Cardiac Vascular Nursing Exam Cardiac Vascular Nursing Exam Pharmacology & Medications 2

Question 1

Which antiplatelet medication's mechanism involves irreversible inhibition of the P2Y12 receptor on platelets?

Accepted Answer

Clopidogrel (Plavix)

Answer

Clopidogrel is an irreversible P2Y12 ADP receptor antagonist; its active metabolite permanently blocks the receptor, preventing ADP-mediated platelet activation for the platelet's 7–10 day lifespan.

Question 2

A nurse prepares to administer IV alteplase (tPA) for acute ischemic stroke. Which cardiac history represents an absolute contraindication?

Accepted Answer

Any prior intracranial hemorrhage

Answer

Prior intracranial hemorrhage is an absolute contraindication to tPA because the fibrinolytic activity dramatically increases risk of re-bleeding into the previous hemorrhage site.

Question 3

Spironolactone improves outcomes in HFrEF through which pharmacological mechanism beyond its diuretic effect?

Accepted Answer

Blocking aldosterone receptors reduces cardiac fibrosis and maladaptive remodeling

Answer

Aldosterone promotes cardiac and vascular fibrosis; spironolactone's blockade of myocardial aldosterone receptors reduces interstitial fibrosis and sympathetic activation independent of its diuretic effect.

Question 4

A patient receiving IV vasopressin for vasodilatory shock develops chest pain. The nurse suspects which complication related to vasopressin's mechanism?

Accepted Answer

Coronary vasoconstriction causing myocardial ischemia

Answer

Vasopressin (V1 receptor agonist) causes non-selective vasoconstriction including coronary arteries, potentially reducing myocardial perfusion and causing ischemia, especially in patients with CAD.

Question 5

Which monitoring parameter is most critical for a patient starting sacubitril/valsartan (Entresto) for heart failure?

Accepted Answer

Blood pressure and renal function, as hypotension and worsening renal function are primary concerns

Answer

Sacubitril/valsartan lowers blood pressure significantly and can reduce renal perfusion; blood pressure and creatinine/potassium levels must be monitored at initiation and dose titration.

Cardiac Vascular Nursing Exam Practice Test

Cardiac Vascular Nursing Exam Practice Test

Cardiac Vascular Nursing Exam Cardiac Vascular Nursing Exam Pharmacology & Medications 2