A patient had CABG surgery 3 days ago. Physical assessment shows diminished lung
sounds in the bases, an SpO2 of 94% on room air, chest tubes with minimal drainage,
and a regular heart rate. The nurse notices new-onset weakness and slurred speech.
Which action is indicated?
A. Encourage PO fluid intake
B. Administer 2L of O2
C. Conduct a blood glucose test
D. Prepare for thrombolytic therapy
Give this one a try later!
, C. Conduct a blood glucose test
Hypoglycemia may cause stroke-like s/s and is easily r/o with a blood
glucose test. Thrombolytic therapy is an absolute contraindication in a
postop patient because of the potential for bleeding. Supplemental
oxygen may be considered, but the SpO2 is satisfactory, so this in not the
best answer. A patient with slurred speech may also have difficulty
swallowing and be at risk for aspiration.
Which patient is at greatest risk for myocarditis? A patient
A. who has not been taking diuretics as prescribed
B. with a history of lupus
C. who smokes marijuana daily
D. being treated for bacterial pneumonia
Give this one a try later!
B. with a history of lupus
Potential causes of myocarditis are recent viral infections, cocaine abuse,
and having autoimmune disease such as lupus.
A patient with a history of chronic alcohol abuse, congestive HF, HTN, and
hyperlipidemia is admitted with increased SOB and lower extremity edema.
Echocardiogram reveals an EF of 25%. The patient's family states "I don't understand,
the cardiologist started him on the metoprolol (Lopressor) last week and it was
supposed to get better. What happened?" The nurse's best response is
A. "We are preparing for immediate ICD placement"
B. "These are symptoms of withdrawal and will not respond to beta-blockers"
C. "Metoprolol can take weeks to show effects"
D. "Metoprolol is contraindicated in alcoholic cardiomyopathy"
,Give this one a try later!
C. "Metoprolol can take weeks to show effects"
Metoprolol can take weeks or months to achieve desired results.
Sometimes, patients have an increase in symptoms prior to seeing
improvement.
A patient with a history of amyloidosis presents with exercise intolerance, dyspnea
with exertion, and S3 and S4 present. The provider orders carvedilol (Coreg), digoxin
(Lanoxin), enoxaparin (Lovenox), furosemide (Lasix), a chest x-ray, and
echocardiogram. Which order should the nurse clarify?
A. carvedilol
B. digoxin
C. enoxaparin
D. furosemide
Give this one a try later!
B. digoxin
The patient has a history of amyloidosis and presents with symptoms of
restrictive cardiomyopathy (hx of amyloidosis, exercise intolerance,
dyspnea with exert, as well as S3 and S4 heart sounds). Digoxin is
contraindicated in patients with restrictive cardiomyopathy due to an
increased risk of digoxin toxicity from the amyloid fibrils.
A family member with Marfan syndrome is visiting and is standing in the hallway
appearing short of breath, coughing, and has a hand on the chest. The person reports
in a hoarse voice, feeling a tearing sensation in the upper abdomen, having back pain,
and feeling a little out of breath. The nurse should suspect
A. acute myocardial infarction
, B. hypertensive crisis
C. angina
D. aortic dissection
Give this one a try later!
D. aortic dissection
Of patients with an aortic aneurysm, 90% have a history of systemic
hypertension. Other causes of aortic aneurysm include atherosclerotic
changes in the thoracic and abdominal aorta, blunt trauma, Marfan
syndrome, pregnancy, injury, or dissection. The classic clinical presentation
is sudden onset of intense, severe, tearing pain, which may be localized
initially in the chest, abdomen, or back. As the aortic tear (dissection)
extends, pain radiates to the back or distally toward the lower extremities.
Many patients have hypertension on initial presentation; the focus is on BP
control and early surgery.
A patient is admitted with a 98% blockage of the right coronary artery (RCA) with
plans for a PTCA. Which ECG abnormality SHOULD the nurse anticipate?
A. ST segment elevation in leads II, III, and aVF
B. reciprocal changes in leads V1-V4
C. ST segment elevation in leads I and aVL
D. inverted T waves in leads I, aVL, V5, and V6
Give this one a try later!
A. ST segment elevation in leads II, III, and aVF
The patient is at risk for acute infarctions of the inferior wall, typically
supplied by the RCA. The preferred leads to monitor are II, III, and aVF. ST
segment elevation is an indication of acute injury which warrants emergent
coronary intervention. ST segment elevation in leads I and aVL is indicative
of damage to the lateral wall which is supplied by the circumflex artery. The
patient is at risk for ischemia/infarct in the inferior wall. Reciprocal changes
to inferior wall damage are seen in leads I and aVL. Reciprocal changes in
sounds in the bases, an SpO2 of 94% on room air, chest tubes with minimal drainage,
and a regular heart rate. The nurse notices new-onset weakness and slurred speech.
Which action is indicated?
A. Encourage PO fluid intake
B. Administer 2L of O2
C. Conduct a blood glucose test
D. Prepare for thrombolytic therapy
Give this one a try later!
, C. Conduct a blood glucose test
Hypoglycemia may cause stroke-like s/s and is easily r/o with a blood
glucose test. Thrombolytic therapy is an absolute contraindication in a
postop patient because of the potential for bleeding. Supplemental
oxygen may be considered, but the SpO2 is satisfactory, so this in not the
best answer. A patient with slurred speech may also have difficulty
swallowing and be at risk for aspiration.
Which patient is at greatest risk for myocarditis? A patient
A. who has not been taking diuretics as prescribed
B. with a history of lupus
C. who smokes marijuana daily
D. being treated for bacterial pneumonia
Give this one a try later!
B. with a history of lupus
Potential causes of myocarditis are recent viral infections, cocaine abuse,
and having autoimmune disease such as lupus.
A patient with a history of chronic alcohol abuse, congestive HF, HTN, and
hyperlipidemia is admitted with increased SOB and lower extremity edema.
Echocardiogram reveals an EF of 25%. The patient's family states "I don't understand,
the cardiologist started him on the metoprolol (Lopressor) last week and it was
supposed to get better. What happened?" The nurse's best response is
A. "We are preparing for immediate ICD placement"
B. "These are symptoms of withdrawal and will not respond to beta-blockers"
C. "Metoprolol can take weeks to show effects"
D. "Metoprolol is contraindicated in alcoholic cardiomyopathy"
,Give this one a try later!
C. "Metoprolol can take weeks to show effects"
Metoprolol can take weeks or months to achieve desired results.
Sometimes, patients have an increase in symptoms prior to seeing
improvement.
A patient with a history of amyloidosis presents with exercise intolerance, dyspnea
with exertion, and S3 and S4 present. The provider orders carvedilol (Coreg), digoxin
(Lanoxin), enoxaparin (Lovenox), furosemide (Lasix), a chest x-ray, and
echocardiogram. Which order should the nurse clarify?
A. carvedilol
B. digoxin
C. enoxaparin
D. furosemide
Give this one a try later!
B. digoxin
The patient has a history of amyloidosis and presents with symptoms of
restrictive cardiomyopathy (hx of amyloidosis, exercise intolerance,
dyspnea with exert, as well as S3 and S4 heart sounds). Digoxin is
contraindicated in patients with restrictive cardiomyopathy due to an
increased risk of digoxin toxicity from the amyloid fibrils.
A family member with Marfan syndrome is visiting and is standing in the hallway
appearing short of breath, coughing, and has a hand on the chest. The person reports
in a hoarse voice, feeling a tearing sensation in the upper abdomen, having back pain,
and feeling a little out of breath. The nurse should suspect
A. acute myocardial infarction
, B. hypertensive crisis
C. angina
D. aortic dissection
Give this one a try later!
D. aortic dissection
Of patients with an aortic aneurysm, 90% have a history of systemic
hypertension. Other causes of aortic aneurysm include atherosclerotic
changes in the thoracic and abdominal aorta, blunt trauma, Marfan
syndrome, pregnancy, injury, or dissection. The classic clinical presentation
is sudden onset of intense, severe, tearing pain, which may be localized
initially in the chest, abdomen, or back. As the aortic tear (dissection)
extends, pain radiates to the back or distally toward the lower extremities.
Many patients have hypertension on initial presentation; the focus is on BP
control and early surgery.
A patient is admitted with a 98% blockage of the right coronary artery (RCA) with
plans for a PTCA. Which ECG abnormality SHOULD the nurse anticipate?
A. ST segment elevation in leads II, III, and aVF
B. reciprocal changes in leads V1-V4
C. ST segment elevation in leads I and aVL
D. inverted T waves in leads I, aVL, V5, and V6
Give this one a try later!
A. ST segment elevation in leads II, III, and aVF
The patient is at risk for acute infarctions of the inferior wall, typically
supplied by the RCA. The preferred leads to monitor are II, III, and aVF. ST
segment elevation is an indication of acute injury which warrants emergent
coronary intervention. ST segment elevation in leads I and aVL is indicative
of damage to the lateral wall which is supplied by the circumflex artery. The
patient is at risk for ischemia/infarct in the inferior wall. Reciprocal changes
to inferior wall damage are seen in leads I and aVL. Reciprocal changes in
