Chapter 42: Cardiac Glycosides, Antianginals, and Antidysrhythmics Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 42: Cardiac Glycosides, Antianginals, and Antidysrhythmics

Test Bank

MULTIPLE CHOICE

1. A client is ordered to receive digoxin (Lanoxin). Based on its half-life of 36 hours, the nurse will anticipate administering the maintenance dose:

a.

once a day.

b.

twice a day.

c.

three times a day.

d.

once a week.

ANS: A

With its half-life, digoxin will be administered daily.

DIF: Cognitive Level: Application REF: p. 625

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

2. The client is being treated with digoxin. She tells the nurse that she frequently self-medicates her depression with St. Johns wort. What is the nurses highest priority instruction to the client?

a.

Take the St. Johns wort; it will have no effect on the digoxin.

b.

Do not take St. Johns wort; it will cause a toxic reaction to the digoxin.

c.

Do not take St. Johns wort; it decreases the effectiveness of the digoxin.

d.

Take the St. Johns wort; it will enhance the effect of the digoxin.

ANS: C

St. Johns wort decreases the absorption of digoxin and thus decreases serum digoxin level.

DIF: Cognitive Level: Application REF: p. 623

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

3. Which symptom would cause the nurse to suspect that the client is experiencing digitalis toxicity?

a.

Abdominal cramping

b.

Bradycardia

c.

Polyuria

d.

Hearing disturbances

ANS: B

This is a sign of digoxin toxicity, because digoxin (Lanoxin) slows and strengthens ventricular contraction.

DIF: Cognitive Level: Application REF: p. 620

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. The nurse instructs a client taking digoxin (Lanoxin) for treatment of congestive heart failure (CHF) to eat:

a.

cabbage.

b.

lima beans.

c.

potatoes.

d.

yogurt.

ANS: C

Potatoes are high in potassium, and potassium-rich foods should be encouraged to help prevent hypokalemia in clients taking digoxin.

DIF: Cognitive Level: Application REF: pp. 623-624

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. The client is being treated with Lanoxin and is also self-medicating with antacids. The nurse expects the combination of these medications to result in _____ digoxin.

a.

anaphylactic reaction to the

b.

increased absorption of

c.

decreased absorption of

d.

toxicity of the

ANS: C

Antacids change the pH of the stomach, decreasing the absorption of many medications.

DIF: Cognitive Level: Application REF: p. 622

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. A client is demonstrating signs and symptoms of digoxin toxicity. The nurse anticipates that the client will be treated with:

a.

vitamin K.

b.

digoxin immune Fab (Digibind).

c.

inamrinone lactate (Inocor).

d.

naloxone (Narcan).

ANS: B

Digoxin immune Fab (Digibind) is the antidote for digoxin toxicity.

DIF: Cognitive Level: Application REF: pp. 621-622

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

7. A nurse is preparing to administer nitroglycerin (NTG) via the sublingual route. The nurse knows that nitroglycerin tablets are administered sublingually to:

a.

avoid the bitter taste.

b.

prevent nausea and vomiting.

c.

absorb readily into the circulation.

d.

undergo first-pass metabolism.

ANS: C

Sublingual medications are absorbed quickly into the bloodstream and are ready for action earlier than oral medications.

DIF: Cognitive Level: Application REF: p. 625

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. A client was prescribed a transdermal nitroglycerin patch, 5 mg/24 hr. What is an important point of instruction for the client?

a.

Leave the old patch on when applying the new patch.

b.

Change to a new site when applying the new nitroglycerin patch.

c.

Apply the nitroglycerin patch only to the chest area.

d.

The patch medication area may be touched while applying it.

ANS: B

The client should change to a new site when applying a new nitroglycerin patch.

DIF: Cognitive Level: Application REF: pp. 625-626

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

9. A client is ordered to take inamrinone lactate (Inocor) for treatment of acute heart failure. The nurse anticipates that this drug will be administered intravenously for no longer than _____ hours.

a.

12

b.

24

c.

36

d.

72

ANS: D

Inamrinone lactate is administered intravenously for no longer than 72 hours because severe cardiac dysrhythmias might result from this drug.

DIF: Cognitive Level: Comprehension REF: p. 622

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. Nifedipine (Procardia), the most potent calcium blocker, promotes vasodilation of the coronary and peripheral vessels. While the client is taking the drug, the nurses highest priority intervention is to monitor for:

a.

elevated blood pressure.

b.

decreased blood pressure.

c.

pulse rate less than 70 beats/minute.

d.

pulse rate greater than 120 beats/minute.

ANS: B

Nifedipine causes hypotension.

DIF: Cognitive Level: Application REF: pp. 627-628

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. A client experiences premature ventricular contractions. The nurse prepares to administer lidocaine (Xylocaine), with the knowledge that it is administered intravenously to correct:

a.

bradycardia.

b.

atrial dysrhythmias.

c.

ventricular dysrhythmias.

d.

heart block.

ANS: C

Lidocaine anesthetizes the ectopic foci, decreasing ectopy and ventricular dysrhythmias.

DIF: Cognitive Level: Application REF: pp. 632-633

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

12. The nurse notes that the client is ordered to receive flecainide (Tambocor) and tocainide (Tonocard). The nurse anticipates that the client has been diagnosed with:

a.

life-threatening ventricular dysrhythmias.

b.

third-degree heart block.

c.

bundle branch block.

d.

asystole.

ANS: A

These are potent antidysrhythmic agents.

DIF: Cognitive Level: Comprehension REF: pp. 632-633

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

13. A nurse is caring for a client with congestive heart failure. The client is ordered to receive nesiritide (Natrecor). The nurse evaluates the effectiveness of this medication by noting which desired effect?

a.

Vasoconstriction

b.

Oliguria

c.

Decreased diuresis

d.

Decreased shortness of breath

ANS: D

This medication allows for diuresis of excess fluids by inhibiting ADH, decreasing pulmonary edema, and decreasing the work of breathing.

DIF: Cognitive Level: Application REF: pp. 622, 624

TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

14. A client is ordered to receive a nitrate to relieve stable angina. What is(are) a common side effect(s) to anticipate in a client receiving this medication?

a.

Nausea and vomiting

b.

Increased blood pressure

c.

Pruritus and skin rash

d.

Pounding headache

ANS: D

The pounding headache is related to vasodilation of the cerebral vessels.

DIF: Cognitive Level: Application REF: p. 626

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

15. The client has been ordered to be treated with Sectral. She is also being treated with a diuretic. The nurse anticipates that the interaction of the two drugs will result in a(n) _____ effect of the _____.

a.

increased; Sectral

b.

increased; diuretic

c.

decreased; Sectral

d.

decreased; diuretic

ANS: A

The combination of Sectral and a diuretic will result in an increased effect from the Sectral.

DIF: Cognitive Level: Application REF: p. 634

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

16. The client has been ordered to be treated with Sectral. The nurse anticipates that the client will experience an increase in which laboratory value?

a.

Calcium

b.

Potassium

c.

Magnesium

d.

Glucose

ANS: B

Sectral will produce an increase in the clients potassium level.

DIF: Cognitive Level: Application REF: p. 634

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

17. The client is being treated with Nitro-stat. She is also being treated with heparin. The nurse anticipates that the combination of the two medications will result in a(n) _____ effect of the _____.

a.

increased; Nitro-stat

b.

increased; heparin

c.

decreased; Nitro-stat

d.

decreased; heparin

ANS: D

The combination of nitroglycerin with heparin will result in a decrease in the effect of the heparin.

DIF: Cognitive Level: Application REF: p. 626

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

18. The nurse is preparing a dose of Lanoxin for a pediatric client. The nurse recognizes that the pediatric medication takes which form?

a.

Elixir

b.

Tablet

c.

Lozenge

d.

Infusion

ANS: A

The pediatric dosage of Lanoxin will usually be in the form of an elixir.

DIF: Cognitive Level: Application REF: p. 621

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

19. The client is being treated with Lanoxin. He is also being treated with quinidine. The nurse anticipates that the combination of the two drugs will result in a(n) _____ level.

a.

increased quinidine

b.

decreased digoxin

c.

increased digoxin

d.

decreased quinidine

ANS: C

The combination of Lanoxin and quinidine will result in an increase in the level of digoxin.

DIF: Cognitive Level: Application REF: p. 621

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

20. The client is being treated with Lanoxin and complains to the nurse of experiencing blurred vision. The highest priority nursing intervention is to recognize that this:

a.

is an expected side effect of the medication; notify the physician.

b.

is indicative of an anaphylactic reaction to the medication.

c.

is an adverse reaction to the medication; notify the physician.

d.

indicates an error in mixing the medication; notify the pharmacist.

ANS: A

Blurred vision is an expected side effect of Lanoxin.

DIF: Cognitive Level: Application REF: p. 621

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

MULTIPLE RESPONSE

1. A client has congestive heart failure and has been taking digoxin (Lanoxin) for 9 years. The client is admitted with signs and symptoms of digoxin toxicity. Which signs and symptoms are associated with digoxin toxicity? (Select all that apply.)

a.

Scomota

b.

Vomiting

c.

Supraventricular tachycardia

d.

Yellow halos in the visual field

e.

Diarrhea

f.

Insomnia

ANS: B, D, E

Vomiting, yellow halos in the visual field and diarrhea are classic signs of digoxin toxicity.

DIF: Cognitive Level: Application REF: p. 621

TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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