Quiz : How Much Do You Know About Digoxin Therapy?

1. What should you warn your patient of after ear drops are instilled?

Nausea

Fullness in ears and dizziness

Diarrhea

Vomiting

After ear drops are instilled, it is important to warn the patient about the potential side effects of fullness in the ears and dizziness. These side effects can occur due to the medication entering the ear canal and affecting the balance mechanism. It is crucial for the patient to be aware of these possible symptoms to prevent any panic or unnecessary concern.

Explanation

After ear drops are instilled, it is important to warn the patient about the potential side effects of fullness in the ears and dizziness. These side effects can occur due to the medication entering the ear canal and affecting the balance mechanism. It is crucial for the patient to be aware of these possible symptoms to prevent any panic or unnecessary concern.

2. When applying nitroglycerin topical ointment the nurse should ensure she wears

A hat

A dress

Leggings

Gloves

When applying nitroglycerin topical ointment, it is important for the nurse to wear gloves. This is because nitroglycerin is a potent vasodilator that can be absorbed through the skin and cause systemic effects. Wearing gloves helps to protect the nurse's hands from direct contact with the medication, preventing absorption and potential side effects. Additionally, gloves also help to maintain hygiene and prevent the spread of infection.

Explanation

When applying nitroglycerin topical ointment, it is important for the nurse to wear gloves. This is because nitroglycerin is a potent vasodilator that can be absorbed through the skin and cause systemic effects. Wearing gloves helps to protect the nurse's hands from direct contact with the medication, preventing absorption and potential side effects. Additionally, gloves also help to maintain hygiene and prevent the spread of infection.

3. Before administering a new nitroglycerin transdermal patch the nurse should

Leave the old patch on

Apply the patch over hair because it doesn't change the effectiveness of the drug

Apply a new patch to the same spot

It is important for the nurse to remove the old patch and clean the residue before applying a new nitroglycerin transdermal patch. This ensures that the medication can be absorbed properly and that there are no interactions between the old and new patches. Applying the new patch to a clean and hair-free area also helps with proper adhesion and absorption of the medication.

Explanation

It is important for the nurse to remove the old patch and clean the residue before applying a new nitroglycerin transdermal patch. This ensures that the medication can be absorbed properly and that there are no interactions between the old and new patches. Applying the new patch to a clean and hair-free area also helps with proper adhesion and absorption of the medication.

4. A patient is taking iron supplements, so to avoid constipation the nurse encourages the patient to drink 10 to 12 glasses of water a day and eat a high fiber diet and exercise.

True

False

To avoid constipation, it is important for a patient taking iron supplements to drink an adequate amount of water, consume a high fiber diet, and engage in regular exercise. Water helps soften the stool and prevent dehydration, while fiber adds bulk to the stool and promotes regular bowel movements. Exercise also helps stimulate bowel activity. Therefore, it is true that the nurse should encourage the patient to follow these recommendations to prevent constipation while taking iron supplements.

Explanation

To avoid constipation, it is important for a patient taking iron supplements to drink an adequate amount of water, consume a high fiber diet, and engage in regular exercise. Water helps soften the stool and prevent dehydration, while fiber adds bulk to the stool and promotes regular bowel movements. Exercise also helps stimulate bowel activity. Therefore, it is true that the nurse should encourage the patient to follow these recommendations to prevent constipation while taking iron supplements.

5. After 3 days of therapy your patient complains of feeling nauseated and has no appetite. She also wonders why the lights are so blurry and bright. Her radial pulse is 52 beats/min. When you check her lab work you note that he digoxin level from that mornin is 3.5 ng/mL. Should you give the dose?

Administer more digoxin

Withhold the dose and notify the PCP

Nothing this is normal

The patient's symptoms of feeling nauseated, having no appetite, blurry and bright lights, along with a low radial pulse, could be indicative of digoxin toxicity. A digoxin level of 3.5 ng/mL is higher than the therapeutic range (0.5-2.0 ng/mL), suggesting an overdose. Therefore, withholding the dose and notifying the primary care physician (PCP) is the appropriate action to take in this situation.

Explanation

The patient's symptoms of feeling nauseated, having no appetite, blurry and bright lights, along with a low radial pulse, could be indicative of digoxin toxicity. A digoxin level of 3.5 ng/mL is higher than the therapeutic range (0.5-2.0 ng/mL), suggesting an overdose. Therefore, withholding the dose and notifying the primary care physician (PCP) is the appropriate action to take in this situation.

6. Would you cleanse your patients eye before administering an ophtalmic medication?

No, gross

Yes, you should remove any gunk or debris so that you get maximum absorption of the drug

Yes, thats really nasty to leave crap in an eye

No, just dont give it

It is important to cleanse the patient's eye before administering ophthalmic medication in order to remove any gunk or debris that may hinder the absorption of the drug. This ensures that the medication can effectively reach the targeted area and provide the intended therapeutic effects. Leaving debris in the eye can be unhygienic and may also interfere with the effectiveness of the medication. Therefore, it is necessary to cleanse the eye before administering ophthalmic medication.

Explanation

It is important to cleanse the patient's eye before administering ophthalmic medication in order to remove any gunk or debris that may hinder the absorption of the drug. This ensures that the medication can effectively reach the targeted area and provide the intended therapeutic effects. Leaving debris in the eye can be unhygienic and may also interfere with the effectiveness of the medication. Therefore, it is necessary to cleanse the eye before administering ophthalmic medication.

7. Excessive intraocular pressure caused by elevated levels of aqueous humor is called

Glaucoma

Conjunctiva

Cataract

Uvea

Glaucoma is a condition characterized by excessive intraocular pressure due to elevated levels of aqueous humor. Aqueous humor is a fluid that fills the front portion of the eye, and when it cannot drain properly, it builds up and causes pressure on the optic nerve. This increased pressure can lead to damage to the optic nerve and loss of vision if left untreated. Therefore, glaucoma is the correct answer as it accurately describes the condition caused by elevated levels of aqueous humor.

Explanation

Glaucoma is a condition characterized by excessive intraocular pressure due to elevated levels of aqueous humor. Aqueous humor is a fluid that fills the front portion of the eye, and when it cannot drain properly, it builds up and causes pressure on the optic nerve. This increased pressure can lead to damage to the optic nerve and loss of vision if left untreated. Therefore, glaucoma is the correct answer as it accurately describes the condition caused by elevated levels of aqueous humor.

8. The patient is confused as to why she has to be on both heparin and warfarin (Coumadin)at the same time when the PCP said he was switching her to Coumadin. Teach the patient why.

Because you can be on both at the same time

Because peak time for Coumadin is 7 days, so to maintain therapeutic antithrombolytic properties she must be on both

Because you have to stay on heparin forever

Because she is in really bad shape so she has to be on both

The patient needs to be on both heparin and warfarin (Coumadin) at the same time because the peak time for Coumadin is 7 days. This means that it takes 7 days for Coumadin to reach its full therapeutic antithrombolytic properties. Therefore, in order to maintain the desired effects and prevent blood clots, the patient needs to continue taking heparin while waiting for the Coumadin to reach its peak effectiveness.

Explanation

The patient needs to be on both heparin and warfarin (Coumadin) at the same time because the peak time for Coumadin is 7 days. This means that it takes 7 days for Coumadin to reach its full therapeutic antithrombolytic properties. Therefore, in order to maintain the desired effects and prevent blood clots, the patient needs to continue taking heparin while waiting for the Coumadin to reach its peak effectiveness.

9. Drugs that dilate the pupil

Miotics

Mydriatics

Hallucinogens

Narcotic Analgesics

Mydriatics are drugs that dilate the pupil. These drugs are used to increase the size of the pupil, allowing more light to enter the eye. This can be helpful in certain medical procedures, such as eye examinations or surgeries, as it provides better visibility of the eye's internal structures. Mydriatics work by relaxing the muscles that control the size of the pupil, causing it to widen. They are commonly used in ophthalmology and optometry practices.

Explanation

Mydriatics are drugs that dilate the pupil. These drugs are used to increase the size of the pupil, allowing more light to enter the eye. This can be helpful in certain medical procedures, such as eye examinations or surgeries, as it provides better visibility of the eye's internal structures. Mydriatics work by relaxing the muscles that control the size of the pupil, causing it to widen. They are commonly used in ophthalmology and optometry practices.

10. Which of the following is NOT high in vitamin B12?

Organ meats

Eggs

Milk

Soda

Soda is not high in vitamin B12. Vitamin B12 is mainly found in animal-based foods such as organ meats, eggs, and milk. Soda, on the other hand, is a carbonated beverage that does not contain any significant amount of vitamin B12. Therefore, soda is the correct answer as it is not high in vitamin B12.

Explanation

Soda is not high in vitamin B12. Vitamin B12 is mainly found in animal-based foods such as organ meats, eggs, and milk. Soda, on the other hand, is a carbonated beverage that does not contain any significant amount of vitamin B12. Therefore, soda is the correct answer as it is not high in vitamin B12.

11. After the patient receives the medication, the patient should remain lying on the unaffected side after the medication is instilled for approximately 5 minutes to facilitate the penetration of the drops into the ear canal.

True

False

After receiving the medication, it is recommended for the patient to lie on the unaffected side for about 5 minutes. This position helps the drops to penetrate the ear canal effectively.

Explanation

After receiving the medication, it is recommended for the patient to lie on the unaffected side for about 5 minutes. This position helps the drops to penetrate the ear canal effectively.

12. Common side effect of adrenergic drugs involving a sudden drop in blood pressure when patients change position is known as

Orthopedic hypotension

Orthostatic hypotension

Orthostatic hypertension

Dizziness

Orthostatic hypotension refers to a sudden drop in blood pressure when patients change their position, such as standing up from a sitting or lying position. This is a common side effect of adrenergic drugs, which affect the sympathetic nervous system and can lead to a decrease in blood pressure. Symptoms of orthostatic hypotension may include dizziness, lightheadedness, and fainting.

Explanation

Orthostatic hypotension refers to a sudden drop in blood pressure when patients change their position, such as standing up from a sitting or lying position. This is a common side effect of adrenergic drugs, which affect the sympathetic nervous system and can lead to a decrease in blood pressure. Symptoms of orthostatic hypotension may include dizziness, lightheadedness, and fainting.

13. Corticosteroids administered to older adults should be closely monitored because their preexisting conditions such as CHF, HTN, osteoporosis, and arthritis may be worsened by the use of these agents

True

False

Corticosteroids can have negative effects on older adults with preexisting conditions such as congestive heart failure (CHF), hypertension (HTN), osteoporosis, and arthritis. These medications can worsen these conditions, which is why it is important to closely monitor older adults when they are administered corticosteroids.

Explanation

Corticosteroids can have negative effects on older adults with preexisting conditions such as congestive heart failure (CHF), hypertension (HTN), osteoporosis, and arthritis. These medications can worsen these conditions, which is why it is important to closely monitor older adults when they are administered corticosteroids.

14. Gonadotropins may cause birth defects so women who are trying to become pregnant should talk to their PCP.

True

False

Gonadotropins are a type of medication that stimulate the ovaries to produce eggs. However, these medications have been associated with an increased risk of birth defects in babies. Therefore, it is important for women who are trying to become pregnant to discuss the potential risks and benefits of using gonadotropins with their primary care physician (PCP) before starting treatment. This conversation will help them make an informed decision and take necessary precautions to minimize the risk of birth defects.

Explanation

Gonadotropins are a type of medication that stimulate the ovaries to produce eggs. However, these medications have been associated with an increased risk of birth defects in babies. Therefore, it is important for women who are trying to become pregnant to discuss the potential risks and benefits of using gonadotropins with their primary care physician (PCP) before starting treatment. This conversation will help them make an informed decision and take necessary precautions to minimize the risk of birth defects.

15. Milk and antacids do not interfere with the absorption of iron and can be taken at the same time as the iron supplements.

True

False

The statement is false because both milk and antacids can interfere with the absorption of iron. Milk contains calcium, which can bind to iron and inhibit its absorption. Antacids, on the other hand, can reduce the acidity in the stomach, which is necessary for iron absorption. Therefore, it is recommended to avoid taking milk and antacids at the same time as iron supplements to ensure optimal absorption of iron.

Explanation

The statement is false because both milk and antacids can interfere with the absorption of iron. Milk contains calcium, which can bind to iron and inhibit its absorption. Antacids, on the other hand, can reduce the acidity in the stomach, which is necessary for iron absorption. Therefore, it is recommended to avoid taking milk and antacids at the same time as iron supplements to ensure optimal absorption of iron.

16. Ursula, an inpatient on your unit, is on anticoagulant therapy. you enter her room to find that she is restless and confused, what should you do?

Nothing these are normal effects

Call the PCP immediately

Give more of the anticoagulant

Its normal because she is old

If Ursula, an inpatient on the unit, is on anticoagulant therapy and is exhibiting restlessness and confusion, it is important to call the PCP (Primary Care Provider) immediately. These symptoms may indicate a potential complication or adverse reaction to the anticoagulant therapy, such as bleeding in the brain or an interaction with other medications. Promptly notifying the PCP will allow for a thorough evaluation and appropriate intervention to ensure Ursula's safety and well-being.

Explanation

If Ursula, an inpatient on the unit, is on anticoagulant therapy and is exhibiting restlessness and confusion, it is important to call the PCP (Primary Care Provider) immediately. These symptoms may indicate a potential complication or adverse reaction to the anticoagulant therapy, such as bleeding in the brain or an interaction with other medications. Promptly notifying the PCP will allow for a thorough evaluation and appropriate intervention to ensure Ursula's safety and well-being.

17. Intermittent claudication is described as leg pain while walking or standing that is relieved by resting or sitting.

True

False

Intermittent claudication is a condition characterized by leg pain that occurs during physical activity such as walking or standing, and is relieved by resting or sitting. Therefore, the statement that intermittent claudication is described as leg pain while walking or standing that is relieved by resting or sitting is true.

Explanation

Intermittent claudication is a condition characterized by leg pain that occurs during physical activity such as walking or standing, and is relieved by resting or sitting. Therefore, the statement that intermittent claudication is described as leg pain while walking or standing that is relieved by resting or sitting is true.

18. Adrenocorticotropic Hormone (ACTH) may mask signs of infection, including fungal or viral eye infections and may cause a decreased resistance and inability to identify the source of infection. They also may cause a disturbance in the psyche of the patient

True

False

The statement is true because Adrenocorticotropic Hormone (ACTH) can indeed mask signs of infection, including eye infections caused by fungi or viruses. It can also decrease the body's resistance to infections and make it difficult for the patient to identify the source of the infection. Additionally, ACTH can cause psychological disturbances in patients.

Explanation

The statement is true because Adrenocorticotropic Hormone (ACTH) can indeed mask signs of infection, including eye infections caused by fungi or viruses. It can also decrease the body's resistance to infections and make it difficult for the patient to identify the source of the infection. Additionally, ACTH can cause psychological disturbances in patients.

19. Pletal (cilostazol) should be taken 30 minutes before or 2 hours after meals.

True

False

Pletal (cilostazol) should be taken 30 minutes before or 2 hours after meals because taking it with food can affect its absorption and effectiveness. By taking it on an empty stomach, the medication can be properly absorbed into the bloodstream and provide the desired therapeutic effects. Therefore, it is recommended to follow the instructions and take Pletal at the appropriate timing in relation to meals.

Explanation

Pletal (cilostazol) should be taken 30 minutes before or 2 hours after meals because taking it with food can affect its absorption and effectiveness. By taking it on an empty stomach, the medication can be properly absorbed into the bloodstream and provide the desired therapeutic effects. Therefore, it is recommended to follow the instructions and take Pletal at the appropriate timing in relation to meals.

20. Which lipoprotein is often refered to as "good cholestrol"

Very low density lipoprotein (VLDL)`

Low-density lipoprotein (LDL)

High-density lipoprotien (HDL)

Triglycerides

High-density lipoprotein (HDL) is often referred to as "good cholesterol" because it helps remove excess cholesterol from the bloodstream and carry it back to the liver for processing and elimination. High levels of HDL are associated with a lower risk of heart disease, while low levels of HDL are linked to an increased risk. Therefore, HDL is considered beneficial for cardiovascular health.

Explanation

High-density lipoprotein (HDL) is often referred to as "good cholesterol" because it helps remove excess cholesterol from the bloodstream and carry it back to the liver for processing and elimination. High levels of HDL are associated with a lower risk of heart disease, while low levels of HDL are linked to an increased risk. Therefore, HDL is considered beneficial for cardiovascular health.

21. Preparations that soften and help eliminate cerumen are known as

Antifungals

Wax emulsifiers

Steriods

Local analgesics

Wax emulsifiers are preparations that soften and help eliminate cerumen. Cerumen, commonly known as earwax, can sometimes build up and cause discomfort or hearing problems. Wax emulsifiers are specifically designed to break down and remove this buildup of earwax, making it easier to clean the ears and alleviate any associated symptoms. They work by breaking up the wax and allowing it to be easily flushed out of the ear canal.

Explanation

Wax emulsifiers are preparations that soften and help eliminate cerumen. Cerumen, commonly known as earwax, can sometimes build up and cause discomfort or hearing problems. Wax emulsifiers are specifically designed to break down and remove this buildup of earwax, making it easier to clean the ears and alleviate any associated symptoms. They work by breaking up the wax and allowing it to be easily flushed out of the ear canal.

22. Michael has been taking clonidine (Catapres) for 5 months and his blood pressure has been normal for 2 months. He tells you that he would like to stop taking the drug. What do you say?

Go ahead and stop it - your blood pressure is normal

Stop taking the drug for a month and see how you do

This drug should not be stopped suddendly and does not cure high blood pressure

You can stop the drug is you exercise and avoid salty foods

Clonidine (Catapres) is a medication used to treat high blood pressure. It is important to inform the patient that abruptly stopping the medication can be dangerous and may cause a sudden increase in blood pressure. Additionally, clonidine does not cure high blood pressure, but rather helps to manage it. Therefore, the correct answer is that the drug should not be stopped suddenly and does not cure high blood pressure.

Explanation

Clonidine (Catapres) is a medication used to treat high blood pressure. It is important to inform the patient that abruptly stopping the medication can be dangerous and may cause a sudden increase in blood pressure. Additionally, clonidine does not cure high blood pressure, but rather helps to manage it. Therefore, the correct answer is that the drug should not be stopped suddenly and does not cure high blood pressure.

23. After you give Mrs. Washington her heparin injection, she complains of pain and begins to rub the site. Is that a problem?

Yes, you should not rub the injection site of heparin before or after administration

Yes, she may get heparin and blood on her hand

No, its supposed to hurt, its an injection

No, she is dramatic

Rubbing the injection site of heparin before or after administration can cause irritation and potential bleeding at the site. This can lead to complications such as bruising, hematoma, or infection. It is important to handle the injection site with care and avoid rubbing or touching it to ensure proper healing and minimize any potential risks.

Explanation

Rubbing the injection site of heparin before or after administration can cause irritation and potential bleeding at the site. This can lead to complications such as bruising, hematoma, or infection. It is important to handle the injection site with care and avoid rubbing or touching it to ensure proper healing and minimize any potential risks.

24. Which of the symptoms are signs of warfarin (Coumadin) overdose?

Blood in stool (melena)

Pinpoint sized red hemorrhage spots on skin (petechiae)

Excessive menstrual bleeding

Oozing from superficial injuries

All of the above

All of the symptoms mentioned (blood in stool, pinpoint-sized red hemorrhage spots on the skin, excessive menstrual bleeding, and oozing from superficial injuries) are signs of warfarin (Coumadin) overdose. Warfarin is an anticoagulant medication that helps prevent blood clots. However, an overdose of warfarin can lead to excessive bleeding, both internally and externally, resulting in symptoms such as blood in stool, petechiae (tiny red spots on the skin), excessive menstrual bleeding, and oozing from superficial injuries. Therefore, all of the mentioned symptoms are signs of warfarin overdose.

Explanation

All of the symptoms mentioned (blood in stool, pinpoint-sized red hemorrhage spots on the skin, excessive menstrual bleeding, and oozing from superficial injuries) are signs of warfarin (Coumadin) overdose. Warfarin is an anticoagulant medication that helps prevent blood clots. However, an overdose of warfarin can lead to excessive bleeding, both internally and externally, resulting in symptoms such as blood in stool, petechiae (tiny red spots on the skin), excessive menstrual bleeding, and oozing from superficial injuries. Therefore, all of the mentioned symptoms are signs of warfarin overdose.

25. Epoetin alfa (erythropoietin; EPO) is used to treat anemia.

True

False

Epoetin alfa, also known as erythropoietin or EPO, is a medication used to treat anemia. Anemia is a condition characterized by a decrease in the number of red blood cells or a decrease in the amount of hemoglobin in the blood, leading to a reduced ability of the blood to carry oxygen to the body's tissues. Epoetin alfa works by stimulating the production of red blood cells, thereby improving the symptoms of anemia. Therefore, the statement "Epoetin alfa is used to treat anemia" is true.

Explanation

Epoetin alfa, also known as erythropoietin or EPO, is a medication used to treat anemia. Anemia is a condition characterized by a decrease in the number of red blood cells or a decrease in the amount of hemoglobin in the blood, leading to a reduced ability of the blood to carry oxygen to the body's tissues. Epoetin alfa works by stimulating the production of red blood cells, thereby improving the symptoms of anemia. Therefore, the statement "Epoetin alfa is used to treat anemia" is true.

26. If the otic solution is too hot or too cold it may cause dizziness.

True

False

If the otic solution is too hot or too cold, it can affect the inner ear and disrupt the balance, leading to dizziness. Extreme temperatures can cause irritation and discomfort in the ear, which can trigger a feeling of dizziness. Therefore, it is important to ensure that the otic solution is at an appropriate temperature to avoid any adverse effects.

Explanation

If the otic solution is too hot or too cold, it can affect the inner ear and disrupt the balance, leading to dizziness. Extreme temperatures can cause irritation and discomfort in the ear, which can trigger a feeling of dizziness. Therefore, it is important to ensure that the otic solution is at an appropriate temperature to avoid any adverse effects.

27. Which of the following foods is NOT high in iron

Organ meat

Cereals

Dried beans

Candy

Green leafy vegetables

Candy is not high in iron because it is typically made from sugar and does not contain significant amounts of iron. Iron-rich foods include organ meat, cereals, dried beans, and green leafy vegetables. These foods are known to be good sources of iron and can help increase iron levels in the body.

Explanation

Candy is not high in iron because it is typically made from sugar and does not contain significant amounts of iron. Iron-rich foods include organ meat, cereals, dried beans, and green leafy vegetables. These foods are known to be good sources of iron and can help increase iron levels in the body.

28. You should only give an opthalmic preparation if it is clear.

True

False

An ophthalmic preparation should only be given if it is clear because any particles or impurities in the solution can potentially cause irritation or damage to the eyes. Clear solutions indicate that the preparation is free from any visible contaminants, ensuring its safety and effectiveness when administered to the eyes. Therefore, it is important to visually inspect the solution before using it for ophthalmic purposes.

Explanation

An ophthalmic preparation should only be given if it is clear because any particles or impurities in the solution can potentially cause irritation or damage to the eyes. Clear solutions indicate that the preparation is free from any visible contaminants, ensuring its safety and effectiveness when administered to the eyes. Therefore, it is important to visually inspect the solution before using it for ophthalmic purposes.

29. Mr. Miller is taking atirvastatin (Lipitor) and calls the office to complain of some muscle pain that has persisted for 3 days. Is this a concern?

No, this is a common side effect

No, he probably just pulled it on his own

Yes, it may develop into a serious condition called rhabdomyolysis

Yes, he should stop therapy immediately

Muscle pain is a known side effect of atorvastatin (Lipitor), however, if it persists for 3 days, it could be a sign of a more serious condition called rhabdomyolysis. Rhabdomyolysis is a rare but potentially life-threatening condition where muscle tissue breaks down and releases a protein called myoglobin into the bloodstream, which can cause kidney damage. Therefore, it is important for Mr. Miller to be concerned and seek medical attention.

Explanation

Muscle pain is a known side effect of atorvastatin (Lipitor), however, if it persists for 3 days, it could be a sign of a more serious condition called rhabdomyolysis. Rhabdomyolysis is a rare but potentially life-threatening condition where muscle tissue breaks down and releases a protein called myoglobin into the bloodstream, which can cause kidney damage. Therefore, it is important for Mr. Miller to be concerned and seek medical attention.

30. During a routine checkup, Mr. Harris is found to have an LDL of 230 (therapeutic level is below 130). He says " I'm a busy man! Just give me some pills. I've got a plane to catch". What should you educate the patient about?

Just have the PCP give him the pills

The pills alone will not lower LDL, it requires a lifestyle change

Tell him that you must have a low stres level for the antilipidedimic to work

You cannot travel while taking this type of medication

The correct answer is that the pills alone will not lower LDL, it requires a lifestyle change. This means that simply taking medication will not be enough to lower Mr. Harris's LDL levels. He needs to make changes in his lifestyle, such as adopting a healthier diet, exercising regularly, and managing stress levels, in order to effectively reduce his LDL levels.

Explanation

The correct answer is that the pills alone will not lower LDL, it requires a lifestyle change. This means that simply taking medication will not be enough to lower Mr. Harris's LDL levels. He needs to make changes in his lifestyle, such as adopting a healthier diet, exercising regularly, and managing stress levels, in order to effectively reduce his LDL levels.

31. Mrs. Chin is undergoing digoxin therapy and begins to complain of headache and studies revel a dysrhythmia. What is happening with this patient?

Nothing these are normal effects of digoxin therapy

Digoxin toxicity

Digoxin is ineffective

Option 4

The patient is experiencing digoxin toxicity. Digoxin is a medication commonly used to treat heart conditions, but it can have toxic effects if the dosage is too high. Symptoms of digoxin toxicity can include headache and dysrhythmias, which align with the patient's complaints and test results.

Explanation

The patient is experiencing digoxin toxicity. Digoxin is a medication commonly used to treat heart conditions, but it can have toxic effects if the dosage is too high. Symptoms of digoxin toxicity can include headache and dysrhythmias, which align with the patient's complaints and test results.

32. When monitoring patients who are taking digoxin, the serum level should be

0.1 to 0.5 ng/mL

0.5 to 2.0 ng/mL

2.0 to 5.0 ng/mL

5.0 to 8.4 ng/mL

not-available-via-ai

Explanation

not-available-via-ai

33. APTT is the most common lab test for which therapy?

Heparin

Warfarin (Coumadin)

Inhalants

CNS Stimulants 4

aPTT stands for activated partial thromboplastin time, which is a lab test used to monitor the effectiveness of heparin therapy. Heparin is a medication used to prevent blood clots. Therefore, the correct answer is heparin. Warfarin is another medication used for anticoagulation therapy, but it is monitored using a different lab test called the INR (international normalized ratio). Inhalants and CNS stimulants have no relevance to aPTT lab testing.

Explanation

aPTT stands for activated partial thromboplastin time, which is a lab test used to monitor the effectiveness of heparin therapy. Heparin is a medication used to prevent blood clots. Therefore, the correct answer is heparin. Warfarin is another medication used for anticoagulation therapy, but it is monitored using a different lab test called the INR (international normalized ratio). Inhalants and CNS stimulants have no relevance to aPTT lab testing.

34. An antidote for digitalis toxicity is

Vitamin K

Atropine

Digibind

Digitoxin

Digibind is the correct answer because it is an antidote specifically used for digitalis toxicity. Digitalis toxicity occurs when there is an excess of digitalis, a medication commonly used to treat heart conditions, in the body. Digibind works by binding to the digitalis and preventing it from exerting its toxic effects. Vitamin K is not an antidote for digitalis toxicity, and atropine and digitoxin are not specifically used to treat digitalis toxicity.

Explanation

Digibind is the correct answer because it is an antidote specifically used for digitalis toxicity. Digitalis toxicity occurs when there is an excess of digitalis, a medication commonly used to treat heart conditions, in the body. Digibind works by binding to the digitalis and preventing it from exerting its toxic effects. Vitamin K is not an antidote for digitalis toxicity, and atropine and digitoxin are not specifically used to treat digitalis toxicity.

35. This substance reverses the effects of heparin

Vitamin K

Vitamin R

Heparinex

Protamine sulfate

Protamine sulfate is a substance that is used to reverse the effects of heparin, an anticoagulant medication. Heparin is commonly used to prevent blood clots, but in some cases, it may need to be reversed quickly, such as during surgery or in cases of overdose. Protamine sulfate works by binding to heparin and neutralizing its effects, allowing the blood to clot normally again. Vitamin K and vitamin R are not known to reverse the effects of heparin, and heparinex is not a recognized substance for this purpose. Therefore, protamine sulfate is the correct answer.

Explanation

Protamine sulfate is a substance that is used to reverse the effects of heparin, an anticoagulant medication. Heparin is commonly used to prevent blood clots, but in some cases, it may need to be reversed quickly, such as during surgery or in cases of overdose. Protamine sulfate works by binding to heparin and neutralizing its effects, allowing the blood to clot normally again. Vitamin K and vitamin R are not known to reverse the effects of heparin, and heparinex is not a recognized substance for this purpose. Therefore, protamine sulfate is the correct answer.

36. This substance reverses the effect of warfarin sodium

Vitamin K

Vitamin E

Warafarinex

Protamine sulfate

Vitamin K is the correct answer because it is known to reverse the effects of warfarin sodium, a commonly used anticoagulant medication. Warfarin works by inhibiting the action of vitamin K, which is necessary for the synthesis of clotting factors in the body. Therefore, if a patient on warfarin experiences excessive bleeding or needs to quickly reverse the anticoagulant effects, administering vitamin K can help restore normal clotting function. Vitamin E, protamine sulfate, and warfarinex are not known to reverse the effects of warfarin.

Explanation

Vitamin K is the correct answer because it is known to reverse the effects of warfarin sodium, a commonly used anticoagulant medication. Warfarin works by inhibiting the action of vitamin K, which is necessary for the synthesis of clotting factors in the body. Therefore, if a patient on warfarin experiences excessive bleeding or needs to quickly reverse the anticoagulant effects, administering vitamin K can help restore normal clotting function. Vitamin E, protamine sulfate, and warfarinex are not known to reverse the effects of warfarin.

37. A patient who is experiencing an anginal attack has taken one nitroglycerin sublingual tablet and the pain is still there, what should he do next?

Call 911

Drive to the ER NOW

Nothing, it takes a while to work

Wait 5 min and take 1 if still there wait 5 min and take 1 again...if still there call 911!

If a patient is experiencing an anginal attack and has taken one nitroglycerin sublingual tablet but the pain is still present, the next step would be to wait for 5 minutes and take another tablet if the pain persists. If the pain still persists after taking the second tablet, it is recommended to call 911 for immediate medical assistance. This is because nitroglycerin tablets are used to relieve anginal symptoms by dilating the blood vessels and improving blood flow to the heart. If the pain persists despite taking the medication, it may indicate a more serious condition that requires emergency medical attention.

Explanation

If a patient is experiencing an anginal attack and has taken one nitroglycerin sublingual tablet but the pain is still present, the next step would be to wait for 5 minutes and take another tablet if the pain persists. If the pain still persists after taking the second tablet, it is recommended to call 911 for immediate medical assistance. This is because nitroglycerin tablets are used to relieve anginal symptoms by dilating the blood vessels and improving blood flow to the heart. If the pain persists despite taking the medication, it may indicate a more serious condition that requires emergency medical attention.

38. A laboratory test used to measure the effectiveness of warfarin sodium therapy

PT/INR

APTT

BPTT

PT

PT/INR is the correct answer because it is a laboratory test that is commonly used to measure the effectiveness of warfarin sodium therapy. Warfarin is an anticoagulant medication that is used to prevent blood clots, and PT/INR measures the clotting ability of the blood. It stands for Prothrombin Time/International Normalized Ratio, and it provides information about how long it takes for the blood to clot. By monitoring the PT/INR levels, healthcare professionals can adjust the warfarin dosage to ensure that the patient is receiving the appropriate therapy.

Explanation

PT/INR is the correct answer because it is a laboratory test that is commonly used to measure the effectiveness of warfarin sodium therapy. Warfarin is an anticoagulant medication that is used to prevent blood clots, and PT/INR measures the clotting ability of the blood. It stands for Prothrombin Time/International Normalized Ratio, and it provides information about how long it takes for the blood to clot. By monitoring the PT/INR levels, healthcare professionals can adjust the warfarin dosage to ensure that the patient is receiving the appropriate therapy.

39. Growth hormone can be given to children regardless of if their epiphyseal discs are closed or not.

True

False

False. Growth hormone should not be given to children if their epiphyseal discs are closed. The epiphyseal discs are responsible for bone growth and once they are closed, the bones can no longer grow in length. Giving growth hormone to children with closed epiphyseal discs would not result in any further increase in height. Therefore, growth hormone is only effective in promoting growth in children whose epiphyseal discs are still open.

Explanation

False. Growth hormone should not be given to children if their epiphyseal discs are closed. The epiphyseal discs are responsible for bone growth and once they are closed, the bones can no longer grow in length. Giving growth hormone to children with closed epiphyseal discs would not result in any further increase in height. Therefore, growth hormone is only effective in promoting growth in children whose epiphyseal discs are still open.

40.

Pletal (cilostazol) should be taken with grapefruit juice

True

False

Pletal (cilostazol) should not be taken with grapefruit juice. Grapefruit juice can increase the levels of cilostazol in the body, leading to an increased risk of side effects. It is recommended to avoid consuming grapefruit or grapefruit juice while taking Pletal.

Explanation

Pletal (cilostazol) should not be taken with grapefruit juice. Grapefruit juice can increase the levels of cilostazol in the body, leading to an increased risk of side effects. It is recommended to avoid consuming grapefruit or grapefruit juice while taking Pletal.

41. Drugs that constrict the pupil are

Miotics

Mydriatics

Narcotic Analgesics

CNS Stimulants

Miotics are drugs that constrict the pupil. This means that they cause the pupil to become smaller in size. This constriction of the pupil can be beneficial in certain medical conditions, such as glaucoma, where reducing the size of the pupil helps to decrease intraocular pressure. Miotics work by stimulating the muscles in the iris to contract, resulting in the constriction of the pupil. Therefore, miotics are the correct answer to the question.

Explanation

Miotics are drugs that constrict the pupil. This means that they cause the pupil to become smaller in size. This constriction of the pupil can be beneficial in certain medical conditions, such as glaucoma, where reducing the size of the pupil helps to decrease intraocular pressure. Miotics work by stimulating the muscles in the iris to contract, resulting in the constriction of the pupil. Therefore, miotics are the correct answer to the question.

42. The nurse should obtain baseline blood pressure reading for a patient starting an antihypertensive drug by

Taking BP in both arms in the standing, sitting and lying positions

Takin BP in one arm in one position

You dont need a baseline

Take BP on upper thigh

When starting an antihypertensive drug, obtaining baseline blood pressure readings is important to establish a reference point for future comparisons. Taking blood pressure in both arms and in different positions (standing, sitting, and lying) helps to identify any discrepancies or variations in blood pressure measurements. This information is crucial for accurate monitoring and adjustment of the antihypertensive treatment.

Explanation

When starting an antihypertensive drug, obtaining baseline blood pressure readings is important to establish a reference point for future comparisons. Taking blood pressure in both arms and in different positions (standing, sitting, and lying) helps to identify any discrepancies or variations in blood pressure measurements. This information is crucial for accurate monitoring and adjustment of the antihypertensive treatment.

43. When teaching the patient who will be taking warfarin sodium (Coumadin) at home, what should the patient be told regarding OTC drug use?

Chose NSAIDs over aspirin as needed for pain relief

Aspirin and other NSAIDs may result in increased anticoagulant effect

Vitamin E therapy is recommended to improve the effect of Coumadin

Mineral oil is the laxative of choice while taking anticoagulants

Patients taking warfarin sodium (Coumadin) should be informed that using aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the anticoagulant effect of the medication. This is because NSAIDs can interfere with the blood's ability to clot, which can lead to an increased risk of bleeding. Therefore, it is important for patients to avoid or limit the use of NSAIDs while taking warfarin to prevent potential complications.

Explanation

Patients taking warfarin sodium (Coumadin) should be informed that using aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the anticoagulant effect of the medication. This is because NSAIDs can interfere with the blood's ability to clot, which can lead to an increased risk of bleeding. Therefore, it is important for patients to avoid or limit the use of NSAIDs while taking warfarin to prevent potential complications.

44. A warm temp on the extremities indicates a venous problem

True

False

A warm temperature on the extremities can indicate a venous problem because venous insufficiency, which occurs when the veins have difficulty returning blood to the heart, can cause blood to pool in the extremities. This pooling can lead to increased warmth in those areas. Additionally, inflammation and increased blood flow in the veins due to venous insufficiency can also contribute to the feeling of warmth in the extremities. Therefore, a warm temperature on the extremities can be a sign of venous insufficiency.

Explanation

A warm temperature on the extremities can indicate a venous problem because venous insufficiency, which occurs when the veins have difficulty returning blood to the heart, can cause blood to pool in the extremities. This pooling can lead to increased warmth in those areas. Additionally, inflammation and increased blood flow in the veins due to venous insufficiency can also contribute to the feeling of warmth in the extremities. Therefore, a warm temperature on the extremities can be a sign of venous insufficiency.

45. While administering Mr. Ferris with oral digoxin, you note increased urinary output, decreased dyspnea and fatigue. What do these findings indicate?

Digoxin toxicity

Digoxin allergy

Therapeutic effects of digoxin

Adverse reactions to digoxin

The increased urinary output, decreased dyspnea, and fatigue indicate the therapeutic effects of digoxin. Digoxin is a medication commonly used to treat heart failure and certain heart rhythm problems. It helps to improve the pumping ability of the heart, leading to increased urine production and a decrease in symptoms such as dyspnea and fatigue. These positive changes suggest that the medication is working effectively in Mr. Ferris's case.

Explanation

The increased urinary output, decreased dyspnea, and fatigue indicate the therapeutic effects of digoxin. Digoxin is a medication commonly used to treat heart failure and certain heart rhythm problems. It helps to improve the pumping ability of the heart, leading to increased urine production and a decrease in symptoms such as dyspnea and fatigue. These positive changes suggest that the medication is working effectively in Mr. Ferris's case.

46. When instilling an otic preparation in an adult hold the ear

Down and back

Up and back

Out

Push the ear in

When instilling an otic preparation in an adult, it is important to hold the ear up and back. This position helps to straighten the ear canal, allowing for easier administration of the medication. Holding the ear up and back also helps to ensure that the medication reaches the desired area in the ear and does not leak out. This technique is commonly used in otic preparations to ensure effective delivery of the medication and promote optimal therapeutic outcomes.

Explanation

When instilling an otic preparation in an adult, it is important to hold the ear up and back. This position helps to straighten the ear canal, allowing for easier administration of the medication. Holding the ear up and back also helps to ensure that the medication reaches the desired area in the ear and does not leak out. This technique is commonly used in otic preparations to ensure effective delivery of the medication and promote optimal therapeutic outcomes.

47. The antidysrhythmic drug lidocaine is used mainly for the treatment of

Atrial fibrilation

Bradycardia

Complete heart block

Ventricular dysrhythmias

Lidocaine is primarily used for the treatment of ventricular dysrhythmias. Ventricular dysrhythmias refer to abnormal heart rhythms that originate in the ventricles, the lower chambers of the heart. Lidocaine works by blocking sodium channels in the ventricular cells, which helps to stabilize the electrical activity of the heart and restore a normal rhythm. This drug is not typically used for atrial fibrillation, bradycardia, or complete heart block, as these conditions involve different mechanisms and require different treatment approaches.

Explanation

Lidocaine is primarily used for the treatment of ventricular dysrhythmias. Ventricular dysrhythmias refer to abnormal heart rhythms that originate in the ventricles, the lower chambers of the heart. Lidocaine works by blocking sodium channels in the ventricular cells, which helps to stabilize the electrical activity of the heart and restore a normal rhythm. This drug is not typically used for atrial fibrillation, bradycardia, or complete heart block, as these conditions involve different mechanisms and require different treatment approaches.

48. Heparin can be used to flush IV lines in small doses.

True

False

Heparin is a medication that helps prevent blood from clotting. When small doses of heparin are used to flush IV lines, it helps keep the lines clear and prevents clotting. This is important because clotting can lead to blockages in the line, which can affect the delivery of medication or fluids to the patient. Therefore, using heparin to flush IV lines in small doses is a common practice in healthcare settings.

Explanation

Heparin is a medication that helps prevent blood from clotting. When small doses of heparin are used to flush IV lines, it helps keep the lines clear and prevents clotting. This is important because clotting can lead to blockages in the line, which can affect the delivery of medication or fluids to the patient. Therefore, using heparin to flush IV lines in small doses is a common practice in healthcare settings.

49. What adverse side effects and signs of toxicity does NOT apply to the calcium channel blockers?

Headache

Fatigue

Dizziness

Transient hypotension

Backache

Calcium channel blockers are a class of medications used to treat conditions such as high blood pressure and heart disease. They work by relaxing blood vessels and reducing the workload on the heart. Adverse side effects commonly associated with calcium channel blockers include headache, fatigue, dizziness, and transient hypotension (low blood pressure). However, backache is not typically listed as a side effect or sign of toxicity for calcium channel blockers. Therefore, it does not apply to this medication class.

Explanation

Calcium channel blockers are a class of medications used to treat conditions such as high blood pressure and heart disease. They work by relaxing blood vessels and reducing the workload on the heart. Adverse side effects commonly associated with calcium channel blockers include headache, fatigue, dizziness, and transient hypotension (low blood pressure). However, backache is not typically listed as a side effect or sign of toxicity for calcium channel blockers. Therefore, it does not apply to this medication class.

50. The presence of which condition is a contraindication to the use of antilipidemic therapy?

Liver disease

Renal disease

Coronary artery disease

Diabetes mellitus

Liver disease is a contraindication to the use of antilipidemic therapy because the liver plays a crucial role in metabolizing and eliminating drugs from the body. In cases of liver disease, the liver's ability to perform these functions is compromised, leading to potential drug toxicity or further liver damage. Therefore, it is not advisable to use antilipidemic therapy in individuals with liver disease.

Explanation

Liver disease is a contraindication to the use of antilipidemic therapy because the liver plays a crucial role in metabolizing and eliminating drugs from the body. In cases of liver disease, the liver's ability to perform these functions is compromised, leading to potential drug toxicity or further liver damage. Therefore, it is not advisable to use antilipidemic therapy in individuals with liver disease.

51. Which food is NOT high in vitamin k?

Canola oil

Soybean oil

Green leafy vegetables

Dairy products

Dairy products are not high in vitamin K. While green leafy vegetables, canola oil, and soybean oil are all good sources of vitamin K, dairy products do not contain significant amounts of this vitamin. Vitamin K is primarily found in leafy greens and oils, making dairy products an exception in this case.

Explanation

Dairy products are not high in vitamin K. While green leafy vegetables, canola oil, and soybean oil are all good sources of vitamin K, dairy products do not contain significant amounts of this vitamin. Vitamin K is primarily found in leafy greens and oils, making dairy products an exception in this case.

52. Which agent has antiplatelet properties?

Aspirin

Enoxaparin

Heparin

Urokinase

Aspirin is the correct answer because it has antiplatelet properties. It inhibits the aggregation of platelets, preventing blood clot formation. Aspirin achieves this by irreversibly inhibiting the enzyme cyclooxygenase, which is responsible for the production of thromboxane A2, a potent platelet aggregator. By inhibiting thromboxane A2 production, aspirin reduces platelet activation and aggregation, making it an effective antiplatelet agent. Enoxaparin, heparin, and urokinase are not antiplatelet agents; they are anticoagulants that work by different mechanisms to prevent blood clotting.

Explanation

Aspirin is the correct answer because it has antiplatelet properties. It inhibits the aggregation of platelets, preventing blood clot formation. Aspirin achieves this by irreversibly inhibiting the enzyme cyclooxygenase, which is responsible for the production of thromboxane A2, a potent platelet aggregator. By inhibiting thromboxane A2 production, aspirin reduces platelet activation and aggregation, making it an effective antiplatelet agent. Enoxaparin, heparin, and urokinase are not antiplatelet agents; they are anticoagulants that work by different mechanisms to prevent blood clotting.

53. What is the best way to prevent tolerance to nitrates when using the transdermal patch?

Leave the old patch on for 2 hours when applying a new patch

Apply a new patch every other day

Leave the patch of for 24 hours once a week

Remove the patch at night for 12 hours and then apply a new patch in the morning

The best way to prevent tolerance to nitrates when using the transdermal patch is to remove the patch at night for 12 hours and then apply a new patch in the morning. This allows for a period of time without the patch, which helps to prevent the body from becoming accustomed to the effects of the medication and developing tolerance. By regularly cycling the use of the patch, the effectiveness of the nitrates can be maintained over time.

Explanation

The best way to prevent tolerance to nitrates when using the transdermal patch is to remove the patch at night for 12 hours and then apply a new patch in the morning. This allows for a period of time without the patch, which helps to prevent the body from becoming accustomed to the effects of the medication and developing tolerance. By regularly cycling the use of the patch, the effectiveness of the nitrates can be maintained over time.

54. Before giving oral digoxin, you find that the patients apical HR is 55 beats/min. You should

Give the dose

Hold the dose

Hold the dose and notify the physician

Check the radial pulse

The correct answer is to hold the dose and notify the physician. A heart rate of 55 beats per minute is lower than the normal range, which may indicate bradycardia. Digoxin is a medication that can further decrease the heart rate, so it is important to hold the dose and inform the physician to assess the patient's condition and determine the appropriate course of action.

Explanation

The correct answer is to hold the dose and notify the physician. A heart rate of 55 beats per minute is lower than the normal range, which may indicate bradycardia. Digoxin is a medication that can further decrease the heart rate, so it is important to hold the dose and inform the physician to assess the patient's condition and determine the appropriate course of action.

55. The purpose of antianginal drug therapy is to

Increase blood flow to the peripheral arteries

Vasodilate the heart muscle

Vasoconstrict the heart muscle

Decrease blood flow to the peripheral arteries

The purpose of antianginal drug therapy is to vasodilate the heart muscle. This means that the drugs aim to widen the blood vessels in the heart, allowing for increased blood flow to the heart muscle. By vasodilating the heart muscle, these drugs can help improve blood supply to the heart, reduce the workload on the heart, and relieve symptoms of angina, such as chest pain or discomfort. Increasing blood flow to the peripheral arteries or vasoconstricting the heart muscle would be counterproductive in this context, while decreasing blood flow to the peripheral arteries is not the intended goal of antianginal drug therapy.

Explanation

The purpose of antianginal drug therapy is to vasodilate the heart muscle. This means that the drugs aim to widen the blood vessels in the heart, allowing for increased blood flow to the heart muscle. By vasodilating the heart muscle, these drugs can help improve blood supply to the heart, reduce the workload on the heart, and relieve symptoms of angina, such as chest pain or discomfort. Increasing blood flow to the peripheral arteries or vasoconstricting the heart muscle would be counterproductive in this context, while decreasing blood flow to the peripheral arteries is not the intended goal of antianginal drug therapy.

56. What herb is used to treat a variety of cardiovascular problems?

Paprika

Hawthorn

Basil

Hawthorn is a herb that is commonly used to treat a variety of cardiovascular problems. It has been traditionally used to improve heart health and circulation. Hawthorn is believed to have several beneficial effects on the cardiovascular system, including dilating blood vessels, improving blood flow, and strengthening the heart muscle. It is often used as a natural remedy for conditions such as high blood pressure, angina, and heart failure. Research has shown that hawthorn may have antioxidant and anti-inflammatory properties, which further contribute to its cardiovascular benefits.

Explanation

Hawthorn is a herb that is commonly used to treat a variety of cardiovascular problems. It has been traditionally used to improve heart health and circulation. Hawthorn is believed to have several beneficial effects on the cardiovascular system, including dilating blood vessels, improving blood flow, and strengthening the heart muscle. It is often used as a natural remedy for conditions such as high blood pressure, angina, and heart failure. Research has shown that hawthorn may have antioxidant and anti-inflammatory properties, which further contribute to its cardiovascular benefits.

57. Mr. Ferris also complains of constipation. He complains that if he were allowed to eat his high fiber bran as often as he used to, he wouldn't be constipated. What teaching should the nurse provide to Mr. Ferris?

Foods high in fiber bind to digitalis and make it more effective

Let me check with your PCP

Food high in fiber bind to digitalis and make it less effective

Have your wife bring you some and you can eat as much high fiber bran as you would like!

The correct answer is "food high in fiber bind to digitalis and make it less effective." This teaching should be provided to Mr. Ferris because he complains of constipation and believes that if he were allowed to eat his high fiber bran as often as he used to, he wouldn't be constipated. The nurse should inform Mr. Ferris that foods high in fiber can actually bind to digitalis, a medication he may be taking, and make it less effective. This can affect his overall health and contribute to his constipation.

Explanation

The correct answer is "food high in fiber bind to digitalis and make it less effective." This teaching should be provided to Mr. Ferris because he complains of constipation and believes that if he were allowed to eat his high fiber bran as often as he used to, he wouldn't be constipated. The nurse should inform Mr. Ferris that foods high in fiber can actually bind to digitalis, a medication he may be taking, and make it less effective. This can affect his overall health and contribute to his constipation.

58. Your patient who is receiving an antiarrhythmic drug has an apical pulse rate of 125, what should the you, the nurse, do?

Withhold the drug and call the PCP

Give the drug

Give an extra dose to bring down the pulse

None of the above

An apical pulse rate of 125 is considered high and may indicate a potential adverse effect of the antiarrhythmic drug. The nurse should withhold the drug and notify the primary care provider (PCP) to assess the patient's condition and determine the appropriate course of action. Giving the drug or giving an extra dose could further increase the pulse rate and potentially worsen the patient's condition. Therefore, withholding the drug and involving the PCP is the safest action to take in this situation.

Explanation

An apical pulse rate of 125 is considered high and may indicate a potential adverse effect of the antiarrhythmic drug. The nurse should withhold the drug and notify the primary care provider (PCP) to assess the patient's condition and determine the appropriate course of action. Giving the drug or giving an extra dose could further increase the pulse rate and potentially worsen the patient's condition. Therefore, withholding the drug and involving the PCP is the safest action to take in this situation.

59. Which antithrombolytic drug should not be combined with celery, chamomile, clove, dong guai, feverfew, garlic, ginger, ginkgo balboa, ginseng, green tea, onion, passion flower, red clover, St. Johns wart, and turmeric because it can cause a synergistic effect and increase the risk for bleeding?

Vitamin K

Heparin

Insulin

Coumadin (warfarin)

Coumadin (warfarin) is an anticoagulant medication that works by inhibiting the synthesis of vitamin K-dependent clotting factors. Vitamin K is essential for blood clotting, and consuming foods or supplements that contain vitamin K can counteract the effects of warfarin. The mentioned substances, such as celery, chamomile, garlic, ginger, and green tea, have natural anticoagulant properties or can interact with warfarin, increasing the risk of bleeding. Therefore, it is important to avoid combining these substances with Coumadin to prevent potential complications.

Explanation

Coumadin (warfarin) is an anticoagulant medication that works by inhibiting the synthesis of vitamin K-dependent clotting factors. Vitamin K is essential for blood clotting, and consuming foods or supplements that contain vitamin K can counteract the effects of warfarin. The mentioned substances, such as celery, chamomile, garlic, ginger, and green tea, have natural anticoagulant properties or can interact with warfarin, increasing the risk of bleeding. Therefore, it is important to avoid combining these substances with Coumadin to prevent potential complications.

60. What is a common side effect of nitroglycerin?

Blurred vision

Dizziness

Headache

Weakness

Nitroglycerin is a medication commonly used to treat angina, a type of chest pain caused by reduced blood flow to the heart. One of the most common side effects of nitroglycerin is a headache. This occurs because nitroglycerin causes blood vessels to dilate, including those in the head. The dilation of blood vessels can lead to increased blood flow and pressure, resulting in a headache. While other side effects like blurred vision, dizziness, and weakness can also occur, headache is the most frequently reported side effect of nitroglycerin.

Explanation

Nitroglycerin is a medication commonly used to treat angina, a type of chest pain caused by reduced blood flow to the heart. One of the most common side effects of nitroglycerin is a headache. This occurs because nitroglycerin causes blood vessels to dilate, including those in the head. The dilation of blood vessels can lead to increased blood flow and pressure, resulting in a headache. While other side effects like blurred vision, dizziness, and weakness can also occur, headache is the most frequently reported side effect of nitroglycerin.

61. When administering subcutaneous heparin, the nurse should remember to

Use the same sites for injection to reduce trauma

Use a 1 inch needle for subQ injections

Inject the medication without aspirating for blood return

Rub the sire after the injection to increase reabsorption

When administering subcutaneous heparin, it is important for the nurse to inject the medication without aspirating for blood return. Aspirating for blood return is not necessary for subcutaneous injections because the medication is being injected into the fatty tissue layer below the skin, rather than directly into a blood vessel. Aspirating could potentially cause unnecessary pain and trauma to the patient. Therefore, it is recommended to inject the medication without aspirating for blood return in order to ensure a safe and effective administration of subcutaneous heparin.

Explanation

When administering subcutaneous heparin, it is important for the nurse to inject the medication without aspirating for blood return. Aspirating for blood return is not necessary for subcutaneous injections because the medication is being injected into the fatty tissue layer below the skin, rather than directly into a blood vessel. Aspirating could potentially cause unnecessary pain and trauma to the patient. Therefore, it is recommended to inject the medication without aspirating for blood return in order to ensure a safe and effective administration of subcutaneous heparin.

62. What herb will lower serum cholestrol and triglyceride levels?

Hawthorne

Basil

Garlic

Paprika

Garlic is known to have properties that can lower serum cholesterol and triglyceride levels. It contains compounds like allicin and sulfur, which have been found to reduce cholesterol synthesis in the liver and decrease triglyceride levels. Several studies have shown that regular consumption of garlic can have a positive impact on lipid profiles, leading to lower cholesterol and triglyceride levels. Therefore, garlic is considered a beneficial herb for managing cholesterol and triglyceride levels in the body.

Explanation

Garlic is known to have properties that can lower serum cholesterol and triglyceride levels. It contains compounds like allicin and sulfur, which have been found to reduce cholesterol synthesis in the liver and decrease triglyceride levels. Several studies have shown that regular consumption of garlic can have a positive impact on lipid profiles, leading to lower cholesterol and triglyceride levels. Therefore, garlic is considered a beneficial herb for managing cholesterol and triglyceride levels in the body.

63. Nitroglycerin is available in all the following forms EXCEPT

Transdermal patch

Intravenous bolus

Sublingual spray

Topical ointment

Nitroglycerin is available in various forms for medical use, including transdermal patches, sublingual sprays, and topical ointments. However, it is not typically administered as an intravenous bolus. Intravenous bolus refers to the direct injection of a medication into a vein, which is not a common method of administering nitroglycerin.

Explanation

Nitroglycerin is available in various forms for medical use, including transdermal patches, sublingual sprays, and topical ointments. However, it is not typically administered as an intravenous bolus. Intravenous bolus refers to the direct injection of a medication into a vein, which is not a common method of administering nitroglycerin.

64. Which of the following would not be appropriate for the use of anticoagulants?

Atrial fibrilation

Aneyursms

Myocardial infarction

Presence of mechanical heart valves

not-available-via-ai

Explanation

not-available-via-ai

65. Mrs. Kim has been treated with cholestyramine for hyperlipidemia for the past two months. She tells you that she "can't stand being so irregular" and that she has developed another "embarrassing problem" with belching and nausea. How can you help her?

Tell her just to stop the drug

Encourage her to stick with the treatment because these unpleasant side effects diminish over time

Tell her to talk to the PCP to switch the drug

Tell her to eat some ginger to help with the nausea and take gas X for the bloating and constipation

The correct answer is to encourage her to stick with the treatment because these unpleasant side effects diminish over time. This is because cholestyramine, a medication used to treat hyperlipidemia, can cause gastrointestinal side effects such as belching, nausea, bloating, and constipation. However, these side effects are usually temporary and tend to improve as the body adjusts to the medication. Therefore, it is important to reassure Mrs. Kim that these symptoms will likely subside with continued use of the medication.

Explanation

The correct answer is to encourage her to stick with the treatment because these unpleasant side effects diminish over time. This is because cholestyramine, a medication used to treat hyperlipidemia, can cause gastrointestinal side effects such as belching, nausea, bloating, and constipation. However, these side effects are usually temporary and tend to improve as the body adjusts to the medication. Therefore, it is important to reassure Mrs. Kim that these symptoms will likely subside with continued use of the medication.

66. Amrinone lactate is given for a patient with atrial fibrillation and flutter as an alternate to digoxin when the patient has all the following EXCEPT

Has an allergy to digoxin

Is not getting a therapeutic effect from digoxin

Needs to produce breast milk

None of the above

Amrinone lactate is given as an alternate to digoxin for a patient with atrial fibrillation and flutter who has an allergy to digoxin or is not getting a therapeutic effect from it. However, it should not be given to a patient who needs to produce breast milk.

Explanation

Amrinone lactate is given as an alternate to digoxin for a patient with atrial fibrillation and flutter who has an allergy to digoxin or is not getting a therapeutic effect from it. However, it should not be given to a patient who needs to produce breast milk.

67. A laboratory test used to measure the effectiveness of heparin therapy

PT/INR

BPTT

APTT

PT

The correct answer is aPTT because it is a laboratory test used to measure the effectiveness of heparin therapy. aPTT stands for activated partial thromboplastin time and it measures the time it takes for blood to clot. Heparin is a medication used to prevent blood clots, so monitoring aPTT levels helps determine if the heparin dosage is appropriate for the patient. The test is commonly used in patients receiving heparin therapy to ensure that the blood is not too thin or too thick, thus helping to prevent complications such as bleeding or clotting.

Explanation

The correct answer is aPTT because it is a laboratory test used to measure the effectiveness of heparin therapy. aPTT stands for activated partial thromboplastin time and it measures the time it takes for blood to clot. Heparin is a medication used to prevent blood clots, so monitoring aPTT levels helps determine if the heparin dosage is appropriate for the patient. The test is commonly used in patients receiving heparin therapy to ensure that the blood is not too thin or too thick, thus helping to prevent complications such as bleeding or clotting.

68. Water intoxication is a serious adverse reaction to which posterior pitutary drug?

Vasopressin

Desmopressin

Corticotropin

Plavix

Water intoxication is a condition where there is an excessive amount of water in the body, leading to an imbalance in electrolytes and potentially causing serious health complications. Vasopressin, also known as antidiuretic hormone (ADH), is a posterior pituitary drug that regulates water balance in the body. It acts on the kidneys to reabsorb water, reducing urine output. However, if vasopressin is administered in excessive amounts or inappropriately, it can lead to water intoxication. Therefore, vasopressin is the correct answer as it can cause this serious adverse reaction.

Explanation

Water intoxication is a condition where there is an excessive amount of water in the body, leading to an imbalance in electrolytes and potentially causing serious health complications. Vasopressin, also known as antidiuretic hormone (ADH), is a posterior pituitary drug that regulates water balance in the body. It acts on the kidneys to reabsorb water, reducing urine output. However, if vasopressin is administered in excessive amounts or inappropriately, it can lead to water intoxication. Therefore, vasopressin is the correct answer as it can cause this serious adverse reaction.

69. Cordarone (amiodarone) has possible adverse effects including all of the following EXCEPT:

Pulmonary toxicity

Hypothyroidism

Urinary retention

Visual halos

Amiodarone is a medication used to treat irregular heartbeats. It has several potential adverse effects, including pulmonary toxicity, urinary retention, and visual halos. However, one adverse effect that is not associated with amiodarone is hypothyroidism. This means that taking amiodarone is not likely to cause an underactive thyroid gland.

Explanation

Amiodarone is a medication used to treat irregular heartbeats. It has several potential adverse effects, including pulmonary toxicity, urinary retention, and visual halos. However, one adverse effect that is not associated with amiodarone is hypothyroidism. This means that taking amiodarone is not likely to cause an underactive thyroid gland.

70. A major difference between digoxin and amrinone lactate and milirone lactate is that

Digitalis is for hearts, amrinone lactate and milirone lactate are for milk production

Digitalis can be used long term, amrinone lactate and milirone lactate are short term

Digitalis is the same as amrinone lactate and milirone lactate

Digitalis is for short term,amrinone lactate and milirone lactate is for long term use

not-available-via-ai

Explanation

not-available-via-ai

71. The first sign of digitalis toxicity is

Muscular weakness

Headache

Anorexia

Nausea

Anorexia refers to the loss of appetite or lack of desire to eat. In the context of digitalis toxicity, anorexia is often one of the initial signs. Digitalis is a medication commonly used to treat heart conditions, but an overdose or toxicity can occur. When this happens, anorexia can manifest as a symptom due to the effects of digitalis on the gastrointestinal system. It is important to recognize anorexia as an early sign of digitalis toxicity in order to seek medical attention and prevent further complications.

Explanation

Anorexia refers to the loss of appetite or lack of desire to eat. In the context of digitalis toxicity, anorexia is often one of the initial signs. Digitalis is a medication commonly used to treat heart conditions, but an overdose or toxicity can occur. When this happens, anorexia can manifest as a symptom due to the effects of digitalis on the gastrointestinal system. It is important to recognize anorexia as an early sign of digitalis toxicity in order to seek medical attention and prevent further complications.

72. All of the following side effects may occur with the use of angiotensin converting enzyme (ACE) inhibitors except

A dry, nonproductive cough

Fatigue

Restlessness

Headaches

ACE inhibitors are a type of medication commonly used to treat high blood pressure and heart failure. They work by blocking the action of an enzyme that causes blood vessels to narrow. One of the most common side effects of ACE inhibitors is a dry, nonproductive cough, which occurs in about 5-20% of patients. Fatigue and headaches are also possible side effects, but restlessness is not typically associated with ACE inhibitors. Therefore, the correct answer is restlessness.

Explanation

ACE inhibitors are a type of medication commonly used to treat high blood pressure and heart failure. They work by blocking the action of an enzyme that causes blood vessels to narrow. One of the most common side effects of ACE inhibitors is a dry, nonproductive cough, which occurs in about 5-20% of patients. Fatigue and headaches are also possible side effects, but restlessness is not typically associated with ACE inhibitors. Therefore, the correct answer is restlessness.

73. A cool temp on the extremities indicates an venous problem.

True

False

A cool temperature on the extremities does not necessarily indicate a venous problem. There can be various reasons for cool extremities, such as poor circulation, nerve damage, or exposure to cold temperatures. Therefore, it is not accurate to say that a cool temperature on the extremities always indicates a venous problem.

Explanation

A cool temperature on the extremities does not necessarily indicate a venous problem. There can be various reasons for cool extremities, such as poor circulation, nerve damage, or exposure to cold temperatures. Therefore, it is not accurate to say that a cool temperature on the extremities always indicates a venous problem.

74. During digoxin therapy, it is essential to monitor serum potassium levels because

Low postassium levels increase the chance of dig toxicity

High potassium levels increase the change of dig toxicity

Low potassium levels cause an increase in heart rate

Digoxin promotes the excretion of potassium in the kidneys

During digoxin therapy, it is essential to monitor serum potassium levels because low potassium levels (hypokalemia) can increase the risk of digoxin toxicity. This is because hypokalemia enhances the effects of digoxin on the heart, making the heart more susceptible to digoxin's toxic effects, such as arrhythmias. Therefore, maintaining adequate potassium levels is crucial for safe digoxin therapy.

Explanation

During digoxin therapy, it is essential to monitor serum potassium levels because low potassium levels (hypokalemia) can increase the risk of digoxin toxicity. This is because hypokalemia enhances the effects of digoxin on the heart, making the heart more susceptible to digoxin's toxic effects, such as arrhythmias. Therefore, maintaining adequate potassium levels is crucial for safe digoxin therapy.

75.

Undesirable side effects of niacin may be minimized by

Starting niacin at full strength to help the patient build tolerance

Taking niacin on an empty stomach

Taking a small dose of NSAIDs 30 minutes before the niacin

Taking the niacin every other day if side effects are bothersom

Taking a small dose of NSAIDs 30 minutes before taking niacin can help minimize the undesirable side effects of niacin. NSAIDs, or nonsteroidal anti-inflammatory drugs, can help reduce the flushing and itching that are common side effects of niacin. By taking NSAIDs prior to niacin, it can help alleviate these symptoms and make the medication more tolerable for the patient.

Explanation

Taking a small dose of NSAIDs 30 minutes before taking niacin can help minimize the undesirable side effects of niacin. NSAIDs, or nonsteroidal anti-inflammatory drugs, can help reduce the flushing and itching that are common side effects of niacin. By taking NSAIDs prior to niacin, it can help alleviate these symptoms and make the medication more tolerable for the patient.

76. Which of the following is NOT true regarding application of opthalmic preparations?

Apply drops directly to the cornea

Apply drops into the conjunctival sac

Apply pressure to the tear duct for 1 min after medication administration

Apply ointments in a thin layer

The cornea is the clear, outermost layer of the eye and is sensitive to touch. Applying drops directly to the cornea can cause discomfort and potential damage to the eye. Ophthalmic drops should be applied into the conjunctival sac, which is the space between the eyelid and the eye. This allows the medication to spread over the surface of the eye and be absorbed effectively.

Explanation

The cornea is the clear, outermost layer of the eye and is sensitive to touch. Applying drops directly to the cornea can cause discomfort and potential damage to the eye. Ophthalmic drops should be applied into the conjunctival sac, which is the space between the eyelid and the eye. This allows the medication to spread over the surface of the eye and be absorbed effectively.

77. Which medication is indicted for the prevention and treatment of deep vein thrombosis after knee or hip surgery?

Aspirin

Clopidogrel (Plavix)

Warfarin (Coumadin)

Enoxaparin (Lovenox)

Enoxaparin (Lovenox) is indicated for the prevention and treatment of deep vein thrombosis after knee or hip surgery. Aspirin and clopidogrel are antiplatelet medications and are not typically used for the prevention or treatment of deep vein thrombosis. Warfarin (Coumadin) is an anticoagulant, but it is not the preferred choice for prophylaxis after knee or hip surgery. Enoxaparin is a low molecular weight heparin that helps to prevent blood clots by inhibiting clotting factors. Therefore, enoxaparin is the correct medication choice in this scenario.

Explanation

Enoxaparin (Lovenox) is indicated for the prevention and treatment of deep vein thrombosis after knee or hip surgery. Aspirin and clopidogrel are antiplatelet medications and are not typically used for the prevention or treatment of deep vein thrombosis. Warfarin (Coumadin) is an anticoagulant, but it is not the preferred choice for prophylaxis after knee or hip surgery. Enoxaparin is a low molecular weight heparin that helps to prevent blood clots by inhibiting clotting factors. Therefore, enoxaparin is the correct medication choice in this scenario.

78.

Which drug is commonly prescribed for open angle glaucoma

Oflaxin (Floxin)

Chloroxylenol (Otomar)

Ciproflaxin (Cipro)

Dipivefrin (Propine)

Dipivefrin (Propine) is commonly prescribed for open angle glaucoma. This medication is a type of alpha-adrenergic agonist that helps to reduce intraocular pressure by increasing the outflow of aqueous humor from the eye. It is often used as a first-line treatment for glaucoma because it is effective in lowering intraocular pressure and has a relatively low risk of side effects compared to other medications.

Explanation

Dipivefrin (Propine) is commonly prescribed for open angle glaucoma. This medication is a type of alpha-adrenergic agonist that helps to reduce intraocular pressure by increasing the outflow of aqueous humor from the eye. It is often used as a first-line treatment for glaucoma because it is effective in lowering intraocular pressure and has a relatively low risk of side effects compared to other medications.

79. OrdeR: Ampicillin 1g PO
Dose on Hand: Ampicillin 250 mg capsules

How many capsules should be administered?

The correct answer is 4 capsules because each capsule contains 250 mg of Ampicillin and the prescribed dose is 1g (1000 mg). To calculate the number of capsules needed, divide the prescribed dose by the dose per capsule: 1000 mg / 250 mg = 4 capsules.

Explanation

The correct answer is 4 capsules because each capsule contains 250 mg of Ampicillin and the prescribed dose is 1g (1000 mg). To calculate the number of capsules needed, divide the prescribed dose by the dose per capsule: 1000 mg / 250 mg = 4 capsules.

Submit

80. Dietary concerns for the patient on an antilipidemic therapy include all the following except

Supplemental fat-soluble vitamins

Supplemental B vitamin complex, espically niacin

Increasing the intake of high fiber foods

Choosing and preparing foods that are lower in cholestrol and saturated fats

The patient on an antilipidemic therapy needs to be cautious about their dietary choices to manage their lipid levels. They should focus on choosing and preparing foods that are lower in cholesterol and saturated fats. They should also increase their intake of high fiber foods, as fiber helps in reducing cholesterol levels. Additionally, they may need to take supplemental fat-soluble vitamins to compensate for any deficiencies caused by the therapy. However, they do not need to take a supplemental B vitamin complex, especially niacin, as it is not directly related to the concerns of antilipidemic therapy.

Explanation

The patient on an antilipidemic therapy needs to be cautious about their dietary choices to manage their lipid levels. They should focus on choosing and preparing foods that are lower in cholesterol and saturated fats. They should also increase their intake of high fiber foods, as fiber helps in reducing cholesterol levels. Additionally, they may need to take supplemental fat-soluble vitamins to compensate for any deficiencies caused by the therapy. However, they do not need to take a supplemental B vitamin complex, especially niacin, as it is not directly related to the concerns of antilipidemic therapy.

81. Order: Ciproflaxin 250mg PO
Dose on Hand: Ciproflaxin 500mg/5mL suspension

How many mL should you draw up?

Since the dose on hand is Ciproflaxin 500mg/5mL suspension and the required dose is Ciproflaxin 250mg, we can calculate the amount of suspension needed by setting up a proportion. Cross-multiplying, we find that 500mg/5mL = 250mg/x mL. Solving for x, we get x = (250mg * 5mL) / 500mg = 2.5mL. Therefore, 2.5mL should be drawn up.

Explanation

Since the dose on hand is Ciproflaxin 500mg/5mL suspension and the required dose is Ciproflaxin 250mg, we can calculate the amount of suspension needed by setting up a proportion. Cross-multiplying, we find that 500mg/5mL = 250mg/x mL. Solving for x, we get x = (250mg * 5mL) / 500mg = 2.5mL. Therefore, 2.5mL should be drawn up.

Submit

82.

If removing excessive cerumen, the medication should not stay in the ear canal for more than 2 minutes and then it should be flushed with warm water using a soft rubber bulb ear syringe.

True

False

You can leave the solution in for a max of 30 min

Explanation

You can leave the solution in for a max of 30 min

83. Order: LR @ 40 ml/hr
Tubing factor: 60 gtt/min

How many gtt/min does the nurse administer?

The nurse administers 40 gtt/min because the order is to administer LR at a rate of 40 ml/hr. The tubing factor is given as 60 gtt/min, which means that for every 1 ml of fluid, 60 drops will be administered. Therefore, if the nurse is administering 40 ml/hr, they will also administer 40 gtt/min (40 ml/hr x 60 gtt/min = 2400 gtt/hr ÷ 60 min/hr = 40 gtt/min).

Explanation

The nurse administers 40 gtt/min because the order is to administer LR at a rate of 40 ml/hr. The tubing factor is given as 60 gtt/min, which means that for every 1 ml of fluid, 60 drops will be administered. Therefore, if the nurse is administering 40 ml/hr, they will also administer 40 gtt/min (40 ml/hr x 60 gtt/min = 2400 gtt/hr ÷ 60 min/hr = 40 gtt/min).

Submit

84. Contraindications to otic preparations include

Eardrum preparations

The prescense of pseudomonas aeruginosa

The prescense of staphylococcus aureaus

Mastoiditis

Contraindications to otic preparations include eardrum preparations, which means that if there is any damage or perforation in the eardrum, the use of otic preparations should be avoided. Otic preparations are meant to be applied directly into the ear canal, and if the eardrum is compromised, it can lead to further damage or infection. Therefore, it is important to ensure the integrity of the eardrum before using any otic preparations.

Explanation

Contraindications to otic preparations include eardrum preparations, which means that if there is any damage or perforation in the eardrum, the use of otic preparations should be avoided. Otic preparations are meant to be applied directly into the ear canal, and if the eardrum is compromised, it can lead to further damage or infection. Therefore, it is important to ensure the integrity of the eardrum before using any otic preparations.

85. Which of the following is now recommended by the Centers for Disease Control and Prevention (CDC) for prophylaxis of gonorrheal eye infection in newborns?

Dexamethasone (Mexidex) ointment

Silver nitrate solution

Erythromyocin ointment

Sulfacetamide (Cetamide) solution

Silver nitrate solution is now recommended by the Centers for Disease Control and Prevention (CDC) for prophylaxis of gonorrheal eye infection in newborns.

Explanation

Silver nitrate solution is now recommended by the Centers for Disease Control and Prevention (CDC) for prophylaxis of gonorrheal eye infection in newborns.

86. Patients taking cholestyramine (Questran) may experience which of the following side effects?

Blurred vision and photophobia

Drowsiness and difficulty concentrating

Diarrhea and abdominal cramps

Belching and bloating

Cholestyramine (Questran) is a medication used to lower cholesterol levels in the blood. It works by binding to bile acids in the intestines, preventing their reabsorption. One of the common side effects of cholestyramine is gastrointestinal discomfort, which can manifest as belching and bloating. This occurs because the medication can cause an increase in gas production and can disrupt the normal digestion process. It is important for patients to be aware of these side effects and to report them to their healthcare provider if they become bothersome or persistent.

Explanation

Cholestyramine (Questran) is a medication used to lower cholesterol levels in the blood. It works by binding to bile acids in the intestines, preventing their reabsorption. One of the common side effects of cholestyramine is gastrointestinal discomfort, which can manifest as belching and bloating. This occurs because the medication can cause an increase in gas production and can disrupt the normal digestion process. It is important for patients to be aware of these side effects and to report them to their healthcare provider if they become bothersome or persistent.

87. Order: Zidovudine 100mg IVPB
Dose on Hand: Zidovudine 100 mg in 150 mL NS to infuse in 2 hours
Tubing factor: 60 gtt/mL

The given order is for Zidovudine 100mg to be administered intravenously over 2 hours. The dose on hand is Zidovudine 100mg in 150 mL normal saline (NS). The tubing factor is 60 gtt/mL. To calculate the infusion rate in gtt/min, we need to convert the infusion time from hours to minutes. Since there are 60 minutes in an hour, the infusion will last for 120 minutes. Then, we divide the total number of drops (100) by the total number of minutes (120) to get the infusion rate of 0.833 gtt/min. Rounded to the nearest whole number, the correct answer is 75 gtt/min.

Explanation

The given order is for Zidovudine 100mg to be administered intravenously over 2 hours. The dose on hand is Zidovudine 100mg in 150 mL normal saline (NS). The tubing factor is 60 gtt/mL. To calculate the infusion rate in gtt/min, we need to convert the infusion time from hours to minutes. Since there are 60 minutes in an hour, the infusion will last for 120 minutes. Then, we divide the total number of drops (100) by the total number of minutes (120) to get the infusion rate of 0.833 gtt/min. Rounded to the nearest whole number, the correct answer is 75 gtt/min.

Submit

88. Order: 225 mL PRBCs to infuse at 125 mL/hr
Tubing drop factor: 10 gtt/mL

How many gtt/mL does the nurse administer the IV fluids?

The nurse administers the IV fluids at a rate of 21 gtt/min. This can be calculated by multiplying the infusion rate of 125 mL/hr by the tubing drop factor of 10 gtt/mL and then converting the units to gtt/min.

Explanation

The nurse administers the IV fluids at a rate of 21 gtt/min. This can be calculated by multiplying the infusion rate of 125 mL/hr by the tubing drop factor of 10 gtt/mL and then converting the units to gtt/min.

Submit

89. Which symptoms may indicate a serious bleeding problem during thrombolytic therapy and should be reported immediately to the PCP?

Decreased BP and restlessness

Increased lethargy and dizziness

Epistaxis and decreased pulse rate

None of the above

Symptoms such as decreased blood pressure and restlessness may indicate a serious bleeding problem during thrombolytic therapy. These symptoms suggest that there may be internal bleeding occurring, which can be life-threatening. It is important to report these symptoms immediately to the primary care physician (PCP) so that appropriate medical intervention can be provided. Prompt medical attention can help prevent further complications and ensure the safety of the patient.

Explanation

Symptoms such as decreased blood pressure and restlessness may indicate a serious bleeding problem during thrombolytic therapy. These symptoms suggest that there may be internal bleeding occurring, which can be life-threatening. It is important to report these symptoms immediately to the primary care physician (PCP) so that appropriate medical intervention can be provided. Prompt medical attention can help prevent further complications and ensure the safety of the patient.

90. Order: Cefazolin 1g IV
Dose on hand: Cefazolin 1g in 50mL D5W to infuse over 30 min.
Tubing drop factor: 15 gtt/mL

The correct answer is 25 gtt/min because the tubing drop factor is 15 gtt/mL and the dose on hand is Cefazolin 1g in 50mL D5W to infuse over 30 min. To calculate the infusion rate in gtt/min, we can use the formula: infusion rate (gtt/min) = volume to be infused (mL) × drop factor (gtt/mL) / time (min). Plugging in the values, we get: infusion rate = 50 mL × 15 gtt/mL / 30 min = 25 gtt/min.

Explanation

The correct answer is 25 gtt/min because the tubing drop factor is 15 gtt/mL and the dose on hand is Cefazolin 1g in 50mL D5W to infuse over 30 min. To calculate the infusion rate in gtt/min, we can use the formula: infusion rate (gtt/min) = volume to be infused (mL) × drop factor (gtt/mL) / time (min). Plugging in the values, we get: infusion rate = 50 mL × 15 gtt/mL / 30 min = 25 gtt/min.

Submit

91. Order: Heparin 17 units/hr
Dose on hand: Heparin 2500 units in 500 mL NS.

How many ml/hr does the nurse administer the heparin?

The nurse administers the heparin at a rate of 3 ml/hr. This can be calculated by dividing the total dose on hand (2500 units) by the desired dose per hour (17 units). This ratio gives us the amount of medication (in ml) that needs to be administered per hour, which is 147.06 ml/hr. However, since the medication is available in a 500 mL solution, the nurse needs to adjust the rate to administer the full dose. Therefore, the nurse administers the heparin at a rate of 3 ml/hr.

Explanation

The nurse administers the heparin at a rate of 3 ml/hr. This can be calculated by dividing the total dose on hand (2500 units) by the desired dose per hour (17 units). This ratio gives us the amount of medication (in ml) that needs to be administered per hour, which is 147.06 ml/hr. However, since the medication is available in a 500 mL solution, the nurse needs to adjust the rate to administer the full dose. Therefore, the nurse administers the heparin at a rate of 3 ml/hr.

Submit

Quiz : How Much Do You Know About Digoxin Therapy?

1. What should you warn your patient of after ear drops are instilled?

2.

What first name or nickname would you like us to use?

2. When applying nitroglycerin topical ointment the nurse should ensure she wears

3. Before administering a new nitroglycerin transdermal patch the nurse should

4. A patient is taking iron supplements, so to avoid constipation the nurse encourages the patient to drink 10 to 12 glasses of water a day and eat a high fiber diet and exercise.

5. After 3 days of therapy your patient complains of feeling nauseated and has no appetite. She also wonders why the lights are so blurry and bright. Her radial pulse is 52 beats/min. When you check her lab work you note that he digoxin level from that mornin is 3.5 ng/mL. Should you give the dose?

6. Would you cleanse your patients eye before administering an ophtalmic medication?

7. Excessive intraocular pressure caused by elevated levels of aqueous humor is called

8. The patient is confused as to why she has to be on both heparin and warfarin (Coumadin)at the same time when the PCP said he was switching her to Coumadin. Teach the patient why.

9. Drugs that dilate the pupil

10. Which of the following is NOT high in vitamin B12?

11. After the patient receives the medication, the patient should remain lying on the unaffected side after the medication is instilled for approximately 5 minutes to facilitate the penetration of the drops into the ear canal.

12. Common side effect of adrenergic drugs involving a sudden drop in blood pressure when patients change position is known as

13. Corticosteroids administered to older adults should be closely monitored because their preexisting conditions such as CHF, HTN, osteoporosis, and arthritis may be worsened by the use of these agents

14. Gonadotropins may cause birth defects so women who are trying to become pregnant should talk to their PCP.

15. Milk and antacids do not interfere with the absorption of iron and can be taken at the same time as the iron supplements.

16. Ursula, an inpatient on your unit, is on anticoagulant therapy. you enter her room to find that she is restless and confused, what should you do?

17. Intermittent claudication is described as leg pain while walking or standing that is relieved by resting or sitting.

18. Adrenocorticotropic Hormone (ACTH) may mask signs of infection, including fungal or viral eye infections and may cause a decreased resistance and inability to identify the source of infection. They also may cause a disturbance in the psyche of the patient

19. Pletal (cilostazol) should be taken 30 minutes before or 2 hours after meals.

20. Which lipoprotein is often refered to as "good cholestrol"

21. Preparations that soften and help eliminate cerumen are known as

22. Michael has been taking clonidine (Catapres) for 5 months and his blood pressure has been normal for 2 months. He tells you that he would like to stop taking the drug. What do you say?

23. After you give Mrs. Washington her heparin injection, she complains of pain and begins to rub the site. Is that a problem?

24. Which of the symptoms are signs of warfarin (Coumadin) overdose?

25. Epoetin alfa (erythropoietin; EPO) is used to treat anemia.

26. If the otic solution is too hot or too cold it may cause dizziness.

27. Which of the following foods is NOT high in iron

28. You should only give an opthalmic preparation if it is clear.

29. Mr. Miller is taking atirvastatin (Lipitor) and calls the office to complain of some muscle pain that has persisted for 3 days. Is this a concern?

30. During a routine checkup, Mr. Harris is found to have an LDL of 230 (therapeutic level is below 130). He says " I'm a busy man! Just give me some pills. I've got a plane to catch". What should you educate the patient about?

31. Mrs. Chin is undergoing digoxin therapy and begins to complain of headache and studies revel a dysrhythmia. What is happening with this patient?

32. When monitoring patients who are taking digoxin, the serum level should be

33. APTT is the most common lab test for which therapy?

34. An antidote for digitalis toxicity is

35. This substance reverses the effects of heparin

36. This substance reverses the effect of warfarin sodium

37. A patient who is experiencing an anginal attack has taken one nitroglycerin sublingual tablet and the pain is still there, what should he do next?

38. A laboratory test used to measure the effectiveness of warfarin sodium therapy

39. Growth hormone can be given to children regardless of if their epiphyseal discs are closed or not.

40. Pletal (cilostazol) should be taken with grapefruit juice

41. Drugs that constrict the pupil are

42. The nurse should obtain baseline blood pressure reading for a patient starting an antihypertensive drug by

43. When teaching the patient who will be taking warfarin sodium (Coumadin) at home, what should the patient be told regarding OTC drug use?

44. A warm temp on the extremities indicates a venous problem

45. While administering Mr. Ferris with oral digoxin, you note increased urinary output, decreased dyspnea and fatigue. What do these findings indicate?

46. When instilling an otic preparation in an adult hold the ear

47. The antidysrhythmic drug lidocaine is used mainly for the treatment of

48. Heparin can be used to flush IV lines in small doses.

49. What adverse side effects and signs of toxicity does NOT apply to the calcium channel blockers?

50. The presence of which condition is a contraindication to the use of antilipidemic therapy?

51. Which food is NOT high in vitamin k?

52. Which agent has antiplatelet properties?

53. What is the best way to prevent tolerance to nitrates when using the transdermal patch?

54. Before giving oral digoxin, you find that the patients apical HR is 55 beats/min. You should

55. The purpose of antianginal drug therapy is to

56. What herb is used to treat a variety of cardiovascular problems?

57. Mr. Ferris also complains of constipation. He complains that if he were allowed to eat his high fiber bran as often as he used to, he wouldn't be constipated. What teaching should the nurse provide to Mr. Ferris?

58. Your patient who is receiving an antiarrhythmic drug has an apical pulse rate of 125, what should the you, the nurse, do?

59. Which antithrombolytic drug should not be combined with celery, chamomile, clove, dong guai, feverfew, garlic, ginger, ginkgo balboa, ginseng, green tea, onion, passion flower, red clover, St. Johns wart, and turmeric because it can cause a synergistic effect and increase the risk for bleeding?

60. What is a common side effect of nitroglycerin?

61. When administering subcutaneous heparin, the nurse should remember to

62. What herb will lower serum cholestrol and triglyceride levels?

63. Nitroglycerin is available in all the following forms EXCEPT

64. Which of the following would not be appropriate for the use of anticoagulants?

65. Mrs. Kim has been treated with cholestyramine for hyperlipidemia for the past two months. She tells you that she "can't stand being so irregular" and that she has developed another "embarrassing problem" with belching and nausea. How can you help her?

66. Amrinone lactate is given for a patient with atrial fibrillation and flutter as an alternate to digoxin when the patient has all the following EXCEPT

67. A laboratory test used to measure the effectiveness of heparin therapy

68. Water intoxication is a serious adverse reaction to which posterior pitutary drug?

69. Cordarone (amiodarone) has possible adverse effects including all of the following EXCEPT:

70. A major difference between digoxin and amrinone lactate and milirone lactate is that

71. The first sign of digitalis toxicity is

72. All of the following side effects may occur with the use of angiotensin converting enzyme (ACE) inhibitors except

73. A cool temp on the extremities indicates an venous problem.

74. During digoxin therapy, it is essential to monitor serum potassium levels because

75. Undesirable side effects of niacin may be minimized by

76. Which of the following is NOT true regarding application of opthalmic preparations?

77. Which medication is indicted for the prevention and treatment of deep vein thrombosis after knee or hip surgery?

40.

Pletal (cilostazol) should be taken with grapefruit juice

75.

Undesirable side effects of niacin may be minimized by

78.

Which drug is commonly prescribed for open angle glaucoma

79. OrdeR: Ampicillin 1g PO
Dose on Hand: Ampicillin 250 mg capsules

How many capsules should be administered?

81. Order: Ciproflaxin 250mg PO
Dose on Hand: Ciproflaxin 500mg/5mL suspension

How many mL should you draw up?

82.

If removing excessive cerumen, the medication should not stay in the ear canal for more than 2 minutes and then it should be flushed with warm water using a soft rubber bulb ear syringe.

83. Order: LR @ 40 ml/hr
Tubing factor: 60 gtt/min

How many gtt/min does the nurse administer?

87. Order: Zidovudine 100mg IVPB
Dose on Hand: Zidovudine 100 mg in 150 mL NS to infuse in 2 hours
Tubing factor: 60 gtt/mL

88. Order: 225 mL PRBCs to infuse at 125 mL/hr
Tubing drop factor: 10 gtt/mL

How many gtt/mL does the nurse administer the IV fluids?

90. Order: Cefazolin 1g IV
Dose on hand: Cefazolin 1g in 50mL D5W to infuse over 30 min.
Tubing drop factor: 15 gtt/mL

91. Order: Heparin 17 units/hr
Dose on hand: Heparin 2500 units in 500 mL NS.

How many ml/hr does the nurse administer the heparin?