Question 1

The nurse is preparing to administer a bolus dose of verapamil (Calan)as follows:
"Give 5-mg bolus of verapamil,IV push,over 2 minutes.May repeat in 30 minutes if needed." The medication is available in a 2.5-mg/mL strength solution.Identify how many milliliters will the nurse draw into the syringe for this dose._______

2 mL

Accepted Answer

2 mL

Question 2

A patient is in the intensive care unit because of an acute myocardial infarction.He is experiencing severe ventricular dysrhythmias.The nurse will prepare to give which drug of choice for this dysrhythmia?

A) Diltiazem (Cardizem)
B) Verapamil (Calan)
C) Amiodarone (Cordarone)
D) Adenosine (Adenocard)

Amiodarone (Cordarone)

Accepted Answer

Amiodarone is the drug of choice for severe ventricular dysrhythmias in the setting of myocardial infarction. It has a wide range of effects on cardiac ion channels, and can correct both supraventricular and ventricular arrhythmias. Diltiazem and verapamil are both calcium channel blockers that are more typically used for supraventricular arrhythmias, while adenosine is primarily used for the treatment of paroxysmal supraventricular tachycardia.

Question 3

A patient will be discharged on quinidine sulfate (Quinidex)extended-release tablets for the treatment of ventricular ectopy.The nurse will include which information in the teaching plan?&#10;A) The medication should be stopped once the cardiac symptoms subside.&#10;B) Signs of cinchonism,such as tinnitus,loss of hearing,or slight blurring of vision,may occur.&#10;C) It is important to use sunscreen products when outside because of increased photosensitivity.&#10;D) If any tablet or capsule is visible in the stool,contact the prescriber immediately.

Accepted Answer

Quinidine sulfate is an antiarrhythmic medication that can cause cinchonism, a toxic reaction associated with quinine-like drugs. Symptoms of cinchonism include tinnitus, hearing loss, and blurred vision. Therefore, the nurse should include this information in the teaching plan to help the patient recognize these symptoms and report them to the prescriber. The medication should not be stopped abruptly without consulting the prescriber, and there is no evidence that quinidine sulfate causes photosensitivity or passes through in the stool.

Question 4

The nurse is reviewing the classes of antidysrhythmic drugs.Amiodarone (Cordarone)is classified on the Vaughan Williams classification as a class III drug,which means it works by which mechanism of action?

A) Blocking slow calcium channels
B) Prolonging action potential duration
C) Blocking sodium channels and affecting phase 0
D) Decreasing spontaneous depolarization and affecting phase 4

Accepted Answer

Class III drugs, such as amiodarone, work by prolonging the action potential duration.

Question 5

A 62-year-old man is to receive lidocaine as treatment for a symptomatic dysrhythmia.Upon assessment,the nurse notes that he has a history of alcoholism and has late-stage liver failure.The nurse will expect which adjustments to his drug therapy?

A) The dosage will be reduced by 50%.
B) A diuretic will be added to the lidocaine.
C) The lidocaine will be changed to an oral dosage form.
D) An increased dosage of lidocaine will be prescribed so as to obtain adequate blood levels.

Accepted Answer

Patients with liver disease have impaired metabolism and clearance of drugs, so the dosage of lidocaine should be reduced to avoid toxic effects. Adding a diuretic or changing the route of administration would not be necessary or helpful in this situation. Increasing the dosage would increase the risk of toxicity.

Question 6

The nurse notes in the patient's medication orders that the patient will be taking ibutilide (Corvert).Based on this finding,the nurse interprets that the patient has which disorder?&#10;A) Ventricular ectopy&#10;B) Atrial fibrillation&#10;C) Supraventricular tachycardia&#10;D) Bradycardia

Accepted Answer

Ibutilide (Corvert) is a medication used to convert atrial fibrillation to normal sinus rhythm. Therefore, the patient likely has atrial fibrillation.

Question 7

Which nursing diagnosis is appropriate for a patient receiving antidysrhythmics?&#10;A) Risk for infection&#10;B) Deficient knowledge&#10;C) Deficient fluid volume&#10;D) Urinary retention

Accepted Answer

Patients receiving antidysrhythmics may have a deficient knowledge regarding their medication, its effects, and potential side effects, making education an important aspect of care.

Question 8

The nurse is preparing to administer adenosine (Adenocard)to a patient who is experiencing an acute episode of paroxysmal supraventricular tachycardia.When giving this medication,which is important to remember?

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 therefore duration of action is very long.

Accepted Answer

Adenosine can cause a brief period of asystole after administration, which is expected and usually resolves quickly.

Question 9

When starting a patient on antidysrhythmic therapy,the nurse will remember that which problem is a potential adverse effect of any antidysrhythmic drug?&#10;A) Deficiency of fat-soluble vitamins&#10;B) Hyperkalemia&#10;C) Heart failure&#10;D) Dysrhythmias

Accepted Answer

One potential adverse effect of antidysrhythmic drugs is the development of new dysrhythmias, which can occur due to the drug's suppression of some rhythms while promoting others. Therefore, careful monitoring of heart rhythm is necessary during therapy. Options A, B, and C are not potential adverse effects of antidysrhythmic therapy.

Question 10

A patient is taking procainamide (Pronestyl)for a cardiac dysrhythmia.The nurse will monitor the patient for which possible adverse effect?&#10;A) Bradycardia&#10;B) Shortened QT interval&#10;C) Dyspnea&#10;D) Diarrhea

Accepted Answer

Diarrhea is a potential adverse effect of procainamide therapy. Prolonged QT interval on the ECG is also possible. The other options are incorrect.

Question 11

A patient is in the emergency department with a new onset of rapid-rate atrial fibrillation,and the nurse is preparing a continuous infusion.Which drug is most appropriate for this dysrhythmia?&#10;A) Diltiazem (Cardizem)&#10;B) Atenolol (Tenormin)&#10;C) Lidocaine&#10;D) Adenosine (Adenocard)

Accepted Answer

The answer of A patient is in the emergency department...

Question 12

A patient has been started on therapy of a continuous infusion of lidocaine after receiving a loading dose of the drug.The nurse will monitor the patient for which adverse effect?&#10;A) Drowsiness&#10;B) Nystagmus&#10;C) Dry mouth&#10;D) Convulsions

Accepted Answer

The answer of A patient has been started on therapy...

Deck 25: Antidysrhythmic Drugs