Chapter 42: Cardiac Glycosides, Antianginals, and Antidysrhythmics

Chapter 42: Cardiac Glycosides, Antianginals, and Antidysrhythmics

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient who has atrial fibrillation is taking digoxin. The nurse expects which medication to be given concurrently to treat this condition?

a.	Hydrochlorothiazide (HydroDIURIL)
b.	Inamrinone (Inocor)
c.	Milrinone (Primacore)
d.	Warfarin (Coumadin)

 

 

ANS:  D

Digoxin is given for atrial fibrillation to restore a normal heart rhythm. To prevent thromboemboli, warfarin is given concurrently. Hydrochlorothiazide is a diuretic medication. Inamrinone and milrinone are inotropic agents that would be used instead of digoxin.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 603

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A patient is diagnosed with heart failure, and the prescriber has ordered digoxin. The patient asks what lifestyle changes will help in the management of this condition. The nurse will recommend which changes?

a.	Aerobic exercise and weight lifting 2 or 3 times weekly
b.	Changing from cigarette smoking to pipe smoking
c.	Consuming 2 teaspoons or less of salt every day
d.	Having no more than one alcoholic beverage per day

 

 

ANS:  D

Alcohol should either be completely avoided or restricted to no more than one per day. Mild exercise, such as walking, is recommended. All nicotine deprives the heart of oxygen. Salt should be limited to no more than one teaspoon per day.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 603

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. A patient with chronic obstructive pulmonary disease (COPD) has increasing dyspnea and is being evaluated for heart failure (HF). Which test will be ordered to help differentiate between dyspnea due to lung dysfunction and dyspnea due to HF?

a.	Atrial natriuretic hormone (ANH) level
b.	Brain natriuretic peptide (BNP) level
c.	Cardiac enzymes
d.	Electrocardiogram (ECG)

 

 

ANS:  B

The BNP is used to differentiate that dyspnea is due to HF and not lung dysfunction. The other tests will all be a part of the diagnostic workup but do not help with this distinction.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension)    REF:   Page 603

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Pathophysiology

 

4. The nurse is preparing to administer digoxin to a patient who has heart failure. The patient reports nausea, vomiting, and a headache. The nurse notes a respiratory rate of 18 breaths per minute, a heart rate of 58 beats per minute, and a blood pressure of 120/78 mm Hg. What will the nurse do next?

a.	Administer the next dose as ordered since these are mild side effects.
b.	Hold the dose and notify the provider of possible digoxin toxicity.
c.	Reassure the patient that these are common, self-limiting side effects.
d.	Request an order for an antiemetic and an analgesic medication.

 

 

ANS:  B

Nausea, vomiting, and headache are common signs of digoxin toxicity as is a heart rate less than 60 beats per minute. The nurse should hold the dose and notify the provider.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 603

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies