Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 29

Question 1 Type: MCSA The nurse is teaching a class on rhythm abnormalities to patients who have experienced dysrhythmias. The nurse knows that teaching has been effective when a patient makes which statement? 1. !ysrhythmias cause serious electrolyte imbalances" this results in heart block. 2. !ysrhythmias are the result of long#standing$ uncontrolled hypertension. 3. !ysrhythmias interrupt the normal electrical pathways in the heart so it can%t beat properly. 4. !ysrhythmias alter the blood flow through the heart and cause it to stop beating. Correct Answer: & ationa!e 1' All dysrhythmias cause a defect in the generation or conduction of electrical impulses across the myocardium. (ack of synchroni)ation of the atria and ventricles may have profound conse*uences such as decreasing cardiac output. !ysrhythmias do not alter blood flow through the heart. Some dysrhythmias may result in heart block$ but dysrhythmias do not cause electrolyte imbalances. !ysrhythmias do not result from hypertension. ationa!e 2' All dysrhythmias cause a defect in the generation or conduction of electrical impulses across the myocardium. (ack of synchroni)ation of the atria and ventricles may have profound conse*uences such as decreasing cardiac output. !ysrhythmias do not alter blood flow through the heart. Some dysrhythmias may result in heart block$ but dysrhythmias do not cause electrolyte imbalances. !ysrhythmias do not result from hypertension. ationa!e 3' All dysrhythmias cause a defect in the generation or conduction of electrical impulses across the myocardium. (ack of synchroni)ation of the atria and ventricles may have profound conse*uences such as decreasing cardiac output. !ysrhythmias do not alter blood flow through the heart. Some dysrhythmias may result in heart block$ but dysrhythmias do not cause electrolyte imbalances. !ysrhythmias do not result from hypertension. ationa!e 4' All dysrhythmias cause a defect in the generation or conduction of electrical impulses across the myocardium. (ack of synchroni)ation of the atria and ventricles may have profound conse*uences such as decreasing cardiac output. !ysrhythmias do not alter blood flow through the heart. Some dysrhythmias may result in heart block$ but dysrhythmias do not cause electrolyte imbalances. !ysrhythmias do not result from hypertension. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' /valuation &earnin$ *utcome: 04#2 Question 2 Type: MCMA The patient tells the nurse$ This educational video you gave me shows normal electrical conduction through the heart$ but , still don%t understand it. Can you explain it to me? 5hat is 6are7 the nurse%s best response6s7? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. Conduction through the bundle of 8is is the slowest in the heart. 2. Conduction begins in the sinoatrial 6SA7 node and travels to the atrioventricular 6A97 node. 3. Conduction continues through the bundle branches to the +urkin:e fibers. 4. Conduction travels from the atrioventricular 6A97 node through the bundle of 8is. ,. The sinoatrial 6SA7 node is located in the left atrium. Correct Answer: 0$&$ationa!e 1' Conduction through the heart originates in the sinoatrial 6SA7 node$ travels through the atrioventricular 6A97 node through the bundle of 8is to the right and left bundle branches to the +urkin:e fibers. Conduction through the atrioventricular 6A97 node is the slowest in the heart. The sinoatrial 6SA7 node is located in the right atrium. ationa!e 2' Conduction through the heart originates in the sinoatrial 6SA7 node$ travels through the atrioventricular 6A97 node through the bundle of 8is to the right and left bundle branches to the +urkin:e fibers. Conduction through the atrioventricular 6A97 node is the slowest in the heart. The sinoatrial 6SA7 node is located in the right atrium. ationa!e 3' Conduction through the heart originates in the sinoatrial 6SA7 node$ travels through the atrioventricular 6A97 node through the bundle of 8is to the right and left bundle branches to the +urkin:e fibers. Conduction through the atrioventricular 6A97 node is the slowest in the heart. The sinoatrial 6SA7 node is located in the right atrium. ationa!e 4' Conduction through the heart originates in the sinoatrial 6SA7 node$ travels through the atrioventricular 6A97 node through the bundle of 8is to the right and left bundle branches to the +urkin:e fibers. Conduction through the atrioventricular 6A97 node is the slowest in the heart. The sinoatrial 6SA7 node is located in the right atrium. ationa!e ,' Conduction through the heart originates in the sinoatrial 6SA7 node$ travels through the atrioventricular 6A97 node through the bundle of 8is to the right and left bundle branches to the +urkin:e fibers.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

Conduction through the atrioventricular 6A97 node is the slowest in the heart. The sinoatrial 6SA7 node is located in the right atrium. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' ,mplementation &earnin$ *utcome: 04#0 Question 3 Type: MCMA The patient tells the nurse$ My doctor says , have atrial fibrillation. ,s this serious and how is it treated? 5hat is 6are7 the best response6s7 by the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. This condition is best treated with what we call antidysrhythmic drugs. 2. This is very common" your doctor will discuss the best treatment with you. 3. !epending upon your symptoms$ your doctor may use an electrical shock. 4. This is *uite serious" did your doctor mention a heart transplant? ,. ,t is very serious$ even more serious than a ventricular dysrhythmia. Correct Answer: 0$& ationa!e 1' Atrial fibrillation is the most common type of dysrhythmia. The physician will determine whether to use nonpharmalogical techni*ues such as cardioversion$ or an implantable cardioverter defibrillator 6,C!7$ or medication. Medications can cause serious side effects and are normally reserved for patients with overt symptoms$ or for patients whose condition cannot be controlled by other means. 9entricular dysrhythmias are more serious than atrial dysrhythmias because they are more likely to interfere with the normal function of the heart. 8eart transplants are not indicated for patients with dysrhythmias. ationa!e 2' Atrial fibrillation is the most common type of dysrhythmia. The physician will determine whether to use nonpharmalogical techni*ues such as cardioversion$ or an implantable cardioverter defibrillator 6,C!7$ or medication. Medications can cause serious side effects and are normally reserved for patients with overt symptoms$ or for patients whose condition cannot be controlled by other means. 9entricular dysrhythmias are more serious than atrial dysrhythmias because they are more likely to interfere with the normal function of the heart. 8eart transplants are not indicated for patients with dysrhythmias.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

ationa!e 3' Atrial fibrillation is the most common type of dysrhythmia. The physician will determine whether to use nonpharmalogical techni*ues such as cardioversion$ or an implantable cardioverter defibrillator 6,C!7$ or medication. Medications can cause serious side effects and are normally reserved for patients with overt symptoms$ or for patients whose condition cannot be controlled by other means. 9entricular dysrhythmias are more serious than atrial dysrhythmias because they are more likely to interfere with the normal function of the heart. 8eart transplants are not indicated for patients with dysrhythmias. ationa!e 4' Atrial fibrillation is the most common type of dysrhythmia. The physician will determine whether to use nonpharmalogical techni*ues such as cardioversion$ or an implantable cardioverter defibrillator 6,C!7$ or medication. Medications can cause serious side effects and are normally reserved for patients with overt symptoms$ or for patients whose condition cannot be controlled by other means. 9entricular dysrhythmias are more serious than atrial dysrhythmias because they are more likely to interfere with the normal function of the heart. 8eart transplants are not indicated for patients with dysrhythmias. ationa!e ,' Atrial fibrillation is the most common type of dysrhythmia. The physician will determine whether to use nonpharmalogical techni*ues such as cardioversion$ or an implantable cardioverter defibrillator 6,C!7$ or medication. Medications can cause serious side effects and are normally reserved for patients with overt symptoms$ or for patients whose condition cannot be controlled by other means. 9entricular dysrhythmias are more serious than atrial dysrhythmias because they are more likely to interfere with the normal function of the heart. 8eart transplants are not indicated for patients with dysrhythmias. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' ,mplementation &earnin$ *utcome: 04#& Question 4 Type: MCSA The nurse has been teaching a class on dysrhythmias to a group of patients with this disorder. The nurse determines that teaching has been effective when a patient makes which statement? 1. ;ur sodium$ potassium$ and magnesium levels must be okay for our hearts to have an electrical impulse. 2. +otassium is the most important electrolyte when it comes to the electrical impulse in our hearts. 3. ;ur sodium$ potassium$ and calcium levels must be okay for our hearts to have an electrical impulse. 4. /nhancing potassium and sodium is how our medications will work to prevent dysrhythmias. Correct Answer: & ationa!e 1' Changes in sodium$ potassium$ and calcium levels generate the action potential in myocardial cells. <or this to occur$ the patient must have normal levels of sodium$ potassium$ and calcium. Changes in sodium$ potassium$ and calcium$ not magnesium$ levels generate the action potential in myocardial cells. Antidysrhythmic
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

drugs work by blocking$ not enhancing$ potassium$ sodium$ or calcium channels. Sodium$ potassium$ and calcium are e*ually important when it comes to the myocardial action potential. ationa!e 2' Changes in sodium$ potassium$ and calcium levels generate the action potential in myocardial cells. <or this to occur$ the patient must have normal levels of sodium$ potassium$ and calcium. Changes in sodium$ potassium$ and calcium$ not magnesium$ levels generate the action potential in myocardial cells. Antidysrhythmic drugs work by blocking$ not enhancing$ potassium$ sodium$ or calcium channels. Sodium$ potassium$ and calcium are e*ually important when it comes to the myocardial action potential. ationa!e 3' Changes in sodium$ potassium$ and calcium levels generate the action potential in myocardial cells. <or this to occur$ the patient must have normal levels of sodium$ potassium$ and calcium. Changes in sodium$ potassium$ and calcium$ not magnesium$ levels generate the action potential in myocardial cells. Antidysrhythmic drugs work by blocking$ not enhancing$ potassium$ sodium$ or calcium channels. Sodium$ potassium$ and calcium are e*ually important when it comes to the myocardial action potential. ationa!e 4' Changes in sodium$ potassium$ and calcium levels generate the action potential in myocardial cells. <or this to occur$ the patient must have normal levels of sodium$ potassium$ and calcium. Changes in sodium$ potassium$ and calcium$ not magnesium$ levels generate the action potential in myocardial cells. Antidysrhythmic drugs work by blocking$ not enhancing$ potassium$ sodium$ or calcium channels. Sodium$ potassium$ and calcium are e*ually important when it comes to the myocardial action potential. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' /valuation &earnin$ *utcome: 04#Question , Type: MCSA The patient asks the nurse$ My doctor said , need cardioversion for my dysrhythmia. 5hy can%t , :ust take medication? 5hat is the nurse%s best response? 1. Antidysrhythmic medications have many side effects" cardioversion is considered safer. 2. Special diets are necessary with antidysrhythmic medications and they are hard to follow. 3. Antidysrhythmic medications don%t really work very well for most dysrhythmias. 4. There is a high risk of sei)ures when you take antidysrhythmic medications. Correct Answer: 2 ationa!e 1' Antidysrhythmic medications can cause serious side effects and are normally reserved for patients with overt symptoms$ or for patients whose condition cannot be controlled by other means$ such as cardioversion. Medications are effective for dysrhythmias" however they have many side effects. There is no indication for a
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

special diet when a patient is taking an antidysrhythmic drug. Antidysrhythmic drugs do not commonly cause sei)ures. ationa!e 2' Antidysrhythmic medications can cause serious side effects and are normally reserved for patients with overt symptoms$ or for patients whose condition cannot be controlled by other means$ such as cardioversion. Medications are effective for dysrhythmias" however they have many side effects. There is no indication for a special diet when a patient is taking an antidysrhythmic drug. Antidysrhythmic drugs do not commonly cause sei)ures. ationa!e 3' Antidysrhythmic medications can cause serious side effects and are normally reserved for patients with overt symptoms$ or for patients whose condition cannot be controlled by other means$ such as cardioversion. Medications are effective for dysrhythmias" however they have many side effects. There is no indication for a special diet when a patient is taking an antidysrhythmic drug. Antidysrhythmic drugs do not commonly cause sei)ures. ationa!e 4' Antidysrhythmic medications can cause serious side effects and are normally reserved for patients with overt symptoms$ or for patients whose condition cannot be controlled by other means$ such as cardioversion. Medications are effective for dysrhythmias" however they have many side effects. There is no indication for a special diet when a patient is taking an antidysrhythmic drug. Antidysrhythmic drugs do not commonly cause sei)ures. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' ,mplementation &earnin$ *utcome: 04#= Question Type: MCSA The patient says to the nurse$ My neighbor said my antidysrhythmic drug can actually cause me to have irregular heartbeats. 8ow can this be? 5hat is the nurse%s best answer? 1. >our medication blocks the flow of the electrolytes in your heart$ and this can cause irregular beats. 2. ,t is better to discuss you medication concerns with a professional$ not a lay person like your neighbor. 3. >ou must take two baby aspirins every other day to avoid the irregular heartbeats. 4. >our medication is not the problem" it is when you mix it with over#the#counter 6;TC7 drugs that you develop irregular beats. Correct Answer: 2 ationa!e 1' Most antidysrhythmic drugs act by interfering with myocardial action potentials$ blocking the action of sodium$ potassium$ and calcium channels and causing some irregular beats. Mixing the medication with over#
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

the#counter 6;TC7 medications might result in irregular beats$ but this is not the best answer. Anticoagulant medication is sometimes indicated$ but it does not re*uire taking two doses of baby aspirin. Although it is best to discuss medications with a professional$ this response does not answer the patient%s *uestion. ationa!e 2' Most antidysrhythmic drugs act by interfering with myocardial action potentials$ blocking the action of sodium$ potassium$ and calcium channels and causing some irregular beats. Mixing the medication with over# the#counter 6;TC7 medications might result in irregular beats$ but this is not the best answer. Anticoagulant medication is sometimes indicated$ but it does not re*uire taking two doses of baby aspirin. Although it is best to discuss medications with a professional$ this response does not answer the patient%s *uestion. ationa!e 3' Most antidysrhythmic drugs act by interfering with myocardial action potentials$ blocking the action of sodium$ potassium$ and calcium channels and causing some irregular beats. Mixing the medication with over# the#counter 6;TC7 medications might result in irregular beats$ but this is not the best answer. Anticoagulant medication is sometimes indicated$ but it does not re*uire taking two doses of baby aspirin. Although it is best to discuss medications with a professional$ this response does not answer the patient%s *uestion. ationa!e 4' Most antidysrhythmic drugs act by interfering with myocardial action potentials$ blocking the action of sodium$ potassium$ and calcium channels and causing some irregular beats. Mixing the medication with over# the#counter 6;TC7 medications might result in irregular beats$ but this is not the best answer. Anticoagulant medication is sometimes indicated$ but it does not re*uire taking two doses of baby aspirin. Although it is best to discuss medications with a professional$ this response does not answer the patient%s *uestion. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' ,mplementation &earnin$ *utcome: 04#? Question . Type: MCSA The nurse is managing care for a group of patients receiving antidysrhythmic medication. 5hich assessment data will the nurse report to the physician? 1. !epression$ irritability$ fatigue$ and nausea 2. Anorexia$ insomnia$ confusion$ and 22 pitting peripheral edema 3. (ow#grade fever$ diaphoresis$ weakness$ and dry mucous membranes 4. +alpitations$ chest pain$ weakness$ and fatigue Correct Answer: ationa!e 1' Side effects of antidysrhythmic medications include palpitations$ chest pain$ weakness$ and fatigue. (ow#grade fever$ diaphoresis$ weakness$ and dry mucous membranes are not side effects of antidysrhythmic
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

medications. Anorexia$ insomnia$ confusion$ and 22 pitting peripheral edema are not side effects of antidysrhythmic medications. !epression$ irritability$ fatigue$ and nausea are not side effects of antidysrhythmic medications. ationa!e 2' Side effects of antidysrhythmic medications include palpitations$ chest pain$ weakness$ and fatigue. (ow#grade fever$ diaphoresis$ weakness$ and dry mucous membranes are not side effects of antidysrhythmic medications. Anorexia$ insomnia$ confusion$ and 22 pitting peripheral edema are not side effects of antidysrhythmic medications. !epression$ irritability$ fatigue$ and nausea are not side effects of antidysrhythmic medications. ationa!e 3' Side effects of antidysrhythmic medications include palpitations$ chest pain$ weakness$ and fatigue. (ow#grade fever$ diaphoresis$ weakness$ and dry mucous membranes are not side effects of antidysrhythmic medications. Anorexia$ insomnia$ confusion$ and 22 pitting peripheral edema are not side effects of antidysrhythmic medications. !epression$ irritability$ fatigue$ and nausea are not side effects of antidysrhythmic medications. ationa!e 4' Side effects of antidysrhythmic medications include palpitations$ chest pain$ weakness$ and fatigue. (ow#grade fever$ diaphoresis$ weakness$ and dry mucous membranes are not side effects of antidysrhythmic medications. Anorexia$ insomnia$ confusion$ and 22 pitting peripheral edema are not side effects of antidysrhythmic medications. !epression$ irritability$ fatigue$ and nausea are not side effects of antidysrhythmic medications. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' Assessment &earnin$ *utcome: 04#@ Question / Type: MCSA The patient is receiving procainamide hydrochloride 6+ronestyl7 for treatment of a dysrhythmia. 5hat is the best patient outcome for medication compliance? 1. The patient will take his medication with food. 2. The patient will take his medication on an empty stomach. 3. The patient will take his medication as directed$ even if he is feeling well. 4. The patient will monitor his pulse and hold his medication if his pulse is less than ?1. Correct Answer: & ationa!e 1' ,t is very important for patients to understand that medication must be taken as directed$ even if the patient is feeling well. +rocainamide hydrochloride 6+ronestyl7 drug can be taken on an empty stomach. The beta#
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

adrenergic blocking drugs cause bradycardia$ not Aroup 2A cardiac antiarrhythmic drugs like procainamide hydrochloride 6+ronestyl7. +rocainamide hydrochloride 6+ronestyl7 can be taken with food. ationa!e 2' ,t is very important for patients to understand that medication must be taken as directed$ even if the patient is feeling well. +rocainamide hydrochloride 6+ronestyl7 drug can be taken on an empty stomach. The beta# adrenergic blocking drugs cause bradycardia$ not Aroup 2A cardiac antiarrhythmic drugs like procainamide hydrochloride 6+ronestyl7. +rocainamide hydrochloride 6+ronestyl7 can be taken with food. ationa!e 3' ,t is very important for patients to understand that medication must be taken as directed$ even if the patient is feeling well. +rocainamide hydrochloride 6+ronestyl7 drug can be taken on an empty stomach. The beta# adrenergic blocking drugs cause bradycardia$ not Aroup 2A cardiac antiarrhythmic drugs like procainamide hydrochloride 6+ronestyl7. +rocainamide hydrochloride 6+ronestyl7 can be taken with food. ationa!e 4' ,t is very important for patients to understand that medication must be taken as directed$ even if the patient is feeling well. +rocainamide hydrochloride 6+ronestyl7 drug can be taken on an empty stomach. The beta# adrenergic blocking drugs cause bradycardia$ not Aroup 2A cardiac antiarrhythmic drugs like procainamide hydrochloride 6+ronestyl7. +rocainamide hydrochloride 6+ronestyl7 can be taken with food. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' +lanning &earnin$ *utcome: 04#B Question 9 Type: MCSA The male patient has been receiving propranolol 6,nderal7 for treatment of a dysrhythmia for ? weeks. 5hat is an important *uestion for the nurse to ask the patient when assessing medication compliance? 1. 8ave you noticed any changes in your sexual functioning? 2. 8as your appetite increased or decreased? 3. 8ave you noticed any changes in your bowel function? 4. 8ave you noticed any difficulty in your ability to concentrate? Correct Answer: 2 ationa!e 1' Side effects such as diminished libido and impotence may result in noncompliance in male patients. Change in bowel function is not an adverse effect of propranolol 6,nderal7. Appetite is not affected by propranolol 6,nderal7. Ability to concentrate is not an adverse effect of propranolol 6,nderal7 except in the elderly who are receiving high doses.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

ationa!e 2' Side effects such as diminished libido and impotence may result in noncompliance in male patients. Change in bowel function is not an adverse effect of propranolol 6,nderal7. Appetite is not affected by propranolol 6,nderal7. Ability to concentrate is not an adverse effect of propranolol 6,nderal7 except in the elderly who are receiving high doses. ationa!e 3' Side effects such as diminished libido and impotence may result in noncompliance in male patients. Change in bowel function is not an adverse effect of propranolol 6,nderal7. Appetite is not affected by propranolol 6,nderal7. Ability to concentrate is not an adverse effect of propranolol 6,nderal7 except in the elderly who are receiving high doses. ationa!e 4' Side effects such as diminished libido and impotence may result in noncompliance in male patients. Change in bowel function is not an adverse effect of propranolol 6,nderal7. Appetite is not affected by propranolol 6,nderal7. Ability to concentrate is not an adverse effect of propranolol 6,nderal7 except in the elderly who are receiving high doses. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' Assessment &earnin$ *utcome: 04#21 Question 10 Type: MCSA The patient with type 2 diabetes mellitus is receiving propranolol 6,nderal7. 5hat is the best outcome for this patient? 1. The patient will maintain blood glucose within normal limits. 2. The patient will decrease the re*uired number of calories.day. 3. The patient will maintain ade*uate peripheral circulation. 4. The patient will perform activities of daily living. Correct Answer: 2 ationa!e 1' +ropranolol 6,nderal7 should be used cautiously in patients with type 2 diabetes mellitus due to its hypoglycemic effects. +eripheral circulation should not be affected by propranolol 6,nderal7. Activities of daily living are important for any patient$ but should not be affected by propranolol 6,nderal7. +ropranolol 6,nderal7 should not affect the patient%s appetite" the patient should not decrease calories. ationa!e 2' +ropranolol 6,nderal7 should be used cautiously in patients with type 2 diabetes mellitus due to its hypoglycemic effects. +eripheral circulation should not be affected by propranolol 6,nderal7. Activities of daily living are important for any patient$ but should not be affected by propranolol 6,nderal7. +ropranolol 6,nderal7 should not affect the patient%s appetite" the patient should not decrease calories.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

ationa!e 3' +ropranolol 6,nderal7 should be used cautiously in patients with type 2 diabetes mellitus due to its hypoglycemic effects. +eripheral circulation should not be affected by propranolol 6,nderal7. Activities of daily living are important for any patient$ but should not be affected by propranolol 6,nderal7. +ropranolol 6,nderal7 should not affect the patient%s appetite" the patient should not decrease calories. ationa!e 4' +ropranolol 6,nderal7 should be used cautiously in patients with type 2 diabetes mellitus due to its hypoglycemic effects. +eripheral circulation should not be affected by propranolol 6,nderal7. Activities of daily living are important for any patient$ but should not be affected by propranolol 6,nderal7. +ropranolol 6,nderal7 should not affect the patient%s appetite" the patient should not decrease calories. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' +lanning &earnin$ *utcome: 04#B Question 11 Type: MCSA The nurse completes medication education with a patient who receives propranolol 6,nderal7. The nurse evaluates the education as effective when the patient makes which statement? 1. C, must take my pulse every day and call my doctor if it is higher than 211. 2. , must call my doctor if my anxiety increases and , start worrying again. 3. , must take my pulse every day and call my doctor if it is less than ?1. 4. , must call my doctor if , lose more than three pounds a week. Correct Answer: & ationa!e 1' Deta blockers decrease contractions of the myocardium and decrease the speed of conduction through the atrioventricular 6A97 node. This can result in a significant decrease in heart rate$ and the patient should let the physician know if his heart rate falls below ?1. Deta blockers decrease$ not increase$ the heart rate. Deta blockers predispose the patient to weight gain$ not weight loss. Deta blockers actually decrease$ not increase$ anxiety. ationa!e 2' Deta blockers decrease contractions of the myocardium and decrease the speed of conduction through the atrioventricular 6A97 node. This can result in a significant decrease in heart rate$ and the patient should let the physician know if his heart rate falls below ?1. Deta blockers decrease$ not increase$ the heart rate. Deta blockers predispose the patient to weight gain$ not weight loss. Deta blockers actually decrease$ not increase$ anxiety. ationa!e 3' Deta blockers decrease contractions of the myocardium and decrease the speed of conduction through the atrioventricular 6A97 node. This can result in a significant decrease in heart rate$ and the patient
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

should let the physician know if his heart rate falls below ?1. Deta blockers decrease$ not increase$ the heart rate. Deta blockers predispose the patient to weight gain$ not weight loss. Deta blockers actually decrease$ not increase$ anxiety. ationa!e 4' Deta blockers decrease contractions of the myocardium and decrease the speed of conduction through the atrioventricular 6A97 node. This can result in a significant decrease in heart rate$ and the patient should let the physician know if his heart rate falls below ?1. Deta blockers decrease$ not increase$ the heart rate. Deta blockers predispose the patient to weight gain$ not weight loss. Deta blockers actually decrease$ not increase$ anxiety. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' /valuation &earnin$ *utcome: 04#4 Question 12 Type: MCSA The patient receives amiodarone 6Cordarone7. The nurse would be concerned about which additional medication that a consulting physician might order? 1. ;xycodone 6;xyContin7 2. ;mepra)ole 6+rilosec7 3. !igoxin 6(anoxin7 4. <luoxetine 6+ro)ac7 Correct Answer: & ationa!e 1' Amiodarone 6Cordarone7 can increase serum digoxin 6(anoxin7 levels by as much as @1E$ resulting in digoxin 6(anoxin7 toxicity. ;xycodone 6;xyContin7 has no interactions with amiodarone 6Cordarone7. <luoxetine 6+ro)ac7 has no interactions with amiodarone 6Cordarone7. ;mepra)ole 6+rilosec7 has no interactions with amiodarone 6Cordarone7. ationa!e 2' Amiodarone 6Cordarone7 can increase serum digoxin 6(anoxin7 levels by as much as @1E$ resulting in digoxin 6(anoxin7 toxicity. ;xycodone 6;xyContin7 has no interactions with amiodarone 6Cordarone7. <luoxetine 6+ro)ac7 has no interactions with amiodarone 6Cordarone7. ;mepra)ole 6+rilosec7 has no interactions with amiodarone 6Cordarone7. ationa!e 3' Amiodarone 6Cordarone7 can increase serum digoxin 6(anoxin7 levels by as much as @1E$ resulting in digoxin 6(anoxin7 toxicity. ;xycodone 6;xyContin7 has no interactions with amiodarone 6Cordarone7. <luoxetine 6+ro)ac7 has no interactions with amiodarone 6Cordarone7. ;mepra)ole 6+rilosec7 has no interactions with amiodarone 6Cordarone7.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

ationa!e 4' Amiodarone 6Cordarone7 can increase serum digoxin 6(anoxin7 levels by as much as @1E$ resulting in digoxin 6(anoxin7 toxicity. ;xycodone 6;xyContin7 has no interactions with amiodarone 6Cordarone7. <luoxetine 6+ro)ac7 has no interactions with amiodarone 6Cordarone7. ;mepra)ole 6+rilosec7 has no interactions with amiodarone 6Cordarone7. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' Assessment &earnin$ *utcome: 04#B Question 13 Type: MCSA The physician has ordered amiodarone 6Cordarone7. +rior to starting this medication$ the nurse would alert the physician to which laboratory result? 1. Sodium 2-1 m/*.( 2. +otassium &.2 m/*.( 3. +otassium =.2 m/*.( 4. ,nternational normali)ed ratio 6,3F7 of 20 seconds Correct Answer: 0 ationa!e 1' 8ypokalemia and hypomagnesemia should be corrected prior to initiating therapy with amiodarone 6Cordarone7. =.2 m/*.( is a normal potassium level. 2-1 m/*.( is a normal sodium level. Twelve seconds is a normal international normali)ed ratio 6,3F7 level. ationa!e 2' 8ypokalemia and hypomagnesemia should be corrected prior to initiating therapy with amiodarone 6Cordarone7. =.2 m/*.( is a normal potassium level. 2-1 m/*.( is a normal sodium level. Twelve seconds is a normal international normali)ed ratio 6,3F7 level. ationa!e 3' 8ypokalemia and hypomagnesemia should be corrected prior to initiating therapy with amiodarone 6Cordarone7. =.2 m/*.( is a normal potassium level. 2-1 m/*.( is a normal sodium level. Twelve seconds is a normal international normali)ed ratio 6,3F7 level. ationa!e 4' 8ypokalemia and hypomagnesemia should be corrected prior to initiating therapy with amiodarone 6Cordarone7. =.2 m/*.( is a normal potassium level. 2-1 m/*.( is a normal sodium level. Twelve seconds is a normal international normali)ed ratio 6,3F7 level. "!o#a! ationa!e: Co$niti%e &e%e!: Applying
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' Assessment &earnin$ *utcome: 04#21 Question 14 Type: MCSA The patient receives verapamil 6Calan7. The patient tells the nurse that he is nervous about taking this medicine. 5hat is the best response by the nurse? 1. This medicine is safe$ and most patients do very well with it. 2. This medicine increases your blood pressure$ but we will be monitoring that. 3. This medicine has many side effects$ but you should be okay. 4. This medicine is a potassium channel blocker and is considered safe. Correct Answer: 2 ationa!e 1' Calcium channel blockers are safe medications that are well tolerated by most patients. All medications have side effects$ but telling the patient that he should be okay is not very reassuring. 9erapamil 6Calan7 is a calcium channel blocker$ not a potassium channel blocker. 9erapamil 6Calan7 lowers$ not increases$ blood pressure and decreases cardiac workload. ationa!e 2' Calcium channel blockers are safe medications that are well tolerated by most patients. All medications have side effects$ but telling the patient that he should be okay is not very reassuring. 9erapamil 6Calan7 is a calcium channel blocker$ not a potassium channel blocker. 9erapamil 6Calan7 lowers$ not increases$ blood pressure and decreases cardiac workload. ationa!e 3' Calcium channel blockers are safe medications that are well tolerated by most patients. All medications have side effects$ but telling the patient that he should be okay is not very reassuring. 9erapamil 6Calan7 is a calcium channel blocker$ not a potassium channel blocker. 9erapamil 6Calan7 lowers$ not increases$ blood pressure and decreases cardiac workload. ationa!e 4' Calcium channel blockers are safe medications that are well tolerated by most patients. All medications have side effects$ but telling the patient that he should be okay is not very reassuring. 9erapamil 6Calan7 is a calcium channel blocker$ not a potassium channel blocker. 9erapamil 6Calan7 lowers$ not increases$ blood pressure and decreases cardiac workload. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' ,mplementation
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

&earnin$ *utcome: 04#4 Question 1, Type: MCSA The patient receives verapamil 6Calan7. The patient asks the nurse if it is okay to take herbal supplements with this medicine. 5hat is the best response by the nurse? 1. Gsing herbal supplements may increase your blood pressure too much. 2. 8erbal supplements are okay as long as you take calcium salts with them. 3. Gsing herbal supplements may lower your blood pressure too much. 4. Most herbal supplements are okay$ but you should avoid St. Hohn%s wort. Correct Answer: & ationa!e 1' 9erapamil 6Calan7 should be used with caution with herbal supplements$ such as hawthorn$ because of the potential for additive hypotensive effects. All herbal supplements$ not :ust St. Hohn%s wort$ should be avoided. Taking calcium salts with herbal supplements will not affect the interactions with verapamil 6Calan7. 8erbal supplements may lower$ not increase$ blood pressure. ationa!e 2' 9erapamil 6Calan7 should be used with caution with herbal supplements$ such as hawthorn$ because of the potential for additive hypotensive effects. All herbal supplements$ not :ust St. Hohn%s wort$ should be avoided. Taking calcium salts with herbal supplements will not affect the interactions with verapamil 6Calan7. 8erbal supplements may lower$ not increase$ blood pressure. ationa!e 3' 9erapamil 6Calan7 should be used with caution with herbal supplements$ such as hawthorn$ because of the potential for additive hypotensive effects. All herbal supplements$ not :ust St. Hohn%s wort$ should be avoided. Taking calcium salts with herbal supplements will not affect the interactions with verapamil 6Calan7. 8erbal supplements may lower$ not increase$ blood pressure. ationa!e 4' 9erapamil 6Calan7 should be used with caution with herbal supplements$ such as hawthorn$ because of the potential for additive hypotensive effects. All herbal supplements$ not :ust St. Hohn%s wort$ should be avoided. Taking calcium salts with herbal supplements will not affect the interactions with verapamil 6Calan7. 8erbal supplements may lower$ not increase$ blood pressure. "!o#a! ationa!e: Co$niti%e &e%e!: Applying C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' ,mplementation &earnin$ *utcome: 04#B Question 1Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

Type: MCSA 5hich of the following statements best explains what happens to cardiac output when the heart rate gets extremely high? 1. Cardiac output is not generally affected by rapid heart rates. 2. Cardiac output lowers when the rapid rate doesnIt allow enough time for complete filling of the heart chambers. 3. Cardiac output will continue to increase as long as the heart rate continues to increase. 4. Cardiac output will increase until the heart rate reaches 2=1 bpm$ at which time it will no longer be affected. Correct Answer: 0 ationa!e 1' Cardiac output lowers when the rapid rate doesnIt allow enough time for complete filling of the heart chambers. ationa!e 2' Cardiac output lowers when the rapid rate doesnIt allow enough time for complete filling of the heart chambers. ationa!e 3' Cardiac output lowers when the rapid rate doesnIt allow enough time for complete filling of the heart chambers. ationa!e 4' Cardiac output lowers when the rapid rate doesnIt allow enough time for complete filling of the heart chambers. "!o#a! ationa!e: Co$niti%e &e%e!: Gnderstanding C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' Assessment &earnin$ *utcome: 04#2 Question 1. Type: MCSA ,n a person with a sinus rhythm$ the primary purpose of the A9 node is to 1. pace the heart at -1J?1 bpm. 2. delay the impulse from the SA node. 3. pace the heart at ?1J211 bpm. 4. inhibit the impulse from the SA node.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

Correct Answer: 0 ationa!e 1' The A9 node delays the impulse as it travels from the atria to the ventricles. The A9 :unction does pace the heart at -1J?1 bpm$ but not when the SA node is pacing the heart. ationa!e 2' The A9 node delays the impulse as it travels from the atria to the ventricles. The A9 :unction does pace the heart at -1J?1 bpm$ but not when the SA node is pacing the heart. ationa!e 3' The A9 node delays the impulse as it travels from the atria to the ventricles. The A9 :unction does pace the heart at -1J?1 bpm$ but not when the SA node is pacing the heart. ationa!e 4' The A9 node delays the impulse as it travels from the atria to the ventricles. The A9 :unction does pace the heart at -1J?1 bpm$ but not when the SA node is pacing the heart. "!o#a! ationa!e: Co$niti%e &e%e!: Femembering C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' /valuation &earnin$ *utcome: 04#0 Question 1/ Type: MCSA A person with a heart rate of 2@1 bpm and a normal KFS duration would most likely be experiencing a 1. yachydysrhythmia originating from the bundle branches. 2. tachydysrhythmia originating from the atria. 3. tachydysrhythmia originating from the ventricles. 4. tachydysrhythmia originating from the +urkin:e fibers. Correct Answer: 0 ationa!e 1' Aiven a normal KFS duration$ the rhythm is not coming from the ventricles but from the atria. ationa!e 2' Aiven a normal KFS duration$ the rhythm is not coming from the ventricles but from the atria. ationa!e 3' Aiven a normal KFS duration$ the rhythm is not coming from the ventricles but from the atria. ationa!e 4' Aiven a normal KFS duration$ the rhythm is not coming from the ventricles but from the atria. "!o#a! ationa!e: Co$niti%e &e%e!: Gnderstanding
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' /valuation &earnin$ *utcome: 04#& Question 19 Type: MCSA !epolari)ation occurs when which two electrolytes rush into the cell? 1. Sodium and potassium 2. Calcium and magnesium 3. Calcium and sodium 4. Chloride and potassium Correct Answer: & ationa!e 1' An action potential begins when sodium and calcium flow into the cell$ resulting in depolari)ation. ationa!e 2' An action potential begins when sodium and calcium flow into the cell$ resulting in depolari)ation. ationa!e 3' An action potential begins when sodium and calcium flow into the cell$ resulting in depolari)ation. ationa!e 4' An action potential begins when sodium and calcium flow into the cell$ resulting in depolari)ation. "!o#a! ationa!e: Co$niti%e &e%e!: Femembering C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' /valuation &earnin$ *utcome: 04#Question 20 Type: MCSA 5hich adverse effect is shared among all antidysrhythmic drugs? 1. /dema 2. ,mpotence 3. +hotosensitivity
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

4. +rodysrhythmic effects Correct Answer: ationa!e 1' All antidysrhythmic agents can worsen existing dysrhythmias or create new ones. ationa!e 2' All antidysrhythmic agents can worsen existing dysrhythmias or create new ones. ationa!e 3' All antidysrhythmic agents can worsen existing dysrhythmias or create new ones. ationa!e 4' All antidysrhythmic agents can worsen existing dysrhythmias or create new ones. "!o#a! ationa!e: Co$niti%e &e%e!: Femembering C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' +lanning &earnin$ *utcome: 04#B Question 21 Type: MCSA 5hich of the following drugs is the primary agent for paroxysmal supraventricular tachycardia 6+S9T7? 1. <lecainide 6Tambocor7 2. Adenosine 6Adenocard7 3. (idocaine 6Lylocaine7 4. +rocainamide 6+ronestyl7 Correct Answer: 0 ationa!e 1' Adenosine is the drug of choice for +S9T. +rocainamide may be used for supraventricular dysrhythmias$ but is not the primary drug for +S9T. (idocaine and flecainide are indicated for ventricular dysrhythmias. ationa!e 2' Adenosine is the drug of choice for +S9T. +rocainamide may be used for supraventricular dysrhythmias$ but is not the primary drug for +S9T. (idocaine and flecainide are indicated for ventricular dysrhythmias. ationa!e 3' Adenosine is the drug of choice for +S9T. +rocainamide may be used for supraventricular dysrhythmias$ but is not the primary drug for +S9T. (idocaine and flecainide are indicated for ventricular dysrhythmias.

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

ationa!e 4' Adenosine is the drug of choice for +S9T. +rocainamide may be used for supraventricular dysrhythmias$ but is not the primary drug for +S9T. (idocaine and flecainide are indicated for ventricular dysrhythmias. "!o#a! ationa!e: Co$niti%e &e%e!: Femembering C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' ,mplementation &earnin$ *utcome: 04#B Question 22 Type: MCSA 5hich antidysrhythmic agent also dilates coronary arteries$ and is fre*uently used to treat angina? 1. 9erapamil 6Calan7 2. Amiodarone 6Cordarone7 3. +rocainamide 6+ronestyl7 4. (idocaine 6Lylocaine7 Correct Answer: 2 ationa!e 1' 9erapamil is a calcium channel blocker that is often used to treat angina by dilating coronary arteries. ationa!e 2' 9erapamil is a calcium channel blocker that is often used to treat angina by dilating coronary arteries. ationa!e 3' 9erapamil is a calcium channel blocker that is often used to treat angina by dilating coronary arteries. ationa!e 4' 9erapamil is a calcium channel blocker that is often used to treat angina by dilating coronary arteries. "!o#a! ationa!e: Co$niti%e &e%e!: Femembering C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' +lanning &earnin$ *utcome: 04#B
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

Question 23 Type: MCSA 5hich drug would be indicated for treating ventricular tachycardia? 1. (idocaine 6Lylocaine7 2. 9erapamil 6Calan7 3. !iltia)em 6Cardi)em7 4. Atropine 6Atropair7 Correct Answer: 2 ationa!e 1' (idocaine is a sodium channel blocker$ and is indicated for ventricular dysrhythmias. 9erapamil and diltia)em are calcium channel blockers indicated for atrial dysrhythmias. Atropine is a cholinergic#blocking agent$ and causes an increase in heart rate. ationa!e 2' (idocaine is a sodium channel blocker$ and is indicated for ventricular dysrhythmias. 9erapamil and diltia)em are calcium channel blockers indicated for atrial dysrhythmias. Atropine is a cholinergic#blocking agent$ and causes an increase in heart rate. ationa!e 3' (idocaine is a sodium channel blocker$ and is indicated for ventricular dysrhythmias. 9erapamil and diltia)em are calcium channel blockers indicated for atrial dysrhythmias. Atropine is a cholinergic#blocking agent$ and causes an increase in heart rate. ationa!e 4' (idocaine is a sodium channel blocker$ and is indicated for ventricular dysrhythmias. 9erapamil and diltia)em are calcium channel blockers indicated for atrial dysrhythmias. Atropine is a cholinergic#blocking agent$ and causes an increase in heart rate. "!o#a! ationa!e: Co$niti%e &e%e!: Femembering C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: 'ursin$/)nte$rated Concepts: 3ursing +rocess' +lanning &earnin$ *utcome: 04#B Question 24 Type: MCMA The nurse is writing a care plan for a patient who has been started on an antiarrhythmic drug for complaints of chest pain and palpitations. The patient says$ , can%t do what , once did. , :ust do not have any energy. 5hich nursing diagnoses would the nurse likely include in this care plan? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

(tandard Te+t: Select all that apply. 1. !ecreased Cardiac ;utput 2. ,neffective Dreathing +attern 3. Activity ,ntolerance 4. ,neffective ,ndividual Coping ,. ,mpaired Aas /xchange Correct Answer: 2$& ationa!e 1' !ecreased cardiac output is a common occurrence in patients who have palpitations and may be the etiology of the patient%s chest pain. ationa!e 2' There is no evidence that this patient is not breathing effectively and not enough information to decide that the patient is at risk of developing problems breathing. ationa!e 3' The statement , can%t do what , once did is an indicator that the patient is not tolerating normal amounts of activity. ationa!e 4' There is no evidence that this patient is not coping with the illness. ationa!e ,' To support this nursing diagnosis$ the patient must have alterations in arterial blood gases. "!o#a! ationa!e: Co$niti%e &e%e!: Analy)ing C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: +hysiological Adaptation 'ursin$/)nte$rated Concepts: 3ursing +rocess' !iagnosis &earnin$ *utcome: 04#B Question 2, Type: MCMA The nurse and a home health patient have established this expected outcome' The patient will be free from adverse effects of administration of diltia)em 6Cardi)em7. 5hich finding indicates this outcome has not been met? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. The patient complains of headache at each visit by the nurse.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

2. The patient has &M edema in the ankles and feet. 3. The patient says$ /verything , eat tastes like metal. 4. The patient says$ , got so di))y yesterday that , had to lie down for a while. ,. The patient%s face is flushed. Correct Answer: 2$0$ationa!e 1' 8eadache is a potential adverse effect of diltia)em. ationa!e 2' /dema of the ankles and feet is a potential adverse effect of diltia)em. ationa!e 3' Metallic taste is not an expected adverse effect of diltia)em. ationa!e 4' !i))iness is an expected adverse effect of diltia)em. ationa!e ,' <acial flushing is not an expected adverse effect of diltia)em. "!o#a! ationa!e: Co$niti%e &e%e!: Analy)ing C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: +harmacological and +arenteral Therapies 'ursin$/)nte$rated Concepts: 3ursing +rocess' /valuation &earnin$ *utcome: 04#B Question 2Type: MCMA A patient is prescribed an additional once#daily antidysrhythmic drug to control persistent atrial fibrillation. 5hat instructions should the nurse provide for this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. Take your first dose of this new medication before you go to bed tonight. 2. !o not eat or drink anything for 0 hours after taking the new medication. 3. Defore you get out of bed in the morning$ sit up on the side of the bed for a few minutes. 4. +lan to return to the clinic to have your electrolytes checked in 0 weeks. ,. Contact the clinic if you notice any loss of hair from your head.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

Correct Answer: 2$&$ationa!e 1' The addition of a second medication makes the patient prone to hypotension. Taking the drug right before bedtime is a safety precaution. ationa!e 2' There is no reason to avoid oral intake for 0 hours after an antidysrhythmic medication. ationa!e 3' ;rthostatic hypotension can be an adverse effect of antidysrhythmic medications$ particularly when multiple drugs are taken. Sitting on the side of the bed before arising is a safety precaution. ationa!e 4' /lectrolyte imbalance can occur secondary to drug therapy for dysrhythmia. /lectrolyte levels should be monitored. ationa!e ,' 8air loss is not an expected adverse effect of antidysrhythmic medications. "!o#a! ationa!e: Co$niti%e &e%e!: Analy)ing C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: +harmacological and +arenteral Therapies 'ursin$/)nte$rated Concepts: 3ursing +rocess' ,mplementation &earnin$ *utcome: 04#B Question 2. Type: MCMA A patient has been taking a potassium channel blocker for - weeks. 5hich statements would indicate to the nurse that additional time for teaching about the medication should be planned? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. , got some sunglasses like you said. !o you like them? 2. !o you have any idea what this rash on my neck and arm is? 3. , must be getting cataracts. , can%t see anything anymore. 4. , wear sunscreen whenever , am outdoors. ,. , think that medicine is making my hair gray. Correct Answer: 0$&$= ationa!e 1' +otassium channel blockers can cause photosensitivity$ and wearing sunglasses protects the eyes.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

ationa!e 2' +otassium channel blockers can cause skin rashes. ationa!e 3' +otassium channel blockers may cause blurred vision. ationa!e 4' +otassium channel blockers cause increased risk of sunburn. ationa!e ,' There is no connection between potassium channel blockers and the development of gray hair. "!o#a! ationa!e: Co$niti%e &e%e!: Analy)ing C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: +hysiological Adaptation 'ursin$/)nte$rated Concepts: 3ursing +rocess' /valuation &earnin$ *utcome: 04#B Question 2/ Type: MCMA The nurse is providing information for a patient who will self#administer a twice#daily antidysrhythmic medication at home. 5hich patient statement would the nurse evaluate as indicating good understanding of this process? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. ,f , get the flu$ , should stop taking the medication until my fever goes down. 2. , should take my doses as close to 20 hours apart as , can. 3. ,f , forget a dose of medication , should take two pills for the next dose. 4. ,f , can%t take the medication for a couple of days because , am sick$ , should call the clinic for advice. ,. , should get my prescription refilled before , am completely out of medicine. Correct Answer: 0$-$= ationa!e 1' Antidysrhythmic medications should not be stopped abruptly. ationa!e 2' !oses of antidysrhythmic medications should be evenly spaced. ationa!e 3' Antidysrhythmic medications should not be double#dosed to make up for missed doses. ationa!e 4' The health care provider should be consulted if the patient is going to miss medication for more than 2 day.
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

ationa!e ,' Abrupt discontinuation of antidysrhythmic medications can have serious side effects$ so an ade*uate supply of the medication should be available. "!o#a! ationa!e: Co$niti%e &e%e!: Analy)ing C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: +harmacological and +arenteral Therapies 'ursin$/)nte$rated Concepts: 3ursing +rocess' /valuation &earnin$ *utcome: 04#B Question 29 Type: MCMA A patient who has been taking medication for a month for an atrial dysrhythmia returns to the clinic for a checkup. 5hich statements indicate the nurse should plan extra time with the patient for additional teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te+t: Select all that apply. 1. Since , can%t drink coffee anymore$ , have started drinking diet cola in the mornings. 2. , have found that a glass of wine after work and one with dinner helps me to relax from my stressful :ob. 3. 5e have celebrated several birthdays since , saw you last. , love chocolate birthday cake. 4. , have really worked at stopping my smoking since , was last here. ,. My friends and , have found several restaurants in our area that offer good$ low#fat meals. Correct Answer: 2$0$& ationa!e 1' Gnless the diet cola is decaffeinated$ it should also be avoided. ationa!e 2' Alcohol should be limited when taking medications for atrial arrhythmias. ationa!e 3' Chocolate contains caffeine$ which should be avoided when taking medications for atrial arrhythmias. ationa!e 4' Smoking cessation should be encouraged in patients taking medications for atrial dysrhythmia. ationa!e ,' (owered fat intake is encouraged in patients taking medications for atrial arrhythmias. "!o#a! ationa!e: Co$niti%e &e%e!: Analy)ing
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.

C!ient 'eed: +hysiological ,ntegrity C!ient 'eed (u#: +harmacological and +arenteral Therapies 'ursin$/)nte$rated Concepts: 3ursing +rocess' /valuation &earnin$ *utcome: 04#B

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, -./ Copyright 012- by +earson /ducation$ ,nc.