C: Nurselabs CARDIO #1 D.

Increasing cardiac output and enhancing renal

1. Which of the following clients is at greatest
risk for digital toxicity?
A. A 25-year-old client with congenital heart
disease
B. A 50-year-old client with CHF
C. A 60-year-old client after myocardial infarction
D. An 80-year-old client with CHF
2. Which of the following is a contraindication
for digoxin administration?
perfusion
8. Before giving milrinone (Primacor) by an IV
infusion to a client with symptoms of CHF,
which of the following nursing actions is
necessary?
A. Record sodium level.
B. Administer loading dose over 15 minutes.
C. Assess CV status.
D. Review medication regimen to identify if client is
on IV furosemide (Lasix).

A. Blood pressure of 140/90 9. Johanna has ventricular ectopy, which of the

B. Heart rate above 80 following drugs is the first line used to treat her
C. Heart rate below 60 condition?
D. Respiratory rate above 20
A. quinidine (Cardioquin)
3. The action of medication is inotropic when it: B. digoxin (Lanoxin)
C. procainamide ( Pronestyl)
A. Decreased afterload D. lidocaine (Xylocaine)
B. Increases heart rate
C. Increases the force of contraction 10. Class IA antiarrhythmic agents have little
D. Is used to treat CHF effect on:

4. Which is the MOST appropriate action for the A. AV node

nurse to take before administering digoxin? B. SA node
C. Purkinje fibers
A. Monitor potassium level D. Bundle of His
B. Assess blood pressure
C. Evaluate urinary output 11. Which of the following drugs can cause
D. Avoid giving with thiazide diuretic severe hematologic disorders?

5. The therapeutic drug level for digoxin is: A. digoxin (Lanoxin)

B. quinidine (Cardioquin)
A. 0.1-2.0 ng/mg C. disopyramide (Norpace)
B. 1.0-2.0 ng/mg D. procainamide (Pronestyl)
C. 0.1-0.5 ng/mg
D. 0.5-2.0 ng/mg 12. Which of the following ECG findings alerts
the nurse that the client needs an
6. Blurred vision or halos are signs of: antiarrhythmic?

A. Subtherapeutic digoxin levels A. Normal sinus rhythm

B. Digoxin toxicity B. Sinus bradycardia
C. Nothing related to digoxin C. Sinus arrhythmia
D. Corneal side effects of digoxin D. Frequent ventricular ectopy

7. Amrinone (Inocor) is used for short term 13. When administering an antiarrhythmic
therapy for CHF and acts by which of the agent, which of the following assessment
following mechanisms? parameters is the most important for the nurse
to evaluate?
A. Increasing stroke volume and heart rate
B. Slowing ventricular rate and increasing cardiac A. ECG
output B. Pulse rate
C. Vasodilating and increasing peripheral vascular C. Respiratory rate
resistance D. Blood pressure
14. Which of the following blood tests will tell 20. When administering dopamine (Intropin), it
the nurse that an adequate amount of drug is is most important for the nurse to know that:
present in the blood to prevent arrhythmias?
A. the drug’s action varies according to the dose.
A. Serum chemistries B. the drug may be used instead of fluid
B. Complete blood counts replacement.
C. Drug levels C. the drug cannot be directly mixed in solutions
D. None of the above containing bicarbonate or aminophylline.
D. the lowest dose to produce the desired effect
15. Which of the following drugs should be should be used.
used only in situations in which the client can
be very closely monitored, such as a critical 21. Dobutamine (Dobutrex) improves cardiac
care unit? output and is indicated for use in all of the
following conditions except:
A. bretylium (Bretylol)
B. digoxin (Lanoxin) A. septic shock
C. quinidine (Cardioquin) B. congestive heart failure
D. inderal (Propranolol) C. arrhythmias
D. pulmonary congestion
16. The most toxic antiarrhythmic agent is:
22. Conduction defects will most likely be an
A. digoxin (Lanoxin) adverse associated with the use of:
B. lidocaine (Xylocaine)
C. amiodarone (Cordarone) A. verapamil
D. quinidine (Cardioquin) B. nifedipine
C. diltiazem
17. Epinephrine is used to treat cardiac arrest D. felodipine
and status asthmaticus because of which of the
following actions? 23. Which of the following calcium channel
blockers has the most potent peripheral
A. Increased speed of conduction and smooth muscle dilator effect?
gluconeogenesis
B. Bronchodilation and increased heart rate, A. diltiazem
contractility, and conduction B. nifedipine
C. Increased vasodilation and enhanced C. nimodipine
myocardial contractility D. verapamil
D. Bronchoconstriction and increased heart rate
24. Which of the following adverse reactions is
18. Following norepinephrine (Levophed) found more often in volume-
administration, it is essential to the nurse to depleted elderly clients?
assess:
A. Bradycardia
A. electrolyte status B. Conduction defects
B. color and temperature of toes and fingers C. Ankle edema
C. capillary refill D. Hypotension
D. ventricular arrhythmias
25. Which of the following calcium channel
19. Norepinephrine (Levophed) is blockers is used to counteract or prevent
contraindicated in which of the following cerebral vasospasm?
conditions?
A. verapamil
A. Hypovolemic shock B. nimodipine
B. Neurogenic shock C. nifedipine
C. Blood pressures above 80-100 mmHg (systolic) D. felodipine
D. Decreased renal perfusion
26. Which of the following effects of calcium
channel blockers causes a reduction in blood
pressure?

A. Increased cardiac output

B. Decreased peripheral vascular resistance
C. Decreased renal blood flow
D. Calcium influx into cardiac muscles

27. Jason James is taking ß blockers, all of the

following should be included in his assessment
except:

A. Pulmonary function tests

B. Baseline ECG
C. Glucose level
D. Blood pressure

28. Routine laboratory monitoring in clients

taking ß blockers should include:

A. Sodium
B. Glucose
C. Thyrotropin
D. Creatine phosphokinase

29. Competitive antagonism of which of the

following occurs at ß receptor sites?

A. Catecholamines
B. Adrenergic sites
C. Acetylcholine
D. Norepinephrine

30. ß blockers should be avoided in which of

the following conditions?
A. Bronchoconstriction
B. Hypertension
C. Angina
D. Myocardial infarction
C: NurseLabs CARDIO #2
1. As a knowledgeable nurse, you know that the
action of nitrates is:
A. Smooth muscle contraction
B. Vasoconstriction
C. Smooth muscle relaxation
D. Increase preload
2. A 50-year-old client is prescribed to take
nitrate each day for his condition. As a
competent nurse, you know the result of nitrate
administration is:
A. Decreased myocardial oxygen demand
B. Increased myocardial oxygen demand
C. Increased left ventricular end-diastolic volume
D. Increased atrial pressure
3. A student nurse is asked to give an example
of a long-acting nitrate. He is correct by saying:
A. nitroglycerin sublingual
B. nitroglycerin IV
C. isosorbide PO
D. nitroglycerin transmucosal
4. When nitrates are administered early to the
acute MI client, the effect is:
A. Hypotension
B. Bradycardia
C. Reduced mortality
D. Reduced morbidity
5. When teaching about nitrate administration,
the nurse should instruct the client to:
A. Change position slowly.
B. Take pulse daily.
C. Reduce salt intake.
D. Chew the sustained-release tablets.
6. ACEs participate in the renin-angiotensin-
aldosterone system to have which of the
following physiologic effects?
A. Inhibit conversion of angiotensin II to angiotensin
I D. Increased sodium excretion and potassium
B. Vasoconstriction and sodium depletion
C. Promote sodium and water retention
D. Stimulate vasodilation and inhibit sodium
depletion
7. Nurse Margie just administered an ACE
inhibitor to her client. Before ambulating the
client for the first time after administration, the
nurse should monitor for:
A. Hypokalemia
B. Irregular heartbeat
C. Edema
D. Hypotension
8. Mira is managing her hypertension with an
ACE inhibitor. Which of the following
statements stated by her indicates a need for
further instruction?
A. “I should not take my pills with food.”
B. “I need to increase my intake of orange juice,
bananas, and green vegetables.”
C. “I will avoid coffee, tea, and colas.”
D. “I will use salt substitutes that are not high
in potassium.”
9. Pepito is a hypertensive client who has been
placed on captopril (Capoten). He states, “Dr.
del Mundo keeps changing my pills and none
are working. I feel like a guinea pig.” Which of
the following responses by the nurse would be
most appropriate?
A. “It often takes a while before the
right medication is found.”
B. “The doctor is just trying to help you control
your blood pressure.”
C. “The action of this drug is to work on both the
arteries and to remove excess fluids.”
D. “This drug is used when other drugs have
failed.”
10. The action of an ACE inhibitor interrupts the
renin-angiotensin-aldosterone mechanism,
thereby producing which of the following?
A. Reduced renal blood flow
B. Reduced sodium and water excretion
C. Increased peripheral vascular resistance
reabsorption
11. Raymund is reviewing on cardiovascular
drugs for his upcoming exam. For a well-
prepared student, he should know that
vasodilators are agents that:
A. Relax smooth muscles
B. Are used to treat hypotension
C. Stimulate the adrenergic receptors of peripheral
sympathetic nerves
D. Cause respiratory depression
12. As a competent nurse, you are aware that
vasodilators are used mainly to treat:
A. Create an osmotic gradient
B. Inhibit the exchange of sodium for potassium
C. Cause metabolic acidosis
D. Work poorly in the presence of endogenous
aldosterone
17. Which of the following is a potential side
effect of IV furosemide (Lasix)?
A. Drowsiness
B. Diarrhea
C. Cystitis
D. Hearing loss

A. Diabetes 18. A 68-year-old client with a history of mild

B. Hypertension CHF and glaucoma is receiving IV mannitol
C. Atrial fibrillation (Osmitrol) to decrease intraocular pressure. The
D. Hypotension nurse would monitor the client for signs and
symptoms of:
13. The drug/drugs used most commonly to
treat peripheral or cerebral vascular obstructive A. Fluid volume excess
disease is/are: B. Fluid volume deficit
C. Hyperkalemia
A. pentoxifylline (Trental) D. Hypernatremia
B. cyclandelate (Cyclan)
C. isoxsuprine (Vasodilan) 19. All potassium-sparing diuretics:
D. All of the above
A. Are required supplements during blood
14. In a 50-year-old widower who had a transfusion
transient ischemic attack, what is the most B. Enhance aldosterone action
common vasodilator used for his treatment? C. Cause hypokalemia
D. Are weak diuretics
A. norepinephrine
B. dopamine (Intropin) 20. Which of the following clients is most likely
C. papaverine (Pavabid) to experience adverse effects from treatment
D. nitroprusside (Nitropress) with diuretics?

15. For a client taking drugs to treat peripheral A. A 21-year-old student

vascular disease, it is important to provide B. A 40-year-old unmarried man
health education about: C. A 60-year-old widower
D. A 75-year-old man
A. Smoking cessation
B. Developing a proper balance between rest and 21. Kylie is reviewing drugs related to
activity cardiovascular therapies. She should be aware
C. Proper foot care that the desired action of lipid-lowering agents
D. All of the above is to:

16. A clinical instructor asks a nursing A. Decrease HDL

student about aldosterone antagonist. The B. Increase TC
student is correct by saying that aldosterone C. Increase LDL
antagonists: D. Increase HDL
22. For lipid-lowering agents to be successful, C. 8 to 12 hours
drug therapy must lower: D. 1 to 2 days

A. HDL 29. Which drug is used to

B. LDL stop bleeding associated with heparin
C. Total fat overdose?
D. All of the above
A. urokinase (Abbokinase)
23. As a competent nurse, you know that the B. aminocaproic acid (Amicar)
most significant contraindication for therapy C. vitamin K (AquaMEPHYTON)
with lipid-lowering agent is: D. protamine sulfate (Protamine)

A. Renal disease 30. During warfarin (Coumadin) administration,

B. Diabetes the nurse can expect that the initial extension of
C. Liver disease PT occurs within _____ hours after therapy
D. Cardiac disease begins.

24. Which of the following vitamins may not be A. 1 to 2

absorbed properly when giving bile acid B. 4 to 6
sequestrants? C. 8 to 12
D. 12 to 24
A. Vitamin B
B. Vitamin C
C. Vitamin B12
D. Vitamin K

25. Which of the following lipid-lowering agents

has the common side effect of constipation?

A. lovastatin (Mevacor)
B. colestipol (Colestid)
C. gemfibrozil (Lopid)
D. niacin (Nicotinic acid)

26. Parenteral anticoagulants work by

disrupting:

A. Conversion of prothrombin to thrombin

B. Formation of thromboplastin
C. Vitamin K-dependent clotting factors
D. Conversion of prothrombin to fibrin

27. SC heparin should be administered in the:

A. Flank
B. Abdominal fat
C. Leg
D. Gluteal area

28. The half-life of heparin is:

A. 10 minutes
B. 1 to 1.5 hours
C: NurseLabs CARDIO 3
1. A nurse is providing instructions to a client
who is receiving warfarin sodium (Coumadin).
Which statement made by the client indicates
the need for further instruction?
A. “I will observe the color of my urine and stool“.
B. “I will take Ecotrin (Enteric coated aspirin) for my
headaches”.
C. “I will avoid drinking alcohol”.
D. “I will take the medicine daily at the same time”.
2. A nurse is caring for a client receiving a
heparin intravenous (IV) infusion. The nurse
expects that which of the following laboratory
will be prescribed to monitor the therapeutic
effect of heparin?
A. Prothrombin time (PT).
B. Activated partial thromboplastin time (aPTT).
C. Hematocrit (Hgb).
D. Hemoglobin (Hct).
3. A client with atrial fibrillation is receiving a
continuous heparin infusion at 1,000 units/hr.
The nurse observes that the client is receiving
the therapeutic effect based on which of the
following results?
A. Activated partial thromboplastin time of 30
seconds.
B. Activated partial thromboplastin time of 60
seconds.
C. Activated partial thromboplastin time of 120
seconds.
D. Activated partial thromboplastin time of 15
seconds.
4. A client is receiving intravenous heparin
therapy. The nurse ensures the availability in
which of the following medication?
A. Acetylcysteine (Mucomyst).
B. Calcium gluconate.
C. Vitamin K (Mephyton).
D. Protamine sulfate.
5. A client is receiving a continuous infusion of
streptokinase (Streptase). The client suddenly
complaints of a difficulty of breathing,
itchiness, and nausea. Which of the following
should be the priority action of the nurse?
A. Stop the infusion and notify the physician.
B. Administer protamine sulfate and provide oxygen
therapy.
C. Administer antihistamine then continue the
infusion.
D. Slow the infusion and administer oxygen.
6. A client with deep vein thrombosis is
receiving Streptokinase (Streptase). The nurse
would notify the physician if which of the
following assessment is noted?
A. A temperature of 99.2° Fahrenheit.
B. A pulse rate of 99 beats per minute.
C. A respiratory rate of 25 breaths per minute.
D. A blood pressure of 185/110 mm Hg.
7. A client who is receiving streptokinase
therapy suddenly had a nose bleeding. The
nurse ensures the availability in which of the
following medication?
A. Vitamin K (Mephyton).
B. Deferoxamine (Desferal).
C. Aminocaproic acid (Amicar).
D. Diphenhydramine (Benadryl).
8. A nurse is providing health teachings
regarding antiplatelet medications. Which of the
following is not true regarding the use of this
medication?
A. Antiplatelet medication inhibits the aggregation
of platelets in the clotting process, thereby
prolonging bleeding time.
B. Antiplatelet medications cannot be used
with anticoagulants.
C. Take the medication with food to prevent
gastrointestinal upset.
D. A routine bleeding time is monitored during the
therapy.
9. A client is receiving Procainamide
(Procanbid) for the treatment of ventricular
arrhythmia. The client suddenly complains
of nausea and drowsiness. Which of the
intervention should the nurse do first?
A. Check the blood pressure and heart rate.
B. Do a 12-lead electrocardiogram right away.
C. Measure the heart rate on the rhythm strip.
D. Give hydralazine (Apresoline) per orem.
10. A client with myocardial infarction is
receiving tissue plasminogen activator,
alteplase (Activase, tPA). While on the therapy,
the nurse plans to prioritize which of the
following?
A. Observe for neurological changes.
B. Monitor for any signs of renal failure.
C. Check the food diary.
D. Observe for signs of bleeding.
11. A nurse is caring a client who is
taking digoxin (Lanoxin) 0.25mcg tab once a
day. The client suddenly complaints of
anorexia, nausea, vomiting, and diarrhea. The
physician is ruling a digoxin toxicity. As a
nurse, you know the therapeutic digoxin rate
is?
A. 0.25-0.5 ng/ml.
B. 0.5-2 ng/ml.
C. 1.5-3 ng/ml.
D. 3.5-4.5 ng/ml.
12. A nurse is monitoring a client who is
taking Carvedilol (Coreg CR). Which of the
following assessment made by the nurse would
warrant a possible complication with the use of
this medication?
A. Baseline blood pressure of 160/100 mm hg
followed by a blood pressure of 120/70 mm hg after
3 doses.
B. Baseline heart rate of 97 bpm followed by a
heart rate of 62 bpm after 3 doses.
C. Complaints of nightmares and insomnia.
D. Complaints of dyspnea.
13. A nurse is interviewing a client who is about
to receive metoprolol. Upon the history taking,
the client is also taking insulin. Which of the
following statements made by the nurse will
correctly explain the possible interaction of
these medications?
A. “This medication will maintain the blood sugar
level on a normal range”.
B. “This medication will have no effect in the blood
sugar level”.
C. “This medication may mask some of the
symptoms of hypoglycemia such as tremor,
palpitation, and rapid heartbeat.
D. “This medication may mask some of the
symptoms of hyperglycemia such as headache,
increased thirst, and blurred vision“.
14. A client is about to receive Metolazone
(Zaroxolyn). The nurse in charge understands
that which of the following laboratory results
are related to the administration of the
medication?
A. Hyperkalemia and hypocalcemia.
B. Hyperkalemia and hypoglycemia.
C. Hypouricemia and hypoglycemia.
D. Hypokalemia and hyperglycemia.
15. A client with congestive heart failure is
being treated with Torsemide (Demadex). The
nurse obtains the following vital signs: Blood
pressure of 100/65 mm hg; pulse rate of 91
beats per minute; and respiration of 25 breaths
per minute? Which of the following will be the
priority assessment of the nurse after the
initiation of the dose?
A. Urine output.
B. Serum potassium and calcium.
C. Blood pressure.
D. Weight.
16. A nurse is giving instruction to a client who
is receiving Cholestyramine (Questran) for the
treatment of hyperlipidemia. Which of the
following statements made by the client
indicates the need for further instructions?
A. “This medication comes in a powder that must
be mixed with juice or water before administration”.
B. “I will avoid eating foods rich in saturated fats”.
C. “I will continue taking nicotinic acid as part of the
treatment”.
D. “Constipation, belching and heartburn are some
of the side effects”.
17. A nurse is providing instructions to a client
who is on nicotinic acid for the treatment of
hyperlipidemia. Which statement made by the
nurse indicates a comprehension of the
instructions?

A. “I should take aspirin 30 minutes before nicotinic

acid”.
B. “I will drink alcohol in moderation”.
C. “Yellowing of the skin is a common side effect”.
D. “This medication is taken on an empty stomach“.

18. A nurse is monitoring a client who is taking

Digoxin (Lanoxin). All of which are the side
effects associated with the medication, except?

A. Anorexia.
B. Blurred vision.
C. Diarrhea.
D. Tremors.

19. A nurse is interviewing a patient who

is about to receive bumetanide (Bumex). Which
of the following is a concern related to the
administration of the medication?

A. Penicillin allergy.
B. Sulfa allergy.
C. Soy containing allergy.
D. Cephalosporin allergy.

20. A client arrives in the emergency with

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

A. Respiratory rate from 20 bpm to 12 bpm.

B. Blood pressure from 120/70 to 100/60 mmHg.
C. The client still complains of chest pain with a
pain scale of 2/10.
D. Cardiac rate of 103 bpm and a normal sinus
rhythm of the ECG.
C: Quizlet & answers CARDIO 4 ulcers, bleeding from trauma
22. clopidogrel: contra? Intracranial hemorrhage, GI
1. acebutolol (Action) blocks beta 1 adrenergic
bleeding
receptors
23. clopidogrel: misuse ↓ effects if given w/ grapefruit
2. acebutolol (adverse) bradycardia
juice
3. acebutolol: albuterol
24. clopidogrel: side Abdominal pain, dizziness,
antoagonist?
effects? epistaxis(nose bleed), headache,
4. acebutolol (avoid what) alcohol, tobacco, caffeine fatigue, chest pain
usage
25. clopidogrel: uses? Prevention of recurrence of MI's
5. acebutolol (monitor Assess BP and pulse. and strokes
what?) Monitor EKG.
26. digoxin (action) increases contraction and
6. acebutolol ( side Dizziness, nausea, vomiting, decreases conduction
effects) anorexia, edema, headache,
27. digoxin(adverse) bradycardia, cardiac
fatigue, ↓ BP, palpation with
dyrhythmias, thrombocytopenia
withdrawl
28. digoxin(anidote) digoxin immune fab (digibind)
7. acebutolol (Uses) HTN, angina, cardiac
dyrhythmias 29. digoxin(asses for?) s&s of toxicity

8. Ace inhibitors: Lisinopril 30. digoxin(hold if?) HR is less than 60

prototype? 31. digoxin(monitor?) serum K+, serum dig levels
9. alpha adrenergic prazosin HCl 32. digoxin(side effects) anorexia, Nausea, vomitting,
blockers: prototype? blurred or yellow vision,
10. Angiotensin II receptor valsartan confusion, fatigue
blockers: protype? 33. digoxin(use) HF, afib, atrial flutter,
11. Antianginal: nitroglycerin 34. diltiazem: action? CALCIUM CHANNEL
prototype? BLOCKER
12. anticoagulant: warfarin Inhibits transport of calcium
prototype? into myocardial & vascular
smooth muscle cells causing
13. anticoagulants: heparin
systemic vasodilation (↓ BP)
protoype?
35. diltiazem: adverse? HF, Stevens Johnson syndrome
14. Antidysrhythmic: acebutolol HCl
prototype? 36. diltiazem: FOOD Grape-fruit juice ↑ drug level
INTERACTION and effects
15. antiplatelet: prototype? Clopidogrel bisulfate
37. diltiazem: NSAIDs ↓ anti- HTN effects;
16. beta blocker: metropolol
interactions? use w/ other beta blockers or
prototype?
digoxin may result in
17. Calcium channel Diltiazem HCl bradycardia; diltiazem ↑ dig
blockers: prototype? levels
18. cardiac glycosides: digoxin 38. diltiazem: Side Peripheral edema, headache,
prototype? effects? dizziness, bradycardia,
19. clopidogrel: action? Inhibit platelet aggregation by abnormal dreams
irreversibly inhibiting the 39. diltiazem: uses? HTN, angina pectoris, A. Fib
binding of ATP to platelet
40. heart failure (left side) blood backs up in lungs
receptors to platelet receptors
41. heart failure (right blood backs up in periphery
20. clopidogrel: adverse? Agranulocytosis, aplastic
sided)
anemia, thrombocytopenia,
Stevens Johnson syndrome 42. heparin: actions? Inhibits thrombin which
prevents conversion of
21. clopidogrel: caution? Hepatic & renal disease, peptic
 fibrinogen to fibrin flow, and decrease O2
64. nitroglycerin severe HTN, paradoxical,
43. heparin: adverse? Hemorrhage, ↑ hepatic (adverse?) bradycardi, circulatory collapse
enzymes, heparin induced 65. nitroglycerin glass bottle(away from light),
thrombocytopenia, risk of (caution) gloves when administering,
bleeding with NSAIDs don't use expired, don't apply
44. heparin: caution? Thrombo-cytopenia, peptic over hairy areas/defib areas
ulcers, head trauma, hepatic or 66. nitroglycerin heparin
renal disease (decrease effects)
45. heparin: contra? Bleeding disorders 67. nitroglycerin (do what rotate patches
46. heparin: interactions? Risk of bleeding when used w/ every 3 hours?)
drugs that affect platelet 68. nitroglycerin ( increase alcohol, beta blockers,
function effects) calcium channel blockers,
47. heparin: side effects? Injection site reaction, anemia, benzos
itching, fever, chills 69. nitroglycerin(side headaches, syncope, fatigue
48. heparin: uses? Prevent/treat DVT's, acute PE, effects)
flushing of lines and arterial line 70. nitroglycerin tabs? 1 tab 5 minx3
potency
71. nitroglycerin(used for) angina, HF, decrease BP
49. HMG CoA reductase Rosuvastatin hypertension emergency,
inhibitors: treat pulmonary edema
50. lisinopril: action blocking conversion of 72. prazosin: action? dilates blood vessels, alpha
angiotension 1 to 2, blocks adrenergic blocker
release of aldosterone
73. prazosin: adverse Orthostatic hypotension,
51. lisinopril: adverse? agranulocytosis, angioedema palpitations, ↑ liver enzymes,
52. lisinopril: asses for? hyperkalemia, BP, Potassium pancreatitis
levels, evaluate lab values for 74. prazosin: cautions bedtime-> orthostatic HTN,
renal function, angina
53. lisinopril: caution? renal dysfunction, angioedema, 75. prazosin: may not have 4 weeks because its a highly
54. lisinopril: contra? contraindicated in pregnancy full therapeutic effect for protein bound drug
how long?
55. lisinopril: monitor? renal function and K+, and
giving diuretics at same time as 76. prazosin: monitor? BP and HR, monitor liver
hypertensives enzymes, weight, retention

56. lisinopril: side effects irritating cough, hyperkalemia, 77. prazosin: side effects? dizziness, ED, nausea,
taste altering, insomnia drowiness, urinary
incontinence, depression
57. lisinopril: uses HTN, HF
78. prazosin: used for? HTN, BPH
58. metropolol: action? blocks action of
catecholemines(decrease blood 79. Rosuvastatin: action? Inhibits enzyme HMG CoA
pressure and heart rate) reductase

59. metropolol: adverse? bradycardia, heart block 80. rosuvastatin: adverse? Rhabdomyolysis, myopathy,
↑ hepatic enzymes,
60. metropolol: caution OTC drugs, diabetics caution
hyperglycemia
for hypoglycemic effects, don't
abruptly stop 81. rosuvastatin: caution Alcoholics, renal
impairment, Asian
61. metropolol: side effets fatigue, ED
population
62. metropolol: used for? HTN, angina, HF, MI
82. rosuvastatin: contra: Acute liver disease and
63. nitroglycerin(action) vasodilation, increase blood pregnancy (cat. X)
83. rosuvastatin: ↑ effect if given w/
interactions propranolol and antacids
84. rosuvastatin: side Abdominal cramps,
effects? constipation, headache,
myalgia, photosensitivity
85. rosuvastatin: uses? ↓ cholesterol levels, ↓ serum
lipids (LDL and
triglycerides)
86. valsartan: action? Potent vasodilator that
inhibits binding of
angiotensin II
87. valsartan: caution: Pregnancy, breast feeding,
renal & hepatic impairment,
hypovolemia, and hyper-
kalemia
88. valsartan: interaction? Hyperkalemia, renal
dysfunction; ↑ ALT/AST
89. valsartan: Side effects Dizziness, hypotension,
headache, fatigue, cough
(rare)
90. valsartan: uses? HTN
91. warfarin: action? Depresses hepatic synthesis of
vit. K clotting factors
92. warfarin: adverse? Bleeding, purple toe
syndrome, ↑ hepatic enzymes
93. warfarin: anidote? foods high in vitamin K
94. warfarin: interactions? Many D/I which both ↑v or ↓
med effects
95. warfarin: side effects? Anorexia, nausea, cramps,
fever, rash
96. warfarin: uses? Thrombo-phlebitis, PE,
embolism formation b/c of A.
Fib
C: Quizlet & Answers CARDIO 5 planning to discontinue a blocker
client's beta blocker. What should NOT
1. A newly admitted client takes digoxin 0.25 b. 0.5 to 2.0 instruction should the nurse be abruptly
mg/day. The nurse knows that which is the ng/mL give the client regarding the stopped; the
serum therapeutic range for digoxin? beta blocker? dose should
be tapered
a. 0.1 to 1.5 ng/mL a. The beta blocker should be down.
b. 0.5 to 2.0 ng/mL abruptly stopped when
c. 1.0 to 2.5 ng/mL another cardiac drug is
d. 2.0 to 4.0 ng/mL prescribed.
2. The client's serum digoxin level is 3.0 a. It is in the b. The beta blocker should
ng/mL. What does the nurse know about high NOT be abruptly stopped; the
this serum digoxin level? (elevated) dose should be tapered down.
range. c. The beta blocker dose
a. It is in the high (elevated) range. should be maintained while
b. It is in the low (decreased) range. taking another antianginal
c. It is within the normal range. drug.
d. It is in the low average range. d. Half the beta blocker dose
should be taken for the next
3. The client is also taking a diuretic that a. Increase
several weeks.
decreases her potassium level. The nurse the serum
expects that a low potassium level digoxin 7. The beta blocker acebutolol c. To block
(hypokalemia) could have what effect on sensitivity (Sectral) is prescribed for the beta1-
the digoxin? level dysrhythmias. The nurse adrenergic
knows that what is the receptors in
a. Increase the serum digoxin sensitivity primary purpose of the drug? the cardiac
level tissues
b. Decrease the serum digoxin sensitivity a. To increase the beta1 and
level beta2 receptors in the cardiac
c. Not have any effect on the serum digoxin tissues
sensitivity level b. To increase the flow of
d. Cause a low average serum digoxin oxygen to the cardiac tissues
sensitivity level c. To block the beta1-
adrenergic receptors in the
4. When a client first takes a nitrate, the nurse b.
cardiac tissues
expects which symptom that often occurs? Headaches
d. To block the beta2-
adrenergic receptors in the
a. Nausea and vomiting
cardiac tissues
b. Headaches
c. Stomach cramps 8. A client is to be discharged a. "Apply the
d. Irregular pulse rate home with a transdermal patch to a
nitroglycerin patch. Which nonhairy
5. The nurse acknowledges that beta blockers c. Decrease
instruction will the nurse area of the
are as effective as antianginals because they heart rate
include in the client's upper torso
do what? and
teaching plan? or arm."
decrease
a. Increase oxygen to the systemic myocardial
a. "Apply the patch to a
circulation. contractility.
nonhairy area of the upper
b. Maintain heart rate and blood pressure.
torso or arm."
c. Decrease heart rate and decrease
b. "Apply the patch to the
myocardial contractility.
same site each day."
d. Decrease heart rate and increase
c. "If you have a headache,
myocardial contractility.
remove the patch for 4 hours
6. The health care provider is b. The beta and then reapply."
 d. "If you have chest pain,
apply a second patch next to
the first patch."
A nurse is monitoring a client
9.
with angina for therapeutic
effects of nitroglycerin.
Which assessment finding
indicates that the
nitroglycerin has been
effective?
a. Blood pressure 120/80 mm
Hg
b. Heart rate 70 beats per
minute
c. ECG without evidence of
ST changes
d. Client stating that pain is 0
out of 10
The nurse is monitoring a
10.
client during IV nitroglycerin
infusion. Which assessment
finding will cause the nurse to
take action?
a. Blood pressure 110/90 mm
Hg
b. Flushing
c. Headache
d. Chest pain
11. Which statement made by the
client demonstrates a need for
further instruction regarding
the use of nitroglycerin?
a. "If I get a headache, I should
keep taking nitroglycerin and
use Tylenol for pain relief."
b. "I should keep my
nitroglycerin in a cool, dry
place."
c. "I should change positions
slowly to avoid getting dizzy."
d. "I can take up to five tablets
at 3-minute intervals for chest
pain if necessary."
12. Which client assessment would
assist the nurse in evaluating
therapeutic effects of a calcium
channel blocker?
a. Client states that she has no
chest pain.
b. Client states that the
d. Client swelling in her feet is reduced.
stating that c. Client states the she does not
pain is 0 out feel dizzy.
of 10 d. Client states that she feels
stronger.
13. What statement is the most d. "This
important for the nurse to medication
include in the teaching plan for will work for
a client who has started on a 24 hours and
transdermal nitroglycerin you will need
patch? to change the
patch daily."
a. "This medication works
faster than sublingual
nitroglycerin works."
b. "This medication is the
d. Chest pain strongest of any nitroglycerin
preparation available."
c. "This medication should be
used only when you are
experiencing chest pain."
d. "This medication will work
for 24 hours and you will need
to change the patch daily."
14. What will the nurse instruct the c. Apply the
client to do to prevent the nitroglycerin patch
development of tolerance to for 14 hours and
d. "I can nitroglycerin? remove it for 10
take up to hours at night.
five tablets a. Apply the nitroglycerin patch
at 3-minute every other day.
intervals for b. Switch to sublingual
chest pain if nitroglycerin when the client's
necessary." systolic blood pressure elevates to
more than 140 mm Hg.
c. Apply the nitroglycerin patch
for 14 hours and remove it for 10
hours at night.
d. Use the nitroglycerin patch for
acute episodes of angina only.
15. The client asks the nurse how b. "It's best to keep
nitroglycerin should be stored it in its original
while traveling. What is the container away
a. Client nurse's best response? from heat and
states that light."
she has no a. "You can protect it from heat by
chest pain. placing the bottle in an ice chest."
b. "It's best to keep it in its original
 container away from heat and
light."
c. "You can put a few tablets in a
resealable bag and carry it in your
pocket."
d. "It's best to lock them in the
glove compartment to keep them
away from heat and light."
Which statement indicates to the
16.
nurse that the client understands
sublingual nitroglycerin
medication instructions?
a. "I will take up to five doses
every 3 minutes for chest pain."
b. "I can chew the tablet for the
quickest effect."
c. "I will keep the tablets locked in
a safe place until I need them."
d. "I should sit or lie down after I
take a nitroglycerin tablet to
prevent dizziness."
17. What instruction should the nurse
provide to the client who needs to
apply nitroglycerin ointment?
a. Use the fingers to spread the
ointment evenly over a 3-inch area.
b. Apply the ointment to a nonhairy
part of the upper torso.
c. Massage the ointment into the
skin.
d. Cover the application paper with
ointment before use.
18. A client receiving intravenous
nitroglycerin at 20 mcg/min
complains of dizziness. Nursing
assessment reveals a blood pressure
of 85/40 mm Hg, heart rate of 110
beats/min, and respiratory rate of 16
breaths/min. What is the nurse's
priority action?
a. Assess the client's lung sounds.
b. Decrease the intravenous
nitroglycerin by 10 mcg/min.
c. Stop the nitroglycerin infusion
for 1 hour, and then restart.
d. Recheck the client's vital signs in
15 minutes but continue the
infusion.
19. The nurse is monitoring a client b. Heart rate 58
taking digoxin (Lanoxin) for beats per minute
treatment of heart failure. Which
assessment finding indicates a
therapeutic effect of the drug?
a. Heart rate 110 beats per minute
b. Heart rate 58 beats per minute
d. "I should sit or c. Urinary output 40 mL/hr
lie down after I take d. Blood pressure 90/50 mm Hg
a nitroglycerin 20. A client's serum digoxin level is a. Administer
tablet to prevent drawn, and it is 0.4 ng/mL. What is ordered dose of
dizziness." the nurse's priority action? digoxin.
a. Administer ordered dose of
digoxin.
b. Hold future digoxin doses.
c. Administer potassium.
d. Call the health care provider.
A client is taking digoxin (Lanoxin) a. Evaluate
21.
0.25 mg and furosemide (Lasix) 40 digoxin levels.
mg. When the nurse enters the
b. Apply the room, the client states, "There are
ointment to a yellow halos around the lights."
nonhairy part of Which action will the nurse take?
the upper torso.
a. Evaluate digoxin levels.
b. Withhold the furosemide
c. Administer potassium.
d. Document the findings and
reassess in 1 hour.
22. Which assessment finding will a. Loss of appetite with
alert the nurse to suspect early slight bradycardia
digoxin toxicity?
b. Decrease the
intravenous a. Loss of appetite with slight
nitroglycerin by 10 bradycardia
mcg/min. b. Blood pressure 90/60 mm
Hg
c. Heart rate 110 beats per
minute
d. Confusion and diarrhea
23. The nurse reviews a client's b. To administer
laboratory values and finds a digoxin immune FAB
digoxin level of 10 ng/mL and (antidote)
a serum potassium level of 5.9
mEq/L. What is the nurse's
primary intervention?
a. To administer atropine
b. To administer digoxin
 immune FAB
c. To administer epinephrine
d. To administer Kayexalate
Which assessment finding will
24.
alert the nurse to possible
toxic effects of amiodarone?
a. Heart rate 100 beats per
minute
b. Crackles in the lungs
c. Elevated blood urea
nitrogen
d. Decreased hemoglobin
What must the nurse monitor
25.
when titrating intravenous
nitroglycerin for a client?
(Select all that apply.)
a. Continuous oxygen
saturation
b. Continuous blood pressures
c. Hourly ECGs
d. Presence of chest pain
e. Serum nitroglycerin levels
f. Visual acuity
A client is taking
26.
hydrochlorothiazide 50
mg/day and digoxin 0.25
mg/day. What type of
electrolyte imbalance does the
nurse expect to occur?
a. Hypocalcemia
b. Hypokalemia
c. Hyperkalemia
d. Hypermagnesemia
What would cause the same
27.
client's electrolyte imbalance?
a. High dose of digoxin
b. Digoxin taken daily
c. Hydrochlorothiazide
d. Low dose of
hydrochlorothiaizde
28. A nurse teaching a client who
has diabetes mellitus and is
taking hydrochlorothiazide
50 mg/day. The teaching
should include the
importance of monitoring
which levels?
a. Hemoglobin and
hematocrit
b. Crackles in the lungs b. Blood urea nitrogen
(BUN)
c. Arterial blood gases
d. Serum glucose (sugar)
29. A client has heart failure and c. High-ceiling (loop)
is prescribed Lasix. The diuretic
nurse is aware that
furosemide (Lasix) is what
kind of drug?
b. Continuous blood a. Thiazide diuretic
pressures b. Osmotic diuretic
d. Presence of chest c. High-ceiling (loop)
pain diuretic
d. Potassium-sparing diuretic
30. The nurse acknowledges that a. Hypokalemia
which condition could occur
when taking furosemide?
a. Hypokalemia
b. Hyperkalemia
c. Hypoglycemia
b. Hypokalemia d. Hypermagnesemia
31. The client has been receiving b. Hyperkalemia
spironolactone (Aldactone)
50 mg/day for heart failure.
The nurse should closely
monitor the client for which
condition?
a. Hypokalemia
b. Hyperkalemia
c. Hypoglycemia
c. Hydrochlorothiazide d. Hypermagnesemia
32. A client who has angina is a. Have the client lie
prescribed nitroglycerin. The down when taking a
nurse reviews which nitroglycerin sublingual
appropriate nursing tablet.
interventions for b. Teach client to repeat
nitroglycerin (Select all that taking a tablet in 5
apply.) minutes if chest pain
d. Serum glucose (sugar) persists.
a. Have the client lie down e. Warn client against
when taking a nitroglycerin ingesting alcohol while
sublingual tablet. taking nitroglycerin.
b. Teach client to repeat
taking a tablet in 5 minutes if
chest pain persists.
 c. Apply Transderm-Nitro 36. A nurse admits a client diagnosed c. The fact that
patch to a hairy area to with pneumonia. The client has a Lasix has shown
protect skin from burning. history of chronic renal efficacy in treating
d. Call the health care insufficiency, and the health care persons with renal
provider after taking 5 tablets provider orders furosemide (Lasix) insufficiency.
if chest pain persists. 40 mg twice a day. What is most
e. Warn client against important to include in the
ingesting alcohol while teaching plan for this client?
taking nitroglycerin.
a. That the medication will have to
33. Which laboratory value will the b. Fasting blood
be monitored very carefully owing
nurse report to the health care glucose level of 140
to the client's diagnosis of
provider as a potential adverse mg/dL
pneumonia.
response to hydrochlorothiazide
b. The fact that Lasix has been
(HydroDIURIL)?
proven to decrease symptoms with
pneumonia.
a. Sodium level of 140 mEq/L
c. The fact that Lasix has shown
b. Fasting blood glucose level of
efficacy in treating persons with
140 mg/dL
renal insufficiency.
c. Calcium level of 9 mg/dL
d. That the medication will need to
d. Chloride level of 100 mEq/L
be given at a higher than normal
34. What is the best information for b. "This dose owing to the client's medical
the nurse to provide to the client combination problems.
who is receiving spironolactone promotes diuresis
37. A client taking spironolactone c. Fish
(Aldactone) and furosemide but decreases the
(Aldactone) has been taught about
(Lasix) therapy? risk of
the therapy. Which menu selection
hypokalemia."
indicates that the client
a. "Moderate doses of two different
understands teaching related to this
diuretics are more effective than a
medication?
large dose of one."
b. "This combination promotes
a. Apricots
diuresis but decreases the risk of
b. Bananas
hypokalemia."
c. Fish
c. "This combination prevents
d. Strawberries
dehydration and hypovolemia."
d. "Using two drugs increases the 38. Which client would the nurse need c. A 47-year-old
osmolality of plasma and the to assess first if the client is client with anuria
glomerular filtration rate." receiving mannitol (Osmitrol)?
35. The nurse is assessing a client who c. Administer 2
a. A 67-year-old client with type 1
is taking furosemide (Lasix). The mEq potassium
diabetes mellitus
client's potassium level is 3.4 chloride per
b. A 21-year-old client with a head
mEq/L, chloride is 90 mmol/L, and kilogram per day
injury
sodium is 140 mEq/L. What is the IV.
c. A 47-year-old client with anuria
nurse's primary intervention?
d. A 55-year-old client receiving
cisplatin to treat ovarian cancer
a. Mix 40 mEq of potassium in 250
mL D5W and infuse rapidly. 39. A client is ordered furosemide b. Assess lung
b. Administer Kayexalate. (Lasix) to be given via intravenous sounds before and
c. Administer 2 mEq potassium push. What interventions should after
chloride per kilogram per day IV. the nurse perform? (Select all that administration.
d. Administer PhosLo, two tablets apply.) c. Assess blood
three times per day. pressure before and
 a. Administer at a rate no faster
than 20 mg/min.
b. Assess lung sounds before and
after administration.
c. Assess blood pressure before
and after administration.
d. Maintain accurate intake and
output record.
e. Monitor ECG continuously.
f. Insert an arterial line for
continuous blood pressure
monitoring.
40. A client with hyperaldosteronism
is prescribed spironolactone
(Aldactone). What assessment
finding would the nurse evaluate as
a positive outcome?
a. Decreased potassium level
b. Decreased crackles in the lung
bases
c. Decreased aldosterone
d. Decreased ankle edema
41. A client with acute pulmonary
edema receives furosemide
(Lasix). What assessment finding
indicates that the intervention is
working?
a. Potassium level decreased from
4.5 to 3.5 mEq/L.
b. Crackles auscultated in the
bases.
c. Lungs clear.
d. Output 30 mL/hr.
42. Which assessment indicates a
therapeutic effect of mannitol
(Osmitrol)?
a. Decreased intracranial
pressure
b. Decreased potassium
c. Increased urine osmolality
d. Decreased serum osmolality
43. A client's blood pressure (BP)
is 145/90. According to the
guidelines for determining
hypertension, the nurse realizes
that the client's BP is at which
stage?
after a. Normal
administration. b. Prehypertension
d. Maintain c. Stage 1 hypertension
accurate intake and d. Stage 2 hypertension
output record. The nurse acknowledges that a. Diuretic
44.
the first-line drug for treating
this client's blood pressure
might be which drug?
a. Diuretic
b. Alpha blocker
c. ACE inhibitor
c. Decreased d. Alpha/beta blocker
aldosterone The nurse is aware that which c. Beta blockers and
45.
group(s) of antihypertensive ACE inhibitors
drugs are less effective in
African-American clients?
a. Diuretics
b. Calcium channel blockers
and vasodilators
c. Beta blockers and ACE
inhibitors
c. Lungs clear. d. Alpha blockers
The nurse knows that which b. hydrochlorothiazide
46.
diuretic is most frequently
combined with an
antihypertensive drug?
a. chlorthalidone
b. hydrochlorothiazide
c. bendroflumethiazide
d. potassium-sparing diuretic
47. The nurse explains that which a. Beta1 blocker
beta blocker category is
a. Decreased preferred for treating
intracranial pressure hypertension?
a. Beta1 blocker
b. Beta2 blocker
c. Beta1 and beta2 blockers
d. Beta2 and beta3 blockers
48. Captopril (Capoten) has been d. Constant, irritating
ordered for a client. The nurse cough
c. Stage 1 hypertension teaches the client that ACE
inhibitors have which
common side effects?
a. Nausea and vomiting
b. Dizziness and headaches
c. Upset stomach
 d. Constant, irritating cough
49. A client is prescribed losartan
(Cozaar). The nurse teaches
the client that an angiotensin
II receptor blocker (ARB) acts
by doing what?
a. Inhibiting angiotensin-
converting enzyme
b. Blocking angiotensin II
from AT1 receptors
c. Preventing the release of
angiotensin I
d. Promoting the release of
aldosterone
50. During an admission
assessment, the client states
that she takes amlodipine
(Norvasc). The nurse wishes
to determine whether or not
the client has any common
side effects of a calcium
channel blocker. The nurse
asks the client if she has
which signs and symptoms?
(Select all that apply.)
a. Insomnia
b. Dizziness
c. Headache
d. Angioedema
e. Ankle edema
f. Hacking cough
51. Which statement indicates that
the client needs additional
instruction about
antihypertensive treatment?
a. "I will check my blood
pressure daily and take my
medication when it is over
140/90."
b. "I will include rest periods
during the day to help me
tolerate the fatigue my
medicine may cause."
c. "I will change my position
slowly to prevent feeling
dizzy."
d. "I will not mow my lawn
until I see how this medication
makes me feel."
b. Blocking angiotensin 52. A nurse is caring for a client who a. Call the health
II from AT1 receptors is taking an angiotensin- care provider to
converting enzyme inhibitor and switch the
develops a dry, nonproductive medication.
cough. What is the nurse's
priority action?
a. Call the health care provider to
switch the medication.
b. Assess the client for other
symptoms of upper respiratory
infection.
c. Instruct the client to take
antitussive medication until the
b. Dizziness symptoms subside.
c. Headache d. Tell the client that the cough
e. Ankle edema will subside in a few days.
53. The nurse is reviewing a d. spironolactone
medication history on a client (Aldactone)
taking an ACE inhibitor. The
nurse plans to contact the health
care provider if the client is also
taking which medication?
a. docusate sodium (Colace)
b. furosemide (Lasix)
c. morphine sulfate
d. spironolactone (Aldactone)
54. A client is prescribed a b. Respiratory
noncardioselective beta1 blocker. assessment
What nursing intervention is a
priority for this client?
a. "I will check my
blood pressure daily a. Assessment of blood glucose
and take my medication levels
when it is over 140/90." b. Respiratory assessment
c. Orthostatic blood pressure
assessment
d. Teaching about potential
tachycardia
55. Which client will the nurse assess c. The client who has
first? stopped taking a
beta blocker due to
a. The client who has been on cost.
beta blockers for 1 day.
b. The client who is on a beta
blocker and a thiazide diuretic.
c. The client who has stopped
taking a beta blocker due to cost.
d. The client who is taking a beta
 blocker and Lasix (furosemide).
The nurse is caring for a client
56.
with hypertension who is
prescribed Clonidine transdermal
preparation. What is the correct
information to teach this client?
a. Change the patch daily at the
same time.
b. Remove the patch before
taking a shower or bath.
c. Do not take other
antihypertensive medications
while on this patch.
d. Get up slowly from a sitting to
a standing position.
57. A calcium channel blocker has
been ordered for a client. Which
condition in the client's history
is a contraindication to this
medication?
a. Hypokalemia
b. Dysrhythmias
c. Hypotension
d. Increased intracranial
pressure
58. Which is a priority nursing
diagnosis for a client taking an
antihypertensive medication?
a. Alteration in cardiac output
related to effects on the
sympathetic nervous system
b. Knowledge deficit related to
medication regimen
c. Fatigue related to side effects
of medication
d. Alteration in comfort related
to nonproductive cough
59. When a newly admitted client is
placed on heparin, the nurse
acknowledges that heparin is
effective for preventing new clot
formation in clients who have
which disorder(s)? (Select all
that apply.)
a. Coronary thrombosis
b. Acute myocardial infarction
c. Deep vein thrombosis (DVT)
d. Cerebrovascular accident
d. Get up slowly (CVA) (stroke)
from a sitting to a e. Venous disorders
standing position. 60. A client who received heparin a. protamine sulfate
begins to bleed, and the
physician calls for the antidote.
The nurse knows that which is
the antidote for heparin?
a. protamine sulfate
b. vitamin K
c. aminocaproic acid
d. vitamin C
A client is prescribed a. A longer half-life
61.
enoxaparin (Lovenox). The than heparin
nurse knows that low-
c. Hypotension molecular-weight heparin
(LMWH) has what kind of half-
life?
a. A longer half-life than heparin
b. A shorter half-life than
heparin
c. The same half-life as heparin
d. A four-times shorter half-life
than heparin
62. The nurse is teaching a client c. Bleeding may
a. Alteration in about clopidogrel (Plavix). What increase when taken
cardiac output related is important information to with aspirin.
to effects on the include?
sympathetic nervous
system a. Constipation may occur.
b. Hypotension may occur.
c. Bleeding may increase when
taken with aspirin.
d. Normal dose is 25 mg tablet per
day.
63. A client is prescribed dalteparin d. Subcutaneously
(Fragmin). LMWH is
administered via which route?
a. Coronary
thrombosis a. Intravenously
b. Acute myocardial b. Intramuscularly
infarction c. Intradermally
c. Deep vein d. Subcutaneously
thrombosis (DVT)
64. A client is being changed from an b. warfarin
d. Cerebrovascular
injectable anticoagulant to an oral (Coumadin)
accident (CVA)
anticoagulant. Which
(stroke)
anticoagulant does the nurse
e. Venous disorders
realize is administered orally?
 a. enoxaparin sodium (Lovenox)
b. warfarin (Coumadin)
c. bivalirudin (Angiomax)
d. lepirudin (Refludan)
65. A client is taking warfarin 5
mg/day for atrial fibrillation. The
client's international normalized
ration (INR) is 3.8. The nurse
would consider the INR to be
what?
a. Within normal range
b. Elevated INR range
c. Low INR range
d. Low average INR range
66. Cilostazol (Pletal) is being
prescribed for a client with
coronary artery disease. The nurse
knows that which is the major
purpose for antiplatelet drug
therapy?
a. To dissolve the blood clot
b. To decrease tissue necrosis
c. To inhibit hepatic synthesis of
vitamin K
d. To suppress platelet aggregation
67. A client is admitted to the
emergency department with an
acute myocardial infarction. Which
drug category does the nurse expect
to be given to the client early for
the prevention of tissue necrosis
following blood clot blockage in a
coronary or cerebral artery?
a. Anticoagulant agent
b. Antiplatelet agent
c. Thrombolytic agent
d. Low-molecular-weight heparin
(LMWH)
68. A client is receiving an intravenous
heparin drip. Which laboratory
value will require immediate action
by the nurse?
a. Platelet count of 150,000
b. Activated partial thromboplastin
time (aPTT) of 120 seconds
c. INR of 1.0
d. Blood urea nitrogen (BUN) level
of 12 mg/dL
A client who has been taking b. Administer
69.
warfarin (Coumadin) is admitted vitamin K.
with coffee-ground emesis. What is
b. Elevated INR the nurse's primary action?
range
a. Administer vitamin E.
*therapeutic range b. Administer vitamin K.
is 2.0-3.0 c. Administer protamine sulfate.
d. Administer calcium gluconate.
70. The client has an international a. Administer an
normalized ratio (INR) value of 1.5. additional dose of
What action will the nurse take? warfarin
(Coumadin).
a. Administer an additional dose of
d. To suppress warfarin (Coumadin).
platelet aggregation b. Hold the next dose of warfarin
(Coumadin).
c. Increase the heparin drip rate.
d. Administer protamine sulfate.
A client is receiving warfarin c. "I will increase
71.
(Coumadin) for a chronic condition. dark-green, leafy
Which client statement requires vegetables in my
immediate action by the nurse? diet."
a. "I will avoid contact sports."
b. "I will take my medication in the
c. Thrombolytic early evening each day."
agent c. "I will increase dark-green, leafy
vegetables in my diet."
d. "I will contact my health care
provider if I develop excessive
bruising."
72. A client is taking enoxaparin a. "I take aspirin daily
(Lovenox) daily. Which for headaches."
client statement requires
additional monitoring?
a. "I take aspirin daily for
headaches."
b. "I take ibuprofen (Motrin)
b. Activated at least once a week for joint
partial pain."
thromboplastin c. "Whenever I have a fever, I
time (aPTT) of 120 take acetaminophen
seconds (Tylenol)."
d. "I take my medicine first
*normal thing in the morning."
therapeutic range
73. A nurse is preparing to c. Administer the
is 45-75 secs
administer enoxaparin medication into
sodium (Lovenox) to a client subcutaneous tissue.
 for prevention of deep vein
thrombosis. What is an
essential nursing
intervention?
a. Draw up the medication in
a syringe with a 22-gauge, 1-
½ inch needle.
b. Utilize the Z-track method
to inject the medication.
c. Administer the medication
into subcutaneous tissue.
d. Rub the administration site
after injecting.
A client has been admitted
74.
through the emergency
department and requires
emergency surgery. The
client has been receiving
heparin. What nursing
intervention is essential?
a. Teach the client about the
phenytoin.
b. Administer protamine
sulfate.
c. Assess the INR before
surgery.
d. Administer vitamin K.
A client who is taking
75.
warfarin (Coumadin) requests
an aspirin for headache relief.
What is the nurse's best
response?
a. Administer 650 mg of
acetylsalicylic acid (ASA)
and reassess pain in 30
minutes.
b. Teach the client of
potential drug interactions
with anticoagulants.
c. Explain to the client that
ASA is contraindicated and
administer ibuprofen as
ordered.
d. Explain that the headache
is an expected side effect and
will subside shortly.
A client is started on
76.
warfarin (Coumadin)
therapy while still receiving therapeutic effect for
intravenous heparin. The warfarin, so the heparin
client questions the nurse is continued until the
about the risk for bleeding. warfarin is therapeutic."
How should the nurse
respond?
a. "Your concern is valid. I
will call the doctor to
discontinue the heparin."
b. "It usually takes about 3
days to achieve a therapeutic
effect for warfarin, so the
heparin is continued until
b. Administer protamine the warfarin is therapeutic."
sulfate. c. "Because of your valve
replacement, it is especially
important for you to be
anticoagulated. The heparin
and warfarin together are
more effective than one
alone."
d. "Because you are now up
and walking, you have a
higher risk of blood clots
and therefore need to be on
both medications."
77. The nurse evaluates that the d. "I should use a soft
client understood discharge toothbrush for dental
b. Teach the client of teaching regarding warfarin hygiene."
potential drug (Coumadin) based on which
interactions with statement?
anticoagulants.
a. "I will double my dose if I
forget to take it the day
before."
b. "I should keep taking
ibuprofen for my arthritis."
c. "I should decrease the
dose if I start bruising
easily."
d. "I should use a soft
toothbrush for dental
hygiene."
78. Which nursing diagnosis c. Risk for injury
would be possible for a
client receiving intravenous
heparin therapy?
b. "It usually takes about a. Potential for fluid volume
3 days to achieve a excess
b. Potential for pain
 c. Risk for injury
d. Potential for body image
disturbance
79. A client has a serum cholesterol
level of 265 mg/dL, triglyceride
level of 235 mg/dL, and LDL of
180 mg/dL. What do these serum
levels indicate?
a. Hypolipidemia
b. Normolipidemia
c. Hyperlipidemia
d. Alipidemia
80. The nurse knows that the client's
cholesterol level should be
within which range?
a. 150 to 200 mg/dL
b. 200 to 225 mg/dL
c. 225 to 250 mg/dL
d. Greater than 250 mg/dL
81. A client's high-density
lipoprotein (HDL) is 60 mg/dL.
What does the nurse
acknowledge concerning this
level?
a. It is lower than the desired
level of HDL.
b. It is the desired level of HDL.
c. It is higher than the desired
level of HDL.
d. It is a much lower HDL level
than desired.
82. A client is taking lovastatin
(Mevacor). Which serum level is
most important for the nurse to
monitor?
a. Blood urea nitrogen
b. Complete blood count
c. Cardiac enzymes
d. Liver enzymes
83. The client is taking rosuvastatin
(Crestor). What severe skeletal
muscle adverse reaction should
the nurse observe for?
a. Myasthenia gravis
b. Rhabdomyolysis
c. Dyskinesia
d. Agranulocytosis
When a client is taking ezetimibe a. Inhibits absorption
84.
(Zetia), she asks the nurse how it of dietary cholesterol
c. Hyperlipidemia works. The nurse should explain in the intestines.
that Zetia does what?
a. Inhibits absorption of dietary
cholesterol in the intestines.
b. Binds with bile acids in the
intestines to reduce LDL levels.
c. Inhibits HMG-CoA reductase,
which is necessary for
cholesterol production in the
liver.
a. 150 to 200 mg/dL
d. Forms insoluble complexes
and reduces circulating
cholesterol in blood.
85. Which statement indicates the b. "I will increase
client understands discharge fiber in my diet."
instructions regarding
cholestyramine (Questran)?
b. It is the desired
a. "I will take Questran 1 hour
level of HDL.
before my other medications."
b. "I will increase fiber in my
diet."
c. "I will weigh myself weekly."
d. "I will have my blood pressure
checked weekly."
86. The nurse plans which b. Administer
intervention to decrease the aspirin 30 minutes
flushing reaction of niacin? before nicotinic
acid.
a. Administer niacin with an
antacid.
d. Liver enzymes
b. Administer aspirin 30 minutes
before nicotinic acid.
c. Administer diphenhydramine
hydrochloride (Benadryl) with
niacin.
d. Apply cold compresses to the
head and neck.
87. The nurse is reviewing b. "Take this
instructions for a client taking an medication at the
b. Rhabdomyolysis
HMG-CoA reductase inhibitor same time each
(statin). What information is day."
essential for the nurse to include?
a. "Take this medication on an
empty stomach."
b. "Take this medication at the
 same time each day."
c. "Take this medication with
breakfast."
d. "Take this medication with an
antacid."
A client is prescribed gemfibrozil
88.
(Lopid) for treatment of
hyperlipidemia type IV. What is
important for the nurse to teach
the client?
a. "Take aspirin before the
medication if you experience
facial flushing."
b. "You may experience
headaches with this medication."
c. "You will need to have weekly
blood drawn to assess for
hyperkalemia."
d. "Cholesterol levels will need to
be assessed daily for one week."
89. Which statement made by the
client indicates understanding
about discharge instructions on
antihyperlipidemic medications?
a. "Antihyperlipidemic
medications will replace the other
interventions I have been doing to
try to decrease my cholesterol."
b. "It is important to double my
dose if I miss one in order to
maintain therapeutic blood
levels."
c. "I will stop taking the
medication if it causes nausea and
vomiting."
d. "I will continue my exercise
program to help increase my high-
density lipoprotein serum levels."
90. A client is prescribed ezetimibe
(Zetia). Which assessment finding
will require immediate action by
the nurse?
a. Headache.
b. Slight nausea.
c. Muscle pain.
d. Fatigue.
91. A nurse is caring for a client
taking cholestyramine (Questran).
The client is complaining of fiber in his diet.
constipation. What will the nurse
do?
a. Call the health care provider to
b. "You may change the medication.
experience b. Tell the client to skip a dose of
headaches with this the medication.
medication." c. Have the client increase fluids
and fiber in his diet.
d. Administer an enema to the
client.
92. Which statement indicates to the d. "I should stir the
nurse that the client needs further powder in as small
medication instruction about an amount of fluid
colestipol (Colestid)? as possible to
maintain potency
a. "The medication may cause of the medication."
constipation, so I will increase
fluid and fiber in my diet."
b. "I should take this medication 1
hour after or 4 hours before my
d. "I will continue
other medications."
my exercise
c. "I might need to take fat-soluble
program to help
vitamins to supplement my diet."
increase my high-
d. "I should stir the powder in as
density lipoprotein
small an amount of fluid as
serum levels."
possible to maintain potency of the
medication."
93. Which assessment finding in a b. Elevated liver
client taking an HMG-CoA function tests
reductase inhibitor will the nurse
act on immediately?
a. Decreased hemoglobin
b. Elevated liver function tests
c. Elevated HDL
d. Elevated LDL
94. A 70-year-old client who is taking b. "These factors
several cardiac antidysrhythmic may put you at
c. Muscle pain. medications has been prescribed higher risk for
simvastatin (Zocor) 80 mg/day. myopathy."
What is essential information for
the nurse to teach the client?
a. "This dose may lower your
cholesterol too much."
b. "These factors may put you at
higher risk for myopathy."
c. "You should not take this drug
c. Have the client
with cardiac medications."
increase fluids and
 d. "This combination will cause
you to have nausea and vomiting."
95. A client diagnosed with b. Hepatic disease
hypercholesterolemia is prescribed
lovastatin (Mevacor). The nurse is
reviewing the client's history and
would contact the health care
provider about which of these
conditions in the client's history?

a. Chronic pulmonary disease

b. Hepatic disease
c. Leukemia
d. Renal disease
96. A nurse is caring for a client with c. gemfibrozil
elevated triglyceride levels who is (Lopid)
unresponsive to HMG-CoA
reductase inhibitors. What
medication will the nurse administer?

a. cholestyramine (Questran)
b. colestipol (Colestid)
c. gemfibrozil (Lopid)
d. simvastatin (Zocor)
97. The nurse would question an order a. Impaction
for cholestyramine (Questran) if the
client has which condition?

a. Impaction
b. Glaucoma
c. Hepatic disease
d. Renal disease
98. The nurse reviews the history for a c. Client is on
client taking atorvastatin (Lipitor). oral
What will the nurse act on contraceptives.
immediately?

a. Client takes medications with

grape juice.
b. Client takes herbal therapy
including kava kava.
c. Client is on oral contraceptives.
d. Client was started on penicillin for
a respiratory infection.
C: Quizlet & Answers CARDIO 5 . EKG Changes - ST depression, T wave alteration,
increased PR interval
1 What is CHF? Congestive heart failure, heart is High doses:
. unable to effectively pump blood - Potential conduction blockages
2 3 Compensatory Hypertrophy: Trying to increase 8. Cardiac Improved CO --> Improved renal
. mechanisms of force of contractions Glycosides: flow --> decreased edema
untreated CHF SNS Activation: NE and epi Kidney
released to increase cardiac output Effect
and blood pressure
9. Cardiac 1. ATPase is inhibited (no power
Kidneys: Renin released to increase
Glycosides: to Na/K pump)
BP
Mechanism 2. Na accumulates in the cell
3 Decreased Cardiac for 3. Na accumulation --> decreased
. Output Chart Myocardial Na/Ca exchanger action
Contractili 4. This leads to slowed loss of Ca
ty 5. Causes stronger myocardial
contraction
6. Also causes stronger
contraction
10. Cardiac - Interference with Na/K pump
Glycosides: slows the return of intracellular K
Mechanism after contraction
for AV - Vagus nerve stimulation slows
Conductio SA and AV conduction
n (lengthens PR and slows
4 Renin Angiotensin repolarization)
. Aldosterone 11. Cardiac Digoxin (Lanoxin)
Mechanism Chart Glycosides: Digitoxin (Digitoxinum)
Examples
12. Define: Front loading of a drug, higher
Digitalizati and more frequent doses to
on of a achieve therapeutic effects
drug rapidly
13. Define: Lower doses which maintain
Maintenan therapeutic levels
ce of a
drug
14. Cardiac Hypokalemia: Increases heart
5 Typical Treatment Mild CHF: Decrease Na+ intake,
Glycosides: sensitivity to toxic levels,
. of CHF (Mild, diuretic therapy
Effects to increases risks of ectopy and
Severe, Tachy) Severe CHF: ACEIs or ARBs
Ca and K arrhythmias
considered
serum
Tachy: Low dose beta blockers
levels Hyperkalemia: Antagonizes
- Digoxin considered when other
effects
drugs arent enough
6 Cardiac Glycosides: 1. Increase FOC Hypercalcemia: Enhances effects
. Pharmacological - Doesn't increase O2 consumption
Effects 2. Decrease HR Hypocalcemia: Reduces effects
- Vagus nerve stimulation
15. Cardiac - Ectopic beats
- Decreased action at AV node
Glycosides: - Can cause PVCs
7 Cardiac Glycosides: Therapeutic Dose: Adverse / - Can cause arrhythmias
 Toxic - Can cause PVC induced VT or 28. ARBs: Primary Bind to Angiotensin II receptors
Effects VF (R on T) Effect to stop Angiotensin II from
Dieuretic - Eliminate excess H2O and Na taking effect
16.
Therapy: via urinary tract 29. ARBs: Vasodilation increases excretion
Primary Secondary Effect of sodium and water
Role 30. ARBs: Examples * End in -sartan
17. Dieuretic - Used to treat CHF Candesartan (Atacand)
Therapy: Irbesartan (Avapro)
Indications Iosartan (Cozaar)
Dieuretic Thiazide Family: Milder, long Valsartan (Diovan)
18.
Therapy: 3 term usage Telmisartan (Micardis)
Common Organic Acids: Potent, used in 31. Nitroglycerin: - Decrease venous return and
Types CHF Primary Effect therefore workload of heart
Aldosterone Antagonists - Contains nitrate ions converted
Dieuretic Thiazide Family: HCTZ to NO in blood which is a
19.
Therapy: 3 Organic Acids: Furosemide smooth muscle relaxant
Common Type (Lasix) 32 Cardiac Action
Examples Aldosterone Antagonists: . Potential
Spironolactone (Aldactazide,
Aldactone)
20. Vasodilator - Relax and dilate blood vessels
Therapy: (Arteries and Veins)
Primary Effect
21. Vasodilator - Lower PVR
Therapy: Why - Lower cardiac workload
are they Used - Lower cardiac O2 consumption
22. Vasodilator - Heart able to pump more blood 33 Anti- - Affect electrophysiological properties
Therapy: Result with less effort . Arrhythmics: of cardiac membrane
- Decreased BP Therapeutic - Restore proper movement of ions
23. ACE Inhibitors: - Decrease Angiotensin II Effects (fixed back to normal or at lease
Primary Effect formation improved)
- Dilate arteries and veins 34 Vaughn-
- Increase excretion of Na and . Williams
H2O Classification
24. Define: - Also known as PVR of
Afterload - Amount of resistance against Antiarrhythmi
which the heart must pump blood cs
out of the ventricles
25. Define: Preload - Amount of blood entering
ventricles prior to systole 35 Class IA - Interfere with Na channels to alter Na
26. ACE Inhibitors: - Decreased bradykinin . Antiarrhythmi movement during cardiac action
Secondary Effect inactivation = vasodilation cs: Mechanism potential
27. ACE Inhibitors: * End in -pril 36 Class IA - Harder for cells to reach action
Examples Captopril (Capoten) . Antiarrhythmi potential
Lisinopril (Zestril, Prinivil) cs: Result - Important for irritable foci
Enalpril (Vasotec) 37 Class IA 1. Slowed conduction velocity - Altered
Ramipril (Altase) . Antiarrhythmi cardiac action potential during phase 0
Fosinopril cs: Overall 2. Prolonger refractory period
 Actions 3. Decreased automaticity of the heart 48 Class IC - - Marked decrease in cardiac
Class IA - - Atrial Flutter . Flecainide conduction phase 0
38
. Quinidine: - A fib (Tambocor) and
Indications - Ventricular arrhythmias Propafenone
(Rythmol):
39 Class IA - - Depression of cardiac conduction Therapeutic
. Quinidine: system excitability Effects
Therapeutic - Slowed conduction
Effects - Depression of myocardium FOC 49 Class IC - - Heart failure, heart block,
. Flecainide bradycardia
40 Class IA - - GI irritation (Tambocor) and
. Quinidine: - Smooth muscle depression Propafenone
Adverse - Widened QT and PR (Rythmol):
Effects - Slowed conduction may lead to PACs Adverse Effects
and PVCs even cardiac arrest
50 Class II: - Blockage of Beta Adrenergic
41 Class IA - - Usually for ventricular arrhythmias Mechanism Receptors
.
. Procainamide - Can be used for Afib or A flutter - Antagonism of Epi and NE which
(Procan): prevents SNS activation
Indications
51 Class II: Result - Heart rate, AV conduction,
42 Class IA - - Slowed conduction automaticity of SA and AV nodes,
.
. Procainamide - Depression of cardiac conduction heart muscle
(Procan): system excitability - Prolonged refractory period
Therapeutic - Depression of myocardium FOC - Eliminates arrhythmias in pts with
Effects increased SNS activity
43 Class IA - - Hypotension (esp with IV push) Class II - - Supraventricular and ventricular
52
. Procainamide - Skin rash Propanolol arrhythmias
.
(Procan): (Inderal):
Adverse Effects Indications
44 Class IB - - Only works on ventricles Class II - - Decreased HR because of slowed
53
. Lidocaine - Used for tachy ventricular Propanolol AV conduction
.
(Xylocaine): arrhythmias (Inderal): - Prolonged refractory period
Indications - Short acting, bolus infusion (only Therapeutic
parenteral) Effects
- Used especially post MI
54 Class II - - Hypotension, bradycardia,
45 Class IB - - Depresses automaticity Propanolol bronchoconstriction
.
. Lidocaine - Depolarization in pacemaker cells (Inderal):
(Xylocaine): esp. ectopic foci Adverse Effects
Therapeutic
Effects 55. Class II - Esmolol - Emergency situations
(Brevibloc): Indications - SNS activity in heart is
46 Class IB - - Rapidly metabolized by the liver
dangerous
. Lidocaine - Possible impaired liver functions
(Xylocaine): with high levels 56. Class II - Esmolol - Depresses chronotropic and
Adverse Effects - High doses = CNS stimulation which (Brevibloc): Therapeutic inotropic effects of SNS
can lead to seizures, CNS depression Effects - Rapidly metabolized
which can cause confusion 57. Class II - Esmolol - OD can lead to bradycardia
47 Class IC - - Last ditch antiarrhythmics (Brevibloc): Adverse and hypotension
. Flecainide - Usually for supraventricular rhythms Effects
(Tambocor) and 58. Class III: Mechanism - Interferance with K
Propafenone channels
(Rythmol):
59. Class III: Result - Slowed leaving of K during
Indications
repolarization which leads to
 a prolonged refractory
period
- Fewer beats = frequency of
arrhythmias
Class III - Amiodarone - Powerful supraventricular
60.
(Cordarone): Indications and ventricular
antiarrhythmic
- Very long half life (1-3
months)
Class III - Amiodarone - Prolonged refractory period
61.
(Cordarone): - HR, AV conduction, PR,
Therapeutic Effects QRS intervals
Class III - Amiodarone - Long half life, used
62.
(Cordarone): Adverse carefully
Effects - Ataxia, thyroid
dysfunction, pulmonary
fibrosis
- Cardiac toxicities:
bradycardia, heart block,
heart failure, pro arrhythmias
e.g. Torsades
63. Class IV: Mechanism - Calcium channel blockers
(CCBs)
- Decreases entry of Ca into
excitable cells (example: SA
and AV nodes)
64. Class IV: Result 1. Altered cardiac action
potential:
- Ca plays important role in
action potential formation
- CCB causes decreased rate
of SA node, therefore
conduction speed of the AV
2. Decreased force of
muscular contraction
- Less Ca entry means less
Ca is available for
contraction
- Not desirable in cardiac
tissue, could cause CHF
- Very useful in vascular
smooth muscle =
vasodilation
65. Class IV - Verapamil - Arrhythmias originating in
(Isoptin), Diltiazem the AV node
(Cardizem): Indications - Other supraventricular
tachycardias
- Also an effective
antihypertensive
66. Class IV - Verapamil - Primary: Decreases and
(Isoptin), Diltiazem slows conduction through
(Cardizem): Therapeutic AV node
Effects - Secondary: Slows firing
of SA node
67. Class IV - Verapamil - High doses can lead to
(Isoptin), Diltiazem heart blocks
(Cardizem): Adverse - Decreased myocardial
Effects contractility
- Hypotension
- Constipation
68. Other Antiarrhythmics - - Terminate SVT
Adenosine (Adenocard): - Duration of action is 15-
Indications 30 seconds
69. Other Antiarrhythmics - - Decreases Ca activity at
Adenosine (Adenocard): the AV node which slows
Therapeutic Effects conduction
- Fewer signals get to
ventricles therefore a
slowed ventricular HR
Other Antiarrhythmics - - Transient asystole,
70.
Adenosine (Adenocard): transient bronchospasm,
Adverse Effects feeling of impending doom
Angina Drugs - Nitrates: - Nitrate ions converted to
71.
Mechanism nitric oxide (potent
vasodilator)
- Vascular smooth muscle
relaxed
Angina Drugs - Nitrates: - Decreased venous return
72.
Results (preload)
- Decreased PVR
(afterload)
- Decreased cardiac
workload, oxygen
consumption, and chest
pain
73. Angina Drugs - Nitrates: - Sublingual (1-3 min
Routes of Admin onset)
- Ointment (30 min onset)
- IV (instant onset)
- Transdermal patch
(gradual release over 24
hours)
- Extended release capsule
(8-12 hour duration)
74. Angina Drugs - Nitrates: - Flushed skin, dizziness,
Adverse Effects headache, faint
- Reflex tachycardia
- Glaucoma
75. Angina Drugs - Beta - Management of SNS 85. Cation Exchange PCT and DCT:
Blockers: Therapeutic stimulation to keep HR and - Na reabsorbed
Action FOC low - H ions secreted into urine
- Minimizes cardiac
workload and O2 DCT specifically:
consumption - Na reabsorbed
- K ions secreted into urine
76. Angina Drugs - - Long term management of angina
- Controlled by aldosterone
Beta Blockers: - Allows increased work capacity
- Carbonic anhydrase catalyzes this
Indications and exercise tolerance
reaction
77. Angina Drugs - - Non selective have the potential - Turns CO2 into H ion
Beta Blockers: for causing bronchoconstriction - Can be exchanged for Na and
Adverse Effects leading to asthma attacks secreted
78. Angina Drugs - Non Selective: Propanolol 86. Chloride Ion - Happens in the LoH
Beta Blockers: (Inderal), Nadolol Transport - Happens through Cl ions being
Examples Selective: Metoprolol (Lopressor), actively reabsorbed and Na ions
Atenolol (Tenormin) following through charge association
79. Angina Drugs - - Decreased cardiac workload by 87. Osmotic Gradient - Pulls water from urine to the blood
CCBs: Therapeutic decreased vascular tone - Happens in the PCT and collecting
Action - Some decrease in SA and AV ducts
node conduction
88. ADH Action and - Pores of collecting ducts open
80. Angina Drugs - Verapamil (Isoptin) Effects - Water rushes towards the Na
CCBs: Examples Diltiazem (Cardizem) - Water returns to the blood and
Amlodipine (Norvasc) causes the urine to be more
Nifidipine (Adalat) concentrated, and the plasma volume
81. Kidney Filtration - Main Role: Water, electrolyte, maintained
and acid-base balance 89. Acid Base - Renal system helps buffer blood to
- Small ions become filtrate: ions, Regulation keep it between 7.35 and 7.45 pH
water, glucose, cell waste products by...
82. 3 Renal Functions 1. Filtration a. Secreting H into urine to make
- In glomerulus blood less acidic
- First line of defence b. Reabsorbing Bicarb (HCO3-) to
- Filters substances from blood to buffer blood pH
nephron 90. Removal of Weak - Weak acids and bases are created
2. Tubular reabsorption Acids and Bases during normal metabolism
- Pulling ions out of the urine back - PCT secretes them into the urine
into the blood - Many drugs are weak acids or
- Happens in the PCT, LoH, DCT bases
3. Tubular secretion - Compete with endogenous acids
- Secretion of substances into urine and bases for secretion sites
- Maintains electrolyte and acid- - Competition may alter drug
base balance excretion
- Happens in the PCT, LoH, DCT
91. Osmotic Compounds which can be filtered
83. Tubular - Some substances are blocked such Diuretics: but not reabsorbed
Reabsoption as blood products and plasma Definition
proteins (too big to fit)
92. Osmotic a. Cannot cross tubular lumen
- Renal tubules reabsorb much of
Diuretics: b. Create osmotic gradient
what is in filtrate
Mechanism c. Water moves into the lumen
84. 2 Mechanisms for 1. Cation exchange (urine)
Na Reabsorption 2. Chloride ion transport d. Na and electrolyte balance not
 altered 104. Potassium Sparing - Inhibit K secretion in DCT
Osmotic Mild diuresis without acid-base or Diuretics: - Risk of hyperkalemia and
93.
Diuretics: Result electrolyte imbalance Mechanism gynecomastia

Osmotic Diuretics - Most common osmotic diuretic 105. Potassium Sparing Spironolactone (Aldactone)
94.
- Mannitol - Given IV Diuretics: Examples Amiloride (Midamor)
(Osmitrol): - Used for cerebral swelling, drug 106. Chronic - Increases peripheral resistance
toxicities, renal failure or damage Hypertension Effects - Leads to decreased blood flow
to kidneys
95. Thiazide Diuretics: - Inhibit Na transport in the
- Triggers RAAS which makes
Mechanism distal nephron
hypertension worse
- Substantial loss of Na and H2O
- Cl and K ions also excreted 107. Vasodilators: - Relaxant of smooth muscle
- Common result is Mechanism leading to decreased BP and
hypochloremic alkalosis and vasodilation
hypokalemia - Used in combo with beta
blockers and diuretics
96. Thiazide Diuretics: - Hypochloremic alkalosis and
Other Adverse hypokalemia 108. Vasodilators: Hydralazine (Apresoline)
Effects - Hypotension and hyponatremia Examples Minoxidil (Lonitem)
- Orthostatic hypotension, 109. Vasodilators: Long term usage can cause lupus
lightheadedness, syncope Adverse Effects like syndrome and rheumatoid
- Muscle spasm and cramps arthritis (autoimmune)
- Electrolyte imbalance
110. How Coagulation 1. After injury, platelets migrate
97. Thiazide Diuretics: Hydrochlorothiazide (HCTZ) Works to damaged area
Examples Chlorothiazide 2. Platelets perform aggregation
and adhesion
Metolazone (Zaroxolyn) 3. Platelets form plug around the
Indapamide (Lozide) injured tissue
98. Carbonic Anhydrase - Diuresis by inhibiting carbonic 4. Circulating clotting factors
Inhibitors: anhydrase interact with new plug to stabilize
Mechanism - Less H and HCO3 ions and strengthen
produced 111. Stabilizing the 1. Production of thromboplastin 2
- Less H available for Na plug/clot mechanisms
exchange Intrinsic: Activity of clotting and
- Na and water get excreted factors stimulates production of
99. Carbonic Anhydrase Acetazolamide (Acetazolam) thromboplastin protein
Inhibitors: Example Extrinsic: Injured tissues release
Factor VII and thromboplastin
100. Refractory vs. Non Refractory Diuretics: No longer
which work together to initiate
Refractory Diuretics function when acid-base balance
coagulation
is altered
101. Organic Acid - Inhibit Na and Cl transport in 2. Thromboplasin converts
Diuretics: LOH prothrombin into thrombin
Mechanism - Stronger than thiazides 3. Thrombin converts fibrinogen
- Useful in pulmonary edema into fibrin
102. Organic Acid Hypotension 4. Fibrin works with active
Diuretics: Adverse Hypokalemia clotting factors, builds fibrin mesh
Effects Hyperuricemia to hold platelets, begins
Hyperglycemia solidification
103. Organic Acid Furosemide (Lasix) 112. Dissolving the Clot 1. After cellular injury tPa is
Diuretics: Examples slowly released by injured tissue
2. After accumulation: conversion
 of plasminogen into plasmin respective clotting factor
3. Plasmin acts on fibrin to break - Max effect within 1-3 hours
down clot - Duration is 24-36 hours
113. Anticoagulant 1. Antiplatelet Drugs 124. Novel Oral Dabigatran (Pradaxa)
Therapy Types 2. Anticoagulants Anticoagulant: Rivaroxaban (Xarelto)
Antiplatelet Drugs: - Inhibit platelet aggregation so Examples Apixaban (Eliquis)
114.
Function platelet plug doesn't form 125. Clinical Indications for - Prophylactic clot prevention
- Inhibit platelet adhesion - won't Anticoagulants (family or personal Hx, post
stick to vessel wall MI)
Antiplatelet Drugs: Make platelets less sticky by - Peripheral vascular disease
115.
Mechanism inhibiting ADP mediated platelet (e.g. Crohn's, previous CVA
aggregation or MI)
- Pregnancy (ONLY
116. Antiplatelet Drugs: Aspirin HEPARIN!), post surgery:
Examples Clopidogrel (Plavix) prevention of DVT
Dipyridamole (Aggrenox: Mix of - During surgery, dialysis, and
ASA and Dipyridamole) transfusions to prevent clotting
Ticlopidine - CAD - preventing blockages
Ticagrelor (Brilinta) - New drug - Oral anticoagulants common
117. Anticoagulants: - Inhibit plasma clotting factors for Afib
Function attach to preformed proteins of Thrombolysis: What What: Thrombolytic enzymes
126.
clotting cascade, disabling normal and How "clot busters" used to dissolve
function clots
- Or block formation of those How:
proteins - Medications activate
118. Anticoagulants - - Binds to thromboplastin to fibrinolysin - breaks clots into
Heparin: Function prevent thrombin formation soluble products
- Fast onset, short duration of - tPa converts plasminogen
action which prevents clotting into plasmin which degrades
cascade from starting fibrin
- Given IV or SC 127. Thrombolysis: - Tissue Plasminogen
119. Anticoagulants - - Given orally Examples Activator: tPa, alteplase
Coumarins: Function - Cause inhibition of clotting (Activase)
factors - Tenecteplase (TNKase)
- Slower onset, longer duration - Streptokinase (Streptase)
(2-10 days) 128. Thrombolysis: Clinical - Acute MI
- This is rat poison! Indications - Acute ISCHEMIA CVA
120. Anticoagulants - Warfarin (Coumadin) - PE
Coumarins: Examples - DVT
121. Anticoagulants - - Major danger: hemorrhage 129. Thrombolysis: - Hemorrhage esp. when
Coumarins: Adverse - Hematuria, bleeding of Adverse Effects combined with other
Effects gums, petechaie anticoagulants
- Requires vitamin K as an - Mild allergic reactions
antidote 130. Thrombolysis: - Active internal bleeding
122. Anticoagulants - - Hemorrhage Contraindications - CVA in the past 2 months
Heparin: Adverse - GI bleeding - Intracranial or intraspinal
Effects - Thrombocytopenia / HIT injury
- Intracranial tumors
123. Novel Oral - High specificity for specific
- Etc, etc, etc,
Anticoagulant: clotting factors
Function - Reversible inhibition of
C: KEE & HAYES CARDIO 6
1. The patient is receiving digoxin for treatment of
heart failure. Which finding would suggest to the
nurse that heart failure is improving?
a. Pale and cool extremities
b. Absence of peripheral edema
c. Urine output of 60 mL/4 h
d. Complaints of increasing dyspnea
2. The patient’s serum digoxin level is 3.0 ng/mL.
What does the nurse know about this serum
digoxin level?
a. It is in the high (elevated) range.
b. It is in the low (decreased) range.
c. It is within the normal range.
d. It is in the low average range.
3. The nurse is assessing a patient for possible
evidence of digitalis toxicity. The nurse
acknowledges that which is included in the signs
and symptoms for digitalis toxicity?
a. Apical pulse rate of 100 beats/min
b. Apical pulse of 72 beats/min with an irregular
rate
c. Apical pulse of 90 beats/min and an irregular rate
d. Apical pulse of 48 beats/min and irregular rate
4. A patient is taking a potassium-depleting diuretic
and digoxin. The nurse expects that a low
potassium level (hypokalemia) could have what
effect on digoxin (Lanoxin)?
a. Increase serum digoxin sensitivity level
b. Decrease serum digoxin sensitivity level
c. Have no effect on serum digoxin sensitivity level
d. Cause a low average serum digoxin sensitivity
level
5. A patient takes an initial dose of a nitrate. Which
symptom(s) will the nurse expect to occur?
a. Nausea and vomiting
b. Headaches
c. Stomach cramps
d. Irregular pulse rate
6. A patient is prescribed a beta blocker. The nurse
acknowledges that beta blockers are as effective as
antianginals because they do what?
a. Increase oxygen to the systemic circulation
b. Maintain heart rate and blood pressure
c. Decrease heart rate and decrease myocardial
contractility
d. Decrease heart rate and increase myocardial
contractility
7. The health care provider is planning to
discontinue a patient’s beta blocker. Which
instruction will the nurse give the patient regarding
the beta blocker?
a. The beta blocker should be abruptly stopped
when another cardiac drug is prescribed.
b. The beta blocker should not be abruptly stopped;
the dose should be tapered down.
c. The beta blocker dose should be maintained
while taking another antianginal drug.
d. Half the beta blocker dose should be taken for
the next several weeks.
8. The beta blocker acebutolol (Sectral) is
prescribed for dysrhythmias. The nurse knows that
what is the primary purpose of the drug?
a. Increase beta1 and beta2 receptors in cardiac
tissues
b. Increase the flow of oxygen to cardiac tissues
c. Block beta1-adrenergic receptors in cardiac
tissues
d. Block beta2-adrenergic receptors in cardiac
tissues
9. A patient who has angina is prescribed
nitroglycerin. Which are appropriate nursing
interventions for nitroglycerin? (Select all that
apply.)
a. Have patient sit or lie down when taking a
nitroglycerin sublingual tablet.
b. Teach patient who has taken a tablet to call 911
in 5 minutes if chest pain persists.
c. Apply Transderm-Nitro patch to a hairy area to
protect skin from burning.
d. Call the health care provider after taking five
tablets if chest pain persists.
e. Warn patient against ingesting alcohol while
taking nitroglycerin
C: KEY AND HAYES CARDIO 7 c. To decrease glucose level
d. To increase glucose level
1. A patient is taking hydrochlorothiazide (HCTZ) 50 mg/
day and digoxin (Lanoxin) 0.25 mg/day. The nurse plans 7. The patient has been receiving spironolactone
to monitor the patient for which potential electrolyte (Aldactone) 50 mg/day for heart failure. The nurse
imbalance? should closely monitor the patient for which condition?
a. Hypocalcemia a. Hypokalemia
b. Hypokalemia b. Hyperkalemia
c. Hyperkalemia c. Hypoglycemia
d. Hypermagnesemia d. Hypermagnesemia

2. The nurse knows that which statement is correct

regarding nursing care of a patient receiving
hydrochlorothiazide (HCTZ)? (Select all that apply.) a.
Monitor patient for signs of hypoglycemia.
b. Administer ordered potassium supplements.
c. Monitor serum potassium and uric acid levels.
d. Assess blood pressure before administration.
e. Notify health care provider if patient has had oliguria
for 24 hours.
f. Assess for decreased cholesterol and triglyceride
levels.

3. A patient has heart failure, and a high dose of

furosemide (Lasix) is ordered. What suggests a
favorable response to Lasix?
a. Decrease in level of consciousness and sleeping
more
b. Respiratory rate decreases from 28/min to 20/min and
the depth increases.
c. Increased congestion heard in breath sounds and
complains of shortness of breath
d. Urine output of 50 mL/4 h and intake of 200 mL

4. What does the nurse know to be correct concerning

the use of mannitol (Osmitrol) in patients?
a. Decreases intracranial pressure
b. Increases intraocular pressure
c. Causes sodium and potassium retention
d. Causes diuresis in several days

5. What should the nurse do when a patient is taking

furosemide (Lasix)?
a. Instruct patient to change positions quickly when
getting out of bed.
b. Assess blood pressure before administration.
c. Administer at bedtime for maximum effectiveness d.
Teach to avoid fruits to prevent hyperkalemia.

6. For the patient taking a diuretic, a combination such

as triamterene and hydrochlorothiazide may be
prescribed. The nurse realizes that this combination is
ordered for which purpose?
a. To decrease serum potassium level
b. To increase serum potassium level
C: KEY AND HAYES CARDIO 8
1. A patient’s blood pressure (BP) is 130/84. The
health care provider plans to suggest
nonpharmacologic methods for the patient. Which
should the nurse include in teaching? (Select all
that apply.)
a. Stress-reduction techniques
b. Starting an exercise program
c. Salt restriction
d. Smoking cessation
e. Diet with increased protein
2. A patient has developed mild hypertension. The
nurse acknowledges that the first-line drug for
treating this patient’s blood pressure might be
which drug?
a. Diuretic
b. Alpha blocker
c. ACE inhibitor
d. Alpha/beta blocker
3. An African-American patient has developed
hypertension. The nurse is aware that which
group(s) of antihypertensive drugs are less
effective in African-American patients?
a. Diuretics
b. Calcium channel blockers and vasodilators c.
Beta blockers and ACE inhibitors
d. Alpha blockers
b. Dizziness and headaches
c. Upset stomach
d. Constant, irritating cough
7. A patient is prescribed losartan (Cozaar). The
nurse teaches the patient that an angiotensin II
receptor blocker (ARB) acts by doing what?
a. Inhibiting angiotensin-converting enzyme
b. Blocking angiotensin II from AT1 receptors
c. Preventing the release of angiotensin I
d. Promoting the release of aldosterone
8. During an admission assessment, a patient
states that she takes amlodipine (Norvasc). The
nurse wishes to determine whether the patient has
any common side effects of a calcium channel
blocker. The nurse asks the patient if she has
which signs and symptoms? (Select all that apply.)
a. Insomnia
b. Dizziness
c. Headache
d. Angioedema
e. Ankle edema
f. Hacking cough

4. The nurse knows that which diuretic is most

frequently combined with an antihypertensive drug?
a. chlorthalidone
b. hydrochlorothiazide
c. bendroflumethiazide
d. potassium-sparing diuretic

5. The nurse is administering a beta blocker to a

patient. Which is an important assessment to
perform before administration?
a. Urine output
b. Apical pulse
c. Potassium level
d. Serum level of medication

6. Captopril (Capoten) has been ordered for a

patient. The nurse teaches the patient that
angiotensin-converting enzyme (ACE) inhibitors
have which common side effects?
a. Nausea and vomiting
C: KEE AND HAYES CARDIO 9
1. A patient is placed on heparin, and the nurse
acknowledges that heparin is effective for
preventing clot formation in patients who have
which disorder(s)? (Select all that apply.)
a. Coronary thrombosis
b. Acute myocardial infarction
c. Deep vein thrombosis
d. Hemorrhagic cerebrovascular accident (stroke)
e. Disseminated intravascular coagulation
2. A patient who received heparin begins to bleed.
The nurse anticipates that the health care provider
will order which antidote?
a. protamine sulfate
b. vitamin K1 (Mephyton)
c. aminocaproic acid (Amicar)
d. potassium chloride (KCl)
3. A patient is prescribed enoxaparin (Lovenox).
The nurse knows that low–molecular-weight
heparin has what kind of half-life?
a. A longer half-life than heparin
b. A shorter half-life than heparin
c. The same half-life as heparin
d. A four times shorter half-life than heparin
4. The nurse is teaching a patient about clopidogrel
(Plavix). Which information will the nurse include in
the patient’s teaching plan?
a. Constipation may occur.
b. Hypotension may occur.
c. Bleeding may increase when taken with aspirin.
d. Normal dose is 25 mg tablet per day.
5. A patient had an orthopedic surgery and is
prescribed dalteparin (Fragmin). What would the
nurse teach the patient and/or family about this
low–molecular-weight heparin (LMWH) before
discharge?
a. How to administer the medication intramuscularly
b. PT and INR monitoring will be done weekly. c.
Avoidance of green leafy vegetables is
recommended.
d. Watch for bleeding or excessive bruising.
6. A patient is being changed from an injectable
anticoagulant to an oral anticoagulant. Which
anticoagulant does the nurse realize is
administered orally?
a. enoxaparin sodium (Lovenox)
b. warfarin (Coumadin)
c. bivalirudin (Angiomax)
d. lepirudin (Refludan)
7. A patient is taking warfarin 5 mg/day for atrial
fibrillation. The patient’s international normalized
ratio (INR) is 3.8. The nurse would consider the
INR to be what?
a. Within normal range
b. Elevated range
c. Low range
d. Low-average range
8. Cilostazol (Pletal) is being prescribed for a
patient with coronary artery disease. The nurse
understands that which is the major purpose for
antiplatelet drug therapy?
a. Dissolve the blood clot
b. Decrease tissue necrosis
c. Inhibit hepatic synthesis of vitamin K
d. Suppress platelet aggregation
9. A patient is to undergo a coronary angioplasty.
The nurse acknowledges that which drug is used
primarily for preventing reocclusion of coronary
arteries following coronary angioplasty?
a. clopidogrel (Plavix)
b. abciximab (ReoPro)
c. warfarin (Coumadin)
d. cilostazol (Pletal)
10. A patient is admitted to the emergency
department with an acute myocardial infarction.
Which drug does the nurse anticipate the health
care provider to order for prevention of tissue
necrosis following blood clot blockage in a coronary
artery?
a. heparin sodium
b. clopidogrel (Plavix)
c. alteplase (rPA, Activase)
d. aminocaproic acid (Amicar)
C: KEE AND HAYES 10
1. A patient has a serum cholesterol level of
265 mg/dL, triglyceride level of 235 mg/dL, and
LDL of 180 mg/dL. What do these serum levels
indicate?
a. Hypolipidemia
b. Normolipidemia
c. Hyperlipidemia
d. Alipidemia
2. The nurse knows that a patient’s total
cholesterol level should be within which range?
a. 150 to 200 mg/dL
b. 200 to 225 mg/dL
c. 225 to 250 mg/dL
d. >250 mg/dL
3. A patient has a low-density lipoprotein (LDL)
of 175 mg/ dL and a high-density lipoprotein
(HDL) of 30 mg/dL. What teaching should the
nurse implement for this patient?
a. Discuss medications ordered, dietary
changes, and exercise.
b. No changes in lifestyle are needed and
continue with current plan.
c. Discuss how to have fat intake be 40% of
caloric intake.
d. Begin keeping a food diary and schedule lab
work to be repeated in 6 months.
4. Which laboratory test value does the nurse
realize can contribute to the development of
cardiovascular disease and stroke?
a. Decreased antidiuretic hormone
b. Increased homocysteine level
c. Decreased triglycerides
d. Increased HDL level
5. A patient is taking lovastatin (Mevacor).
Which serum level is most important for the
nurse to monitor?
a. Blood urea nitrogen
b. Complete blood count
c. Cardiac enzymes
d. Liver enzymes
6. For what severe skeletal muscle adverse
reaction should the nurse observe in a patient
taking rosuvastatin (Crestor)?
a. Myasthenia gravis
b. Rhabdomyolysis
c. Dyskinesia
d. Agranulocytosis
7. A patient is taking ezetimibe (Zetia) and asks
the nurse how it works. The nurse should
explain that ezetimibe does what?
a. Inhibits absorption of dietary cholesterol in
the intestines.
b. Binds with bile acids in the intestines to
reduce LDL levels.
c. Inhibits HMG-CoA reductase, which is
necessary for cholesterol production in the
liver.
d. Forms insoluble complexes and reduces
circulating cholesterol in the blood.
8. A patient is diagnosed with peripheral
arterial disease. He is prescribed pentoxifylline
(Trental). What does the nurse realize are the
effects of pentoxifylline? (Select all that apply.)
a. May lead to hypertension and bradycardia
b. Improves microcirculation and tissue
perfusion
c. Decreases blood viscosity and improves
flexibility of erythrocytes
d. Alleviates intermittent claudication
e. Commonly causes an adverse effect of
rhabdomyolysis
f. Allows vasodilation of arteries in skeletal
muscles