Drugs Affecting the Renal/Urinary and Cardiovascular Systems Visovsky: Introduction to Clinical Pharmacology, 10th Edition

1. Which body system works with the renal/urinary system to maintain fluid balance and remove waste products from the body? a. Biliary system b. Cardiovascular system c. CNS d. Gastrointestinal system B. Cardibascular system 2. A patient with newly diagnosed hypertension is prescribed a thiazide diuretic. The patient asks how thiazide diuretic drugs reducehigh blood pressure. What is your best response? a. "Thiazide diuretics reduce blood volume and relax vascular smooth muscle in the arterioles, reducing blood pressure." b. "Thiazide diuretics increase potassium excretion and slow heart contractions, reducing blood pressure." c. "Thiazide diuretics release sodium from cellular storage sites to reduce blood pressure." d. "Thiazide diuretics increase the reabsorption of sodium, potassium and chlorides, reducing blood pressure." a. "Thiazide diuretics reduce blood volume and relax vascular smooth muscle in the arterioles, reducing blood pressure." 3. You are teaching a patient about the side effects of diuretics. Which health problem is a potential side effect or adverse reaction of any class of diuretic drug? a. Dehydration b. Heart failure c. Blurred vision d. Urinary tract infection a. Dehydration 4. A patient has been prescribed furosemide (Lasix) for the treatment of heart failure. Which statement made by the patient indicates the need for more teaching? a. "Since I work at night, I take my drug when I first wake up rather than in the morning." b. "If my hearing decreases, I will notify my healthcare provider." c. "I make sure to space my fluid intake evenly throughout the day." d. "When I travel long distances, I will plan to skip my diuretic that day." d. "When I travel long distances, I will plan to skip my diuretic that day." 5. The LPN is caring for a patient who has recently been prescribed nitrate drug. The patient reports a throbbing headache. Which response is the most appropriate? a. "Throbbing headache is a symptom of an allergic response to the drug." b. "Throbbing headache is a symptom of developing tolerance to the drug." c. "Throbbing headache is a temporary symptom that should disappear within a few weeks." d. "Throbbing headache is a symptom of interaction with your other drugs." c. "Throbbing headache is a temporary symptom that should disappear within a few weeks." 6. Which of the following side effects is seen in patients taking angiotensin-converting enzyme inhibitors but rarely seen in patients taking angiotensin II receptor blockers? a. Orthostatic hypotension b. Cough c. Dizziness d. Hypotension Down B.cough 7. Why is it important to warn a patient prescribed to take finasteride (Proscar) for benign prostatic hyperplasia to wear a condom when having sex with a pregnant woman or one who could become pregnant? a. The drug contains a hormone that can greatly increase the risk for early birth when absorbed by a pregnant woman. b. The drug can be absorbed by the pregnant woman and cause birth defects in the fetus. c. The drug reduces local immunity and increases the risk for transmitting HIV. d. The drug increases the risk for vaginal infections in pregnant women. b. The drug can be absorbed by the pregnant woman and cause birth defects in the fetus. 8. The LPN is obtaining a patient history on a patient who is scheduled to begin treatment with a nitrate drug for the treatment of angina. Which information is most important for the LPN to obtain? a. The patient's future plans to become pregnant b. The patient's past use of recreational drugs c. The patient's sexual history d. The patient's description of anginal pain d. The patient's description of anginal pain 9. A pregnant nurse is scheduled to care for a patient benign prostatic hypertrophy. Which of the following drugs listed here should not be handled by a pregnant nurse? a. Finasteride (Proscar) B b. Oxybutynin (Ditropan) c. Tamsulosin (Flomax) d. Tolterodine (Detrol) a. Finasteride (Proscar) 10. You are teaching a 75-year-old male patient who has angina about nitroglycerine sublingual tablets. Which patient statement indicates an accurate understanding of the correct way to store nitroglycerin? a. "I will need to keep my nitroglycerine in the refrigerator." b. "I can keep my nitroglycerin together with my other pills in my pillbox." c. "I should keep my nitroglycerine in the original container." d. "I should keep my nitroglycerin stored on the kitchen countertop." c. "I should keep my nitroglycerine in the original container." 11. You are caring for a patient with angina in the home who develops chest pain. The patient has a recently filled prescription for sublingual nitroglycerin that has never been taken before. You give the patient the nitroglycerine sublingually to relieve the angina pain. What action should you take until an ambulance arrives? a. Take the patient's blood pressure every 5 minutes. b. Assess the patient's lung sounds. c. Raise the patient's legs above the level of the heart. d. Place the patient in supine position. a. Take the patient's blood pressure every 5 minutes. 12. The LPN/VN is teaching a patient who has had a myocardial infarction (MI) about using sublingual NTG tablets for the onset of chest pain. Which of the following statements by the patient indicates that he or she understands the teaching? a. "I need to chew the NTG tablet thoroughly." b. "I will swallow the pill like all of my other heart pills." c. "I will place the NTG under my tongue when I have chest pain." d. "I can take my NTG with applesauce to disguise the metallic taste." c. "I will place the NTG under my tongue when I have chest pain." 13. The nurse is instructing the patient about a statin drug. Which statement indicates a need for further instruction? a. "I can drink beer only while taking this drug since it has a lower alcohol content." b. "I will need to have my cholesterol checked in 4 to 12 weeks after starting this drug." c. "I will report severe muscle aches or changes in my urine." d. "I will avoid grapefruit juice while taking this drug." a. "I can drink beer only while taking this drug since it has a lower alcohol content." 14. The nurse is caring for a patient who is receiving a loop diuretic for the treatment of heart failure. Which statement indicates that the patient has an accurate understanding of nutritional requirements associated with loop diuretics? a. "I should increase the amount of protein in my diet by eating peanut butter." b. "I should increase the amount of calcium in my diet by eating dairy products." c. "I should increase the amount of fiber in my diet by eating raw vegetables." d. "I should increase the amount of potassium in my diet by eating foods like bananas." d. "I should increase the amount of potassium in my diet by eating foods like bananas." 15. A patient contacts the LPN at the healthcare provider's office and tells the nurse that she forgot to take her daily dose of antihypertensive drug that was due 4 hours ago. How should the nurse advise the patient? a. "Take the next dose of drug at the regularly scheduled time." b. "Double the next regularly scheduled dose of drug." c. "Take the drug with a full glass of orange juice." d. "Take a dose of drug now to avoid a missed dose." d. "Take a dose of drug now to avoid a missed dose." 16. The LPN is obtaining a health history on a 52-year-old male patient who has been receiving treatment with an antihypertensive drug who decided to stop taking the drug. Which question is most important for the nurse to ask the patient? a. "Do you wear a MedicAlert bracelet?" b. "Have you experienced any sexual side effects?" c. "Do you store your drug away from children?" d. "Do you remember to only salt your food after it is cooked?" b. "Have you experienced any sexual side effects?" 17. A patient has been prescribed phenazopyridine as part of treatment for a urinary tract infection. Which manifestation warrants the nurse's immediate intervention? a. Reddish-orange urine b. Vertigo c. Nausea and vomiting d. Yellow sclera d. Yellow sclera 18. A nurse is caring for a patient with a history of coronary artery disease who reports chest pain 6/10. After obtaining the patient's vital signs and giving nitroglycerin, the nurse carefully monitors the patient for which adverse reaction to the drug? a. Tachypnea b. Bradycardia c. Hypotension d. Hypothermia c. Hypotension 19. The nurse is caring for a patient who presents to the emergency department with atrial fibrillation. Once stabilized, she is discharged home with a prescription for an oral calcium channel blocker. Which drug does the nurse anticipate that the healthcare provider will prescribe? a. Metoprolol (Lopressor) b. Verapamil (Calan) c. Quinidine (Quinaglute) d. Disopyramide (Norpace) b. Verapamil (Calan) 20. The home health nurse makes a visit to a patient with chronic heart failure who is receiving digoxin therapy. The nurse obtains the following vital signs: blood pressure 142/92 mm Hg, respirations 26 breaths/min, apical pulse 54 beats/min, and temperature 98.4 F. The patient reports dizziness and weakness. What action should the nurse take next? a. Verify that the patient received the flu vaccine. b. Reassure the patient that these symptoms are expected with digoxin therapy. c. Encourage the patient to get more rest. d. Call the primary healthcare provider and request an order for blood work. d. Call the primary healthcare provider and request an order for blood work. 1. A 62-year-old male patient is in the hospital for an exacerbation related to congestive heart failure (CHF). The patient is taking furosemide (Lasix), a loop diuretic. The nurse is reviewing a nursing care plan for this patient. List the actions the nurse will include for a patient on diuretics. (Select all that apply.) a. Monitor intake and output. b. Weigh every day at the same time. c. Remind to stand up slowly. CONTINUED.....