CAMILLA FRANKLIN I HUMAN ACTUAL
EXAMINATION WEEK TEN 2026
QUESTIONS WITH ANSWERS GRADED A+
⩥ Mike Martin is a 78 year old man admitted to the Med-Surg unit with
CHF. During your daily assessment, when you palpate his radial pulse,
you notice it is has an irregular rhythm.
Mike states, "I have been feeling fine, but I have been more tired lately."
Describe how you would explain to Mike how A-fib can cause fatigue.
Answer: Can lead to decreased cardiac output, which puts a greater
workload on the heart, causing fatigue in the individual
⩥ Mike Martin is a 78 year old man admitted to the Med-Surg unit with
CHF. During your daily assessment, when you palpate his radial pulse,
you notice it is has an irregular rhythm.
What assessments would indicate decreased cardiac output? Answer:
Variations in BP (may increase due to compensation), tachycardia, S3
heart sound, fatigue, weakness, dyspnea, tachypnea, restlessness, change
in mental status, dizziness/syncope, diminished peripheral pulses, cool
extremities, pallor/cyanosis of skin, slow cap refill, decreased urinary
output, edema, JVD
,⩥ Mike Martin is a 78 year old man admitted to the Med-Surg unit with
CHF. During your daily assessment, when you palpate his radial pulse,
you notice it is has an irregular rhythm.
The provider orders a stat ECG and echocardiogram, telemetry
monitoring, CXR, CBC, Thyroid function, and Chemistry panel.
What are the rationale for these orders? Answer: ECG - confirm AF;
check rate
Echo - check for thrombus in heart
Tele - monitor rhythm and rate
CXR - check for PE; check for fluid in lungs (R sided HF)
CBC - look for anemia or infection (may trigger AF)
Thyroid function - thyroid disease (usually hyperthyroidism) can
trigger AF
Chemistry panel - check kidney function and electrolytes as this can
trigger AF
⩥ Mike Martin is a 78 year old man admitted to the Med-Surg unit with
CHF. During your daily assessment, when you palpate his radial pulse,
you notice it is has an irregular rhythm.
, Mike asks "What is the difference between an echocardiogram and an
ECG?" What will you explain to him? Answer: ECG looks at the
electrical activity of different areas of the heart.
Echo is an ultrasound of the heart, to create pictures of the heart - able to
look at valves, look inside chambers, how blood flows, volumes of
blood in the heart
⩥ The echocardiogram shows an Ejection Fraction of 40%. The provider
orders metoprolol (Toprol) 60mg, warfarin (Coumadin) 2mg, and a daily
INR and a synchronized cardioversion in 8 weeks. Explain the rationale
for these orders. Answer: Normal EF <55%. 40% may indicate HF.
Metoprolol ordered to control heart rate so that heart isn't having to work
so hard. Coumadin ordered to prevent clotting with AF. INR needed to
monitor Coumadin dosing. Synchronized cardioversion will be done
when heart rate is stable to try to shock heart back into NSR.
⩥ Explain the discharge teaching you will perform for Mike regarding
these medications.
CHF Answer: Metoprolol - need to monitor HR and BP; watch for s/sx
of hypotension (syncope, dizziness, fatigue, blurry vision, loss of
consciousness)
-Coumadin - consistent Vit K in diet, s/sx of bleeding (fatigue, syncope,
blood in stools/urine/sputum, SOB, change in LOC)
⩥ Mike returns in 8 weeks for his scheduled synchronized cardioversion
with conscious sedation. Describe: Answer: the pre-procedure nursing
interventions
EXAMINATION WEEK TEN 2026
QUESTIONS WITH ANSWERS GRADED A+
⩥ Mike Martin is a 78 year old man admitted to the Med-Surg unit with
CHF. During your daily assessment, when you palpate his radial pulse,
you notice it is has an irregular rhythm.
Mike states, "I have been feeling fine, but I have been more tired lately."
Describe how you would explain to Mike how A-fib can cause fatigue.
Answer: Can lead to decreased cardiac output, which puts a greater
workload on the heart, causing fatigue in the individual
⩥ Mike Martin is a 78 year old man admitted to the Med-Surg unit with
CHF. During your daily assessment, when you palpate his radial pulse,
you notice it is has an irregular rhythm.
What assessments would indicate decreased cardiac output? Answer:
Variations in BP (may increase due to compensation), tachycardia, S3
heart sound, fatigue, weakness, dyspnea, tachypnea, restlessness, change
in mental status, dizziness/syncope, diminished peripheral pulses, cool
extremities, pallor/cyanosis of skin, slow cap refill, decreased urinary
output, edema, JVD
,⩥ Mike Martin is a 78 year old man admitted to the Med-Surg unit with
CHF. During your daily assessment, when you palpate his radial pulse,
you notice it is has an irregular rhythm.
The provider orders a stat ECG and echocardiogram, telemetry
monitoring, CXR, CBC, Thyroid function, and Chemistry panel.
What are the rationale for these orders? Answer: ECG - confirm AF;
check rate
Echo - check for thrombus in heart
Tele - monitor rhythm and rate
CXR - check for PE; check for fluid in lungs (R sided HF)
CBC - look for anemia or infection (may trigger AF)
Thyroid function - thyroid disease (usually hyperthyroidism) can
trigger AF
Chemistry panel - check kidney function and electrolytes as this can
trigger AF
⩥ Mike Martin is a 78 year old man admitted to the Med-Surg unit with
CHF. During your daily assessment, when you palpate his radial pulse,
you notice it is has an irregular rhythm.
, Mike asks "What is the difference between an echocardiogram and an
ECG?" What will you explain to him? Answer: ECG looks at the
electrical activity of different areas of the heart.
Echo is an ultrasound of the heart, to create pictures of the heart - able to
look at valves, look inside chambers, how blood flows, volumes of
blood in the heart
⩥ The echocardiogram shows an Ejection Fraction of 40%. The provider
orders metoprolol (Toprol) 60mg, warfarin (Coumadin) 2mg, and a daily
INR and a synchronized cardioversion in 8 weeks. Explain the rationale
for these orders. Answer: Normal EF <55%. 40% may indicate HF.
Metoprolol ordered to control heart rate so that heart isn't having to work
so hard. Coumadin ordered to prevent clotting with AF. INR needed to
monitor Coumadin dosing. Synchronized cardioversion will be done
when heart rate is stable to try to shock heart back into NSR.
⩥ Explain the discharge teaching you will perform for Mike regarding
these medications.
CHF Answer: Metoprolol - need to monitor HR and BP; watch for s/sx
of hypotension (syncope, dizziness, fatigue, blurry vision, loss of
consciousness)
-Coumadin - consistent Vit K in diet, s/sx of bleeding (fatigue, syncope,
blood in stools/urine/sputum, SOB, change in LOC)
⩥ Mike returns in 8 weeks for his scheduled synchronized cardioversion
with conscious sedation. Describe: Answer: the pre-procedure nursing
interventions
