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Pharmacology Final Exam REVIEW!!!!.pdf
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Pharmacology Final Exam REVIEW!!!!A patient about to receive his morning dose of digoxin has an apical pulse of 70 beats
per minute. What will the nurse do?
A. Administer the dose.
B. Administer the dose and notify the physician.
C. Check the radial pulse for 1 full minute.
D. Withhold the dose and notify the -answer A. Administer the dose.
In assessing a patient before administration of a cardiac glycoside, the nurse knows that
what condition can predispose a patient to digitalis toxicity?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia - answer A. Hypokalemia; control ventricular response to atrial
fibrillation and a derived from foxglove. Digoxin is the only available cardiac glycoside---
positive inotropic---inhibits sodium potassium pump (adenosine tripphophatase) Sodium
and calcium rise. Cholinergic stimulation via the vagus nerve of Parasympathetic
nervous system. ---Negative chronotropic---Negative Dromotropic effect
,While assessing a patient who is receiving intravenous digitalis, the nurse recognizes
that the drug has a negative chronotropic effect. How would this drug effect be evident
in the patient?
A. Increased heart rate
B. Decreased heart rate
C. Decreased conduction
D. Increased ectopic beats - answer B. Decreased heart rate
A patient has been taking digoxin at home but has taken an accidental overdose and
has developed toxicity. He has been admitted to the telemetry unit where the physician
has ordered digoxin immune Fab (Digibind). The patient asks the nurse why the
medication is ordered. What is the nurse's best response?
A. "It works faster than digoxin."
B. "It is safer than digoxin and can be taken orally."
C. "It helps to convert the irregular heart rhythm to a more normal rhythm."
D. "This drug is an antidote to digoxin and will help to lower the blood levels." - answer
D. "This drug is an antidote to digoxin and will help to lower the blood levels." (severe
bradycardia, advanced heart block, ventricularr tachycardia, fibrillation, and
hyperkalemia); available in parental form. Clinical signs and symptoms are monitored
NOT serum levels----used for systolic heart failure and atrial fibrillation.
,5. A patient has been placed on a milrinone infusion as part of the therapy for end-stage
heart failure. What risks involved with this drug will the nurse keep in mind while
assessing this patient during the infusion?
A. Hypertension
B. Hyperkalemia
C. Nausea and vomiting
D. Cardiac dysrhythmias - answer D. Cardiac dysrhythmias (contraindictated with
ventricular tachycardia, and fibrillation) used for treatment of atrial fibrillation. Available
in Oral and injection form.
6. A patient with atrial fibrillation was started on digoxin, and 1 week later a digoxin level
was drawn. Which result is within normal therapeutic levels for digoxin?
A. 0.4 ng/mL
B. 0.7 ng/mL
C. 2.1 ng/mL
D. 2.6 ng/mL or higher - answer B. 0.7 ng/mL (normal 0.5 to 2.0 ng/mL
7. When reviewing the list of medications taken by a patient who will be receiving a new
prescription for digoxin, the nurse would be concerned about which medication that may
interact with the digoxin?
A. aspirin
B. acetaminophen (Tylenol)
C. furosemide (Lasix)
, D. vitamin K - answer C. furosemide (Lasix); (loop Diuretics); numerous ones on page
341
8. The nurse is reviewing discharge teaching for a patient who will be taking digoxin
(Lanoxin) therapy. The patient should be taught to avoid which foods when taking the
digoxin?
A. Leafy green vegetables
B. Dairy products
C. Grapefruit juice
D. Bran muffins - answer D. Bran muffins
9. In assessing a patient before administration of a cardiac glycoside, the nurse knows
that which lab result can increase the toxicity of the drug?
A. Potassium level 2.8 mEq/L
B. Potassium level 4.9 mEq/L
C. Sodium level 140 mEq/L
D. Calcium level 10 mg/dL - answer A. Potassium level 2.8 mEq/L (low potassium
normal is 3.5 to 5.0)
10. The nurse administering the phosphodiesterase inhibitor inamrinone recognizes that
this drug should have a positive inotropic effect. This effect will result in increased
A. heart rate.
B. blood vessel dilation.
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