungs B. By directly relaxing bronchial smooth muscle C. By increasing mucus production D. By suppressing the immune response

Answer 325

Answer: B (SABAs stimulate beta-2 receptors in the lungs, causing bronchodilation.)

Question 326

2. Indications for SABAs Which conditions are SABAs commonly used to treat? (Select all that apply.) A. Acute asthma exacerbation B. Exercise-induced bronchospasm C. Chronic obstructive pulmonary disease (COPD) D. Pulmonary fibrosis E. Acute bronchospasm

Answer 326

✅ A. Acute asthma exacerbation ✅ B. Exercise-induced bronchospasm ✅ C. Chronic obstructive pulmonary disease (COPD) ❌ D. Pulmonary fibrosis ✅ E. Acute bronchospasm Correct Answers: A, B, C, E (SABAs treat acute asthma attacks, COPD exacerbations, and exercise-induced bronchospasm but are not used for pulmonary fibrosis.)

Question 327

3. Onset of Action How quickly does albuterol begin to relieve bronchospasm? A. Within 5–15 minutes B. 30 minutes C. 1–2 hours D. 4–6 hours

Answer 327

Answer: A (SABAs work quickly, usually within 5–15 minutes, making them rescue inhalers.)

Question 328

4. Albuterol Side Effects Which side effect is most commonly associated with albuterol? A. Bradycardia B. Tremors C. Sedation D. Constipation

Answer 328

Answer: B (Albuterol can cause tremors due to beta-2 receptor stimulation.)

Question 329

5. Administration Timing for Exercise-Induced Asthma When should a patient use albuterol to prevent exercise-induced bronchospasm? A. Immediately after exercising B. 5–30 minutes before exercising C. Only during an asthma attack D. At bedtime

Answer 329

Answer: B (Albuterol should be taken 5–30 minutes before exercise to prevent bronchospasm.)

Question 330

6. Contraindications for SABAs Which patient should use albuterol with caution? A. A patient with seasonal allergies B. A patient with hypertension and tachycardia C. A patient with mild asthma D. A patient with a history of pneumonia

Answer 330

Answer: B (Albuterol can cause tachycardia and should be used cautiously in patients with heart disease.)

Question 331

7. Patient Teaching for Albuterol Inhaler Use Which instruction should the nurse give a patient using an albuterol metered-dose inhaler (MDI)? A. “Shake the inhaler before use.” B. “Inhale quickly and forcefully.” C. “Exhale immediately after inhaling the medication.” D. “Use this inhaler daily, even when feeling fine.”

Answer 331

Answer: A (MDIs should be shaken before use for proper medication dispersion.)

Question 332

8. Use of a Spacer Device Why is a spacer recommended when using a metered-dose inhaler (MDI)? A. It increases medication absorption in the bloodstream B. It improves medication delivery to the lungs C. It decreases the effectiveness of the medication D. It prevents the medication from entering the airway

Answer 332

Answer: B (A spacer helps direct more medication into the lungs instead of the throat.)

Question 333

9. Drug Interactions with Albuterol Which medication may increase the risk of tachycardia when taken with albuterol? A. Beta-blockers B. NSAIDs C. Thyroid hormones D. Acetaminophen

Answer 333

Answer: C (Thyroid hormones can increase the risk of tachycardia when combined with albuterol.)

Question 334

11. Monitoring for Overuse of SABAs Which sign suggests that a patient may be overusing albuterol? A. Increased blood pressure B. Frequent episodes of rebound bronchospasm C. Excessive mucus production D. Dry mouth

Answer 334

Answer: B (Overuse of SABAs can lead to rebound bronchospasm, reducing their effectiveness.)

Question 335

12. Prioritization in an Asthma Attack A patient is having an acute asthma attack. What is the nurse’s priority action? A. Administer albuterol via nebulizer B. Give a corticosteroid inhaler C. Apply oxygen and wait for the physician’s order D. Provide a leukotriene receptor antagonist

Answer 335

Answer: A (Albuterol is the first-line treatment for acute asthma attacks.)

Question 336

13. Expected Outcomes of Albuterol Therapy Which findings indicate that albuterol therapy is effective? (Select all that apply.) A. Increased oxygen saturation B. Decreased wheezing C. Easier breathing D. Increased respiratory distress E. Improved peak expiratory flow rate (PEFR)

Answer 336

✅ A. Increased oxygen saturation ✅ B. Decreased wheezing ✅ C. Easier breathing ❌ D. Increased respiratory distress ✅ E. Improved peak expiratory flow rate (PEFR) Correct Answers: A, B, C, E (Effective therapy improves oxygenation, decreases wheezing, and enhances lung function.)

Question 337

1. Mechanism of Action How do anticholinergic bronchodilators improve breathing? A. By blocking acetylcholine receptors in the airway, leading to bronchodilation B. By stimulating beta-2 receptors in the lungs C. By increasing mucus secretion D. By decreasing inflammation in the airways

Answer 337

Answer: A (Anticholinergic bronchodilators block muscarinic receptors, preventing bronchoconstriction.)

Question 338

2. Indications for Anticholinergic Bronchodilators Which of the following conditions are commonly treated with anticholinergic bronchodilators? (Select all that apply.) A. Chronic obstructive pulmonary disease (COPD) B. Asthma maintenance therapy C. Acute asthma exacerbation (as monotherapy) D. Bronchospasm due to chronic bronchitis E. Pulmonary embolism

Answer 338

✅ A. Chronic obstructive pulmonary disease (COPD) ✅ B. Asthma maintenance therapy ❌ C. Acute asthma exacerbation (as monotherapy) ✅ D. Bronchospasm due to chronic bronchitis ❌ E. Pulmonary embolism Correct Answers: A, B, D (Anticholinergics are mainly used for COPD and asthma maintenance but are not first-line for acute asthma attacks.)

Question 339

Which medication is a long-acting anticholinergic bronchodilator? A. Ipratropium B. Tiotropium C. Albuterol D. Salmeterol

Answer 339

Answer: B (Tiotropium is a long-acting muscarinic antagonist (LAMA) used for maintenance therapy in COPD.)

Question 340

4. Anticholinergic Side Effects Which of the following is a common side effect of ipratropium? A. Dry mouth B. Increased mucus production C. Hypotension D. Diarrhea

Answer 340

Answer: A (Anticholinergics commonly cause dry mouth due to reduced secretions.)

Question 341

5. Administration of Tiotropium (Spiriva) Which statement indicates that a patient understands how to use a tiotropium inhaler? A. "I will swallow the capsule whole with water." B. "I will insert the capsule into the inhaler and inhale the powder." C. "I will use this medication only during an asthma attack." D. "I will use this inhaler along with my rescue inhaler."

Answer 341

Answer: B (Tiotropium capsules must be inserted into a HandiHaler device and inhaled, not swallowed.)

Question 342

6. Ipratropium vs. Albuterol Which statement best describes the difference between ipratropium and albuterol? A. "Ipratropium works faster than albuterol." B. "Ipratropium prevents bronchospasm but does not work immediately." C. "Ipratropium can be used for acute asthma attacks as monotherapy." D. "Ipratropium and albuterol have the same mechanism of action."

Answer 342

Answer: B (Ipratropium is slower-acting and used for maintenance, whereas albuterol is a rapid-acting rescue inhaler.)

Question 343

7. Anticholinergic Bronchodilators & Eye Protection Why should a patient avoid spraying ipratropium into their eyes? A. It may cause blurred vision and increased intraocular pressure B. It reduces the effectiveness of the medication C. It can cause an allergic reaction D. It leads to excessive mucus production

Answer 343

Answer: A (Anticholinergic inhalers can cause pupil dilation and worsen glaucoma if sprayed into the eyes.)

Question 344

8. Patient Teaching for Ipratropium Inhalers Which instruction should the nurse give a patient using an ipratropium inhaler? A. "Shake the inhaler before use." B. "Use this medication as a rescue inhaler during an asthma attack." C. "Rinse your mouth after using this inhaler." D. "Take this medication only at bedtime."

Answer 344

Answer: C (Rinsing the mouth helps prevent dry mouth and irritation.)

Question 345

9. Contraindications for Anticholinergic Bronchodilators Which patient should NOT take an anticholinergic bronchodilator? A. A patient with COPD B. A patient with a history of narrow-angle glaucoma C. A patient with exercise-induced bronchospasm D. A patient with allergic rhinitis

Answer 345

Answer: B (Anticholinergics can increase intraocular pressure and worsen glaucoma

Question 346

10. Select-All-That-Apply (SATA): Side Effects of Anticholinergic Bronchodilators Which of the following are common side effects of anticholinergic bronchodilators? (Select all that apply.) A. Dry mouth B. Blurred vision C. Urinary retention D. Diarrhea E. Constipation

Answer 346

✅ A. Dry mouth ✅ B. Blurred vision ✅ C. Urinary retention ❌ D. Diarrhea ✅ E. Constipation Correct Answers: A, B, C, E (Anticholinergics cause dry mouth, blurred vision, urinary retention, and constipation.)

Question 347

11. Prioritization in a COPD Exacerbation A patient with COPD is experiencing increased shortness of breath. What is the nurse’s first action? A. Administer ipratropium via nebulizer B. Give tiotropium immediately C. Provide a leukotriene receptor antagonist D. Start corticosteroid therapy

Answer 347

Answer: A (Ipratropium via nebulizer is commonly used for acute COPD exacerbations.)

Question 348

12. Anticholinergic & Beta-Agonist Combination Therapy Why are ipratropium and albuterol often combined in COPD treatment? A. They have opposite mechanisms of action B. They work synergistically to improve bronchodilation C. They both reduce inflammation in the lungs D. They increase mucus secretion

Answer 348

Answer: B (Combining an anticholinergic with a beta-agonist provides enhanced bronchodilation.)

Question 349

13. Long-Term Use of Tiotropium How often should a patient take tiotropium for COPD maintenance therapy? A. Every 4–6 hours as needed B. Once daily C. Only during flare-ups D. Before bedtime only

Answer 349

Answer: B (Tiotropium is a long-acting bronchodilator taken once daily for COPD maintenance.)

Question 350

14. Expected Outcomes of Anticholinergic Bronchodilator Therapy Which of the following indicate that an anticholinergic bronchodilator is effective? (Select all that apply.) A. Improved ability to breathe without shortness of breath B. Increased exercise tolerance C. Decreased wheezing and airway resistance D. Increased mucus production E. Prevention of COPD exacerbations

Answer 350

Correct Answers: A, B, C, E (Effective therapy reduces wheezing, improves breathing, and prevents exacerbations.)

Question 351

1. Mechanism of Action How do methylxanthine derivatives improve breathing? A. By blocking histamine release in the lungs B. By inhibiting phosphodiesterase, leading to bronchodilation C. By stimulating the vagus nerve to reduce coughing D. By reducing mucus production

Answer 351

Answer: B (Methylxanthines inhibit phosphodiesterase, increasing cAMP levels, which relaxes bronchial smooth muscles and causes bronchodilation.)

Question 352

2. Indications for Use Which of the following conditions are commonly treated with methylxanthine derivatives? (Select all that apply.) A. Chronic obstructive pulmonary disease (COPD) B. Asthma (long-term management) C. Acute asthma exacerbation (as monotherapy) D. Chronic bronchitis E. Pulmonary embolism

Answer 352

✅ A. Chronic obstructive pulmonary disease (COPD) ✅ B. Asthma (long-term management) ❌ C. Acute asthma exacerbation (as monotherapy) ✅ D. Chronic bronchitis ❌ E. Pulmonary embolism Correct Answers: A, B, D (Methylxanthines are used for long-term control of asthma and COPD but are not first-line for acute exacerbations.)

Question 353

3. Theophylline Therapeutic Range Which theophylline blood level is considered therapeutic? A. 5–10 mcg/mL B. 10–20 mcg/mL C. 20–30 mcg/mL D. 30–40 mcg/mL

Answer 353

Answer: B (The therapeutic range for theophylline is 10–20 mcg/mL; levels above this increase toxicity risk.)

Question 354

4. Signs of Theophylline Toxicity Which symptom suggests theophylline toxicity? A. Drowsiness B. Nausea and tachycardia C. Hypertension and bradycardia D. Constipation

Answer 354

Answer: B (Early signs of theophylline toxicity include nausea, vomiting, tachycardia, and CNS stimulation.)

Question 355

5. Drug Interactions with Theophylline Which medication increases the risk of theophylline toxicity? A. Acetaminophen B. Cimetidine C. Ibuprofen D. Furosemide

Answer 355

Answer: B (Cimetidine inhibits the metabolism of theophylline, increasing toxicity risk.)

Question 356

6. Theophylline and Caffeine Why should a patient taking theophylline avoid excessive caffeine intake? A. Caffeine reduces theophylline absorption B. Caffeine increases the risk of CNS stimulation and toxicity C. Caffeine inhibits the action of theophylline D. Caffeine worsens respiratory depression

Answer 356

Answer: B (Both theophylline and caffeine are methylxanthines, increasing the risk of CNS stimulation and toxicity.)

Question 357

7. Contraindications for Methylxanthines Which patient should NOT take theophylline? A. A patient with stable COPD B. A patient with a history of peptic ulcer disease C. A patient with mild asthma D. A patient with seasonal allergies

Answer 357

Answer: B (Theophylline increases gastric acid secretion and can worsen peptic ulcers.)

Question 358

8. Patient Teaching for Theophylline What should the nurse include in patient teaching for theophylline? A. “Take this medication with high-fat meals for better absorption.” B. “Avoid caffeine and smoking as they can alter drug levels.” C. “Stop taking the medication if your breathing improves.” D. “This medication works best for acute asthma attacks.”

Answer 358

Answer: B (Caffeine and smoking can affect theophylline metabolism, increasing or decreasing drug levels.)

Question 359

9. Smoking & Theophylline Metabolism How does smoking affect theophylline levels? A. Increases drug absorption B. Speeds up metabolism, leading to decreased drug levels C. Causes toxic accumulation D. Has no effect

Answer 359

Answer: B (Smoking induces liver enzymes, causing faster theophylline metabolism and decreased effectiveness.)

Question 360

10. Select-All-That-Apply (SATA): Side Effects of Methylxanthines Which of the following are common side effects of theophylline? (Select all that apply.) A. Tachycardia B. Insomnia C. Nausea D. Bradycardia E. Tremors

Answer 360

✅ A. Tachycardia ✅ B. Insomnia ✅ C. Nausea ❌ D. Bradycardia ✅ E. Tremors Correct Answers: A, B, C, E (Theophylline can cause tachycardia, insomnia, nausea, and tremors due to CNS stimulation.)

Question 361

11. Theophylline Toxicity Management A patient on theophylline has a blood level of 25 mcg/mL and is experiencing nausea and palpitations. What is the nurse’s priority action? A. Administer an antiemetic B. Hold the next dose and notify the provider C. Increase fluid intake D. Encourage the patient to rest

Answer 361

Answer: B (Theophylline toxicity occurs above 20 mcg/mL; the drug should be held, and the provider notified.)

Question 362

12. Prioritization in a COPD Patient A COPD patient on theophylline reports increased nausea, insomnia, and a rapid heart rate. What is the nurse’s first action? A. Assess the patient’s theophylline level B. Encourage deep breathing exercises C. Administer oxygen therapy D. Provide an inhaled corticosteroid

Answer 362

Answer: A (Theophylline toxicity can cause these symptoms, so checking drug levels is the priority.)

Question 363

13. Theophylline & Food Interactions Which food should a patient taking theophylline avoid? A. Leafy green vegetables B. Charbroiled meats C. Dairy products D. Bananas

Answer 363

Answer: B (Charbroiled meats can speed up theophylline metabolism, reducing its effectiveness.)

Question 364

14. Theophylline vs. Beta-Agonists How does theophylline differ from beta-agonists like albuterol? A. Theophylline is used only for acute asthma attacks B. Theophylline is a long-term bronchodilator, while albuterol is a short-acting rescue inhaler C. Theophylline and albuterol have the same mechanism of action D. Theophylline reduces inflammation directly

Answer 364

Answer: B (Theophylline is used for long-term asthma/COPD control, while albuterol is a fast-acting rescue inhaler.)

Question 365

15. Expected Outcomes of Theophylline Therapy Which findings indicate that theophylline therapy is effective? (Select all that apply.) A. Decreased frequency of asthma attacks B. Improved ease of breathing C. Increased exercise tolerance D. Increased mucus production E. Fewer COPD exacerbations

Answer 365

Correct Answers: A, B, C, E (Successful theophylline therapy reduces asthma attacks, improves breathing, and enhances exercise tolerance.)

Question 366

1. Mechanism of Action How do leukotriene receptor antagonists (LTRAs) help manage asthma? A. By stimulating beta-2 receptors to cause bronchodilation B. By blocking leukotrienes, reducing inflammation and bronchoconstriction C. By inhibiting acetylcholine, preventing mucus production D. By breaking down mucus in the airways

Answer 366

Answer: B (LTRAs block leukotrienes, preventing inflammation, airway edema, and bronchoconstriction.)

Question 367

2. Indications for LTRAs Which of the following conditions are leukotriene receptor antagonists commonly used to treat? (Select all that apply.) A. Chronic asthma maintenance B. Exercise-induced bronchospasm prevention C. Allergic rhinitis D. Acute asthma exacerbation E. COPD with acute bronchospasm

Answer 367

✅ A. Chronic asthma maintenance ✅ B. Exercise-induced bronchospasm prevention ✅ C. Allergic rhinitis ❌ D. Acute asthma exacerbation ❌ E. COPD with acute bronchospasm Correct Answers: A, B, C (LTRAs are used for long-term asthma control, exercise-induced bronchospasm, and allergic rhinitis but not for acute attacks.)

Question 368

3. Montelukast Administration Timing When should montelukast be taken for optimal effectiveness? A. In the morning before breakfast B. At bedtime C. Only when symptoms occur D. Every 4 hours as needed

Answer 368

Answer: B (Montelukast is most effective when taken once daily in the evening.)

Question 369

4. Montelukast vs. Beta-Agonists How does montelukast differ from albuterol? A. Montelukast is a short-acting bronchodilator B. Montelukast is used for long-term asthma control, while albuterol is a rescue inhaler C. Montelukast directly relaxes airway smooth muscles D. Montelukast and albuterol have the same mechanism of action

Answer 369

Answer: B (Montelukast is for long-term asthma prevention, while albuterol is a quick-relief bronchodilator.)

Question 370

5. Side Effects of Montelukast Which of the following is a potential adverse effect of montelukast? A. Drowsiness B. Neuropsychiatric effects (e.g., mood changes, suicidal thoughts) C. Hypertension D. Urinary retention

Answer 370

Answer: B (Montelukast has been associated with mood changes, depression, and suicidal ideation.)

Question 371

6. Contraindications for LTRAs Which patient should NOT take montelukast? A. A patient with exercise-induced asthma B. A patient with chronic allergic rhinitis C. A patient experiencing acute bronchospasm D. A patient with seasonal allergies

Answer 371

Answer: C (Montelukast is not used for acute bronchospasm because it does not act quickly.)

Question 372

7. Patient Teaching for Montelukast What should the nurse include in patient teaching for montelukast? A. "Take this medication only when wheezing occurs." B. "Monitor for mood changes and report depression or suicidal thoughts." C. "Use this medication as a rescue inhaler for asthma attacks." D. "You can stop this medication once you feel better."

Answer 372

Answer: B (Patients should be monitored for mood changes while taking montelukast.)

Question 373

8. Montelukast in Pediatric Patients For which age group is montelukast approved for asthma maintenance? A. Infants under 6 months B. Children 6 months and older C. Children 1 year and older D. Children 12 years and older

Answer 373

Answer: C (Montelukast is approved for children 1 year and older for asthma prevention.)

Question 374

9. Select-All-That-Apply (SATA): Benefits of LTRAs Which of the following are benefits of leukotriene receptor antagonists? (Select all that apply.) A. Reduce airway inflammation B. Decrease mucus production C. Prevent exercise-induced bronchospasm D. Provide immediate relief for asthma attacks E. Improve asthma symptoms over time

Answer 374

✅ A. Reduce airway inflammation ✅ B. Decrease mucus production ✅ C. Prevent exercise-induced bronchospasm ❌ D. Provide immediate relief for asthma attacks ✅ E. Improve asthma symptoms over time Correct Answers: A, B, C, E (LTRAs help reduce inflammation, decrease mucus production, and prevent bronchospasms but do not work immediately.)

Question 375

10. Prioritization in an Asthma Patient A patient with asthma is experiencing shortness of breath and wheezing. They are prescribed montelukast and albuterol. What is the nurse’s priority action? A. Administer montelukast B. Administer albuterol via nebulizer C. Have the patient lie down and rest D. Check peak expiratory flow rate (PEFR)

Answer 375

Answer: B (Albuterol is the priority medication for acute asthma symptoms. Montelukast is not for emergency use.)

Question 376

11. Drug Interactions Which medication can interfere with the effectiveness of montelukast? A. Ibuprofen B. Warfarin C. Phenobarbital D. Furosemide

Answer 376

Answer: C (Phenobarbital can decrease montelukast levels, making it less effective.)

Question 377

12. Expected Outcomes of LTRA Therapy Which of the following indicate that montelukast therapy is effective? (Select all that apply.) A. Fewer nighttime asthma symptoms B. Improved lung function C. Reduced need for rescue inhalers D. Immediate relief of acute bronchospasm E. Better control of exercise-induced asthma

Answer 377

✅ A. Fewer nighttime asthma symptoms ✅ B. Improved lung function ✅ C. Reduced need for rescue inhalers ❌ D. Immediate relief of acute bronchospasm ✅ E. Better control of exercise-induced asthma Correct Answers: A, B, C, E (Montelukast improves asthma control and reduces symptoms but does not provide immediate relief.)

Question 378

1. Mechanism of Action How do glucocorticoids help manage respiratory conditions? A. By blocking beta-2 receptors to reduce airway inflammation B. By suppressing the immune response and reducing airway inflammation C. By relaxing bronchial smooth muscles D. By thinning mucus secretions in the airways

Answer 378

Answer: B (Glucocorticoids suppress the immune response, decreasing inflammation in the airways.)

Question 379

2. Indications for Glucocorticoids Which of the following conditions are commonly treated with glucocorticoids? (Select all that apply.) A. Chronic asthma maintenance B. COPD exacerbations C. Autoimmune disorders (e.g., lupus, rheumatoid arthritis) D. Acute asthma attack as first-line treatment E. Allergic rhinitis

Answer 379

✅ A. Chronic asthma maintenance ✅ B. COPD exacerbations ✅ C. Autoimmune disorders (e.g., lupus, rheumatoid arthritis) ❌ D. Acute asthma attack as first-line treatment ✅ E. Allergic rhinitis Correct Answers: A, B, C, E (Glucocorticoids help with chronic asthma, COPD, autoimmune diseases, and allergies but are not first-line for acute asthma attacks.)

Question 380

3. Inhaled vs. Oral Glucocorticoids Which statement best describes the difference between inhaled and oral glucocorticoids? A. "Inhaled glucocorticoids are used for long-term control, while oral glucocorticoids are used for short-term exacerbations." B. "Oral glucocorticoids work faster than inhaled glucocorticoids in acute asthma attacks." C. "Inhaled glucocorticoids have more systemic side effects than oral glucocorticoids." D. "Both inhaled and oral glucocorticoids should be used daily for acute asthma attacks."

Answer 380

Answer: A (Inhaled glucocorticoids are used for long-term control, while oral glucocorticoids are used short-term for exacerbations.)

Question 381

4. Patient Teaching for Inhaled Glucocorticoids What is the most important patient teaching point for using an inhaled corticosteroid? A. "Take this medication only when symptoms appear." B. "Rinse your mouth after each use to prevent oral thrush." C. "Use this medication for immediate relief of wheezing." D. "Stop taking this medication once your symptoms improve."

Answer 381

Answer: B (Rinsing the mouth prevents oral candidiasis (thrush), a common side effect of inhaled corticosteroids.)

Question 382

5. Side Effects of Systemic Glucocorticoids Which of the following is a major side effect of long-term systemic glucocorticoid use? A. Hypoglycemia B. Osteoporosis C. Increased muscle mass D. Hypotension

Answer 382

Answer: B (Long-term glucocorticoid use can cause osteoporosis due to bone demineralization.)

Question 383

6. Tapering of Oral Glucocorticoids Why should oral glucocorticoids like prednisone be tapered instead of stopped suddenly? A. To prevent rebound asthma symptoms B. To allow adrenal glands to resume natural cortisol production C. To avoid excessive weight loss D. To prevent tachycardia

Answer 383

Answer: B (Long-term glucocorticoid use suppresses adrenal function, requiring a taper to prevent adrenal insufficiency.)

Question 384

7. Contraindications for Glucocorticoids Which patient should NOT receive long-term systemic glucocorticoid therapy? A. A patient with asthma needing daily maintenance therapy B. A patient with rheumatoid arthritis C. A patient with active tuberculosis D. A patient with allergic rhinitis

Answer 384

Answer: C (Glucocorticoids suppress the immune system and can worsen active infections like TB.)

Question 385

8. Drug Interactions with Glucocorticoids Which medication may require a higher dose when taken with glucocorticoids? A. Insulin B. Warfarin C. Acetaminophen D. NSAIDs

Answer 385

Answer: A (Glucocorticoids increase blood glucose, so insulin doses may need adjustment.)

Question 386

9. Select-All-That-Apply (SATA): Side Effects of Glucocorticoids Which of the following are common side effects of glucocorticoids? (Select all that apply.) A. Hyperglycemia B. Weight gain C. Hypertension D. Bradycardia E. Immunosuppression

Answer 386

✅ A. Hyperglycemia ✅ B. Weight gain ✅ C. Hypertension ❌ D. Bradycardia ✅ E. Immunosuppression Correct Answers: A, B, C, E (Glucocorticoids can cause hyperglycemia, weight gain, hypertension, and immunosuppression.)

Question 387

10. Inhaled Corticosteroid Therapy Monitoring Which sign indicates that inhaled corticosteroid therapy is effective? A. Increased mucus production B. Reduced asthma exacerbations C. Worsening wheezing D. Increased use of a rescue inhaler

Answer 387

Answer: B (Effectiveness is shown by reduced asthma flare-ups and improved lung function.)

Question 388

11. Prioritization in an Asthma Exacerbation A patient with an asthma exacerbation is prescribed prednisone. What is the nurse’s priority assessment?

Answer 388

Answer: A (Prednisone can cause hyperglycemia, so blood glucose must be monitored.)

Question 389

12. Patient Teaching for Oral Glucocorticoids Which statement by a patient taking prednisone requires further teaching? A. "I will take this medication in the morning with food." B. "I will stop taking this medication when I feel better." C. "I should avoid being around sick people." D. "I may gain some weight while on this medication."

Answer 389

Answer: B (Stopping prednisone abruptly can cause adrenal insufficiency and must be tapered under medical supervision.)

Question 390

13. Long-Term Effects of Glucocorticoids Which long-term effect is most concerning for a patient on chronic glucocorticoid therapy? A. Cushing’s syndrome B. Hypoglycemia C. Increased hair loss D. Decreased blood pressure

Answer 390

Answer: A (Prolonged glucocorticoid use can cause Cushing’s syndrome, characterized by moon face, buffalo hump, and weight gain.)

Question 391

14. Expected Outcomes of Glucocorticoid Therapy Which of the following indicate that glucocorticoid therapy is effective? (Select all that apply.) A. Decreased airway inflammation B. Improved lung function C. Reduced frequency of asthma attacks D. Immediate relief of acute bronchospasm E. Reduced COPD exacerbations

Answer 391

✅ A. Decreased airway inflammation ✅ B. Improved lung function ✅ C. Reduced frequency of asthma attacks ❌ D. Immediate relief of acute bronchospasm ✅ E. Reduced COPD exacerbations Correct Answers: A, B, C, E (Glucocorticoids reduce airway inflammation, improve lung function, and prevent exacerbations.)