Pathophysiology and Pharmacology
Final Practice Questions (ATI/Test/Quiz)
A patient is admitted to the intensive care unit with increased intracranial pressure. The
nurse would anticipate administering
A.furosemide.
B.mannitol.
C.triamterene.
D.spironolactone - answersANS: B
Osmotic diuretics such as mannitol (Osmitrol) increase the osmolality and sodium
reabsorption in the proximal tubule and loop of Henle. Sodium, chloride, potassium, and
water are excreted. This group of drugs is used to prevent kidney failure, to decrease
intracranial pressure, and to decrease intraocular pressure. Mannitol is a potent osmotic
potassium-wasting diuretic frequently used in emergency situations such as ICP and
IOP.
Which statement about aldosterone does the nurse identify as being true? Aldosterone
•
A.promotes sodium excretion.
B.is a mineralocorticoid hormone.
C.promotes potassium retention.
D.is secreted by the pancreas. - answersANS: B
Aldosterone is a mineralocorticoid hormone that promotes sodium retention, and
potassium excretion. is not secreted by the pancreas.
A patient with chronic glaucoma is most likely to receive which drug?
A.A thiazide diuretic
B.A loop diuretic
C.A potassium-sparing diuretic
D.A carbonic anhydrase inhibitor - answersANS: D
Carbonic anhydrase inhibitors are primarily used to decrease IOP in patients with open-
angle (chronic) glaucoma. Thiazides and loop diuretics are used to treat hypertension
,and peripheral edema. Potassium-sparing diuretics are used as mild diuretics in
combination with other diuretics.
A patient's serum lipids are cholesterol 197 mg/dL, low-density lipoprotein (LDL) 110
mg/dL, and high-density lipoprotein (HDL) 35 mg/dL. What does the nurse know 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. - answersANS: B
The normal range for cholesterol is 150 to 200. The normal range for LDL is less than
100. The normal range for HDL is 45 to 60.
A nurse who is administering atorvastatin calcium realizes the importance of monitoring
for which serious adverse reaction?
A.Pharyngitis
B.Rash/pruritus
C.Rhabdomyolysis
D.Agranulocytosis - answersANS: C
Serious adverse reactions of atorvastatin include rhabdomyolysis, myalgia,
photosensitivity, and cataracts. Less serious side effects include headache, rash,
pruritus, constipation, diarrhea, sinusitis, and pharyngitis.
A patient is receiving medication therapy for peripheral vascular disease. Which
medication does the nurse identify as an antiplatelet drug?
A.Cilostazol
B.Papaverine
C.Prazosin
D.Nifedipine - answersANS: A
Cilostazol (Pletal) is an antiplatelet drug. Papaverine (Para-Time) is a direct-acting
peripheral vasodilator. Prazosin (Minipress) is an alpha blocker, and nifedipine
(Procardia) is a calcium channel blocker.
Which herb is most often associated with the treatment of intermittent claudication?
A.Ginseng
B.Valerian
C.St. John's wort
D.Ginkgo biloba - answersANS: D
,The herb Ginkgo biloba, taken with an antiplatelet drug, has been used to treat
intermittent claudication, because of its vasodilating and antioxidant effects, although
this herb has not been approved by the FDA
A patient is prescribed aspirin, 81 mg, and clopidogrel. The nurse identifies the drug
classification of clopidogrel as
A.anticoagulant.
B.thrombotic inhibitor.
C.antiplatelet.
D.thrombolytic. - answersANS: C
Clopidogrel is an antiplatelet drug.
A patient arrived in the emergency department 2 hours after an acute ischemic stroke.
The patient is given an intravenous (IV) injection of alteplase tPA. It is most important
for the nurse to monitor what? (Select all that apply.)
A.Bleeding
B.Vital signs
C.PT levels
D.Allergic reactions
E.Electrocardiogram - answersANS: A, B, D, E
The nurse should monitor the patient receiving thrombolytics for adverse effects, such
as bleeding, allergic reactions, and cardiac dysrhythmias. An increased heart rate with a
decreased BP usually indicates blood loss from bleeding.
A patient is on heparin therapy secondary to deep vein thromboses. The nurse has
which medication on hand as an antidote in case it is needed?
A.Vitamin K
B.Protamine sulfate
C.Warfarin
D.Aminocaproic acid - answersANS: B
Vitamin K is the antidote for warfarin (Coumadin), not heparin, therapy; warfarin
(Coumadin) is an anticoagulant, and aminocaproic acid (Amicar) is a plasminogen
inactivator used to control excessive bleeding from hyperfibrinolysis.
Four patients are considered as potential candidates for thrombolytic therapy. Which
patient is most likely to receive thrombolytic therapy?
A.The patient who recently used acetaminophen
B.The patient with a history of severe hypertension
C.The patient who recently had spinal surgery
D.The patient with a history of warfarin use - answersANS: A
, Acetaminophen (Tylenol) does not interfere with the coagulation system.
Contraindications for use of thrombolytics include a recent CVA, active bleeding, severe
hypertension, recent history of traumatic injury, especially head injury, and
anticoagulant therapy. The nurse should report if the patient takes aspirin or NSAIDs.
The nurse is caring for a patient who received alteplase tPA for treatment of acute
coronary syndrome. The patient starts to bleed. The nurse anticipates administration of
which medication?
A.Protamine sulfate
B.Vitamin K
C.Warfarin
D.Aminocaproic acid - answersANS: D
Aminocaproic acid (Amicar) is used to stop bleeding by inhibiting plasminogen
activation, which inhibits thrombolysis
A patient visits an outpatient clinic. The patient has been noncompliant with
anticoagulation therapy and states, "I don't like having to have blood work all of the
time." The nurse anticipates prescription of which medication?
A.Abciximab
B.Tirofiban
C.Eptifibatide
D.Rivaroxaban - answersANS: D
Two oral anticoagulants form a new anticoagulant category called Xa inhibitors.
Rivaroxaban (Xarelto) was FDA-approved in July 2011, and apixaban (Eliquis) was
FDA-approved in December 2012. These drugs do not require routine coagulation
monitoring and are given q.d. or b.i.d. The other medications are administered
intravenously.
A patient is recovering from surgery to replace her right hip. In the early postoperative
phase, the nurse anticipates administration of which drug to prevent deep vein
thrombosis?
A.Dipyridamole
B.Low-molecular-weight heparin
C.Abciximab
D.Anagrelide - answersANS: B
Low-molecular-weight heparins are derivatives of standard heparin and were introduced
to prevent venous thromboembolism. The other drugs are platelet inhibitors.
Antiplatelets are used to prevent thrombosis in the arteries by suppressing platelet
aggregation.
The patient develops a deep vein thrombosis. The nurse anticipates administration of
which medication?
Final Practice Questions (ATI/Test/Quiz)
A patient is admitted to the intensive care unit with increased intracranial pressure. The
nurse would anticipate administering
A.furosemide.
B.mannitol.
C.triamterene.
D.spironolactone - answersANS: B
Osmotic diuretics such as mannitol (Osmitrol) increase the osmolality and sodium
reabsorption in the proximal tubule and loop of Henle. Sodium, chloride, potassium, and
water are excreted. This group of drugs is used to prevent kidney failure, to decrease
intracranial pressure, and to decrease intraocular pressure. Mannitol is a potent osmotic
potassium-wasting diuretic frequently used in emergency situations such as ICP and
IOP.
Which statement about aldosterone does the nurse identify as being true? Aldosterone
•
A.promotes sodium excretion.
B.is a mineralocorticoid hormone.
C.promotes potassium retention.
D.is secreted by the pancreas. - answersANS: B
Aldosterone is a mineralocorticoid hormone that promotes sodium retention, and
potassium excretion. is not secreted by the pancreas.
A patient with chronic glaucoma is most likely to receive which drug?
A.A thiazide diuretic
B.A loop diuretic
C.A potassium-sparing diuretic
D.A carbonic anhydrase inhibitor - answersANS: D
Carbonic anhydrase inhibitors are primarily used to decrease IOP in patients with open-
angle (chronic) glaucoma. Thiazides and loop diuretics are used to treat hypertension
,and peripheral edema. Potassium-sparing diuretics are used as mild diuretics in
combination with other diuretics.
A patient's serum lipids are cholesterol 197 mg/dL, low-density lipoprotein (LDL) 110
mg/dL, and high-density lipoprotein (HDL) 35 mg/dL. What does the nurse know 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. - answersANS: B
The normal range for cholesterol is 150 to 200. The normal range for LDL is less than
100. The normal range for HDL is 45 to 60.
A nurse who is administering atorvastatin calcium realizes the importance of monitoring
for which serious adverse reaction?
A.Pharyngitis
B.Rash/pruritus
C.Rhabdomyolysis
D.Agranulocytosis - answersANS: C
Serious adverse reactions of atorvastatin include rhabdomyolysis, myalgia,
photosensitivity, and cataracts. Less serious side effects include headache, rash,
pruritus, constipation, diarrhea, sinusitis, and pharyngitis.
A patient is receiving medication therapy for peripheral vascular disease. Which
medication does the nurse identify as an antiplatelet drug?
A.Cilostazol
B.Papaverine
C.Prazosin
D.Nifedipine - answersANS: A
Cilostazol (Pletal) is an antiplatelet drug. Papaverine (Para-Time) is a direct-acting
peripheral vasodilator. Prazosin (Minipress) is an alpha blocker, and nifedipine
(Procardia) is a calcium channel blocker.
Which herb is most often associated with the treatment of intermittent claudication?
A.Ginseng
B.Valerian
C.St. John's wort
D.Ginkgo biloba - answersANS: D
,The herb Ginkgo biloba, taken with an antiplatelet drug, has been used to treat
intermittent claudication, because of its vasodilating and antioxidant effects, although
this herb has not been approved by the FDA
A patient is prescribed aspirin, 81 mg, and clopidogrel. The nurse identifies the drug
classification of clopidogrel as
A.anticoagulant.
B.thrombotic inhibitor.
C.antiplatelet.
D.thrombolytic. - answersANS: C
Clopidogrel is an antiplatelet drug.
A patient arrived in the emergency department 2 hours after an acute ischemic stroke.
The patient is given an intravenous (IV) injection of alteplase tPA. It is most important
for the nurse to monitor what? (Select all that apply.)
A.Bleeding
B.Vital signs
C.PT levels
D.Allergic reactions
E.Electrocardiogram - answersANS: A, B, D, E
The nurse should monitor the patient receiving thrombolytics for adverse effects, such
as bleeding, allergic reactions, and cardiac dysrhythmias. An increased heart rate with a
decreased BP usually indicates blood loss from bleeding.
A patient is on heparin therapy secondary to deep vein thromboses. The nurse has
which medication on hand as an antidote in case it is needed?
A.Vitamin K
B.Protamine sulfate
C.Warfarin
D.Aminocaproic acid - answersANS: B
Vitamin K is the antidote for warfarin (Coumadin), not heparin, therapy; warfarin
(Coumadin) is an anticoagulant, and aminocaproic acid (Amicar) is a plasminogen
inactivator used to control excessive bleeding from hyperfibrinolysis.
Four patients are considered as potential candidates for thrombolytic therapy. Which
patient is most likely to receive thrombolytic therapy?
A.The patient who recently used acetaminophen
B.The patient with a history of severe hypertension
C.The patient who recently had spinal surgery
D.The patient with a history of warfarin use - answersANS: A
, Acetaminophen (Tylenol) does not interfere with the coagulation system.
Contraindications for use of thrombolytics include a recent CVA, active bleeding, severe
hypertension, recent history of traumatic injury, especially head injury, and
anticoagulant therapy. The nurse should report if the patient takes aspirin or NSAIDs.
The nurse is caring for a patient who received alteplase tPA for treatment of acute
coronary syndrome. The patient starts to bleed. The nurse anticipates administration of
which medication?
A.Protamine sulfate
B.Vitamin K
C.Warfarin
D.Aminocaproic acid - answersANS: D
Aminocaproic acid (Amicar) is used to stop bleeding by inhibiting plasminogen
activation, which inhibits thrombolysis
A patient visits an outpatient clinic. The patient has been noncompliant with
anticoagulation therapy and states, "I don't like having to have blood work all of the
time." The nurse anticipates prescription of which medication?
A.Abciximab
B.Tirofiban
C.Eptifibatide
D.Rivaroxaban - answersANS: D
Two oral anticoagulants form a new anticoagulant category called Xa inhibitors.
Rivaroxaban (Xarelto) was FDA-approved in July 2011, and apixaban (Eliquis) was
FDA-approved in December 2012. These drugs do not require routine coagulation
monitoring and are given q.d. or b.i.d. The other medications are administered
intravenously.
A patient is recovering from surgery to replace her right hip. In the early postoperative
phase, the nurse anticipates administration of which drug to prevent deep vein
thrombosis?
A.Dipyridamole
B.Low-molecular-weight heparin
C.Abciximab
D.Anagrelide - answersANS: B
Low-molecular-weight heparins are derivatives of standard heparin and were introduced
to prevent venous thromboembolism. The other drugs are platelet inhibitors.
Antiplatelets are used to prevent thrombosis in the arteries by suppressing platelet
aggregation.
The patient develops a deep vein thrombosis. The nurse anticipates administration of
which medication?
