Class IV antidysrhythmics or calcium channel blockers have what action on the cardiovascular system?
Increase blood vessel spasm.
Decrease flow of calcium ions thus decreasing heart rate and contractions.
Decrease refractory period.
Increase heart rate.
The Correct Answer is B
Class IV antidysrhythmics or calcium channel blockers decrease the flow of calcium ions into cardiac and vascular smooth muscle cells, thus decreasing heart rate and contractions. By reducing the calcium influx, they also decrease the slope of phase 0 and 4 and prolong phase 2 of the cardiac action potential. This results in vasodilation, reduced myocardial oxygen demand, and decreased conduction through the AV node.
Choice A is wrong because calcium channel blockers do not increase blood vessel spasm, but rather cause vasodilation.
Choice C is wrong because calcium channel blockers do not decrease refractory period, but rather prolong it by extending phase 2 of the cardiac action potential.
Choice D is wrong because calcium channel blockers do not increase heart rate, but rather decrease it by slowing down the pacemaker activity and AV nodal conduction.
Normal ranges for heart rate are 60 to 100 beats per minute, and for blood pressure are 120/80 mmHg or lower.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Digibind is the trade name forantidigoxin, which is an antibody made up of anti-digoxin immunoglobulin fragments.It is thespecific antidoteto digoxin toxicity, which can occur even when the serum digoxin concentration is within the therapeutic range.Digoxin toxicity causes anorexia, nausea, vomiting, neurological symptoms and arrhythmias.
Choice A, Protamine sulfate, is wrong because it is the antidote for heparin overdose, not digoxin toxicity.
Protamine sulfate reverses the anticoagulant effect of heparin by binding to it and forming a stable complex.
Choice B, Acetylcysteine, is wrong because it is the antidote for acetaminophen overdose, not digoxin toxicity.
Acetylcysteine replenishes glutathione, which is depleted by acetaminophen metabolites that cause hepatotoxicity.
Choice D, Vitamin K, is wrong because it is the antidote for warfarin overdose, not digoxin toxicity.
Vitamin K restores the synthesis of clotting factors that are inhibited by warfarin.
Normal ranges for serum digoxin concentration are 0.6 to 1.2 nanomol/L (0.5 to 0.9 nanograms/mL) for heart failure and unknown for atrial fibrillation without heart failure.
Normal ranges for serum potassium level are 3.5 to 5.0 mmol/L and for serum magnesium level are 0.7 to 1.0 mmol/L.
Correct Answer is B
Explanation
Furosemide is a diuretic that lowers blood pressure and increases urine output. It also causes potassium loss, which can lead to hypokalemia (low potassium levels). The patient’s blood pressure is already low when sitting, and the serum potassium is below the normal range of 3.5 to 5.0 mEq/L. Administering furosemide could worsen these conditions and cause adverse effects such as dehydration, dizziness, muscle weakness, cardiac arrhythmias, and renal impairment. Therefore, the nurse should contact the provider before giving the medication and report the vital signs and laboratory results.
Choice A. Administer medication is wrong because it could harm the patient as explained above.
Choice C. Hold medication until next dose is wrong because it does not address the underlying problem of fluid retention and hypokalemia.
The nurse should not delay notifying the provider about the patient’s condition.
Choice D. Check urine output before giving medication is wrong because it is not enough to ensure the patient’s safety.
The nurse should also check the blood pressure and serum potassium levels, which are more critical indicators of the patient’s status.
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