Pharmacology Ch 27 EAQ
Which statement by the nurse is incorrect and requires further education about the general pathogenesis of heart failure?
"The renin-angiotensin-aldosterone system decreases preload to the heart." "Decreased sympathetic stimulation also increases peripheral vasoconstriction."
Which drug would the nurse anticipate the health care provider to prescribe for a patient who has a digoxin level of 2.5ng/mL one week after initiation of therapy?
Digoxin-immune FAB
Which statement is true regarding digoxin?
Digoxin-immune Fab is antidote used for digoxin toxicity
Which adverse effect of digoxin can precipitate digoxin toxicity?
Hypernatremia
Which adverse effect of digoxin can precipitate digoxin toxicity?
Hypokalemia
When assessing patient with heart failure, the nurse suspects progression of the disease. Which finding would lead to this suspicion?
Hyponatremia
Which nursing action in the provision of care to patients with heart failure requires correction?
Mixing milrinone and furosemide Administering valsartan-sacubitril to a patient who is currently receiving lisinopril Administering ivabradine with grapefruit juice
Which condition belongs to Stage A according to the American College of Cardiology Foundation and the American Heart Association?
Obesity Diabetes Hypertension Atherosclerotic disease
Which patient is al treated risk for digoxin toxicity, resulting in the nurse contacting the health care provider?
Patient B 64 beats/min Heparin
Which statement made by the nursing student regarding monitoring parameters for the drug captopril indicates a need for further instruction?
"I will monitor hemoglobin levels."
By which mechanism of action does an angiotensin-converting enzyme inhibitor reduce the circulatory blood volume (preload)?
Inhibits the secretion of aldosterone
When the nurse is reinforcing teaching to a patient who underwent heart surgery about self-care techniques at home, which statement made by the patient indicates a need for further education?
"I will ambulate immediately after eating."
Which statement by the nurse about digoxin is accurate?
"I will monitor for any signs of visual disturbances." "I will check the apical pulse before administering digoxin." "I need to obtain kidney function test values before initiating therapy."
Which finding in a patient with hypertension may indicated an increased risk of heart failure?
1. B-type natriuretic peptide (BNP) level of 322 pg/mL
Which intervention would the nurse perform when administering digoxin to an adult patient?
Administer the drug to a patient who has a digoxin level of 1.1 ng/mL. Take an apical pulse for 1 minute before administering the drug.
Which symptom is the first sign of digoxin toxicity in an older adult?
Anorexia
When assessing a client who is on digoxin, the nurse suspects digoxin toxicity. Which symptom would be evidence to suggest digoxin toxicity?
Anorexia Nightmares Blurred vision
Which drug and effect may occur when given concomitantly with digoxin?
Atenolol/digoxin toxicity Hydrochlorothiazide/digoxin toxicity Cholestyramine/reduced digoxin efficacy
Which clinical manifestation is first to be observed in children who may be developing digoxin toxicity?
Atrial dysrhythmias
Which drug may be prescribed to a patient with digoxin-induced dysrhythmias?
Atropine Phenytoin
Which drug class prevents heart failure through inhibition of renin release and suppression of the effect of elevated circulating catecholamines?
Beta adrenergic blocker
Which beta-adrenergic drug is effective in treating heart failure?
Bisoprolol Carvedilol Long-acting metoprolol
Which comorbid condition may induce digoxin toxicity?
Chronic kidney disease Severe respiratory disease Acute myocardial infarction
The nurse is caring for a patient with heart failure who is receiving digoxin, and the serum digoxin level is found to be 0.3 g/mL. Which intervention would be appropriate in this patient?
Contact the health care provider to increase the dose of digoxin.
Which symptom is a non cardiac effect of digoxin?
Extreme fatigue Weakness of arms and legs Nightmares Blurred vision
Which type of juice increases the therapeutic and toxic effects of ivabradine?
Grapefruit
Cardiac patient states, I am unable to continue my morning walk and also have pain in my chest both at ret and after climbing the few steps to my home. " Which class of heart failure would this patient be included in, according to the New York Heart Association (NYHA) Functional Classification System?
IV
Which statement best explains the mechanism of action of milrinone?
It increases the force of cardiac contraction and velocity.
Which description of heart failure with preserved ejection fraction (HFpEF) is inaccurate?
May result in heart failure because the right ventricle develops stiffness May result in heart failure because the right ventricle fails to relax enough between contractions
When the nurse is assessing a patient, which sign or symptom would be a potential indicator of heart failure?
Peripheral edema Presence of nocturia Jugular vein distention Paroxysmal nocturnal dyspnea
Which adverse event may occur in a patient with heart failure who is taking milrinone 1.24 mg/kg/day?
Platelet count of 40,000/mm3
A male patient with heart failure is newly prescribed high-dose milrinone. Two days later, the health care provider suggests discontinuation of therapy. Which laboratory value supports this decision?
Platelet count of 45,000/mm3
Which laboratory value would the nurse monitor in a patient taking milrinone?
Platelets levels
The health care provider suspects enhanced therapeutic and toxic effects of digoxin after reviewing the medical history of a patient who is taking digoxin for heart failure. Which other medication could be responsible for the health care provider's suspicion?
Propranolol Furosemide Clarithromycin
Which sign might the nurse observe in a patient with heart failure?
Pulmonary crackles Cheyne-Stokes respirations
By which mechanism of action does captopril work in heart failure?
Reduce afterload
Which outcome does the nurse anticipate in a patient who is given a long-term prescription for digoxin and begins taking St. John's wort?
Reduced therapeutic effect
Which effect might verapamil have on a patient is receiving digoxin?
Risk for digoxin toxicity
Which herbal supplement may decrease the therapeutic effects of digoxin?
ST. John's wort
Which intervention would be beneficial to a patient diagnosed with digoxin toxicity who is experiencing digoxin-induced dysrhythmias?
Start administering phenytoin.
Which treatment option is used for digoxin-induced dysrhythmias?
Stop potassium-depleting diuretics Administer potassium for associated hypokalemia Administer phenytoin Pacemaker
Which statement best explains digoxin's mechanism of action?
The force of contraction is increased
Which medication reduces both preload and afterload in patients with heart failure?
Valsartan-sacubitril Milrinone
