NR 341 CMS EXAM PART 2 WITH FULL PACK SOLUTIONS
1.What xare xmedications xfor xangina xand xMI?: xMONA x(ONAM xis xcorrect
xorder) x+ xbeta xblocker
2.Important xnursing xconsiderations xfor xa xpatient xthat xhad xa xcardiac
xcatheteri- xzation: x-HOB xno xhigher xthan x30 xdegrees
-Keep xthe xaffected xextremity xstraight
-Stay xon xbed xrest xfor x4-8 xhrs
-If xpt xcoughs, xhold xpressure xover xsite
-Inc. xfluids xto xhelp xexcrete xdye
3.When xmeds xare xprescribed xto xa xpatient xupon xdischarge xwho xhas
xhad xa xcardiac xcatheterization?: xAspirin xand xclopidogrel
x(antiplatelet xmeds)
4.What xis xthe xpurpose xof xa xCABG?: xTo xrevascularize xthe xheart
5.Common xcomplications xfollowing xCABG: x-Hypothermia
-Bleeding
-Bradycardia x(treated xwith xa xtransvenous xpacemaker)
6.What xdoes xa xlow xCVP xmean?: xThe xpatient xneeds xmore xvolume
7.What xmedications xare xtypically xprescribed xto xa xpatient xfollowing xa
1 x/
x16
, x CABG?-
: x-Beta xblockers
-ACE xinhibitors
-Statins
8.What xis xit xcalled xif xthe xPR xinterval xis xlonger xthan xnormal x(norm x= x0.12-
0.2)?-
: xFirst-degree xAV xblock x(delay xin xconduction xfrom xSA xnode xto xpurkinje
xfibers)
9.Education xfor xa xpatient xwith xa xpacemaker: x-Report xHR xlower xthan
xthe xset xamount
-Avoid xhigh xoutput xelectric xgenerators
-Avoid xMRI
-Carry xpacemaker xcard xwith xthem xat xall xtimes
-It xis xsafe xto xuse xmicrowave xovens
-Do xnot xuse xcell xphones xon xthe xsame xside xthe xpacemaker xis xin
-Do xnot xmove xarm xabove xshoulder xfor xabout x2 xweeks xfollowing
xprocedure
10.How xlong xdoes xa xpacemaker xlast?: xIt xdepends xon xhow xoften xthe
xpatient xneeds xto xuse xthe xpacemaker
(usually xlasts xfrom x5-10 xyears)
11. A xpatient xhas xa xnasogastric xtube xordered xfor xa xpeptic xulcer, xwhat
xare xpriority xinterventions xafter xplacement xof xthe xtube?: xMonitor xthe
xamount xof xfluid xcoming xout xand xthe xcolor
12.If xa xpatient xhas xhad xa xgastrectomy xand xyou xnote xblood xdraining xfrom
xthe xnasogastric xtube, xis xthis xcause xfor xconcern?: xIt's xnormal xto xsee
xblood xin xthe xtubing xpost-op xinitially xbut xthat xblood xshould xstart xto
xclear xup xand xturn xa xbile xcolor xin x12-24 xhours.
2 x/
x16
, 13.A xpatient xhas xan xupper xGI xbleed xand xis xvomiting xblood, xwhat xis xthis
xpatient xat xan xincreased xrisk xfor?: xThe xpatient xcan xbegin xto xpresent
xwith xshock xdepending xon xhow xmuch xvolume xthey xare xlosing,
xcausing xan xairway xproblem xand xputting xthem xat xhigh xrisk xfor
xaspiration; xthis xpatient xmay xneed xto xbe xintubated
14. If xa xpatient xwith xa xGI xbleed xbegins xto xvomit xblood xin xbed, xwhat xis
xyour xpriority xintervention?: xRoll xthe xpatient xon xtheir xside xto xprevent
xaspiration xand xsuction xthe xoral xcavity
15.What xshould xyou xdo xprior xto xinitiating xa xgastric xlavage?: xAssess xthe
xclient xfor xa xgag xreflex. xIf xthe xpatient xhas xa xdiminished xor xabsence
xof xa xgag xreflex, xthis xis xa xcontraindication xof xthis xprocedure xbecause
xthe xaspiration xrisk xwill xbe xhigh.
16.How xdo xyou xperform xa xgastric xlavage?: x-Insert xa xnasogastric xtube
-Use x0.9% xNS x(room xtemp xor xslightly xwarm)
-Use x60 xmL xsyringe xand xlavage xset
-Instill xthe xprescribed xvolume x(typically x200-300 xmL)
-Reconnect xthe xpatient xto xthe xsuction xordered x(or xthe xHCP xmay xwant
xthis xto xflow xout xvia xgravity)
-Document xthe xamount, xcolor, xand xcontents
17.What xis ximportant xto xmonitor xfor xfollowing xa xgastric xlavage?: xMonitor
xfor xfluid xand xelectrolyte ximbalances
18.If xa xpatient xis xresponsive xwe xfollow xABCs; xif xa xpatient xis
xunresponsive, xhowever, xwhat xorder xdo xwe xfollow?: xCAB
19.Emergency xcare xfor xupper xGI xbleeds: x-2 xlarge xbore xIVs
-O2 xNC x- xnonrebreather xmask
-ECG xmonitoring
-Insert xNG xtube
-Keep xNPO
-Obtain xblood xfor xCBC, xclotting xstudies, xtype, xand xcrossmatch
-Assess xamount/color xof xemesis
-Replace xvolume xlosses
-Strict xI&O
20.Common xrisk xfactors xfor xpeptic xulcer xdisease: xStress
H.
xpylori
xAlcoho
l
xSmoki
ng
3 x/
x16
1.What xare xmedications xfor xangina xand xMI?: xMONA x(ONAM xis xcorrect
xorder) x+ xbeta xblocker
2.Important xnursing xconsiderations xfor xa xpatient xthat xhad xa xcardiac
xcatheteri- xzation: x-HOB xno xhigher xthan x30 xdegrees
-Keep xthe xaffected xextremity xstraight
-Stay xon xbed xrest xfor x4-8 xhrs
-If xpt xcoughs, xhold xpressure xover xsite
-Inc. xfluids xto xhelp xexcrete xdye
3.When xmeds xare xprescribed xto xa xpatient xupon xdischarge xwho xhas
xhad xa xcardiac xcatheterization?: xAspirin xand xclopidogrel
x(antiplatelet xmeds)
4.What xis xthe xpurpose xof xa xCABG?: xTo xrevascularize xthe xheart
5.Common xcomplications xfollowing xCABG: x-Hypothermia
-Bleeding
-Bradycardia x(treated xwith xa xtransvenous xpacemaker)
6.What xdoes xa xlow xCVP xmean?: xThe xpatient xneeds xmore xvolume
7.What xmedications xare xtypically xprescribed xto xa xpatient xfollowing xa
1 x/
x16
, x CABG?-
: x-Beta xblockers
-ACE xinhibitors
-Statins
8.What xis xit xcalled xif xthe xPR xinterval xis xlonger xthan xnormal x(norm x= x0.12-
0.2)?-
: xFirst-degree xAV xblock x(delay xin xconduction xfrom xSA xnode xto xpurkinje
xfibers)
9.Education xfor xa xpatient xwith xa xpacemaker: x-Report xHR xlower xthan
xthe xset xamount
-Avoid xhigh xoutput xelectric xgenerators
-Avoid xMRI
-Carry xpacemaker xcard xwith xthem xat xall xtimes
-It xis xsafe xto xuse xmicrowave xovens
-Do xnot xuse xcell xphones xon xthe xsame xside xthe xpacemaker xis xin
-Do xnot xmove xarm xabove xshoulder xfor xabout x2 xweeks xfollowing
xprocedure
10.How xlong xdoes xa xpacemaker xlast?: xIt xdepends xon xhow xoften xthe
xpatient xneeds xto xuse xthe xpacemaker
(usually xlasts xfrom x5-10 xyears)
11. A xpatient xhas xa xnasogastric xtube xordered xfor xa xpeptic xulcer, xwhat
xare xpriority xinterventions xafter xplacement xof xthe xtube?: xMonitor xthe
xamount xof xfluid xcoming xout xand xthe xcolor
12.If xa xpatient xhas xhad xa xgastrectomy xand xyou xnote xblood xdraining xfrom
xthe xnasogastric xtube, xis xthis xcause xfor xconcern?: xIt's xnormal xto xsee
xblood xin xthe xtubing xpost-op xinitially xbut xthat xblood xshould xstart xto
xclear xup xand xturn xa xbile xcolor xin x12-24 xhours.
2 x/
x16
, 13.A xpatient xhas xan xupper xGI xbleed xand xis xvomiting xblood, xwhat xis xthis
xpatient xat xan xincreased xrisk xfor?: xThe xpatient xcan xbegin xto xpresent
xwith xshock xdepending xon xhow xmuch xvolume xthey xare xlosing,
xcausing xan xairway xproblem xand xputting xthem xat xhigh xrisk xfor
xaspiration; xthis xpatient xmay xneed xto xbe xintubated
14. If xa xpatient xwith xa xGI xbleed xbegins xto xvomit xblood xin xbed, xwhat xis
xyour xpriority xintervention?: xRoll xthe xpatient xon xtheir xside xto xprevent
xaspiration xand xsuction xthe xoral xcavity
15.What xshould xyou xdo xprior xto xinitiating xa xgastric xlavage?: xAssess xthe
xclient xfor xa xgag xreflex. xIf xthe xpatient xhas xa xdiminished xor xabsence
xof xa xgag xreflex, xthis xis xa xcontraindication xof xthis xprocedure xbecause
xthe xaspiration xrisk xwill xbe xhigh.
16.How xdo xyou xperform xa xgastric xlavage?: x-Insert xa xnasogastric xtube
-Use x0.9% xNS x(room xtemp xor xslightly xwarm)
-Use x60 xmL xsyringe xand xlavage xset
-Instill xthe xprescribed xvolume x(typically x200-300 xmL)
-Reconnect xthe xpatient xto xthe xsuction xordered x(or xthe xHCP xmay xwant
xthis xto xflow xout xvia xgravity)
-Document xthe xamount, xcolor, xand xcontents
17.What xis ximportant xto xmonitor xfor xfollowing xa xgastric xlavage?: xMonitor
xfor xfluid xand xelectrolyte ximbalances
18.If xa xpatient xis xresponsive xwe xfollow xABCs; xif xa xpatient xis
xunresponsive, xhowever, xwhat xorder xdo xwe xfollow?: xCAB
19.Emergency xcare xfor xupper xGI xbleeds: x-2 xlarge xbore xIVs
-O2 xNC x- xnonrebreather xmask
-ECG xmonitoring
-Insert xNG xtube
-Keep xNPO
-Obtain xblood xfor xCBC, xclotting xstudies, xtype, xand xcrossmatch
-Assess xamount/color xof xemesis
-Replace xvolume xlosses
-Strict xI&O
20.Common xrisk xfactors xfor xpeptic xulcer xdisease: xStress
H.
xpylori
xAlcoho
l
xSmoki
ng
3 x/
x16
