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EXAM 2 questions GNUR 294 cardiac (1)
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EXAM 2 questions GNUR 294 cardiacA patient is prescribed a beta blocker for a cardiac condition. You know this medication
blocks the beta receptors in the body so ____________ and __________ cannot bind to
the receptor site and elicit a _______ ________ _________ response.
A. angiotensin II and angiotensin I; sympathetic nervous system
B. dopamine and norepinephrine; parasympathetic nervous system
C. norepinephrine and epinephrine; sympathetic nervous system
D. dopamine and acetylcholine; parasympathetic nervous system - ANS-C.
norepinephrine and epinephrine; sympathetic nervous system
A patient is admitted with a dysrhythmia. The physician prescribes Propranolol. Which
statement by the patient requires the nurse to hold the ordered dose and notify the
physician for further orders?
A. "I use an inhaler at home for asthma."
B. "My heart feels like it is racing, and I feel very weak."
C. "I had caffeine this morning with breakfast."
D. "I smoke 2 packs of cigarettes per day." - ANS-A. "I use an inhaler at home for
asthma."
Select all the beta blocker medications listed below that affect ONLY beta 1 receptors:
A. Timolol
B. Atenolol
C. Metoprolol
D. Esmolol - ANS-B. Atenolol
C. Metoprolol
D. Esmolol
At 1000 your patient is scheduled to take a dose of Atenolol. What finding below would
require you to hold the scheduled dose and notify the physician?
A. The patient's heart rate is 120 beats per minute.
B. The patient's blood pressure is 102/76.
C. The patient has swelling in lower extremities, dyspnea, and crackles in lung fields. -
ANS-C. The patient has swelling in lower extremities, dyspnea, and crackles in lung
fields.
The answer is C. In option C, the patient is showing signs and symptoms of
uncompensated heart failure (beta blockers are not used when uncompensated heart
failure presents, but they can be sometimes be used when the patient is in
,compensated/stable heart failure). The reason is because beta blockers slow down the
heart rate and decrease the strength of contractions (negative inotropic effect), which
can lead to heart failure in SOME patients, and this is why the nurse must monitor for
this.
A patient with diabetes and hypertension is being discharged home. The patient will be
taking Sotalol and insulin per sliding scale. Which statement by the patient
demonstrates they did NOT understand your discharge instructions about the side
effects of Sotalol?
A. "This medication can affect my blood glucose levels."
B. "I will monitor my heart rate and blood pressure everyday while taking this
medication."
C. "While taking this medication I will monitor for a fast heart rate because this is an
early indication that my blood glucose level is low."
D. "I will report to my physician if I develop shortness of breath, weight gain, or swelling
in my feet - ANS-C. "While taking this medication I will monitor for a fast heart rate
because this is an early indication that my blood glucose level is low."
The answer is C. Beta blockers can prevent tachycardia (increased heart rate). An
increased heart rate is a sign for most diabetics that they are experiencing a low blood
glucose level. Therefore, the patient who is taking beta blocker (especially a
nonselective type) needs to be re-educated that a fast heart rate is NOT a reliable way
of determining hypoglycemia and should check their blood glucose regularly.
A patient is prescribed Metoprolol. Which statement by the patient requires the nurse to
re-educate the patient on how to take the medication properly?
A. "After I stop taking this medication I will let my physician know."
B. "I take this medication with my breakfast every morning."
C. "I will change positions slowly while I'm taking this medication."
D. "While I'm taking this medication I will monitor my heart rate." - ANS-A. "After I stop
taking this medication I will let my physician know."
The answer is A. The patient should NOT just stop taking the medication. It must be
tapered off over a period of time (usually about 2 weeks). This will prevent the
development of rebound hypertension, myocardial ischemia, and angina.
What signs and symptoms below would demonstrate a patient is experiencing an
overdose of a beta blocker medication? Select all that apply:
A. Blood pressure 200/110
B. Heart rate 35 beats per minute
C. EKG shows atrial fibrillation with rapid ventricular rate (RVR)
, D. Patient is maniac and agitated
E. Dyspnea
F. Patient is severely drowsy
G. EKG shows 3rd degree AV block - ANS-B. Heart rate 35 beats per minute
E. Dyspnea
F. Patient is severely drowsy
G. EKG shows 3rd degree AV block
Your patient is prescribed a calcium channel blocker. As the nurse you know that these
medication works to block calcium channels in what areas of the body? Select all that
apply:
A. Vagal nerve cells
B. Vascular smooth muscle
C. Cardiac nodal tissue
D. Peripheral nervous cells
E. Cardiac myocytes - ANS-B. Vascular smooth muscle
C. Cardiac nodal tissue
E. Cardiac myocytes
. A patient is prescribed Verapamil for treatment of a supraventricular arrhythmia. As the
nurse you know that this calcium channel blocker will help control the heart rate and
rhythm by causing which of the following changes in the heart? Select all that apply:
A. Negative inotropic effect
B. Positive inotropic effect
C. Negative chronotropic effect
D. Positive chronotropic effect
E. Negative dromotropic effect
F. Positive dromotropic effect - ANS-A. Negative inotropic effect
C. Negative chronotropic effect
E. Negative dromotropic effect
Which type of calcium channel blockers below are considered non-dihydropyridines and
can provide anti-arrhythmic effects? Select all that apply:
A. Nifedipine
B. Diltiazem
C. Amlodipine
D. Verapamil - ANS-B. Diltiazem
D. Verapamil
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