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Pharmacology > UNIT 3 POST TEST > Flashcards

UNIT 3 POST TEST Flashcards

1
Q

The primary treatment for heart failure (HF) is ___________.

A. Increasing the heart rate so the heart can pump more blood
B. Decreasing the heart rate so the heart can rest
C. Increasing contractility so the heart will be able to pump more blood
D. Decreasing contractility to prevent muscle fatigue

A

Increasing contractility so the heart will be able to pump more blood

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2
Q

The most common cause of HF is ______________.

A. Hypertension
B. Valvular heart diseases
C. Cardiomyopathy
D. Coronary artery disease (CAD)

A

Coronary artery disease (CAD)

It accounts for 95% of HF cases. CAD results to insufficient supply of blood in the heart. This leads to hypoxia and loss of function of heart muscles.

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3
Q

Digoxin was prescribed to a patient with ventricular tachycardia. What should the nurse do?

A. Administer the drug as ordered.
B. Discuss the order with the doctor.
C. Discontinue other intravenous medications before administering digoxin.
D. Count apical pulse for one full minute before administering.

A

Discuss the order with the doctor.

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4
Q

What is the antidote for digoxin intoxication?

A. Diphenhydramine
B. Atropine sulfate
C. Digoxin immune fab (Digibind, DigiFab).
D. Phosphodiesterase inhibitors

A

Digoxin immune fab (Digibind, DigiFab).

Digoxin Immune Fab or DigiFab, DigiBind should be administered for serum digoxin levels of >10 ng/mL and serum potassium level of >5 mEq/mL.

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5
Q

An infant who is receiving cardiac glycosides has an apical pulse of 80 beats per minute. Which is the best nursing intervention for this assessment finding?

A. Administer drug as ordered.
B. Withdraw the drug and notify doctor.
C. Assess apical pulse every hour for the next five hours.
D. Decrease drug dose and administer.

A

Withdraw the drug and notify doctor.

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6
Q

What signals the novice nurse that intravenous milrinone was combined to furosemide in management of patients with heart failure?

A. Presence of bubbles
B. Pink discoloration of the solution
C. Formation of precipitates
D. No obvious sign. Solution is clear.

A

Formation of precipitates

Phosphodiesterase inhibitor-furosemide combination should be avoided. Alternate lines should be used if both of these drugs are given intravenously.

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7
Q

What signals the novice nurse that intravenous milrinone was combined to furosemide in management of patients with heart failure?

A. Presence of bubbles
B. Pink discoloration of the solution
C. Formation of precipitates
D. No obvious sign. Solution is clear.

A

Formation of precipitates

Phosphodiesterase inhibitor-furosemide combination should be avoided. Alternate lines should be used if both of these drugs are given intravenously.

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8
Q

In severe cardiac glycoside toxicity, all of the following should be in the bedside, except _________.

A. Lidocaine
B. Phenytoin
C. Calcium channel blocker
D. A and B only

A

Calcium channel blocker

Lidocaine and potassium salts are used to treat arrhythmias. Phenytoin is for the treatment of seizures. Other medications and equipment at the bedside include atropine for treatment of increased heart rate, and a cardiac monitor.

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9
Q

What is the therapeutic level for digoxin?
1/1
A. 0.5-2 ng/mL
B. 1.5-2 ng/mL
C. 0.5-1.5 mg/mL
D. 0.5-2 mg/mL

A

0.5-2 ng/mL

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10
Q

Type of angina which involves spasm of the blood vessels

A. Stable angina
B. Pre-infarction angina
C. Unstable angina
D. Prinzmetal angina

A

Prinzmetal angina

It is an unusual type of angina that involves the spasm of blood vessels and not just by narrowing of vessels. Person with prinzmetal angina has angina at rest and associated ECG changes.

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11
Q

Contraction and relaxation in each cardiac cycle is controlled by

A. autonomic nervous system
B. the heart
C. cranial nerves
D. central nervous system

A

the heart

Contraction and relaxation is controlled by impulses arising spontaneously in the SA node and transmitted via a specialized conducting system to activate all parts of the muscle almost simultaneously. These rhythmic and continuous contractions are controlled by the heart itself.

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12
Q

All of the following can cause arrhythmia, except:

A. acidosis
B. respiratory depression
C. hyperkalemia
D. none of the above

A

none of the above

Electrolyte disturbances, hypoxic conditions, acidosis or accumulation of waste products, and structural damage of the conduction system can lead to arrhythmia.

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13
Q

Verapamil and diltiazem belong to which class of antiarrhythmic?
A. Class IV
B. Class III
C. Class Ia
D. Class II

A

Class IV

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14
Q

The conduction system of the heart include the following:

A. Sinoatrial node
B. Bundle of Purkinje
C. His Fibers
D. Atriomyocardial node

A

Sinoatrial node

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15
Q

The phase of cardiac muscle cell action potential characterized by calcium entering the cell and potassium leaving the cell.

A. Phase 1
B. Phase 2
C. Phase 3
D. Phase 4

A

Phase 2

It is also called as plateau stage. Calcium enters the cell and potassium leaves it as it becomes less permeable to sodium. Phase 1 is when sodium level becomes equal inside and outside the cell. Phase 3 is also called rapid repolarization stage, where sodium gates are already closed and potassium flows out of the cell. Phase 4 occurs when the cell comes to rest.

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16
Q

Beta-adrenergic blockers belong to which class of antiarrhythmic?

A. Class Ia
B. Class Ib
C. Class II
D. Class IV

A

Class Ib

17
Q

Which class of antiarrhythmics blocks potassium channels?

A. Class Ia
B. Class IV
C. Class Ib
D. Class III

A

Class III

18
Q

This is the preferred antiarrhythmic in Advanced Cardiac Life Support protocol.

A. ibutilide (Corvert)
B. propranolol (Inderal)
C. procainamide (Pronestyl)
D. amiodarone (Cordarone)

A

amiodarone (Cordarone)

Within the framework of ACLS, amiodarone is used primarily to treat ventricular fibrillation and ventricular tachycardia that occurs during cardiac arrest and is unresponsive to shock delivery, CPR, and vasopressors.
Amiodarone should only be used after defibrillation/cardioversion and first line drugs such as epinephrine and vasopressin have failed to convert VT/VF.
Amiodarone should not be used in individuals with polymorphic VT as it associated with a prolonged QT interval which is made worse with antiarrhythmic drugs.
The maximum cumulative dose in a 24 hour period should not exceed 2.2 grams.

19
Q

What is the difference between Class Ia and Ib antiarrhythmic?

A. Ia depresses phase 0 and Ib depressed phase I.
B. Ia shortens the duration of action potential and Ib prolongs the duration of action potential.
C. Ia prolongs the duration of action potential and Ib shortens the duration of action potential.
D. Ia extremely slows down conduction and Ib has no effect on conduction.

A

Ia prolongs the duration of action potential and Ib shortens the duration of action potential.

20
Q

A patient who is receiving quinidine should avoid the following foods, except:

A. skim milk
B. broccoli
C. Both A and B
D. none of the above

A

C. Both A and B

21
Q

The drug of choice for treatment of supraventricular tachycardia associated with Wolff-Parkinson-White syndrome.

A. adenosine
B. verapamil
C. digoxin
D. lidocaine

A

adenosine

22
Q

Lipid levels of individuals with coronary artery disease (CAD) is usually high. All of the following are factors of CAD, except:

A. Men
B. Gout
C. Untreated Chlamydia infections
D. None of the above

A

D. None of the above

The incidence of CAD in men is higher than premenopausal women. Gout injures the blood vessels because of accumulation of uric acid. Untreated bacterial infections can also contribute to CAD.

23
Q

Antihyperlipidemic agent that is used to decrease plasma cholesterol levels.

A. HMG-CoA reductase inhibitors
B. Phosphodiesterase inhibitors
C. Bile acid sequestrants
D. Cholesterol absorption inhibitor

A

Bile acid sequestrants

Bile acid contains a lot of cholesterol and bile acid sequestrants bind to them to form an insoluble complex that is then excreted in the feces.

24
Q

A pregnant woman needs a lipid-lowering agent. What would be the best class of lipid-lowering agent for pregnant women?
A. HMG-CoA reductase inhibitors
B. Bile acid sequestrants
C. Cholesterol absorption inhibitors
D. Phosphodiesterase inhibitors

A

Bile acid sequestrants

25
Q

The only statin with outcome data to show effectiveness in decreasing CAD and incidence of myocardial infarction.
A. atorvastatin (Lipitor)
B. simvastatin (Zocor)
C. pravastatin (Pravachol)
D. fluvastatin (Lescol)

A

pravastatin (Pravachol)

Pravastatin is an HMG-CoA reductase inhibitor that can prevent first MI even in patients who do not have documented increase in cholesterol concentration.

26
Q

Which of the following medical conditions will render antihyperlipidemics ineffective?

A. biliary obstruction
B. diabetes mellitus
C. both A and B
D. none of the above

A

biliary obstruction

This condition can interfere with the mechanism of action of the drug, thereby reducing its effectiveness.

27
Q

This drug works on the brush border of the intestines.

A. ezetimibe
B. pitavastatin
C. gemfibrozil
D. colestipol

A

ezetimibe

It belongs to cholesterol absorption inhibitor class and by acting on the brush border of the intestines, absorption of cholesterol is not allowed.

28
Q

A patient who is taking a bile acid sequestrant complains of abdominal distention and nausea. What should the nurse do?

A. Document, withdraw drug, and notify doctor.
B. Provide comfort measures.
C. Prepare emergency equipment at bedside.
D. Dismiss the complaint.

A

Provide comfort measures.

GI discomforts as evidenced by abdominal distention, nausea, and vomiting are common complaints by patients taking bile acid sequestrants. The nurse should provide comfort measures to help patients tolerate drug effects.

29
Q

What vitamin plays a role in lowering cholesterol concentration?

A. Vitamin C
B. Vitamin E
C. Vitamin B3
D. Vitamin B2

A

. Vitamin B3 Niacin is used as a treatment for hyperlipidemia that does not respond to diet and weight loss.

30
Q

When should statins be taken to maximize its therapeutic effects?

A. After meals
B. During meals
C. At night
D. In the mornings

A

At night

It is when the liver is processing the most lipids (midnight to 5 AM).

31
Q

The doctor ordered atorvastatin for an obese client’s hyperlipidemia. This patient is receiving erythromycin for a toe infection at the same time. The nurse knows that this combination should be avoided because?

A. It increases risk of atorvastatin toxicity.
B. It can result to potentially fatal lipolysis.
C. It can result to breakdown of muscles.
D. It decreases the effectiveness of erythromycin.

A

B. It can result to potentially fatal lipolysis.

32
Q

Which organ(s) produce(s) clotting factors?

A. Bone marrow
B. Spleen and other lymphoid tissues
C. Liver
D. Both B and C

A

. Liver

The liver produces a cascade of clotting factors that contributes to the process of coagulation by breaking down fibrinogen into insoluble fibrin threads.

33
Q

What is the first reaction to a blood vessel injury?

A. Vasodilation and swelling
B. Vasoconstriction
C. Bleeding
D. Blood coagulation

A

Vasoconstriction

This is especially helpful for very small injuries to the blood vessel because vasoconstriction can seal off any break and allow the area to heal.

34
Q

Which of the following substances will alert the nurse for an increased risk of bleeding in a patient taking clopidogrel?

A. Chamomile tea
B. Orange juice
C. Candied mushrooms
D. Peanuts

A

Chamomile tea

Increased bleeding with no other cause or link found should lead to the possibility of herbal interactions with drugs. Other herbal sources that can increase the risk of bleeding in patients taking anticoagulants include psyllium, turmeric, garlic, ginkgo, chestnut seed, and goldenseal.

35
Q

When administering oral iron tablets, the nurse should keep in mind that the most appropriate substance, other than water, to give with these tablets is

a pudding.
b an antacid.
c milk.
d orange juice.

A

orange juice.

36
Q

The nurse is teaching a patient about oral iron supplements. Which statement is correct?
a “You need to take this medication on an empty stomach or else it won’t be absorbed.”
b“It is better absorbed on an empty stomach, but if that causes your stomach to be upset, you can take it with food.”
c“Take this medication with a sip of water, and then lie down to avoid problems with low blood pressure.”
d“If you have trouble swallowing the tablet, you may crush it

A

“It is better absorbed on an empty stomach, but if that causes your stomach to be upset, you can take it with food.”

Pharmacology (12 decks)

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