Question 1

A mother brings her 10-month-old daughter into the clinic because of diarrhea that has lasted for 8 hours.Which are signs of dehydration that the nurse would expect to see in this infant?

Accepted Answer

A)   Decreased respiration and pulse
B)   Slight moisture on mucous membranes
C)   Discoloration around the nail beds
D)   Hypotension and concentrated urine D

Question 2

The physician has started a patient on propranolol (Inderal LA),a beta blocker.The nurse knows this drug is used in the treatment of migraine headaches and which other conditions?

Accepted Answer

A)   Angina
B)   Hyperlipidemia
C)   Bradycardia
D)   Bronchospasm A

Question 3

Diet and exercise alone may not lower a patient's risk for having high cholesterol.Which medication would help to lower a patient's cholesterol level?

Accepted Answer

A)   Clonidine (Catapres) , a central adrenergic inhibitor
B)   Simvastatin (Zocor) , a reductase inhibitor
C)   Nadolol (Corgard) , a beta-adrenergic blocker
D)   Terazosin (Hytrin) , an alpha1-adrenergic blocker B

Question 4

A patient has taken five or six nitroglycerin tablets per day to prevent chest pain for more than 2 years.His health care provider has recommended that he decrease the amount of medication he takes a day to no more than three tablets.This patient should reduce his medication according to which timetable?

Accepted Answer

A)   Stop taking the medication all at once.
B)   Take one fewer tablet every 2 months.
C)   Gradually cut down over a period of time.
D)   Take the medication once a week.

Question 5

For which patient would the nurse anticipate oral replacement therapy would be contraindicated?

Accepted Answer

A)   An 18-year-old with mild diarrhea
B)   A 35-year-old with constipation
C)   A 65-year-old with a bowel perforation
D)   A 50-year-old with flu-like symptoms

Question 6

A 70-year-old female patient has kidney disease and increasing bilateral edema in her legs and feet.Her health care provider has placed her on a potassium-sparing diuretic.Based on this patient's history,which represents the diuretic action the patient needs from her medication?

Accepted Answer

A)   The medication should increase reabsorption of sodium and potassium.
B)   The medication should decrease sodium transport and increase potassium levels.
C)   The medication should excrete water and sodium but save potassium.
D)   The medication should excrete potassium and save water and sodium.

Question 7

A patient with hypertension for 10 years has been told by his health care provider that he has developed nephrotic syndrome,causing generalized edema.Which diuretic will work in the treatment of his condition?

Accepted Answer

A)   Furosemide, a loop diuretic
B)   Polythiazide, a thiazide diuretic
C)   Metolazone, a sulfonamide diuretic
D)   Spironolactone, a potassium-sparing diuretic

Question 8

The physician has discontinued a patient's diuretic medication.Which way would the nurse expect this medication to be discontinued?

Accepted Answer

A)   Reduced gradually
B)   Stopped immediately
C)   Taken every other week for a month
D)   Stopped after two more doses

Question 9

A patient arrives in the emergency department with abdominal distention,pain,and nausea with vomiting.IV fluids with sodium and potassium are started for which reason?

Accepted Answer

A)   To increase diarrhea and clean out the colon
B)   To decrease the abdominal distention and pain
C)   To prevent overhydration and maintain electrolyte balance
D)   To prevent dehydration and electrolyte losses

Question 10

The LPN/LVN should have some understanding about fluid and electrolyte balance.Which is a good rule to remember about this concept?

Accepted Answer

A)   Sodium follows potassium, water remains in the cell.
B)   Potassium leaves the cell, water remains in the cell.
C)   Water remains with potassium in the cell while sodium leaves.
D)   Water tends to follow sodium out of the cell.

Question 11

The treatment of hypertension in patients is accomplished at many sites in the body.The nurse administers diuretics to help achieve the goal of reducing the blood pressure through which means? (Select all that apply.)

Accepted Answer

A)   Water is lost with fluid intake directly.
B)   Indirect production of sodium and water loss
C)   Lowering peripheral resistance
D)   Reduction of arterial tone
E)   Reduction of arterial rigidity

Question 12

A nurse gives a patient discharge instructions about how to store nitroglycerin sublingual tablets to keep the medication fresh for use at all times.Since nitroglycerin is easily destroyed,the nurse would tell the patient to store the medication in which way?

Accepted Answer

A)   In plastic or a tight cardboard box
B)   With cotton over the top of the medication
C)   In a dark glass bottle out of the sunlight
D)   In the refrigerator tightly closed

Question 13

A serum digitalis level is needed to evaluate whether the patient has reached a therapeutic level.Which is an acceptable therapeutic level for digoxin?

Accepted Answer

A)   2.5 ng/mL
B)   3.0 ng/mL
C)   0.2 ng/mL
D)   0.5 ng/mL

Question 14

A patient is scheduled to leave the hospital tomorrow.He has been instructed to take nitroglycerin sublingually if angina is experienced.Which instruction would the nurse give concerning the use of this medication?

Accepted Answer

A)   "During an acute attack of angina, you may repeat the dose after 5 to 10 minutes one time. If the pain is not relieved, go to the physician's office."
B)   "You should never repeat a dose, but you should notify the physician if the pain is not relieved."
C)   "If the pain is not relieved within 3 minutes, you should repeat the dose every 3 minutes times two more doses. If there is still no relief, you should go immediately to an emergency department."
D)   "You can take as many tablets as necessary until the pain is relieved, then report it to the physician."

Question 15

A patient has a history of angina and has been told to reduce his caloric intake and lose 20 pounds.Which situation might this patient avoid so as to help prevent angina attacks?

Accepted Answer

A)   Watching television
B)   Heavy exercise
C)   Using the computer
D)   Walking 30 minutes

Question 16

The LPN/LVN must be aware that digitalis can cause toxicity; it can also cause hormonal effects in male patients.Which hormonal problems can this medication cause a male patient?

Accepted Answer

A)   Increased appetite and weight gain
B)   Swelling in the legs and feet
C)   Gynecomastia and tender breasts
D)   Discoloration around the neck and eyes

Question 17

Procainamide was prescribed for a patient who has ventricular tachycardia.Which adverse actions of this medication should the nurse explain to the patient? (Select all that apply.)

Accepted Answer

A)   Anorexia
B)   Hypotension
C)   Flushness in the face
D)   Cool hands
E)   Headache

Question 18

An elderly man with hypocalcemia asks the nurse why the physician changed his loop diuretic medication to a thiazide diuretic medication that would do the same thing for the edema in his legs.Which represents the best response to this question?

Accepted Answer

A)   "Changing this medication helps keep you from becoming addicted."
B)   "The thiazide medication will help your bones."
C)   "You have to ask the physician about your medication."
D)   "The thiazide medication will improve your blood count."

Question 19

The nurse is providing discharge teaching about the use of antihyperlipidemics.The patient must understand that timing is very important.The nurse tells the patient that other medications should be taken at which time?

Accepted Answer

A)   30 minutes before taking the antihyperlipidemic
B)   1 hour after taking the antihyperlipidemic
C)   Any time before taking the antihyperlipidemic
D)   4 to 6 hours after taking the antihyperlipidemic

Question 20

The nurse is teaching a patient about the loss of potassium when taking diuretics.The physician started this patient on spironolactone (Aldactone).Which is a special characteristic of this diuretic?

Accepted Answer

A)   It blocks active transport of sodium and potassium excretion.
B)   It is used when there is high renal filtration.
C)   It affects the exchange of sodium and potassium excretion.
D)   It gives a peak effect in diuretic use.

Exam 12: Cardiovascular and Renal Medications