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Chapter 23: Drugs Used to Treat Dysrhythmias Test
Bank
MULTIPLE CHOICE
1. What is the action of amiodarone (Cordarone), a class III agent used to treat cardiac
dysrhythmias?
a. It acts as a myocardial depressant by inhibiting sodium ion movement.
b. It prolongs the duration of the electrical stimulation on cells and the refractory time
between electrical impulses.
c. It acts as a beta adrenergic agent.
d. It slows the rate of electrical conduction and prolongs the time between contractions.
ANS: D
Class I antidysrhythmic drugs act as a myocardial depressant by inhibiting sodium ion
movement. Class II antidysrhythmic drugs act as beta adrenergic agents. Class III agents slow
the rate of electrical conduction and prolong the time between contractions. Class IV
antidysrhythmic drugs prolong the duration of the electrical stimulation on cells and the
refractory time between electrical impulses.
DIF: Cognitive Level: ComprehensionREF: p. 396 OBJ: 3
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
2. How many milligrams of lidocaine will the nurse administer via intravenous (IV) bolus to a 30
year old patient with ventricular tachycardia who weighs 75 kg after a myocardial infarction?
a. 10
b. 25
c. 50
d. 75
ANS: D
The initial lidocaine bolus is 1 to 1.5 mg/kg, decreased by half in older adults, patients with
hepatic disease, and patients with heart failure. Doses of 10, 25, and 50 mg are too low for a
patient of this weight.
DIF: Cognitive Level: Application REF: p. 393 OBJ: 4
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
3. A patient is taking amiodarone (Cordarone) for hypertrophic cardiomyopathy and begins to
complain of dizziness. What will the nurse instruct the patient to do?
a. Discontinue the medication immediately.
b. Decrease the medication dosage for 1 week, and then resume the original order.
c. Change positions slowly.
d. Increase the dosage per health care provider directions.
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ANS: C
Many adverse effects are dose related and resolve with reducing the dosage or discontinuing
therapy. Patients should be taught to rise slowly from a supine or sitting position and sit or lie
down if feeling faint. Medication should be discontinued only for serious adverse effects and
with the consent of the health care provider. Changes in dose should be done only with the
consent of the health care provider. Increasing the dose will likely increase the symptoms.
DIF: Cognitive Level: Application REF: pp. 396-397 OBJ: 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
4. A patient who is started on phenytoin (Dilantin), who is also taking amiodarone (Cordarone),
should be assessed for what possible effect?
a. Central nervous system depression and sedation
b. Decrease in effectiveness of phenytoin
c. Respiratory depression
d. Increase in serum phenytoin levels
ANS: D
Elevation of phenytoin serum levels (200% to 300%) is observed over several weeks. The
dosage of phenytoin must be gradually reduced based on patient response. The combination
of phenytoin and amiodarone does not produce sedation and depression, decrease the
effectiveness of either drug, or produce respiratory depression.
DIF: Cognitive Level: Knowledge REF: p. 398 OBJ: 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
5. Which lidocaine preparation is appropriate for the treatment of cardiac dysrhythmias?
a.0.1 % lidocaine with preservative
b.2 % lidocaine for topical use
c.Lidocaine patch
d.Injectable lidocaine without preservative
ANS: D
Lidocaine for IV use is different from lidocaine used as a local anesthetic. The label for
lidocaine for IV use should read “lidocaine for dysrhythmias” or “lidocaine without
preservatives.” The 0.1% lidocaine, 2% lidocaine for topical use, and lidocaine patch are for
topical anesthetic use.
DIF: Cognitive Level: Application REF: p. 393 OBJ: 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
6. Patients who are on neuromuscular blocking agents and lidocaine must be closely observed
for which complication?
a. Hyperkalemia
b. Respiratory depression
c. Neurotoxicity
d. Seizures
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Chapter 23: Drugs Used to Treat Dysrhythmias Test
Bank
MULTIPLE CHOICE
1. What is the action of amiodarone (Cordarone), a class III agent used to treat cardiac
dysrhythmias?
a. It acts as a myocardial depressant by inhibiting sodium ion movement.
b. It prolongs the duration of the electrical stimulation on cells and the refractory time
between electrical impulses.
c. It acts as a beta adrenergic agent.
d. It slows the rate of electrical conduction and prolongs the time between contractions.
ANS: D
Class I antidysrhythmic drugs act as a myocardial depressant by inhibiting sodium ion
movement. Class II antidysrhythmic drugs act as beta adrenergic agents. Class III agents slow
the rate of electrical conduction and prolong the time between contractions. Class IV
antidysrhythmic drugs prolong the duration of the electrical stimulation on cells and the
refractory time between electrical impulses.
DIF: Cognitive Level: ComprehensionREF: p. 396 OBJ: 3
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
2. How many milligrams of lidocaine will the nurse administer via intravenous (IV) bolus to a 30
year old patient with ventricular tachycardia who weighs 75 kg after a myocardial infarction?
a. 10
b. 25
c. 50
d. 75
ANS: D
The initial lidocaine bolus is 1 to 1.5 mg/kg, decreased by half in older adults, patients with
hepatic disease, and patients with heart failure. Doses of 10, 25, and 50 mg are too low for a
patient of this weight.
DIF: Cognitive Level: Application REF: p. 393 OBJ: 4
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
3. A patient is taking amiodarone (Cordarone) for hypertrophic cardiomyopathy and begins to
complain of dizziness. What will the nurse instruct the patient to do?
a. Discontinue the medication immediately.
b. Decrease the medication dosage for 1 week, and then resume the original order.
c. Change positions slowly.
d. Increase the dosage per health care provider directions.
This study source was downloaded by 100000761823232 from CourseHero.com on 04-12-2021 14:42:05 GMT -05:00
https://www.coursehero.com/file/19255141/ch24/
Downloaded by: Sophiie |
Distribution of this document is illegal
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ANS: C
Many adverse effects are dose related and resolve with reducing the dosage or discontinuing
therapy. Patients should be taught to rise slowly from a supine or sitting position and sit or lie
down if feeling faint. Medication should be discontinued only for serious adverse effects and
with the consent of the health care provider. Changes in dose should be done only with the
consent of the health care provider. Increasing the dose will likely increase the symptoms.
DIF: Cognitive Level: Application REF: pp. 396-397 OBJ: 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
4. A patient who is started on phenytoin (Dilantin), who is also taking amiodarone (Cordarone),
should be assessed for what possible effect?
a. Central nervous system depression and sedation
b. Decrease in effectiveness of phenytoin
c. Respiratory depression
d. Increase in serum phenytoin levels
ANS: D
Elevation of phenytoin serum levels (200% to 300%) is observed over several weeks. The
dosage of phenytoin must be gradually reduced based on patient response. The combination
of phenytoin and amiodarone does not produce sedation and depression, decrease the
effectiveness of either drug, or produce respiratory depression.
DIF: Cognitive Level: Knowledge REF: p. 398 OBJ: 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
5. Which lidocaine preparation is appropriate for the treatment of cardiac dysrhythmias?
a.0.1 % lidocaine with preservative
b.2 % lidocaine for topical use
c.Lidocaine patch
d.Injectable lidocaine without preservative
ANS: D
Lidocaine for IV use is different from lidocaine used as a local anesthetic. The label for
lidocaine for IV use should read “lidocaine for dysrhythmias” or “lidocaine without
preservatives.” The 0.1% lidocaine, 2% lidocaine for topical use, and lidocaine patch are for
topical anesthetic use.
DIF: Cognitive Level: Application REF: p. 393 OBJ: 6
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
6. Patients who are on neuromuscular blocking agents and lidocaine must be closely observed
for which complication?
a. Hyperkalemia
b. Respiratory depression
c. Neurotoxicity
d. Seizures
This study source was downloaded by 100000761823232 from CourseHero.com on 04-12-2021 14:42:05 GMT -05:00
https://www.coursehero.com/file/19255141/ch24/
Downloaded by: Sophiie |
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