Nokea
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
Correct Answer: D
Rationale: 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.
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The nurse is preparing a staff education program about beta-blockers and their function in the cardiovascular system. Which of the following information should the nurse include? Select all that apply.
- A. block catecholamines from binding to the beta receptors.
- B. reduce myocardial oxygen demand.
- C. increase cardiac contractility.
- D. increase cardiac output.
- E. prevent sodium and water resorption by inhibiting aldosterone secretion.
Correct Answer: A,B
Rationale: Beta-blockers block catecholamines at beta receptors, reducing heart rate and myocardial oxygen demand. They do not increase contractility or cardiac output and are not involved in aldosterone secretion.
The nurse is teaching a continuing education course regarding cardiovascular medications. It would be appropriate for the nurse to reinforce which condition is a contraindication to administering calcium channel blockers?
- A. Atrial fibrillation
- B. Hypertension
- C. Peripheral vascular disease
- D. Systolic heart failure
Correct Answer: D
Rationale: Calcium channel blockers, especially non-dihydropyridines, are contraindicated in systolic heart failure due to their negative inotropic effects. They may be used in atrial fibrillation, hypertension, or peripheral vascular disease.
The nurse is counseling a client with congestive heart failure (CHF) about newly prescribed bumetanide. The nurse determines that the teaching has been effective when the client plans to
- A. increase their daily intake of protein.
- B. record their daily urinary output.
- C. weigh themselves daily.
- D. take their blood pressure and pulse daily.
Correct Answer: C
Rationale: Bumetanide, a loop diuretic, requires daily weight monitoring to assess fluid status in CHF. Protein intake, urinary output records, or vital signs monitoring are less critical.
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
Correct Answer: B,D,E,F,G
Rationale: 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.
The nurse in the emergency department (ED) is caring for a client with a myocardial infarction. The nurse anticipates a prescription for which medications? Select all that apply.
- A. labetalol
- B. morphine sulfate
- C. nitroglycerin
- D. enalapril
- E. isosorbide
- F. diltiazem
Correct Answer: B,C,E
Rationale: Morphine sulfate (for pain), nitroglycerin (for vasodilation), and isosorbide (for preload reduction) are used in myocardial infarction. Labetalol, enalapril, and diltiazem are not first-line treatments.