NR161: Pharmacology M7+M8 quiz bank:
Antihypertensive and antibiotics
When the nurse is administering topical nitroglycerin ointment, which technique is correct?
a.Apply the ointment on the skin on the forearm.
b.Apply the ointment only in the case of a mild angina episode.
c.Remove the old ointment before new ointment is applied.
d.Massage the ointment gently into the skin, and then cover the area with plastic wrap. - ANS ANS: C
The old ointment should be removed before a new dose is applied. The ointment should be applied to
clean, dry, hairless skin of the upper arms or body, not below the elbows or below the knees. The
ointment is not massaged or spread on the skin, and it is not indicated for the treatment of acute
angina.
The nurse is giving intravenous nitroglycerin to a patient who has just been admitted because of an
acute myocardial infarction. Which statement is true regarding the administration of the intravenous
form of this medication?
a.The solution will be slightly colored green or blue.
b.The intravenous form is given by bolus injection.
c.It can be given in infusions with other medications.
d.Non-polyvinylchloride (non-PVC) plastic intravenous bags and tubing must be used. - ANS ANS: D
The non-PVC infusion kits are used to avoid absorption and/or uptake of the nitrate by the intravenous
tubing and bag and/or decomposition of the nitrate. The medication is given by infusion via an infusion
pump and not with other medications. It is not given by bolus injection. If the parenteral solution is
discolored blue or green, it should be discarded.
A patient has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin
tablets. When teaching the patient how to use sublingual nitroglycerin, the nurse will include which
instruction?
,a.Take up to 5 doses at 15-minute intervals for an angina attack.
b.If the tablet does not dissolve quickly, chew the tablet for maximal effect.
c.If the chest pain is not relieved after one tablet, call 911 immediately.
d.Wait 1 minute between doses of sublingual tablets, up to 3 doses. - ANS ANS: C
According to current guidelines, if the chest pain or discomfort is not relieved in 5 minutes, after 1 dose,
the patient (or family member) must call 911 immediately. The patient may take one more tablet while
awaiting emergency care and may take a third tablet 5 minutes later, but no more than a total of three
tablets. The sublingual dose is placed under the tongue, and the patient needs to avoid swallowing until
the tablet has dissolved.
A 74-year-old professional golfer has chest pain that occurs toward the end of his golfing games. He says
the pain usually goes away after one or two sublingual nitroglycerin tablets and rest. What type of
angina is he experiencing?
a.Classic
b.Variant
c.Unstable
d.Prinzmetal's - ANS ANS: A
Classic, or chronic stable, angina is triggered by either exertion or stress and usually subsides within 15
minutes with either rest or drug therapy.
A patient arrives in the emergency department with severe chest pain. The patient reports that the pain
has been occurring off and on for a week now. Which assessment finding would indicate the need for
cautious use of nitrates and nitrites?
a.Blood pressure of 88/62 mm Hg
b.Apical pulse rate of 110 beats/min
c.History of renal disease
,d.History of a myocardial infarction 2 years ago - ANS ANS: A
Hypotension is a possible contraindication to the use of nitrates because the medications may cause the
blood pressure to decrease. The other options are incorrect.
A calcium channel blocker (CCB) is prescribed for a patient, and the nurse provides instructions to the
patient about the medication. Which instruction is correct?
a.Chew the tablet for faster release of the medication.
b.To increase the effect of the drug, take it with grapefruit juice.
c.If the adverse effects of chest pain, fainting, or dyspnea occur, discontinue the medication
immediately.
d.A high-fiber diet with plenty of fluids will help prevent the constipation that may occur. - ANS ANS: D
Constipation is a common effect of CCBs, and a high-fiber diet and plenty of fluids will help to prevent it.
Grapefruit juice decreases the metabolism of CCBs. Extended-release tablets must never be chewed or
crushed. These medications should never be discontinued abruptly because of the risk for rebound
hypertension.
When applying transdermal nitroglycerin patches, which instruction by the nurse is correct?
a."Rotate application sites with each dose."
b."Use only the chest area for application sites."
c."Temporarily remove the patch if you go swimming."
d."Apply the patch to the same site each time." - ANS ANS: A
Application sites for transdermal nitroglycerin patches need to be rotated. Apply the transdermal patch
to any nonhairy area of the body; the old patch should first be removed. The patch may be worn while
swimming, but if it does come off, it should be replaced after the old site is cleansed.
, A patient has been taking a beta blocker for 4 weeks as part of his antianginal therapy. He also has type
II diabetes and hyperthyroidism. When discussing possible adverse effects, the nurse will include which
information?
a."Watch for unusual weight loss."
b."Monitor your pulse for increased heart rate."
c."Use the hot tub and sauna at the gym as long as time is limited to 15 minutes."
d."Monitor your blood glucose levels for possible hypoglycemia or hyperglycemia." - ANS ANS: D
Beta blockers can cause both hypoglycemia and hyperglycemia. They may also cause weight gain if heart
failure is developing, and decreased pulse rate. The use of hot tubs and saunas is not recommended
because of the possibility of hypotensive episodes.
What action is often recommended to help reduce tolerance to transdermal nitroglycerin therapy?
a.Omit a dose once a week.
b.Leave the patch on for 2 days at a time.
c.Cut the patch in half for 1 week until the tolerance subsides.
d.Remove the patch at bedtime, and then apply a new one in the morning. - ANS ANS: D
To prevent tolerance, remove the transdermal patch at night for 8 hours, and apply a new patch in the
morning. Transdermal patches must never be cut or left on for 2 days, and doses must not be omitted.
While assessing a patient who is taking a beta blocker for angina, the nurse knows to monitor for which
adverse effect?
a.Nervousness
b.Hypertension
c.Bradycardia
d.Dry cough - ANS ANS: C
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