Nokea
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.
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A client has been prescribed an antiarrhythmic. Which of the following points should the nurse include in the client teaching plan?
- A. Decrease the dose if adverse effects occur.
- B. Chew the tablets well before swallowing.
- C. Take frequent sips of water or chew gum.
- D. Take the drug only on an empty stomach.
Correct Answer: C
Rationale: The nurse should instruct the client to take frequent sips of water or chew gum to avoid dryness of the mouth. The nurse should instruct the client not to stop the medication or change the dose and schedule without consulting the health care provider. The tablets should not be chewed or crushed. They should be swallowed whole. Taking the drug on an empty stomach may cause gastric upset. The drug should be taken with food.
The nurse should monitor a client receiving lidocaine (Xylocaine) IV closely for which of the following? Select all that apply.
- A. Heartburn
- B. Apprehension
- C. Hypotension
- D. Auditory changes
- E. Bradycardia
Correct Answer: B,C,E
Rationale: The nurse must observe the client closely for signs of apprehension, hypotension, and bradycardia. Auditory changes are seen with quinidine, not lidocaine. Heartburn is associated with mexiletine.
A nurse assesses the results of a client's complete blood count observing for agranulocytosis for a client receiving which antiarrhythmic? Select all that apply.
- A. Verapamil (Calan)
- B. Lidocaine (Xylocaine)
- C. Sotalol (Betapace)
- D. Quinidine (Quinaglute)
- E. Mexiletine (Mexitil)
Correct Answer: A,D,E
Rationale: Agranulocytosis has been reported with the use of verapamil, quinidine, and mexiletine.
When evaluating a client who is receiving antiarrhythmic therapy, which of the following would the nurse interpret as an expected outcome? Select all that apply.
- A. No evidence of injury is seen.
- B. No evidence of infection is seen.
- C. Client is free of nausea.
- D. Client urinates adequately.
- E. Oral mucous membranes are intact and moist
Correct Answer: A,B,C,D,E
Rationale: Absence of injury, infection, and nausea, adequate renal function, and intact, moist oral mucous membranes are expected outcomes for antiarrhythmic therapy.
Quinidine is prescribed to a client with cardiac arrhythmia. When documenting the client's drug history, the nurse inquires about the concomitant use of any other drug. Which of the following drugs when given concomitantly may cause an increase in serum quinidine levels?
- A. Cimetidine
- B. Rifampin
- C. Hydantoins
- D. Nifedipine
Correct Answer: A
Rationale: Cimetidine, when given concurrently with quinidine, may cause an increase in serum quinidine levels. Hydantoins and nifedipine cause a decrease in serum quinidine levels. Rifampin does not interact with quinidine.