NRSG 3420 EXAM 2 With Correct Solutions.

NRSG 3420 EXAM 2 With Correct
Solutions.




A client with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should
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inform the client about what potential adverse effects?
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A) Nervousness or paresthesia
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B)Throbbing headache or dizziness j j j




C) Drowsiness or blurred vision
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D) Tinnitus or diplopia - CORRECT ANSWER✔✔Correct response:
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Throbbing headache or dizziness
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Explanation: j




Headache and dizziness commonly occur when nitroglycerin is taken at the beginning of therapy.
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Nervousness, paresthesia, drowsiness, blurred vision, tinnitus, and diplopia do not typically occur as a result
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of nitroglycerin therapy.
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,Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
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Philadelphia, Wolters Kluwer, 2018, Chapter 27: Management of Patients with Coronary Vascular Disorders,
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Chart 27-3, p. 759.
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Chapter 27: Management of Patients with Coronary Vascular Disorders - Page 759
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The physical therapist notifies the nurse that a client with coronary artery disease (CAD) experiences a much
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greater-than-average increase in heart rate during physical therapy. The nurse recognizes that an increase in
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heart rate in a client with CAD may result in what?
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A) Development of an atrial-septal defect
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B) Myocardial ischemia
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C) Formation of a pulmonary embolism
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D) Release of potassium ions from cardiac cells - CORRECT ANSWER✔✔Correct response:
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Myocardial ischemia j




Explanation:

Unlike other arteries, the coronary arteries are perfused during diastole. An increase in heart rate shortens
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diastole and can decrease myocardial perfusion. Clients, particularly those with CAD, can develop myocardial
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ischemia. An increase in heart rate will not usually result in a pulmonary embolism or create electrolyte
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imbalances. Atrial-septal defects are congenital.
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Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
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Philadelphia, Wolters Kluwer, 2018, Chapter 25: Assessment of Cardiovascular Function, Coronary Arteries,
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p. 675.
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Chapter 25: Assessment of Cardiovascular Function - Page 675
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,The nurse is providing care for a client with high cholesterol and triglyceride values. In teaching the client
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about therapeutic lifestyle changes such as diet and exercise, the nurse realizes that the desired goal for
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cholesterol levels is which of the following?
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A) High HDL values and high triglyceride values
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B) Absence of detectable total cholesterol levels
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C) Elevated blood lipids, fasting glucose less than 100
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D) Low LDL values and high HDL values - CORRECT ANSWER✔✔Correct response:
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Low LDL values and high HDL values
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Explanation:

The desired goal for cholesterol readings is for a client to have low LDL and high HDL values. LDL exerts a
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harmful effect on the coronary vasculature because the small LDL particles can be easily transported into the
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vessel lining. In contrast, HDL promotes the use of total cholesterol by transporting LDL to the liver, where it is
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excreted. Elevated triglycerides are also a major risk factor for cardiovascular disease. A goal is also to keep
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triglyceride levels less than 150 mg/dL. All individuals possess detectable levels of total cholesterol.
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Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
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Philadelphia, Wolters Kluwer, 2018, Chapter 27: Management of Patients with Coronary Vascular Disorders,
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Controlling Cholesterol Abnormalities, p. 753.
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Chapter 27: Management of Patients with Coronary Vascular Disorders - Page 753
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The health care provider has placed a central venous pressure (CVP) monitoring line in an acutely ill client so
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right ventricular function and venous blood return can be closely monitored. The results show decreased
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CVP. What does this indicate?
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, A) Possible hypovolemia
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B) Possible myocardial infarction (MI)
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C) Left-sided heart failure
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D) Aortic valve regurgitation - CORRECT ANSWER✔✔Correct response:
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Possible hypovolemia j




Explanation:

Hypovolemia may cause a decreased CVP. MI, valve regurgitation and heart failure are less likely causes of
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decreased CVP.
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Reference: Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
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Philadelphia, Wolters Kluwer, 2018, Chapter 25: Assessment of Cardiovascular Function, Central Venous
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Pressure Monitoring, p. 706.
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Chapter 25: Assessment of Cardiovascular Function - Page 706
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The nursing instructor is teaching nursing students about myocardial contractility and ejection fractions.
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What diagnostic tests can determine client ejection fractions? Select all that apply.
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A) Echocardiogram
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B) Cardiac catheterization
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C) Magnetic resonance imaging
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D) Positron emission tomography scan
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E) Troponin levels - CORRECT ANSWER✔✔Correct response:
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Echocardiogram

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