Immersion Cardiac exam with correct answers and rationale
Exam 1
(1) A nurse is caring for a client admitted 2days ago with myocardial infection
.upon assessment the nurse notes a new systolic murmur at the cardiac apex.
The nurse should assess the client for which of the following conditions?
(A) A. Ventricular aneurysm
(B) Acute pericarditis
(C) Papillary muscle dysfunction
(D) Pulmonary embolism
2. Which one of the following is an uncontrollable risk factor that has been
linked to development of coronary artery disease(CAD)
(A) Exercise
(B) obesity
(C) stress
(D) heredity
Rationale:
Uncontrollable risks are factors that can not be modified like genetics, heredity, age
Controllable factors are those that are modifiable like - lifestyle(exercise, nutrition),
obesity and stress.
3. A 21 year old male client is transported by ambulance to the emergency unit. He complains of
severe pain in his right chest where he struck the steering wheel. Which is the primary client goal at this time?
A. Reduce client’s anxiety
B. Maintain adequate oxygenation
C. Decrease chest pain
D. Maintain adequate circulating volume
4. The following finding is suggestive of a pneumothorax in a patient with chest trauma;
(A) absent breath sounds
(B) inspiratory wheezing
(C) dullness on chest percussion
(D) pronounced crackles
Rationale:
Pneumothorax - collapsed lung due to changes in pressure within pleural space and
chest wall, causing air to leak out. Leading to a collapsed lung, no ventilation hence
absent breath sounds.
(5) The primary reason for administering digoxin (Lanoxin) to a patient is to,
, (A) Relax the walls of the heart’s arteries.
(B) Improve the strength of the heartbeat.
(C) Prevent irregularities in ventricular contractions .
(D) Decrease inflammation of the heart wall.
Rationale :
6) The priority nursing diagnosis for a patient with heart failure and pulmonary oedema is,
(A) Risk for infection related to stasis of alveolar secretions
(B) Impaired skin integrity related to pressure (C) Activity
intolerance related to pump failure D)Constipation related to
immobility
(7) When preparing a patient for colonoscopy procedure the nurse should,
(A) Perform a high colonic washout procedure the night before the procedure
(B) Ensure the patient takes a high roughage diet with a laxative the night before
procedure
(C) Educate the patient to report any “needle prick” sensations within 12 hrs after the
procedure
(D) Advise the patient to take low fiber diet for 1 week before the procedure
8) The characteristics of a “Cushingoid” appearance in Cushing’s disease include,
(A) Hypotension, Kussmauls’ breathing, hunchback & diaphoresis
(B) Moon face, buffalo hump, central obesity & thin musculature
(C) Mood swings, slow wound healing, hypertension & tunnel vision
(D) Flushing, brittle skin, abdominal pain and encephalopathy
Rationale:
,In women, it can cause menstrual irregularities(amenorrhea, no periods or
menorrhagia-heavy period or irregular periods. Also, infertility, hypertrophy of the clitoris, atrophy of vaginal
muscles, deepening of voice and decreased libido may
occur in women related to inhibition of pulsatile secretion of luteinizing hormone (LH) and follicle-stimulating hormone
(FSH), which likely is due to interruption of
luteinizing hormone-releasing hormone (LHRH) pulse generation. In men, inhibition of
, LHRH and FSH/LH function may lead to decreased libido and impotence. Can cause baldness in med
(10) The sensitivity part of a culture & sensitivity test is for the purpose of,
(A) Identifying the causative organism for the infection diagnosed
(B) Identifying the most effective antibiotics against the causative organism
(C) Identifying the antibiotics that the patient is resistant to
(D) Testing the concentration of antibiotic required to cure an infection 1
(11) A client with a cataract would most likely complain of,
(A) Halos and rainbows around lights
(B) Eye pain and irritation that worsens at night
(C) Blurred and hazy vision
(D) Eye strain and headache when doing close work
12) The primary rationales for tube feeding for a client post total laryngectomy
due to cancer of larynx is to,
(A) Meet dietary needs and prevent fistula formation
(B) Maintain an open airway and prevent aspiration
(C) Meet fluid & dietary needs and prevent aspiration
(D) Prevent fistula formation and reduce aspiration
13) When a burn occurs in an adult,
(A) Using rule of nine, right arm is calculated as being 18% & right leg 9%.
Exam 1
(1) A nurse is caring for a client admitted 2days ago with myocardial infection
.upon assessment the nurse notes a new systolic murmur at the cardiac apex.
The nurse should assess the client for which of the following conditions?
(A) A. Ventricular aneurysm
(B) Acute pericarditis
(C) Papillary muscle dysfunction
(D) Pulmonary embolism
2. Which one of the following is an uncontrollable risk factor that has been
linked to development of coronary artery disease(CAD)
(A) Exercise
(B) obesity
(C) stress
(D) heredity
Rationale:
Uncontrollable risks are factors that can not be modified like genetics, heredity, age
Controllable factors are those that are modifiable like - lifestyle(exercise, nutrition),
obesity and stress.
3. A 21 year old male client is transported by ambulance to the emergency unit. He complains of
severe pain in his right chest where he struck the steering wheel. Which is the primary client goal at this time?
A. Reduce client’s anxiety
B. Maintain adequate oxygenation
C. Decrease chest pain
D. Maintain adequate circulating volume
4. The following finding is suggestive of a pneumothorax in a patient with chest trauma;
(A) absent breath sounds
(B) inspiratory wheezing
(C) dullness on chest percussion
(D) pronounced crackles
Rationale:
Pneumothorax - collapsed lung due to changes in pressure within pleural space and
chest wall, causing air to leak out. Leading to a collapsed lung, no ventilation hence
absent breath sounds.
(5) The primary reason for administering digoxin (Lanoxin) to a patient is to,
, (A) Relax the walls of the heart’s arteries.
(B) Improve the strength of the heartbeat.
(C) Prevent irregularities in ventricular contractions .
(D) Decrease inflammation of the heart wall.
Rationale :
6) The priority nursing diagnosis for a patient with heart failure and pulmonary oedema is,
(A) Risk for infection related to stasis of alveolar secretions
(B) Impaired skin integrity related to pressure (C) Activity
intolerance related to pump failure D)Constipation related to
immobility
(7) When preparing a patient for colonoscopy procedure the nurse should,
(A) Perform a high colonic washout procedure the night before the procedure
(B) Ensure the patient takes a high roughage diet with a laxative the night before
procedure
(C) Educate the patient to report any “needle prick” sensations within 12 hrs after the
procedure
(D) Advise the patient to take low fiber diet for 1 week before the procedure
8) The characteristics of a “Cushingoid” appearance in Cushing’s disease include,
(A) Hypotension, Kussmauls’ breathing, hunchback & diaphoresis
(B) Moon face, buffalo hump, central obesity & thin musculature
(C) Mood swings, slow wound healing, hypertension & tunnel vision
(D) Flushing, brittle skin, abdominal pain and encephalopathy
Rationale:
,In women, it can cause menstrual irregularities(amenorrhea, no periods or
menorrhagia-heavy period or irregular periods. Also, infertility, hypertrophy of the clitoris, atrophy of vaginal
muscles, deepening of voice and decreased libido may
occur in women related to inhibition of pulsatile secretion of luteinizing hormone (LH) and follicle-stimulating hormone
(FSH), which likely is due to interruption of
luteinizing hormone-releasing hormone (LHRH) pulse generation. In men, inhibition of
, LHRH and FSH/LH function may lead to decreased libido and impotence. Can cause baldness in med
(10) The sensitivity part of a culture & sensitivity test is for the purpose of,
(A) Identifying the causative organism for the infection diagnosed
(B) Identifying the most effective antibiotics against the causative organism
(C) Identifying the antibiotics that the patient is resistant to
(D) Testing the concentration of antibiotic required to cure an infection 1
(11) A client with a cataract would most likely complain of,
(A) Halos and rainbows around lights
(B) Eye pain and irritation that worsens at night
(C) Blurred and hazy vision
(D) Eye strain and headache when doing close work
12) The primary rationales for tube feeding for a client post total laryngectomy
due to cancer of larynx is to,
(A) Meet dietary needs and prevent fistula formation
(B) Maintain an open airway and prevent aspiration
(C) Meet fluid & dietary needs and prevent aspiration
(D) Prevent fistula formation and reduce aspiration
13) When a burn occurs in an adult,
(A) Using rule of nine, right arm is calculated as being 18% & right leg 9%.
