ATI RN
Pharmacology of Cardiovascular Drugs Questions
Question 1 of 5
A client, who is taking transdermal selegiline (Emsam) for depressive symptoms, states, “My physician told me there was no need to worry about dietary restrictions.” Which would be the most appropriate nursing response?
Correct Answer: A
Rationale: The most appropriate nursing response in this scenario is option A) “Because your dose of Emsam is 6 mg in 24 hours, dietary restrictions are not recommended.” This response is correct because transdermal selegiline (Emsam) at a lower dose of 6 mg/24 hours does not require the same dietary restrictions as oral MAOIs. Option B is incorrect as it provides inaccurate information by stating that all MAOIs have dietary restrictions, which is not true for transdermal selegiline at this lower dose. Option C is incorrect as it simplifies the dietary restrictions associated with MAOIs, implying that only oral MAOIs require dietary restrictions, which is not entirely accurate. Option D is incorrect as it provides a blanket statement that all transdermal MAOIs do not require dietary modifications, which is not true for higher doses or other transdermal formulations. From an educational perspective, it is crucial for healthcare providers to understand the specific pharmacological properties of different medications, such as the dose-dependent dietary restrictions associated with MAOIs like selegiline. Proper education can help prevent medication errors and ensure the safety and well-being of patients.
Question 2 of 5
A patient who is a recovering alcoholic has been diagnosed as having panic attacks. The psychiatrist mentions plans to treat the patient with daily doses of medication. Of the medications listed below, for which drug should the nurse plan patient teaching?
Correct Answer: A
Rationale: In this scenario, the correct answer is A) Paroxetine (Paxil). Paroxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat panic attacks and other anxiety disorders. The rationale for choosing Paroxetine for patient teaching lies in its mechanism of action and suitability for a recovering alcoholic. Unlike benzodiazepines such as Alprazolam (B) which can be habit-forming and have a high potential for abuse, SSRIs like Paroxetine are non-addictive and safe for individuals with a history of substance abuse. Educating the patient about the importance of taking Paroxetine consistently, understanding its delayed onset of action, and potential side effects is crucial for treatment success. Alprazolam (Xanax) (B) is not the ideal choice for a recovering alcoholic due to its addictive nature and potential for abuse. Chlorpromazine (Thorazine) (C) is an antipsychotic medication not typically used for panic attacks. Propranolol (Inderal) (D) is a beta-blocker that can be effective for performance anxiety but is not the first-line treatment for panic attacks. In an educational context, understanding the rationale behind choosing the appropriate medication for a specific patient scenario is vital for nursing practice. It emphasizes the importance of considering factors such as past medical history, substance abuse, and pharmacological mechanisms when selecting the most appropriate treatment option for patients.
Question 3 of 5
Choose the correct list of recreational drugs in order of the public health harm caused by them (from greatest to least public health harm), measured in terms of both mortality (deaths) and morbidity (hospital days and shortened life expectancy) directly attributable to those drugs:
Correct Answer: A
Rationale: In pharmacology, understanding the public health impact of different drugs is crucial for healthcare professionals. Option A, ranking alcohol, tobacco, and illicit drugs in order of greatest to least public health harm, is the correct choice. Alcohol is the most harmful due to its widespread use, contributing to a high number of deaths and significant morbidity globally. Tobacco follows closely, causing a substantial burden of disease through conditions like cancer and cardiovascular diseases. Illicit drugs, though harmful, generally result in fewer deaths and hospitalizations compared to alcohol and tobacco. Option B is incorrect because tobacco is considered to be more harmful than alcohol in terms of mortality and morbidity. Option C is incorrect as illicit drugs are generally less prevalent and cause fewer health issues compared to tobacco and alcohol. Option D is incorrect as alcohol poses a higher public health risk than illicit drugs. Educationally, this question emphasizes the importance of understanding the relative harms of different drugs to inform public health policies and clinical practice. It highlights the need for healthcare providers to be knowledgeable about the impact of substances on individual and population health to provide effective care and interventions.
Question 4 of 5
Which question would be most appropriate for the nurse to ask a patient with depression who is experiencing nausea, palpitations, and “a terrible headache and chest pain” after physical examination reveals elevated blood pressure and temperature, dilated pupils, flushed head and face, and diaphoresis?
Correct Answer: A
Rationale: This question requires analytical decision making to identify hypertensive crises and data for the evaluation process. Knowing when the last dose of the monoamine oxidase inhibitor (MAOI) was taken helps determine immediate treatment. Although the ingestion of alcohol is pertinent to determining what tyramine-containing foods the patient may have had, it is not as crucial as knowing when the last dose of MAOI was consumed. Although natural foods may produce similar bioactivity and other antidepressants should not be taken along with an MAOI, these answers do not reflect medication assessment and evaluation. The patient is experiencing the clinical manifestation of hypertensive crisis. The classic symptoms of this condition are severe occipital headache, dilated pupils, hypertension, and palpitations or arrhythmias. This syndrome can be caused when the patient who is taking an MAOI ingests food containing tyramine, an amino acid released from foods that undergo hydrolysis (e.g., fermentation, aging, pickling, smoking, spoilage). This inhibits the monoamine oxidase and allows tyramine to reach the adrenergic nerve endings and cause the release of excess norepinephrine, which causes hypertensive crisis. To confirm the physical syndrome, first determine whether the patient is taking an MAOI. Knowing when the last dose was ingested provides a window for the duration of hypertension and therapeutic nursing interventions.
Question 5 of 5
A student nurse mutters that it seems entirely unnecessary to have to struggle with understanding the anatomy and physiology of the neurologic system. The mentor would base a response on the understanding that it is:
Correct Answer: D
Rationale: In the context of pharmacology, understanding the anatomy and physiology of the neurologic system is crucial for nurses, including psychiatric nurses. The correct answer, option D, states that it is necessary for planning psychiatric care. This is because many psychiatric medications act on the central nervous system and understanding neuroanatomy helps in comprehending how these drugs work, their side effects, and potential interactions. Option A is incorrect because even psychiatric nurses need a solid foundation in neuroanatomy to provide holistic care. Option B is inaccurate as nurses do utilize neurologic principles in their practice, especially when administering medications affecting the nervous system. Option C is also incorrect as knowledge of neuroanatomy is vital not just for assessment but also for developing effective and safe treatment plans. Educationally, grasping neuroanatomy enhances a nurse's ability to assess, intervene, and educate patients effectively. It allows for a deeper understanding of drug actions, adverse effects, and patient responses, leading to improved patient outcomes and safety. Therefore, integrating neurologic concepts into nursing education is essential for developing competent and knowledgeable nurses.