CARDIOVASCULAR DRUGS AND d.

Increasing cardiac output and

MEDICATIONS PHARMACOLOGY enhancing renal perfusion.
QUIZ
Before giving milrinone (Primacor) by an IV
Which of the following clients is at greatest infusion to a client with symptoms of CHF,
risk for digitalis toxicity? which of the following nursing actions is
necessary?
a. A 25-year-old client with congenital
heart disease. a. Record sodium level.
b. A 50-year-old client with CHF. b. Administer loading dose over 15
c. A 60-year-old client after myocardial minutes.
infarction. c. Assess CV status.
d. An 80-year-old client with CHF. d. Review medication regimen to
identify if the client is on IV
Which of the following is a contraindication
furosemide (Lasix).
for digoxin administration?
Johanna has ventricular ectopy, which of the
a. Blood pressure of 140/90.
following drugs is the first line used to treat
b. Heart rate above 80.
her condition?
c. Heart rate below 60.
d. Respiratory rate above 20. a. Quinidine (Cardioquin)
b. Digoxin (Lanoxin)
The action of medication is inotropic when
c. Procrainamide (Pronestyl)
it:
d. Lidocaine (Xylocaine)
a. Decreased afterload.
Class IA antiarrhythmic agents have little
b. Increases heart rate.
effect on:
c. Increases the force of contraction.
d. Is used to treat CHF. a. AV node
b. SA node
Which is the most appropriate action for the
c. Purkinje fibers
nurse to take before administering digoxin?
d. Bundle of His
a. Monitor potassium level.
Which of the following drugs can cause
b. Assess blood pressure.
severe hematologic disorders?
c. Evaluate urinary output.
d. Avoid giving with thiazide diuretic. a. digoxin (Lanoxin)
b. quinidine (Cardioquin)
The therapeutic drug level for digoxin is:
c. disopyramide (Norpace)
a. 0.1-2.0 ng/mg d. procainamide (Pronestyl)

b. 1.0-2.0 ng/mg Which of the following ECG findings alerts

the nurse that the client needs an
c. 0.1-0.5 ng/mg antiarrhythmic?
d. 0.5-2.0 ng/mg a. Normal sinus rhythm
Blurred vision or halos are signs of: b. Sinus bradycardia
c. Sinus arrhythmia
a. Digoxin levels. d. Frequent ventricular ectopy
b. Digoxin toxicity.
c. Nothing related to digoxin. When administering an antiarrhythmic
d. Corneal side effects of digoxin. agent, which of the following assessment
parameters is the most important for the
Amrinone (Inocor) is used for short term nurse to evaluate?
therapy for CHF and acts by which of the
following mechanisms? a. ECG
b. Pulse rate
a. Increasing stroke volume and heart c. Respiratory rate
rate. d. Blood pressure
b. Slowing ventricular rate and
increasing cardiac output. Which of the following blood tests will tell
c. Vasodilating and increasing the nurse that an adequate amount of drug is
peripheral vascular resistance. present in the blood to prevent arrhythmias?
 a. Serum chemistries c. The drug cannot be directly mixed in
b.  Complete blood counts solutions containing bicarbonate or
c. Drug levels aminophylline.
d. None of the above d. The lowest dose to produce the
desired effect should be used.
Which of the following drugs should be used
only in situations in which the client can be Dobutamine (Dobutrex) improves cardiac
very closely monitored, such as a critical output and is indicated for use in all of the
care unit? following conditions except:
a. bretylium (Bretylol) a. Septic shock
b. digoxin (Lanoxin) b. Congestive heart failure
c. quinidine (Cardioquin) c. Arrhythmias
d. inderal (Propranolol) d. Pulmonary congestion
The toxic antiarrhythmic agent is: Conduction defects will most likely be an
adverse associated with the use of:
a. digoxin (Lanoxin).
b. lidocaine (Xylocaine). a. verapamil (Isoptin)
c. amiodarone (Cordarone). b. nifedipine (Adalat CC)
d. quinidine (Cardioquin). c.  diltiazem (Cardizem)
d. felodipine (Plendil)
Epinephrine is used to treat cardiac arrest
and status asthmaticus because of which of Which of the following calcium channel
the following actions? blockers has the most potent peripheral
smooth muscle dilator effect?
a. Increased speed of conduction and
gluconeogenesis. a. diltiazem (Cardizem)
b. Bronchodilation and increased heart b. nifedipine (Adalat CC)
rate, contractility, and conduction. c. nimodipine (Nymalize)
c. Increased vasodilation and enhanced d. verapamil (Calan)
myocardial contractility.
Which of the following adverse reactions is
d. Bronchoconstriction and increased
found more often in volume-depleted elderly
heart rate.
clients?
Following (Levophed) administration, it is
a. Bradycardia
essential to the nurse to assess:
b. Conduction defects
a. Electrolyte status. c. Ankle edema
b. Color and temperature of toes and d. Hypotension
fingers.
Which of the following calcium channel
c. Capillary refill.
blockers is used to counteract or prevent
d. Ventricular arrhythmias
cerebral vasospasm?
Norepinephrine (Levophed) is
a. Verapamil
contraindicated in which of the following
b. Nimodipine
conditions?
c. Nifedipine
a. Hypovolemic shock. d. Felodipine
b. Neurogenic shock.
Which of the following effects of calcium
c. Blood pressures above 80-100
channel blockers causes a reduction in blood
mmHg (systolic).
pressure?
d. Decreased renal perfusion.
a. Increased cardiac output.
When administering dopamine (Intropin), it
b. Decreased peripheral vascular
is most important for the nurse to know that:
resistance.
a. The drug's action varies according to c. Decreased renal blood flow.
the dose. d. Calcium influx into cardiac muscles.
b. The drug may be used instead of
Jason James is taking ß blockers, all of the
fluid replacement.
following should be included in his
assessment except:
 a. Pulmonary function tests c. Reduced mortality
b. Baseline ECG d. Reduced morbidity
c. Glucose level
When teaching about nitrate administration,
d. Blood pressure
the nurse should instruct the client to:
Routine laboratory monitoring in clients
a. Change position slowly.
taking ß blockers should include:
b. Take a pulse daily.
a. Sodium c. Reduce salt intake.
b. Glucose d. Chew the sustained-release tablets.
c. Thyrotropin
ACEs participate in the renin-angiotensin-
d. Creatine phosphokinase
aldosterone system to have which of the
Competitive antagonism of which of the following physiologic effects?
following occurs at ß receptor sites?
a. Inhibit conversion of angiotensin II to
a. Catecholamines angiotensin I.
b. Adrenergic sites
b. Vasoconstriction and sodium depletion.
c. Acetylcholine
d. Norepinephrine c. Promote sodium and water retention.
ß blockers should be avoided in which of the d. Stimulate vasodilation and inhibit sodium
following conditions? depletion.
a. Bronchoconstriction Nurse Margie just administered an ACE
b. Hypertension inhibitor to her client. Before ambulating the
c. Angina client for the first time after administration,
d. Myocardial infarction the nurse should monitor for:
As a knowledgeable nurse, you know that a. Hypokalemia
the action of nitrates is: b. Irregular heartbeat
c. Edema
a. Smooth muscle contraction
d. Hypotension
b. Vasoconstriction
c. Smooth muscle relaxation Mira is managing her hypertension with an
d. Increase preload ACE inhibitor. Which of the following
statements stated by her indicates a need for
A 50-year-old client is prescribed to take
further instruction?
nitrate each day for his condition. As a
competent nurse, you know the result of a. "I should not take my pills with
nitrate administration is: food."
b. "I need to increase my intake of
a. Decreased myocardial oxygen
orange juice, bananas, and green
demand.
vegetables.
b. Increased myocardial oxygen
c. "I will avoid coffee, tea, and colas."
demand.
d. "I will use salt substitutes that are not
c.  Increased left ventricular end-
high in potassium."
diastolic volume.
d.  Increased atrial pressure. Pepito is a hypertensive client who has been
placed on captopril (Capoten). He states,
A student nurse is asked to give an example
“Dr. del Mundo keeps changing my pills and
of a long-acting nitrate. He is correct by
none are working. I feel like a guinea pig.”
saying:
Which of the following responses by the
a. Nitroglycerin sublingual nurse would be most appropriate?
b. Nitroglycerin IV
a. "It often takes a while before the
c. Isosorbide PO
right medication is found."
d. Nitroglycerin transmucosal
b. "The doctor is just trying to help you
When nitrates are administered early to the control your blood pressure."
acute MI client, the effect is: c. "The action of this drug is to work on
both the arteries and to remove
a. Hypotension
excess fluids."
b. Bradycardia
 d. "This drug is used when other drugs A clinical instructor asks a nursing student
have failed." about an aldosterone antagonist. The student
is correct by saying that aldosterone
The action of an ACE inhibitor interrupts the
antagonists:
renin-angiotensin-aldosterone mechanism,
thereby producing which of the following? a. Create an osmotic gradient.
b. Inhibit the exchange of sodium for
a. Reduced renal blood flow.
potassium.
b. Reduced sodium and water
c. Cause metabolic acidosis.
excretion.
d. Work poorly in the presence of
c. Increased peripheral vascular
endogenous aldosterone.
resistance.
d. Increased sodium excretion and Which of the following is a potential side
potassium reabsorption. effect of IV furosemide (Lasix)?
Raymund is reviewing cardiovascular drugs a. Drowsiness
for his upcoming exam. For a well-prepared b. Diarrhea
student, he should know that vasodilators are c. Cystitis
agents that: d. Hearing loss
a. Relax smooth muscles. A 68-year-old client with a history of mild
b. Are used to treat hypotension. CHF and glaucoma is receiving IV mannitol
c. Stimulate the adrenergic receptors of (Osmitrol) to decrease intraocular pressure.
peripheral sympathetic nerves. The nurse would monitor the client for signs
d. Cause respiratory depression. and symptoms of:
As a competent nurse, you are aware that a. Fluid volume excess.
vasodilators are used mainly to treat: b. Fluid volume deficit.
c. Hyperkalemia.
a. Diabetes
d. Hypernatremia.
b. Hypertension
c. Atrial fibrillation All potassium-sparing diuretics:
d. Hypotension
a. Are required supplements during
The drug/drugs used most commonly to treat blood transfusion.
peripheral or cerebral vascular obstructive b. Enhance aldosterone action.
disease is/are: c. Cause hypokalemia.
d.  Are weak diuretics.
a. pentoxifylline (Trental)
b. cyclandelate (Cyclan) Which of the following clients is most likely
c. isoxsuprine (Vasodilan) to experience adverse effects from treatment
d. All of the above with diuretics?
In a 50-year-old widower who had a a. A 21-year-old student
transient ischemic attack, what is b. A 40-year-old unmarried man
the most common vasodilator used for his c. A 60-year-old widower
treatment? d. A 75-year-old man
a. Norepinephrine Kylie is reviewing drugs related to
b. dopamine (Intropin) cardiovascular therapies. She should be
c. papaverine (Pavabid) aware that the desired action of lipid-
d. nitroprusside (Nitropress) lowering agents is to:
For a client taking drugs to treat peripheral a. Decrease high-density lipoprotein
vascular disease, it is important to provide (HDL).
health education about: b. Increase total cholesterol (TC).
c.  Increase low-density lipoprotein
a. Smoking cessation.
(LDL).
b. Developing a proper balance
d. Increase high-density lipoprotein
between rest and activity.
(HDL).
c. Proper foot care.
d. All of the above. For lipid-lowering agents to be successful,
drug therapy must lower:
 a. HDL During the warfarin (Coumadin)
b. LDL administration, the nurse can expect that the
c. Total fat initial extension of PT occurs within how
d. All of the above many hours after therapy begins?
As a competent nurse, you know that the a. 1 to 2
most significant contraindication for therapy b. 4 to 6
with lipid-lowering agent is: c. 8 to 12
d. 12 to 24
a. Renal disease
b. Diabetes A nurse is providing instructions to a client
c. Liver disease who is receiving warfarin sodium
d. Cardiac disease (Coumadin). Which statement made by the
client indicates the need for further
Which of the following vitamins may not be
instruction?
absorbed properly when giving bile acid
sequestrants? a.  "I will observe the color of my urine and
stool".
a. bVitamin B
b. Vitamin C b. "I will take Ecotrin (Enteric-coated
c. Vitamin B12 aspirin) for my headaches".
d. Vitamin K
c. "I will avoid drinking alcohol".
Which of the following lipid-lowering
 "I will use a hair removing cream on my d.
agents has the common side effect of
legs".
constipation?
A nurse is caring for a client receiving a
a. lovastatin (Mevacor)
heparin intravenous (IV) infusion. The nurse
b. colestipol (Colestid)
expects that which of the following
c. gemfibrozil (Lopid)
laboratory will be prescribed to monitor the
d. niacin (Nicotinic acid)
therapeutic effect of heparin?
Parenteral anticoagulants work by
a. Prothrombin time (PT)
disrupting:
b. Activated partial thromboplastin time
a. Formation of thromboplastin. (aPTT)
b. Conversion of prothrombin to c. Hematocrit (Hgb)
thrombin. d. Hemoglobin (Hct)
c. Vitamin K-dependent clotting
A client with atrial fibrillation is receiving a
factors.
continuous heparin infusion at 1,000
d. Conversion of prothrombin to fibrin.
units/hr. The nurse observes that the client is
SC heparin should be administered in the: receiving the therapeutic effect based on
which of the following results?
a. Flank
b. Abdominal fat a. Activated partial thromboplastin time
c. Leg of 30 seconds.
d. Gluteal area b. Activated partial thromboplastin time
of 60 seconds.
The half-life of heparin is:
c. Activated partial thromboplastin time
a. 10 minutes of 120 seconds.
b. 1 to 1.5 hours d. Activated partial thromboplastin time
c. 8 to 12 hours of 15 seconds.
d. 1 to 2 days
A client is receiving intravenous heparin
Which drug is used to stop bleeding therapy. The nurse ensures the availability of
associated with heparin overdose? which of the following medication?

a. urokinase (Abbokinase). a. acetylcysteine (Mucomyst)

b. aminocaproic acid (Amicar). b.  calcium gluconate (Calcium
c. protamine sulfate (Protamine). gluconate)
d.  vitamin K (AquaMEPHYTON). c. vitamin K (Mephyton)
d. protamine sulfate (Protamine)
A client is receiving a continuous infusion of b. Do a 12-lead electrocardiogram right
streptokinase (Streptase). The client away.
suddenly complains of a difficulty of c. Measure the heart rate on the rhythm
breathing, itchiness, and nausea. Which of strip.
the following should be the priority action of d. Give hydralazine (Apresoline) per
the nurse? orem.
a. Stop the infusion and notify the A client with myocardial infarction is
physician. receiving tissue plasminogen activator,
b. Administer protamine sulfate and alteplase (Activase, tPA). While on the
provide oxygen therapy. therapy, the nurse plans to prioritize which
c. Administer antihistamine then of the following?
continue the infusion.
a. Observe for neurological changes.
d. Slow the infusion and administer
b. Monitor for any signs of renal
oxygen.
failure.
A client with deep vein thrombosis is c. Check the food diary.
receiving Streptokinase (Streptase). The d. Observe for signs of bleeding
nurse would notify the physician if which of
A nurse is caring for a client who is taking
the following assessments is noted?
digoxin (Lanoxin) 0.25mcg tab once a day.
a. A temperature of 99.2° Fahrenheit. The client suddenly complaints of anorexia,
b. A pulse rate of 99 beats per minute. nausea, vomiting, and diarrhea. The
c. A respiratory rate of 25 breaths per physician is ruling a digoxin toxicity. As a
minute. nurse, you know the therapeutic digoxin rate
d. A blood pressure of 185/110 mm Hg. is?
A client who is receiving streptokinase a. 0.25-0.5 ng/ml
therapy suddenly had a nosebleed. The nurse
b. 0.5-2 ng/ml
ensures the availability of which of the
following medication? c. 1.5-3 ng/ml
a. vitamin K (Mephyton) d. 3.5-4.5 ng/ml
b. deferoxamine (Desferal)
c. aminocaproic acid (Amicar) A nurse is monitoring a client who is taking
d. diphenhydramine (Benadryl) carvedilol (Coreg CR). Which of the
following assessment made by the nurse
A nurse is providing health teachings would warrant a possible complication with
regarding antiplatelet medications. Which of the use of this medication?
the following is not true regarding the use of
this medication? a. Baseline blood pressure of 160/100
mm hg followed by a blood pressure
a. Antiplatelet medication inhibits the of 120/70 mm hg after 3 doses.
aggregation of platelets in the b. Baseline heart rate of 97 bpm
clotting process, thereby prolonging followed by a heart rate of 62 bpm
bleeding time. after 3 doses.
b. Antiplatelet medications cannot be c. Complaints of nightmares and
used with anticoagulants. insomnia.
c. Take the medication with food to d. Complaints of dyspnea.
prevent gastrointestinal upset.
d. A routine bleeding time is monitored A nurse is interviewing a client who is about
during the therapy. to receive metoprolol. Upon the history
taking, the client is also taking insulin.
A client is receiving procainamide Which of the following statements made by
(Procanbid) for the treatment of ventricular the nurse will correctly explain the possible
arrhythmia. The client suddenly complains interaction of these medications?
of nausea and drowsiness. Which of the
intervention should the nurse do first? a. "This medication will maintain the
blood sugar level on a normal
a. Check the blood pressure and heart range".
rate. b. "This medication will have no effect
on blood sugar level".
 c.  "This medication may mask some of a.  "I should take aspirin 30 minutes before
the symptoms of hypoglycemia such nicotinic acid".
as tremor, palpitation, and rapid
b. "I will drink alcohol in moderation".
heartbeat.
d. This medication may mask some of c.  "Yellowing of the skin is a common side
the symptoms of hyperglycemia such effect".
as headache, increased thirst, and
blurred vision". d.  "This medication is taken on an empty
stomach".
A client is about to receive metolazone
(Zaroxolyn). The nurse in charge A nurse is monitoring a client who is taking
understands which of the following digoxin (Lanoxin). All of which are the side
laboratory results are related to the effects associated with the
administration of the medication? medication, except?

a. Hyperkalemia and hypocalcemia a. Anorexia

b. Blurred vision
b. Hyperkalemia and hypoglycemia c. Diarrhea
d. Tremors
c. Hypouricemia and hypoglycemia
A nurse is interviewing a patient who is
d. Hypokalemia and hyperglycemia
about to receive bumetanide (Bumex).
A client with congestive heart failure is Which of the following is a concern related
being treated with torsemide (Demadex). to the administration of the medication?
The nurse obtains the following vital signs:
a. Penicillin allergy
Blood pressure of 100/65 mm hg; pulse rate
b. Sulfa allergy
of 91 beats per minute; and respiration of 25
c. Soy-containing allergy
breaths per minute? Which of the following
d. Cephalosporin allergy
will be the priority assessment of the nurse
after the initiation of the dose? A client arrives in the emergency with
complaints of chest pain and is diagnosed
a. Urine output
with acute MI. A morphine 4mg IV was
b. Serum potassium and calcium given 5 minutes ago. Which of the following
assessments made by the nurse indicates a
c. Blood pressure
further immediate action?
d. Weight
a. Respiratory rate from 20 bpm to 12
A nurse is giving instruction to a client who bpm.
is receiving cholestyramine (Questran) for b. Blood pressure from 120/70 to
the treatment of hyperlipidemia. Which of 100/60 mmHg.
the following statements made by the client c. The client still complains of chest
indicates the need for further instructions? pain with a pain scale of 2/10.
d. Cardiac rate of 103 bpm and a
a. "This medication comes in a powder normal sinus rhythm of the ECG.
that must be mixed with juice or
water before administration".
b. "I will avoid eating foods rich in
PSYCHIATRIC DRUGS AND
saturated fats".
MEDICATIONS NURSING
c. "I will take my Vitamin A 30
PHARMACOLOGY QUIZ
minutes after cholestyramine".
d. "Constipation, belching and
heartburn are some of the side
effects".
A nurse is providing instructions to a client
who is on nicotinic acid for the treatment of
hyperlipidemia. Which statement made by
the nurse indicates a comprehension of the
instructions?