NURS 2474 RASMUSSEN FINAL
EXAM TESTBANK 150
QUESTIONS AND ANSWERS
Part B
101. A patient is taking a calcium channel blocker (CCB) for stable angina.
The patient's spouse asks how calcium channel blockers relieve pain. The
nurse will explain that CCBs:
a. help relax peripheral arterioles to reduce afterload.
b. improve coronary artery perfusion.c. increase the heart rate to improve
myocardial contractility. d. increase the QT interval.
a. help relax peripheral arterioles to reduce afterload.
*Calcium channel blockers (CCBs) work by blocking the influx of calcium
ions into smooth muscle cells in blood vessels and the heart that helps
relax peripheral arterioles, leading to vasodilation.
102. A patient with stable exertional angina has been receiving a beta
blocker. Before giving the drug, the nurse notes a resting heart rate of 55
beats per minute. Which is an appropriate nursing action?
a. Administer the drug as ordered, because this is a desired effect.
b. Withhold the dose and notify the provider of the heart rate.
c. Request an order for a lower dose of the medication.
d. Request an order to change to another antianginal medication.
b. Withhold the dose and notify the provider of the heart rate.
,*less than 60 bpm or systolic less than 100, hold beta-blocker and notify
provider.
103. A nurse provides teaching to a patient with angina who also has type
2 diabetes mellitus, asthma, and hypertension. Which statement by the
patient indicates a need for further teaching?
a. "An ACE inhibitor, in addition to nitroglycerin, will lower my risk of
cardiovascular death."
b. "Beta blockers can help control hypertension."
c. "I should begin regular aerobic exercise."
d. "Long-acting, slow-release calcium channel blockers can help with
anginal pain."
b. "Beta blockers can help control hypertension."
*contraindicated in patients with asthma, because they cause
bronchoconstriction.
104. A patient with atrial fibrillation is receiving warfarin (Coumadin). The
nurse notes that the patient's INR is 2.7. Before to giving the next dose of
warfarin, the nurse will notify the provider and:
a. administer the dose as ordered.
b. request an order to decrease the dose.
c. request an order to give vitamin K (phytonadione).
d. request an order to increase the dose.
a. administer the dose as ordered.
*therapeutic range is 2.0-3.0
,105. A patient who takes warfarin for atrial fibrillation undergoes hip
replacement surgery. On the second postoperative day, the nurse
assesses the patient and notes an oxygen saturation of 83%, pleuritic
chest pain, shortness of breath, and hemoptysis. The nurse will contact
the provider to report possible _____ and request an order for _____.
a. congestive heart failure furosemide (Lasix)
b. hemorrhage vitamin K (phytonadione)
c. myocardial infarction tissue plasminogen activator (tPA) d. pulmonary
embolism heparin
d. pulmonary embolism heparin
*Symptoms of a PE are shortness of breath, low O2 saturation, especially
after surgery. Heparin is fast acting.
106. A patient who takes warfarin (Coumadin) is brought to the
emergency department after accidentally taking too much warfarin. The
patient's heart rate is 78 beats per minute and the blood pressure is
120/80 mm Hg. A dipstick urinalysis is normal. The patient does not have
any obvious hematoma or petechiae and does not complain of pain. The
nurse will anticipate an order for:
a. vitamin K (phytonadione).
b. protamine sulfate.
c. a PTT.
d. a PT and an INR.
d. a PT and an INR.
*there are no signs of bleeding as of now to indicate the Vitamin K
reversal is needed.
, 107. A patient who has taken warfarin (Coumadin) for a year begins taking
carbamazepine. The nurse will anticipate an order to:
a. decrease the dose of carbamazepine.
b. increase the dose of warfarin.
c. perform more frequent aPTT monitoring.
d. provide extra dietary vitamin K.
a. decrease the dose of carbamazepine.
*Carbamazepine is known to induce the cytochrome P450 enzyme system,
which can increase the metabolism of warfarin and reduce its
effectiveness. As a result, the patient's INR may decrease, leading to a
decreased anticoagulant effect of warfarin.
108. A patient who is taking warfarin (Coumadin) has just vomited blood.
The nurse notifies the provider, who orders lab work revealing a PT of 42
seconds and an INR of 3.5. The nurse will expect to administer:
a. phytonadione (vitamin K1) 1 mg IV over 1 hour.
b. phytonadione (vitamin K1) 2.5 mg PO.
c. protamine sulfate 20 mg PO.
d. protamine sulfate 20 mg slow IV push.
a. phytonadione (vitamin K1) 1 mg IV over 1 hour.
*IV ordered for rapid acting over the PO option since there are signs of
bleeding and an elevated INR.
109. A patient who has chronic adrenal insufficiency is admitted to the
hospital for an open cholecystectomy. The nurse obtaining the admission
EXAM TESTBANK 150
QUESTIONS AND ANSWERS
Part B
101. A patient is taking a calcium channel blocker (CCB) for stable angina.
The patient's spouse asks how calcium channel blockers relieve pain. The
nurse will explain that CCBs:
a. help relax peripheral arterioles to reduce afterload.
b. improve coronary artery perfusion.c. increase the heart rate to improve
myocardial contractility. d. increase the QT interval.
a. help relax peripheral arterioles to reduce afterload.
*Calcium channel blockers (CCBs) work by blocking the influx of calcium
ions into smooth muscle cells in blood vessels and the heart that helps
relax peripheral arterioles, leading to vasodilation.
102. A patient with stable exertional angina has been receiving a beta
blocker. Before giving the drug, the nurse notes a resting heart rate of 55
beats per minute. Which is an appropriate nursing action?
a. Administer the drug as ordered, because this is a desired effect.
b. Withhold the dose and notify the provider of the heart rate.
c. Request an order for a lower dose of the medication.
d. Request an order to change to another antianginal medication.
b. Withhold the dose and notify the provider of the heart rate.
,*less than 60 bpm or systolic less than 100, hold beta-blocker and notify
provider.
103. A nurse provides teaching to a patient with angina who also has type
2 diabetes mellitus, asthma, and hypertension. Which statement by the
patient indicates a need for further teaching?
a. "An ACE inhibitor, in addition to nitroglycerin, will lower my risk of
cardiovascular death."
b. "Beta blockers can help control hypertension."
c. "I should begin regular aerobic exercise."
d. "Long-acting, slow-release calcium channel blockers can help with
anginal pain."
b. "Beta blockers can help control hypertension."
*contraindicated in patients with asthma, because they cause
bronchoconstriction.
104. A patient with atrial fibrillation is receiving warfarin (Coumadin). The
nurse notes that the patient's INR is 2.7. Before to giving the next dose of
warfarin, the nurse will notify the provider and:
a. administer the dose as ordered.
b. request an order to decrease the dose.
c. request an order to give vitamin K (phytonadione).
d. request an order to increase the dose.
a. administer the dose as ordered.
*therapeutic range is 2.0-3.0
,105. A patient who takes warfarin for atrial fibrillation undergoes hip
replacement surgery. On the second postoperative day, the nurse
assesses the patient and notes an oxygen saturation of 83%, pleuritic
chest pain, shortness of breath, and hemoptysis. The nurse will contact
the provider to report possible _____ and request an order for _____.
a. congestive heart failure furosemide (Lasix)
b. hemorrhage vitamin K (phytonadione)
c. myocardial infarction tissue plasminogen activator (tPA) d. pulmonary
embolism heparin
d. pulmonary embolism heparin
*Symptoms of a PE are shortness of breath, low O2 saturation, especially
after surgery. Heparin is fast acting.
106. A patient who takes warfarin (Coumadin) is brought to the
emergency department after accidentally taking too much warfarin. The
patient's heart rate is 78 beats per minute and the blood pressure is
120/80 mm Hg. A dipstick urinalysis is normal. The patient does not have
any obvious hematoma or petechiae and does not complain of pain. The
nurse will anticipate an order for:
a. vitamin K (phytonadione).
b. protamine sulfate.
c. a PTT.
d. a PT and an INR.
d. a PT and an INR.
*there are no signs of bleeding as of now to indicate the Vitamin K
reversal is needed.
, 107. A patient who has taken warfarin (Coumadin) for a year begins taking
carbamazepine. The nurse will anticipate an order to:
a. decrease the dose of carbamazepine.
b. increase the dose of warfarin.
c. perform more frequent aPTT monitoring.
d. provide extra dietary vitamin K.
a. decrease the dose of carbamazepine.
*Carbamazepine is known to induce the cytochrome P450 enzyme system,
which can increase the metabolism of warfarin and reduce its
effectiveness. As a result, the patient's INR may decrease, leading to a
decreased anticoagulant effect of warfarin.
108. A patient who is taking warfarin (Coumadin) has just vomited blood.
The nurse notifies the provider, who orders lab work revealing a PT of 42
seconds and an INR of 3.5. The nurse will expect to administer:
a. phytonadione (vitamin K1) 1 mg IV over 1 hour.
b. phytonadione (vitamin K1) 2.5 mg PO.
c. protamine sulfate 20 mg PO.
d. protamine sulfate 20 mg slow IV push.
a. phytonadione (vitamin K1) 1 mg IV over 1 hour.
*IV ordered for rapid acting over the PO option since there are signs of
bleeding and an elevated INR.
109. A patient who has chronic adrenal insufficiency is admitted to the
hospital for an open cholecystectomy. The nurse obtaining the admission
