Chapter 16-Antirrhythmic agents

Question 1

The nurse understands that which of the following calcium channel antagonists is approved for use as an antiarrhythmic agent?

Answer 1

verapamil-

Verapamil and diltiazem are the only two calcium channel antagonists that are approved as antiarrhythmic agents.

Question 2

The nurse is caring for a client with a history of bronchial asthma and understands that this client should not be given:

Answer 2

propranolol. Because propranolol can cause bronchoconstriction, it is contraindicated in clients with an asthma history.

Question 3

Before administering digoxin or a related cardiac glycoside, the nurse should:

Answer 3

auscultate and count the apical pulse for 1 minute

Question 4

The pulse rate at which the nurse would withhold a dose of digoxin in an adult is:

Answer 4

less than 60 beats per minute.

Question 5

For the 7-year-old child who is to receive a dose of digoxin and whose pulse rate is 88, the nurse would

Answer 5

administer the child’s dose of digoxin. The nurse should administer the dose because the pulse rate is not less than 70.

Question 6

In caring for adults who are receiving cardiac glycosides, the nurse should report to the health care provider when the client’s heart rate exceeds:

Answer 6

100 beats per minute.

Question 7

The nurse assesses the client receiving digoxin for an early sign of digoxin toxicity, which is:

Answer 7

visual disturbances.

Question 8

The nurse understands that which of the following agents works by blocking the passage of calcium in the heart, resulting in vascular smooth-muscle relaxation?

Answer 8

verapamil-Verapamil is a calcium channel blocking agent or antagonist.

Question 9

When teaching the client receiving quinidine, the nurse should include:

Answer 9

that the doses should be administered near mealtimes.

To avoid or minimize GI symptoms, quinidine should be timed to coincide with meals.

Question 10

The nurse should ask the client or family about hypersensitivity reactions to local anesthetics before administering the first dose of:

Answer 10

lidocaine-In addition to being an antiarrhythmic agent, lidocaine also is a local anesthetic.

Question 11

The nurse should assess closely which of the following clients taking disopyramide?

Answer 11

a client with glaucoma-Because of the anticholinergic adverse effects of disopyramide, the client with glaucoma should be closely monitored.

Question 12

The nurse should monitor the client taking verapamil for:

Answer 12

hypotension-Verapamil causes vasodilation, which can lead to hypotension.

Question 13

The nurse prepares to administer an intravenous dose of lidocaine by:

Answer 13

using only the preservative-free/catecholamine-free form that may be administered IV.

Question 14

Nifedipine is typically used to:

Answer 14

treat angina and hypertension.- Nifedipine is a calcium channel antagonist used to treat hypertension and angina.

Question 15

A client taking amiodarone has developed the most significant adverse effect associated with this drug, and the nurse prepares the client for:

Answer 15

intubation and mechanical ventilation. Amiodarone-induced pulmonary toxicity is the most significant adverse effect of amiodarone.

Question 16

The client receiving high-dose, long-term amiodarone therapy should be monitored every 3 to 6 months for:

Answer 16

pulmonary toxicity

Question 17

The nurse monitors which of the following clients for the greatest risk of digoxin toxicity? The client with a:

Answer 17

potassium level of 3 mEq/L.

Question 18

The nurse is planning care for a client in shock and determines the priority nursing diagnosis is:

Answer 18

ineffective tissue perfusion related to trauma.
This is the priority nursing diagnosis for a client in shock, because regardless of the type of shock, hypoperfusion occurs.

Question 19

For the client in shock receiving atropine sulfate, the nurse must:

Answer 19

monitor the pulse every 5 minutes. Atropine increases the heart rate, which can lead to tachyarrhythmias.

Question 20

When teaching a client about home administration of digoxin, the nurse realizes that further instruction is needed when the client states:

Answer 20

“I can still take my Saint John’s wort for anxiety.”

Saint John’s wort decreases digoxin levels by increasing digoxin renal excretion.

Question 21

Twelve hours after a client begins receiving IV verapamil HCl, blood pressure is 89/60 with a pulse rate of 45 beats per minute. The nurse should:

Answer 21

stop the verapamil infusion

Question 22

The nurse caring for a client taking digoxin

what should the nurse monitor .

Answer 22

a. potassium level
b. digoxin level
c. renal function

Question 23

What is true concerning DigiFab?.

Answer 23

b. The client should be on premedication with an antihistamine, if unsure about allergies.
c. The client should be tested for hypersensitivity to sheep.
e. The medication is for use in clinically significant digoxin toxicity.
f. The medication is prescribed in mg doses or the number of digoxin immune vials to be given.

Question 24

What is true concerning dobutamine HCl? Select all that apply.

Answer 24

a. It is a vasopressor.
b. It strengthens myocardial contractions.
d. It is administered IV only.
e. It has an onset time of 1 to 2 minutes with peak effect up to 10 minutes.

Question 25

The nurse teaching a client home administration of digoxin will include which of the following in the teaching plan?

Answer 25

Manufacturing differences can affect serum drug levels when switching brands.

Question 26

When monitoring a client taking quinidine, the nurse assesses for manifestations of:

Answer 26

tinnitus and vertigo

Question 27

The nurse is caring for a cardiac client who has developed a lupus erythematosus-like syndrome. The nurse anticipates that the client is taking:

Answer 27

procainamide

Question 28

For the client taking a cardiac glycoside, the nurse should monitor for:

Answer 28

bradycardia. Because a cardiac glycoside slows and strengthens the heart rate, bradycardia is the most common adverse effect.

Question 29

A drug that exerts a positive inotropic effect will

Answer 29

increase the force of contraction of the heart.

Question 30

The nurse understands that the primary pacemaker of the heart is the:

Answer 30

SA node. The sinoatrial node is the pacemaker of the heart.

Question 31

The client receiving intravenous dopamine has an infiltration at the IV site. The nurse prepares to administer which of the following to prevent tissue necrosis?

Answer 31

phentolamine

Question 32

The nurse understands that under normal circumstances digoxin exerts which of the following effects?

Answer 32

negative chronotropic; negative dromotropic; positive inotropic
Digoxin slows heart rate (negative chronotropic) and impulse conduction (negative dromotropic) and strengthens contractility (positive inotropic) of the heart.

Question 33

The nurse is caring for a client with potentially life-threatening digoxin toxicity and prepares to administer:

Answer 33

digoxin immune fab.