Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 20

Question 1

Type: MCMA

Which disorders are associated with an increased risk for heart failure? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Diabetes
2. Coronary artery disease
3. Chronic hypertension
4. Myocardial infarction
5. Renal insufficiency

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 315

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 20-1 Identify the major risk factors associated with the progression to heart failure.

Question 2

Type: MCSA

The client asks the nurse to explain heart failure. Which statement should be included in the teaching by the nurse?

1. There are no known risk factors for developing heart failure.
2. Heart failure is the inability of the ventricles to pump enough blood to meet the body’s metabolic demands.
3. Medications, diet, and exercise can cure heart failure.
4. Heart failure is very uncommon in people over age 70.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 315

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-1 Identify the major risk factors associated with the progression to heart failure.

Question 3

Type: MCSA

A client who has a history of angina and hypertension now complains of fatigue, shortness of breath, and cough. Based on this assessment finding, what does the nurse suspect that the client might be developing?

1. Peripheral edema
2. Left-sided heart failure
3. Hypokalemia
4. Right-sided heart failure

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 316

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-2 Relate how the symptoms associated with heart failure may be caused by weakened heart muscle.

Question 4

Type: MCSA

A client has been diagnosed with right-sided heart failure. What does the nurse expect to observe when assessing this client?

1. Decreased body temperature
2. Increased body temperature
3. Fatigue, shortness of breath, and cough
4. Peripheral edema

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Page Number: 316

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 20-2 Relate how the symptoms associated with heart failure may be caused by weakened heart muscle.

Question 5

Type: MCMA

Which medications are the first choices of pharmacotherapy for heart failure? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Beta-adrenergic blockers
2. Phosphodiesterase inhibitors
3. ACE inhibitors
4. Diuretics
5. Alpha blockers

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 318

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-4 Identify drug classes that are used as first-line and second-line choices for the pharmacotherapy of heart failure.

Question 6

Type: MCMA

Which medications are second-choice pharmacotherapy for heart failure? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Beta-adrenergic blockers
2. Phosphodiesterase inhibitors
3. Diuretics
4. ACE inhibitors
5. Alpha blockers

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 319

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-4 Identify drug classes that are used as first-line and second-line choices for the pharmacotherapy of heart failure.

Question 7

Type: MCSA

A client has been prescribed furosemide (Lasix) for heart failure. What does the nurse know about furosemide (Lasix) in regards to its choice of treatment?

1. It is a first-choice pharmacotherapy.
2. It is a second-choice pharmacotherapy.
3. It is a third-choice pharmacotherapy.
4. It is a fourth-choice pharmacotherapy.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 318

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-4 Identify drug classes that are used as first-line and second-line choices for the pharmacotherapy of heart failure.

Question 8

Type: MCSA

A client has been prescribed lisinopril (Prinivil), and asks the nurse to explain the common side effects of this drug. What is the best response by the nurse?

1. “The most common adverse effects are headache, angioedema, and rash.”
2. “There are no common adverse effects of this medication.”
3. “The most common adverse effects are cough, dizziness, and orthostatic hypotension.”
4. “The most common adverse effects of this medication are hypertension, hypokalemia, and difficulty breathing.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 319

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-6 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain the mechanisms of drug action, primary actions, and important adverse effects.

Question 9

Type: MCSA

A client has been prescribed an ACE inhibitor to treat heart failure. Which medication is an ACE inhibitor?

1. Furosemide (Lasix)
2. Hydrochlorothiazide (Microzide)
3. Candesartan (Atacand)
4. Quinapril (Accupril)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 320

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-6 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain the mechanisms of drug action, primary actions, and important adverse effects.

Question 10

Type: MCSA

The physician tells the nurse that a thiazide diuretic has been prescribed for the client. The nurse expects which medication to be prescribed?

1. Spironolactone (Aldactone)
2. Hydrochlorothiazide (Microzide)
3. Eplerenone (Inspra)
4. Furosemide (Lasix)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 320

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-6 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain the mechanisms of drug action, primary actions, and important adverse effects.

Question 11

Type: MCSA

The nurse is teaching a client recently prescribed digoxin (Lanoxin). Which teaching point indicates the correct primary action of this medication?

1. It decreases blood pressure.
2. It increases the force of contraction.
3. It decreases respiratory rate.
4. It increases diuresis.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 321

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-6 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain the mechanisms of drug action, primary actions, and important adverse effects.

Question 12

Type: MCSA

The nurse checks the serum digoxin level for a client, and the result is 2.0 mg/mL. The nurse anticipates which medication to be ordered because of this level?

1. Digoxin immune fab (Ovine)
2. The same dose of digoxin (Lanoxin)
3. Furosemide (Lasix)
4. An increased dose of digoxin (Lanoxin)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 322

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-6 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain the mechanisms of drug action, primary actions, and important adverse effects.

Question 13

Type: MCMA

The client with digoxin (Lanoxin) toxicity might exhibit which symptoms? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Blurred vision
2. Tachycardia
3. Loss of appetite
4. Confusion
5. Bradycardia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 322

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-6 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain the mechanisms of drug action, primary actions, and important adverse effects.

Question 14

Type: MCMA

A client has been prescribed carvedilol (Coreg) to treat heart failure. Which statements are true regarding carvedilol (Coreg) and treatment of heart failure? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Carvedilol (Coreg) should not be used to treat heart failure.
2. Carvedilol (Coreg) has the potential to worsen heart failure.
3. Carvedilol (Coreg) slows the heart rate and decreases blood pressure.
4. Carvedilol (Coreg) is a first-line drug for treating heart failure.
5. Carvedilol (Coreg) should not be used with other medications when treating heart failure.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 323

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-6 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain the mechanisms of drug action, primary actions, and important adverse effects.

Question 15

Type: MCMA

The client has been prescribed a vasodilator for the treatment of heart failure. The nurse knows there are two vasodilators used to treat heart failure. Which vasodilators does the nurse anticipate? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Hydralazine (Apresoline)
2. Isosorbide dinitrate (Isordil)
3. Lisinopril (Prinivil)
4. Carvedilol (Coreg)
5. Furosemide (Lasix)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 323

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-6 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain the mechanisms of drug action, primary actions, and important adverse effects.

Question 16

Type: MCSA

The client is receiving milrinone (Primacor). Which side effect is potentially life-threatening for this drug?

1. Ventricular dysrhythmia
2. Hypokalemia
3. Hypernatremia
4. Angioedema

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 324

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-6 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain the mechanisms of drug action, primary actions, and important adverse effects.

Question 17

Type: MCMA

The nurse is caring for a client receiving ACE inhibitor therapy for heart failure. Which statements are true regarding ACE inhibitor treatment of heart failure? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. ACE inhibitors lower blood pressure.
2. ACE inhibitors reduce blood volume.
3. ACE inhibitors enlarge the heart’s pumping action.
4. ACE inhibitors increase cardiac output.
5. ACE inhibitors decrease the workload of the heart.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 320

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-5 Categorize heart failure drugs based on their classifications and mechanisms of action.

Question 18

Type: MCSA

Which medication is reserved for clients unable to tolerate the adverse effects of ACE inhibitors?

1. Bumetanide (Bumex)
2. Valsartan (Diovan)
3. Lisinopril (Prinivil)
4. Furosemide (Lasix)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 320

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-5 Categorize heart failure drugs based on their classifications and mechanisms of action.

Question 19

Type: MCSA

The nurse is caring for a client receiving furosemide (Lasix) for heart failure. What symptoms will the nurse monitor while the client is receiving this medication?

1. Symptoms of hypernatremia
2. Symptoms of increased WBCs
3. Symptoms of anemia
4. Symptoms of hypokalemia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 320

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-5 Categorize heart failure drugs based on their classifications and mechanisms of action.

Question 20

Type: MCSA

The nurse is instructing a group of students about the ability to increase the strength of a cardiac contraction. Which medical term is appropriate for the nurse to use when referring to this topic?

1. Positive inotropic effect
2. Negative chronotropic effect
3. Preload
4. Afterload

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 317

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-5 Categorize heart failure drugs based on their classifications and mechanisms of action.

Question 21

Type: MCSA

Which drug class, with a negative inotropic effect, is prescribed for the treatment of heart failure?

1. Diuretics
2. Cardiac glycosides
3. Beta-adrenergic blockers
4. Phosphodiesterase inhibitors

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Page Number: 322

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 20-5 Categorize heart failure drugs based on their classifications and mechanisms of action.

Question 22

Type: MCMA

Vasodilators have limited use due to which side effects? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Hypertension
2. Orthostatic hypotension
3. Blurry vision
4. Reflex tachycardia
5. Hypokalemia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 323

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 20-5 Categorize heart failure drugs based on their classifications and mechanisms of action.

Question 23

Type: MCSA

The nurse is caring for a client who has not responded well to other treatments for heart failure. Which drug class is used for 2–3 days when other drugs have failed?

1. Beta-adrenergic blockers
2. Phosphodiesterase inhibitors
3. Angiotensin-receptor blockers
4. Cardiac glycosides

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 324

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 20-5 Categorize heart failure drugs based on their classifications and mechanisms of action.

Question 24

Type: MCSA

The client is ordered to receive a cardiac glycoside. Which vital signs finding would make the nurse question administering this medication?

1. Blood pressure 119/66
2. Apical pulse 55 beats per minute
3. Temperature 99.4°F
4. Respirations 12 breaths per minute

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 324

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 20-5 Categorize heart failure drugs based on their classifications and mechanisms of action.

Question 25

Type: MCMA

Which are the three primary characteristics of heart function? (Select all that apply) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Blood pressure

2. Speed of conduction

3. Contractility of heart

4. Respirations

5. Heart rate

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 317

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 20-3 Describe the three fundamental characteristics of cardiac function.

Question 26

Type: MCSA

Heart failure clients have distinct signs and symptoms associated with the disease. Most drugs focus improving which characteristic of heart function?

1. Blood pressure

2. Heart rate

3. Contractility

4. Electrical impulse conduction

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 317

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 20-3 Describe the three fundamental characteristics of cardiac function.