Basic Pharmacology for Nurses 17th Ed by Clayton - Willihnganz
Basic Pharmacology for Nurses 17th Ed by Clayton - Willihnganz
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Chapter 23: Drugs Used to Treat Dysrhythmias
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | It acts as a myocardial depressant by inhibiting sodium ion movement. |
| b. | It prolongs the duration of the electrical stimulation on cells and the refractory time between electrical impulses. |
| c. | It acts as a beta-adrenergic agent. |
| d. | It slows the rate of electrical conduction and prolongs the time between contractions. |
ANS: D
Class I antidysrhythmic drugs act as a myocardial depressant by inhibiting sodium ion movement. Class II antidysrhythmic drugs act as beta-adrenergic agents. Class III agents slow the rate of electrical conduction and prolong the time between contractions. Class IV antidysrhythmic drugs prolong the duration of the electrical stimulation on cells and the refractory time between electrical impulses.
DIF: Cognitive Level: Comprehension REF: Page 365 | Page 372
OBJ: 2 TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment
| a. | 10 |
| b. | 25 |
| c. | 50 |
| d. | 75 |
ANS: D
The initial lidocaine bolus is 1 to 1.5 mg/kg, decreased by half in older adults, patients with hepatic disease, and patients with heart failure. Doses of 10, 25, and 50 mg are too low for a patient of this weight.
DIF: Cognitive Level: Application REF: Page 369 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment
| a. | Discontinue the medication immediately. |
| b. | Decrease the medication dosage for 1 week, and then resume the original order. |
| c. | Change positions slowly. |
| d. | Increase the dosage per health care provider directions. |
ANS: C
Many adverse effects are dose related and resolve with reducing the dosage or discontinuing therapy. Patients should be taught to rise slowly from a supine or sitting position and sit or lie down if feeling faint. Medication should be discontinued only for serious adverse effects and with the consent of the health care provider. Changes in dose should be done only with the consent of the health care provider. Increasing the dose will likely increase the symptoms.
DIF: Cognitive Level: Application REF: Page 372 OBJ: 4
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
NOT: CONCEPT(S): Clinical Judgment; Patient Education; Safety
| a. | Central nervous system depression and sedation |
| b. | Decrease in effectiveness of phenytoin |
| c. | Respiratory depression |
| d. | Increase in serum phenytoin levels |
ANS: D
Elevation of phenytoin serum levels (200% to 300%) is observed over several weeks. The dosage of phenytoin must be gradually reduced based on patient response. The combination of phenytoin and amiodarone does not produce sedation and depression, decrease the effectiveness of either drug, or produce respiratory depression.
DIF: Cognitive Level: Knowledge REF: Page 374 OBJ: 4
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety
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