Exam 2 - Pharmacology Lesson 9-12

1.

1 point

Which one of these objective data is a "stronger predictor of CV disease in elderly patients"?

Isolated Diastolic Hypertension

Isolated Systolic Hypertension

Isolated Systolic Hypotension

Isolated Diastolic Hypotension

Neither

2.

1 point

A BP reading of 149/90 is classified as what kind of hypertension/blood pressure?

Stage 2 hypertension

Neither

Normal

Pre-hypertension

Stage 1 hypertension

3.

1 point

Which of these is not a "consequence of HTN"?

Hair loss

Kidney Disease

Blindness

Heart Disease

4.

1 point

What is the name of the diet recommended for patients with hypertension?

MASH Diet

Seafood Diet

DASH Diet

Low-Protein Diet

5.

1 point

What is the "most noticeable response" of the body when "baroreceptors sense low arteriole pressure"?

Orthostatic Hypotension

Reflex tachypnea

Reflex tachycardia

Orthostatic Hypertension

6.

1 point

Which of these classes of drugs does not contribute to decreasing Cardiac Output?

Beta blockers

Alpha blockers

Diuretics

Calcium Channel blockers

7.

1 point

For achieving BP goal for patients with HTN, if taking multiple drugs, they need to be from the same class to minimize drug to drug interactions.

True

False

8.

1 point

Out of these classes/drugs of anti-HTN, which is the most dangerous to pregnant women and the fetus?

Thiazide diuretics

ACE Inhibitors

Loop diuretics

Spironolactone

9.

1 point

When taking Loop Diuretics, the greatest adverse effect to look for is:

K+ level of 3.0

Hypoglycemia

K+ level of 7

Hypotension

10.

1 point

When administering Calcium Channel blockers to patients, which side effect would you not consider notifying the provider?

constipation

shortness of breath

edema in the ankles or feet

weight gain

11.

1 point

Which is not a severe adverse effect of taking sodium nitroprusside?

cyanide poisoning

excessive hypotension

thiocyanate toxicity

extensive cyanosis

12.

1 point

You are about to administer digoxin to four different patients, which of the following patients will you withhold administering the medication?

Patient that has an apical pulse of >60 bpms

Patient that has a digoxin level of 0.5 ng/ml

Patient that has a digoxin level of 0.8 ng/ml

Patient that has been ordered to take verapamil

13.

1 point

ARBs do not improve mortality and morbidity for patients with heart failure. Why?

It only prevents strokes

It only prevents MIs

Do not cause significant hyperkalemia

Do not increase bradykinin

14.

1 point

Digoxin is NOT...

a positive inotropic agent

a positive chronotropic agent

a negative dromotropic agent

a negative chronotropic agent

15.

1 point

The client diagnosed with primary hypertension is taking furosemide. Which statement by the client warrants notifying the client’s health care provider?

“I really wish my mouth would not be so dry”

“I usually have one or two glasses of wine a day”

“I get a little dizzy when I get up too fast”

“I have been experiencing really bad leg cramps”

16.

1 point

A client diagnosed with CHF is prescribed enalapril, an ACE-I. Which statement explains scientific rationale for administering this medication?

ACE-I increase levels of angiotensin II in the blood vessels

ACE-I decrease the effects of bradykinin in the body

ACE-I dilate arteries, which reduces the workload of the heart

ACE-I increase aldosterone effects on the kidneys

17.

1 point

A client being discharged after an acute MI is prescribed captopril. Which instruction should the nurse include when teaching about this medication?

Instruct the client to monitor BP weekly

Encourage the client to take medication on an empty stomach

Discuss the need to raise slowly from lying to a standing position

Advise the client to look out for signs of hypokalemia

18.

1 point

A patient is taking furosemide, which of these drugs/class of drugs would you not give the patient due to the possibility of increasing the risk of hearing loss?

aminoglycosides

captopril

spironolactone

hydrochlorothiazides

19.

1 point

Which of the following drug is used for both treating hypertension and dysrhythmias?

captopril

verapamil

atorvastatin

spironolactone

20.

1 point

Which of these are not a common side effect of nitroglycerin?

blurred vision

hypotension

flushing

headache

21.

1 point

Which classes of dysrhythmias have similar cardiac effects because beta-receptors are coupled to calcium channels?

Class III and Class IV

Class I and Class IV

Class I and Class II

Class II and Class IV

22.

1 point

All classes of anti-dysrhythmics cause dysrhythmias except for Class II because they are nonselective Beta blockers.

True

False

23.

1 point

Which of these anti-dsyrhythmia drugs are not used for supraventricular tachycardia?

amiodarone

verapamil

quinidine

propranalol

24.

1 point

Patients with supraventricular dysrhythmias have a high risk for what, and should supplement their drug therapy with what?

ototoxicity... furosemide

hypoglycemia... glucagon

stroke... warfarin

hypokalemia... verapamil

25.

1 point

Which of the anti-dysrhythmia drugs is the most toxic to pregnant women?

amiodarone

propranolol

lidocaine

quinidine

26.

1 point

quinidine side effects include which of the following

endocrine adverse effects

visual disturbances

cinchonism

ototoxicity

27.

1 point

The following antidysrhythmia drugs prolong PR except for:

propranalol

quinidine

amiodarone

verapamil

28.

1 point

Regarding anti-dysrhythmic drugs, which action results in torsades de pointes

Prolonged QR

Prolonged QT

Prolonged PR

Prolonged PT

29.

1 point

Amiodarone has many adverse effects, which of these is not one of the many side effects of amiodarone?

Dermatologic effects

Lung toxicity

Ototoxicity effects

Ophthalmic effects

30.

1 point

Which of the following anti cholesterol drugs is under pregnancy category X

cholesevelam

simvastatin

nicotinic acid

gemfibrozil

31.

1 point

Which of these antianginal drugs is not effective against variant angina?

propranalol

nifedipine

verapamil

nitroglycerin

32.

1 point

When treating a patient for angina, your patient states that their nitroglycerin patch that they have been getting daily is not as effective as before, what would be the reason for the tolerance to the drug?

the patient's skin has scabbed over and is preventing the medicine to pass through

there is an increase of nitrogenase, which eliminates nitroglycerin in the body

depletion of sulfhydryl groups in their body

their body has developed antibodies against nitroglycerin

33.

1 point

A patient has received instructions regarding cholesterol and the body. Which statement made by the patient would indicate the patient needs further teaching?

It is more important to limit saturated and trans fat in my diet than the total amount of cholesterol

I want to lower my LDL levels to reduce my risk of stroke or heart attack

My cholesterol can be high even if I eat a low fat diet and exercise regularly

When I achieve my goal cholesterol level, I can stop taking my lipid lowering medication

34.

1 point

Protamine sulfate is used for sever overdose of what medication

morphine

acetaminophen

tPA

heparin

35.

1 point

A patient has been taking heparin for the past week, their latest aPTT was 50 seconds. What would be the next step for the nurse?

Reduce the dose of heparin

Recommend an increase dose of heparin.

Nothing, the value is within the therapeutic dose for heparin therapy

immediately call a "code blue" and notify the provider

36.

1 point

A patient taking warfarin is experiencing an overdose event, what should the patient receive?

K+ sparing diuretics

Vitamin K

Potassium rich fruits, such as bananas

Vitamin C

37.

1 point

Warfarin is pregnancy category X.

True

False

38.

1 point

Which is not true about enoxaparin?

blocks thrombin and Factor Xa

it is a low molecular weight heparin

preferentially blocks Factor Xa

decreases fibrin production

39.

1 point

Which of these statements are not true about heparin

lab monitoring: aPTT

mechanism of action: activates antithrombin

can be given PO, IV, or subQ

has a rapid onset

40.

1 point

Which of these statements is not true for warfarin?

use vitamin K for antidote

mechanism of action: inhibits vitamin k

is "OK" to be used during pregnancy

has a long (days) duration

41.

1 point

A patient taking clopidogrel has been issued to take omeprazole, what would that do to the levels of clopidogrel in the body.

increase, because omeprazole supresses the enzyme that breaks down clopidogrel

decrease, because omeprazole binds to clopidogrel and renders it ineffective

decrease, because omeprazole binds to the same receptors as clopidogrel

decrease, because omeprazole inhibits the enzyme that activates clopidogrel

42.

1 point

What is the underlying mechanism of cholesterol lowering by lovastatin?

Blocks cholesterol synthesis, which leads to increasing the number of LDL receptors

Activating a receptor that promotes breakdown of lipids

Promoting the elimination of bile

Inhibiting a receptor that promotes cholesterol synthesis

43.

1 point

Which formulation of nitroglycerin is appropriate for a sudden anginal attack?

Sublingual

Topical

Sustained release capsules

Transdermal

44.

1 point

Which anti-anginal drug preferentially dilates veins over arteries?

Nitroglycerin

Verapamil

Propranolol

Nifedipine

45.

1 point

Which drug would be appropriate to give to a pregnant woman to prevent deep vein thrombosis?

Heparin

Aspirin

Warfarin

Tylenol

46.

1 point

A client who has been taking warfarin is planning to get rhinoplasty. What pre op drug history question would the RN ask?

“Have you continued taking warfarin as prescribed?”

“Have you discontinue warfarin several days before the procedure?”

“Did you contact the prescriber about increasing the dose of warfarin?”

“Are you aware that you will discontinue warfarin after the procedure?”

47.

1 point

A patient is experiencing and overdose of alteplase, what would be the appropriate treatment?

administer IV aminocaproic acid for excessive fibrinolysis

give potassium supplements as ordered by the provider

supplement food with vitamin K rich fruits

give protamine sulfate

48.

1 point

The nurse is preparing to administer warfarin. The patient’s laboratory values are as follows: ?INR 2/PT 12s/aPTT 40?. What intervention should the nurse implement

Administer the medication as ordered

Notify the prescriber to increase the dose

Prepare to administer Vitamin K

Prepare to administer Protamine Sulfate

49.

1 point

The nurse is preparing to administer heparin. The patient’s laboratory values are as follows:?INR 1.5/PT 12s/aPTT 90s. ?What intervention should the nurse implement

Prepare to administer Protamine sulfate

Notify the prescriber to increase the dose

Administer the medication as ordered

Prepare to administer Aminocaptoric acid

50.

1 point

The physiologic changes that normally occur in the older adult have which of the following implications for the nurse who is assessing drug response in the patient (from jeopardy slides)

protein binding is more efficient

drug elimination is faster

drug half-life is lengthened

drug metabolism is faster