Chapter 19: Adrenergic-Blocking Drugs

Chapter 19: Adrenergic-Blocking Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. During therapy with a beta blocker, the patient notices that she has swollen feet, has gained 3 pounds within 2 days, feels short of breath even when walking around the house, and has been dizzy. The nurse suspects that which of these is occurring?

a.	The patient is experiencing an allergic reaction.
b.	The patient may be developing heart failure.
c.	More time is needed for the patient to see a therapeutic response to the drug.
d.	The patient is experiencing expected adverse effects of the drug.

 

 

ANS:  B

Even though some beta blockers may be used for the treatment of some types of heart failure, the patient needs to be assessed often for the development of heart failure, a potential adverse effect of the drugs. These symptoms do not indicate expected adverse effects, an allergic reaction, or a therapeutic response.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 318

TOP:   NURSING PROCESS: Evaluation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A patient is going home with a new prescription for the beta-blocker atenolol (Tenormin). The nurse will include which content when teaching the patient about this drug?

a.	Never stop taking this medication abruptly.
b.	The medication will be stopped once symptoms subside.
c.	If adverse effects occur, stop taking the drug for 24 hours, and then resume.
d.	Be watchful for first-dose hypotension.

 

 

ANS:  A

Patients need to be weaned off these medications slowly because rebound hypertension and chest pain are possible with abrupt withdrawal. The drugs should never be stopped abruptly nor doses skipped. First-dose hypotension occurs with alpha blockers.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   p. 318

TOP:   NURSING PROCESS: Implementation

MSC:  NCLEX: Physiological Integrity: Reduction of Risk Potential

 

3. During initial rounds, the nurse notes that a dobutamine infusion has extravasated into the forearm of a patient. After stopping the infusion, the nurse follows standing orders and immediately injects phentolamine (Regitine) subcutaneously in a circular fashion around the extravasation site. What is the mechanism of action of the phentolamine in this situation?

a.	It neutralizes the extravasated dobutamine immediately.
b.	It causes arterial vasoconstriction and reduced pain and swelling at the site.
c.	It increases peripheral vascular resistance and reduces arterial pressure at the site.
d.	It increases blood flow to the ischemic site by vasodilation to prevent tissue damage.

 

 

ANS:  D

Phentolamine is an alpha blocker that reduces peripheral vascular resistance when given systemically, but local subcutaneous injection around the site of extravasated vasoconstrictive drugs, such as dobutamine, causes an alpha-adrenergic receptor blockade and vasodilation. This allows for increased blood flow to the ischemic tissue and may prevent permanent tissue damage.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension)    REF:   p. 312

TOP:   NURSING PROCESS: Implementation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A 58-year-old man has had a myocardial infarction (MI), has begun rehabilitation, and is ready for discharge. He is given a prescription for metoprolol (Lopressor) and becomes upset after reading the patient education pamphlet. “I don’t have high blood pressure—why did my doctor give me this medicine?” Which explanation by the nurse is correct?

a.	“This medication will prevent blood clots that may lead to another heart attack.”
b.	“Beta blockers will improve blood flow to the kidneys.”
c.	“This drug is prescribed to prevent the high blood pressure that often occurs after a heart attack.”
d.	“Studies have shown that this medication has greatly increased survival rates in patients who have had a heart attack.”

 

 

ANS:  D

Beta blockers are frequently given to patients after they have suffered an MI because of their cardioprotective properties. The other responses are incorrect.

 

DIF:    COGNITIVE LEVEL: Analyzing (Analysis)                     REF:   p. 313

TOP:   NURSING PROCESS: Implementation

MSC:  NCLEX: Psychosocial Integrity