Deck 30: Drugs for Dysrhythmias

Question 1

In a person with a sinus rhythm, the primary purpose of the AV node is to

A) pace the heart at 40-60 bpm.
B) delay the impulse from the SA node.
C) pace the heart at 60-100 bpm.
D) enhance the impulse from the SA node.

Answer 1

delay the impulse from the SA node.

Question 2

A person with a heart rate of 170 bpm and a normal QRS duration would most likely be experiencing a

A) tachydysrhythmia originating from the bundle branches.
B) tachydysrhythmia originating from the atria.
C) tachydysrhythmia originating from the ventricles.
D) tachydysrhythmia originating from the Purkinje fibers.

Answer 2

tachydysrhythmia originating from the atria.

Question 3

The patient receives verapamil (Calan). The patient tells the nurse that he is nervous about taking this medicine. What is the best response by the nurse?

A) "This medicine is safe, and most patients do very well with it."
B) "This medicine increases your blood pressure, but we will be monitoring that."
C) "This medicine has many side effects, but you should be okay."
D) "This medicine is a potassium channel blocker and is considered safe."

Answer 3

"This medicine is safe, and most patients do very well with it."

Question 4

Which statement best explains what happens to cardiac output when the heart rate gets extremely high?

A) Cardiac output is not generally affected by rapid heart rates.
B) Cardiac output lowers when the rapid rate doesn't allow enough time for complete filling of the heart chambers.
C) Cardiac output will continue to increase as long as the heart rate continues to increase.
D) Cardiac output will increase until the heart rate reaches 150 bpm, at which time it will no longer be affected.

Question 5

The nurse completes medication education with a patient who receives propranolol (Inderal). The nurse evaluates the education as effective when the patient makes which statement?

A) "I must take my pulse every day and call my doctor if it is higher than 100."
B) "I must call my doctor if my anxiety increases and I start worrying again."
C) "I must take my pulse every day and call my doctor if it is less than 60."
D) "I must call my doctor if I lose more than three pounds a week."

Question 6

The nurse is teaching a class on rhythm abnormalities to patients who have experienced dysrhythmias. Which information would the nurse include in this teaching?

A) "Dysrhythmias cause serious electrolyte imbalances; this results in heart block."
B) "Dysrhythmias are the result of long-standing, uncontrolled hypertension."
C) "Dysrhythmias interrupt the normal electrical pathways in the heart so it can't beat properly."
D) "Dysrhythmias alter the blood flow through the heart and cause it to stop beating."

Question 7

The patient asks the nurse, "My doctor said I need cardioversion for my dysrhythmia. Why can't I just take medication?" What is the nurse's best response?

A) "Antidysrhythmic medications have many side effects; cardioversion is considered safer."
B) "Special diets are necessary with antidysrhythmic medications, and they are hard to follow."
C) "Antidysrhythmic medications don't really work very well for most dysrhythmias."
D) "There is a high risk of seizures when you take antidysrhythmic medications."

Question 8

The patient receives amiodarone (Cordarone). The nurse would be concerned about which additional medication that a consulting physician prescribed?

A) Oxycodone (OxyContin)
B) Omeprazole (Prilosec)
C) Digoxin (Lanoxin)
D) Fluoxetine (Prozac)

Question 9

Rillation. Is this serious and how is it treated?" What are the best responses by the nurse?

A) "This condition is best treated with what we call antidysrhythmic drugs."
B) "This is very common; your doctor will discuss the best treatment with you."
C) "Depending on your symptoms, your doctor may use an electrical shock."
D) "This is quite serious; did your doctor mention a heart transplant?"
E) "It is very serious, even more serious than a ventricular dysrhythmia."

Question 10

The patient receives verapamil (Calan). The patient asks the nurse if it is okay to take herbal supplements with this medicine. What is the best response by the nurse?

A) "Using herbal supplements may increase your blood pressure too much."
B) "Herbal supplements are okay as long as you take calcium salts with them."
C) "Using herbal supplements may lower your blood pressure too much."
D) "Most herbal supplements are okay, but you should avoid St. John's wort."

Question 11

The patient is receiving procainamide hydrochloride (Pronestyl) for treatment of a dysrhythmia. What is the best patient outcome for medication compliance?

A) The patient will take his medication with food.
B) The patient will take his medication on an empty stomach.
C) The patient will take his medication as directed, even if he is feeling well.
D) The patient will monitor his pulse and hold his medication if his pulse is less than 60.

Question 12

The physician has ordered amiodarone (Cordarone). Prior to starting this medication, the nurse would alert the physician to which laboratory result?

A) Sodium 140 mEq/L
B) Potassium 3.1 mEq/L
C) Potassium 4.9 mEq/L
D) International normalized ratio (INR) of 12 seconds

Question 13

Which adverse effect is shared among all antidysrhythmic drugs?

A) Edema
B) Impotence
C) Photosensitivity
D) Prodysrhythmic effects

Question 14

The male patient has been receiving propranolol (Inderal) for treatment of a dysrhythmia for 6 weeks. What is an important question for the nurse to ask the patient when assessing medication compliance?

A) "Have you noticed any changes in your sexual functioning?"
B) "Has your appetite increased or decreased?"
C) "Have you noticed any changes in your bowel function?"
D) "Have you noticed any difficulty in your ability to concentrate?"

Question 15

The nurse is managing care for a group of patients receiving antidysrhythmic medication. Which assessment data will the nurse discuss with the prescriber as adverse effects of these medications?

A) Depression, irritability, fatigue, and nausea
B) Anorexia, insomnia, confusion, and 2+ pitting peripheral edema
C) Low-grade fever, diaphoresis, weakness, and dry mucous membranes
D) Palpitations, chest pain, weakness, and fatigue

Question 16

The patient tells the nurse, "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?" What are the nurse's best responses?

A) "Conduction through the bundle of His is the slowest in the heart."
B) "Conduction begins in the sinoatrial (SA) node and travels to the atrioventricular (AV) node."
C) "Conduction continues through the bundle branches to the Purkinje fibers."
D) "Conduction travels from the atrioventricular (AV) node through the bundle of His."
E) "The sinoatrial (SA) node is located in the left atrium."

Question 17

Depolarization occurs when which two electrolytes rush into the cell?

A) Sodium and potassium
B) Calcium and magnesium
C) Calcium and sodium
D) Chloride and potassium

Question 18

The patient says to the nurse, "My neighbor said my antidysrhythmic drug can actually cause me to have irregular heartbeats. How can this be?" What is the nurse's best answer?

A) "Your medication blocks the flow of the electrolytes in your heart, and this can cause irregular beats."
B) "It is better to discuss your medication concerns with a professional, not a lay person like your neighbor."
C) "You must take two baby aspirins every other day to avoid the irregular heartbeats."
D) "Your medication is not the problem; it is when you mix it with over-the-counter (OTC) drugs that you develop irregular beats."

Question 19

The nurse has been teaching a class on dysrhythmias to a group of patients with this disorder. The nurse determines that teaching has been effective when a patient makes which statement?

A) "Our sodium, potassium, and magnesium levels must be okay for our hearts to have an electrical impulse."
B) "Potassium is the most important electrolyte when it comes to the electrical impulse in our hearts."
C) "Our sodium, potassium, and calcium levels must be okay for our hearts to have an electrical impulse."
D) "Enhancing potassium and sodium is how our medications will work to prevent dysrhythmias."

Question 20

The patient with type 1 diabetes mellitus is receiving propranolol (Inderal). What is the best outcome for this patient?

A) The patient will maintain blood glucose within normal limits.
B) The patient will decrease the required number of calories/day.
C) The patient will maintain adequate peripheral circulation.
D) The patient will perform activities of daily living.

Question 21

The nurse and a home health patient have established this expected outcome: "The patient will be free from adverse effects of administration of verapamil (Calan)." Which finding indicates this outcome has not been met?

A) The patient complains of headache at each visit by the nurse.
B) The patient has 3+ edema in the ankles and feet.
C) The patient says, "Everything I eat tastes like metal."
D) The patient says, "I got so dizzy yesterday that I had to lie down for a while."
E) The patient's face is flushed.

Question 22

The nurse is providing community education about heart disease. Place the following steps of the cardiac conduction pathway in the order the nurse would present them.

A) Action potential moves over the bundle branches
B) Action potential moves through the AV node
C) SA node generates an action potential
D) Action potential travels across the bundle of His
E) Action potential crosses the Purkinje fibers.
Standard Text: Click and drag the options below to move them up or down.

Question 23

Which antidysrhythmic agent also dilates coronary arteries and is frequently used to treat angina?

A) Verapamil (Calan)
B) Amiodarone (Cordarone)
C) Procainamide (Pronestyl)
D) Lidocaine (Xylocaine)

Question 24

Which drug would be indicated for treating ventricular tachycardia?

A) Lidocaine (Xylocaine)
B) Verapamil (Calan)
C) Diltiazem (Cardizem)
D) Atropine (Atropair)

Question 25

A patient who has been taking medication for a month for an atrial dysrhythmia returns to the clinic for a checkup. Which statements indicate the nurse should plan extra time with the patient for additional teaching?

A) "Since I can't drink coffee anymore, I have started drinking diet cola in the mornings."
B) "I have found that a glass of wine after work and one with dinner helps me to relax from my stressful job."
C) "We have celebrated several birthdays since I saw you last. I love chocolate birthday cake."
D) "I have really worked at stopping my smoking since I was last here."
E) "My friends and I have found several restaurants in our area that offer good, low-fat meals."

Question 26

A patient has been taking a potassium channel blocker for 4 weeks. Which statements would indicate to the nurse that additional time for teaching about the medication should be planned?

A) "I got some sunglasses like you said. Do you like them?"
B) "Do you have any idea what this rash on my neck and arm is?"
C) "I must be getting cataracts. I can't see anything anymore."
D) "I wear sunscreen whenever I am outdoors."
E) "I think that medicine is making my hair gray."

Question 27

A patient is prescribed an additional once-daily antidysrhythmic drug to control persistent atrial fibrillation. What instructions should the nurse provide for this patient?

A) "Take your first dose of this new medication before you go to bed tonight."
B) "Do not eat or drink anything for 2 hours after taking the new medication."
C) "Before you get out of bed in the morning, sit up on the side of the bed for a few minutes."
D) "Plan to return to the clinic to have your electrolytes checked in 2 weeks."
E) "Contact the clinic if you notice any loss of hair from your head."

Question 28

The nurse is writing a care plan for a patient who has been started on an antiarrhythmic drug for complaints of chest pain and palpitations. The patient says, "I can't do what I once did. I just do not have any energy." Which nursing diagnoses would the nurse likely include in this care plan?

A) Decreased Cardiac Output
B) Ineffective Breathing Pattern
C) Activity Intolerance
D) Ineffective Individual Coping
E) Impaired Gas Exchange

Question 29

Which drug is the primary agent for paroxysmal supraventricular tachycardia (PSVT)?

A) Flecainide (Tambocor)
B) Adenosine (Adenocard)
C) Lidocaine (Xylocaine)
D) Procainamide (Pronestyl)

Question 30

The nurse is providing information for a patient who will self-administer a twice-daily antidysrhythmic medication at home. The nurse would provide additional education if the patient makes which statement?

A) "If I get the flu, I should stop taking the medication until my fever goes down."
B) "I should take my doses as close to 12 hours apart as I can."
C) "If I forget a dose of medication I should take two pills for the next dose."
D) "If I can't take the medication for a couple of days because I am sick, I should call the clinic for advice."
E) "I should get my prescription refilled before I am completely out of medicine."