Pharm Lilley Ch. 25
1. The nurse is reviewing the classes of antidysrhythmic drugs. Amiodarone (Cordarone) is
classified on the Vaughan Williams classification as a class III drug, which means it works by
which mechanism of action?
a. Blocking slow calcium channels
b. Prolonging action potential duration
c. Blocking sodium channels and affecting phase 0
d. Decreasing spontaneous depolarization and affecting phase 4 - ANSANS: B
Vaughan Williams class III drugs (amiodarone, dronedarone, sotalol, ibutilide, and dofetilide)
increase the action potential duration by prolonging repolarization in phase 3. The other
answers are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 396
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. A patient is taking procainamide (Pronestyl) for a cardiac dysrhythmia. The nurse will monitor
the patient for which possible adverse effect?
a. Bradycardia
b. Shortened QT interval
c. Dyspnea
d. Diarrhea - ANSANS: D
Diarrhea is a potential adverse effect of procainamide therapy. Prolonged QT interval on the
ECG is also possible. The other options are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 398
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. Which nursing diagnosis is appropriate for a patient receiving antidysrhythmics?
a. Risk for infection
b. Deficient knowledge
c. Deficient fluid volume
d. Urinary retention - ANSANS: B
Deficient knowledge related to lack of experience with medication therapy is a potential nursing
diagnosis for a patient receiving antidysrhythmics. The other options are incorrect.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 406
TOP: NURSING PROCESS: Nursing Diagnosis
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
, 4. A patient will be discharged on quinidine sulfate (Quinidex) extended-release tablets for the
treatment of ventricular ectopy. The nurse will include which information in the teaching plan?
a. The medication should be stopped once the cardiac symptoms subside.
b. Signs of cinchonism, such as tinnitus, loss of hearing, or slight blurring of vision, may occur.
c. It is important to use sunscreen products when outside because of increased photosensitivity.
d. If any tablet or capsule is visible in the stool, contact the prescriber immediately. - ANSANS: B
Quinidine, a cinchona alkaloid, may cause the symptoms of cinchonism, including tinnitus, loss
of hearing, slight blurring of vision, and gastrointestinal upset. The medication will need to be
continued even after symptoms subside, or the symptoms may return. Tablets or capsules that
are visible in the stool are actually the wax matrices that contained the drug; the medication is
extracted while in the intestines. Photosensitivity occurs with class III drugs, not with quinidine
(class Ia).
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 401
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. A patient is in the intensive care unit because of an acute myocardial infarction. He is
experiencing severe ventricular dysrhythmias. The nurse will prepare to give which drug of
choice for this dysrhythmia?
a. Diltiazem (Cardizem)
b. Verapamil (Calan)
c. Amiodarone (Cordarone)
d. Adenosine (Adenocard) - ANSANS: C
Amiodarone (Cordarone) is the drug of choice for ventricular dysrhythmias according to the
Advanced Cardiac Life Support guidelines. The other drugs are not used for acute ventricular
dysrhythmias.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 403
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is preparing to administer adenosine (Adenocard) to a patient who is experiencing
an acute episode of paroxysmal supraventricular tachycardia. When giving this medication,
which is important to remember?
a. The onset of action occurs in 5 minutes.
b. The medication must be given as a slow intravenous (IV) push.
c. Asystole may occur for a few seconds after administration.
d. The medication has a long half-life, and therefore duration of action is very long. - ANSANS:
C
Adenosine has an extremely short half-life of less than 10 seconds; its onset occurs within 1
minute; and it must be given as a fast IV push injection. In addition, a very brief episode of
asystole may occur after administration.
1. The nurse is reviewing the classes of antidysrhythmic drugs. Amiodarone (Cordarone) is
classified on the Vaughan Williams classification as a class III drug, which means it works by
which mechanism of action?
a. Blocking slow calcium channels
b. Prolonging action potential duration
c. Blocking sodium channels and affecting phase 0
d. Decreasing spontaneous depolarization and affecting phase 4 - ANSANS: B
Vaughan Williams class III drugs (amiodarone, dronedarone, sotalol, ibutilide, and dofetilide)
increase the action potential duration by prolonging repolarization in phase 3. The other
answers are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 396
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. A patient is taking procainamide (Pronestyl) for a cardiac dysrhythmia. The nurse will monitor
the patient for which possible adverse effect?
a. Bradycardia
b. Shortened QT interval
c. Dyspnea
d. Diarrhea - ANSANS: D
Diarrhea is a potential adverse effect of procainamide therapy. Prolonged QT interval on the
ECG is also possible. The other options are incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension) REF: p. 398
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. Which nursing diagnosis is appropriate for a patient receiving antidysrhythmics?
a. Risk for infection
b. Deficient knowledge
c. Deficient fluid volume
d. Urinary retention - ANSANS: B
Deficient knowledge related to lack of experience with medication therapy is a potential nursing
diagnosis for a patient receiving antidysrhythmics. The other options are incorrect.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 406
TOP: NURSING PROCESS: Nursing Diagnosis
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
, 4. A patient will be discharged on quinidine sulfate (Quinidex) extended-release tablets for the
treatment of ventricular ectopy. The nurse will include which information in the teaching plan?
a. The medication should be stopped once the cardiac symptoms subside.
b. Signs of cinchonism, such as tinnitus, loss of hearing, or slight blurring of vision, may occur.
c. It is important to use sunscreen products when outside because of increased photosensitivity.
d. If any tablet or capsule is visible in the stool, contact the prescriber immediately. - ANSANS: B
Quinidine, a cinchona alkaloid, may cause the symptoms of cinchonism, including tinnitus, loss
of hearing, slight blurring of vision, and gastrointestinal upset. The medication will need to be
continued even after symptoms subside, or the symptoms may return. Tablets or capsules that
are visible in the stool are actually the wax matrices that contained the drug; the medication is
extracted while in the intestines. Photosensitivity occurs with class III drugs, not with quinidine
(class Ia).
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 401
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. A patient is in the intensive care unit because of an acute myocardial infarction. He is
experiencing severe ventricular dysrhythmias. The nurse will prepare to give which drug of
choice for this dysrhythmia?
a. Diltiazem (Cardizem)
b. Verapamil (Calan)
c. Amiodarone (Cordarone)
d. Adenosine (Adenocard) - ANSANS: C
Amiodarone (Cordarone) is the drug of choice for ventricular dysrhythmias according to the
Advanced Cardiac Life Support guidelines. The other drugs are not used for acute ventricular
dysrhythmias.
DIF: COGNITIVE LEVEL: Applying (Application) REF: p. 403
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. The nurse is preparing to administer adenosine (Adenocard) to a patient who is experiencing
an acute episode of paroxysmal supraventricular tachycardia. When giving this medication,
which is important to remember?
a. The onset of action occurs in 5 minutes.
b. The medication must be given as a slow intravenous (IV) push.
c. Asystole may occur for a few seconds after administration.
d. The medication has a long half-life, and therefore duration of action is very long. - ANSANS:
C
Adenosine has an extremely short half-life of less than 10 seconds; its onset occurs within 1
minute; and it must be given as a fast IV push injection. In addition, a very brief episode of
asystole may occur after administration.
