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MED-SURG- chapter 25 solution guide
CHAPTER 25 - answer ✅✅CHAPTER 25 Ans: Systole - answer (^) ✅✅A nurse is describing the process by which blood is ejected into circulation as the chambers of the heart become smaller. The instructor categorizes this action of the heart as what? Ans: Left midclavicular line of the chest at the fifth intercostal space - answer ✅✅During a shift assessment, the nurse is identifying the client's point of maximum impulse (PMI). Where will the nurse best palpate the PMI? Ans: 46 mm Hg - answer ✅✅The nurse is calculating a cardiac patient's pulse pressure. If the patient's blood pressure is 122/76 mm Hg, what is the patient's pulse pressure? Ans: This is an accurate indicator of myocardial injury. - answer ✅✅The^ nurse^ is^ caring^ for^ a^ patient^ admitted^ with^ unstable angina. The laboratory result for the initial troponin I is elevated
in this patient. The nurse should recognize what implication of this assessment finding? Ans: Increased LDL and decreased HDL increase my risk of coronary artery disease. - answer ✅✅The nurse is conducting patient teaching about cholesterol levels. When discussing the patient's elevated LDL and lowered HDL levels, the patient shows an understanding of the significance of these levels by stating what? Ans: Possible hypovolemia - answer ✅✅The physician has placed a central venous pressure (CVP) monitoring line in an acutely ill patient so right ventricular function and venous blood return can be closely monitored. The results show decreased CVP. What does this indicate? Ans: A 20-year-old patient - answer ✅✅While auscultating a patient's heart sounds, the nurse hears an extra heart sound immediately after the second heart sound (S2). An audible S would be considered an expected finding in what patient? Ans: Myocardial ischemia - answer ✅✅The physical therapist notifies the nurse that a patient with coronary artery disease (CAD) experiences a much greater-than-average increase in
Ans: To assess the patient's response to fluid and drug administration - answer ✅✅The critical care nurse is caring for a patient with a pulmonary artery pressure monitoring system. The nurse is aware that pulmonary artery pressure monitoring is used to assess left ventricular function. What is an additional function of pulmonary artery pressure monitoring systems? Ans: SA node to AV node to bundle of His to Purkinje fibers - answer (^) ✅✅The cardiac care nurse is reviewing the conduction system of the heart. The nurse is aware that electrical conduction of the heart usually originates in the SA node and then proceeds in what sequence? Ans: Myocardium - answer ✅✅A patient has had a myocardial infarction and has been diagnosed as having damage to the layer of the heart responsible for the pumping action. You are aware that the damage occurred where? Ans: Arterial vasoconstriction - answer ✅✅The nurse working on a cardiac care unit is caring for a patient whose stroke volume has increased. The nurse is aware that afterload influences a patient's stroke volume. The nurse recognizes that afterload is increased when there is what?
Ans: Inform the patient that she will remain on bed rest following the procedure. - answer ✅✅A nurse is preparing a patient for scheduled transesophageal echocardiography. What action s Ans: Cardiac catheterization is usually done to assess how blocked or open a patients coronary arteries are. - answer ✅✅The nurse is caring for a patient admitted with angina who is scheduled for cardiac catheterization. The patient is anxious and asks the reason for this test. What is the best response? Ans: Pulmonary artery pressure monitoring (PAPM) - answer ✅✅The critical care nurse is caring for a patient who has had an MI. The nurse should expect to assist with establishing what hemodynamic monitoring procedure to assess the patient's left ventricular function? Ans: Perfusion distal to the insertion site - answer ✅✅A critically ill patient is admitted to the ICU. The physician decides to use intra-arterial pressure monitoring. After this intervention is performed, what assessment should the nurse prioritize in the plan of care?
physiologic characteristics of the nodal and Purkinje cells that provide this synchronization? Select all that apply. Ans: Risk for falls related to orthostatic hypotension - answer ✅✅The nurse's assessment of an older adult client reveals the following data: Lying BP 144/82 mm Hg; sitting BP 121/69 mm Hg; standing BP 98/56 mm Hg. The nurse should consequently identify what nursing diagnosis in the patient's plan of care? Ans: Heart failure - answer ✅✅A brain (B-type) natriuretic peptide (BNP) sample has been drawn from an older adult patient who has been experienced vital fatigue and shortness of breath. This test will allow the care team to investigate the possibility of what diagnosis? Ans: After a 12-hour fast - answer ✅✅A lipid profile has been ordered for a patient who has been experiencing cardiac symptoms. When should a lipid profile be drawn in order to maximize the accuracy of results? Ans: A transducer, A flush system, A pressure bag - answer ✅✅When hemodynamic monitoring is ordered for a patient, a catheter is inserted into the appropriate blood vessel or heart chamber. When assessing a patient who has such a device in
place, the nurse should check which of the following components? Select all that apply. Ans: SA node - answer ✅✅The critical care nurse is caring for a patient who has been experiencing bradycardia after cardiovascular surgery. The nurse knows that the heart rate is determined by myocardial cells with the fastest inherent firing rate. Under normal circumstances where are these cells located? Ans: An aspirin a day can help prevent some of the blockages that can cause chest pain or heart attacks. - answer ✅✅The nurse is doing discharge teaching with a patient who has coronary artery disease. The patient asks why he has to take an aspirin every day if he doesn't have any pain. What would be the nurse's best response? Ans: Inflammation - answer ✅✅The physician has ordered a high-sensitivity C-reactive protein (hs-CRP) drawn on a patient. The results of this test will allow the nurse to evaluate the role of what process that is implicated in the development of atherosclerosis? Ans: A 12-hour fast is necessary before drawing the blood sample, Genetic factors can elevate homocysteine levels, A diet
What does this catheter measure that is particularly important in critically ill patients? Ans: The cycle of depolarization and repolarization - answer ✅✅A patient's declining cardiac status has been attributed to decreased cardiac action potential. Interventions will be aimed at restoring what aspect of cardiac physiology? Ans: Establish peripheral IV access. - answer ✅✅A patient has been scheduled for cardiovascular computed tomography (CT) with contrast. To prepare the patient for this test, what action should the nurse perform? Ans: Need for careful monitoring for cardiac symptoms, Need for carefully regulated exercise, Need for dietary modifications - answer ✅✅The student nurse is preparing a teaching plan for a patient being discharged status post MI. What should the student include in the teaching plan? (Mark all that apply.) Ans: Stop the test and monitor the patient closely. - answer ✅✅The nurse is caring for a patient who is undergoing an exercise stress test. Prior to reaching the target heart rate, the patient develops chest pain. What is the nurse's most appropriate response?
CHAPTER 26 - answer ✅✅CHAPTER 26 Recognize that the view of the electrical current changes in relation to the lead placement. - answer ✅✅The nurse is caring for a patient who has had an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. How should the nurse best respond? T wave - answer ✅✅The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting state of the patient's heart? QRS complex - answer ✅✅The nursing educator is presenting a case study of an adult patient who has abnormal ventricular depolarization. This pathologic change would be most evident in what component of the ECG? Fewer QRS complexes than P waves - answer ✅✅An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic will the ECG most likely show?
Defibrillation - answer ✅✅A nurse is caring for a patient who is exhibiting ventricular tachycardia (VT). Because the patient is pulseless, the nurse should prepare for what intervention? Control ventricular heart rate - answer ✅✅A patient converts from normal sinus rhythm at 80 bpm to atrial fibrillation with a ventricular response at 166 bpm. Blood pressure is 162/74 mm Hg. Respiratory rate is 20 breaths per minute with normal chest expansion and clear lungs bilaterally. IV heparin and Cardizem are given. The nurse caring for the patient understands that the main goal of treatment is what? Epinephrine 1 mg IV push - answer ✅✅The nurse and the other members of the team are caring for a patient who converted to ventricular fibrillation (VF). The patient was defibrillated unsuccessfully and the patient remains in VF. According to national standards, the nurse should anticipate the administration of what medication? Avoid exposure to high-voltage electrical generators. - answer ✅✅The nurse is planning discharge teaching for a patient with a newly inserted permanent pacemaker. What is the priority teaching point for this patient?
Administer atropine 0.5 mg as an IV bolus every 3 to 5 minutes to a maximum of 3.0 mg. - answer ✅✅A patient is brought to the ED and determined to be experiencing symptomatic sinus bradycardia. The nurse caring for this patient is aware the medication of choice for treatment of this dysrhythmia is the administration of atropine. What guidelines will the nurse follow when administering atropine? Gently abrade the skin by rubbing the electrode sites with dry gauze or cloth. - answer ✅✅An ECG has been ordered for a newly admitted patient. What should the nurse do prior to electrode placement? Cardiac monitoring - answer ✅✅The nurse is caring for a patient who has just undergone catheter ablation therapy. The nurse in the step-down unit should prioritize what assessment? Ensure no one is touching the patient at the time shock is delivered. - answer ✅✅The ED nurse is caring for a patient who has gone into cardiac arrest. During external defibrillation, what action should the nurse perform?
ago. The nurse reviews the result of the patient's most recent cardiac imaging, which notes the presence of scarring on the atria. How should the nurse best respond to this finding? Destruction of specific cardiac cells - answer ✅✅A patient is scheduled for catheter ablation therapy. When describing this procedure to the patient's family, the nurse should address what aspect of the treatment? Risk for activity intolerance - answer ✅✅A patient has undergone diagnostic testing and received a diagnosis of sinus bradycardia attributable to sinus node dysfunction. When planning this patient's care, what nursing diagnosis is most appropriate? Wolf-Parkinson-White (WPW) syndrome - answer ✅✅The nurse is caring for a patient on telemetry. The patient's ECG shows a shortened PR interval, slurring of the initial QRS deflection, and prolonged QRS duration. What does this ECG show? Monitoring for pacemaker malfunction or battery failure - answer ✅✅A patient is undergoing preoperative teaching before his cardiac surgery and the nurse is aware that a
temporary pacemaker will be placed later that day. What is the nurse's responsibility in the care of the patient's pacemaker? Trancutaneous pacemaker - answer ✅✅The nurse caring for a patient whose sudden onset of sinus bradycardia is not responding adequately to atropine. What might be the treatment of choice for this patient? Changes in level of consciousness - answer ✅✅The nurse is caring for a patient who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output (CO). What change in status may signal to the nurse a decrease in cardiac output? Document this as an expected assessment finding. - answer ✅✅Following cardiac resuscitation, a patient has been placed in a state of mild hypothermia before being transferred to the cardiac intensive care unit. The nurse's assessment reveals that the patient is experiencing neuromuscular paralysis. How should the nurse best respond? Resynchronization - answer ✅✅The nurse is caring for a patient who has had a biventricular pacemaker implanted.
"The difference is the timing of the delivery of the electric current." - answer ✅✅During a CPR class, a participant asks about the difference between cardioversion and defibrillation. What would be the instructor's best response? Diagnose the dysrhythmia. - answer ✅✅A patient is admitted to the cardiac care unit for an electrophysiology (EP) study. What goal should guide the planning and execution of the patient's care? Oversensing of dysrhythmias - answer ✅✅A patient calls his cardiologist's office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what?
