CONCEPTS, QUESTIONS & ANSWER
1. Pt is prescribed milrinone for acute heart failure. what assessment should the
nurse monitor when infusing?
pt. cardiac status must be monitored closely
pt must be monitored when infusing
hypertension is the primary effect seen with excessive doses
drug may cause reddish discolouration of the extremities
2. A patient calls the cardiac clinic you are working at and reports that they
have taken 3 sublingual doses of Nitroglycerin as prescribed for chest pain,
but the chest pain is not relieved. What do you educate the patient to do
next?*
Take two doses of Nitroglycerin in 5 minutes
Take another dose of Nitroglycerin in 5 minutes.
Lie down and rest to see if that helps with relieving the pain
Call 911 immediately
3. A patient with a history of coronary artery spasms is experiencing chest pain.
Which medication would you prioritize for immediate relief and why?
Calcium channel blockers, because they are effective in relieving
coronary artery spasms.
Beta blockers, as they reduce heart rate and oxygen demand.
Nitrates, since they dilate blood vessels and improve blood flow.
Diuretics, to reduce fluid overload and lower blood pressure.
,4. The nurse is caring for a patient receiving amiodarone (Cordarone). Which
drug, if added to the patient's current medication regimen would cause the
nurse concern?
Lasix
Lidocaine
Warfarin
Ibuprofen
5. A nurse is preparing to administer subcutaneous heparin to a patient. If the
nurse mistakenly aspirates before injecting, what potential complication
could arise?
Decreased effectiveness of the medication.
No impact on the administration process.
Increased risk of bleeding at the injection site.
Improved absorption of the medication.
6. What is the most serious side effect associated with milrinone?
Heart failure.
Hypotension.
Cardiac dysrhythmias.
Liver toxicity.
7. If a patient on heparin presents with a platelet count of 45,000/mL, what
should be the nurse's immediate action?
Continue heparin and monitor platelet counts weekly.
Discontinue heparin and notify the healthcare provider.
, Administer a platelet transfusion immediately.
Increase the heparin dosage to improve platelet levels.
8. Describe how reflex tachycardia occurs as a side effect of nitrate
administration.
Reflex tachycardia occurs due to vasodilation caused by nitrates,
leading to a compensatory increase in heart rate.
Reflex tachycardia is a direct effect of nitrates on heart muscle.
Reflex tachycardia is unrelated to the effects of nitrates.
Reflex tachycardia is caused by increased blood pressure from
nitrates.
9. What is the specific antidote for dabigatran?
Idarucizumab
Andexanet alfa
Protamine sulfate
Vitamin K
10. What is the best way to prevent tolerance to nitrates when using transdermal
patches?
Leave the patch off for 24 hours once a week.
Leave the old patch on for 2 hours when applying a new patch.
Apply a new patch every other day.
Remove the patch at night for 8 hours, and then apply a new patch
in the morning.
, 11. Your patient is taking a beta blocker for angina. What do they need to know?
these drugs should be carried with you at all times, in case of an
angina episode
these drugs are for long term prevention of angina episodes
these drugs should be taken as soon as angina pain occurs
12. The HCP has prescribed a medication with a pro dysrhythmic effect. What
clinical manifestation will the nurse monitor for this patient?
A decrease in dysrhythmias
New dysrhythmia
Reduced BP
Decreased HR
13. A patient has been placed on a milrinone infusion as part of the therapy for
end-stage heart failure. What risks involved with this drug will the nurse keep
in mind while assessing this patient during the infusion?
Hyperkalemia
Nausea and vomiting
Hypertension
Cardiac dysrhythmias
14. Nitroglycerin, a potent vasodilator, is often administered sublingually. What
are the advantages of this route of administration?
quick onset of action
bypass of first-pass metabolism
bypass of stomach acid destruction of drug