Introduction to Pharmacology 12th Edition By Mary Kaye Asperheim – Test Bank

Chapter 11: Drugs that Affect the Circulatory System

Test Bank

MULTIPLE CHOICE

1. A patient who has been digitalized reports to the nurse that she is experiencing nausea, vomiting, and visual disturbances. The nurse will tell the patient that these are:
a. Common side effects of digitalis and not cause for any concern
b. Signs of a drug interaction with another medication and should be investigated soon
c. Early signs of digitalis toxicity, and the amount of medication prescribed may have to be reduced immediately
d. Signs that the medication is working

ANS: C

Feedback
A These are not common side effects of therapeutic levels of digoxin and are cause for some concern.
B These are not signs of interaction with another medication.
C Nausea, vomiting, and visual disturbances are side effects that warn of early overdose of digoxin.
D These are not signs of a therapeutic level of digoxin and should not be allowed to con-tinue or increase.

DIF: Cognitive Level: Understand REF: Page 90

2. The antidote for digitalis overdose is:
a. Vitamin K
b. Protamine
c. Digibind
d. Acetylcysteine

ANS: C

Feedback
A Vitamin K is the antidote for Coumadin (warfarin) overdose.
B Protamine is the antidote for heparin overdose.
C Digoxin immune Fab (Digibind) is given for life-threatening digoxin toxicity or overdose.
D Acetylcysteine is given as an antidote for acetaminophen (Tylenol) overdose.

DIF: Cognitive Level: Remember REF: Page 96 and 97

3. A patient who has had a myocardial infarction has residual problems with left ven-tricular dysfunction. Which of the following may be prescribed for this condition?
a. An angiotensin-converting enzyme (ACE) inhibitor
b. A diuretic agent
c. A nitrate medication
d. A calcium channel blocker

ANS: A

Feedback
A ACE inhibitors appear to minimize or prevent left ventricular dilation after a myocardial infarction.
B Although diuretic agents are useful in resolving cardiac problems, they are used in con-junction with other medications that have specific actions on the myocardium.
C Nitrate medications cause vasodilation and therefore affect the vessels, not the myocar-dium.
D Calcium channel blockers are useful in managing hypertension.

DIF: Cognitive Level: Understand REF: Page 90

4. A patient with hypertension has been unable to tolerate ACE inhibitors. Which of the following drugs might be prescribed for the patient instead?
a. Telmisartan (Micardis)
b. Acebutolol (Sectral)
c. Captopril (Capoten)
d. Propranolol (Inderal)

ANS: A

Feedback
A Micardis is an angiotensin II receptor agonist and is often used for patients who cannot tolerate the ACE inhibitors.
B Sectral is a beta-blocker that has greatest benefit in reducing ejection fraction.
C Capoten is an ACE inhibitor.
D Inderal is an antiarrhythmic agent.

DIF: Cognitive Level: Understand REF: Pages 91-92

5. For treatment of atrial fibrillation, which of the following might be prescribed?
a. Procainamide (Pronestyl)
b. Lidocaine (Xylocaine)
c. Midodrine (ProAmatine)
d. Quinidine

ANS: D

Feedback
A Procainamide is used for treatment of ventricular arrhythmias.
B Lidocaine is used for treatment of ventricular arrhythmias.
C Midodrine is used for the treatment of orthostatic hypotension.
D Quinidine is used to decrease the number of times the atrial muscle can contract in a given time.

DIF: Cognitive Level: Understand REF: Page 93

6. Which of the following drugs is extremely effective in controlling and preventing ventricular fibrillation?
a. Lidocaine (Xylocaine)
b. Glyceryl trinitrate (Nitroglycerin)
c. Amiodarone (Cordarone)
d. Clonidine (Catapres)

ANS: A

Feedback
A Intravenous lidocaine has been shown to be extremely effective in the control and pre-vention of ventricular fibrillation.
B Nitroglycerin is a vasodilator and would not limit the scope of activity of the lidocaine.
C Amiodarone is used to treat cardiac arrhythmias.
D Clonidine is used to treat hypertension.

DIF: Cognitive Level: Understand REF: Page 93

7. Which of the following possible side effects should be mentioned when instructing a patient who is starting treatment with methyldopa (Aldomet)?
a. Drowsiness, impotence, gynecomastia
b. Dizziness, skin rash, insomnia
c. Edema, dyspepsia, blurred vision
d. Skin hyperpigmentation, sun sensitivity, anorexia

ANS: A

Feedback
A Drowsiness, impotence, and gynecomastia are fairly common side effects of methyldo-pa.
B Dizziness, skin rash, and insomnia are not common side effects of methyldopa.
C Edema, dyspepsia, and blurred vision are not common side effects of methyldopa.
D Skin hyperpigmentation, sun sensitivity, and anorexia are not common side effects of methyldopa.

DIF: Cognitive Level: Understand REF: Page 95

8. In addition to measuring prothrombin times, which of the following is also used to monitor the effectiveness of anticoagulation therapy with heparin?
a. Partial thromboplastin time
b. International normalized ratio (INR)
c. D-dimer
d. Thrombin time

ANS: B

Feedback
A Partial thromboplastin time is used to measure the effectiveness of warfarin.
B The INR is derived from calibrations of commercial thromboplastin reagents against an international reference population.
C D-dimer is used as a marker for intravascular coagulation.
D Thrombin time is used to investigate possible acquired or inherited disorders of hemosta-sis or cases of unexplained thrombosis.

DIF: Cognitive Level: Understand REF: Page 97

9. What is one of the greatest advantages of taking warfarin (Coumadin) for antico-agulation therapy instead of heparin?
a. It is safe to take with any herbal medication.
b. It is less likely to interact with other drugs.
c. It can be taken by mouth.
d. It is safe to take during intervals when dental procedures are performed.

ANS: C

Feedback
A Coumadin may react with numerous herbal medications such as coenzyme Q10, garlic, Ginkgo biloba, and St. John’s wort.
B Coumadin may react with many other medications such as other heart medications, an-tibiotic agents, aspirin and other nonsteroidal anti-inflammatory drugs, and cimetidine.
C Coumadin is available for use by injection, but it is most commonly prescribed for oral administration.
D Coumadin should be discontinued for at least 3 days before any surgical procedure in which bleeding might occur.

DIF: Cognitive Level: Understand REF: Page 99

10. Alteplase (Activase) is useful in the treatment of myocardial infarction because of its ability to do which of the following?
a. Dissolve blood clots
b. Improve right ventricular function
c. Stabilize the myocardium
d. Decrease the ejection fraction

ANS: A