Pharm: Cardio Test Questions With Verified Answers Graded A+
Potassium chloride intravenously is prescribed
for a client with hypokalemia. Which actions A client with atrial fibrillation is receiving a
should the nurse take to plan for preparation and continuous heparin infusion at 1000 units/hour.
administration of the potassium? Select all that The nurse determines that the client is receiving
apply. the therapeutic effect based on which results?
1. Obtain an intravenous (IV) infusion pump. 1. Prothrombin time of 12.5 seconds
2. Monitor urine output during administration. 2. Activated partial thromboplastin time of 60
3. Prepare the medication for bolus seconds
administration. 3. Activated partial thromboplastin time of 28
4. Monitor the IV site for signs of infiltration or seconds
phlebitis. 4. Activated partial thromboplastin time longer
5. Ensure that the medication is diluted in the than 120 seconds - ANSWER -2. Activated
appropriate volume of fluid. partial thromboplastin time of 60 seconds
6. Ensure that the bag is labeled so that it reads
the volume of potassium in the solution. - Rationale:
ANSWER -1. Obtain an intravenous (IV) Common laboratory ranges for activated partial
infusion pump. thromboplastin time (aPTT) are 30 to 40
2. Monitor urine output during administration. seconds. Because the aPTT should be 1.5 to 2.5
4. Monitor the IV site for signs of infiltration or times the normal value, the client's aPTT would
phlebitis. be considered therapeutic if it was 60 seconds.
5. Ensure that the medication is diluted in the Prothrombin time assesses response to warfarin
appropriate volume of fluid. therapy.
6. Ensure that the bag is labeled so that it reads
the volume of potassium in the solution.
Rationale: The nurse provides discharge instructions to a
Potassium chloride administered intravenously client who is taking warfarin sodium. Which
must always be diluted in IV fluid and infused via statement, by the client, reflects the need for
an infusion pump. Potassium chloride is never further teaching?
given by bolus (IV push). Giving potassium
chloride by IV push can result in cardiac arrest. 1. "I will avoid alcohol consumption."
The nurse should ensure that the potassium is 2. "I will take my pills every day at the same
diluted in the appropriate amount of diluent or time."
fluid. The IV bag containing the potassium 3. "I have already called my family to pick up a
chloride should always be labeled with the MedicAlert bracelet."
volume of potassium it contains. The IV site is 4. "I will take coated aspirin for my headaches
monitored closely because potassium chloride is because it will coat my stomach." -
irritating to the veins and there is risk of phlebitis. ANSWER -4. "I will take coated aspirin for
In addition, the nurse should monitor for my headaches because it will coat my stomach."
infiltration. The nurse monitors urinary output
during administration and contacts the health Rationale:
care provider if the urinary output is less than 30 Aspirin-containing products need to be avoided
mL/hour. when a client is taking this medication. Alcohol
consumption should be avoided by a client taking
warfarin sodium. Taking the prescribed
,Pharm: Cardio Test Questions With Verified Answers Graded A+
medication at the same time each day increases Rationale:
client compliance. The MedicAlert bracelet Signs of toxicity from procainamide include
provides health care personnel with emergency confusion, dizziness, drowsiness, decreased
information. urination, nausea, vomiting, and
tachydysrhythmias. If the client complains of
dizziness, the nurse should assess the vital signs
first. Although measuring the heart rate on the
A client who is receiving digoxin daily has a rhythm strip and obtaining a 12-lead
serum potassium level of 3 mEq/L (3 mmol/L) electrocardiogram may be interventions, these
and is complaining of anorexia. The health care would be done after the vital signs are taken.
provider prescribes a serum digoxin level to be Nitroglycerin is a vasodilator and will lower the
done. The nurse checks the results and should blood pressure.
expect to note which level that is outside of the
therapeutic range?
1. 0.3 ng/mL The nurse is monitoring a client who is taking
2. 0.5 ng/mL propranolol. Which assessment finding indicates
3. 0.8 ng/mL a potential adverse complication associated with
4. 1.0 ng/mL - ANSWER -4. 1.0 ng/mL this medication?
Rationale: 1. The development of complaints of insomnia
The optimal therapeutic range for digoxin is 0.5 2. The development of audible expiratory
to 0.8 ng/mL. If the client is experiencing wheezes
symptoms such as anorexia and is experiencing 3. A baseline blood pressure of 150/80 mm Hg
hypokalemia as evidenced by a low potassium followed by a blood pressure of 138/72 mm Hg
level, digoxin toxicity is a concern. Therefore, after 2 doses of the medication
option 4 is correct because it is outside of the 4. A baseline resting heart rate of 88
therapeutic level and an elevated level. beats/minute followed by a resting heart rate of
72 beats/minute after 2 doses of the medication -
ANSWER -2. The development of audible
expiratory wheezes
A client is being treated with procainamide for a
cardiac dysrhythmia. Following intravenous Rationale:
administration of the medication, the client Audible expiratory wheezes may indicate a
complains of dizziness. What intervention should serious adverse reaction, bronchospasm. Beta
the nurse take first? blockers may induce this reaction, particularly in
clients with chronic obstructive pulmonary
1. Measure the heart rate on the rhythm strip. disease or asthma. Normal decreases in blood
2. Administer prescribed nitroglycerin tablets. pressure and heart rate are expected. Insomnia
3. Obtain a 12-lead electrocardiogram is a frequent mild side effect and should be
immediately. monitored.
4. Auscultate the client's apical pulse and obtain
a blood pressure. - ANSWER -4.
Auscultate the client's apical pulse and obtain a
blood pressure. A client with a clot in the right atrium is receiving
a heparin sodium infusion at 1000 units/hour and
,Pharm: Cardio Test Questions With Verified Answers Graded A+
warfarin sodium 7.5 mg at 5:00 p.m. daily. The 2. Monitor psychosocial status.
morning laboratory results are as follows: 3. Monitor for signs of bleeding.
activated partial thromboplastin time (aPTT), 32 4. Have heparin sodium available. -
seconds; international normalized ratio (INR), ANSWER -3. Monitor for signs of bleeding.
1.3. The nurse should take which action based
on the client's laboratory results? Rationale:
Tissue plasminogen activator is a thrombolytic.
1. Collaborate with the health care provider Hemorrhage is a complication of any type of
(HCP) to discontinue the heparin infusion and thrombolytic medication. The client is monitored
administer the warfarin sodium as prescribed. for bleeding. Monitoring for renal failure and
2. Collaborate with the HCP to obtain a monitoring the client's psychosocial status are
prescription to increase the heparin infusion and important but are not the most critical
administer the warfarin sodium as prescribed. interventions. Heparin may be administered after
3. Collaborate with the HCP to withhold the thrombolytic therapy, but the question is not
warfarin sodium since the client is receiving a asking about follow-up medications.
heparin infusion and the aPTT is within the
therapeutic range.
4. Collaborate with the HCP to continue the
heparin infusion at the same rate and to discuss The nurse is planning to administer
use of dabigatran etexilate in place - hydrochlorothiazide to a client. The nurse should
ANSWER -2. Collaborate with the HCP to monitor for which adverse effects related to the
obtain a prescription to increase the heparin administration of this medication?
infusion and administer the warfarin sodium as
prescribed. 1. Hypouricemia, hyperkalemia
2. Increased risk of osteoporosis
Rationale: 3. Hypokalemia, hyperglycemia, sulfa allergy
When a client is receiving warfarin for clot 4. Hyperkalemia, hypoglycemia, penicillin allergy
prevention due to atrial fibrillation, an INR of 2 to - ANSWER -3. Hypokalemia,
3 is appropriate for most clients. Until the INR hyperglycemia, sulfa allergy
has achieved a therapeutic range, the client
should be maintained on a continuous heparin Rationale:
infusion with the aPTT ranging between 60 and Thiazide diuretics such as hydrochlorothiazide
80 seconds. Therefore, the nurse should are sulfa-based medications, and a client with a
collaborate with the HCP to obtain a prescription sulfa allergy is at risk for an allergic reaction.
to increase the heparin infusion and to Also, clients are at risk for hypokalemia,
administer the warfarin as prescribed. hyperglycemia, hypercalcemia, hyperlipidemia,
and hyperuricemia.
A client is diagnosed with an ST segment
elevation myocardial infarction (STEMI) and is The home health care nurse is visiting a client
receiving a tissue plasminogen activator, with elevated triglyceride levels and a serum
alteplase. Which action is a priority nursing cholesterol level of 398 mg/dL (10 mmol/L). The
intervention? client is taking cholestyramine and the nurse
teaches the client about the medication. Which
1. Monitor for kidney failure. statement, by the client, indicates the need for
, Pharm: Cardio Test Questions With Verified Answers Graded A+
further teaching? gastrointestinal manifestations such as anorexia,
nausea, vomiting, and diarrhea. Subsequent
1. "Constipation and bloating might be a manifestations include headache; visual
problem." disturbances such as diplopia, blurred vision,
2. "I'll continue to watch my diet and reduce my yellow-green halos, and photophobia;
fats." drowsiness; fatigue; and weakness. Cardiac
3. "Walking a mile each day will help the whole rhythm abnormalities can also occur. The nurse
process." also monitors the digoxin level. The optimal
4. "I'll continue my nicotinic acid from the health therapeutic range for digoxin is 0.5 to 0.8 ng/mL
food store." - ANSWER -4. "I'll continue my
nicotinic acid from the health food store."
Rationale: Prior to administering a client's daily dose of
Nicotinic acid, even an over-the-counter form, digoxin, the nurse reviews the client's laboratory
should be avoided because it may lead to liver data and notes the following results: serum
abnormalities. All lipid-lowering medications also calcium, 9.8 mg/dL (2.45 mmol/L); serum
can cause liver abnormalities, so a combination magnesium, 1.0 mEq/L (0.5 mmol/L); serum
of nicotinic acid and cholestyramine resin needs potassium, 4.1 mEq/L (4.1 mmol/L); serum
to be avoided. Constipation and bloating are the creatinine, 0.9 mg/dL (79.5 mcmol/L). Which
2 most common adverse effects. Walking and result should alert the nurse that the client is at
the reduction of fats in the diet are therapeutic risk for digoxin toxicity?
measures to reduce cholesterol and triglyceride
levels. 1. Serum calcium level
2. Serum potassium level
3. Serum creatinine level
4. Serum magnesium level - ANSWER -4.
The nurse is monitoring a client who is taking Serum magnesium level
digoxin for adverse effects. Which findings are
characteristic of digoxin toxicity? Select all that Rationale:
apply. An increased risk of toxicity exists in clients with
hypercalcemia, hypokalemia, hypomagnesemia,
1. Tremors hypothyroidism, and impaired renal function. The
2. Diarrhea calcium, creatinine, and potassium levels are all
3. Irritability within normal limits. The normal range for
4. Blurred vision magnesium is 1.3 to 2.1 mEq/L (0.65 to 1.05
5. Nausea and vomiting - ANSWER -2. mmol/L) and the results in the correct option are
Diarrhea reflective of hypomagnesemia.
4. Blurred vision
5. Nausea and vomiting
Rationale: A client being treated for heart failure is
Digoxin is a cardiac glycoside. The risk of toxicity administered intravenous bumetanide. Which
can occur with the use of this medication. outcome indicates that the medication has
Toxicity can lead to life-threatening events and achieved the expected effect?
the nurse needs to monitor the client closely for
signs of toxicity. Early signs of toxicity include 1. Cough becomes productive of frothy pink
Potassium chloride intravenously is prescribed
for a client with hypokalemia. Which actions A client with atrial fibrillation is receiving a
should the nurse take to plan for preparation and continuous heparin infusion at 1000 units/hour.
administration of the potassium? Select all that The nurse determines that the client is receiving
apply. the therapeutic effect based on which results?
1. Obtain an intravenous (IV) infusion pump. 1. Prothrombin time of 12.5 seconds
2. Monitor urine output during administration. 2. Activated partial thromboplastin time of 60
3. Prepare the medication for bolus seconds
administration. 3. Activated partial thromboplastin time of 28
4. Monitor the IV site for signs of infiltration or seconds
phlebitis. 4. Activated partial thromboplastin time longer
5. Ensure that the medication is diluted in the than 120 seconds - ANSWER -2. Activated
appropriate volume of fluid. partial thromboplastin time of 60 seconds
6. Ensure that the bag is labeled so that it reads
the volume of potassium in the solution. - Rationale:
ANSWER -1. Obtain an intravenous (IV) Common laboratory ranges for activated partial
infusion pump. thromboplastin time (aPTT) are 30 to 40
2. Monitor urine output during administration. seconds. Because the aPTT should be 1.5 to 2.5
4. Monitor the IV site for signs of infiltration or times the normal value, the client's aPTT would
phlebitis. be considered therapeutic if it was 60 seconds.
5. Ensure that the medication is diluted in the Prothrombin time assesses response to warfarin
appropriate volume of fluid. therapy.
6. Ensure that the bag is labeled so that it reads
the volume of potassium in the solution.
Rationale: The nurse provides discharge instructions to a
Potassium chloride administered intravenously client who is taking warfarin sodium. Which
must always be diluted in IV fluid and infused via statement, by the client, reflects the need for
an infusion pump. Potassium chloride is never further teaching?
given by bolus (IV push). Giving potassium
chloride by IV push can result in cardiac arrest. 1. "I will avoid alcohol consumption."
The nurse should ensure that the potassium is 2. "I will take my pills every day at the same
diluted in the appropriate amount of diluent or time."
fluid. The IV bag containing the potassium 3. "I have already called my family to pick up a
chloride should always be labeled with the MedicAlert bracelet."
volume of potassium it contains. The IV site is 4. "I will take coated aspirin for my headaches
monitored closely because potassium chloride is because it will coat my stomach." -
irritating to the veins and there is risk of phlebitis. ANSWER -4. "I will take coated aspirin for
In addition, the nurse should monitor for my headaches because it will coat my stomach."
infiltration. The nurse monitors urinary output
during administration and contacts the health Rationale:
care provider if the urinary output is less than 30 Aspirin-containing products need to be avoided
mL/hour. when a client is taking this medication. Alcohol
consumption should be avoided by a client taking
warfarin sodium. Taking the prescribed
,Pharm: Cardio Test Questions With Verified Answers Graded A+
medication at the same time each day increases Rationale:
client compliance. The MedicAlert bracelet Signs of toxicity from procainamide include
provides health care personnel with emergency confusion, dizziness, drowsiness, decreased
information. urination, nausea, vomiting, and
tachydysrhythmias. If the client complains of
dizziness, the nurse should assess the vital signs
first. Although measuring the heart rate on the
A client who is receiving digoxin daily has a rhythm strip and obtaining a 12-lead
serum potassium level of 3 mEq/L (3 mmol/L) electrocardiogram may be interventions, these
and is complaining of anorexia. The health care would be done after the vital signs are taken.
provider prescribes a serum digoxin level to be Nitroglycerin is a vasodilator and will lower the
done. The nurse checks the results and should blood pressure.
expect to note which level that is outside of the
therapeutic range?
1. 0.3 ng/mL The nurse is monitoring a client who is taking
2. 0.5 ng/mL propranolol. Which assessment finding indicates
3. 0.8 ng/mL a potential adverse complication associated with
4. 1.0 ng/mL - ANSWER -4. 1.0 ng/mL this medication?
Rationale: 1. The development of complaints of insomnia
The optimal therapeutic range for digoxin is 0.5 2. The development of audible expiratory
to 0.8 ng/mL. If the client is experiencing wheezes
symptoms such as anorexia and is experiencing 3. A baseline blood pressure of 150/80 mm Hg
hypokalemia as evidenced by a low potassium followed by a blood pressure of 138/72 mm Hg
level, digoxin toxicity is a concern. Therefore, after 2 doses of the medication
option 4 is correct because it is outside of the 4. A baseline resting heart rate of 88
therapeutic level and an elevated level. beats/minute followed by a resting heart rate of
72 beats/minute after 2 doses of the medication -
ANSWER -2. The development of audible
expiratory wheezes
A client is being treated with procainamide for a
cardiac dysrhythmia. Following intravenous Rationale:
administration of the medication, the client Audible expiratory wheezes may indicate a
complains of dizziness. What intervention should serious adverse reaction, bronchospasm. Beta
the nurse take first? blockers may induce this reaction, particularly in
clients with chronic obstructive pulmonary
1. Measure the heart rate on the rhythm strip. disease or asthma. Normal decreases in blood
2. Administer prescribed nitroglycerin tablets. pressure and heart rate are expected. Insomnia
3. Obtain a 12-lead electrocardiogram is a frequent mild side effect and should be
immediately. monitored.
4. Auscultate the client's apical pulse and obtain
a blood pressure. - ANSWER -4.
Auscultate the client's apical pulse and obtain a
blood pressure. A client with a clot in the right atrium is receiving
a heparin sodium infusion at 1000 units/hour and
,Pharm: Cardio Test Questions With Verified Answers Graded A+
warfarin sodium 7.5 mg at 5:00 p.m. daily. The 2. Monitor psychosocial status.
morning laboratory results are as follows: 3. Monitor for signs of bleeding.
activated partial thromboplastin time (aPTT), 32 4. Have heparin sodium available. -
seconds; international normalized ratio (INR), ANSWER -3. Monitor for signs of bleeding.
1.3. The nurse should take which action based
on the client's laboratory results? Rationale:
Tissue plasminogen activator is a thrombolytic.
1. Collaborate with the health care provider Hemorrhage is a complication of any type of
(HCP) to discontinue the heparin infusion and thrombolytic medication. The client is monitored
administer the warfarin sodium as prescribed. for bleeding. Monitoring for renal failure and
2. Collaborate with the HCP to obtain a monitoring the client's psychosocial status are
prescription to increase the heparin infusion and important but are not the most critical
administer the warfarin sodium as prescribed. interventions. Heparin may be administered after
3. Collaborate with the HCP to withhold the thrombolytic therapy, but the question is not
warfarin sodium since the client is receiving a asking about follow-up medications.
heparin infusion and the aPTT is within the
therapeutic range.
4. Collaborate with the HCP to continue the
heparin infusion at the same rate and to discuss The nurse is planning to administer
use of dabigatran etexilate in place - hydrochlorothiazide to a client. The nurse should
ANSWER -2. Collaborate with the HCP to monitor for which adverse effects related to the
obtain a prescription to increase the heparin administration of this medication?
infusion and administer the warfarin sodium as
prescribed. 1. Hypouricemia, hyperkalemia
2. Increased risk of osteoporosis
Rationale: 3. Hypokalemia, hyperglycemia, sulfa allergy
When a client is receiving warfarin for clot 4. Hyperkalemia, hypoglycemia, penicillin allergy
prevention due to atrial fibrillation, an INR of 2 to - ANSWER -3. Hypokalemia,
3 is appropriate for most clients. Until the INR hyperglycemia, sulfa allergy
has achieved a therapeutic range, the client
should be maintained on a continuous heparin Rationale:
infusion with the aPTT ranging between 60 and Thiazide diuretics such as hydrochlorothiazide
80 seconds. Therefore, the nurse should are sulfa-based medications, and a client with a
collaborate with the HCP to obtain a prescription sulfa allergy is at risk for an allergic reaction.
to increase the heparin infusion and to Also, clients are at risk for hypokalemia,
administer the warfarin as prescribed. hyperglycemia, hypercalcemia, hyperlipidemia,
and hyperuricemia.
A client is diagnosed with an ST segment
elevation myocardial infarction (STEMI) and is The home health care nurse is visiting a client
receiving a tissue plasminogen activator, with elevated triglyceride levels and a serum
alteplase. Which action is a priority nursing cholesterol level of 398 mg/dL (10 mmol/L). The
intervention? client is taking cholestyramine and the nurse
teaches the client about the medication. Which
1. Monitor for kidney failure. statement, by the client, indicates the need for
, Pharm: Cardio Test Questions With Verified Answers Graded A+
further teaching? gastrointestinal manifestations such as anorexia,
nausea, vomiting, and diarrhea. Subsequent
1. "Constipation and bloating might be a manifestations include headache; visual
problem." disturbances such as diplopia, blurred vision,
2. "I'll continue to watch my diet and reduce my yellow-green halos, and photophobia;
fats." drowsiness; fatigue; and weakness. Cardiac
3. "Walking a mile each day will help the whole rhythm abnormalities can also occur. The nurse
process." also monitors the digoxin level. The optimal
4. "I'll continue my nicotinic acid from the health therapeutic range for digoxin is 0.5 to 0.8 ng/mL
food store." - ANSWER -4. "I'll continue my
nicotinic acid from the health food store."
Rationale: Prior to administering a client's daily dose of
Nicotinic acid, even an over-the-counter form, digoxin, the nurse reviews the client's laboratory
should be avoided because it may lead to liver data and notes the following results: serum
abnormalities. All lipid-lowering medications also calcium, 9.8 mg/dL (2.45 mmol/L); serum
can cause liver abnormalities, so a combination magnesium, 1.0 mEq/L (0.5 mmol/L); serum
of nicotinic acid and cholestyramine resin needs potassium, 4.1 mEq/L (4.1 mmol/L); serum
to be avoided. Constipation and bloating are the creatinine, 0.9 mg/dL (79.5 mcmol/L). Which
2 most common adverse effects. Walking and result should alert the nurse that the client is at
the reduction of fats in the diet are therapeutic risk for digoxin toxicity?
measures to reduce cholesterol and triglyceride
levels. 1. Serum calcium level
2. Serum potassium level
3. Serum creatinine level
4. Serum magnesium level - ANSWER -4.
The nurse is monitoring a client who is taking Serum magnesium level
digoxin for adverse effects. Which findings are
characteristic of digoxin toxicity? Select all that Rationale:
apply. An increased risk of toxicity exists in clients with
hypercalcemia, hypokalemia, hypomagnesemia,
1. Tremors hypothyroidism, and impaired renal function. The
2. Diarrhea calcium, creatinine, and potassium levels are all
3. Irritability within normal limits. The normal range for
4. Blurred vision magnesium is 1.3 to 2.1 mEq/L (0.65 to 1.05
5. Nausea and vomiting - ANSWER -2. mmol/L) and the results in the correct option are
Diarrhea reflective of hypomagnesemia.
4. Blurred vision
5. Nausea and vomiting
Rationale: A client being treated for heart failure is
Digoxin is a cardiac glycoside. The risk of toxicity administered intravenous bumetanide. Which
can occur with the use of this medication. outcome indicates that the medication has
Toxicity can lead to life-threatening events and achieved the expected effect?
the nurse needs to monitor the client closely for
signs of toxicity. Early signs of toxicity include 1. Cough becomes productive of frothy pink
