NR 293 Quiz 3

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Chamberlain University

NR-293: Pharmacology for Nursing Practice

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Date

Quiz 3: Pharmacology Review

1. Patient Concern: Black Bowel Movements After Iron Tablets

A patient calls the office three days after beginning therapy with oral iron tablets and expresses concern about having black bowel movements. The nurse should:
- a. Not instruct the patient to stop the iron tablets for a week.
- b. Not recommend taking the tablets every other day instead of daily.
- c. Not ask the patient to come into the office for a checkup.
- d. Explain that black stools are an expected side effect of iron supplementation. (Chapter 54)

2. Epoetin Alfa Therapy in a Patient with Chronic Renal Failure

Connie, a 58-year-old patient with chronic renal failure, is prescribed epoetin alfa (Epogen) for extreme weakness. During therapy, it is crucial to monitor:
- Hemoglobin levels and hematocrit. A rapid increase in hemoglobin or levels above 12 g/dL may lead to hypertension or seizures. (Chapter 22)

3. Adverse Effects of ACE Inhibitors

The nurse should consider the following adverse effects when administering ACE inhibitors (select all that apply):
- a. Diarrhea
- b. Fatigue
- c. Restlessness
- d. Headaches
- e. A dry cough
- f. Tremors

4. Hypertensive Emergency Treatment

When treating a patient with a hypertensive emergency, the nurse should expect the use of:
- a. Sodium nitroprusside (Nitropress)
- b. Not Losartan (Cozaar)
- c. Not Captopril (Capoten)
- d. Not Prazosin (Minipress)

5. Adverse Effects of Beta1 Blockers in Heart Failure and Hypertension

When a beta1 blocker is prescribed to a patient with heart failure and hypertension, the nurse should monitor for the following adverse effects, which could indicate a serious issue (select all that apply):
- a. Edema
- b. Nightmares
- c. Shortness of breath
- d. Nervousness
- e. Constipation

6. Patient Education on Alpha Blockers for Hypertension

When initiating alpha blocker therapy for hypertension, the nurse should instruct the patient to:
- c. Change positions slowly to prevent dizziness or fainting.

7. ACE Inhibitor Selection Based on Patient Characteristics

a. Irene (with liver dysfunction and high blood pressure): Captopril is preferred because it is not a prodrug and can be safely used in patients with liver disease.
b. Kory (with poor adherence): Long-acting ACE inhibitors, such as lisinopril or benazepril, are ideal due to their extended half-life.

8. Antihypertensives for African-American Patients

Calcium channel blockers and diuretics are considered more effective for treating hypertension in African-American patients compared to white patients.

9. Purpose of Antianginal Drug Therapy

The primary goal of antianginal drug therapy is:
- c. To increase blood flow to ischemic cardiac muscle. (Chapter 23)

10. Treatment for Coronary Artery Spasms

- The most effective antianginal medication for coronary artery spasms is:
  - b. Calcium channel blockers

11. Nitroglycerin and Chest Pain

- If a man experiences worsening chest pain after taking one sublingual nitroglycerin tablet, the priority action is to:
  - a. **Call 911** immediately. (Chapter 24)

12. ACE Inhibitor Effects in Heart Failure

- When starting ACE inhibitors in heart failure patients, the nurse should monitor for:
  - c. Hyperkalemia

13. Digoxin and Low Radial Pulse

- Before administering oral digoxin (Lanoxin) to a patient with a radial pulse of 52 beats per minute, the nurse should:
  - d. **Check the apical pulse** for one minute before deciding on further action.

14. Digoxin and Potassium Levels

- Low potassium levels increase the risk of digoxin toxicity.

15. Digoxin Therapy and Therapeutic Response

- Increased urinary output and reduced dyspnea are therapeutic effects of digoxin. The nurse should advise the patient to avoid consuming bran as it interferes with digoxin absorption.

16. Sudden Cardiac Death Prevention After Myocardial Infarction

- A patient hospitalized after a myocardial infarction should be prescribed a Class II antidysrhythmic or beta-blocker to reduce the risk of sudden cardiac death. In patients with asthma, cardioselective beta-blockers are preferred. (Chapter 26)