Pharmacology Chapter 19: NCLEX Questions

When screening a patient who will be taking a nonspecific/nonselective beta-blocker, the nurse knows that a patient with which condition may have serious problems while on this medication? A. Angina B. Hypertension C. Glaucoma D. Asthma

asthma

A patient is experiencing diastolic heart failure. The nurse expects which beta-blocker to be ordered for this patient? A. atenolol (Tenormin) B. carvedilol (Coreg) C. acebutolol (Sectral) D. esmolol (Brevibloc)

carvedilol (Coreg)

A 58-year-old man has had a myocardial infarction (MI), has begun rehabilitation, and is ready for discharge. He is given a prescription for metoprolol (Lopressor), and he becomes upset. "I don't have high blood pressure—why did my doctor give me this medicine?" The nurse explains to him that A. this medication prevents emboli that may lead to another MI. B. beta-blockers will improve blood flow to the kidneys. C. it is being prescribed to prevent the hypertension that often occurs post-MI. D. studies have shown that this medication has greatly increased survival rates in patients after an MI.

d. studies have shown that this medication has greatly increased survival rates in patients after an MI.

A patient is going home with a new prescription for the beta-blocker atenolol (Tenormin). The nurse should include which content when teaching the patient about this drug? A. Never stop taking this medication abruptly. B. The medication should be stopped once symptoms subside. C. If adverse effects occur, skip a dose for a "drug holiday."< /font> D. Be watchful for first-dose hypotension.

never stop taking the medication abruptly

Patient teaching for a patient being discharged on a beta-blocker includes which statement? A) "If you take your pulse and it is less than 60, hold your medicine and call your health care provider for instructions." B) "If you become dizzy, do not take your medication for 2 days and then restart on the third day." C) "This medication may make you fatigued; increasing caffeine in your diet may help alleviate this problem." D) "Increase intake of green leafy vegetables to prevent bleeding problems that can be caused by this medication."

A. "If you take your pulse and it is less than 60, hold your medicine and call your health care provider for instructions."

Beta-blockers are used to treat which disorders? (Select all that apply.) A) Hypertension B) COPD C) Angina pectoris D) Cardiac dysrhythmias

A. Hypertension C. Angina pectoris D. Cardiac dysrhythmias

The priority nursing diagnosis for a patient taking metoprolol (Lopressor) would be A) Ineffective tissue perfusion (cerebral and cardiovascular) related to effects of medication. B) Disturbed sensory perception related to adverse central nervous system effects of the drug. C) Deficient knowledge related to therapeutic regimen. D) Risk for injury related to possible side effects of the adrenergic blockers.

A. Risk for decreased cardiac tissue perfusion related to effects of medication.

The nurse is admitting a patient with a history of angina and hypertension who is currently experiencing moderate heart failure. The patient's current medication regimen includes digoxin, furosemide, and accupril. Which medication would be most beneficial to add to this patient's treatment plan? A) carvedilol (Coreg) B) propranolol (Inderal) C) esmolol (Brevibloc) D) sotalol (Betapace)

A. carvedilol (Coreg)

Propranolol (Inderal) is an effective A) selective alpha-adrenergic antagonist. B) nonselective beta-adrenergic antagonist. C) beta1-adrenergic antagonist. D) beta2-adrenergic antagonist.

B) nonselective beta-adrenergic antagonist.

During assessment of a patient diagnosed with pheochromocytoma, the nurse auscultates a blood pressure of 210/110 mm Hg. The nurse would expect to administer which medication? A) nadolol (Corgard) B) phentolamine (Regitine) C) dobutamine (Dobutrex) D) verapamil (Calan)

B. phentolamine (Regitine)

An example of a cardioselective beta-blocker includes A) propranolol (Inderal). B) labetalol (Normodyne). C) atenolol (Tenormin). D) sotalol (Betapace).

C) atenolol (Tenormin).

The teaching for a patient who is taking tamsulosin (Flomax) to reduce urinary obstruction due to benign prostatic hyperplasia should include which of the following? A. Fluids should be restricted while on this medication. B. Take the medication with breakfast to promote the maximum effects of the drug. C. Lightheadedness may occur when standing up after sitting or lying down. D. Blood pressure should be monitored because the medication may cause hypertension.

C. Lightheadedness may occur when standing up after sitting or lying down. pg 321

During a teaching session about self-monitoring while taking a beta-blocker at home, the nurse has taught a patient to take his apical pulse daily for 1 minute. If the pulse rate decreases to less than 60 per minute, he should be instructed to A. contact his physician for instructions. B. reduce the dose of his beta-blocker by half. C. continue the medication because this is an expected effect. D. skip the medication dose that day and check his pulse again the next day.

CONTACT HIS PHYSICIAN FOR INSTRUCTIONS

When assessing for cardiovascular effects of a beta-blocker, the nurse understands that these drugs produce A) a positive inotropic, positive chronotropic, and positive dromotropic effect. B) a positive inotropic, negative chronotropic, and negative dromotropic effect. C) a negative inotropic, positive chronotropic, and positive dromotropic effect. D) a negative inotropic, negative chronotropic, and negative dromotropic effect.

D) a negative inotropic, negative chronotropic, and negative dromotropic effect.

When teaching a patient about beta-blockers such as atenolol (Tenormin) and metoprolol (Lopressor), it is important to inform the patient that A) these medications may be taken with antacids to minimize gastrointestinal distress. B) hot baths and showers will help enhance the therapeutic effects and are encouraged. C) alcohol intake is encouraged for its vasodilating effects. D) abrupt medication withdrawal may lead to a rebound hypertensive crisis.

D. abrupt medication withdrawal may lead to a rebound hypertensive crisis

Nonselective beta-blockers may be used to treat hypertension and A) chronic obstructive pulmonary disease (COPD). B) heart failure. C) heart block. D) supraventricular arrhythmias.

D. supraventricular dysrhythmias.

A beta-blocker is prescribed for a patient with angina. The nurse reviews the orders for other drugs that may interact with the beta-blocker. Which drugs or drug classes are known to have an interaction with a beta-blocker? Select all that apply. A. Diuretics B. Anticholinergics C. Penicillins D. Oral hypoglycemics E. Thyroid replacement hormones F. Anticoagulants

Diuretics, Anticholinergics, Oral hypoglycemics

A 49-year-old patient is in the clinic for a follow-up visit 6 months after starting a beta-blocker for treatment of hypertension. During this visit, his blood pressure is 169/98 mm Hg, and he eventually confesses that he stopped taking this medicine 2 months ago because of an " embarrassing problem." What problem did he most likely experience with this medication that caused him to stop taking it? A. Urge incontinence B. Dizziness when standing up C. Excessive flatus D. Impotence

Impotence

During initial rounds, the nurse notes that a dopamine infusion has extravasated into the forearm of a patient. After stopping the infusion, the nurse follows standing orders and immediately injects phentolamine subcutaneously in a circular fashion around the extravasation site. What is the mechanism of action of the phentolamine in this situation? A. It neutralizes the extravasated dopamine immediately. B. It causes arterial vasoconstriction and reduced pain and swelling at the site. C. It increases peripheral vascular resistance and reduces arterial pressure at the site. D. It increases blood flow to the ischemic site by vasodilation to prevent tissue damage.

It increases blood flow to the ischemic site by vasodilation to prevent tissue damage.

During therapy with a beta-blocker, a patient notices that she has swollen feet, has gained 3 pounds within 2 days, feels short of breath even when walking around the house, and has been dizzy. The nurse suspects that which of the following is occurring? A. The patient is experiencing expected adverse effects of the drug. B. The patient is experiencing an allergic reaction. C. More time is needed for the patient to see a therapeutic response to the drug. D. The patient may be developing heart failure.

The patient may be developing heart failure.