Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. A nurse is providing patient teaching to a patient who has been experiencing
unstable angina. What will the nurse’s explanation of this condition include?
a. A coronary vessel has become completely occluded and is unable to deliver
blood to your heart.
b. The pain is caused by a spasm of a blood vessel, not just from the vessel
narrowing.
c. There is serious narrowing of a coronary artery that is causing a reduction
in oxygen to the heart.
d. Your body’s response to a lack of oxygen in the heart muscle is pain.
Ans: C
Feedback:
Unstable angina is described as increased narrowing of coronary arteries with the
heart experiencing episodes of ischemia even at rest. If a coronary vessel is
completely occluded and unable to deliver blood to the cardiac muscle, a myocardial
infarction has occurred. Prinzmetal’s angina is an unusual form of angina caused by
spasm of the blood vessel and not just by vessel narrowing. Although pain is the
body’s response to ischemia in the heart muscle, this description could encompass
angina or a myocardial infarction and is not specific enough to explain the condition.
2. The nurse cautions the patient taking nadolol (Corgard) for angina that they may
experience what adverse effect?
a. Dry mouth
b. Decreased exercise tolerance
c. Constipation
d. Problems with urination
Ans: B
Feedback:
Nadolol is a beta-blocker that can cause a decreased tolerance to exercise because of
the inability to experience the effects of the stress reaction. Dry mouth, constipation,
and problems with urination are effects often seen with anticholinergic drugs but not
with beta-blockers.
3. A patient who has been taking cyclosporine to prevent rejection of a kidney
transplant has had diltiazem ordered. Why would the nurse question this order?
a. Serious diltiazem toxicity could occur.
b. The combination may result in elevated or even toxic cyclosporine levels.
c. The combination could lead to kidney rejection.
, d. A kidney recipient would not effectively excrete the diltiazem.
Ans: B
Feedback:
Potentially serious adverse effects to keep in mind include increased serum levels and
toxicity of cyclosporine if they are taken with diltiazem. This combination is not
associated with diltiazem toxicity. A functioning implanted kidney should still excrete
diltiazem. This drug would not cause rejection of a transplanted kidney.
4. A nurse is teaching the patient newly prescribed sublingual nitroglycerin how to
take the medication. What will the nurse instruct the patient to do first?
a. To check his radial pulse
b. To place the tablet in the buccal cavity
c. To take a sip of water
d. To lie down for 15 minutes before administration
Ans: C
Feedback:
The nurse should instruct the patient to take a sip of water to moisten the mucous
membranes so the tablet will dissolve quickly. The patient does not need to take his
pulse or lie down before drug administration. For sublingual administration, the
patient will place the tablet under his tongue and not in the buccal cavity (cheek area).
5. The nurse, caring for a patient taking a beta-blocker and a nitrate to treat angina,
recognizes the need for careful monitoring as the result of what secondary
diagnosis?
a. Chronic obstructive pulmonary disease (COPD)
b. Rheumatoid arthritis (RA)
c. Irritable bowel syndrome (IBS)
d. Chronic urinary tract infection (UTI)
Ans: A
Feedback:
The nurse should assess for COPD, because the effect of beta-blockers in reducing
effects of the sympathetic nervous system could exacerbate the respiratory condition.
RA, IBS, and chronic UTI are not affected by the use of beta-blockers or nitrates to
treat angina.
6. What drug would the nurse administer to the patient to control angina caused by
atherosclerosis that would also slow the development of further plaque buildup on
the arterial wall?
a. Diltiazem (Cardizem)
b. Propranolol (Inderal)
c. Amyl Nitrates (generic)
1. A nurse is providing patient teaching to a patient who has been experiencing
unstable angina. What will the nurse’s explanation of this condition include?
a. A coronary vessel has become completely occluded and is unable to deliver
blood to your heart.
b. The pain is caused by a spasm of a blood vessel, not just from the vessel
narrowing.
c. There is serious narrowing of a coronary artery that is causing a reduction
in oxygen to the heart.
d. Your body’s response to a lack of oxygen in the heart muscle is pain.
Ans: C
Feedback:
Unstable angina is described as increased narrowing of coronary arteries with the
heart experiencing episodes of ischemia even at rest. If a coronary vessel is
completely occluded and unable to deliver blood to the cardiac muscle, a myocardial
infarction has occurred. Prinzmetal’s angina is an unusual form of angina caused by
spasm of the blood vessel and not just by vessel narrowing. Although pain is the
body’s response to ischemia in the heart muscle, this description could encompass
angina or a myocardial infarction and is not specific enough to explain the condition.
2. The nurse cautions the patient taking nadolol (Corgard) for angina that they may
experience what adverse effect?
a. Dry mouth
b. Decreased exercise tolerance
c. Constipation
d. Problems with urination
Ans: B
Feedback:
Nadolol is a beta-blocker that can cause a decreased tolerance to exercise because of
the inability to experience the effects of the stress reaction. Dry mouth, constipation,
and problems with urination are effects often seen with anticholinergic drugs but not
with beta-blockers.
3. A patient who has been taking cyclosporine to prevent rejection of a kidney
transplant has had diltiazem ordered. Why would the nurse question this order?
a. Serious diltiazem toxicity could occur.
b. The combination may result in elevated or even toxic cyclosporine levels.
c. The combination could lead to kidney rejection.
, d. A kidney recipient would not effectively excrete the diltiazem.
Ans: B
Feedback:
Potentially serious adverse effects to keep in mind include increased serum levels and
toxicity of cyclosporine if they are taken with diltiazem. This combination is not
associated with diltiazem toxicity. A functioning implanted kidney should still excrete
diltiazem. This drug would not cause rejection of a transplanted kidney.
4. A nurse is teaching the patient newly prescribed sublingual nitroglycerin how to
take the medication. What will the nurse instruct the patient to do first?
a. To check his radial pulse
b. To place the tablet in the buccal cavity
c. To take a sip of water
d. To lie down for 15 minutes before administration
Ans: C
Feedback:
The nurse should instruct the patient to take a sip of water to moisten the mucous
membranes so the tablet will dissolve quickly. The patient does not need to take his
pulse or lie down before drug administration. For sublingual administration, the
patient will place the tablet under his tongue and not in the buccal cavity (cheek area).
5. The nurse, caring for a patient taking a beta-blocker and a nitrate to treat angina,
recognizes the need for careful monitoring as the result of what secondary
diagnosis?
a. Chronic obstructive pulmonary disease (COPD)
b. Rheumatoid arthritis (RA)
c. Irritable bowel syndrome (IBS)
d. Chronic urinary tract infection (UTI)
Ans: A
Feedback:
The nurse should assess for COPD, because the effect of beta-blockers in reducing
effects of the sympathetic nervous system could exacerbate the respiratory condition.
RA, IBS, and chronic UTI are not affected by the use of beta-blockers or nitrates to
treat angina.
6. What drug would the nurse administer to the patient to control angina caused by
atherosclerosis that would also slow the development of further plaque buildup on
the arterial wall?
a. Diltiazem (Cardizem)
b. Propranolol (Inderal)
c. Amyl Nitrates (generic)
