Question 1

The nurse completes medication education with a client who receives propranolol (Inderal). The nurse evaluates the education as effective when the client makes which statement?&#10;A) &#34;I must call my doctor if I lose more than 1.5 kilograms a week.&#34;&#10;B) &#34;I must call my doctor if my anxiety increases and I start worrying again.&#34;&#10;C) &#34;I must take my pulse every day and call my doctor if it is less than 60.&#34;&#10;D) &#34;I must take my pulse every day and call my doctor if it is higher than 100.&#34;

Accepted Answer

Monitoring of pulse rate is important while taking propranolol as it can cause bradycardia (heart rate less than 60 bpm). The client should call the doctor if their pulse rate drops below 60 bpm. Losing more than 1.5 kg a week or increase in anxiety are not related to medication therapy with propranolol. A heart rate higher than 100 bpm is tachycardia, which may indicate other medical conditions but is not related to propranolol therapy.

Question 2

The client with diabetes mellitus, type 1 is receiving propranolol (Inderal). What is the best outcome for this client?&#10;A) The client will maintain blood glucose within normal limits.&#10;B) The client will perform activities of daily living.&#10;C) The client will decrease the required number of calories/day.&#10;D) The client will maintain adequate peripheral circulation.

Accepted Answer

Propranolol can mask the symptoms of hypoglycemia and decrease glycogenolysis, which can lead to hypoglycemia in clients with diabetes mellitus, type 1. Therefore, the best outcome for this client is to maintain blood glucose within normal limits. Performing activities of daily living, decreasing the required number of calories/day, and maintaining adequate peripheral circulation are important outcomes for clients with diabetes, but they are not as closely related to the medication propranolol.

Question 3

The physician has ordered amiodarone (Cordarone). Prior to starting this medication, the nurse would alert the physician to which laboratory result?&#10;A) potassium 5.0 mmol/L&#10;B) international normalized ratio (INR) of 1.1&#10;C) sodium 140 mmol/L&#10;D) potassium 3.1 mmol/L

Accepted Answer

Hypokalemia (low potassium) increases the risk of amiodarone-induced arrhythmias. Therefore, the nurse should alert the physician to a potassium level of 3.1 mmol/L, which is below the normal range of 3.5-5.0 mmol/L. The other laboratory values listed are within normal range and do not require immediate attention before starting amiodarone.

Question 4

The client receives amiodarone (Cordarone). The nurse would be concerned about which additional medication that a consulting physician might order?&#10;A) Digoxin (Lanoxin)&#10;B) Omeprazole (Prilosec)&#10;C) Fluoxetine (Prozac)&#10;D) Oxycodone (OxyContin)

Accepted Answer

Amiodarone can increase the serum levels of digoxin and potentially lead to toxicity. Therefore, caution must be taken when administering these two medications together. Omeprazole (B) is a proton-pump inhibitor used to treat acid reflux and would not interact with amiodarone. Fluoxetine (C) and oxycodone (D) are also not known to interact with amiodarone.

Question 5

The client receives verapamil (Isoptin). The client tells the nurse that he is nervous about taking this medicine. What is the best response by the nurse?&#10;A) &#34;This medicine is a potassium channel blocker and is considered safe.&#34;&#10;B) &#34;This medicine increases your blood pressure, but we will be monitoring that.&#34;&#10;C) &#34;This medicine has many side effects, but you should be okay.&#34;&#10;D) &#34;This medicine is safe, and most clients do very well with it.&#34;

Accepted Answer

Option D provides reassurance to the client and is accurate. Verapamil is generally well tolerated and considered safe. Options A and B provide incorrect information regarding the action of the medication, and option C is not reassuring and may increase the client's anxiety.

Question 6

The client tells the nurse, &#34;This educational video you gave me shows normal electrical conduction through the heart, but I still don't understand it. Can you explain it to me&#34;? What is(are) the nurse's best response(s)? Select all that apply.&#10;A) &#34;Conduction through the bundle of His is the slowest in the heart.&#34;&#10;B) &#34;Conduction begins in the sinoatrial (SA) node and travels to the atrioventricular (AV) node.&#10;C) &#34;Conduction continues through the bundle branches to the Purkinje fibres.&#34;&#10;D) &#34;The sinoatrial (SA) node is located in the left atrium.&#34;&#10;E) &#34;Conduction travels from the atrioventricular (AV) node through the bundle of His.&#34;

Accepted Answer

The nurse should explain that conduction of electrical impulses through the heart begins in the sinoatrial (SA) node, travels to the atrioventricular (AV) node, continues through the bundle branches to the Purkinje fibers, and then spreads throughout the ventricles. Therefore, the correct responses are B, C, and E. Option A is incorrect because conduction through the bundle of His is actually the fastest in the heart. Option D is incorrect because the SA node is actually located in the right atrium.

Question 7

The client receives verapamil (Isoptin). The client asks the nurse if it is okay to take herbal supplements with this medicine. What is the best response by the nurse?&#10;A) &#34;Most herbal supplements are okay, but you should avoid St. John's wort.&#34;&#10;B) &#34;Using herbal supplements may increase your blood pressure too much.&#34;&#10;C) &#34;Using herbal supplements may lower your blood pressure too much.&#34;&#10;D) &#34;Herbal supplements are okay as long as you take calcium salts with them.&#34;

Accepted Answer

Verapamil is a calcium channel blocker, which can lower blood pressure. Using herbal supplements in combination with this medication may cause a further drop in blood pressure, which can be dangerous. Therefore, it is recommended to avoid herbal supplements, especially those known to lower blood pressure like garlic, ginseng, and ginger. St. John's wort should also be avoided as it can decrease the effectiveness of Verapamil. Taking calcium salts with herbal supplements is not a recommended practice.

Question 8

The client tells the nurse, &#34;My doctor says I have atrial fibrillation. Is this serious and how is it treated?&#34; What is(are) the best response(s) by the nurse? Select all that apply.&#10;A) &#34;This condition is best treated with what we call antidysrhythmic drugs.&#34;&#10;B) &#34;This is quite serious; did your doctor mention a heart transplant?&#34;&#10;C) &#34;Depending upon your symptoms, your doctor may use an electrical shock.&#34;&#10;D) &#34;It is very serious, even more serious than a ventricular dysrhythmia.&#34;&#10;E) &#34;This is very common; your doctor will discuss the best treatment with you.&#34;

Accepted Answer

Atrial fibrillation is a common cardiac dysrhythmia, but can still have serious consequences depending on the individual's underlying health and symptoms. Treatment may include the use of antidysrhythmic drugs, but electrical shock (cardioversion) may also be used. Choice B is incorrect and may cause unnecessary alarm. Choice D is incorrect; ventricular dysrhythmias (such as ventricular tachycardia or ventricular fibrillation) are generally considered more serious than atrial dysrhythmias.

Question 9

The male client has been receiving propranolol (Inderal) for treatment of a dysrhythmia for 6 weeks. What is an important question for the nurse to ask the client when assessing medication compliance?&#10;A) &#34;Has your appetite increased or decreased?&#34;&#10;B) &#34;Have you noticed any difficulty in your ability to concentrate?&#34;&#10;C) &#34;Have you noticed any changes in your sexual functioning?&#34;&#10;D) &#34;Have you noticed any changes in your bowel function?&#34;

Accepted Answer

Propranolol, a non-selective beta-blocker, can cause sexual dysfunction as a side effect. This may affect the patient's compliance with the medication regimen, making it important for the nurse to inquire about changes in sexual functioning.

Question 10

The client asks the nurse, &#34;My doctor said I need cardioversion for my dysrhythmia. Why can't I just take medication&#34;? What is the nurse's best response?&#10;A) &#34;Special diets are necessary with antidysrhythmic medications and they are hard to follow.&#34;&#10;B) &#34;Antidysrhythmic medications have many side effects; cardioversion is considered safer.&#34;&#10;C) &#34;Antidysrhythmic medications don't really work very well for most dysrhythmias.&#34;&#10;D) &#34;There is a high risk of seizures when you take antidysrhythmic medications.&#34;

Accepted Answer

Antidysrhythmic medications can have many side effects, while cardioversion is considered to be a safer treatment option with fewer side effects. It may also have a more immediate and effective outcome in restoring normal heart rhythm.

Question 11

The client says to the nurse, &#34;My neighbour said my antidysrhythmic drug can actually cause me to have irregular heartbeats. How can this be?&#34; What is the nurse's best answer?&#10;A) &#34;Your medication is not the problem; it is when you mix it with over -the -counter (OTC) drugs that you develop irregular beats.&#34;&#10;B) &#34;You must take two baby aspirins every other day to avoid the irregular heart beats.&#34;&#10;C) &#34;Your medication blocks the flow of the electrolytes in your heart, and this can cause irregular beats.&#34;&#10;D) &#34;It is better to discuss you medication concerns with a professional, not a lay person like your neighbour.&#34;

Accepted Answer

The answer of The client says to the nurse, &#34;My...

Question 12

The client is receiving procainamide hydrochloride (Pronestyl) for treatment of a dysrhythmia. What is the best client outcome for medication compliance?&#10;A) The client will monitor his pulse and hold his medication if his pulse is less than 60.&#10;B) The client will take his medication with food.&#10;C) The client will take his medication as directed, even if he is feeling well.&#10;D) The client will take his medication on an empty stomach.

Accepted Answer

The answer of The client is receiving procainamide hydrochloride (Pronestyl)...

Question 13

The nurse has been teaching a class on dysrhythmias to a group of clients with this disorder. The nurse determines that teaching has been effective when a client makes which statement?&#10;A) &#34;Our sodium, potassium, and calcium levels must be okay for our hearts to have an electrical impulse.&#34;&#10;B) &#34;Enhancing potassium and sodium is how our medications will work to prevent dysrhythmias.&#34;&#10;C) &#34;Potassium is the most important electrolyte when it comes to the electrical impulse in our hearts.&#34;&#10;D) &#34;Our sodium, potassium, and magnesium levels must be okay for our hearts to have an electrical impulse.&#34;

Accepted Answer

The answer of The nurse has been teaching a class...

Question 14

The nurse is teaching a class on rhythm abnormalities to clients who have experienced dysrhythmias. The nurse knows that teaching has been effective when a client makes which statement?&#10;A) &#34;Dysrhythmias interrupt the normal electrical pathways in the heart so it can't beat properly.&#34;&#10;B) &#34;Dysrhythmias alter the blood flow through the heart and cause it to stop beating.&#34;&#10;C) &#34;Dysrhythmias cause serious electrolyte imbalances; this results in heart block.&#34;&#10;D) &#34;Dysrhythmias are the result of long -standing, uncontrolled hypertension.

Accepted Answer

The answer of The nurse is teaching a class on...

Question 15

The nurse is managing care for a group of clients receiving antidysrhythmic medication. Which assessment data will the nurse report to the physician?&#10;A) anorexia, insomnia, confusion, and 1+ pitting peripheral edema&#10;B) palpitations, chest pain, weakness, and fatigue&#10;C) depression, irritability, fatigue, and nausea&#10;D) low grade fever, diaphoresis, weakness, and dry mucous membranes

Accepted Answer

The answer of The nurse is managing care for a...

Deck 25: Drugs for Dysrhythmias