Question 1

Which statement made by a patient who is prescribed to take clonidine twice daily indicates the need for more teaching?

Accepted Answer

Taking double doses of a medication is not recommended and can lead to harmful side effects. The patient needs further education on the importance of not doubling up on missed doses. Choices A, C, and D indicate appropriate understanding of medication management and monitoring.

Question 2

Why are "statins" avoided during pregnancy and breast-feeding?

Accepted Answer

Statins are avoided during pregnancy and breast-feeding because they lower cholesterol levels in the fetus and infant. Cholesterol is essential for the development of the nervous system, and low levels of cholesterol can lead to developmental abnormalities. Additionally, statins have not been studied extensively in pregnant and breast-feeding women, so their safety in these populations is not well-established. It is important for women to discuss any medication use with their healthcare provider before becoming pregnant or while breast-feeding.

Question 3

Which category of drugs for hypertension has the potential to make heart failure worse?

Accepted Answer

Calcium channel blockers can potentially worsen heart failure because they can decrease the force of heart contractions and lead to fluid retention.

Question 4

How do thiazide and thiazide-like diuretic drugs reduce high blood pressure?

Accepted Answer

Thiazide and thiazide-like diuretic drugs work by decreasing blood volume by promoting the excretion of salt and water through the kidneys. They also have a secondary effect of relaxing the smooth muscles of blood vessels, which further reduces blood pressure.

Question 5

How do bile acid sequestrants work to lower blood lipids?

Accepted Answer

Bile acid sequestrants bind to bile acids in the intestines, forming a complex that is then eliminated through feces. This process reduces the amount of bile available for lipid absorption, leading to increased excretion of dietary fat and ultimately lower blood lipid levels.

Question 6

What are the most common side effects of any drug used to manage hypertension?

Accepted Answer

The most common side effect of drugs used to manage hypertension is low blood pressure, which can increase the risk for falls. Headaches and nosebleeds may occur as well but are less common. Water retention and low sodium levels may occur with certain types of drugs but are not as common as low blood pressure. Low potassium levels and hearing loss are uncommon side effects.

Question 7

Which statement made by a patient taking a loop diuretic indicates the need for more teaching?

Accepted Answer

Skipping the diuretic dose while traveling can lead to fluid buildup and negative effects on the patient's heart and lungs. It is important for the patient to take their medication as prescribed, even when traveling.

Question 8

Which precaution is most important for the LPN/VN to teach a patient newly prescribed to take 10 mg of amiloride (Midamor) orally daily?

Accepted Answer

Amiloride is a potassium-sparing diuretic that can cause hyperkalemia (high potassium levels) as a side effect. Salt substitutes typically contain potassium, so patients taking amiloride should avoid using them to decrease the risk of hyperkalemia. Options B and D are not related to the medication or its side effects, and option C is incorrect because consuming excessive amounts of potassium can actually increase the risk of hyperkalemia.

Question 9

Which category of diuretic drugs exerts its mechanism of action in the collecting duct?

Accepted Answer

Potassium-sparing diuretics, such as spironolactone and amiloride, exert their mechanism of action in the collecting duct of the nephron, where they either block aldosterone receptors or inhibit sodium channels, respectively, leading to decreased sodium reabsorption and increased potassium retention.

Question 10

Which precaution is most important to teach patients who are taking any "statin" drug?

Accepted Answer

Statins are used to lower cholesterol levels, and their effectiveness can be impacted by alcohol and acetaminophen, which can also increase the risk of liver damage.

Question 11

When checking a patient's blood pressure before giving a drug specifically prescribed for hypertension, the reading is 84/50 mm Hg. What is your best action?

Accepted Answer

The blood pressure reading of 84/50 mm Hg is below normal range and may indicate hypotension. Holding the dose and notifying the healthcare provider is the best action to ensure the patient's safety and avoid any adverse reactions or complications.

Question 12

Which health problem is a potential side effect or adverse reaction of any class of diuretic drug?

Accepted Answer

Dehydration is a potential side effect of all classes of diuretic drugs, as they increase the loss of water and electrolytes from the body through urine. This can lead to dehydration if fluids and electrolytes are not adequately replaced. Heart failure, blurred vision, and urinary tract infections are not commonly associated with diuretic use as adverse effects.

Question 13

A patient newly prescribed to take propranolol for hypertension has all of the following health problems. For which one will you check with the healthcare provider before giving?

Accepted Answer

Propranolol can worsen the symptoms of asthma by constricting the airways, so it is important to check with the healthcare provider before giving it to a patient with asthma.

Question 14

How does phenazopyridine help reduce the symptoms of a bladder infection (cystitis)?

Accepted Answer

Phenazopyridine is a urinary analgesic that helps to reduce the discomfort and pain associated with cystitis. It works by reducing the irritation of the bladder lining, which can lead to a decrease in the frequency and urgency of urination, as well as an improvement in overall bladder function. It does not kill off the bacteria causing the infection, nor does it affect the strength of bladder contractions or the color and smell of urine.

Question 15

A patient who has been taking lisinopril for 2 years calls the clinic to report that her tongue and lips are swelling, making it hard for her to talk and swallow. What is your priority action?

Accepted Answer

The symptoms reported by the patient suggest she is experiencing an allergic reaction, which can quickly progress to anaphylaxis. Therefore, the priority action is to advise her to seek emergency medical attention immediately. Any delay in treatment can lead to life-threatening conditions. After advising the patient to seek medical attention, the nurse may choose to take a complete history of her allergies over the phone, notify her healthcare provider, and remind the patient to carry an EpiPen in case of allergies in the future.

Question 16

A patient who has been taking atorvastatin for 6 months reports that he has stopped exercising because his muscles and joints are always so sore. What is the nurse's best action?

Accepted Answer

Sore muscles and joints are potential symptoms of myopathy associated with atorvastatin. Holding the drug and notifying the healthcare provider immediately is the best action to ensure prompt intervention and prevention of more serious adverse effects, such as rhabdomyolysis. Assessing joint motion or suggesting the patient take aspirin is not appropriate in this situation. Documenting the report is important but not sufficient as the patient's health is at possible risk.

Question 17

You are teaching a patient about drug therapy for hyperlipidemia. Which statement made by the patient indicates that more teaching is needed?

Accepted Answer

Hyperlipidemia cannot be cured by drugs, it can only be managed. This statement indicates a misunderstanding about the purpose of the medication. More education is needed to clarify this misconception.

Question 18

Which body system works with the renal/urinary system to maintain fluid balance and remove waste products from the body?

Accepted Answer

The cardiovascular system works with the renal/urinary system to maintain fluid balance and remove waste products from the body. The cardiovascular system helps to circulate blood through the kidneys, which filter out waste products and excess fluid from the blood. The circulatory system then transports these waste products to the urinary system, where they are expelled from the body in the form of urine.

Question 19

A nursing home patient who currently takes furosemide is now prescribed to receive the first dose of losartan. You are aware that both drugs are used to manage hypertension. What is your best action?

Accepted Answer

Furosemide and losartan can be prescribed together for hypertension as they work through different mechanisms. Furosemide is a diuretic that helps reduce blood volume, while losartan is an angiotensin receptor blocker that relaxes blood vessels. This combination can be effective in managing hypertension more effectively than either drug alone.

Question 20

Why is it important to warn a patient prescribed to take finasteride (Proscar) for benign prostatic hyperplasia to wear a condom when having sex with a pregnant woman or one who could become pregnant?

Accepted Answer

Finasteride can be absorbed by a pregnant woman and cause birth defects in the fetus, particularly affecting the development of male genitalia. Therefore, it is important to warn patients taking this medication to use a condom during sexual activity with pregnant women or women who could become pregnant to prevent the potential harm to the fetus.

Quiz 8: Drugs Affecting Therenalurinary and Cardiovascular Problems