NUR 411 Exam 1 Practice Questions
The nurse is caring for a patient admitted with chest pain that has some diagnostic
procedures ordered. The patient's family is concerned because the patient has a very
sensitive gag reflex. The nurse knows that the family needs some further explanation
about which of the following procedures?
A. 12-lead electrocardiogram
B. transesophageal echocardiogram
C. portable chest x-ray
D. cardiac catheterization - answerB. trans esophageal echocardiogram
All four are diagnostic procedures, but only 2 are invasive, therefore unlikely that a 12
lead ECG or CXR would every cause gagging. A TEE goes into the mouth and down
the throat and can illicit gagging and will likely require some medication to help with this.
Cardiac catheterization is invasive but does not do anything specifically in the mouth or
throat and would not be a best answer choice for this question.
The nurse is preparing a faculty in-service about congestive heart failure treatment.
Which of the following statements would require follow-up?
A. Treatment is geared at limiting the progression of the disease
B. Treatment is started at stage 2 of the disease
C. (Carvediol) Coreg and (Furosemide) Lasix are both used
D. (Captopril) Capoten should be held if there is renal insufficiency - answerB.
Treatment is started at stage 2 of the disease
Treatment needs to be started at stage one of the disease to try and limit its progression
to later stages. All other statements are true—treatment is aimed at limiting the
progression of the disease (it also provides symptom relief in many cases). Coreg,
Lasix, and Capoten are all common medications used in CHF treatment. NOTE: ACE
inhibitors should be held if there is renal insufficiency as they can cause hyperkalemia—
something to keep in mind if you are about to administer this medication to your patient.
The nurse is caring for a patient that had a cardiac stent placed 4 hours ago. The nurse
has identified a complication to this therapy and is preparing to send the patient for a
coronary artery bypass graft (CABG). The nurse knows that which of the following
complications has led to this decision?
A. Retroperitoneal bleeding
B. Hypotension
C. ST segment elevation
D. Multiple premature ventricular contractions (PVCs) - answerC. ST segment elevation
Common complications of a stent being placed are: bleeding, hemodynamic instability,
reperfusion complications, and re-occlusion. The only one that would specifically
warrant open heart surgery is the re-occlusion complication. How does one tell that is
happening—a new heat attack—ST elevation would be a signal of this.
, The nurse is caring for a patient with both right and left sided congestive heart failure
(CHF).
The nurse knows that which of the following of the following statements is true? (select
all that apply).
A. The patient will likely have crackles
B. The patient will likely have decreased CVP
C. The patient will likely have a decreased PA diastolic
D. The patient will likely have an increased cardiac output
E. The patient will likely have increased preload and afterload - answerA. The patient
will likely have crackles and
E. The patient will likely have increased preload and afterload.
In a patient with both left and right sided heart failure there is likely build up of fluid and
an inability to circulate it (pump) it properly. There would be symptoms seen on both
sides (lung and systemic), so likely the patient would have crackles and an elevated
CVP. It is also likely that the preload would be elevated in both the left and right
ventricle (supports elevated CVP and elevated PA diastolic) as they cannot deal with
the fluid in their system well. This inability to pump and eject blood from the heart would
likely lead to a decreased CO and likely decreased BP. The body/brain would feel that
drop in perfusion pressure and constrict the systemic vessels leading to an increased
afterload on the heart.
The nurse is caring for a patient with the following morning vital signs and
hemodynamics:
Temp: 97.4 F, HR: 107 bpm, BP: 90/40 (56) mmHg
RAP: 3, SVR: 1400
The nurse knows to anticipate which of the following? (select all that apply)
A. Cool extremities
B. Jugular Vein Distention
C. Decrease Urine Output
D. Dry mucous membranes
E. Pitting Peripheral Edema - answerA. Cool extremities,
C. Decreased urine output and
D. Dry mucous membranes
The Vital Signs and Hemodynamics all show signs of dehydration—tachycardia and low
BP with a low normal CVP, with an elevated SVR. The s/s associated best with
dehydration and low BP would be cool extremities and dry mucous membranes. Likely
the UOP would be decreased as the perfusion pressure is low and the body would be
trying to retain fluid. JVD and Pitting edema can both been seen in fluid volume excess,
and there is no reason to think the patient is third spacing any fluid causing edema.
The nurse is caring for a patient that has just had a hernia repair. The patient complains
of chest pain while walking down the hall. The provider orders a 12-lead ECG
immediately. The nurse knows to anticipate which other order?
The nurse is caring for a patient admitted with chest pain that has some diagnostic
procedures ordered. The patient's family is concerned because the patient has a very
sensitive gag reflex. The nurse knows that the family needs some further explanation
about which of the following procedures?
A. 12-lead electrocardiogram
B. transesophageal echocardiogram
C. portable chest x-ray
D. cardiac catheterization - answerB. trans esophageal echocardiogram
All four are diagnostic procedures, but only 2 are invasive, therefore unlikely that a 12
lead ECG or CXR would every cause gagging. A TEE goes into the mouth and down
the throat and can illicit gagging and will likely require some medication to help with this.
Cardiac catheterization is invasive but does not do anything specifically in the mouth or
throat and would not be a best answer choice for this question.
The nurse is preparing a faculty in-service about congestive heart failure treatment.
Which of the following statements would require follow-up?
A. Treatment is geared at limiting the progression of the disease
B. Treatment is started at stage 2 of the disease
C. (Carvediol) Coreg and (Furosemide) Lasix are both used
D. (Captopril) Capoten should be held if there is renal insufficiency - answerB.
Treatment is started at stage 2 of the disease
Treatment needs to be started at stage one of the disease to try and limit its progression
to later stages. All other statements are true—treatment is aimed at limiting the
progression of the disease (it also provides symptom relief in many cases). Coreg,
Lasix, and Capoten are all common medications used in CHF treatment. NOTE: ACE
inhibitors should be held if there is renal insufficiency as they can cause hyperkalemia—
something to keep in mind if you are about to administer this medication to your patient.
The nurse is caring for a patient that had a cardiac stent placed 4 hours ago. The nurse
has identified a complication to this therapy and is preparing to send the patient for a
coronary artery bypass graft (CABG). The nurse knows that which of the following
complications has led to this decision?
A. Retroperitoneal bleeding
B. Hypotension
C. ST segment elevation
D. Multiple premature ventricular contractions (PVCs) - answerC. ST segment elevation
Common complications of a stent being placed are: bleeding, hemodynamic instability,
reperfusion complications, and re-occlusion. The only one that would specifically
warrant open heart surgery is the re-occlusion complication. How does one tell that is
happening—a new heat attack—ST elevation would be a signal of this.
, The nurse is caring for a patient with both right and left sided congestive heart failure
(CHF).
The nurse knows that which of the following of the following statements is true? (select
all that apply).
A. The patient will likely have crackles
B. The patient will likely have decreased CVP
C. The patient will likely have a decreased PA diastolic
D. The patient will likely have an increased cardiac output
E. The patient will likely have increased preload and afterload - answerA. The patient
will likely have crackles and
E. The patient will likely have increased preload and afterload.
In a patient with both left and right sided heart failure there is likely build up of fluid and
an inability to circulate it (pump) it properly. There would be symptoms seen on both
sides (lung and systemic), so likely the patient would have crackles and an elevated
CVP. It is also likely that the preload would be elevated in both the left and right
ventricle (supports elevated CVP and elevated PA diastolic) as they cannot deal with
the fluid in their system well. This inability to pump and eject blood from the heart would
likely lead to a decreased CO and likely decreased BP. The body/brain would feel that
drop in perfusion pressure and constrict the systemic vessels leading to an increased
afterload on the heart.
The nurse is caring for a patient with the following morning vital signs and
hemodynamics:
Temp: 97.4 F, HR: 107 bpm, BP: 90/40 (56) mmHg
RAP: 3, SVR: 1400
The nurse knows to anticipate which of the following? (select all that apply)
A. Cool extremities
B. Jugular Vein Distention
C. Decrease Urine Output
D. Dry mucous membranes
E. Pitting Peripheral Edema - answerA. Cool extremities,
C. Decreased urine output and
D. Dry mucous membranes
The Vital Signs and Hemodynamics all show signs of dehydration—tachycardia and low
BP with a low normal CVP, with an elevated SVR. The s/s associated best with
dehydration and low BP would be cool extremities and dry mucous membranes. Likely
the UOP would be decreased as the perfusion pressure is low and the body would be
trying to retain fluid. JVD and Pitting edema can both been seen in fluid volume excess,
and there is no reason to think the patient is third spacing any fluid causing edema.
The nurse is caring for a patient that has just had a hernia repair. The patient complains
of chest pain while walking down the hall. The provider orders a 12-lead ECG
immediately. The nurse knows to anticipate which other order?
