Quiz about NSG 308/Pharm Exam 3 Cardiac Quiz 2

Question 1

Which class of HTN medications would be most likely prescribed to a black patient who is genetically predisposed to be resistant to traditional medications such as ACEI/ARB used for monotherapy?

Accepted Answer

Calcium Channel Blockers

Answer

Beta Blockers

Answer

ACE Inhibitors

Answer

Alpha Blockers

Question 2

What are the basic considerations when treating hypertension?

Accepted Answer

- Requires lifetime treatment - 130/80 HTN threshold, 180/120 HTN crisis AT REST - Primary Factors that Affect BP: - Peripheral vascular resistance - Myocardial contractility - Heart rate - Blood volume

Answer

- Only requires treatment during symptoms - 150/90 HTN threshold, 200/130 HTN crisis AT REST - Primary Factors that Affect BP: - Renal filtration rate - Liver enzymes - Blood glucose - Platelet count

Answer

- Treatment is optional for mild cases - 120/70 HTN threshold, 160/100 HTN crisis AT REST - Primary Factors that Affect BP: - Oxygen saturation - White blood cell count - Cholesterol level - Body temperature

Answer

- Only diet modification is necessary - 140/90 HTN threshold, 170/110 HTN crisis AT REST - Primary Factors that Affect BP: - Lung capacity - Insulin sensitivity - Calcium levels - Skin turgor

Question 3

What is the function of baroreceptors in the vascular system (via SNS)?

Accepted Answer

They sense pressure within large vessels, aorta/carotid, and relay that information to the vasomotor center in the brain.

Answer

They sense pressure within peripheral vessels and relay that information to the vasomotor center in the brain.

Answer

They sense pressure within large vessels, aorta/carotid, and relay that information to the temporal cortex in the brain.

Answer

They filter waste products from the blood.

Question 4

The vasomotor center will direct smooth muscles in arteries to either constrict (alpha 1) or relax (alpha 2).

Accepted Answer

True

Answer

False

Question 5

The baroreceptor reflex frequently _______ attempts to reduce BP with medications.

Accepted Answer

Opposes

Answer

Supports

Answer

Ignores

Answer

Violently Enhances

Question 6

In people with hypertension, the "set point" of baroreceptors is high because high BP is what the baroreceptors think is 'normal.'

Accepted Answer

True

Answer

False

Question 7

When medications lower BP, baroreceptors may respond by causing vasoconstriction and increasing HR in an attempt to raise BP.

Accepted Answer

True

Answer

False

Question 8

Renin is released in response to _____ renal blood flow and ______ BP.

Accepted Answer

low, low

Answer

high, high

Answer

low, high

Answer

high, low

Question 9

Renin stimulates production of angiotensin I from ______.

Accepted Answer

angiotensinogen

Answer

albumin

Answer

angiotensin II

Answer

aldosterone

Question 10

Angiotensin I is converted into angiotensin II by ACE (angiotensin converting enzyme) in the ______.

Accepted Answer

lungs

Answer

liver

Answer

kidneys

Answer

stomach

Question 11

Angiotensin II acts as a potent vasoconstrictor and stimulates the release of ______.

Accepted Answer

aldosterone

Answer

insulin

Answer

thyroxine

Answer

glucagon

Question 12

Aldosterone promotes sodium and water retention.

Accepted Answer

True

Answer

False

Question 13

ACE inhibitors work in the body to treat hypertension by:

Accepted Answer

Blocking the conversion of angiotensin I to angiotensin II

Answer

Increasing heart rate

Answer

Stimulating aldosterone secretion

Answer

Constriction of blood vessels

Question 14

ACE inhibitors will possibly cause which negative, adverse effect to which electrolyte? Which types of concurrent medications/dietary choices should be avoided with ACEI due to this?

Accepted Answer

ACE inhibitors may cause hyperkalemia; potassium-sparing diuretics and potassium-rich foods should be avoided.

Answer

ACE inhibitors may cause hypokalemia; sodium-rich foods should be avoided.

Answer

ACE inhibitors may cause hypernatremia; calcium supplements should be avoided.

Answer

ACE inhibitors may cause hypocalcemia; magnesium supplements should be avoided.

Question 15

Common side effects for ALL ACE inhibitors include which of the following, and what is the FIRST recommended plan of action if intolerable side effects develop?

Accepted Answer

Cough and angioedema; discontinue ACE inhibitor and switch to an angiotensin receptor blocker

Answer

Bradycardia and rash; continue ACE inhibitor at a lower dose

Answer

Cough and weight gain; add a beta-blocker

Answer

Angioedema and blurred vision; switch to a calcium channel blocker

Question 16

Calcium Channel Blockers (CCB) work in the body to treat hypertension by:

Accepted Answer

relaxing blood vessels by inhibiting calcium entry into muscle cells

Answer

increasing heart rate and cardiac output

Answer

relaxing blood vessels by increasing calcium entry into muscle cells

Answer

constricting blood vessels to raise blood pressure

Answer

relaxing blood vessels by destroying all calcium ions in the peripheral vasculature

Question 17

How do each category of CCBs work in the body and which drugs fall into which category? When would each category be used versus the other?

Accepted Answer

CCBs are divided into dihydropyridines (e.g., amlodipine, nifedipine) which mainly act on vascular smooth muscle, and non-dihydropyridines (e.g., verapamil, diltiazem) which act on the heart; dihydropyridines are used for hypertension, while non-dihydropyridines are used for arrhythmias and hypertension.

Answer

CCBs are divided into dihydropyridines (e.g., verapamil, diltiazem) which mainly act on vascular smooth muscle, and non-dihydropyridines which act on the heart (e.g., amlodipine, nifedipine); dihydropyridines are used for hypertension, while non-dihydropyridines are used for arrhythmias and hypertension.

Answer

CCBs are divided into dihydropyridines (e.g., amlodipine, nifedipine) which mainly act on vascular smooth muscle, and non-dihydropyridines (e.g., verapamil, diltiazem) which act on the heart; dihydropyridines are used for hypotension, while non-dihydropyridines are used for arrhythmias and hypotension.

Answer

CCBs are divided into dihydropyridines (e.g., verapamil, diltiazem) which mainly act on vascular smooth muscle, and non-dihydropyridines which act on the heart (e.g., amlodipine, nifedipine); dihydropyridines are used for hypertension, while non-dihydropyridines are used for heart failure and hypertension.

Question 18

Which of the following are signs & symptoms of heart failure?

Accepted Answer

Shortness of breath, fatigue, and swelling in the legs

Answer

Pulmonary edema and pleuritis

Answer

Sudden weight loss and excessive sweating with lethally high pulse rate

Answer

Orthopnea, left sided weakness, swelling in the face and bradycardia

Question 19

What is the inability of the heart to produce adequate cardiac output (CO) to meet metabolic needs called?

Accepted Answer

Heart failure (HF)

Answer

Hypertension

Answer

Arrhythmia

Answer

Myocardial infarction

Question 20

Which of the following is NOT a major underlying cause of heart failure (HF)?

Accepted Answer

Diabetes mellitus

Answer

Chronic hypertension

Answer

Viral heart disease

Answer

Cardiomyopathy

Question 21

Fill in the blank: Poor renal perfusion in heart failure can lead to ________ and increased blood pressure (BP).

Accepted Answer

fluid retention

Answer

muscle wasting

Answer

fluid excretion

Answer

fluid loss

Question 22

Which statement describes Stage 4 heart failure?

Accepted Answer

Significant activity limitation due to s/s. Comfortable only at rest

Answer

No limitation of physical activity, ordinary activity does not cause symptoms

Answer

Slight limitation of physical activity, comfortable at rest

Answer

Symptoms at rest, unable to carry on any physical activity without discomfort

Question 23

In heart failure, insufficient tissue perfusion leads to shortness of breath (SOB) and poor exercise tolerance.

Accepted Answer

True

Answer

False

Question 24

Which of the following is a LATE sign of heart failure?

Accepted Answer

Low blood pressure (BP)

Answer

High blood pressure (BP)

Answer

Increased cardiac output (CO)

Answer

Decreased heart rate

Question 25

What is the first step in the vicious cycle of maladaptive compensatory responses to a failing heart?

Accepted Answer

Cardiac remodeling leads to reduced cardiac output

Answer

Increased renal sodium and water retention

Answer

Activation of the sympathetic nervous system

Answer

Development of pulmonary edema

Question 26

Which of the following is NOT a clinical manifestation of heart failure (HF)?

Accepted Answer

ischemic stroke

Answer

reduced exercise tolerance

Answer

fatigue

Answer

compensatory HTN

Answer

compensatory tachycardia

Question 27

Which compensatory response occurs in heart failure to increase oxygen to body tissue?

Accepted Answer

Tachycardia

Answer

Bradycardia

Answer

Hypotension

Answer

Hyperthermia

Question 28

Fill in the blank: Cardiomegaly is a clinical manifestation of increased _______ and reduced ejection fraction (EF) in heart failure.

Accepted Answer

filling pressures

Answer

heart rate

Answer

angioedema

Answer

cardiac glycosides

Question 29

Which of the following is a sign of increased blood volume and decreased ventricular ejection in heart failure?

Accepted Answer

A) Pulmonary or peripheral edema

Answer

B) Bradycardia

Answer

C) Hypotension

Answer

D) Cyanosis

Question 30

Weight gain and hepatomegaly are clinical manifestations of heart failure due to increased blood volume and decreased ventricular ejection.

Accepted Answer

True

Answer

False

Question 31

Which side of heart failure is associated with lung involvement?

Accepted Answer

Left side

Answer

Right side

Question 32

Patients with left-sided heart failure may require more _______ to sleep at night and cannot sleep in supine position.

Accepted Answer

pillows

Answer

blankets

Answer

medications

Answer

windows

Question 33

Which of the following is NOT a symptom of left-sided heart failure?

Accepted Answer

JVD and ascites

Answer

Cough and noisy breathing

Answer

Frothy pink sputum

Answer

Waking up gasping for air

Question 34

Digoxin is given to patients for which of the following reasons?

Accepted Answer

To treat heart failure in conjunction with certain types of arrhythmias

Answer

To treat heart failure in conjunction with certain types of cardiac glycosides

Answer

To treat heart failure in conjunction with certain types of varicose vasculature

Answer

To treat heart failure in conjunction with certain types of cardiomyopathy

Question 35

Digoxin has which of the following effects on the heart?

Accepted Answer

It increases the force of cardiac contractions.

Answer

It decreases heart rate by blocking beta 2 receptors.

Answer

It causes significant vasoconstriction of coronary arteries.

Answer

It acts as a diuretic to reduce blood volume.

Question 36

Which of the following lists the signs and symptoms of digoxin toxicity?

Accepted Answer

Nausea, vomiting, visual disturbances, and arrhythmias

Answer

Fever, cough, and sore throat

Answer

Joint pain, swelling, and redness

Answer

Weight gain, increased appetite, and insomnia

Question 37

There are special directions for digoxin medication administration.

Accepted Answer

True

Answer

False

Answer

Sometimes

Answer

Only for children

Question 38

PRIORITY labs to assess when administering digoxin include:

Accepted Answer

Potassium, creatinine, and digoxin levels

Answer

Hemoglobin, hematocrit, and potassium levels

Answer

Creatinine, magnesium, and sodium levels

Answer

Liver enzymes, bilirubin, and digoxin levels

Answer

Potassium, lithium, albumin levels

Question 39

The most effective diuretic class at removing excess fluid from the body is:

Accepted Answer

Loop diuretics

Answer

Thiazide diuretics

Answer

Potassium-sparing diuretics

Answer

Carbonic anhydrase inhibitors

Question 40

What are signs and symptoms of fluid overload?

Accepted Answer

Pitting edema, pulmonary edema, cyanosis, HTN, HF, weight gain, SOB

Answer

Dry skin, hypotension, bradycardia, weight loss, SOB

Answer

Jaundice, pruritus, dark urine, clay-colored stools, HTN, SOB

Answer

Polyuria, polydipsia, weight loss, blurred vision, HF, HTN

Question 41

How would a beta blocker work in the body to treat heart failure?

Accepted Answer

Slow pulse rate, reduce blood pressure, decrease vascular tone, and decrease workload on the heart

Answer

Increase heart rate and contractility, raising cardiac output

Answer

Stimulate the sympathetic nervous system to increase blood pressure, decrease workload on the heart

Answer

Cause vasoconstriction and increase afterload, making the heart work harder

Question 42

How do ACE inhibitors work in the body to treat heart failure?

Accepted Answer

Reduces afterload and preload. ACEIs should be prescribed for ALL HF patients. Switch to ARBs if patient develops cough.

Answer

Increase heart rate and contractility to improve cardiac output. ACEIs should be prescribed for SOME HF patients. Switch to ARBs if patient develops cough.

Answer

Directly stimulate beta-adrenergic receptors to enhance myocardial function. ACEIs should be prescribed for ALL HF patients. Switch to statins if patient develops cough.

Answer

Block calcium channels to decrease myocardial oxygen demand. ACEIs should be prescribed for ONLY ADHF patients. Switch to ARMs if patient develops cough.

Question 43

What is the therapeutic effect of an alpha 1 blocker?

Accepted Answer

Reduction of arteriolar smooth muscle tone, reduction of venous return to the heart

Answer

Increase in heart rate and cardiac output

Answer

Stimulation of beta-2 receptors causing bronchodilation

Answer

Increase in aldosterone secretion leading to sodium retention

Question 44

What are some common side effects of alpha 1 blockers?

Accepted Answer

Cholinergic effects. Orthostatic hypotension most severe with initial doses.

Answer

Anticholinergic effects. Hyperglycemia, weight gain, and increased appetite.

Answer

Cholinergic effects. Nephrotoxicity, ototoxicity, and red man syndrome.

Answer

Anticholinergic effects. Bradycardia, dry cough, and angioedema.

Question 45

A patient would be prescribed a less selective alpha-1 blocker such as doxazosin instead of a more prostate selective medication such as tamsulosin when:

Accepted Answer

they have both hypertension and benign prostatic hyperplasia (BPH).

Answer

they have only benign prostatic hyperplasia (BPH).

Answer

they have only hypertension.

Answer

they have a history of prostate cancer.

Answer

they have both hypotension and big balls disease (BBD).

Question 46

A serious side effect of anticoagulants is:

Accepted Answer

Excess bleeding

Answer

Weight gain

Answer

Nonselective clot dissolution

Answer

Viscous blood

Question 47

Factors including dietary and drug-drug interactions that affect warfarin levels include:

Accepted Answer

Vitamin K intake, certain antibiotics, and antifungal medications

Answer

Vitamin K intake, lack of exercise and certain barbiturates

Answer

Vitamin K intake, sunlight exposure and certain benzodiazepines

Answer

Vitamin K intake, calcium supplements and iron-rich foods

Question 48

Anticoagulants given to patients at increased risk for developing a blood clot to PREVENT this from happening include:

Accepted Answer

Heparin

Answer

Aspirin

Answer

Acetaminophen

Answer

Ibuprofen

Question 49

HIT is a condition that can be identified by a nurse if a patient develops which of the following signs after heparin administration, and what should the nurse do if HIT is suspected?

Accepted Answer

A significant drop in platelet count; notify the healthcare provider and stop heparin

Answer

An increase in blood pressure; administer more heparin

Answer

A decrease in heart rate; encourage ambulation

Answer

A rise in white blood cell count; start antibiotics and stop the heparin immediately

Answer

A significant spike in thrombolytics; just go on ahead and get the body bag ready

Question 50

Which anticoagulants have specific reversal agents/antidotes, and what are they?

Accepted Answer

Warfarin (Vitamin K/FFP), Dabigatran (Idarucizumab), Apixaban/Rivaroxaban (Andexanet alfa), Heparin (Protamine Sulfate)

Answer

Heparin (Protamine), Aspirin (Vitamin K/FFP), Clopidogrel (Idarucizumab)

Answer

Warfarin (Protamine Tartrate/FFP), Dabigatran (Vitamin K), Apixaban (Protamine Sulfate)

Answer

Rivaroxaban (Vitamin K), Heparin (Idarucizumab), Warfarin (Andexanet alfa/FFP)

Question 51

Thrombolytics work in the body by:

Accepted Answer

Dissolving blood clots

Answer

Increasing platelet production

Answer

Preventing blood clots

Answer

Blocking thrombus absorption

Question 52

Thrombolytics should be administered for which of the following conditions?

Accepted Answer

Acute myocardial infarction, ischemic stroke, and massive pulmonary embolism

Answer

Chronic stable angina, hemorrhagic stroke, peripheral edema

Answer

Hypertensive crisis, chronic venous insufficiency, hemorrhagic stroke

Answer

Left ventricular heart failure, life threatening hypotension, massive blood loss secondary to trauma

Question 53

Contraindications that would prevent safe administration of thrombolytics include:

Accepted Answer

Active internal bleeding

Answer

Poorly controlled hypertension

Answer

History of seasonal allergies

Answer

Impaction

Question 54

The first factor that should be determined when a patient comes to the ED with stroke-like symptoms to assess for tPA eligibility is:

Accepted Answer

Time of symptom onset

Answer

Patient's blood pressure

Answer

History of diabetes insipidus

Answer

Concurrent use of bile acid sequestrants

Question 55

After tPA is administered, bleeding can occur in various locations and may present with which of the following signs and symptoms?

Accepted Answer

Sudden severe headache, decreased level of consciousness, and hematuria

Answer

Increased appetite and weight gain

Answer

Improved muscle strength and coordination

Answer

Persistent cough and sore throat

Question 56

The PRIMARY therapeutic effect of aspirin, clopidogrel, and ticagrelor is:

Accepted Answer

Inhibition of platelet aggregation

Answer

Increase in red blood cell production

Answer

Anticoagulation

Answer

Dissolution of clots

Question 57

Nitroglycerin would be prescribed for which of the following reasons?

Accepted Answer

To relieve chest pain

Answer

To treat hypertension

Answer

To treat heart pants on

Answer

To reduce LDL cholesterol levels by 25-60%

Answer

To treat heart failure

Question 58

Common side effects of long acting nitrates include:

Accepted Answer

Headache

Answer

Bradycardia

Answer

Constipation

Answer

Hypoglycemia

Question 59

The differences in medication administration according to the different routes include:

Accepted Answer

Absorption rate, onset of action, and potential side effects

Answer

Only the color of the medication

Answer

The brand name of the medication

Answer

The time of day the medication is given

Question 60

Alternatives to statins for high cholesterol include niacin. What are the potential side effects of taking niacin?

Accepted Answer

Flushing and liver toxicity

Answer

Cyanosis and kidney failure

Answer

Lethal drop in blood pressure when used with sildenafil

Answer

MI and hemorrhagic stroke

Answer

Spontaneous combustion

Question 61

Fibrates/Fibric Acid Derivatives are used to:

Accepted Answer

reduce triglycerides and increase HDL

Answer

increase LDL and decrease HDL

Answer

decrease HDL and LDL

Answer

increase triglycerides

Question 62

Bile Acid Sequestrants bind to _______ in the intestine.

Accepted Answer

bile acids

Answer

amino acids

Answer

fatty acids

Answer

glucose

Question 63

What is an example of a fibrate/fibric acid derivative used as an alternative to statins?

Accepted Answer

fenofibrate, gemfibrozil

Answer

atorvastatin, rosuvastatin

Answer

ezetimibe, evolocumab

Answer

niacin, vitamin B13

Question 64

If a patient complains of chest pain outside a healthcare facility, what is the first step in the administration protocol for acute chest pain?

Accepted Answer

The patient should take a rapid acting nitrate and wait 5 minutes to see if the pain dissipates.

Answer

The patient should immediately start chest compressions on themselves.

Answer

The patient should take a rapid acting nitrate and wait 5 days to see if the pain dissipates.

Answer

The patient should take a long acting nitrate and wait 5 minutes to see if the pain dissipates.

Answer

The patient should take a long acting nitrate and wait 5 decades to see if the pain dissipates.

NSG 308/Pharm Exam 3 Cardiac Quiz 2

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