Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. A patient with a history of atrial fibrillation has had a worsening of his or her
condition. The nurse knows that the drug of choice for long-term stabilization of
atrial fibrillation following electrocardioversion is what?
a. Disopyramide (Norpace)
b. Moricizine (Ethmozine)
c. Procainamide (Pronestyl)
d. Quinidine (generic)
Ans: D
Feedback:
Quinidine is often the drug of choice for long-term stabilization of atrial fibrillation
after the rhythm is converted by electrocardioversion. Quinidine is a class I
antiarrhythmic and stabilizes the cell membrane by binding to sodium channels,
depressing phase 0 of the action potential, and changing the duration of the action
potential. Disopyramide, moricizine, and procainamide are all used in the treatment of
life-threatening ventricular arrhythmias.
2. What class of antiarrhythmics drug blocks potassium channels, prolonging phase 3
of the action potential and slowing the rate and conduction of the heart?
a. I
b. II
c. III
d. IV
Ans: C
Feedback:
The class III antiarrhythmics block potassium, prolonging phase 3 of the action
potential, which prolongs repolarization and slows the rate and conduction of the
heart. Class I drugs block the sodium channels in the cell membrane during an action
potential. Class II drugs are beta-adrenergic blockers that block beta-receptors,
causing a depression of phase 4 of the action potential. Class IV drugs block calcium
channels in the cell membrane leading to a depression of depolarization and a
prolongation of phases I and II of repolarization, which slows automaticity.
3. The nurse is caring for a pediatric patient who has been diagnosed with paroxysmal
atrial tachycardia. The order reads digoxin 10 mcg/kg orally. The child weighs 44
pounds. How many mcg will the nurse administer?
a. 50 mcg
b. 100 mcg
, c. 150 mcg
d. 200 mcg
Ans: D
Feedback:
The nurse will administer 200 mcg. (2.2 pounds: 1 kg = X: 20 kg, 20(10) = 200 mcg).
4. The nurse is providing drug teaching about quinidine in preparation for the
patient’s discharge. The nurse discusses drugfood interactions and advises the
patient to drink what?
a. Apple juice
b. Grapefruit juice
c. Milk
d. Orange juice
Ans: A
Feedback:
Apple juice would be the best choice. Quinidine requires a slightly acidic urine
(normal state) for excretion. Patients receiving quinidine should avoid foods that
alkalinize the urine (e.g., citrus juices, vegetables, antacids, milk products), which
could lead to increased quinidine levels and toxicity. Grapefruit juice has been shown
to interfere with the metabolism of quinidine, leading to increased serum levels and
toxic effects; this combination should be avoided.
5. A patient has had sotalol (Betapace) ordered for treatment of a ventricular
arrhythmia. What will the nurse consider when administering the drug?
a. Sotalol has a very short duration of action
b. Food increases the bioavailability of the drug
c. Absorption of sotalol is decreased by the presence of food
d. The drug is best administered intramuscularly
Ans: C
Feedback:
This drug should not be taken with food because absorption is decreased. The drug
should be given 1 hour before or 2 hours after a meal. Adenosine, not sotalol, has a
very short duration of action and food increases the bioavailability of propranolol.
Sotalol is administered by oral route only.
6. The nurse is caring for a patient who reports insomnia since starting the
antiarrhythmic agent prescribed for him or her. What antiarrhythmic agent would
the nurse expect this patient is taking?
a. Disopyramide (Norpace)
b. Amiodarone (Cordarone)
c. Procainamide (Pronestyl)
1. A patient with a history of atrial fibrillation has had a worsening of his or her
condition. The nurse knows that the drug of choice for long-term stabilization of
atrial fibrillation following electrocardioversion is what?
a. Disopyramide (Norpace)
b. Moricizine (Ethmozine)
c. Procainamide (Pronestyl)
d. Quinidine (generic)
Ans: D
Feedback:
Quinidine is often the drug of choice for long-term stabilization of atrial fibrillation
after the rhythm is converted by electrocardioversion. Quinidine is a class I
antiarrhythmic and stabilizes the cell membrane by binding to sodium channels,
depressing phase 0 of the action potential, and changing the duration of the action
potential. Disopyramide, moricizine, and procainamide are all used in the treatment of
life-threatening ventricular arrhythmias.
2. What class of antiarrhythmics drug blocks potassium channels, prolonging phase 3
of the action potential and slowing the rate and conduction of the heart?
a. I
b. II
c. III
d. IV
Ans: C
Feedback:
The class III antiarrhythmics block potassium, prolonging phase 3 of the action
potential, which prolongs repolarization and slows the rate and conduction of the
heart. Class I drugs block the sodium channels in the cell membrane during an action
potential. Class II drugs are beta-adrenergic blockers that block beta-receptors,
causing a depression of phase 4 of the action potential. Class IV drugs block calcium
channels in the cell membrane leading to a depression of depolarization and a
prolongation of phases I and II of repolarization, which slows automaticity.
3. The nurse is caring for a pediatric patient who has been diagnosed with paroxysmal
atrial tachycardia. The order reads digoxin 10 mcg/kg orally. The child weighs 44
pounds. How many mcg will the nurse administer?
a. 50 mcg
b. 100 mcg
, c. 150 mcg
d. 200 mcg
Ans: D
Feedback:
The nurse will administer 200 mcg. (2.2 pounds: 1 kg = X: 20 kg, 20(10) = 200 mcg).
4. The nurse is providing drug teaching about quinidine in preparation for the
patient’s discharge. The nurse discusses drugfood interactions and advises the
patient to drink what?
a. Apple juice
b. Grapefruit juice
c. Milk
d. Orange juice
Ans: A
Feedback:
Apple juice would be the best choice. Quinidine requires a slightly acidic urine
(normal state) for excretion. Patients receiving quinidine should avoid foods that
alkalinize the urine (e.g., citrus juices, vegetables, antacids, milk products), which
could lead to increased quinidine levels and toxicity. Grapefruit juice has been shown
to interfere with the metabolism of quinidine, leading to increased serum levels and
toxic effects; this combination should be avoided.
5. A patient has had sotalol (Betapace) ordered for treatment of a ventricular
arrhythmia. What will the nurse consider when administering the drug?
a. Sotalol has a very short duration of action
b. Food increases the bioavailability of the drug
c. Absorption of sotalol is decreased by the presence of food
d. The drug is best administered intramuscularly
Ans: C
Feedback:
This drug should not be taken with food because absorption is decreased. The drug
should be given 1 hour before or 2 hours after a meal. Adenosine, not sotalol, has a
very short duration of action and food increases the bioavailability of propranolol.
Sotalol is administered by oral route only.
6. The nurse is caring for a patient who reports insomnia since starting the
antiarrhythmic agent prescribed for him or her. What antiarrhythmic agent would
the nurse expect this patient is taking?
a. Disopyramide (Norpace)
b. Amiodarone (Cordarone)
c. Procainamide (Pronestyl)
