Exam 4 Flashcards
Hair and Turbinates
shell-shaped structures in nose and cilia in the upper and lower airways
Trap and remove foreign particles from the air
Mucosal lining
Upper and lower airways
Warms and humidifies air
Irritant receptors
Trigger a sneeze or cough reflex to remove foreign particles
Immune protections
Immune coating in the respiratory tract mucosa macrophages in the alveoli
Ventilation
The movement of air between the atmosphere are the respiratory portion of the lungs
Perfusion
The flow of blood through the lungs
Diffusion
The transfer of gases between the air-filled spaces in the lungs and the blood
Inspiration
Air is drawn into the lungs as the respiratory muscles expand the chest cavity
Expiration
Air moves out of the lungs as the chest muscles recoil and the chest cavity becomes smaller
Respiratory Control: Centers in the brain
Brainstem (neurons in pons and medulla)
Respiratory Control: Lung receptors
Located in the epithelium and smoot muscles of airways near alveolar-capillary junctions
Respiratory Control: Chemoreceptors
Critical sensors for alterations in blood chemistry (detects oxygen, carbon dioxide, and acid-base status)
Lung Capacity: Tidal Volume (TV)
Aprox. 500 mL at rest
Amount of air that moves into and out of the lungs during a normal breath
Lung Capacity: Inspiratory reserve volume (IRV)
Aprox. 3000 mL at rest
The amount of air that can be inhaled after a normal breath
Lung Capacity: Expiratory reserve volume (ERV)
Aprox. 1100 mL at rest
The amount of air that can be exhaled after a normal breath
Lung Capacity: Vital Capacity (VC)
Aprox. 4600 mL at rest
Equals the IRV plus the TV plus the ERV
The maximum amount of air that can be moved in and out of the lungs with forced inhalation and exhalation
Lung Capacity: Forced vital capacity (FVC)
The maximum amount of air that is exhaled from the lungs during a forced exhalation
Lung Capacity: Forced expiratory volume in 1 second (FEV1)
Max amount of air that can expire from the lungs in 1 second
Lung Capacity: Residual Volume (RV)
The air that remains in the lungs after forced respiration
Lung Capacity: Total lung capacity (TLC)
The total amount of air in the lungs when they are maximally expanded and is the sum of the VC and RV
Description of Pattern: Eupnea
The expected pattern of breathing is characterized by a rate between 10 and 20 breaths/min in adults, 500 and 800 mL in-depth, and a regular rhythm
Description of Pattern: Tachypnea
Rapid shallow breathing characterized by a rate of breathing above 24 breaths/min in adults
Description of Pattern: Apnea
Cessation of breathing for 10 seconds longer usually interspersed with another breathing
Description of Pattern: Hyperpnea
Increase in the rate and depth of breathing. Hyperpnea is responsive to PaO2/PaCO2 requirements; hyperventilation occurs in excess of what is needed to maintain PaCO2
Description of Pattern: Bradypnea
Slow breathing with regular depth and rate. Hypoventilation refers to decreased and inadequate ventilation
Description of Pattern: Cheyne-Strokes
A breathing pattern that alternates hyperpnea in a crescendo-decrescendo pattern and periods of apnea
Description of Pattern: Ataxic breathing
A breathing pattern of unpredictable irregularity. Can combine any or all breathing patterns
Description of Pattern: Obstructive breathing
Prolonged and incomplete expiration to overcome increased airways resistance and air trapping
Reason for Occurrence: Eupnea
Effective and responsive gas exchange
Reason for Occurrence: Tachypnea
The body needs to release excess carbon dioxide and respond by increasing the breathing rate. This is an expected response to fever fear or excersie can also occur with respiratory insufficiency pneumonia or injury to respiratory centers
Reason for Occurrence: Apnea
Can result from brain injury, premature birth or as an obstructive process during sleep
Reason for Occurrence: Hyperpnea
Excess carbon dioxide needs to be released. This can occur with extreme exertion, fear, or anxiety or with diabetes, ketoacidosis, aspirin overdose or brain injury. Hyperventilation blows off excessive CO2 causing a decreased level in the blood.
Reason for Occurrence: Bradypnea
During-induced depression of the respiratory centers increased intracranial pressure in a diabetic coma
Reason for Occurrence: Cheyne-Strokes
Increased intracranial pressure, bilateral damage to breathing areas in the cerebral hemisphere or diencephalon, during induced respiratory depression, heart failure, uremia
Reason for Occurrence: Ataxic breathing
Severe head trauma and damage to respiratory centers, brain abscess, heat stroke, spinal meningitis, and encephalitis.
Reason for Occurrence: Obstructive breathing
Chronic obstructive lung disease, asthma, chronic bronchitis
Diffusion
Oxygen and carbon dioxide are exchanged at alveolar capillary junctions
Partial pressure
The collision of oxygen and carbon dioxide creases pressure
Functions of Bronchial Smooth Muscles
The tone of the bronchial smooth muscles surrounding the airways determines the radius of the airway
Impaired Ventilation
A problem of blocking airflow in and out of the lungs
Impaired Diffusion
Restricted transfer of oxygen or carbon dioxide across the alveolar-capillary junction
Hypoxemia
Decreased oxygen in the arterial blood
This leads to a decrease in PaO2
Hypoxia
Oxygen deprivation in the cells
Hypercapnia
Increased carbon dioxide in the blood
Hypoxemia results from:
Inadequate O2 in the air
Disease of the respiratory system
Dysfunction of the neurological system
Alterations in circulatory function
Hypoxemia Mechanisms:
Hypoventilation
Impaired diffusion of gasses
Inadequate circulation of blood through the pulmonary capillaries
Mismatching of ventilation and perfusion
Hypercapnia
Too much carbon dioxide in the blood
Symptoms of respiratory distress and hypoxia: Early symptoms
Restlessness
Tachycardia
Tachypnea,
exertion dyspnea
Orthopnea
Tripod positioning
anxiety
difficulty speaking
poor judgment
confusion
disorientation
Symptoms of respiratory distress and hypoxia: Late Symptoms
Extreme restlessness to stupor
Severe dyspnea
Slowing of respiratory rate
Dradycardia
Cyanosis
Intercostal retraction
Cyanosis
Oxygen saturation <85% with bluish or purple discoloration of the skin
Asthma Pathophysiology
Intermittent or persistent airway obstruction due to:
Bronchial hyper-responsiveness
Chronic inflammation
Bronchoconstriction
Excess mucous production
Chronic Obstructive Pulmonary Disease (COPD) Types
Emphyseam-Enlargement of air spaces and destruction of lung tissue
Chronic Obstructive Bronchitis-Obstruction of small airways
Emphysema Pathophysiology
Irreversible enlargement of the air spaces beyond terminal bronchioles
Emphysema Treatment
Maintaining optimal lung function to allow the individual to perform the desired activities of daily life:
Smoking cessation
Pharmacologic therapy
Lung volume reduction or transplant
Chronic Bronchitis Pathophysiology
Persistent productive cough lasting greater than or equal to 3 months for greater than or equal to 2 years
Chronic Bronchitis Treatment
Smoking cessation
Pulmonary rehabilitation
Pharmacologic therapy
supplemental oxygen
Pneumonia Pathophysiology
Infectious process
Respiratory droplet spread
causes inflammation of the lungs
It occurs commonly in the bronchioles, interstitial lung tissue, and the alveoli.
Products of inflammation accumulate and cause consolidation.
Pneumonia Treatment
Restore optimal ventilation and diffusion
Identify pathogen and target with appropriate pharmacologic treatment
Supplement oxygen
ARDS Pathophysiology
Progression from lung injury to respiratory distress within 24-48 hr
Severe acute inflammation and pulmonary edema without evidence of fluid overload or impaired cardiac function
The mortality rate of 30%-40% from multisystem organ failure in those untreated
ARDS Treatment
Humidified O2
sedatives
opioids
neuromuscular blockers
sodium bicarbonate
IV fluids
vasopressors
Antimicrobial drugs
diuretics
correction of electrolyte acid-base imbalances
COVID 19
Corona group of viruses that cause respiratory from mild cold to severe depending on the type of coronavirus
Lifethreatening-Severe acute respiratory system corona virus(SARS-COV) Midle East respiratory syndrome (MERS-CoV) SARS-CoV 2=COVID 19
COVID 19 Treatment
Prevention with vaccines, masking, and social distancing
Respiratory Syncytial Virus (RSV)
Common viral infection of the lungs and respiratory tract
Most children will have at least once by the age of 2
It can be severe in babies under 12 months or elderly patients
Asthma medications: Low-flow humidified oxygen
maintains stas >90
Asthma medications: Beta-2 Agonists
Albuterol
Salmeterol
Levalbuterol
Formoterol
Asthma medications: Anticholinergics
Ipratropuim
Tiotropium
Asthma medications: Anti-inflammatory drugs
Glucocorticoids-Beclomethasone, prdnisone, fluticasone, dubesonide
Mast cell stabilizer-Cromolyn
Asthma medications: Leukotriene modifiers
Montelukast
Beta-2 agonists: Mechanism of action
Selectively activate beta-2 receptors of lungs, which results in bronchodilators (AKA bronchodilators)
Beta-2 agonists: Adverse reaction
Tachycardia
Tremor
angina
Inhaled Glucocorticoids: Mechanism of action
Primarily suppress inflammation
It may increase the number of beta-2 receptors, improve response to beta-2 agonists, decrease mucus production
Inhaled Glucocorticoids: Adverse Reactions
Hoarseness
Oropharyngeal candidiasis
Order of inhaler use if PT has multiple inhalers
When using a beta-2 agonist inhaler and glucocorticoid inhaler, the beta-2 agonist is used first, then the glucocorticoid inhaler.
When using three inhalers, the short-acting beta-2 agonist is always first, and the glucocorticoid last.
Separate administration of different medications by 5 min
Theophylline: Mechanism of action
Relaxes the smooth muscle of the bronchi, causing bronchodilation
Inhaled Anticholinergic Drugs: Mechanism of action
Improves lung function by blocking muscarinic receptors in the bronchi, thereby reducing bronchoconstriction
Leukotriene modifiers: Mechanism of action
Block leukotriene receptors and/or synthesis, which results in:
Bronchodilation
decreased airway inflammation
edema
decreased mucus plugging of the airway
Leukotriene modifiers: Adverse reaction
The black box warning for neuropsychiatric disorders-suicide ideation/depression and aggressive behavior
Drugs for Upper respiratory disorders Antihistamines: Mechanism of action
Inhibits H1 receptors in various sites (blood vessels of skin and mucus membranes; nerves) to block the effects of histamine
Drugs for Upper Respiratory Disorder Sympathomimetic (Decongestants): Mechanisms of action
Stimulates alpha-1 receptors of blood vessels-vasoconstriction-decreased edema
Drug for Upper Respiratory Disorder Sympathomimetric (Decongestants): Adverse reaction
Intranasal rebound congestion f used >3-5 days.
Oral CNS stimulation cardiac increased BO and HR abuse potential.
Drug for Upper Respiratory disorders intranasal glucocorticoids: Mechanism of action
Block inflammatory response to allergens. Relieves symptoms of allergic rhinitis
Drug for upper respiratory disorders intranasal glucocorticoids: Adverse reactions
A patient with asthma will be using a metered-dose inhaler (MDI) for delivery of an inhaled medication. The provider has ordered 2 puffs to be given twice daily. It is important for the nurse to teach this patient that:
Group of answer choices
Headaches are to be expected after using.
It should only be given at night.
The patient should wait 1 minute between puffs.
The patient should immediately drink a glass of water after taking.
The patient should wait 1 minute between puffs.
A patient who has been given a prescription for an inhaled glucocorticoid for chronic asthma states they have a friend who got oral candidiasis when using this medication. What can the nurse recommend to the patient to prevent this from happening?
Group of answer choices
Begin eating yogurt every day.
a. Ask their doctor for a prescription for an antifungal medication.
Gargle/rinse out their mouth after each dose of the glucocorticoid.
Ask the doctor for an oral glucocorticoid.
Gargle/rinse out their mouth after each dose of the glucocorticoid.
A patient is receiving theophylline. Which assessment finding indicates possible toxicity in the patient?
Group of answer choices
Blood pressure of 125/80 mm/Hg.
Heart rate of 122 beats per minute.
Urine output of 450 ml/shift.
Easy, unlabored respirations.
Heart rate of 122 beats per minute.
A nurse is instructing a client about the use of albuterol and beclomethasone inhalation therapy at home. The nurse should instruct the client to:
Group of answer choices
Alternate the order of use each time to prevent tolerance.
Use the bronchodilator followed by the corticosteroid.
Use the corticosteroid followed by the bronchodilator.
Take one of the medications in the morning and the other at night.
Use the bronchodilator followed by the corticosteroid.
A nurse is teaching a client who is taking bronchodilators. Which statement by the client indicates that the client understands the teaching?
Group of answer choices
“I can use salmeterol for an asthmatic crisis.”
“I can use montelukast for an asthmatic crisis.”
“I can use beclomethasone for an asthmatic crisis.”
“I can use albuterol for an asthmatic crisis.”
“I can use albuterol for an asthmatic crisis.”
On auscultation, the nurse hears wheezing in a client with asthma. Considering the pathophysiology of asthma, what would the nurse identify as the primary cause of this type of lung sound?
Group of answer choices
Dilation of the respiratory bronchioles and increased mucus.
Increased inspiratory pressure in the upper airways.
Movement of air through narrowed airways.
Increased pulmonary compliance.
Movement of air through narrowed airways.
The nurse is monitoring a patient who is experiencing an acute asthma attack. What observations would indicate an improvement in the client’s condition?
Group of answer choices
Pulse rate of 110 beats per minutes.
Respiratory rate of 18 breaths per minute.
Pulse oximetry of 88%.
Productive cough with rapid breathing.
Respiratory rate of 18 breaths per minute.
A patient reports that she is having difficulty breathing and feels she cannot get enough air. What term should the nurse use to document this condition?
Group of answer choices
Hyperpnea
Dyspnea
Orthopnea
Cyanosis
Dyspnea
A patient presents to the ER for difficulty breathing. Physical exam reveals bluish skin and mucous membranes. How should the nurse document this physical finding?
Group of answer choices
Hematemesis
Cyanosis
Ischemia
Hemoptysis
Cyanosis
A 30-year-old male is involved in a motor vehicle accident and sustains trauma to the lungs and chest wall. He experiences respiratory failure. Which of the following lab values would the nurse expect?
Group of answer choices
Elevated hematocrit
Elevated electrolytes
Elevated pH
Elevated PaCO2
Elevated PaCO2
The nurse assisting the client with chronic obstructive pulmonary disease would use which of the following statements to explain why dyspnea occurs?
Group of answer choices
“Decreased surfactant causes many of your alveoli to collapse.”
“You have difficulty breathing in enough air.”
“Your lung compliance is decreased.”
“Your airways open wider on inspiration, and trap air on expiration.”
“Your airways open wider on inspiration, and trap air on expiration.”
A firefighter involved in fighting a house fire is hospitalized for smoke inhalation. About 18 hours later, he develops severe hypoxemia requiring intubation and ventilation. Which of the following is the most likely cause?
Group of answer choices
Acute respiratory distress syndrome (ARDS)
Bacterial pneumonia
Exercise-induced asthma
Chronic obstructive pulmonary disease (COPD)
Acute respiratory distress syndrome (ARDS)
A patient with chronic bronchitis presents to the ER. Tests reveal closure of the airway during expiration. When planning care, the nurse recalls this is most likely caused by:
Group of answer choices
Thick mucus from hypertrophied glands
Ventilation-perfusion mismatch
Hyperventilation
Thinning smooth muscle in the bronchioles
Thick mucus from hypertrophied glands
A patient is diagnosed with restrictive lung disease caused by fibrosis. The nurse would expect to see _______ on their pulmonary functions test.
Group of answer choices
Decreased respiratory rate
Decreased functional residual capacity.
Increased compliance
Increased tidal volume
Decreased functional residual capacity.
A nurse is preparing to teach the staff about asthma. Which information should the nurse include? Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by:
Group of answer choices
Type II alveolar cell injury and decreased surfactant
Collapse of the cartilaginous rings in the bronchi
Mucus secretion, bronchoconstriction, and airway edema
Alveolar fibrosis and pulmonary edema
Mucus secretion, bronchoconstriction, and airway edema
When sympathomimetics such as oxymetazoline (Afrin) are used intranasally for more than 3-5 days, a common ADR is:
Group of answer choices
Rebound congestion
Nausea/vomiting
Coughing
Tachypnea
Rebound congestion
Deactivation of surfactant and/or decreased surfactant production lead to:
Group of answer choices
Bronchodilation.
Alveolar collapse.
Bronchoconstriction.
Alveolar distension.
Alveolar collapse.
When CO2 levels in the blood rise, a state of hypercapnia occurs in the body. What factors contribute to hypercapnia? (Select all that apply)
Group of answer choices
Disturbance in gas exchange function
Abnormalities in respiratory function
Decrease in carbon dioxide production
Changes in neural control of respiration
Disturbance in gas exchange function
Abnormalities in respiratory function
Changes in neural control of respiration
Which of the following describes diffusion in the lungs?
Group of answer choices
The movement of air between the atmosphere and the lungs.
The flow of blood through the lungs.
The transfer of gases between the air-filled spaces of the lungs and the blood
The transfer of gases between the air-filled spaces of the lungs and the blood
Which of the following describes total lung capacity?
Group of answer choices
The amount of air in the lungs when they are maximally expanded.
The volume of air remaining in the lungs after a forced respiration.
The amount of air inhaled in a normal breath.
The amount of air that moves in and out of the lungs during a normal breath.
The amount of air in the lungs when they are maximally expanded.
When would a nurse expect a patient’s blood pressure to be the highest?
Group of answer choices
Mid-Morning
After meals
At bedtime
During the night
Mid Morning
Angiotensin II produces ________ in systemic vascular resistance.
Group of answer choices
an increase
a decrease
no change
wide variability
An increase
A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient?
Group of answer choices
The fetus must be monitored closely while the patient is taking this drug.
The patient’s prescriber probably will change her medication to an ARB.
The patient should stop taking the medication and contact her provider immediately.
The fetus most likely will have serious congenital defects.
The patient should stop taking the medication and contact her provider immediately.
_______ is the primary factor influencing systolic blood pressure, and _______is the major determinant of diastolic pressure.
Group of answer choices
Systemic vascular resistance; stroke volume
Cardiac output; heart rate
Heart rate; cardiac output
Stroke volume; systemic vascular resistance.
Stroke volume; systemic vascular resistance
A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do?
Group of answer choices
Report the presence of constipation to the prescriber.
Make sure the patient takes a potassium supplement.
Instruct the patient not to get up without assistance.
Request an order for a diuretic to counter the side effects of the ACE inhibitor.
Instruct the patient not to get up without assistance
Which of the following is the most common form of hypertension?
Group of answer choices
Secondary hypertension
Primary hypertension
Orthostatic hypertension
Combined hypertension.
Primary Hypertension
A provider has ordered captopril for a patient who has hypertension. The patient reports a history of swelling of the tongue and lips after taking enalapril in the past. Which action by the nurse is correct?
Group of answer choices
Request an order to administer fosinopril instead of captopril.
Administer the captopril and monitor for adverse effects.
Reassure the patient that this is not a serious side effect.
Hold the dose and notify the provider.
Hold the dose and notify the provider
A patient has been prescribed furosemide. Which symptom would indicate a possible adverse reaction of this drug?
Group of answer choices
Tall peaked T waves on EKG
4+ deep tendon reflexes
Hunger and fatigue
Dehydration.
Dehydration
What is the mean arterial pressure (MAP)?
Group of answer choices
The calculated average pressure within the circulatory system throughout the cardiac cycle
The peak pressure during cardiac systole
The primary factor influencing systolic pressure
The lowest pressure during cardiac diastole
The calculated average pressure within the circulatory system
What is the equation used to express cardiac output (CO)?
Group of answer choices
CO = SV x HR
CO = AV x SV
CO = HR x AV
CO = HR x EF
CO=SV x HR
A nurse has provided education for a patient newly diagnosed with hypertension who is just beginning therapy with antihypertensive medications. Which statement by the patient indicates a need for further teaching?
Group of answer choices
I will need to take medications on a long-term basis.
I may experience serious long-term problems even if I am not having symptoms.
I should report side effects to the provider since other drugs may be substituted.
When my symptoms subside, I may discontinue the medications.
When my symptoms subside, I may discontinue the medication
What is the recommended diuretic for initial treatment of primary hypertension?
Group of answer choices
Osmotic
Thiazide
Loop
Potassium-sparing
Thiazide
The nurse is taking the blood pressure of an elderly patient with a history of hypertension. What should the nurse take into consideration to ensure the reading is accurate?
Group of answer choices
Arterial lines are the only way to get accurate blood pressure readings.
Elderly patients can have an auscultatory gap
Blood pressure always increases for the elderly in medical offices.
Elderly patients can have an auscultatory gap
A patient is being prescribed clonidine for hypertension. What education should the nurse provide?
Group of answer choices
Discontinue the medication when your blood pressure decreases.
Use caution when driving, as this medication causes drowsiness.
Increase salt intake.
Use caution when driving, as this medication causes drowsiness
A side effect of drugs that block calcium access to the cells is:
Group of answer choices
Dry, hacking cough.
Increased blood pressure.
Diarrhea.
Constipation.
Constipation
What is the primary difference between hypertensive urgency and hypertensive crisis?
Group of answer choices
Hypertensive urgency occurs slowly.
Hypertensive crisis is not reversible.
Hypertensive crisis involves organ damage.
The blood pressures in hypertensive crisis are significantly higher than in hypertensive urgency.
Hypertensive crisis involves organ damage
A patient describes dizziness and blurred vision when getting out of bed. The patient is likely experiencing ______________________.
Group of answer choices
Primary hypotension.
Orthostatic hypotension.
Secondary hypertension.
Primary hypertension.
Orthostatic hypotension
What are examples of modifiable risk factors for hypertension? Select all that apply.
Group of answer choices
Obesity.
Diet.
Family history.
Age.
Sedentary lifestyle.
Obesity
Diet
Sedentary lifestyle
Pregnancy-induced hypertension would be classified as:
Group of answer choices
Diastolic hypertension.
Primary hypertension.
Stage 2 hypertension.
Secondary hypertension.
Secondary Hypertension
Parasympathetic stimulation of the heart results in:
Group of answer choices
increased heart rate and faster AV conduction.
decreased heart rate and increased contractility.
decreased heart rate and slower AV conduction.
increased heart rate and decreased contractility.
Decrease heartrate and slower AV conduction
The impulse delay produced by the AV node allows the atria to:
Group of answer choices
repolarize simultaneously.
send impulses to the bundle of His.
complete their filling.
contract before the ventricles.
Contract before the ventricles
Beta blockers, such as metoprolol and atenolol, and calcium channel blocers, such as diltiazem may be used to treat:
Group of answer choices
sinus arrest.
sinus tachycardia.
sinus arrhythmia.
sinus bradycardia.
Sinus Tachycardia
Which cycle describes cardiac cells at rest?
Group of answer choices
early repolarization
polarization
rapid depolarization
No answer text provided.
polarization
The treatment of choice for a patient with ventricular fibrillation is:
defibralization
What is the function of the pulmonary circulation?
Group of answer choices
To circulate hormones.
To supply blood to the extremities of the body.
To carry waste products to the kidneys.
To move blood through the lungs and facilitate gas exchange.
To move blood through the lungs and facilitate gas exchange
A patient who is being monitored by telemetry has a sinus rhythm with a heart rate of 54 beats per minute. The nurse appropriately documents this rhythm as:
Group of answer choices
sinus arrhythmia.
sinus tachycardia.
sinus bradycardia.
accelerated nodal rhythm.
Sinus bradycardia
What are some of the causes of turbulent blood flow? Select all that apply.
Group of answer choices
Atherosclerosis.
Aneurysms.
Hypertension.
Artery stenosis.
All options are correct
Which assessment data should the nurse obtain prior to administering a calcium channel blocker?
Group of answer choices
the patient’s radial pulse
the serum calcium level
the current telemetry reading
the patient’s blood pressure
The patients blood pressure
What is the primary function of the pericardium?
Group of answer choices
To help reduce preload of the heart.
To help with conduction of electrical impulses.
To allow for one-way bloodflow.
To protect the heart.
To protect the heart
A patient is being placed on continuous telemetry monitoring. The monitor alarms that the patient is in asystole. What is the correct primary action by the nurse?
Group of answer choices
Call a code blue.
Start CPR.
Assess the patient.
Put oxygen on the patient.
assess the patient
Which of the following is an adverse effect of adenosine? Select all that apply.
Group of answer choices
Dyspnea.
Sinus bradycardia.
Hypertension.
Facial flushing.
Dyspnea
Sinus Bradycardia
Facial Flushing
A patient reports weakness, dizziness, and light-headedness, and is exhibiting sinus bradycardia on their telemetry strip. The nurse administers atropine sulfate intravenously. Which finding best demonstrates that the medication was effective?
Group of answer choices
The patient’s oral mucosa is moist.
The patient’s apical pulse rate is 68 beats per minute.
The patient ambulates to the bathroom safely.
The patient’s blood pressure is 110/70.
The patients apical pulse rate is 68 beats per minute
Increased afterload leads to ____________cardiac workload.
Group of answer choices
Increased.
Decreased.
Increased
Which plasma lipoprotein level is most concerning when considering the risk of coronary atherosclerosis?
Group of answer choices
HDL of 80 mg/dL
Total cholesterol of 150 mg/dL
LDL of 180 mg/dL
Plasma lipoproteins are not related to atherosclerosis
LDL of 180 mg/dL
Which of the following is NOT a side effect of nicotinic acid?
Group of answer choices
Itching
GI upset
Hypoglycemia
Facial flushing
Hypoglycemia
A nurse is instructing a patient receiving a cholesterol lowering drug. Which information should the nurse include in the patient education?
Group of answer choices
It is important for you to double your dose if you miss one to maintain therapeutic blood levels.
Stop taking the medication if you experience constipation.
This medication will replace other interventions you have been trying.
You should continue an exercise program with the medication.
You should continue an exercise program with the medication
Which will the nurse anticipate in a patient who is taking both gemfibrozil and warfarin?
Group of answer choices
Increased bleeding time
Decreased effectiveness of gemfibrozil
Increased levels of gemfibrozil
Increased triglyceride levels
Increased bleeding time
Lovastatin (Mevacor) is prescribed for a patient for the first time. The nurse should provide the patient with which instruction?
Group of answer choices
Take this medication before breakfast.
d. Take this medication in the afternoon.
Take this medication in the evening.
Take this medication with lunch.
Take this medication in the evening
A patient who is taking simvastatin (Zocor) develops an infection and the provider orders azithromycin to treat the infection. The nurse should be concerned if the patient complains of:
Group of answer choices
Tiredness
Muscle pain
Nausea
Headache
muscle pain
A patient taking nicotinic acid reports uncomfortable flushing of the face, neck, and ears when taking the drug. What should the nurse tell the patient?
Group of answer choices
You should stop taking the nicotinic acid immediately since this is a serious side effect.
Ask your provider about assessing your serum uric acid levels which may be elevated.
Taking 325 mg of aspirin 30 minutes before each dose of nicotinic acid may prevent this side effect.
Ask your provider about taking an immediate-release form of the medication.
Taking 325 mg of aspirin 30 before each dose of nicotinic acid may prevent this side effect
A 55-year-old patient died of a myocardial infarction. Autopsy would most likely reveal:
Group of answer choices
Smooth muscle dysplasia in the coronary artery.
Fibrin clot formation within an atherosclerotic coronary artery.
Decreased ventricular diastolic filling time.
Embolization of plaque from the aorta.
Fibrin clot formation within an atherosclerotic coronary artery
After an MI, impaired ventricular function occurs due to:
Group of answer choices
Too much stress on the heart.
A temporary alteration in electrolyte balance.
Ischemia leading to hypoxic injury and myocardial cell death.
Enlargement of the right atria.
Ischemia leading to hypoxic injury and mypcardial cell death
Fatty streaks cause damage to vessels by secreting:
Group of answer choices
Smooth muscle cells.
Inflammatory cytokines.
Macrophages.
Clotting factors.
Inflammatory cytokines
A 56-year-old male is diagnosed with coronary artery disease. Which of the following modifiable risk factors would the nurse suggest the patient stop?
Group of answer choices
Drinking tomato juice
Eating meat
Smoking cigarettes
Living by himself
smoking cigarettes
A 51-year-old male presents with recurrent chest pain on exertion. He is diagnosed with angina pectoris. When he asks what causes the pain, how should the nurse respond? The pain occurs when:
Group of answer choices
The vagus nerve is stimulated.
Cardiac output has fallen below normal levels.
The myocardial oxygen supply has fallen below demand.
Myocardial stretch has exceeded the upper limits.
The myocardial oxygen supply has fallen below demand
The progression of atherosclerosis begins with:
Group of answer choices
Endothelial injury and inflammation.
An increase in antithrombotic substances.
High serum cholesterol levels.
Congenital heart disease.
endothelial injury and inflammation
A patient presents to the ER reporting chest pain. He has a history of stable angina that now appears to be unstable. He most likely has:
Group of answer choices
Electrical conduction problems in the heart.
Mild atherosclerosis.
Impending myocardial infarction.
Decreased myocardial oxygen demand.
Impending myocardial infarction
After walking from his car to the clinic, a patient develops substernal pain and discomfort in his left shoulder and his jaw that lasts for 2 minutes and subsides with rest. He indicates that this has occurred frequently over the past few months with similar exertion. The nurse suspects he is most likely experiencing:
Group of answer choices
Myocardial infarction
Printzmetal angina
Unstable angina
Stable angina
Stable angina
An important side effect of nitroglycerin that patients should be instructed about is:
Group of answer choices
Excessive salivation.
Erectile dysfunction.
Bradycardia.
Orthostatic hypotension.
Orthostatic Hypotension
What causes Printzmetal angina?
Group of answer choices
Atherosclerosis
Venous emboli
Idiopathic vasospasm
Arterial emboli from the mitral valve
Idiopathic Vasospasm
A patient had severe chest pain. Lab tests reveal elevated levels of cardiac troponins I and T. Based upon these findings, the nurse suspects which of the following has occurred?
Group of answer choices
Silent angina
Varicose veins
Hypertensive crisis
Myocardial infarction
Myocardial Infarction
The patient above has an EKG revealing ST elevation. Which of the following interventions would be most beneficial?
Group of answer choices
Encourage exercise to increase heart rate.
Apply oxygen to increase myocardial oxygen supply.
Give an antibiotic to decrease infection.
Administer a diuretic to decrease volume.
Apply oxygen to increase myocardial oxygen supply
Which type of angina occurs more often in women and can be a result of stress?
Group of answer choices
Unstable
Prinzmetal
Silent
Stable
Unstable
