NCLEX Pharmacology Quiz 13 Cardiovascular Drugs

1. Which of the following is a contraindication for digoxin administration?

Blood pressure of 140/90

Heart rate above 80

Heart rate below 60

Respiratory rate above 20

The apical heart rate must be monitored during therapy with digoxin. and the drug held for pulse below 60 and above 120. Remember that digoxin lowers the heart rate; therefore. the choice that reflects a low heart rate is the best selection.

Explanation

The apical heart rate must be monitored during therapy with digoxin. and the drug held for pulse below 60 and above 120. Remember that digoxin lowers the heart rate; therefore. the choice that reflects a low heart rate is the best selection.

2. Blurred vision or halos are signs of:

Subtherapeutic digoxin levels

Digoxin toxicity

Nothing related to digoxin

Corneal side effects of digoxin

Halos is a hallmark sign of digoxin toxicity. A. C and D are incorrect because subtherapeutic digoxin levels have no such effects.

Explanation

Halos is a hallmark sign of digoxin toxicity. A. C and D are incorrect because subtherapeutic digoxin levels have no such effects.

3. Which of the following clients is at greatest risk for digital toxicity?

A 25-year-old client with congenital heart disease

A 50-year-old client with CHF

A 60-year-old client after myocardial infarction

An 80-year-old client with CHF

Extremely old clients are at greater risk for digitalis toxicity. Remember when it comes to adversity. the very old and very young are always at highest risk.

Explanation

Extremely old clients are at greater risk for digitalis toxicity. Remember when it comes to adversity. the very old and very young are always at highest risk.

4. The action of medication is inotropic when it:

Decreased afterload

Increases heart rate

Increases the force of contraction

Is used to treat CHF

Inotropic drugs increase the force of contraction. Preload. not afterload. is decreased. Chronotropic drugs increase heart rate. Treatment of CHF is an indication for use not an action of inotropic drug.

Explanation

Inotropic drugs increase the force of contraction. Preload. not afterload. is decreased. Chronotropic drugs increase heart rate. Treatment of CHF is an indication for use not an action of inotropic drug.

5. Which is the MOST appropriate action for the nurse to take before administering digoxin?

Monitor potassium level

Assess blood pressure

Evaluate urinary output

Avoid giving with thiazide diuretic

Monitoring potassium is especially important because hypokalemia potentiates digoxin toxicity. B and C are incorrect because these data reflect overall CV status but are not specific for digoxin. Choice D are drugs usually administered with digoxin.

Explanation

Monitoring potassium is especially important because hypokalemia potentiates digoxin toxicity. B and C are incorrect because these data reflect overall CV status but are not specific for digoxin. Choice D are drugs usually administered with digoxin.

6. The therapeutic drug level for digoxin is:

0.1-2.0 ng/mg

1.0-2.0 ng/mg

0.1-0.5 ng/mg

0.5-2.0 ng/mg

This is the correct therapeutic range for digoxin. Every nurse should know this information.

Explanation

This is the correct therapeutic range for digoxin. Every nurse should know this information.

7. Before giving milrinone (Primacor) by an IV infusion to a client with symptoms of CHF. which of the following nursing actions is necessary?

Record sodium level.

Administer loading dose over 15 minutes.

Assess CV status.

Review medication regimen to identify if client is on IV furosemide (Lasix).

Milrinone (Primacor) is incompatible with IV furosemide (Lasix). and many clients with CHF are taking furosemide. Assessing potassium. not sodium. is essential. Choice B is not done before administration but during administration. Assessment of CV status is not specific for milrinone and is indicated for any drug that affects the circulatory system.

Explanation

Milrinone (Primacor) is incompatible with IV furosemide (Lasix). and many clients with CHF are taking furosemide. Assessing potassium. not sodium. is essential. Choice B is not done before administration but during administration. Assessment of CV status is not specific for milrinone and is indicated for any drug that affects the circulatory system.

8. Class IA antiarrhythmic agents have little effect on:

AV node

SA node

Purkinje fibers

Bundle of His

Class IA antiarrhythmics have little effect on the SA node.

Explanation

Class IA antiarrhythmics have little effect on the SA node.

9. Johanna has ventricular ectopy. which of the following drugs is the first line used to treat her condition?

Quinidine (Cardioquin)

Digoxin (Lanoxin)

Procainamide ( Pronestyl)

Lidocaine (Xylocaine)

Lidocaine is the only choice used to treat ventricular ectopy. A and C are class IA antiarrhythmics. Digoxin is a cardiac glycoside.

Explanation

Lidocaine is the only choice used to treat ventricular ectopy. A and C are class IA antiarrhythmics. Digoxin is a cardiac glycoside.

10. Amrinone (Inocor) is used for short term therapy for CHF and acts by which of the following mechanisms?

Increasing stroke volume and heart rate

Slowing ventricular rate and increasing cardiac output

Vasodilating and increasing peripheral vascular resistance

Increasing cardiac output and enhancing renal perfusion

The action of amrinone (Inocor) is to increase stroke volume. ejection fraction. and heart rate. Lanoxin. not amrinone. slows ventricular rate and increases cardiac output. The vasodilator effect of amrinone decreases peripheral vascular resistance. Any increase in cardiac output will enhance renal perfusion; this is not just specific to amrinone.

Explanation

The action of amrinone (Inocor) is to increase stroke volume. ejection fraction. and heart rate. Lanoxin. not amrinone. slows ventricular rate and increases cardiac output. The vasodilator effect of amrinone decreases peripheral vascular resistance. Any increase in cardiac output will enhance renal perfusion; this is not just specific to amrinone.