NCLEX Pharmacology Quiz 48 Cardiovascular Medications

1. A nurse is caring a client who is taking digoxin (Lanoxin) 0.25mcg tab once a day. The client suddenly complaints of anorexia. nausea. vomiting. and diarrhea. The physician is ruling a digoxin toxicity. As a nurse. you know the therapeutic digoxin rate is?

0.25-0.5 ng/ml.

0.5-2 ng/ml.

1.5-3 ng/ml.

3.5-4.5 ng/ml.

The therapeutic level of digoxin is 0.5-2 ng/ml.

Explanation

The therapeutic level of digoxin is 0.5-2 ng/ml.

2. A nurse is interviewing a client who is about to receive metoprolol. Upon the history taking. the client is also taking insulin. Which of the following statements made by the nurse will correctly explain the possible interaction of these medications?

“This medication will maintain the blood sugar level on a normal range”.

“This medication will have no effect in the blood sugar level”.

“This medication may mask some of the symptoms of hypoglycemia such as tremor. palpitation. and rapid heartbeat.

“This medication may mask some of the symptoms of hyperglycemia such as headache. increased thirst. and blurred vision”.

Beta-blockers such as metoprolol may increase the risk of hypoglycemia in patients receiving insulin. In addition. beta-blockers may mask some of the symptoms of hypoglycemia such as tremor. palpitation. and rapid heartbeat. making it more difficult to recognize an oncoming episode.

Explanation

Beta-blockers such as metoprolol may increase the risk of hypoglycemia in patients receiving insulin. In addition. beta-blockers may mask some of the symptoms of hypoglycemia such as tremor. palpitation. and rapid heartbeat. making it more difficult to recognize an oncoming episode.

3. A nurse is monitoring a client who is taking Carvedilol (Coreg CR). Which of the following assessment made by the nurse would warrant a possible complication with the use of this medication?

Baseline blood pressure of 160/100 mm hg followed by a blood pressure of 120/70 mm hg after 3 doses.

Baseline heart rate of 97 bpm followed by a heart rate of 62 bpm after 3 doses.

Complaints of nightmares and insomnia.

Complaints of dyspnea.

Complaints of dyspnea is a sign of bronchospasm which is one of the serious complication of beta blockers.Options A and B shows a decrease in the blood pressure and heart rate which are expected in this therapy.Option C is a side effect of this medication.

Explanation

Complaints of dyspnea is a sign of bronchospasm which is one of the serious complication of beta blockers.Options A and B shows a decrease in the blood pressure and heart rate which are expected in this therapy.Option C is a side effect of this medication.

4. A nurse is giving instruction to a client who is receiving Cholestyramine (Questran) for the treatment of hyperlipidemia. Which of the following statements made by the client indicates the need for further instructions?

“This medication comes in a powder that must be mixed with juice or water before administration”.

“I will avoid eating foods rich in saturated fats”.

“I will continue taking nicotinic acid as part of the treatment”.

“Constipation. belching and heartburn are some of the side effects”.

A combination of Cholestyramine (Questran) and nicotinic acid damages the liver.Options A. B. and D are true regarding this medication.

Explanation

A combination of Cholestyramine (Questran) and nicotinic acid damages the liver.Options A. B. and D are true regarding this medication.

5. A nurse is interviewing a patient who is about to receive bumetanide (Bumex). Which of the following is a concern related to the administration of the medication?

Penicillin allergy.

Sulfa allergy.

Soy containing allergy.

Cephalosporin allergy.

Loop diuretics such as bumetanide are sulfa-based medications. and a client with sulfa allergy is at risk for an allergic reaction.

Explanation

Loop diuretics such as bumetanide are sulfa-based medications. and a client with sulfa allergy is at risk for an allergic reaction.

6. A client with congestive heart failure is being treated with Torsemide (Demadex). The nurse obtains the following vital signs: Blood pressure of 100/65 mm hg; pulse rate of 91 beats per minute; and respiration of 25 breaths per minute? Which of the following will be the priority assessment of the nurse after the initiation of the dose?

Urine output.

Serum potassium and calcium.

Blood pressure.

Weight.

The priority assessment in this situation will be the monitoring of the blood pressure because hypotension poses a risk in this medication.Options A. B. and D are monitored but they are not the priority.

Explanation

The priority assessment in this situation will be the monitoring of the blood pressure because hypotension poses a risk in this medication.Options A. B. and D are monitored but they are not the priority.

7. A client is about to receive Metolazone (Zaroxolyn). The nurse in charge understands that which of the following laboratory results are related to the administration of the medication?

Hyperkalemia and hypocalcemia.

Hyperkalemia and hypoglycemia.

Hypouricemia and hypoglycemia.

Hypokalemia and hyperglycemia.

Metolazone is a thiazide diuretic that may put clients risk for hypokalemia. hyperglycemia. hyperlipidemia. hypercalcemia and hyperuricemia.

Explanation

Metolazone is a thiazide diuretic that may put clients risk for hypokalemia. hyperglycemia. hyperlipidemia. hypercalcemia and hyperuricemia.

8. A nurse is providing instructions to a client who is on nicotinic acid for the treatment of hyperlipidemia. Which statement made by the nurse indicates a comprehension of the instructions?

“I should take aspirin 30 minutes before nicotinic acid”.

“I will drink alcohol in moderation”.

“Yellowing of the skin is a common side effect”.

“This medication is taken on an empty stomach”.

The use of aspirin or a nonsteroidal anti-inflammatory drug 30 minutes before decreases flushing which is a side effect of taking nicotinic acid.Option B: Drinking alcohol will cause liver abnormalities.Option C is a sign of liver dysfunction and should be immediately informed the physician.Option D: This medication is taken with meals to decrease gastrointestinal upset.

Explanation

The use of aspirin or a nonsteroidal anti-inflammatory drug 30 minutes before decreases flushing which is a side effect of taking nicotinic acid.Option B: Drinking alcohol will cause liver abnormalities.Option C is a sign of liver dysfunction and should be immediately informed the physician.Option D: This medication is taken with meals to decrease gastrointestinal upset.

9. A nurse is monitoring a client who is taking Digoxin (Lanoxin). All of which are the side effects associated with the medication. except?

Anorexia.

Blurred vision.

Diarrhea.

Tremors.

Signs of digoxin toxicity are as follows. anorexia. nausea. vomiting. diarrhea. and blurred vision.

Explanation

Signs of digoxin toxicity are as follows. anorexia. nausea. vomiting. diarrhea. and blurred vision.

10. A client arrives in the emergency with complaints of chest pain and is diagnosed with acute MI. A morphine 4mg IV was given 5 minutes ago. Which of the following assessment made by the nurse indicates a further immediate action?

Respiratory rate from 20 bpm to 12 bpm.

Blood pressure from 120/70 to 100/60 mmHg.

The client still complains of chest pain with a pain scale of 2/10.

Cardiac rate of 103 bpm and a normal sinus rhythm of the ECG.

The goal for the client with an acute myocardial infarction is to eliminate the pain. Even pain related at a level of 2/10 should be managed with an additional dose of morphine.Options A. B. and D: although hypotension. respiratory depression. and tachycardia are the side effects of morphine but they do not require further action at this time.

Explanation

The goal for the client with an acute myocardial infarction is to eliminate the pain. Even pain related at a level of 2/10 should be managed with an additional dose of morphine.Options A. B. and D: although hypotension. respiratory depression. and tachycardia are the side effects of morphine but they do not require further action at this time.