RNSG 2539 E3 Flashcards


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1

a pt has an mi you should begin with giving metoprolol IV 5MG, Q___MIN, FOR ___ DOSES
a. 5;3
b. 2;5
c. 3;2
d. 2;3

d.

2

heart skipped a beat
a. PAC
b. PVC
c. AFIB
d. VFIB

a.

3

Premature Atrial Contractions (PAC) = contraction that originates in the ___, but not in the sinus node. In healthy persons, isolated incidents usually are not significant
a. atrium
b. ventricle
c. Purkinje fibers
d. bundle of his

a.

4

In healthy persons with premature atrial contractions, isolated incidents usually are not significant.
a. true
b. false

a.

5

to treat PAC or premature atrial contractions,
a. amiodarone / lidocaine
b. lidocaine/beta bs
c. beta blockers / no caff
d. amniodorone / no caff

c.

6

In pts w/ _____, frequent incidents of PAC may warn of or initiate more serious arrhythmias

a. diabetes
b. anemia
c. heart disease
d. pulmonary edema

c.

7

Rhythm is regular… Distorted P wave … ____ may be stopped, delayed or conducted normally
a. sa node
b. av node

b.

8

Causes in a normal heart = normal stress, physical fatigue, caffeine, tobacco, alcohol, hypoxia, electrolyte imbalance, hyperthyroidism, COPD, CAD
a. pac
b. pvc
c. vfib
d. atrial flutter

a.

9

Atrioventricular (AV) conduction is evaluated by assessing the relationship between the ____ and QRS complexes.
a. st seg
b. p wave
c. t wave
d. u wave

b.

10

carvedilol is a ______
a. beta blocker
b. anti dysrhythmic
c. anti-platelet
d. vasopressor

a.

11

sotalol is a _____
a. beta blocker
b. anti dysrhythmic
c. anti-platelet
d. vasopressor

a.

12

metoprolol is a ______
a. beta blocker
b. anti dysrhythmic
c. anti-platelet
d. vasopressor

a.

13

adenosine is a _______
a. beta blocker
b. anti dysrhythmic
c. anti-platelet
d. vasopressor

a.

14

Rebound excitation causing angina pain or MI with sudden withdrawal of beta blocker in client with CHD
a. metoprolol
b. atenolol
c. metformin
d. adenosine

a.

15

Which of the following cardiovascular conditions does NOT contraindicate the use of metoprolol?

A) Moderate to severe heart failure
B) 1st degree heart block
C) Cardiogenic shock
D) Peripheral vascular disease

d.

16

A nurse is reviewing an ECG of a patient who reports feeling like their heart "skipped a beat." The nurse notices premature beats with a distorted P wave. What is the most likely diagnosis?

a. Ventricular fibrillation

b. Premature atrial contractions (PAC)

c. Sinus bradycardia

d. Atrial fibrillation

b.

17

A patient with frequent premature atrial contractions(PAC) is being assessed. The nurse understands that PACs in patients with heart disease can:
a. Decrease the risk of developing more serious arrhythmias.
b. Indicate a high risk of immediate heart failure.
c. Warn of or initiate more serious arrhythmias.
d. Always require immediate electrical cardioversion.

c.

18

Which medication is contraindicated in peripheral vascular disease and Raynaud’s disease?
a. metaprolol
b. atenolol
c. metformin
d. adenosine

b.

19

1. A nurse is reviewing an ECG of a patient who reports feeling like their heart "skipped a beat." The nurse notices premature beats with a distorted P wave. What is the most likely diagnosis?

a. Ventricular fibrillation

b. Premature atrial contractions (PAC)

c. Sinus bradycardia

d. Atrial fibrillation

b.

20

A patient with frequent premature atrial contractions (PAC) is being assessed. The nurse understands that PACs in patients with heart disease can:

a. Are more commonly nothing serious if managed with moderate exercise with frequent rest periods.

b. Indicate a high risk of immediate heart failure.

c. Warn of or initiate more serious arrhythmias.

d. Always require immediate electrical cardioversion.

c.

21

During a health history interview, a patient mentions occasional consumption of large amounts of caffeine. The nurse knows that this can cause:
a. chronic premature atrial contractions (PAC).
b. Increased risk of developing premature atrial contractions (PAC).
c. No change in cardiac rhythm or rate.
d. Stabilization of the sinus node.

b.

22

A patient's ECG shows premature atrial contractions (PAC). What treatment might the nurse anticipate for a patient with a healthy heart and isolated incidents? a. administration of IV beta-blockers. b. Lifestyle modifications and monitoring. c. Urgent cardiac catheterization. d. Starting a daily regimen of aspirin.

b.

23

In educating a patient with frequent PACs about potential causes, the nurse should mention all the following except: a. Physical fatigue. b. Excessive alcohol consumption. c. High intake of fatty foods. d. Electrolyte imbalances.

c.

24

When monitoring a patient with PACs, the nurse knows to assess for which potential symptom? a. A sensation of the heart skipping a beat. b. Consistent chest pain radiating to the left arm. c. A steady, unchanging heart rate. d. Severe dizziness leading to loss of consciousness.

a.

25

A nurse is providing education on managing premature atrial contractions (PAC). Which lifestyle modification is least likely to be recommended? a. Reducing caffeine intake. b. Increasing physical activity. c. Avoiding tobacco use. d. Limiting alcohol consumption.

b.

26

For a patient with known heart disease and frequent PACs, the nurse anticipates administration of which medication to prevent more serious arrhythmias? a. Calcium channel blockers b. Beta blockers c. Diuretics d. Antibiotics

b.

27

A patient experiencing PACs asks the nurse why they feel their heart "skipping beats." The nurse explains this sensation is due to: a. An extra beat originating in the ventricles. b. A contraction that originates in the atrium, not in the sinus node. c. The heart pausing before the next normal beat. d. A rapid succession of beats from the atria.

b.

28

A patient with PACs is being discharged. What advice should the nurse give to prevent future episodes? a. "Try to avoid stressful situations as much as possible." b. "It's important to limit your caffeine intake to no more than 400 mg per day." c. "You should limit physical activity to reduce heart strain." d. "Take a daily aspirin PRN up to 3 times per day.”

a.

29

A nurse is reviewing a patient's EKG strip and notes the presence of wide and bizarre QRS complexes that occur earlier than expected. This finding is consistent with: A. Atrial fibrillation. B. Ventricular tachycardia. C. Premature Ventricular Contractions (PVCs). D. First-degree heart block.

c.

30

A patient's EKG shows ventricular ectopic beats that are identical in shape, suggesting they are originating from the same ectopic focus. These are best described as: A. Multifocal PVCs. B. Unifocal PVCs. C. Ventricular tachycardia. D. Ventricular fibrillation.

b.

31

During a telemetry reading, a nurse notices a pattern where every other heartbeat is a premature ventricular contraction. This pattern is known as: A. Ventricular bigeminy. B. Ventricular trigeminy. C. Ventricular quadrigeminy. D. A couplet of PVCs.

a

32

A patient's EKG strip demonstrates a pattern where every third beat is a premature ventricular contraction. How should the nurse document this observation? A. Ventricular bigeminy. B. Ventricular trigeminy. C. A triplet of PVCs. D. Multifocal PVCs.

b.

33

If a patient's EKG shows two consecutive premature ventricular contractions, the nurse recognizes this as: A. Ventricular tachycardia. B. A couplet. C. Ventricular bigeminy. D. Multifocal PVCs.

b.

34

When assessing a patient with suspected hypovolemic shock, which initial symptom is most indicative of compensatory mechanisms being activated? a. Hypertension b. Increased heart rate c. Increased urine output d. Bradypnea

b.

35

In hypovolemic shock, the term "third spacing" refers to fluid loss primarily through: a. Hemorrhage b. Shift of fluid to the interstitial spaces c. Increased diuresis d. Exhalation during tachypnea

b.

36

Which clinical finding is a direct consequence of a significant decrease in preload due to hypovolemia? a. Decreased stroke volume & decreased CO b. Increased central venous pressure c. Hypertension d. Polyuria

a.

37

For a patient presenting with symptoms of hypovolemic shock, which laboratory finding would support this diagnosis? a. Decreased lactate levels b. Increased specific gravity of urine c. Elevated hemoglobin and hematocrit d. Decreased serum sodium

b.

38

The management of a patient with more than 30% volume loss due to hypovolemic shock includes: a. Immediate replacement with blood products b. Administration of diuretics to shift fluid into intracellular space c. Oral hydration therapy d. Application of a tourniquet to the extremities to conserve blood volume

a.

39

A patient with hypovolemic shock is most at risk for developing: a. Hyperthermia b. Irreversible tissue damage due to lack of perfusion c. Hypoglycemia d. Polycythemia

b.

40

Which intervention is least appropriate for a patient experiencing hypovolemic shock due to third spacing? a. Intravenous fluid resuscitation b. Use of vasodilators to decrease blood pressure c. Monitoring for signs of organ failure d. Administration of blood products as indicated

b.

41

The first step in managing a patient with absolute hypovolemia and signs of shock should be: a. Inserting a urinary catheter to measure output b. Ensuring patent airway and supporting breathing c. Immediate initiation of enteral feeding to provide nutrition d. Providing a thermal blanket

b.

42

Which diagnostic test result is expected in a patient with severe hypovolemic shock? a. Decreased hematocrit due to hemodilution b. Increased lactate indicating anaerobic metabolism c. Elevated cardiac enzymes indicative of potential lethal arrhythmia d. Decreased blood urea nitrogen (BUN) due to renal compensation

b.

43

The physiological response to hypovolemic shock includes all of the following except: a. Parasympathetic nervous system activation to decrease heart rate b. Sympathetic nervous system activation to increase heart rate c. Decrease in central venous pressure due to fluid loss d. Tachypnea to increase oxygen delivery to tissues

a.

44

A 44-year-old man admitted with a peptic ulcer has a nasogastric (NG) tube in place. When the patient develops sudden, severe upper abdominal pain, diaphoresis, and a firm abdomen, which action should the nurse take? a. Irrigate the NG tube. b. Check the vital signs. c. Give the ordered antacid. d. Elevate the foot of the bed.

b.

45

Which assessment should the nurse perform first for a patient who just vomited bright red blood? a. Measuring the quantity of emesis b. Palpating the abdomen for distention c. Auscultating the chest for breath sounds d. Taking the blood pressure (BP) and pulse

d.

46

Which order from the health care provider will the nurse implement first for a patient who has vomited 1200 mL of blood? a. Give an IV H2 receptor antagonist. b. Draw blood for typing and crossmatching. c. Administer 1000 mL of lactated Ringers solution. d. Insert a nasogastric (NG) tube and connect to suction.

c.

47

A 46-year-old patient is admitted to the emergency department with severe abdominal pain and rebound tenderness. Vital signs include temperature 102 F (38.3 C), pulse 120, respirations 32, and blood pressure (BP) 82/54. Which prescribed intervention should the nurse implement first?
a. Administer IV ketorolac (Toradol) 15 mg.
b. Draw blood for a complete blood count (CBC).
c. Obtain a computed tomography (CT) scan of the abdomen.
d. Infuse 1 liter of lactated Ringers solution over 30 minutes.

d.

48

20-year-old female is brought to the emergency department with a knife handle protruding from the abdomen. During the initial assessment of the patient, the nurse should a. remove the knife and assess the wound. b. determine the presence of Rovsing sign. c. check for circulation and tissue perfusion. d. insert a urinary catheter and assess for hematuria.

c.

49

Which patient should the nurse assess first after receiving change-of-shift report? a. 60-year-old patient whose new ileostomy has drained 800 mL over the previous 8 hours b. 50-year-old patient with familial adenomatous polyposis who has occult blood in the stool c. 40-year-old patient with ulcerative colitis who has had six liquid stools in the previous 4 hours d. 30-year-old patient who has abdominal distention and an apical heart rate of 136 beats / per min

d.

50

After receiving change-of-shift report, which patient should the nurse assess first? a. Patient who is scheduled for the drain phase of a peritoneal dialysis exchange b. Patient with stage 4 chronic kidney disease who has an elevated phosphate level c. Patient with stage 5 chronic kidney disease who has a potassium level of 3.4 mEq/L L d. Patient who has just returned from having hemodialysis and has a heart rate of 124/min

d.

51

nurse is caring for a patient admitted with diabetes insipidus (DI). Which information is most important to report to the health care provider?
a. The patient is confused and lethargic.
b. The patient reports a recent head injury.
c. The patient has a urine output of 400 mL/hr.
d. The patients urine specific gravity is 1.003.

a.

52

the emergency department (ED) nurse receives report that a patient involved in a motor vehicle crash is being transported to the facility with an estimated arrival in 1 minute. In preparation for the patients arrival, the nurse will obtain a. hypothermia blanket. b. lactated Ringers solution. c. two 14-gauge IV catheters. d. dopamine (Intropin) infusion.

c.

53

Which finding is the best indicator that the fluid resuscitation for a patient with hypovolemic shock has been effective? a. Hemoglobin is within normal limits. b. Urine output is 60 mL over the last hour. c. Central venous pressure (CVP) is normal. d. Mean arterial pressure (MAP) is 72 mm Hg.

b.

54

The nurse is caring for a patient with a massive burn injury and possible hypovolemia. Which assessment data will be of most concern to the nurse? a. Blood pressure is 90 40 mm Hg. b. Urine output is 30 mL over the last hour. c. Oral fluid intake is 100 mL for the last 8 hours. d. There is prolonged skin tenting over the sternum.

a.

55

Eight hours after a thermal burn covering 50% of a patients total body surface area (TBSA) the nurse assesses the patient. Which information would be a priority to communicate to the health care provider? a. Blood pressure is 95/48 per arterial line. b. Serous exudate is leaking from the burns. c. Cardiac monitor shows a pulse rate of 108. d. Urine output is 20 mL per hour for the past 2 hours. /

d.

56

The nurse monitors a patient after chest tube placement for a hemopneumothorax. The nurse is most concerned if which assessment finding is observed? a. A large air leak in the water-seal chamber b. 400 mL of blood in the collection chamber c. Complaint of pain with each deep inspiration d. Subcutaneous emphysema at the insertion site

b.