K/H Cardiac Glycosides
A client is ordered to receive digoxin (Lanoxin). Based on its half-life of 36 hours, the nurse will anticipate administering the maintenance dose: 1. once a day 2. twice a day 3. three times a day 4. once a week
ANS: 1 With its half-life, digoxin will be administered daily. DIF: Cognitive Level: Application REF: 625 TOP: Nursing Process: Planning
Nifedipine (Procardia), the most potent calcium blocker, promotes vasodilation of the coronary and peripheral vessels. The nurse should assess for: 1. elevated blood pressure 2. decreased blood pressure 3. pulse rate <70 beats/minute 4. pulse rate >120 beats/minute
ANS: 2 Nifedipine causes hypotension. DIF: Cognitive Level: Comprehension REF: 632 | 634 TOP: Nursing Process: Analysis
A nurse is caring for a client with congestive heart failure. The client is ordered to receive nesiritide (Natrecor). The nurse evaluates the effectiveness of this medication in achieving the desired effect by noting: 1. vasoconstriction 2. oliguria 3. decreased diuresis 4. decreased shortness of breath
ANS: 4 This medication allows for diuresis of excess fluids by inhibiting ADH, decreasing pulmonary edema, and decreasing the work of breathing. DIF: Cognitive Level: Application REF: 628 TOP: Nursing Process: Evaluation
The slow calcium channel blocker that acts by decreasing excitability and contractility of the myocardium is: 1. verapamil (Calan) 2. nifedipine (Procardia) 3. diltiazem (Cardizem) 4. nicardipine (Cardene)
ANS: 1 Verapamil is an effective calcium channel blocker. DIF: Cognitive Level: Comprehension REF: 638 TOP: Nursing Process: Analysis
Antianginal drugs are prescribed for relief of anginal pain. Anginal pain is characterized by the following except: 1. pain that lasts for 24 hours 2. tightness and pressure in the center of the chest 3. pain that may radiate down the left arm 4. pain that lasts for a few minutes
ANS: 1 Anginal pain is shorter term. Longer-lasting pain is more indicative of necrosis and myocardial infarct. DIF: Cognitive Level: Comprehension REF: 628 TOP: Nursing Process: Assessment
Adverse reactions to lidocaine (Xylocaine) include: 1. hypotension and bradycardia 2. hypertension and tachycardia 3. vomiting and diarrhea 4. abdominal cramps and tachycardia
ANS: 1 By suppressing the ectopic beats, lidocaine may cause bradycardia. DIF: Cognitive Level: Comprehension REF: 638 TOP: Nursing Process: Analysis
The nurse administers lidocaine (Xylocaine) and monitors for adverse reactions. These include: 1. hypotension and bradycardia 2. hypertension and tachycardia 3. vomiting and diarrhea 4. abdominal cramps and tachycardia
ANS: 1 Lidocaine decreases blood pressure. DIF: Cognitive Level: Application REF: 638 TOP: Nursing Process: Assessment
A client is ordered to receive flecainide (Tambocor) and tocainide (Tonocard). They are effective in the treatment of: 1. life-threatening ventricular dysrhythmias 2. third-degree heart block 3. bundle branch block 4. asystole
ANS: 1 These are potent antidysrhythmic agents. DIF: Cognitive Level: Comprehension REF: 636 TOP: Nursing Process: Analysis
The serum potassium level that determines hypokalemia is: 1. <3.5 mEq/L 2. <4.5 mEq/L 3. <5.3 mEq/L 4. >6 mEq/L
ANS: 1 This is the normal value for hypokalemia. DIF: Cognitive Level: Comprehension REF: 627 TOP: Nursing Process: Analysis
A client was prescribed a transdermal nitroglycerin patch, 5 mg/24 hours. A health teaching point is: 1. to leave the old patch on when applying the new patch 2. to change to a new site when applying the new nitroglycerin patch 3. to apply the nitroglycerin patch only to the chest area 4. that the patch medication area may be touched while applying it
ANS: 2 Option 2 is the only true option. Nurses should avoid touching the nitroglycerin to preclude severe headache in reaction to the vasodilation. DIF: Cognitive Level: Application REF: 634 TOP: Nursing Process: Intervention/Teaching
A client is being assessed for signs and symptoms of digitalis toxicity that include which of the following? 1. abdominal cramping 2. bradycardia 3. polyuria 4. hearing disturbances
ANS: 2 This is a sign of digoxin toxicity as digoxin (Lanoxin) slows and strengthens ventricular contraction. DIF: Cognitive Level: Application REF: 624 TOP: Nursing Process: Assessment
A client is demonstrating signs and symptoms of digoxin toxicity. The antidote for cardiac/digitalis glycoside toxicity is: 1. vitamin K 2. digoxin immune Fab (Digibind) 3. inamrinone lactate (Inocor) 4. naloxone (Narcan)
ANS: 2 This is the antidote for digoxin toxicity. DIF: Cognitive Level: Comprehension REF: 625 TOP: Nursing Process: Analysis
A client has congestive heart failure and has been taking digoxin (Lanoxin) for 9 years. The client is admitted with signs and symptoms of digoxin toxicity. Select all of the following that are associated with digoxin toxicity: 1. scomata 2. vomiting 3. supraventricular tachycardia 4. yellow halos in the visual field 5. diarrhea 6. insomnia
ANS: 2, 4, 5 These are classic signs of digoxin toxicity. DIF: Cognitive Level: Application REF: 624 TOP: Nursing Process: Evaluation
Antacids taken with digoxin (Lanoxin) cause: 1. anorexia and nausea 2. increased absorption of digoxin 3. decreased absorption of digoxin 4. diarrhea
ANS: 3 Antacids change the pH of the stomach, decreasing the absorption of many medications. DIF: Cognitive Level: Comprehension REF: 625 TOP: Nursing Process: Analysis
A client who is taking digoxin (Lanoxin) also has a history of gastroesophageal reflux disease. The client takes Mylanta II (magnesium and aluminum hydroxide) and Tums (calcium carbonate). The client needs to space the medications apart because antacids taken with digoxin cause: 1. anorexia and nausea 2. increased absorption of digoxin 3. decreased absorption of digoxin 4. diarrhea
ANS: 3 Antacids interfere with the absorption of digoxin. DIF: Cognitive Level: Application REF: 625 TOP: Nursing Process: Planning
The nurse reviews a client's history before administering nadolol (Corgard) for treatment of angina. The nurse plans to contact the health care provider if the client has which of the following conditions? 1. cataracts 2. glaucoma 3. second-degree AV heart block 4. thrombocytopenia
ANS: 3 Clients with a history of second- or third-degree AV heart block should not take beta blockers. Use of beta-blockers may worsen second- or third-degree AV heart block. DIF: Cognitive Level: Application REF: 630 TOP: Nursing Process: Planning
A positive inotropic action is one of the effects of digitalis drugs. Positive inotropic action means: 1. decreased conduction of the myocardium 2. decreased heart rate 3. increased myocardial contraction 4. decreased myocardial contraction
ANS: 3 Inotropic means myocardial contractility. DIF: Cognitive Level: Comprehension REF: 623 TOP: Nursing Process: Analysis
A client experiences premature ventricular contractions. The nurse prepares to administer lidocaine (Xylocaine), with the knowledge that it is administered intravenously to correct: 1. bradycardia 2. atrial dysrhythmias 3. ventricular dysrhythmias 4. heart block
ANS: 3 Lidocaine anesthetizes the ectopic foci, decreasing ectopy and ventricular dysrhythmias. DIF: Cognitive Level: Application REF: 636 TOP: Nursing Process: Planning
The nurse instructs a client taking digoxin (Lanoxin) for treatment of congestive heart failure (CHF) to eat which of the following? 1. cabbage 2. lima beans 3. potatoes 4. yogurt
ANS: 3 Potatoes are high in potassium, and potassium-rich foods should be encouraged to help prevent hypokalemia in clients taking digoxin. DIF: Cognitive Level: Application REF: 627 TOP: Nursing Process: Intervention/Teaching
The nurse is aware that which of the following herbal preparations decreases the absorption of digoxin? 1. garlic 2. ginger 3. St. John's wort 4. saw palmetto
ANS: 3 St. John's wort decreases the absorption of digoxin and thus decreases serum digoxin level. DIF: Cognitive Level: Comprehension REF: 627 TOP: Nursing Process: Analysis
A nurse is preparing to administer nitroglycerin (NTG) via the sublingual route. The nurse knows that nitroglycerin tablets are administered sublingually: 1. to avoid the bitter taste 2. to prevent nausea and vomiting 3. to absorb readily into the circulation 4. to undergo first-pass metabolism
ANS: 3 Sublingual medications are absorbed quickly into the bloodstream and are ready for action earlier than oral medications. DIF: Cognitive Level: Application REF: 629 TOP: Nursing Process: Analysis
An antidysrhythmic agent used during life-threatening situations to convert ventricular fibrillation to normal sinus rhythm when lidocaine (Xylocaine) and procainamide (Pronestyl) are ineffective is: 1. phenytoin (Dilantin) 2. tocainide (Tonocard) 3. atropine 4. bretylium (Bretylol)
ANS: 4 Bretylium is the agent used to convert aberrant rhythms when lidocaine and procainamide are ineffective. DIF: Cognitive Level: Comprehension REF: 638 TOP: Nursing Process: Analysis
A client is ordered to take inamrinone lactate (Inocor) for treatment of acute heart failure. The nurse anticipates that this drug will be administered intravenously for no longer than: 1. 12 hours 2. 24 hours 3. 36 hours 4. 72 hours
ANS: 4 Inamrinone lactate is administered intravenously for no longer than 72 hours as severe cardiac dysrhythmias might result from this drug. DIF: Cognitive Level: Comprehension REF: 627 TOP: Nursing Process: Analysis
A client is ordered to receive a nitrate to relieve stable angina. A common side effect to anticipate in a client receiving this medication includes: 1. nausea and vomiting 2. increased blood pressure 3. pruritus and skin rash 4. a pounding headache
ANS: 4 The pounding headache is related to vasodilation of the cerebral vessels. DIF: Cognitive Level: Application REF: 630 TOP: Nursing Process: Assessment