Exam 2 Pharmacology-Cardiac 225
complete detailed solutions.
Exam 2 Pharmacology-Cardiac 225
complete detailed solutions.
Of the drugs that target the RAAS cascade, which one has the adverse effect of a cough?
A. Spirolactone
B. ACE inhibitor
C. ARB - ANSWER B. ACE inhibitor (Lisinopril) cough occurs over a couple days to weeks. Angioedema
happens quickly.
Does the adverse effect of cough from ACE inhibition occur right away?
A. Usually, but it can occur later in treatment
B. It usually happens after years of use
C. D/t histamine, the cough usually occurs in the first 1-2 days of treatment - ANSWER A. Usually, but it
can occur later in treatment d/t to bradykinin in lungs, but can also occur later if asthma. Right away
means 1-2 weeks of continuous medication use= when most adverse effects occur.
Which drug works highest on the RAAS cascade?
A. Aliskiren (Tekturna)
B. Lisinopril (Zestril)
C. Losartan (Cozaar) - ANSWER A. Direct renin inhibitors such as Aliskiren (Tekturna)
Which drug is listed as a diuretic and as a RAAS system drug?
A. Aliskiren (Tekturna)
B. Lisinopril (Zestril)
C. Losartan (Cozaar)
D. Spironolactone (Aldactone) - ANSWER D. Spironolactone (Aldactone) blocks aldosterone and is a K
sparing diuretic.
,Exam 2 Pharmacology-Cardiac 225
complete detailed solutions.
What considerations do all of the RAAS drugs have in common?
A. They all have the potential of causing hypoglycemia and are safe for pregnancy
B. They all have the potential of causing hyperkalemia and have risks for pregnancy
C. They all the potential to dehydrate patients and have risks for falls
D. They all have the potential to worse asthma symptoms and have risks for children - ANSWER D. All
have the potential of causing hyperkalemia and have risks for pregnancy because block the action of
aldosterone thus excrete Na and H2O which is needed for the amniotic fluid especially during the 2nd
and 3rd trimester.
Which Calcium channel blocker (CCB) works better on the cardiac myocyte?
A) Verapamil (Non DHP)
B) Nifedipine (DHP) - ANSWER A. Verapamil (Non-DHP) works better on the cardiac myocyte as it also
affects the SA and AVnodes.
Which antihypertensive agents are not good for renal impairment?
A. Potassium sparing diuretics
B. Ace Inhibitor - Lisinopril/Zestril
C. ARB - Losartan/Cozaar
D. Macrolide - Doxycycline/Doxy - ANSWER A. Thiazides and K+ sparing diuretics do not work well in
renal impairment.
Which drug has biggest potential to cause toxicities of other drugs (IE: Digoxin)?
A. Spironolactone
B. Lisinopril
C. Nifedipine
D. Furosemide - ANSWER D. Loop diuretics since they diuresis aggressively which is why they are used in
CHF.
Which agent should be avoided in a person with a history of gout?
,Exam 2 Pharmacology-Cardiac 225
complete detailed solutions.
A. Doxazosin
B. Clonidine
C. Methyldopa
D. Hydochlorothiazide - ANSWER D. Thiazide can cause hyperuricemia, high uric acid level and
exacerbate gout.
Which drug is frequently given IV over 1-2 min?
A. Furosemide
B. Clonidine
C. Lorazepam
D. Methyldopa - ANSWER A. Furosemide (Lasix) given IV over 1-2min.
Do all diuretics have risks for K+ imbalance?
Yes
No - ANSWER Yes, loop diuretics have most pronounced hypokalemia while K+ sparing diuretics have
more risk for hyperkalemia
Do all diuretics have health risks for the diabetic?
Yes
No - ANSWER Yes, caution should be taken when using diuretics in diabetics.
A patient reports during a routine check-up that he is experiencing chest pain and shortness of breath
while performing activities. He states the pain goes away when he rests. This is known as:
A) Unstable angina
B) Variant angina
C) Stable angina
D) Prinzmetal angina - ANSWER C. Stable angina is predictable.
, Exam 2 Pharmacology-Cardiac 225
complete detailed solutions.
A 48 year old black male with a history of type 2 diabetes mellitus comes to the emergency department
with a frontal headache and generalized complaints of "not feeling well." Upon examination, his BP is
210/120 mm Hg, his pulse is 98, and his respirations are 24 and labored. When is it important to lower
this patient's BP within 1 hour rather than slowly as for most hypertensive patients?
A. When the nurse is busiest and has multiple patients and this will help to move the patient to the
medical surgical unit faster.
B. When the patient has had chronic hypertension for > 3 months
C. Lowering BP within 1 hour is necessary when associated with organ damage, such as papilledema,
intracranial hemorrhage, myocardial infarction, or heart failure.
D. When the patient's BP drops > 20 mmHg upon standing. - ANSWER C. Lowering BP within 1 hour is
necessary when associated with organ damage, such as papilledema, intracranial hemorrhage,
myocardial infarction, or heart failure.
The resident writes an order for IV nitroprusside 80 mcg/min. What precautions should the nurse take
while administering this medication? Use good clinical judgement. (Select all that apply.)
A. The nurse should keep the patient supine to avoid dizziness and postural hypotension
B. The nurse should monitor the blood pressure every 4 hours
C. The nurse should monitor the heart rate continuously and the blood pressure every 4-8 hours
The nurse should monitor the patient and his blood pressure continuously
D. The nurse should use an IV pump for safety so the pump will deliver a consistent dose. - ANSWER
A,D,E. Nitroprusside is a medication used to lower blood pressure. Can have dizziness and orthostatic
hypotension as adverse effects.
A 78 year old patient is seen in the emergency department in hypertensive crisis. She is 5 feet and 2
inches tall and weighs 125 pounds. Her BP is 230/130 mm Hg and she is very edematous. She has a
history of alcohol abuse. IV nitroprusside sodium at 0.3 mcg/kg/min is prescribed. The nurse assess the
solution to be sure it is not deeply colored blue, green, or dark red. The nurse knows that a faint brown
color to freshly prepared solutions is acceptable. The drug is administered in a large vein using an
infusion pump while protecting the solution from light with aluminum foil covering. The patient
suddenly becomes diaphoretic and complains of nausea, palpitations, and headache. What should the
nurse do? The nurse should check a radial pulse and a BP. If the BP has dropped more than 30 mm Hg in
2 minutes, continue the infusion and recheck in another 2 minutes.
complete detailed solutions.
Exam 2 Pharmacology-Cardiac 225
complete detailed solutions.
Of the drugs that target the RAAS cascade, which one has the adverse effect of a cough?
A. Spirolactone
B. ACE inhibitor
C. ARB - ANSWER B. ACE inhibitor (Lisinopril) cough occurs over a couple days to weeks. Angioedema
happens quickly.
Does the adverse effect of cough from ACE inhibition occur right away?
A. Usually, but it can occur later in treatment
B. It usually happens after years of use
C. D/t histamine, the cough usually occurs in the first 1-2 days of treatment - ANSWER A. Usually, but it
can occur later in treatment d/t to bradykinin in lungs, but can also occur later if asthma. Right away
means 1-2 weeks of continuous medication use= when most adverse effects occur.
Which drug works highest on the RAAS cascade?
A. Aliskiren (Tekturna)
B. Lisinopril (Zestril)
C. Losartan (Cozaar) - ANSWER A. Direct renin inhibitors such as Aliskiren (Tekturna)
Which drug is listed as a diuretic and as a RAAS system drug?
A. Aliskiren (Tekturna)
B. Lisinopril (Zestril)
C. Losartan (Cozaar)
D. Spironolactone (Aldactone) - ANSWER D. Spironolactone (Aldactone) blocks aldosterone and is a K
sparing diuretic.
,Exam 2 Pharmacology-Cardiac 225
complete detailed solutions.
What considerations do all of the RAAS drugs have in common?
A. They all have the potential of causing hypoglycemia and are safe for pregnancy
B. They all have the potential of causing hyperkalemia and have risks for pregnancy
C. They all the potential to dehydrate patients and have risks for falls
D. They all have the potential to worse asthma symptoms and have risks for children - ANSWER D. All
have the potential of causing hyperkalemia and have risks for pregnancy because block the action of
aldosterone thus excrete Na and H2O which is needed for the amniotic fluid especially during the 2nd
and 3rd trimester.
Which Calcium channel blocker (CCB) works better on the cardiac myocyte?
A) Verapamil (Non DHP)
B) Nifedipine (DHP) - ANSWER A. Verapamil (Non-DHP) works better on the cardiac myocyte as it also
affects the SA and AVnodes.
Which antihypertensive agents are not good for renal impairment?
A. Potassium sparing diuretics
B. Ace Inhibitor - Lisinopril/Zestril
C. ARB - Losartan/Cozaar
D. Macrolide - Doxycycline/Doxy - ANSWER A. Thiazides and K+ sparing diuretics do not work well in
renal impairment.
Which drug has biggest potential to cause toxicities of other drugs (IE: Digoxin)?
A. Spironolactone
B. Lisinopril
C. Nifedipine
D. Furosemide - ANSWER D. Loop diuretics since they diuresis aggressively which is why they are used in
CHF.
Which agent should be avoided in a person with a history of gout?
,Exam 2 Pharmacology-Cardiac 225
complete detailed solutions.
A. Doxazosin
B. Clonidine
C. Methyldopa
D. Hydochlorothiazide - ANSWER D. Thiazide can cause hyperuricemia, high uric acid level and
exacerbate gout.
Which drug is frequently given IV over 1-2 min?
A. Furosemide
B. Clonidine
C. Lorazepam
D. Methyldopa - ANSWER A. Furosemide (Lasix) given IV over 1-2min.
Do all diuretics have risks for K+ imbalance?
Yes
No - ANSWER Yes, loop diuretics have most pronounced hypokalemia while K+ sparing diuretics have
more risk for hyperkalemia
Do all diuretics have health risks for the diabetic?
Yes
No - ANSWER Yes, caution should be taken when using diuretics in diabetics.
A patient reports during a routine check-up that he is experiencing chest pain and shortness of breath
while performing activities. He states the pain goes away when he rests. This is known as:
A) Unstable angina
B) Variant angina
C) Stable angina
D) Prinzmetal angina - ANSWER C. Stable angina is predictable.
, Exam 2 Pharmacology-Cardiac 225
complete detailed solutions.
A 48 year old black male with a history of type 2 diabetes mellitus comes to the emergency department
with a frontal headache and generalized complaints of "not feeling well." Upon examination, his BP is
210/120 mm Hg, his pulse is 98, and his respirations are 24 and labored. When is it important to lower
this patient's BP within 1 hour rather than slowly as for most hypertensive patients?
A. When the nurse is busiest and has multiple patients and this will help to move the patient to the
medical surgical unit faster.
B. When the patient has had chronic hypertension for > 3 months
C. Lowering BP within 1 hour is necessary when associated with organ damage, such as papilledema,
intracranial hemorrhage, myocardial infarction, or heart failure.
D. When the patient's BP drops > 20 mmHg upon standing. - ANSWER C. Lowering BP within 1 hour is
necessary when associated with organ damage, such as papilledema, intracranial hemorrhage,
myocardial infarction, or heart failure.
The resident writes an order for IV nitroprusside 80 mcg/min. What precautions should the nurse take
while administering this medication? Use good clinical judgement. (Select all that apply.)
A. The nurse should keep the patient supine to avoid dizziness and postural hypotension
B. The nurse should monitor the blood pressure every 4 hours
C. The nurse should monitor the heart rate continuously and the blood pressure every 4-8 hours
The nurse should monitor the patient and his blood pressure continuously
D. The nurse should use an IV pump for safety so the pump will deliver a consistent dose. - ANSWER
A,D,E. Nitroprusside is a medication used to lower blood pressure. Can have dizziness and orthostatic
hypotension as adverse effects.
A 78 year old patient is seen in the emergency department in hypertensive crisis. She is 5 feet and 2
inches tall and weighs 125 pounds. Her BP is 230/130 mm Hg and she is very edematous. She has a
history of alcohol abuse. IV nitroprusside sodium at 0.3 mcg/kg/min is prescribed. The nurse assess the
solution to be sure it is not deeply colored blue, green, or dark red. The nurse knows that a faint brown
color to freshly prepared solutions is acceptable. The drug is administered in a large vein using an
infusion pump while protecting the solution from light with aluminum foil covering. The patient
suddenly becomes diaphoretic and complains of nausea, palpitations, and headache. What should the
nurse do? The nurse should check a radial pulse and a BP. If the BP has dropped more than 30 mm Hg in
2 minutes, continue the infusion and recheck in another 2 minutes.
