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

Question 1

The nurse is preparing medications for a patient experiencing an acute myocardial infarction.Which medication will dilate the patient's coronary blood vessels?

A) Heparin
B) Fibrinolytics
C) Nitroglycerin
D) Beta blockers

Answer 1

Nitroglycerin

Question 2

A patient with cardiogenic shock has an intra-aortic balloon pump (IABP).What should the nurse include when caring for this patient?

A) Elevated the affected leg on a pillow
B) Elevate the head of the bed 45 degrees
C) Keep the affected leg straight at all times
D) Keep the bed flat with a small pillow under the head

Answer 2

Keep the affected leg straight at all times

Question 3

The nurse notes that a patient with cardiomyopathy has been prescribed an angiotensin-converting enzyme inhibitor.What is the purpose of this medication?

A) Reduce afterload
B) Improve heart muscle contractions
C) Reduce fluid accumulation in the lungs
D) Decrease sympathetic response to decreased cardiac output

Answer 3

Reduce afterload

Question 4

During a home visit the nurse notes that a patient recovering from an acute myocardial infarction has not had medication prescriptions filled at the pharmacy.What should the nurse say in response to this observation?

A) "I don't blame you.I don't like to take medications every day either."
B) "As long as you aren't having any symptoms,delaying the medications is acceptable."
C) "Most people don't like to take medications but try to remember to get the prescriptions filled."
D) "The medications will help treat the effects of your current health problem and prevent any future events."

Question 5

The nurse is preparing to obtain a pulmonary artery wedge pressure (PAWP)on a patient.What action should be taken to ensure for the patient's safety?

A) Inflate the balloon 1.5 mL
B) Place the patient in the Trendelenburg position
C) Monitor the waveform after inflating the balloon
D) Deflate the balloon within five minutes of obtaining the pressure

Question 6

A patient in the intensive care unit is experiencing chest pain.What assessment finding indicates that cardiogenic shock is being compensated?

A) Hypotension
B) Increased heart rate
C) Absent urine output
D) Mottled and cyanotic skin

Question 7

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?

A) "I will not smoke."
B) "I will eat a heart healthy-diet."
C) "I will walk for at least 30 minutes three times a week."
D) "I will make sure my blood sugar level stays under 100 mg/dL."

Question 8

The nurse wants to evaluate a patient's right heart preload.Which approach should be used to obtain this measurement?

A) Zero the arterial line
B) Measure the central venous pressure
C) Measure the pulmonary artery wedge pressure
D) Attach the proximal infusion port to an intravenous solution

Question 9

The health-care provider wants an SvO2 level on a patient with a pulmonary artery catheter.From where should this sample be taken?

A) Distal lumen
B) Balloon inflation lumen
C) Proximal injectable port
D) Proximal infusion port

Question 10

The nurse hears crackles when auscultating the lung sounds of a patient with cardiomyopathy.What should this finding indicate to the nurse?

A) Atelectasis
B) Pneumothorax
C) Stasis pneumonia
D) Pulmonary edema

Question 11

The health-care provider wants to determine a patient's cardiac contractility.What should be used to make this determination?

A) Cardiac output
B) Mean arterial pressure
C) Pulmonary artery measurement
D) Central venous pressure measurement

Question 12

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?

A) Troponin
B) Prothrombin time
C) Creatine kinase-MB
D) Complete blood count

Question 13

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?

A) Nitroglycerin
B) Morphine sulfate
C) Norepinephrine (Levophed)
D) Dobutamine hydrochloride (Dobutamine)

Question 14

The nurse is reviewing the manifestations of an acute myocardial infarction with a patient diagnosed with type 2 diabetes mellitus.What should the nurse emphasize as being an atypical manifestation of this cardiac disorder?

A) Fatigue
B) Dyspnea
C) Tachycardia
D) Hypertension

Question 15

A patient recovering from cardiogenic shock is observed walking to the patient lounge.What should the nurse recommend to this patient?

A) Call for help when wanting to walk
B) Limit sitting out of bed to 30 minutes
C) Increase activity by 15 minutes every day
D) Important to obtain as much rest as possible

Question 16

The nurse suspects that a patient in cardiogenic shock is experiencing oxygen deprivation.What would confirm the nurse's suspicion?

A) Sudden drop in serum lactate level
B) Slowly increasing serum calcium level
C) Acute reduction in hemoglobin and hematocrit
D) Metabolic acidosis upon arterial blood gas analysis

Question 17

The nurse is caring for a patient experiencing an acute myocardial infarction.Which assessment finding indicates a decrease in this patient's cardiac output?

A) Chest pain
B) Restlessness
C) Low urine output
D) ST segment elevation

Question 18

A patient with dilated cardiomyopathy has developed a productive cough.What additional manifestation supports fluid overload in this patient?

A) Fainting
B) Sleeplessness
C) Loss of appetite
D) Jugular vein distention

Question 19

The nurse is reviewing medications prescribed for a patient with hypertrophic cardiomyopathy.Which medication should the nurse question before administering?

A) ACE-I
B) Diuretic
C) Digoxin
D) Beta blocker

Question 20

The nurse suspects that a patient with cardiomyopathy is experiencing heart failure.What finding did the nurse use to make this clinical decision?

A) Dizziness
B) Chest pain
C) Palpitations
D) SOB when supine

Question 21

A patient with cardiomyopathy asks for salt when the breakfast tray arrives.What should the nurse respond to this request?

A) "I will get some for you."
B) "You should avoid adding salt if at all possible."
C) "Restricting salt helps prevent the development of other health problems."
D) "I know the food tastes bad.I'll see if there is some salt in the staff kitchen."

Question 22

A patient with cardiomyopathy comes into the emergency department with chest pain and dyspnea after running a 5K race.What should the nurse explain to this patient?

A) Signs of overexertion
B) Importance to limit activity
C) Need for frequent rest periods
D) Alternatives to physical exercise