Question 1

The nurse administers isosorbide dinitrate (Isordil, Coronex) sublingually to the client. What is the best instruction to give the client?&#10;A) &#34;Rinse your mouth and brush your teeth before this medication.&#34;&#10;B) &#34;Do not walk around until the tablet has dissolved.&#34;&#10;C) &#34;Rinse your mouth thoroughly after the tablet has dissolved.&#34;&#10;D) &#34;Do not talk or drink while the tablet is dissolving.&#34;

Accepted Answer

Isosorbide dinitrate is administered sublingually for rapid absorption, and the patient should not talk or drink while the tablet is dissolving to ensure the medication is fully absorbed through the oral mucosa.

Question 2

The client has heart failure and receives digoxin (Lanoxin). Prior to discharge, what will the best teaching plan of the nurse include?&#10;A) &#34;If you miss a dose, take two doses.&#34;&#10;B) &#34;Report a weight gain of 1 or more kilos per day.&#34;&#10;C) &#34;Report mental changes such as euphoria.&#34;&#10;D) &#34;Stop the medication if your pulse is 56.&#34;

Accepted Answer

Reporting weight gain of 1 or more kilos per day is important because it may indicate worsening heart failure and could be a sign of fluid retention. Missing a dose should not be made up with an extra dose and should be reported to the healthcare provider. Mental changes such as euphoria can be a sign of toxicity and should be immediately reported to the healthcare provider. Digoxin should not be stopped abruptly, even if the pulse rate is low, without instructions from a healthcare provider.

Question 3

The client receives enalapril (Vasotec) as treatment for heart failure. What is the best nursing assessment following the initial administration of this drug?&#10;A) Assess the client for a serious rash.&#10;B) Assess the client's blood pressure.&#10;C) Assess the client for an irregular pulse.&#10;D) Assess the client for ototoxicity.

Accepted Answer

Enalapril belongs to a class of medications called ACE inhibitors, which are commonly used to manage heart failure. These drugs can cause a rapid and significant drop in blood pressure, especially after the first dose or during the first few days of treatment. Therefore, monitoring the client's blood pressure following the initial administration is important to detect any significant changes and adjust the dose as needed. While rashes, irregular pulse, and ototoxicity are also potential adverse effects of enalapril, they are less common and less urgent to assess in the immediate post-administration period.

Question 4

The client receives furosemide (Lasix) and digoxin (Lanoxin) together. Which laboratory findings will the nurse assess as increasing the client's risk for digoxin (Lanoxin) toxicity?&#10;A) hypokalemia and hypocalcemia&#10;B) hyponatremia and hyperkalemia&#10;C) hypermagnesemia and hyponatremia&#10;D) hypercalcemia and hyperkalemia

Accepted Answer

Furosemide (Lasix) is a loop diuretic that can cause hypokalemia and may increase the risk of digoxin toxicity, as hypokalemia enhances the effect of digoxin on the heart. Similarly, hypocalcemia can also increase the risk of digoxin toxicity. Hyponatremia, hypermagnesemia, hypercalcemia, and hyperkalemia are not known to increase the risk of digoxin toxicity.

Question 5

The nurse teaches the client about lisinopril (Zestril) and evaluates that additional teaching is required when the client makes which statement?&#10;A) &#34;I will monitor my blood pressure until my next appointment.&#34;&#10;B) &#34;I don't need to worry about having blood tests done.&#34;&#10;C) &#34;I will avoid using salt substitutes for seasoning.&#34;&#10;D) &#34;It takes a while for this medication to take effect.&#34;

Accepted Answer

Blood tests may be required while taking lisinopril to ensure proper kidney function and electrolyte levels.

Question 6

The client has a history of cardiac disease and receives digoxin (Lanoxin). The nurse determines that education about dietary needs with this medication has been effective when the client makes which selection for lunch?

A) green bean soup, whole -wheat bread, and an apple
B) cottage cheese and peach salad, and blueberry pie
C) hamburger, french fries, and chocolate chip cookies
D) baked fish, sweet potatoes, and banana pudding

Accepted Answer

The best choice for the client taking digoxin would be baked fish, sweet potatoes, and banana pudding. This is because digoxin can interact with certain foods, such as those high in fiber, and increase the risk of digoxin toxicity. The other options contain foods that are high in fiber (option A), contain dairy products that can interfere with digoxin absorption (option B), or contain high amounts of fat and sodium (option C).

Question 7

The client will receive an IV infusion of milrinone (Apo -Milrinone) as treatment for acute heart failure. What is the priority plan of the nurse?&#10;A) Plan to monitor for hypertension.&#10;B) Plan to monitor for atrial fibrillation.&#10;C) Plan to monitor the ECG continuously.&#10;D) Plan to take vital signs every 15 minutes.

Accepted Answer

Milrinone can cause potentially serious cardiac arrhythmias, so continuous ECG monitoring is essential to detect any changes in the heart's rhythm. Monitoring for hypertension and taking vital signs are important but not the priority over continuous ECG monitoring. Monitoring for atrial fibrillation may be important, but it is secondary to the need for continuous ECG monitoring.

Question 8

The client has hypertension and asks the nurse how this can lead to heart failure. What is the best response by the nurse?&#10;A) &#34;Hypertension limits the ability of your heart to stretch before emptying, or afterload; your heart works harder, and weakens.&#34;&#10;B) &#34;Hypertension causes resistance in your aorta, or afterload; your heart works harder and weakens.&#34;&#10;C) &#34;Hypertension causes resistance in your blood vessels, or afterload; your heart works harder, and weakens.&#34;&#10;D) &#34;Hypertension limits the amount of blood entering your left ventricle, or afterload; your heart works harder, and weakens.&#34;

Accepted Answer

Hypertension causes resistance in blood vessels, specifically the peripheral arteries. This increased afterload makes it harder for the heart to pump blood out to the body. Over time, this increased workload can lead to left ventricular hypertrophy (enlargement of the heart muscle) and eventually heart failure.

Question 9

The client comes to the emergency department complaining of coughing and difficulty breathing. The client's diagnosis is heart failure. He asks the nurse how difficulty breathing could be a heart problem. What is the best response by the nurse? Select all that apply.

A) "The right side of your heart has weakened and blood has entered your lungs."
B) "The right side of your heart has enlarged and cannot effectively pump blood."
C) "The left side of your heart is weak and pumps blood too quickly."
D) "The left side of your heart has weakened and blood has entered your lungs."
E) "What you have is called congestive heart failure."

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Accepted Answer

When the left side of the heart weakens, it can lead to pulmonary congestion as blood backs up into the lungs, causing difficulty breathing. Congestive heart failure is a common term used to describe this condition.

Question 10

The nurse volunteers at a senior citizen centre. The nurse assesses which senior citizen as having the greatest risk of developing heart failure?&#10;A) a 69 -year -old aboriginal male with hypertension&#10;B) a 75 -year -old white male who is overweight&#10;C) a 52 -year -old white female with asthma&#10;D) a 50 -year -old african female who smokes

Accepted Answer

Hypertension is a major risk factor for heart failure, and the 69-year-old aboriginal male with hypertension has the highest risk among the given options. The other options may also have some risks for heart failure, but they are not as high as having hypertension.

Question 11

The client receives digoxin (Lanoxin). Which assessment findings would indicate adverse effects to this medication?&#10;A) tachycardia and hypotension&#10;B) anorexia and constipation&#10;C) anorexia and nausea&#10;D) blurred vision and tachycardia

Accepted Answer

The answer of The client receives digoxin (Lanoxin). Which assessment...

Question 12

The client receives captopril (Capoten) as treatment for heart failure. Which adverse effect will the nurse plan to report to the physician?&#10;A) The client develops diarrhea.&#10;B) The client develops dehydration.&#10;C) The client develops a cough.&#10;D) The client develops facial flushing.

Accepted Answer

The answer of The client receives captopril (Capoten) as treatment...

Question 13

The nurse teaches the client about digoxin (Lanoxin) toxicity and determines that learning has occurred when the client makes which statement(s)? Select all that apply.&#10;A) &#34;I should limit my fluids while taking this medication.&#34;&#10;B) &#34;If I have nausea, it means I must stop the medication.&#34;&#10;C) &#34;It is okay to keep taking my ginseng.&#34;&#10;D) &#34;I can drink orange juice every morning.&#34;&#10;E) &#34;I must check my pulse and not take the medication if it is less than 60.&#34;

Accepted Answer

The answer of The nurse teaches the client about digoxin...

Question 14

The client takes insulin for diabetes mellitus. The physician orders metoprolol (Lopresor) for hypertension. After medication teaching, the nurse determines that learning has occurred when the client makes which statement?

A) "I might not need to check my blood sugars as often with metoprolol (Lopresor)."
B) "I might need less insulin when I take metoprolol (Lopresor)."
C) "I might need more insulin when I take metoprolol (Lopresor)."
D) "I might be able to change from insulin to a pill with metoprolol (Lopresor)."

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Accepted Answer

The answer of The client takes insulin for diabetes mellitus....

Question 15

The physician orders metoprolol (Lopresor) for several clients. The nurse will hold the medication and contact the physician for which client?&#10;A) the client with an apical pulse rate of 100&#10;B) the client with compensated heart failure&#10;C) the client with chronic bronchitis&#10;D) the client with a history of migraines

Accepted Answer

The answer of The physician orders metoprolol (Lopresor) for several...

Deck 24: Drugs for Heart Failure