NURS2407 Module 09 End of Module Open Book Quiz

Module 09 Content

Question 1A client is experiencing edema. Which over-the-counter medication might be reducing the diuretic effects of her lisinopril?

1. St John’s Wort

2.Ibuprofen

3. Vitamin C

4. Glucosamine

Question 2The nurse is providing patient education to a client who has just been given a new prescription for sublingual nitroglycerin tablets. Which statement by the client would indicate a need for additional teaching?

1. “I should store my nitroglycerin in its original dark bottle to protect it from light.”

2. “I should dissolve the tablet under my tongue and be careful not to swallow it.”

3. “I can take one tablet every 5 minutes, up to three times unless I get dizzy.”

4 “I should take the nitro every 2 to 3 minutes until my pain goes away.”

Question 3A client, who has been seeing multiple doctors, reports that she is taking lisinopril and another antihypertensive medication, the name of which she can’t recall. What type of antihypertensive is contraindicated when people are taking angiotensin-converting enzyme (ACE) inhibitors due to risk of compound effects?

1. Calcium channel blockers

2. Potassium-sparing diuretics

3. Beta blockers

4.Thiazide diuretics

Question 4 A client with stable angina is starting treatment with nifedipine. The client’s spouse asks how nifedipine alleviates chest pain. How should the nurse respond?

1. “It increases the heart rate and contractility.”

2. “It improves cardiac circulation through vasoconstriction.”

3. “It helps the heart propel blood forward by reducing aortic blood pressure.”

4. “It reduces platelet aggregation.”

Question 5 In preparing discharge education for a client who has just begun hydrochlorothiazide therapy, a nurse reviews the client’s lab results. Which finding should the nurse be concerned about in relationship to the discharge prescription?

1.Potassium level of 4.8 mEq/L

2. Blood sugar level of 80 mg/dL

3.Potassium level of 3.1 mEq/L

4. Hemoglobin of 15 g/dL

Question 6A client has been taking digoxin 0.25 mg, and furosemide 40 mg, daily. Upon routine assessment by the nurse, the client states, “I see yellow halos around the lights.” The nurse should perform which of the following actions based on this assessment?

1. Document the findings and reassess in 1 hour.

2. Consult the provider then request a digoxin and potassium level check.

3. Withhold the next dose of furosemide.

4.Continue to monitor the patient for heart failure.

Question 7While preparing to administer a scheduled dose of digoxin, the nurse finds a new lab result showing a digoxin level of 0.7 ng/mL. What action should the nurse take?

1. Check the patient’s apical pulse, and if it is within a safe range, administer the digoxin.

2.Administer Digibind to counteract the toxicity.

3. Withhold the drug and notify the prescriber immediately.

4. Hold the drug for an hour and reassess the level.

Question 8A client who has been taking lisinopril complains of a dry cough. How should the nurse respond to this complaint?

1. The cough is a result of immune suppression. The client should stop the medicine immediately.

2. The cough is a sign of impending angioedema. The client should stop the medicine immediately.

3. The cough is a common side effect lisinopril. Angiotensin II receptor blockers (ARBs) may be prescribed as an alternative, if the cough becomes disruptive.

4. The cough will subside within 5 to 7 days when the body becomes accustomed to the medicine.

Question 9Potassium chloride 10 mEq intravenously has been ordered for a client whose potassium is 2.9 following diuretics. How will the nurse administer the potassium dose?

1. Dilute the dose in a 50 ml intravenous fluids and infuse over a minimum of 30 minutes

2. Push the dose intravenously in increments over 10 minutes

3.Ask to inject the dose in a large muscle since the intravenously route is too dangerous

4. Push the dose as a rapid intravenous push because of the patient’s dangerously low potassium level

Question 10A client with stable angina asks why the physician told her to put her nitro patch on at 8am and take it off at 8pm. What explanation should he be given?

1. The patch should be replaced, not removed at bedtime.

2.The doctor is trying to reduce your risk of night falls.

3. Patch-free intervals are needed to sustain medication effectiveness.

4.You should follow this advice for any patch medications you use.

Question 11A client with angina is preparing to go home with a prescription for a calcium channel blocker. What should the client be taught?

1.Elevate the feet when sitting to avoid edema side effects.

2. Drink grapefruit juice with breakfast to reduce the risk of plaque.

3. Use salt substitute to replenish potassium losses due to diuretic effects.

4. Eat cheese regularly to restore calcium and manage loose stools.

Question 12A client is being discharged to his home on enoxaparin injections for treatment of deep vein thrombosis (DVT). Which of the following statements made by the client indicates a need for further discharge teaching by the nurse?

1. “I will call my physician if I pass black tarry stools or pink urine.”

2. “I will inject the enoxaparin into the fatty tissue of my abdomen.”

3. “I hate needles, but I know enoxaparin doesn’t come in pill form.”

4. “I will go to the clinic every day to have my partial thromboplastin time (PTT) drawn.”

Question 13A client presents to the emergency department with chest pain. On a scale of 1:10 he rates the pain as a 6. His respiratory rate is 22 breaths/minute. His blood pressure is 156/92 mm Hg. His heart rate is 110 beats/minute. He is afebrile. What other information should the nurse obtain before administering nitroglycerin?

1. Has the client used any alcohol or drugs for erectile dysfunction recently?

2. Has the client had a previous heart attack?

3. Has the client experienced any dizziness or nausea within the last two weeks?

4.Has the client taken any drugs within the past 12 hours?

Question 14A client is starting sildenafil for the treatment of pulmonary hypertension. Which of these medications could cause a serious reaction if they are taken with sildenafil? (Select all that apply.)

1. Clopidigrel

2. CoEnzyme Q-10

3. Doxazosin

4. Simvastatin

5. Nitroglycerin

Question 15A client has had hypertension for approximately 7 years and now is interested in becoming pregnant. What is the safest anti-hypertensive for a women in the early stages of pregnancy?

1. Valsartan

2. Lisinopril

3. Methyldopa

4. Amlodipine

Question 16A client is brought to the emergency department for an accidental warfarin overdose. The nurse determines that the client has no apparent signs of bleeding. Which action should the nurse take next?

1.Obtain a stat partial thromboplastin time (PTT).

2. Administer protamine sulfate.

3. Obtain a stat prothrombin time (PT) or international normalized ratio (INR).

4.Type and cross-match the client’s blood.

Question 17If a client is taking carvedilol, a beta blocker, which adverse effect should the nurse watch for?

1. Hyperglycemia

2. Sinus tachycardia

3. Dizziness

4.Hypoventilation

Question 18Atenolol has been prescribed for a client who is recovering from a recent heart attack. The nurse would consult the provider before giving the medicine in which of these situations? (Select all that apply.)

1. Blood glucose 50 mg/dL

2. Tension headache

3. Pulse 52 beats/minute

4. Parkinsonian tremors

5.Blood pressure 110/86 mm Hg

6. Respirations 32 breaths/minute with wheezes

Question 19A client presents in the clinic with concerns of having taken his dabigitran twice this morning. Realizing that this is a new oral anticoagulant (NOAC), what should the nurse do next? (Select all that apply.)

1.Seek advice from the provider

2. Assess for signs of active bleeding

3. Ask the client to share how the overdose happened

4. Insist that the client receive fresh frozen plasma immediately

5. Have the client eat a spinach salad

6.Have the lab check a stat international normalized ration (INR)

Question 20In which of the following situations should the nurse prepare to administer protamine sulfate?

1. A client on warfarin with an international normaized ratio (INR) of 4 and tarry stools

2. A client on a heparin drip with a patial thromboplastin time (PTT) >120 seconds and active gastrointentional (GI) bleeding.

3. A client on a heparin drip with a partial thromboplastin time (PTT) of 60 seconds and pink-tinged urine.

4. A client on warfarin with a prothrombin time (PT) of 12 seconds and bleeding from a laceration

 

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