Focus on Nursing Pharmacology, 6th Edition by Amy M. Karch
Focus on Nursing Pharmacology, 6th Edition by Amy M. Karch
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Chapter 44- Cardiotonic Agents
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | A patient presents to the emergency department with rales, wheezing, and blood-tinged sputum. What does the nurse recognize that these symptoms indicate? | |
| A) | Cardiomyopathy | |
| B) | Cardiomegaly | |
| C) | Valvular heart disease | |
| D) | Pulmonary edema | |
| Ans: | D | |
| Feedback: | ||
| In left-sided heart failure, the left ventricle pumps inefficiently resulting in a backup of blood into the lungs causing pulmonary vessel congestion and fluid leaks into the alveoli and lung tissue. As more fluid continues to collect in the alveoli, pulmonary edema develops. The patient will present with rales, wheezes, blood-tinged sputum, low oxygenation, and development of a third heart sound. Cardiomyopathy can occur as a result of a viral infection, alcoholism, anabolic steroid abuse, or a collagen disorder. It causes muscle alterations and ineffective contraction and pumping. Cardiomegaly is an enlargement of the heart due to compensatory mechanisms in congestive heart failure (CHF) and leads to ineffective pumping and eventually exacerbated CHF. Valvular heart disease leads to an overload of the ventricles because the valves do not close adequately causing blood to leak backward. This causes muscle stretching and increased demand for oxygen and energy. | ||
| 2. | What electrolyte inactivates troponin and allows actin and myosin to form a bridge enabling the muscle fibers to contract? | |
| A) | Magnesium | |
| B) | Calcium | |
| C) | Potassium | |
| D) | Sodium | |
| Ans: | B | |
| Feedback: | ||
| Calcium must be present to deactivate troponin so that actin and myosin can react to form actinomycin bridges. Potassium, sodium, and magnesium do not affect troponin. | ||
| 3. | A 62-year-old African American man diagnosed with congestive heart failure and hypertension has BiDil included in his drug therapy. What nursing assessment finding would indicate the patient is developing a complication from this drug? | |
| A) | Alopecia | |
| B) | Photosensitivity | |
| C) | Anorexia | |
| D) | Orthostatic hypotension | |
| Ans: | D | |
| Feedback: | ||
| Orthostatic hypotension is an adverse effect of a combination of isosorbide dinitrate and hydralazine called BiDil. This could lead to safety concerns and should be addressed in drug teaching for this patient. Alopecia, photosensitivity, and anorexia are not adverse effects related to this drug. | ||
| 4. | The nurse is preparing digoxin for an infant. What is the nurse’s priority intervention? | |
| A) | To perform hand hygiene | |
| B) | To have another nurse check dosage calculations | |
| C) | To check the child’s apical pulse | |
| D) | To identify the patient by checking the ID bracelet | |
| Ans: | B | |
| Feedback: | ||
| The margin of safety for the dosage of this drug is very narrow in children. The dosage needs to be very carefully calculated and should be double-checked by another nurse before administration. The other options are important and the nurse should implement all three. However, these actions are of lower priority. | ||
| 5. | A patient asks the nurse what cardiac glycosides do to improve his condition. What is the nurse’s best response? | |
| A) | “They decrease the force of myocardial contractions.” | |
| B) | “They help renal blood flow and increase urine output.” | |
| C) | “They increase heart rate.” | |
| D) | “They increase conduction velocity.” | |
| Ans: | B | |
| Feedback: | ||
| Cardiac glycosides increase intracellular calcium and allow more calcium to enter myocardial cells. This action causes an increased force of myocardial contraction, an increased cardiac output, and renal perfusion that increases urine output. Cardiac glycosides also serve to slow the heart rate and decrease conduction velocity. | ||
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