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Unit 8: Drugs that Affect the Cardiovascular System

Total questions: 93

Worksheet time: 3hrs 4mins

Name
Class
Date
1.

A nurse is caring for a patient with edema. What assessments should the nurse perform on this patient to promote an optimal response to therapy? Select all that apply

a)

measure & record patient's weight daily

b)

check the pupils every 2 hours for dilation

c)

measure fluid intake and output every 8 hours

d)

assess respiratory rate every 4 hours

e)

check the patient's response to light

2.

A nurse is caring for a patient taking a diuretic. During assessment, the nurse observes that the patient is experiencing GI upset after taking the prescribed drug. Which of the following interventions should the nurse perform when caring for this client?

a)

ensure that the drug is taken on an empty stomach

b)

ensure that the drug is taken with food and milk

c)

instruct the patient to reduce fluid intake

d)

avoid any consumption of fibrous food by the patient

3.

A nurse is caring for a patient with edema due to HF. The PHCP has prescribed with spironolactone drug to the patient. Which of the following adverse reactions to the drug should the nurse monitor for in the patient?

a)

vertigo

b)

paresthesias

c)

hyperkalemia

d)

anorexia

4.

A PHCP has prescribed a chlorothiazide drug to a patient with hypertension. The patient informs the nurse that he is also taking an antidiabetic drug for controlling diabetes. What interaction between these two drugs should the nurse monitor for in the patient?

a)

increased risk of ototoxicity

b)

increased risk of hyperglycemia

c)

increased hypersensitivity to antidiabetic

d)

increased chlorothiazide effect

5.

A PHCP has prescribed treatment with an antihypertensive drug along with a diuretic to a patient as a treatment for hypertension. The patient informs the nurse about his preference for herbal extracts over medical drugs. What information regarding herbal extracts should the nurse provide to the patient. Select all that apply

a)

no herbal diuretic should be taken unless approved by PHCP

b)

Some herbal extracts have been associated with renal damage

c)

herbal extracts are more effective than caffeine

d)

most plant and herbal extracts available as diuretics are nontoxic

e)

consume diuretic teas like juniper berries

6.

A nurse preparing diet information for the patient taking a diuretic. Which of the following food should be included in a diet to replenish potassium lost from the diuretic? Select all that apply

a)

Dried apricots

b)

carrots

c)

green beans

d)

molasses

7.

a nurse is caring for a patient with renal dysfunction. The PHCP has prescribed a metolazone drug for the patient. what should the nurse monitor for in the patient before administering the drug. Select all that apply

a)

serum cholesterol levels

b)

levels of serum electrolytes

c)

fluid loss every hour

d)

creatinine clearance levels

e)

blood urea nitrogen level

8.

a nurse is caring for a Pt who complains of cramps and muscle pain. assessment reveals that the PT is experiencing oliguria, hypotension, and GI disturbances. which of the following conditions is the PT experiencing?

a)

exercise exhaustion

b)

electrolyte imbalance

c)

influenza

d)

HF

9.

a PT is prescribed amiloride, a potassium sparing diuretic, by the HCP. in which of the following conditions should the nurse discontinue the drug?

a)

If the patient experiences gout attacks

b)

If the patient's urine tests positive for glucose

c)

If the patient's serum potassium levels exceed 5.3 mEq/mL

d)

If excess fluid has been removed from the patient's body

10.

which of the following is an example of a loop diuretic?

a)

Furosemide

b)

Acetazolamide

c)

hydrochlorothiazide

d)

spironolactone

11.

Which of the following exerts its diuretic effects by increasing the density of the filtrate in the glomerulus

a)

Mannitol

b)

Furosemide

c)

Hydrochlorothiazide

d)

Spironolactone

12.

which of the following exerts is diuretic effect by antagonizing the action of aldosterone?

a)

spironolactone

b)

furosemide

c)

Hydrochlorothiazide

d)

acetazolamide

13.

which of the following exerts is effects by depressing the reabsorption of sodium in the kidney tubules, thereby increasing sodium and water excretion?

a)

Furosemide

b)

Hydrochlorothiazide

c)

Acetazolamide

d)

Triamterene

14.

which of the following exerts is diuretic effect by inhibiting the reabsorption of sodium and chlorine ions in the amending loop of Henle and the early distal tube of the nephron?

a)

Hydrochlorothiazide

b)

Acetazolamide

c)

Furosemide

d)

Spironolactone

15.

A nurse is caring for a PT undergoing ezetimibe drug therapy. What instruction should the nurse provide to the PT if the drug is to be taken w/ Cholestyramine, a bile acid sequestrate?

a)

Take the drug 2 hours before a bile acid sequestrate

b)

Ensure a time gap of 1 hour between the intake of these two drugs

c)

Take both drugs 30 minutes before meals

d)

Take the bile acid sequestrate with warm water

16.

A PT is to begin taking atorvastatin for hyperlipidemia. The nurse checks the patient's medical history for which of the following contraindicated conditions?

a)

Visual disturbances

b)

biliary obstruction

c)

serious liver disorders

d)

renal dysfunction

17.

A nurse is caring for a patient with primary hypercholesterolemia who is taking the drug ezetimibe. What adverse reaction to the drug should the nurse monitor for in the patient?

a)

vertigo

b)

headache

c)

cholelithiasis

d)

arthralgia

18.

A patient is undergoing gemfribrozile drug therapy for high serum triglyceride levels. The patient is also receiving an anticoagulant as a blood thinner. What interaction of these two drugs should the nurse monitor for in the patient?

a)

increased hypoglycemic effects

b)

increased risk of severe myopathy

c)

enhanced effect of the anticoagulant

d)

increased risk of hypertension

19.

in which of the following patient ailments should the nurse exercise caution and monitor for exacerbation of problems while caring for PT taking HMGCoA reductase inhibitors? Select all that apply

a)

peptic ulcer

b)

acute infection

c)

visual disturbances

d)

unstable angina

e)

endocrine disorders

20.

A PT tells a nurse that he has heard that garlic will lower serum cholesterol and triglyceride levels. This PT is taking warfarin as an anticoagulant. What should the nurse tell the PT is a potential adverse reaction when these are taken together?

a)

bleeding

b)

peptic ulcers

c)

irritation

d)

skin rashes

21.

A nurse is caring for an older patient using bile acid sequestrates. What should the nurse monitor for in the Pt? Select all that apply

a)

difficulty in passing stools

b)

hard, dry stools

c)

constipation

d)

mouth dryness

e)

urinary hesitancy

22.

A nurse is caring for a PT receiving an antihyperlipidemic drug. The nurse paradoxical elevation of blood lipid levels in the PT. What is a priority nursing intervention in this situation?

a)

Notify HCP for a different antihyperlipidemic drug

b)

Collect blood samples for further examination

c)

administer next dose of the drug with milk

d)

record the fluid intake and output every hour

23.

A PT informs the nurse that he has been taking a natural product - red yeast to improve his blood lipid profile. Which toxic reaction associated with red yeast when taking a statin drug should the nurse relay to the patient

a)

headache

b)

dyspnea

c)

muscle damage

d)

dyspepsia

24.

A nurse is caring for a patient who has been prescribed colestipol for the treatment of hyperlipidemia. This drug is known to cause constipation. What instructions should the nurse provide to the PT to help prevent constipation? Select all that apply

a)

exercise daily

b)

consume food high in dietary fiber

c)

take the drug 1 hour after meals

d)

increase fluid intake

e)

take oral Vitamin K supplements

25.

Which of the following are examples of modifiable risk factors for hyperlipidemia? Select all that apply

a)

weight

b)

diet

c)

postmenopause

d)

age older than 55 years (women)

e)

age older than 45 years (men)

26.

Increased levels of low density lipoprotein (LDL) combined with certain risk factors can lead to the development of which medical condition?

a)

diabetes

b)

glaucoma

c)

benign prostatic hyperplasia

d)

heart disease

27.

Which of the following herbal products have been promoted by the natural food industry to lower serum cholesterol and triglycerides? Select all that apply

a)

ginseng

b)

red yeast rice

c)

garlic

d)

feverfew

e)

black cohosh

28.

Which of the following classes of medications are used to treat hyperlipidemia? select all that apply

a)

HMG-CoA reductase inhibitors

b)

Fibric Acid derivatives

c)

Bile acid resins

d)

calcium channel blockers

e)

angiotensin II receptor blockers

29.

Bile acid resins can decrease serum levels of several medications, primarily via which mechanism

a)

inhibition of hepatic enzymes

b)

decreased GI absorption

c)

modifying liver metabolism

d)

increased renal excretion

30.

when assessing a 40-year-old PT, the nurse observes an increase in the PT's blood pressure. Which of the following changes in BP is indicative of prehypertension?

a)

systolic pressure between 120 and 130

b)

systolic pressure between 100 and 119

c)

systolic pressure between 80 and 99

d)

systolic pressure between 60 and 79

31.

A PT is diagnosed with renal impairment and hypertension. which of the following drugs is contraindicated in renal impairment?

a)

doxazosin

b)

captopril

c)

hydralazine

d)

minoxidil

32.

a nurse monitoring a PT admitted to the ER in a hypertension emergency. which of the following drugs should be administered in such situations?

a)

amlodipine

b)

acebutolol

c)

diltiazem

d)

nitroprusside

33.

a PT with diabetes mellitus and hypertension is on insulin and enalapril for hypertension. which of the following interactions would occur with the combined administration of both drugs?

a)

increased risk of hypersensitivity reaction

b)

increased risk of electrolyte imbalance

c)

increased risk fo hypoglycemia

d)

increased risk of hypotensive effect

34.

a PT has developed a headache following the use of prazosin for hypertension. which of the following instructions should the nurse provide the PT receiving prazosin? select all that apply

a)

lie down and elevate legs above head level

b)

withhold administration of prazosin

c)

apply a cool cloth over the forehead

d)

engage in progressive body relaxation

e)

take an analgesic drug for the pain

35.

a nurse is monitoring a PT on minoxidil for hypertension. which of the following findings should the nurse report IMMEDIATELY to the HCP when the PT is taking minoxidil? select all that apply.

a)

swelling of the face

b)

pulse rate increase of more than 5 beats per minute

c)

weight gain of 1 lb

d)

difficulty breathing

e)

angina and severe hypertension

36.

a nurse is caring for a PT receiving captopril for hypertension. which of the following precautions should the nurse take when administering captopril?

a)

administer captopril 1 hour before of 2 hours after food

b)

rub the PT's back before administering captopril

c)

ensure that the PT exercises before administering captopril

d)

take captopril along with antacids

37.

A PT receiving terazosin for hypertension complains o dizziness when sitting up. which of the following instructions should the nurse give the PT? select all that apply.

a)

rise slowly from sitting or lying position

b)

increase fluid intake

c)

apply a cool cloth over the forehead

d)

rest on the bed for 1 to 2 minutes before rising

e)

stand still for a few minutes after rising

38.

a nurse is required to educate PTs on the consequences of hypertension. which of the following may develop as a consequence of untreated hypertension? select all that apply.

a)

adrenal tissue

b)

blindness

c)

stroke

d)

heart disease

e)

obesity

39.

a PT asks the nurse about natural supplements to help reduce blood pressure. the nurse knows some products will interact with hypertensive medications. which o the following would the nurse identify as having possible interaction? select all that apply.

a)

hawthorn tea

b)

St. Johns wort

c)

orange juice

d)

grapefruit

40.

a nurse checks a PT's BP and finds it to be 130/82. this PT should be classified as having which stage of hypertension?

a)

prehypertension

b)

stage 1 hypertension

c)

stage 2 hypertension

d)

normotension

41.

which if the following lowers blood pressure primarily via suppression of rennin-angiotensin-aldosterone system?

a)

verapamil

b)

dilitiazem

c)

lisinopril

d)

furosemide

42.

hypertension increases a person's risk for which of the following? select all that apply.

a)

heart failure

b)

tuberculosis

c)

hearing loss

d)

kidney disease

e)

liver disease

43.

Once a PT developed primary hypertension, therapy should last for how long?

a)

until blood pressure is 120/80

b)

1 year

c)

for life

d)

5 years

44.

select the cause of secondary hypertension

a)

weight gain

b)

kidney disease

c)

smoking

d)

hip fractures

45.

A patient has been admitted to an urgent care facility for treatment of sever acute angina. A nurse is administering sublingual nitroglycerin to the patient every 5 minutes. What is the maximum nitroglycerin the nurse should administer before reporting no improvement to HCP

a)

3 doses in 15-minute period

b)

5 doses in a 30-minute period

c)

7 doses in a 30 minute period

d)

9 doses in a 60-minute period

46.

A nurse caring a PT who has been prescribed a nitrate for anginas attacks should assess which of the following before creating a written teach plan

a)

what fruit juices does the PT like to drink

b)

a thorough pain assessment

c)

health literacy level

d)

Im so tired :)

47.

The drug minoxidil, used PVD, is also used for another condition because of one of the adverse reactions. What other condition is minoxidil used for?

a)

male-pattern baldness

b)

gynecomastia

c)

hypertension

d)

weight gain

48.

Which activity is most likely to precipitate an angina attack?

a)

Watching TV late at night

b)

cutting vegetables at a sink

c)

sitting in a boat

d)

climbing a flight of stairs

49.

A patient has been admitted for the management of PVD. Which of the following drugs are used to treat PVD? Select all that apply

a)

Hydralazine

b)

Nitroglycerine

c)

minoxidil

d)

bosentan

50.

A nurse is educating a group of nursing student on the various effects of calcium channel blockers on the heart. Which of the following are the effects of calcium channel blockers on the heart? Select all that apply

a)

increase the heart rate

b)

slow the conduction velocity

c)

depress myocardial contractility

d)

cause rapid atrial muscle contraction

e)

dilate the coronary arteries

51.

A PT is admitted to a telemetry unit for angina management and is started in IV dilitazem. Which of the following adverse reactions should the nurse monitor for in the patient? Select all that apply

a)

hypertension

b)

tachycardia

c)

rash

d)

headache

e)

dizziness

52.

A nurse is caring for a patient in the ICU with an IV nitroglycerin drip. The student nurse asks why there is special tubing with this IV. What is the correct rationale?

a)

the drug is light sensitive

b)

the hospital is switching IV products

c)

Nitroglycerin reacts w/ plastic tubing

d)

The IV does not need special tubing

53.

A PT taking transdermal nitrates lives with his and two small grandchildren. What should the nurse teach the family as a safe method to dispose of the transdermal patches?

a)

cut into small pieces before disposal

b)

fold the adhesive sides together when removing

c)

flush them immediately in the toilet

d)

put in a plastic bag

54.

Pulmonary arterial hypertension (PAH) is associated with autoimmune diseases. Which of the following patient panels should the primary health care provider routinely screen for PAH?

a)

Systemic lupus erythematosus

b)

sarcoidosis

c)

scleroderma

d)

Sjorgen syndrome

55.

Which of the following statements are true in regards to nitrates? Select all that apply

a)

Nitrates relax the smooth muscle layer of blood vessels

b)

nitrates increase the lumen of the artery or arteriole

c)

nitrates slow the conduction velocity of the cardiac impulse

d)

nitrates depress myocardial contractility

e)

nitrates increase the amount of blood flowing through the vessel

56.

Nitrates are available in which of the following dosage forms? Select all that apply

a)

sublingual

b)

transdermal

c)

parenteral

d)

rectal

e)

aerosol spray

57.

Which of the following laboratory tests should be done before a patient starts drug therapy for PAH

a)

hepatic enzymes

b)

thyroid stimulating hormone (TSH) level

c)

IGRA tuberculosis test

d)

pregnancy test

58.

Nitrates can result in which of the following adverse reactions? Select all the apply

a)

headache

b)

flushing

c)

diarrhea

d)

hypotension

e)

blurred vision

59.

Nitrates should not be used in PT's with which of the following

a)

closed-angle glaucoma

b)

asthma

c)

diabetes

d)

hypertension

60.

alteplase has been prescribed to a PT with acute ischemic stroke. which of the following adverse reactions associated with drug administration should the nurse monitor for in the PT? select all that apply.

a)

gingival bleeding

b)

erythema

c)

epistaxis

d)

ecchymosis

e)

anemia

61.

a nurse is caring for a PT who has been prescribed abcixmab for coronary angioplasty. the PT is also taking aspirin for pain relief. what effects of the interactions between these two drugs should the nurse observe for in the PT?

a)

decreased effectiveness of aspirin

b)

increased effectiveness of abciximab

c)

increased risk of bleeding

d)

decreased absorption of abciximab

62.

a nurse is required to start anticoagulant drug therapy for a patient. in which of the following conditions of the PT is an anticoagulant contraindicated? select all that apply.

a)

diabetic retinopathy

b)

tuberculosis

c)

GI bleeding

d)

leukemia

e)

hemorrhage disease

63.

a PT says he must refuse the anticoagulant die to a religious objection to pork products. which of the following drugs is not derived from pork?

a)

warfarin

b)

fondaparinux

c)

enoxaparin

d)

dalteparin

64.

a nurse caring for a PT taking antiplatelet drugs. what instruction should the nurse include in the teaching plan for this PT?

a)

use a soft toothbrush

b)

take foods low in vitamin K

c)

take meds with food

d)

take the drug at a different time each day

65.

A Pt is undergoing warfarin therapy. after taking the drug the Pt develops signs of GI bleeding. which of the following tasks is the best intervention to monitor bleeding by the nurse?

a)

inspect urine for red-orange color

b)

monitor VS every 4 hours

c)

inspect for bright red to black stools

d)

monitor PTs I&O

66.

a nurse is caring for a PT who has been administered heparin after the administration of a thrombolytic drug to prevent another thrombus from forming. what should the nurse monitor for in the PT after the administration of heparin?

a)

internal bleeding

b)

difficulty in breathing

c)

excessive perspiration

d)

skin rash

67.

a nurse is required to administer heparin to a PT. what should the nurse do to avoid the possibility of the development of local irritation, pain, or hematoma?

a)

avoid application of firm pressure after the injection

b)

avoid administration sites such as the button and lateral thighs

c)

use an area 2 in of the umbilicus for drug administration

d)

avoid intramuscular (IM) administration of the drug

68.

a nurse is caring for a PT receiving parenteral anticoagulant drug therapy. the nurse suspects the patient may have an overdose of the drug. what intervention should the nurse perform if administration of this drug is necessary?

a)

measure the PT's body temp every hour

b)

monitor the Pt's pulse rate every 2 hours

c)

observe the PT for new evidence of bleeding

d)

administer the drug to the PT via the IV route

69.

a PT is administered a thrombolytic drug. the drug us known to cause bleeding. which of the following symptoms of internal bleeding should the nurse monitor for in the PT? select all that apply.

a)

black, tarry stools

b)

hematuria

c)

leg cramps

d)

petechiae

e)

coffee-ground emesis

70.

which of the following is used to treat a warfarin (Coumadin) overdose?

a)

protamine

b)

urokinase

c)

phytonadione

d)

alteplase

71.

use of St. Johns wort during warfarin therapy can result in which of the following?

a)

increased risk of bleeding

b)

increased risk of thrombus formation

c)

increased blood pressure

d)

increased platelet count

72.

when is it indicated to administer a 300-mg dose of clopidogrel (Plavix) to a PT, instead of the 75-mg oral dose?

a)

as a maintenance dose

b)

in treatment of myocardial infarction

c)

in treatment of stroke

d)

as a loading dose

73.

thrombolytic drugs are contraindicated in which of the following? select all that apply.

a)

active bleeding

b)

history of stroke

c)

active infection

d)

history of aneurysm

e)

recent abdominal surgery

74.

enoxaparin (lovenox) should be administered via which route?

a)

subcutaneous injection

b)

IM injection

c)

intravenous infusion

d)

orally

75.

A patient arrives at an urgent care center complaining of dyspnea and a hacking cough. The nurse assessing the patient notes that there are distended jugular veins, edema of the extremities, and reduced ejection fraction. Which of the following conditions do these symptoms indicate

a)

heart failure

b)

glomerulonephritis

c)

pulmonary disease

d)

hypothyroidism

76.

A patient is diagnosed with heart failure and is started on digoxin. The patient informs the nurse that he is taking a benzodiazepine for anxiety. Which of the following interventions should the nurse implement?

a)

increase the dosage of digoxin

b)

monitor for signs of digoxin toxicity

c)

increase the dosage of benzodiazepine

d)

monitor for signs of reduced effectiveness of digoxin

77.

A nurse educating a group of nursing students on the uses of digitalis. For which of the following conditions may digitalis be used?

a)

ventricular tachycardia

b)

atrioventricular block

c)

atrial fibrillation

d)

renal failure

78.

When caring for a patient on digoxin, the nurse observes that the patient's pulse rate is 56 BPM. the patient is also complaining of nausea and vomiting. Which of the following is the most appropriate intervention in this situation

a)

administer milrinone

b)

increase the rate of digoxin infusion

c)

perform GI suction

d)

withhold drug and notify HCP

79.

Digitalis comes from a natural plant source. Identify the plant

a)

St. John's Wort

b)

Garlic

c)

Foxglove

d)

hawthorn

80.

A PT has been admitted for heart failure and is on digoxin. The nurse monitoring the patient notes that the serum digoxin level is 2.5 mg/mL. Which of the following signs would validate a case of digoxin toxicity? Select all that apply

a)

anorexia

b)

headache

c)

weakness

d)

blurred vision

e)

vomiting

81.

A PT is being digitalized for HF. The HCP assessing the PT orders an analysis of serum electrolytes. Which of the following electrolyte changes indicates digoxin toxicity and needs to be reported? Select all that apply

a)

hyponatremia

b)

hypokalemia

c)

hypomagnesemia

d)

hypophosphatemia

e)

hypocalcemia

82.

A nurse is caring for a PT on digitalis. The PT complains of nausea and vomiting after 2 days of digitalis administration. Which of the following is the appropriate nursing intervention in this situation? Select all that apply

a)

ensure that the PT takes double the drug dosage

b)

Ensure that the PT consumes small, frequent meals

c)

Ensure that the PT consumes fluids 1 hr before meal

d)

ensure that the PT rinses his or her mouth after the consumption of meals

e)

Restrict fluid consumption at meals times

83.

A PT is admitted to an ED with atrial flutter. The PT complains of headache after the first does of digitalis is administered. Which of the following additional adverse effects of digitalis should a nurse assess for in such a situation. Select all that apply

a)

hepatotoxicity

b)

angina

c)

drowsiness

d)

vomiting

e)

arrhythmia

84.

Cardiotonic drugs are used to treat which medical condition? Select all that apply

a)

heart failure

b)

hypothyroidism

c)

hyperlipidemia

d)

atrial fibrillation

e)

hypertension

85.

Milrinone is an inotropic drug used in the short-term management of heart failure. What is the only way this drug is approved to be administered?

a)

IV

b)

IM

c)

SubQ

d)

PO

86.

Which of the following classes of medications are currently used as first-line treatments of heart failure? Select all that apply

a)

Angiotensin-converting enzyme inhibitors (ACEIs)

b)

Loop diuretic

c)

cardiotonics

d)

beta blockers

e)

ARBS

87.

Which of the following is the result of positive inotropic activity?

a)

increased cardiac output

b)

decreased heart rate

c)

increased preload

d)

increased conduction velocity

88.

a PT has been prescribed antiarrythmic drugs for cardiac arrhythmia. which of the following possible side effects of the drug should the nurse inform the PT of?

a)

hypertension

b)

insomnia

c)

lightheadedness

d)

urinary frequency

89.

a PT on amiodarone reports that she is pregnant. the HCP informs her to stop the use fo the drug as it might cause fetal harm. which of the following FDA pregnancy categories does amiodarine belong to?

a)

category b

b)

category c

c)

category d

d)

category x

90.

a nurse is required to monitor the VS of a PT with paroxysmal atrial tachycardia who is on an antiarrythmic agent. which of the following pulse rates should be IMMEDIATLY reported to the HCP?

a)

82

b)

92

c)

102

d)

142

91.

a PT who is on antiarrhytmic drug therapy complains of nausea after taking the drug. which of the following instructions should the nurse provide the PT to help nausea?

a)

take the drug 2 hours before taking food

b)

lie down flat at least 1 hour after taking the drug

c)

eat small, frequent meals rather than large meals

d)

drink lots of water after taking the med

92.

a nurse is caring for an 86-year-old PT on antiarrhytmic drugs. which of the following signs, if present, indicates the development of HF in the PT?

a)

decrease in weight

b)

shortness fo breath

c)

increased volume of urine

d)

chills and fever

93.

when drug therapy is started and a new or worsening arrhytmia happens, what is the term for this cardiac event?

a)

atrial fibrillation

b)

proarrhythmic effect

c)

atrial flutter

d)

threshold