A patient is taking a beta 1-adrenergic drug to improve the stroke volume of the heart. The nurse caring for this patient knows that this drug acts by increasing:

Myocardial contractility

Cardiac afterload

Venous return

Cardiac preload

Answer and Explanation

The Correct Answer is A

Choice A reason: Beta 1-adrenergic drugs, like dobutamine, stimulate beta-1 receptors in the heart, increasing cyclic AMP and calcium influx, enhancing myocardial contractility. This increases stroke volume by strengthening heart contractions, directly improving cardiac output, making this the correct choice for the drug’s mechanism of action.

Choice B reason: Cardiac afterload is the resistance the heart pumps against. Beta 1-adrenergic drugs don’t directly reduce afterload; they increase contractility. Increasing afterload would decrease stroke volume, opposing the drug’s purpose, making this choice incorrect for the drug’s effect on stroke volume.

Choice C reason: Venous return affects preload, not directly influenced by beta 1-adrenergic drugs. These drugs enhance contractility, increasing stroke volume independently of venous return. While preload impacts output, it’s not the primary mechanism of beta-1 stimulation, making this choice incorrect.

Choice D reason: Cardiac preload is the initial stretch of the heart, influenced by venous return. Beta 1-adrenergic drugs increase contractility, not preload, to boost stroke volume. Preload changes are secondary and not the primary action of these drugs, making this choice incorrect.

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Correct Answer is B

Explanation

Choice A reason: Beta blockers decrease renin release, reducing angiotensin II and aldosterone, which lowers blood pressure. This statement is accurate, reflecting correct understanding, so it does not indicate a need for further teaching.

Choice B reason: Beta blockers do not primarily decrease peripheral vascular resistance; they reduce heart rate and contractility. Peripheral resistance is more affected by alpha blockers or vasodilators, so this incorrect statement indicates a need for further teaching.

Choice C reason: Beta blockers reduce heart rate and myocardial contractility, decreasing cardiac output and blood pressure. This statement is correct, showing proper understanding, so it does not require additional teaching.

Choice D reason: While beta blockers do not directly block angiotensin II, they reduce its production by decreasing renin. The statement is imprecise but not entirely wrong, making it less indicative of a teaching need than choice B.

A. Sodium level of 140 mEq/L B. Oxygen saturation of 95% C. Potassium level of 3.0 mEq/L D. Blood glucose level of 100 mg/dL

Correct Answer is C

Explanation

Choice A reason: A sodium level of 140 mEq/L is within the normal range (135-145 mEq/L). While furosemide can cause hyponatremia, this value is not concerning. Hypokalemia is a greater risk with furosemide and digoxin, as it potentiates digoxin toxicity, making this choice less critical than potassium.

Choice B reason: Oxygen saturation of 95% is normal (95-100%). Crackles suggest pulmonary edema, but this saturation doesn’t indicate severe hypoxia requiring immediate action. Hypokalemia poses a greater risk with digoxin and furosemide, as it increases toxicity potential, making this choice less concerning.

Choice C reason: A potassium level of 3.0 mEq/L (normal: 3.5-5.0 mEq/L) indicates hypokalemia, exacerbated by furosemide’s diuretic effect. In digoxin use, low potassium increases cardiac toxicity risk, causing arrhythmias, especially with an irregular heart rate noted, making this the most concerning value requiring immediate attention.

Choice D reason: A blood glucose level of 100 mg/dL is normal (70-110 mg/dL fasting). It’s unrelated to digoxin or furosemide’s primary risks (e.g., electrolyte imbalances, arrhythmias). Hypokalemia is a more immediate concern due to its synergistic toxicity with digoxin, making this choice less critical.

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A patient is taking a beta 1-adrenergic drug to improve the stroke volume of the heart. The nurse caring for this patient knows that this drug acts by increasing:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Explanation

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