Question 1

The indirect anticholinergic effect of quinidine (Quinaglute)may lead to a dangerous tachycardiac response.With an appropriate order,which medication could the nurse administer before the quinidine to prevent ventricular acceleration?

A) Digoxin (Lanoxin)
B) Disopyramide phosphate (Norpace)
C) Phenytoin (Dilantin)
D) Procainamide (Pronestyl)

Digoxin (Lanoxin)

Accepted Answer

Digoxin (Lanoxin) is used to control the heart rate and is effective in preventing ventricular acceleration, which can be a side effect of quinidine's indirect anticholinergic effects.

Question 2

The nurse would conclude that a client who has recently started antidysrhythmic drug therapy with mexiletine (Mexitil)is experiencing common adverse drug effects after the client reports which of the following?

A) Flatulence and abdominal bloating
B) Nausea and abdominal discomfort
C) Muscle aches and joint pains
D) Dizziness and blurred vision

Nausea and abdominal discomfort

Accepted Answer

Mexiletine, an antidysrhythmic medication, commonly causes gastrointestinal side effects such as nausea and abdominal discomfort.

Question 3

Which of the following statements should the nurse include in discharge teaching about disopyramide (Norpace)?&#10;A) &#34;Make sure you weigh yourself once a month to check for fluid gain.&#34;&#10;B) &#34;You should make sure to check your blood pressure three times a day.&#34;&#10;C) &#34;Make sure you don't skip or stop your medication abruptly without contacting your physician.&#34;&#10;D) &#34;It is recommended that you take in at least 2 ounces of alcohol a day to enhance the drug's effect.&#34;&#10;

Accepted Answer

Disopyramide should not be stopped abruptly, as this can result in serious arrhythmias. Patients should be advised to contact their physician if they want to stop taking the medication. Weighing oneself to check for fluid gain is important in patients taking diuretics, not disopyramide. Checking blood pressure three times a day is a general guideline for hypertension management, but not specifically related to disopyramide. Alcohol consumption should be avoided while taking disopyramide.

Question 4

A client asks the nurse how quinidine sulfate (Quinora)will aid in the treatment of atrial fibrillation.In formulating a response,the nurse would include that quinidine has which of the following properties?

A) It increases automaticity,conduction velocity,and rate of the heart.
B) It helps the sinoatrial node become more impulse generating for the ventricles.
C) It stabilizes specific cardiac cell membranes and prevents the exchange of sodium and potassium.
D) It allows an increase in impulse generation in the Purkinje fibers.

Accepted Answer

Quinidine sulfate (Quinora) is a class Ia antiarrhythmic medication that stabilizes specific cardiac cell membranes and prevents the exchange of sodium and potassium. This leads to a decrease in automaticity and conduction velocity of the heart, making it useful in the treatment of atrial fibrillation and other types of arrhythmias. Options A, B, and D are incorrect because they describe properties that are opposite to the effects of quinidine sulfate.

Question 5

A client being discharged home with antidysrhythmic drug therapy is at risk for heart failure.To detect this complication early,the nurse should advise the client to report which of the following if they occur?

A) Flulike symptoms
B) Palpitations
C) Weight gain and edema
D) Lightheadedness on rising

Accepted Answer

Weight gain and edema may indicate heart failure in a client on antidysrhythmic drug therapy. Flulike symptoms are not typically associated with heart failure. Palpitations may be a side effect of the antidysrhythmic drug therapy but do not necessarily indicate heart failure. Lightheadedness on rising may be a side effect of the drug therapy or an indicator of orthostatic hypotension, but it does not specifically indicate heart failure.

Question 6

The nurse would assess the client during administration of intravenous procainamide (Pronestyl)for which of the following adverse effects of this drug?&#10;A) Hypotension&#10;B) Increase in heart rate&#10;C) Decline in oxygen saturation&#10;D) Abdominal pain&#10;

Accepted Answer

Intravenous procainamide (Pronestyl) can cause hypotension, which is a potential adverse effect. It is important for the nurse to monitor the client's blood pressure closely during administration. The medication does not commonly cause an increase in heart rate, a decline in oxygen saturation, or abdominal pain.

Question 7

A client was successfully cardioverted from atrial fibrillation to sinus rhythm.The nurse prepares to administer which drug as ordered to prevent recurrence of the atrial fibrillation?&#10;A) Acebutolol (Sectral)&#10;B) Lidocaine (Xylocaine)&#10;C) Bretylium (Bretylol)&#10;D) Procainamide (Pronestyl)&#10;

Accepted Answer

Procainamide is an antiarrhythmic medication used to maintain sinus rhythm after cardioversion from atrial fibrillation.

Question 8

Which of the following nursing diagnoses is appropriate for a client who is receiving an antidysrhythmic drug?&#10;A) Risk for infection&#10;B) Deficient fluid volume&#10;C) Risk for injury&#10;D) Impaired sensory perception&#10;

Accepted Answer

Antidysrhythmic drugs can have side effects such as dizziness, confusion, and fainting, which increase the risk for injury in the client. Therefore, the nursing diagnosis of Risk for injury is appropriate in this case. The other options are not directly related to the administration of antidysrhythmic drugs.

Question 9

The nurse would assess the client for which of the following symptoms of cinchonism as an adverse effect of quinidine (Quinaglute)?&#10;A) Hypothermia&#10;B) Constipation&#10;C) Salty taste in mouth&#10;D) Tinnitus&#10;

Accepted Answer

Quinidine can cause tinnitus as a symptom of cinchonism, which is a toxic reaction to quinidine. Hypothermia and constipation are not typically associated with quinidine. A salty taste in the mouth may be a side effect of other medications, but not quinidine.

Question 10

The nurse is aware that bretylium (Bretylol)is indicated mainly for the management of a client with which of the following health problems?&#10;A) Digoxin-induced dysrhythmias&#10;B) Cardiac arrest&#10;C) Congestive heart failure&#10;D) Ventricular tachycardia&#10;

Accepted Answer

Bretylium is primarily used for the management of ventricular tachycardia, a life-threatening arrhythmia that can cause cardiac arrest. It works by stabilizing the electrical activity of the heart muscle, which can help to restore a normal heart rhythm. It is not indicated for the management of congestive heart failure or digoxin-induced dysrhythmias.

Question 11

The nurse overhears a physician state that a client receiving lidocaine will be started on an oral analog of this drug.The nurse reviews the physician order sheet for which of the following newly ordered medications?

A) Amiodarone (Cordarone)
B) Tocainide (Tonocard)
C) Disopyramide (Norpace)
D) Bretylium (Bretylol)

Accepted Answer

The answer of The nurse overhears a physician state that...

Question 12

The nurse expects to find in the medical record that a client taking flecainide (Tambocor)has which of the following disorders?&#10;A) Sinus arrest&#10;B) Heart block&#10;C) Ventricular arrhythmias&#10;D) Poor left ventricular function&#10;

Accepted Answer

The answer of The nurse expects to find in the...

Question 13

Which of the following instructions would the nurse give to the client who is receiving an antidysrhythmic drug?&#10;A) &#34;Stop taking the medication when you start feeling better.&#34;&#10;B) &#34;Take your apical pulse rate for 5 minutes.&#34;&#10;C) &#34;Avoid beverages that contain caffeine.&#34;&#10;D) &#34;Take the medication only when you feel an abnormal heart rhythm.&#34;&#10;

Accepted Answer

The answer of Which of the following instructions would the...

Question 14

The nurse places highest priority on teaching a client receiving an antidysrhythmic drug about which of the following items that should be monitored before each dose taken at home?&#10;A) Blood pressure&#10;B) 1-minute pulse count&#10;C) Daily weight&#10;D) Urine color and characteristics&#10;

Accepted Answer

The answer of The nurse places highest priority on teaching...

Question 15

The nurse should question an order for quinidine (Quinaglute)for a client who has which of the following health problems?&#10;A) Parkinson's disease&#10;B) Cerebral palsy&#10;C) Myasthenia gravis&#10;D) Tourette's syndrome&#10;

Accepted Answer

The answer of The nurse should question an order for...

Question 16

Which of the following adverse effects would the nurse monitor for while administering intravenous lidocaine (Xylocaine)?&#10;A) Bleeding tendencies&#10;B) Central nervous system reactions&#10;C) Renal shutdown&#10;D) Cerebral emboli&#10;

Accepted Answer

The answer of Which of the following adverse effects would...

Question 17

The nurse would not be concerned about which of the following in a client who is taking disopyramide (Norpace)and a $\beta$-blocker such as atenolol (Tenormin)?&#10;A) Syncope&#10;B) Chronic heart failure&#10;C) Tachycardia&#10;D) Hypotension

Accepted Answer

The answer of The nurse would not be concerned about...

Question 18

The nurse concludes that which of the following drugs prescribed for various clients is not prescribed for the treatment of dysrhythmias?&#10;A) Lidocaine (Xylocaine)&#10;B) Phenytoin (Dilantin)&#10;C) Digoxin (Lanoxin)&#10;D) Mexiletine (Mexitil)&#10;

Accepted Answer

The answer of The nurse concludes that which of the...

Question 19

The nurse assessing a client taking disopyramide (Norpace)concludes that which symptom exhibited by the client is not associated with the use of disopyramide?&#10;A) Drooling&#10;B) Diarrhea&#10;C) Dry mouth&#10;D) Anorexia&#10;

Accepted Answer

The answer of The nurse assessing a client taking disopyramide...

Question 20

The mechanism responsible for initiating ectopic beats in the heart is&#10;A) the reentry phenomenon.&#10;B) the refractory phenomenon.&#10;C) bidirectional block.&#10;D) automaticity.&#10;

Accepted Answer

The answer of The mechanism responsible for initiating ectopic beats...

Question 21

The nurse instructs a client taking amiodarone (Cordarone)to avoid which of the following items to avoid adverse effects that are unique to this drug?&#10;A) Sunlight&#10;B) Alcohol&#10;C) Excess dietary sodium&#10;D) Cigarettes&#10;

Accepted Answer

The answer of The nurse instructs a client taking amiodarone...

Deck 26: Antidysrhythmics