Exam 4

Question 1

After a stressful event a client’s bp and heart rate rise. The nurse understands that the system most responsible for this physiologic change is:
a. respiratory system
b. parasympathetic system
c. the acid base buffer system
d. the autonomic nervous system

Answer 1

d. the autonomic nervous system

Question 2

A nurse is preparing to administer a medication that will cause constriction of the arteries. The nurse expect that which vital sign parameter will be monitored most closely after administration of this medication.
a. respiratory rate
b. blood pressure
c. temperature
d. pulse rate

Answer 2

b. blood pressure

Question 3

A Dehydrated client quickly receives a liter of intravenous fluid infusion to increase circulating blood volume. The nurse would expect which changes in the clients vital signs?
a. a decrease in respiratory rate from 20 bpm to 12 bpm
b. a blood pressure drop from 180/100 to 90/60
c. A pulse increase from 75 bpm to 120 bpm.
D. a blood pressure increase from 90/60 to 120/78

Answer 3

D. a blood pressure increase from 90/60 to 120/78

Question 4

The vasomotor center of the brain raises or lowers BP based on information from the:

a. baroreceptors and chemoreceptors
b. anterior and posterior pituitary
c. adrenal medulla and adrenal cortex
d. medulla oblongata and chemoreceptor trigger zone

Answer 4

a. baroreceptors and chemoreceptors

Question 5

A nurse administers an IV antihypertensive medication causing an immediate reduction in bp. The baroreceptors respond by attempting to return blood pressure back to normal. The resulting accelerated heart rate is known as:

a. reflex tachycardia
b. ventricular tachycardia
c. re-entry tachycardia
d. supraventricular tachycardia

Answer 5

a. reflex tachycardia

Question 6

The nurse is assessing a client prior to administration of a diuretic. the nurse knows it is essential to assess which vital signs respirations at this time?
a. temp and pulse
b. pulse and bp
c. respirations and bp
d. blood pressure and pain

Answer 6

b. pulse and blood pressure

Question 7

The nurse is caring for a client admitted to the medical – surgical unit with hypervolimia that has resulted from Renal failure. The nurse anticipates what medication may be ordered to treat this condition would include:
a. Furosemide (lasix)
b. Epoetin alfa (procrit)
C.) Polystyrene Sulfate (Kayexalate)
d. sodium bicarbonate

Answer 7

a. Furosemide (Lasix)

Question 8

The nurse is caring for a clients on a renal failure unit and recognizes which of the following as indications for diuretic therapy?

a. confusion and ataxia
b. visual and auditory hallucinations
c. blood pressure 200/98 mm/Hg
d. Pinpoint pupils and extreme paranoia

Answer 8

c. blood pressure 200/98 mm/Hg

Question 9

Spirinolactone (Aldactone) is prescribed for a client with hypertension. The nurse recognizes which information as providing the most support for the use of this drug?
1. Diagnosis of renal failure
2. Diagnosis of hepatic failure
3. Insufficient therapeutic response to hydrochlorothiazide
4. Insufficient therapeutic response to furosemide (Lasix)

Answer 9

2. diagnosis of hepatic failure

Question 10

The nurse is caring for 4 clients on a renal failure unit and recognizes which drug as safe to administer to a client with hypokalemia?
a. amiloride (Midamor)
b. Chlorothiazide (Diuril)
c. Bumatnide (Bumex)
d. Ethacrynic acid (Edecrin)

Answer 10

a. amiloride (midamor)

Question 11

a client receiving bumatanide (BUMEX) asks the nurse, “what is all this about ‘loops’ in my medicine?” The nurse’s best response is:
a. this medication reabsorbs potassium in henle’s loop in your kidney
b. this medication blocks sodium reabsorption in what is known as bowman’s capsule
c. this is a loop diuretic, which refers to the location where it acts in your kidneys
d. this is a loop diuretic, which means it works in the proximal tubule of your kidney

Answer 11

c. this is a loop diuretic, which refers to the location where it acts in your kidneys

Question 12

The nurse is assessing a client prior to the administration of a diuretic. The nurse knows it is esssiential to assess which vital signs at this time?

A. Temp and pulse
B. Pulse and Bp
C. Respiration and Bp
D. Bp and pain

Answer 12

B. Pulse and Bp

Question 13

An older adult reports ringing in the ears while the nurse administers a dose of ethavrynic acid (edericn) Intravenously. The priority intervention for this client is to:

a. schedule a hearing test
b. stop the infusion and notify the md
c. question the client about hearing loss
d. review the client’s fluid intake

Answer 13

b. stop the infusion and notify md

Question 14

a client is taking fuorisemide (lasix) to treat edematous ankles. Which finding indicates that the next dose should be withheld?
a. elevated serum ph
b. decreased serum potassium
c. increased seizure frequency
d. nausea and dizziness

Answer 14

b. decreased serum potassium

Question 15

which nursing measures should be a priority for a client when beginning mantel (osmitrol)?
a. keep the urnal or bedpan available for clients with immobility
b.assess for hypoalkalemia and encourage foods high in potassium
c. monitor intake and output ratio and weight client daily
d. monitor bp and assess for level of consciuosness

Answer 15

d. monitor bp and assess for level of consciuosness

Question 16

hydrochlorathiazide is a ____ diuretic?
a. potassium wasting
b. non-potassium sparing
c.non-sodium sparing
d. hey!

Answer 16

a. potassium wasting

Question 17

the nurse should question an order for propanalol (inderal) in treatment of hypertension when the client has which associated disorders?
a.angina
b. dysrthymias
c. asthma
d. liver failure

Answer 17

C. asthma

Question 18

prazosin (mini press) is given to a client for treating high blood pressure. which measure should be used by the nurse to prevent the 1st dose phenomenon?
a. give the dosage early in the morning before breakfast
b. give the initial dose at bed time
c. give the dose with meals
d. give the initial high dose and then lower gradually

Answer 18

b. give the initial dose at bed time

Question 19

a client diagnosed with hypertension is prescribed atenolol (tenormin). the nurse knows that this medication is a selective beta blocker and can be safely used for clients with which diagnosis?
a. asthma
b. diabtes
c. heart failure
d. hepatic disease

Answer 19

a. asthma

Question 20

which medication should the nurse anticipate to be prescribed for a client with asthma and hypertension?
a. metaprolol (lopressor)
b. propanalol (inderal)
c. sotalol (betaspace)
d. nadol (procar

Answer 20

a. metaprolol (lopressor)

Question 21

What instructions should the nurse include in the discharge teaching plan of a client being treated with propanolol (inderal) for angina?
a. salt and salt substitutes can be used with this medication
b. take a double dose if you miss one
c. do not stop taking this medication without talking to your doctor
d. use an OTC medication in case you develop nasal allergies

Answer 21

c. do not stop taking this medication without talking to your doctor

Question 22

a client prescribed propanalol (inderal) for angina asked the nurse why does drugs should not be abruptly discontinued. The nurse would be correct in telling the client that brought withdrawal could lead to which result?
a. extreme weight loss
b. increase in blood glucose levels
c. rebound chest pain or heart attack
d. insomnia

Answer 22

c. rebound chest pain or heart attack

Question 23

an older client is taking prazosin (mini press) for hypertension is given a prescription of sildenafil for impotency. the nurse should caution the client about which effect?
a. sildenfil will cause rapid elimination of doxazosin through the kidneys
b.sildenfil will potentiate the hypotensive effects of doxazosin
c. sildenafil blocks the absorption of doxazosin from the GI tract
d. sildenfil causes hypertension blocking the effects

Answer 23

b.sildenfil will potentiate the hypotensive effects of doxazosin

Question 24

A client is seen in the clinic for migraine headaches. The nurse anticipates which medication that you prescribed as a prophylaxis for migraines?
a. propanolol (inderall)
b. acebutol]
c. carvedilol (coreg)
d. metaprolol

Answer 24

a. propanolol (inderall)

Question 25

The nurse is teaching a client about the role of calcium in hypertension and explains that a high concentration of calcium in arterial smooth muscle cells lead to?
a. elevation of blood pressure
b. hypercalcemia
c. decrease in blood pressure
d. hypocalcemia

Answer 25

a. elevation of blood pressure

Question 26

The nurse is preparing to administer both a calcium channel blocker and a beta-adrenergic blocker to a client with hypertension plans to monitor the client’s response based on an understanding that these drugs?
a. promote calcium influx into vascular smooth muscle
b. blocks sympathetic impulses into sarcolemma membranes
c. prevents calcium influx into vascular smooth muscle
d.promote urinary excretion of sodium

Answer 26

c. prevents calcium influx into vascular smooth muscle

Question 27

The nurse is preparing to minister medications including verapamil (veralin), a calcium channel blocker, and metapolol (lopressor), a beta-adrergenic blocker, to a client with hypertension. an entry in the client’s chart says that he has developed AV block. the nurse will:
a. administer both metaprolol and verapamil and notify the physician
b. hold both metaprolo and verapamil and notify the md
c.hold metaprolol and administer verapamil
d. hold verapamil and administer the metaprolol

Answer 27

b. hold both metaprolo and verapamil and notify the md

Question 28

a beta adrergenic antagonist drug has been added to the regimen of a client with angina pectoris. who is taking amlodipine (norvasc) . the nurse identifies which assessment finding as representing a goal of therapy related to a common mechanism of both drugs?
a. perpheral edema
b. decreased bp
c. flushing
d. constipation

Answer 28

b. decreased bp

Question 29

The nurse observes that a client orthopedic surgery also has a diagnosis of atrial fibrillation. which drug can achieve a therapeutic effect relative to the client’s diagnosis of atrial fib?
a. isradipine (dyna circ)
b. nifidipine (procardia)
c. nicardipine (cardene_
d. diltiazem (cardizem)

Answer 29

a. isradipine (dyna circ)

Question 30

A nurse is monitoring a client who is receiving spironolactone (Aldactone). Which of the following findings should the nurse report to the provider?

a. serum sodium 148 mEq/L
b. urine output of 120 mL in 4 hr.
c. serum potassium 5.2 mEq/L
d. blood pressure 140/90 mm Hg

Answer 30

c. serum potassium 5.2 mEq/L

Question 31

A nurse is caring for a client who is starting captopril (Capoten) for hypertentsion. For which of the following adverse effects should the nurse monitor the client?

a. hypokalemia
b. hypernatremia
c. neutropenia
d. anemia

Answer 31

c. neutropenia

Question 32

A client is taking verapamil to treat hypertension and chronic stable anginia. which assessment finding is of greatest concern relative to potential adverse effects of amplodipine for this client?
a. facial flushing
b. respriratyory rate of 22 breaths per minute
c. pedal edema 1+
d. heart rate of 132 beats per minute

Answer 32

d. heart rate of 132 beats per minute

Question 33

The peptide that is circulating in the blood that can cause profound vasoconstriction is called:
1. Fibrogen.
2. Angiotensin.
3. Kinase.
4. Sodium.

Answer 33

Angiotensin II

Question 34

The nurse knows that there are____ key enzymatic steps in the renin-angiotensin?
a. one
b. two
c. three
d. four

Answer 34

b. two

Question 35

The angiotensin-converting enzyme converts angiotensin I almost instantly to:
1. Renin.
2. Aldosterone.
3. Angiotensinogen.
4. Angiotensin II.

Answer 35

Angiotensin II

Question 36

ACE inhibitor drugs prevent ACE from breaking down _______, which results in some of the serious adverse effects of the ACE inhibitors.
1. Bradykinin
2. Renin
3. Aldosterone
4. RAAS

Answer 36

Bradykinin

Question 37

ACE inhibitor drugs function in the control of blood pressure:
1. By blocking the conversion of angiotensin II to angiotensinogen.
2. By blocking the conversion of angiotensin I to angiotensin II.
3. By blocking the effects of angiotensin II.
4. By directly inhibiting renin.

Answer 37

By blocking the conversion of angiotensin I to angiotensin II.

Question 38

Angiotensin receptor blockers work in the body to lower blood pressure by:
1. Blocking AT1 receptors, which prevent angiotensin from raising blood pressure.
2. Blocking the conversion of angiotensin I to angiotensin II.
3. Blocking the formation of renin in the RAAS system.
4. Inhibiting the stimulation of aldosterone secretion.

Answer 38

1. Blocking AT1 receptors, which prevent angiotensin from raising blood pressure.

Question 39

The major difference in adverse effect profile between ACE inhibitors and ARBs is that ARBs do not cause:
1. Cough.
2. Angioedema.
3. Headache.
4. Dizziness.

Answer 39

Cough

Question 40

Aldosterone antagonist drugs work to lower blood pressure by:
1. Blocking receptors for aldosterone in the adrenal glands.
2. Blocking the AT1 receptors in the RAAS pathway.
3. Blocking the formation of renin in the RAAS pathway.
4. Blocking receptors for aldosterone in the kidneys.

Answer 40

Blocking receptors for aldosterone in the kidneys

Question 41

A 35-years-old client is going to be started on lisinopril therapy for hypertension. The nurse first performs a test on the client to rule out pregnancy because of which of the following?
1. Lisinopril can cause hypotension in late pregnancy.
2. Lisinopril is pregnancy category C and D.
3. Lisinopril is pregnancy category B.
4. Lisinopril can cause hyperkalemia in pregnant women.

Answer 41

Lisinopril is pregnancy category C and D.

Question 42

The client is starting on lisinopril therapy for hypertension and heart failure. The nurse instructs the client to return for laboratory monitoring because of the risk of:
1. Hyponatremia.
2. Hyperkalemia.
3. Hypokalemia.
4. Hypernatremia.

Answer 42

Hyperkalemia.

Question 43

a nurse is caring for a client taking simvastatin (zocor). Which of the following should the nurse include in the teaching?
a. take this medication on the evening
b. change positions slowly when rising
c. maintain a steady intake of green leafy veggies
d. consume no more than 1 L of fluids a day

Answer 43

a. take this medication on the evening

Question 44

The nurse planning care for a patient newly diagnosed with elevated serum cholesterol, triglycerides, and LDL initiates a dietary consult because:
1. Dietary modifications can be useful for lipid disorders, but only as an adjunct intervention after pharmacologic therapy for clients has been initiated.
2. This particular pattern of dyslipidemia is not amenable to pharmacological agents.
3. These levels are sufficiently high that pharmacologic intervention alone is unlikely to be successful.
4. Non-pharmacologic approaches to dyslipidemia should be initiated before pharmacologic agents are prescribed.

Answer 44

Non-pharmacologic approaches to dyslipidemia should be initiated before pharmacologic agents are prescribed.

Question 45

which statement indicates that the client understands teaching about avorstatin (lipitor)?
a. I should always take this drug on an empty stomach
b. I should stop taking the drug if I decide to become pregnant
c.I might have to increase my dose of digoxin
d. I should take this drug with breakfast

Answer 45

b. I should stop taking the drug if I decide to become pregnant

Question 46

A client who takes avorstatin (Lipitor) daily has been prescribed erythromycin for sinusitis. To prevent consequences of an adverse effect of this combination of drugs, it is most important for the nurse to monitor this client for
1. Lack of expected response to erythromycin.
2. Abdominal pain and cramping.
3. New onset of muscle pain.
4. Bleeding from the oral cavity and bruising.

Answer 46

New onset of muscle pain.

Question 47

a client is receiving intermittent IV heparin therapy asks how the “blood thinner” works. What is the best response for the nurse?
a. heparin dissolves the clot
b. heparin makes the blood less vicious
c. heparin decreases the number of platelets so the blood clots more slowly
d. heparin prevents clots from forming

Answer 47

d. heparin prevents clots from forming

Question 48

a client is receiving intermittent IV heparin therapy to treat deep vein thrombosis (DVT). Which lab value should the nurse review prior to administering the medication. What is the best response by the nurse?
a. Prothrombin time (PT)
b. fibrinogen level
c. activated partial thromboplastin time (APTT)
d. Factor VIII level

Answer 48

c. activated partial thromboplastin time (APTT)

Question 49

A client with a newly placed prosthetic heart valve will be maintained on long term anticoagulant therapy. Which medication should the nurse anticipate being used for this purpose?
a.enopaparin (lovenox)
b. dalteparin (fragmin)
c.heparin
d. warfarin (coumadin

Answer 49

d. warfarin (coumadin

Question 50

A nurse is caring for a hospitalized client who is receiving IV heparin for a deep-vein thrombosis. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?

a. vitamin K1 (Phytonadione)
b. atropine
c. protamine
d. calcium gluconate

Answer 50

C. Protamine