Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 23

Question 1

Type: MCSA

What is the correct medical term for dysrhythmias that originate in the atria?

1. Supraventricular
2. Fibrillation
3. Heart block
4. Tachycardia

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 359

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 23-2 Classify dysrhythmias based on their location and type of conduction abnormality.

Question 2

Type: MCMA

The nurse educates the client on dysrhythmia. According to the nurse, which diseases are associated with dysrhythmias? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Arthritis
2. Hypertension
3. Strokes
4. Myocardial infarction
5. Diabetes

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 360

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 23-1 Identify patient symptoms associated with cardiac dysrhythmias.

Question 3

Type: MCSA

A client asks the nurse to explain how a normal heart works. Which statement by the nurse should be included in client teaching?

1. “The electrical impulse causes the ventricles to contract, and then the atria contract.”
2. “A normal resting heart rate is 50 beats per minute.”
3. “For the heart to function properly, the atria must contract simultaneously, sending their blood into the ventricles.”
4. “The heart generates electrical impulses that start in the atrioventricular node.”

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 360

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-3 Illustrate the flow of electrical impulses through the normal heart.

Question 4

Type: MCMA

Which disorders can cause an extra beat that often originates from a source other than the SA node? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Ventricular fibrillation
2. Premature ventricular contraction
3. Premature atrial contraction
4. Atrial fibrillation
5. Cardiogenic shock

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 360

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 23-2 Classify dysrhythmias based on their location and type of conduction abnormality.

Question 5

Type: MCSA

The client asks the nurse what the medical term for a slow heart rate is. Which response by the nurse is the most appropriate?

1. “Atrial fibrillation.”
2. “Bradycardia.”
3. “Premature ventricular contraction.”
4. “Tachycardia.”

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 360

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-1 Identify patient symptoms associated with cardiac dysrhythmias.

Question 6

Type: MCSA

A client has a heart rate of 130 beats per minute. How does the nurse plan to document this heart rate in the medical record?

1. Atrial fibrillation
2. Bradycardia
3. Tachycardia
4. Premature ventricular contraction

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 360

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-1 Identify patient symptoms associated with cardiac dysrhythmias.

Question 7

Type: MCSA

Most medications used to treat dysrhythmias block ion channels. Which ion is not blocked when treating dysrhythmia?

1. Magnesium
2. Sodium
3. Calcium
4. Potassium

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 362

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-4 Explain the importance of ion channels to cardiac function and the pharmacotherapy of dysrhythmias.

Question 8

Type: MCSA

The physician has ordered a nonpharmacologic therapy for a client diagnosed with bradycardia. The nurse anticipates what to be ordered for this client?

1. External defibrillation
2. Catheter ablation
3. Calcium channel blockers
4. Increased exercise

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Numbers: 363–364

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 23-5 Explain the basic mechanisms by which antidysrhythmic drugs act.

Question 9

Type: MCSA

The client asks the nurse how most medications for dysrhythmias work. What is the best response by the nurse?

1. “Blocking potassium, sodium, or calcium ion channels is the primary way to prevent or terminate dysrhythmias.”
2. “Most medications for dysrhythmias shorten the refractory period.”
3. “These medications will lower your blood pressure, which will change the rhythm of your heart.”
4. “The mechanism of these drugs is unknown.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 362

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-5 Explain the basic mechanisms by which antidysrhythmic drugs act.

Question 10

Type: MCMA

A client has been prescribed propranolol (Inderal) for a dysrhythmia. Which side effects noted in the nursing assessment might be related to propranolol (Inderal)? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Bradycardia
2. Tachycardia
3. Hypertension
4. Hypotension
5. Hyperglycemia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 367

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-7 Explain the role of beta-adrenergic blockers in treating dysrhythmias.

Question 11

Type: MCSA

The nurse caring for a client with a dysrhythmia understands the effects of which antidysrhythmic drug can last 4–8 weeks after the drug is discontinued because it has an extended half-life that can exceed 50 days?

1. Digoxin (Lanoxin)
2. Verapamil (Calan)
3. Propranolol (Inderal)
4. Amiodarone (Cordarone)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 368

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-8 Explain the role of potassium channel blockers in treating dysrhythmias.

Question 12

Type: MCSA

The client has just been started on procainamide (Procan SR). The nurse will assess for which common side effects?

1. Drowsiness and lethargy
2. GI upset and diarrhea
3. Anxiety and tremors
4. Confusion and dizziness

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 366

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-6 Explain the role of sodium channel blockers in treating dysrhythmias.

Question 13

Type: MCSA

The client has been started on propranolol (Inderal). What finding does the nurse expect?

1. Increased respiratory rate
2. Lowered heart rate
3. Higher oxygen saturation
4. Stabilized blood pressure

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 367

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-7 Explain the role of beta-adrenergic blockers in treating dysrhythmias.

Question 14

Type: MCSA

The client is receiving digoxin (Lanoxin) for a dysrhythmia. Why does the nurse expect medication levels in the blood to be monitored closely?

1. Digoxin causes ventricular dysrhythmias.
2. Excessive levels can produce serious dysrhythmias.
3. Subtherapeutic levels are fatal.
4. Interactions with other medications are common.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 369

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-10 Explain the role of digoxin and adenosine in treating dysrhythmias.

Question 15

Type: MCSA

The nurse is preparing to administer adenosine (Adenocard) to a client. What is the half-life for the medication?

1. 10 days
2. 10 seconds
3. 10 hours
4. 10 minutes

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 369

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-10 Explain the role of digoxin and adenosine in treating dysrhythmias.

Question 16

Type: MCMA

A client has been prescribed diltiazem (Cardizem). According to the nurse instructing the client, occurrence of which side effects should be notified to the physician? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Systolic blood pressure is less than 90 mmHg.
2. Dizziness occurs when standing up quickly.
3. Heart rate is less than 60 beats per minute.
4. Blood glucose increases.
5. Nausea and vomiting occurs.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 369

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-9 Explain the role of calcium channel blockers in treating dysrhythmias.

Question 17

Type: MCMA

The nurse is caring for a client with a dysrhythmia. The nurse anticipates this client may be placed on which classes of medications to treat dysrhythmias? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Sodium channel blockers
2. Potassium channel blockers
3. Magnesium channel blockers
4. Angiotensin channel blockers
5. Antihyperlipidemics

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Numbers: 362–363

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-4 Explain the importance of ion channels to cardiac function and the pharmacotherapy of dysrhythmias.

Question 18

Type: MCMA

A client has been prescribed a beta blocker for a dysrhythmia. Which side effects could be related to the beta blocker therapy? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Hypertension
2. Hypotension
3. Tachycardia
4. Bradycardia
5. Hyperkalemia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 367

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-7 Explain the role of beta-adrenergic blockers in treating dysrhythmias.

Question 19

Type: MCSA

The physician orders a potassium channel blocker for a client. Which medication would the nurse anticipate the physician to order?

1. Amiodarone (Cordarone)
2. Acebutolol (Sectral)
3. Lidocaine (Xylocaine)
4. Mexiletine (Mexitil)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 367

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-8 Explain the role of potassium channel blockers in treating dysrhythmias.

Question 20

Type: MCMA

A client asks the nurse why an antidysrhythmic drug is not prescribed for prophylaxis. Which statement should the nurse include in the response? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. “You should speak with your physician about receiving a prescription for prophylaxis.”
2. “These drugs are only prescribed for prophylaxis if you have a family history of dysrhythmias.”
3. “Research studies have found that the use of antidysrhythmic medications for prophylaxis can actually increase patient mortality.”
4. “Antidysrhythmics have the ability not only to correct dysrhythmias but also to worsen or even create new dysrhythmias.”
5. “These drugs cannot be prescribed for prophylaxis since you have a history of diabetes.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 363

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-2 Classify dysrhythmias based on their location and type of conduction abnormality.

Question 22

Type: MCSA

A client with cardiac rhythm disturbance is hospitalized during the initial stage of antidysrhythmic therapy. What is the best explanation to the client about the need for hospitalization?

1. High dosages of medication will have to be administered.
2. Continual ECG monitoring will be necessary.
3. The safety margin of dosing is very narrow.
4. The client will be able to recover sooner.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 363

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-2 Classify dysrhythmias based on their location and type of conduction abnormality.

Question 23

Type: MCSA

The nurse learns that the client has been started on sotalol (Betapace). What is the most likely rationale for this?

1. Hypertension
2. Serious ventricular dysrhythmia
3. Atrial dysrhythmia
4. Chronic atrial fibrillation

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 367

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-8 Explain the role of potassium channel blockers in treating dysrhythmias.

Question 24

Type: MCSA

The client has a dysrhythmia, and is started on a calcium channel blocker. What is the rationale for why this client is being treated with this type of medication?

1. Is not a candidate for an ICD
2. Will have fewer side effects
3. Has an atrial dysrhythmia
4. Will respond quicker

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 369

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-9 Explain the role of calcium channel blockers in treating dysrhythmias.

Question 25

Type: MCSA

The client with asthma has just been placed on a beta blocker for a dysrhythmia. What symptom should the nurse assess this client for due to the beta blocker?

1. Elevated blood pressure
2. Dizziness and fainting
3. Increased asthma attacks
4. Bradycardia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 367

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-7 Explain the role of beta-adrenergic blockers in treating dysrhythmias.

Question 26

Type: MCSA

A client asks the nurse about having a pacemaker placed in the “AV node”. Which statement by the nurse best describes a pacemaker placed in the AV node?

1. This pacemaker will generate an electrical signal from the atria to the ventricles.

2. This pacemaker will generate an electrical signal from the sinoatrial node.

3. This pacemaker will generate a mechanical disruption of force to the entire heart.

4. This pacemaker will generate a force of contraction from the ventricles to the atria.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 361

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-3 Illustrate the flow of electrical impulses through the normal heart.

Question 27

Type: MCSA

The client has just been started on disopyramide (Norpace). The client asks why they are getting so many ECGs. Which is the nurse’s best response?

1. The prescriber believes these are necessary.

2. The medication can cause new dysrhythmias to occur.

3. Insurance companies are suggesting this helps with treatment.

4. I will call the prescriber for clarification.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 366

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 23-6 Explain the role of sodium channel blockers in treating dysrhythmias.