Card 0 of 20
Which of the following is an adverse effect in the client being treated for hypertension with enalapril?
A swelling of the tongue indicates that a client may be allergic to enalapril. Other indicators include rash, hives, itching, difficulty breathing, and tightness in the chest.
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Which of the following describes the mechanism of action of the class of drugs known as beta blockers?
Beta blockers act by blocking response to beta-adrenergic stimulation. In that way they are beta-adrenergic antagonists, rather than agonists. ACE (angiotensin-converting enzyme) inhibitors, not beta blockers, block the production of angiotensin II, but both act to decrease blood pressure. Beta blockers have nothing to do with beta cells of the pancreatic islets, which secrete insulin.
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When educating a patient on a new beta blocker prescription which of the following safety information is most critical?
The most critical safety information a patient must know when initiating beta blocker therapy is that they can not abruptly stop taking their beta blocker, due to the risk of rebound hypertension. A beta blocker would be more likely to cause bradycardia and a depressed effect than anxiety and tachycardia. Beta blockers are not associated with any type of esophagitis and they are not fat soluble, thus it is not crucial to eat a fatty meal with the drug in order to improve absorption.
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Which of the following is the most common adverse effect of calcium channel blockers?
All of these are possible side effects of calcium channel blockers, but the most common side effect is edema. Calcium channel blockers decrease blood pressure by hindering the influx of calcium into myocardial cells. They may also increase the diameter of blood vessels, which always results in decreased blood pressure.
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Which of the following medications is a non-selective beta-adrenoceptor and alpha-adrenergic blocker?
Carvedilol is a non-selective beta-adrenoceptor and alpha-adrenergic blocker. Lisinopril is an ACE (angiotensin-converting enzyme) inhibitor. Clonidine is an alpha-adrenergic agonist, and amiodarone is a sodium-channel blocker.
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Which of the following heart medications is most likely to cause a chronic dry cough?
Enalapril is an ACE (angiotensin-converting enzyme) inhibitor. One of the most commonly reported side effects of ACE inhibitor use is a chronic dry cough. This is likely due to the medication's inhibition of kininase II (ACE), which results in a buildup of kinins in the respiratory tract.
None of the other medications listed are associated with persistent cough.
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Which of the following conditions can be treated with hydrochlorothiazide?
Hydrochlorothiazide is a thiazide diuretic, used primarily in the treatment of hypertension and edema.
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What is the antidote for overdose of warfarin?
The proper antidote for overdose of warfarin is vitamin K. Heparin will not reverse the effects of too much warfarin (it would only aggravate the problem). Protamine sulfate is the antidote for overdose of heparin. IV magnesium may be used to antidote digoxin if digibind is unavailable.
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What class of drug is losartan?
Losartan is an angiotensin receptor blocker (ARB). This class of drugs lowers blood pressure by blocking the conversion of angiotensin I to angiotensin II and is useful for patients who cannot tolerate ACE (angiotensin-converting enzyme) inhibitors' adverse effects.
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Diltiazem is an example of what class of cardiovascular medication?
Diltiazem is an example of a calcium channel blocker. This class of drugs reduces blood pressure by relaxing smooth muscles in the walls of arteries, leading to vasodilation and decreased peripheral resistance.
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You are a nurse in a primary care setting. One of your patients is diagnosed with hypercholesterolemia, and after failing to see cholesterol improvements with diet and exercise, is started on atorvastatin. Which of the following best describes the mechanism of action of atorvastatin?
The correct answer is "HMG-CoA reductase inhibition," as this is the accurate mechanism of action of atorvastatin, a commonly-prescribed lipid-lowering agent for patients with a number of medical conditions, including hypercholesterolemia. HMG-CoA reductase is an enzyme found within the liver that catalyzes a major reaction involved in cholesterol formation. By inhibiting this enzyme with a medication such as a statin, the new production of LDL cholesterol is decreased, and the number of LDL receptors is upregulated (which decreases circulating LDL, therefore lowering LDL cholesterol).
Atorvastatin is neither an alpha-adrenergic inhibitor, beta-adrenergic inhibitor, PPAR activator (fibrates), or Na-K-2Cl symporter inhibitor (loop diuretics).
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You are a nurse working on an inpatient medicine floor. One of your patients is advised to discuss starting gemfibrozil, a fibrate medication, after he is discharged. Which of the following best describes the mechanism of action of gemfibrozil?
The correct answer is "Peroxisome proliferator-activated receptor (PPAR) activation," as this is the accurate mechanism of action for fibrate medications, such as gemfibrozil. Fibrates are commonly-used medications used to treat high cholesterol, as well as a number of other metabolic abnormalities in patients. Fibrates have the relatively unique property of lowering LDL (the "bad" cholesterol), increasing HDL (the "good" cholesterol), and lowering triglycerides, making them a popular choice when administered either alone, or with statin medications for patients with hypercholesterolemia.
HMG-CoA reductase inhibition is the mechanism of action of statins.
Vitamin-K-dependent clotting factor synthesis inhibition is the mechanism of action of warfarin.
Alpha-adrenergic inhibition is the mechanism of action of phenoxybenzamine, among other medications.
Beta-adrenergic inhibition is the mechanism of action of propranolol, among other medications.
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You are the nurse taking care of a patient hospitalized for a deep vein thrombosis. You are reviewing his discharge medications, and counsel him about the benefits and risks associated with apixaban. Which of the following is a major possible adverse effect associated with apixaban?
The correct answer is "bleeding."
Apixaban is a novel anti-coagulant medication that functions by directly inhibiting factor Xa in the clotting cascade. You can remember this mechanism of action by noting the letters "Xa" in apiXaban. Apixaban is used with increasing frequency now in the treatment of deep vein thrombosis, pulmonary embolism, and atrial fibrillation. A very serious potential adverse effect of apixaban though is that since it is an anticoagulant agent, it can predispose to serious bleeding events. Furthermore, one of the biggest dangers of apixaban is that there is no readily available antidote for it yet, and as such if a bleeding event occurs, there is no simple way to reverse it, as there is with other anti-coagulants like warfarin or heparin.
Thrombosis, myocardial infarction, and ischemic stroke are all typically thrombotic (e.g. clot-related) issues. Apixaban may be used in the treatment of conditions associated with clotting, but is not known to cause clots, as it is an anti-coagulant.
Apixaban has no known association with bowel movement frequency.
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You are a nurse taking care of a patient during a rapid response call. The patient is bradycardic and you are asked to administer atropine. Which of the following best describes the mechanism of action of atropine?
The correct answer is "Muscarinic acetylcholine receptor antagonist," as this accurately describes the mechanism of action of atropine.
Atropine is an anticholinergic medication used for a number of reasons, including to treat bradycardia, various nerve agent poisonings, and intraoperatively at times to diminish the amount of saliva generated. Typical anticholinergic medication side effects can be associated with atropine including pupil dilation, urine retention, dry mouth, constipation, and tachycardia.
Muscarinic acetylcholine receptor agonist is incorrect as this is the opposite of how atropine works.
Beta-adrenergic blocker is incorrect. This class of medications would actually serve to decrease heart rate, which would be highly dangerous in a patient whose reason for intervention is bradycardia.
Neither alpha-adrenergic blockade nor monoamine oxidase inhibition describes the mechanism of action of atropine.
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You are the nurse taking care of a 78-year old female who is in atrial fibrillation with rapid ventricular response. She is started on metoprolol and diltiazem. Which of the following best describes the mechanism of diltiazem?
The correct answer is "Calcium-channel blocker." Diltiazem, which is more specifically a non-dihydropyridine calcium-channel blocker is a commonly given medication that functions to dilate both coronary and peripheral vessels (with a negligible reflex adrenergic response). It also is useful in reducing cardiac contractility, having negative inotropy, chronotropy, and dromotropy characteristics.
The other choices are incorrect. Beta-adrenergic blocker is the mechanism of action of metoprolol. Alpha-adrenergic blocker is the mechanism of action of doxazosin. Mu-opioid receptor agonist is the mechanism of action of morphine. Mu-opioid receptor antagonist is the mechanism of action of naloxone.
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Which of the following is an adverse effect in the client being treated for hypertension with enalapril?
A swelling of the tongue indicates that a client may be allergic to enalapril. Other indicators include rash, hives, itching, difficulty breathing, and tightness in the chest.
Compare your answer with the correct one above
Which of the following describes the mechanism of action of the class of drugs known as beta blockers?
Beta blockers act by blocking response to beta-adrenergic stimulation. In that way they are beta-adrenergic antagonists, rather than agonists. ACE (angiotensin-converting enzyme) inhibitors, not beta blockers, block the production of angiotensin II, but both act to decrease blood pressure. Beta blockers have nothing to do with beta cells of the pancreatic islets, which secrete insulin.
Compare your answer with the correct one above
When educating a patient on a new beta blocker prescription which of the following safety information is most critical?
The most critical safety information a patient must know when initiating beta blocker therapy is that they can not abruptly stop taking their beta blocker, due to the risk of rebound hypertension. A beta blocker would be more likely to cause bradycardia and a depressed effect than anxiety and tachycardia. Beta blockers are not associated with any type of esophagitis and they are not fat soluble, thus it is not crucial to eat a fatty meal with the drug in order to improve absorption.
Compare your answer with the correct one above
Which of the following is the most common adverse effect of calcium channel blockers?
All of these are possible side effects of calcium channel blockers, but the most common side effect is edema. Calcium channel blockers decrease blood pressure by hindering the influx of calcium into myocardial cells. They may also increase the diameter of blood vessels, which always results in decreased blood pressure.
Compare your answer with the correct one above
Which of the following medications is a non-selective beta-adrenoceptor and alpha-adrenergic blocker?
Carvedilol is a non-selective beta-adrenoceptor and alpha-adrenergic blocker. Lisinopril is an ACE (angiotensin-converting enzyme) inhibitor. Clonidine is an alpha-adrenergic agonist, and amiodarone is a sodium-channel blocker.
Compare your answer with the correct one above