Nokea
A client is admitted to the cardiology unit of a health care facility for ventricular arrhythmia. In which of the following conditions can an antiarrhythmic drug be safely administered?
- A. Aortic stenosis
- B. Premature ventricular contraction
- C. Third-degree heart block
- D. Severe heart failure
Correct Answer: B
Rationale: The nurse can safely administer an antiarrhythmic drug if the client has premature ventricular contractions. Aortic stenosis, third-degree heart block, and severe congestive heart failure are contraindications for the use of antiarrhythmic drugs.
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A nurse is preparing to administer an antiarrhythmic and identifies the drug as a class III potassium channel blocker. Which drug would the nurse be most likely to administer?
- A. Amiodarone
- B. Flecainide
- C. Mexiletine
- D. Propafenone
Correct Answer: A
Rationale: Amiodarone is a class III potassium channel blocker. Flecainide, mexiletine, and propafenone are class I sodium channel blockers.
A nurse is caring for a client receiving an oral antiarrhythmic drug. Which apical pulse rate would lead the nurse to withhold the drug and notify the health care provider immediately?
- A. 58 beats/min
- B. 68 beats/min
- C. 78 beats/min
- D. 88 beats/min
Correct Answer: A
Rationale: The nurse should withhold the drug and report to the primary health care provider whenever the client's pulse rate falls below 60 beats/min or rises to more than 120 beats/min. Pulse rates of 68 beats/min, 78 beats/min, and 88 beats/min fall within the normal range.
A client with cardiac arrhythmia is prescribed verapamil. The nurse would instruct the client about which of the following as a possible adverse reaction?
- A. Diarrhea
- B. Hyperactivity
- C. Peripheral edema
- D. Hypertension
Correct Answer: C
Rationale: The nurse should inform the client that peripheral edema could be an adverse reaction to verapamil therapy. Diarrhea, hyperactivity, and hypertension are not adverse reactions associated with verapamil therapy. Other adverse reactions associated with verapamil are constipation, mental depression, and hypotension.
After administering an antiarrhythmic drug, the nurse would report which of the following electrocardiogram (ECG) changes to the physician? Select all that apply.
- A. Tachycardia
- B. Prolongation of PR interval
- C. Prolongation of QT interval
- D. Widening of the QRS complex
- E. Bradycardia
Correct Answer: A,B,C,D,E
Rationale: The nurse reports to the physician any abnormalities or significant interval changes of the ECG, including tachycardia, prolongation of the PR interval or QT interval, widening of the QRS complex, or bradycardia.
When describing arrhythmias to a group of nursing students, the instructor explains that arrhythmias may be triggered by which of the following? Select all that apply.
- A. Emotional stress
- B. Heart disease
- C. Electrolyte imbalance
- D. Diabetes
- E. Hypoxia
Correct Answer: A,B,C,E
Rationale: Arrhythmias may occur as a result of heart disease, a disorder that affects cardiovascular function, emotional stress, hypoxia, and electrolyte imbalances. Diabetes is not a direct trigger for arrhythmias but may contribute indirectly through cardiovascular complications.