Ati nurs 180 pharmacology exam
Total Questions : 21
Showing 21 questions, Sign in for moreThe nurse is caring for a client who experienced a dry-non productive cough associated with an ACE inhibitor. Which of the following drugs is an alternative to ACE inhibitors?
Explanation
A. Losartan is an angiotensin receptor blocker (ARB) that serves as an effective alternative to ACE inhibitors, particularly for patients who experience cough as a side effect.
B. Metoprolol is a beta-blocker, which is not a direct alternative to ACE inhibitors and is used for different indications such as heart rate and blood pressure control.
C. Furosemide is a diuretic that does not directly substitute for the actions of ACE inhibitors.
D. Hydralazine is a direct vasodilator used for hypertension but does not share the same mechanism as ACE inhibitors or serve as a direct alternative.
A client presents to the healthcare setting after beginning treatment with an Angiotensin Converting Enzyme (ACE) inhibitor. Which of the following side- effects will the nurse be sure to assess for?
Explanation
A. Hypokalemia can occur with some antihypertensives, but it is more associated with diuretics rather than ACE inhibitors. Vomiting is not a common side effect.
B. A dry, non-productive cough is a well-known side effect of ACE inhibitors, which the nurse should specifically assess for during follow-up.
C. Epistaxis (nosebleed) and headache are not common or specific side effects associated with ACE inhibitors.
D. Nausea and vomiting can occur with various medications, but they are not specifically indicative of ACE inhibitor use.
The nurse is educating a client on the possible side effects associated with quinapril (Accupril). Which of the following side effects are associated with this medication classification? (Select All that Apply)
Explanation
A. Hypokalemia is not typically associated with ACE inhibitors like quinapril; rather, hyperkalemia (increased potassium levels) is a concern.
B. First dose phenomenon refers to significant hypotension that can occur after the first dose of an ACE inhibitor and should be monitored.
C. Hepatotoxicity is not a common side effect of ACE inhibitors.
D. A dry non-productive cough is a common side effect of ACE inhibitors, including quinapril.
E. Orthostatic hypotension can occur with ACE inhibitors, especially after the initial dose, making patient education important.
The nurse is caring for a client who suffers from frequent blood clots and currently taking argatroban (Hospira). Which of the following conditions in the client's medical history would require them to take argatroban (Hospira)?
Explanation
A. Argatroban is specifically indicated for patients with heparin-induced thrombocytopenia (HIT), as it is a direct thrombin inhibitor that does not cause further platelet depletion.
B. Myocardial infarction is treated with different classes of anticoagulants or antiplatelet medications, not specifically argatroban.
C. Gastrointestinal bleeding would generally be a contraindication to anticoagulation therapy rather than an indication for argatroban use.
D. Hepatotoxicity could be a concern when using argatroban, especially as it is metabolized in the liver, but it does not indicate a need for this medication.
A client with hypertension and benign prostate hyperplasia is prescribed doxazosin (Cardura). Which of the following statements below would the nurse emphasize regarding doxazosin (Cardura)?
Explanation
A. Daily weight monitoring is not specifically required with doxazosin and is more relevant for medications that may cause fluid retention or significant weight changes.
B. First-dose hypotension is a common and significant side effect of doxazosin, and advising the patient to lie down after the first dose helps mitigate the risk of dizziness and falls.
C. Impaired taste is not a known side effect of doxazosin, making this statement inaccurate.
D. While potassium intake is important for overall health, doxazosin does not typically require dietary potassium adjustments.
A client who suffers from hypertension and headaches is prescribed esmolol (Brevibloc). The nurse would educate the client on which side effects associated with this medication?(Select All that Apply.)
Explanation
A. Rebound hypotension can occur with the abrupt withdrawal of beta-blockers like esmolol, so clients should be advised against suddenly stopping the medication.
B. Vomiting is not a typical or common side effect of esmolol.
C. Bradycardia is a known effect of beta-blockers, including esmolol, and should be monitored.
D. Esmolol can mask the symptoms of hypoglycemia in diabetic patients, which is an important consideration for patient education.
E. Tremors are not commonly associated with esmolol; rather, they might be seen in other conditions or medications.
F. Bronchoconstriction can occur with non-selective beta-blockers; however, esmolol is cardioselective, so the risk is lower but still possible, especially in patients with underlying respiratory conditions.
A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation digoxin toxicity? (Select all that apply.)
Explanation
A. Anorexia is a common early sign of digoxin toxicity, indicating the need for monitoring.
B. Vomiting is also a classic symptom of digoxin toxicity and should be reported immediately.
C. Dark red urine is not associated with digoxin toxicity; instead, it may indicate other conditions.
D. Constipation can occur with digoxin use but is not a direct manifestation of toxicity.
E. Bradycardia is a serious sign of digoxin toxicity and must be monitored closely, as digoxin slows heart rate.
F. Green halos in visual fields are a unique visual disturbance related to digoxin toxicity, indicating the need for prompt assessment.
A client who has just experienced a pulmonary embolism is administered alteplase (Activase). Which of the following side effects associated with this medication would the nurse assess for?
Explanation
A. Hypokalemia is not a common side effect of alteplase; instead, it may result from other factors.
B. Internal bleeding is a significant risk associated with thrombolytics like alteplase, as they promote the breakdown of clots but can also affect hemostasis.
C. Pancytopenia is not directly associated with alteplase use; it may occur with other medications or conditions.
D. Hypertension is not a common side effect of alteplase; instead, blood pressure may fluctuate but is not typically increased as a direct result of the medication.
The nurse is preparing to administer digoxin (Lanoxin) to a client experiencing atrial fibrillation. Which of the following electrolyte imbalances would the nurse assess to reduce the incidence of toxicity with digoxin (Lanoxin)?
Explanation
A. Hypocalcemia is not directly linked to digoxin toxicity; rather, it is more associated with calcium channel blockers.
B. Hypokalemia increases the risk of digoxin toxicity, as low potassium levels can enhance the effects of digoxin on the heart.
C. Hyperkalemia is not directly associated with toxicity; however, it can cause complications in patients taking digoxin.
D. Hypernatremia does not have a direct impact on digoxin toxicity; monitoring potassium levels is more critical.
A client presents to the emergency healthcare setting and diagnosed with a life-threatening ventricular dysrhythmia. Which of the following medications would the nurse begin to prepare?
Explanation
A. Atenolol is a beta-blocker used for various cardiac conditions but is not typically the first-line treatment for acute ventricular dysrhythmias.
B. Lisinopril is an ACE inhibitor, which is not indicated for immediate management of ventricular dysrhythmias.
C. Procainamide is an antiarrhythmic medication specifically used to treat ventricular dysrhythmias and would be appropriate in this scenario.
D. Adenosine is typically used for rapid atrial dysrhythmias, not specifically for ventricular dysrhythmias, making procainamide the better choice.
A client is started on gemfibrozil (Lopid) to assist in the lowering of triglyceride level. Which of the following side effects is associated with gemfibrozil (Lopid)?
Explanation
A. Increased creatinine clearance is not a common effect of gemfibrozil; rather, it may lead to liver function changes or muscle-related side effects.
B. Gemfibrozil does not typically decrease prothrombin time (PT); this option does not relate to its mechanism of action.
C. Hyperkalemia is not a typical side effect of gemfibrozil; it may be more relevant to other medications, particularly those affecting the kidneys.
D. Gallstones are a known side effect of gemfibrozil, as the drug can increase biliary cholesterol saturation, leading to the formation of stones.
The nurse is caring for a client following a myocardial infarction (MI) and prescribed asprin 325mg PO daily. Which of following effects of this medication would this client benefit from following a MI?
Explanation
A. While aspirin has anti-inflammatory properties, this is not the primary reason it is prescribed after an MI.
B. Aspirin does not primarily function as an anti-pyretic in this context; its use is focused on cardiovascular benefits.
C. Aspirin does not have antiemetic properties and is not indicated for nausea control.
D. Inhibiting platelet aggregation is the key therapeutic effect of aspirin in preventing further clot formation, which is critical following an MI to reduce the risk of subsequent cardiovascular events.
The nurse is caring for a client who is taking atorvastatin (Lipitor) to assist in lowering his LDL cholesterol. Which lab value must be routinely done with this medication to prevent complications?
Explanation
A. Lung function tests are not relevant to atorvastatin therapy; they are more commonly associated with medications affecting the respiratory system.
B. Platelet counts are not routinely monitored for patients on atorvastatin unless there are specific concerns related to bleeding or clotting.
C. Liver function tests are critical for patients on atorvastatin because the medication can cause liver enzyme elevations, indicating potential hepatotoxicity. Routine monitoring ensures early detection of any liver complications.
D. Hemoglobin levels are not specifically related to atorvastatin use and are generally monitored in contexts involving anemia or bleeding.
The nurse is caring for a client who currently has a deep vein thrombosis. Which of the following medications would be administered to lyse existing clots? (Select All that Apply.)
Explanation
A. Aspirin is an antiplatelet medication that prevents new clots but does not actively lyse existing clots.
B. Low-molecular weight heparin is primarily used for preventing clot formation rather than lysing existing clots.
C. Heparin prevents further clot formation but does not dissolve existing clots.
D. Alteplase (Activase) is a thrombolytic agent specifically indicated for the dissolution of existing clots in acute situations like deep vein thrombosis.
E. Warfarin is an anticoagulant that prevents clotting but does not directly lyse clots; it is used for long-term management.
F. Anistreplase (Eminase) is another thrombolytic agent used to lyse existing clots and is indicated in similar situations.
A client newly prescribed niacin (Nicotonic Acid) presents to the healthcare setting with complaints of flushing following doses. Which of the following medications would the nurse anticipate being administered?
Explanation
A. Calcium channel blockers are not typically used to manage flushing associated with niacin.
B. NSAIDs can help with flushing symptoms; however, beta blockers are more commonly used for this purpose.
C. Beta blockers, such as propranolol, are effective in preventing flushing associated with niacin therapy by blocking the vasodilatory effects.
D. Fibric acid derivatives are used to lower triglycerides and cholesterol but do not address flushing caused by niacin.
A nurse is caring for a client who is diagnosed with a deep vein thrombosis (DVT) and is receiving heparin. The client asks the nurse how long it will take for the heparin to dissolve the clot, which of the following responses should the nurse give?
Explanation
A. PT/INR is more relevant for monitoring anticoagulant therapy like warfarin, not heparin.
B. This response is accurate; heparin prevents further clot formation but does not dissolve existing clots, which can take time for the body to reabsorb.
C. Heparin begins to exert its effects quickly, and therapeutic levels are not measured by PT/INR but by aPTT or anti-factor Xa levels.
D. Clots do not dissolve immediately after the first dose of heparin; the medication's role is to prevent clot extension.
A client presents to the healthcare setting and ordered verapamil (Calan) to treat his hypertension. Which assessment finding by the nurse would determine if the medication should be held?
Explanation
A. A pulse oximetry of 92% indicates potential hypoxia but is not a direct contraindication for administering verapamil.
B. A respiratory rate of 12 is not an immediate concern for verapamil; it is considered a normal rate in many cases.
C. A recent history of myocardial infarction does not automatically contraindicate verapamil but should be assessed in the context of the client’s overall health and physician’s orders.
D. A pulse of 78 is within a normal range; however, if the pulse were significantly low (e.g., below 60 bpm), verapamil would generally be held due to its potential to further decrease heart rate.
A client arrives to the healthcare setting currently taking atorvastatin (Lipitor) daily. Which assessment finding associated with atorvastatin (Lipitor) would need immediate reporting to the healthcare provider?
Explanation
A. Bradycardia is not a direct side effect of atorvastatin and may require further context for concern.
B. Elevated HDL cholesterol is a positive outcome of atorvastatin therapy and does not require reporting.
C. A migraine headache is not typically a direct side effect of atorvastatin but could warrant discussion if it affects the client's overall well-being.
D. Dark-red urine may indicate potential muscle breakdown (rhabdomyolysis) associated with atorvastatin and should be reported immediately due to the risk of kidney damage.
The nurse is caring for a client newly diagnosed with hypertension and requires medication therapy. Which of the following medications below is considered a first line treatment for hypertension?
Explanation
A. Doxazosin is an alpha-1 blocker that can be used for hypertension but is not a first-line option.
B. Carvedilol is a beta-blocker used in heart failure and post-MI but is not the first choice for initial hypertension treatment.
C. Lisinopril, an ACE inhibitor, is widely recognized as a first-line treatment for hypertension due to its effectiveness and favorable side effect profile.
D. Clonidine is generally not considered a first-line treatment for hypertension due to potential side effects and the availability of more effective alternatives.
A nurse is teaching a client who has angina about nitroglycerin sublingual tablets. Which of the following statements should the nurse include in the teaching?
Explanation
A. While the administration schedule is partly correct, the maximum number of doses should not exceed 3 in 15 minutes without contacting emergency services.
B. Nitroglycerin is not a first-line treatment for hypertension; it is primarily used for angina relief.
C. Nitroglycerin does not dissolve clots; it works by relaxing and dilating blood vessels to improve blood flow and reduce chest pain.
D. This statement accurately describes the action of nitroglycerin, emphasizing its role in dilating blood vessels and improving oxygen delivery to the heart muscle.
A nurse is caring for a client admitted to the intensive care unit for a cardiac dysrhythmia. The nurse understands the prescribed calcium channel blocker has which of the following mechanisms of action?
Explanation
A. Calcium channel blockers primarily decrease heart rate and contractility, not increase them.
B. While they can indirectly improve oxygen supply by reducing myocardial oxygen demand, they do not directly increase systemic oxygen.
C. This option accurately describes the mechanism of action of calcium channel blockers, which decrease heart contractility and conduction through the AV node, helping to manage dysrhythmias.
D. Calcium channel blockers do not act on beta cells; they specifically inhibit calcium influx into cardiac and vascular smooth muscle cells.
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