ß blockers should be avoided in which of the following conditions?
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Solution
Bronchoconstriction
ß blockers should be avoided in bronchoconstrictive disease. B, C, and D are indications for the use of ß blockers.
Competitive antagonism of which of the following occurs at ß receptor sites?
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Solution
Catecholamines
Catecholamine receptor sites are blocked by the action of ß-blocking agents. Adrenergic sites may be blocked, but the more appropriate response is catecholamine receptors. Acetylcholine is not affected by ß blockers. Norepinephrine is a catecholamine.
Routine laboratory monitoring in clients taking ß blockers should include:
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Solution
Glucose
ß blockers influence glucose metabolism. Although A, C, and D are nice to have, there is no indication that routine assessment of thyrotropin, sodium, or creatine phosphokinase is needed.
Jason James is taking ß blockers, all of the following should be included in his assessment except:
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Solution
Pulmonary function tests
Unless the client has a history of pulmonary disease and pulmonary function tests are indicated, there is no need to include this in the routine assessment of the client taking ß blockers.
Which of the following effects of calcium channel blockers causes a reduction in blood pressure?
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Solution
Decreased peripheral vascular resistance
One of the effects of calcium channel blockers is to decrease peripheral vascular resistance. A, C, and D describe the opposite effects of calcium channel blockers.
Which of the following calcium channel blockers is used to counteract or prevent cerebral vasospasm?
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Solution
nimodipine
Nimodipine is given in the neurologic client to prevent cerebral vasospasm. Choices A, C, and D are given in cardiac disease and in the management of hypertension only.
Which of the following adverse reactions is found more often in volume-depleted elderly clients?
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Solution
Hypotension
Hypotension is more likely to occur in the elderly. Choices A, B, and C may occur but are not necessarily increased in frequency in elderly clients.
Which of the following calcium channel blockers has the most potent peripheral smooth muscle dilator effect?
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Solution
nifedipine
Nifedipine has the strongest peripheral smooth muscle dilator effect of all the calcium channel blockers. Other choices have less of a vasodilator effect.
Conduction defects will most likely be an adverse associated with the use of:
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Solution
verapamil
Verapamil (Calan) has the strongest chronotropic effect and will cause a delay in conduction at the SA and AV nodes.
Dobutamine (Dobutrex) improves cardiac output and is indicated for use in all of the following conditions except:
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Solution
arrhythmias
Dobutamine (Dobutrex) is not used to treat arrhythmias. Choices A, B, and D are conditions are conditions that respond to dobutamine.