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Cardiovascular Pharmacology NCLEX RN

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Question 1 of 5.

Extract:The following scenario applies to the next 6 items The clinic nurse is caring for a 38-year-old male Item 1 of 6 Nurses' Notes 1456 - 38-year-old male reports to the clinic for an annual physical examination and to establish care. The client reports no acute concerns but does admit to gaining a few pounds over the past several months. The client reports having decreased physical activity. He reports his dietary habits have changed because of his job, where he relies on fast food for breakfast and lunch. On assessment, the client is alert and completely oriented to person, place, and situation. The skin is warm and dry—patches of darkening and thickening of the skin around the skin folds. Lung sounds are clear; S1/S2 heart tones are auscultated. Peripheral pulses palpable, 2+. Bowel sounds are active in all quadrants. He denies any dysuria and reports his sex drive has decreased over the past several months. He reports occasional constipation, which causes him to use stool softeners. He reported no medical or surgical history besides an appendectomy four years ago. His parents are living, his mother is being treated for ovarian cancer, and his father has hypothyroidism and had a myocardial infarction two years ago. He recently started taking daily over-the-counter aspirin because of his father's cardiovascular disease. He takes a multivitamin 'when he remembers.' He is separated from his wife and currently going through what he describes as a bitter divorce which has been 'stressing him out.' He has one child. He denies using tobacco products but drinks one to two glasses of wine weekly. Current weight 269 pounds (122.27 kilograms); Body Mass Index 29; 40 inches (102 cm) waist size. Oral temperature 98.6°F (37° C) Pulse 92 Respiratory Rate 17 Blood Pressure 141/92 mm Hg Pulse oximetry 96% on room air

Select the client findings that require follow-up. Select all that apply.

A. respiratory rate

B. blood pressure

C. pulse

D. waist size

E. body mass index (BMI)

F. dietary habits

G. darkening patches in the skin folds

Explanation: Blood pressure (141/92 mm Hg) indicates hypertension, waist size (40 inches) and BMI (29) suggest obesity, dietary habits (fast food reliance) contribute to cardiovascular risk, and darkening skin patches (acanthosis nigricans) may indicate insulin resistance, all requiring follow-up. Respiratory rate (17) and pulse (92) are within normal limits.

Question 2 of 5.

Extract:Cardiovascular Pharmacology NCLEX RN

The nurse is caring for a client newly diagnosed with an abdominal aortic aneurysm. The nurse should anticipate a prescription for which of the following medications?

A. naproxen

B. digoxin

C. prednisone

D. atenolol

Explanation: Atenolol, a beta-blocker, is often prescribed to manage blood pressure and reduce stress on the aortic wall in clients with an abdominal aortic aneurysm to prevent rupture. Naproxen (an NSAID), digoxin (a cardiac glycoside), and prednisone (a corticosteroid) are not typically used for this condition.

Question 3 of 5.

The nurse is caring for a client with the following clinical data. Based on the vital signs, which medications would the nurse clarify with the primary healthcare provider (PHCP) prior to administration? See the exhibit. Select all that apply.

A. Atenolol 50 mg PO Daily

B. Spironolactone 50 mg PO Daily

C. Albuterol 2.5 mg via nebulizer Daily

D. Fentanyl 50 mcg IV Push q 6 hours PRN Pain

E. Modafinil 100 mg PO Daily

Explanation: Without specific vital signs provided, atenolol (a beta-blocker) may need clarification if the client has low heart rate (bradycardia) or low blood pressure, as it can exacerbate these conditions. Spironolactone, albuterol, fentanyl, and modafinil are less likely to require clarification based solely on vital signs unless specific contraindications (e.g., severe hypotension or respiratory distress) are present.

Question 4 of 5.

The nurse has taught a client who has been prescribed clonidine via a transdermal patch. Which of the following statements by the client would indicate a need for further teaching?

A. I can wear this patch while I shower.

B. I should keep this patch on for five days.

C. This medication may make me drowsy.

D. If I ever have to have a magnetic resonance imaging (MRI), I will need to remove the patch before the test.

Explanation: Clonidine transdermal patches are typically changed every 7 days, not 5 days, so the statement about keeping the patch on for five days indicates a need for further teaching. The other statements are correct: clonidine patches are water-resistant, can cause drowsiness, and must be removed before an MRI due to potential metal content.

Question 5 of 5.

The nurse has taught a client who has been prescribed nitroglycerin transdermal. Which of the following statements by the client would indicate a correct understanding of the teaching?

A. It is okay for me to apply this patch to the area that has been shaven.

B. This patch should be removed for 4 to 6 hours to avoid me developing a tolerance.

C. It is okay for me to wear this patch while I shower.

D. I should apply this patch below my knee to lessen my chance of getting a headache.

Explanation: Applying a nitroglycerin transdermal patch to a shaved area ensures good adhesion and absorption, indicating correct understanding. Nitroglycerin patches are typically removed for 10-12 hours to prevent tolerance, not 4-6 hours. While water-resistant, applying below the knee is not standard and does not reduce headache risk.

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