A client with multiple cardiac diagnoses receives a prescription for verapamil. Which therapeutic response(s) should the nurse anticipate for a client taking this medication? Select all that apply.
Presence of normal sinus rhythm.
Decreased anginal pain.
Potassium level within normal limits.
Decreased hypertensive blood pressure.
Increased frequency of urine output.
Correct Answer : A,B,D
A. Verapamil is a calcium channel blocker (non-dihydropyridine) that slows conduction through the AV node and can help control heart rate and rhythm, particularly in dysrhythmias such as atrial fibrillation or supraventricular tachycardia. This can result in restoration or maintenance of a normal sinus rhythm.
B. Verapamil decreases myocardial oxygen demand by reducing heart rate and contractility, and it also causes coronary artery vasodilation. These effects improve blood flow to the heart muscle and help reduce anginal pain.
C. Verapamil does not directly regulate potassium levels. Potassium balance is more closely affected by medications such as diuretics, ACE inhibitors, or potassium supplements. Therefore, a normal potassium level is not a direct therapeutic response to this medication.
D. Verapamil causes vasodilation and decreases cardiac contractility, which leads to a reduction in systemic vascular resistance and cardiac output. These effects contribute to lowering blood pressure, making it effective in managing hypertension.
E. Verapamil is not a diuretic and does not increase urine output. In some cases, calcium channel blockers may even cause fluid retention rather than increased diuresis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}
Explanation
Rationale for correct choices:
- New onset angina: The client presents with chest pain described as pressure and tightness that started during activity (mowing the lawn) and worsened despite rest, which is consistent with unstable or new-onset angina. The ECG shows ST depression, indicating myocardial ischemia without infarction. Normal troponin levels confirm that no myocardial cell death has occurred, differentiating angina from myocardial infarction.
- Troponin: Troponin T and I are specific biomarkers for myocardial injury. In this client, troponin levels are within normal limits, indicating that myocardial necrosis has not occurred. This supports the diagnosis of angina rather than myocardial infarction.
Rationale for incorrect choices:
- Myocardial infarction: MI typically presents with prolonged chest pain and ST-segment changes on ECG plus elevated troponin, indicating cardiac muscle damage. This client’s troponin levels are normal, making MI unlikely at this time.
- Aortic aneurysm: Usually presents with sudden, severe, tearing chest or back pain, often radiating to the back. ST depression on ECG is not associated with aortic aneurysm.
- Prothrombin time (PT) or C-reactive protein (CRP): PT assesses coagulation, and CRP is a marker of general inflammation. Neither is specific for myocardial ischemia, so normal levels do not confirm or exclude angina. Troponin is the key biomarker for cardiac injury.
Correct Answer is ["42"]
Explanation
Step 1: Identify the formula
gtt/min = (Total volume × Drop factor) ÷ Time (in minutes)
Step 2: Insert values
Total volume = 1000 mL, Drop factor = 10 gtt/mL, Time = 4 hr × 60 min/hr = 240 min
gtt/min = (1000 × 10) ÷ 240
Step 3: Calculate
= 10,000 ÷ 240
≈ 41.67
Step 4: Round to the nearest whole number
≈ 42 gtt/min
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