C HAPTER 12: C ARDIOVASCULAR
T HERAPEUTIC M ANAGEMENT
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. Adenosine is an antidysrhythmic agent that is give n primaril y what
reason?
a. To convert supraventricular tachycardias
b. To suppress premature ventricular contractions (PVCs)
c. To treat second - and third-degree AV blocks
d. To coarsen ventricular fibrillation so that defibrillation is
effective
ANS: A
Adenosine occurs endogenousl y in the body as a building block of
adenosine triphosphate (ATP). Given in intravenous boluses, adenosine
slows conduction through the atrioventricular (AV) node, causing
transient AV block. It is used clinicall y to convert supraventricul ar
tachycardias and to facilitate the differential diagnosis of rapid
dysrhythmias.
PTS: 1 DIF: Cognitive Level: Understanding OBJ:
Nursing Process Step: Implementation TOP:
Cardiovascular Therapeutic Management MSC: NC LEX:
Physiological Integrity: Pharmacological Therapies
,2. Which dosage of dopamine results in stimulation of beta1 receptors and
increased m yocardial contractilit y?
a. 1 mcg/kg/min
b. 5 mcg/kg/min
c. 15 mcg/kg/min
d. 20 mcg/kg/min
ANS: B
At low dosages of 1 to 2 mcg/kg/min, dopamine stimulates
dopaminergic receptors, causing renal and mesenteric vasodilation.
Moderate dosages result in stimulation of beta1 receptors to increase
myocardial contractilit y and improve cardiac output. At dosages
greater than 10 mg/kg/min, dopamine predominantl y stimula tes alpha
receptors, resulting in vasoconstriction that often negates both the
beta-adrenergic and dopaminergic effects.
PTS: 1 DIF: Cognitive Level: Understanding OBJ:
Nursing Process Step: Implementation TOP:
Cardiovascular Therapeutic Management MSC: NC LEX:
Physiological Integrity: Pharmacological Therapies
3. A patient is admitted with left -sided heart failure and a blood pressure
of 220/118 mm Hg. Which drug will be most effective in decreasing the
blood pressure and reducing afterload?
a. Dopamine
b. Verapamil
c. Propranolol
d. Sodium nitroprusside
, ANS: D
Sodium nitroprusside (Nipride) is a potent, rapidl y acting venous and
arterial vasodilator, particularl y suitable for rapid reduction of blood
pressure in hypertensive emergencies and perioperativel y. It also is
effective for afterload reduction in the setting of severe heart failure.
The drug is administered by continuous intravenous infusion, with the
dosage titrated to maintain the desired blood pressure and systemic
vascular resistance.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Cardiovascular
Therapeutic Management MSC: NC LEX:
Physiological Integrity: Pharmacological Therapies
4. Through what mechanism does enalapril decrease blood pressure?
a. Direct arteri al vasodilation.
b. Block the conversion of angiotensin I to angiotensin II.
c. Increase fluid excretion at the loop of Henle.
d. Peripheral vasoconstriction and central vasodilation.
ANS: B
Enalapril is an angiotensin -converting enzyme (ACE) inhibitors which
produces vasodilation by blocking the conversion of angiotensin I to
angiotensin II. Because angiotensin is a potent vasoconstrictor,
limiting its production decreases peripheral vascular resistance. In
contrast to the direct vasodilators and nifedipine, ACE inhibitors do
not cause reflex tachycardia or induce sodium and water retention.
T HERAPEUTIC M ANAGEMENT
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. Adenosine is an antidysrhythmic agent that is give n primaril y what
reason?
a. To convert supraventricular tachycardias
b. To suppress premature ventricular contractions (PVCs)
c. To treat second - and third-degree AV blocks
d. To coarsen ventricular fibrillation so that defibrillation is
effective
ANS: A
Adenosine occurs endogenousl y in the body as a building block of
adenosine triphosphate (ATP). Given in intravenous boluses, adenosine
slows conduction through the atrioventricular (AV) node, causing
transient AV block. It is used clinicall y to convert supraventricul ar
tachycardias and to facilitate the differential diagnosis of rapid
dysrhythmias.
PTS: 1 DIF: Cognitive Level: Understanding OBJ:
Nursing Process Step: Implementation TOP:
Cardiovascular Therapeutic Management MSC: NC LEX:
Physiological Integrity: Pharmacological Therapies
,2. Which dosage of dopamine results in stimulation of beta1 receptors and
increased m yocardial contractilit y?
a. 1 mcg/kg/min
b. 5 mcg/kg/min
c. 15 mcg/kg/min
d. 20 mcg/kg/min
ANS: B
At low dosages of 1 to 2 mcg/kg/min, dopamine stimulates
dopaminergic receptors, causing renal and mesenteric vasodilation.
Moderate dosages result in stimulation of beta1 receptors to increase
myocardial contractilit y and improve cardiac output. At dosages
greater than 10 mg/kg/min, dopamine predominantl y stimula tes alpha
receptors, resulting in vasoconstriction that often negates both the
beta-adrenergic and dopaminergic effects.
PTS: 1 DIF: Cognitive Level: Understanding OBJ:
Nursing Process Step: Implementation TOP:
Cardiovascular Therapeutic Management MSC: NC LEX:
Physiological Integrity: Pharmacological Therapies
3. A patient is admitted with left -sided heart failure and a blood pressure
of 220/118 mm Hg. Which drug will be most effective in decreasing the
blood pressure and reducing afterload?
a. Dopamine
b. Verapamil
c. Propranolol
d. Sodium nitroprusside
, ANS: D
Sodium nitroprusside (Nipride) is a potent, rapidl y acting venous and
arterial vasodilator, particularl y suitable for rapid reduction of blood
pressure in hypertensive emergencies and perioperativel y. It also is
effective for afterload reduction in the setting of severe heart failure.
The drug is administered by continuous intravenous infusion, with the
dosage titrated to maintain the desired blood pressure and systemic
vascular resistance.
PTS: 1 DIF: Cognitive Level: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Cardiovascular
Therapeutic Management MSC: NC LEX:
Physiological Integrity: Pharmacological Therapies
4. Through what mechanism does enalapril decrease blood pressure?
a. Direct arteri al vasodilation.
b. Block the conversion of angiotensin I to angiotensin II.
c. Increase fluid excretion at the loop of Henle.
d. Peripheral vasoconstriction and central vasodilation.
ANS: B
Enalapril is an angiotensin -converting enzyme (ACE) inhibitors which
produces vasodilation by blocking the conversion of angiotensin I to
angiotensin II. Because angiotensin is a potent vasoconstrictor,
limiting its production decreases peripheral vascular resistance. In
contrast to the direct vasodilators and nifedipine, ACE inhibitors do
not cause reflex tachycardia or induce sodium and water retention.
