Pharmacology Cardiovascular Drugs NClex Questions

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Pharmacology: Cardiac Exam

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• 0.5 to 2.0 ng/mLA newly admitted client takes digoxin 0.25 mg/day. The nurse knows that which is

the serum therapeutic range for digoxin?

• 0.1 to 1.5 ng/mL
• 0.5 to 2.0 ng/mL
• 1.0 to 2.5 ng/mL
• 2.0 to 4.0 ng/mL
• It is in the high (elevated) range.The client's serum digoxin level is 3.0 ng/mL. What does the nurse know about this

serum digoxin level?

• It is in the high (elevated) range.
• It is in the low (decreased) range.
• It is within the normal range.
• It is in the low average range.
• Pulse below 60 beats/min and irregular rateThe nurse is assessing the client for possible evidence of digitalis toxicity. The

nurse acknowledges that which is included in the signs and symptoms for digitalis toxicity?

• Pulse (heart) rate of 100 beats/min
• Pulse of 72 with an irregular rate
• Pulse greater than 60 beats/min and irregular rate
• Pulse below 60 beats/min and irregular rate

• Increase the serum digoxin sensitivity levelThe client is also taking a diuretic that decreases her potassium level. The nurse

expects that a low potassium level (hypokalemia) could have what effect on the digoxin?

• Increase the serum digoxin sensitivity level
• Decrease the serum digoxin sensitivity level
• Not have any effect on the serum digoxin sensitivity level
• Cause a low average serum digoxin sensitivity level
• HeadachesWhen a client first takes a nitrate, the nurse expects which symptom that often

occurs?

• Nausea and vomiting
• Headaches
• Stomach cramps
• Irregular pulse rate
• Decrease heart rate and decrease myocardial

contractility.The nurse acknowledges that beta blockers are as effective as antianginals because they do what?

• Increase oxygen to the systemic circulation.
• Maintain heart rate and blood pressure.
• Decrease heart rate and decrease myocardial contractility.
• Decrease heart rate and increase myocardial contractility.
• The beta blocker should NOT be abruptly stopped; the

dose should be tapered down.The health care provider is planning to discontinue a client's beta blocker. What instruction should the nurse give the client regarding the beta blocker?

• The beta blocker should be abruptly stopped when another cardiac drug is

prescribed.

• The beta blocker should NOT be abruptly stopped; the dose should be tapered

down.

• The beta blocker dose should be maintained while taking another antianginal

drug.

• Half the beta blocker dose should be taken for the next several weeks.
• To block the beta1-adrenergic receptors in the cardiac

tissues The beta blocker acebutolol (Sectral) is prescribed for dysrhythmias. The nurse knows that what is the primary purpose of the drug?

• To increase the beta1 and beta2 receptors in the cardiac tissues
• To increase the flow of oxygen to the cardiac tissues
• To block the beta1-adrenergic receptors in the cardiac tissues
• To block the beta2-adrenergic receptors in the cardiac tissues
• "Apply the patch to a nonhairy area of the upper torso

or arm." A client is to be discharged home with a transdermal nitroglycerin patch. Which instruction will the nurse include in the client's teaching plan?

• "Apply the patch to a nonhairy area of the upper torso or arm."
• "Apply the patch to the same site each day."
• "If you have a headache, remove the patch for 4 hours and then reapply."
• "If you have chest pain, apply a second patch next to the first patch."

• Client stating that pain is 0 out of 10A nurse is monitoring a client with angina for therapeutic effects of nitroglycerin.

Which assessment finding indicates that the nitroglycerin has been effective?

• Blood pressure 120/80 mm Hg
• Heart rate 70 beats per minute
• ECG without evidence of ST changes
• Client stating that pain is 0 out of 10
• Chest painThe nurse is monitoring a client during IV nitroglycerin infusion. Which assessment

finding will cause the nurse to take action?

• Blood pressure 110/90 mm Hg
• Flushing
• Headache
• Chest pain
• "I can take up to five tablets at 3-minute intervals for

chest pain if necessary." Which statement made by the client demonstrates a need for further instruction regarding the use of nitroglycerin?

• "If I get a headache, I should keep taking nitroglycerin and use Tylenol for pain

relief."

• "I should keep my nitroglycerin in a cool, dry place."
• "I should change positions slowly to avoid getting dizzy."
• "I can take up to five tablets at 3-minute intervals for chest pain if necessary."
• Client states that she has no chest pain.Which client assessment would assist the nurse in evaluating therapeutic effects of

a calcium channel blocker?

• Client states that she has no chest pain.
• Client states that the swelling in her feet is reduced.
• Client states the she does not feel dizzy.
• Client states that she feels stronger.
• "This medication will work for 24 hours and you will

need to change the patch daily." What statement is the most important for the nurse to include in the teaching plan for a client who has started on a transdermal nitroglycerin patch?

• "This medication works faster than sublingual nitroglycerin works."
• "This medication is the strongest of any nitroglycerin preparation available."
• "This medication should be used only when you are experiencing chest pain."
• "This medication will work for 24 hours and you will need to change the patch

daily."

• Apply the nitroglycerin patch for 14 hours and remove

it for 10 hours at night.What will the nurse instruct the client to do to prevent the development of tolerance to nitroglycerin?

• Apply the nitroglycerin patch every other day.
• Switch to sublingual nitroglycerin when the client's systolic blood pressure

elevates to more than 140 mm Hg.

• Apply the nitroglycerin patch for 14 hours and remove it for 10 hours at night.
• Use the nitroglycerin patch for acute episodes of angina only.

• Assess blood pressure.Before the nurse administers isosorbide mononitrate (Imdur), what is a priority

nursing assessment?

• Assess serum electrolytes.
• Measure blood urea nitrogen and creatinine.
• Assess blood pressure.
• Monitor level of consciousness.
• "It's best to keep it in its original container away from

heat and light." The client asks the nurse how nitroglycerin should be stored while traveling. What is the nurse's best response?

• "You can protect it from heat by placing the bottle in an ice chest."
• "It's best to keep it in its original container away from heat and light."
• "You can put a few tablets in a resealable bag and carry it in your pocket."
• "It's best to lock them in the glove compartment to keep them away from heat

and light."

• "I should sit or lie down after I take a nitroglycerin

tablet to prevent dizziness." Which statement indicates to the nurse that the client understands sublingual nitroglycerin medication instructions?

• "I will take up to five doses every 3 minutes for chest pain."
• "I can chew the tablet for the quickest effect."
• "I will keep the tablets locked in a safe place until I need them."
• "I should sit or lie down after I take a nitroglycerin tablet to prevent dizziness."
• Apply the ointment to a nonhairy part of the upper

torso.What instruction should the nurse provide to the client who needs to apply nitroglycerin ointment?

• Use the fingers to spread the ointment evenly over a 3-inch area.
• Apply the ointment to a nonhairy part of the upper torso.
• Massage the ointment into the skin.
• Cover the application paper with ointment before use.
• Decrease the intravenous nitroglycerin by 10 mcg/min. A client receiving intravenous nitroglycerin at 20 mcg/min complains of dizziness.

Nursing assessment reveals a blood pressure of 85/40 mm Hg, heart rate of 110 beats/min, and respiratory rate of 16 breaths/min. What is the nurse's priority action?

• Assess the client's lung sounds.
• Decrease the intravenous nitroglycerin by 10 mcg/min.
• Stop the nitroglycerin infusion for 1 hour, and then restart.
• Recheck the client's vital signs in 15 minutes but continue the infusion.
• Heart rate 58 beats per minuteThe nurse is monitoring a client taking digoxin (Lanoxin) for treatment of heart

failure. Which assessment finding indicates a therapeutic effect of the drug?

• Heart rate 110 beats per minute
• Heart rate 58 beats per minute
• Urinary output 40 mL/hr
• Blood pressure 90/50 mm Hg