Exam 3- Cardiovascular Practice
Questions And Answers 2023/2024
A prescriber has ordered clonidine [Catapres] for a patient who has hypertension. The
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nurse teaches the patient about side effects of this drug. Which statement by the patient
indicates understanding of the teaching?
a. "I should chew sugar-free gum or drink water to reduce dry mouth."
b. "I should not drive as long as I am taking this drug."
c. "I should stand up slowly when taking this medication."
d."I should stop taking this drug if I feel anxious or depressed." - >>ANS: A
Xerostomia is a common side effect of clonidine and is often uncomfortable enough that
patients stop using the drug. Counseling patients to chew sugar-free gum and take
frequent sips of liquid can help alleviate this discomfort. Drowsiness is common, but this
side effect becomes less intense over time. Patients should be counseled to avoid
hazardous activities in the first weeks of therapy if they feel this effect. The hypertensive
effects of clonidine are not posture dependent, as they are with the peripheral alphaadrenergic blockers, so orthostatic hypotension is minimal with this drug. Clonidine
causes euphoria, hallucinations, and sedation in high doses and can cause anxiety or
depression, although the last two effects are less common. The drug should not be
stopped abruptly because of the risk of rebound hypertension, so patients experiencing
unpleasant central nervous system (CNS) effects should consult their provider about
withdrawing the medication slowly.
A patient complains to the nurse that the clonidine [Catapres] recently prescribed for
hypertension is causing drowsiness. Which response by the nurse to this concern is
appropriate?
a.
"Drowsiness is a common side effect initially, but it will lessen with time."
b.
"You may also experience orthostatic hypotension along with the drowsiness."
c.
"You may be at risk for addiction if you have central nervous system side effects."
d.
"You should discontinue the medication and contact your prescriber." - >>ANS: A
CNS depression, evidenced in this patient by drowsiness, is common in about 35% of
the population. These responses become less intense with continued drug use.
Orthostatic hypotension is less likely with clonidine, because its antihypertensive effects
are not posture dependent. The experience of drowsiness does not indicate abuse
potential. The patient should not discontinue the medication abruptly because of the
potential for rebound hypertension; the patient should contact the prescriber before
stopping the medication.
A patient who has been taking clonidine [Catapres] for several weeks complains of
drowsiness and constipation. What will the nurse do?
a.
Recommend that the patient take most of the daily dose at bedtime.
b.
Suggest asking the provider for a transdermal preparation of the drug.
c.
Suspect that the patient is overusing the medication.
d.
Tell the patient to stop taking the drug and call the provider - >>ANS: A
CNS depression is common with clonidine, but this effect lessens over time.
Constipation is also a common side effect. Patients who take most of the daily amount
at bedtime can minimize daytime sedation. Transdermal forms of clonidine do not alter
adverse effects. Patients who are abusing clonidine often experience euphoria and
hallucinations along with sedation, but they generally find these effects desirable and
would not complain about them to a healthcare provider. Clonidine should not be
withdrawn abruptly, because serious rebound hypertension can occur.
A patient with hypertension has a previous history of opioid dependence. Which
medication would the nurse question?
a.
Clonidine [Catapres]
b.
Guanabenz [Wytensin]
c.
Methyldopa
d.
Reserpine [Serpasil] - >>ANS: A
Patients who abuse cocaine, opioids, and other such drugs also frequently abuse
clonidine, so this agent would not be the best choice for this patient. The other drugs do
not share this abuse potential.
A prescriber orders transdermal clonidine [Catapres TTS] for a patient with
hypertension. What will the nurse teach this patient?
a.
That medication given by transdermal patch has fewer systemic side effects
b.
That localized skin reactions are uncommon
c.
To apply the patch to intact skin on the forearm or leg
d.
To change the patch every week - >>ANS: D
Transdermal patches are to be changed every 7 days. Medication administered by
patch has the same therapeutic effect and adverse effects as that given by other routes,
except that localized skin reactions may occur and are common with clonidine patches.
The patch should be applied to intact, hairless skin on the upper arm or torso.
A prescriber orders clonidine [Kapvay] ER tablets for a 12-year-old child. The nurse
understands that this drug is being given to treat which condition?
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