Deck 7: Drug Therapy of Coronary Atherosclerosis and Its Repercussions

Question 1

Nitrates _________.

A)should be used 24 hrs for at least 2 weeks at the beginning of therapy
B)may have their anti-anginal effect hastened by the patient if he/she leans back and takes short breaths
C)might be used 4-6 times before an attack is terminated
D)taken sublingually should produce a tingling or burning sensation

Answer 1

taken sublingually should produce a tingling or burning sensation

Question 2

Which one of the following statements concerning heparin is false?

A)It can be administered at different molecular weights.
B)It prevents the conversion of prothrombin to thrombin.
C)It is used to treat deep vein thrombosis, pulmonary embolism, and selected cases of MIs.
D)It can cause excessive bleeding, which cannot be easily stopped.

Answer 2

It can cause excessive bleeding, which cannot be easily stopped.

Question 3

Which of the following statements concerning thrombosis is false?

A)Platelet aggregator inhibitors are used prophylactically.
B)Anticoagulants are used to prevent formation or extension of a clot.
C)Thrombolytics are used to dissolve a clot.
D)All of the above

Answer 3

All of the above

Question 4

Aspirin _________.

A)inhibits platelet aggregation
B)inhibits the enzyme cyclooxygenase reversibly
C)is given as 80 mg per day for its anti-platelet effect
D)allows normal platelet function about 32 hours after cessation of therapy

Question 5

Which one of the following statements concerning warfarin is false?

A)It interferes with the synthesis of vitamin K dependent clotting factors.
B)Ingestion of large amounts of broccoli and cauliflower enhance its activity.
C)It should not be used during pregnancy.
D)It takes as many as 5 days to reach therapeutic levels.

Question 6

Patients using aspirin _________.

A)should be watched for bruising and joint swelling
B)and NSAIDs simultaneously experience reduced aspirin effects
C)can expect adverse GI-effects
D)and experiencing the first signs of a MI or stroke should take one 325 mg aspirin

Question 7

Which one of the following adverse effects is associated with nitroglycerin?

A)Hypertension
B)Throbbing headache
C)Bradycardia
D)Abdominal bloating

Question 8

You are treating a patient who is wearing a nitroglycerin transdermal patch.Which of the following interventions would be most contraindicated?

A)Dexterity training
B)Hand exercises with the aid of a biofeedback device
C)Ultrasound to the knee
D)Hot pack application to the left shoulder

Question 9

Thrombolytic agents _________.

A)facilitate the action of warfarin
B)must be given within 12 hrs of an MI
C)are given by infusion
D)can save all or some of the myocardium from the damaging effects of ischemia

Question 10

The role of nitrates in the treatment of angina is to do which of the following?

A)Reduce cardiac contractility
B)Enhance sodium excretion
C)Reduce preload and afterload
D)Increase the heart rate

Question 11

Which of the following statements is false?

A)Thromboxane A2 causes platelet aggregation.
B)Leukotrienes cause vasoconstriction.
C)Leukotrienes and thromboxane are formed by cyclooxygenase.
D)Thrombin converts fibrinogen to fibrin.

Question 12

Which one of the following is true regarding the administration of nitroglycerin?

A)Nitroglycerin patches should be worn for 24 hours at a time
B)Up to three sublingual doses may be administered within 15 minutes
C)Nitroglycerin is stable up to an unspecified time
D)Nitroglycerin can be exposed to light

Question 13

Which one of the following statements is false?

A)Bile acid binding drugs will remain in the intestines but can interfere with the action of other drugs.
B)Fibrates act to decrease lipoprotein lipase and increase the risk of kidney stones.
C)Niacin reduces free fatty acid mobilization and causes flushing and GI-upset.
D)A dark urine can be indicative of drug-induced muscle damage.

Question 14

Which of the following statements about statin drugs is false?

A)They inhibit endogenous formation of cholesterol.
B)They vary greatly in efficacy.
C)They carry the risk of liver and muscle damage.
D)Cost can be a factor in choosing the right drug.

Question 15

The major determinants of myocardial oxygen demand are all of the following except _________.

A)heart rate
B)contractility
C)coronary blood flow
D)wall stress

Question 16

Which one of the following combinations is false?

A)Nitrates can cause a throbbing headache.
B)Beta-blockers can cause dyspnea during exercise.
C)Calcium channel blockers can cause a severe cough.
D)All of the above

Question 17

Which one of the following interventions is contraindicated in patients receiving anticoagulant therapy?

A)Rigorous manual techniques
B)Chest percussions
C)Deep tissue massages
D)All of the above

Question 18

Thrombolytic agents are useful after a myocardial infarction to ______________.

A)act as an anticoagulant
B)lyse the blood clot
C)dilate the coronary arteries
D)constrict the coronary arteries

Question 19

Beta-blockers _________.

A)act by reducing heart rate and contractility
B)are beneficial in all types of angina
C)should not reduce heart rate below 80 beats/min
D)All of the above

Question 20

Which of the following statements concerning clopidogrel and ticlopidine is false?

A)They block prostaglandin induced platelet aggregation.
B)It takes about a week for normal platelet functions to recover after therapy has stopped.
C)They can cause increased bleeding episodes.
D)They can increase the risk of hemorrhagic strokes.

Question 21

The rehab therapist would monitor which of the following laboratory values to determine the effectiveness of oral anticoagulants (warfarin)?

A)Blood urea nitrogen
B)Activated partial thromboplastin time (APTT)
C)INR
D)Complete blood count (CBC)

Question 22

Your patient asks about the best way to store sublingual nitrates during travel to your clinic for therapy.The correct answer is which of the following?

A)Put one in a plastic bag and bring it to the clinic in your pocket.
B)Protect it from heat by transporting it in an ice chest.
C)Lock it in the glove compartment in your car.
D)Store it in the original container to keep it away from heat and light.

Question 23

A patient in ambulation training is on warfarin after a stroke.He is developing some tendonitis and is asking your opinion on which aspirin-type drug is better for pain,Aleve or Motrin.Your best response should be which of the following?

A)Inform the patient of the potential drug interactions with anticoagulants.
B)Inform the patient to administer a 650-mg dose of aspirin.
C)Explain that tendonitis is an expected outcome of therapy and it will improve shortly with more therapy.
D)Suggest that the patient take ibuprofen instead.

Question 24

Statins decrease lipid levels by which of the following mechanisms?

A)They prevent absorption of cholesterol through the GI tract.
B)They bind to bile, causing cholesterol to be excreted in the feces.
C)They block the HMG-CoA reductase enzyme.
D)They stimulate the excretion of dietary cholesterol.

Question 25

A patient who has been taking oral anticoagulants (warfarin)for stroke prevention is admitted to the emergency room with GI bleeding.The therapist should anticipate the patient receiving which of the following?

A)Vitamin K
B)Vitamin E
C)A plasmin supplement
D)Vitamin C

Question 26

When working with patients on statins,you should ask the patient to report which of the following side effects?

A)Muscle pain
B)Headache
C)Fatigue
D)Bruising

Question 27

Transdermal nitroglycerin patches are indicated for which of the following conditions?

A)To end angina
B)For use with ventricular fibrillation
C)To prevent angina
D)For use with type II heart block

Question 28

A patient who is taking sublingual nitrates reports dizziness after dosing.What should your response to the patient be?

A)Sit or lie down to prevent dizziness.
B)Drink water to wash any remaining nitrates out of the mouth.
C)Perform isometric fisting exercises.
D)Take a second nitrate.

Question 29

Which of the following represents a therapeutic dose of warfarin (oral anticoagulant)? An INR = _____________.

A)1 to 2
B)1.5 to 2.0
C)2.0 to 3.0
D)3.0 to 4.0

Question 30

Question 31