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NURS100 EXAM-MEDS QUESTIONS WITH ANSWERS 2022 UPDATE
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NURS100 EXAM-MEDS QUESTIONS WITH ANSWERS 2022UPDATE
A client experiences orthostatic hypotension while receiving furosemide (Lasix) to treat hypertension. How
should the nurse intervene?
Instruct the client to flex the calf muscles and then sit up for several minutes before standing.
RATIONALES: To minimize the effects of orthostatic hypotension ﾧ, the nurse should instruct the client to
flex the calf muscles and then rise slowly to a standing position, such as by sitting up for several minutes
first. Administering I.V. fluids would be inappropriate (unless the client is dehydrated ﾧ) because it would
counteract the effects of furosemide, possibly leading to fluid imbalance. Administering a vasodilator
would further reduce the client's blood pressure, worsening orthostatic hypotension. Inserting an
indwelling urinary catheter would aid urine output monitoring but wouldn't minimize the effects of
orthostatic hypotension.
Before discharge, which instruction should the nurse give to a client receiving flecainide (Tambocor)
to reduce the risk of heart failure ﾧ?
"Limit your fluid intake."
RATIONALES: The nurse should tell the client receiving flecainide to limit fluid intake. The client
shouldn't take a diuretic ﾧ unless prescribed by the physician; if prescribed, the diuretic should be taken
early in the day to prevent nocturia. Sodium (not potassium) should be limited because excessive sodium
intake causes water retention. The client's electrolyte levels don't need to be measured weekly.
The nurse is teaching a client who receives nitrates for the relief of chest pain. Which of the following
instructions should the nurseemphasize?
"Lie down or sit in a chair for 5 to 10 minutes after taking the drug."
RATIONALES: Nitrates act primarily to relax coronary smooth muscle and produce vasodilation. They
can cause hypotension, which makes the client dizzy and weak. Nitrates are taken at the first sign of chest
pain and before activities that might induce chest pain. Sublingual ﾧ nitroglycerin is taken every 5 minutes
for three doses. If the pain persists, the client should seek medical assistance immediately. Nitrates must be
stored in a dark place in a closed container. Sunlight causes the medication to lose its effectiveness.
Alcohol is prohibited because nitrates may enhance the effects of the alcohol.
Which treatment would be the best therapy for a stable client with digoxin toxicity?
Time and symptomatic treatment
RATIONALES: Stable clients with digoxin toxicity are best treated with time while their kidneys
excrete the metabolites and with symptomatic treatment for the rhythm disturbances or nausea resulting
from the toxicity. Activated charcoal is effective only if the client has taken an overdose of digoxin and a
large amount of unabsorbed drug is in the GI tract, before the serum level is elevated. Hemodialysis is
reserved for clients who are extremely unstable despite symptomatic treatment or who have inadequate
renal
function to excrete the drug. Atropine might be used to treat the bradycardia ﾧ that results from digoxin
toxicity, but it isn't necessarily used to treat the toxicity itself.
A client is prescribed furosemide (Lasix) to manage his heart failure. What laboratory values should be
monitored while the client receives this medication?
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Complete blood count
Serum potassium
RATIONALES: Complete blood count should be monitored because furosemide can cause
agranulocytosis, anemia, leukopenia, and thrombocytopenia. Because loop diuretics such as furosemide
promote excretion of potassium, the nurse should also monitor serum potassium levels. Potassium
replacement therapy may be necessary to prevent hypokalemia. Thrombin time, PT, and INR don't have
to be monitored in a client receiving furosemide.
The nurse reviews a client's medication history before administering a cholinergic ﾧ blocking agent. Which
of the following drugs may have delayed absorption because of the adverse effects of a cholinergic
blocking agent?
Nitroglycerin (Nitrostat)
RATIONALES: A cholinergic blocking agent may delay the sublingual ﾧ absorption of nitroglycerin
because of dry mouth. The nurse should offer the client sips of water before administering nitroglycerin.
Amantadine, digoxin, and diphenhydramine can interact with a cholinergic blocking agent but not through
delayed absorption. Amantadine and diphenhydramine enhance the effects of anticholinergic agents.
The nurse is teaching a client how to take nitroglycerin (Nitrostat) to treat angina pectoris ﾧ. The client
verbalizes an understanding of the need to take up to three sublingual ﾧ nitroglycerin tablets at 5-minute
intervals, if necessary, and to notify the physician immediately if chest pain doesn't subside within 15
minutes. The nurse informs the client that nitroglycerin may cause:
headache, hypotension, dizziness, and flushing.
RATIONALES: Headache, hypotension, dizziness, and flushing are classic adverse effects of
nitroglycerin, a vasodilator. Nausea, vomiting, depression, fatigue, and impotence are adverse effects of
propranolol, a beta-adrenergic blocker. Sedation, nausea, vomiting, constipation, and respiratory
depression are common adverse effects of morphine, an opioid ﾧ analgesic ﾧ used to relieve pain
associated with acute myocardial infarction. Flushing, dizziness, headache, and pedal edema are common
adverse effects of nifedipine, a calcium channel blocker.
A client is receiving heparin I.V. for the treatment of thrombophlebitis. Which laboratory value should the
nurse monitor throughout heparin therapy?
Partial thromboplastin time (PTT)
Platelet count
RATIONALES: Heparin is at a therapeutic level when PTT is 1.5 to 2 times the control. Therefore, the
nurse should monitor PTT throughout heparin therapy. An adverse reaction associated with heparin is
thrombocytopenia (ﾧﾧ[ˌθrɒmbəˌsaɪtə'pi:ni:ə] ), so the nurse should also monitor platelet
count. INR and PT should be obtained before initiating heparin therapy, but it isn't necessary to monitor
these values throughout therapy. Sodium levels don't have to be monitored routinely during heparin
therapy.
The nurse administers furosemide (Lasix) to treat a client with heart failure ﾧ. Which adverse effect must
the nurse watch for mostcarefully?
Low serum potassium level
RATIONALES: Furosemide is a potassium-wasting diuretic ﾧ. The nurse must monitor the serum
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,NURS100 EXAM-MEDS QUESTIONS WITH ANSWERS 2022
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potassium level and assess for signs of low potass
During digoxin (Lanoxin) therapy, the nurse should closely monitor the client's:
serum potassium and magnesium levels
RATIONALES: During digoxin therapy, the nurse should closely monitor the client's serum potassium and
magnesium levels. This is because hypokalemia or hypomagnesemia can predispose the client to digoxin
toxicity. Glucose and ketones aren't usually in the urine except in a client with uncontrolled diabetes, and
digoxin isn't known to affect these levels in the diabetic. CK levels may be elevated if digoxin is
administered I.M., but this route of administration isn't recommended.
A 40-year-old female client who is taking nifedipine (Procardia) for hypertension tells the nurse that she
has noticed a "little swelling" in her ankles. What should be the nurse's first response?
"When did you first notice this?"
RATIONALES: The nurse should first attempt to obtain more information regarding the patient's
complaint. Assuming that the patient is using too much salt is inappropriate. Although peripheral edema is
a common adverse effect of nifedipine, the physician needs to determine whether the client's ankle
swelling is caused by the medication or another condition. After the cause is determined, the physician
may need to change the medication.
Considering a client's atrial fibrillation, the nurse must administer digoxin (Lanoxin) with caution because
it:
stimulates the parasympathetic division of the autonomic nervous system, increasing vagal tone.
RATIONALES: The nurse must administer digoxin with caution in a client with atrial fibrillation because
digoxin stimulates the parasympathetic division of the autonomic nervous system, increasing vagal tone.
The vagal effect slows the heart rate, increases the refractory period, and slows conduction through the
atrioventricular node and junctional tissue, thus increasing the potential for new arrhythmias to develop.
Digoxin doesn't constrict arteries. Although it can trigger proarrhythmias, it does so by increasing vagal
tone (not stroke volume).
A client is receiving captopril (Capoten) for heart failure ﾧ. Which finding indicates that the medication
isn't producing the desiredtreatment outcome and requires the nurse to notify the physician?
Peripheral edema
RATIONALES: Peripheral edema is a sign of fluid volume overload and worsening heart failure. A skin
rash, dry cough, and orthostatic hypotension ﾧ are adverse reactions to captopril, but they don't indicate
that therapy is ineffective.
A client with chronic arterial occlusive disease undergoes percutaneous transluminal coronary angioplasty
(PTCA)ﾧ for mechanical dilation of the right femoral artery. After the procedure, the client will
require long-term administration of:
aspirin.
RATIONALES: After PTCA, the client should begin long-term aspirin therapy to prevent
thromboembolism. Although heparin is given for anticoagulation during this procedure, the client doesn't
need long-term heparin or warfarin therapy afterward. The physician may prescribe short-term
acetaminophen therapy to manage fever or discomfort, but prolonged therapy isn't warranted. After the
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, NURS100 EXAM-MEDS QUESTIONS WITH ANSWERS 2022
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procedure, the client may need an antibiotic, such as penicillin, for a brief period to prevent infection
□ associated with an invasive procedure; long-term therapy isn't necessary.
A client with known coronary artery disease reports intermittent chest pain, usually on exertion. The
physician diagnoses angina pectoris ﾧ and prescribes sublingual ﾧ nitroglycerin to treat acute angina
episodes. When teaching the client about nitroglycerin administration, the nurse should provide which
instruction?
"Be sure to take safety precautions because nitroglycerin may cause orthostatic hypotension."
RATIONALES: Nitroglycerin commonly causes orthostatic hypotension ﾧ and dizziness. To minimize
these problems, the nurse should teach the client to take safety precautions, such as changing to an upright
position slowly, climbing up and down stairs carefully, and lying down at the first sign of dizziness. To
ensure the freshness of sublingual nitroglycerin, the client should replace tablets every 3 months, not
every 6 months, and store them in a tightly closed container in a cool, dark place. Many brands of
sublingual nitroglycerin no longer produce a burning sensation. The client should take a sublingual
nitroglycerin tablet at the first sign of angina and may repeat the dose every 10 to 15 minutes for up to
three doses; if this doesn't bring relief, the client should seek immediate medical attention.
Which of the following classes of medications protects the ischemic myocardium by blocking
catecholamines and sympathetic nerve stimulation?
Beta-adrenergic blockers
Beta-adrenergic blockers work by blocking beta receptors in the myocardium, reducing the response to
catecholamines and sympathetic nerve stimulation. They protect the myocardium, helping to reduce the
risk of another infarction by decreasing the workload of the heart and decreasing myocardial oxygen
demand. Calcium channel blockers reduce the workload of the heart by decreasing the heart rate.
Narcotics reduce myocardial oxygen demand, promote vasodilation, and decreased anxiety. Nitrates
reduce myocardial oxygen consumption by decreasing left ventricular end-diastolic pressure (preload) and
systemic vascular resistance (afterload).
Which of the following parameters should be checked before administering digoxin?
Apical pulse
An apical pulse is essential or accurately assessing the client’s heart rate before administering digoxin. The
apical pulse is the most accurate point in the body. Blood pressure is usually only affected if the heart rate
is too low, in which case the nurse would withhold digoxin. The radial pulse can be affected by cardiac
and vascular disease and therefore, won’t always accurately depict the heart rate. Digoxin has no effect on
respiratory function.
Toxicity from which of the following medications may cause a client to see a green halo around lights?
Digoxin
One of the most common signs of digoxin toxicity is the visual disturbance known as the green halo sign.
The other medications aren’t associated with such an effect.
Which of the following classes of drugs is most widely used in the treatment of
cardiomyopathy? Beta-adrenergic blockers
By decreasing the heart rate and contractility, beta-adrenergic blockers improve myocardial filling and
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