Question

A nurse is caring for a client.

Answer 1

Correct Answers

Blank 1 Correct Option: intravenous
Blank 2 Correct Option: ventricular dysrhythmias

Rationale :

💉Milrinone is a phosphodiesterase-3 inhibitor administered by the intravenous route for short-term management of severe heart failure.

❤️By increasing intracellular cyclic AMP, milrinone increases myocardial contractility while producing vasodilation.

⚡A serious adverse effect of milrinone is the development of ventricular dysrhythmias, requiring continuous cardiac monitoring.

🩺The nurse should also monitor blood pressure and cardiac rhythm because hypotension and potentially dangerous arrhythmias can occur during therapy.

📌Core Message

Milrinone is administered intravenously and requires close monitoring for ventricular dysrhythmias because of its potent cardiovascular effects.

Answer 2

Correct Answers:

"I should increase my fiber intake when taking this drug."
"Palpitations should be reported to the healthcare provider."
"Grapefruit Juice can increase drug levels and effects."

Rationale :

🥗Increasing dietary fiber can help prevent constipation, an adverse effect particularly associated with some calcium channel blockers such as verapamil.

👩🏻‍🤝‍🧑🏿Clients should report palpitations because they may indicate an abnormal cardiac response or dysrhythmia requiring evaluation.

🍊Grapefruit juice can inhibit intestinal CYP3A4 metabolism of some calcium channel blockers, increasing drug concentrations and adverse effects.

💊Calcium channel blockers should be taken consistently as prescribed, rather than only when symptoms such as chest pain or hypertension are present.

📌Core Message

Clients taking calcium channel blockers should manage constipation, report palpitations, and avoid grapefruit products that may increase medication levels.

Answer 3

Correct Answers:

"Metoprolol helps slow the heart and reduce its need for oxygen."

Rationale :

💁‍♂️Metoprolol is a selective beta1-adrenergic blocker that decreases heart rate and myocardial contractility.

📉By slowing the heart, metoprolol reduces myocardial oxygen demand and decreases excessive sympathetic stimulation.

❤️In stable heart failure, long-term beta-blocker therapy can improve ventricular function and reduce morbidity and mortality.

🩺The medication does not work primarily by removing fluid, blocking aldosterone, or directly improving renal waste elimination.

📌Core Message

Metoprolol benefits heart failure by slowing the heart and reducing myocardial workload and oxygen demand.

Answer 4

Correct Answers:

The client's current blood pressure is 88/64.

Rationale :

📉Amlodipine causes arterial vasodilation and can further lower blood pressure in a client who is already hypotensive.

🚨A blood pressure of 88/64 mm Hg indicates clinically significant hypotension that warrants holding the medication and contacting the healthcare provider.

🩺Administering amlodipine in this situation could worsen tissue perfusion, dizziness, syncope, or cardiovascular instability.

🦶Mild peripheral edema is a common adverse effect of amlodipine, but severe hypotension is the more immediate safety concern.

📌Core Message

Amlodipine should be held when significant hypotension is present because further vasodilation can reduce tissue perfusion.

Answer 5

Correct Answers

Do not stop taking the medication abruptly. [ Appropriate ]
Engage in regular exercise [ Appropriate ]
Blood pressure should be monitored regularly at home. [ Appropriate ]
A low sodium diet is recommended. [ Appropriate ]

Rationale :

💊Abrupt discontinuation of some antihypertensive medications can cause rebound hypertension or worsening cardiovascular symptoms.

🏃Regular physical activity can help lower blood pressure and improve overall cardiovascular health when medically appropriate.

🩺Routine home blood-pressure monitoring allows the client and healthcare team to evaluate response to therapy and identify abnormal readings.

🧂A low-sodium diet helps reduce fluid retention and supports effective blood-pressure control.

📌Core Message

Effective antihypertensive therapy combines consistent medication use with exercise, home blood-pressure monitoring, and reduced sodium intake.

Answer 6

Correct Answers:

Draw blood for a PT/INR level.

Rationale :

🩸Warfarin increases bleeding risk by reducing vitamin K-dependent clotting factor activity.

💁‍♂️The PT/INR is the laboratory test used to evaluate the anticoagulant effect of warfarin and determine whether the client is excessively anticoagulated.

🚨Persistent epistaxis for four hours requires prompt evaluation for excessive anticoagulation and ongoing blood loss.

💉Further treatment may include holding warfarin or administering vitamin K depending on the INR, severity of bleeding, and provider prescription.

📌Core Message

Persistent bleeding in a client taking warfarin requires prompt PT/INR assessment to determine the degree of anticoagulation.

Answer 7

Correct Answers:

Depression

Rationale :

🧠Montelukast carries an important warning for serious neuropsychiatric adverse effects.

😔Clients should report depression, mood changes, agitation, abnormal dreams, or suicidal thoughts promptly to the healthcare provider.

⚠️Recognition of behavioral and mood changes is particularly important because these reactions can become clinically serious.

👉Montelukast is a leukotriene receptor antagonist used mainly for asthma maintenance and allergic rhinitis rather than immediate relief of acute bronchospasm.

📌Core Message

Clients taking montelukast should promptly report depression or other neuropsychiatric changes because these reactions can be serious.

Answer 8

Correct Answers:

Tachycardia

Rationale :

🔴Hydralazine directly relaxes arteriolar smooth muscle, producing peripheral vasodilation and lowering blood pressure.

📉The sudden decrease in vascular resistance can trigger reflex sympathetic activation, resulting in tachycardia.

⚡Tachycardia and palpitations are clinically important adverse effects because they increase myocardial oxygen demand.

🩺Clients receiving hydralazine should have heart rate and blood pressure monitored closely during therapy.

📌Core Message

Hydralazine can cause reflex tachycardia because arterial vasodilation activates the sympathetic nervous system.

Answer 9

Correct Answers:

Peripheral edema

Rationale :

🦶Peripheral edema is a common adverse reaction associated with amlodipine and other dihydropyridine calcium channel blockers.

🩸Amlodipine causes arteriolar vasodilation, increasing hydrostatic pressure in peripheral capillaries and promoting fluid movement into surrounding tissues.

👣The swelling commonly occurs in the ankles and feet and should be monitored during treatment.

📋The nurse should assess the severity of edema, blood pressure, and other cardiovascular findings to determine whether additional intervention is necessary.

📌Core Message

Amlodipine commonly causes peripheral edema because arteriolar vasodilation promotes fluid accumulation in dependent tissues.

Answer 10

Correct Answers:

Jaundice

Rationale :

🧪Fenofibrate can cause hepatotoxicity and elevations in liver enzymes during therapy.

🟡Jaundice may indicate significant liver dysfunction and should be reported promptly to the healthcare provider.

🩺Clients taking fenofibrate may require periodic monitoring of liver-function tests to detect hepatic injury early.

⚠️Fenofibrate can also increase the risk of myopathy and gallstones, particularly when combined with certain lipid-lowering medications.

📌Core Message

Jaundice during fenofibrate therapy may indicate hepatotoxicity and requires prompt healthcare evaluation.

Nursing Education	Appropriate	Not Appropriate
Do not stop taking the medication abruptly.
Engage in regular exercise
Blood pressure should be monitored regularly at home.
A low sodium diet is recommended.

W5 NR293 Exam-2

No.

1 :
A nurse is caring for a client.

Correct Answers

2 :
The nurse provided education to a client who was prescribed a calcium channel blocker. Which client statement(s) indicate an understanding of the education? Select all that apply.

3 :
The nurse is providing education to a client who is prescribed metoprolol as an adjunct treatment for heart failure. Which client statement indicates an understanding of the teaching?

4 :
The nurse is preparing to administer amlodipine to a client with angina. Which finding should cause the nurse to hold the drug and contact the healthcare provider?

5 :
The nurse is planning education for a client who has been prescribed an antihypertensive drug.

Correct Answers

6 :
A client being treated with warfarin for atrial fibrillation presents to the emergency department with 4 hours of nose bleeding. The client reports that bleeding only improved minimally when pinching the nose. What action should the nurse take?

7 :
The nurse is planning discharge education for a client with a new prescription for montelukast. Which adverse effect should the nurse instruct the client to report to the healthcare provider?

8 :
What clinical finding is associated with hydralazine toxicity?

9 :
The nurse is caring for a client taking amlodipine. For which adverse reaction should the nurse monitor?

10 :
Which finding indicates an adverse reaction to fenofibrate?

W5 NR293 Exam-2

No.

1 : A nurse is caring for a client.

Correct Answers

2 : The nurse provided education to a client who was prescribed a calcium channel blocker. Which client statement(s) indicate an understanding of the education? Select all that apply.

3 : The nurse is providing education to a client who is prescribed metoprolol as an adjunct treatment for heart failure. Which client statement indicates an understanding of the teaching?

4 : The nurse is preparing to administer amlodipine to a client with angina. Which finding should cause the nurse to hold the drug and contact the healthcare provider?

5 : The nurse is planning education for a client who has been prescribed an antihypertensive drug.

Correct Answers

6 : A client being treated with warfarin for atrial fibrillation presents to the emergency department with 4 hours of nose bleeding. The client reports that bleeding only improved minimally when pinching the nose. What action should the nurse take?

7 : The nurse is planning discharge education for a client with a new prescription for montelukast. Which adverse effect should the nurse instruct the client to report to the healthcare provider?

8 : What clinical finding is associated with hydralazine toxicity?

9 : The nurse is caring for a client taking amlodipine. For which adverse reaction should the nurse monitor?

10 : Which finding indicates an adverse reaction to fenofibrate?

1 :
A nurse is caring for a client.

2 :
The nurse provided education to a client who was prescribed a calcium channel blocker. Which client statement(s) indicate an understanding of the education? Select all that apply.

3 :
The nurse is providing education to a client who is prescribed metoprolol as an adjunct treatment for heart failure. Which client statement indicates an understanding of the teaching?

4 :
The nurse is preparing to administer amlodipine to a client with angina. Which finding should cause the nurse to hold the drug and contact the healthcare provider?

5 :
The nurse is planning education for a client who has been prescribed an antihypertensive drug.

6 :
A client being treated with warfarin for atrial fibrillation presents to the emergency department with 4 hours of nose bleeding. The client reports that bleeding only improved minimally when pinching the nose. What action should the nurse take?

7 :
The nurse is planning discharge education for a client with a new prescription for montelukast. Which adverse effect should the nurse instruct the client to report to the healthcare provider?

8 :
What clinical finding is associated with hydralazine toxicity?

9 :
The nurse is caring for a client taking amlodipine. For which adverse reaction should the nurse monitor?

10 :
Which finding indicates an adverse reaction to fenofibrate?