pharm test 7
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| Which two classes of antidysrhythmic drugs have nearly identical cardiac effects? | Beta blockers and calcium channel blockers
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| A patient with atrial fibrillation is taking verapamil (Calan). The patient has read about the drug on the Internet and wants to know why a drug that affects the rate of ventricular contraction is used to treat an abnormal atrial contraction. What will th | “Atrial dysrhythmias can have life-threatening effects on ventricular function.”
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| A nurse is teaching a patient who is about to undergo direct-current (DC) cardioversion to treat atrial flutter. The patient has been taking verapamil and warfarin for 6 months. Which statement by the patient indicates understanding of the teaching? | “I may need long-term therapy with another cardiac medication after the procedure.”
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| A nurse is teaching a group of nursing students about antidysrhythmic medications. Which statement by a student indicates understanding of the teaching? | “Antidysrhythmic drugs can cause new dysrhythmias or worsen existing ones.”
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| A patient is taking digoxin (Lanoxin) and quinidine to treat sustained ventricular tachycardia. Before giving medications, the nurse reviews the patient’s electrocardiogram (ECG) and notes a QRS complex that has widened by 50% from the baseline ECG. What | Withhold the quinidine and contact the provider to report the ECG finding.
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| A nurse provides teaching for a patient who will begin taking procainamide (Procanbid) for long-term suppression of a dysrhythmia. Which statement by the patient indicates a need for further teaching? | “I may have increased bruising, but this is a temporary side effect.”
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| A prescriber has ordered propranolol (Inderal) for a patient with recurrent ventricular tachycardia. The nurse preparing to administer this drug will be concerned about what in the patient’s history? | Asthma
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| A nurse is providing teaching to a patient who is admitted to the hospital for initiation of treatment with amiodarone (Cordarone) for atrial fibrillation that has been refractory to other medications. Which statement by the patient indicates a need for f | “I may have itching, malaise, and jaundice, but these symptoms will subside.”
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| A patient is in the intensive care unit after a myocardial infarction. The nurse notes that the QT interval on this patient’s electrocardiogram has been elongating. The nurse is concerned that which cardiac dysrhythmia may occur? | Torsades de pointes
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| A prescriber is considering prescribing the amiodarone derivative dronedarone (Multaq) for a patient with atrial flutter. The nurse should be concerned about which of the following? | QT interval of 520 msec
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| A patient arrives in the emergency department complaining of chest pain that has lasted longer than 1 hour and is unrelieved by nitroglycerin. The patient’s electrocardiogram reveals elevation of the ST segment. Initial cardiac troponin levels are negativ | Aspirin 325 mg chewable
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| A nurse is discussing fibrinolytic therapy for the acute phase of STEMI management with a group of nursing students. Which statement by a student indicates understanding of this therapy? | “Fibrinolytics should be used with caution in patients with a history of cerebrovascular accident.”
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| A nurse is evaluating a patient admitted to the emergency department with an evolving STEMI for possible administration of thrombolytic therapy. Which information, identified during history taking, would contraindicate this type of therapy? | The patient has a history of a small cerebral aneurysm.
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| A patient diagnosed with STEMI is about to undergo a primary percutaneous coronary intervention (PCI). Which combination of pharmacotherapeutic agents will be given to augment this procedure? | Heparin, aspirin, and clopidogrel
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| A patient is admitted to the coronary care unit from the emergency department after initial management of STEMI. A primary percutaneous coronary intervention has been performed. The nurse notes an initial heart rate of 56 beats per minute and a blood pres | Beta blocker
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| A nurse is giving aspirin to a patient during acute management of STEMI. The patient asks why a chewable tablet is given. Which response by the nurse is correct? | “Aspirin is absorbed more quickly when it is chewed.”
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| A patient has undergone a primary percutaneous coronary intervention with a sirolimus-eluting stent. The provider has ordered a daily dose of 243 mg of aspirin. What will the nurse tell this patient about the dose of aspirin? | It will decrease to 162 mg per day in 3 months.
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| A patient has undergone a PCI, and the provider orders clopidogrel to be given for 12 months, along with an ACE inhibitor and heparin. What will the nurse do? | Request an order for aspirin.
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| A nurse is educating the staff nurses about ketoacidosis. To evaluate the group’s understanding, the nurse asks, “Which sign and symptoms would not be consistent with ketoacidosis?” The group gives which correct answer? | Blood glucose level of 60 mg/dL
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| The nurse assesses a newly diagnosed patient for short-term complications of diabetes. What does this assessment include? | Evaluation for hyperglycemia, hypoglycemia, and ketoacidosis
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| Which statement is accurate about the long-term complications of diabetes? | Tightly controlling both types of diabetes reduces the risk of eye, kidney, and nerve damage.
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| A nurse provides dietary counseling for a patient newly diagnosed with type 1 diabetes. Which instruction should be included? | “Most of your calories should be in the form of carbohydrates and monounsaturated fats.”
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| What is the most reliable measure for assessing diabetes control over the preceding 3-month period? | Glycosylated hemoglobin level
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| A patient with type 1 diabetes reports mixing NPH and regular insulin to allow for one injection. What should the nurse tell the patient? | This is an acceptable practice.
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| Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the nurse administer this drug? | Once daily at bedtime
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| A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned? | The beta blocker can mask the symptoms of hypoglycemia.
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| A nurse obtaining an admission history on an adult patient notes that the patient has a heart rate of 62 beats per minute, a blood pressure of 105/62 mm Hg, and a temperature of 96.2° F. The patient appears pale and complains of always feeling cold and ti | Hypothyroidism
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| The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient? | Neuropsychologic deficits in the fetus can occur if the condition is not treated.
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| A nurse caring for a patient notes that the patient has a temperature of 104° F and a heart rate of 110 beats per minute. The patient’s skin is warm and moist, and the patient complains that the room is too warm. The patient appears nervous and has protub | Graves’ disease.
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| A patient in her twenties with Graves’ disease who takes methimazole (Tapazole) tells a nurse that she is trying to conceive and asks about disease management during pregnancy. What will the nurse tell her? | The patient should discuss changing to propylthiouracil from now until her second trimester with her provider.
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| A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine (Synthroid). Which statement by the patient indicates a need for further teaching? | “If I take calcium supplements, I may need to decrease my dose of Synthroid.”
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| A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse learns that the patient also takes warfarin (Coumadin). The nurse will notify the provider to discuss _____ the _____ dose. | reducing; warfarin
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| The nurse prepares a patient with Graves’ disease for radioactive iodine (131I) therapy. Which statement made by the patient best demonstrates understanding of 131I therapy? | “This drug will be taken up by the thyroid gland and will destroy the cells to reduce my hyperthyroidism.”
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| A patient who has chronic adrenal insufficiency is admitted to the hospital for an open cholecystectomy. The nurse obtaining the admission history learns that the patient takes hydrocortisone 25 mg PO daily in the morning. The patient’s surgery is schedul | administer hydrocortisone 75 mg IV before surgery.
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| A patient who has been newly diagnosed with adrenal hormone deficiency will begin taking hydrocortisone. The nurse provides teaching for this patient. Which statement by the patient indicates understanding of the teaching? | “When I am sick, I should take three times the normal dose for 3 days in a row.”
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| A patient who has been taking 25 mg of hydrocortisone each morning for several months reports feeling fatigued late in the day each day. What will the nurse tell the patient to discuss with the provider? | Splitting the daily dose into a morning and an evening dose
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| A patient with arthritis is admitted to the hospital. The patient’s serum glucose level is 350 gm/dL, and the blood pressure is 182/98 mm Hg. The nurse notes that the patient’s face appears rounded and puffy. The patient complains of feeling weak. What wi | Ask which drugs the patient takes for arthritis.
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| A patient is given 1 mg of dexamethasone at 11:00 PM; a plasma cortisol level recorded at 8:00 PM the next day is normal. The nurse knows that this is an indication the patient has what condition? | Cushing’s syndrome
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| A nurse is explaining congenital adrenal hyperplasia (CAH) to a group of nursing students. Which statement by a student indicates understanding of the teaching? | “CAH is the result of an inability to synthesize glucocorticoids.”
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| The nurse is providing patient education to a patient who will begin taking fludrocortisone (Florinef) as adjunctive therapy to hydrocortisone. Which statement by the patient indicates understanding of the teaching? | “I should report any swelling of my hands and feet.”
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| The nurse is providing patient education about glucocorticoid therapy to a patient preparing to be discharged home. Which statement made by the patient best demonstrates understanding of glucocorticoid therapy? | “I may take two-thirds of the dose in the morning and one-third in the evening.”
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