CARDIOVASCULAR DRUGS AND MEDICATIONS
EXAM (ACTUAL 2025) QUESTIONS AND
VERIFIED ANSWERS
What is the MOST appropriate action for the nurse to take
before administering digoxin?
a. monitor potassium level
b. assess blood pressure
c. evaluate urinary output
d. avoid giving with thiazide diuretic
a. monitor potassium level
Monitoring potassium is especially important because
hypokalemia potentiates digoxin toxicity. Digoxin exhibits its
therapeutic and toxic effects by poisoning the sodium-
potassium ATPase. The subsequent increase in intracellular
sodium leads to increased intracellular calcium by decreasing
calcium expulsion through the sodium-calcium, cation
exchanger. Blood pressure and urinary output are incorrect
because these data reflect overall CV status but are not
specific for digoxin.
Which of the following clients is at greatest risk for digital
toxicity?
A. a 25 yr old client with congenital heart disease.
,B. a 50 yr old client with CHF
C. a 60 yr old client after myocardial infarction
D. an 80 yr old with CHF
D. an 80 yr old with CHF
Extremely old clients are at greater risk for digitalis toxicity.
Remember when it comes to adversity, the very old and very
young are always at the highest risk. There are no evidence-
based guidelines for the management of mild to moderate
toxicity so there is a wide variation in treatment. Severe
toxicity requires hospital admission and consideration of the
need for digoxin-specific antibody fragments. Although
digoxin-specific antibody fragments are safe and effective,
randomized trials have not been performed.
A 50-year-old client is prescribed to take nitrate each day for
his condition. As a competent nurse, you know the result of
nitrate administration is:
A. Decreased myocardial oxygen demand.
B. Increased myocardial oxygen demand.
C. Increased left ventricular end-diastolic volume.
D. Increased atrial pressure.
A. decreased myocardial oxygen demand
,Nitrate administration will result in reduced preload and a
decrease in myocardial oxygen demand and left ventricular
end-diastolic volume. Nitrates exert their pharmacological
effect by being activated by mitochondrial or cytosolic
aldehyde dehydrogenase (ALDH2) into nitric oxide (NO), an
endothelium-derived relaxing factor (EDRF). NO is generally
produced by the endothelium to dilate the blood vessels;
however, endothelial dysfunction in diseases such as
atherosclerosis can deplete NO levels.
A student nurse is asked to give an example of a long-acting
nitrate. He is correct by saying:
A. Nitroglycerin sublingual.
B. Nitroglycerin IV.
C. Isosorbide PO.
D. Nitroglycerin transmucosal
C. isosorbide PO
Isosorbide is one of the most frequently administered long-
acting nitrates. PO nitrates are longer acting than IV or SL
agents. Other forms of commonly used nitrates include
isosorbide dinitrate, isosorbide mononitrate, and isosorbide
mononitrate sustained-release (SR). These forms are taken
orally and have a longer duration of action.
, When nitrates are administered early to the acute MI client,
the effect is:
A. Hypotension.
B. Bradycardia.
C. Reduced mortality.
D. Reduced morbidity. C. reduced mortality
When teaching about nitrate administration, the nurse should
instruct the client to:
A. Change position slowly.
B. Take a pulse daily.
C. Reduce salt intake.
D. Chew the sustained-release tablets.
A. change position slowly
Clients taking nitrates should change position slowly to avoid
orthostatic hypotension. Poor right ventricular contractility
causes the patients to be pre-load sensitive, and nitrates may
cause severe hypotension. Decreased left ventricular volume
from decreased preload will worsen the outflow tract
obstruction.
EXAM (ACTUAL 2025) QUESTIONS AND
VERIFIED ANSWERS
What is the MOST appropriate action for the nurse to take
before administering digoxin?
a. monitor potassium level
b. assess blood pressure
c. evaluate urinary output
d. avoid giving with thiazide diuretic
a. monitor potassium level
Monitoring potassium is especially important because
hypokalemia potentiates digoxin toxicity. Digoxin exhibits its
therapeutic and toxic effects by poisoning the sodium-
potassium ATPase. The subsequent increase in intracellular
sodium leads to increased intracellular calcium by decreasing
calcium expulsion through the sodium-calcium, cation
exchanger. Blood pressure and urinary output are incorrect
because these data reflect overall CV status but are not
specific for digoxin.
Which of the following clients is at greatest risk for digital
toxicity?
A. a 25 yr old client with congenital heart disease.
,B. a 50 yr old client with CHF
C. a 60 yr old client after myocardial infarction
D. an 80 yr old with CHF
D. an 80 yr old with CHF
Extremely old clients are at greater risk for digitalis toxicity.
Remember when it comes to adversity, the very old and very
young are always at the highest risk. There are no evidence-
based guidelines for the management of mild to moderate
toxicity so there is a wide variation in treatment. Severe
toxicity requires hospital admission and consideration of the
need for digoxin-specific antibody fragments. Although
digoxin-specific antibody fragments are safe and effective,
randomized trials have not been performed.
A 50-year-old client is prescribed to take nitrate each day for
his condition. As a competent nurse, you know the result of
nitrate administration is:
A. Decreased myocardial oxygen demand.
B. Increased myocardial oxygen demand.
C. Increased left ventricular end-diastolic volume.
D. Increased atrial pressure.
A. decreased myocardial oxygen demand
,Nitrate administration will result in reduced preload and a
decrease in myocardial oxygen demand and left ventricular
end-diastolic volume. Nitrates exert their pharmacological
effect by being activated by mitochondrial or cytosolic
aldehyde dehydrogenase (ALDH2) into nitric oxide (NO), an
endothelium-derived relaxing factor (EDRF). NO is generally
produced by the endothelium to dilate the blood vessels;
however, endothelial dysfunction in diseases such as
atherosclerosis can deplete NO levels.
A student nurse is asked to give an example of a long-acting
nitrate. He is correct by saying:
A. Nitroglycerin sublingual.
B. Nitroglycerin IV.
C. Isosorbide PO.
D. Nitroglycerin transmucosal
C. isosorbide PO
Isosorbide is one of the most frequently administered long-
acting nitrates. PO nitrates are longer acting than IV or SL
agents. Other forms of commonly used nitrates include
isosorbide dinitrate, isosorbide mononitrate, and isosorbide
mononitrate sustained-release (SR). These forms are taken
orally and have a longer duration of action.
, When nitrates are administered early to the acute MI client,
the effect is:
A. Hypotension.
B. Bradycardia.
C. Reduced mortality.
D. Reduced morbidity. C. reduced mortality
When teaching about nitrate administration, the nurse should
instruct the client to:
A. Change position slowly.
B. Take a pulse daily.
C. Reduce salt intake.
D. Chew the sustained-release tablets.
A. change position slowly
Clients taking nitrates should change position slowly to avoid
orthostatic hypotension. Poor right ventricular contractility
causes the patients to be pre-load sensitive, and nitrates may
cause severe hypotension. Decreased left ventricular volume
from decreased preload will worsen the outflow tract
obstruction.
