Chapter 20: Beta-Blockers

Chapter 20: Beta-Blockers

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. An 80-year-old patient with chronic stable angina has begun taking nadolol (Corgard) 20 mg once daily in addition to taking nitroglycerin as needed. After 1 week, the patient reports no change in frequency of nitroglycerin use. The primary care nurse practitioner (NP) should change the dose of nadolol to _____ mg _____ daily.

ANS:  A

b-Blockers are the treatment of choice for chronic stable and unstable angina. Their therapeutic effect is dose dependent, and drug titration should be based on frequency of angina symptoms and nitroglycerin use. Nadolol should be started at 20 mg daily for elderly patients when treating angina and should be increased by 20 mg every 3 to 7 days if symptoms do not improve. Nadolol is given once daily.

DIF:    Cognitive Level: Applying (Application)                           REF:   259| Table 20-7

2. A patient is in the clinic for a follow-up examination after a myocardial infarction (MI). The patient has a history of left ventricular systolic dysfunction. The primary care NP should expect this patient to be taking:

ANS:  B

The 2012 guides for prevention of cardiovascular disease recommend that b-blocker therapy should be used in all patients with left ventricular systolic dysfunction with heart failure or prior MI. Use should be limited to carvedilol, metoprolol succinate, or bisoprolol.

DIF:    Cognitive Level: Understanding (Comprehension)             REF:   259

3. An 80-year-old patient has begun taking propranolol (Inderal) and reports feeling tired all of the time. The primary care NP should:

ANS:  D

Elderly patients have described sedation and sleep disturbances with b-blockers. Elderly patients often need lower doses of these drugs. Patients should not be advised to discontinue the medication abruptly.

DIF:    Cognitive Level: Applying (Application)                           REF:   260

4. A patient with a history of coronary heart disease develops atrial fibrillation. The primary care NP refers the patient to a cardiologist who performs direct current cardioversion. The NP should expect the patient to begin taking which b-blocker medication?

ANS:  B

Sotalol is classified as a class II and III antiarrhythmic and is a preferred agent in patients with a history of coronary heart disease.

DIF:    Cognitive Level: Applying (Application)                           REF:   259