NR-293 Pharmacology for Nursing Practice - Set 2 - Part 3

Correct Answer: Notify the provider and obtain an electrocardiogram

Pain that survives the full sublingual sequence suggests infarction rather than ordinary angina, so the situation becomes an emergency. Rapid provider notification and a tracing drive reperfusion decisions and further drug orders. Option a is incorrect because the sequence stops at three tablets, and continuing alone delays recognition of an evolving infarction. Additional nitrate also erodes blood pressure without opening a completely blocked vessel. Option c is incorrect because ongoing ischemia kills myocardium every minute it continues, and comfort measures cannot restore coronary flow. Waiting an hour would place the client well past the reperfusion window. Option d is incorrect because exertion increases cardiac workload precisely when supply already falls short of demand. Breathing exercises have no effect on a thrombus sitting in a coronary artery.

Correct Answer: Stop the infusion and notify the provider

A sudden severe headache with vomiting during thrombolysis suggests bleeding inside the skull. Stopping the drug removes the ongoing insult, and the provider is told at once so emergency imaging can follow. Option b is incorrect because medicating the pain masks the very sign that signals intracranial bleeding. The drug continues to dissolve fibrin while the analgesic works, so the hemorrhage would keep expanding. Option c is incorrect because delay of any length allows more fibrin breakdown in a brain that is already bleeding. Waiting to see whether symptoms worsen wastes the only minutes that still matter. Option d is incorrect because positioning is a comfort measure that leaves the infusion running. Elevation may help intracranial pressure slightly, yet it does nothing about the drug driving the bleed.

Correct Answer: Assist the client to lie down flat

Sudden loss of angiotensin two vasoconstriction in a volume depleted client causes a steep first dose drop. Lying flat restores cerebral perfusion at once and prevents a fall while help is summoned. Option a is incorrect because more drug would deepen a pressure that is already dangerously low. The situation calls for holding therapy and reporting it, not for pushing the next tablet forward. Option c is incorrect because a laboratory draw takes time the client does not have while standing pressure is collapsing. Potassium matters across this therapy, though it does not explain a hypotensive episode. Option d is incorrect because walking a dizzy, sweating client with a collapsing pressure invites syncope and a serious injury. Movement should wait until the reading recovers and the prescriber has been informed.

Correct Answer: Contact the provider about the required washout period

Overlapping an angiotensin converting enzyme inhibitor with this combination stacks two pathways that let bradykinin accumulate, and angioedema is the result. A washout of thirty six hours is required in either direction, so the provider is contacted. Option a is incorrect because taking both at once is precisely the combination that swells the lips, tongue, and larynx. Airway compromise from that overlap is the reason the schedule matters. Option b is incorrect because moving the dose to the evening shortens nothing. Only a full interval without the older drug clears the way, and a nurse cannot set that interval alone. Option c is incorrect because a future laboratory draw does address hyperkalemia, a real concern with this drug. It does nothing about the immediate overlap that could close this client's airway.

Correct Answer: Seeing yellow green halos around the lights

Visual disturbance is the classic sign of digoxin toxicity. Halos, blurring, and a yellow green tint appear along with anorexia and vomiting, and they mean the level and potassium must be checked promptly. Option a is incorrect because warmth and flushing after a hot shower reflect normal cutaneous vasodilation. Digoxin does not dilate skin vessels, and this complaint carries no warning about the drug level. Option b is incorrect because headache belongs with the vasodilating antihypertensives such as hydralazine and the dihydropyridine calcium channel blockers. It is not part of the toxicity picture this drug produces. Option d is incorrect because a persistently dry mouth points toward a centrally acting agent such as clonidine. Nothing about salivary flow tracks the serum concentration of this cardiac glycoside.

Correct Answer: "I will count my pulse daily and report fainting"

A daily radial pulse counted for sixty seconds detects the bradycardia this drug can cause, and fainting signals a dangerous drop in rate or pressure. Both belong in the provider report. Option b is incorrect because symptoms often lag behind a falling rate, so waiting to feel unwell misses early bradycardia. Routine daily counting is what makes the trend visible to the client. Option c is incorrect because abruptly halting a cardiac drug can unleash rebound tachycardia and worsening angina. The client calls the prescriber for guidance rather than deciding independently to discontinue therapy. Option d is incorrect because loss of consciousness is never an acceptable part of therapy and points toward profound bradycardia or block. Such an event requires prompt evaluation, not quiet acceptance.

Correct Answer: New crackles with increasing breathlessness

Removing digoxin also removes its inotropic support, so heart failure can worsen within hours of the antidote. Crackles and increasing breathlessness point to pulmonary congestion and need reporting, along with a potassium that falls quickly. Option a is incorrect because thirst and a dry mouth are minor and easily managed with sips or mouth care. They signal nothing about the pump function that the antidote has just altered. Option c is incorrect because a small rise in pressure is expected once perfusion improves and often reassures the team. The threat after this antidote is congestion, not a modest pressure reading. Option d is incorrect because local redness calls for a site change and continued observation by the nurse. Infusion site irritation is a local problem rather than the systemic deterioration being screened for here.

Correct Answer: "I will take diltiazem to stop a sudden attack"

Calcium channel blockers prevent episodes by relaxing coronary and peripheral arteries over hours, and they cannot abort an attack in progress. The sublingual nitrate remains the rescue agent. Option a is incorrect because swallowing an extended release capsule intact is exactly right, since crushing or chewing dumps the whole day's amount at once. That statement shows correct understanding. Option b is incorrect because the rapid acting nitrate truly is the drug for pain that starts suddenly. Keeping it available and using it promptly is precisely the behaviour the nurse wants. Option c is incorrect because gingival overgrowth is a recognised effect of this class, making meticulous mouth care and dental visits appropriate. The client has absorbed that instruction accurately.

Correct Answer: Stronger contractions with a slower heart rate

Digoxin blocks the sodium and potassium pump, leaving more calcium inside the myocardial cell, so contraction is stronger. Added vagal tone slows the sinus rate and atrioventricular conduction, which is why rate control improves. Option b is incorrect because vagal stimulation from digoxin slows conduction through the atrioventricular node rather than speeding it. That negative dromotropic effect is exactly what controls the ventricular rate in atrial fibrillation. Option c is incorrect because weakened contraction describes a negative inotrope such as verapamil or a beta blocker. Digoxin does the opposite, and it has little direct effect on arterial pressure. Option d is incorrect because a rising pulse would signal the drug is not working or that toxicity has developed. Digoxin lowers the rate while raising the force of each beat.

Correct Answer: Expect the flushing to fade and take aspirin beforehand

Cutaneous flushing from niacin is prostaglandin driven, not allergic, and most clients build tolerance within weeks. Taking aspirin about half an hour before the dose and avoiding hot drinks blunts the reaction. Option a is incorrect because warmth and redness without swelling, wheeze or hives is not anaphylaxis. Summoning an ambulance for an expected prostaglandin effect frightens the client and wastes emergency resources. Option b is incorrect because halting therapy for a predictable and self limiting reaction undermines adherence to a drug that raises high density lipoprotein more than any other agent. Reassurance serves the client better. Option d is incorrect because hot beverages widen skin vessels and make the flush worse rather than better. Clients are told to avoid hot drinks, alcohol and spicy food around the time of each dose.