NSG 6005 Advanced Pharmacology Final Exam
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Cases, Prescribing Principles & Study Guide|
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The nurse is reviewing the orders for a patient and notes a new order for an
ACE inhibitor. The nurse checks the current medication orders, knowing that
this drug class may have a serious interaction with what other drug class?
A. Calcium channel blockers
B. Diuretics
C. Nonsteroidal antiinflammatory drugs (NSAIDs)
D. Nitrates
Correct Answer: C. Nonsteroidal antiinflammatory drugs (NSAIDs) (iburprohen
can reduce the effect of ACE and predispose the pt. with acute renal failure);
other adverse effects: potassium levels above 5 mEq/L because they promote
hyperkalemia, lactating women, children, bilateral renal disease); rash, pruritus,
anemia, neutropenia, thrombocytosis, and agranulocytosis.
A patient about to receive his morning dose of digoxin has an apical pulse of 70
beats per minute. What will the nurse do?
A. Administer the dose.
B. Administer the dose and notify the physician.
C. Check the radial pulse for 1 full minute.
D. Withhold the dose and notify the
Correct Answer: A. Administer the dose.
In assessing a patient before administration of a cardiac glycoside, the nurse
knows that what condition can predispose a patient to digitalis toxicity?
A. Hypokalemia
,B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
Correct Answer: A. Hypokalemia; control ventricular response to atrial
fibrillation and a derived from foxglove. Digoxin is the only available cardiac
glycoside---positive inotropic---inhibits sodium potassium pump (adenosine
tripphophatase) Sodium and calcium rise. Cholinergic stimulation via the vagus
nerve of Parasympathetic nervous system. ---Negative chronotropic---Negative
Dromotropic effect
While assessing a patient who is receiving intravenous digitalis, the nurse
recognizes that the drug has a negative chronotropic effect. How would this
drug effect be evident in the patient?
A. Increased heart rate
B. Decreased heart rate
C. Decreased conduction
D. Increased ectopic beats
Correct Answer: B. Decreased heart rate
A patient has been taking digoxin at home but has taken an accidental overdose
and has developed toxicity. He has been admitted to the telemetry unit where
the physician has ordered digoxin immune Fab (Digibind). The patient asks the
nurse why the medication is ordered. What is the nurse's best response?
A. "It works faster than digoxin."
B. "It is safer than digoxin and can be taken orally."
C. "It helps to convert the irregular heart rhythm to a more normal rhythm."
D. "This drug is an antidote to digoxin and will help to lower the blood levels."
Correct Answer: D. "This drug is an antidote to digoxin and will help to lower the
blood levels." (severe bradycardia, advanced heart block, ventricularr
tachycardia, fibrillation, and hyperkalemia); available in parental form. Clinical
signs and symptoms are monitored NOT serum levels----used for systolic heart
failure and atrial fibrillation.
5. A patient has been placed on a milrinone infusion as part of the therapy for
end-stage heart failure. What risks involved with this drug will the nurse keep in
mind while assessing this patient during the infusion?
A. Hypertension
B. Hyperkalemia
C. Nausea and vomiting
D. Cardiac dysrhythmias
,Correct Answer: D. Cardiac dysrhythmias (contraindictated with ventricular
tachycardia, and fibrillation) used for treatment of atrial fibrillation. Available in
Oral and injection form.
6. A patient with atrial fibrillation was started on digoxin, and 1 week later a
digoxin level was drawn. Which result is within normal therapeutic levels for
digoxin?
A. 0.4 ng/mL
B. 0.7 ng/mL
C. 2.1 ng/mL
D. 2.6 ng/mL or higher
Correct Answer: B. 0.7 ng/mL (normal 0.5 to 2.0 ng/mL
7. When reviewing the list of medications taken by a patient who will be
receiving a new prescription for digoxin, the nurse would be concerned about
which medication that may interact with the digoxin?
A. aspirin
B. acetaminophen (Tylenol)
C. furosemide (Lasix)
D. vitamin K
Correct Answer: C. furosemide (Lasix); (loop Diuretics); numerous ones on
page 341
8. The nurse is reviewing discharge teaching for a patient who will be taking
digoxin (Lanoxin) therapy. The patient should be taught to avoid which foods
when taking the digoxin?
A. Leafy green vegetables
B. Dairy products
C. Grapefruit juice
D. Bran muffins
Correct Answer: D. Bran muffins
9. In assessing a patient before administration of a cardiac glycoside, the nurse
knows that which lab result can increase the toxicity of the drug?
A. Potassium level 2.8 mEq/L
B. Potassium level 4.9 mEq/L
C. Sodium level 140 mEq/L
D. Calcium level 10 mg/dL
Correct Answer: A. Potassium level 2.8 mEq/L (low potassium normal is 3.5 to
5.0)
, 10. The nurse administering the phosphodiesterase inhibitor inamrinone
recognizes that this drug should have a positive inotropic effect. This effect will
result in increased
A. heart rate.
B. blood vessel dilation.
C. force of cardiac contraction.
D. conduction of electrical impulses across the heart.
Correct Answer: C. force of cardiac contraction. (increase cAMP) positive
inotropic (by more calcium available in SR)effect and vasodilation, (inodilators)--
-positive chornotropic effect); USED IN ICU; ADVERSE
EFFECT...thrombocytopenia, dysrhythmia, ventricular, hypotension and angina,
hypokalemia, tremor.
11. The nurse notes in a patient's medical record that nesiritide has been
ordered. Based on this order, the nurse interprets that the patient has which
disorder?
A. Atrial fibrillation
B. Acutely decompensated heart failure with dyspnea at rest
C. Systolic heart failure
D. Long-term treatment of heart failure.
Correct Answer: B. Acutely decompensated heart failure with dyspnea at rest
1. When a patient is experiencing digoxin toxicity, which clinical situation would
necessitate the use of digoxin immune Fab (Digibind)? Select all that apply.
A. The patient reports seeing colorful halos around lights.
B. The patient's serum potassium level is above 5 mEq/L.
C. The patient is experiencing nausea and anorexia.
D. The patient is experiencing severe sinus bradycardia that does not respond
to cardiac pacing.
E. The patient has taken an overdose of greater than 10 mg of digoxin.
Correct Answer:
B. The patient's serum potassium level is above 5 mEq/L.
D. The patient is experiencing severe sinus bradycardia that does not respond
to cardiac pacing. (E) might be right as well a person taking 10mg of digoxin is a
indication of toxicity...page 340 states life threatening digoxin overdose in adults
and 4 mg in children)
Prep | High-Yield Q&A, Drug Interactions, Clinical
Cases, Prescribing Principles & Study Guide|
Expert Guarantee Pass and 100% Accurate |
Graded A+ , Final Review and Updated | Latest
Exam and Newest Version!!!
The nurse is reviewing the orders for a patient and notes a new order for an
ACE inhibitor. The nurse checks the current medication orders, knowing that
this drug class may have a serious interaction with what other drug class?
A. Calcium channel blockers
B. Diuretics
C. Nonsteroidal antiinflammatory drugs (NSAIDs)
D. Nitrates
Correct Answer: C. Nonsteroidal antiinflammatory drugs (NSAIDs) (iburprohen
can reduce the effect of ACE and predispose the pt. with acute renal failure);
other adverse effects: potassium levels above 5 mEq/L because they promote
hyperkalemia, lactating women, children, bilateral renal disease); rash, pruritus,
anemia, neutropenia, thrombocytosis, and agranulocytosis.
A patient about to receive his morning dose of digoxin has an apical pulse of 70
beats per minute. What will the nurse do?
A. Administer the dose.
B. Administer the dose and notify the physician.
C. Check the radial pulse for 1 full minute.
D. Withhold the dose and notify the
Correct Answer: A. Administer the dose.
In assessing a patient before administration of a cardiac glycoside, the nurse
knows that what condition can predispose a patient to digitalis toxicity?
A. Hypokalemia
,B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
Correct Answer: A. Hypokalemia; control ventricular response to atrial
fibrillation and a derived from foxglove. Digoxin is the only available cardiac
glycoside---positive inotropic---inhibits sodium potassium pump (adenosine
tripphophatase) Sodium and calcium rise. Cholinergic stimulation via the vagus
nerve of Parasympathetic nervous system. ---Negative chronotropic---Negative
Dromotropic effect
While assessing a patient who is receiving intravenous digitalis, the nurse
recognizes that the drug has a negative chronotropic effect. How would this
drug effect be evident in the patient?
A. Increased heart rate
B. Decreased heart rate
C. Decreased conduction
D. Increased ectopic beats
Correct Answer: B. Decreased heart rate
A patient has been taking digoxin at home but has taken an accidental overdose
and has developed toxicity. He has been admitted to the telemetry unit where
the physician has ordered digoxin immune Fab (Digibind). The patient asks the
nurse why the medication is ordered. What is the nurse's best response?
A. "It works faster than digoxin."
B. "It is safer than digoxin and can be taken orally."
C. "It helps to convert the irregular heart rhythm to a more normal rhythm."
D. "This drug is an antidote to digoxin and will help to lower the blood levels."
Correct Answer: D. "This drug is an antidote to digoxin and will help to lower the
blood levels." (severe bradycardia, advanced heart block, ventricularr
tachycardia, fibrillation, and hyperkalemia); available in parental form. Clinical
signs and symptoms are monitored NOT serum levels----used for systolic heart
failure and atrial fibrillation.
5. A patient has been placed on a milrinone infusion as part of the therapy for
end-stage heart failure. What risks involved with this drug will the nurse keep in
mind while assessing this patient during the infusion?
A. Hypertension
B. Hyperkalemia
C. Nausea and vomiting
D. Cardiac dysrhythmias
,Correct Answer: D. Cardiac dysrhythmias (contraindictated with ventricular
tachycardia, and fibrillation) used for treatment of atrial fibrillation. Available in
Oral and injection form.
6. A patient with atrial fibrillation was started on digoxin, and 1 week later a
digoxin level was drawn. Which result is within normal therapeutic levels for
digoxin?
A. 0.4 ng/mL
B. 0.7 ng/mL
C. 2.1 ng/mL
D. 2.6 ng/mL or higher
Correct Answer: B. 0.7 ng/mL (normal 0.5 to 2.0 ng/mL
7. When reviewing the list of medications taken by a patient who will be
receiving a new prescription for digoxin, the nurse would be concerned about
which medication that may interact with the digoxin?
A. aspirin
B. acetaminophen (Tylenol)
C. furosemide (Lasix)
D. vitamin K
Correct Answer: C. furosemide (Lasix); (loop Diuretics); numerous ones on
page 341
8. The nurse is reviewing discharge teaching for a patient who will be taking
digoxin (Lanoxin) therapy. The patient should be taught to avoid which foods
when taking the digoxin?
A. Leafy green vegetables
B. Dairy products
C. Grapefruit juice
D. Bran muffins
Correct Answer: D. Bran muffins
9. In assessing a patient before administration of a cardiac glycoside, the nurse
knows that which lab result can increase the toxicity of the drug?
A. Potassium level 2.8 mEq/L
B. Potassium level 4.9 mEq/L
C. Sodium level 140 mEq/L
D. Calcium level 10 mg/dL
Correct Answer: A. Potassium level 2.8 mEq/L (low potassium normal is 3.5 to
5.0)
, 10. The nurse administering the phosphodiesterase inhibitor inamrinone
recognizes that this drug should have a positive inotropic effect. This effect will
result in increased
A. heart rate.
B. blood vessel dilation.
C. force of cardiac contraction.
D. conduction of electrical impulses across the heart.
Correct Answer: C. force of cardiac contraction. (increase cAMP) positive
inotropic (by more calcium available in SR)effect and vasodilation, (inodilators)--
-positive chornotropic effect); USED IN ICU; ADVERSE
EFFECT...thrombocytopenia, dysrhythmia, ventricular, hypotension and angina,
hypokalemia, tremor.
11. The nurse notes in a patient's medical record that nesiritide has been
ordered. Based on this order, the nurse interprets that the patient has which
disorder?
A. Atrial fibrillation
B. Acutely decompensated heart failure with dyspnea at rest
C. Systolic heart failure
D. Long-term treatment of heart failure.
Correct Answer: B. Acutely decompensated heart failure with dyspnea at rest
1. When a patient is experiencing digoxin toxicity, which clinical situation would
necessitate the use of digoxin immune Fab (Digibind)? Select all that apply.
A. The patient reports seeing colorful halos around lights.
B. The patient's serum potassium level is above 5 mEq/L.
C. The patient is experiencing nausea and anorexia.
D. The patient is experiencing severe sinus bradycardia that does not respond
to cardiac pacing.
E. The patient has taken an overdose of greater than 10 mg of digoxin.
Correct Answer:
B. The patient's serum potassium level is above 5 mEq/L.
D. The patient is experiencing severe sinus bradycardia that does not respond
to cardiac pacing. (E) might be right as well a person taking 10mg of digoxin is a
indication of toxicity...page 340 states life threatening digoxin overdose in adults
and 4 mg in children)
