Chapter 12: Cardiovascular and Renal Medications

Chapter 12: Cardiovascular and Renal Medications

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse is visiting an 80-year-old female patient in her home. She is receiving 0.15 mg of oral digoxin daily. She also takes hydrochlorothiazide 50 mg twice a day. She complains of blurred vision and nausea. The nurse observes that she is confused and disoriented at times. Which is most likely to be the problem?

a.	The patient needs to have her hydrochlorothiazide increased.
b.	The patient may have digitalis toxicity.
c.	The patient may have developed chronic heart failure.
d.	The patient may have Alzheimer disease.

 

 

ANS:  B

Cardiotonics are very powerful and can act as poisons on the heart. When a patient begins to show toxic or harmful reactions from too much medication, the term digitalis toxicity is used.

 

DIF:    Cognitive Level: Apply                   REF:   p. 216             OBJ:   2

TOP:   Cardiotonic Reactions                     KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Physiological Integrity: Pharmacological Therapies

 

2. The physician has started a patient on propranolol (Inderal LA), a beta blocker. The nurse knows this drug is used in the treatment of migraine headaches and which other conditions?

a.	Angina
b.	Hyperlipidemia
c.	Bradycardia
d.	Bronchospasm

 

 

ANS:  A

Propranolol (Inderal LA) is a class II beta blocker used in the treatment of migraines and angina.

 

DIF:    Cognitive Level: Understand            REF:   Table 12-4      OBJ:   5

TOP:   Beta Blockers                                 KEY:  Nursing Process Step: Diagnosis

MSC:  NCLEX: Physiological Integrity

 

3. The physician tells the nurse that a patient is hypokalemic. He has been taking a thiazide medication for treatment of his high blood pressure. Which should the nurse instruct him to increase his dietary intake of?

a.	Green leafy vegetables
b.	Sodium
c.	Bananas and citrus fruits
d.	Low-fat products

 

 

ANS:  C

Thiazide may lead to significant loss of potassium. The patient should take the medication with a full glass of orange juice (unless not permitted by his or her diet). Other potassium-rich foods include bananas.

 

DIF:    Cognitive Level: Apply                   REF:   p. 220 | p. 229

OBJ:   6                    TOP:   Thiazides       KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity

 

4. A patient has an acute myocardial infarction. Her electrocardiogram is normal except for a heart rate of 150 beats per minute. Her physician prescribes digoxin in both an initial “digitalizing” dose and a daily maintenance dose so that which will occur?

a.	A specific level of medication will be reached in the blood.
b.	Her heart rate will first speed up.
c.	The drug will begin to weaken her heart’s contraction.
d.	The drug will improve her appetite.

 

 

ANS:  A

The nurse should know about two different types of dosages for patients taking digoxin: the initial digitalizing dose and maintenance doses. More frequent and higher digitalizing doses are given when a patient begins taking digoxin so that a specific level of medication can be reached in the blood. Smaller maintenance doses are given once a day to maintain the blood level.

 

DIF:    Cognitive Level: Analyze                REF:   pp. 216-217    OBJ:   4

TOP:   Slowing Heart Rate                         KEY:  Nursing Process Step: N/A

MSC:  NCLEX: Physiological Integrity

 

5. A patient has acute angina upon exercise. The physician starts this patient on a long-acting nitrate. This medication is used for acute angina for which reasons?

a.	It reduces blood going to vessels, reducing pain.
b.	It opens vessels, increasing blood supply to the heart during exercise.
c.	It controls returning blood going to the heart.
d.	It thins returning blood going to the heart.

 

 

ANS:  B

Long-acting nitrates are used to prevent or treat angina attacks when they are likely to occur with exercise.

 

DIF:    Cognitive Level: Apply                   REF:   p. 202             OBJ:   1

TOP:   Nitrates          KEY:  Nursing Process Step: Assessment

MSC:   NCLEX: Safe, Effective Care Environment: Coordinated Care