ATI RN
Pharmacology of Cardiovascular Drugs Questions
Question 1 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 2 of 5
A patient is receiving instructions regarding the use of caffeine. The nurse shares that caffeine should be used with caution if which of these conditions is present?
Correct Answer: A
Rationale: In the context of pharmacology, understanding the implications of caffeine use in different medical conditions is crucial for safe and effective patient care. In this scenario, the correct answer is A) A history of peptic ulcers. Caffeine is known to stimulate gastric acid secretion, which can exacerbate peptic ulcers or increase the risk of developing ulcers in individuals with a history of this condition. Therefore, caution is warranted when advising patients with peptic ulcers regarding caffeine consumption. Regarding the incorrect options: B) Migraine headaches: Caffeine is actually used in some headache medications due to its vasoconstrictive properties that can help alleviate headaches. C) Asthma: While caffeine can act as a bronchodilator, it is not generally contraindicated in asthma. D) A history of kidney stones: Caffeine intake is not typically associated with an increased risk of kidney stones formation. Educationally, this question highlights the importance of considering a patient's medical history and potential drug interactions when recommending caffeine use. It underscores the need for healthcare providers to be aware of how caffeine can impact various health conditions to provide safe and personalized care to their patients.
Question 3 of 5
A patient about to receive a morning dose of digoxin has an apical pulse of 53 beats/minute. What will the nurse do next?
Correct Answer: D
Rationale: In this scenario, the correct answer is D) Withhold the dose, and notify the prescriber. Digoxin is a drug that directly affects the heart by increasing the strength of the heart muscle contractions. A low heart rate (bradycardia) such as 53 beats/minute in a patient about to receive digoxin can be a sign of digoxin toxicity. Administering the dose in this situation could exacerbate the toxicity and lead to serious cardiac complications like arrhythmias or even cardiac arrest. Option A is incorrect because administering the dose without addressing the low heart rate could be harmful to the patient. Option B is also incorrect because simply notifying the prescriber without taking immediate action to withhold the dose could result in a delay in necessary intervention. Option C, checking the radial pulse, is not the most appropriate action in this situation as the apical pulse is a more accurate reflection of the heart rate and its irregularities. From an educational perspective, this scenario highlights the importance of assessing vital signs before administering medications, especially those that directly affect cardiac function. It also emphasizes the significance of recognizing signs of potential medication toxicity and the need for prompt action to ensure patient safety. Healthcare providers must be vigilant in monitoring patients receiving medications with narrow therapeutic indices like digoxin to prevent adverse events.
Question 4 of 5
Furosemide (Lasix) is prescribed for a patient who is about to be discharged, and the nurse provides instructions to the patient about the medication. Which statement by the nurse is correct?
Correct Answer: D
Rationale: The correct answer is option D: “Be sure to change positions slowly and rise slowly after sitting or lying so as to prevent dizziness and possible fainting because of blood pressure changes.” This statement is correct because furosemide is a loop diuretic that can cause fluid and electrolyte imbalances, leading to orthostatic hypotension. Advising the patient to change positions slowly helps prevent sudden drops in blood pressure and reduces the risk of falls and injuries. Option A is incorrect because furosemide is usually recommended to be taken in the morning to prevent disruptions in sleep due to increased urination at night. Option B is incorrect as patients taking furosemide should actually consume potassium-rich foods to prevent hypokalemia, a potential side effect of the medication. Option C is incorrect because significant weight gain should be addressed promptly rather than waiting for the next routine visit, as it could indicate worsening heart failure or fluid retention. In an educational context, understanding the pharmacology of furosemide is crucial for healthcare professionals to ensure safe and effective medication management for patients with cardiovascular conditions. Teaching patients about medication administration, potential side effects, and lifestyle modifications is essential for promoting adherence and optimizing therapeutic outcomes.
Question 5 of 5
During drug therapy with epoetin alfa (Epogen), the nurse knows that therapy must be stopped if which laboratory result is noted?
Correct Answer: B
Rationale: When hemoglobin levels are above 12 g/dL and the epoetin alfa is continued, patients may experience serious adverse events, including heart attack, stroke, and death. Epoetin must not be given to patients with renal disorders unless their hemoglobin level is less than 12 g/dL. In cancer patients, the hemoglobin level needs to be less than 10 g/dL. The other options are incorrect.