NURS 601 Pharm Cardiovascular Medications Questions and Answers- University of San Francisco
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NURS 601 Pharm Cardiovascular Medications Questions and Answers- University of San Francisco/NURS 601 Pharm Cardiovascular Medications Questions and Answers- University of San Francisco/NURS 601 Pharm Cardiovascular Medications Questions and Answers- University of San Francisco/NURS 601 Pharm Cardi...
nurs 601 pharm cardiovascular medications questions and answers university of san francisconurs 601 pharm cardiovascular medications questions and answers university of san francisconurs 601 pharm
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KEY:
All un-highlighted questions are required for Patho-Pharm 1
Red Text = Should Understand
Green Text = Absolutely Should Know
Yellow Highlight = Patho-Pharm 2 Material (Skip in Patho-Pharm 1)
Blue Highlight = Skip (In both Patho-Pharm 1 & 2)
Cardiovascular Pharmacology
1. Potassium chloride intravenously is prescribed for a client with hypokalemia. Which actions
should the nurse take to plan for preparation and administration of the potassium? Select all that apply.
1. Obtain an intravenous (IV) infusion pump.
2. Monitor urine output during administration.
3. Prepare the medication for bolus administration.
4. Monitor the IV site for signs of infiltration or phlebitis.
5. Ensure that the medication is diluted in the appropriate volume of fluid.
6. Ensure that the bag is labeled so that it reads the volume of potassium in the solution.
Correct answer: 1, 2, 4, 5, 6
Rationale: Potassium chloride administered intravenously must always be diluted in IV fluid and infused
via an infusion pump. Potassium chloride is never given by bolus (IV push). Giving potassium chloride by
IV push can result in cardiac arrest. The nurse should ensure that the potassium is diluted in the
appropriate amount of diluent or fluid. The IV bag containing the potassium chloride should always be
labeled with the volume of potassium it contains. The IV site is monitored closely because potassium
chloride is irritating to the veins and there is risk of phlebitis. In addition, the nurse should monitor for
infiltration. The nurse monitors urinary output during administration and contacts the health care
provider if the urinary output is less than 30 mL/hour. The following are all the option DIVs for the
individual question types They should be the same size as the option-area DIV above.
2. A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hour. The
nurse determines that the client is receiving the therapeutic effect based on which results?
1. Prothrombin time of 12.5 seconds
2. Activated partial thromboplastin time of 60 seconds
3. Activated partial thromboplastin time of 28 seconds
4. Activated partial thromboplastin time longer than 120 seconds
Correct answer: 2
,Rationale: Common laboratory ranges for activated partial thromboplastin time (aPTT) are 30 to 40
seconds. Because the aPTT should be 1.5 to 2.5 times the normal value, the client's aPTT would be
considered therapeutic if it was 60 seconds. Prothrombin time assesses response to warfarin therapy.
3. The nurse provides discharge instructions to a client who is taking warfarin sodium. Which
statement, by the client, reflects the need for further teaching?
1. "I will avoid alcohol consumption."
2. "I will take my pills every day at the same time."
3. "I have already called my family to pick up a MedicAlert bracelet."
4. "I will take coated aspirin for my headaches because it will coat my stomach."
Correct answer: 4
Rationale: Aspirin-containing products need to be avoided when a client is taking this medication.
Alcohol consumption should be avoided by a client taking warfarin sodium. Taking the prescribed
medication at the same time each day increases client compliance. The MedicAlert bracelet provides
health care personnel with emergency information.
4. A client who is receiving digoxin daily has a serum potassium level of 3 mEq/L (3 mmol/L) and is
complaining of anorexia. The health care provider prescribes a serum digoxin level to be done. The nurse
checks the results and should expect to note which level that is outside of the therapeutic range?
Rationale: The optimal therapeutic range for digoxin is 0.5 to 0.8 ng/mL. If the client is experiencing
symptoms such as anorexia and is experiencing hypokalemia as evidenced by a low potassium level,
digoxin toxicity is a concern. Therefore, option 4 is correct because it is outside of the therapeutic level
and an elevated level.
5. A client is being treated with procainamide for a cardiac dysrhythmia. Following intravenous
administration of the medication, the client complains of dizziness. What intervention should the nurse
take first?
1. Measure the heart rate on the rhythm strip.
2. Administer prescribed nitroglycerin tablets
3. Obtain a 12-lead electrocardiogram immediately.
4. Auscultate the client's apical pulse and obtain a blood pressure.
,Correct answer: 4
Rationale: Signs of toxicity from procainamide include confusion, dizziness, drowsiness, decreased
urination, nausea, vomiting, and tachydysrhythmias. If the client complains of dizziness, the nurse should
assess the vital signs first. Although measuring the heart rate on the rhythm strip and obtaining a 12-lead
electrocardiogram may be interventions, these would be done after the vital signs are taken.
Nitroglycerin is a vasodilator and will lower the blood pressure.
6. The nurse is monitoring a client who is taking propranolol. Which assessment finding indicates a
potential adverse complication associated with this medication?
1. The development of complaints of insomnia
2. The development of audible expiratory wheezes
3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after
2 doses of the medication
4. A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of 72
beats/minute after 2 doses of the medication
Correct answer: 2
Rationale: Audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm. Beta
blockers may induce this reaction, particularly in clients with chronic obstructive pulmonary disease or
asthma. Normal decreases in blood pressure and heart rate are expected. Insomnia is a frequent mild
side effect and should be monitored
7. A client with a clot in the right atrium is receiving a heparin sodium infusion at 1000 units/hour
and warfarin sodium 7.5 mg at 5:00 p.m. daily. The morning laboratory results are as follows: activated
partial thromboplastin time (aPTT), 32 seconds; international normalized ratio (INR), 1.3. The nurse
should take which action based on the client's laboratory results?
1. Collaborate with the health care provider (HCP) to discontinue the heparin infusion and administer the
warfarin sodium as prescribed.
2. Collaborate with the HCP to obtain a prescription to increase the heparin infusion and administer the
warfarin sodium as prescribed.
3. Collaborate with the HCP to withhold the warfarin sodium since the client is receiving a heparin
infusion and the aPTT is within the therapeutic range.
4. Collaborate with the HCP to continue the heparin infusion at the same rate and to discuss use of
dabigatran etexilate in place of warfarin sodium.
Correct answer: 2
Rationale: When a client is receiving warfarin for clot prevention due to atrial fibrillation, an INR of 2 to 3
is appropriate for most clients. Until the INR has achieved a therapeutic range, the client should be
maintained on a continuous heparin infusion with the aPTT ranging between 60 and 80 seconds.
, Therefore, the nurse should collaborate with the HCP to obtain a prescription to increase the heparin
infusion and to administer the warfarin as prescribed.
8. A client is diagnosed with an ST segment elevation myocardial infarction (STEMI) and is receiving
a tissue plasminogen activator, alteplase. Which action is a priority nursing intervention?
1. Monitor for kidney failure.
2. Monitor psychosocial status.
3. Monitor for signs of bleeding.
4. Have heparin sodium available.
Correct answer: 3
Rationale: Tissue plasminogen activator is a thrombolytic. Hemorrhage is a complication of any type of
thrombolytic medication. The client is monitored for bleeding. Monitoring for renal failure and
monitoring the client's psychosocial status are important but are not the most critical interventions.
Heparin may be administered after thrombolytic therapy, but the question is not asking about follow-up
medications.
9. The nurse is planning to administer hydrochlorothiazide to a client. The nurse should monitor for
which adverse effects related to the administration of this medication?
Rationale: Thiazide diuretics such as hydrochlorothiazide are sulfa-based medications, and a client with a
sulfa allergy is at risk for an allergic reaction. Also, clients are at risk for hypokalemia, hyperglycemia,
hypercalcemia, hyperlipidemia, and hyperuricemia.
10. The home health care nurse is visiting a client with elevated triglyceride levels and a serum
cholesterol level of 398 mg/dL (10 mmol/L). The client is taking cholestyramine and the nurse teaches
the client about the medication. Which statement, by the client, indicates the need for further teaching?
1. "Constipation and bloating might be a problem."
2. "I'll continue to watch my diet and reduce my fats."
3. "Walking a mile each day will help the whole process."
4. "I'll continue my nicotinic acid from the health food store."
Correct answer: 4
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