Pharmacology Final Exam REVIEW!!!!
A patient about to receive his morning dose of digoxin has an apical pulse of 70 beats per
minute. What will the nurse do?
A. Administer the dose.
B. Administer the dose and notify the physician.
C. Check the radial pulse for 1 full minute.
D. Withhold the dose and notify the - ANSA. Administer the dose.
In assessing a patient before administration of a cardiac glycoside, the nurse knows that what
condition can predispose a patient to digitalis toxicity?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia - ANSA. Hypokalemia; control ventricular response to atrial fibrillation and a
derived from foxglove. Digoxin is the only available cardiac glycoside---positive
inotropic---inhibits sodium potassium pump (adenosine tripphophatase) Sodium and calcium
rise. Cholinergic stimulation via the vagus nerve of Parasympathetic nervous system.
---Negative chronotropic---Negative Dromotropic effect
While assessing a patient who is receiving intravenous digitalis, the nurse recognizes that the
drug has a negative chronotropic effect. How would this drug effect be evident in the patient?
A. Increased heart rate
B. Decreased heart rate
C. Decreased conduction
D. Increased ectopic beats - ANSB. Decreased heart rate
A patient has been taking digoxin at home but has taken an accidental overdose and has
developed toxicity. He has been admitted to the telemetry unit where the physician has ordered
digoxin immune Fab (Digibind). The patient asks the nurse why the medication is ordered. What
is the nurse's best response?
A. "It works faster than digoxin."
B. "It is safer than digoxin and can be taken orally."
C. "It helps to convert the irregular heart rhythm to a more normal rhythm."
D. "This drug is an antidote to digoxin and will help to lower the blood levels." - ANSD. "This
drug is an antidote to digoxin and will help to lower the blood levels." (severe bradycardia,
advanced heart block, ventricularr tachycardia, fibrillation, and hyperkalemia); available in
parental form. Clinical signs and symptoms are monitored NOT serum levels----used for systolic
heart failure and atrial fibrillation.
,5. 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?
A. Hypertension
B. Hyperkalemia
C. Nausea and vomiting
D. Cardiac dysrhythmias - ANSD. Cardiac dysrhythmias (contraindictated with ventricular
tachycardia, and fibrillation) used for treatment of atrial fibrillation. Available in Oral and injection
form.
6. A patient with atrial fibrillation was started on digoxin, and 1 week later a digoxin level was
drawn. Which result is within normal therapeutic levels for digoxin?
A. 0.4 ng/mL
B. 0.7 ng/mL
C. 2.1 ng/mL
D. 2.6 ng/mL or higher - ANSB. 0.7 ng/mL (normal 0.5 to 2.0 ng/mL
7. When reviewing the list of medications taken by a patient who will be receiving a new
prescription for digoxin, the nurse would be concerned about which medication that may interact
with the digoxin?
A. aspirin
B. acetaminophen (Tylenol)
C. furosemide (Lasix)
D. vitamin K - ANSC. furosemide (Lasix); (loop Diuretics); numerous ones on page 341
8. The nurse is reviewing discharge teaching for a patient who will be taking digoxin (Lanoxin)
therapy. The patient should be taught to avoid which foods when taking the digoxin?
A. Leafy green vegetables
B. Dairy products
C. Grapefruit juice
D. Bran muffins - ANSD. Bran muffins
9. In assessing a patient before administration of a cardiac glycoside, the nurse knows that
which lab result can increase the toxicity of the drug?
A. Potassium level 2.8 mEq/L
B. Potassium level 4.9 mEq/L
C. Sodium level 140 mEq/L
D. Calcium level 10 mg/dL - ANSA. Potassium level 2.8 mEq/L (low potassium normal is 3.5 to
5.0)
10. The nurse administering the phosphodiesterase inhibitor inamrinone recognizes that this
drug should have a positive inotropic effect. This effect will result in increased
A. heart rate.
B. blood vessel dilation.
, C. force of cardiac contraction.
D. conduction of electrical impulses across the heart. - ANSC. force of cardiac contraction.
(increase cAMP) positive inotropic (by more calcium available in SR)effect and vasodilation,
(inodilators)---positive chornotropic effect); USED IN ICU; ADVERSE
EFFECT...thrombocytopenia, dysrhythmia, ventricular, hypotension and angina, hypokalemia,
tremor.
11. The nurse notes in a patient's medical record that nesiritide has been ordered. Based on this
order, the nurse interprets that the patient has which disorder?
A. Atrial fibrillation
B. Acutely decompensated heart failure with dyspnea at rest
C. Systolic heart failure
D. Long-term treatment of heart failure. - ANSB. Acutely decompensated heart failure with
dyspnea at rest
SELECT ALL THAT APPLY:
1. When a patient is experiencing digoxin toxicity, which clinical situation would necessitate the
use of digoxin immune Fab (Digibind)? Select all that apply.
A. The patient reports seeing colorful halos around lights.
B. The patient's serum potassium level is above 5 mEq/L.
C. The patient is experiencing nausea and anorexia.
D. The patient is experiencing severe sinus bradycardia that does not respond to cardiac
pacing.
E. The patient has taken an overdose of greater than 10 mg of digoxin. - ANSB. The patient's
serum potassium level is above 5 mEq/L.
D. The patient is experiencing severe sinus bradycardia that does not respond to cardiac
pacing. (E) might be right as well a person taking 10mg of digoxin is a indication of
toxicity...page 340 states life threatening digoxin overdose in adults and 4 mg in children)
2. Which drug classes are considered first-line treatment for heart failure? Select all that apply.
A. Angiotensin converting enzyme (ACE) inhibitors
B. Angiotensin II receptor blockers (ARBs)
C. Digoxin (cardiac glycoside)
D. Beta-blockers
E. Nesiritide (Natrecor), the B-type natriuretic peptide - ANSACE
ARBS
Beta-blockers
loop diuretics
1.When administering topical nitroglycerin ointment, the nurse should use which technique?
A. The ointment should be applied on the chest over the heart.
B. The ointment should be used only in the case of a mild angina episode.
A patient about to receive his morning dose of digoxin has an apical pulse of 70 beats per
minute. What will the nurse do?
A. Administer the dose.
B. Administer the dose and notify the physician.
C. Check the radial pulse for 1 full minute.
D. Withhold the dose and notify the - ANSA. Administer the dose.
In assessing a patient before administration of a cardiac glycoside, the nurse knows that what
condition can predispose a patient to digitalis toxicity?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia - ANSA. Hypokalemia; control ventricular response to atrial fibrillation and a
derived from foxglove. Digoxin is the only available cardiac glycoside---positive
inotropic---inhibits sodium potassium pump (adenosine tripphophatase) Sodium and calcium
rise. Cholinergic stimulation via the vagus nerve of Parasympathetic nervous system.
---Negative chronotropic---Negative Dromotropic effect
While assessing a patient who is receiving intravenous digitalis, the nurse recognizes that the
drug has a negative chronotropic effect. How would this drug effect be evident in the patient?
A. Increased heart rate
B. Decreased heart rate
C. Decreased conduction
D. Increased ectopic beats - ANSB. Decreased heart rate
A patient has been taking digoxin at home but has taken an accidental overdose and has
developed toxicity. He has been admitted to the telemetry unit where the physician has ordered
digoxin immune Fab (Digibind). The patient asks the nurse why the medication is ordered. What
is the nurse's best response?
A. "It works faster than digoxin."
B. "It is safer than digoxin and can be taken orally."
C. "It helps to convert the irregular heart rhythm to a more normal rhythm."
D. "This drug is an antidote to digoxin and will help to lower the blood levels." - ANSD. "This
drug is an antidote to digoxin and will help to lower the blood levels." (severe bradycardia,
advanced heart block, ventricularr tachycardia, fibrillation, and hyperkalemia); available in
parental form. Clinical signs and symptoms are monitored NOT serum levels----used for systolic
heart failure and atrial fibrillation.
,5. 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?
A. Hypertension
B. Hyperkalemia
C. Nausea and vomiting
D. Cardiac dysrhythmias - ANSD. Cardiac dysrhythmias (contraindictated with ventricular
tachycardia, and fibrillation) used for treatment of atrial fibrillation. Available in Oral and injection
form.
6. A patient with atrial fibrillation was started on digoxin, and 1 week later a digoxin level was
drawn. Which result is within normal therapeutic levels for digoxin?
A. 0.4 ng/mL
B. 0.7 ng/mL
C. 2.1 ng/mL
D. 2.6 ng/mL or higher - ANSB. 0.7 ng/mL (normal 0.5 to 2.0 ng/mL
7. When reviewing the list of medications taken by a patient who will be receiving a new
prescription for digoxin, the nurse would be concerned about which medication that may interact
with the digoxin?
A. aspirin
B. acetaminophen (Tylenol)
C. furosemide (Lasix)
D. vitamin K - ANSC. furosemide (Lasix); (loop Diuretics); numerous ones on page 341
8. The nurse is reviewing discharge teaching for a patient who will be taking digoxin (Lanoxin)
therapy. The patient should be taught to avoid which foods when taking the digoxin?
A. Leafy green vegetables
B. Dairy products
C. Grapefruit juice
D. Bran muffins - ANSD. Bran muffins
9. In assessing a patient before administration of a cardiac glycoside, the nurse knows that
which lab result can increase the toxicity of the drug?
A. Potassium level 2.8 mEq/L
B. Potassium level 4.9 mEq/L
C. Sodium level 140 mEq/L
D. Calcium level 10 mg/dL - ANSA. Potassium level 2.8 mEq/L (low potassium normal is 3.5 to
5.0)
10. The nurse administering the phosphodiesterase inhibitor inamrinone recognizes that this
drug should have a positive inotropic effect. This effect will result in increased
A. heart rate.
B. blood vessel dilation.
, C. force of cardiac contraction.
D. conduction of electrical impulses across the heart. - ANSC. force of cardiac contraction.
(increase cAMP) positive inotropic (by more calcium available in SR)effect and vasodilation,
(inodilators)---positive chornotropic effect); USED IN ICU; ADVERSE
EFFECT...thrombocytopenia, dysrhythmia, ventricular, hypotension and angina, hypokalemia,
tremor.
11. The nurse notes in a patient's medical record that nesiritide has been ordered. Based on this
order, the nurse interprets that the patient has which disorder?
A. Atrial fibrillation
B. Acutely decompensated heart failure with dyspnea at rest
C. Systolic heart failure
D. Long-term treatment of heart failure. - ANSB. Acutely decompensated heart failure with
dyspnea at rest
SELECT ALL THAT APPLY:
1. When a patient is experiencing digoxin toxicity, which clinical situation would necessitate the
use of digoxin immune Fab (Digibind)? Select all that apply.
A. The patient reports seeing colorful halos around lights.
B. The patient's serum potassium level is above 5 mEq/L.
C. The patient is experiencing nausea and anorexia.
D. The patient is experiencing severe sinus bradycardia that does not respond to cardiac
pacing.
E. The patient has taken an overdose of greater than 10 mg of digoxin. - ANSB. The patient's
serum potassium level is above 5 mEq/L.
D. The patient is experiencing severe sinus bradycardia that does not respond to cardiac
pacing. (E) might be right as well a person taking 10mg of digoxin is a indication of
toxicity...page 340 states life threatening digoxin overdose in adults and 4 mg in children)
2. Which drug classes are considered first-line treatment for heart failure? Select all that apply.
A. Angiotensin converting enzyme (ACE) inhibitors
B. Angiotensin II receptor blockers (ARBs)
C. Digoxin (cardiac glycoside)
D. Beta-blockers
E. Nesiritide (Natrecor), the B-type natriuretic peptide - ANSACE
ARBS
Beta-blockers
loop diuretics
1.When administering topical nitroglycerin ointment, the nurse should use which technique?
A. The ointment should be applied on the chest over the heart.
B. The ointment should be used only in the case of a mild angina episode.
