Calcium Channel Blocker Therapy, Beta Blocker practice questions, Treatment Modalities for the Renal and Urologic Systems, Patho Treatment Modalities for Peripheral Vascular Disorders Sherpath Lesson, Inflammatory and Infectious Diseases of the Cardi...

A patient diagnosed with angina is being discharged home with sublingual nitroglycerin. Which statement by the patient indicates an understanding of when to take the medication?

"As soon as I start having chest pain, I will take the nitroglycerin." The patient with angina needs to understand that sublingual nitroglycerin should be taken with the first sign of chest pain. If the chest pain is not relieved within 5 minutes of the initial dose, the dose should be repeated for a maximum of 3 doses. An emergency medical service should be contacted to transport the patient to the nearest emergency department.

Which non-pharmacologic treatment recommendation is given to a person with urethritis?

"Avoid having sexual intercourse until your symptoms subside"

Which kind of advice is provided to female patients with a urinary tract infection (UTI)?

"Be sure to wipe yourself from front to back"

A patient who has hypertension and asthma asks, "Why can't I take a beta blocker for my hypertension?" Which nursing response is appropriate?

"Beta blocker medications can cause bronchospasm, which can trigger an asthma attack." Nonselective beta blockers have effects on beta1 and beta2 receptors and can cause bronchospasm, so they are contraindicated in patients who have asthma. Cardioselectivity of beta1 blockers does not confer absolute protection from bronchoconstriction, so these drugs are not recommended.

The charge nurse is teaching a group of new nurses about safe administration of beta blockers. Which statements indicate that further teaching is required?

"Beta blockers increase the heart rate and force of cardiac contraction." "Metoprolol can cause liver failure, so laboratory values are required." "Beta blockers are only used to treat hypertension."

Which patient statements require further nursing action?

"I take my beta blocker with my verapamil so I don't forget." "I take my verapamil when I drink my morning grapefruit juice."

A patient taking a newly prescribed calcium channel blocker states, "I can't seem to get my shoes to fit. My feet feel puffy." Which nursing response is appropriate?

"I will call the health care provider because you may need a diuretic."

The nurse is teaching a patient who is being discharged with a prescription for metoprolol. Which patient statement indicates understanding of the teaching?

"I will not drive until I know how this medication affects me."

A patient has been taking metoprolol IR for 6 weeks. Current assessment data includes a heart rate of 72 beats per minute and blood pressure of 126/74 mm Hg. The patient reports occasional dizziness, insomnia, and fatigue. Which recommendation will the nurse provide for this patient?

"It is important to discuss these symptoms with the health care provider."

A patient who is taking metoprolol questions the nurse regarding the need for liver function tests. Which nursing response is appropriate?

"Patients with decreased liver function may experience toxic effects from this drug."

Which teaching would the nurse include for a patient who is being discharged home from an acute care setting on a calcium channel blocker?

"Record each angina attack in a journal." Assess your heart rate before taking your medication." Do not chew or crush the sustained-release medication." "Keep a daily record of your blood pressure."

The nurse administers a prescribed dose of amlodipine to a patient at 0800 on Monday. At which time would the nurse anticipate the onset of this medication?

0800 on Tuesday Tuesday at 0800 is within the time that the nurse would anticipate the antihypertensive effect because the onset is within 24 to 48 hours of the first dose.

The nurse administers an oral dose of metoprolol at 0800 to a patient with hypertension. At which time will the nurse anticipate the peak effect?

1000

Cardiac heart defects are estimated to affect approximately how many infants per year?

40,000

Which activities may cause angina pain to occur?

A heated argument with a co-worker Mowing the lawn in the summer heat Running down the street to catch a bus

Which person is at highest risk of developing arteriosclerosis?

A man with diabetes mellitus

Which individuals are at an increased risk for an episode of angina?

A middle-aged person with severe anemia A person with pulmonary disease who smokes A person with atherosclerosis who runs up many stairs

Which statements describe coarctation of the aorta?

A typically asymptomatic condition, but may present with dyspnea and feeding difficulties. Narrowing or constriction of the aorta reduces blood flow to systemic circulation, causing the extremities to be cold with weak pulse.

Which classification of heart defect results in oxygenated systemic blood flow, but at a reduced rate?

Acyanotic

Which statement describes what a patient can expect from a surgical embolectomy procedure?

An incision will be made into the vessel to remove the clot

Which individuals are at risk for peripheral artery disease (PAD)?

An individual who has diabetes An individual who smokes cigarettes An individual who has a high cholesterol diet

Which term describes plaque buildup in the arterial lumen?

Atherosclerosis

Which congenital heart defects are acyanotic in nature?

Atrial septal defect (ASD) Coarctation of aorta Patent ductus arteriosus (PDA)

Which describe the effect of peripheral artery disease (PAD) on the skin?

Becomes dry Becomes hairless Becomes cyanotic when elevated Develops rubor when legs are dangling

Place the blood flow through the heart in tetralogy of Fallot in the order that it occurs.

Blood collects in the right ventricle. Pulmonary valve stenosis restricts blood outflow to the lungs. The buildup of pressure causes hypertrophy in the ventricle. Unoxygenated blood is forced into systemic circulation through an aortic dextraposition which is positioned over VSD. The body receives a mix of oxygenated and unoxygenated blood, causing cyanosis.

Which is the rationale for the reversal of blood flow shunts in septal defects?

Blood flow from one shunt builds up pressure in the opposing ventricle causing a reversal of the shunt.

Which explains the flow of blood in ventricular septal defect (VSD)?

Blood from the left side of the heart is recycled to the right side and to the lungs, resulting in more blood entering the pulmonary circulation, some of which is already oxygenated.

The nurse is teaching a course on calcium channel blockers. Which description of the mechanism of action will the nurse provide?

Calcium channel blockers prevent contraction of smooth muscle and allow dilation of the coronary arteries.

Which is a common clinical manifestation following a myocardial infarction?

Cardiac arrhythmias

The nurse is caring for a patient with newly diagnosed hypertension who has been prescribed metoprolol. Which teaching would the nurse include?

Change positions slowly.

Which medication is prescribed for a person with a complicated urinary tract infection (UTI)?

Ciprofloxacin (Cipro)

Which medication is intended to be used in the setting of peripheral vascular disease (PAD) in order to decrease platelet adhesion?

Clopidogrel

Which heart defect manifests as a narrowing of the artery, typically closest to the heart, and causes a weakened pulse in the extremities.

Coarctation of aorta

Which are presenting symptoms of transposition of vessels in a newborn?

Cyanosis and dyspnea

An individual takes a small dose of aspirin (ASA) daily. Which statement describes the intended effect of this treatment?

Decreases platelet adhesion to reduce the risk of thrombus

Which complication is associated with loss of blood supply to the limb due to total occlusion in an individual with peripheral artery disease (PAD)?

Development of gangrene Gangrene is a bacterial infection of necrotic tissue and is a complication associated with loss of blood supply to the limb due to total occlusion. When people have gangrene, they may need the affected limb to be amputated to prevent the further spread of the infection to other parts of the body.

Which factors increase low-density lipoproteins and thus increase the risk of acute coronary syndrome (ACS)?

Diabetes mellitus Cigarette smoking Sedentary lifestyle

The nurse monitors blood pressure while administering nitroglycerin intravenously knowing that the medication has which therapeutic action?

Dilating vessels Nitroglycerin acts directly on vascular smooth muscle, which relaxes and dilates the vessels. Vessel dilation results in lower blood pressure. If the blood pressure becomes too low, the dose may need to be decreased.

The nurse is teaching about nondihydropyridine calcium channel blockers. Which medication would the nurse include?

Diltiazem

An individual is prescribed pletal (Cilostazol). Which statement describes the mechanism of action of this drug?

Directly dilates arteries and inhibits platelet aggregation

A patient with a history of angina and peripheral vascular disease inquires about taking sildenafil for erectile dysfunction while on extended-release oral nitroglycerin. Which educational information would the nurse provide?

Drugs for erectile dysfunction should not be taken with nitroglycerin. Drugs for erectile dysfunction, such as sildenafil, can increase the blood pressure-lowering effects of nitroglycerin and should not be taken together. If the two classes of drugs are taken together, severe hypotension could develop.

Which manifestations are associated with an intolerance to exercise common to individuals with heart defects?

Dyspnea Tachypnea Tachycardia

Which describes the rationale for regular exercise in an individual at risk of development of blood clots?

Exercise helps lessen peripheral resistance

Which procedure reroutes the blood flow around a diseased artery by sewing a graft above and below the affected artery?

Femoral-tibial bypass graft

Which would a pathologist expect to find in the composition of an atheroma removed from an atherosclerotic artery?

Fibrin Lipids Platelets Cellular debris

Which image indicates excellent coronary arterial blood flow?

First image

The charge nurse is teaching a new nurse about beta blockers. Which teaching would the nurse include?

First-generation beta blockers are nonselective and block beta1 and beta2 receptors. The nurse would include this in the teaching because first-generation beta blockers are nonselective and block beta1 and beta2 receptors.

Which process can lead to impairment of muscle activity in cases of partial occlusion?

Formation of atheromas in the femoral artery

Match the arrhythmia with the manifestation

Heart rate of 52 beats per minute Bradycardia Heart rate of 120 beats per minute Tachycardia Atrial heart rate of 320 beats per minute Fibrillation

Which medications are classified as anticoagulants and will help prevent blood clots?

Heparin Lovenox Warfarin

The nurse is conducting a health history on a patient who is taking a beta blocker. Which assessment data present contraindications or cautions to beta blocker therapy?

History of asthma Second-degree atrioventricular (AV) block on telemetry monitor Type 2 diabetes

The health care provider prescribes a maintenance dose of metoprolol 250 mg orally twice daily for hypertension. Which action would the nurse take upon receiving the prescription?

Hold the medication and ask the health care provider about the dose.

A patient is admitted to the emergency department with a blood pressure of 222/110 mm Hg. For which reason would the nurse anticipate intravenous (IV) beta blocker administration?

IV forms of beta blockers have immediate effects.

Which treatment option would manage a situation in which a patient is at risk of having a blood clot in the leg break away and travel up to the heart or lung?

IVC filter implantation

Place the steps of an angioplasty in order, beginning with the first step.

Identify the artery where the plaque is located Insert the balloon catheter into the artery using a closed stent Set the stent in place Expand the balloon to expand the stent Remove the balloon from the artery

Which is a clinical manifestation of progressive peripheral artery disease (PAD)?

Intermittent claudication Intermittent claudication is leg pain associated with exercise and walking due to muscle ischemia, which is a key indicator that the PAD is progressing.

The nurse is caring for a patient who is receiving prescribed digoxin and diltiazem. Which assessment data alerts the nurse to a potential interaction?

Irregular heart rate

Which clinical manifestation may be noted in a person diagnosed with atheromas of the coronary arteries?

Ischemia

Which statement describes the function of a surgically-implanted IVC filter?

It helps to prevent pulmonary emboli

Which statement describes a surgical embolectomy?

It removes an embolism to improve blood flow

Which statement is accurate regarding a surgical bypass procedure?

It reroutes the flow of blood around a diseased artery

Which clinical manifestations are associated with angina pectoris?

Jaw pain Chest pain Diaphoresis

Which medication is an option for an individual whose lipid profile includes an LDL of 240 mg/dL?

Lipitor

Which lifestyle factor may increase the incidence of angina pectoris in an individual?

Manages a busy restaurant

Match the medication to the type of urethritis infection it treats.

Monilial infection Fluconazole (Diflucan) Bacterial infection Doxycycline (Vibramycin) Trichomonas infection Clotrimazole (Mycelex) Ciprofloxacin (Cipro)

Which patient assessment data indicates additional teaching by the nurse is required for Ms. James?

Ms. James reports eating grapefruit for breakfast each morning on her new diet. Grapefruit can interfere with the absorption of calcium channel blockers (CCBs) producing higher than normal levels of the drug in the bloodstream. This indicates additional teaching is required for Ms. Jones.

Which is a manifestation common to all heart defects, regardless of location or classification?

Murmur

Which clinical manifestations are commonly associated with angina pectoris?

Nausea Chest pain Diaphoresis

The charge nurse is teaching a class of nurses about nifedipine. Which teaching would the charge nurse include?

Nifedipine blocks calcium channels in vascular smooth muscle. The nurse would include this teaching because nifedipine does block calcium channels in vascular smooth muscle.

Which is a clinical manifestation of progressive peripheral artery disease (PAD)?

Pain in the legs will become more severe including at rest.

A person arrives at the emergency room and reports chest pain. Which additional manifestation helps to determine if the pain is cardiac in origin?

Pain is relieved with nitroglycerin

Which rhythm is depicted on the right side of this ECG rhythm?

Paroxysmal artrial tachycardia

Match the area of inflammatory impact with the associated inflammatory issue.

Pericarditis Inflammation of the sac covering the heart. Myocarditis Inflammation of muscle layer of the heart. Endocarditis Inflammation of inner layer of the heart. Rheumatic Fever Systemic inflammation.

Which medication can be effective for treating symptoms of intermittent claudication?

Pletal

Which stage of peripheral artery disease (PAD) is associated with pain in the legs during exercise that resolves with rest?

Progressing

Which explains why tetralogy of Fallot is often referred to as "blue baby" syndrome?

Pulmonary valve stenosis causes a deficit of oxygen in the body due to the right-to-left shunt causing the entry of deoxygenated blood into the systemic circuit.

A patient receives a dose of streptokinase, but the medication seems to have no effect on the thrombus. Which is the most appropriate action to take?

Record the information in the patient's chart

Which statement describes blood flow through an incompetent valve?

Regurgitation occurs in incompetence, allowing blood to backflow and not move forward easily.

Which medication has the intended effect of lowering cholesterol?

Simvastatin

Which is an appropriate action for a person to take at the onset of angina pain?

Sit down and rest

The nurse is teaching Ms. Jones about her new prescription for metoprolol. What teachings will the nurse include?

Sit on the side of the bed for a few moments prior to standing up." "Inform all health care providers that you are taking metoprolol." "Notify your health care provider if dizziness becomes excessive."

Which lifestyle modifications are appropriate for management of peripheral vascular disease?

Smoking cessation Exercising regularly Limiting high fat foods

Which is true regarding the prevalence of acute coronary syndrome?

Someone dies every minute from acute coronary syndrome. Someone has an acute coronary syndrome episode every 25 seconds.

Which are common signs and symptoms of congenital heart disease?

Tachycardia Pallor or cyanosis Dyspnea and tachypnea Marked intolerance to exercise and cold

Which action should an individual take to relieve anginal pain?

Take a nitroglycerin tablet.

Which medications are prescribed to reduce urethral sphincter resistance to urinary outflow?

Terazosin (Hytrin), Alfuzosin (Uroxatral), Doxazosin (Cardura), Tamsulosin (Flomax)

Which congenital heart defect is characterized as cyanotic in nature?

Tetralogy of Fallot

The nurse administers a prescribed dose of intravenous verapamil to a patient with a baseline blood pressure (BP) of 210/110 mm Hg at 0800. Which BP reading would the nurse expect to see 15 minutes after administration?

The BP will start to increase, returning to baseline within 10 to 20 minutes.

What happens in the latest stages of the atheromatous plaque formation in peripheral artery disease?

The atheroma calcifies.

Which is the order in which an atheroma develops?

The development of an atheroma begins with endothelial damage, in which lipids are deposited into the vessel. From there, macrophages arrive to the site and phagocytize the lipids, forming a mass of lipid-laden macrophages. Platelets then attach to the growing atheroma, further occluding the vessel. Finally, the atheroma calcifies.

Which finding indicates that an individual has sustained a myocardial infarction as opposed to angina?

The individual has elevated cardiac enzymes.

Which individual is at risk for developing peripheral artery disease?

The individual with a recent diagnosis of diabetes

Which situations associated with peripheral artery disease (PAD) require immediate intervention?

The individual's limb is cold the individual's pulse cannot be detected in the limb.

Which findings may indicate a person is experiencing angina pain?

The pain is intermittent. The pain is relieved with rest. The pain is relieved with nitroglycerin.

Which is true of a person with a history of cardiac disease and a new diagnosis of arteriosclerosis?

There is a high risk for organ ischemia in the person.

A 30-year-old female patient who is taking a beta blocker asks the nurse, "Can I take this drug if I am considering pregnancy?" Which nursing response is appropriate?

There is potential risk to the fetus because metoprolol crosses the placental barrier."

Which effect does PAD have on peripheral pulses?

They become diminished or absent.

Which are etiologies of myocardial infarction?

Thrombus Embolus Atheroma

A patient asks why a nitroglycerin patch cannot be worn for 24 hours. Which response by the nurse is appropriate?

Tolerance to the nitroglycerin can develop with 24-hour use of a nitroglycerin patch. Tolerance to nitroglycerin can develop with 24-hour use of a nitroglycerin patch. A drug-free or patch-free period prevents the development of tolerance to nitroglycerin.

Which route of administration for nitroglycerin is associated with development of tolerance if a drug-free interval is not established?

Transdermal Tolerance to nitroglycerin can develop with transdermal nitroglycerin if left on continuously. Having a drug-free interval on a daily basis is important to minimize the development of tolerance.

A patient who is taking sustained-release diltiazem is having difficulty swallowing the medication. What teaching is appropriate?

Try swallowing the medication whole in pudding or applesauce.

Which diagnosis is considered a type of acute coronary syndrome (ACS)?

Unstable angina

Which are considered acute coronary syndrome (ACS) diseases?

Unstable angina ST elevated myocardial infarction (STEMI) Non-ST elevated myocardial infarction (NSTEMI)

Which is the term describing failure of a valve to close completely, causing blood to regurgitate or leak backward?

Valvular incompetence

A person reports chest pain that is intermittent. Testing reveals the chest pain is caused by vasospasm. Which type of angina is described by this scenario?

Variant angina

Which heart defect often heals before the end of childhood and is sometimes seen in conjunction with tetralolgy of Fallot?

Ventricular septal defect

Which defects are associated with tetralogy of Fallot?

Ventricular septal defect Pulmonary valve stenosis Dextraposition of the aorta Right ventricular hypertrophy

Which are causes of congenital heart defects?

Viral infections Maternal diabetes Chromosomal abnormalities Maternal alcohol consumption

A nurse is preparing to administer nitroglycerin ointment. Which action by the nurse is most important when handling nitroglycerin?

Wear gloves when handling nitroglycerin. Nitroglycerin can be absorbed very quickly through the skin and can cause systemic vasodilation. Nurses would wear gloves when handling nitroglycerin to prevent systemic effects.

Which are modifiable risk factors that lower the risk of developing acute coronary syndrome (ACS)?

Weight Sedentary lifestyle Cigarette smoking Diabetes mellitus

Which manifestation is unique to chronic pericarditis?

adhesions in the pericardium

Which patient is most at risk for developing a cardiac arrhythmia?

an 80-year-old male with coronary artery disease

Which is the most common type of abnormal conduction pattern?

atrial fibrillation

Which describes the pharmacologic treatment of a person who is discharged from the hospital after having acute pyelonephritis?

continuing to treat the person with oral antibiotics for an additional 14-21 days

Which manifestations of pericardial effusion cause cardiac muscle compression?

excessive fluid in the pericardial space

Which are etiologies of endocarditis?

fungus, bacteria

The nurse is providing teaching to a patient regarding the difference between side effects of nitroglycerin that can be managed and adverse effects, which may necessitate discontinuation of the drug. Which conditions are considered side effects of nitroglycerin?

headache, hypotension, tachycardia

Which clinical manifestations indicate progression from rheumatic fever to rheumatic heart disease?

heart failure, mitral valve leaflet vegetations

Which are the most common sites of partial occlusion in the peripheral circulation?

iliac, abdominal aorta, femoral

Which manifestation is expected in the early stages of peripheral artery disease (PAD)?

increased fatigue and weakening of the legs

Which is accurate regarding the pathophysiology of rheumatic fever?

inflammatory response involving the heart, joints, skin, and brain

Which are clinical manifestations of atrial fibrillation?

irregular heart rate, increased heart rate,

Which cells phagocytize lipids?

macrophages

Which clinical finding may be the cause of a cardiac arrhythmia?

oxygen saturation of 80%

Which is a manifestation of intermittent claudication?

pain in the legs upon exertion

Which symptoms are typical in an individual with peripheral artery disease (PAD)?

pain, tingling, burning, numbness

A patient has converted from sinus rhythm to atrial fibrillation. Which clinical manifestations may be seen?

palpitations, irregular heart contractions, atrial heart rate over 350 beats per minute

Which clinical finding is characteristic of cardiac tamponade?

pulsus paradoxus

Which is a predisposing factor for pericarditis?

renal failure, heart surgery, myocardial infarction, systemic lupus erythematosus

Which clinical manifestations are associated with acute endocarditis?

spiking fever, sudden onset, impaired cardiac function

Which route of administration for nitroglycerin is most common?

sublingual Sublingual is the most common route of administration due to its quick onset of action.

The health care provider orders a medication for a patient to dissolve a blood clot that formed. Which medication is the health care provider mostlikely to order?

tPA

Which is a pharmacologic treatment option for a person who gets repeated urinary tract infections (UTIs)?

taking a daily low dose of an antibiotic

Which is a true statement regarding clinical manifestations of peripheral artery disease (PAD)?

the skin may become dry and hairless. With PAD, the skin becomes dry and hairless due to decreased blood flow.

Why should cranberry supplements be taken with caution when a person has a urinary tract infection (UTI)?

they can irritate the bladder

Which are effects of total occlusion of blood supply to a limb due to PAD?

ulcers necrosis gangrene

Restricting sodium intake is recommended for which urological system disorders?

urinary tract calculi, acute poststreptococcal glomerulonephritis

Which rhythm is depicted in the strip shown?

ventricular fibrillation

Which electrical conduction change is associated with a bundle branch block arrhythmia?

widened QRS

How long after administering nitroglycerin intravenously (IV) would the nurse expect the patient's chest pain to be relieved?

within seconds Onset of action for nitroglycerin IV should be in seconds (immediate) upon administration.