CCRN Questions and Correct Answers |
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The nurse is caring for a patient with acute inferior wall MI, post-coronary artery stent
deployment, For optimal care of the patient, the nurse should:
✓ -:- Continuously monitor the patient in lead II
It is best practice to monitor the patient status post PCI with stent, in the lead that was
most abnormal during the acute occlusion.
The ECG demonstrates ST elevation in leads II, III and aVF. The nurse needs to monitor the
patient closely for which of the following?
✓ -:- Complication likely to occur after an acute inferior wall MI include
bradycardia secondary to ischemia to the SA and/or AV node, and
papillary muscle rupture or dysfunction due to the anatomical distance
between the RCA and the papillary muscle.
Which of the following hemodynamic profiles would benefit from the aggressive fluid
administration, pressers and antibiotics therapy?
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a. RAP: 1mm Hg; PAOP: 4 mmHg; SVR: 1800 dynes/sec; CO: 2L/min
b. RAP: 5; PAOP: 7; SVR: 400; CO; 8L
✓ -:- B. the hemodynamic profile of RAP 5, PAOP 7, SVR 400 is typical of
septic shock, and choice B would be the best approach.
Which of the following is indicative of a mixed acid-base disorder?
A. pH 7.18; PaCO2 25; PaO2 64; HCO3 11
B. pH 7.33; PaCO2 29; PaO2 72; HCO3 15
✓ -:- The decrease in PaCO2 is evidence of respiratory alkalosis and the
decreased HCO3 is evidenced of a metabolic acidosis. The pt with severe
sepsis or septic shock may present with this mixed acid -base disorder.
The patient with a temporary pacemaker develops pacemaker malfunction. The oriented is
instructed to reposition the patient to try and correct the problem. The cardiac monitor
most likely demonstrates?
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✓ -:- Failure to capture (pacemaker without a QRS) may be corrected by
repositioning the patient to the side.
The patient with diastolic heart develops SVT, heart rate 220/min. The most dangerous
hemodynamic effect is a decrease in:
✓ -:- coronary artery perfusion.
Diastolic heart failure results in a problem with left ventricular FILLING secondary to
ventricular thickening, and contractility and ejection are maintained in diastolic failure. The
rapid heart rate will decrease filling time, worsen left ventricular filling and because coronary
artery perfusion occurs during diastole, this arrhythmia may be life-threatening.
The patient is receiving heparin infusion for the treatment of pulmonary embolism. There
has been a 60% decrease in the platelet count and no clinical change. Which of the following
is indicated?
✓ -:- Discontinue heparin and being argatroban.
The patient most likely has HIT. Exposure to heparin needs to discontinued and a direct
thrombin inhibitor started for continued anticoagulation.
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The patient with oat cell carcinoma has the following clinical findings: low urine output, low
serum osmolality, hyponatremia, and elevated urine sodium. The nurse anticipates which of
the following as part of the treatment plan?
✓ -:- Phenytoin (Dilantin), 3% saline.
The patient has signs of SIADH which results in production of excessive ADH. Dilantin will
inhibit ADH secretion and 3% saline will increase serum sodium.
Peep therapy and mechanical ventilation are ordered for the patient with acute respiratory
failure. Which of the following is a possible complication?
✓ -:- Barotrauma
The addition of positive end-expiratory pressure will increase alveolar recruitment, prevent
atelectasis and improve oxygenation. However, the increase in intrathoracic pressure may
lead to pneumothorax or subcutaneous emphysema.
The postoperative thoracic surgery patient has bubbling in the water seal drainage chamber
of the chest tube. Which of the following interventions is indicated?
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