NU 578 Exam 3 Prep – Solutions Manual For Exam
Questions
A 76-year-old retired postal worker with rheumatoid arthritis and chronic
heart disease presents with a cardiac arrhythmia and is being
considered for treatment with procainamide. She is already receiving an ACE
inhibitor, digoxin, and hydrochlorothiazide for her cardiac condition. 1. In
deciding on a treatment regimen with procainamide for this patient, which of
the following statements is most ? (A) A probable drug interaction with
digoxin suggests that digoxin blood levels should be obtained before and after
starting procainamide.
(B) Hyperkalemia should be avoided to reduce the likelihood of procainamide
toxicity.
(C) Procainamide cannot be used if the patient has asthma because it has a β-
blocking effect. (D) Procainamide cannot be used if the patient has angina
because it has a β-agonist effect. (E) Procainamide is not active by the oral
route.
Accurate Answer:- B
If this patient should take an overdose and manifest severe acute
procainamide toxicity with markedly prolonged QRS, which of the following
should be given immediately? (A) A calcium chelator such as EDTA
(B) Adenosine
(C) Nitroprusside
(D) Potassium chloride
(E) Sodium lactate
Accurate Answer:- E
A 54-year-old airline pilot is admitted to the emergency department with
chest pain and a rapid heart rhythm. The ECG shows an inferior myocardial
infarction and ventricular tachycardia. Amiodarone is ordered. Amiodarone
(A) Decreases PR interval in normal sinus rhythm
(B) Increases action potential duration
(C) Increases contractility
(D) Often causes liver function abnormalities
(E) Reduces resting potential
Accurate Answer:- B
,A 36-year-old woman with a history of poorly controlled thyrotoxicosis has
recurrent episodes of tachycardia with severe shortness of breath. During
elective surgery to remove her thyroid, she develops a heart rate of 200 with a
slightly decreased blood pressure. Which of the following drugs would be
most suitable? (A) Amiodarone
(B) Disopyramide
(C) Esmolol
(D) Quinidine
(E) Verapamil
Accurate Answer:- C
A 16-year-old girl has paroxysmal attacks of rapid heart rate with palpitations
and shortness of breath. These episodes occasionally terminate spontaneously
but often require a visit to the emergency department of the local hospital.
Her ECG during these episodes reveals an AV nodal tachycardia, (A)
Adenosine
(B) Amiodarone
(C) Flecainide
(D) Propranolol
(E) Verapamil
Accurate Answer:- E
A 55-year-old man is admitted to the emergency department and is found to
have an abnormal ECG. Overdose of an antiarrhythmic drug is considered.
Which of the following drugs is ly paired with its ECG effects? (A)
Quinidine: Increased PR and decreased QT intervals
(B) Flecainide: Increased QRS interval
(C) Verapamil: Decreased PR interval
(D) Lidocaine: Decreased QRS and PR interval
(E) Metoprolol: Increased QRS duration
Accurate Answer:- B
A 60-year-old woman comes to the emergency department with atypical chest
pain. Her ECG reveals ventricular tachycardia with rare normal sinus beats,
and ST-segment elevation. Troponin C levels are markedly increased,
suggesting myocardial damage. A diagnosis of myocardial infarction is made,
and the woman is admitted to the cardiac intensive care unit. Her arrhythmia
will probably be treated initially with (A) Adenosine
(B) Digoxin
,(C) Lidocaine
(D) Quinidine
(E) Verapamil
Accurate Answer:- C
Which of the following drugs slows conduction through the AV node and has a
duration of action of 10-20 seconds? (A) Adenosine
(B) Amiodarone
(C) Diltiazem
(D) Esmolol
(E) Flecainide
(F) Lidocaine
(G) Mexiletine
(H) Procainamide
(I) Quinidine.
Accurate Answer:- A
When working in outlying areas, this 62-year-old rancher is away from his
house for 12-14 h at a time. He has an arrhythmia that requires chronic
therapy. Which of the following has the longest half-life of all antiarrhythmic
drugs? (A) Adenosine
(B) Amiodarone
(C) Disopyramide
(D) Esmolol
(E) Flecainide
(F) Lidocaine
(G) Mexiletine
(H) Procainamide
(I) Quinidine
(J) Verapamil
Accurate Answer:- A
A drug was tested in the electrophysiology laboratory to determine its effects
on the cardiac action potential in normal ventricular cells. The results are
shown in the diagram.
Which of the following drugs does this agent most resemble?. (A)
Amiodarone
(B) Flecainide
, (C) Mexiletine
(D) Procainamide
(E) Verapamil
Accurate Answer:- B
A 70-year-old retired businessman with a history of chronic heart failure has
been taking digoxin and furosemide. He is now admitted with a history of
vomiting, acute decompensated heart failure, and metabolic derangements.
He has marked peripheral edema and metabolic alkalosis (pH, 7.50; pCO2, 45;
HCO3, 36; Na+, 140). Which of the following drugs is most appropriate for the
treatment of his edema? (A) Acetazolamide
(B) Digoxin
(C) Eplerenone
(D) Hydrochlorothiazide
(E) Tolvaptan
Accurate Answer:- A
A 50-year-old man has a history of frequent episodes of renal colic with
calcium-containing renal stones. A careful workup indicates that he has a
defect in proximal tubular calcium reabsorption, which results in high
concentrations of calcium salts in the tubular urine. The most useful diuretic
agent in the treatment of recurrent calcium stones is (A) Chlorthalidone
(B) Diazoxide
(C) Ethacrynic acid
(D) Mannitol
(E) Spironolactone
ACCURATE ANSWER:- A
Which of the following is an important effect of chronic therapy with loop
diuretics? (A) Decreased urinary excretion of calcium
(B) Elevation of blood pressure
(C) Elevation of pulmonary vascular pressure
(D) Metabolic alkalosis
(E) Teratogenic action in pregnancy
Accurate Answer:- D
Which drug is ly associated with its actions in the following table? (+ indicates
increase and - indicates decrease.) Answer Spironolactone causes acidosis
Questions
A 76-year-old retired postal worker with rheumatoid arthritis and chronic
heart disease presents with a cardiac arrhythmia and is being
considered for treatment with procainamide. She is already receiving an ACE
inhibitor, digoxin, and hydrochlorothiazide for her cardiac condition. 1. In
deciding on a treatment regimen with procainamide for this patient, which of
the following statements is most ? (A) A probable drug interaction with
digoxin suggests that digoxin blood levels should be obtained before and after
starting procainamide.
(B) Hyperkalemia should be avoided to reduce the likelihood of procainamide
toxicity.
(C) Procainamide cannot be used if the patient has asthma because it has a β-
blocking effect. (D) Procainamide cannot be used if the patient has angina
because it has a β-agonist effect. (E) Procainamide is not active by the oral
route.
Accurate Answer:- B
If this patient should take an overdose and manifest severe acute
procainamide toxicity with markedly prolonged QRS, which of the following
should be given immediately? (A) A calcium chelator such as EDTA
(B) Adenosine
(C) Nitroprusside
(D) Potassium chloride
(E) Sodium lactate
Accurate Answer:- E
A 54-year-old airline pilot is admitted to the emergency department with
chest pain and a rapid heart rhythm. The ECG shows an inferior myocardial
infarction and ventricular tachycardia. Amiodarone is ordered. Amiodarone
(A) Decreases PR interval in normal sinus rhythm
(B) Increases action potential duration
(C) Increases contractility
(D) Often causes liver function abnormalities
(E) Reduces resting potential
Accurate Answer:- B
,A 36-year-old woman with a history of poorly controlled thyrotoxicosis has
recurrent episodes of tachycardia with severe shortness of breath. During
elective surgery to remove her thyroid, she develops a heart rate of 200 with a
slightly decreased blood pressure. Which of the following drugs would be
most suitable? (A) Amiodarone
(B) Disopyramide
(C) Esmolol
(D) Quinidine
(E) Verapamil
Accurate Answer:- C
A 16-year-old girl has paroxysmal attacks of rapid heart rate with palpitations
and shortness of breath. These episodes occasionally terminate spontaneously
but often require a visit to the emergency department of the local hospital.
Her ECG during these episodes reveals an AV nodal tachycardia, (A)
Adenosine
(B) Amiodarone
(C) Flecainide
(D) Propranolol
(E) Verapamil
Accurate Answer:- E
A 55-year-old man is admitted to the emergency department and is found to
have an abnormal ECG. Overdose of an antiarrhythmic drug is considered.
Which of the following drugs is ly paired with its ECG effects? (A)
Quinidine: Increased PR and decreased QT intervals
(B) Flecainide: Increased QRS interval
(C) Verapamil: Decreased PR interval
(D) Lidocaine: Decreased QRS and PR interval
(E) Metoprolol: Increased QRS duration
Accurate Answer:- B
A 60-year-old woman comes to the emergency department with atypical chest
pain. Her ECG reveals ventricular tachycardia with rare normal sinus beats,
and ST-segment elevation. Troponin C levels are markedly increased,
suggesting myocardial damage. A diagnosis of myocardial infarction is made,
and the woman is admitted to the cardiac intensive care unit. Her arrhythmia
will probably be treated initially with (A) Adenosine
(B) Digoxin
,(C) Lidocaine
(D) Quinidine
(E) Verapamil
Accurate Answer:- C
Which of the following drugs slows conduction through the AV node and has a
duration of action of 10-20 seconds? (A) Adenosine
(B) Amiodarone
(C) Diltiazem
(D) Esmolol
(E) Flecainide
(F) Lidocaine
(G) Mexiletine
(H) Procainamide
(I) Quinidine.
Accurate Answer:- A
When working in outlying areas, this 62-year-old rancher is away from his
house for 12-14 h at a time. He has an arrhythmia that requires chronic
therapy. Which of the following has the longest half-life of all antiarrhythmic
drugs? (A) Adenosine
(B) Amiodarone
(C) Disopyramide
(D) Esmolol
(E) Flecainide
(F) Lidocaine
(G) Mexiletine
(H) Procainamide
(I) Quinidine
(J) Verapamil
Accurate Answer:- A
A drug was tested in the electrophysiology laboratory to determine its effects
on the cardiac action potential in normal ventricular cells. The results are
shown in the diagram.
Which of the following drugs does this agent most resemble?. (A)
Amiodarone
(B) Flecainide
, (C) Mexiletine
(D) Procainamide
(E) Verapamil
Accurate Answer:- B
A 70-year-old retired businessman with a history of chronic heart failure has
been taking digoxin and furosemide. He is now admitted with a history of
vomiting, acute decompensated heart failure, and metabolic derangements.
He has marked peripheral edema and metabolic alkalosis (pH, 7.50; pCO2, 45;
HCO3, 36; Na+, 140). Which of the following drugs is most appropriate for the
treatment of his edema? (A) Acetazolamide
(B) Digoxin
(C) Eplerenone
(D) Hydrochlorothiazide
(E) Tolvaptan
Accurate Answer:- A
A 50-year-old man has a history of frequent episodes of renal colic with
calcium-containing renal stones. A careful workup indicates that he has a
defect in proximal tubular calcium reabsorption, which results in high
concentrations of calcium salts in the tubular urine. The most useful diuretic
agent in the treatment of recurrent calcium stones is (A) Chlorthalidone
(B) Diazoxide
(C) Ethacrynic acid
(D) Mannitol
(E) Spironolactone
ACCURATE ANSWER:- A
Which of the following is an important effect of chronic therapy with loop
diuretics? (A) Decreased urinary excretion of calcium
(B) Elevation of blood pressure
(C) Elevation of pulmonary vascular pressure
(D) Metabolic alkalosis
(E) Teratogenic action in pregnancy
Accurate Answer:- D
Which drug is ly associated with its actions in the following table? (+ indicates
increase and - indicates decrease.) Answer Spironolactone causes acidosis
