Pharmacology: Cardiovascular Medications Flashcards
35 cards from real NCLEX practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 20 Pharmacology: Cardiovascular Medications flashcards as text
A patient is prescribed metoprolol succinate. Which condition is this medication primarily used to treat?
Answer: Heart failure and hypertension
Metoprolol succinate is a beta-1 selective blocker used to treat heart failure, hypertension, and angina by reducing heart rate and myocardial oxygen demand.
The nurse is administering digoxin. Which assessment finding requires holding the medication and notifying the provider?
Answer: Heart rate of 54 bpm
Digoxin should be held if the apical heart rate is less than 60 bpm in adults. A rate of 54 indicates bradycardia and risk for digoxin toxicity.
A patient taking warfarin has an INR of 4.8. Which action should the nurse take first?
Answer: Hold the warfarin and notify the provider
An INR of 4.8 is supratherapeutic (therapeutic range 2–3 for most indications), indicating a high bleeding risk. The nurse should hold warfarin and notify the provider for further instructions.
Which electrolyte imbalance most increases the risk of digoxin toxicity?
Answer: Hypokalemia
Hypokalemia (low potassium) increases the risk of digoxin toxicity because digoxin and potassium compete for the same binding sites on the Na+/K+ ATPase pump.
A patient is starting lisinopril for hypertension. Which side effect should the nurse include in patient teaching?
Answer: Dry, persistent cough
ACE inhibitors like lisinopril commonly cause a dry, persistent cough due to accumulation of bradykinin. This is a known side effect and may require switching to an ARB.
The nurse is caring for a patient receiving IV heparin. Which lab value is used to monitor heparin therapy?
Answer: aPTT
The aPTT (activated partial thromboplastin time) is used to monitor unfractionated heparin therapy. Therapeutic range is typically 60–100 seconds (1.5–2.5 times normal).
A patient with atrial fibrillation is prescribed amiodarone. Which finding requires immediate provider notification?
Answer: QTc interval of 520 milliseconds
Amiodarone prolongs the QT interval. A QTc of 520 ms significantly exceeds the safe threshold (men >450 ms, women >470 ms) and raises risk for torsades de pointes, a life-threatening dysrhythmia.
Which teaching point is most important for a patient prescribed nitroglycerin sublingual tablets for angina?
Answer: Take up to 3 tablets every 5 minutes; call 911 if pain persists after the third tablet
For acute angina, nitroglycerin SL may be repeated every 5 minutes up to 3 doses. If pain is unrelieved after 3 tablets, the patient should call 911 as this may indicate MI.
The nurse is administering amlodipine (Norvasc) to a patient. Which food should the nurse advise the patient to avoid?
Answer: Grapefruit juice
Grapefruit juice inhibits CYP3A4 enzymes in the gut, increasing amlodipine blood levels and risk of hypotension and adverse effects.
A nurse is educating a patient about taking atorvastatin (Lipitor). Which instruction is most important?
Answer: Report unexplained muscle pain or weakness immediately
Statins can cause myopathy or rhabdomyolysis, a serious condition involving muscle breakdown. Unexplained muscle pain, weakness, or dark urine should be reported immediately.
Which assessment finding is a priority concern when a patient is receiving IV furosemide (Lasix) for heart failure?
Answer: Serum potassium of 2.8 mEq/L
Furosemide causes potassium loss (hypokalemia). A potassium of 2.8 mEq/L is below normal (3.5–5.0) and can cause life-threatening cardiac dysrhythmias, requiring immediate intervention.
A patient is receiving IV dopamine. The nurse notes the infusion infiltrated the IV site. Which action is the priority?
Answer: Stop the infusion and prepare to administer phentolamine locally
Dopamine extravasation causes severe vasoconstriction and local tissue necrosis. Phentolamine (an alpha-adrenergic blocker) should be infiltrated locally to counteract vasoconstriction and prevent tissue damage.
A patient taking spironolactone should be monitored for which electrolyte imbalance?
Answer: Hyperkalemia
Spironolactone is a potassium-sparing diuretic that blocks aldosterone, causing sodium and water excretion while retaining potassium, which can lead to hyperkalemia.
The nurse is teaching a patient about clopidogrel (Plavix) after coronary stent placement. Which statement indicates further teaching is needed?
Answer: I can stop this medication if I develop a minor headache
Stopping clopidogrel early after coronary stent placement greatly increases the risk of stent thrombosis, a life-threatening event. Minor side effects do not justify stopping therapy without provider guidance.
Which antihypertensive class is contraindicated in pregnancy due to risk of fetal renal damage?
Answer: ACE inhibitors
ACE inhibitors are teratogenic and contraindicated in pregnancy (especially 2nd and 3rd trimesters) due to risk of fetal renal dysplasia, oligohydramnios, and neonatal death.
A patient receiving alteplase (tPA) for acute ischemic stroke develops sudden severe headache and changes in consciousness. The nurse should prioritize which action?
Answer: Stop the infusion immediately and notify the provider
Sudden severe headache and altered consciousness during tPA suggest intracranial hemorrhage, a life-threatening complication. The infusion must be stopped immediately and the provider notified.
A patient is prescribed carvedilol for heart failure. Which statement about this medication is accurate?
Answer: It blocks both alpha-1 and beta receptors
Carvedilol is a non-selective beta-blocker that also blocks alpha-1 adrenergic receptors. This dual blockade reduces heart rate, contractility, and peripheral vascular resistance.
A nurse is caring for a patient on a heparin infusion who develops a platelet count drop from 280,000 to 62,000 over 5 days. What condition does this suggest?
Answer: Heparin-induced thrombocytopenia (HIT)
A platelet drop of >50% occurring 5–10 days after starting heparin is classic for HIT, an immune-mediated reaction that paradoxically causes thrombosis despite low platelets.
Which patient should the nurse question before administering a prescribed dose of IV metoprolol?
Answer: Patient with acute asthma exacerbation
Beta-blockers like metoprolol can cause bronchoconstriction and are relatively contraindicated in patients with reactive airway diseases such as asthma or COPD.
A patient taking simvastatin is prescribed clarithromycin for a respiratory infection. The nurse should recognize this combination places the patient at risk for:
Answer: Increased statin levels and rhabdomyolysis
Clarithromycin inhibits CYP3A4, which metabolizes simvastatin. This inhibition increases statin blood levels dramatically, raising the risk of myopathy and rhabdomyolysis.