Deck 14: Cardiovascular Medications

Question 1

If a patient prescribed a beta-blocker presents with a new onset of dyspnea,ankle edema,and orthopnea,which of the following actions would be the BEST next step for the physical therapist?

A)Monitor vital signs more closely and proceed with low-intensity exercise.
B)Defer treatment and discuss findings with the physician before resuming.
C)Monitor vital signs and incorporate interval training with frequent rest periods.
D)Discharge the patient from physical therapy and encourage the patient to visit a physician.

Answer 1

B
If a patient on a beta-blocker,regardless of the reason that they were initially put on the drug,begins to complain of new onset dyspnea,ankle or extremity edema,or orthopnea,or there are other signs/symptoms of heart failure,the appropriate physical therapy intervention is to defer treatment and discuss these findings with the physician before continuing with treatment.

Question 2

Which of the following types of drug receptors mediate the actions of neurotransmitters?

A)Enzymes
B)Regulatory proteins
C)Transport proteins
D)Structural proteins

Answer 2

B
Drug receptors are cellular macromolecules and generally are cellular proteins.Regulatory proteins mediate the actions of neurotransmitters,hormones,and autacoids.

Question 3

Which of the following processes must occur to initiate the formation of a thrombus at the site of an atherosclerotic lesion?

A)Platelet adhesion and aggregation
B)Release of agents that stimulate platelet aggregation
C)An injury to the vessel wall or blood cells
D)Activation of the clotting mechanism

Answer 3

C
Injury to the vascular wall and adjacent tissue (extrinsic)or injury to blood cells (intrinsic)is needed to provide a conducive surface on which the thrombus can form or to initiate conversion of prothrombin to thrombin and increased platelet aggregation and adherence.

Question 4

Which of the following tissue types has an affinity for MOSTLY extracellular calcium?

A)Striated muscle
B)Smooth muscle
C)Myocardium
D)Coronary veins

Question 5

Which of the following statements is MOST true regarding thrombolytic agents with a patient who is experiencing myocardial ischemia?

A)The effect is coronary vasodilation and decreased coronary artery spasm.
B)The effect is to facilitate the conversion of plasminogen to plasmin for clot lysis.
C)The effect is a decrease in systemic vascular resistance without an increase in heart rate.
D)The effect is to decrease the platelet's ability to adhere and aggregate at the site of injury.

Question 6

Which of the following BEST describes the advantage of parenteral drugs in the management of hemodynamic instability in an emergence or critical care settings?

A)Bioavailability is greater.
B)The first pass effect is greater.
C)Onset of drug action is slower.
D)Drug clearance is slow.

Question 7

The clinical method for myocardial oxygen demand assessment,double product or RPP,is determined by which of the following?

A)Direct measurement of oxygen consumed
B)Product of heart rate and systolic blood pressure
C)Product of heart rate and diastolic blood pressure
D)Product of respiratory rate and systolic blood pressure

Question 8

Which of the following organ is considered the principal organ of the first pass effect?

A)Stomach
B)Intestine
C)Liver
D)Kidney

Question 9

Which of the following autonomic receptors would MOST likely cause vasodilation of vascular smooth muscle or bronchodilation in the respiratory system?

A)Alpha₁
B)Beta₁
C)Beta₂
D)Nicotinic

Question 10

Which of the following situations related to side effects of thrombolytic agents would MOST likely occur during a physical therapy intervention?

A)Gastrointestinal bleeding
B)Genitourinary bleeding
C)Soft tissue injury
D)Excessive bleeding from manual shaving

Question 11

Administration of drugs to the body through a route that bypasses the absorption within the gastrointestinal system is BEST termed which of the following?

A)Enteral
B)Parenteral
C)Rectal
D)Transdermal

Question 12

Which of the following physiological changes is considered a negative effect of a prescribed nonselective beta-blocker to decrease myocardial oxygen demand?

A)Enhancing bronchospasm
B)Decreasing heart rate
C)Decreasing heart contractility
D)Decreasing blood pressure

Question 13

Which of the following group of drugs mimics the activity of the endogenous chemicals of the sympathetic nervous system?

A)Sympatholytics
B)Adrenergic antagonist
C)Adrenergic agonist
D)Cholinergic agonist

Question 14

Which of the following conditions would MOST likely lead to a decrease in myocardial oxygen demand?

A)Exercise
B)Increased systemic vascular resistance
C)Anemia
D)Use of beta-blockers

Question 15

If a patient in a physical therapy clinic takes a sublingual nitroglycerin tablet,which of the following side effects would MOST likely lead the physical therapist to encourage the patient to sit in a chair first?

A)Headache
B)Reflex tachycardia
C)Hypotension
D)Flushing of the skin

Question 16

Administering a medication at certain time intervals throughout the day by any route BEST describes which of the following components of pharmacokinetics?

A)Bioavailability
B)Distribution
C)Clearance
D)Dosage

Question 17

Which of the following factors contribute to compliance of a prescribed drug regimen?

A)Cost of the drugs
B)Poorly tolerated side effects and undesirable interactions
C)Difficulty with a complicated regimen
D)A prescriber who is sensitive to noncompliance factors

Question 18

Which of the following components does calcium MOST affect to facilitate a muscle contraction?

A)Actin
B)Myosin
C)Troponin
D)Tropomyosin

Question 19

A patient who presents with clinical symptoms of heart failure is BEST identified by which of the following heart failure stages?

A)Stage I
B)Stage II
C)Stage III
D)Stage IV

Question 20

Which of the following functions BEST describes pharmacodynamics?

A)Mechanism of the drug action
B)How the drug is absorbed
C)Availability of drug to be delivered (bioavailability)
D)Metabolism and excretion (clearance)

Question 21

Which of the following classes of antiarrhythmic agent drugs act as membrane depressants affecting the fast sodium channels?

A)Class I
B)Class II
C)Class III
D)Class IV

Question 22

In a critical care situation,management with which of the following drug classes would serve to reduce afterload on the heart in a patient with chronic heart failure?

A)Sympathetic antagonists
B)Diuretics
C)Cardiac glycosides
D)Calcium-channel blockers

Question 23

In a heart transplant patient,rejection that occurs in days to weeks after transplantation and is associated with an antibody BEST describes which of the following rejection types?

A)Hyperacute rejection
B)Acute cellular rejection
C)Acute humoral or vascular rejection
D)Chronic rejection

Question 24

Bipyridines inhibitors (positive inotrope medications)increase myocardial contractility by which of the following mechanisms?

A)Increase intracellular calcium influx by inhibition of cyclic nucleotide phosphodiesterase.
B)Inhibiting the sodium-potassium pump (Na+-K+ pump).
C)Stimulate Beta₁ adrenoceptors of the myocardium.
D)Stimulate Beta₁ myocardial receptors.

Question 25

A patient who is prescribed a combination of diuretics for hypertension should be monitored for symptoms associated with which of the following abnormalities before,during,or after an exercise session?

A)Hypotension
B)Arrhythmias
C)Altered mental status
D)All of the above

Question 26

A patient being evaluated as a home health patient is noted to be taking a diuretic and angiotensin-converting enzyme inhibitor.Which of the following statements describes BEST how this drug combination is acting to reduce the patient's hypertension?

A)Acts to reduce circulating fluid volume and inhibits the conversion of angiotensin I to angiotensin II.
B)Acts to reduce circulating fluid volume and acts as angiotensin II receptor antagonists.
C)Acts to reduce circulating fluid volume and acts directly on vascular smooth muscle cells to reduce peripheral vascular resistance.
D)Acts to reduce circulating fluid volume and acts to block beta adrenoreceptors in juxtaglomerular cells inhibiting release of rennin.

Question 27

Which of the following situations are considered recommendations to a patient with diabetes when participating in an exercise session?

A)Avoid exercise immediately after injection of insulin dose.
B)Avoid injecting insulin into muscle,but instead into subcutaneous tissue.
C)Avoid resistance training at moderate to high intensity.
D)Avoid eating snacks within 90 to 120 minutes of the exercise session.

Question 28

A patient presents with pulmonary congestion in which cardiac output is normal,but left ventricular filling pressure is elevated.Which of the following pharmacological therapies would be MOST appropriate?

A)Observation
B)Volume replacement
C)Diuretics
D)Use of circulatory assist agents

Question 29

Resting muscle pain is a common side effect of statin medication prescribed for dyslipidemia within the first few weeks.

Question 30

Impairment of effective drug elimination in an elderly patient is MOST likely related to poor functioning in which of the following organs?

A)Cardiac conduction system
B)Liver
C)Kidney
D)Body composition

Question 31

The goal for normal blood pressure in a child with ambulatory high blood pressure and obesity using drug therapy is which of the following values?

A)Less than 95th percentile based on gender and age
B)Less than 90th percentile based on gender and age
C)Less than 140 systolic and less than 90 diastolic
D)Less than 120 systolic and less than 80 diastolic