Description
Pharmacology and the Nursing Process 5th Edition Lilley Snyder Test Bank
ISBN-13: 978-0323044868
ISBN-10: 0323044867
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Lilley: Pharmacology and the Nursing Process, 5th Edition
Test Bank
Chapter 18: Adrenergic-Blocking Drugs
MULTIPLE CHOICE
- Pulmonary hypertension has caused the blood oxygen level in a neonate to decrease. If the usual supportive measures are not able to compensate for this, which a-blocker would the nurse expect to give to this neonate?
| a. | prazosin |
| b. | tolazoline |
| c. | phentolamine |
| d. | ergotamine tartrate |
ANS: B
Tolazoline is primarily used for this purpose.
DIF: COGNITIVE LEVEL: Analysis REF: Text Page: 287
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
- A patient is going home with a new prescription for the beta-blocker atenolol. The nurse should include which content when teaching the patient about this drug?
| a. | Never stop taking this medication abruptly. |
| b. | The medication should be stopped once symptoms subside. |
| c. | If adverse effects occur, skip a dose for a “drug holiday.” |
| d. | Be watchful for first-dose hypotension. |
ANS: A
Patients should be weaned off these medications slowly because rebound hypertension and chest pain is possible with abrupt withdrawal. First-dose hypotension occurs with a-blockers.
DIF: COGNITIVE LEVEL: Application REF: Text Page: 293
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
- During initial rounds, the nurse notes that a dopamine infusion has extravasated into the forearm of a patient. After stopping the infusion, the nurse follows standing orders and immediately injects phentolamine subcutaneously in a circular fashion around the extravasation site. What does this do?
| a. | It causes vasoconstriction and rapid uptake of the extravasated dopamine. |
| b. | It causes arterial vasoconstriction and reduced pain and swelling at the site. |
| c. | It increases peripheral vascular resistance and reduces arterial pressure at the site. |
| d. | It increases blood flow to the ischemic site by vasodilation and prevents permanent tissue damage. |
ANS: D
Phentolamine is an a-blocker that reduces peripheral vascular resistance when given systemically, but local SC injection around extravasated vasoconstrictive drugs such as dopamine causes an a-adrenergic receptor blockade and vasodilation and thus increased blood flow to the ischemic tissue, hopefully preventing permanent tissue damage.
DIF: COGNITIVE LEVEL: Analysis REF: Text Page: 286
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
- A 58-year-old man has had a myocardial infarction (MI), has begun rehabilitation, and is ready for discharge. He is given a prescription for metoprolol (Lopressor), and he becomes upset. “I don’t have high blood pressure—why did my doctor give me this medicine?” The nurse explains to him that:
| a. | This medication prevents emboli that may lead to another MI. |
| b. | Beta-blockers are routinely prescribed for all post-MI patients. |
| c. | It is being prescribed to prevent hypertension that often occurs post-MI. |
| d. | Studies have shown that this medication has greatly increased survival in patients after an MI. |
ANS: D
b-blockers are frequently given to patients after they have suffered an MI because of their cardioprotective properties; however, some contraindications may preclude the use of b-blockers for all post-MI patients.
DIF: COGNITIVE LEVEL: Analysis REF: Text Page: 291
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Psychosocial Integrity
- Patient teaching for the patient who is taking prazosin (Minipress) to reduce urinary obstruction due to benign prostatic hyperplasia (BPH) should include which of the following?
| a. | Fluids should be restricted while on this medication. |
| b. | Take the medication with breakfast to promote maximum effects of the drug. |
| c. | Lightheadedness may occur when standing up after sitting or lying down until a tolerance is built up. |
| d. | Blood pressure should be monitored because the medication may cause hypertension due to vasoconstriction. |
ANS: C
This medication is used to relieve impaired urinary flow in men with BPH, but it also has antihypertensive effects. Because of these effects, the BP may become dramatically lowered, and orthostatic hypotension and lightheadedness may occur until tolerance is developed. For this reason, the first few doses should be taken at bedtime.
DIF: COGNITIVE LEVEL: Application REF: Text Page: 287
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
- A female patient has been admitted to the emergency department after an accidental overdose of ergotamine tartrate. Her daughter states that her mother developed a severe migraine headache and called to tell her that she took a double dose this morning because the headache “just would not go away.” She is now dizzy, nauseated, and very weak. The nurse’s immediate action should be to:
| a. | Administer activated charcoal. |
| b. | Force intravenous and oral fluids. |
| c. | Empty the stomach by gastric lavage. |
| d. | Administer a cathartic such as sorbitol. |
ANS: C
In an acute ergotamine tartrate overdose, the patient’s stomach should be emptied immediately by gastric lavage.
DIF: COGNITIVE LEVEL: Analysis REF: Text Page: 285-286
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
- Which beta-blocker is helpful in the treatment of diastolic dysfunction heart failure?
| a. | atenolol |
| b. | carvedilol |
| c. | acebutolol |
| d. | esmolol |
ANS: B
Certain beta-blockers such as carvedilol and metoprolol have given the best results in the treatment of heart failure.
DIF: COGNITIVE LEVEL: Comprehension REF: Text Page: 288
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
- During a teaching session about self-monitoring while taking a beta-blocker at home, the nurse has taught a patient to take his apical pulse daily for 1 minute. If the pulse rate decreases to less than 60 per minute, he should be instructed to:
| a. | Contact his physician for instructions. |
| b. | Reduce the dose of his b-blocker by half. |
| c. | Continue the medication, as this is an expected effect. |
| d. | Skip the medication dose that day, and check his pulse again the next day. |
ANS: A
Cardiac depression can occur with beta-blockers; the patient should be told to contact his physician if his pulse rate decreases to less than 60 per minute.
DIF: COGNITIVE LEVEL: Analysis REF: Text Page: 293
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential
- A 49-year-old patient is in the clinic for a follow-up visit 6 months after starting a beta-blocker for treatment of hypertension. During this visit, his blood pressure is 169/98 mm Hg, and he eventually confesses that he stopped taking this medicine 2 months ago because of an “embarrassing problem.” What problem did he most likely experience with this medication that caused him to stop taking it?
| a. | Urge incontinence |
| b. | Dizziness when standing up |
| c. | Excessive flatus |
| d. | Impotence |
ANS: D
Impotence is a potential adverse effect of beta-blockers, and may cause patients to stop taking the medication.
DIF: COGNITIVE LEVEL: Analysis REF: Text Page: 289
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
MATCHING
For each condition listed below, indicate whether the appropriate drug would be:
| a. | an alpha-blocker drug |
| b. | a beta-blocker drug |
| c. | both |
- Migraine headaches
- Hypertension
- Benign prostatic hyperplasia
- Angina
- Certain dysrhythmias
- Glaucoma
- ANS: C DIF: COGNITIVE LEVEL: Application
REF: Text Page: 284, 288 TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
NOT: Alpha-blockers are used to treat benign prostatic hyperplasia. Beta-blockers are used to treat angina, certain dysrhythmias, and glaucoma. Both alpha- and beta-blockers are used to treat migraine headaches and hypertension.
- ANS: C DIF: COGNITIVE LEVEL: Application
REF: Text Page: 284, 288 TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
NOT: Alpha-blockers are used to treat benign prostatic hyperplasia. Beta-blockers are used to treat angina, certain dysrhythmias, and glaucoma. Both alpha- and beta-blockers are used to treat migraine headaches and hypertension.
- ANS: A DIF: COGNITIVE LEVEL: Application
REF: Text Page: 284, 288 TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
NOT: Alpha-blockers are used to treat benign prostatic hyperplasia. Beta-blockers are used to treat angina, certain dysrhythmias, and glaucoma. Both alpha- and beta-blockers are used to treat migraine headaches and hypertension.
- ANS: B DIF: COGNITIVE LEVEL: Application
REF: Text Page: 284, 288 TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
NOT: Alpha-blockers are used to treat benign prostatic hyperplasia. Beta-blockers are used to treat angina, certain dysrhythmias, and glaucoma. Both alpha- and beta-blockers are used to treat migraine headaches and hypertension.
- ANS: B DIF: COGNITIVE LEVEL: Application
REF: Text Page: 284, 288 TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
NOT: Alpha-blockers are used to treat benign prostatic hyperplasia. Beta-blockers are used to treat angina, certain dysrhythmias, and glaucoma. Both alpha- and beta-blockers are used to treat migraine headaches and hypertension.
- ANS: B DIF: COGNITIVE LEVEL: Application
REF: Text Page: 284, 288 TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
NOT: Alpha-blockers are used to treat benign prostatic hyperplasia. Beta-blockers are used to treat angina, certain dysrhythmias, and glaucoma. Both alpha- and beta-blockers are used to treat migraine headaches and hypertension.
