{NGN} HESI Pharmacology Exit Exam Quiz Bank 2023/2024 281 questions with complete solutions

Assess AP for a full minute; if its below 60 or above 100 then hold the drug. correct answer: What do you do before administering Digoxin? Postive & negative correct answer: Digoxin has a _______ inotrope &_________ chronotrope. Positive inotrope correct answer: increases force of contraction Negative chronotrope correct answer: decreases HR Digoxin toxicity correct answer: Lasix can cause hypokalemia, which can lead to what toxicity? dig toxicity correct answer: A client with longterm hx use of digoxin and lasix can create a high risk of what? 0.5 - 2 ng/mL correct answer: What is the normal range for digoxin? 3.5 - 5.0 mEq/L correct answer: What is the normal level for potassium? potassium and magnesium correct answer: What 2 electrolyte deficiency would cause a increase risk for digoxin toxicity? Anorexia, bradycardia, HA, dizziness, confusion, nausea, and visual disturbances (blurred vision, yellow vision, and/or halo vision). correct answer: What are the S/S of digoxin toxicity? HTN correct answer: Labetalol is a beta blocker used to tx what condition? Notify the prescriber for the low pulse (bradycardia) and do not give the med. correct answer: Patient is about to be administered Labetalol for HTN. The nurse checks the patient's pulse and it is below 60. What step does the nurse take next? Weight gain (fluid retention); Monitor patient's weight daily. 1 kg = 2.2 lb = 1,000 mL fluid gain or loss in 24 hours. correct answer: Major SE of labetalol? How do you assess for this? Chest Pain correct answer: Nitroglycerin transdermal patch is for tx of..... at bedtime to allow 8 hours without patch ( can produce tolerance in 24 hours) correct answer: When do you remove the nitroglycerin patch? patient may use SL nitro when wearing patch if patient having chest pain. correct answer: A patient who is prescribed the nitroglycerin patch for angina is still continuing to have chest pain. What is a nursing consideration for this? B/c it can cause severe vasodilation, decrease in BP, & intense HA. correct answer: Why wear gloves when applying a nitroglycerin patch? They can take APAP for the HA. correct answer: What can a patient take if experiencing a HA while taking nitroglycerin? decrease rate of nitro drip correct answer: Pt. in CCU/ICU on nitro drip; becomes hypotensive, what does the nurse do? Yes b/c nitrates cause hypotension. correct answer: is it OK to give nitroglycerin to a patient who is hypertensive?) blood vessels; blood vessels & heart correct answer: CCB "dipines" affect the ______ only. While CCBs Verapamil & diltiazem affects the _________ & ________. vasodilation correct answer: CCBs "dipines" causes ? vasoconstriction correct answer: CCBs Verapamil & diltiazem causes? dizziness, facial flushing, hypotension, edema, constipation correct answer: SE of CCBs Monitor HR, BP. Avoid grapefruit juice. correct answer: Nursing considerations CCBs HTN correct answer: Aliskiren (Tekturna) is a direct renin inhibitor that tx for? 1. Don't take if pregnant (Stop drug is become pregnant). 2. Don't take with high fat meal. 3. May increase potassium so don't take with other drugs that increase potassium. correct answer: Teaching for Aliskiren (Tekturna)? pulmonary edema correct answer: Lasix is a loop diuretic that used for rapid diuresis in emergencies. It tx for.... Asses for muscle cramps, and muscle weakness. correct answer: Lasix may produce hypokalemia. How do you assess for this? Hypokalemia, hypotension, F/E abnormalities, and dehydration, dizziness, HA, tinnitus, N/V/D, hypokalemia, ototoxicity with aminoglycosides (-mycin). correct answer: SE of lasix 1. Avoid taking lasix with aminoglycosides due to potential risk of ototoxicity. 2. Pt may need to be potassium supplements. correct answer: Lasix nursing considerations. Dried fruits, fish, leafy veggies, squash, beans, meats, nuts, bananas, potatoes, dairy products. correct answer: Foods containing potassium.... 1. assess overall condition of the veins. Use large vein, like antecubital (AC) vein when administering potassium. 2. Venous access is important because IV potassium can irritate the vein. 3. Have patient notify nurse immediately if burning at site. IV K+ extravasation can cause necrosis of tissues. 4. Calculate and set the rate as ordered, know anticipated duration of therapy. 5. Know restrictions imposed by patient's history. 6. Don't give IV push; use at a rate no greater than 10 mEq/hr for peripheral IV and 20 mEq/hr for central line. Always use infusion pump. 7. Assess IV site every hour. 8. Treatment of hypokalemia adults IV: 10-20 mEq/dose (maximum 40 mEq/dose) to infuse over 2-3 hr (maximum infusion rate: 40mEq/hr) correct answer: IV potassium KCL nursing considerations Elderly correct answer: Antihypertensive effects are more pronounced in the ACE inhibitors (-pril), aldosterone antagonists (-one), direct renin inhibitor Aliskiren (Tekturna) correct answer: Which antihypertensives will raise potassium? Osmitrol (Mannitol) correct answer: This Osmotic diuretic effectiveness is determined by ↓ ICP. NOT used for peripheral edema; used to treat pt. with closed head injury; effective response is decreased ICP. Potassium Sparing Diuretics correct answer: Spironolactone (Aldactone), amiloride (Midamor); triamterene (Dyrenium) are all in what class of drugs? potassium-sparing diuretic correct answer: this class of diuretics can cause ↑K+. Blocks receptors for aldosterone. Inhibits sodium and water reabsorption. Teach: Take in a.m. (diuretics in the morning if possible); avoid salt substitutes, ACE inhibitors, ARBs. Often taken with other (thiazide) diuretics to treat edema, hypertension, heart failure. Can be taken with other meds that lower K+. atorvastatin (lipitor), rosuvastatin (Crestor), fluvastatin, lovastatin, simvastatin, pravastatin. correct answer: Statin drugs include.... HDL should increase; LDL and total cholesterol decrease. correct answer: How do you evaluate effectiveness of statin drugs? Check LFTs due to risk of hepatotoxicity risk & CK for any c/o of muscle pain. correct answer: What labs should be routinely checked during Statin therapy? 1.) Take lovastatin with evening meals. 2.) All other statins can be taken without regards to meals. 3.) Dosing in the evenings is preferred for all satins. 4.) Take with at least 6 oz. of water. 5.) Take with food to decrease GI distress. 6.) Avoid alcohol 7.) Avoid foods that are high in fats 8.) Increase fiber in diet due to constipation SE. correct answer: Statin Teaching diet. Vasoconstriction correct answer: Alpha 1 stimulation causes heart ("1 heart") correct answer: Beta 1 causes stimulation of the lungs ("2 lungs") correct answer: Beta 2 causes stimulation of the Mydriatics correct answer: agents used to produce dilation of pupils for eye exams and ocular surgery Tamsulosin (Flomax) correct answer: alpha1 adrenergic blocker; ↓ smooth muscle contraction of prostate capsule and bladder neck. Used for treating sx of BPH. Antihypertensives correct answer: Alpha 1 blockers -zosin have what kind of indication? 1) dopaminergic activation; 2) Shock; 3) renal correct answer: The effects of ___(1)___ activation causes dilation of the renal vasculature; this effect is exploited in the treatment of ___(2)___; by dilating ___(3)___ blood vessels, we can improve renal perfusion and can thereby reduce the risk of renal failure. Dopamine correct answer: Which drug is the only drug available that can activate dopamine receptors? Cardiac performance (because it actives beta1 receptors in the heart.) correct answer: When dopamine is given to treat shock, the drug also enhances? why? epinephrine, norepinephrine, dopamine, dobutamine, etc.) correct answer: What are some names Catecholamines drugs? Extravasation correct answer: Catecholamines must be watched carefully for what? 1) sloughing 2) necrosis 3) infiltrated 4) saline 5) hypodermic 6) hyperemic 7) 12 hours correct answer: The FDA has this to say about treating dopamine extravasation: To prevent ___(1)___ and ___(2)___ in ischemic areas, the area should be ___(3)___ as soon as possible with 10 to 15 mL of ___(4)___ solution containing 5 to 10 mg of Regitine (brand of phentolamine), an adrenergic blocking agent. A syringe with a fine ___(5)___ needle should be used, and the solution liberally infiltrated throughout the ischemic area. Sympathetic blockade with phentolamine causes immediate and conspicuous local ___(6)___ changes if the area is infiltrated within ___(7)___ hours. Therefore, phentolamine should be given as soon as possible after the extravastation is noted. Epi-Pen correct answer: This Epinephrine Auto Injector is a single dose of epinephrine that can be injected (IM) into the middle of the outer thigh (even through clothes). Seek emergency medical treatment immediately. increase in heart rate, stronger or irregular heartbeat, sweating, nausea or vomiting, difficulty breathing, paleness, dizziness, weakness, shakiness, headache, apprehension, nervousness or anxiety. correct answer: SE of Epi-Pen (Epinephrine Auto Injector): *These side effects may go away if patient rests.* Sympathomimetic correct answer: Remember that many decongestants and bronchodilators have _________ effects (adrenergic effects). SE include ↑ HR, nervousness, insomnia, etc. β1 correct answer: Bronchodilators that stimulate β2 receptors can also stimulate _______ if dose is high enough (loses selectivity). 1) Teach how to avoid bleeding: soft toothbrush, electric razor, don't go without shoes, etc.; 2) Teaching maintain vitamin K foods (greens- spinach, mustard greens, swiss chard, etc.) in diet (don't increase or decrease); 3) PT/INR monitored routinely 4) avoid activities that may cause bleeding. correct answer: Patient is discharged on warfarin (Coumadin), what are some teaching instructions for the patient?