Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 21

Question 1

Type: MCSA

What is the correct medical term used to describe impaired blood flow in the coronary arteries?

1. Myocardial infarction
2. Angina pectoris
3. Cerebrovascular accident
4. Coronary heart disease

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 330

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21-1 Describe how the myocardium receives its oxygen and nutrient supply.

Question 2

Type: MCSA

The nurse is describing angina to a family member of a client recently diagnosed with the condition. Which characterization of angina is the most appropriate?

1. Chest pain on physical exertion or emotional stress
2. Slow heart rate and difficulty standing
3. Difficulty breathing and increased temperature
4. Sudden weakness with severe headache

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 330

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21-2 Explain the pathophysiology of angina pectoris.

Question 3

Type: MCSA

A client asks the nurse to explain the difference between stable and unstable angina. What is the best response by the nurse?

1. “Stable angina is predictable in its frequency, intensity, and duration. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest.”
2. “"Unstable angina is caused by spasms of the coronary arteries. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest.”
3. “Unstable angina is predictable in its frequency, intensity, and duration. Stable angina is when angina episodes become more frequent or severe, and occur during periods of rest.”
4. “Stable angina is caused by spasms of the coronary arteries. Unstable angina is when angina episodes become more frequent or severe, and occur during periods of rest.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 330

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-2 Explain the pathophysiology of angina pectoris.

Question 4

Type: MCMA

A client presents in the Emergency Department with chest pain. The nurse knows that which conditions can cause chest pain? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Arthritis
2. Peptic ulcer disease
3. Myocardial infarction
4. Gastric reflux
5. Pelvic inflammatory disease

Cognitive Level: Applying

Page Number: 331

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-2 Explain the pathophysiology of angina pectoris.

Question 5

Type: MCSA

The nurse recognizes the need for further teaching when the client makes which statement about lifestyle changes to reduce the development and progression of coronary artery disease?

1. “I will check my weight gain/loss regularly.”
2. “I’ll make sure to take my high blood pressure pills.”
3. “I am going to a smoking cessation class.”
4. “As long as I exercise, stress at my job will not bother me.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 331

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 21-3 Identify positive lifestyle changes that may be implemented to manage symptoms of angina.

Question 6

Type: MCSA

The client with angina is being discharged to home. The nurse is instructing the client on dietary changes. What should be included in this teaching?

1. Decrease salt and fat intake and limit alcohol intake.
2. There are no dietary restrictions for a person diagnosed with angina.
3. Limit smoking and increase protein and sugar intake.
4. Increase fruits, vegetables, and foods high in cholesterol.

Cognitive Level: Remembering

Client Need: Physiological Integrity

Page Number: 331

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-3 Identify positive lifestyle changes that may be implemented to manage symptoms of angina.

Question 7

Type: MCSA

A client arrives in the Emergency Department with severe chest pain. What is the best explanation by the nurse to differentiate angina from a myocardial infarction?

1. “Angina usually goes away with rest, and is rarely fatal, but a myocardial infarction requires immediate treatment, and can be life threatening.”
2. “There is no way to tell the difference between the two. You will be treated for a myocardial infarction.”
3. “Both are caused by a clot blocking the coronary arteries. Angina occurs if a small vessel is blocked, and a myocardial infarction occurs if a large vessel is blocked.”
4. “Angina does not cause severe chest pain, but a myocardial infarction always causes severe chest pain.”

Cognitive Level: Applying

Page Number: 330

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 20-2 Explain the pathophysiology of angina pectoris.

Question 8

Type: MCSA

A client has ordered a thrombolytic medication for treatment of CVA. Which type of stroke does the nurse know should not be treated with a thrombolytic?

1. Hemorrhagic stroke
2. Thrombotic stroke
3. Both types can be treated with a thrombolytic
4. Neither type can be treated with a thrombolytic

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 341

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-5 Describe the pharmacologic treatment of stroke.

Question 9

Type: MCSA

A client taking nitroglycerin (Nitrostat) complains of a headache. Which conclusion is most appropriate by the nurse?

1. A headache indicates a serious allergic reaction to nitroglycerin.
2. The client will not have a headache if the nitroglycerin is taken with a high-fat meal.
3. Nitroglycerin does not cause a headache.
4. The most common side effect of nitroglycerin is a headache.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 334

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-7 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain their mechanisms of drug action, primary actions, and important adverse effects as they relate to the treatment of angina, MI, or stroke.

Question 10

Type: MCMA

A client taking nitroglycerin (Nitrostat) for angina asks the nurse to explain possible side effects. What should be included in client teaching? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Reflex tachycardia
2. Hyperkalemia
3. Dizziness
4. Hyponatremia
5. Hypotension

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 334

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-7 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain their mechanisms of drug action, primary actions, and important adverse effects as they relate to the treatment of angina, MI, or stroke.

Question 11

Type: MCSA

A client has been prescribed diltiazem (Cardizem), and asks the nurse what type of drug this is. Which response by the nurse is most appropriate?

1. “A beta blocker.”
2. “A sodium channel blocker.”
3. “An alpha blocker.”
4. “A calcium channel blocker.”

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 337

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-7 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain their mechanisms of drug action, primary actions, and important adverse effects as they relate to the treatment of angina, MI, or stroke.

Question 12

Type: MCSA

A client has been prescribed several medications. Which medication is a beta blocker?

1. Atenolol (Tenormin)
2. Verapamil (Calan)
3. Captopril (Capoten)
4. Clopidogrel (Plavix)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 333

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-7 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain their mechanisms of drug action, primary actions, and important adverse effects as they relate to the treatment of angina, MI, or stroke.

Question 13

Type: MCSA

The client is being discharged with nitroglycerin (Nitrostat). What should the nurse include in the client education?

1. “Your chest pain should go away with one tablet.”
2. “If your chest pain doesn’t go away after three tablets, call 911; you might be having a heart attack.”
3. “If your chest pain doesn’t go away with one tablet, you can repeat the dose as many times as you need to.”
4. “Be sure to call 911 before you take any tablets.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 335

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-4 Explain the pharmacologic treatment of MI.

Question 14

Type: MCSA

The nurse is caring for a client who has chronic angina. Treatment for the condition has been unsuccessful. Which medication does the nurse anticipate will be prescribed?

1. Atenolol (Tenormin)
2. Nitroglycerin (Nitrostat)
3. Sildenafil (Viagra)
4. Ranolazine (Ranexa)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 332

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-4 Explain the pharmacologic treatment of MI.

Question 15

Type: MCSA

The nurse is preparing to administer atenolol (Tenormin) to a client with angina. Which vital sign would cause the nurse to question administering this drug?

1. Respirations 12 breaths per minute
2. Pulse 52 beats per minute
3. Blood pressure 134/72
4. Oxygen saturation 95%

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 336

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-7 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain their mechanisms of drug action, primary actions, and important adverse effects as they relate to the treatment of angina, MI, or stroke.

Question 16

Type: MCSA

Reteplase (Retavase) has been ordered for a client diagnosed with an MI. The nurse understands that this drug needs to be administered within which time frame following the onset of symptoms?

1. 45 minutes to 18 hours
2. 30 minutes to 12 hours
3. 90 minutes to 36 hours
4. 60 minutes to 24 hours

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 338

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-7 For each of the classes listed in the Drug Snapshot, identify representative drugs and explain their mechanisms of drug action, primary actions, and important adverse effects as they relate to the treatment of angina, MI, or stroke.

Question 17

Type: MCSA

Following a stroke, a client has been started on clopidogrel (Plavix). Why is this medication being administered?

1. To prevent stroke in high-risk patients, such as those with prosthetic heart valves
2. To decrease blood pressure
3. To increase heart rate
4. To provide antiplatelet activity in patients who cannot tolerate aspirin

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 341

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-5 Describe the pharmacologic treatment of stroke.

Question 18

Type: MCMA

A client presents in the Emergency Department with a suspected MI. Which medications should be given as soon as possible? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Clopidogrel (Plavix)
2. Morphine
3. Aspirin (ASA)
4. Metoprolol (Lopressor)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 341

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-4 Explain the pharmacologic treatment of MI.

Question 19

Type: MCSA

The client asks the nurse why an ACE inhibitor has been prescribed following an MI. What is the best response by the nurse?

1. “This medication will lower your potassium level.”
2. “ACE inhibitors have been found to reduce mortality following MI.”
3. “ACE inhibitors are always prescribed with a beta blocker and calcium channel blocker following an MI.”
4. “This medication will treat your hypotension.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 341

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-6 Categorize drugs used to treat angina, MI, and stroke based on their classification and mechanisms of action.

Question 20

Type: MCSA

Which drug class has been found to decrease mortality if given within 8 hours of an MI due to a decrease in cardiac workload?

1. Antiplatelet
2. Beta-adrenergic blockers
3. ACE inhibitors
4. Calcium channel blockers

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 341

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-6 Categorize drugs used to treat angina, MI, and stroke based on their classifications and mechanisms of action.

Question 21

Type: MCMA

A client has been prescribed a calcium channel blocker for angina. The nurse knows this medication should be used with caution in combination with which drug classes? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. NSAIDs
2. Cardiac glycosides
3. Beta blockers
4. Diuretics
5. Hypolipidemics

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 337

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-6 Categorize drugs used to treat angina, MI, and stroke based on their classification and mechanisms of action.

Question 22

Type: MCMA

The client asks the nurse what common side effects of calcium channel blockers are. What should the nurse include in client teaching? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Headache
2. Constipation
3. Epistaxis
4. Edema of lower extremities
5. Dysuria

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 337

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-6 Categorize drugs used to treat angina, MI, and stroke based on their classification and mechanisms of action.

Question 23

Type: MCSA

The client asks the nurse why the nitrate patch needs to be off for 8 hours per day. What is the best response by the nurse?

1. “There is no reason to take the patch off each day.”
2. “The patch can be addictive; leaving it off reduces the addiction.”
3. “You should only leave the patch off for 15 minutes.”
4. “Leaving the patch off for 8 hours per day helps to delay the development of tolerance.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 334

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 21-6 Categorize drugs used to treat angina, MI, and stroke based on their classification and mechanisms of action.

Question 24

Type: MCSA

A client has been prescribed a drug to prevent angina pain. What is the first type of medication prescribed to prevent angina?

1. Beta blockers
2. Alpha blockers
3. Calcium channel blockers
4. Organic nitrates

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 336

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 21-6 Categorize drugs used to treat angina, MI, and stroke based on their classification and mechanisms of action.

Question 25

Type: MCMA

The nurse is caring for a client who has been diagnosed with angina. Which drug classes are used to treat angina? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Calcium channel blockers
2. Organic nitrates
3. Alpha blockers
4. Beta blockers
5. Diuretics

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 332

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 21-6 Categorize drugs used to treat angina, MI, and stroke based on their classification and mechanisms of action.

Question 26

Type: MCMA

Which parts of the body need continuous supply of oxygen and vital nutrients to support life and death? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Heart

2. Liver

3. Kidneys

4. Brain

5. Muscles

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 329

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 21-1 Describe how the myocardium receives its oxygen and nutrient supply.