NCLEX Pharmacology Quiz 16 Cardiovascular Drugs

1. As a knowledgeable nurse. you know that the action of nitrates is:

Smooth muscle contraction

Vasoconstriction

Smooth muscle relaxation

Increase preload

Nitrates cause smooth muscle relaxation. vasodilation. reduction of preload. and improved blood flow to the myocardium. Other choices have opposite effect of nitrates.

Explanation

Nitrates cause smooth muscle relaxation. vasodilation. reduction of preload. and improved blood flow to the myocardium. Other choices have opposite effect of nitrates.

2. 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:

Decreased myocardial oxygen demand

Increased myocardial oxygen demand

Increased left ventricular end-diastolic volume

Increased atrial pressure

Nitrate administration will result in reduced preload and a decrease in myocardial oxygen demand and left ventricular end-diastolic volume.

Explanation

Nitrate administration will result in reduced preload and a decrease in myocardial oxygen demand and left ventricular end-diastolic volume.

3. Nurse Margie just administered an ACE inhibitor to her client. Before ambulating the client for the first time after administration. the nurse should monitor for:

Hypokalemia

Irregular heartbeat

Edema

Hypotension

ACE inhibitors prevent vasoconstriction and lower blood pressure. placing the client at greater risk for postural (orthostatic) hypotension. ACE inhibitors reduce potassium excretion placing the client at risk for hyperkalemia. ACE inhibitors do not affect heart rate. ACE inhibitor promote sodium excretion thereby decreasing edema.

Explanation

ACE inhibitors prevent vasoconstriction and lower blood pressure. placing the client at greater risk for postural (orthostatic) hypotension. ACE inhibitors reduce potassium excretion placing the client at risk for hyperkalemia. ACE inhibitors do not affect heart rate. ACE inhibitor promote sodium excretion thereby decreasing edema.

4. When teaching about nitrate administration. the nurse should instruct the client to:

Change position slowly.

Take pulse daily.

Reduce salt intake.

Chew the sustained-release tablets.

Clients taking nitrates should change position slowly to avoid orthostatic hypotension. It is not necessary to take the pulse before taking this drug. It is also not necessary to change the diet while taking this drug. It is contraindicated to chew sustained-release tablets.

Explanation

Clients taking nitrates should change position slowly to avoid orthostatic hypotension. It is not necessary to take the pulse before taking this drug. It is also not necessary to change the diet while taking this drug. It is contraindicated to chew sustained-release tablets.

5. A student nurse is asked to give an example of a long-acting nitrate. He is correct by saying:

Nitroglycerin sublingual

Nitroglycerin IV

Isosorbide PO

Nitroglycerin transmucosal

Isosorbide is one of the most frequently administered long-acting nitrates. PO nitrates are longer acting than IV or SL agents.

Explanation

Isosorbide is one of the most frequently administered long-acting nitrates. PO nitrates are longer acting than IV or SL agents.

6. The action of an ACE inhibitor interrupts the renin-angiotensin-aldosterone mechanism. thereby producing which of the following?

Reduced renal blood flow

Reduced sodium and water excretion

Increased peripheral vascular resistance

Increased sodium excretion and potassium reabsorption

The inhibition of aldosterone increases sodium excretion and reduces potassium excretion. ACE inhibitors increases renal blood flow. Excretion of sodium and water is enhanced by ACE inhibitors. Peripheral vascular resistance is decreased by vasodilation effect of ACE inhibitors.

Explanation

The inhibition of aldosterone increases sodium excretion and reduces potassium excretion. ACE inhibitors increases renal blood flow. Excretion of sodium and water is enhanced by ACE inhibitors. Peripheral vascular resistance is decreased by vasodilation effect of ACE inhibitors.

7. When nitrates are administered early to the acute MI client. the effect is:

Hypotension

Bradycardia

Reduced mortality

Reduced morbidity

Research has shown that when nitrates are administered early to the acute MI client. the effect is reduced mortality. infarct size. infarct extension. and related complications. Hypotension will result from nitrate administration. but it is not the reason for prescribing the drug. Tachycardia rather than bradycardia is more likely to occur with nitrate administration. The morbidity is already present because the client has the pain.

Explanation

Research has shown that when nitrates are administered early to the acute MI client. the effect is reduced mortality. infarct size. infarct extension. and related complications. Hypotension will result from nitrate administration. but it is not the reason for prescribing the drug. Tachycardia rather than bradycardia is more likely to occur with nitrate administration. The morbidity is already present because the client has the pain.

8. Mira is managing her hypertension with an ACE inhibitor. Which of the following statements stated by her indicates a need for further instruction?

“I should not take my pills with food.”

“I need to increase my intake of orange juice, bananas, and green vegetables.”

“I will avoid coffee, tea, and colas.”

“I will use salt substitutes that are not high in potassium.”

Statement D is incorrect because ACE inhibitors can cause the body to retain potassium, and using salt substitutes that are high in potassium can further increase potassium levels in the body. It's important for patients taking ACE inhibitors to avoid high-potassium foods and salt substitutes unless directed otherwise by their healthcare provider.

Explanation

Statement D is incorrect because ACE inhibitors can cause the body to retain potassium, and using salt substitutes that are high in potassium can further increase potassium levels in the body. It's important for patients taking ACE inhibitors to avoid high-potassium foods and salt substitutes unless directed otherwise by their healthcare provider.

9. ACEs participate in the renin-angiotensin-aldosterone system to have which of the following physiologic effects?

Inhibit conversion of angiotensin II to angiotensin I

Vasoconstriction and sodium depletion

Promote sodium and water retention

Stimulate vasodilation and inhibit sodium depletion

Angiotensin is a potent vasoconstrictor that stimulate the release of aldosterone. Aldosterone release promotes sodium and water retention. The conversion of angiotensin I to II is not inhibited. Aldosterone promotes sodium retention not depletion. Vasoconstriction not vasodilation results.

Explanation

Angiotensin is a potent vasoconstrictor that stimulate the release of aldosterone. Aldosterone release promotes sodium and water retention. The conversion of angiotensin I to II is not inhibited. Aldosterone promotes sodium retention not depletion. Vasoconstriction not vasodilation results.

10. Pepito is a hypertensive client who has been placed on captopril (Capoten). He states. "Dr. del Mundo keeps changing my pills and none are working. I feel like a guinea pig." Which of the following responses by the nurse would be most appropriate?

“It often takes a while before the right medication is found.”

“The doctor is just trying to help you control your blood pressure.”

“The action of this drug is to work on both the arteries and to remove excess fluids.”

“This drug is used when other drugs have failed.”

This response provides accurate information about the medication. Choice A placates the client and provides no information about the new medication. Choice B is defensive. Although choice C is true. there is no information provided to motivate the client.

Explanation

This response provides accurate information about the medication. Choice A placates the client and provides no information about the new medication. Choice B is defensive. Although choice C is true. there is no information provided to motivate the client.