Nokea
A patient has been started on therapy of a continuous infusion of lidocaine after receiving a loading dose of the drug. The nurse will monitor the patient for which adverse effect?
- A. Drowsiness
- B. Nystagmus
- C. Dry mouth
- D. Convulsions
Correct Answer: D
Rationale: Lidocaine toxicity can cause convulsions due to central nervous system effects. Drowsiness, nystagmus, and dry mouth are not primary adverse effects of lidocaine.
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The nurse is preparing to administer a bolus dose of verapamil as follows: 'Give 5-mg bolus of verapamil, IV push, over 2 minutes. May repeat in 30 minutes if needed.' The medication is available in a 2.5-mg/mL strength solution. Identify how many milliliters will the nurse draw into the syringe for this dose.
Correct Answer: 2 mL
Rationale: To calculate: 2.5 mg/1 mL = 5 mg/x mL. Cross-multiply: (2.5 * x) = (1 * 5); 2.5x = 5; x = 5/2.5 = 2 mL.
The nurse is preparing to administer adenosine to a patient who is experiencing an acute episode of paroxysmal supraventricular tachycardia. When giving this medication, which is important to remember?
- A. The onset of action occurs within 5 minutes.
- B. The medication must be given as a slow intravenous (IV) push.
- C. Asystole may occur for a few seconds after administration.
- D. The medication has a long half-life, and therefore duration of action is very long.
Correct Answer: C
Rationale: Adenosine has a very short half-life (<10 seconds) and is given as a rapid IV push. A brief period of asystole may occur, which is expected due to its transient AV node blockade. Slow IV push or long half-life are incorrect.
The nurse notes in the patient's medication orders that the patient will be taking ibutilide. Based on this finding, the nurse interprets that the patient has which disorder?
- A. Ventricular ectopy
- B. Atrial fibrillation
- C. Supraventricular tachycardia
- D. Bradycardia
Correct Answer: B
Rationale: Ibutilide, a class III antidysrhythmic, is used to convert atrial fibrillation or flutter to normal sinus rhythm. It is not indicated for ventricular ectopy, supraventricular tachycardia, or bradycardia.
A patient is in the emergency department with a new onset of rapid-rate atrial fibrillation, and the nurse is preparing a continuous infusion. Which drug is most appropriate for this dysrhythmia?
- A. Diltiazem
- B. Atenolol
- C. Lidocaine
- D. Adenosine
Correct Answer: A
Rationale: Diltiazem is used for rate control in atrial fibrillation by slowing AV node conduction, making it appropriate for rapid-rate atrial fibrillation. Atenolol, lidocaine, and adenosine are not primarily used for this purpose.
A patient is taking quinidine for the treatment of dysrhythmias. The nurse will monitor for which adverse effect of this drug?
- A. Diarrhea
- B. Tachycardia
- C. Tinnitus
- D. Dry mouth
Correct Answer: C
Rationale: Quinidine, a class Ia antidysrhythmic, can cause cinchonism, characterized by tinnitus, hearing loss, and gastrointestinal upset. Diarrhea, tachycardia, and dry mouth are not primary adverse effects.