Nursing 1141- Pharmacology » Fall 2022 » Mastery EAQ Ch. 25
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Question #1
The nurse knows that which structure in the heart is referred to as the pacemaker?
A.
Purkinje fibers
B.
SA node
C.
Bundle of His
D.
AV node
Question #2
The nurse recognizes which drug as a class III antidysrhythmic?
A.
Verapamil
B.
Amiodarone
C.
Lidocaine
D.
Atenolol
Question #3
When preparing a teaching plan for a patient with a new prescription for amiodarone, which food or drink would the nurse advise the patient to avoid?
A.
Gluten
B.
Whole milk
C.
Grapefruit juice
D.
Poultry
Question #4
Which class of drugs in the Vaughan Williams classification system is emerging as among the most widely used antidysrhythmics?
A.
Class III
B.
Class I
C.
Class IV
D.
Class II
Question #5
Which class of antidysrhythmic drugs is used for paroxysmal supraventricular tachycardia?
A.
Class IV
B.
Class II
C.
Class Ic
D.
Class III
Question #6
Which common adverse effect is found with the use of beta-blockers?
A.
Pulmonary toxicity
B.
Prodysrhythmic effect
C.
Torsades de pointes
D.
Altered blood glucose levels
Question #7
Which antipsychotic drug prolongs the QT interval?
A.
Terbutaline
B.
Sotalol
C.
Haldoperidol
D.
Droperidol
Question #8
Which class of drugs has a “cardioprotective” effect?
A.
Class III
B.
Class IV
C.
Class Ia
D.
Class II
Question #9
Which condition necessitates a dosage reduction of 50% for lidocaine?
A.
Epilepsy
B.
Lung disease
C.
Tuberculosis
D.
Liver cirrhosis
Question #10
Which drug has an immediate onset of action and peak plasma concentration and is used when verapamil has been ineffective or is contraindicated?
A.
Dofetilide
B.
Diltiazem
C.
Sotalol
D.
Adenosine
Question #11
Which medication increases the duration of the action potential by prolonging repolarization in phase 3?
A.
Flecainide
B.
Verapamil
C.
Sotalol
D.
Adenosine
Question #12
Which medication blocks sodium channels, delays repolarization, and increases the duration of the action potential?
A.
Lidocaine
B.
Amiodarone
C.
Flecainide
D.
Quinidine
Question #13
The patient demonstrates understanding of the nurse’s teaching about quinidine when the patient makes which statement?
A.
"There are different salt forms that I can take interchangeably."
B.
"I should always take this medicine on an empty stomach."
C.
"Lightheadedness is expected. I should just change positions slowly."
D.
"I should call my doctor immediately if my ears are ringing."
Question #14
A patient taking atenolol and amiodarone by mouth reports not being able to complete his usual exercise routine. The patient attributes this complaint to the medication because the atenolol is a new medication. Which response by the nurse is appropriate?
A.
"Feeling tired is normal when you exercise a lot."
B.
"You should report your fatigue to your health care provider."
C.
"As we age, exercising is a challenge and fatigue is normal."
D.
"You should not be exercising at all while taking this medication."
Question #15
A nurse is caring for a patient who is prescribed quinidine. For which adverse effect would the nurse assess in the patient?
A.
Tachycardia
B.
Prolonged QT interval
C.
Agranulocytosis
D.
Dyspnea
Question #16
A patient with a history of gastroesophageal reflux asks the nurse if it is okay to take over-the-counter medication for heartburn with the newly prescribed antidysrhythmic drug. Which response by the nurse is correct?
A.
"You can take an antacid along with the antidysrhythmic 30 minutes before eating."
B.
"Take an antacid, if needed, 2 hours before or 2 hours after the antidysrhythmic."
C.
"It’s best to take the antidysrhythmic on an empty stomach if heartburn occurs."
D.
"An over-the-counter antacid is fine to take with your antidysrhythmic."
Question #17
An intravenous bolus dose of diltiazem 0.25 mg/kg over 2 minutes is prescribed for a patient in the cardiac intensive care unit. Diltiazem is available in a 25-mg vial 5 mg/mL. The patient weighs 168 pounds. How many milliliters will the nurse administer?
A.
2.5 mL
B.
3.8 mL
C.
1.5 mL
D.
2.2 mL
Question #18
Which is the most appropriate outcome criterion for a patient who has been prescribed an antidysrhythmic medication?
A.
Weight gain of 5 lb in 1 week
B.
Systolic blood pressure 90 mm Hg
C.
Palpated radial and pedal pulses
D.
Increased cardiac output
Question #19
A nurse is caring for a patient who is taking lidocaine. For which adverse effect would the nurse monitor in the patient?
A.
Bradycardia
B.
Anorexia
C.
Bronchospasm
D.
Prodysrhythmic effect
Question #20
A nurse is caring for a patient who is prescribed procainamide. Which nursing action is appropriate when providing care to the patient?
A.
Assessing for signs of thrombophlebitis
B.
Asking the patient about any changes in vision
C.
Measuring blood pressure regularly
D.
Monitoring for tachycardia
Question #21
The health care provider discontinues a patient’s quinidine and prescribes procainamide. The patient asks the nurse about the possible side effects of this medication. Which response by the nurse is correct?
A.
"Use over-the-counter steroid cream if a red, swollen rash occurs."
B.
"Taking an antacid with this medication will relieve digestive problems."
C.
"Diphenhydramine can be taken with the medication if you develop a rash or breathing problems."
D.
"Take this medication with food to relieve an upset stomach."
Question #22
Before administering amiodarone, which assessment is most important for the nurse to complete?
A.
Allergy history
B.
Temperature
C.
Respiratory rate
D.
Skin integrity
Question #23
Verapamil 0.3 mg/kg × one dose is prescribed for a 5-year-old child. Verapamil is available for injection in vials of 2.5 mg/mL. The child weighs 52 pounds. How many milliliters should the nurse administer?
A.
3.2 mL
B.
1.8 mL
C.
2.8 mL
D.
2.0 mL
Question #24
The nurse is caring for a patient who is prescribed amiodarone. Which assessment would the nurse perform to identify adverse effects of this medication?
A.
Complete blood count, Visual changes, Bilirubin levels, Echocardiogram
B.
Visual changes, Bilirubin levels, Respiratory rate, Echocardiogram
C.
Respiratory rate, Visual changes, Echocardiogram, Complete blood count
D.
Bilirubin levels, Respiratory rate, Echocardiogram, Complete blood count
Question #25
The nurse is caring for a patient who is currently being treated with digoxin. The health care provider plans to begin treatment with amiodarone. The nurse anticipates that the interaction of the two drugs will require which dosage adjustment?
A.
The dose of digoxin will be reduced by 50%.
B.
The dose of digoxin will be increased by 50%.
C.
The dose of amiodarone will be increased by 50%.
D.
The dose of amiodarone will be reduced by 50%.
Question #26
The nurse has administered quinidine parenterally and would carefully monitor the patient for which adverse effect?
A.
Tinnitus, Diarrhea, Blurred vision
B.
Hypertension, Tinnitus, Increased appetite
C.
Hypertension, Blurred vision, Increased appetite
D.
Diarrhea, Hypertension, Increased appetite
Question #27
A patient has been prescribed amiodarone. Which topic would the nurse include when teaching the patient about this medication?
A.
High-fiber diet, Photophobia and wearing sunglasses, Decreased fluid intake, Gastrointestinal (GI) upset
B.
Decreased fluid intake, Gastrointestinal (GI) upset, Sunscreen use, High-fiber diet
C.
Gastrointestinal (GI) upset, Sunscreen use, High-fiber diet, Photophobia and wearing sunglasses
D.
Decreased fluid intake, Sunscreen use, High-fiber diet, Photophobia and wearing sunglasses
Question #28
The cardiac monitor alarm alerts the nurse that a patient is experiencing paroxysmal supraventricular tachycardia (PSVT) with a heart rate of 180 beats/min. Which fast-acting medication would the nurse expect to administer?
A.
Epinephrine
B.
Adenosine
C.
Lidocaine
D.
Amiodarone
Question #29
The nurse can safely administer verapamil to a patient with which vital signs?
A.
Apical pulse of 58 beats/min
B.
Cardiac monitor rate of 60 beats/min
C.
Radial pulse of 110 beats/min
D.
Systolic blood pressure of 110 mm Hg
Question #30
The nurse is caring for a patient who has been experiencing atrial fibrillation that has been resistant to drug therapy. The nurse anticipates that the patient will now be placed on which class of drug?
A.
Class III drug
B.
Class Ic drug
C.
Class II drug
D.
Class IV drug
Question #31
Which food or beverage is appropriate to include when developing a dietary teaching plan for a patient started on antidysrhythmic medication without a history of heart failure?
A.
More citrus fruits, Extra servings of dairy products
B.
Extra servings of dairy products, Chocolate
C.
Decaffeinated coffee, Eight glasses of water daily
D.
Chocolate, More citrus fruits
Question #32
The nurse would monitor for which adverse effect after amiodarone is administered?
A.
Photosensitivity, Hyperthyroidism, Elevated liver enzymes, Hypertension
B.
Hyperthyroidism, Elevated liver enzymes, Hypertension, Dyspnea
C.
Hypertension, Dyspnea, Photosensitivity, Hyperthyroidism
D.
Dyspnea, Photosensitivity, Hyperthyroidism, Elevated liver enzymes
Question #33
After administering diltiazem to a patient experiencing paroxysmal supraventricular tachycardia (PSVT), the nurse monitors the patient for which side effect?
A.
Prolonged QRS interval
B.
Prominent U wave
C.
Prolonged P-R interval
D.
Prolonged Q-T interval
Question #34
A patient with blood pressure of 124/74 mm Hg has been prescribed metoprolol after a recent myocardial infarction. Which best answers if the patient asks why metoprolol has been prescribed?
A.
After a heart attack, to help decrease the chance for sudden cardiac death
B.
To help relax the blood vessels in the cardiovascular system
C.
After a heart attack, to help keep blood pressure under control
D.
For many reasons, not just to control blood pressure
Question #35
A nurse is providing care to several patients on a medical-surgical unit. The nurse understands that the patient taking which medication would benefit from thyroid studies?
A.
Amiodarone
B.
Diltiazem
C.
Sotalol
D.
Atenolol
Question #36
The nurse is caring for a patient who has been experiencing ventricular dysrhythmias without atrial involvement. The nurse anticipates that the patient will be placed on which class of drug?
A.
Class II drug
B.
Class Ia drug
C.
Class Ic drug
D.
Class Ib drug
Question #37
The nurse is caring for a patient who is taking amiodarone. The patient has also been on a treatment regimen that includes digoxin. Based on this information, the nurse knows to monitor the patient closely for evidence of which adverse effect?
A.
Decreased digoxin levels
B.
Prolonged QT interval
C.
AV block
D.
Tachycardia
Question #38
The nurse is caring for four patients who are on antidysrhythmic medications. The patient taking which medication would the nurse recognize as being at risk for developing a systemic lupus erythematosus (SLE)–like syndrome?
A.
Procainamide
B.
Flecainide
C.
Quinidine
D.
Amiodarone
Question #39
Which food selection would be an appropriate choice for a patient undergoing treatment with an antidysrhythmic drug?
A.
Bacon and eggs
B.
Cheeseburger with French fries
C.
Whole-grain cereal with milk
D.
Turkey and cheese sandwich
Question #40
The nurse is caring for a patient who is being treated with amiodarone. The nurse notes that the patient is experiencing a hacking cough. Which action by the nurse is best?
A.
Administer the cough syrup that has been prescribed.
B.
Notify the health care provider regarding this symptom.
C.
Administer medication to help the patient rest.
D.
Document the findings in the patient’s chart.
Question #41
The nurse is caring for a patient who is being treated with amiodarone. After the patient is on the medication for 6 weeks, labwork drawn on the patient shows evidence of hypothyroidism developing. How would the nurse interpret this information?
A.
This is a possible adverse reaction to the medication.
B.
This is indicative of an inadequate dosage of the medication.
C.
This is indicative of a toxic dosage of the medication.
D.
The patient is developing an anaphylactic reaction to the medication.
Question #42
The nurse is administering a class IV antidysrhythmic drug to a patient. How would the nurse evaluate for the therapeutic effectiveness of the medication?
A.
Assess pain, Monitor cardiac output, Check blood pressure, Count ventricular rate
B.
Listen to breath sounds, Check for pupil constriction, Assess pain, Monitor cardiac output,
C.
Check blood pressure, Count ventricular rate, Listen to breath sounds, Check for pupil constriction
D.
Monitor cardiac output, Check for pupil constriction, Check blood pressure, Listen to breath sounds
Question #43
A patient that has been started on oral quinidine calls the clinic reporting that he has had a lot of "ringing" in his ears. Which response by the nurse is appropriate?
A.
"Stop the medication immediately."
B.
"I’ll talk to the prescriber right away."
C.
"Earplugs are helpful at night."
D.
"Decrease your dose by half."
Question #44
Which method of administration of diltiazem by the nurse is correct?
A.
Intravenous (IV) tubing in a delivery pump
B.
Hanging the medication secondary to a free-hanging dextrose solution.
C.
Pushing IV over 30 seconds.
D.
Drawing up the medication in a heparin flush
Question #45
Verapamil has been administered to a patient parenterally. The nurse would closely monitor for which adverse effect of this drug?
A.
Dizziness, Decreased blood pressure, Complaints of constipation, Heart block evident on cardiac monitor
B.
Equivocal atrial and ventricular rates, Dizziness, Decreased blood pressure, Complaints of constipation
C.
Complaints of constipation, Heart block evident on cardiac monitor, Equivocal atrial and ventricular rates, Dizziness
D.
Decreased blood pressure, Complaints of constipation, Heart block evident on cardiac monitor, Equivocal atrial and ventricular rates
Question #46
The nurse would be least concerned about toxic effects of medication in which patient?
A.
68-year-old treated with procainamide
B.
40-year-old treated with lidocaine
C.
54-year-old treated with adenosine
D.
34-year-old treated with amiodarone
Question #47
A patient who is diagnosed with heart failure is prescribed digoxin and amiodarone. Which clinical manifestation would the nurse assess for if these medications are co-administered?
A.
Bradycardia
B.
Nausea and vomiting
C.
Increased bleeding
D.
Constipation
Question #48
The nurse is assessing patients who are prescribed acebutolol. A patient with which condition would benefit from the administration of digoxin?
A.
Cardiac failure
B.
Bradycardia
C.
Bronchospasm
D.
Hypotension
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