Nokea
A patient is taking procainamide for a cardiac dysrhythmia. The nurse will monitor the patient for which possible adverse effect?
- A. Bradycardia
- B. Shortened QT interval
- C. Dyspnea
- D. Diarrhea
Correct Answer: D
Rationale: Procainamide, a class Ia antidysrhythmic, can cause gastrointestinal side effects like diarrhea. Bradycardia, shortened QT interval, and dyspnea are not commonly associated with procainamide.
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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.
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 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.
When starting a patient on antidysrhythmic therapy, the nurse will remember that which problem is a potential adverse effect of any antidysrhythmic drug?
- A. Deficiency of fat-soluble vitamins
- B. Hyperkalemia
- C. Heart failure
- D. Dysrhythmias
Correct Answer: D
Rationale: Antidysrhythmic drugs can cause new dysrhythmias (prodysrhythmic effect) due to their effects on cardiac electrophysiology. Fat-soluble vitamin deficiency, hyperkalemia, and heart failure are not universal adverse effects.
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.