Pharm Ch 22 24 25 Nclex

Front 1

Indications for the antidysrhythmic drug lidocaine include:

Back 1

Ventricular arrhythmias.
Lidocaine is a sodium channel blocking drug used specifically to treat ventricular arrhythmias.

Front 2

When giving adenosine, it is important to remember to:

Back 2

Give it as a fast intravenous push.
Adenosine must be given as rapidly as possible, followed by a 50 mL normal saline flush in order to get all of the medication into the circulation quickly since the half-life of adenosine is A10 seconds.

Front 3

To prevent the occurrence of cinchonism in a patient prescribed quinidine, the nurse emphasizes the importance of:

Back 3

Increasing dietary intake of potassium
Cinchonism can result from concurrent use of antacids and quinidine secondary to blocked renal excretion of the quinidine.

Front 4

Adenosine is used to treat:

Back 4

Paroxysmal supraventricular tachycardia (PSVT)
The only therapeutic indication of use for adenosine is the treatment of PSVT.

Front 5

Sodium channel blockers are considered which class of antiarrhythmic drugs?

Back 5

Class I
Sodium channel blockers are classified as class I drugs.

Front 6

Ibutilide (Corvert) is a class III antiarrhythmic drug that is uses for:

Back 6

Conversion of recent-onset atrial fibrillation and flutter.
Ibutilide is specifically indicated only for treatment of recent-onset atrial fibrillation and flutter.

Front 7

For what potential side effects would the nurse monitor patients prescribed amiodarone?

Back 7

bluish skin discoloration (pulmonary?), hyper- or hypothyroidism, photosensitivity, visual halos, dry eyes, decreased libido (corneal microdeposits)

Front 8

Before administering a dose of an antiarrhythmic drug to an assigned patient, what would the priority assessment be?

Back 8

Apical pulse and blood pressure
Antiarrhythmic drugs can cause both hypotension and bradycardia; therefore it is important to assess blood pressure and apical pulse before administration. Peripheral pulses are not as reliable as the apical pulse assessment.

Front 9

Which of the following classifications of drugs is used to treat both hypertension and dysrhythmias?

Back 9

Calcium channel blockers
Calcium channel blockers are effective intreating both hypertension and dysrhythmias secondary to their negative inotropic and chronotropic effects.

Front 10

Calcium channel blockers have which of the following pharmacodynamic effects?

Back 10

Coronary vasodilation
Calcium channel blockers cause coronary vasodilation, a negative inotropic effect, a negative chronotropic effect, and a negative dromotropic effect.

Front 11

Amiodarone toxicity is evidenced in which body system?

Back 11

Pulmonary
Patients taking amiodarone must have baseline and serial pulmonary function tests in order to monitor for potential pulmonary toxicity.

Front 12

A patient with a rapid, irregular heart rhythm is being treated in the emergency department with adenosine. During administration of this drug, the nurse should be prepared to monitor the patient for what effect?

Back 12

Transitory asystole

Front 13

When assessing a patinet who has been taking amiodarone for 6 months, what adverse reaction might the nurse identify?

Back 13

Photophobia

Front 14

The nurse is assessing a patient who has been taking quinidine and asks about adverse effects. Adverse effects associated with the use of this drug include ...

Back 14

Tinnitus

Front 15

Tinnitus

Back 15

A subjective noise sensation, often described as ringing, heard in one or both ears. It may be a sign of acoustic trauma, Meniere's disease, otosclerosis, presbycusis, or an accumulation of cerumen impinging on the eardrum or occluding the external auditory canal.

Front 16

presbycusis

Back 16

Hearing loss associated with aging.

Front 17

A patient calls the family practice office to report that he has seen his pills in his stools when he has a bowel movement. What should be the nurse's response?

Back 17

"What you are seeing is the waxy matrix that contained the medication, but the drug has been absorbed."

Front 18

What condition would be a caution for the use of a class I antidysrhythmic?

Back 18

Renal dysfunction

Front 19

What adverse effect is of concern for the older adult patient taking antihypertensive drugs?

Back 19

Hypotension

Front 20

When giving antihypertensive drugs, the nurse must consider giving the first dose at bedtime for what classess of drugs?

Back 20

A-blockers such as prazosin (Minipress)

Front 21

A 56-yr-old man started antihypertensive drug therapy 3 months earlier and is in the office for a follow-up visit. While the nurse is taking his blood pressure, he informs the nurse that he has had some problems with sexual intercourse. What would be the most appropriate response by the nurse?

Back 21

“The physician can work with you on changing the dose and/or drugs.”

Front 22

When a patient is being taught about the potential adverse effects of an ACE inhibitor, what should be mentioned as possibly occurring when this drug is taken to treat hypertension?

Back 22

Dry, nonproductive cough

Front 23

A patient has a new prescription for an adrenergic drug. During a review of the patient's list of current medications, what would cause concern about a possible interaction with this new prescription?

Back 23

A benzodiazepine taken as needed for allergies

Front 24

The nurse is reviewing the medications that have been ordered for a patient for whom a loop diuretic has been newly prescribed. The loop diuretic may have a possible interaction with ...

Back 24

NSAIDs

Front 25

When monitoring laboratory test results for patients receiving loop and thiazide diuretics, the nurse knows to look for what re: serum levels?

Back 25

Decreased serum levels of potassium

Front 26

When the nurse is checking the laboratory data for a patient taking spironolactone (Aldactone), what result would be a potential concern?

Back 26

Serum potassium level of 5.8 mEq/L

Front 27

What statement should be included in patient education for a 81 year old woman with heart failure who is taking daily doses of spironolactone (Aldactone)?

Back 27

“Avoid foods that are high in potassium”.

Front 28

A patient with diabetes has a new prescription for a thiazide diuretic. What statement should the nurse include when teaching the patient about the thiazide drug?

Back 28

“Monitor your blood glucose closely, because the thiazide may cause the levels to increase”.

Front 29

What statement, if made by your patient, signifies that additional patient teaching regarding antihypertensive treatment is required?

Back 29

“I will check my blood pressure every day and take my medication when it is over 140/90”
Antihypertensive medications need to be taken routinely in order to maintain a normotensive state and prevent occurrence of complications. Many patients do not adhere to this regimen because hypertension itself does not cause symptoms, whereas the medication can cause some untoward effects. Patient teaching is essential.

Front 30

An annoying side effect of ACE inhibitors that may be minimized by switching to an angiotensin receptor blocking drug includes...

Back 30

A dry, nonproductive cough
ACE inhibitors prevent the breakdown of bradykinin, frequently causing a nonproductive cough. Angiotensin receptor blocking drugs do not block this breakdown, thus minimizing this annoying side effect.

Front 31

What would the nurse question if ordered concurrently with ACE inhibitors?

Back 31

Potassium
ACE inhibitors block the conversion of angiotensin I to angiotensin II, thus also blocking the stimulus for aldosterone production. Aldosterone is responsible for potassium excretion – decreased aldosterone can result in increased serum potassium.

Front 32

What would be a priority assessment prior to administering Eplerenone (Inspra)?

Back 32

Serum electrolytes
Eplerenone (Inspra) is contraindicated in patients with an elevated serum potassium level (greater than 5.5) or severe renal impairment. Therefore, it is imperative that the nurse assess the patient's most recent serum electrolytes prior to administering this medication.

Front 33

The nurse would plan to administer which channel blocking drug to a patient with cerebral arterial spasms following a subarachnoid hemorrhage?

Back 33

Nimodipine (Nimotop)
Nimodipine crosses the blood-brain barrier and has a greater effect on the cerebral srteries than on other arteries in the body, thus it is indicated for the treatment of cerebral arterial spasm following subarachnoid hemorrhage.

Front 34

The nurse would question an order for a calcium channel blocking drug in a patient with ...

Back 34

Hypotension
Calcium channel blockers cause vasodilation and thus a drop in blood pressure. They are contraindicated in the presence of hypotension.

Front 35

What would be an appropriate statement during discharge teaching for a patient receiving transdermal clonidine (Catapres)?

Back 35

“The patch should be applied to a non-hairy site, and abrupt withdrawals should be avoided”.

Front 36

When explaining different medication regimens to treat hypertension during a community education program, it would be accurate to state that African-Americans probably respond best to what combination of medications?

Back 36

Diuretics and calcium channel blockers
Research has demonstrated that African-Americans do not typically respond therapeutically to beta-blockers or ACE inhibitors. They respond better to diuretics and calcium channel blockers.

Front 37

Carvedilol (Coreg) is classified as a:

Back 37

Dual action alpha1- and beta-receptor blocker.
Carvedilol blocks both the alpha1- and beta-receptors of the adrenergic nervous system.