Cardiovascular Pharmacology NCLEX RN
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Question 1 of 5.
Extract:The clinic nurse is caring for a 38-year-old male Item 3 of 6 Diagnostic Results Basic Metabolic Panel (fasting) • Serum calcium 9.6 mg/dL (2.39 mmol/l) [9.0-10.5 mg/dL (2.24 - 2.61 mmol/l) • Serum chloride 94 mEq/l (94 mmol/l) 90 to 110 mEq/L (90 -110 mmol/l) • Serum glucose 126 mg/dL (6.99 mmol/l) 70-110 mg/dL (3.88 - 6.10 mmol/l) • Serum potassium 4.2 mEq/l (4.2 mmol/l) 3.5 to 5.0 mEq/l (3.5 to 5.0 mmol/l) • Serum sodium 136 mEq/l (136 mmol/l) 135 to 145 mEq/l (135 to 145 mmol/l) • Serum creatinine 0.9 mg/dl (79.5 mcmol/l) 0.6 to 1.1 mg/dl (53 to 106 mcmol/l) • Blood urea nitrogen 19 mg/dl (6.78 mmol/l) 10 to 20 mg/dl (3.57 to 7.14 mmol/l) Lipid Panel (fasting) • Total cholesterol 235 mg/dl (6.07 mmol/l) [less than 200 mg/dl (<5.18 mmol/l)] • High-density lipoprotein (HDL) 35 mg/dl (0.91 mmol/l) [more than 45 mg/dL (>0.75 mmol/L) for men; more than 55 mg/dL (>0.91 mmol/L) for women] • Low-density lipoprotein (LDL) 135 mg/dl (3.49 mmol/l) [less than 130 mg/dL (< 3.36 mmo/l)] • Triglycerides 299 mg/dL [Females: 35-135 mg/dL or 0.40-1.52 mmol/L; Males: 40-160 mg/dL or 0.45-1.81 mmol/L] Thyroid Panel • Triiodothyronine (T3) 87 ng/dL (1.3 nmol/L) [80-200 ng/dL (1.2-3 nmol/L)] • Thyroxine (T4) 5.4 µg/dL (69 nmol/L) [5.4-11.5 (69-148 nmol/L)] • Thyroid-stimulating hormone (TSH) 4.0 µIU/mL (4.0 mIU/L) [0.45-4.5 µIU/mL (0.45-4.5 mIU/L)] Follow-up Nurses' Notes 1345 - Client presents for a one-week follow-up appointment to review his laboratory results. The client reports no acute complaints, denies pain, and states he has been checking his blood pressure while at the grocery store "with the top number being in the 150s". Oral temperature 98.6°F (37° C) Pulse 88 Respiratory Rate 16 Blood Pressure 143/91 mm Hg Pulse oximetry 95% on room air. Current weight 270 pounds (122.72 kilograms); Body Mass Index 29. 41 inches (102 cm) waist size.
The nurse completes and reviews the follow-up nurses' notes and the laboratory results.Complete the following sentence below from the list of options. Based on the clinical data, this client is at the highest risk of developing.............
A. hypothyroidism
B. metabolic syndrome
C. renal insufficiency
D. secondary hypertension
Explanation: The client has elevated blood pressure (143/91 mm Hg), high fasting glucose (126 mg/dL), hyperlipidemia (high cholesterol, LDL, triglycerides, low HDL), and obesity (BMI 29, waist 41 inches), which are diagnostic criteria for metabolic syndrome.
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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