Question

21. Which is the mechanism of action of lisinopril (Prinivil) when given for hypertension?

A) Dilates the arterioles

B) Causes peripheral vasodilation

C) Increase myocardial afterload

D) Regulates heart rhythm

22. The nurse is caring for patient taking digoxin (Lanoxin). Which other medication seen on the medication administration record (MAR) would cause the nurse concern about administering digoxin (Lanoxin)?

A) Patient taking spironolactone (Aldactone)

B) Patient taking metolazone (Zaroxolyn)

C) Apical pulse of 68 beats/minute

D) Normal serum sodium level

23. An older adult male is admitted to the emergency department (ED) with chest pain and has an order for nitroglycerin (NTG) sublingual. Which is the priority action for the nurse to take?

A) Place one nitroglycerin (NTG) tablet under the patient’s tongue, repeat every 5 minutes x 3

B) Ask the patient if he has taken medication for erectile dysfunction over the past 6 hours

C) Draw blood for a cardiac workup and monitor the patient while waiting for the results

D) Encourage the patient to drink 240 mL with first dose of nitroglycerin (NTG)

24. Which are the common drug interactions of a calcium channel blocker? (Select all that apply).

A) Statins

B) Beta blockers

C) Amlodipine (Norvasc)

D) Lanoxin (digoxin)

E) Verapamil (Calan)

25. The nurse is caring for a patient with type 2 diabetes who has proteinuria and is taking angiotensin-converting enzyme (ACE) inhibitor. Which is the rationale for the healthcare provider prescribing an ACE inhibitor?

A) Promotes fluid output

B) Renal protective effects

C) Cardo protective effects

D) Reduces blood pressure

26. The nurse is caring for a patient taking a beta blocker for angina. Which adverse effect would the nurse monitor in the patient?

A) Dry cough

B) Low heart rate

C) High blood pressure

D) Anxiety

27. The nurse is caring for a patient taking simvastatin (Zocor). Which is the primary purpose of this drug?

A) Increase potassium levels in the blood

B) Decrease the level of LDL in the blood

C) Increase triglyceride levels in the blood

D) Decrease the level of HDL in the blood

28. The nurse is administering somatropin (Humatrope), which is used in the treatment of which condition?

A) Metabolic syndrome

B) Growth failure

C) Type 2 diabetes

D) Cushing’s syndrome

29. The nurse is reviewing a medication administration record (MAR) for a patient taking oral hypoglycemic drugs. Which drug from the patient’s MAR could cause an interaction with oral hypoglycemic drugs?

A) Vitamin supplements

B) Thyroid replacement drugs

C) Beta blockers

D) Antibiotics

30. While caring for a patient who recently had an acute myocardial infarction, the nurse notes severe ventricular dysrhythmias on the patient’s cardiac monitor. Which drug would the nurse anticipate the healthcare provider to order to treat this dysrhythmia?

A) Diltiazem (Cardizem)

B) Adenosine (Adenocard)

C) Amiodarone (Cordarone)

D) Verapamil (Calan)

31. The nurse should assess the client for which common adverse effect of procainamide?

A) Drowsiness

B) Nystagmus

C) Convulsions

D) Dry mouth

32. The nurse is caring for a patient taking niacin to lower her lipid levels in the blood. For which adverse effects would the nurse monitor the patient?

A) Hair loss

B) Abdominal discomfort

C) Halos when looking at light

D) Increased appetite

E) Hepatotoxicity

33. The nurse working in the emergency department (ED) is caring for a patient who is admitted for an acute myocardial infarction (MI). The healthcare provider has ordered a continuous nitroglycerin drip. Which statement is true about intravenous nitroglycerin administration?

A) Nonpolyvinylchloride (nonPVC) plastic intravenous bags and tubing must be used

B) Nitroglycerin can be given in the same line as other medications

C) There is not a continuous intravenous form; nitroglycerin is given

D) The nitroglycerin solution will be slightly colored green or blue

34. The nurse is caring for a patient receiving atenolol (Tenormin). Which information does the nurse need to know about the patient prior to administering this drug?

A) Serum potassium level

B) Serum albumin level

C) Pulse and blood pressure

D) Daily height and weight

35. The nurse is caring for a patient with heart failure. Which medication will have a positive inotropic effect?

A) Valsartan (Diovan)

B) Atenolol (Tenormin)

C) Digoxin (Lanoxin)

D) Diltiazem (Cardizem)

36. The nurse is caring for a patient who recently had a myocardial infarction (MI). Which medications would the nurse anticipate the health care provider will recommend to this patient as prevention of another MI.

A) Vitamin K and an anti-inflammatory

B) Omega 3 supplement and an iron supplement

C) Omega 3 supplement and a baby aspirin daily

D) Vitamin A and an anticoagulant

37. The nurse is caring for a patient with essential hypertension who is taking a calcium channel blocker. The nurse would hold the patient’s medication based on which assessment finding?

A) Patient complains of a nonproductive cough

B) Blood pressure of 128/86

C) An oral temperature pf 102 F

D) Patient complains of dizziness when standing

38. The nurse is discharging an older adult who lives alone and will need to take a diuretic drug for hypertension. Which would be important for the nurse to emphasize during the discharge teaching?

A) Stop taking the medication if feeling dizzy, and take potassium

B) The diuretic should be taken with the evening meal

C) Do not take the diuretic if leaving the house for the day

D) Stand slowly and carefully to prevent orthostatic hypotension

39. The nurse is caring for a child taking somatropin (Humatrope). The nurse knows to monitor the patient for which therapeutic response?

A) Decreased muscle strength

B) Decreased urinary output

C) Increased growth pattern

D) Increased caloric intake

40. The nurse is reviewing a medication administration record (MAR) for a patient and reads the order, “Give levothyroxine (Synthroid), 20 mcg, PO once every evening.” Which action should the nurse take?

A) Question the order, because the dose is too high

B) Give the medication as ordered; the order is correct

C) Question the order, because the time of day is incorrect

D) Change the dose to 200 mg, because that is the correct dose

41. The nurse is caring for a patient taking lispro (Humalog) insulin. In which time frame will the insulin take effect?

A) 3 to 5 hours

B) 15 minutes

C) 45 minutes

D) 1 to 2 hours

42. The nurse is planning discharge teaching for a patient who will self-administer insulin at home. Which information would be to include in the teaching plan?

A) Insulin should not be mixed in the same syringe, because they will crystalize when mixed

B) Insulins should be drawn up into the same syringe with the clear first and cloudy second

C) Injections should be given in sites that are most accessible and convenient for the patient

D) When administering two insulins, each insulin injection should be given in a different site

43. The nurse is caring for a patient who is taking a biguanide, metformin (Glucophage), for metabolic syndrome. Which is the purpose of this patient taking metformin?

A) Decreasing insulin resistance

B) Decreasing pancreatic secretion of insulin

C) Increasing blood glucose levels

D) Increasing pancreatic uptake of insulin

44. The nurse is developing a discharge plan for a patient taking an antithyroid drug. Which information about nutrition would be important to include?

A) Avoid foods that contain iodine

B) Restrict all fluids to 100 mL per meal

C) Increase potassium-rich foods

D) Use only iodized salt when cooking

45. The nurse is caring for a diabetic patient taking oral antidiabetic drug. Which lab result will inform the nurse that the patient is having the correct therapeutic response?

A) Fasting blood glucose between 70 and 100 mg/dL

B) Random blood glucose of 170 mg/dL at 3 p.m.

C) Blood glucose of 50 mg/dL taken after meals

D) HS blood glucose of 80 mg/dL

46. The nurse is checking lab values on a patient with type 2 diabetes and reviews the hemoglobin A1C level. Which does a hemoglobin A1C of 6 inform the nurse about the patient and the medication plan?

A) The patient is adhering to the medication plan

B) The patient takes her medication some days

C) The patient is taking too much medication

D) The patient has stopped taking her medication

47. The nurse is caring for patient with type 2 diabetes who is receiving intravenous corticosteroid. Which adverse effect of the corticosteroids would the nurse monitor for?

A) Halos when looking at light

B) Increased urinary output

C) Increased heart rate

D) Increased blood glucose levels

48. The nurse is caring for a newly diagnosed type 2 diabetes who is taking Januvia. Which adverse effects can occur with this drug? (Select all that apply).

A) Runny or stuffy nose

B) Increased blood glucose

C) Increased appetite

D) Nausea

E) Headache

49. The nurse is caring for a school-aged child who is taking somatropin (Humatrope). Which is the anticipated outcome of this pharmacotherapy?

A) Slowing down growth

B) Increasing growth

C) Slowing down of weight gain

D) Increasing muscle strength

Answer 1

21. Answer is option C.

Lisinopril is a ACE inhibitor. It works by preventing conversion of Angiotensin1 into Angiotensin2 , which is a potent vasoconstrictor and have positive inotropic effect. These effects are useful in treating hypertension and heart failure. Lisinopril also facilitates coronary bloodflow.

22. Answer is option B.

Digoxin (lanoxin) is a cardiac glycoside which acts by slowing heart rate and increasing force of contraction and its side effect is that it causes hypokalemia while Metalazone is a diuretic which causes excess urination and it also have hypokalemic property. So taking digoxin and Metalazone at same time may cause severe hypokalemia which need to be monitored time to time as hypokalemia may cause slow heart rate, nausea, vomiting, muscular cramps and many more other severe I'll effects.

23. Answer is option A.

Nitroglycerin is a potent vasodilator. As the patient is admitted to emergency ward and these symptoms may be of Cardiac arrest. So 1st priority is to relieve pain and make patient stable and conscious. Nitroglycerin given sublingually is very helpful in such cases which acts by improving coronary bloodflow and further medications should be given afterward.

24. Answer is option C and E.

Amilodipine and Verapamil both belongs to greater class known as calcium channel blockers in which Amilodipine belongs to dihydroxypyridone and Verapamil belongs to non- dihydroxypyridone.

25. Answer is option C.

ACE inhibitors reduces intraglomerular pressure by efferent arteriole vasoconstricton which help kidney in reliving work load and this effect is nephroprotective and independent of antihypertensive effect.

26. Answer is option B.

Beta blockes exhibits increase in force of contraction and decrease in heart rate so heart needs to be monitored because it may cause severe bradycardia.