Deck 32: Coordinating Care for Critically Ill Patients With Cardiovascular Dysfunction

Question 1

The healthcare provider wants an SvO₂ level on a patient with a pulmonary artery catheter. The nurse collects this sample from which port of the catheter?
1)Distal lumen port
2)Balloon port
3)Proximal injectable port
4)Proximal infusion port

Answer 1

1

Question 2

A patient is being evaluated for chest pain in the emergency department. Which laboratory test is the best to determine if this patient has experienced an acute myocardial infarction?
1)Troponin
2)Creatine kinase
3)Creatine kinase MB
4)Serum lactate level

Answer 2

1

Question 3

The nurse correlates damage to which area of the heart in patients who experience an inferior wall myocardial infarction (MI)?
1)Sinoatrial (SA) node
2)Atrioventricular (AV) node
3)Purkinje fibers
4)Ventricles

Answer 3

1

Question 4

The nurse correlates damage to which area of the heart in the patient who has complete occlusion of the left anterior descending (LAD) artery?
1)Anterior wall
2)Inferior wall
3)Lateral wall
4)Posterior wall

Question 5

The nurse provides care to a patient with an arterial line. Which is the priority nursing action when providing care to this patient?
1)Labeling the line, "No IV medications"
2)Observing the pulse oximetry waveform every shift
3)Flushing the arterial line every hour to prevent clotting
4)Ensuring the site used for the line is covered with an occlusive dressing

Question 6

In setting up hemodynamic monitoring equipment, the nurse correlates which action as the rationale for zeroing the transducer?
1)Preventing air from entering the system
2)Offsetting atmospheric pressure that may alter the reading
3)Minimizing the risk of infection
4)Providing pressure in the system

Question 7

The nurse correlates which measurement as an indirect measurement of cardiac contractility?
1)Central venous pressure
2)Left ventricular stroke index (LVSWI)
3)Mean arterial pressure
4)Systemic vascular resistance

Question 8

The nurse recognizes which clinical manifestation in the patient with right-sided heart failure?
1)Increased central venous pressure
2)Increased left atrial pressure
3)Decreased blood pressure
4)Decreased systemic vascular resistance

Question 9

The nurse conducts an Allen test for a patient who requires the placement of an arterial line. Which finding indicates a positive test?
1)Normal color returns in 13 seconds
2)Normal color returns in 12 seconds
3)Normal color returns in 11 seconds
4)Normal color returns in 10 seconds

Question 10

In administering an angiotensin-converting enzyme inhibitor to a patient with cardiomyopathy, the nurse correlates which rationale for this medication?
1)Reduce afterload
2)Improve heart muscle contractions
3)Reduce fluid accumulation in the lungs
4)Decrease sympathetic response to decreased cardiac output

Question 11

The nurse provides instructions to a patient who is being discharged after treatment for a myocardial infarction. Which patient statement indicates a need for additional teaching?
1)"I will take the Lipitor to reduce my cholesterol levels."
2)"I will take the Lopressor to decrease my heart's demand for oxygen."
3)"I will take the Plavix to prevent the platelets from forming new clots."
4)"I will take the sublingual nitroglycerin each day to prevent chest pain."

Question 12

The nurse instructs a patient recovering from an acute myocardial infarction on the Life's Simple 7 actions. Which patient statement indicates that additional teaching is required?
1)"I will not smoke."
2)"I will eat a heart-healthy diet."
3)"I will walk for at least 30 minutes three times a week."
4)"I will make sure my blood sugar level stays under 100 mg/dL."

Question 13

The nurse correlates which arterial blood gas results to compensated metabolic acidosis in the patient with cardiogenic shock?
1)pH 7.30 PaCO₂ 38 mm Hg HCO₃ 18 mEq/L
2)pH 7.38 PaCO₂ 32 mm Hg HCO₃ 20 mEq/L
3)pH 7.40 PaCO₂ 40 mm Hg HCO₃ 23 mEq/L
4)pH 7.48 PaCO₂ 40 mm Hg HCO₃ 28 mEq/L

Question 14

The nurse monitors for which hemodynamic parameter in the patient with cardiogenic shock?
1)Increased afterload
2)Increased venous oxygen saturation
3)Increased cardiac output
4)Increased mean arterial pressure

Question 15

The nurse is preparing to obtain a pulmonary artery occlusive pressure (PAOP) on a patient and implements which action to ensure the patient's safety?
1)Inflating the balloon 1.5 mL
2)Placing the patient in the Trendelenburg position
3)Manually deflating the balloon
4)Deflating the balloon within 5 minutes of obtaining the pressure

Question 16

The nurse is caring for a patient experiencing cardiogenic shock. Which medication should the nurse expect to be prescribed to improve this patient's cardiac output?
1)Nitroglycerin
2)Morphine sulfate
3)Norepinephrine (Levophed)
4)Dobutamine hydrochloride (Dobutamine)

Question 17

The nurse is reviewing medications prescribed for a patient with hypertrophic cardiomyopathy. Which medication does the nurse question as a primary treatment for this condition?
1)Angiotensin-converting enzyme inhibitor (ACE-I)
2)Diuretic
3)Digoxin
4)Beta blocker

Question 18

The nurse correlates electrocardiogram (ECG) lead changes in leads II, III, and aVF to which type of myocardial infarction?
1)Anterior wall
2)Inferior wall
3)Lateral wall
4)Posterior wall

Question 19

The nurse is preparing medications for a patient experiencing an acute myocardial infarction. Which medication will dilate the patient's coronary blood vessels?
1)Heparin
2)Fibrinolytics
3)Nitroglycerin
4)Beta blockers

Question 20

The nurse correlates which rationale to the administration of positive inotropic medications to a patient in cardiogenic shock?
1)Increase heart rate
2)Increase cardiac contractility
3)Decrease venous return
4)Decrease systemic vascular resistance

Question 21

In administering nitroglycerin to the patient in cardiogenic shock, the nurse recognizes which of the following as the rationale?
1)Increases heart rate
2)Increases systemic vascular resistance
3)Decreases cardiac contractility
4)Decreases afterload

Question 22

The nurse correlates which assessment data to unstable angina? Select all that apply.
1)Chest pain that is not relieved by rest
2)Chest pain that is associated with exercise
3)Chest pain accompanied by elevated troponin
4)Chest pain that has no relationship to myocardial infarction
5)Chest pain with transient ST segment changes

Question 23

The nurse provides care for a patient whose blood pressure is 90/60 mm Hg. The nurse documents the mean arterial pressure as ____________________.

Question 24

The nurse is assigned to a patient with a newly inserted central line. What actions should be taken to prevent the patient from developing an infection? Select all that apply.
1)Performing line care
2)Using aseptic technique
3)Minimizing handling of the line
4)Using normal saline to flush the line
5)Ensuring an occlusive dressing is applied

Question 25

The nurse is providing care for a patient ordered a heparin infusion after suffering a myocardial infarction. The heparin is infusing at 20 mL/hour with 25,000 units of heparin in 500 mL of D₅W. The nurse calculates that the patient is receiving how many units/hour?

Question 26

The nurse is caring for a patient in the intensive care unit because of cardiogenic shock secondary to a massive inferior wall myocardial infarction. The patient is receiving several intravenous medications. Which medications does the nurse correlate to providing vasopressor support to maintain an adequate mean arterial pressure? Select all that apply.
1)Dopamine
2)Dobutamine
3)Nitroglycerin
4)Norepinephrine
5)Phenylephrine

Question 27

A patient with cardiomyopathy is scheduled for a biventricular implantable cardioverter defibrillator. What should the nurse include when teaching the patient about this device? Select all that apply.
1)Part of the thickened overgrown septum is removed.
2)A pacer wire is placed in the right and left ventricles.
3)A small part of the thickened heart muscle is destroyed.
4)The automatic defibrillator will deliver a shock if necessary.
5)The automatic defibrillator monitors the heart for dysrhythmias.

Question 28

The nurse suspects that a patient is experiencing a complication from a pulmonary artery catheter based on which data? Select all that apply.
1)Bleeding
2)Bradycardia
3)Elevated body temperature
4)Acute onset of shortness of breath
5)Development of a cardiac dysrhythmia

Question 29

A patient with atypical chest pain is prescribed a 12-lead electrocardiogram. What findings would support this patient is experiencing an acute myocardial infarction? Select all that apply.
1)Q waves
2)Junctional rhythm
3)ST segment elevation
4)Prolonged PR interval
5)Premature ventricular contractions

Question 30

A patient with cardiogenic shock has an intra-aortic balloon pump (IABP). Which actions does the nurse include in the patient's plan of care?
1)Elevate the affected leg on a pillow
2)Elevate the head of the bed 45 degrees
3)Keep the affected leg straight at all times
4)Keep the bed flat with a small pillow under the head