Med Surg Cardiac Questions HESI RN

Med Surg Cardiac Questions HESI RN A patient is receiving distal peripheral bypass graft surgery using a synthetic graft. Which medications would you expect the provider to order? Select all the apply a. aspirin b. metoprolol c. warfarin d. clopidogrel A and D Dual therapy is recommended for one year after surgery Which patient teaching by a student nurse to a patient with Raynaud's phenomenon would warrant correction by the RN? a. Wear loose fitting warm clothing. b. Avoid coffee and caffeinated teas. c. You may continue to smoke, but you should discontinue for other health reasons d. Avoid temperature extremes. Try immersing your hands in warm water. C Smoking has a vasoconstrictive effect. Which patient teaching by a student nurse to a patient with undergoing peripheral bypass surgery would warrant correction by the RN? a. Participate in supervised exercise for 60 mins/day for 3-5 days a week b. Increase your zinc intake. c. Monitor your feet for signs of impaired healing or infection d. Wear all wool socks with round toed shoes. A Exercise should be for 30 minutes per day to begin with. A patient with intermittent claudication is receiving an order for cilostazol. The nurse would question these orders based on what in the patients medical history? a. Stroke 2 years ago b. asthma c. Heart failure d. Allergies to sulfa drugs C Heart failure is contraindicated for this drug It is recommended for diabetic patients with PAD to maintain a glycosated hemoglobin below what? a. 8.5% b. 8.0% c. 7.0% d. 6.0% C It is recommended for diabetic patients to keep their A1C below 7.0%, and optimally as near to 6.0% as possible but not below. Which of the following is not a clinical manifestation of PAD? a. Critical limb ischemia b. Dependant rubor c. Paresthesia d. intermittent claudication e. Lower leg edema E Lower leg edema is not present in arterial disease. Pain at rest for more than 2 weeks, redness in the legs when they are in the defendant position, numbness of the toes and feet, and ischemic pain during exercise may all be clinical manifestations of Arterial disease. Which of the following are risk factors for PAD? Select all that apply. a. Male gender b. White race c. Chronic kidney disease d. Young age e. hypercholesterolemia C and E Women, african americans, chronic kidney disease, 6th to 8th decade of life, tobacco use, hypertension, and hypercholesterolemia are all risk factors. A patient is being discharged on lenoxaparin. Which of the following would warrant correction by the nurse? a. "I will not rub or itch the injection site" b. "I will give the injection 2 inches from the umbilicus" c. "I will remove the air bubble from the syringe" d. "I will pinch the skin to give the injection" C The air bubble should not be removed. The air bubble allows the exact amount of medication to be given. The heart cells ability to transmit an impulse along a membrane in an orderly manner is called what? a. automaticity b. Excitability c. Conductivity d. Contractility C Conductivity. When would artifact be seen on the monitor of an EKG? Select all that apply. a. The patient is shivering b. The conductive gel is dry c. There is electrical interference d. The skin is hairless where the electrodes meet the skin A, B, and C All would produce extra activity on the monitor. Which of the following would cause sinus bradycardia? a. hypothermia b. hypoxia c. hypotension d. hypovolemia A. Hypothermia would cause a slow heart rate. Which of the following would not be used to treat paroxysmal supra ventricular tachycardia? a. valsalva maneuver b. carotid massage c. beta blockers d. synchronized cardioversion e. defibrillator E Defibrillation would not be a treatment option. Upgrade to remove ads Only $3.99/month Which of the following dysrhythmias puts a patient at highest risk for stroke? a. atrial fibrillation b. Ventricular fibrillation c. atrial flutter d. ventricular tachycardia A A fib patients are given an anticoagulant to prevent stroke. A nurses 69 year old patient goes into ventricular tachycardia without a pulse. Which of the following is the priority action of the nurse? a. defibrillation b. synchronized cardioversion c. administering vasopressin d. CPR e. administering epinephrine D CPR should be started immediately. Except for synchronized cardioversion, all the others are forms of treatment for ventricular tachycardia. Which of the following is not a charge used for pulseless ventricular tachycardia using a defibrillator. a. 160 b. 260 c. 300 d. 360 A 160 is too low for defibrillation. Synchronized cardioversion uses lower charges. Which of the following statements by the patient demonstrate proper patient teaching about an ICD? Select all that apply. a. "I will keep the incision dry for four days" b. "I will not life my arms above my head before my doctor tells me it is safe to do so" c. "I should join a support group" d. "I may not travel until my doctor tells me it is safe to do so" e. "This device may act as a pacemaker and a defibrillator" A, B, C, and E Travel is permitted but the patient should let airport security know about the ICD because it may set off the metal detector. Which of the following are indications for temporary pacemakers? Select all that apply. a. maintenance of heart rate during surgery b. Cardiomyopathy c. during drug therapy that may cause bradycardia d. Heart failure e. Electrophysiologic studies the evaluate a patient with a bradydysrhythmia or tachydisrhythmia A, C, E Cardiomyopathy and heart failure are indications for permanent pacemakers. Which of the following is not a phase in the pathogenesis of atherosclerosis? a. Complicated lesion b. fatty streak c. lipid core formation d. Fibrous Plaque C Non modifiable risk factors for coronary artery disease include all except which factor? a. Increasing age b. Diabetes c. Male gender d. Ethnicity e. Genetic predisposition B Diabetes, type II, is considered a modifiable risk factor along with serum lipid levels, high blood pressure, tobacco use, physical inactivity, and obesity. Which patient is considered most at risk for coronary artery disease? a. A 60 year old hispanic woman with a sedentary lifestyle b. A 74 year old white male with hypertension. c. An 84 year old african american woman with a stressful job d. A 58 year old native american man who smokes cigarettes B Increased age, white ethnicity, male gender, and hypertension are all risk factors for CAD Which statement by the student nurse, who is educating a patient on reducing risk factors for CAD, warrants correction by the nurse? a. "Get up 30minutes earlier so that breakfast is not eaten on the way to work" b. "You should consider eating smaller more frequent meals" c. "Soy, tofu, and quinoa shouldn't be used as a meat substitute." d. "Avoid muffins and doughnuts." C Soy, tofu, and quinoa are plant based meat substitutes that should be incorporated into recipes. Which of the following would not be included in patient teaching for Niacin? a. Most side effects subside with time. b. Take an aspirin 30 minutes before the drug to prevent flushing. c. Rise slowly from bed, allowing time to dangle your feet over the edge. d. Report any muscle pain to your health care provider. D Muscle pain, or myopathy, is a side effect of statins, not niacin. Upgrade to remove ads Only $3.99/month Which drug does not have any effect on HDL levels in the body? a. Niacin b. Fatty acid Derivatives c. Statins d. Bile Acid sequestrants D Bile-acid sequestrants lower LDL levels by binding with bile acids in the intestine, forming an insoluble complex and excreted into the feces. The binding results in removal of LDL and cholesterol. Which of the following are precipitating factors of Angina? Select all that apply. a. Temperature extremes b. Strong emotions c. Eating a heavy holiday meal d. Cocaine use e. Waking up in the morning A, B, C, D, and E All are precipitating factors. Which of the following suggests proper patient teaching for a patient taking short acting nitrates for chronic stable angina? Select all that apply. a. " If my tongue tingles it means the drug is working" b. "I should sit down when I take this medication" c. "The tablets, once opened, should be replaced every 6 months" d. "I should apply the ointment on a flat muscular area that is free of hair" e. "A headache is common after taking my medication" D Nitroglycerin ointment is a long acting nitrate, but should be administered on a flat muscular area that is free of hair. Which of the following regarding cardiac catheterization is false? a. It is a diagnostic study used for all anginal patients b. It uses radiation and IV contrast dye c. Patients should have BUN and creatinine labs before procedure d. Assess the patient for shellfish before procedure A It is done for patients with increasing angina symptoms who are candidates for percutaneous or surgical revascularization. A patient tells the nurse he has been experiencing chest pain for the past few hours. Which biomarker do you expect the HCP will screen for? a. CK-MB b. Myoglobin c. Creatinine d. Troponin D Troponin is the best cardiac specific biomarker for indications of MI. A 62 year old male patient comes to the ER at with complaints of pain in the jaw, left arm, and between the shoulders. He states that at 1800 during dinner it felt like "an elephant was sitting on his chest". At what time would the lab results show the greatest quantities of CK-MB? a. 0000 b. 1800 c. 1200 d. 0600 C CK-MB levels peak at 18 hours after an MI. Which duty does the RN know she can delegate to the LPN following a cardiac catheterization? a. Compare baseline vitals b. Monitor the EKG for dysrhythmias c. Teach patient and caregiver about discharge drugs d. Check for bleeding at catheter insertion site every 15 minutes D This is a duty that could be done by the nurse but may be delegated. Which of the following is not a way that the renal system effects blood pressure? a. Stimulates the release of ADH which increases water retention b. Increases venous return to the heart through sodium and water retention c. Angiotensin II is a potent vasoconstrictor and increases SVR d. Prostaglandins have a vasodilator effect A The endocrine system is in charge of releasing ADH Which of the following are causes of secondary hypertension? Select all that apply. a. Cirrhosis b. Pregnancy c. Sleep apnea d. Brain tumors e. Diabetes A, B, C, D Diabetes does not cause secondary hypertension. It is however a risk factor for primary hypertension. Which of the following are manifestations of target organ damage from hypertension? Select all that apply. a. Left ventricular hypertrophy b. Blurred or loss of vision c. Proteinuria d. Stroke e. Intermittent caudication A, B, C, D, E All are signs of target organ damage to either the heart, brain, peripheral vascular system, kidneys, or eyes. Upgrade to remove ads Only $3.99/month Which of the following statements by a patient after education of lifestyle modifications for hypertension, indicates a need for further teaching? a. "I will limit my alcohol intake to no more than three drinks per day" b. "I will limit my salt intake to less than or equal to 2300 mg/day" c. "I will exercise for at least 30 minutes per day, 3-5 times per week" d. "I should stop smoking" A Alcohol should be limited to at most 2 drinks per day. What would the nurse not educate her patient on about antihypertensive medications? a. The side effects reduce over time b. This is not a drug you will have to take forever c. Allow yourself plenty of time to rise from bed, dangling feet off of bed before standing d. Sexual problems may occur, if they do call your HCP to ask about switching medications B Antihypertensives are lifelong drugs and must be taken consistently for the benefits. Which statement by the student nurse warrants further teaching on the difference between Hypertensive emergency and hypertensive urgency? a. Hypertensive urgency develops over days to weeks b. Hypertensive emergency has evidence of target organ damage c. Hypertensive emergency often presents with symptoms such as severe headache, nausea, vomiting, seizures, confusion, and coma d. Both always require hospitalization to correct. D Hypertensive urgency does not always require hospitalization