Question 1

Which of the following are adverse effects associated with the use of procainamide (Procan SR)?&#10;A)Tinnitus&#10;B)Shortened QT interval&#10;C)Constipation&#10;D)Diarrhea

Accepted Answer

Diarrhea is a potential side effect of procainamide therapy.

Question 2

A patient has been started on lidocaine (Xylocaine).The nurse will monitor the patient for which of the following adverse effects of this drug?&#10;A)Drowsiness&#10;B)Nystagmus&#10;C)Dry mouth&#10;D)Convulsions

Accepted Answer

Convulsions are possible with an overdose of lidocaine.

Question 3

What is the drug of choice for acute ventricular dysrhythmias associated with myocardial infarction (MI)?&#10;A)diltiazem (Cardizem)&#10;B)bretylium&#10;C)lidocaine (Xylocaine)&#10;D)adenosine (Adenocard)

Accepted Answer

Lidocaine is the drug of choice for acute ventricular dysrhythmias associated with MI.
Bretylium is used when patients do not respond to lidocaine or other medications.

Question 4

Which of the following should be monitored closely in a patient who is taking class IV antidysrhythmics?&#10;A)Urine output and specific gravity&#10;B)Temperature and skin turgor&#10;C)Heart rhythm and blood pressure&#10;D)Level of consciousness

Accepted Answer

Patients receiving class IV antidysrhythmics initially or having their doses altered must have their heart rhythm monitored by electrocardiogram (ECG).In addition,blood pressure and other vital signs need to be monitored frequently.

Question 5

The nurse needs to administer adenosine (Adenocard)to a patient who is experiencing an acute episode of paroxysmal supraventricular tachycardia (PSVT).What important information should the nurse remember when giving this medication?

A)The onset of action occurs in 5 minutes.
B)The medication must be given as a slow intravenous (IV)push.
C)Asystole may occur for a few seconds after administration.
D)The medication has a long half-life,and the duration of action is very long.

Accepted Answer

A very brief episode of asystole may occur after administration of adenosine.
Adenosine has an extremely short half-life of less than 10 seconds,its onset occurs within 1 minute,and it must be given as a fast IV push medication.

Question 6

Which of the following instructions is appropriate for the nurse to tell a patient taking an antidysrhythmic drug? Select all that apply.&#10;A)Do not chew or crush extended-release forms of medication.&#10;B)Capsules may be opened if they cannot be swallowed.&#10;C)Take the medication with food if gastrointestinal distress occurs.&#10;D)If a dose is missed,the missed dose should be taken with the next dose that is due.&#10;E)Take the medications with an antacid if gastrointestinal distress occurs.&#10;F)Limit or avoid the use of caffeine.g.Presence of a capsule in the stool should be reported to the physician immediately.

Accepted Answer

"Do not chew or crush extended-release forms of medication," "Take the medication with food if gastrointestinal distress occurs," and "Limit or avoid the use of caffeine" reflect appropriate instructions for the patient taking an antidysrhythmic drug.
Capsules should not be opened,and medications should not be taken with an antacid.The presence of a portion of a capsule or tablet in the stool is actually the wax matrix that carried the medication,which has been absorbed,and the physician does not need to be notified.Medication doses should not be doubled.

Question 7

Amiodarone is categorized on the Vaughan Williams classification as a Class III drug.Which of the following best describes how this drug works?&#10;A)By blocking slow calcium channels&#10;B)By prolonging action potential duration&#10;C)By blocking sodium channels and affecting phase 0&#10;D)By decreasing spontaneous depolarization and affecting phase 4

Accepted Answer

These drugs control dysrhythmias by inhibiting repolarization and prolonging refractoriness and the action potential duration (APD).

Question 8

Which of the following nursing diagnoses is appropriate for a patient receiving antidysrhythmics?&#10;A)Risk for infection&#10;B)Risk for injury to self&#10;C)Excess fluid volume&#10;D)Impaired skin integrity

Accepted Answer

Dizziness,fatigue,and orthostatic hypotension are possible adverse effects that may cause injury.

Question 9

A patient will be discharged on quinidine sulfate (Apo-Quin-G)extended-release tablets for the treatment of ventricular ectopy.What important information should the nurse tell the patient about this medication?

A)Stop the medication once the cardiac symptoms subside.
B)Signs of cinchonism,such as tinnitus,loss of hearing,or slight blurring of vision,may occur.
C)Sunscreen products should be used when outside because of an increased photosensitivity.
D)Any tablet or capsule visible in the stool indicates an absorption problem and should be reported immediately.

Accepted Answer

Quinidine,a cinchona alkaloid,may cause the symptoms of cinchonism.
The medication will need to be continued even after symptoms subside or the symptoms may return.Tablets or capsules that are visible in the stool are actually the wax matrixes;the medication is extracted while in the intestines.Photosensitivity occurs with Class III drugs,not with quinidine,which is a Class I-a drug.

Question 10

A 62-year-old male is to receive lidocaine (Xylocaine)as treatment for symptomatic episodes of ventricular tachycardia.He has been taking propranolol (Inderal)and digoxin (Lanoxin)at home,and his blood pressure (BP)is 100/56.Which of the following is considered a risk factor that may cause a toxic reaction to lidocaine?

A)Hypotension
B)Digoxin therapy
C)Age and diagnosis
D)Concurrent administration of propranolol

Accepted Answer

Lidocaine toxicity may result from the concurrent administration of propranolol.

Deck 23: Antidysrhythmic Drugs