Adult. CV pharmacology exam

Emily is a 58-year-old female with a 10-year history of hypertension and Type 2 diabetes mellitus. She has been non-compliant with her medication regimen and presents today with elevated blood pressure. Losartan has been prescribed as part of her management plan.

Which adverse effects should the nurse monitor for in a patient taking losartan? Select all that apply

A 56-year-old female patient presents to the clinic with a history of hypertension, currently controlled with medication.
During her most recent visit, her lab results were abnormally elevated.
Based on her medical history and current lab results, the healthcare provider is considering initiating fenofibrate therapy.

Complete the diagram below by dragging from the choices below what condition the client is most likely experiencing, two actions the nurse would take to address that condition, and two parameters the nurse would monitor to assess the client’s progress.

A 68-year-old female patient with a history of congestive heart failure is admitted to the cardiology ward. After reviewing the medical order, a nurse mistakenly administered 250 mg of digoxin IV instead of the intended 0.25 mg.
The patient soon exhibits bradycardia and visual disturbances.
Other initial interventions, including the administration of atropine, have not corrected the heart rate.
The attending nurse immediately informs the charge nurse about the error.
What should be the next step in managing this patient?

A 45-year-old female with a history of severe anemia has been prescribed a blood transfusion.
One hour into the transfusion, she began to complain of chills, back pain, and dyspnea. The nurse promptly stops the transfusion, suspecting a transfusion reaction.
What is the appropriate next two steps for the nurse to take?

A 59-year-old female patient with congestive heart failure and diabetes type 2 (CHF) has been stabilized on diuretics and an angiotensin-converting enzyme (ACE) inhibitor. Recently, carvedilol has been added to her medication regimen.
The nurse should prioritize monitoring the patient for two potential effects of the carvedilol.

Patient Information:

• Name: Michael Thompson
• Age: 47
• Michael is a 47-year-old male with a recent history of coronary artery bypass graft (CABG) surgery, hypertension, and obesity. He has no known allergies and has been stable postoperatively. However, he has a history of mild chronic kidney disease (CKD) and has required diuretics intermittently.

James is a 64-year-old male with a history of acute coronary syndrome, hypertension, and hyperlipidemia. He was recently admitted for unstable angina and has been placed on a nitroglycerin IV drip to manage his chest pain. He reports continued chest discomfort that worsens with exertion but improves with rest. The healthcare provider has ordered nitroglycerin IV to be titrated based on the patient’s pain and blood pressure.

Vital Signs:

• BP: 150/92 mmHg
• HR: 78 bpm
• RR: 20 breaths/min
• SpO2: 98% on room air

What should the nurse monitor when administering IV nitroglycerin to James? Select all that apply

A 60-year-old male patient with a history of pulmonary embolism has been initiated on dabigatran therapy.
During his outpatient follow-up, which aspects of dabigatran therapy should the nurse consider and which not?

A 62-year-old male with a history of coronary artery disease has been prescribed ticagrelor after a recent angioplasty. The nurse educates the client regarding the medication.

Which of the following three client statements suggests a need for further instruction?

A 68-year-old female patient with a history of chronic heart failure is admitted to the medical unit with acute pulmonary edema. The health care provider orders intravenous furosemide.
The nurse preparing to administer the medication realizes that the prescribed route is for a rapid IV push.
Given the patient's condition and the prescribed route of administration for the furosemide, which of the following is a potential concern or complication?                 
Select all that apply

A 58-year-old male patient with a diagnosis of hypertension is attending a follow-up appointment at the cardiology clinic. He has been on hydrochlorothiazide, a thiazide diuretic, for the past three months. During the assessment, he mentions several new symptoms he has experienced since starting the medication.

Based on the patient's current medication, which of the following are potential side effects associated with thiazide diuretics? Select all that apply

A 65-year-old female patient recently diagnosed with chronic stable angina is prescribed sublingual nitroglycerin tablets. During a follow-up visit, the nurse discusses the medication's appropriate use.
Which statement by the patient indicates an understanding of the medication's purpose and which does not?

Mrs. Ana Garcia, a 52-year-old Hispanic woman with a history of Prinzmetal’s angina, was admitted to the cardiac unit for ongoing management of her condition.
Mrs. Garcia, a schoolteacher with a 10-year history of hypertension and hyperlipidemia, has been experiencing intermittent episodes of chest pain, predominantly in the early mornings.
Upon admission, the nurse's notes indicated she is a nonsmoker with a sedentary lifestyle.
The cardiac monitor showed a PR interval of 0.32 seconds, raising concerns about her current medication management.

Considering Mrs. Garcia's diagnosis and the observed PR interval of 0.32 seconds on the cardiac monitor, which of her prescribed medications should the nurse consider withholding and consult with the healthcare provider (HCP)?

Alice is a 74-year-old female with a history of hypertension, mild congestive heart failure, and osteoporosis. She has been prescribed indapamide to manage her blood pressure and reduce fluid retention.

 What should the nurse monitor in Alice while she is on indapamide therapy?

A 58-year-old female patient with a history of stable angina has been prescribed isosorbide dinitrate sustained-release capsules. During the clinic visit, the nurse reviews the medication details with the patient.
Which statement by the patient would indicate an understanding of the purpose of this medication?

A 62-year-old male patient calls the clinic complaining of fatigue and palpitations that began earlier this morning. He has a history of hypertension and heart failure and is currently taking spironolactone, lisinopril, and metoprolol.
Upon reviewing his medical records, which of the following actions should the nurse prioritize?

A 72-year-old male is admitted to the cardiology unit following complaints of chest discomfort. An electrocardiogram reveals abnormal heart rhythms, and the attending physician orders intravenous lidocaine.
As the nurse reviews the patient's history and physical examination findings, which of the following conditions would make the nurse proceed with caution when administering lidocaine?

A 63-year-old male patient diagnosed with chronic stable angina has recently been started on ivabradine as an adjunct therapy to his atenolol. During a follow-up visit, he mentions to the nurse a peculiar effect he's been experiencing, saying, "I occasionally see bright flashes of light, even when my eyes are closed."

Which of the following responses by the nurse would be most appropriate?

A 52-year-old male patient presents to the emergency department with sudden onset shortness of breath, sharp chest pain that worsens with deep breaths, and a cough-producing blood-tinged sputum. He recently underwent a total knee replacement surgery. 

Given the patient's clinical presentation and diagnosis, which of the following treatments might the healthcare team consider? Select all that apply

A 57-year-old male patient began treatment for his hypertension and his nurse made the following statement.
Complete the following sentence by using the list of options


Patients taking should be cautious of   and avoid conditions, situations, or medications that could intensify this reaction.

A 56-year-old male with a history of hypertension is brought to the emergency department by his family after accidentally ingesting a large number of amlodipine tablets.

Considering the patient's presentation, which of the following complications or interventions are relevant in the context of an amlodipine overdose? Select all that apply
 

George is a 59-year-old male with a history of heart failure with reduced ejection fraction (HFrEF) and hypertension. He has been prescribed eplerenone as an add-on therapy to his current regimen of ACE inhibitors and beta-blockers.

George reports feeling well, but he is concerned about potential side effects and interactions with his current medications. He is also on a low-sodium diet.

Vital Signs:

• BP: 132/80 mmHg
• HR: 68 bpm
• RR: 18 breaths/min
• SpO2: 97% on room air

Question: What are the priority assessments and interventions when starting George on eplerenone?

A 55-year-old female patient with atrial fibrillation has been started on apixaban therapy to reduce the risk of stroke. During a follow-up visit, which of the following statements made by the patient suggests an understanding of the medication? Select all that apply

A client with heart failure is due for the prescribed digoxin, spironolactone, lisinopril, and furosemide.
 
What is the priority action of the nurse?

Patient Information:

• Name: Sarah Williams
• Age: 62