NSG 229 FINAL EXAM WITH
COMPLETE SOLUTION
When titrating IV nitroglycerin for a patient with a myocardial infarction
(MI), which action will the nurse take to evaluate the effectiveness of the
drug? - ANSWER Ask about chest pain
After the nurse teaches the patient about the use of carvedilol (Coreg) in
preventing anginal episodes, which statement by a patient indicates that the
teaching has been effective? - ANSWER "It is important not to suddenly stop
taking the carvedilol."
A patient admitted to the coronary care unit (CCU) with an
ST-segment-elevation myocardial infarction (STEMI) is restless and anxious.
The blood pressure is 86/40 mm Hg, and heart rate is 132 beats/min. Based
on this information, which nursing diagnosis is a priority for the patient? -
ANSWER Decreased cardiac output related to cardiogenic shock
Which electrocardiographic (ECG) change is most important for the nurse to
report to the health care provider when caring for a patient with chest pain? -
ANSWER ST-segment Elevation
A patient who has chest pain is admitted to the emergency department (ED),
and all of the following are ordered. Which one should the nurse arrange to
be completed first? - ANSWER Electrocardiogram (ECG)
When caring for a patient with acute coronary syndrome who has returned to
the coronary care unit after having angioplasty with stent placement, the
nurse obtains the following assessment data. Which data indicate the need
,for immediate action by the nurse? - ANSWER Report of severe chest pain
A patient who is being admitted to the emergency department with
intermittent chest pain gives the following list of daily medications to the
nurse. Which medication has the most immediate implications for the
patient's care? - ANSWER sildenafil (Viagra)
A patient who has had chest pain for several hours is admitted with a
diagnosis of rule out acute myocardial infarction (AMI). Which laboratory
test should the nurse monitor to best determine whether the patient has had
an AMI? - ANSWER Cardiac-specific troponin
Which assessment finding by the nurse caring for a patient who has had
coronary artery bypass grafting using a right radial artery graft is most
important to communicate to the health care provider? - ANSWER Pallor and
weakness of the right hand
The standard policy on the cardiac unit states, "Notify the health care
provider for mean arterial pressure (MAP) less than 70 mm Hg." The nurse
will need to call the health care provider about the: - ANSWER postoperative
patient with a BP of 116/42 mm Hg.
A few days after experiencing a myocardial infarction (MI) and successful
percutaneous coronary intervention, the patient states, "It was just a little
chest pain. As soon as I get out of here, I'm going for my vacation as
planned." Which reply would be most appropriate for the nurse to make? -
ANSWER "What do you think caused your chest pain?"
Which action by a new registered nurse (RN) who is orienting to the
telemetry unit indicates a good understanding of the treatment of heart
dysrhythmias? - ANSWER Gives the prescribed dose of diltiazem (Cardizem)
, to a patient with new-onset type II second degree AV block
A patient's heart monitor shows sinus rhythm, rate 64. The PR interval is 0.18
seconds at 1:00 AM, 0.22 seconds at 2:30 PM, and 0.28 seconds at 4:00 PM.
Which action should the nurse take next? - ANSWER Call the health care
provider before giving scheduled metoprolol (Lopressor).
An older patient with cardiogenic shock is cool and clammy. Hemodynamic
monitoring indicates a high systemic vascular resistance (SVR). Which
intervention should the nurse anticipate? - ANSWER Increase the rate for the
sodium nitroprusside infusion.
A nurse is assessing a patient who is receiving a nitroprusside infusion to
treat cardiogenic shock. Which finding indicates that the drug is effective? -
ANSWER Warm, pink and dry skin
After the nurse has finished teaching a patient about the use of sublingual
nitroglycerin (Nitrostat), which patient statement indicates that the teaching
has been effective? - ANSWER "I will call an ambulance if I still have pain
after taking three nitroglycerin 5 minutes apart."
In preparation for discharge, the nurse teaches a patient with chronic stable
angina how to use the prescribed short-acting and long-acting nitrates.
COMPLETE SOLUTION
When titrating IV nitroglycerin for a patient with a myocardial infarction
(MI), which action will the nurse take to evaluate the effectiveness of the
drug? - ANSWER Ask about chest pain
After the nurse teaches the patient about the use of carvedilol (Coreg) in
preventing anginal episodes, which statement by a patient indicates that the
teaching has been effective? - ANSWER "It is important not to suddenly stop
taking the carvedilol."
A patient admitted to the coronary care unit (CCU) with an
ST-segment-elevation myocardial infarction (STEMI) is restless and anxious.
The blood pressure is 86/40 mm Hg, and heart rate is 132 beats/min. Based
on this information, which nursing diagnosis is a priority for the patient? -
ANSWER Decreased cardiac output related to cardiogenic shock
Which electrocardiographic (ECG) change is most important for the nurse to
report to the health care provider when caring for a patient with chest pain? -
ANSWER ST-segment Elevation
A patient who has chest pain is admitted to the emergency department (ED),
and all of the following are ordered. Which one should the nurse arrange to
be completed first? - ANSWER Electrocardiogram (ECG)
When caring for a patient with acute coronary syndrome who has returned to
the coronary care unit after having angioplasty with stent placement, the
nurse obtains the following assessment data. Which data indicate the need
,for immediate action by the nurse? - ANSWER Report of severe chest pain
A patient who is being admitted to the emergency department with
intermittent chest pain gives the following list of daily medications to the
nurse. Which medication has the most immediate implications for the
patient's care? - ANSWER sildenafil (Viagra)
A patient who has had chest pain for several hours is admitted with a
diagnosis of rule out acute myocardial infarction (AMI). Which laboratory
test should the nurse monitor to best determine whether the patient has had
an AMI? - ANSWER Cardiac-specific troponin
Which assessment finding by the nurse caring for a patient who has had
coronary artery bypass grafting using a right radial artery graft is most
important to communicate to the health care provider? - ANSWER Pallor and
weakness of the right hand
The standard policy on the cardiac unit states, "Notify the health care
provider for mean arterial pressure (MAP) less than 70 mm Hg." The nurse
will need to call the health care provider about the: - ANSWER postoperative
patient with a BP of 116/42 mm Hg.
A few days after experiencing a myocardial infarction (MI) and successful
percutaneous coronary intervention, the patient states, "It was just a little
chest pain. As soon as I get out of here, I'm going for my vacation as
planned." Which reply would be most appropriate for the nurse to make? -
ANSWER "What do you think caused your chest pain?"
Which action by a new registered nurse (RN) who is orienting to the
telemetry unit indicates a good understanding of the treatment of heart
dysrhythmias? - ANSWER Gives the prescribed dose of diltiazem (Cardizem)
, to a patient with new-onset type II second degree AV block
A patient's heart monitor shows sinus rhythm, rate 64. The PR interval is 0.18
seconds at 1:00 AM, 0.22 seconds at 2:30 PM, and 0.28 seconds at 4:00 PM.
Which action should the nurse take next? - ANSWER Call the health care
provider before giving scheduled metoprolol (Lopressor).
An older patient with cardiogenic shock is cool and clammy. Hemodynamic
monitoring indicates a high systemic vascular resistance (SVR). Which
intervention should the nurse anticipate? - ANSWER Increase the rate for the
sodium nitroprusside infusion.
A nurse is assessing a patient who is receiving a nitroprusside infusion to
treat cardiogenic shock. Which finding indicates that the drug is effective? -
ANSWER Warm, pink and dry skin
After the nurse has finished teaching a patient about the use of sublingual
nitroglycerin (Nitrostat), which patient statement indicates that the teaching
has been effective? - ANSWER "I will call an ambulance if I still have pain
after taking three nitroglycerin 5 minutes apart."
In preparation for discharge, the nurse teaches a patient with chronic stable
angina how to use the prescribed short-acting and long-acting nitrates.
