Question 1

A patient has an order for carvedilol (Coreg)6.25 mg twice a day PO.The tablets are 3.125 mg.Identify how many tablets will the nurse administer per dose._______

Accepted Answer

2 tablets

Question 2

A 58-year-old man has had a myocardial infarction (MI),has begun rehabilitation,and is ready for discharge.He is given a prescription for metoprolol (Lopressor)and becomes upset after reading the patient education pamphlet."I don't have high blood pressure-why did my doctor give me this medicine?" Which explanation by the nurse is correct?

A) "This medication will prevent blood clots that may lead to another heart attack."
B) "Beta blockers will improve blood flow to the kidneys."
C) "This drug is prescribed to prevent the high blood pressure that often occurs after a heart attack."
D) "Studies have shown that this medication has greatly increased survival rates in patients who have had a heart attack."

Accepted Answer

Beta blockers are frequently given to patients after they have suffered an MI because of their cardioprotective properties. The other responses are incorrect.

Question 3

During therapy with a beta blocker,the patient notices that she has swollen feet,has gained 3 pounds within 2 days,feels short of breath even when walking around the house,and has been dizzy.The nurse suspects that which of these is occurring?

A) The patient is experiencing an allergic reaction.
B) The patient may be developing heart failure.
C) More time is needed for the patient to see a therapeutic response to the drug.
D) The patient is experiencing expected adverse effects of the drug.

Accepted Answer

The symptoms described suggest that the patient may be developing heart failure, which is a potential side effect of beta blockers. Swollen feet, sudden weight gain, and shortness of breath are all indicators of fluid buildup in the body, which is a common symptom of heart failure. Dizziness can also be a symptom of heart failure due to reduced blood flow to the brain. The nurse should notify the healthcare provider and monitor the patient closely for further signs and symptoms of heart failure.

Question 4

During initial rounds,the nurse notes that a dobutamine infusion has extravasated into the forearm of a patient.After stopping the infusion,the nurse follows standing orders and immediately injects phentolamine (Regitine)subcutaneously in a circular fashion around the extravasation site.What is the mechanism of action of the phentolamine in this situation?

A) It neutralizes the extravasated dobutamine immediately.
B) It causes arterial vasoconstriction and reduced pain and swelling at the site.
C) It increases peripheral vascular resistance and reduces arterial pressure at the site.
D) It increases blood flow to the ischemic site by vasodilation to prevent tissue damage.

Accepted Answer

Phentolamine is a non-selective alpha-adrenergic antagonist that causes vasodilation, increasing blood flow to the area and helping to prevent tissue damage from the extravasated dobutamine.

Question 5

A patient is experiencing diastolic heart failure.The nurse expects which beta blocker to be ordered for this patient?&#10;A) Atenolol (Tenormin)&#10;B) Carvedilol (Coreg)&#10;C) Acebutolol (Sectral)&#10;D) Esmolol (Brevibloc)

Accepted Answer

Carvedilol is a non-selective beta blocker with alpha-blocking properties, making it effective in treating both systolic and diastolic heart failure. It also has antioxidant properties which may be helpful in reducing oxidative stress in the heart. Atenolol, Acebutolol, and Esmolol are cardioselective beta blockers and may not be as effective in treating diastolic heart failure.

Question 6

A patient is taking an alpha blocker as treatment for benign prostatic hyperplasia.The nurse will monitor for which potential drug effect?&#10;A) Orthostatic hypotension&#10;B) Increased blood pressure&#10;C) Decreased urine flow&#10;D) Discolored urine

Accepted Answer

Alpha blockers can cause relaxation of smooth muscle in blood vessels, which can result in orthostatic hypotension (a sudden drop in blood pressure when standing up).

Question 7

During a teaching session about self-monitoring while taking a beta blocker at home,the nurse has taught the patient to take his apical pulse daily for 1 minute.If the pulse rate decreases to less than 60 beats/min,the nurse will instruct the patient to:

A) notify his prescriber.
B) reduce the dose of his beta blocker by half.
C) continue the medication because this is an expected effect.
D) skip the medication dose that day,and check his pulse again the next day.

Accepted Answer

A heart rate less than 60 beats/min while taking a beta blocker can indicate bradycardia and should be reported to the prescriber. Adjustments to the medication may need to be made to prevent further complications.

Question 8

The teaching for a patient who is taking tamsulosin (Flomax)to reduce urinary obstruction due to benign prostatic hyperplasia will include which of these?&#10;A) Fluids need to be restricted while on this medication.&#10;B) Take the medication with breakfast to promote the maximum effects of the drug.&#10;C) Get up slowly from a sitting or lying position.&#10;D) Blood pressure must be monitored because the medication may cause hypertension.

Accepted Answer

Tamsulosin can cause postural hypotension, so patients should be advised to get up slowly from sitting or lying positions to avoid falls. Restricting fluids is not necessary while taking tamsulosin. The medication can be taken with or without food. Tamsulosin does not typically cause hypertension, although it can lower blood pressure.

Question 9

A 49-year-old patient is in the clinic for a follow-up visit 6 months after starting a beta blocker for treatment of hypertension.During this visit,his blood pressure is 169/98 mm Hg,and he eventually confesses that he stopped taking this medicine 2 months ago because of an "embarrassing problem." What problem did the patient most likely experience with this medication that caused him to stop taking it?

A) Urge incontinence
B) Dizziness when standing up
C) Excessive flatus
D) Impotence

Accepted Answer

Beta blockers are known to cause sexual dysfunction, including impotence, in some patients. This may be an embarrassing problem for the patient, leading them to discontinue the medication.

Question 10

A patient is going home with a new prescription for the beta-blocker atenolol (Tenormin).The nurse will include which content when teaching the patient about this drug?&#10;A) Never stop taking this medication abruptly.&#10;B) The medication will be stopped once symptoms subside.&#10;C) If adverse effects occur,stop taking the drug for 24 hours,and then resume.&#10;D) Be watchful for first-dose hypotension.

Accepted Answer

Patients need to be weaned off these medications slowly because rebound hypertension and chest pain are possible with abrupt withdrawal. The drugs should never be stopped abruptly nor doses skipped. First-dose hypotension occurs with alpha blockers.

Question 11

The nurse is screening a patient who will be taking a nonspecific/nonselective beta blocker.Which condition,if present,may cause serious problems if the patient takes this medication?&#10;A) Angina&#10;B) Hypertension&#10;C) Glaucoma&#10;D) Asthma

Accepted Answer

The answer of The nurse is screening a patient who...

Question 12

A patient has a new prescription for tamsulosin (Flomax)as treatment for benign prostatic hyperplasia.The nurse is checking his current medication list and will contact the prescriber regarding a potential interaction if the patient is also taking which drug?

A) Levothyroxine (Synthroid)for hypothyroidism
B) Sildenafil (Viagra),an erectile dysfunction medication
C) Omeprazole (Prilosec),a proton pump inhibitor
D) Low-dose aspirin for stroke prevention

Accepted Answer

The answer of A patient has a new prescription for...

Deck 19: Adrenergic-Blocking Drugs