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NCLEX RN Exam Bank: Cardiac Medications, Inotropes,
Anticoagulants, and Antiarrhythmics
Table of Contents
Subtopic 1: Inotropes Mechanism, Indications, and Nursing Considerations ..................... 2
Subtopic 2: Anticoagulants Types, Uses, and Nursing Care ............................................ 10
Subtopic 3: Antiarrhythmics Classification, Uses, and Side Effects................................. 18
Subtopic 4: Inotropes and Vasopressors Dosage, Administration, and Complications ...... 27
Subtopic 5: Anticoagulant and Antiplatelet Drug Interactions, Side Effects, and Patient
Education ................................................................................................................... 35
Subtopic 6: Inotropic Agents Mechanisms, Indications, and Nursing Considerations ....... 43
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Subtopic 1: Inotropes Mechanism, Indications, and
Nursing Considerations
1.
A nurse is administering digoxin to a patient with heart failure. Which of the following
assessment findings should the nurse report immediately?
A) Heart rate of 72 bpm
B) Serum potassium level of 3.2 mEq/L
C) Blood pressure of 130/80 mm Hg
D) Clear lung sounds
Correct answer: B) Serum potassium level of 3.2 mEq/L
Rationale: Hypokalemia increases the risk of digoxin toxicity. Serum potassium below 3.5
mEq/L is dangerous and should be addressed promptly.
2.
Which of the following is the primary therapeutic effect of positive inotropes?
A) Vasodilation of peripheral vessels
B) Increase myocardial contractility
C) Slow heart rate
D) Decrease cardiac conduction velocity
Correct answer: B) Increase myocardial contractility
Rationale: Positive inotropes increase the strength of myocardial contraction, improving
cardiac output, especially in heart failure.
3.
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A patient receiving dobutamine develops tachycardia and chest pain. What is the nurse’s
priority action?
A) Administer a beta blocker as ordered
B) Notify the healthcare provider immediately
C) Increase the dobutamine infusion rate
D) Encourage deep breathing exercises
Correct answer: B) Notify the healthcare provider immediately
Rationale: Dobutamine can increase heart rate and myocardial oxygen demand, potentially
causing ischemia; chest pain requires urgent evaluation.
4.
Which electrolyte imbalance increases the risk of digoxin toxicity?
A) Hypercalcemia
B) Hyperkalemia
C) Hypokalemia
D) Hyponatremia
Correct answer: C) Hypokalemia
Rationale: Low potassium potentiates digoxin’s effects, increasing toxicity risk.
5.
What is an important nursing consideration when administering milrinone?
A) Monitor for hyperglycemia
B) Assess for thrombocytopenia
C) Observe for hypotension and arrhythmias
D) Encourage high potassium diet
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Correct answer: C) Observe for hypotension and arrhythmias
Rationale: Milrinone is a phosphodiesterase inhibitor with vasodilating and inotropic
effects; hypotension and arrhythmias are common adverse effects.
6.
The nurse is preparing to administer an intravenous bolus of digoxin. What is the
appropriate rate of administration?
A) Over 1 minute
B) Over 5 minutes
C) Over 10 to 15 minutes
D) Over 30 minutes
Correct answer: C) Over 10 to 15 minutes
Rationale: Rapid IV digoxin administration can cause cardiac arrhythmias; it should be
given slowly over 10 to 15 minutes.
7.
Which of the following symptoms in a patient on digoxin indicates early toxicity?
A) Blurred vision and green or yellow halos around lights
B) Hypertension and headache
C) Cough and shortness of breath
D) Dry mouth and constipation
Correct answer: A) Blurred vision and green or yellow halos around lights
Rationale: Visual disturbances, including halos and blurred vision, are classic signs of
digoxin toxicity.
NCLEX RN Exam Bank: Cardiac Medications, Inotropes,
Anticoagulants, and Antiarrhythmics
Table of Contents
Subtopic 1: Inotropes Mechanism, Indications, and Nursing Considerations ..................... 2
Subtopic 2: Anticoagulants Types, Uses, and Nursing Care ............................................ 10
Subtopic 3: Antiarrhythmics Classification, Uses, and Side Effects................................. 18
Subtopic 4: Inotropes and Vasopressors Dosage, Administration, and Complications ...... 27
Subtopic 5: Anticoagulant and Antiplatelet Drug Interactions, Side Effects, and Patient
Education ................................................................................................................... 35
Subtopic 6: Inotropic Agents Mechanisms, Indications, and Nursing Considerations ....... 43
, 2
Subtopic 1: Inotropes Mechanism, Indications, and
Nursing Considerations
1.
A nurse is administering digoxin to a patient with heart failure. Which of the following
assessment findings should the nurse report immediately?
A) Heart rate of 72 bpm
B) Serum potassium level of 3.2 mEq/L
C) Blood pressure of 130/80 mm Hg
D) Clear lung sounds
Correct answer: B) Serum potassium level of 3.2 mEq/L
Rationale: Hypokalemia increases the risk of digoxin toxicity. Serum potassium below 3.5
mEq/L is dangerous and should be addressed promptly.
2.
Which of the following is the primary therapeutic effect of positive inotropes?
A) Vasodilation of peripheral vessels
B) Increase myocardial contractility
C) Slow heart rate
D) Decrease cardiac conduction velocity
Correct answer: B) Increase myocardial contractility
Rationale: Positive inotropes increase the strength of myocardial contraction, improving
cardiac output, especially in heart failure.
3.
, 3
A patient receiving dobutamine develops tachycardia and chest pain. What is the nurse’s
priority action?
A) Administer a beta blocker as ordered
B) Notify the healthcare provider immediately
C) Increase the dobutamine infusion rate
D) Encourage deep breathing exercises
Correct answer: B) Notify the healthcare provider immediately
Rationale: Dobutamine can increase heart rate and myocardial oxygen demand, potentially
causing ischemia; chest pain requires urgent evaluation.
4.
Which electrolyte imbalance increases the risk of digoxin toxicity?
A) Hypercalcemia
B) Hyperkalemia
C) Hypokalemia
D) Hyponatremia
Correct answer: C) Hypokalemia
Rationale: Low potassium potentiates digoxin’s effects, increasing toxicity risk.
5.
What is an important nursing consideration when administering milrinone?
A) Monitor for hyperglycemia
B) Assess for thrombocytopenia
C) Observe for hypotension and arrhythmias
D) Encourage high potassium diet
, 4
Correct answer: C) Observe for hypotension and arrhythmias
Rationale: Milrinone is a phosphodiesterase inhibitor with vasodilating and inotropic
effects; hypotension and arrhythmias are common adverse effects.
6.
The nurse is preparing to administer an intravenous bolus of digoxin. What is the
appropriate rate of administration?
A) Over 1 minute
B) Over 5 minutes
C) Over 10 to 15 minutes
D) Over 30 minutes
Correct answer: C) Over 10 to 15 minutes
Rationale: Rapid IV digoxin administration can cause cardiac arrhythmias; it should be
given slowly over 10 to 15 minutes.
7.
Which of the following symptoms in a patient on digoxin indicates early toxicity?
A) Blurred vision and green or yellow halos around lights
B) Hypertension and headache
C) Cough and shortness of breath
D) Dry mouth and constipation
Correct answer: A) Blurred vision and green or yellow halos around lights
Rationale: Visual disturbances, including halos and blurred vision, are classic signs of
digoxin toxicity.
