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Class IV Antidysrhythmic Drugs – NCLEX-Style Questions on Calcium Channel Blockers (Verapamil & Diltiazem) with Answers and Rationales | A Graded Pharmacology Exam Prep
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Chapter 25 – Antidysrhythmic Drugs | NCLEX-Style Pharmacology Questions with Answers & Rationales | A-Graded Nursing Exam Resource Which effect on the electrocardiogram (ECG) will the nurse expect to see in a patient who is receiving
Class IV antidysrhythmic drugs prolong PR intervals, which delays the atrioventricular conduction, thereby decreasing the heart rate. Which statement is an accurate description of the mechanism of action for verapamil?
Calcium channel blockers block the slow influx of calcium ions into the slow calcium channels. Which cardiovascular condition is treated with nondihydropyridine calcium channel blockers?
Calcium channel blockers are indicated for supraventricular tachycardia, atrial dysrhythmias, hypertension, and angina. Which route of administration for verapamil is appropriate for maintenance therapy?
verapamil is usually administered along with digoxin. Mr. Allen, a 73-year-old patient with a history of mitral valve regurgitation, is admitted to the hospital with chest pain. His ECG shows atrial fibrillation at a rate of 140 beats/min. He is initially treated with verapamil 5 mg IV push for two doses before he converts to sinus rhythm with a rate of 86 beats/min. To prevent further dysrhythmias, Mr. Allen is prescribed verapamil 80 mg PO TID. The nurse's assessment indicates Mr. Allen has no more chest pain. His lungs are clear, and his abdomen is soft.
He has 1+ edema to his ankles and feet bilaterally. Mr. Allen's vital signs are as follows: BP 124/66, HR 56, R 20, and T 97.8°F. Which of Mr. Allen's vital sign findings will indicate to the nurse to hold the verapamil?
Mr. Allen, a 73-year-old patient with a history of mitral valve regurgitation, is admitted to the hospital with chest pain. His ECG shows atrial fibrillation at a rate of 140 beats/min. He is initially treated with verapamil 5 mg IV push for two doses before he converts to sinus rhythm with a rate of 86 beats/min. To prevent further dysrhythmias, Mr. Allen is prescribed verapamil 80 mg PO TID. The nurse's assessment indicates Mr. Allen has no more chest pain. His lungs are clear, and his abdomen is soft. He has 1+ edema to his ankles and feet bilaterally. Mr. Allen's vital signs are as follows: BP 124/66, HR 56, R 20, and T 97.8°F. The nurse notes Mr. Allen, who is taking verapamil, has edema to his ankles and feet. Which medical
Class IV antidysrhythmic drugs, such as verapamil, could cause heart failure. Swelling of the ankles and feet could be an early indicator of heart failure. Which statement is accurate regarding the interaction between verapamil and grapefruit juice?
Grapefruit juice can inhibit the metabolism of verapamil, raising serum drug levels with potential toxicity. A patient is noted to be experiencing a cardiac dysrhythmia. Which parameter would the nurse use to
minutes Diltiazem intravenous should be administered slowly over 2 minutes while monitoring the cardiac rhythm for any changes in rate or rhythm. Which instruction would the nurse provide a patient about the proper administration of extended-
The nurse would hold the diltiazem until the prescription can be clarified with the health care provider. Giving diltiazem to a patient who is already taking digoxin and metoprolol could suppress the cardiac function and cause severe bradycardia, decrease atrioventricular conduction, and decrease cardiac contractility. Beta blockers and diltiazem should be administered several hours apart to minimize the risk of cardiosuppression. A patient who is being discharged on diltiazem tells the nurse that cooking with herbs and taking supplements has improved the patient's physical stamina. Which response by the nurse is
diltiazem." Great! You're focusing on Class IV Antidysrhythmic Drugs, which are Calcium Channel Blockers (CCBs) like verapamil and diltiazem, primarily used to manage supraventricular dysrhythmias.
Rationale: Class IV drugs (verapamil, diltiazem) block calcium channels, particularly affecting SA and AV nodal conduction, which slows heart rate and reduces conduction velocity.
Rationale: Class IV CCBs are effective for SVTs because they slow AV nodal conduction.
Rationale: Diltiazem can cause hypotension and bradycardia. Always assess vital signs before administering.
Rationale: Constipation is a frequent side effect of verapamil. Patients should be encouraged to increase fiber intake.
Rationale: Grapefruit juice can inhibit metabolism of verapamil and increase risk of toxicity. Patients should avoid it.
Rationale: The patient is bradycardic and hypotensive, which are signs of CCB toxicity. The nurse should stop the drug and alert the provider.
Reduction of myocardial contractility A patient with atrial fibrillation is being discharged on verapamil. Which symptoms will the nurse
Dyspnea Swelling to feet and ankles