CEN Exam 4 | 150 Questions With Correct Answers 2024

CEN Exam 4 | 150 Questions With Correct Answers 2024 1. A pt presents who had experienced chest pain but is now pain free. EKG's have been repeated twice, and troponin levels repeated at 4 hour intervals are within normal limits. The pt has no significant risk factor for heart disease. The nurse anticipates: A. Admission to the ICU to rule out MI B. Admission to the cardiac cath lab for eval of coronary anatomy C. That the pt will be discharged home, with instructions for close follow up with their PCP because the risk of an adverse coronary event is low D. Admission to the telemetry unit to rule out an MI C. That the pt will be discharged home, with instructions for close follow up with their PCP because the risk of an adverse coronary event is low In adult pts with chest pain who demonstrates two negative findings for serial biomarkers, nonconcerning vital signs and nonischemic EKG findings, short term clinically relevant adverse cardiac events are rare and commonly iatrogenic, inpatient admission may not be beneficial 2. A pt who became unconscious during ascent while scuba diving arrives via EMS. The pt is unconscious and hypotensive. What is the most appropriate position in which to place this pt during their examination by physician?: A. Left lateral decubitus, head down B. Right lateral decubitus, head down C. Left lateral decubitus, head up D. Supine A. Left lateral decubitus, head down Head down position prevents air from traveling through the right side of the heart into the pulmonary arteries, leading to a possible right ventricular outflow obstruction 3. In which pt would the nurse question on order for morphine sulfate?: A. A pt with aortic dissection B. A pt with a ST elevation MI C. A pt with unstable angina D. A pt with non-ST MI D. A pt with non-ST MI An increase of mortality has been associated with the use of morphine sulfate in pts with non-ST segment elevation 4. Following the administration of 2L IV crystalloids, the ED nurse begins to administer IV dobutamine (Dobutrex) to a pt who has been diagnosed with a right ventricular infarction. The ED nurse identifies that this medication has been effective when the pt demonstrates which of the following?: A. Bradycardia B. Increase in blood pressure C. Presence of distended neck veins D. Onset of A-fib B. Increase in blood pressure Pts who experience RVI as preload dependent and require additional fluids to increase their blood pressure. If the pts BP does not respond to the additional fluid administration, the administration of Dobutamine is indicated to increase the pts cardiac output, thereby increasing the BP