Pharmacology Final Exam REVIEW!!! ln ln ln
!| exam questions and answers| correct
ln ln ln ln ln ln
verified A+ ln
1. A patient about to receive his morning dose of digoxin has an apical pul
ln ln ln ln ln ln ln ln ln ln ln ln ln
seof 70 beats per minute. What will
n
l ln
ln the nurse do? ln ln n
l ln ln ln ln
A. Administer the dose. ln ln
B. Administer the dose and notify the physician. ln ln ln ln ln ln
C. Check the radial pulse for 1 full minute. ln ln ln ln ln ln ln
D. Withhold the dose and notify the: A. Administer the dose.
ln ln ln ln ln ln ln ln ln
2. In assessing a patient before administration of a cardiac glycoside, the n
ln ln ln ln ln ln ln ln ln ln ln
urse knows that what condition can predispose a patient to digitalis toxicity?
ln ln ln ln ln ln ln ln ln ln ln
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia: A. Hypokalemia; control ventricular response to atrial fibrillation ln ln ln ln ln ln ln ln
and a derived from foxglove. Digoxin is the only available cardiac glycoside---
ln ln ln ln ln ln ln ln ln ln ln
positiveinotropic--- ln
inhibits sodium potassium pump (adenosine tripphophatase) Sodium and calcium
ln ln ln ln ln ln ln ln ln
rise. Cholinergic stimulation via the vagus nerve of Parasympathetic nervous syst
ln ln ln ln ln ln ln ln ln ln
em. ---Negative chronotropic---Negative Dromotropic effect
ln ln ln ln
3. While assessing a patient who is receiving intravenous digitalis, the nurs
ln ln ln ln ln ln ln ln ln ln
erecognizes that the drug has a negative chronotropic effect. How would t
n
l ln ln ln ln ln ln ln ln ln ln ln
hisdrug effect be evident in the patient?
n
l ln ln ln ln ln ln
A. Increased heart rate ln ln
B. Decreased heart rate ln ln
C. Decreased conduction ln
D. Increased ectopic beats: B. Decreased heart rate ln ln ln ln ln ln
4. A patient has been taking digoxin at home but has taken an accidental o
ln ln ln ln ln ln ln ln ln ln ln ln ln
verdose and has developed toxicity. He has been admitted to the telemetry
ln ln ln ln ln ln ln ln ln ln ln l
nunit where the physician has ordered digoxin immune Fab (Digibind). The
ln ln ln ln ln ln ln ln ln ln ln
patient asks the nurse why the medication is ordered. What is the nurse's best
ln ln ln ln ln ln ln ln n
l ln ln ln ln
response?
A. "It works faster than digoxin."
ln ln ln ln
B. "It is safer than digoxin and can be taken orally."
ln ln ln ln ln ln ln ln ln
C. "It helps to convert the irregular heart rhythm to a more normal rhythm."
ln ln ln ln ln ln ln ln ln ln ln ln
D. "This drug is an antidote to digoxin and will help to lower the blood leve
ln ln ln ln ln ln ln ln ln ln ln ln ln ln
ls.": D. "This drug is an antidote to digoxin and will help to lower the blood levels.
ln ln ln ln ln ln ln ln ln ln ln ln ln ln ln ln
" (severe bradycardia, advanced heart block, ventricularr tachycardia, fibrilla-
ln ln ln ln ln ln ln ln
tion, and hyperkalemia); available in parental form. Clinical signs and symptoms are
ln ln ln ln ln ln ln ln ln ln ln ln ln
monitored NOT serum levels----used for systolic heart failure and atrial fibrillation.
ln ln ln ln ln ln ln ln ln ln
5. 5. A patient has been placed on a milrinone infusion as part of the thera
ln ln ln ln ln ln ln ln ln ln ln ln ln ln
pyfor end-n
l ln
1ln/ln31
, Pharmacology Final Exam REVIEW!!! ln ln ln
!| exam questions and answers| correct
ln ln ln ln ln ln
stage heart failure. What risks involved with this drug will the nurse keep i
ln ln ln ln ln ln ln ln ln ln ln ln ln
ln ln
verified A+
n mind while assessing
ln this patient during the infusion?
ln
ln ln ln ln ln
2ln/ln31
, Pharmacology Final Exam REVIEW!!! ln ln ln
!| exam questions and answers| correct ln ln ln ln ln ln
A. Hypertensionverified A+ ln
B. Hyperkalemia
C. Nausea and vomiting
ln ln
D. Cardiac dysrhythmias: D. Cardiac dysrhythmias (contraindictated with ventric-
ln ln ln ln ln ln ln
ular tachycardia, and fibrillation) used for treatment of atrial fibrillation. Available in
ln ln ln ln ln ln ln ln ln ln ln ln ln
Oral and injection form.
ln ln ln
6. 6. A patient with atrial fibrillation was started on digoxin, and 1 week later
ln ln ln ln ln ln ln ln ln ln ln ln ln ln
adigoxin level was drawn. Which result is within normal therapeutic levels f
n
l ln ln ln ln ln ln ln ln ln ln ln
or digoxin? ln
A. 0.4 ng/mL ln
B. 0.7 ng/mL ln
C. 2.1 ng/mL ln
D. 2.6 ng/mL or higher: B. 0.7 ng/mL (normal 0.5 to 2.0 ng/mL
ln ln ln ln ln ln ln ln ln ln ln
7. 7. When reviewing the list of medications taken by a patient who will be r
ln ln ln ln ln ln ln ln ln ln ln ln ln ln
eceiving a new prescription for digoxin, the nurse would be concerned about
ln ln ln ln ln ln ln ln ln ln ln n
l
which medication that may interact with the digoxin?
ln ln ln ln ln ln ln
A. aspirin
B. acetaminophen (Tylenol) ln
C. furosemide (Lasix) ln
D. vitamin K: C. furosemide (Lasix); (loop Diuretics); numerous ones on page 341
ln ln ln ln ln ln ln ln ln ln ln
8. 8. The nurse is reviewing discharge teaching for a patient who will be takin
ln ln ln ln ln ln ln ln ln ln ln ln ln
gdigoxin (Lanoxin) therapy. The patient should be taught to avoid which foo
n
l ln ln ln ln ln ln ln ln ln ln ln
dswhen taking the digoxin?
n
l ln ln ln
A. Leafy green vegetables ln ln
B. Dairy products ln
C. Grapefruit juice ln
D. Bran muffins: D. Bran muffins ln ln ln ln
9. 9. In assessing a patient before administration of a cardiac glycoside, th
ln ln ln ln ln ln ln ln ln ln ln
enurse knows that which lab result can increase the toxicity of the drug?
n
l ln ln ln ln ln ln ln ln ln ln ln ln
A. Potassium level 2.8 mEq/L ln ln ln
B. Potassium level 4.9 mEq/L ln ln ln
C. Sodium level 140 mEq/L ln ln ln
D. Calcium level 10 mg/dL: A. Potassium level 2.8 mEq/L (low potassium norma
ln ln ln ln ln ln ln ln ln ln ln
lis 3.5 to 5.0)
ln ln ln ln
10. 10. The nurse administering the phosphodiesterase inhibitor inamrinon
ln ln ln ln ln ln ln
erecognizes that this drug should have a positive inotropic effect. This eff
n
l ln ln ln ln ln ln ln ln ln ln ln
ectwill result in increased
n
l ln ln ln
A. heart rate. ln
B. blood vessel dilation. ln ln
3ln/ln31
, Pharmacology Final Exam REVIEW!!! ln ln ln
!| exam questions and answers| correct ln ln ln ln ln ln
C. force of cardiac contraction.
verified A+ ln ln ln
ln
D. conduction of electrical impulses across the heart.: C. force of cardiac con ln ln ln ln ln ln ln ln ln ln ln
-traction. (increase cAMP) positive inotropic
ln
(by more calcium available in SR)ef-
ln ln ln ln ln ln ln ln ln ln
fect and vasodilation, (inodilators)---
ln ln ln ln
positive chornotropic effect); USED IN ICU; ADVERSE EFFECT...thrombocytopen
ln ln ln ln ln ln ln
ia, dysrhythmia, ventricular, hypotension andangina, hypokalemia, tremor.
ln ln ln ln ln ln ln
11. 11. The nurse notes in a patient's medical record that nesiritide has bee
ln ln ln ln ln ln ln ln ln ln ln ln
nordered. Based on this order, the nurse interprets that the patient has whi
n
l ln ln ln ln ln ln ln ln ln ln ln ln
chdisorder? n
l
A. Atrial fibrillation ln
B. Acutely decompensated heart failure with dyspnea at rest ln ln ln ln ln ln ln
C. Systolic heart failure ln ln
D. Long-
term treatment of heart failure.: B. Acutely decompensated heart failurewith dys
ln ln ln ln ln ln ln ln ln ln ln
pnea at rest ln ln
12. SELECT ALL THAT APPLY: ln ln ln
1. When a patient is experiencing digoxin toxicity, which clinical situation
ln ln ln ln ln ln ln ln ln ln
would necessitate the use of digoxin immune Fab (Digibind)? Select all th
ln ln ln ln ln ln ln ln ln ln ln
atapply. n
l
A. The patient reports seeing colorful halos around lights.
ln ln ln ln ln ln ln
B. The patient's serum potassium level is above 5 mEq/L.
ln ln ln ln ln ln ln ln
C. The patient is experiencing nausea and anorexia.
ln ln ln ln ln ln
D. The patient is experiencing severe sinus bradycardia that does not respond
ln ln ln ln ln ln ln ln ln ln
to cardiac pacing. ln ln
E. The patient has taken an overdose of greater than 10 mg of digoxin.: B. Th
ln ln ln ln ln ln ln ln ln ln ln ln ln ln
epatient's serum potassium level is above 5 mEq/L.
ln ln ln ln ln ln ln ln
D. The patient is experiencing severe sinus bradycardia that does not respond to c
ln ln ln ln ln ln ln ln ln ln ln ln ln
ardiac pacing. (E) might be right as well a person taking 10mg of digoxin is a indic
ln ln ln ln ln ln ln ln ln ln ln ln ln ln ln ln
ation of toxicity...page 340 states life threatening digoxin overdose in adults and4 mg
ln ln ln ln ln ln ln ln ln ln ln ln ln ln
in children) ln
13. 2. Which drug classes are considered first-
ln ln ln ln ln ln
line treatment for heart failure?Select all that apply.
ln ln ln ln n
l ln ln ln
A. Angiotensin converting enzyme (ACE) inhibitors ln ln ln ln
B. Angiotensin II receptor blockers (ARBs) ln ln ln ln
C. Digoxin (cardiac glycoside) ln ln
D. Beta-blockers
E. Nesiritide (Natrecor), the B- ln ln ln
type natriuretic peptide: ACEARBS ln ln ln ln
4ln/ln31
!| exam questions and answers| correct
ln ln ln ln ln ln
verified A+ ln
1. A patient about to receive his morning dose of digoxin has an apical pul
ln ln ln ln ln ln ln ln ln ln ln ln ln
seof 70 beats per minute. What will
n
l ln
ln the nurse do? ln ln n
l ln ln ln ln
A. Administer the dose. ln ln
B. Administer the dose and notify the physician. ln ln ln ln ln ln
C. Check the radial pulse for 1 full minute. ln ln ln ln ln ln ln
D. Withhold the dose and notify the: A. Administer the dose.
ln ln ln ln ln ln ln ln ln
2. In assessing a patient before administration of a cardiac glycoside, the n
ln ln ln ln ln ln ln ln ln ln ln
urse knows that what condition can predispose a patient to digitalis toxicity?
ln ln ln ln ln ln ln ln ln ln ln
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia: A. Hypokalemia; control ventricular response to atrial fibrillation ln ln ln ln ln ln ln ln
and a derived from foxglove. Digoxin is the only available cardiac glycoside---
ln ln ln ln ln ln ln ln ln ln ln
positiveinotropic--- ln
inhibits sodium potassium pump (adenosine tripphophatase) Sodium and calcium
ln ln ln ln ln ln ln ln ln
rise. Cholinergic stimulation via the vagus nerve of Parasympathetic nervous syst
ln ln ln ln ln ln ln ln ln ln
em. ---Negative chronotropic---Negative Dromotropic effect
ln ln ln ln
3. While assessing a patient who is receiving intravenous digitalis, the nurs
ln ln ln ln ln ln ln ln ln ln
erecognizes that the drug has a negative chronotropic effect. How would t
n
l ln ln ln ln ln ln ln ln ln ln ln
hisdrug effect be evident in the patient?
n
l ln ln ln ln ln ln
A. Increased heart rate ln ln
B. Decreased heart rate ln ln
C. Decreased conduction ln
D. Increased ectopic beats: B. Decreased heart rate ln ln ln ln ln ln
4. A patient has been taking digoxin at home but has taken an accidental o
ln ln ln ln ln ln ln ln ln ln ln ln ln
verdose and has developed toxicity. He has been admitted to the telemetry
ln ln ln ln ln ln ln ln ln ln ln l
nunit where the physician has ordered digoxin immune Fab (Digibind). The
ln ln ln ln ln ln ln ln ln ln ln
patient asks the nurse why the medication is ordered. What is the nurse's best
ln ln ln ln ln ln ln ln n
l ln ln ln ln
response?
A. "It works faster than digoxin."
ln ln ln ln
B. "It is safer than digoxin and can be taken orally."
ln ln ln ln ln ln ln ln ln
C. "It helps to convert the irregular heart rhythm to a more normal rhythm."
ln ln ln ln ln ln ln ln ln ln ln ln
D. "This drug is an antidote to digoxin and will help to lower the blood leve
ln ln ln ln ln ln ln ln ln ln ln ln ln ln
ls.": D. "This drug is an antidote to digoxin and will help to lower the blood levels.
ln ln ln ln ln ln ln ln ln ln ln ln ln ln ln ln
" (severe bradycardia, advanced heart block, ventricularr tachycardia, fibrilla-
ln ln ln ln ln ln ln ln
tion, and hyperkalemia); available in parental form. Clinical signs and symptoms are
ln ln ln ln ln ln ln ln ln ln ln ln ln
monitored NOT serum levels----used for systolic heart failure and atrial fibrillation.
ln ln ln ln ln ln ln ln ln ln
5. 5. A patient has been placed on a milrinone infusion as part of the thera
ln ln ln ln ln ln ln ln ln ln ln ln ln ln
pyfor end-n
l ln
1ln/ln31
, Pharmacology Final Exam REVIEW!!! ln ln ln
!| exam questions and answers| correct
ln ln ln ln ln ln
stage heart failure. What risks involved with this drug will the nurse keep i
ln ln ln ln ln ln ln ln ln ln ln ln ln
ln ln
verified A+
n mind while assessing
ln this patient during the infusion?
ln
ln ln ln ln ln
2ln/ln31
, Pharmacology Final Exam REVIEW!!! ln ln ln
!| exam questions and answers| correct ln ln ln ln ln ln
A. Hypertensionverified A+ ln
B. Hyperkalemia
C. Nausea and vomiting
ln ln
D. Cardiac dysrhythmias: D. Cardiac dysrhythmias (contraindictated with ventric-
ln ln ln ln ln ln ln
ular tachycardia, and fibrillation) used for treatment of atrial fibrillation. Available in
ln ln ln ln ln ln ln ln ln ln ln ln ln
Oral and injection form.
ln ln ln
6. 6. A patient with atrial fibrillation was started on digoxin, and 1 week later
ln ln ln ln ln ln ln ln ln ln ln ln ln ln
adigoxin level was drawn. Which result is within normal therapeutic levels f
n
l ln ln ln ln ln ln ln ln ln ln ln
or digoxin? ln
A. 0.4 ng/mL ln
B. 0.7 ng/mL ln
C. 2.1 ng/mL ln
D. 2.6 ng/mL or higher: B. 0.7 ng/mL (normal 0.5 to 2.0 ng/mL
ln ln ln ln ln ln ln ln ln ln ln
7. 7. When reviewing the list of medications taken by a patient who will be r
ln ln ln ln ln ln ln ln ln ln ln ln ln ln
eceiving a new prescription for digoxin, the nurse would be concerned about
ln ln ln ln ln ln ln ln ln ln ln n
l
which medication that may interact with the digoxin?
ln ln ln ln ln ln ln
A. aspirin
B. acetaminophen (Tylenol) ln
C. furosemide (Lasix) ln
D. vitamin K: C. furosemide (Lasix); (loop Diuretics); numerous ones on page 341
ln ln ln ln ln ln ln ln ln ln ln
8. 8. The nurse is reviewing discharge teaching for a patient who will be takin
ln ln ln ln ln ln ln ln ln ln ln ln ln
gdigoxin (Lanoxin) therapy. The patient should be taught to avoid which foo
n
l ln ln ln ln ln ln ln ln ln ln ln
dswhen taking the digoxin?
n
l ln ln ln
A. Leafy green vegetables ln ln
B. Dairy products ln
C. Grapefruit juice ln
D. Bran muffins: D. Bran muffins ln ln ln ln
9. 9. In assessing a patient before administration of a cardiac glycoside, th
ln ln ln ln ln ln ln ln ln ln ln
enurse knows that which lab result can increase the toxicity of the drug?
n
l ln ln ln ln ln ln ln ln ln ln ln ln
A. Potassium level 2.8 mEq/L ln ln ln
B. Potassium level 4.9 mEq/L ln ln ln
C. Sodium level 140 mEq/L ln ln ln
D. Calcium level 10 mg/dL: A. Potassium level 2.8 mEq/L (low potassium norma
ln ln ln ln ln ln ln ln ln ln ln
lis 3.5 to 5.0)
ln ln ln ln
10. 10. The nurse administering the phosphodiesterase inhibitor inamrinon
ln ln ln ln ln ln ln
erecognizes that this drug should have a positive inotropic effect. This eff
n
l ln ln ln ln ln ln ln ln ln ln ln
ectwill result in increased
n
l ln ln ln
A. heart rate. ln
B. blood vessel dilation. ln ln
3ln/ln31
, Pharmacology Final Exam REVIEW!!! ln ln ln
!| exam questions and answers| correct ln ln ln ln ln ln
C. force of cardiac contraction.
verified A+ ln ln ln
ln
D. conduction of electrical impulses across the heart.: C. force of cardiac con ln ln ln ln ln ln ln ln ln ln ln
-traction. (increase cAMP) positive inotropic
ln
(by more calcium available in SR)ef-
ln ln ln ln ln ln ln ln ln ln
fect and vasodilation, (inodilators)---
ln ln ln ln
positive chornotropic effect); USED IN ICU; ADVERSE EFFECT...thrombocytopen
ln ln ln ln ln ln ln
ia, dysrhythmia, ventricular, hypotension andangina, hypokalemia, tremor.
ln ln ln ln ln ln ln
11. 11. The nurse notes in a patient's medical record that nesiritide has bee
ln ln ln ln ln ln ln ln ln ln ln ln
nordered. Based on this order, the nurse interprets that the patient has whi
n
l ln ln ln ln ln ln ln ln ln ln ln ln
chdisorder? n
l
A. Atrial fibrillation ln
B. Acutely decompensated heart failure with dyspnea at rest ln ln ln ln ln ln ln
C. Systolic heart failure ln ln
D. Long-
term treatment of heart failure.: B. Acutely decompensated heart failurewith dys
ln ln ln ln ln ln ln ln ln ln ln
pnea at rest ln ln
12. SELECT ALL THAT APPLY: ln ln ln
1. When a patient is experiencing digoxin toxicity, which clinical situation
ln ln ln ln ln ln ln ln ln ln
would necessitate the use of digoxin immune Fab (Digibind)? Select all th
ln ln ln ln ln ln ln ln ln ln ln
atapply. n
l
A. The patient reports seeing colorful halos around lights.
ln ln ln ln ln ln ln
B. The patient's serum potassium level is above 5 mEq/L.
ln ln ln ln ln ln ln ln
C. The patient is experiencing nausea and anorexia.
ln ln ln ln ln ln
D. The patient is experiencing severe sinus bradycardia that does not respond
ln ln ln ln ln ln ln ln ln ln
to cardiac pacing. ln ln
E. The patient has taken an overdose of greater than 10 mg of digoxin.: B. Th
ln ln ln ln ln ln ln ln ln ln ln ln ln ln
epatient's serum potassium level is above 5 mEq/L.
ln ln ln ln ln ln ln ln
D. The patient is experiencing severe sinus bradycardia that does not respond to c
ln ln ln ln ln ln ln ln ln ln ln ln ln
ardiac pacing. (E) might be right as well a person taking 10mg of digoxin is a indic
ln ln ln ln ln ln ln ln ln ln ln ln ln ln ln ln
ation of toxicity...page 340 states life threatening digoxin overdose in adults and4 mg
ln ln ln ln ln ln ln ln ln ln ln ln ln ln
in children) ln
13. 2. Which drug classes are considered first-
ln ln ln ln ln ln
line treatment for heart failure?Select all that apply.
ln ln ln ln n
l ln ln ln
A. Angiotensin converting enzyme (ACE) inhibitors ln ln ln ln
B. Angiotensin II receptor blockers (ARBs) ln ln ln ln
C. Digoxin (cardiac glycoside) ln ln
D. Beta-blockers
E. Nesiritide (Natrecor), the B- ln ln ln
type natriuretic peptide: ACEARBS ln ln ln ln
4ln/ln31
