Pharm Exam #3 Review

Thao Ho

How do diuretics work?

They block reabsorption of sodium and cloride to increase
urine flow

Diuretics are used to treat what type

of diseases?

Pulmonary edema in CHF

Edema associated with ascites, cardiac, or renal origins
Hypertension
Acute renal failure (increase renal blood flow)

Loop and thiazide diuretics both

cause what?

Hypokalemia, needs potassium supplements

glucose, uric acid, lipids
Dehydration

What happens if the nurse push IV too

fast when administering loop diuretics?
Ototoxicity, loop diuretics should not be given with ototoxic
drugs (amphotericin B, gentamicin)

How many routes loop diuretics can

be delivered?
Oral onset 60 minutes and lasts for 8 hours
IV onset 5 minutes and lasts for 2 hours

Why should the nurse only give

diuretics before 2pm?
To avoid nocturia

What are other drugs that should be

avoided with loop and thiazide diuretics?
Potassium depleting diuretics
Digoxin
Lithium
Caution with hypertensive drugs
NSAIDS

What are signs of hypokalemia?

Weakness and fatigue
Drowsiness and confusion (fall risk)
Abnormal EKG flat T wave, weak irregular pulse
Postural hypotension
Flaccid paralysis, muscle weakness, leg cramps

What are signs of hyperkalemia?

Abnormal EKG peaked T wave, irregular wave
Muscle weakness/ paresthesias, hyporeflexia, fatigue
Confusion, restless, anxiety
seizures

The nurse should caution when

giving potassium intravascular by?
All IV solutions must be diluted (40 mEq/1000ml, <20
mEq/hour)
Never give IV bolus
Check for extravasation
Ensure adequate renal function

What are K sparing diuretics?

Spironolactone aldosterone antagonist
Triamterene, amiloride

In which situation the nurse should

give Kayexalate?
When the patient experience hyperkalemia
Kayexalate removes K by exchanging Na for K in large
intestines
Can be given po or by enema (retention for 30 minutes)
Big side effects are diarrhea, N, V, Na retention

K sparing diuretics should not be

given with?
Other potassium sparing diuretics
Potassium supplements
Salt substitutes
Anticoagulants
Digoxin
Lithium
ACE inhibitors
ARBs
DRIs

Why should the nurse be cautioned with blood

transfusions with a patient on K sparing diuretics?
Potassium stored in RBCs, leading to hyperkalemia

What are characteristics of mannitol that

make it different from other diuretics?
Mannitol remains in the nephrons, pulls water into tubule
Must use filtered needle to draw
IV only
Indicated for ICP and IOP

Before administering mannitol, the

nurse must perform which actions?
IV test dose procedure, check renal function
Monitor electrolyte and renal lab values <30 ml/ hr Dont give

Does colchicine have any effect on

uric acid levels?
NO, colchicine only has anti-inflammatory effect
Used to treat acute gout attack

What are unusual side effects of

cochicine?
GI toxicity 25% even on low doses
Alopecia
Myelosuppression

What is urate-lowering therapy?

It is xanthine oxidase inhibitor (XO inhibitor) reduce uric
acid blood levels
Prevents chronic gout and urate nephropathy

How much urine output patients should void

when they are on drug therapy for gout?
2L/ day, alkaline urine necessary
No alcohol (purine)

What are side effects of allopurinol, a

drug used for chronic tophaceous gout?
Hypersensitivity syndrome rash, fever, pruritus
GI distress
Drowsiness, HA
Prolonged use cataracts
Do not give with anticoagulant drugs toxicity

What is the nurses first action

before giving Uloric, a drug for gout?
Check LFTs

What are the most adverse effects

of Krystexxa?
Anaphylaxis (black box warning) and chest pain

Besides treatment of hyperuricemia,

Benemids second effect is?
Prolong the effects of penicillins and cephalosporins
Increase blood concentrations of antibiotics

What is the most widely used antibacterial agents

for chronic and recurrent urinary tract infections?
Bactrim and Septra, combination drug

Side effects of Bactrim and Septa?

Diarrhea common sign, give on an empty stomach
HA, dizziness
Hypersensitivity reactions rash, pruritus
Hyperkalemia
Blood dyscrasias
Crystalluria, hematuria acidic urine, avoid acidic fluids

Antibacterial drug that only has effect in the urine,

little or no systemic effects, 2nd line treatment?
Macrodantin, Macrobid
Brown urine color
Encourage acidic food to enhance drug effects

Pyridium?
Dysuria
Short-term use 2 days
Side effects: skin/eye pigmentation, reddish/orange urine
color

BNP is secreted by which

mechanism?
LV fails CO myocardium stretches BNP secreted
Natriuresis occurs, blood volume
BNP =< 100 pg/ml normal

Drugs for heart failure?

ACE inhibitors
Diuretics
Beta blockers
Inotropic agents
Natrecor
Digoxin

Even though dopamine and doputamine are inotropic

agents, they can cause different side effects since:
Dopamine cause tachycardia and afterload, O2 demand
Doputamine reduces afterload because it does not have
alpha1 receptor

Natrecor
Inhibits ADH and promotes vasodilation
For severe CHF with dyspnea at rest
< 90 mmHg Hold drug

Digoxin is a very potent drug

because:
Very narrow therapeutic index (0.5 2)
Very highly protein bound, stays in body for a long time
Can be toxic even though levels in normal range

What are nursing implications to

digoxin?
Monitor for electrolyte imbalance, acid/base imbalances
Draw blood before and after daily dose
Take apical pulse for 1 full minute, note rate and rhythm
Administer 1 hour before or 2 hours after meals, same time
each day
Check weight at same time every day
Sodium restriction (2g)

Signs of digoxin toxicity:

Anorexia, N, V, diarrhea (hypokalemia)
Visual disturbances blurred, colored, white halo
Weakness, confusion

Side effects of Beta blockers?

Bradycardia
Hypotension
Rebound cardiac excitation
Bronchospasm
Hypoglycemia
Sexual dysfunction

Nursing implications for beta

blockers
Monitor sitting and standing BP
Pulse less than 60 bpm Hold drug
Determine daily weight
Caution with diabetic patients
Caution with pulmonary patient if nonselective
Beta blockade will suppress reflex tachycardia occurring
when blood pressure falls

What are the advantages ACE inhibitor

(the prils) has over Beta blocker?
Minimal orthostatic hypotension
Can use with patients with asthma
No sexual dysfunction
Slows progression of renal disease
Reverse the pathologic changes in heart and blood vessels

Common side effects of ACE the

prils
Hypotension
Cough
Hyperkalemia
Rash, angioedema, neutropenia
Anorexia

ARBs the sartans is different from

ACEs the prils by
Little effect on potassium and cough
Can cause nasal congestion

Side effects of DRI Tekturna

Dose dependent diarrhea
Rash
Gout
Renal stones
Hyperkalemia
Angioedema, cough - rare

Nursing implication for CCB the

dipines?
Monitor for bradycardia and hypotension
Assess for weight gain, edema
HR <50 bpm Hold drug
Encourage dental hygiene due to gingival hyperplasia
Eat high fiber diet to prevent constipation
Empty stomach
Do not crush or chew
Do not take with grapefruit juice

NTG side effects

HA good sign
OH
Reflex tachycardia
Facial flushing
Blurred vision

NTG is effective if
Bursing, stinging sensation occurs

How to store NTG?

In tightly closed, dark container, good for 6 months
Avoid air, heat, moisture

Procedure to apply NTG oitment

Use special NTG papers
Don gloves
Rotate sites
Write date, time, initials
Remove used patches before applying new one

NTG is contraindicated with?

Viagra class drug, can cause severe low blood pressure

Ranexa
Only apply for chronic angina
Side effects: dizziness, HA, constipation, N, V
No grapefruit juice

Drugs for dysrhythmias

Procainamide
Lidocaine
Amiodarone

Procainamide
Treatment of atrial and ventricular dysrhythmias
Drug induced SLE, brusing, anorexia, hypotension
Give IV slowly to prevent severe hypotension
Monitor for emboli if given for A-fib
DC if BP falls more than 15 mmHg

Lidocaine
Ventricular dysrhythmias only
Can cause dyspnea, muscle twitching, bradycardia,
anorexia, tremors

Amiodarone
A-fib and V-fib
Side effects: visual disturbances, dyspnea, skin discoloration,
coagulation abnormalities, hepatotoxicity, pulmonary fibrosis
No grapefruit juice
Contraindicated with digoxin and Coumadin

dronedarone
Less effective than amiodarone but safer
No pulmonary side effects
Less hepatoxicity
Oral alternative
Indicated for A-fib

How often do you replace

NTG?
5 minute intervals, 3 doses maximum

How do you know if NTG is

working?
Burning, stinging sensation

What are the numbers for total

cholesterol, HDL, LDL, triglycerides?
Total cholesterol <200
HDL >40
LDL <100
Triglycerides <150

What is the normal value for

potassium?
3.5 - 5

What med causes a blue-gray skin

discoloration?
amiodarone

What electrolyte potentiates an overdose of digoxin,

and is it when the electrolyte is hypo or hyper?
Hypokalemia < 3.5

Who is more at risk for high

cholesterol - Apo E 2, 3, or 4?
4

What antilipidemic drug causes a

flush?
Nicotinic Acid

How can you prevent the flush?

ASA 30 minutes prior to meds

Why are some patients noncompliant with the ACE Inhibitors?

Allergic reactions: rash, angioedema; hyperkalemia,
hypotension

What should the nurse educate her

patient about drugs for dysrhythmia?
Limit caffeine and check HR

What are drugs that cannot be

given with grapefruit juice?
CCB
Ranexa chronic angina
amiodarone

Know the difference between

Multag and amiodarone:
Multag po only
Multag: no skin color change, no pulmonary fibrosis
Multag rare hepatic injury

What is atrial fibrillation?

Lives in the pulmonary vein
Saw-tooth P-waves
4-5X stroke risk

What is the action of statins?

Decreases LDLnumber
Reduce mortality post-CABG by stabilizing plaque

What statins adverse effect would

the nurse notify HCP?
Muscle weakness

When taking statins, patients should

be educated about:
No heavy drinking increases # of small HDL - bad
Report pregnancy
Report muscle pain
Contraindications: erythromycin, antifungals, digoxin
E4 patients are resistant to Statins

Niacins works by:

Increases LDL size
Increases HDL # and size
Decreases Lp(a)

Why patients should never use

Niacins OTC extended release?
Liver toxicity

Common side effects of Niacins?

Flushing avoid hot, spicy food, take ASA
Increases pigmentation harmless
Avoid acetaminophen & other potential hepatotoxics
Increases homocysteine high risk of heart attack
Hypotension take at bed time

Fibrates main mechanism

Decreases triglycerides

Fibrates nursing implication

Report muscle pain
Can be used in children
Start slow
Extreme caution with renal function issue

Bile Acid Binding Resins Choles

Main side effect is constipation
Need high fiber diet
Monitor LFTs and RFTs
Other side effects same as fibrates

Cholesterol Absorption Inhibitor

Zetia
Prevents cholesterol absorption in intestine
Diarrhea, back pain, arthralgia
Do not take if history of liver dysfunction
Best treatment for E4

Fish oil
Decreases LDL and TG
Do not apply for E4 type
Freeze them to maintain effect

Vitamin D3
Prevent cancer and CVD

What drugs work best for E4 type?

Zetia
Vytorin (Zetia and simvastatin)

Loop diuretic acts on

Ascending loop of Henle

Thiazide diuretic acts on

Distal tubule

The nurse knows NTG is effective

when the patient says
I should expect to get headache after taking my NTG

Why the client should avoid grapefruit

juice when receiving a CCB?
Because it can cause the CCB to rise to toxic levels

The nurse should explain to her patient the adverse

relation between NTG and Viargra class drug
because?
Both drugs are vasodilators which can lead to severe
hypotension

The most dangerous side effect of

statins is?
Fatal rhabdomyolysis, any muscle pain or tenderness should
be reported to the HCP immediately

Why cholestyramine, a bile acid sequestrant

should be administered with fruit juice?
Cholestyramine can cause constipation and impaction and
should be given with water, fruit juice, soup or pulpy fruit to
reduce the risk of esophageal impaction

How does the nurse know if digoxin

is effective?
Listen for lung sounds bilaterally
SOB is the main symptom of CHF and should be monitor
closely

A patient taking loop diuretic is experiencing leg

cramps, what should the nurse do?
Hold drug until the potassium level is corrected because leg
cramps is a sign of hypokalemia

Does digoxin affect blood pressure?

No, digoxin does not cause orthopedic hypotension

The nurse should discontinue ACE inhibitor and

report to the HCP when her patient is experiencing:
An intractable dry cough

What is angioedema?
Localized edematous areas, accompanied by intense itching

Side effects of Bactrim, Septa

diarrhea (changes in intestinal flora), anorexia, N, V
HA, dizziness, depression
pruritis, rash hypersensitivity reaction, photosensitivity
hyperkalemia (with high dose therapy)
blood dyscrasias
crystalluria, hematuria sulfonamides precipitate in acidic
urine

Nursing implications for Bactrim and

Septa
maintain adequate hydration drink at least 3 liters of fluid
per day [avoid acidic fluids and acidic vitamins (C)]
give on an empty stomach with adequate water
monitor for the presence of crystals
assess for allergic or toxic reactions, dermatological
reactions (hives)
educate patient about risk of photosensitivity
monitor urinary output for renal toxicity (crystal-induced),
blood studies for dyscrasias
take full course of therapy

Side effects of Macrodantin and

Macrobid
GI disturbances N, V, diarrhea, anorexia
pulmonary reaction (hypersensitivity type)
neuropathy with chronic use
brown urine color

Nursing implications for Pyridium

give with or after meals
colored urine will stain fabrics, contact lenses
discontinue drug and report to physician the appearance of
yellowish tinge to skin or sclerae (possible drug accumulation
due to renal impairment)
discontinue drug when urinary pain and discomfort are
relieved but finish antibiotic agent regimen

A patient about to receive his morning

dose of digoxin has an apical pulse of 70
beats per minute. What will the nurse do?
A. Administer the dose.
B. Administer the dose and notify the physician.
C. Check the radial pulse for 1 full minute.
D. Withhold the dose and notify the`

A. Administer the dose

In assessing a patient before administration of a

cardiac glycoside, the nurse knows that what
condition can predispose a patient to digitalis toxicity?
A.Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia

A.Hypokalemia

While assessing a patient who is

receiving intravenous digitalis, the
nurse recognizes that the drug has a
negative chronotropic effect. How
would this drug effect be evident in the
patient?
A. Increased heart rate
B. Decreased heart rate
C. Decreased conduction
D. Increased ectopic beats B. Decreased heart rate

B. Decreased heart rate

A patient has been taking digoxin at home but has

taken an accidental overdose and has developed
toxicity. He has been admitted to the telemetry unit
where the physician has ordered digoxin immune
Fab (Digibind). The patient asks the nurse why the
medication is ordered. What is the nurse's best
response?
A. "It works faster than digoxin."
B. "It is safer than digoxin and can be taken orally."
C. "It helps to convert the irregular heart rhythm to a more
normal rhythm."
D. "This drug is an antidote to digoxin and will help to lower
the blood levels."

D. "This drug is an antidote to digoxin and will help to

lower the blood levels."

A patient with atrial fibrillation was started on digoxin,

and 1 week later a digoxin level was drawn. Which
result is within normal therapeutic levels for digoxin?
A. 0.4 ng/mL
B. 0.7 ng/mL
C. 2.1 ng/mL
D. 2.6 ng/mL or higher

B. 0.7 ng/mL

When reviewing the list of medications taken by a

patient who will be receiving a new prescription for
digoxin, the nurse would be concerned about which
medication that may interact with the digoxin?
A. aspirin
B. acetaminophen (Tylenol)
C. furosemide (Lasix)
D. vitamin K

C. furosemide (Lasix)

The nurse is reviewing discharge teaching for a patient who

will be taking digoxin (Lanoxin) therapy. The patient should
be taught to avoid which foods when taking the digoxin?
A. Leafy green vegetables
B. Dairy products
C. Grapefruit juice
D. Bran muffins

D. Bran muffins

In assessing a patient before

administration of a cardiac glycoside,
the nurse knows that which lab result
can increase the toxicity of the drug?
A. Potassium level 2.8 mEq/L
B. Potassium level 4.9 mEq/L
C. Sodium level 140 mEq/L
D. Calcium level 10 mg/dL

A. Potassium level 2.8 mEq/L (low

potassium normal is 3.5 to 5.0)

The nurse administering the

phosphodiesterase inhibitor inamrinone
recognizes that this drug should have a
positive inotropic effect. This effect will
result in increased
A. heart rate.
B. blood vessel dilation.
C. force of cardiac contraction.
D. conduction of electrical impulses across the heart.

C. force of cardiac contraction.

When a patient is experiencing digoxin

toxicity, which clinical situation would
necessitate the use of digoxin immune
Fab (Digibind)? Select all that apply.
A. The patient reports seeing colorful halos around lights.
B. The patient's serum potassium level is above 5 mEq/L.
C. The patient is experiencing nausea and anorexia.
D. The patient is experiencing severe sinus bradycardia that
does not respond to cardiac pacing.
E. The patient has taken an overdose of greater than 10 mg
of digoxin.

B. The patient's serum potassium level is

above 5 mEq/L.
D. The patient is experiencing severe sinus
bradycardia that does not respond to cardiac
pacing. (E) might be right as well a person
taking 10mg of digoxin is a indication of
toxicity...page 340 states life threatening
digoxin overdose in adults and 4 mg in
children)

Which drug classes are considered first-line

treatment for heart failure? Select all that apply.
A. Angiotensin converting enzyme (ACE) inhibitors
B. Angiotensin II receptor blockers (ARBs)
C. Digoxin (cardiac glycoside)
D. Beta-blockers
E. Nesiritide (Natrecor), the B-type natriuretic peptide

ACE
ARBS
Beta-blockers
loop diuretics

When administering topical nitroglycerin

ointment, the nurse should use which technique?
A. The ointment should be applied on the chest over the
heart.
B. The ointment should be used only in the case of a mild
angina episode.
C. The old ointment should be removed before new ointment
is applied.
D. The ointment should be massaged gently into the skin,
then covered with plastic wrap.

C. The old ointment should be removed

before new ointment is applied.

A 53-year-old man has been admitted for evaluation

of chest pain. He has been diagnosed with angina
and will be given a prescription for sublingual
nitroglycerin tablets. When teaching the patient how
to use sublingual nitroglycerin, what instruction
should the nurse include?
A. Take up to five doses at 15-minute intervals for an angina
attack.
B. If the tablet does not dissolve quickly, chew the tablet for
maximal effect.
C. If the chest pain is not relieved after one tablet, call 911
immediately to activate emergency medical services.
D. Wait 1 minute between doses of sublingual tablets, up to
three doses.

 C. If the chest pain is not relieved after one tablet, call 911
immediately to activate emergency medical services.

A 74-year-old professional golfer has chest

pain that occurs toward the end of his golfing
games. He says the pain usually goes away
after 1 or 2 sublingual nitroglycerin tablets
and rest. What type of angina does he have?
A. Classic
B. Variant
C. Unstable
D. Prinzmetal's

A. Classic

A patient arrives in the emergency

department with severe chest pain. She says
she has had pain off and on for a week now.
Which assessment finding would indicate the
need for cautious use of nitrates and nitrites?
A. Blood pressure of 98/68 mm Hg
B. History of liver disease
C. History of heart failure
D. History of a myocardial infarction 2 years ago

A. Blood pressure of 98/68 mm Hg

A calcium channel blocker (CCB) is

prescribed for a patient, and the nurse
provides instructions to the patient about the
medication. What does the nurse tell the
patient?
A. The tablet should be chewed for faster release of the
medication.
B. To increase the effect of the drug, take it with grapefruit
juice.
C. If the adverse effects of chest pain, fainting, or dyspnea
occur, discontinue the medication immediately.
D. A high-fiber diet with plenty of fluids will help prevent the
constipation that may occur.

D. A high-fiber diet with plenty of fluids will help

prevent the constipation that may occur.

When applying transdermal nitroglycerin

patches, how will the nurse instruct the patient?
A. "Use any nonhairy area on the body."
B. "Use only the chest area for application sites."
C. "Temporarily remove the patch if you go swimming."
D. "Apply the patch to the same site consistently."

A. "Use any nonhairy area on the

body.

A patient has been taking a beta-blocker for

4 weeks as part of his antianginal therapy.
He also has type II diabetes and
hyperthyroidism. When discussing possible
adverse effects, the nurse should include
which information?
A. "Watch for unusual weight loss."
B. "Monitor your pulse for increased heart rate."
C. "Use the hot tub and sauna at the gym as long as time is
limited to 15 minutes."
D. "Monitor your blood glucose levels for possible
hypoglycemia or hyperglycemia."

D. "Monitor your blood glucose levels for possible

hypoglycemia or hyperglycemia."

What action is recommended to help reduce the

tolerance to transdermal nitroglycerin therapy that
commonly develops?
A. Omit a dose once a week.
B. Leave the patch on for 2 days at a time.
C. Cut the patch in half for a week until the tolerance
subsides.
D. Remove the patch at bedtime, then apply a new one in the
morning.

D. Remove the patch at bedtime,

then apply a new one in the morning.

While assessing a patient who is taking a beta-blocker

for angina, the nurse knows to monitor for which
adverse effect?
A. Nervousness
B. Hypertension
C. Bradycardia
D. Dry cough

C. Bradycardia

A patient is experiencing chest pain while

playing tennis. He has a bottle of sublingual
nitroglycerin with him. Which of the actions
are appropriate for the patient to take at this
time? Select all that apply.
A. Stop the activity and lie down or sit down.
B. Call 911 immediately.
C. Call 911 if the pain is not relieved after taking 1 sublingual
tablet.
D. Call 911 if the pain is not relieved after taking 3 sublingual
tablets in 15 minutes.
E. Place a tablet under the tongue.
F. Place a tablet in the space between the gum and cheek.
G. Take another sublingual tablet if chest pain is not relieved
after 5 minutes, up to three, total.

 A. Stop the activity and lie down or sit down

C. Call 911 if the pain is not relieved after taking 1 sublingual
tablet.
E. Place a tablet under the tongue.
F. Place a tablet in the space between the gum and cheek.
G. Take another sublingual tablet if chest pain is not relieved
after 5 minutes, up to three, total.

When counseling a male patient about the possible

adverse effects of antihypertensive drugs, the nurse
should discuss which potential problem?
A. Impotence
B. Bradycardia
C. Increased libido
D. Increased weight

A. Impotence

Antihypertensive drug therapy for a

newly diagnosed, stage 1 hypertensive
African American patient would most
likely include which drug or drug
classes?
A. Vasodilators alone
B. ACE inhibitors alone
C. Calcium channel blockers with thiazide diuretic
D. Beta-blockers with thiazide diuretic

C. Calcium channel blockers with thiazide diuretic

The nurse is creating a plan of care for

a patient with a new diagnosis of
hypertension. Which is a potential
nursing diagnosis for the patient taking
antihypertensive medications?
A. Diarrhea
B. Sexual dysfunction
C. Stress urinary incontinence
D. Impaired memory

B. Sexual dysfunction

A patient with primary hypertension is

prescribed drug therapy for the first time. The
patient asks how long drug therapy will be
needed. Which answer by the nurse is the
most correct response?
A. "This therapy should take about 3 months."
B. "This therapy should take about a year."
C. "This therapy should go on until your symptoms
disappear."
D. "Therapy for high blood pressure is usually life-long."

D. "Therapy for high blood pressure is usually lifelong."

A patient who has been taking

antihypertensive drugs for a few months
complains of having a persistent dry cough.
The nurse knows that this cough is an
adverse effect of which class of
antihypertensive drugs?
A. Beta-blockers
B. Angiotensin-converting enzyme (ACE) inhibitors
C. Angiotensin-receptor blockers (ARBs)
D. Calcium channel blockers

B. Angiotensin-converting enzyme (ACE) inhibitors

A patient diagnosed with prehypertension has a blood

pressure reading of _____ mm Hg systolic _____ mm
Hg diatolic.
A. less than 120; and less than 80
B. 120 and 139; or 80 and 89
C. 140 and 159; or 90 and 99
D. 160 and 179; or 100 and 109

B. 120 and 139; or 80 and 89

A patient has hypertension along with

type I diabetes mellitus and proteinuria.
The nurse anticipates that a drug from
which drug class will be ordered for its
renal-protective effects?
A. Beta-blockers
B. ACE inhibitors
C. Diuretics
D. Calcium channel blockers

B. ACE inhibitors

The nurse is reviewing the orders for a

patient and notes a new order for an ACE
inhibitor. The nurse checks the current
medication orders, knowing that this drug
class may have a serious interaction with
what other drug class?
A. Calcium channel blockers
B. Diuretics
C. Nonsteroidal antiinflammatory drugs (NSAIDs)
D. Nitrates

C. Nonsteroidal antiinflammatory drugs (NSAIDs)

The nurse should monitor a patient for

signs and symptoms of hyperkalemia if
the patient is taking which of the
following diuretics?
A. hydrochlorothiazide (HydroDIURIL)
B. furosemide (Lasix)
C. metolazone (Zaroxolyn)
D. spironolactone (Aldactone)

D. spironolactone (Aldactone)

Mannitol (Osmitrol) has been ordered

for a patient with acute renal failure.
The nurse knows to administer this
drug using which procedure?
A. Intravenously, through a filter
B. By rapid intravenous bolus
C. By mouth in a single morning dose
D. Through a gravity intravenous drip with standard tubing

A. Intravenously, through a filter

Furosemide (Lasix) is prescribed for a

patient who is about to be discharged,
and the nurse provides instructions to
the patient about the medication.
Which statement by the nurse is
correct?
A. "Keep a weekly journal or log of your weight."
B. "Avoid foods high in potassium, such as bananas,
oranges, fresh vegetables, and dates."
C. "If you experience weight gain, such as five or more
pounds a week, be sure to tell your physician during your
next routine visit."
D. "Be sure to change your position slowly and rise slowly
after sitting or lying so as to prevent dizziness and possible
fainting because of blood pressure changes."

D. "Be sure to change your position slowly and rise slowly after sitting or lying
so as to prevent dizziness and possible fainting because of blood pressure
changes."

When reviewing the mechanisms of action of

diuretics, the nurse knows that which statement is true
about the loop diuretics?
A. They work by inhibiting aldosterone.
B. They are very potent, having a diuretic effect that lasts at
least 6 hours.
C. They are particularly useful when rapid diuresis is desired
because their onset of action is rapid.
D. They have the disadvantage of ceasing to be effective
when the creatinine clearance decreases below 25 mL/min.

C. They are particularly useful when rapid diuresis is

desired because their onset of action is rapid.

When teaching about

hydrochlorothiazide, the nurse should
be sure the patient knows to be
cautious in taking which medications
with hydrochlorothiazide?
A. Digitalis
B. Penicillin
C. Potassium supplements
D. Over-the-counter vitamins

A. Digitalis

When a patient is receiving diuretic therapy, which of

the following would best reflect the patient's fluid
volume status?
A. Blood pressure and pulse
B. Serum potassium and sodium levels
C. Intake, output, and daily weight
D. Measurements of abdominal girth and calf circumference

C. Intake, output, and daily weight

A patient is being discharged to home on a

single daily dose of a diuretic. The health
care provider instructs the patient to take the
dose at which time so it will be least
disruptive to the patient's daily routine?
A. In the morning
B. At noon
C. With supper
D. At bedtime

A. In the morning

A patient is started on a diuretic for

antihypertensive therapy. The nurse
expects that a drug in which of the
following classes is likely to be used
initially?
A. Loop diuretics
B. Osmotic diuretics
C. Thiazide diuretics
D. Vasodilators

C. Thiazide diuretics

A patient in the neurologic intensive care unit

is being treated for cerebral edema and is
given which type of drug to reduce
intracranial pressure?
A. Loop diuretics
B. Osmotic diuretics
C. Thiazide diuretics
D. Vasodilators

B. Osmotic diuretics

A 79-year-old patient is taking a diuretic for

treatment of hypertension. This patient is very
independent and wants to continue to live at home,
despite his diagnosis of mild heart failure. The nurse
will know that which teaching point is important for
this patient?
A. He should take the diuretic with his evening meal.
B. He should skip the diuretic dose if he plans to leave the
house.
C. If he feels dizzy while on this medication, he should stop
taking it and take potassium supplements instead.
D. He should take extra precautions when standing up
because of possible orthostatic hypotension and resulting
injury from falls.

 D. He should take extra precautions when standing up

because of possible orthostatic hypotension and resulting
injury from falls.

A patient on diuretic therapy calls the clinic

because he's had the flu, with "terrible
vomiting and diarrhea," and he has not kept
anything down for 2 days. He feels weak and
extremely tired. What will the nurse advise
this patient?
A. "It's important to try to stay on your prescribed medication.
Try to take it with sips of water."
B. "Stop taking the diuretic for a few days, then restart it
when you feel better."
C. "You will need an increased dosage of the diuretic
because of your illness. Let me speak to the physician."
D. "Please come into the clinic for an evaluation to make
sure there are no complications."

 D. "Please come into the clinic for an evaluation to make

sure there are no complications."

When assessing a patient who is receiving a

loop diuretic, the nurse looks for the
manifestations of potassium deficiency,
which would include which symptoms?
Select all that apply.
A. Dyspnea
B. Constipation
C. Tinnitus
D. Muscle weakness
E. Leg cramps
F. Lethargy

 D. Muscle weakness
E. Leg cramps
F. Lethargy

When reviewing the health history of a

patient, the nurse recalls that
potassium supplements are
contraindicated in patients with a
history of which problem?
A. Burns
B. Diarrhea
C. Renal disease
D. Cardiac tachydysrhythmias

C. Renal disease

The nurse is preparing to administer intravenous

potassium. Which administration technique is correct?
A. The intravenous rate should not exceed 30 mEq/hr.
B. Oral forms should be given on an empty stomach to
maximize absorption.
C. Intravenous solutions should not contain more than 60
mEq/L of potassium.
D. When given intravenously, potassium must always be
given in diluted form.

 D. When given intravenously, potassium must always be

given in diluted form.

When monitoring a patient for signs of

hypokalemia, the nurse looks for what early sign?
A. Seizures
B. Cardiac dysrhythmias
C. Stomach cramps
D. Muscle weakness

D. Muscle weakness

Nicotinic acid is prescribed for a patient

with elevated lipid levels. The nurse
informs the patient that which adverse
effects may occur with this medication?
A. Pruritus, cutaneous flushing
B. Tinnitus, urine with a burnt odor
C. Myalgia, fatigue
D. Blurred vision, headaches

A. Pruritus, cutaneous flushing

A patient reports having adverse

effects with nicotinic acid. The nurse
can suggest that the patient do which
of the following to minimize these
undesirable effects?
A. Take the drug on an empty stomach.
B. Take the medication every other day until these effects
subside.
C. Take small doses of aspirin 30 minutes before taking the
nicotinic acid.
D. Take the drug with large amounts of fiber.

C. Take small doses of aspirin 30 minutes before

taking the nicotinic acid.

A patient calls the clinic office saying that the

cholestyramine powder he started yesterday
clumps and sticks to the glass when he tries
to mix it. The nurse should suggest what
method for mixing this medication for
administration?
A. The powder dissolves faster in a carbonated soda drink.
B. Add it to any liquid and stir vigorously to dissolve it quickly.
C. Mix it with food or fruit such as crushed pineapple, or at
least 4 to 6 ounces of fluid.
D. Sprinkle the powder into a spoon and take it dry, followed
by a glass of water.

C. Mix it with food or fruit such as crushed pineapple,

or at least 4 to 6 ounces of fluid.

A patient is concerned about the adverse

effects of the medication she is taking to
lower her cholesterol level, a fibric acid
derivative. The adverse effects of this class
of medication include which of the following?
A. Constipation
B. Diarrhea
C. Joint pain
D. Dry mouth

B. Diarrhea

While a patient is receiving antilipemic

therapy, the nurse knows to monitor the
patient closely for the development of
which problem?
A. Photosensitivity
B. Pulmonary problems
C. Vitamin C deficiency
D. Liver dysfunction

D. Liver dysfunction

A patient who has recently started therapy

on a statin drug asks the nurse how long it
will take until he sees an effect on his serum
cholesterol. Which of the following would be
the nurse's best response?
A. "Blood levels return to normal within a week of beginning
therapy."
B. "It takes several weeks to see a change in cholesterol
levels."
C. "It takes at least 6 months to see a change in cholesterol
levels."
D. "You will need to take this medication for almost a year to
see significant results."

 B. "It takes several weeks to see a change in cholesterol

levels."

The nurse should monitor for muscle pain and

possible myopathy when a patient is taking which
class of antilipemic drugs?
A. Bile acid sequestrants
B. HMG-CoA reductase inhibitors
C. Fibric acid derivatives
D. Niacin

B. HMG-CoA reductase inhibitors

The nurse is conducting a class about antilipemic

drugs. The newer antilipemic drug ezetimibe (Zetia)
works by which mechanism?
A. Preventing resorption of bile acids from the small
intestines
B. Inhibiting HMG-CoA reductase
C. Activating lipase, which breaks down cholesterol
D. Inhibiting cholesterol absorption in the small intestine

D. Inhibiting cholesterol absorption in the small

intestine

A nurse is monitoring a client with angina for therapeutic

effects of nitroglycerin. Which assessment finding
indicates that the nitroglycerin has been effective?
A) Blood pressure 120/80 mm Hg
B) Heart rate 70 beats per minute
C) ECG without evidence of ST changes
D) Client stating that pain is 0 out of 10

D) Client stating that pain is 0 out of

10

The nurse is monitoring a client during IV nitroglycerin

infusion. Which assessment finding will cause the
nurse to take action?
A) a. Blood pressure 110/90 mm Hg
B) b. Flushing
C) c. Headache
D) d. Chest pain

D) d. Chest pain

Which client assessment would assist the nurse in

evaluating therapeutic effects of a calcium channel
blocker?
A) a. Client states that she has no chest pain.
B) b. Client states that the swelling in her feet is reduced.
C) c. Client states the she does not feel dizzy.
D) d. Client states that she feels stronger.

a. Client states that she has no chest pain.

What will the nurse instruct the client to do to prevent

the development of tolerance to nitroglycerin?
A) a. Apply the nitroglycerin patch every other day.
B) b. Switch to sublingual nitroglycerin when the clients
systolic blood pressure elevates to more than 140 mm Hg.
C) c. Apply the nitroglycerin patch for 14 hours and remove it
for 10 hours at night.
D) d. Use the nitroglycerin patch for acute episodes of
angina only.

 c. Apply the nitroglycerin patch for 14 hours and remove it for

10 hours at night.

The client asks the nurse how nitroglycerin should be

stored while traveling. What is the nurse's best
response?
A) a. You can protect it from heat by placing the bottle in an
ice chest.
B) b. Its best to keep it in its original container away from
heat and light.
C) c. You can put a few tablets in a resealable bag and carry
it in your pocket.
D) d. Its best to lock them in the glove compartment to keep
them away from heat and light.

b. Its best to keep it in its original

container away from heat and light.

Which statement indicates to the nurse that the client

understands sublingual nitroglycerin medication
instructions?
A) a. I will take up to five doses every 3 minutes for chest
pain.
B) b. I can chew the tablet for the quickest effect.
C) c. I will keep the tablets locked in a safe place until I need
them.
D) d. I should sit or lie down after I take a nitroglycerin tablet
to prevent dizziness.

D) d. I should sit or lie down after I take a

nitroglycerin tablet to prevent dizziness.

What instruction should the nurse provide to the

client who needs to apply nitroglycerin ointment?
A) a. Use the fingers to spread the ointment evenly over a 3inch area.
B) b. Apply the ointment to a nonhairy part of the upper torso.
C) c. Massage the ointment into the skin.
D) d. Cover the application paper with ointment before use.

b. Apply the ointment to a nonhairy part of the upper

torso.

A client receiving intravenous nitroglycerin at

20 mcg/min complains of dizziness. Nursing
assessment reveals a blood pressure of
85/40 mm Hg, heart rate of 110 beats/min,
and respiratory rate of 16 breaths/min. What
is the nurse's priority action?
A) a. Assess the clients lung sounds.
B) b. Decrease the intravenous nitroglycerin by 10 mcg/min.
C) c. Stop the nitroglycerin infusion for 1 hour, and then
restart.
D) d. Recheck the clients vital signs in 15 minutes but
continue the infusion.

b. Decrease the intravenous

nitroglycerin by 10 mcg/min.

The nurse is monitoring a client taking digoxin (Lanoxin)

for treatment of heart failure. Which assessment finding
indicates a therapeutic effect of the drug?
A) a. Heart rate 110 beats per minute
B) b. Heart rate 58 beats per minute
C) c. Urinary output 40 mL/hr
D) d. Blood pressure 90/50 mm Hg

b. Heart rate 58 beats per minute

A client's serum digoxin level is drawn, and it is

0.4 ng/mL. What is the nurse's priority action?
A) a. Administer ordered dose of digoxin.
B) b. Hold future digoxin doses.
C) c. Administer potassium.
D) d. Call the health care provider.

a. Administer ordered dose of

digoxin.

Which assessment finding will alert the

nurse to suspect early digitalis toxicity?
A) a. Loss of appetite with slight bradycardia
B) b. Blood pressure 90/60 mm Hg
C) c. Heart rate 110 beats per minute
D) d. Confusion and diarrhea

a. Loss of appetite with slight bradycardia

What must the nurse monitor when titrating

intravenous nitroglycerin for a client? (Select all that
apply.)
A) a. Continuous oxygen saturation
B) b. Continuous blood pressures
C) c. Hourly ECGs
D) d. Presence of chest pain
E) e. Serum nitroglycerin levels
F) f. Visual acuity

 B, D.
Intravenous nitroglycerin can cause hypotension and
tachycardia. Relief of chest pain and systolic blood pressure
<90 mm Hg are typical parameters used for titrating
nitroglycerin. Pulse should also be monitored.

The nurse is assessing a client who is taking

furosemide (Lasix)[potent loop diuretic]. The
client's potassium level is 3.4 mEq/L,
chloride is 90 mmol/L, and sodium is 140
mEq/L. What is the nurse's primary
intervention?
A) a. Mix 40 mEq of potassium in 250 mL D5W and infuse
rapidly.
B) b. Administer Kayexalate.
C) c. Administer 2 mEq potassium chloride per kilogram per
day IV.
D) d. Administer PhosLo, two tablets three times per day.

c. Administer 2 mEq potassium chloride per kilogram

per day IV.

A client taking spironolactone (Aldactone)

[potassium-sparing diuretic] has been taught
about the therapy. Which menu selection
indicates that the client understands
teaching related to this medication?
A) a. Apricots
B) b. Bananas
C) c. Fish
D) d. Strawberries

c. Fish

Which client would the nurse need to assess

first if the client is receiving mannitol (Osmitrol)?
A) a. A 67-year-old client with type 1 diabetes mellitus
B) b. A 21-year-old client with a head injury
C) c. A 47-year-old client with anuria
D) d. A 55-year-old client receiving cisplatin to treat ovarian
cancer

C) c. A 47-year-old client with anuria

A client is ordered furosemide (Lasix)

to be given via intravenous push. What
interventions should the nurse
perform? (Select all that apply.)
A) a. Administer at a rate no faster than 20 mg/min.
B) b. Assess lung sounds before and after administration.
C) c. Assess blood pressure before and after administration.
D) d. Maintain accurate intake and output record.
E) e. Monitor ECG continuously.
F) f. Insert an arterial line for continuous blood pressure
monitoring.

 A,B,C,D
Furosemide (Lasix) can be infused via intravenous push at
the rate of 20 mg/min. Furosemide is a diuretic and will
decrease fluid in alveoli, and assessing lung sounds can help
to determine therapeutic effect. Blood pressure should
decrease with the administration of a diuretic. It is
appropriate to monitor before and after administration. It is
appropriate to monitor intake and output for a client receiving
a diuretic.

A client with hyperaldosteronism is

prescribed spironolactone (Aldactone).
What assessment finding would the
nurse evaluate as a positive outcome?
A) a. Decreased potassium level
B) b. Decreased crackles in the lung bases
C) c. Decreased aldosterone
D) d. Decreased ankle edema

C) c. Decreased aldosterone

A client with acute pulmonary edema receives

furosemide (Lasix). What assessment finding
indicates that the intervention is working?
A) a. Potassium level decreased from 4.5 to 3.5 mEq/L.
B) b. Crackles auscultated in the bases.
C) c. Lungs clear.
D) d. Output 30 mL/hr.

C) c. Lungs clear

Which assessment indicates a

therapeutic effect of mannitol (Osmitrol)?
A) a. Decreased intracranial pressure
B) b. Decreased potassium
C) c. Increased urine osmolality
D) d. Decreased serum osmolality

a. Decreased intracranial pressure

Which intervention will the nurse

perform when monitoring a client
receiving triamterene (Dyrenium)
[potassium-sparing diuretic]?
A) a. Assess urinary output hourly.
B) b. Monitor for side effect of hypoglycemia.
C) c. Assess potassium levels.
D) d. Monitor for Hypernatremia.

c. Assess potassium levels

A nurse is caring for a client who is

taking an angiotensin-converting
enzyme inhibitor and develops a dry,
nonproductive cough. What is the
nurse's priority action?
A) a. Call the health care provider to switch the medication.
B) b. Assess the client for other symptoms of upper
respiratory infection.
C) c. Instruct the client to take antitussive medication until the
symptoms subside.
D) d. Tell the client that the cough will subside in a few days.

A) a. Call the health care provider to switch the

medication.

A client is prescribed a noncardioselective beta1

blocker. What nursing intervention is a priority for this
client?
A) a. Assessment of blood glucose levels
B) b. Respiratory assessment
C) c. Orthostatic blood pressure assessment
D) d. Teaching about potential tachycardia

B) b. Respiratory assessment

Which client will the nurse assess

first?
A) a. The client who has been on beta blockers for 1 day.
B) b. The client who is on a beta blocker and a thiazide
diuretic.
C) c. The client who has stopped taking a beta blocker due to
cost.
D) d. The client who is taking a beta blocker and Lasix
(furosemide)

c. The client who has stopped taking a beta blocker

due to cost.

A calcium channel blocker has been

ordered for a client. Which condition in
the client's history is a contraindication
to this medication?
A) a. Hypokalemia
B) b. Dysrhythmias
C) c. Hypotension
D) d. Increased intracranial pressure

c. Hypotension

Which is a priority nursing diagnosis for a client

taking an antihypertensive medication?
A) a. Alteration in cardiac output related to effects on the
sympathetic nervous system
B) b. Knowledge deficit related to medication regimen
C) c. Fatigue related to side effects of medication
D) d. Alteration in comfort related to nonproductive cough

a. Alteration in cardiac output related to effects

on the sympathetic nervous system

The nurse is reviewing instructions for

a client taking an HMG-CoA reductase
inhibitor (statin). What information is
essential for the nurse to include?
A) a. Take this medication on an empty stomach.
B) b. Take this medication at the same time each day.
C) c. Take this medication with breakfast.
D) d. Take this medication with an antacid.

 B.
Because the liver produces the most cholesterol during the
night, it was previously believed that statin drugs, which work
to decrease this synthesis, should be given during the
evening so that blood levels were highest coinciding with this
production. However, with the prolonged duration of action of
some statin drugs, administration does not have to be
specifically in the evening, but it is important to take them at
approximately the same time every day.

A client is prescribed ezetimibe (Zetia). Which

assessment finding will require immediate action by
the nurse?
A) a. Headache.
B) b. Slight nausea.
C) c. Muscle pain.
D) d. Fatigue.

 C.
Clients who experience severe muscle pain while taking
Ezetimibe (Zetia) need to report the findings right away, as
this may be indicative of a serious problem.

A nurse is caring for a client taking

cholestyramine (Questran). The client
is complaining of constipation. What
will the nurse do?
A) a. Call the health care provider to change the medication.
B) b. Tell the client to skip a dose of the medication.
C) c. Have the client increase fluids and fiber in his diet.
D) d. Administer an enema to the client.

 C.
Cholestyramine is an anion exchange resin that binds to bile
to form an insoluble complex that is excreted. Constipation
can occur and can be treated with conventional therapy,
which includes increasing fluid and fiber in the diet.

The nurse is assessing the client for

possible evidence of digitalis toxicity.
The nurse acknowledges that which is
included in the signs and symptoms for
digitalis toxicity?
a. Pulse (heart) rate of 100 beats/min
b. Pulse of 72 with an irregular rate
c.

Pulse greater than 60 beats/min and irregular rate

d. Pulse below 60 beats/min and irregular rate

d.Pulse below 60 beats/min and irregular rate

The client is also taking a diuretic that

decreases her potassium level. The
nurse expects that a low potassium
level (hypokalemia) could have what
effect on the digoxin?
a. Increase the serum digoxin sensitivity level
b. Decrease the serum digoxin sensitivity level
c.

Not have any effect on the serum digoxin sensitivity level

d. Cause a low average serum digoxin sensitivity level

a.Increase the serum digoxin sensitivity level

When a client first takes a nitrate, the nurse

expects which symptom that often occurs?
a. Nausea and vomiting
b. Headaches
c.

Stomach cramps

d. Irregular pulse rate

b.Headaches

The nurse acknowledges that beta blockers are as

effective as antianginals because they do what?
a. Increase oxygen to the systemic circulation.
b. Maintain heart rate and blood pressure.
c. Decrease heart rate and decrease myocardial
contractility.
d. Decrease heart rate and increase myocardial
contractility.

c. Decrease heart rate and decrease myocardial

contractility.

What would cause the same client's

electrolyte imbalance?
a. High dose of digoxin
b. Digoxin taken daily
c.

Hydrochlorothiazide

d. Low dose of hydrochlorothiazide

c. Hydrochlorothiazide

A nurse is teaching a client who has

diabetes mellitus and is taking
hydrochlorothiazide 50 mg/day. The
teaching should include the importance
of monitoring which levels?
a. Hemoglobin and hematocrit
b. Blood urea nitrogen (BUN)
c.

Arterial blood gases

d. Serum glucose (sugar)

d.Serum glucose (sugar)

A client has heart failure and is prescribed Lasix. The

nurse is aware that furosemide (Lasix) is what kind of
drug?
a. Thiazide diuretic
b. Osmotic diuretic
c.

High-ceiling (loop) diuretic

d. Potassium-sparing diuretic

c. High-ceiling (loop) diuretic

For the client taking a diuretic, a combination

such as triamterene and hydrochlorothiazide
may be prescribed. The nurse realizes that
this combination is ordered for which
purpose?
a. To decrease the serum potassium level
b. To increase the serum potassium level
c.

To decrease the glucose level

d. To increase the glucose level

b.To increase the serum potassium

level

A client who has angina is prescribed nitroglycerin. The nurse reviews

which appropriate nursing interventions for nitroglycerin? (Select all that
apply.)
a. Have client lie down when taking a nitroglycerin sublingual tablet.
b. Teach client to repeat taking a tablet in 5 minutes if chest pain
persists.
c. Apply Transderm-Nitro patch to a hairy area to protect skin from
burning.
d. Call the health care provider after taking 5 tablets if chest pain
persists.
e. Warn client against ingesting alcohol while taking nitroglycerin.

ABE

The nurse acknowledges that the first-line drug for

treating this client's blood pressure might be which
drug?
a. Diuretic
b. Alpha blocker
c.

ACE inhibitor

d. Alpha/beta blocker

a.Diuretic

The nurse is aware that which group(s) of

antihypertensive drugs are less effective in AfricanAmerican clients?
a. Diuretics
b. Calcium channel blockers and vasodilators
c.

Beta blockers and ACE inhibitors

d. Alpha blockers

c. Beta blockers and ACE inhibitors

A client is prescribed losartan (Cozaar).

The nurse teaches the client that an
angiotensin II receptor blocker (ARB)
acts by doing what?
a. Inhibiting angiotensin-converting enzyme
b. Blocking angiotensin II from AT1 receptors
c.

Preventing the release of angiotensin I

d. Promoting the release of aldosterone

b.Blocking angiotensin II from AT1

receptors

During an admission assessment, the client states

that she takes amlodipine (Norvasc). The nurse
wishes to determine whether or not the client has
any common side effects of a calcium channel
blocker. The nurse asks the client if she has which
signs and symptoms? (Select all that apply.)
a. Insomnia
b. Dizziness
c.

Headache

d. Angioedema
e. Ankle edema
f.

Hacking cough

B, C, E

A clients serum lipids are cholesterol 197

mg/dl, low-density lipoprotein (LDL) 110
mg/dl, and
high-density lipoprotein (HDL) 35 mg/dl. The
nurse
knows what about these values?
A. Serum lipids are within desirable values.
B. Cholesterol is within desirable value, but LDL and HDL
are not.
C. Cholesterol is not within desirable value, though LDL and
HDL are.
D. Cholesterol, LDL, and HDL are not within desirable
values.

B. Cholesterol is within desirable value, but LDL and

HDL are not.

A client is prescribed gemfibrozil

(Lopid) for treatment of hyperlipidemia
type IV. What is important for the nurse
to teach the client?
A) a. Take aspirin before the medication if you experience
facial flushing.
B) b. You may experience headaches with this medication.
C) c. You will need to have weekly blood drawn to assess for
hyperkalemia.
D) d. Cholesterol levels will need to be assessed daily for
one week.

b. You may experience headaches

with this medication.

Which statement made by the client indicates

understanding about discharge instructions on
antihyperlipidemic medications?
A) a. Antihyperlipidemic medications will replace the other
interventions I have been doing to try to decrease my
cholesterol.
B) b. It is important to double my dose if I miss one in order
to maintain therapeutic blood levels.
C) c. I will stop taking the medication if it causes nausea and
vomiting.
D) d. I will continue my exercise program to help increase
my high-density lipoprotein serum levels.

D) d. I will continue my exercise program to help

increase my high-density lipoprotein serum levels.

A 70-year-old client who is taking several

cardiac antidysrhythmic medications has
been prescribed simvastatin (Zocor){a
Antihyperlipidemics statin} 80 mg/day. What
is essential information for the nurse to teach
the client?
A) a. This dose may lower your cholesterol too much.
B) b. These factors may put you at higher risk for myopathy.
C) c. You should not take this drug with cardiac
medications.
D) d. This combination will cause you to have nausea and
vomiting.

b. These factors may put you at higher risk for

myopathy.

A client diagnosed with hypercholesterolemia

is prescribed lovastatin (Mevacor){a
Antihyperlipidemics statin}. The nurse is
reviewing the client's history and would
contact the health care provider about which
of these conditions in the client's history?
A) a. Chronic pulmonary disease
B) b. Hepatic disease
C) c. Leukemia
D) d. Renal disease

b. Hepatic disease