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Exam (elaborations) Week 4 – Cardiovascular (CV) solved (NURSING100)

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Exam (elaborations) Week 4 – Cardiovascular (CV) solved (NURSING100) An adult patient reports frequent episodes of syncope and lightheadedness. The provider notes a heart rate of 70 beats per minutes. What will the provider do next? Evaluate the patient’s orthostatic vital signs Which are causes of secondary hypertension? (Select all that apply.) Nonsteroidal anti-inflammatory drugs Sleep apnea Oral contraceptives You're treating your patient for heart failure exacerbation. Which medications could potentially exacerbate heart failure? Naproxen Aspirin Atorvastatin Furosemide While doing the cardiac exam on a 45-year-old, you notice any irregular rhythm with a pulse rate of 110 bpm. The patient is alert and not in distress. What is the likely diagnosis? Atrial fibrillation Atrial fibrillation is an irregular rhythm. In ventricular fibrillation patient would be unstable. Right bundle branch block does not cause rhythm irregularities. Second-degree AV block can cause rhythm irregularity, but is usually accompanied with bradycardia. A child with a history of asthma is brought to the clinic with a rapid heart rate. A cardiac monitor shows a heart rate of 225 beats per minute. The provider notifies transport to take the child to the emergency department. What initial intervention may be attempted in the clinic? Using a vagal maneuver or carotid massage Which are factors can cause a heart murmur? (Select all that apply.) High rates of flow through a normal valve Backward flow through a septal defect Forward flow into a dilated vessel A 28-year-old has a grade 3 murmur. Which characteristic indicates a need for referral? A fixed split A split this created because of closure of valves. For example, and S2 is created by closure of an aortic and pulmonic valve. Normal these split with inspiration and almost never with expiration. Splits should never be fixed. This could indicate pathology such as atrial septal defect, pulmonic stenosis, or possibly mitral regurgitation. Mr. Smith is a 72-year-old patient takes warfarin for chronic atrial fibrillation. His INR today is 4. The nurse practitioner should: Stop the warfarin today and repeat INR tomorrow. INR range for atrial fibrillation is usually 2-3 for chronic atrial fibrillation. Stopping warfarin for 4 days with certainly decrease INR, but his overkill, and would put patient at risk for thromboembolism when INR is subtherapeutic. Vitamin K is not necessary for patients who are not bleeding due to high INR, or whose INR is less than 8. Which are causes of secondary hypertension? (Select all that apply.) Oral contraceptives Isometric exercises Increased salt intake ct! Sleep apnea ! Nonsteroidal anti-inflammatory drugs The AHA recommends early CPR and AED use for adult victims of cardiac arrest outside of a hospital setting because most victims have which arrhythmia? Atrial fibrillation ct! Ventricular fibrillation Atrial flutter Ventricular tachycardia A patient with poorly controlled hypertension and history of myocardial infarction 6 years ago presents today with mild shortness of breath. He takes quinapril, aspirin, metoprolol, and statin daily. What symptom is not indicative of heart failure?Correct! Headache Cough Orthopnea

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Week 4 – Cardiovascular (CV)
solved

Week 4 – Cardiovascular (CV)

An adult patient reports frequent episodes of syncope and lightheadedness. The provider notes a heart
rate of 70 beats per minutes. What will the provider do next?
Evaluate the patient’s orthostatic vital signs



Which are causes of secondary hypertension? (Select all that apply.)
Nonsteroidal anti-inflammatory drugs

Sleep apnea

Oral contraceptives



You're treating your patient for heart failure exacerbation. Which medications could potentially
exacerbate heart failure?
Naproxen
Aspirin
Atorvastatin
Furosemide



While doing the cardiac exam on a 45-year-old, you notice any irregular rhythm with a pulse rate of 110
bpm. The patient is alert and not in distress. What is the likely diagnosis?
Atrial fibrillation
Atrial fibrillation is an irregular rhythm. In ventricular fibrillation patient would be unstable.
Right bundle branch block does not cause rhythm irregularities. Second-degree AV block can
cause rhythm irregularity, but is usually accompanied with bradycardia.



A child with a history of asthma is brought to the clinic with a rapid heart rate. A cardiac monitor shows a
heart rate of 225 beats per minute. The provider notifies transport to take the child to the emergency
department. What initial intervention may be attempted in the clinic?
Using a vagal maneuver or carotid massage



Which are factors can cause a heart murmur? (Select all that apply.)
High rates of flow through a normal valve
Backward flow through a septal defect
Forward flow into a dilated vessel

,Week 4 – Cardiovascular (CV)
solved


A 28-year-old has a grade 3 murmur. Which characteristic indicates a need for
referral? A fixed split
A split this created because of closure of valves. For example, and S2 is created by closure of an
aortic and pulmonic valve. Normal these split with inspiration and almost never with
expiration. Splits should never be fixed. This could indicate pathology such as atrial septal
defect, pulmonic stenosis, or possibly mitral regurgitation.



Mr. Smith is a 72-year-old patient takes warfarin for chronic atrial fibrillation. His INR today is 4.
The nurse practitioner should:
Stop the warfarin today and repeat INR tomorrow.
INR range for atrial fibrillation is usually 2-3 for chronic atrial fibrillation. Stopping warfarin
for 4 days with certainly decrease INR, but his overkill, and would put patient at risk for
thromboembolism when INR is subtherapeutic. Vitamin K is not necessary for patients who
are not bleeding due to high INR, or whose INR is less than 8.



Which are causes of secondary hypertension? (Select all that apply.)
Oral contraceptives
Isometric exercises
Increased salt intake ct!
Sleep apnea !
Nonsteroidal anti-inflammatory drugs



The AHA recommends early CPR and AED use for adult victims of cardiac arrest outside of a hospital
setting because most victims have which arrhythmia?
Atrial fibrillation ct!
Ventricular fibrillation
Atrial flutter
Ventricular tachycardia



A patient with poorly controlled hypertension and history of myocardial infarction 6 years ago presents
today with mild shortness of breath. He takes quinapril, aspirin, metoprolol, and statin daily. What
symptom is not indicative of heart failure?Correct!
Headache
Cough
Orthopnea

, Week 4 – Cardiovascular (CV)
solved

Fatigue
Headache is a nonspecific symptom and is not typical for heart failure. All the other symptoms
are classic for worsening heart failure.




A 28-year-old has a grade 3 murmur. Which characteristic indicates a need for referral?
A fixed split
An increase in splitting with inspiration
Split S2 with inspiration wered
Changes in intensity with position changes
A split this created because of closure of valves. For example, and S2 is created by closure of
an aortic and pulmonic valve. Normal these split with inspiration and almost never with
expiration. Splits should never be fixed. This could indicate pathology such as atrial septal
defect, pulmonic stenosis, or possibly mitral regurgitation.



A health care provider in a clinic finds a patient in a room, unresponsive and pale. Which possible signs
should be used to identify the need to initiate cardiopulmonary resuscitation (CPR)?
Correct!
Assessment of gasping breaths or not
breathing Determination of pulselessness or
bradycardia



An African-American patient who is being treated with a thiazide diuretic for chronic hypertension
reports blurred vision and shortness of breath. The provider notes a blood pressure of 185/115. What is
the recommended action for this patient?
Admit to the hospital for evaluation and treatment



A patient reports sustained, irregular heart palpitations. What is the most likely cause of these
symptoms?
Atrial fibrillation



A patient taking atorvastatin for newly diagnosed dyslipidemia complains of fatigue, weakness, muscle
aches in his lower back, arms, legs for the past 3 days. It has not improved with rest. How should this be
managed initially?
Stop atorvastatin immediately

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