The nurse is performing a physical assessment on a patient with heart failure. If Starling's Law were to break down, what is the most significant clinical manifestation the patient could display?
a. Increased heart rate.
b. Decreased blood volume.
c. Incr
d. Shortness of breath
In an effort by the body to compensate for low arterial pressure, the kidneys retain which electrolyte?
a. Sodium
b. Glucose
c. Potassium
d. Chloride
a. Sodium
When providing education for a patient taking clonidine (Catapres), an alpha2 agonist, the nurse should inform the patient to anticipate which likely side effect?
a. Sodium loss
b. Diarrhea
c. Dry mouth
d. Weight loss
c. Dry mouth
The nurse is teaching a group of patients about hypertension. A patient who has been diagnosed with uncomplicated primary hypertension asks the nurse what the preferred initial antihypertensive drug regimen is. Which of the following is the nurse's best r
b. Thiazide diuretics, as long as renal disease is not a factor.
The prescriber orders propranolol (Inderal) for a patient with a blood pressure reading of 200/106 mm Hg. An electrocardiogram taken shortly afterward shows an atrioventricular (AV) block. The nurse should immediately hold the propranolol and report this
b. Beta blockers can intensify an AV block.
A patient with increasing renal insufficiency and nephrosclerosis is admitted to the unit and is started on oral antihypertensive therapy. Given the patient's medical history, the nurse would question a prescription for
a. Propranolol (Inderal).
b. Methyl
d. Spironolactone (Aldactone).
The patient is being treated with an angiotensin-converting enzyme (ACE) inhibitor. The nurse should advise the patient that ACE inhibitors should not be taken concurrently with which of the following drugs?
a. Thiazide diuretics
b. Beta blockers
c. Potas
c. Potassium-sparing diuretics
The nurse is providing patient education about digoxin (Lanoxin) to a 50-year-old woman. Which statment by the patient demonstrates a need for further teaching?
a. "I should monitor my heart rate prior to taking this medication."
b. "This medication prolo
b. "This medication prolongs life in women.
Which of the following outcomes can be expected with administration of digoxin (Lanoxin)?
a. Decreased heart rate, slowed cardiac conduction speed, and strengthened cardiac contractions.
b. Increased heart rate, slowed cardiac conduction speed, and streng
a. Decreased heart rate, slowed cardiac conduction speed, and strengthened cardiac contractions.
The nurse is teaching a group of cardiac care nurses about the various cardiac rhythms and drug management. Which of the following drugs, named by the group, best reflects accurate understanding of the management of paroxysmal supraventricular tachycardia
b. Adenosine (Adenocard)
A patient is admitted to the cardiac care unit from the ED. He is receiving amiodarone (Cordarone), because his frequent runs of ventricular tachycardia have proved refractory to other drugs. The rationale for using this very toxic, potentially ventricula
b. delays repolarization
The only calcium channel blockers that have antidysrhythmic properties are verapamil and diltiazem. The nurse is especially cautious administering either of these drugs to a patient who takes digoxin because of the increased risk of
a. AV block
b. suprave
a. AV block
The nurse is caring for a patient who has been taking amiodarone (Cordarone) for several months. The patient begins to exhibit dyspnea and coughing and complains of chest pain. The nurse is correct to suspect
a. cardiovascular toxicity
b. pulmonary toxici
b. pulmonary toxicity
A nurse is providing education about the various routes of administering nitroglycerin (NTG). The nurse correctly states that sublingual NTG can be used in lower dosages than drugs given by other routes, because it
a. is not directly absorbed into the blo
b. bypasses the liver
A hospitalized patient complains of acute chest pain, which he rates as a 9 on a scale of 0 to 10. The nurse administers a 0.4 mg sublingual nitroglycerin tablet, but the patient continues to complain of pain, although his vital signs are stable. The nurs
a. provide a second dose of nitroglycerin in 5 minutes.
A patient presents with stable angina. The patient's spouse begins asking questions about the calcium channel blockers (CCBs). The spouse asks how CCBs relieve pain, and the nurse explains, "CCBs
a. reduce platelet aggregation."
b. dilate arterioles and r
b. dilate arterioles and reduce afterload.
A patient applies a transdermal nitroglycerin patch at 0900. What additional instruction should be provided by the nurse regarding the patch?
a. "Leave the patch in place until the following morning, when a new patch will be applied."
b. "Apply an additio
c. "Remove the patch at 9 PM.
Which of the following INR results warrants a call to the prescriber by the nurse for adjustment of the daily warfarin (Coumadin) dosage?
a. Patient with DVT with an INR or 1.8
b. Patient with atrial fibrillation with an INR of 2.6
c. Patient with a pulmo
a. Patient with DVT with an INR or 1.8
A patient is 2 days postoperative for a hip replacement, and her mobility is limited. The patient complains of pleuritic chest pain, shortness of breath, and hemoptysis, and her oxygen saturation level is 82% to 84%. The nurse should anticipate administra
a. heparin; pulmonary embolus
Comparing the adverse effects of the antiplatelet drug clopidogrel (Plavix) with those of aspirin, the nurse should draw which of the following conclusions?
a. Clopidogrel causes less GI bleeding than aspirin.
b. Rash commonly occurs with aspirin but not
a. Clopidogrel causes less GI bleeding than aspirin.
In which of the following situations should the nurse prepare for administration of protamine sulfate?
a. A patient on warfarin with an INR of 4 and tarry stools.
b. A patient on warfarin with a PT of 12 seconds and bleeding from a laceration.
c. A patien
c. A patient on a heparin drip with a PTT >120 seconds and active GI bleeding.
Assessment of a patient's right lower extremity reveals swelling and warmth, and the patient reports pain in the extremity. The nurse would anticipate the administration of which drug?
a. Aspirin (ASA)
b. Clopidogrel (Plavix)
c. Enoxaparin (Lovenox)
d. Bi
c. Enoxaparin (Lovenox)
The nurse understands that the primary indications for use of glycoprotein IIb/IIIa-receptor antagonists are
a. to dislodge venous thrombi and to treat arterial stenosis.
b. to prevent clots in intravascular devices and to prevent strokes.
c. to enhance t
d. for acute coronary syndromes and percutaneous coronary interventions.
The nurse has just received an order for Alteplace (Activase) for a patient experiencing a stroke. The nurse administering this drug is aware:
a. It has an initial bolus dose given then a timed infusion but this drug is only given if symptoms are diagnose
a. It has an initial bolus dose given then a timed infusion but this drug is only given if symptoms are diagnosed within 3 hrs.
The nurse is serving as a preceptor for a new nurse on the unit. The preceptor is assessing the new nurse's understanding of antidysrhythmic drugs. Which statements made by the new nurse about the use of antidysrhythmic drugs best demonstrates correct und
d. "These drugs can actually worsen existing dysrhythmias or cause new dysrhythmias.
A patient is admitted to the cardiac care unit from the emergency department. He is receiving amiodarone (Cordarone), because his frequent runs of ventricular tachycardia have proved refractory to other drugs. The rationale for using this very toxic, pote
b. delays repolarization
A patient comes to the clinic for a follow-up appointment after being treated in the hospital for angina and released. The nurse is discussing his medication, nitroglycerin. The nurse is correct to state that the principal way this medication relieves the
b. reducing cardiac oxygen demand
The nurse is providing patient education to a patient who has just been given a new prescription for sublingual nitroglycerin tablets. Which statement by the patient would indicate a need for additional teaching? "I should
a. take the nitro every 2 to 3 m
a. take the nitro every 2 to 3 minutes until my pain goes away.
The nurse determines that a patient is experiencing the therapeutic effect of a continuous heparin drip if which of the following is noted?
a. The patient's INR is 3.
b. The patient's PT is 12 seconds.
c. The patient's PTT is 65 seconds.
d. The patient's
c. The patient's PTT is 65 seconds.
A patient is being discharged to his home on enoxaparin (Lovenox) injections for treatment of deep vein thrombosis (DVT). Which of the following statements made by the patient indicates a need for further discharge teaching by the nurse?
a. "I will inject
c. "I will need to go to my doctor's office each day to have my blood drawn to see whether enoxaparin is working.
You are orienting a new cardiothoracic nurse. You know the nurse understands why dobutamine is used based on the follow statement:
a. "It is only given as a continuous infusion IV for it's negative inotropic effects for patients with HF and cardiogenic sh
c. It is only given as a continuous infusion IV for it's positive inotropic effects for patients with HF and cardiogenic shock
A patient is being treated with betapace (Sotal). The nurse should be most concerned with which of the following?
a. Frequent ECG checks because beta blockers can cause heart blocks.
b. Establishing baseline ECG because this medication can cause QT prolon
b. Establishing baseline ECG because this medication can cause QT prolongation leading to ventricular tachycardia.
The nurse understands that cholesterol is carried through the blood by way of lipoproteins. Which lipoprotein is most closely associated with coronary atherosclerosis?
a. Very-low-density lipoprotein (VLDL)
b. Apolipoprotein B-100
c. Low-density lipoprote
c. Low-density lipoprotein (LDL)
Norpace is:
a. A vasodilator
b. A beta blocker
c. An antiarrhythmic
d. An inotrope
c. An antiarrhythmic
A patient is receiving sodium nitroprusside (Nitropress) for hypertensive crisis. To prevent complications of this drug related to fluid retention, the nurse should avoid rapid infusion and be prepared to administer which of the following?
a. Furosemide (
a. Furosemide (Lasix) to prevent edema
A patient comments, "I don't understand why I have chest pain at times when I'm resting or exercising. How will metoprolol (Toprol XL) help?" Which of the following comments made by the nurse is correct?
a. "It improves sympathetic stimulation to the hear
c. "It improves the right ventricular ejection fraction.
The nurse is providing discharge instructions for a patient going home on warfarin (Coumadin). Which of the following statements made by the patient indicates a need for further teaching regarding warfarin?
a. "I will avoid participating in heavy contact
c. "I will take aspirin if I get a headache.
A patient with a history of hypertension is admitted for a procedure. If the patient's arterial pressure decreases, which clinical manifestation would the nurse expect to see?
a. Decreased heart rate.
b. Increased heart rate.
c. Decreased blood pressure.
b. Increased heart rate.
A nurse is providing education on losartan (Cozaar) to a group of nurses. The nurse asks the participants, "Which of the following patients would most specifically benefit from the administration of losartan?" A participant would be correct to choose whic
a. The patient at risk for stroke
The prescriber has ordered clonidine (Catapres) for a patient newly diagnosed with hypertension. The nurse should educate the patient on the most likely side effect of _________ and monitor the patient for _______.
a. seizures; CNS hyperactivity
b. restle
c. dry mouth; rebound hypertension
The neurophormonal systems, including the sympathetic nervous system (SNS) and the renin-angiotension-aldosterone system (RAAS), greatly affect cardiac remodeling with declining cardiac performance. What is the ultimate effect of this pathology?
a. A prog
a. A progressive decline in cardiac output
A nurse prepares to administer a scheduled dose of verapamil (Calan) to a patient with atrial flutter. The nurse records a heart rate of 92/minute and a blood pressure of 110/76 mm Hg. In light of these findings, the nurse should
a. administer the dose as
a. administer the dose as prescribed.
The nurse is caring for a patient on the cardiac unit with a history of atrial flutter. The nurse understands that the patient may be treated with which drug?
a. Procainamide (Procanbid)
b. Atropine
c. Lidocaine
d. Digoxin (Lanoxin)
d. Digoxin (Lanoxin)
Which adverse effect is the greatest concern with thrombolytic therapy?
a. Anaphylaxis
b. Intracranial hemorrhage
c. Cerebral edema
d. Hemophilia
b. Intracranial hemorrhage
Nurses are discussing emergency care of patients and identify the following medication as one that will assist in increasing blood pressure
a. Epinephrine (Epi)
b. Nitroprusside
c. Aspirin
d. Sotalol
a. Epinephrine (Epi)
Promatime sulfate is the antidote for:
a. Warfarin
b. Aspirin
c. Clonidine
d. Heparin
d. Heparin
Blood flows from the point of higher pressure toward the point of lower pressure. Resistance to flow is determined by
a. Vessel diameter, vessel length, and blood viscosity.
b. Vessel diameter, vessel strength, and blood osmolarity.
c. If the vessel is na
a. Vessel diameter, vessel length, and blood viscosity.
Hydralazine is described as this type of medication
a. A calcium channel blocker
b. A thiazide diuretics
c. A drug that suppresses the RAAS
d. Sympatholytics (antiadrenergic drugs) direct acting vasodilator
d. Sympatholytics (antiadrenergic drugs) direct acting vasodilator
In order to minimize ischemic damage to a patient's heart, you know the following therapy is going to be initiated:
a. Nitroprusside, Beta Blocker, Supplemental O2, IV morphine, Calcium channel blocker.
b. Nitroglycerin, calcium channel blocker, supplemen
c. Nitroglycerin, beta blocker, IV morphine, ACE inhibitor, place on a monitor to watch for ECG changes.
You know that the new nurse that you are orienting to your unit fully understands the purpose of Aspirin (ASA) with the following statement:
b. Therapeutic uses: Ischemic stroke, TIA, Chronic stable angina, Unstable angina, Coronary stenting, Acute MI, Previous MI, Primary prevention of MI. Adverse Effects: Bleeding, GI Bleeding, and hemorrhagic stroke. Enteric-coated tablets may not reduce th