Deck 10: The Modulat Ion of Oxygenat Ion and Perfusion

Question 1

When using aspirin as an antiplatelet agent, how many days before any planned surgery or dental procedures should be stopped?

A) 2 days.
B) 7 days.
C) 14 days.
D) 21 days.

Answer 1

7 days.

Question 2

The current optimal drug therapy in the management of heart failure is:

A) the cardiac glycoside, digoxin.
B) the dopamine agonist, dobutamine.
C) a non-selective β-blocker.
D) an ACE inhibitor and a diuretic.

Answer 2

an ACE inhibitor and a diuretic.

Question 3

Which of the following antihypertensive agents may be considered during pregnancy?

A) β-blockers.
B) Calcium channel blockers
C) ACE inhibitors.
D) Angiotensin II receptor antagonists.

Answer 3

β-blockers.

Question 4

Which of the following antihypertensive agents should be avoided in a client with constipation?

A) Calcium channel blockers.
B) Centrally-acting agents.
C) Angiotensin II antagonists.
D) ACE inhibitors.

Question 5

If a second dose of diuretic is required, this is usually administered:

A) mid-morning.
B) midday or early afternoon
C) early evening.
D) at bedtime.

Question 6

In considering therapy with HMG-CoA reductase inhibitors, it is important for the client to have regular:

A) liver function tests.
B) renal function tests.
C) blood clotting tests.
D) respiratory function tests.

Question 7

Which one of the following chemical mediators can alter blood pressure via vasoconstriction?

A) Prostacyclin.
B) Endothelin-1.
C) Nitric oxide.
D) Prostaglandin E_2.

Question 8

Which antihypertensive drug group should be avoided when a person has a pre-existing respiratory condition like asthma?

A) Diuretics.
B) Calcium channel antagonists.
C) ACE inhibitors.
D) β-blockers.

Question 9

The form of angina pectoris that is associated with coronary vasospasm is called:

A) variant angina.
B) exertional angina.
C) classic angina.
D) stable angina.

Question 10

Nimodipine is a calcium channel blocker that:

A) is used widely in the management of angina.
B) is relatively selective for cerebral blood vessels.
C) increases cardiac workload.
D) is most beneficial when it is administered prophylactically.

Question 11

Clients who have renal impairment are at risk of developing ________ during treatment with ACE inhibitors.

A) hypokalaemia
B) hyperkalaemia
C) hyponatraemia
D) hypernatraemia

Question 12

Which one of the following mechanisms describes the general action of antidysrhythmic agents?

A) Impeding the movement of ions across cardiac cell membranes.
B) Enhancing cardiac automaticity.
C) Shortening the cardiac action potential.
D) Enhancing impulse conduction in the heart.

Question 13

A hormone that affects blood pressure by facilitating an increased excretion of sodium and water is:

A) aldosterone.
B) ADH (vasopressin).
C) ANF.
D) oestrogen.

Question 14

Which of the following diuretic agents is not recommended to be given with an ACE inhibitor?

A) Chlorothiazide.
B) Frusemide.
C) Ethacrynic acid.
D) Spironolactone.

Question 15

Which one of the following is not a pathophysiological change associated with heart failure?

A) Increased myocardial oxygen demand.
B) Cardiac remodelling.
C) Decreased angiotensin II production.
D) Decreased myocardial contractility.

Question 16

To avoid tolerance associated with continuous use of nitrate patches, the client should be advised to:

A) only apply the patches in the morning and evening.
B) only apply the patches when the angina symptoms become apparent.
C) have a 'nitrate-free' time from the patches for about 12 hours each day.
D) only apply the patches at bedtime.

Question 17

When timing the dose for the fibrate gemfibrozil, the client should be advised to take it:

A) at bedtime.
B) upon arising in the morning.
C) with food.
D) half an hour before food.

Question 18

Which phase of the cardiac action potential is characterised by the opening of the sodium channel activation gate?

A) Phase 0.
B) Phase 1.
C) Phase 2.
D) Phase 3.

Question 19

β-blockers should not be used in clients with the following conditions except:

A) complicated hypertension.
B) cardiac tamponade.
C) second-degree heart block.
D) sick sinus syndrome.

Question 20

In the treatment of erectile dysfunction, phosphodiesterase inhibitors:

A) act to trigger the release of nitric oxide.
B) are used when the cause is psychological.
C) may interact negatively with organic nitrate therapy.
D) must be administered directly into the penis.

Question 21

Which one of the following respiratory illnesses affects approximately 10% of adult Australians?

A) Bronchial asthma.
B) Chronic bronchitis.
C) Emphysema.
D) Cystic Fibrosis

Question 22

The form of erythropoietin for clinical use:

A) may induce a hypertensive state during therapy.
B) is extracted from human urine.
C) induces a rise in haemoglobin levels within two days of starting therapy.
D) contains iron supplements in order to facilitate haemoglobin production.

Question 23

Intravenous potassium should never be administered:

A) through a peripheral line.
B) through the subclavian vein.
C) as a bolus through the side arm of the intravenous line.
D) through the jugular vein.

Question 24

Which one of the following is considered a cause of anaemia?

A) Vitamin D₃ deficiency.
B) Exposure to anabolic steroids.
C) Chronic renal failure.
D) Elemental iron overload.

Question 25

To reverse anticoagulation caused by heparin, ________ is usually administered.

A) prostaglandin
B) warfarin
C) tranexamic acid
D) protamine

Question 26

The benefit of ________ for the treatment of thrombosis is that it is clot specific thereby reducing the risk of generalised haemorrhage.

A) warfarin
B) urokinase
C) streptokinase
D) tissue plasminogen activator

Question 27

Which one of the following statements about oxygen therapy is true?

A) Prolonged therapy with 100% oxygen can lead to toxicity regardless of underlying pathology.
B) Standard oxygen therapy for clients with long-term chronic obstructive airways disease will lead to hyperventilation.
C) Hyperbaric oxygen therapy is useful in the care of premature infants.
D) Peak flow readings determine the level of oxygen therapy required.

Question 28

To which drug group do many cough suppressants belong?

A) NSAIDs.
B) Narcotics.
C) Benzodiazepines.
D) Dopamine antagonists.

Question 29

Which one of the following antiasthma agents acts directly on intracellular cAMP levels?

A) Muscarinic antagonists.
B) Methylxanthines.
C) β agonists.
D) Leukotriene receptor antagonists.

Question 30

The hypokalaemia that may be induced by a loop diuretic can be lessened or prevented by concurrent use of:

A) potassium chloride.
B) an angiotensin II receptor antagonist.
C) an ACE inhibitor.
D) all of the above.

Question 31

High levels of which of the following lipoproteins can be beneficial?

A) VLDL.
B) HDL.
C) LDL.
D) IDL.

Question 32

Which diuretics promote the greatest diuresis?

A) Thiazides.
B) Loop diurectics.
C) Aldosterone inhibitors.
D) Potassium-sparing diuretics.

Question 33

Inhaled corticosteroids should be considered as part of the medication regime for asthma if the person is using their β₂ agonists more than:

A) one time each month.
B) three times each month.
C) three to four times each week.
D) two times each month.

Question 34

The inclusion of ________ in the diet may help to avoid hypercholesterolaemia.

A) chicken
B) sardines
C) mutton
D) beef

Question 35

Cough suppressants should not be given to children under:

A) 5 years.
B) 4 years.
C) 3 years.
D) 2 years.

Question 36

To reduce the gastric irritation associated with oral iron therapy, the person should be advised to:

A) take the preparation as a suppository.
B) take the preparation with or immediately after meals.
C) take the preparation at bedtime.
D) take the preparation with an antacid.

Question 37

An unwelcome but possibly benign effect of nicotinic acid treatment is:

A) petechial rash.
B) constipation.
C) loose stools.
D) skin flushes and itching.

Question 38

The extrinsic form of asthma is characterised by:

A) an autonomic nervous system imbalance.
B) a tendency to develop in older individuals.
C) the release of chemical mediators from immune cells in lung tissue.
D) the dominance of the parasympathetic stimulation of the airways.

Question 39

Which of these diuretics promotes potassium retention?

A) Spironolactone.
B) Frusemide.
C) Chlorothiazide.
D) Ethacrynic acid.

Question 40

An important consideration associated with anaemias caused by vitamin B₁₂ deficiency is that:

A) high doses of vitamin B₁₂ can induce hyperkalaemia.
B) in pernicious anaemia, vitamin B₁₂ must be administered parenterally.
C) the clinical form of vitamin B₁₂ is called pyridoxine.
D) solutions of vitamin B₁₂ must be kept refrigerated.

Question 41

Long term statin therapy has been linked to an increased incidence of

A) stroke.
B) heart disease.
C) cataract development.
D) Alzheimer's disease.

Question 42

Treatment with iron supplementation is usually continued for about ________ to ensure replenishment of iron stores in iron deficiency anaemia.

A) two weeks
B) one month
C) two months
D) three months

Question 43

Which of the following is an example of an isotonic solution?

A) 4% glucose with 0.18% sodium chloride.
B) 0.45% sodium chloride.
C) 10% glucose.
D) 25% mannitol.

Question 44

Premature babies receiving long-term oxygen therapy are at risk of:

A) otitis media.
B) ototoxicity.
C) retinal damage.
D) macular degeneration.

Question 45

The benefits of enoxaprin over heparin include that it:

A) is less likely to cause thrombocytopaenia and is more effective in reducing mortality and myocardial infarction in unstable angina.
B) has a longer half-life requiring less frequent monitoring and is safer in pregnancy.
C) A and B.
D) neither A or B.

Question 46

After about ________ of oral anticoagulant therapy with warfarin, the heparin can be withdrawn as it takes this amount of time for the oral anticoagulant to exert its effect.

A) two hours
B) twelve hours
C) 24 hours
D) 48 hours

Question 47

The antiplatelet agent abciximab is structurally related to

A) calcium channel blockers.
B) a bacterial enzyme.
C) the ADP receptor.
D) a vaccine.

Question 48

Which of the following actions will not reduce the effectiveness of acetylcysteine nebuliser solution used for the treatment of cystic fibrosis?

A) Making contact between the acetylcysteine nebuliser solution and rubber.
B) Making contact between the acetylcysteine nebuliser solution and iron.
C) Making contact between the acetylcysteine nebuliser solution and copper.
D) Diluting the acetylcysteine nebuliser solution with equal volumes of sodium chloride 0.9%.

Question 49

The mechanism of action of the antihyperlipidaemic agents called the statins involves:

A) inhibition of the rate-limiting enzyme in hepatic cholesterol synthesis.
B) binding to bile salts removing them from the body.
C) an interaction with peroxisome proliferator-activated receptor alpha.
D) inhibiting the absorption of dietary cholesterol from the gastrointestinal tract.

Question 50

Which of the following chemical mediators can alter blood pressure via vasodilation?

A) Nitric oxide
B) Endothelin-1
C) ANF
D) Vasopressin

Question 51

Which one of the following antihypertensive drug groups is thought to reduce sympathetic drive in the myocardium and mediate the release of renin?

A) β-blockers.
B) Calcium channel antagonists.
C) Angiotensin II receptor antagonists.
D) Thiazides.

Question 52

Which of the following antihypertensive agents should be avoided in a person with depression?

A) Calcium channel blockers.
B) Centrally acting agents.
C) Angiotensin II antagonists.
D) ACE inhibitors.

Question 53

Which one of the following is an endogenous substance known to inhibit coagulation?

A) cAMP.
B) Thromboxane A₂.
C) ADP.
D) von Willebrand factor.

Question 54

Infusing a hypotonic solution will have which of the following cellular effects?

A) There will be no net shift of fluid.
B) Fluid will shift from the intracellular space to dilute the extracellular space causing cell shrinkage.
C) Sodium will move from the extracellular space into the intracellular space.
D) Fluid will shift from the extracellular space to a more concentrated intracellular space causing cell swelling.

Question 55

The main site of action of the potassium-sparing diuretic spironolactone is the:

A) proximal convoluted tubule.
B) ascending limb of Henle.
C) distal convoluted tubule.
D) glomerulus.

Question 56

Calcium channel blockers have which of the following effects?

A) Depressed cardiac contractility.
B) Depressed cardiac conduction.
C) Reduced vascular tone.
D) All of the above.

Question 57

To avoid ototoxicity, intravenous (IV) frusemide must be injected no faster than 4 mg/min. If the dose ordered is 20 mg IV how quickly can it be administered?

A) Over at least 5 minutes.
B) Over at least 4 minutes.
C) Over at least 12 seconds.
D) Over at least 10 minutes

Question 58

Which of the following nitrate formulations is not used to prevent angina symptoms?

A) Oral isosorbide dinitrate controlled-release tablets.
B) Oral isosorbide mononitrate controlled-release tablets.
C) Transdermal glyceryl trinitrate.
D) Sublingual isosorbide dinitrate.

Question 59

Metabolic imbalances associated with thiazides can be avoided by:

A) starting off with a small dose and titrating according to therapeutic response.
B) starting off with a high dose and gradually titrating according to therapeutic response.
C) administering the dose once a day.
D) administering the dose two times a day.

Question 60

Clients on atorvastatin should avoid ________ during therapy because it may increase the amount of atorvastatin in their circulation and therefore increase the chances of adverse effects occurring.

A) alcohol
B) milk
C) grapefruit juice
D) leafy green vegetables

Question 61

Nasal decongestants are contraindicated in patients taking

A) antihistamines.
B) certain types of antidepressants.
C) antitussive agents.
D) salicylate preparations.

Question 62

The cardiac glycoside digoxin is also known as

A) digitalis.
B) ACE.
C) carvedilol.
D) captopril.

Question 63

High doses of vitamin B12 may cause

A) hypotension.
B) hypokalaemia.
C) constipation.
D) folate deficiency.

Question 64

The absorption of iron in the gut may be enhanced by

A) vitamin A.
B) vitamin E.
C) vitamin C.
D) folate.

Question 65

Hyoscine is contraindicated in patients with

A) glaucoma.
B) depression.
C) heart failure.
D) diabetes.

Question 66

Adverse effects such as an unproductive cough and taste disturbances may occur from which category of medicine frequently used for treatment of heart failure?

A) Diuretics.
B) Aldosterone antagonists.
C) Cardiac glycosides.
D) ACE inhibitors.