Chapter 46: Vasodilators

Chapter 46: Vasodilators

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse is administering a vasodilator that dilates resistance vessels. The nurse understands that this drug will have which effect on the patient?

a.	Decreased cardiac preload
b.	Decreased cardiac output
c.	Increased tissue perfusion
d.	Increased ventricular contraction

 

 

ANS:  C

Vasodilators that dilate resistance vessels, or arterioles, cause a decrease in afterload, which allows cardiac output and tissue perfusion to increase. A decrease in preload would be the result of dilation of capacitance vessels, or veins. Dilation of arterioles increases cardiac output. Ventricular contraction results when preload is increased.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 494

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. A patient is taking a vasodilator that relaxes smooth muscles in veins. To help minimize drug side effects, the nurse caring for this patient will:

a.	caution the patient not to get up abruptly.
b.	encourage the patient to increase fluid intake.
c.	tell the patient to report shortness of breath.
d.	warn the patient about the possibility of bradycardia.

 

 

ANS:  A

Postural hypotension occurs when moving from a supine or seated position to an upright position. It is caused by relaxation of smooth muscle in veins, which allows blood to pool in veins and decreases venous return of blood to the heart. Patients taking such drugs should avoid abrupt transitions to prevent falls. Prolonged use of vasodilators can lead to expansion of blood volume and fluid overload, so increasing fluid intake is not appropriate. Shortness of breath is a symptom associated with heart failure. Tachycardia can occur when the blood pressure drops as a result of the baroreceptor reflex.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 494-495

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

3. A nurse is caring for a patient who will begin taking hydralazine to treat hypertension. Which statement by the patient indicates understanding of the nurse’s teaching about this drug?

a.	“I will need to ask for assistance when getting up out of a chair.”
b.	“I will also take a beta blocker medication with this drug to prevent rapid heart rate.”
c.	“I may develop joint pain, but this side effect will decrease over time.”
d.	“This drug may cause excessive hair growth on my face, arms, and back.”

 

 

ANS:  B

Hydralazine can cause severe reflex tachycardia; a beta blocker is usually given to counter this effect.  Postural hypotension is minimal with hydralazine. Patients should be taught to report joint pain, which indicates an SLE syndrome and requires discontinuation of the drug. Minoxidil can cause excessive hair growth, not hydralazine.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 496

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

4. The nurse is caring for a patient who is taking a vasodilator that dilates capacitance vessels. The nurse will expect which effect in this patient?

a.	Decrease in cardiac work
b.	Increase in cardiac output
c.	Increase in tissue perfusion
d.	Increase in venous return

 

 

ANS:  A

Vasodilators that dilate capacitance vessels, or veins, lead to a decrease in venous return to the heart, which reduces preload and the force of ventricular contraction. The resultant effect is a decrease in cardiac work. With a decrease in ventricular contraction, cardiac output is reduced, as is tissue perfusion. Dilation of veins causes a decrease in venous return.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 494

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies