Chapter 9

b. Atrial fibrillation.

A common supraventricular arrhythmia is: a. Torsade de pointes. b. Atrial fibrillation. c. Premature ventricular contractions. d. Ventricular fibrillation.

c. II and III

A female patient is diagnosed with metabolic syndrome in the presence of which of the following? I. Fasting glucose <110 mg/dl II. High-density lipoprotein cholesterol <50 mg/dl III. Triglycerides <150 mg/dl a. I and II b. I and III c. II and III d. I, II, and III

c. Gallstones.

A side effect of using gemfibrozil in the treatment of high cholesterol is: a. Flushing. b. Myopathy. c. Gallstones. d. Diarrhea.

a. Inducing vasodilation.

ACE inhibitors are used to reduce the work of the heart by: a. Inducing vasodilation. b. Correcting an electrolyte imbalance. c. Improving cardiac contractility. d. Slowing the heart rate.

vasodilation

ACE inhibitors decrease afterload by inducing ________________.

positive chronotropic

Administration of a ________________ causes an increase in heart rate.

a. Magnesium.

All of the following ions are influential in the conduction system of the heart except: a. Magnesium. b. Sodium. c. Potassium. d. Calcium.

d. A phosphodiesterase inhibitor

Amrinone is classified as which of the following? a. A beta blocker b. An anticholinergic c. A calcium-channel blocker d. A phosphodiesterase inhibitor

P wave

Atrial depolarization is represented on an ECG tracing as a ________________.

b. I and III

Beneficial effects of ACE inhibitors for the treatment of heart failure include which of the following? I. Decrease in pulmonary capillary wedge pressure II. Control of the ventricular rate III. Decrease in systemic vascular resistance a. I and II b. I and III c. II and III d. I, II, and III

negative

Beta blockers are prescribed for treatment of heart failure because of their ________________ inotropic effects.

d. I, II, and III

Cardiac cells can become excited in which of the following situations? I. Oxygen deficit II. Electrolyte imbalance III. Ischemia a. I and II b. I and III c. II and III d. I, II, and III

b. A beta blocker.

Carvedilol (Coreg) is an example of: a. An angiotensin II receptor blocker. b. A beta blocker. c. A beta agonist. d. A diuretic.

Potassium moves out of the cell as sodium moves in, causing depolarization. When potassium moves back into the cell and sodium moves out, repolarization occurs. Calcium influences actin and myosin, which control cardiac cell length and muscle contraction.

Describe the role of sodium, calcium, and potassium in the pacemaking and conduction of impulses in the myocardium.

b. Potassium levels.

Diabetic care includes monitoring of all of the following except: a. Glucose levels. b. Potassium levels. c. Triglycerides. d. Cholesterol.

sodium calcium

Digoxin inhibits the sodium/potassium exchange pump in the heart, resulting in increased intracellular ________________ and ________________.

a. To reduce excess fluid retention, which increases the workload of the heart

Diuretic therapy is used in patients with heart failure for which of the following reasons? a. To reduce excess fluid retention, which increases the workload of the heart b. To treat hyperkalemia, which can cause arrhythmias c. To increase cardiac output d. To decrease vasoconstriction and improve afterload

inotropic

Drugs that affect the force of contraction are referred to as _______________.

SA node

Electrical impulses of the heart originate in the ________________.

c. Increased fluid removal by the kidneys.

In heart failure, all of the following conditions can occur except: a. Enlarged heart. b. Ankle edema. c. Increased fluid removal by the kidneys. d. Pulmonary edema.

a. Verapamil.

Pharmacologic agents used to treat shock include all of the following except: a. Verapamil. b. Dopamine. c. Epinephrine. d. Vasopressin.

No, because they can cause bronchoconstriction.

Should a beta-blocking agent be prescribed to treat a patient with heart failure who has a history of asthma?

coronary

The _______________ arteries are responsible for supplying oxygenated blood to the heart muscle.

tricuspid mitral

The ________________ valve separates the right atrium and ventricle, and the ________________ valve separates the left atrium and ventricle.

atrial fibrillation

The most common dysrhythmia in older adults is _______________.

c. The sinoatrial node

The normal pacemaker for the electrical conduction system of the heart is which of the following? a. The atrioventricular node b. Parasympathetic nerves c. The sinoatrial node d. Sympathetic nerves

b. Maintenance of oxygen balance.

The role of the kidneys in cardiac function includes all of the following except the: a. Regulation of fluid balance. b. Maintenance of oxygen balance. c. Maintenance of acid-base balance. d. Maintenance of electrolyte balance.

refractory period

The time in which cardiac cells cannot be excited after electrical stimulation is called the _________________________.

20 seconds

To allow time for ventricular filling, there is a slight delay of approximately ______________ before the impulse travels through the bundle of His.

c. Plavix

Treatment of acute coronary syndrome with non-ST-segment elevation would involve which of the following medications? a. Lovastatin b. Niacin c. Plavix d. Zetia

True

True or False? Adenosine is an example of a negative dromotropic agent.

False

True or False? Aldosterone antagonists used in the treatment of heart failure for their diuretic effect cause potassium depletion.

True

True or False? Beta blockers used to treat a heart condition can cause bronchoconstriction.

False

True or False? Cardiac action potential is controlled by the conduction system within the atria.

True

True or False? Digoxin is an inotropic drug that affects the force of contraction of the heart muscle.

True

True or False? Heart failure can occur as right-sided or left-sided failure.

False

True or False? Intravenous nitroprusside increases afterload and preload.

True

True or False? Oral insulin agents can only be prescribed for the treatment of type II diabetes.

True

True or False? Statin drugs used in the treatment of high cholesterol block enzymes that produce cholesterol.

False

True or False? The QRS complex represents repolarization of the ventricles.

c. Digoxin.

Vasodilators that are used to decrease the afterload forces on the heart include all the following except: a. Hydralazine. b. ACE inhibitors. c. Digoxin. d. Nitrates.

- to restore and maintain normal sinus rhythm. - to suppress ectopic foci that fire outside the normal conduction pathway. - to control ventricular rate and optimize cardiac output.

What are the therapeutic goals for drug use in treating cardiac arrhythmias?

Statin drugs may be combined with BARs or ezetimibe. Niacin or fish oil caplets may be used with BARs or statins. Statins or BARs may be combined with gemfibrozil. The combination is determined by monitoring a patient's lipid profile for LDL, HDL, and triglyceride levels to identify which specific lipoprotein disorder is present.

What combination of drugs might be prescribed for a patient who has been diagnosed with high cholesterol, and how is the combination drug therapy determined?

Nitroglycerin can be administered as a sublingual, or buccal spray for the alleviation of anginal attacks. Prophylactic treatment may include nitroglycerin administered orally or as a transdermal patch, calcium-channel blockers, and beta blockers

What medications could be prescribed to a patient who has just been diagnosed with angina? Discuss agents that would be administered to provide immediate relief and those that would be used prophylactically.

ectopic foci

When electrical stimulation occurs outside the normal conduction pathway, it is referred to as ________________.

c. Digoxin

Which of the following antiarrhythmic drugs causes an increase in total calcium, resulting in an increase in the contractility of the heart? a. Apresoline b. Theophylline c. Digoxin d. Metoprolol

a. Milrinone

Which of the following drugs is a phosphodiesterase inhibitor that results in increased vascular smooth muscle contraction and increased heart contractility? a. Milrinone b. Dobutamine c. Aldactone d. Dopamine

c. Nitroprusside

Which of the following drugs used for heart failure must be shielded from heat or light to maintain stability? a. Nesiritide b. Nitroglycerin c. Nitroprusside d. Milrinone

c. Torsade de pointes

Which of the following is a ventricular arrhythmia? a. Supraventricular tachycardia b. Atrial flutter c. Torsade de pointes d. Atrial fibrillation

c. Pacemaker origination in the SA node

Which of the following is not considered a cause of arrhythmias? a. Proarrhythmics b. Antiarrhythmic drug toxicity c. Pacemaker origination in the SA node d. Electrolyte imbalance

d. Nitroglycerin

Which of the following is the agent of choice for relief of anginal pain? a. Nitroprusside b. Dopamine c. Levophed d. Nitroglycerin

d. Simvastatin

Which of the following lipid-lowering agents blocks cholesterol biosynthesis? a. Colestipol b. Ezetimibe c. Gemfibrozil d. Simvastatin

c. Digoxin

Which of the following medications results in increased contractility of the heart? a. Bretylium b. Dopamine c. Digoxin d. Dobutamine

Nitroglycerin

________________ is beneficial in heart failure for its coronary vasodilating properties.

Afterload

________________ refers to the force against which the heart must pump.