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?

Accepted Answer

Potassium-sparing diuretics increase the excretion of water and sodium but save potassium.These drugs are used for patients with kidney disease and in older adult patients with poor kidney function who have hypokalemia.

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?

Accepted Answer

Potassium-sparing diuretics increase the excretion of water and sodium but save potassium.

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?

Accepted Answer

The nurse should know about two different types of dosages for patients taking digoxin: the initial digitalizing dose and maintenance doses.More frequent and higher digitalizing doses are given when a patient begins taking digoxin so that a specific level of medication can be reached in the blood.Smaller maintenance doses are given once a day to maintain the blood level.

Question 4

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

Accepted Answer

Low potassium levels are commonly produced by antihypertensive medications,and a potassium supplement may be required.

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?

Accepted Answer

Thiazide diuretics work to promote reabsorption of calcium,which may make them a good choice for older adults with osteoporosis.

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?

Accepted Answer

Simvastatin is an HMG-CoA reductase inhibitor and is used in the treatment of hyperlipidemia.It is also highly effective at lowering low-density lipoproteins.

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?

Accepted Answer

Irregular heart action occurs when the cells in the heart's conduction system do not have enough oxygen,when they are destroyed or damaged through disease,or when electrolytes are not present in the right balance.

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?

Accepted Answer

Loop diuretics work well on patients with very low glomerular filtration rates,because they are so efficient in limiting the reabsorption of sodium.They are often used for patients with kidney disease and to treat chronic heart failure,cirrhosis of the liver,and nephrotic syndrome of kidney disease in which a powerful diuretic is required.

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?

Accepted Answer

Nitroglycerin medication should be stored in the original dark glass container out of the sunlight,with the cotton removed and the container tightly capped.

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?

Accepted Answer

Geriatric patients can become lightheaded when taking antihypertensive medications that can cause postural hypotension.This places them at risk for falls.

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?

Accepted Answer

Thiazide may lead to significant loss of potassium.The patient should take the medication with a full glass of orange juice (unless not permitted by his or her diet).Other potassium-rich foods include bananas.

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?

Accepted Answer

Long-acting nitrates are used to prevent or treat angina attacks when they are likely to occur with exercise.

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?

Accepted Answer

When oral fluid intake is impaired,fluid and electrolytes may be given parenterally to prevent dehydration and replace 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?

Accepted Answer

Propranolol (Inderal LA)is a class II beta blocker used in the treatment of migraines and angina.

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?

Accepted Answer

Vasodilator drugs relax the smooth muscle of peripheral arterial blood vessels and help lead to better circulation to the arms and legs.

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?

Accepted Answer

A person using a nitrate for a long period of time should gradually cut down the amount taken to avoid causing more anginal attacks,which may happen if the drug is stopped suddenly.

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?

Accepted Answer

Patients who have angina should avoid things that cause pain such as stress,heavy exercise,and foods that stimulate the heart (e.g.,soft drinks and chocolate).

Question 18

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

Accepted Answer

When a diuretic is discontinued,it is recommended that the drug be reduced gradually to avoid the development of serious edema.

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?

Accepted Answer

The patient should take any other medication 1 hour before or 4 to 6 hours after taking antihyperlipidemics,because these medications are like glue and will delay the absorption of other drugs if taken at the same time.

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?

Accepted Answer

Cardiotonics are very powerful and can act as poisons on the heart.When a patient begins to show toxic or harmful reactions from too much medication,the term digitalis toxicity is used.

Quiz 12: Cardiovascular and Renal Medications