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Exam II Pharmacology 807: Questions With Solutions
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Exam II Pharmacology 807: Questions With SolutionsWhich assessment would be considered a priority for a client receiving
amiodarone?
urine outputs
heart rate checks
lung sounds
muscle rigidity Right Ans - CHECK HR
An effect of the medication is to increase the ventricular fibrillation threshold.
The nurse assesses the client's heart rate and the cardiac rhythm; the heart
rate and rhythm should be regular, with a rate between 60 and 100 beats per
minute. It is important to assess urine output, but it is not the primary focus
since renal function is not the focus of the therapy. Amiodarone may diminish
lungs sounds, but it will not cause an increase in lung sounds. The effect of
amiodarone is to decrease muscle strength, not cause rigidity.
A patient is administered diltiazem (Cardizem) IV followed by propranolol
(Inderal) IV. What effect will this medication combination produce?
Hypertensive crisis
Anaphylaxis
Heart block
Bradycardia Right Ans - BRADY
Diltiazem administered with propranolol intravenously will produce
potentially fatal bradycardia and hypotension. The administration of IV
diltiazem and propranolol will not produce hypertensive crisis, anaphylaxis,
or heart block.
An adult client with a long-standing dysrhythmia has been taking oral
propranolol for the last several months, resulting in acceptable symptom
control. What is a priority teaching point for the nurse to communicate to this
client?
the need to measure the radial pulse for 1 minute prior to each dose of
propranolol
the importance of not stopping the medication abruptly
the need to avoid taking over-the-counter antacids
the need to limit intake of high-potassium foods Right Ans - NOT STOP
ABRUPTLY
Clients need to realize that they should not stop taking propranolol abruptly
because this action can cause the dysrhythmia to worsen. There is no need to
,restrict potassium intake, to avoid antacids, or to measure the radial pulse
prior to each dose of propranolol.
A client has an elevated BUN. The client has been prescribed digoxin for heart
failure. What aspect of care is the priority regarding this client?
The client should be taught to increase sodium in the diet.
The dose should be increased when the heart rate is below 60.
The dose should be decreased in this client.
The dosage should be 1.0 mg per mouth daily. Right Ans - DOSE
The dose must be reduced in the presence of renal failure because most of the
digoxin is excreted unchanged by the kidneys, leading to drug accumulation
and toxicity. The client should be taught to limit sodium intake in the diet. The
client's heart rate should remain above 60. If the heart rate falls below 60, the
digoxin should be held. The dose of 1.0 mg is too large for a client with altered
renal function.
A client with a history of heart failure is being treated with digoxin. The nurse
knows that this medication increases the force of contractions of the heart.
What effect improves the contractility of the heart?
positive chronotropic effect
positive inotropic effect
negative inotropic effect
negative dromotropic effect Right Ans - + INOTROPIC EFFECT
In heart failure, digoxin exerts cardiotonic or positive inotropic effect that
improves the contractility and pumping ability of the heart. A positive
chronotropic effect accelerates the rate of the heart, which is not
recommended in a client with heart failure. A negative inotropic effect
accelerates the heart, which is not recommended in a client with heart failure.
A negative dromotropic effect changes the conductivity of muscle fiber,
increasing heart rate.
A client who has been prescribed digoxin (Lanoxin) is also taking furosemide
(Lasix) 20 mg daily. Which electrolyte imbalances will precipitate the client to
develop digoxin toxicity?
Hyperkalemia
Hypokalemia
Hypermagnesemia
Hyponatremia Right Ans - HYPOKALEMIA
, Hypokalemia will contribute to the client developing digoxin toxicity.
Hyperkalemia, hypermagnesemia, and hyponatremia will not contribute to
the development of digoxin toxicity.
A client has been administered nesiritide to manage symptoms of acute heart
failure. What is the primary action of this drug?
exhibits mild inotropic action and decreased platelet aggregation
compensates for cardiac deterioration by reducing preload and afterload
corrects hyperthyroidism by inhibiting synthesis of the thyroid hormone
increases the concentration of acetylcholine to potentiate the action of ACE
Right Ans - COMPENSATES
Nesiritide compensates for cardiac deterioration by reducing preload and
afterload. Dipyridamole exhibits mild inotropic action and decreased platelet
aggregation. It would not be used in acute heart failure. Methimazole corrects
hyperthyroidism by inhibiting synthesis of the thyroid hormone.
Physostigmine increases the concentration of acetylcholine to potentiate the
action of ACE on the skeletal muscle.
A patient presents at the clinic with sneezing and coughing. He is diagnosed
with the common cold. Which type of microorganism causes the common
cold?
Gram-positive bacteria
Gram-negative bacteria
Virus
Fungus Right Ans - VIRUS
The common cold, a viral infection of the upper respiratory tract, is the most
common respiratory tract infection. The common cold is not caused by gram-
negative or gram-positive bacteria. Fungal infections are not the cause of the
common cold.
A client has hypertension and wants to take a nasal decongestant for cold
symptoms. Which statement by the nurse indicates the effect of hypertensive
medications on hypertension?
"The administration of a nasal decongestant will increase blood pressure due
to vasoconstriction of blood vessels."
"The administration of a nasal decongestant will cause bradycardia and
increase peripheral blood pressure."
"The administration of a nasal decongestant will decrease the thyroid
production and increase blood pressure."
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