NUR 257 EXAM 3 UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS
Question:
Pt has a hx of PE with sudden onset of CP and SOB, what should you do?
Answer:
Raise the head of the bed and assess
Question:
A patient with a spinal curve may have issues lying
flat. This is new info what should you do with a pending surgery.
Answer:
Notify the surgical/anesthesia team. Assess the curve. Work with the surgical team on
positioning.
Question:
What valvular disorder is associated with pulmonary HTN and hemoptysis?
Answer:
Mitral valve stenosis indicative of pulmonary hypertension presenting with fatigue
hemoptysis and SOB.
Question:
Bacterial Endocarditis Treatment
Answer:
Antibiotic therapy until complete eradication achieved
Question:
Patient starting an ACE-inhib or
diuretics. What VS is a primary assessment?
Answer:
Blood pressure (both medications can affect bp, monitor for effectiveness and safety)
Question:
Labs...pt should do what prior?
Answer:
Lipid profiles and lab work require at least 12 hr fasting time for accuracy. BNP can
give preliminary diagnosis of heart failure. Cholesterol findings could lead to finds of
atherosclerosis. High levels of CPK usually indicate some sort of stress or injury to your
heart or other muscles.
,Question:
Mechanical valve education
Answer:
lifetime use of warfarin prophylactic antibiotics Anticoagulation therapy (warfarin:
take as prescribed, monitor INR 2.5-3.5, no grapefruit juice), Dietary: Vit K can affect
INR levels, no grapefruit juice, limit
alcohol. Prevent infection: endocarditis risk (oral hygiene, prophylactic antibiotics)
Recognize complications (blood clots, valve malfunction, signs of bleeding.)
Question:
Cardiac stress test looks for what diseases
Answer:
CAD, arrhythmias, HF, Ischemic heart disease, valvular heart disease, cardiomyopathy,
pulmonary HTN, peripheral artery disease.
Question:
What do you do if during the stress test pt develops cp?
Answer:
Stop the test and assess the pt
Question:
Frequency of cardiac labs for a MI?
Answer:
Serial labs are typically every 3 -4 hours when trending cardiac enzymes like troponin
and CK-MB. This normally runs for 12 hrs.
Question:
What does pericarditis sound like?
Answer:
friction rub (like sandpaper rubbed on wood)
Question:
What are the goals of intervention?
Answer:
Improve cardiac output and peripheral blood flow, increase activity tolerance and
improve gas exchange, reduce anxiety. (cluster activities; legs down/monitoring
edema)(slide 58)
Question:
Heart failure what might you hear?
Answer:
Third and fourth heart sounds s3, s4. murmurs. crackles (rales)
, Question:
Dilated cardiomyopathy
(DCM) is what
(phys. Descipt. Of the heart)
Answer:
Muscle fibers have stretched heart chambers enlarged. (walls of the heart become thin
and the heart gets larger)
Question:
Can your HF intervention intervene with a persons job?
Answer:
Yes. Physical limitations, medication side effects, medical appointments, emotional and
cognitive effects all affect a persons job.
Question:
Cardiomyopathy related to young/athletes?
Answer:
Hypertrophic cardiomyopathy (HCM)(condition where heart muscles become
abnormally thick, makes it hard for the heart to pump blood) is what we are seeing in
young athletes who are falling out on the field.
Question:
What do we expect to happen/treat cardiac tamponade?
Answer:
Cardiac tamponade is the restriction of heart function because of this fluid, resulting in
decreased venous return and decreased CO. Cardinal signs of cardiac tamponade:
falling systolic BP, narrowing pulse pressure, rising venous pressure, distant heart
sounds. Pulsus paradoxus, SOB, chest pain, engorged neck veins. Treatment:
pericardiocentesis (removing the fluid from around the heart)
Question:
Definitive test to treat endocarditis (ID ABX)?
Answer:
blood cultures are needed to verify abx type in treating endocarditis.
Question:
Valvuloplasty can be done where?
Answer:
OR, or cathlab
Question:
Myocarditis has what type of symptoms?
Answer:
flu-like s/s (signs of a viral infection; fatigue, dyspnea/SOB, syncope, palpitations, chest
pain, indigestion.)
CORRECT ANSWERS
Question:
Pt has a hx of PE with sudden onset of CP and SOB, what should you do?
Answer:
Raise the head of the bed and assess
Question:
A patient with a spinal curve may have issues lying
flat. This is new info what should you do with a pending surgery.
Answer:
Notify the surgical/anesthesia team. Assess the curve. Work with the surgical team on
positioning.
Question:
What valvular disorder is associated with pulmonary HTN and hemoptysis?
Answer:
Mitral valve stenosis indicative of pulmonary hypertension presenting with fatigue
hemoptysis and SOB.
Question:
Bacterial Endocarditis Treatment
Answer:
Antibiotic therapy until complete eradication achieved
Question:
Patient starting an ACE-inhib or
diuretics. What VS is a primary assessment?
Answer:
Blood pressure (both medications can affect bp, monitor for effectiveness and safety)
Question:
Labs...pt should do what prior?
Answer:
Lipid profiles and lab work require at least 12 hr fasting time for accuracy. BNP can
give preliminary diagnosis of heart failure. Cholesterol findings could lead to finds of
atherosclerosis. High levels of CPK usually indicate some sort of stress or injury to your
heart or other muscles.
,Question:
Mechanical valve education
Answer:
lifetime use of warfarin prophylactic antibiotics Anticoagulation therapy (warfarin:
take as prescribed, monitor INR 2.5-3.5, no grapefruit juice), Dietary: Vit K can affect
INR levels, no grapefruit juice, limit
alcohol. Prevent infection: endocarditis risk (oral hygiene, prophylactic antibiotics)
Recognize complications (blood clots, valve malfunction, signs of bleeding.)
Question:
Cardiac stress test looks for what diseases
Answer:
CAD, arrhythmias, HF, Ischemic heart disease, valvular heart disease, cardiomyopathy,
pulmonary HTN, peripheral artery disease.
Question:
What do you do if during the stress test pt develops cp?
Answer:
Stop the test and assess the pt
Question:
Frequency of cardiac labs for a MI?
Answer:
Serial labs are typically every 3 -4 hours when trending cardiac enzymes like troponin
and CK-MB. This normally runs for 12 hrs.
Question:
What does pericarditis sound like?
Answer:
friction rub (like sandpaper rubbed on wood)
Question:
What are the goals of intervention?
Answer:
Improve cardiac output and peripheral blood flow, increase activity tolerance and
improve gas exchange, reduce anxiety. (cluster activities; legs down/monitoring
edema)(slide 58)
Question:
Heart failure what might you hear?
Answer:
Third and fourth heart sounds s3, s4. murmurs. crackles (rales)
, Question:
Dilated cardiomyopathy
(DCM) is what
(phys. Descipt. Of the heart)
Answer:
Muscle fibers have stretched heart chambers enlarged. (walls of the heart become thin
and the heart gets larger)
Question:
Can your HF intervention intervene with a persons job?
Answer:
Yes. Physical limitations, medication side effects, medical appointments, emotional and
cognitive effects all affect a persons job.
Question:
Cardiomyopathy related to young/athletes?
Answer:
Hypertrophic cardiomyopathy (HCM)(condition where heart muscles become
abnormally thick, makes it hard for the heart to pump blood) is what we are seeing in
young athletes who are falling out on the field.
Question:
What do we expect to happen/treat cardiac tamponade?
Answer:
Cardiac tamponade is the restriction of heart function because of this fluid, resulting in
decreased venous return and decreased CO. Cardinal signs of cardiac tamponade:
falling systolic BP, narrowing pulse pressure, rising venous pressure, distant heart
sounds. Pulsus paradoxus, SOB, chest pain, engorged neck veins. Treatment:
pericardiocentesis (removing the fluid from around the heart)
Question:
Definitive test to treat endocarditis (ID ABX)?
Answer:
blood cultures are needed to verify abx type in treating endocarditis.
Question:
Valvuloplasty can be done where?
Answer:
OR, or cathlab
Question:
Myocarditis has what type of symptoms?
Answer:
flu-like s/s (signs of a viral infection; fatigue, dyspnea/SOB, syncope, palpitations, chest
pain, indigestion.)
