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NUR 254 Test Exam 1 and Final Exam New Latest Version
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A nurse is working hard to stay up-to-date on current practice and continuing to grow in skill and knowledge for his speciality. The nurse is not looking to advance his career, but to remain in his current position. Which of the following phases of the nursing career is this nurse most likely in? ------------ Correct Answer ----------- Harvest phase Which of the following organizations focuses on providing nurses with evidence-based practice, trends in the field, and standards of specialty practice? ------------ Correct Answer ----------- Specialty Organizations This lab value is elevated in response to inflammation ----------- Correct Answer ------------- c reactive protein (CRP) usually elevated in CAD Your pt is on a heparin drip and the lab reports that the PTT is 80, what do you do? Shut off the drip, increase it, or decrease it? ----------- Correct Answer ------------- Leave the rate the same ` Your pt is diagnosed with pulmonary embolus, what is one essential nursing intervention? -------- --- Correct Answer ------------- Anticoagulants and O2 to keep the sat over 93% Norepinephrine/Lopressor would show what ----------- Correct Answer ------------- Elevated MAP/increased blood pressure Hyperkalemia (K of 7) would show us what on a 12 lead ----------- Correct Answer ------------- peaked 12 lead Which of the following is a reason why all nurses should join the American Nurses Association? ------------ Correct Answer ----------- The American Nurses Association lobbies legislators to promote the passage of laws affecting the practice of nursing Which of the following is the most effective method of coping with the transition from student to nurse? ------------ Correct Answer ----------- Identify nurses who were able to make the transition successfully and discuss work-related issues with them Which of the following is a challenge some new nurses may face when transitioning from student to nurse? ------------ Correct Answer ----------- Employers expect new nurses to be able to provide safe care and set work priorities right from the first day Which of the following most accurately describes a current concern in health care today? --------- --- Correct Answer ----------- Gun violence has become a rising public health concern Which of the following is a benefit of the U.S. health-care system? ------------ Correct Answer ---
-------- The use of technology is projected to decrease health-care costs and improve clinical outcomes Which of the following is a change enacted by the Patient Protection and Affordable Care Act? -- ---------- Correct Answer ----------- Expansion of school-based health centers Which of the following is a nursing issue of concern today? ------------ Correct Answer ----------- Safe staffing Which of the following is the best argument for lower nurse-to-patient ratio? ------------ Correct Answer ----------- Greater patient-to-nurse ratios decrease patient mortality Although there is projected to be a small surplus of nurses by 2030, some states will continue to see nursing shortages. Which of the following is the best explanation for this situation? -----------
- Correct Answer ----------- Workforce availability Which of the following is expected to most likely be true in the near future? ------------ Correct Answer ----------- Increased focus on care transitions will involve nursing A new model for health care in the future would be best to include which of the following? ------- ----- Correct Answer ----------- Care that encourages a healthy environment Which of the following best describes the public image of nurses today? ------------ Correct Answer ----------- Nurses are assistants to physicians Which of the following is the best way to improve nursing's image? ------------ Correct Answer -- --------- Take every opportunity to speak to the public about nursing Which of the following is the best way for a nurse to improve quality of care? ------------ Correct Answer ----------- Collaborate with other health-care professionals, patients, and their families Which of the following is the best action an individual nurse can take to exert leadership in supporting the profession of nursing? ------------ Correct Answer ----------- Talk about health-care issues to everyone who will listen, including legislators Which of the following is true regarding the Affordable Care Act? ------------ Correct Answer ---- ------- The Affordable Care Act attempted to address many of the issues of interest to nursing, but came with much controversy Which of the following new opportunities might a new nurse see in the future? ------------ Correct Answer ----------- Transitional Care Which of the following best describes a major concern about the health-care system in the United States? ------------ Correct Answer ----------- Quality of care What are the differences between functional, team, total patient care, and primary nursing? -------
Which of the following is the best recommendation for resume writing? ------------ Correct Answer ----------- State what you will be able to do for the organization An experienced nurse has moved to a new state and is applying for a position. The nurse has moved several times in the past few years and held several different positions. Which of the following resume types is most appropriate? ------------ Correct Answer ----------- Functional Which of the following questions is most important to ask yourself in order to write a clear objective statement? ------------ Correct Answer ----------- What level of responsibility do I want? Which of the following best describes the purpose of a cover letter? ------------ Correct Answer -- --------- An introduction to your resume and to you A new nurse is preparing for a job interview. Knowing that the interviewer may ask about weaknesses, the nurse is prepared to address the lack of experience and explain how prior skills learned will assist in the position. Asking about weaknesses best falls under which of the following interview categories? ------------ Correct Answer ----------- Professional questions A new nurse is undergoing the transition from student to nurse. Which of the following is true regarding the transition? ------------ Correct Answer ----------- A new nurse is expected to provide leadership to ancillary staff Which of the following is the best recommendation to assist a new nurse to become accustomed to his or her new position? ------------ Correct Answer ----------- Participate in formal mentoring programs Which of the following is true regarding internship and residency programs for new nurses? ----- ------- Correct Answer ----------- Residency programs teach new nurses clinical leadership skills Which of the following is true about most orientation programs? ------------ Correct Answer ------ ----- Orientation programs are best when consistent preceptors are utilized Which of the following recommendations is true regarding the transition to practice? ------------ Correct Answer ----------- Do not try to change everything at once; focus on a few key areas If you want to learn more about the issues related to nursing practice and health-care policy and participate in active discussions about these issues, which organization should you focus on? ----- ------- Correct Answer ----------- American Nurses Association The purpose of which of the following organizations is to use nursing knowledge to advance health policy and practice? ------------ Correct Answer ----------- American Academy of Nursing A student nurse is looking for opportunities to develop leadership skills and prepare for initial licensing. Which of the following professional organizations should the student nurse join? ------ ------ Correct Answer ----------- National Student Nurses Association
An experienced registered nurse (RN) is reflecting over the chosen career path. The RN has recently passed the certification examination for his or her chosen speciality. Which of the following career stages is the RN most likely in? ------------ Correct Answer ----------- Momentum phase As nurses grow in their profession, it is important to have a career-building toolbox. Which of the following is a professional activity to consider for the toolbox? ------------ Correct Answer --- -------- Join a committee at work What are ways to empower nurses? ------------ Correct Answer ----------- - Decision Making: Control of nursing practice within an organization
- Autonomy: Ability to act on the basis of one's knowledge and experience
- Manageable Workload: Reasonable work assignments
- Reward and Recognition: Appreciation, both tangible (raises, bonuses) and intangible (praise), received for a job well done
- Fairness: Consistent, equitable treatment of all staff Leadership theories and how would you recognize the difference between them? ------------ Correct Answer ----------- What are key motivational factors a nurse leader should possess? ------------ Correct Answer -----
What are the benefits and consequences of conflict? How can conflict resolution be a good thing? ------------ Correct Answer ----------- What are some activities a nurse can do to grow in their profession? ------------ Correct Answer --
What are the 3 stages or phases of a nurse's career? ------------ Correct Answer ----------- What is a hierarchy? ------------ Correct Answer ----------- Key qualities and behaviors an effective nurse leader should have ------------ Correct Answer ----
Key steps to being a better follower ------------ Correct Answer ----------- - If you discover a problem, inform your team leader or manager right away
- Even better, include a suggestion for solving the problem in your report
- Freely invest your interest and energy in your work
- Be supportive of new ideas and new directions suggested by others
- When you disagree, explain why
- Listen carefully and reflect on what your leader or manager says
- Continue to learn as much as you can about your speciality areas
- Share what you learn
- Be alert for behaviors that precede violence, such as verbal expressions of anger and frustration, threatening body language, signs of drug or alcohol use, or the presence of a weapon
- Know your patients
- Maintain behavior that helps to defuse anger
- If you cannot defuse the situation, then remove yourself from it quickly, call security, and report the situation to management What does SWOT mean? ------------ Correct Answer ----------- Developing Strengths, Weaknesses, Opportunities, and Threats analysis What are factors that support a caring environment? ------------ Correct Answer ----------- The good and bad of EMR's ------------ Correct Answer ----------- - Advantages: track data through time; identify which patients need preventive screenings or checkups; monitor patients status regarding health maintenance and prevention, such as blood pressure readings or vaccinations; evaluate and improve the overall quality of care within the specific practice
- Disadvantage: does not easily move out of the specific provider practice or health-care institution What are vital considerations when delegating? ------------ Correct Answer ----------- The RN has been assigned to care for a group of patients on an inpatient unit. The RN is assigned an LPN and an NAP to assist in caring for the group of patients. Patients are assigned to the RN and nursing team for their entire length of stay on the unit. Which of the following types of nursing does this scenario best represent? ------------ Correct Answer ----------- Dyad primary nursing An ICU RN has been assigned to a high acuity patient who needs constant assessment and evaluation. What type of nursing is this RN performing? ------------ Correct Answer ----------- Total patient care A charge nurse is faced with a unit that is short staffed. The charge nurse reviews the tasks that need to be completed and assigns them to the best person. Which of the following types of nursing does this describe? ------------ Correct Answer ----------- Functional nursing Initial dose of amiodarone bolus IV ----------- Correct Answer ------------- 300mg The med is administrated rapid iv push resulting In a brief flatline, used for SVT, code cart must be at bedside ----------- Correct Answer ------------- adenosine what are the doses for adenosine? ----------- Correct Answer ------------- 6mg, 12 mg, 12mg rapid IV push medication used PRN for angina ----------- Correct Answer ------------- Nitro- warn of HA, low BP
Each large box on the ecg paper represents how many seconds ----------- Correct Answer --------- ---- 20 seconds wo serum lab tests that would be elevated with MI ----------- Correct Answer ------------- CK (CREATININE KINASE) and Troponin What complication of CABG presents with manifestations of decreased urinary output, crackles, jvd, s3 gallop ----------- Correct Answer ------------- pump failure (heart failure) Most carbohydrates in the diet should be complex such as whole grains. Name 2 foods that would be considered complex carbs ----------- Correct Answer ------------- whole grain breads/pasta, legumes, potatoes What would a high CVP reading indicate (normal readings are 3-12mmhg)(dehydrated means 2- 3mmhg)(20-22mmhg hypervolemia) ----------- Correct Answer ------------- hypervolemia what would you see on an EKG with a pt with Hyperkalemia? ----------- Correct Answer ---------- --- peaked T waves A PATIENT WITH HIGH LDL SHOULD BE ADVISED TO REPLACE FOODS HIGH IN SATURATED FAT WITH FOODS HIGHER IN UNSATURATED FAT. NAME THREE (3) FOODS THE PATIENT SHOULD AVOID THAT ARE HIGH IN SATURATED FAT. --------- -- Correct Answer ------------- BUTTER, CHEESE, MILK, CREAM, ICE CREAM, COCONUT OIL AND FATTY MEATS ASIDE FROM PACER SPIKES WITH SUBSEQUENT P WAVES OR QRS COMPLEXES, HOW WOULD A NURSE ASSESS THE INTENDED OUTCOMES OF A PACEMAKER? (THERE ARE SEVERAL, NAME AT LEAST ONE CORRECTLY) ----------- Correct Answer - ------------ HEART RATE >60, NORMOTENSIVE, SKIN COLOR APPROPRIATE WHICH CLASS OF ANTIHYPERTENSIVE MEDICATIONS HAS A COMMON SIDE EFFECTS OF COUGH, HYPERKALEMIA (TOO HIGH) AND HYPOTENSION? ----------- Correct Answer ------------- ANGIOTENSION CONVERTING ENZYME (ACE) INHIBITORS THIS ANTICHOLINERGIC MEDICATION IS ADMINISTERED 0.5 MG TO 1 MG IV PUSH FOR SYMPTOMATIC BRADYCARDIA ----------- Correct Answer ------------- ATROPINE CHEST PAIN RELIEVED BY REST IS REFERRED TO AS ----------- Correct Answer ---------- --- STABLE ANGINA NAME THREE (3) MODIFIABLE RISK FACTORS FOR CAD ----------- Correct Answer ------ ------- HYPERLIPIDEMIA CIGARETTE SMOKING/TOBACCO USE HTN DM OBESITY
WHAT IS THE PRIORITY INTERVENTION FOR VENTRICULAR FIBRILLATION, THAT
HAS THE GREATEST IMPACT ON SURVIVAL RATE? ----------- Correct Answer ------------- defib A PATIENT DEVELOPS PSVT AND IS SYMPTOMATIC. PRIOR TO ADENOSINE OR CARDIOVERSION, WHAT IS A NONPHARMACOLOGIC INTERVENTION FOR PSVT? -- --------- Correct Answer ------------- ELICIT VAGAL RESPONSE/VALSALVA MANEUVER WHAT DIAGNOSTIC TEST IS ESSENTIAL IN THE DIAGNOSIS OF STEMI (ST ELEVATION MYOCARDIAL INFARCTION)? ----------- Correct Answer ------------- EKG WHAT DIAGNOSTIC TEST IS ESSENTIAL IN THE DIAGNOSIS OF STEMI (ST ELEVATION MYOCARDIAL INFARCTION)? ----------- Correct Answer ------------- echocardiogram WHAT IS THE MOST LIKELY IMMEDIATE COMPLICATION FOLLOWING CARDIAC CATHETERIZATION SHEATH REMOVAL? ----------- Correct Answer ------------- bleeding Shock is a SYNDROME resulting from a decrease in a. ____________, that causes inadequate b. __________ resulting in ischemic organs/tissues that cannot carry out cellular metabolism. ---- ------- Correct Answer ------------- a. blood flow b. oxygenation When monitoring for effectiveness of treatment, which value is often used to titrate medications such as norepinepherine, as it is an indicator of tissue perfusion. ----------- Correct Answer ------- ------ MAP Which findings indicates progression from early (I) to intermediate (II)?
- decreased U/O
- increased lactic acid/ hyperkalemia
- fluid shift from interstitial space INTO capillaries
- MAP drop 12 mmHg ----------- Correct Answer ------------- 2. increased lactic acid/ hyperkalemia if norepinephrine, dobutamine or dopamine infiltrates in a peripheral site which medication should be used as an antidote? ----------- Correct Answer ------------- Phentolamine Four factors necessary to maintain cellular metabolism. When one of these is disrupted, shock occurs. ----------- Correct Answer ------------- 1. Cardiac output
- Vessel diameter and tone
- Blood volume
- Tissues ability to extract and use O All of the manifestations of shock can be directly related to the body's attempts to maintain __________. ----------- Correct Answer ------------- Perfusion of vital organs (heart and brain) In stage I of shock, compensatory mechanisms begin when there is a volume loss of approximately 1000 mL which causes a MAP drop of __________ mmHg ----------- Correct Answer ------------- 10 - 15 mmhg A patient is involved in a MVC. Which finding would indicate neruogenic shock as opposed to hypovolvemic shock?
- Decreased hgb and hct
- Bradycardia
- Tachycardia
- Hypotension
- Hypertension ----------- Correct Answer ------------- 2. bradycardia What test might be used to diagnose septic shock (as opposed to cardiogenic shock)? 1. lactic acid level 2. BNP 3. blood cultures 4. EKG ----------- Correct Answer ------------- blood cultures When administering norepinepherine to a patient in shock the expected outcome (goal) is often: - ---------- Correct Answer ------------- MAP > 65 or SBP > 80- 100 What are the three (3) components of Virchow's Triad? ----------- Correct Answer ------------- 1. Endothelial damage (smoking, HTN)
- Hypercoagulability (obesity, hormones)
- Stasis (immobility, polycythemia) Which of the following is NOT a clinical manifestation of PE? Dyspnea, anxiety, tachycardia, low grade fever, syncope, ischemic chest pain. ----------- Correct Answer ------------- ischemic chest pain is not a manifestation of PE. Pleuritic chest pain is characteristic of PE A patient with a known DVT (deep vein thrombosis) may have a surgical procedure to place this, which would "catch" any clots that may dislodge ----------- Correct Answer ------------- Inferior Vena Cava (IVC) filter How will the nurse quantify the expected outcome of a heparin drip? ----------- Correct Answer -- ----------- Titrate Heparin with a partial thromboplastin time (PTT) of 2 - 3 times the baseline
components must be working appropriately? ----------- Correct Answer ------------- Adequate cardiac output Tissues must be able to extract and use oxygen Blood vessel diameter and tone must be adequate Blood volume must be adequate a sign/symptom of early/Stage I shock? ----------- Correct Answer ------------- Tachycardia Which of the following are signs/symptoms of the intermediate/Stage II of shock? ----------- Correct Answer ------------- Lactic acidosis Third spacing edema Oliguria Profound hypotension tachypnea What are effects of shock on the GI system? ----------- Correct Answer ------------- Stress ulcers and possible hemorrhage Paralytic ileus When administering crystalloid solutions to a patient in hypovolemic shock the nurse understands that __________ type of solution would result in fluid staying in the vascular space and therefore helping most with hypovolemia? ----------- Correct Answer ------------- isotonic (NS 0.9%) When administering a colloid/volume expander such as albumin 5% IV to a patient with hypovolemic shock, the nurse would be astute to which of the following unexpected outcomes of this therapy? ----------- Correct Answer ------------- Decreased platelet function/coagulation interventions appropriate for a patient with cardiogenic shock? ----------- Correct Answer --------- ---- Diuretic therapy (furosemide) Cardiac glycoside therapy (digoxin) Which of the following diagnostic results would be expected for a patient experiencing LATE septic shock? ----------- Correct Answer ------------- Prolonged capillary refill Hypotension LOC = Lethergy/obtunded what interventions would the nurse anticipate for a client experiencing anaphylactic shock? ------ ----- Correct Answer ------------- Assess WBC count with differential, particularly eosinophil count
Monitor ABG Administer albuterol Administer corticosteroids Norepinephrine (Levophed) Vasopressors/Vasoconstrictors SHOCK med ----------- Correct Answer ------------- indicated for hypotension, shock, cardiac arrest, & sepsis & septic shock. Considered peripheral vasoconstrictor or vasopressor (alpha- adrenergic), inotropic stimulator, & dilator of coronary arteries (beta-adrenergic) Initial dose 8-12 mcg/min and usual maintenance dose 2-4 mcg/min and adjust to maintain SBP
80-100 or MAP > 65 via central line to prevent extravasation ischemia. Can mix D5W of D5NS but not NS alone. Don't infuse anything else in this line. Usually 8mg/250 D5W(final concentration is 32 mcg/mL) (Regitine is antidote). Contraindications/Precautions-Mesenteric or peripheral vascular thrombosis (↑ ischemia and can extend infarction), use of cyclopropane and halothane anesthetics (produce Vtach of Vfib) Use with extreme caution with patients on MAIO's (causes severe, prolonged hypertension) & those who have anaphylactic sx to sulfites Dobutamine (Dobutrex)- Inotrope Shock med ----------- Correct Answer ------------- indicated for HF, septic shock, cardiogenic shock. Considered a direct-acting inotropic agent and ↑ CO with ↑ HR Usual premixed infusions are 250mg/250 mL, 500 mg/500 mL, 500 mg/250 mL, or 1000mg/ mL D5W or NS Usual dose 2.5-15 mcg/kg/min Contraindicated/Precautions-hypersensitive patients to bisulfites or idiopathic hypertrophic subaortic stenosis. Use cautiously with MI, HTN, afib, or pregnancy patients. Antidote is phentolamine Dopamine (inotropin) Inotrope SHOCK med ----------- Correct Answer ------------- indicated for hypotension, septic shock, trauma, MI, CHF, renal failure. Considered a direct-acting inotropic agent that ↑ CO with ↑ HR & neurotransmitter. Also a chronotropic agent for cardiac doses 5- 10 mcg/kg/min vs. 10- 20 mcg/kg/min considered a pressor dose and has strong effect on blood vessels (vasoconstriction) but this can worsen renal fx and cause cardiac arrhythmias IV rate normal 2-20 mcg/kg/min via central line
Antiarrhythmic agents Broad spectrum antibiotics Corticosteroids Morphine cardiac S/S of compensatory/ early shock ----------- Correct Answer ------------- Adequate early stages. Heart rate increased, but BP normal. cardiac S/S of progressive/ intermediate shock ----------- Correct Answer ------------- HR > bpm. Vasoconstriction = thread pulses. BP drops overall with narrowing pulse pressure. Acidosis/hypoxia and hyperkalemia lead to altered conduction/dysrhythmias. respiratory S/S of compensatory/ early shock ----------- Correct Answer ------------- Tachypnea early on. respiratory S/S of progressive/ intermediate shock ----------- Correct Answer ------------- # of alveoli perfused decreases as shock progresses. Hypoxemia and respiratory acidosis. If this persists ARDS may develop. GI S/S of compensatory/ early shock ----------- Correct Answer ------------- Initially, decreased blood flow is minimal. Early liver perfusion changes may result in increased glucose levels. GI S/S of progressive/ intermediate shock ----------- Correct Answer ------------- As splanchnic circulation decreases "stress ulcers" which may hemorrhage. Also, paralytic ileus. If limitation continues may result in necrotic bowel. As liver perfusion decreases liver can't regulate glycogen and hypoglycemia. Also, can't remove lactic acid therefore more metabolic acidosis. Neuro S/S of compensatory/ early shock ----------- Correct Answer ------------- Initially, cerebral hypoxia-anxiety. neuro S/S of progressive/ intermediate shock ----------- Correct Answer ------------- As shock progresses cerebral edema and acidosis leads to lethargy&progresses to coma. Renal S/S of compensatory/ early shock ----------- Correct Answer ------------- nothing early on renal S/S of progressive/ intermediate shock ----------- Correct Answer ------------- Progressive stage blood is shunted away from kidneys to heart and brain. Decrease in U/O. Oliguria of < ml/hr (<30 X 2 hours warrants a call). Waste products will be elevated. May result in permanent kidney damage in older adults or chronically ill. skin, temp, thirst S/S of compensatory/ early shock ----------- Correct Answer ------------- Pale very early on. Be sure to assess lips and mucous membranes in darker skin colors. skin, temp, thirst S/S of progressive/ intermediate shock ----------- Correct Answer -------------
Cool and moist as it progresses. Will also see third spacing edema as it progresses. Decreased body temperature and increased thirst response. You are caring for a pediatric client in hypovolemic shock following a bicycle crash. The family members refuse blood, explaining that it is against their religious beliefs. How will you respond? ----------- Correct Answer ------------- As a nurse, you would educate the family on the importance of the blood, explaining that their child has lost a lot of blood, is in shock, and needs that volume replaced. If they still refuse, there are nonblood products that can be used to expand the volume, and the family probably will agree to this. What options for treatment might be considered for this child that do not conflict with the family's religious beliefs? ----------- Correct Answer ------------- Volume expanders can be used to increase the circulating volume. At times, clients who refuse blood will agree to albumin, which works well for hypovolemic shock. Contrast the administration of IV fluids for the client in hypovolemic shock versus the client in cardiogenic shock. ----------- Correct Answer ------------- With hypovolemic shock, as much fluid as possible is needed to replace volume. In cardiogenic shock, IV fluids are given cautiously so as not to overload the heart. Contrast the administration of colloids versus crystalloids in treating the client with hypovolemic shock. ----------- Correct Answer ------------- Crystalloid solutions only minimally increase fluid volume. Only a small amount stays within the vascular system. Colloid solutions do not diffuse through the capillary walls, but remain in the vascular system and therefore are good plasma volume expanders. What are the two (2) components of the cardiac output equation ----------- Correct Answer -------- ----- stroke volume HR What would INCREASE the cardiac output? ----------- Correct Answer ------------- Increased heart rate Decreased afterload Increased preload Increased contractility If the sinoatrial (SA) node is unable to pace the heart due to damage, the atrioventricular (AV) node will take over. What will the heart rate range be if this occurs? ----------- Correct Answer --- ---------- 40 - 60 BPM Which of the following factors INCREASE the heart rate? ----------- Correct Answer ------------- Exercise Fever Hypovolemia Standing position Hypoxia
were experiencing heart failure after myocardial infarction which of the following readings would indicate hypervolemia? 3 mmHg 0 mmHg 10 mmHg 22 mmHg ----------- Correct Answer ------------- 22 mmHg The contrast agent used during cardiac catheterization and angiography can lead to nephropathy (renal damage) in patients with diabetes, heart failure, renal disease, and the elderly. What interventions can be used to prevent this complication? ----------- Correct Answer ------------- hydrating prior to the procedure hydrating after the procedure administering acetylcystine When receiving a patient after a cardiac catheterization which of the following nursing interventions are necessary? ----------- Correct Answer ------------- Continuous telemetry monitoring Monitoring skin color Monitoring peripheral pulses (comparing extremities) Monitoring site for bleeding/bruising Which of the following are non-modifiable risk factors for coronary artery disease? ----------- Correct Answer ------------- family hx of CAD increasing age Physiologically why does diabetes accelerate the development of heart disease? ----------- Correct Answer ------------- Hyperglycemia results in dyslipidemia The TLC (Therapeutic Lifestyle Change) diet is recommended by NCEP (National Cholesterol Education Program). The recommendation is no more than how many mg of cholesterol each day? ----------- Correct Answer ------------- 200 A 65 year old, obese patient who has been extremely sedentary for most of her life is diagnosed with coronary artery disease. You are educating her with regards to physical activity. What would a reasonable initial goal be? ----------- Correct Answer ------------- Park in the farthest parking spots and increase your walk to work and at stores. The pain associated with angina is: ----------- Correct Answer ------------- related to ischemia relieved by rest Which of the following ECG changes are seen with myocardial infarction (MI)? ----------- Correct Answer ------------- pathologic Q waves
Within 1 hour of an MI which of the following complications would be most likely to occur and result in death? ----------- Correct Answer ------------- VFIB A client complains of chest pain and the nurse administers 0.4 mg of SL nitro. Prior to administering a second dose 5 minutes later, the nurse should assess which of the following? ----- ------ Correct Answer ------------- check bp reassess pain After administering nitroglycerin a patient complains of headache. The nurse knows this is: ------ ----- Correct Answer ------------- the result of vasodilation in the cerebral vessels The nurse is preparing to administer metoprolol to a patient with coronary artery disease. She notes the apical heart rate is 58. The nurse should: ----------- Correct Answer ------------- administer the medication The nurse is administering aspirin 81 mg to a patient on the cardiovascular telemetry unit. The nurse is aware the most likely rationale is: ----------- Correct Answer ------------- for the antiplatelet effect A patient is experiencing STEMI (ST elevation myocardial infarction). The nurse has administred SL nitro every 5 minutes X 3 with no relief. What analgesic will the nurse anticipate administering next? ----------- Correct Answer ------------- morphine A patient with myocardial infarction is ordered the fibrinolytic streptokinase. Which of the following would contraindicate its use? ----------- Correct Answer ------------- a patient that fell 3 days ago A patient has been receiving enoxaparin. Which of the following labs is important to monitor to detect HIT (heparin induced thrombocytopenia)? ----------- Correct Answer ------------- platelet count A patient with coronary artery disease has been taking aspirin 81 mg daily for more than a year. The physician prescribes clopidogrel after the patient has a cardiac cath with stent placement. The physician continues the aspirin order as well. The nurse should: ----------- Correct Answer -- ----------- administer the medication as it acts differently to prevent platelet aggregation than aspirin What nutritional recommendations will you teach the client with, or at risk for, CAD? ----------- Correct Answer ------------- The nurse will recommend a low-salt, low-fat, low-cholesterol diet, and, if the client is overweight, a reduction diet as well, with calories to be determined by a dietician. The nurse can also provide foods in each group that would be good for the client. What will you teach the client about physical fitness and exercise in regards to reducing the risk of CAD? ----------- Correct Answer ------------- The nurse will help the client determine which activities precipitate episodes of pain and will encourage regular moderate exercise. The client
