Exam (elaborations)
Rasmussen Pharmacology Exam 2 questions with verified answers
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- MED SURG.
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- Rasmussen College
Rasmussen Pharmacology Exam 2 questions with verified answers
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Rasmussen Pharmacology Exam 2 questions withverified answers
A client comes in with atrial fibrillation (a-fib). Their heart was shocked, and they
had been converted. What medication can you anticipate the provider prescribing
for arrhythmia? Ans✓✓✓ amiodarone (Pacerone)
-Class III antiarrhythmic that is used to treat ventricular arrhythmias
A client was discharged from the hospital on nifedipine. In a follow-up call, the
client states, "I've been taking my nifedipine with a glass of grapefruit juice in the
morning." What is wrong with how the client takes their medication? Ans✓✓✓
taking nifedipine with grapefruit juice can lead to toxicity and heart block
A nurse is caring for a patient receiving dronedarone [Multaq] for treatment of
atrial fibrillation. What electrocardiogram (ECG) change indicates an adverse
effect of this medication?
A. Previously upright T waves now are inverted.
B. Previously rounded, upright P waves now are notched.
C. ST segments previously on the baseline now are depressed.
D. The QT-interval measurement changes from 400 to 520 msec. Ans✓✓✓ D. The
QT-interval measurement changes from 400 to 520 msec.
Dronedarone prolongs the QT interval by about 10 msec. A QT-interval
measurement of 400 msec in a normal heart rate (60 to 100 beats/min) is normal.
Prolongation to 520 msec would increase the risk of torsades de pointes. Newly
inverted T waves and ST-segment depression can be signs of ischemia or
infarction and warrant further investigation through analysis of troponin levels.
Notched P waves can be a sign of valvular heart disease and are unrelated to
treatment with dronedarone.
,A patient develops supraventricular tachycardia (SVT) and is hypotensive. Which
medication should the nurse anticipate will be administered?
A. Lidocaine
B. Adenosine
C. Amiodarone
D. Phenytoin Ans✓✓✓ B. Adensosine
The drug of choice for terminating supraventricular tachycardia (SVT) is
adenosine. Lidocaine is used for ventricular dysrhythmias; amiodarone is used for
atrial and ventricular dysrhythmias; and phenytoin is used for digoxin-induced
dysrhythmias.
A patient diagnosed with a pulmonary embolism is receiving a continuous heparin
infusion at 1000 units/hr. Of which findings should the nurse immediately notify
the healthcare provider? Select all that apply.
A. aPTT of 65 seconds
B. aPTT of 40 seconds Correct
C. Nosebleeds Correct
D. aPTT of 100 seconds Correct
E. Platelet count of 300,000/mcL Ans✓✓✓ B, C, D
Measurement of the aPTT is essential to determine whether the heparin infusion
is having the desired effect. If the normal value of the aPTT is 40 seconds, the goal
is to achieve a therapeutic range of a factor of 1.5 to 2 (60 to 80 seconds).
Because 40 seconds is too short (increases the risk for clotting) and 100 seconds is
too long (increases the risk for bleeding), the physician requires notification for
adjustment of the infusion rate. Evidence of bleeding, such as nosebleeds,
,hematuria, and red or tarry stools, warrant a call to the physician. An aPTT of 65
seconds indicates that a therapeutic effect has been achieved, and a platelet
count of 300,000/mcL is within normal limits, indicating no evidence of
thrombocytopenia.
A patient is admitted to the hospital with a diagnosis of hypertension. The nurse
understands that which medication works by preventing angiotensin II from
binding with its receptor sites?
A. Quinapril
B. Aliskiren
C. Eplerenone
D. Candesartan Ans✓✓✓ D. Candesartan
Candesartan is an angiotensin II receptor blocker (ARB) and thus prevents the
binding of angiotensin II at its receptor sites.
A patient is admitted to the unit in a hypertensive emergency and examination
reveals papilledema. The nurse should expect which IV medications to be
administered to achieve rapid, controlled reduction of the patient's blood
pressure?
A. Furosemide
B. Sodium nitroprusside
C. Metoprolol
D. Diltiazem Ans✓✓✓ B. Sodium nitroprusside
Hypertensive emergency associated with papilledema, intracranial hemorrhage,
myocardial infarction, or acute heart failure is a severe emergency, and the BP
must be lowered rapidly (within 1 hour). Intravenous sodium nitroprusside
, [Nitropress] usually is the drug of choice first used, because its effects begin
within seconds of initiation of the continuous IV infusion, and they fade rapidly
when the infusion is stopped. Furosemide, metoprolol, and diltiazem are not used
for rapid reduction of BP in hypertensive crisis.
A patient is being discharged from the hospital on warfarin [Coumadin] for deep
vein thrombosis prevention. Which instructions should the nurse include in the
patient's discharge teaching plan? Select all that apply.
A. Wear a medical alert bracelet.
B. Check all urine and stool for discoloration.
C. Do not start any new medication without first talking to your healthcare
provider.
D. Enteric-coated aspirin and any aspirin products can be used unless they cause a
gastrointestinal ulcer.
E. No laboratory or home monitoring of international normalized ratio (INR) is
required after the first 6 months. Ans✓✓✓ A, B, C
Advise the patient to wear some form of identification (e.g., Medic Alert bracelet)
to alert emergency personnel to warfarin use. Bleeding is a major complication of
warfarin therapy. Inform patients about the signs of bleeding, which include
discolored urine or stools. Inform patients that warfarin is subject to a large
number of potentially dangerous drug interactions. Instruct them to avoid all
prescription and nonprescription drugs that have not been specifically approved
by the prescriber. Aspirin and aspirin products should be avoided because aspirin
can increase the effects of warfarin to promote bleeding and on the
gastrointestinal tract to cause ulcers, thereby initiating bleeding. The INR should
be determined frequently: daily during the first 5 days, twice a week for the next
1 to 2 weeks, once a week for the next 1 to 2 months, and every 2 to 4 weeks
thereafter.
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