Chapter 30 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

Chapter 30 Pharmacology For Nurses A Pathophysiologic Approach 5th Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The nurse is teaching a class on rhythm abnormalities to patients who have experienced dysrhythmias. Which information would the nurse include in this teaching?

1. “Dysrhythmias cause serious electrolyte imbalances; this results in heart block.”
2. “Dysrhythmias are the result of long-standing, uncontrolled hypertension.”
3. “Dysrhythmias interrupt the normal electrical pathways in the heart so it can’t beat properly.”
4. “Dysrhythmias alter the blood flow through the heart and cause it to stop beating.”

Correct Answer: 3

Rationale 1: Some dysrhythmias may result in heart block, but dysrhythmias do not cause electrolyte imbalances.

Rationale 2: Dysrhythmias do not result from hypertension.

Rationale 3: All dysrhythmias cause a defect in the generation or conduction of electrical impulses across the myocardium. Lack of synchronization of the atria and ventricles may have profound consequences such as decreasing cardiac output.

Rationale 4: Dysrhythmias do not alter blood flow through the heart.

Global Rationale: All dysrhythmias cause a defect in the generation or conduction of electrical impulses across the myocardium. Lack of synchronization of the atria and ventricles may have profound consequences such as decreasing cardiac output. Dysrhythmias do not alter blood flow through the heart. Some dysrhythmias may result in heart block, but dysrhythmias do not cause electrolyte imbalances. Dysrhythmias do not result from hypertension.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 30-1 Explain how rhythm abnormalities can affect cardiac function.

MNL Learning Outcome: 4.7.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 445

 

Question 2

Type: MCMA

The patient tells the nurse, “This educational video you gave me shows normal electrical conduction through the heart, but I still don’t understand it. Can you explain it to me?” What are the nurse’s best responses?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “Conduction through the bundle of His is the slowest in the heart.”
2. “Conduction begins in the sinoatrial (SA) node and travels to the atrioventricular (AV) node.”
3. “Conduction continues through the bundle branches to the Purkinje fibers.”
4. “Conduction travels from the atrioventricular (AV) node through the bundle of His.”
5. “The sinoatrial (SA) node is located in the left atrium.”

Correct Answer: 2,3,4

Rationale 1: Conduction through the atrioventricular (AV) node is the slowest in the heart.

Rationale 2: Conduction through the heart originates in the sinoatrial (SA) node and travels to the atrioventricular (AV) node.

Rationale 3: Conduction travels through the right and left bundle branches to the Purkinje fibers.

Rationale 4: Conduction through the heart originates in the sinoatrial (SA) node and travels through the atrioventricular (AV) node through the bundle of His.

Rationale 5: The sinoatrial (SA) node is located in the right atrium.

Global Rationale: Conduction through the heart originates in the sinoatrial (SA) node and travels through the atrioventricular (AV) node through the bundle of His to the right and left bundle branches to the Purkinje fibers. Conduction through the atrioventricular (AV) node is the slowest in the heart. The sinoatrial (SA) node is located in the right atrium.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-2 Illustrate the flow of electrical impulses through the normal heart.

MNL Learning Outcome: 4.7.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 446

 

Question 3

Type: MCMA

The patient tells the nurse, “My doctor says I have atrial fibrillation. Is this serious and how is it treated?” What are the best responses by the nurse?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. “This condition is best treated with what we call antidysrhythmic drugs.”
2. “This is very common; your doctor will discuss the best treatment with you.”
3. “Depending on your symptoms, your doctor may use an electrical shock.”
4. “This is quite serious; did your doctor mention a heart transplant?”
5. “It is very serious, even more serious than a ventricular dysrhythmia.”

Correct Answer: 2,3

Rationale 1: Medications can cause serious side effects and are normally reserved for patients with overt symptoms or for patients whose condition cannot be controlled by other means.

Rationale 2: Atrial fibrillation is the most common type of dysrhythmia. The physician will determine treatment.

Rationale 3: The physician will determine whether to use nonpharmacologic techniques, such as cardioversion, or an implantable cardioverter defibrillator (ICD).

Rationale 4: Heart transplants are not indicated for patients with dysrhythmias.

Rationale 5: Ventricular dysrhythmias are more serious than atrial dysrhythmias because they are more likely to interfere with the normal function of the heart.

Global Rationale: Atrial fibrillation is the most common type of dysrhythmia. The physician will determine whether to use nonpharmacologic techniques, such as cardioversion, an implantable cardioverter defibrillator (ICD), or medication. Medications can cause serious side effects and are normally reserved for patients with overt symptoms or for patients whose condition cannot be controlled by other means. Ventricular dysrhythmias are more serious than atrial dysrhythmias because they are more likely to interfere with the normal function of the heart. Heart transplants are not indicated for patients with dysrhythmias.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-3 Classify dysrhythmias based on their location and type of rhythm abnormality.

MNL Learning Outcome: 4.7.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 447

 

Question 4

Type: MCSA

The nurse has been teaching a class on dysrhythmias to a group of patients with this disorder. The nurse determines that teaching has been effective when a patient makes which statement?

1. “Our sodium, potassium, and magnesium levels must be okay for our hearts to have an electrical impulse.”
2. “Potassium is the most important electrolyte when it comes to the electrical impulse in our hearts.”
3. “Our sodium, potassium, and calcium levels must be okay for our hearts to have an electrical impulse.”
4. “Enhancing potassium and sodium is how our medications will work to prevent dysrhythmias.”

Correct Answer: 3

Rationale 1: Changes in sodium, potassium, and calcium, not magnesium, levels generate the action potential in myocardial cells.

Rationale 2: Sodium, potassium, and calcium are equally important when it comes to the myocardial action potential.

Rationale 3: Changes in sodium, potassium, and calcium levels generate the action potential in myocardial cells. For this to occur, the patient must have normal levels of sodium, potassium, and calcium.

Rationale 4: Antidysrhythmic drugs work by blocking, not enhancing, potassium, sodium, or calcium channels.

Global Rationale: Changes in sodium, potassium, and calcium levels generate the action potential in myocardial cells. For this to occur, the patient must have normal levels of sodium, potassium, and calcium. Changes in sodium, potassium, and calcium, not magnesium, levels generate the action potential in myocardial cells. Antidysrhythmic drugs work by blocking, not enhancing, potassium, sodium, or calcium channels. Sodium, potassium, and calcium are equally important when it comes to the myocardial action potential.

 

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: III.A.1 Demonstrate knowledge of basic scientific methods and processes.

AACN Essentials Competencies: III.1 Explain the interrelationships among theory, practice, and research.

NLN Competencies: Knowledge and Science: Integration of knowledge from nursing and other disciplines.

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 30-4 Explain how an action potential is controlled by the flow of sodium, potassium, and calcium ions across the myocardial membrane.

MNL Learning Outcome: 4.7.1 Examine etiology, pathophysiology, and clinical manifestations.

Page Number: 448