Medical Surgical Nursing: Cardiovascular care

1. Before undergoing cardiac catherization, it is important for the nurse to ask the patient if they have any allergies to:

Shellfish

Egg

Avocados

Peanuts

Allergy to shellfish indicates a risk to radioplaque dyes and iodine. An antihistamine and corticosteroid are given prior to the procedure.

Explanation

Allergy to shellfish indicates a risk to radioplaque dyes and iodine. An antihistamine and corticosteroid are given prior to the procedure.

2. A nurse is providing teaching to a patient scheduled for a stress test. The patient understands instruction when he states:

"I shouldn't use my Verapamil before the test."

"It is important that I have a large meal before the test."

"I'm allowed to drink my coffee on the day of the test."

"I'm going to take a long hot shower after the test."

Calcium channel blockers, like Verapamil should be withheld before the test to allow the heart rate to increase during the test

Explanation

Calcium channel blockers, like Verapamil should be withheld before the test to allow the heart rate to increase during the test

3. The patient is being discharged with warfarin (Coumadin). What labs should be routinely monitored for this patient?

Serum lipid panel

PTT

CBC

PT and INR

PT (prothrombin time) and INR (international normalized ratio) are monitored for the therapeutic effects of the anticoagulant

Explanation

PT (prothrombin time) and INR (international normalized ratio) are monitored for the therapeutic effects of the anticoagulant

4. Which of the following is the correct method in identifying for postural hypotension?

First check the BP at the sitting position. After 3 minutes, have patient at the prone position. Wait for 1 minute to auscultate the BP and count the radial pulse.

First check the BP at the supine position, After 3 minutes, have patient sit or stand. Wait for 1 minute to auscultate the BP and count the radial pulse.

First check the BP at the prone position, After 3 minutes, have patient sit or stand. Wait for 1 minute to auscultate the BP and count the radial pulse.

Postural hypotension is when there is a decrease of more than 20 mm Hg in systolic pressure or greater than 10 mm Hg in dystolic pressure. When a patient moves from a supine to a sitting or standing position, they are experiencing dizziness due to postural hypotension.

Explanation

Postural hypotension is when there is a decrease of more than 20 mm Hg in systolic pressure or greater than 10 mm Hg in dystolic pressure. When a patient moves from a supine to a sitting or standing position, they are experiencing dizziness due to postural hypotension.

5. Which electrolyte does not play a major role in cardiovascular performance?

Magnesium

Chloride

Potassium

Calcium

Chloride maintains osmotic pressure and plays a role in the buffering mechanism of the body

Explanation

Chloride maintains osmotic pressure and plays a role in the buffering mechanism of the body

6. Which of the following is the correct definition of a stroke volume?

The volume of blood stretching the left ventricle at the end of diastole

The volume of blood ejected by the left ventricle during each contraction

The pressure against which the ventricles has to eject blood through the semilunar valves

The volume of blood pumped from the left ventricle in one minute

Choice B is correct

Explanation

Choice B is correct

7. A nurse is reviewing an ECG reading and notes an increased U wave with a depressed ST. The nurse interprets this reading as what electrolyte imbalance?

Hypocalcemia

Hypercalcemia

Hypokalemia

Hyperkalemia

Increased U waves with a depressed ST and flat, inverted T waves are normally found in hypokalemia.

Explanation

Increased U waves with a depressed ST and flat, inverted T waves are normally found in hypokalemia.

8. A patient who is being hemodynamically monitored has an increased RA pressure. How does the nurse interpret this finding?

Pulmonary rupture

Hypovolemia

Right ventricular failure

Afterload reduction

Normal RA ranges between 1-8 mm Hg. An increased RA indicates right ventricular failure whereas a low RA indicates hypovolemia

Explanation

Normal RA ranges between 1-8 mm Hg. An increased RA indicates right ventricular failure whereas a low RA indicates hypovolemia

9. A nurse is interviewing a 56-year-old patient who states that after sleeping for two hours, he feels like he's suffocating. He also says that "Once I sit up and dangle my legs off the bed, I feel better." The nurse interprets these findings as:

Orthopnea

Anxiety

Insomnia

Paroxysmal nocturnal dyspnea

PND occurs when the patient lies down for a few hours and is awakened with shortness of breath. Reclining and dangling the legs off the bed relieves their dyspnea.

Explanation

PND occurs when the patient lies down for a few hours and is awakened with shortness of breath. Reclining and dangling the legs off the bed relieves their dyspnea.

10. A nurse is reviewing a patient's chart. Which lab finding would reveal to the nurse that the patient has an MI? (Select all that apply)

CK-MB

CK-MM

CK-BB

Troponins

Creatinine

CK-MB and troponins are not found in a healthy patients; therefore, an elevation of both indicates an infarct

Explanation

CK-MB and troponins are not found in a healthy patients; therefore, an elevation of both indicates an infarct

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11. An ER nurse is reviewing the charts of several patients. Which of the following patients would the nurse interpret as having an angina?

A 39-year-old female patient complaining of indigestion, discomfort, and states that she feels like she has to "catch her breath."

A 51-year-old male patient who states "It hurts when I breathe!"

A 42-year-old female patient complaining of pain traveling up and down her chest

A 27-year old male patient complaining of a dull ache on his chest, palpitations, and numbness in his fingertips

As opposed to men, women have atypical signs of an angina pectoris. Signs and symptoms include, dyspnea, stabbing chest pain, indigestion, fatigue, nausea and vomiting.

Explanation

As opposed to men, women have atypical signs of an angina pectoris. Signs and symptoms include, dyspnea, stabbing chest pain, indigestion, fatigue, nausea and vomiting.

12. A nurse in the telemetry unit is caring for a patient who has a weak pulse that changes to a strong pulse. The nurse would document this finding as:

Paradoxical pulse

Gallop

Hyperkinetic pulse

Pulsus alternans

Pulsus alternans is where a weak pulse alternates with a stronger one.

Explanation

Pulsus alternans is where a weak pulse alternates with a stronger one.

13. A nurse is providing preoperative teaching to a patient who will undergo cardiac catheterization. Which of the following statements indicates further teaching?

"I shouldn't take my digoxin before catheterization."

"I will be under general anesthesia."

"I shouldn't eat anything after midnight."

"Coughing is normal during the procedure."

Local anesthesia is given so that the patient may report chest pain or pressure on the site

Explanation

Local anesthesia is given so that the patient may report chest pain or pressure on the site

14. Which of the following is a normal finding in the aging adult?

Conduction time decreases

Baroreceptors become more sensitive

The left ventricle increases in size

Systemic vascular resistance decreases

An increased left ventricle is a common finding in the aging adult

Explanation

An increased left ventricle is a common finding in the aging adult

15. While the nurse is doing a cardiovascular assessment on a 67-year-old patient, she hears an atrial gallop (S4). The nurse should evaluate this finding as:

Possibility for hypertension

Possibility for aortic stenosis

Possibility for ventricular hypertrophy

A normal finding

This would be a normal finding for this particular patient since the ventricles stiffen in the aging adult

Explanation

This would be a normal finding for this particular patient since the ventricles stiffen in the aging adult