Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
1. A patient presents to the emergency department with rales, wheezing, and blood-
tinged sputum. What does the nurse recognize that these symptoms indicate?
a. Cardiomyopathy
b. Cardiomegaly
c. Valvular heart disease
d. Pulmonary edema
Ans: D
Feedback:
In left-sided heart failure, the left ventricle pumps inefficiently resulting in a backup
of blood into the lungs causing pulmonary vessel congestion and fluid leaks into the
alveoli and lung tissue. As more fluid continues to collect in the alveoli, pulmonary
edema develops. The patient will present with rales, wheezes, blood-tinged sputum,
low oxygenation, and development of a third heart sound. Cardiomyopathy can occur
as a result of a viral infection, alcoholism, anabolic steroid abuse, or a collagen
disorder. It causes muscle alterations and ineffective contraction and pumping.
Cardiomegaly is an enlargement of the heart due to compensatory mechanisms in
congestive heart failure (CHF) and leads to ineffective pumping and eventually
exacerbated CHF. Valvular heart disease leads to an overload of the ventricles
because the valves do not close adequately causing blood to leak backward. This
causes muscle stretching and increased demand for oxygen and energy.
2. What electrolyte inactivates troponin and allows actin and myosin to form a bridge
enabling the muscle fibers to contract?
a. Magnesium
b. Calcium
c. Potassium
d. Sodium
Ans: B
Feedback:
Calcium must be present to deactivate troponin so that actin and myosin can react to
form actinomycin bridges. Potassium, sodium, and magnesium do not affect troponin.
3. A 62-year-old African American man diagnosed with congestive heart failure and
hypertension has BiDil included in his drug therapy. What nursing assessment
finding would indicate the patient is developing a complication from this drug?
, a. Alopecia
b. Photosensitivity
c. Anorexia
d. Orthostatic hypotension
Ans: D
Feedback:
Orthostatic hypotension is an adverse effect of a combination of isosorbide dinitrate
and hydralazine called BiDil. This could lead to safety concerns and should be
addressed in drug teaching for this patient. Alopecia, photosensitivity, and anorexia
are not adverse effects related to this drug.
4. The nurse is preparing digoxin for an infant. What is the nurse’s priority
intervention?
a. To perform hand hygiene
b. To have another nurse check dosage calculations
c. To check the child’s apical pulse
d. To identify the patient by checking the ID bracelet
Ans: B
Feedback:
The margin of safety for the dosage of this drug is very narrow in children. The
dosage needs to be very carefully calculated and should be double-checked by another
nurse before administration. The other options are important and the nurse should
implement all three. However, these actions are of lower priority.
5. A patient asks the nurse what cardiac glycosides do to improve his condition. What
is the nurse’s best response?
a. They decrease the force of myocardial contractions.
b. They help renal blood flow and increase urine output.
c. They increase heart rate.
d. They increase conduction velocity.
Ans: B
Feedback:
Cardiac glycosides increase intracellular calcium and allow more calcium to enter
myocardial cells. This action causes an increased force of myocardial contraction, an
increased cardiac output, and renal perfusion that increases urine output. Cardiac
glycosides also serve to slow the heart rate and decrease conduction velocity.
6. What is the priority nursing assessment for a patient who is about to begin digoxin
therapy?
a. Blood glucose levels
b. Neurological function
1. A patient presents to the emergency department with rales, wheezing, and blood-
tinged sputum. What does the nurse recognize that these symptoms indicate?
a. Cardiomyopathy
b. Cardiomegaly
c. Valvular heart disease
d. Pulmonary edema
Ans: D
Feedback:
In left-sided heart failure, the left ventricle pumps inefficiently resulting in a backup
of blood into the lungs causing pulmonary vessel congestion and fluid leaks into the
alveoli and lung tissue. As more fluid continues to collect in the alveoli, pulmonary
edema develops. The patient will present with rales, wheezes, blood-tinged sputum,
low oxygenation, and development of a third heart sound. Cardiomyopathy can occur
as a result of a viral infection, alcoholism, anabolic steroid abuse, or a collagen
disorder. It causes muscle alterations and ineffective contraction and pumping.
Cardiomegaly is an enlargement of the heart due to compensatory mechanisms in
congestive heart failure (CHF) and leads to ineffective pumping and eventually
exacerbated CHF. Valvular heart disease leads to an overload of the ventricles
because the valves do not close adequately causing blood to leak backward. This
causes muscle stretching and increased demand for oxygen and energy.
2. What electrolyte inactivates troponin and allows actin and myosin to form a bridge
enabling the muscle fibers to contract?
a. Magnesium
b. Calcium
c. Potassium
d. Sodium
Ans: B
Feedback:
Calcium must be present to deactivate troponin so that actin and myosin can react to
form actinomycin bridges. Potassium, sodium, and magnesium do not affect troponin.
3. A 62-year-old African American man diagnosed with congestive heart failure and
hypertension has BiDil included in his drug therapy. What nursing assessment
finding would indicate the patient is developing a complication from this drug?
, a. Alopecia
b. Photosensitivity
c. Anorexia
d. Orthostatic hypotension
Ans: D
Feedback:
Orthostatic hypotension is an adverse effect of a combination of isosorbide dinitrate
and hydralazine called BiDil. This could lead to safety concerns and should be
addressed in drug teaching for this patient. Alopecia, photosensitivity, and anorexia
are not adverse effects related to this drug.
4. The nurse is preparing digoxin for an infant. What is the nurse’s priority
intervention?
a. To perform hand hygiene
b. To have another nurse check dosage calculations
c. To check the child’s apical pulse
d. To identify the patient by checking the ID bracelet
Ans: B
Feedback:
The margin of safety for the dosage of this drug is very narrow in children. The
dosage needs to be very carefully calculated and should be double-checked by another
nurse before administration. The other options are important and the nurse should
implement all three. However, these actions are of lower priority.
5. A patient asks the nurse what cardiac glycosides do to improve his condition. What
is the nurse’s best response?
a. They decrease the force of myocardial contractions.
b. They help renal blood flow and increase urine output.
c. They increase heart rate.
d. They increase conduction velocity.
Ans: B
Feedback:
Cardiac glycosides increase intracellular calcium and allow more calcium to enter
myocardial cells. This action causes an increased force of myocardial contraction, an
increased cardiac output, and renal perfusion that increases urine output. Cardiac
glycosides also serve to slow the heart rate and decrease conduction velocity.
6. What is the priority nursing assessment for a patient who is about to begin digoxin
therapy?
a. Blood glucose levels
b. Neurological function
