AGNP Board Exam – Cardiovascular Prescribing Exam Signs and symptoms of digitalis toxicity include:
constipation and muscle spasms.
bradycardia
... [Show More] and tinnitus.
headache and dizziness.
blurred vision and persistent diarrhea. Correct
Explanation:
Signs and symptoms of digitalis toxicity include: confusion, irregular pulse, loss of
appetite, nausea, vomiting, diarrhea, fast heart beat, and visual changes (blurred vision,
blind spots, green-yellow color disturbances, halo effect). Regardless of route of
administration, digoxin levels should be checked at 12-24 hours after the last dose.
However, depending on the clinical situation, wait at least 6-8 hours after the last dose
to check levels.
2. Question:
A side effect of beta-blockers that is more common in children than adults is:
decreased appetite.
muscle weakness.
vivid dreams.
a cough that produces mucus. Correct
Explanation:
Side effects of beta-blockers that are more common in children than adults may include
a mucus-producing cough, difficulty breathing, or tightness in the chest. Beta-blockers
are not recommended as initial therapy in children due to potential adverse outcomes
including increased bronchial obstruction and airway reactivity in children with
asthma.
3. Question:
Spironolactone (Aldactone) is highly protein bound and has a duration of:
6 hours.
12 hours.
24 hours.
48 hours. Correct
Explanation:
Spironolactone (Aldactone) is greater than 90% protein bound, has a half-life
elimination of 1.4 hours and a duration of 48-72 hours. It is classified as an aldosterone
receptor antagonist. This class blocks the effects of aldosterone, which increases sodium
reabsorption by the kidneys.
4. Question:
Nonselective beta-blockers block the stimulation of:
beta-1 receptors in the heart.
beta-2 receptors in the lungs.
both beta-1 receptors in the heart and beta-2 receptors in the lungs. Correct
neither beta-1 receptors in the heart nor beta-2 receptors in the lungs.
Explanation:
Nonselective beta-blockers (i.e., propranolol [Inderal]) block the stimulation of both
beta-1 receptors in the heart and beta-2 receptors in the lungs. Selective beta-blockers
(i.e. metoprolol [Lopressor]) specifically block beta-1 receptors, but may also block beta-
2 receptors at higher doses. Because they also block beta-2 receptors in the lungs,
nonselective beta-blockers are contraindicated in patients with asthma or chronic
obstructive pulmonary disease.
5. Question:
Dabigatran (Pradaxa), an anticoagulant, is also classified as a:
direct factor Xa inhibitor.
direct thrombin inhibitor. Correct
indirect thrombin inhibitor.
factor V inhibitor.
Explanation:
Dabigatran (Pradaxa) is a direct thrombin inhibitor (DTI). Medications in this class
inactivate circulating and clotting thrombin (factor IIa). They prevent thrombin (central
to the generation of a thrombus) from attaching fibrinogen to fibrin. DTIs bind directly
to thrombin and do not require a cofactor such as antithrombin to exert their effect.
They can inhibit both soluble thrombin and fibrin-bound thrombin. Key advantages of
using DTIs instead of heparin is that they: produce a more predictable anticoagulant
effect due to their lack of binding to other plasma proteins; exert an antiplatelet effect;
and do not cause immune-mediated thrombocytopenia. [Show Less]