Chapter 48: Antidysrhythmic Drugs

Chapter 48: Antidysrhythmic Drugs

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. The class I antidysrhythmic drugs block sodium channels. However, the nurse needs to realize that class I drugs have different actions. Which category of class I antidysrhythmic drugs accelerates repolarization?

a.	Class IA
b.	Class IB
c.	Class IC
d.	Class IA and IB

 

 

ANS:   B

Only class IB drugs increase repolarization.

Class IA drugs delay repolarization.

Class IC drugs prolong prodysrhythmic actions.

Class IA drugs delay repolarization; class IB drugs increase repolarization.

 

DIF:    Cognitive Level: Application             REF:    p. 543

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. The nurse educator is providing patient education about the Cardiac Arrhythmia Suppression Trial (CAST). The nurse correctly explains that the trial demonstrated that pharmacologic suppression of dysrhythmias

a.	reduced mortality by 50% but increased morbidity.
b.	significantly reduced the risk of a second myocardial infarction.
c.	doubled the risk of a second myocardial infarction.
d.	should be used in all patients who have had an MI regardless of rhythm.

 

 

ANS:   C

In the CAST, class IC dysrhythmic drugs were used to prevent dysrhythmias after MI. These drugs were found to actually double the rate of mortality.

The antidysrhythmic drugs did not reduce mortality or the risk of a second MI. They should not be used for any MI patients with associated dysrhythmias unless the dysrhythmias are life-threatening.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 538

TOP:    Nursing Process: Evaluation

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

 

3. The nurse is serving as a preceptor for new nurse on the unit. The preceptor is assessing the new nurse’s understanding of antidysrhythmic drugs. Which statement made by the new nurse about the use of antidysrhythmic drugs best demonstrates correct understanding?

a.	“It is best to use as low a dose as possible of the drugs to reduce the risk of dysrhythmias.”
b.	“To be effective, these drugs must be used in high doses.”
c.	“Many patients may have a hypersensitivity to these drugs.”
d.	“These drugs can actually worsen existing dysrhythmias or cause new dysrhythmias.”

 

 

ANS:   D

Virtually all of the drugs used to treat dysrhythmias can worsen existing dysrhythmias and generate new ones, therefore these patients must be carefully monitored.

Using either low or high doses of these drugs can trigger lethal dysrhythmias. The point is that antidysrhythmic drugs are risky and have adverse effects.

All nurses know that some patients may have an allergic response to any drug that is administered.

 

DIF:    Cognitive Level: Comprehension      REF:    p. 538

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A nurse is caring for a patient taking quinidine to suppress sustained ventricular tachycardia. The nurse observes that the patient’s ECG shows QRS complexes that have widened by 60% from the baseline measurement. The nurse should

a.	continue administering the medication as ordered.
b.	check with the prescriber on rounds about increasing the dosage.
c.	check with the prescriber on the next shift’s rounds about the drug.
d.	discontinue the medication and notify the prescriber immediately.

 

 

ANS:   D

Cardiotoxicity has occurred, as indicated by the QRS complex widening by more than 50% from baseline. The medication should be discontinued and the prescriber notified.

The medication should not be administered or increased, because this can complicate the cardiotoxicity.

The drug needs to be stopped immediately and the prescriber notified. This information cannot wait to be shared at a later time.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 542

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies