NURS 2245: Exam 1 Questions With Complete Solutions
1st intervention for a client with a hematoma after
catheterization? Correct Answer PRESSURE to site
56 year old man: chest pain, elevated troponin levels, ST
segment depression: nurse interpretation of these findings?
Correct Answer patient is experiencing: NSTEMI
a client has a HR: 46bpm
which meds would be most concerning? Correct Answer
digoxin
metoprolol
NOT ACE-I because client has a normal BP and the ACE-I is
keeping BP normal
a client with MI suddenly becomes tachycardic and coughs pink,
frothy sputum. Which of the following breath sounds might the
nurse auscultate? Correct Answer crackles
pink, frothy sputum: acute
if diminished lung sounds are heard: can occur over time;
chronic; pleural effusion
a client with pulmonary edema has an order for additional IV
furosemide and a new order for digoxin. Which laboratory result
is important to verify before administering the medications?
Correct Answer **Potassium level
no digoxin level to look at when it is a new order*
,a patient on statin therapy asks the nurse about healthy eating
choices to reduce lipid levels. Which of the following food
choices should be avoided? Correct Answer grapefruit
grapefruit juice
a priority intervention during initial ACE inhibitor therapy is
monitoring Correct Answer blood pressure
a single lead CANNOT? Correct Answer - identify/locate an
infarct
- identify axis deviation or chamber enlargement
- identify right to left differences in conduction
- the quality or presence of pumping action
- EKG: only ELECTRICAL activity
ACE inhibitors (ACEI) actions Correct Answer block
conversion of angiotensin I to angiotensin II
cause peripheral arterial and venous vasodilation, decreasing
SVR
possible improved diastolic functioning
decrease apoptosis (stops remodeling): probable reduced loss of
myocardial cells
Action: venodilators Correct Answer dilate veins to decrease
amount of blood returning to the heart
tolerance can develop: no longer effect
Active: Lifestyle changes Correct Answer exercise: 30 mins:
lower LDL, increase HDL
lose wt
quit smoking: increase HDL
,activity intolerance and fatigue r/t... Correct Answer
inadequate tissue perfusion secondary to CHF
goal: manage energy to facilitate ADLs
initially need physical and emotional rest: chair for meals,
monitor ability to tolerate: BP and HR (monitor with activity)
**increase by 20bpm: not tolerating well
increase, decrease by 20***
Activity intolerance phases Correct Answer planned cardiac
rehabilitation
1 hospitalization; nursing and PT supervised progressive
ambulation
2 convalescence: outpatient cardiac rehab
3 long-term conditioning: independent
acute coronary syndrome (ACS) Correct Answer angina
unstable angina (UA)
Non ST elevation MI (NSTEMI)
ST elevation MI (STEMI)
Acute HF Drugs Correct Answer morphine: vasodilation:
better fluid and exchange
lasix: IVP, check K level
IV nitroglycerin: vasodilation
Milrinone: enhances contractility; heartbeat stronger
acute vs. chronic heart failure Correct Answer acute: occurs
SUDDENLY: heart attack, arrhythmia, virus, drugs:
chemotherapy
, chronic: develops OVER TIME: HTN, valve disease
* a person with chronic can have an acute episode
additional info: amiodarone (cordarone) Correct Answer stop
tachydysrhythmias
long half-life
significant s/e
iodine bound
bluish/red skin
cornea: vision
adult CO range? Correct Answer 4-7L/min
adverse effects of morphine sulfate Correct Answer
respiratory depression
hypotension: low BP
constipation
adverse effects: therapeutic hypothermia Correct Answer fluid
and electrolyte imbalance
arrhythmias
insulin resistance
shivering
coagulation problems
pain concerns
sedation concerns
afterload Correct Answer pressure ventricles must overcome
to eject blood into the peripheral blood vessels
1st intervention for a client with a hematoma after
catheterization? Correct Answer PRESSURE to site
56 year old man: chest pain, elevated troponin levels, ST
segment depression: nurse interpretation of these findings?
Correct Answer patient is experiencing: NSTEMI
a client has a HR: 46bpm
which meds would be most concerning? Correct Answer
digoxin
metoprolol
NOT ACE-I because client has a normal BP and the ACE-I is
keeping BP normal
a client with MI suddenly becomes tachycardic and coughs pink,
frothy sputum. Which of the following breath sounds might the
nurse auscultate? Correct Answer crackles
pink, frothy sputum: acute
if diminished lung sounds are heard: can occur over time;
chronic; pleural effusion
a client with pulmonary edema has an order for additional IV
furosemide and a new order for digoxin. Which laboratory result
is important to verify before administering the medications?
Correct Answer **Potassium level
no digoxin level to look at when it is a new order*
,a patient on statin therapy asks the nurse about healthy eating
choices to reduce lipid levels. Which of the following food
choices should be avoided? Correct Answer grapefruit
grapefruit juice
a priority intervention during initial ACE inhibitor therapy is
monitoring Correct Answer blood pressure
a single lead CANNOT? Correct Answer - identify/locate an
infarct
- identify axis deviation or chamber enlargement
- identify right to left differences in conduction
- the quality or presence of pumping action
- EKG: only ELECTRICAL activity
ACE inhibitors (ACEI) actions Correct Answer block
conversion of angiotensin I to angiotensin II
cause peripheral arterial and venous vasodilation, decreasing
SVR
possible improved diastolic functioning
decrease apoptosis (stops remodeling): probable reduced loss of
myocardial cells
Action: venodilators Correct Answer dilate veins to decrease
amount of blood returning to the heart
tolerance can develop: no longer effect
Active: Lifestyle changes Correct Answer exercise: 30 mins:
lower LDL, increase HDL
lose wt
quit smoking: increase HDL
,activity intolerance and fatigue r/t... Correct Answer
inadequate tissue perfusion secondary to CHF
goal: manage energy to facilitate ADLs
initially need physical and emotional rest: chair for meals,
monitor ability to tolerate: BP and HR (monitor with activity)
**increase by 20bpm: not tolerating well
increase, decrease by 20***
Activity intolerance phases Correct Answer planned cardiac
rehabilitation
1 hospitalization; nursing and PT supervised progressive
ambulation
2 convalescence: outpatient cardiac rehab
3 long-term conditioning: independent
acute coronary syndrome (ACS) Correct Answer angina
unstable angina (UA)
Non ST elevation MI (NSTEMI)
ST elevation MI (STEMI)
Acute HF Drugs Correct Answer morphine: vasodilation:
better fluid and exchange
lasix: IVP, check K level
IV nitroglycerin: vasodilation
Milrinone: enhances contractility; heartbeat stronger
acute vs. chronic heart failure Correct Answer acute: occurs
SUDDENLY: heart attack, arrhythmia, virus, drugs:
chemotherapy
, chronic: develops OVER TIME: HTN, valve disease
* a person with chronic can have an acute episode
additional info: amiodarone (cordarone) Correct Answer stop
tachydysrhythmias
long half-life
significant s/e
iodine bound
bluish/red skin
cornea: vision
adult CO range? Correct Answer 4-7L/min
adverse effects of morphine sulfate Correct Answer
respiratory depression
hypotension: low BP
constipation
adverse effects: therapeutic hypothermia Correct Answer fluid
and electrolyte imbalance
arrhythmias
insulin resistance
shivering
coagulation problems
pain concerns
sedation concerns
afterload Correct Answer pressure ventricles must overcome
to eject blood into the peripheral blood vessels
