A client with symptoms of a heart attack should be transported to the emergency department by ambulance rather than driving there.
Correct Answer
True
True. Emergency crews can start cardiac monitoring and give drugs on the way, and a life-threatening dysrhythmia can cause sudden fainting while driving. Early treatment can limit heart muscle death.
Category: Acute Coronary Syndrome Drugs
Question 2
Rapid infusion of large volumes of IV fluid is the main treatment for cardiogenic shock.
Correct Answer
False
False. In cardiogenic shock the problem is a failing pump, not low volume, and large fluid volumes can worsen pulmonary congestion. Treatment centers on restoring coronary blood flow and on drugs that support contraction and blood pressure.
Category: Shock Basics
Question 3
Vasopressin raises blood pressure in vasodilatory shock without stimulating adrenergic receptors.
Correct Answer
True
True. Vasopressin acts on V1 receptors in vascular smooth muscle to constrict vessels, so it raises blood pressure by a non-adrenergic route and is added when a client stays hypotensive despite fluids and catecholamine vasopressors.
Category: Vasopressors and Inotropes
Question 4
Diphenhydramine can replace epinephrine as the first drug for anaphylaxis.
Correct Answer
False
False. Epinephrine is the first and most important drug for anaphylaxis because it constricts vessels and opens the airways. Antihistamines such as diphenhydramine only ease itching and hives and are adjuncts given after epinephrine, never in its place.
Category: Epinephrine and Anaphylaxis
Question 5
Intramuscular epinephrine for anaphylaxis may be repeated if the symptoms persist.
Correct Answer
True
True. Epinephrine acts briefly, and a single injection does not always reverse anaphylaxis, so the dose can be repeated while help is on the way or IV treatment is started. Breathing, blood pressure and oxygen saturation are rechecked after each dose.
Category: Epinephrine and Anaphylaxis
Question 6
Procainamide is a safe choice for a client with myasthenia gravis because it has no effect on neuromuscular transmission.
Correct Answer
False
False. Procainamide can impair neuromuscular transmission and worsen weakness in myasthenia gravis, so it is avoided in these clients. It is also contraindicated in complete heart block and lupus.
Category: Emergency Dysrhythmia Drugs
Question 7
Morphine given for ischemic chest pain can lower blood pressure, so the nurse checks blood pressure before and after each dose.
Correct Answer
True
True. Morphine dilates veins and can cause hypotension, which would reduce coronary perfusion in a client with myocardial ischemia, so blood pressure is checked around each dose along with respiratory rate and level of sedation. A low blood pressure is reported to the provider before more is given.
Category: Acute Coronary Syndrome Drugs
Question 8
An MAO inhibitor has no effect on a client's response to dopamine.
Correct Answer
False
False. MAO inhibitors block the breakdown of dopamine and greatly intensify its effects, which can cause severe hypertension and dysrhythmias, so the provider must know about this drug before dopamine is started. Tricyclic antidepressants can also intensify its pressor effect.
Category: Vasopressors and Inotropes
Question 9
Dobutamine is incompatible with sodium bicarbonate and other alkaline solutions, so it is not mixed with them.
Correct Answer
True
True. Alkaline solutions inactivate dobutamine, and it is incompatible with many other drugs, so it is given through a separate line or checked for compatibility before any drug is infused with it.
Category: Vasopressors and Inotropes
Question 10
Norepinephrine improves insulin sensitivity, so clients with diabetes often need less insulin during the infusion.
Correct Answer
False
False. Norepinephrine decreases insulin sensitivity, so blood glucose is checked more often and clients with diabetes may need more insulin while it runs.
Category: Vasopressors and Inotropes
Question 11
Stopping a norepinephrine infusion abruptly can cause rebound hypotension.
Correct Answer
True
True. When the infusion stops suddenly, blood vessels relax and blood pressure can drop sharply, so the infusion is reduced gradually while blood pressure is monitored.
Category: Vasopressors and Inotropes
Question 12
Combining norepinephrine with a tricyclic antidepressant can cause severe hypertension.
Correct Answer
True
True. Tricyclic antidepressants block the reuptake of norepinephrine, and MAO inhibitors block its breakdown, so either can produce a profound rise in blood pressure during a norepinephrine infusion.
Category: Vasopressors and Inotropes
Question 13
Nitroglycerin is a good choice to relieve chest pain in a client who is in shock.
Correct Answer
False
False. Shock and circulatory failure are contraindications to nitroglycerin, because its vasodilation would lower an already inadequate blood pressure and reduce perfusion further.
Category: Acute Coronary Syndrome Drugs
Question 14
In anaphylaxis, large volumes of isotonic IV fluid are given because fluid shifts out of the blood vessels into the tissues.
Correct Answer
True
True. Leaky, dilated vessels leave too little volume in the circulation, so normal saline or lactated Ringer's is infused rapidly once IV access is established to support blood pressure.
Category: Epinephrine and Anaphylaxis
Question 15
Mental status is usually unaffected in shock.
Correct Answer
False
False. Poor perfusion of the brain commonly causes restlessness, confusion, decreased responsiveness or loss of consciousness. Other general signs of shock include hypotension, tachycardia, tachypnea and cool, clammy skin.
Category: Shock Basics
Question 16
A rising serum lactate level in a client with shock indicates that tissue perfusion is improving.
Correct Answer
False
False. Lactate rises when poorly perfused cells switch to anaerobic metabolism, so an increasing level signals worsening perfusion. A falling lactate is one sign that resuscitation is working.
Category: Shock Basics
Question 17
If a client develops symptomatic hypotension after nitroglycerin, the nurse withholds further doses and notifies the provider.
Correct Answer
True
True. Hypotension is a common adverse effect of nitroglycerin, and a client who becomes lightheaded or faint with a low blood pressure should not receive more until the provider is notified. The nurse also has the client sit or lie down.
Category: Acute Coronary Syndrome Drugs
False. Morphine eases pain and anxiety, which lowers heart rate and myocardial oxygen demand. Respiratory depression is its most serious risk, so naloxone should be available.
Category: Acute Coronary Syndrome Drugs
Question 19
After anaphylaxis is treated with epinephrine, the client is observed because symptoms can return once the drug wears off.
Correct Answer
True
True. Epinephrine acts briefly, and symptoms can return later without new exposure to the trigger, so the client is monitored after treatment. A client who self-injects epinephrine at home still seeks emergency care right away.
Category: Epinephrine and Anaphylaxis
Question 20
Aspirin given for a suspected myocardial infarction works by dissolving the clot that blocks the coronary artery.
Correct Answer
False
False. Aspirin irreversibly blocks platelet aggregation, which keeps the clot from growing; it does not break down an existing clot. Dissolving a clot is the job of thrombolytic drugs.
Category: Acute Coronary Syndrome Drugs