NRS 301 EXAM 7 (EAQ) QUESTIONS
WITH ACCURATE SOLUTIONS AND
RATED A.
Which are beneficial effects that can be derived from simvastatin and other
drugs in this class? Select all that apply.
1
Improvement of liver function
2
Reduction of risk of cardiovascular events
3
Reduction of low-density lipoproteins (LDLs)
4
Elevation of high-density lipoproteins (HDLs)
5
Stabilization of the plaque in coronary arteries
2, 3, 4, 5
The statin drugs have many benefits, the most important being reduction of
LDLs. They also promote an increase in HDLs, stabilization of atherosclerotic
plaque, and reduced inflammation at the plaque site. Among other benefits,
they also slow progression of coronary artery calcification. The statins reduce
the overall risk of cardiovascular events. They can have serious adverse
effects on the liver, but these are relatively rare.
The patient is receiving anticoagulant therapy. The international
normalized ratio (INR) value for the patient today is 1.5. In response to
this, the nurse could anticipate the healthcare provider placing which
order?
1
Administer protamine sulfate.
2
,Increase the heparin drip rate.
3
Hold the next dose of warfarin.
4
Administer an additional dose of warfarin.
4
A therapeutic INR is 2 to 3.5. The patient needs more warfarin to reach a
therapeutic level. It should not be held because that would increase the risk of
clotting. Heparin is not ordered; that would be indicated by monitoring the
activated partial thromboplastin time, not prothrombin time and INR.
Protamine sulfate is the antidote for heparin overdose.
Before the nurse administers isosorbide mononitrate, what is a priority
nursing assessment?
1
Assess blood pressure.
2
Assess serum electrolytes.
3
Monitor level of consciousness.
4
Measure blood urea nitrogen and creatinine.
1
Isosorbide mononitrate is a vasodilator and thus can cause hypotension. It is
important to assess blood pressure before administering. The nurse also may
assess electrolyte levels, level of consciousness, and renal function; however,
these are not the priority assessments in relation to the known expected and
side effects of vasodilators.
Which statement by a patient demonstrates a need for further teaching
regarding nitroglycerin?
1
"I should keep my nitroglycerin in a cool, dry place."
2
, "I will change positions slowly to avoid getting dizzy."
3
"If I get a headache, I should use acetaminophen for pain relief."
4
"I will take up to five tablets at 3-minute intervals for chest pain."
4
Patients are instructed to take up to three tablets every 5 minutes. If no relief
from chest pain is obtained after one tablet, they should seek medical
assistance. Acetaminophen is administered if there is a drug-related
headache. The nurse instructs the patient to keep nitroglycerin in a cool, dry
place as exposure to heat can result in a loss of drug potency. The patient is
instructed to change positions slowly to prevent syncope or dizziness.
Which medication is the treatment of choice for ST-segment elevation
myocardial infarction (STEMI)-associated pain?
1
Aspirin
2
Morphine
3
Lorazepam
4
Hydromorphone
2
Morphine treats pain and improves hemodynamics. By promoting venodilation,
the drug reduces cardiac preload. By promoting modest arterial dilation, it
may cause some reduction in afterload. The combined reductions in preload
and afterload lower the cardiac oxygen demand, thereby helping to
preserve the ischemic myocardium and relieving the patient's pain. Aspirin and
hydromorphone may provide pain relief but are not the best choice.
Lorazepam would not treat the pain, nor is it a drug of choice for STEMI
treatment.
WITH ACCURATE SOLUTIONS AND
RATED A.
Which are beneficial effects that can be derived from simvastatin and other
drugs in this class? Select all that apply.
1
Improvement of liver function
2
Reduction of risk of cardiovascular events
3
Reduction of low-density lipoproteins (LDLs)
4
Elevation of high-density lipoproteins (HDLs)
5
Stabilization of the plaque in coronary arteries
2, 3, 4, 5
The statin drugs have many benefits, the most important being reduction of
LDLs. They also promote an increase in HDLs, stabilization of atherosclerotic
plaque, and reduced inflammation at the plaque site. Among other benefits,
they also slow progression of coronary artery calcification. The statins reduce
the overall risk of cardiovascular events. They can have serious adverse
effects on the liver, but these are relatively rare.
The patient is receiving anticoagulant therapy. The international
normalized ratio (INR) value for the patient today is 1.5. In response to
this, the nurse could anticipate the healthcare provider placing which
order?
1
Administer protamine sulfate.
2
,Increase the heparin drip rate.
3
Hold the next dose of warfarin.
4
Administer an additional dose of warfarin.
4
A therapeutic INR is 2 to 3.5. The patient needs more warfarin to reach a
therapeutic level. It should not be held because that would increase the risk of
clotting. Heparin is not ordered; that would be indicated by monitoring the
activated partial thromboplastin time, not prothrombin time and INR.
Protamine sulfate is the antidote for heparin overdose.
Before the nurse administers isosorbide mononitrate, what is a priority
nursing assessment?
1
Assess blood pressure.
2
Assess serum electrolytes.
3
Monitor level of consciousness.
4
Measure blood urea nitrogen and creatinine.
1
Isosorbide mononitrate is a vasodilator and thus can cause hypotension. It is
important to assess blood pressure before administering. The nurse also may
assess electrolyte levels, level of consciousness, and renal function; however,
these are not the priority assessments in relation to the known expected and
side effects of vasodilators.
Which statement by a patient demonstrates a need for further teaching
regarding nitroglycerin?
1
"I should keep my nitroglycerin in a cool, dry place."
2
, "I will change positions slowly to avoid getting dizzy."
3
"If I get a headache, I should use acetaminophen for pain relief."
4
"I will take up to five tablets at 3-minute intervals for chest pain."
4
Patients are instructed to take up to three tablets every 5 minutes. If no relief
from chest pain is obtained after one tablet, they should seek medical
assistance. Acetaminophen is administered if there is a drug-related
headache. The nurse instructs the patient to keep nitroglycerin in a cool, dry
place as exposure to heat can result in a loss of drug potency. The patient is
instructed to change positions slowly to prevent syncope or dizziness.
Which medication is the treatment of choice for ST-segment elevation
myocardial infarction (STEMI)-associated pain?
1
Aspirin
2
Morphine
3
Lorazepam
4
Hydromorphone
2
Morphine treats pain and improves hemodynamics. By promoting venodilation,
the drug reduces cardiac preload. By promoting modest arterial dilation, it
may cause some reduction in afterload. The combined reductions in preload
and afterload lower the cardiac oxygen demand, thereby helping to
preserve the ischemic myocardium and relieving the patient's pain. Aspirin and
hydromorphone may provide pain relief but are not the best choice.
Lorazepam would not treat the pain, nor is it a drug of choice for STEMI
treatment.
