Cardiac Vascular Nursing Exam Cardiac Vascular Nursing Exam Pharmacology & Medications

Question 1

Which mechanism of action explains why beta-blockers reduce mortality in heart failure with reduced ejection fraction?

Accepted Answer

Blocking catecholamine overstimulation reduces cardiac remodeling, improves ejection fraction, and prevents arrhythmic death

Answer

Beta-blockers primarily reduce preload by blocking aldosterone receptors

Answer

Beta-blockers increase cardiac output acutely by improving contractility

Answer

Beta-blockers prevent heart failure by directly inhibiting RAAS activation

Question 2

A nurse is administering IV heparin for STEMI management. Which laboratory value must be monitored to guide dosing?

Accepted Answer

Activated partial thromboplastin time (aPTT)

Answer

International normalized ratio (INR)

Answer

Anti-Xa level only (not aPTT for unfractionated heparin)

Answer

Platelet count exclusively

Question 3

Which class of medication is contraindicated in patients with bilateral renal artery stenosis and must be avoided when initiating heart failure treatment?

Accepted Answer

ACE inhibitors and ARBs

Answer

Beta-blockers

Answer

Loop diuretics

Answer

Aldosterone antagonists

Question 4

A patient on amiodarone for atrial fibrillation also takes warfarin. The nurse anticipates which drug interaction?

Accepted Answer

Amiodarone inhibits warfarin metabolism, increasing INR and bleeding risk

Answer

Amiodarone increases warfarin metabolism, decreasing anticoagulant effect

Answer

Amiodarone displaces warfarin from protein binding, reducing its effectiveness

Answer

No significant interaction exists between amiodarone and warfarin

Question 5

Which pharmacological property of digoxin makes narrow therapeutic index monitoring essential?

Accepted Answer

Digoxin has a narrow margin between therapeutic and toxic plasma concentrations, with toxicity enhanced by hypokalemia

Answer

Digoxin is rapidly metabolized requiring frequent large doses to maintain levels

Answer

Digoxin toxicity is prevented solely by renal dose adjustment without serum level monitoring

Answer

Digoxin's therapeutic index is wide; monitoring is done for cost efficiency only

Question 6

Nitroglycerin relieves angina primarily through which mechanism?

Accepted Answer

Venous dilation reduces cardiac preload, decreasing myocardial oxygen demand

Answer

Direct coronary artery vasodilation increasing oxygen supply only

Answer

Arterial vasodilation reducing afterload as the primary antianginal mechanism

Answer

Negative chronotropic effect slowing heart rate to reduce oxygen consumption