Exam 2-NCLEX practice questions

ALH 2202-General Pharmacology Exam 2-NCLEX practice questions

CHAPTER 18

The nurse has a prescription to infuse dobutamine (Dobutrex) intravenously at 3 mcg/kg/min in a pediatric patient with cardiac decompensation. The patient's weight is 77 lb. What is the correct dosage to administer?a)105 mcg/min The patient's weight of 77 lb is converted to kilograms by dividing 77 by 2.2, which equals 35 kg. 3 mcg/kg/min multiplied by 35 kg equals 105 mcg/min.The nurse has a prescription to infuse dopamine (Intropin) intravenously at 30 mcg/kg/min in an adult patient for cardiopulmonary arrest. If the patient weighs 143 lb, what is the correct dosage to administer?a)1950 mcg/min The patient's weight of 143 lb is converted to kilograms by dividing 143 by 2.2, which equals 65 kg. When 65 kg is multiplied by 30 mcg/kg/min, the result is 1950 mcg/min.The health care provider has prescribed dopamine (Intropin) to treat the patient’s hypovolemic shock secondary to severe blood loss. For the medication to be effective, the health care provider must also prescribe which treatment?

a) Fluid replacement

Dopamine increases blood pressure secondary to vasoconstriction, which has a limited effect if there is not enough volume within the circulatory system.

b) Temporary pacing

c) Beta-stimulating drugs

d) Induced hypothermia

A patient weighing 176 lb is to receive a dopamine (Intropin) continuous intravenous (IV) infusion at 5 mcg/kg/min. The solution strength available is dopamine 400 mg in 500 mL D5W. The nurse will infuse the medication at which rate?

• 30 mL/hr

The patient’s weight of 176 lb is converted to kilograms by dividing 176 by 2.2, which equals 80 kg. 5 mcg/kg/min multiplied by 80 kg equals 400 mcg, or 0.4 mg/min.Page 1

Dividing 0.4 mg/min by 400 mg/500 mL = 0.5 mL/min, which when multiplied by 60 minutes = 30 mL/hour.

• 50 mL/hr
• 40 mL/hr
• 20 mL/hr

When assessing for cardiovascular effects of an adrenergic (sympathomimetic) drug, the nurse understands that these drugs produce which effect on the heart?

a) A positive inotropic, positive chronotropic, and positive dromotropic effect

Adrenergic stimulation of the beta1-adrenergic receptors on the myocardium and in the conduction system of the heart results in an increased heart rate (positive chronotropic effect), increased contractility (positive inotropic effect), and increased conductivity (positive dromotropic effect).

b) A positive inotropic, negative chronotropic, and negative dromotropic effect

c) A negative inotropic, positive chronotropic, and positive dromotropic effect

d) A negative inotropic, negative chronotropic, and negative dromotropic effect

A hypertensive crisis may occur if adrenergic (sympathomimetic) drugs are given along with which of the following drug classes?

a) Alpha1 blockers

b) Direct renin inhibitors

c) Monoamine oxidase inhibitors (MAOIs)

Adrenergic drugs combined with MAOIs may cause a possibly life-threatening hypertensive crisis. All of the other drugs listed are used to treat hypertension.Page 2

d) Beta blockers

The nurse assesses the patient’s IV site, and it has infiltrated during the infusion of dopamine (Intropin).The nurse will prepare which medication to treat this infiltration?

a) Naloxone (Narcan)

b) Lidocaine (Xylocaine)

c) Phentolamine (Regitine)

Phentolamine is an alpha blocker that causes vasodilation, thus counteracting the vasoconstrictive effects of the infiltrated dopamine. The vasodilation will increase blood flow to the site and decrease the risk of tissue necrosis.

d) Nitroprusside (Nipride)

A patient using Afrin nasal spray complains of worsening cold symptoms and tells the nurse, “I don’t understand why this is not working. I am using it almost every 3 hours.” The nurse’s response is based on knowledge of which drug information?

a) The patient is experiencing rebound congestion related to excessive use of the

medication.Afrin nasal spray is a sympathomimetic drug with both alpha- and beta-adrenergic effects. The alpha-adrenergic activity is responsible for causing vasoconstriction in the nasal mucosa. However, excessive use of nasal decongestants can lead to greater congestion because of a rebound phenomenon that occurs when use of the product is stopped.

b) The medication needs to be used every 30 minutes for maximum effectiveness.

c) Afrin nasal spray may be minimally effective to relieve the nasal congestion.

d) Adrenergic decongestants should only be used prophylactically, not to treat acute congestion.

Epinephrine, as an adrenergic (sympathomimetic) drug, produces which therapeutic effect?Page 3

a) Urinary retention

b) Bronchial constriction

c) Decreased intestinal motility

d) Increased heart rate and contractility

Epinephrine causes sympathomimetic actions, including increased heart rate and contractility. The other effects listed are parasympathomimetic in nature.

CHAPTER 19

Nonselective beta blockers may be used to treat hypertension and what other condition?

a) Chronic obstructive pulmonary disease (COPD)

b) Heart failure

c) Supraventricular dysrhythmias

Nonselective beta blockers are used to treat supraventricular dysrhythmias secondary to their negative chronotropic effects (decreasing heart rate). They may exacerbate heart failure, COPD, and heart block secondary to their negative inotropic effect (heart failure), blocking of bronchodilation (COPD), and negative chronotropic effects (heart block).

d) Heart block

The nurse knows which drug is an example of a cardioselective beta blocker?

a) Atenolol (Tenormin)

At therapeutic dosages, atenolol selectively blocks only the beta1 receptors in the heart, not the beta2 receptors located in the lungs.

b) Sotalol (Betapace)

c) Labetalol (Normodyne)

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