Cardiac Meds Quiz

When preparing to administer Metoprolol, the nurse takes the apical pulse. The client's pulse is 48 bpm. What is the priority action for the nurse to take?

• Administer the medication as prescribed.
• Increase the dosage of Metoprolol.
• Monitor the pulse for one hour before taking action.
• Hold the medication and notify the healthcare provider.

Answer explanation

Davis Drug Guide says to hold the metoprolol if the pulse is <50 bpm and to notify the HCP

The textbook says an apical pulse <60 bpm should be when the med should be held. I went with the drug guide, but answer the real exam at your own risk

The nurse knows that medications like metoprolol and propranolol are beta-blockers and are used to?

Select all that apply

• Increase heart rate and blood pressure

• Decrease the frequency of chest pain (angina)

• Prevent MI and Ventricular Arrythmias

• Decrease heart rate and blood pressure

• Treat HTN, and Anxiety

When administering a beta-blocker the nurse should educate the patient to?

Select all that apply

• Stop taking the medication if feeling dizzy to prevent fall injuries

• Take the medication only when symptoms occur to prevent toxicity

• Not stop abruptly to avoid rebound HTN, angina, arrythmias

• Monitor heart rate and blood pressure regularly.
• Change positions slowly to prevent orthostatic hypotension

The nurse is preparing to give propranolol to a 45 y/o female client in for treatment of her HTN. She has a PMH: of diabetes, COPD, and HTN. What is the appropriate action?

• Assess blood pressure and heart rate before administration.
• Hold the medication and notify the HCP

• Check her home meds to see if they also cause a decrease in HR before giving

• Assess her BG level before giving

Answer explanation

Beta-blockers are contraindicated in people with COPD because it can cause bronchospasms

The nurse walks into a room of a female client receiving warfarin and notices the client looks pale and tired. On further inspection the client's IV site has a thin stream of blood leaking from it. The client's morning labs show: Hgb 10, Hct 30, RBC 3.7. What will the nurse expect to administer?

• Warfarin

• Protamine sulfate

• Vitamin K

• Andexanet Alfa

Answer explanation

She has been given too much warfarin and is suffering from a bleed. She will receive the antidote, vitamin K.

I do not know if the labs on here are accurate for a bleed/hemorrhage caused by warfarin. But I just threw some together for the scenario.

The nurse is preparing a client's 0800 meds. The client is taking warfarin and has an INR level of 4.6. What is the priority action?

• Perform a blood transfusion right away.
• Increase the warfarin dosage immediately.
• Administer the warfarin as scheduled.
• Hold the warfarin and notify the HCP

A client is receiving bumetanide (Bumex) and asks the nurse to clarify the teaching the RN had given. The nurse should provide what educations?

Select all that apply

• Take med earlier in the day, and avoid administering at night

• Take w/ food or milk

• Wear protective clothing and sunscreen when outside

• Get your potassium level checked while on bumex

• You should not take if you are allergic to sulfonamides

A client taking spironolactone is about to receive her 0800 dose. Her K+ level is 5.6. What is the priority action?

• Administer the dose as scheduled.
• Increase potassium intake before the next dose.
• Monitor the patient for symptoms of dehydration.
• Hold the dose and notify the HCP.

Answer explanation

Spironolactone is a potassium-sparing diuretic, so her potassium level is not going down when she takes this diuretic. The med should be held, and the HCP should be notified.

Before administering spironolactone, the nurse knows to?

Select all that apply

• Check serum potassium levels.
• Monitor blood glucose levels.
• Check liver function tests.
• Check blood pressure.

With all diuretics the nurse knows to monitor what?

Select all that apply

• Daily weights

• Intake and output

• Serum potassium level

• Blood pressure