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Unit 4ABCD Flashcards | StudBud
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Unit 4ABCD
Unit 4ABCD
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1
RN is caring for pt w/ HF. Which symptoms does the nurse assess?
Fatigue
Tachycardia
Chest discomfort or pain
Expectorating thick, yellow sputum
2
Which assessment result obtained a day after a pt w/ HF was admitted is the best indicator that treatment has worked?
Pt has diuresis of 400mL in 24hrs
Pt has an apical pulse of 82 bpm
Pt's weight decreases by 2.5kg
Pt's blood pressure is 122/84 mmHg
3
Which symptoms support the diagnosis of infective endocarditis instead of pericarditis or rheumatic carditis?
Splinter hemorrhages
Thickening of the endocardium
Friction rub auscultated at the left lower sternal border
Pain aggravated by breathing, coughing, and swallowing
4
Increased preload can lead to and/or be caused by what?
Hypervolemia
Hypovolemia
Regurgitation of cardiac valves
Dehydration
5
Pt needs to receive edu on the drug Plavix, what do you say?
“You may experience red tinged vomiting.”
“Avoid aspirin while taking this drug.”
“Discontinue this drug 2 days before CABG.”
“Take the Plavix w/ food.”
6
What are the goals for treatment regarding ACS?
Promote blood flow
Increase O2 supply
Decrease myocardial O2 demand
Increase myocardial CO2 demand
7
Stacy is receiving edu on how to reduce her risk of an MI, what do you teach her?
Cholesterol of <200 mg/day
Low level of physical activity 15 mins/day
Can skip her insulin medication admin if she doesn’t feel good
Low sodium diet
8
Which pt is best to assign to the LPN working on the telemetry unit?
Pt w/ rheumatic fever who has a new systolic murmur
Pt w/ pericarditis who has paradoxical pulse & JVD
Pt w/ dilated cardiomyopathy who uses O2 for exertional dyspnea
Pt w/ heart failure who is receiving dobutamine
9
After a stress test, the pt will need to avoid a hot shower because of what potential effect?
Shortness of Breath
Vertigo
Dysthymias
Hypotension
10
Who is the most common to have metabolic syndrome?
African Americans
Alaska Natives
American Indians
Mexican Americans
11
Lower extremity pain caused by intermittent claudication can be relieved by:
Lowering the lower extremities
Elevating the lower extremities
12
What must you assess before giving Digoxin?
PT, PTT, & INR
Serum K+ level
Blood pressure
Apical pulse
13
Pt arrives at ER c/o chest pain. 12 lead EKG is performed & MD notes MI is occurring. Who should greet the pt next?
Rapid Response Team
Cath Lab
Patient care tech to get heart rate and other vital signs
Cardiac nurse w/ 15 yrs of experience
14
Which of the following assessments corresponds with decreased cardiac output?
Normal sinus rhythm
Blood pressure 140/80
Urine output of 400mL over a 12hr shift
Peripheral edema
15
Which best describes the PR interval on the EKG?
Atrial relaxation and filling with blood
Ventricular depolarization through the purkinji fibers
Electrical current traveling from the atria to the ventricles
Coronary perfusion and ischemia
16
Pt w/ HF is taking furosemide. Which finding concerns the RN w/ this new prescription?
Crt of 1.0 mg/dL
Na+ level of 135 mEq/L
K+ level of 2.8 mEq/L
Mg+ level of 1.9 mEq/L
17
Older adult pt is 4hrs postop CABG & has BP of 80/50 mmHg. What action does the nurse take first?
Assess PAWP
No action required, low BP is normal for older adults
No action required for postop CABG pts
Give ordered loop diuretics
18
Pt begins therapy w/ Lisinopril. What does the RN consider at the start of the therapy with this med?
Liver function tests
The risk for hypotension
The potential for bradycardia
Pt's ability to understand medication teaching
19
RN discusses importance of restricting Na+ in pt's diet for HF. Which pt statement indicates need for more edu?
"I need to avoid eating hamburgers."
"I wont put the salt shaker on the table anymore."
"I must cut out bacon and canned foods."
"I need to avoid lunchmeats, but may cook my own turkey."
20
T or F: One of the key assessments made, which indicates Rheumatic Carditis, is the presence of a strep infection.
False
True
21
T or F: Upon auscultation, the apical heart sound is at the right 5th intercostal space midclavicular line.
True
False
22
After receiving change-of-shift report, which pt does the RN assess first?
55yr old w/ pulmonary edema on furosemide & O2 sat is 94%
68yr old w/ pericarditis reporting sharp, stabbing chest pain
46yr old w/ aortic stenosis taking digoxin & new-onset early ventric contrx
23
T or F: Before a stress test is performed, the pt needs to be NPO.
True
False
24
Select all that apply regarding drug information for Morphine:
Decreases O2 demand
Can be given up to 10mg every 5-15 mins
Watch for hypotension, bradycardia, & vomiting
Can be given via IM with Narcan in room
25
T or F: Nitroglycerin can be chewed in order to relieve chest pain.
False
True
26
To validate that a pt had a MI, the nurse assesses for positive findings on which tests?
Homocysteine and C-reactive protein
Troponin
CK-MB and alkaline phosphatase
Total cholesterol, LDL, and HDL
27
Which nursing action may be delegated to an unlicensed assistive personnel?
Monitor the pain level for a pt w/ acute pericarditis
Check for peripheral edema in a pt w/ endocarditis
Determine the usual alcohol intake for a pt w/ cardiomyopathy
Obtain daily weights for several pts w/ class 4 HF
28
Female pt has: aching jaw, pain b/tw shoulders, and indigestion. No chest pain. What could this pt be experiencing?
Atypical Myocardial Infarction
Myocardial Infarction
Angina
29
RN is caring for pt in phase 1 cardiac rehab. Which activity does the RN suggest?
Consultation w/ social worker for disability planning
Planning & participating in a walking program
Placing a chair in the shower for independent hygiene
The need to increase activities slowly at home
30
How does the RN recognize that the pt w/ HF has demonstrated a positive outcome related to metoprolol?
Pt states her HR declined from 95bpm to 62bpm when standing
Ejection fraction is 25%
Pt states that she is able to sleep on one pillow
Pt was hospitalized 5 times last yr w/ pulmonary edema
31
Which diagnostic test result is consistent with a diagnosis of HF?
Ejection fraction of 60%
BNP of 760 pg/mL
Serum K+ level of 3.2 mEq/L
Chest x-ray report showing right middle lobe consolidation
32
Pt has 99.8F oral temp, 48 bpm pulse, 20 breaths per minute, K+ 3.2 mEq/L. Pt has orders for digoxin. What does RN do?
Give drug, document assessment findings in the medical record
Hold drug, and obtain order for K+ supplement
Give drug, reassess the heart rate in 30 minutes
Hold drug, and obtain order for additional dose of furosemide
33
Elderly pt has history of rheumatic fever as a child. What potential problem should the nurse explore for this pt?
Increased risk for pericarditis
Cardiomegaly
Increased risk for diabetic complications
Heart failure & valve damage
34
What is the primary purpose for the administration of morphine to a pt w/ an MI?
To decrease the pt’s anxiety
To decrease the pt’s pain
To sedate the pt
To decrease the O2 demand on the pt’s heart
35
LPN is floated to the cardiac unit. Which pt does the charge nurse assign to the LPN?
Stable 66yr old w/ order for NTG patch & is scheduled for discharge today
62yr old 4days postop mitral valve replacement & has oral temp of 100.8F
60yr old admitted today for pacemaker insertion w/ 3rd deg heart block
36
Pt has radiating pain to left arm, high stress before pain onset, & pain relieved by NTG. What does this info describe?
Atypical Myocardial Infarction
Angina
Myocardial Infarction
37
Pt had a large MI. How does the nurse recognize onset of left ventricular failure?
Urine output of 1500mL on the preceding day
Expectoration of yellow sputum
Pedal edema
Crackles in the lung fields
38
T or F: A symptom that is indicative of an MI is substernal chest pressure relieved only by opioids.
False
True
39
Prompt pain management w/ MI is essential for which reason?
Pain relief improves oxygen supply and decreases oxygen demand
Relief of pain indicates that the MI is resolving
The discomfort will increase pt anxiety and reduce coping
Pain med would not be used until a definitive diagnosis has been est.
40
95% of sudden cardiac arrest victims die before reaching the hospital due to what?
Vfib
Afib
41
T or F: Heparin cannot be used to help prevent re-occlusion from thrombus formation.
True
False
42
Which medication, when given in heart failure, may improve morbidity and mortality?
Bumetanide
Carvedilol
Dobutamine
Digoxin
43
Pt w/ HF gained 5 pounds in the past 3 days.The pt states, "I feel so tired and SOB." Which action does the RN take 1st?
Remind the pt about dietary sodium restrictions
Notify the health care provider about the pt's weight gain
Assess the pt for peripheral edema
Auscultate the pt's posterior breath sounds
44
The surgeon has chosen to use the internal mammary artery to perform a CABG. Why did the surgeon choose this artery?
This is what the surgeon prefers because it is easier
These arteries remain open longer
So pt will not need to have a leg incision
The surgeon chose this because of the pt's age
45
T or F: A pt will have normal heart sounds documented as S1 & S2.
True
False
46
Pt in ER has fatigue, 3 pound weight gain in the past 2 days, ascites, and dependent edema.
Left-sided heart failure
Right-sided heart failure
47
Pt's BP 88/52 & HR 138bpm. Order of 0.25mg Digoxin IV push. Available 0.5mg/2mL. Calculate the dose to be administered.
Give 3mL
Hold the med because pt's BP is too low
Give 1mL
Give 0.5mL
48
Increased afterload can lead to and/or be caused by what?
Orthostatic hypotension
Hypertension
Edema
Vasoconstriction
49
When examining an EKG strip, RN notes that p waves aren't present. Which of the following best describes this finding?
The ventricles are not contracting
The heart beat is being initiated outside the SA node
Sinus bradycardia is present
The heart rhythm is irregular
50
T or F: Aspirin can be chewed in order to relieve chest pain.
True
False
51
Which items are correct regarding the drug Aspirin?
Decreases the chances of blood clot formation
Can be chewed
Must check the pt for bleeding
Inhibits platelet aggregation
52
RN is providing discharge edu to pt w/ HF. Which pt statement indicates correct understanding of the teaching?
"I will call the doctor if I have a cough lasting 3 or more days."
"I will report to the doctor weight loss of 2-3 pounds in a day."
"I will try walking for 1 hour each day."
53
Which pt do you assess first at the beginning of your shift?
Pt w/ 3rd degree heart block, HR 68bpm, after having an inferior MI
Pt w/ PCA who has a dose of heparin scheduled
Pt w/ bradycardia after MI & now has heart paced at 64bpm
Pt w/ ACS who has a 3-pound weight gain and dyspnea
54
Which intervention best assists the pt w/ acute pulmonary edema in reducing anxiety and dyspnea?
Monitor pulse ox and cardiac rate/rhythm
Reassure the pt that his distress can be relieved w/ proper intervention
Place the pt in high-Fowler's position w/ legs down
55
What is the most important factor when assessing a pt’s risk for ACS?
Gender
Age
Smoking history
Diet
56
What is the most important thing to do before giving a Fibrinolytic for a STEMI?
Perform neuro check
Monitor pt for bleeding
Prepare to give NTG if Fibrinolytic does not work
Perform EKG after med admin
57
Which of the following describes central venous pressure (CVP)?
Average arterial blood pressure
Pressure in the left ventricle
Volume of blood that remains in the atria during diastole
Pressure in the right atria
58
RN is assessing a pt who is postop CABG. Which nursing action would be performed first?
Monitor mental status
Monitor the heart rate for dysrhythmias
Assess for postop pain at the pt's incision site
Assess coping skills
59
Which of the following describes cardiac output?
Volume of blood pumped by the heart in one minute
Pressure required for LV contraction
Volume of blood returning to the RA
Volume of blood pumped w/ each ventricular contraction
60
Pt in ER has fatigue, dizziness, acute confusion, weakness, and cough w/ blood tinged sputum. EKG shows tachycardia.
Left-sided heart failure
Right-sided heart failure
61
When following up w/ HF pt, how does the RN recognize the pt has been compliant with fluid restrictions?
Auscultation of crackles
Reports sucking on ice chips all day for dry mouth
Weight loss of 6 pounds since last visit
Pedal edema
62
Pt arrives in ER after MVA 30 mins ago. Pt has significant chest injury. What assmt might indicate cardiac tamponade?
JVD
Muffled heart sounds
Increased cardiac output
Decreases arterial pressure
63
Which characteristics put women at high risk for an MI?
Family history
Abdominal obesity
Increasing age
Breast Cancer
64
T or F: Atherosclerosis is the primary factor in developing CAD & ACS.
False
True
65
Pt diagnosed w/ left-sided HF. Which assessment findings will the RN expect the pt to have?
Crackles in both lungs
Breathlessness
Peripheral edema
Ascites
66
Pt is immediately postop CABG. Which finding does the nurse contact the surgeon about?
Serum K+ 3.9 mEq/L
Oral temp 98.2F
Chest tube drainage 175mL last hr
Incisional pain 6 on scale of 0 to 10
67
In a pt w/ chest pain, how would you evaluate the effectiveness of Nitroglycerin?
Decrease in chest pain
Decrease in O2 demand
Decrease in blood pressure
Increase in SpO2
68
HF pt is now exhibiting signs of air hunger & anxiety. Which nursing intervention does the RN perform 1st?
Positions the pt to alleviate dyspnea
Monitors and documents heart rate, rhythm, and pulses
Determines the pt's physical limitations
Encourages alternate rest and activity periods
69
Male pt has: jaw/back/shoulder pain lasting 35 minutes & only relieved by opioids. What does the info provided describe?
Atypical Myocardial Infarction
Angina
Myocardial Infarction
70
Pt comes into ER w/ chest discomfort. Which action does the nurse perform first?
Remain calm and stay with the pt
Provide pain relief medication
Administer oxygen therapy
Obtains pt's description of chest discomfort
71
82yr old pt admitted w/ exacerbation of HF.RN asks about which med use b/c it raises suspicion of worsening the pt's HF?
NPH insulin
Hydrochlorothiazide
Levothyroxine
Ibuprofen
72
Pt has 12 lead EKG performed. No P-wave appears and pt has HR of 42 beats/min. What is happening?
AV node is having to start the electrical impulse
SA node is failing to fire
Electrical impulse is starting at the Bundle of His
Pt is in extreme heart failure due to ventricles failing to pump
73
Which of the following disorders will you see have atrial fibrillation?
Aortic regurgitation
Mitral stenosis
Mitral regurgitation
Aortic stenosis
74
Pt has been given nitroglycerin for chest pain, what do you do?
Monitor the pt’s blood pressure
Evaluate chest pain after 5 mins of med admin
Send to cath lab after 1st dose if chest pain is unrelieved
Wear sterile gloves if giving medication via NTG patch
