Nursing Pharmacology: Cardiovascular Drugs 2026 Exam 2
1. Question
Dobutamine (Dobutrex) improves cardiac output and is indicated for use in all of
the following conditions except:
A. Septic shock
B. Congestive heart failure
C. Arrhythmias
Correct
D. Pulmonary congestion
Correct
Correct Answer: C. Arrhythmias
Dobutamine (Dobutrex) is not used to treat arrhythmias. Dobutamine is approved
by the Food and Drug Administration (FDA) for short-term use in patients with
decreased contractility due to heart failure or cardiac surgical procedures leading
to cardiac decompensation.
,Option A: Short-term intravenous inotropic support should be given to patients in
cardiogenic shock to preserve systemic blood flow and protect from end-organ
damage.
Option B: Patients can reasonably receive dobutamine in continuous intravenous
form for inotropic support to bridge patients with late-stage heart failure, stage D,
that is refractory to guideline-directed medical therapy until patients who are
candidates for and awaiting cardiac transplantation or mechanical circulatory
support receive the appropriate long-term treatment.
Option D: In addition to the well-known beta-1 activity, dobutamine has shown to
have some beta-2 activity, which contributes to the reduction in the systemic
vascular resistance, and alpha-1 activity, to an even lesser extent, whose
vasoconstrictive effects are negated by the baroreceptor mediated response and
beta-2 activity.
2. Question
Conduction defects will most likely be an adverse associated with the use of:
A. verapamil (Isoptin)
Correct Answer
B. nifedipine (Adalat CC)
Incorrect
C. diltiazem (Cardizem)
D. felodipine (Plendil)
,Incorrect
Correct Answer: A. verapamil (Isoptin).
Verapamil (Isoptin) has the strongest chronotropic effect and will cause a delay in
conduction at the SA and AV nodes. Verapamil also increases myocardial oxygen
delivery, which helps patients with vasospastic angina. Verapamil correlates with
negative chronotropic effects and a decrease in sympathetic nervous system
activity.
Option B: The reduced intracellular calcium, results in a reduction of peripheral
arterial vascular resistance and dilatation of coronary arteries, leading to a
reduction in systemic blood pressure and increased myocardial oxygen delivery.
Nifedipine thus has hypotensive and antianginal properties.
Option C: Diltiazem is a negative inotrope (decreased force) and negative
chronotrope (decreased rate). The combination, along with coronary artery
vasodilation, leads to decreased myocardial oxygen demand, decreased heart
rate, and reduced blood pressure.
Option D: Research shows that felodipine has a higher selectivity than other
commonly used dihydropyridine calcium channel blockers like amlodipine and
nifedipine for vascular tissue in comparison to cardiac tissue. Also, the clinical
trials of felodipine have not shown any negative inotropic effect.
3. Question
, Which of the following calcium channel blockers has the most potent peripheral
smooth muscle dilator effect?
A. diltiazem (Cardizem)
A. diltiazem (Cardizem)
B. nifedipine (Adalat CC)
Correct Answer
C. nimodipine (Nymalize)
D. verapamil (Calan)
Incorrect
Incorrect
Correct Answer: B. nifedipine (Adalat CC)
Nifedipine has the strongest peripheral smooth muscle dilator effect of all the
calcium channel blockers. Nifedipine inhibits the entry of calcium ions by blocking
these voltage-dependent L-type calcium channels in vascular smooth muscle and
myocardial cells. The reduced intracellular calcium, results in a reduction of
peripheral arterial vascular resistance and dilatation of coronary arteries, leading
to a reduction in systemic blood pressure and increased myocardial oxygen
delivery. Other choices have less of a vasodilator effect.
1. Question
Dobutamine (Dobutrex) improves cardiac output and is indicated for use in all of
the following conditions except:
A. Septic shock
B. Congestive heart failure
C. Arrhythmias
Correct
D. Pulmonary congestion
Correct
Correct Answer: C. Arrhythmias
Dobutamine (Dobutrex) is not used to treat arrhythmias. Dobutamine is approved
by the Food and Drug Administration (FDA) for short-term use in patients with
decreased contractility due to heart failure or cardiac surgical procedures leading
to cardiac decompensation.
,Option A: Short-term intravenous inotropic support should be given to patients in
cardiogenic shock to preserve systemic blood flow and protect from end-organ
damage.
Option B: Patients can reasonably receive dobutamine in continuous intravenous
form for inotropic support to bridge patients with late-stage heart failure, stage D,
that is refractory to guideline-directed medical therapy until patients who are
candidates for and awaiting cardiac transplantation or mechanical circulatory
support receive the appropriate long-term treatment.
Option D: In addition to the well-known beta-1 activity, dobutamine has shown to
have some beta-2 activity, which contributes to the reduction in the systemic
vascular resistance, and alpha-1 activity, to an even lesser extent, whose
vasoconstrictive effects are negated by the baroreceptor mediated response and
beta-2 activity.
2. Question
Conduction defects will most likely be an adverse associated with the use of:
A. verapamil (Isoptin)
Correct Answer
B. nifedipine (Adalat CC)
Incorrect
C. diltiazem (Cardizem)
D. felodipine (Plendil)
,Incorrect
Correct Answer: A. verapamil (Isoptin).
Verapamil (Isoptin) has the strongest chronotropic effect and will cause a delay in
conduction at the SA and AV nodes. Verapamil also increases myocardial oxygen
delivery, which helps patients with vasospastic angina. Verapamil correlates with
negative chronotropic effects and a decrease in sympathetic nervous system
activity.
Option B: The reduced intracellular calcium, results in a reduction of peripheral
arterial vascular resistance and dilatation of coronary arteries, leading to a
reduction in systemic blood pressure and increased myocardial oxygen delivery.
Nifedipine thus has hypotensive and antianginal properties.
Option C: Diltiazem is a negative inotrope (decreased force) and negative
chronotrope (decreased rate). The combination, along with coronary artery
vasodilation, leads to decreased myocardial oxygen demand, decreased heart
rate, and reduced blood pressure.
Option D: Research shows that felodipine has a higher selectivity than other
commonly used dihydropyridine calcium channel blockers like amlodipine and
nifedipine for vascular tissue in comparison to cardiac tissue. Also, the clinical
trials of felodipine have not shown any negative inotropic effect.
3. Question
, Which of the following calcium channel blockers has the most potent peripheral
smooth muscle dilator effect?
A. diltiazem (Cardizem)
A. diltiazem (Cardizem)
B. nifedipine (Adalat CC)
Correct Answer
C. nimodipine (Nymalize)
D. verapamil (Calan)
Incorrect
Incorrect
Correct Answer: B. nifedipine (Adalat CC)
Nifedipine has the strongest peripheral smooth muscle dilator effect of all the
calcium channel blockers. Nifedipine inhibits the entry of calcium ions by blocking
these voltage-dependent L-type calcium channels in vascular smooth muscle and
myocardial cells. The reduced intracellular calcium, results in a reduction of
peripheral arterial vascular resistance and dilatation of coronary arteries, leading
to a reduction in systemic blood pressure and increased myocardial oxygen
delivery. Other choices have less of a vasodilator effect.
