Antidysthythmics

A patient taking atenolol complains of not being able to complete a usual exercise routine. The patient attributes this complaint to the medication. What is the nurse's best response? 1 "Feeling tired is normal when you exercise a lot." 2 "You should report your fatigue to your healthcare provider." 3 "As we age, exercising is a challenge, and fatigue is normal." 4 "You should not be exercising at all while taking this medication."

2

Amiodarone [Cordarone] is prescribed for a patient with atrial fibrillation. Which is the most important nursing intervention before administering this medication? 1 Explain that a dermatologic evaluation is needed. 2 Obtain baseline serum thyroid and liver-function studies. 3 Document that an ophthalmic examination was performed. 4 Maintain NPO for transesophageal echocardiogram (TEE).

2

The cardiac monitor alarm alerts the nurse that a patient is experiencing paroxysmal supraventricular tachycardia (PSVT) with a heart rate of 180 beats/min; the nurse would expect to administer which injectable, fast-acting medication? 1 Lidocaine 2 Adenosine 3 Epinephrine 4 Amiodarone

2

The nurse is administering intravenous lidocaine [Xylocaine] to a patient with a ventricular dysrhythmia. Which is the priority nursing intervention to prevent a potential complication with this drug? 1 Obtain a complete blood count. 2 Monitor the electrocardiogram (ECG). 3 Keep naloxone [Narcan] at the bedside. 4 Instruct the patient to report any chest pain.

2

The nurse is caring for a patient who has been experiencing atrial fibrillation that has been resistant to drug therapy. The nurse would anticipate that the patient will now be placed on which class drug? 1 Class II 2 Class III 3 Class IC 4 Class IV

2

The nurse is caring for a patient who is being treated with amiodarone [Cordarone]. After 6 weeks on the medication, lab work is drawn on the patient and shows evidence of hypothyroidism developing. How should the nurse interpret this information? 1 This is indicative of a toxic dosage of the medication. 2 This is an expected adverse reaction to the medication. 3 This is indicative of an inadequate dosage of the medication. 4 The patient is developing an anaphylactic reaction to the medication.

2

A patient has been started on oral quinidine 324 mg every 6 hours. The patient calls the clinic and tells the nurse that he has had a lot of ringing in his ears. What is the nurse's best response? 1 "Notify the prescriber." 2 "Wear earplugs at night." 3 "Stop the medication immediately." 4 Administer half a tablet every 6 hours.

1

An intravenous (IV) bolus of lidocaine is prescribed for the patient experiencing ventricular dysrhythmias. Which available lidocaine medication should the nurse use to prepare this bolus? 1 Lidocaine vial of clear solution 2 Lidocaine vial of light yellow solution 3 Lidocaine with epinephrine vial of clear solution 4 Lidocaine pre-mixed in 50 mL normal saline prepared within past 48 hours

1

Before administering amiodarone, what is the most important assessment for the nurse to complete? 1 Heart rate 2 Temperature 3 Skin integrity 4 Respiratory rate

1

The healthcare provider prescribes procainamide. The patient asks the nurse about how to manage the possible side effects of this medication. What is the nurse's best response? 1 "Take this medication with food to relieve an upset stomach." 2 "Use over-the-counter steroid cream if a red, swollen rash occurs." 3 "Taking an antacid with this medication will relieve digestive problems." 4 "Take diphenhydramine [Benadryl] with the medication if you develop a rash or breathing problems."

1

The long half-life of amiodarone [Cordarone] contributes to which complication? 1 Liver toxicity 2 Decreased dosing 3 Short onset of action 4 Enhanced therapeutic effects

1

The nurse is caring for a patient receiving amiodarone [Cordarone]. Which body system should the nurse assess for serious adverse effects of this medication? 1 Respiratory 2 Integumentary 3 Gastrointestinal 4 Musculoskeletal

1

The nurse is caring for patient who is being treated with amiodarone [Cordarone]. The nurse notes that the patient is experiencing a hacking cough. What is the nurse's priority action? 1 Notify the provider regarding this symptom. 2 Document the findings in the patient's chart. 3 Administer medication to help the patient rest. 4 Administer the cough syrup that has been ordered.

1

When observing a new staff nurse preparing to administer diltiazem [Cardizem], the charge nurse should approve which action? 1 Administering the drug via an infusion pump. 2 Drawing up the medication in a heparin flush. 3 Pushing the medication intravenously over 30 seconds. 4 Hanging the medication secondary to a free hanging dextrose solution.

1

Which is a risk for a patient who has developed atrial flutter? 1 Stroke 2 Hypertension 3 Cardiac asthma 4 Decreased ventricular rate

1

Which is the most appropriate outcome for a patient who has been prescribed an antidysrhythmic medication? 1 Cardiac output increased 2 Weight gain in 1 week ≥ 5 lb 3 Systolic blood pressure 90 mm Hg 4 Palpated radial pulses > pedal pulses

1

Which is the most important assessment to complete before the nurse administers an antidysrhythmic medication? 1 Pulse 2 Temperature 3 Respiratory rate 4 Auscultation of lungs

1

Which patient may be prescribed beta blockers with the least concerns for complications? 1 A patient with atrial fibrillation 2 A patient who has a history of asthma 3 A patient with peripheral vascular disease 4 A diabetic patient who is experiencing chest pain

1

Which should the nurse include in a teaching plan for a patient receiving digoxin therapy? 1 "Digoxin toxicity can cause dysrhythmias." 2 "Therapy should not last more than 1 month." 3 "Digoxin-induced dysrhythmias are not treatable." 4 "Digoxin cannot be taken with other cardiac medications."

1

Which statement by a patient demonstrates the need for further teaching regarding atrial fibrillation? 1 This condition is always reversible 2 A possible complication is a stroke. 3 Atrial fibrillation can be a permanent condition. 4 Anticoagulation is necessary while I am in atrial fibrillation.

1

before administering amiodarone, what is the most important assessment for the nurse to complete? 1 Heart rate 2 Temperature 3 Skin integrity 4 Respiratory rate

1

When administering Adenosine [Adenocard], what is the nurse's most important action? 1 Administer an IV bolus over 1 minute. 2 Ensure patency and placement of the IV catheter. 3 Remind the patient not to chew or crush sustained-release tablets. 4 Check IV compatibility before diluting in lactated Ringer's solution.

2

Which is the most common sustained dysrhythmia among the U.S. population? 1 Atrial flutter 2 Atrial fibrillation 3 Ventricular premature beats 4 Sustained supraventricular tachycardia

2

A patient develops supraventricular tachycardia (SVT) and is hypotensive. Which medication should the nurse anticipate will be prescribed? 1 Phenytoin [Dilantin] 2 Lidocaine [Xylocaine] 3 Adenosine [Adenocard] 4 Amiodarone [Cordarone]

3

A patient who is receiving amiodarone [Cordarone] has developed a chronic cough and dyspnea. Which is the best action for this patient? 1 Obtain an order for a steroid preparation. 2 Use an over-the-counter cold medication. 3 Hold the medication and notify the provider. 4 Obtain an order for a sympathomimetic medication.

3

A patient who is receiving antidysrhythmic drugs exhibits improved cardiac output, increased activity tolerance, blood pressure 120/76, pulse 86, and has voided 400 mL of urine during the past 8-hour shift. What is the nurse's best action? 1 Notify the healthcare provider. 2 Increase the continuous intravenous fluid rate. 3 Document the findings in the client's medical record. 4 Place the patient in Trendelenburg's position to improve venous return.

3

The healthcare provider has prescribed amiodarone for a patient with ventricular dysrhythmias. Upon reviewing the patient's medical history, which statement by the patient would lead the nurse to notify the healthcare provider? 1 "I get faint when I see needles." 2 "I wear eyeglasses to read print up close." 3 "I take a blood thinner so I don't get clots." 4 "I break out in a rash when I take antibiotics."

3

The nurse is teaching a patient whose dysrhythmia is being treated with medication therapy. Which fact should the nurse include in the teaching plan? 1 "Medication is only taken during the time the dysrhythmia is occurring." 2 "Medication therapy often does not work for dysrhythmias." 3 "Almost all drugs used to treat dysrhythmias can cause dysrhythmias." 4 "Drug therapy is only used for bradydysrhythmias."

3

The nurse should teach a patient with intractable atrial fibrillation about which characteristic of amiodarone [Cordarone]? 1 This is a first-line drug. 2 This drug causes hypertension. 3 This drug has some severe toxicities. 4 This drug treats only ventricular dysrhythmias.

3

Which assessment finding in a patient with cardiac risk factors should be reported immediately if the patient is taking a nonselective beta blocker? 1 Chest pain 2 Weight loss 3 History of asthma 4 History of alcohol abuse

3

Which drug administered by the nurse typically produces asystole before converting tachycardia to a sinus rhythm? 1 Atenolol [Tenormin] 2 Diltiazem [Cardizem] 3 Adenosine [Adenocard] 4 Procainamide [Pronestyl]

3

Which statement by a patient demonstrates correct understanding of the nurse's teaching about quinidine? 1 "A side effect is increased appetite." 2 "I should always take this medicine on an empty stomach." 3 "I should call my provider immediately if my ears are ringing." 4 "Lightheadedness is expected. I should just change positions slowly."

3

Which statement indicates the nurse understands the action of calcium channel blockers? 1 "These medications increase automaticity." 2 "These medications increase repolarization." 3 "These medications slow cardiac conduction." 4 "These medications shorten the action potential."

3

Which structure in the heart is referred to as the pacemaker? 1 Bundle of His 2 Purkinje fibers 3 Sinoatrial (SA) node 4 Atrioventricular (AV) node

3

A patient has received three times the ordered dose of propafenone [Rythmol]. The charge nurse is called into the room and observes that the patient is unresponsive with no pulse. What is the nurse's priority action? 1 Notify the provider. 2 Place the patient on cardiac monitoring. 3 Start an IV line with a large-bore catheter. 4 Begin cardiopulmonary resuscitation efforts.

4

A patient visiting the clinic has been taking amiodarone for several months. The nurse observes a bluish discoloration in the patient's skin. Which action should the nurse perform first? 1 Apply an oxygen mask. 2 Call the healthcare provider. 3 Call for crash cart to resuscitate the patient. 4 Apply a pulse oximeter to check oxygen levels.

4

In what part of the conduction pathway in a healthy heart is the electrical impulse delayed to provide time for the blood to fill the ventricles? 1 Bundle of His 2 Purkinje system 3 Internodal pathways 4 Atrioventricular node

4

The nurse is caring for a patient receiving dronedarone [Multaq] for treatment of atrial fibrillation. Which electrocardiogram (ECG) change indicates an adverse effect of this medication? 1 Previously upright T waves now are inverted. 2 Previously rounded, upright P waves now are notched. 3 ST segments previously on the baseline now are depressed. 4 The QT-interval measurement changes from 400 msec to 520 msec.

4

The nurse is interpreting an electrocardiogram (ECG). Which component represents the depolarization of the ventricles? 1 T wave 2 P wave 3 ST segment 4 QRS complex

4

The nurse is planning care for a patient at risk for dysrhythmias. The nurse understands that the Cardiac Arrhythmia Suppression Trial (CAST) confirmed which finding? 1 Most rhythm problems result in bradydysrhythmias. 2 Most atrial rhythm problems should be treated with medication. 3 After a myocardial infarction, all dysrhythmias should be treated. 4 Dysrhythmias should be treated only when they are symptomatically significant.

4

The nurse teaches a patient that supraventricular dysrhythmia is less serious than a ventricular dysrhythmia. What is the rationale for this statement? 1 Atrial dysrhythmias are easily treated. 2 Atrial conduction is not influenced by medication. 3 Atrial heart rate does not influence ventricular rate. 4 Atrial action does not significantly reduce cardiac output.

4

Which drug is a class III antidysrhythmic? 1 Atenolol 2 Lidocaine 3 Verapamil 4 Amiodarone

4

Which instruction should be included in the discharge teaching for a patient with atrial fibrillation? Select all that apply. A Atrial fibrillation is not treatable. B Patients cannot live with atrial fibrillation. C Atrial fibrillation may cause rapid ventricular rates. D Atrial fibrillation is the most common dysrhythmia. E There is a high risk of stroke with atrial dysrhythmia.

C, D, E

The nurse is caring for a patient prescribed quinidine for a supraventricular dysrhythmia. Which is a common adverse effect of this drug? 1 Diarrhea 2 Leg cramps 3 Blurred vision 4 Urinary retention

a

The nurse has administered quinidine parenterally and should carefully monitor the patient for which adverse effects? Select all that apply. A Diarrhea B Tinnitus C Hypertension D Blurred vision E Increased appetite

a, b, d

Which effect will beta blockers have on the conduction system in the heart? Select all that apply A Increased cardiac output B Increased sympathetic stimulation C Reduced contractility in the atria and ventricles D Slowed conduction in the atrioventricular (AV) node E Reduction of automaticity in the sinoatrial (SA) node

c, d, e

Which instruction should be included in the discharge teaching for a patient with atrial fibrillation? Select all that apply. A Atrial fibrillation is not treatable. B Patients cannot live with atrial fibrillation. C Atrial fibrillation may cause rapid ventricular rates. D Atrial fibrillation is the most common dysrhythmia. E There is a high risk of stroke with atrial dysrhythmia.

c, d, e