Deck 12: Cardiovascular and Renal Medications

Question 1

A 70-year-old female patient has kidney disease and increasing bilateral edema in her legs and feet.Her health care provider has placed her on a potassium-sparing diuretic.Based on this patient's history,which represents the diuretic action the patient needs from her medication?

A) The medication should increase reabsorption of sodium and potassium.
B) The medication should decrease sodium transport and increase potassium levels.
C) The medication should excrete water and sodium but save potassium.
D) The medication should excrete potassium and save water and sodium.

Answer 1

The medication should excrete water and sodium but save potassium.

Question 2

The nurse is teaching a patient about the loss of potassium when taking diuretics.The physician started this patient on spironolactone (Aldactone).Which is a special characteristic of this diuretic?

A) It blocks active transport of sodium and potassium excretion.
B) It is used when there is high renal filtration.
C) It affects the exchange of sodium and potassium excretion.
D) It gives a peak effect in diuretic use.

Answer 2

It affects the exchange of sodium and potassium excretion.

Question 3

A patient has an acute myocardial infarction.Her electrocardiogram is normal except for a heart rate of 150 beats per minute.Her physician prescribes digoxin in both an initial "digitalizing" dose and a daily maintenance dose so that which will occur?

A) A specific level of medication will be reached in the blood.
B) Her heart rate will first speed up.
C) The drug will begin to weaken her heart's contraction.
D) The drug will improve her appetite.

Answer 3

A specific level of medication will be reached in the blood.

Question 4

When giving patients a thiazide,which electrolyte replacement should be supplemented?

A) Vitamins
B) Minerals
C) Calcium
D) Potassium

Question 5

An elderly man with hypocalcemia asks the nurse why the physician changed his loop diuretic medication to a thiazide diuretic medication that would do the same thing for the edema in his legs.Which represents the best response to this question?

A) "Changing this medication helps keep you from becoming addicted."
B) "The thiazide medication will help your bones."
C) "You have to ask the physician about your medication."
D) "The thiazide medication will improve your blood count."

Question 6

Diet and exercise alone may not lower a patient's risk for having high cholesterol.Which medication would help to lower a patient's cholesterol level?

A) Clonidine (Catapres), a central adrenergic inhibitor
B) Simvastatin (Zocor), a reductase inhibitor
C) Nadolol (Corgard), a beta-adrenergic blocker
D) Terazosin (Hytrin), an alpha1-adrenergic blocker

Question 7

A patient arrives at the emergency department with a heart rate that is 58 and irregular.After a diagnostic workup,the patient is found to have a cardiac conduction problem.The nurse caring for this patient knows this cardiac disease occurs in patients who have which abnormalities?

A) An increased oxygen level in cardiac muscle cells
B) A decreased oxygen level in cardiac muscle cells
C) Low level of vitamin B complex
D) High level of vitamin B complex

Question 8

A patient with hypertension for 10 years has been told by his health care provider that he has developed nephrotic syndrome,causing generalized edema.Which diuretic will work in the treatment of his condition?

A) Furosemide, a loop diuretic
B) Polythiazide, a thiazide diuretic
C) Metolazone, a sulfonamide diuretic
D) Spironolactone, a potassium-sparing diuretic

Question 9

A nurse gives a patient discharge instructions about how to store nitroglycerin sublingual tablets to keep the medication fresh for use at all times.Since nitroglycerin is easily destroyed,the nurse would tell the patient to store the medication in which way?

A) In plastic or a tight cardboard box
B) With cotton over the top of the medication
C) In a dark glass bottle out of the sunlight
D) In the refrigerator tightly closed

Question 10

A geriatric patient is started on an antihypertensive medication.The nurse explains to the patient to be careful when changing positions.This precaution is necessary for which reason?

A) Geriatric patients have visual problems.
B) Geriatric patients have joint disease.
C) Geriatric patients' hearing problems change their balance.
D) Geriatric patients experience postural hypotension.

Question 11

The physician tells the nurse that a patient is hypokalemic.He has been taking a thiazide medication for treatment of his high blood pressure.Which should the nurse instruct him to increase his dietary intake of?

A) Green leafy vegetables
B) Sodium
C) Bananas and citrus fruits
D) Low-fat products

Question 12

A patient has acute angina upon exercise.The physician starts this patient on a long-acting nitrate.This medication is used for acute angina for which reasons?

A) It reduces blood going to vessels, reducing pain.
B) It opens vessels, increasing blood supply to the heart during exercise.
C) It controls returning blood going to the heart.
D) It thins returning blood going to the heart.

Question 13

A patient arrives in the emergency department with abdominal distention,pain,and nausea with vomiting.IV fluids with sodium and potassium are started for which reason?

A) To increase diarrhea and clean out the colon
B) To decrease the abdominal distention and pain
C) To prevent overhydration and maintain electrolyte balance
D) To prevent dehydration and electrolyte losses

Question 14

The physician has started a patient on propranolol (Inderal LA),a beta blocker.The nurse knows this drug is used in the treatment of migraine headaches and which other conditions?

A) Angina
B) Hyperlipidemia
C) Bradycardia
D) Bronchospasm

Question 15

A patient has been having increased bilateral leg cramps for a few weeks.The health care provider has diagnosed her with peripheral vascular disease (PVD).In caring for this patient,a nurse would expect her to be started on a vasodilator drug that has which effects?

A) Decreases arterial blood flow, allowing more blood to reach the vessels
B) Opens arteries by relaxing smooth muscle, allowing more blood to reach the vessels
C) Blocks closed vessels, allowing collateral circulation to other vessels
D) Slows venous circulation, allowing arterial blood to flow more easily to vessels

Question 16

A patient has taken five or six nitroglycerin tablets per day to prevent chest pain for more than 2 years.His health care provider has recommended that he decrease the amount of medication he takes a day to no more than three tablets.This patient should reduce his medication according to which timetable?

A) Stop taking the medication all at once.
B) Take one fewer tablet every 2 months.
C) Gradually cut down over a period of time.
D) Take the medication once a week.

Question 17

A patient has a history of angina and has been told to reduce his caloric intake and lose 20 pounds.Which situation might this patient avoid so as to help prevent angina attacks?

A) Watching television
B) Heavy exercise
C) Using the computer
D) Walking 30 minutes

Question 18

The physician has discontinued a patient's diuretic medication.Which way would the nurse expect this medication to be discontinued?

A) Reduced gradually
B) Stopped immediately
C) Taken every other week for a month
D) Stopped after two more doses

Question 19

The nurse is providing discharge teaching about the use of antihyperlipidemics.The patient must understand that timing is very important.The nurse tells the patient that other medications should be taken at which time?

A) 30 minutes before taking the antihyperlipidemic
B) 1 hour after taking the antihyperlipidemic
C) Any time before taking the antihyperlipidemic
D) 4 to 6 hours after taking the antihyperlipidemic

Question 20

A nurse is visiting an 80-year-old female patient in her home.She is receiving 0.15 mg of oral digoxin daily.She also takes hydrochlorothiazide 50 mg twice a day.She complains of blurred vision and nausea.The nurse observes that she is confused and disoriented at times.Which is most likely to be the problem?

A) The patient needs to have her hydrochlorothiazide increased.
B) The patient may have digitalis toxicity.
C) The patient may have developed chronic heart failure.
D) The patient may have Alzheimer disease.

Question 21

A patient is found to have high cholesterol and triglyceride levels.He is told he has type II hyperlipidemia.Which should be explained to this patient concerning this condition?

A) There is no effective medication to treat this condition.
B) Diet therapy is the only effective treatment with this type of condition.
C) This condition is curable with a regular diet and medications for life.
D) Diet modifications and medication are helpful in normalizing lipid levels.

Question 22

Regarding the use of nitrate products for coronary artery disease,the nurse should instruct a patient about the benefits of taking nitrates using which of the following statements? (Select all that apply.)

A) Oxygen demands are reduced in the heart.
B) Small blood vessels are increased in the heart.
C) The inner heart has less oxygen supply.
D) Oral nitrates have a slow onset of action.
E) Oral nitrates are changed in the liver to inactive products.

Question 23

A patient comes to the physician's office complaining of constipation after starting his antihyperlipidemic medication.The nurse tells the patient to take the laxative the physician has prescribed and to eat a diet high in bulk.Which is a high-bulk food?

A) Potatoes
B) Corn
C) Bran
D) Bread

Question 24

A patient is scheduled to leave the hospital tomorrow.He has been instructed to take nitroglycerin sublingually if angina is experienced.Which instruction would the nurse give concerning the use of this medication?

A) "During an acute attack of angina, you may repeat the dose after 5 to 10 minutes one time. If the pain is not relieved, go to the physician's office."
B) "You should never repeat a dose, but you should notify the physician if the pain is not relieved."
C) "If the pain is not relieved within 3 minutes, you should repeat the dose every 3 minutes times two more doses. If there is still no relief, you should go immediately to an emergency department."
D) "You can take as many tablets as necessary until the pain is relieved, then report it to the physician."

Question 25

Under which condition should the nurse hold the patient's digitalis medication?

A) The patient has headaches.
B) The patient's stool contains blood.
C) The patient's apical rate is less than 60.
D) The patient's apical rate is greater than 100.

Question 26

The LPN/LVN should have some understanding about fluid and electrolyte balance.Which is a good rule to remember about this concept?

A) Sodium follows potassium, water remains in the cell.
B) Potassium leaves the cell, water remains in the cell.
C) Water remains with potassium in the cell while sodium leaves.
D) Water tends to follow sodium out of the cell.

Question 27

The treatment of hypertension in patients is accomplished at many sites in the body.The nurse administers diuretics to help achieve the goal of reducing the blood pressure through which means? (Select all that apply.)

A) Water is lost with fluid intake directly.
B) Indirect production of sodium and water loss
C) Lowering peripheral resistance
D) Reduction of arterial tone
E) Reduction of arterial rigidity

Question 28

Which is a nitrate compound that is used therapeutically to relieve acute attacks of angina?

A) Quinidine sulfate
B) Nitroglycerin
C) Digitalis
D) Minoxidil

Question 29

Which is primarily used as an antidysrhythmic drug?

A) Digitalis
B) Verapamil
C) Reserpine
D) Clonidine

Question 30

Lidocaine may be used for treating dysrhythmias in which situation?

A) The dysrhythmias are not ventricular in nature.
B) The label indicates that the medication contains preservatives.
C) The medication is given intravenously.
D) The patient is alert and responsive.

Question 31

For which patient would the nurse anticipate oral replacement therapy would be contraindicated?

A) An 18-year-old with mild diarrhea
B) A 35-year-old with constipation
C) A 65-year-old with a bowel perforation
D) A 50-year-old with flu-like symptoms

Question 32

Which is a life-threatening dysrhythmia that is often treated with lidocaine (Xylocaine)?

A) Atrial flutter
B) Ventricular fibrillation
C) Atrial tachycardia
D) Ventricular bradycardia

Question 33

Procainamide was prescribed for a patient who has ventricular tachycardia.Which adverse actions of this medication should the nurse explain to the patient? (Select all that apply.)

A) Anorexia
B) Hypotension
C) Flushness in the face
D) Cool hands
E) Headache

Question 34

A serum digitalis level is needed to evaluate whether the patient has reached a therapeutic level.Which is an acceptable therapeutic level for digoxin?

A) 2.5 ng/mL
B) 3.0 ng/mL
C) 0.2 ng/mL
D) 0.5 ng/mL

Question 35

The LPN/LVN must be aware that digitalis can cause toxicity; it can also cause hormonal effects in male patients.Which hormonal problems can this medication cause a male patient?

A) Increased appetite and weight gain
B) Swelling in the legs and feet
C) Gynecomastia and tender breasts
D) Discoloration around the neck and eyes

Question 36

Prior to administering digoxin,what should the nurse do first?

A) Assess the patient's apical heart rate.
B) Evaluate the patient's response to the medication.
C) Record patient's weight.
D) Collect a urine sample.

Question 37

The nurse is caring for an older adult patient with fever,dehydration,and diarrhea.Which does the nurse anticipate will be used in treating this patient? (Select all that apply.)

A) Lipoprotein
B) Caffeine
C) Carbohydrates
D) Minerals
E) Electrolytes

Question 38

Which symptoms exhibited by a patient taking quinidine indicate toxicity? (Select all that apply.)

A) Headache and lightheadedness
B) Fever and vertigo
C) Tinnitus, nausea, and vomiting
D) Arthralgia
E) Hypoglycemia

Question 39

A mother brings her 10-month-old daughter into the clinic because of diarrhea that has lasted for 8 hours.Which are signs of dehydration that the nurse would expect to see in this infant?

A) Decreased respiration and pulse
B) Slight moisture on mucous membranes
C) Discoloration around the nail beds
D) Hypotension and concentrated urine

Question 40

The nurse instructs a cardiac patient about the freshness of nitroglycerin sublingual tablets.Which instructions are important for the nurse to tell the patient about the medication? (Select all that apply.)

A) It should be replaced every 3 months.
B) It is no longer good if there is burning under the tongue.
C) It should cause a throbbing in the head.
D) It should cause blurred vision and dry mouth.
E) It should not cause a headache.