NSG 318 EXAM 3 QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026

NSG 318 EXAM 3 QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026 acute HF - Answers -heart muscle weakens and enlarges -loses ability to pump blood adequately -compensatory mechanisms fail -lungs/periphery become congested R sided heart failure - Answers blood backs up in periphery -peripheral edema & weight gain L sided heart failure - Answers blood backs up into lungs -pulmonary edema, shortness of breath, dyspnea, cough cardiomegaly is common with - Answers heart failure heart failure nonpharmacologic tx - Answers -limit salt and saturated fat intake (limit to 2g/1tsp/day) -limit/avoid alcohol intake (avoid/1 drink/day) -stop smoking -perform mild exercise -fluid intake (may be dec) Digoxin class - Answers cardiac glycoside digoxin use - Answers HF, a-fib (oral/IV admin) digoxin action - Answers inhibits Na/K+ ATPase; inc cardiac contractility, CO and tissue perfusion digoxin side effects/adverse effects - Answers hypokalemia, blurred/yellow vision, green/yellow halos w toxicity Digoxin contraindications - Answers V-fib, hypokalemia caution w/ acute MI, AV block, HTN, older adults digoxin drug interactions - Answers -Diuretics and cortisone: inc risk for toxicity (diuretics may cause hypokalemia) -Antacids: dec digoxin absorption digoxin CAM interactions - Answers -Ginseng: inc digitalis levels -St. John's wort and psyllium: dec absorption -Hawthorn: inc effects -Licorice, aloe, ephedra: inc risk of toxicity digoxin interventions - Answers -assess apical pulse before administering; DON'T ADMINISTER IF HR 60bpm -advise client to eat foods high in K+ Antidote for digoxin toxicity - Answers digoxin immune FAB digoxin therapeutic serum level - Answers 0.5-1ng/mL digoxin effects on heart muscle - Answers -inc. myocardial contractility and CO -dec. HR and conduction angina - Answers acute cardiac pain caused by inadequate blood flow to myocardium antianginal drugs - Answers -nitrates -beta blockers -Ca channel blockers nitroglycerin class - Answers antianginal (Nitrate) nitroglycerin uses - Answers control angina, acute MI and HF nitroglycerin action - Answers dec myocardial demand for O2 consumption (vasodilator) Nitroglycerin Contraindications - Answers inc intracranial pressure; heat and light dec potency of drug. keep in dark bottle nitroglycerin routes of administration - Answers -SL spray: 1-3min onset. space out over 5mins and call 911 before taking 2nd dose -Topical cream: wipe off old cream 1st (4-8hr duration) -Transdermal: leave off for 12hrs to give break nitroglycerin side effects/adverse effects - Answers CNS effects, syncope, tolerance, GI distress, circulatory collapse nitroglycerin drug interactions - Answers -alcohol, beta blockers, Ca channel blockers, antihypertensives, Aspirin, benzos, vasodilators: inc effect -heparin: dec effect nitroglycerin CAM interactions - Answers -Hawthorn: inc. levels nitroglycerin interventions - Answers -for SL spray, call 911 if 1st dose doesn't work -proper storage of tabs -administer SL tab if chest pain occurs Atenolol class - Answers beta 1 adrenergic blocker atenolol use - Answers tx of hypertension, prophylaxis, and acute MI atenolol action - Answers blocks beta 1 adrenergic receptor sites (NE and Epinephrine), depress SNS, suppress RAAS, dec workload and O2 demands of heart what ethnicity may beta blockers not work for - Answers African Americans (unless paired with diuretics) Atenolol contraindications - Answers sinus bradycardia, heart block, pulm edema, bronchospasm, pregnancy atenolol drug interactions - Answers -Atropine/anticholinergics: inc absorption -NSAIDs: dec effects -Insulin and sulfonylureas: inc risk of hypoglycemia Atenolol side effects/adverse effects - Answers ED, CNS effects, GI distress, cool extremities, hypotension, bradycardia, dyspnea, bronchospasm, thrombocytopenia atenolol interventions - Answers -teach pt to not stop taking abruptly to avoid rebound HTN (wean off 1-2 weeks) -warn male clients of dose related ED -assist with ambulation (ortho hypotension) Diltiazem class - Answers calcium channel blocker diltiazem use - Answers tx hypertension and atrial dysrhythmias (brings more O2 to myocardium and dec cardiac workload) diltiazem action - Answers inhibits transport of Ca ions to myocardial cells Diltiazem Contraindications - Answers hypotension, AV heart block, bleeding aneurysm diltiazem drug interactions - Answers -Digoxin/beta blockers: partial/complete heart block, HF, or dysrhythmias -Digoxin: inc digoxin levels -Beta blockers/antihypertensives: cause hypotension diltiazem CAM interactions - Answers -St. Johns and ginseng: dec effectiveness -Garlic and hawthorn: inc hypotensive effect diltiazem side effects - Answers CNS effects, edema of ankles/feet, bradycardia, hypotension abrupt withdrawal may cause acute angina episode diltiazem overdose - Answers -atropine reverses bradycardia -CaCl can reverse hypotension or heart block diltiazem interventions - Answers -avoid use of extended release in elderly (promotes fluid retention and exacerbates HF) -Monitor BP and HR and EKG -Monitor digoxin levels Hydrochlorothiazide class - Answers thiazide hydrochlorothiazide uses - Answers inc urine output and tx hypertension, edema, HF, nephrotic syndrome, and ascites hydrochlorothiazide action - Answers excretion of Na and H2O by inhibiting Na reabsorption in distal tubule. promotes excretion of Na, Cl and H2O. dec BP and edema hydrochlorothiazide contraindications - Answers renal failure, hypersensitivity caution w/ gout and hypotension hydrochlorothiazide side effects/adverse effects - Answers CNS and GI effects, hypotension, hyperglycemia, photosensitivity, blurred vision, gout, Steven Johnson hydrochlorothiazide drug interactions - Answers -inc digitalis toxicity if hypokalemia present -Aspirin: inc renal toxicity -Steroids: inc K+ loss -Antidiabetics: dec effects -NSAIDs: dec absorption of thiazides hydrochlorothiazide CAM interactions - Answers -Aloe: dec serum K+ level -Gingko: inc BP -Licorice: inc K+ loss -Hawthorn: potentiate hypotension hydrochlorothiazide interventions - Answers -assess daily weight (concerning if 2.2lbs gained in one day- kidney failure) -assess I&Os -teach pt. to take in AM to avoid sleep disturbances from nocturia -observe for hypokalemia furosemide class - Answers loop diuretic furosemide use - Answers tx HF, renal dysfunction, hypertension, nephrotic syndrome, acute pulmonary and peripheral edema furosemide action - Answers inhibits reabsorption of Na and H2O in the loop of Henle and distal renal tubules. K+, Mg, and Ca may be excreted Furosemide Contraindications - Answers hypovolemia, severe electrolyte imbalance, anuria, hepatic coma, hypersensitivity to sulfa drugs caution w patients w hearing impairment Furosemide Side effects/Adverse reactions - Answers CNS and GI effects, hyperglycemia, blurred vision, hyperuricemia, hypokalemia, hyponatremia, hypomagnesemia, HEARING LOSS Furosemide drug interactions - Answers -Alcohol: inc orthostatic hypotension -Aminoglycosides: inc ototoxicity -Steroids: inc K+ loss -Digoxin and hypokalemia: inc digitalis toxicity and cardiac dysrhythmias furosemide CAM interactions - Answers -Licorice: inc K+ loss -Hawthorne: potentiate hypotension -Ginseng: dec action of loop diuretics furosemide interventions - Answers -VERY potent drug -Admin IV slowly (to avoid hearing loss) -Monitor K+ levels (especially pt taking digoxin) -Consume foods high in K+ Spironolactone class - Answers potassium sparing diuretic Spironolactone use - Answers tx hypokalemia, acne, peripheral/pulmonary edema, circulatory overload, hypertension, HF spironolactone action - Answers acts on distal renal tubules to promote Na and H2O excretion and K+ retention does spironolactone deplete K+ - Answers No, it holds on to it and can cause hyperkalemia. shouldn't be combined with other drugs/foods that can inc K+ level spironolactone contraindications - Answers renal failure, hyperkalemia caution w renal/hepatic dysfunction spironolactone drug interactions - Answers -K+ supplements: inc serum K+ -inc effects of anti-hypertensives and lithium -ACE inhibitor: hyperkalemia (life threatening) spironolactone side effects - Answers CNS and GI effects, muscle cramps, severe hyperkalemia, thrombocytopenia, hepatotoxicity, Stevens Johnson spironolactone interventions - Answers -advise pt with high serum K+ levels to avoid foods high in K+ -administer in AM to avoid nocturia -observe for hyperkalemia -monitor urinary output -don't take OTC K+ diuretics CAMS that dec BP - Answers -Hawthorne -Parsley -Licorice -Goldenseal CAMS that inc BP - Answers -Gingko -Ephedra CAMS that dec K+ - Answers -Licorice -Aloe nonpharmacologic therapy of hypertension - Answers -stress reduction techniques -exercise -salt restriction -dec alcohol ingestion -smoking cessation how long are antihypertensives taken - Answers BP meds are likely to be taken for the rest of the patient's life Metoprolol class - Answers beta-1 blocker metoprolol use - Answers control hypertension, acute MI, angina, and HF metoprolol action - Answers promotes BP reduction via beta 1 blocking effects by also dec pulse Metoprolol Contraindications - Answers heart block, cardiogenic shock, hypotension, acute HF, bradycardia caution w hepatic/thyroid dysfunction, asthma, PVD, DM, COPD, cerebrovascular disease metoprolol side effects/adverse reactions - Answers CNS and GI effects, dry mouth, blurred vision, insomnia, tinnitus, ED Bradycardia, hypotension, stroke, thrombocytopenia, DM, AV heart block, bronchospasm, HF metoprolol interventions - Answers -don't stop abruptly (rebound hypertension) -monitor BUN, serum creatinine, AST, and LDL -teach pt they will probably be taking this for the rest of their life prazosin hydrochloride class - Answers alpha adrenergic blocker prazosin hydrochloride use - Answers control hypertension prazosin hydrochloride action - Answers dilates peripheral blood vessels by blocking alpha adrenergic receptors prazosin hydrochloride contraindications - Answers caution: priapism, angina, ortho hypotension, syncope, ocular surgery, pregnancy prazosin hydrochloride side effects/adverse reactions - Answers CNS and GI effects, tinnitus, dry mouth, peripheral edema, ED, urinary incontinence, palpitations, pancreatitis, elevated liver enzymes prazosin hydrochloride drug interactions - Answers -Antihypertensives, Nitrates, Diuretics, and alcohol: inc hypotensive effects -NSAIDs: dec effects prazosin hydrochloride interventions - Answers -monitor urine output (less than 600mL is concerning-renal failure) -observe for rebound hypertension if abruptly stopped -do not take OTC cold, cough, or allergy meds without consulting with HCP -dec salt intake lisinopril class - Answers ACE inhibitor lisinopril use - Answers tx hypertension lisinopril action - Answers inhibits formation of angiotensin 2 and blocks release of aldosterone lisinopril contraindications - Answers hyperkalemia and pregnancy lisinopril should not be combined with ________ because it can cause hyperkalemia - Answers spironolactone lisinopril side effects/adverse reactions - Answers cough, CNS effects, orthostatic hypotension, angioedema lisinopril drug interactions - Answers -NSAIDs: dec antihypertensive act. -K+ sparing diuretics: hyperkalemia lisinopril food interactions - Answers -excessive intake of foods rich in K+ and K+ based salt substitutes: hyperkalemia lisinopril interventions - Answers -assess BP before admin valsartan class - Answers Angiotensin II Receptor Blocker (ARBs) valsartan use - Answers tx of hypertension and HF valsartan action - Answers potent vasodilator that inhibits binding of angiotensin II valsartan contraindications - Answers -black box warning for pregnancy caution w renal/hepatic impairments, hypotension, HF, hypovolemia, hyperkalemia valsartan drug interaction - Answers -Anti-hypertensives, diuretics, MAOIs, and alc: may inc hypotensive effects -ACE inhibitors and aspirin: may inc hyperkalemia and renal dysfunction -Digoxin and NSAIDs: may inc renal dusfunction valsartan side effects/adverse reactions - Answers CNS effects, palpitations, abdominal and back pain, arthralgia, ED, hyperkalemia, Rhabdomyolysis, neutropenia anticoagulants - Answers -Prevent the formation of new clots -don't dissolve clots -used in pt. with venous and arterial disorders antiplatelets (antithrombotics) - Answers prevent platelet aggregation (prevent thrombosis in arteries) -mainly for prophylactic use to: prevent MI/stroke for clients with family hx prevent repeat MI/stroke prevent stroke for clients having TIAs thrombolytics - Answers clot busters converts plasminogen to plasmin and destroys fibrin in clot a thrombosis/clot disintegrates when a thrombolytic drug is administered- ideally: - Answers -within 3-4hrs or within 30mins of arrival at hospital for acute MI -within 3hrs of thrombolytic stroke heparin class - Answers Anticoagulant heparin uses - Answers prevent thrombosis associated w/ PE, MI, unstable angina, prosthetic heart valves, DVT, treats DIC heparin action - Answers inhibits thrombin which prevents conversion of fibrinogen to fibrin heparin route - Answers IV: acute thrombosis SQ: prophylactically heparin 1/2 life - Answers 1-5hrs heparin contraindications - Answers bleeding disorders caution w head trauma, peptic ulcer, hemophilia, DIC, diverticulitis heparin drug interactions - Answers -Aspirin, NSAIDs, thrombolytics, antibiotics, SSRIs: inc effects of heparin -Nitroglycerin, protamine sulfate: dec effects of heparin antidote for heparin OD - Answers protamine sulfate heparin side effects/adverse reactions - Answers priapism, hematoma, hemorrhage, heparin induced thrombocytopenia heparin interventions - Answers -monitor PTT before admin -monitor platelet counts -monitor for signs of bleeding -keep antidote AVAILABLE warfarin class - Answers Anticoagulant