NR 340 CRITICAL CARE NURSING
Hemodynamic
Pharmacology
Latest Review Exam
Q&A
2024
,1. A patient with acute heart failure is prescribed a medication that
increases cardiac contractility. Which pharmacological agent achieves this
by inhibiting phosphodiesterase?
A. Nitroglycerin
B. Dobutamine
C. Milrinone
D. Enalapril
Answer: C. Milrinone
Rationale: Milrinone is a phosphodiesterase inhibitor that increases
intracellular cyclic AMP, leading to increased calcium influx into
myocardial cells, thereby increasing cardiac contractility.
2. In managing a patient with cardiogenic shock, which vasopressor is
preferred to increase myocardial perfusion pressure?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Phenylephrine
Answer: B. Norepinephrine
Rationale: Norepinephrine is the vasopressor of choice in cardiogenic
shock because it increases systemic vascular resistance, leading to an
increase in blood pressure and myocardial perfusion pressure without
significantly increasing heart rate.
3. A nurse is caring for a patient who is receiving vasodilator therapy for
heart failure. Which hemodynamic parameter is the primary target for
improvement with this therapy?
A. Cardiac output
B. Systemic vascular resistance
C. Pulmonary capillary wedge pressure
D. Central venous pressure
Answer: B. Systemic vascular resistance
Rationale: Vasodilators are used in heart failure to reduce systemic
vascular resistance, which decreases the workload on the heart and
improves cardiac output.
4. When administering a beta-blocker to a patient with hypertension and
, chronic obstructive pulmonary disease (COPD), which of the following is
a critical consideration?
A. The potential for bronchospasm
B. The risk of hyperglycemia
C. The likelihood of causing tachycardia
D. The chance of increasing diuresis
Answer: A. The potential for bronchospasm
Rationale: Beta-blockers can cause bronchospasm, which is a concern in
patients with COPD. Therefore, beta-blockers with higher beta-1
selectivity are preferred in these patients to minimize the risk.
5. A patient is prescribed an ACE inhibitor for the management of chronic
heart failure. Which of the following is a common adverse effect that the
nurse should monitor?
A. Hypokalemia
B. Dry cough
C. Tachycardia
D. Hypercalcemia
Answer: B. Dry cough
Rationale: A common side effect of ACE inhibitors is a persistent dry
cough, which is thought to be related to the accumulation of bradykinin in
the respiratory tract.
6. For a patient experiencing a hypertensive crisis, which intravenous
medication would provide rapid reduction of blood pressure?
A. Atenolol
B. Hydralazine
C. Furosemide
D. Sodium nitroprusside
Answer: D. Sodium nitroprusside
Rationale: Sodium nitroprusside is a potent vasodilator that can rapidly
decrease blood pressure in hypertensive emergencies.
7. A patient with pulmonary arterial hypertension (PAH) is being treated
with a prostacyclin analog. What is the primary therapeutic action of this
class of medication?
A. Bronchodilation
B. Vasoconstriction
Hemodynamic
Pharmacology
Latest Review Exam
Q&A
2024
,1. A patient with acute heart failure is prescribed a medication that
increases cardiac contractility. Which pharmacological agent achieves this
by inhibiting phosphodiesterase?
A. Nitroglycerin
B. Dobutamine
C. Milrinone
D. Enalapril
Answer: C. Milrinone
Rationale: Milrinone is a phosphodiesterase inhibitor that increases
intracellular cyclic AMP, leading to increased calcium influx into
myocardial cells, thereby increasing cardiac contractility.
2. In managing a patient with cardiogenic shock, which vasopressor is
preferred to increase myocardial perfusion pressure?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Phenylephrine
Answer: B. Norepinephrine
Rationale: Norepinephrine is the vasopressor of choice in cardiogenic
shock because it increases systemic vascular resistance, leading to an
increase in blood pressure and myocardial perfusion pressure without
significantly increasing heart rate.
3. A nurse is caring for a patient who is receiving vasodilator therapy for
heart failure. Which hemodynamic parameter is the primary target for
improvement with this therapy?
A. Cardiac output
B. Systemic vascular resistance
C. Pulmonary capillary wedge pressure
D. Central venous pressure
Answer: B. Systemic vascular resistance
Rationale: Vasodilators are used in heart failure to reduce systemic
vascular resistance, which decreases the workload on the heart and
improves cardiac output.
4. When administering a beta-blocker to a patient with hypertension and
, chronic obstructive pulmonary disease (COPD), which of the following is
a critical consideration?
A. The potential for bronchospasm
B. The risk of hyperglycemia
C. The likelihood of causing tachycardia
D. The chance of increasing diuresis
Answer: A. The potential for bronchospasm
Rationale: Beta-blockers can cause bronchospasm, which is a concern in
patients with COPD. Therefore, beta-blockers with higher beta-1
selectivity are preferred in these patients to minimize the risk.
5. A patient is prescribed an ACE inhibitor for the management of chronic
heart failure. Which of the following is a common adverse effect that the
nurse should monitor?
A. Hypokalemia
B. Dry cough
C. Tachycardia
D. Hypercalcemia
Answer: B. Dry cough
Rationale: A common side effect of ACE inhibitors is a persistent dry
cough, which is thought to be related to the accumulation of bradykinin in
the respiratory tract.
6. For a patient experiencing a hypertensive crisis, which intravenous
medication would provide rapid reduction of blood pressure?
A. Atenolol
B. Hydralazine
C. Furosemide
D. Sodium nitroprusside
Answer: D. Sodium nitroprusside
Rationale: Sodium nitroprusside is a potent vasodilator that can rapidly
decrease blood pressure in hypertensive emergencies.
7. A patient with pulmonary arterial hypertension (PAH) is being treated
with a prostacyclin analog. What is the primary therapeutic action of this
class of medication?
A. Bronchodilation
B. Vasoconstriction
