41.3.16: Chapter 17

1. c. Based on the ECG data (no discernable P waves and narrow QRS complexes) and heart rate (greater than 100 beats per minute), the client has atrial fibrillation with rapid ventricular response.

2. d. Beta-adrenergic blockers such as metoprolol are an option for treating atrial fibrillation with rapid ventricular response.

1. c. Metoprolol is a beta-adrenergic blocker that slows the heart rate. If a client takes too much metoprolol, they may experience bradycardia.

2. c. Verapamil is a nondihydropyridine calcium channel blocker. It can decrease cardiac contractility, which can exacerbate congestive heart failure.

3. b. Procainamide is a sodium channel blocker antidysrhythmic drug, but it also has activity as a potassium channel blocker. Potassium blocker drugs require monitoring of the QT interval.

4. d. Quinidine is associated with a high incidence of diarrhea. Because diarrhea can cause electrolyte abnormalities, excessive diarrhea should be reported to the health care provider.

5. b. Metoprolol is a beta-adrenergic blocker. Beta-adrenergic blockers can cause fatigue.

6. a. Potassium channel blockers slow repolarization and are associated with torsade de pointes, a serious ventricular dysrhythmia.

7. b. Amiodarone can cause photosensitivity resulting in a bluish-gray color of sun-exposed skin.

8. b. Metoprolol tartrate does not require inpatient initiation. Dofetilide and sotalol require inpatient initiation. Mexiletine is used for ventricular arrhythmias.

9. c. Diltiazem and verapamil have FDA warnings concerning interactions with simvastatin. Diltiazem and verapamil inhibit the metabolism of simvastatin, increasing simvastatin plasma levels and the risk for adverse effects.

10. a. Because digoxin is eliminated by the kidneys, acute kidney injury puts the client at risk for digoxin toxicity. Some symptoms of digoxin toxicity are stomach upset, visual changes, and confusion.