1st Exam Flashcards
- Which information would the nurse include in teaching a patient about CAD? (select all that apply)
a. Diffuse involvement of plaque formation in coronary veins
b. Abnormal levels of cholesterol, especially low-density lipoproteins
c. Accumulation of lipid and fibrous tissue within the coronary arteries
d. Development of angina due to a decreased blood supply to the heart muscle
e. Chronic vasoconstriction of coronary arteries leading to permanent vasospasm
b. Abnormal levels of cholesterol, especially low-density lipoproteins
c. Accumulation of lipid and fibrous tissue within the coronary arteries
d. Development of angina due to a decreased blood supply to the heart muscle
- After teaching a patient about ways to decrease risk factors for CAD, which patient statement indicates to the nurse that further instruction is needed?
a. “I can keep my blood pressure normal with medication.”
b. “I would like to add weightlifting to my exercise program.”
c. “I can change my diet to decrease my intake of saturated fats.”
d. “I will change my lifestyle to reduce activities that increase my stress.”
b. “I would like to add weightlifting to my exercise program.”
- A hospitalized patient with a history of chronic stable angina tells the nurse they are having chest pain. Which information about ischemia would the nurse use as a basis for planning care?
a. It will always progress to myocardial infarction.
b. It can be relieved by rest, nitroglycerin, or both.
c. It is often associated with vomiting and extreme fatigue.
d. It indicates that irreversible myocardial damage is occurring.
b. It can be relieved by rest, nitroglycerin, or both.
- The nurse is caring for a patient who is 2 days post MI. The patient reports that chest pain when taking a deep breath. Which action would be a priority?
a. Notify the provider STAT and obtain a 12-lead ECG.
b. Obtain vital signs and auscultate for a pericardial friction rub.
c. Apply high-flow O2 by face mask and auscultate breath sounds.
d. Medicate the patient with an opiate analgesic and reevaluate in 30 minutes.
b. Obtain vital signs and auscultate for a pericardial friction rub.
- A patient is in the ICU with a diagnosis of NSTEMI. Which drugs would the nurse expect the patient to receive? (select all that apply)
a. Oral statin therapy
b. Antiplatelet therapy
c. Thrombolytic therapy
d. Prophylactic antibiotics
e. Intravenous nitroglycerin
a. Oral statin therapy
b. Antiplatelet therapy
e. Intravenous nitroglycerin
- A patient is recovering from an uncomplicated MI. Which rehabilitation guideline is a priority to include in the teaching plan?
a. Refrain from sexual activity for a minimum of 3 weeks.
b. Plan a diet program that aims for a 1- to 2-lb. weight loss per week.
c. Begin an exercise program that aims for at least 5 30-minute sessions per week.
d. Consider the use of erectile agents and prophylactic NTG before sexual activity.
c. Begin an exercise program that aims for at least 5 30-minute sessions per week.
- Which statements accurately describe heart failure with preserved ejection fraction (HFpEF)? (select all that apply)
a. Uncontrolled hypertension is a primary cause.
b. Left ventricular ejection fraction may be within normal limits.
c. The pathophysiology involves ventricular relaxation and filling.
d. Multiple evidence-based therapies have been shown to decrease mortality.
e. Therapies focus on symptom control and treatment of underlying conditions.
a. Uncontrolled hypertension is a primary cause.
b. Left ventricular ejection fraction may be within normal limits.
c. The pathophysiology involves ventricular relaxation and filling.
e. Therapies focus on symptom control and treatment of underlying conditions.
- Which compensatory mechanism involved in both chronic heart failure and acute decompensated heart failure leads to fluid retention and edema?
a. Ventricular dilation
b. Ventricular hypertrophy
c. Increased systemic blood pressure
d. Renin-angiotensin-aldosterone activation
d. Renin-angiotensin-aldosterone activation
- Which finding is the strongest predictor of risk for sudden cardiac death?
a. Aortic valve disease
b. Mitral valve disease
c. Left ventricular dysfunction
d. Atherosclerotic heart disease
c. Left ventricular dysfunction
- The nurse is caring for a patient with acute decompensated heart failure who is receiving IV dobutamine. Which drug action is expected? (select all that apply)
a. Raises the heart rate
b. Dilates renal blood vessels
c. Increases heart contractility
d. Acts as a selective β-agonist
e. Increases systemic vascular resistance
c. Increases heart contractility
d. Acts as a selective β-agonist
- A patient with chronic heart failure and atrial fibrillation is treated with low-dose digitalis and a loop diuretic. Which actions would the nurse take to prevent complications of this drug combination? (select all that apply)
a. Monitor serum potassium levels.
b. Teach the patient how to take a pulse rate.
c. Keep an accurate measure of intake and output.
d. Withhold digitalis if the pulse rhythm is irregular.
e. Teach the patient about diet potassium restrictions.
a. Monitor serum potassium levels.
b. Teach the patient how to take a pulse rate.
- Which factor is a significant barrier to hospice referrals for patients with stage D heart failure?
a. Family member refusal
b. Scarcity of hospice care
c. History of pacemaker placement
d. Difficulty in estimating prognosis
d. Difficulty in estimating prognosis
- The hemodynamic changes the nurse expects to find after successful initiation of intraaortic balloon pump therapy include (select all that apply)
a. decreased SV.
b. decreased SVR.
c. decreased PAWP.
d. increased diastolic BP.
e. decreased myocardial O2 consumption.
b. decreased SVR.
c. decreased PAWP.
d. increased diastolic BP.
e. decreased myocardial O2 consumption.
- Which findings would the nurse expect when assessing a patient with infective endocarditis? (select all that apply)
a. Retinal hemorrhages
b. Splinter hemorrhages
c. Presence of Osler’s nodes
d. Painless nodules over bony prominences
e. Erythematous macules on the palms and soles
a. Retinal hemorrhages
b. Splinter hemorrhages
c. Presence of Osler’s nodes
e. Erythematous macules on the palms and soles
- Which are the greatest risks for patients in the first year after heart transplantation? (select all that apply)
a. Cancer
b. Infection
c. Rejection
d. Vasculopathy
e. Sudden cardiac death
b. Infection
c. Rejection
e. Sudden cardiac death
- The nurse is caring for a patient newly admitted with heart failure secondary to dilated cardiomyopathy. Which intervention would be a priority?
a. Encourage caregivers to learn CPR.
b. Consider a consultation with hospice for palliative care.
c. Monitor the patient’s response to prescribed medications.
d. Arrange for the patient to enter a cardiac rehabilitation program.
c. Monitor the patient’s response to prescribed medications
- Which intervention is a priority in nursing management of a patient with myocarditis?
a. Providing meticulous skincare
b. Assuring tight glycemic control
c. Administering antibiotic prophylaxis
d. Monitoring oxygenation and ventilation
d. Monitoring oxygenation and ventilation
- A patient with syncope has continuous ECG monitoring. The rhythm strip shows: Atrial rate 74 beats/min and regular; ventricular rate 62 beats/min and irregular; P wave normal shape; PR interval lengthens progressively until a P wave is not conducted; QRS normal shape. Which intervention would the nurse prioritize?
a. Administer epinephrine 1 mg IV push.
b. Prepare the patient for synchronized cardioversion.
c. Observe for symptoms of hypotension and angina.
d. Apply transcutaneous pacemaker pads on the patient.
c. Observe for symptoms of hypotension and angina.
Coronary Artery Disease (CAD)
Causes/Risk factors
hypertension, smoking, high cholesterol, diabetes, obesity, sedentary lifestyle, and family history
Coronary Artery Disease (CAD)
Assessment
Patient history, physical examination, and symptoms like chest pain or shortness of breath.
Coronary Artery Disease (CAD)
Diagnostics
ECG, stress testing, coronary angiography, lipid panel
Coronary Artery Disease (CAD)
Medications
Angina
Types of Angina
stable, unstable, and variant (Prinzmetal or vasospatic)
Angina
Causes
Often due to decreased oxygen supply to the heart, commonly related to CAD
Angina
Assessments
Pain characteristics (location, quality, duration), triggers, response to rest/nitroglycerin.
Angina
Diagnostics
ECG, stress test, coronary angiography
Angina
Medications/Treatments
Nitroglycerin, beta-blockers, calcium channel blockers, lifestyle changes, possible revascularization procedures.
Heart Failure
Treatment/Medication
ACE inhibitors, beta-blockers, diuretics, lifestyle changes, and surgical options for severe cases
Heart Failure
Diagnostics
Echocardiogram, BNP levels, chest X-ray, ECG
Heart Failure
Assessment
Fluid overload symptoms (e.g., edema, weight gain), respiratory issues, fatigue
Heart Failure
Prioritization
Managing symptoms, preventing exacerbations, and optimizing cardiac function.
Cardiomyopathy
Treatment/Medications
Medications, lifestyle changes, potential use of devices (pacemakers, defibrillators), or transplant in severe cases.
Cardiomyopathy
Diagnostics
Echocardiogram, MRI, ECG, genetic testing (if applicable)
Cardiomyopathy
Assessment
Signs of heart failure, arrhythmias, fatigue.
Cardiomyopathy
Prioritization
Controlling symptoms, improving quality of life, and monitoring for complications.
