NCLEX- Cardiac Meds

Question 1

A patient who was admitted with deep vein thrombophlebitis is complaining of difficulty breathing and chest pain. What is the most likely cause of these symptoms?

1. Anxiety
2. Medication reaction
3. Embolus to the lungs
4. Fatigue from the extra work of walking with pain

Answer 1

Embolus to the lungs

A thrombus can become an embolus and travel to the lungs. This pulmonary embolus can cause chest pain and difficulty breathing. It is not likely that anxiety, a medication reaction, or fatigue would cause chest pain and dyspnea in this case.

Question 2

A patient is to be discharged with a transdermal nitroglycerin patch. Which instruction should the nurse include in the patient’s teaching plan?

1. “Apply the patch to the same site each day.”
2. “Apply the patch to a nonhairy area of the upper torso or arm.”
3. “If you have chest pain, apply a second patch next to the first patch.”
4. “If you have a headache, remove the patch for 4 hours and then reapply.”

Answer 2

“Apply the patch to a nonhairy area of the upper torso or arm.”

A nitroglycerin patch should be applied to a nonhairy area for the best and most consistent absorption rates. Sites should be rotated to prevent skin irritation. Sublingual nitroglycerin should be used to treat chest pain, and the patient should only have one patch on at a time. The drug should be continued if headache occurs, because tolerance will develop.

Question 3

The nurse knows that simvastatin exerts its action by doing what?

1. By inhibiting lipolysis in the adipose tissue
2. By activating the lipoprotein lipase enzyme
3. By preventing the reabsorption of bile acids
4. By inhibiting the enzyme HMG-CoA reductase

Answer 3

By inhibiting the enzyme HMG-CoA reductase

Simvastatin exerts its action by inhibiting the enzyme HMG-CoA reductase, reducing the rate of cholesterol production. Antilipemic drugs are known to inhibit lipolysis in the adipose tissue, decrease esterification of the triglycerides in the liver, and increase the activity of lipoprotein lipase. Fibric acid drugs are believed to work by activating the lipoprotein lipase, an enzyme responsible for the breakdown of cholesterol. Bile acid sequestrants bind to bile salts and prevent the resorption of bile acids from the small intestine.

Question 4

What should the nurse teach the patient to ensure patient understanding of pharmacologic therapy for hypertension?

1. “Urinary output determines blood pressure.”
2. “Blood pressure is determined by heart contraction.”
3. “Sympathetic stimulation causes blood pressure to decrease.”
4. “Blood pressure is a product of cardiac output and vascular resistance.”

Answer 4

“Blood pressure is a product of cardiac output and vascular resistance.”

Blood pressure is determined by cardiac output (4 to 8 L/min) and systemic vascular resistance (SVR). Cardiac output is the amount of blood that is ejected from the left ventricle and is measured in liters per minute. SVR is the resistance to blood flow that is determined by the diameter of the blood vessel and the vascular musculature. It is calculated by the blood pressure divided by the cardiac output.

Question 5

A patient has overdosed on warfarin. Which substance will the nurse administer to reverse the effect of warfarin?

1. Aspirin
2. Calcium
3. Potassium
4. Vitamin K

Answer 5

Vitamin K

The administration of vitamin K will help to reverse the action of warfarin. Warfarin interferes with vitamin K–dependent clotting factors. Administration of vitamin K will reverse this action. Aspirin is an antiplatelet aggregator which can increase the risk of bleeding. Calcium and potassium do not reverse the effects of warfarin.

Question 6

A patient is prescribed digoxin for supraventricular dysrhythmia. The nurse instructs the patient to avoid consuming bran. What is the reason behind this instruction?

1. Bran decreases digoxin absorption.
2. Bran and digoxin cause constipation.
3. Bran and digoxin cause urinary retention.
4. Bran increases the digoxin concentration in the body.

Answer 6

Bran decreases digoxin absorption.

Bran is a high-fiber food. It binds to the digoxin and affects the absorption and bioavailability of the drug. Bran decreases the absorption of digoxin, so the patient should avoid consuming bran while taking digoxin. Bran is a high-fiber food, and fiber treats constipation. Bran and digoxin do not affect urinary function and therefore do not cause urinary retention. Bran does not produce an additive effect and thus does not increase the digoxin concentration in the body.

Question 7

The nurse is assessing a patient who has hyperlipidemia and who is treated with antihyperlipidemic medications. During the assessment, the patient tells the nurse, “These days, my urine has a burnt odor.” Which medications prescribed for the patient may be responsible for such an adverse effect? Select all that apply.

1. Ezetimibe
2. Colestipol
3. Fluvastatin
4. Gemfibrozil
5. Cholestyramine

Answer 7

Colestipol & Cholestyramine

Urine with a burnt odor is an adverse effect of bile acid sequestrants such as colestipol and cholestyramine. Ezetimibe, fluvastatin, and gemfibrozil are antihyperlipidemics not associated with a burnt odor of the urine. Ezetimibe increases the risk of liver damage and discoloration of urine. Fluvastatin causes constipation, heartburn, and insomnia. Gemfibrozil may cause upset stomach, stomach pain, and diarrhea.

Question 8

The nurse is teaching a patient about idiopathic hypertension. What statement should be included in the teaching plan?

1. “This type of hypertension is not treatable.”
2. “Once you have surgery, this will go away.”
3. “This type of hypertension has a definitive cause.”
4. “The cause of your hypertension is unknown, but treatable.”

Answer 8

“The cause of your hypertension is unknown, but treatable.”

Idiopathic hypertension is essential hypertension. The specific cause is unknown but it is treatable. Surgical treatment may cure secondary hypertension but not idiopathic hypertension.

Question 9

The patient is being treated with abciximab. The nurse assesses the patent’s laboratory test results and finds that the platelet count has dropped to 75,000/mm3. What action will the nurse perform next?

1. Prepare to administer protamine sulfate.
2. No action is needed; this is a normal finding.
3. Notify the primary care provider of this finding.
4. Document the finding and continue to monitor the patient.

Answer 9

Notify the primary care provider of this finding.

If at any time during treatment with this drug the platelet count drops below 90,000/mm3, the health care provider should be notified. Protamine sulfate is the antidote for an excessive amount of heparin.

Question 10

A patient will be discharged to continue treatment with simvastatin. The nurse will teach the patient to report which symptom?

1. Fatigue
2. Headache
3. Muscle pain
4. Nausea and vomiting

Answer 10

Muscle pain

Muscle pain must be reported because it could signify rhabdomyolysis, the uncommon but serious adverse effect that is associated with statin drugs like simvastatin. Fatigue, headache, and nausea and vomiting are also adverse effects of statin drugs, but they are generally not severe.

Question 11

Which assessment is most important before administering digoxin?

1. Apical pulse
2. Homans sign
3. Breath sounds
4. Weight in kilograms

Answer 11

Apical pulse

It is crucial to measure the patient’s apical pulse rate (auscultate the apical heart rate, found at the apical impulse located at the fifth left midclavicular intercostal space) for 1 full minute before administering digoxin. The Homans sign is checked to deduce clots. Breathing sounds are assessed to check chronic obstructive pulmonary disease. Weight is checked before administration of any medication related to cardiovascular disease.

Question 12

Which statement made by the patient indicates an understanding of discharge instructions on antihyperlipidemic medications?

1. “I will stop taking the medication if it causes nausea and vomiting.”
2. “It is important to double my dose if I miss one in order to maintain therapeutic blood levels.”
3. “I will continue my exercise program to help increase my high-density lipoprotein serum levels.”
4. “Antihyperlipidemic medications will replace the other interventions I have tried to decrease my cholesterol.”

Answer 12

“I will continue my exercise program to help increase my high-density lipoprotein serum levels.”

Antihyperlipidemic medications are an addition to, not a replacement for, the therapeutic regimen used to decrease serum cholesterol levels. Patients should not stop taking the medication without consulting the provider. The dose should never be doubled if one is missed or stopped because of side effects.

Question 13

A patient receiving atorvastatin therapy to reduce high cholesterol levels calls the clinic and reports, “I am experiencing severe pain in both my legs.” What is the nurse’s best response?

1. “Stop taking the drug and visit the clinic immediately.”
2. “Continue taking the drug; leg pain is a common side effect.”
3. “Stop taking the drug if the symptoms persist for another week.”
4. “Continue taking the drug along with antilipemic drugs and a painkiller.”

Answer 13

“Stop taking the drug and visit the clinic immediately.”

The patient may have pain in both legs due to myopathy, an adverse effect of atorvastatin. It progresses to a life-threatening condition called rhabdomyolysis, which involves the breakdown of muscle proteins, leading to renal failure and death. The nurse should instruct the patient to stop taking the drug and immediately visit the clinic. The nurse will not instruct the patient to continue the drug, because myopathy is a life-threatening condition and requires immediate medical attention. The nurse will instruct the patient to watch for the symptoms; rhabdomyolysis further worsens the patient’s condition, leading to renal failure. Administration of antilipemic drugs along with atorvastatin further increases the breakdown of muscle proteins and causes rhabdomyolysis. The nurse should ask the patient to stop taking the medication until the cause of the leg pain is confirmed.

Question 14

The nurse is caring for a patient with hypertension who is prescribed a clonidine transdermal patch. What should the nurse teach this patient?

1. “Change the patch daily at the same time.”
2. “Remove the patch before taking a shower or bath.”
3. “Get up slowly from a sitting to a standing position.”
4. “Do not take other antihypertensive medications while using this patch.”

Answer 14

“Get up slowly from a sitting to a standing position.”

Clonidine can cause dizziness. Patient safety is a priority. The patch is left on for 7 days and can be left on while bathing. This medication is often prescribed with other drugs.

Question 15

Which complication may be experienced by a patient who is prescribed lisinopril?

1. Insomnia
2. Hyperkalemia
3. Abdominal pain
4. Cardiac dysrhythmia

Answer 15

Hyperkalemia

Lisinopril is an angiotensin-converting enzyme inhibitor, which causes the kidney to retain potassium, leading to hyperkalemia. Insomnia and abdominal pain are known side effects of nesiritide, not lisinopril. Cardiac dysrhythmia is a side effect of milrinone, not lisinopril.

Question 16

Which medication acts by blocking sodium channels, accelerating repolarization, and decreasing the duration of the action potential?

1. Lidocaine
2. Verapamil
3. Propafenone
4. Dronedarone

Answer 16

Lidocaine

Lidocaine acts by blocking the sodium channels, accelerating repolarization, and decreasing the action potential duration. Verapamil is a calcium channel blocker, which works by inhibiting the calcium channels, resulting in a shortening of the action potential. Verapamil delays repolarization. Propafenone also acts by blocking sodium channels but has little effect on repolarization or action potential duration. Dronedarone increases the action potential duration by prolonging repolarization in phase 3.

Question 17

Cilostazol belongs to which drug class?

1. Antiplatelet
2. Thrombolytic
3. Anticoagulant
4. Antifibrinolytic

Answer 17

Antiplatelet

Cilostazol is an antiplatelet drug, which works through inhibition of type 3 phosphodiesterase in the platelets and primarily lower-extremity blood vessels. Thrombolytics break down blood clots. Anticoagulants prevent or delay coagulation of the blood. Antifibrinolytics prevent the lysis of fibrin thus promoting clot formation.

Question 18

Which assessment finding in a patient receiving nitrate therapy requires immediate nursing intervention?

1. Headache
2. Severe anemia
3. Anginal episode
4. Ischemic heart disease

Answer 18

Severe anemia

If a patient with severe anemia is administered nitrates, the vasodilatory effects of the nitrates can worsen the anemia. Headache is a side effect of nitrates therapy. Nitrates will minimize the frequency of angina episodes in a patient with ischemic heart disease.

Question 19

Which are expected clinical manifestations of hypomagnesemia? Select all that apply.

1. Edema
2. Anorexia
3. Insomnia
4. Twitching
5. Hyperactive reflexes

Answer 19

Twitching & Hyperactive reflexes

Hypomagnesemia is the medical term for low levels of serum magnesium. It causes involuntary muscle contraction and relaxation, resulting in twitching. Hypomagnesemia can also cause central nervous system excitability and result in hyperactive reflexes. Edema can be caused by many factors but is not a clinical manifestation of low magnesium levels. Anorexia is sometimes associated with low levels of potassium, but not low levels of magnesium. Insomnia is a side effect of nesiritide but is not caused by low magnesium.

Question 20

A patient is admitted to the emergency department experiencing symptoms of a thrombolytic stroke. Which medication should the nurse expect to be prescribed for the patient?

1. Heparin
2. Alteplase
3. Clopidogrel
4. Fondaparinux

Answer 20

Alteplase

Alteplase is a tissue plasminogen activator, which can be administered to treat a thrombolytic stroke within a specified time frame after symptom onset. Heparin is an anticoagulant, which prevents clot formation by inhibiting clotting factors IIa and Xa. Clopidogrel is an antiplatelet medication that interferes with platelet function, thereby preventing platelet aggregation. Fondaparinux is an anticoagulant medication, which prevents clot formation by inhibiting factor Xa.

Question 21

A patient is receiving transdermal clonidine. What information does the nurse need to include in the teaching plan?

1. “Take the medication on an empty stomach.
2. “Remove the old patch before applying the new patch.”
3. “Stay in bed for at least an hour after receiving a new patch.”
4. “Keep the new patch on for 30 minutes before removing the old patch.”

Answer 21

“Remove the old patch before applying the new patch.”

The patient needs to remove the old patch before applying a new one.

Question 22

When teaching the nursing student about coronary heart disease, which statement will the nurse include in the session?

1. “Coronary heart disease occurs due to the formation of atherosclerotic plaques.”
2. “Coronary heart disease cannot be prevented by changing lifestyle modifications.”
3. “Coronary heart disease is due to decreases in the cholesterol levels to below 200 mg/dL.”
4. “Coronary heart disease is nonlethal and cannot be prevented by antilipemic medications.”

Answer 22

“Coronary heart disease occurs due to the formation of atherosclerotic plaques.”

Coronary heart disease (CHD) occurs due to the formation of atherosclerotic plaques inside the walls of the coronary arteries. The risk of CHD also increases with an unhealthy lifestyle, which should be modified. Cholesterol levels above 200 mg/dL increase the risk for developing coronary artery disease. CHD is lethal and can be prevented by antilipemic medications that lower the serum cholesterol levels, if diagnosed early. Antilipemic therapy is used as primary prevention in patients with known risk factors for CHD.

Question 23

Which drugs are referred to as positive chronotropic drugs?

1. Drugs that affect heart rate
2. Drugs that affect blood pressure
3. Drugs that affect conduction velocity
4. Drugs that affect myocardial contractility

Answer 23

Drugs that affect heart rate

Drugs that affect heart rate by accelerating the rate of impulse formation in the sinoatrial node are referred to as positive chronotropic drugs. Drugs that affect blood pressure are referred as vasopressor drugs. Drugs that increase the rate of conduction of electrical impulses through the myocardium are referred to as positive dromotropic drugs. Drugs that increase the force of myocardial contraction are referred to as positive inotropic drugs.

Question 24

A patient who receives digoxin therapy states, “I missed one dose of the drug.” The nurse learns that the patient hasn’t taken the drug for the past 12 hours. What should the nurse do next?

1. Instruct the patient to stop taking digoxin.
2. Immediately inform the primary health care provider.
3. Instruct the patient to double up on the next digoxin dose.
4. Instruct the patient to take two doses of digoxin with a 6-hour gap.

Answer 24

Immediately inform the primary health care provider.

The nurse should immediately inform the primary health care provider if the patient goes more than 12 hours after a missed dose. Without the primary health care provider’s prescription, the nurse should not instruct the patient to stop taking digoxin, because it may be harmful for the patient. The nurse should not instruct the patient to double the next digoxin dose, because it can cause severe toxicity the patient. The nurse should not instruct the patient to take two doses of digoxin with a 6-hour gap, because it may cause severe toxicity in the patient.

Question 25

What statement indicates to the nurse that the patient needs additional instruction about antihypertensive treatment?

1. “I will change my position slowly to prevent feeling dizzy.”
2. “I will not mow my lawn until I see how this medication makes me feel.”
3. “I will check my blood pressure daily and take my medication when it is over 140/90 mm Hg.”
4. “I will include rest periods during the day to help me tolerate the fatigue my medicine may cause.”

Answer 25

“I will check my blood pressure daily and take my medication when it is over 140/90 mm Hg.”

Antihypertensive medications need to be taken routinely to maintain a normotensive state and prevent complications. Many patients do not adhere to this regimen because hypertension itself does not cause symptoms, whereas the medication can cause some untoward effects. Patient teaching is essential. If the patient indicates an intention to take rest periods and change positions slowly to prevent orthostatic hypotension, this demonstrates compliance with the treatment regimen.

Question 26

The nurse is teaching a patient about the reason for the administration of calcium channel blockers. What statement should be included in the teaching plan?

1. “This medication will help your body to get rid of sodium.”
2. “This medication will work to cause your body to get rid of fluid.”
3. “This medication will help you to lose weight to lower your blood pressure.”
4. “This medication will vasodilate your blood vessels to lower your blood pressure.”

Answer 26

“This medication will vasodilate your blood vessels to lower your blood pressure.”

Calcium channel blockers cause vasodilation and are used for hypertension to lower blood pressure. They cause direct vasodilation by blocking calcium influx in smooth muscles in the blood vessels. This medication class does not help to rid the body of fluids, decrease sodium, or help the patient to lose weight.

Question 27

The nurse is teaching a group of nursing students about cardiac glycosides. Which condition indicates an excess dose of cardiac glycosides?

1. Polyuria
2. Dizziness
3. Halo vision
4. Photophobia

Answer 27

Halo vision

Cardiac glycosides cause halo vision, a condition in which colored or luminous rings are seen around lights. Intake of diuretics inhibits sodium and water resorption, thereby causing frequent urination. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and beta blockers cause dizziness when patients stand up. Amiodarone, an antidysrhythmic drug, causes abnormal intolerance to light, called photophobia.

Question 28

After talking with a patient who is receiving warfarin sodium therapy, the nurse believes that the patient is at increased risk for bleeding. Which statement made by the patient supports the nurse’s conclusion?

1. “I do not take aspirin for pain relief.”
2. “I eat one cup of green leafy vegetables daily.”
3. “I take ginkgo supplements for memory enhancement.”
4. “I refrain from drinking coffee and citrus fruit juices daily.

Answer 28

“I take ginkgo supplements for memory enhancement.”

Warfarin sodium is an anticoagulant medication that reduces the synthesis of vitamin K–dependent clotting factors and inhibits clot formation. Herbal supplements such as ginkgo interact with warfarin sodium and increase the risk of bleeding. Aspirin is a nonsteroidal antiinflammatory drug that prevents platelet aggregation and increases risk of bleeding. Therefore, refraining from taking aspirin will reduce the risk of bleeding in the patient. Though green leafy vegetables are rich in vitamin K, consistent intake of green leafy vegetables does not result in food-drug interaction. Therefore, the nurse should advise the patient to consume the same amount of green leafy vegetables daily. The intake of coffee and citrus fruit does not impair the clotting process and does not increase risk of bleeding.

Question 29

A patient who has been taking warfarin is admitted with coffee-ground emesis. What can the nurse anticipate being prescribed for this patient?

1. Vitamin E
2. Vitamin K
3. Protamine sulfate
4. Calcium gluconate

Answer 29

Vitamin K

Vitamin K is the antagonist for warfarin. Vitamin E and calcium gluconate are not used to counteract the effects of warfarin. If a heparin overdose occurs, the antidote is protamine sulfate.

Question 30

A calcium channel blocker has been prescribed for a patient. Which condition in the patient’s history is a contraindication to this medication?

1. Hypotension
2. Hypokalemia
3. Dysrhythmias
4. Increased intracranial pressure

Answer 30

Hypotension​

Calcium channel blockers cause vasodilation and thus a drop in blood pressure. They are contraindicated in the presence of hypotension. They are not contraindicated for the patient with a history of hypokalemia, dysrhythmias, or increased intracranial pressure.

Question 31

Which adjunct drug is useful in the long-term management of open-angle glaucoma?

1. Mannitol
2. Acetazolamide
3. Spironolactone
4. Hydrochlorothiazide

Answer 31

Acetazolamide​

Acetazolamide is the diuretic drug that is prescribed as adjunct therapy along with topical miotics for management of long-term glaucoma. Mannitol is an osmotic diuretic useful for vasodilation and for the treatment of edema. Spironolactone is useful in ascites associated with liver cirrhosis. Hydrochlorothiazide is useful for treating diabetes insipidus and hypertension. These drugs do not reduce intraocular pressure, because they do not affect the production or the outflow of aqueous humor.

Question 32

The patient is scheduled to receive argatroban. Which is the correct route by which to administer the drug?

1. Intradermal
2. Intravenous
3. Subcutaneous
4. Intramuscular

Answer 32

Intravenous

Argatroban, which has the same trade name, is given only by the intravenous route.

Question 33

The nurse is administering amlodipine. What assessment finding requires immediate action?

1. Calcium level of 8 mEq/dL
2. Potassium level of 5 mEq/dL
3. Apical pulse of 100 beats/min
4. Blood pressure of 80/60 mm Hg

Answer 33

Blood pressure of 80/60 mm Hg

Amlodipine is the most common calcium channel blocker used for hypertension. Blood pressure that goes below 100 mm Hg should be reported to the health care provider immediately, and the medication should be held. The patient’s calcium and potassium levels and apical pulse are within normal limits and do not require immediate action.

Question 34

A patient asks the nurse about taking potassium supplements while taking triamterene. What is the nurse’s best response?

1. “I will call your health care provider to discuss your concerns.”
2. “You are correct about potassium. I will make sure that you get some right away.”
3. “You are on a diuretic that is potassium-sparing, so there is no need for extra potassium.”
4. “Your potassium level was normal in this morning’s laboratory report, so no supplement is needed.

Answer 34

“You are on a diuretic that is potassium-sparing, so there is no need for extra potassium.”

Triamterene is a potassium-sparing diuretic. It causes sodium and water to be excreted while potassium is retained. It inhibits both aldosterone-induced and basal sodium reabsorption. Patients undergoing triamterene therapy neither need to discuss potassium supplements with the health care provider nor need potassium supplements. Monitoring the patient’s potassium level is important, but for potassium-sparing diuretics, potassium supplements are not required.

Question 35

A patient taking adrenergic drugs for hypertension is being given discharge teaching about the therapy. What information should be included in this teaching plan?

1. “This therapy will cause bruising.”
2. “Take this medication after dinner.”
3. “Take this medication before dinner
4. “Do not drink alcohol when using this therapy.”

Answer 35

“Do not drink alcohol when using this therapy.”

Alcohol and other central nervous system depressants can cause increased central nervous system depression when taken with these medications. The medication will not cause bruising and does not have to be taken before or after dinner.

Question 36

What is the primary cause of ischemic heart disease?

1. Clotting
2. Atherosclerosis
3. Angina pectoris
4. Myocardial infarction (MI)

Answer 36

Atherosclerosis

Atherosclerosis is a disease of the coronary arteries that involves fatty plaque deposits in the arterial walls. This disease process causes ischemic heart disease. Clotting, angina pectoris and myocardial infarction can be consequences of ischemic heart disease, but not the cause of the pathology.

Question 37

A patient is admitted to the hospital for an intestinal obstruction and has been placed on strict nothing by mouth (NPO) status. The nurse is reconciling the patient’s home medications and notes that the patient’s daily dose of the antihypertensive lisinopril has not been prescribed by the health care provider. Which action should the nurse take?

1. Address hypertensive episodes only when they arise.
2. Obtain a prescription to administer the lisinopril intravenously.
3. Obtain a prescription for the daily lisinopril and give with a sip of water.
4. Collaborate with the health care provider to determine whether intravenous enalapril can be prescribed.

Answer 37

Collaborate with the health care provider to determine whether intravenous enalapril can be prescribed.

Because the patient has an intestinal obstruction and must maintain strict NPO status, a parenteral form of an ACE inhibitor is needed to keep the patient’s blood pressure under control. Enalapril is the only ACE inhibitor that is available in parenteral form. All medications should be reconciled on admission, so collaboration with the health care provider is essential.

Question 38

A patient has a serum digoxin level of 0.4 ng/mL. What can the nurse interpret from the scenario?

1. It is on the therapeutic level.
2. It has reached the toxic level.
3. It is above the therapeutic level.
4. It is below the therapeutic level.

Answer 38

It is below the therapeutic level.

A serum digoxin level of 0.4 ng/mL is below the normal therapeutic level of 0.5 to 2 ng/mL. Any value over 2 ng/mL is considered above the therapeutic level. The toxic level can only be attained through an extensive application of digoxin administration, for example 5 mEq/L.

Question 39

The health care provider has prescribed amiodarone for a patient with ventricular dysrhythmias. The nurse verifies the patient’s medical history; the nurse should notify the health care provider when the patient makes which statement?

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.”

Answer 39

“I take a blood thinner so I don’t get clots.”

Amiodarone has two very significant drug interactions, namely with digoxin and warfarin. Patients often refer to anticoagulants as “blood thinners.” The nurse should verify which medication the patient is taking, then notify the health care provider. When amiodarone is prescribed in patients taking warfarin, it is recommended to reduce the dose of warfarin by 50% at the start of warfarin therapy. The nurse can provide emotional reassurance and compassionately administer the amiodarone to help reduce the patient’s fears. Amiodarone’s adverse effects include visual halos, photophobia, and dry eyes, but wearing eyeglasses is not a contraindication. Amiodarone is an antidysrhythmic, and there should be no cross-sensitivities with antibiotics. The patient may get faint at the sight of needles; however the priority of care is to eliminate dysrhythmias.

Question 40

Which medication acts by blocking calcium channels?

1. Digoxin
2. Ibutilide
3. Diltiazem
4. Lidocaine

Answer 40

Diltiazem​

Diltiazem acts by blocking calcium channels. Digoxin cannot be categorized under one particular classification. Ibutilide increases the action potential duration by prolonging repolarization in phase 3. Lidocaine blocks sodium channels, which delays repolarization and increases the action potential duration.