Final Exam uWu Flashcards
Propranolol (Inderal) is prescribed for a patient diagnosed with hypertension. The nurse should consult with the health care provider before giving this medication when the patient reveals a history of
a. asthma.
b. daily alcohol use.
c. peptic ulcer disease.
d. myocardial infarction (MI).
a. asthma
The high-pressure alarm on a patient’s ventilator goes off. When the nurse enters the room to assess the patient, who has acute respiratory distress syndrome (ARDS), the oxygen saturation monitor reads 87% and the patient is struggling to sit up. Which action should the nurse take first?
A) Reassure the patient that the ventilator will do the work of breathing for him.
B) Manually ventilate the patient while assessing possible reasons for the high-pressure alarm.
C) Increase the fraction of inspired oxygen (Fio2) on the ventilator to 100% in preparation for endotracheal suctioning.
D) Insert an oral airway to prevent the patient from biting on the endotracheal tube.
B) Manually ventilate the patient while assessing possible reasons for the high-pressure alarm.
Rationale:
Manual ventilation of the patient will allow the nurse to deliver an Fio2 of 100% to the patient while attempting to determine the cause of the high-pressure alarm. The patient may need reassurance, suctioning, or insertion of an oral airway, but the first step should be assessing the reason for the high-pressure alarm and resolving the hypoxemia.
A patient diagnosed with hypertension has been prescribed captopril. Which information is most important to teach the patient about this drug?
A. Include high-potassium foods such as bananas in the diet
B. Change position slowly to help prevent dizziness and falls
C. Increase fluid intake if dryness of the mouth is a problem
D. Check the blood pressure in both arms before taking the drug
B. Change position slowly to help prevent dizziness and falls
A patient who was admitted with a myocardial infarction experiences a 45-second episode of ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98 beats/minute. Which of the following actions should the nurse take next?
a. Immediately notify the health care provider.
b. Document the rhythm and continue to monitor the patient.
c. Perform synchronized cardioversion per agency dysrhythmia protocol.
d. Prepare to give IV amiodarone (Cordarone) per agency dysrhythmia protocol.
D. Prepare to give IV amiodarone (Cordarone) per agency dysrhythmia protocol.
The burst of sustained ventricular tachycardia indicates that the patient has significant ventricular irritability, and antidysrhythmic medication administration is needed to prevent further episodes. The nurse should notify the health care provider after the medication is started. Defibrillation is not indicated given that the patient is currently in a sinus rhythm. Documentation and continued monitoring are not adequate responses to this situation
A nurse is caring for a patient with ARDS who is being treated with mechanical
ventilation and high levels of positive end-expiratory pressure (PEEP). Which assessment finding by the nurse indicates that the PEEP may need to be reduced?
a. The patient’s PaO2 is 50 mm Hg and the SaO2 is 88%.
b. The patient has subcutaneous emphysema on the upper thorax.
c. The patient has bronchial breath sounds in both the lung fields.
d. The patient has a first-degree atrioventricular heart block with a rate of 58 beats/min.
b. The patient has subcutaneous emphysema on the upper thorax.
The subcutaneous emphysema indicates barotrauma caused by positive pressure ventilation and PEEP.
Bradycardia, hypoxemia, and bronchial breath sounds are all concerns and will need to be addressed, but
they are not specific indications that PEEP should be reduced.
When assessing a patient with ARF, the nurse finds a new onset of agitation and confusion. Which action should the nurse take first?
a. Check pupils for reaction to light.
b. Notify the health care provider.
c. Attempt to calm and reorient the patient.
d. Assess oxygenation using pulse oximetry.
d. Assess oxygenation using pulse oximetry.
Because agitation and confusion are frequently the initial indicators of hypoxemia, the nurse’s initial
action should be to assess O2
saturation. The other actions are also appropriate, but assessment of
oxygenation takes priority over other assessments and notification of the health care provider.
The nurse assesses vital signs for a patient admitted 2 days ago with gram-negative sepsis: temperature of 101.2° F, blood pressure of 90/56 mm Hg, pulse of 92 beats/min, and respirations of 34 breaths/min. Which action should the nurse take next?
a. Give the scheduled IV antibiotic.
b. Give the PRN acetaminophen (Tylenol).
c. Obtain oxygen saturation using pulse oximetry.
d. Notify the health care provider of the patient’s vital signs.
c. Obtain oxygen saturation using pulse oximetry.
The patient’s increased respiratory rate in combination with the admission diagnosis of gram-negative sepsis indicates that acute respiratory distress syndrome (ARDS) may be developing. The nurse should
check for hypoxemia, a hallmark of ARDS. The health care provider should be notified after further
assessment of the patient. Giving the scheduled antibiotic and the PRN acetaminophen will also be done,
but they are not the highest priority for a patient who may be developing ARDS.
The nurse correlates the P wave on the ECG tracing to which cardiac action?
a) Repolarization of the purkinje fibers
b) Repolarization of the ventricles
c) Depolarization of the atria
d) Depolarization of the ventricles
c) Depolarization of the atria
A patient with acute respiratory distress syndrome (ARDS) and acute kidney injury has the following drugs ordered. Which drug should the nurse discuss with the health care provider before giving?
a. gentamicin 60 mg IV
b. pantoprazole (Protonix) 40 mg IV
c. sucralfate (Carafate) 1 g per nasogastric tube
d. methylprednisolone (Solu-Medrol) 60 mg IV
a. gentamicin 60 mg IV
Gentamicin, which is one of the aminoglycoside antibiotics, is potentially nephrotoxic, and the nurse should clarify the drug and dosage with the health care provider before administration. The other drugs are appropriate for the patient with ARDS
When analyzing a patient’s electrocardiogram, the nurse correlates which information as descriptive of a normal P wave?
a. ) Represents conduction through the AV node
b. ) Represents ventricular depolarization
c. ) The height of the P wave is 4 mm
d. ) The P length is 0.10 seconds
d.) The P length is 0.10 seconds
What does the P wave represent?
Atrial depolarization

What does the QRS complex represent?
Ventricular depolarization

What does the T wave represent?
Ventricular repolarization

A patient is being evaluated for a blockage in the cardiac ventricles. The nurse assesses which part of the ECG as evidence of this blockage?
a. ) T wave
b. ) U wave
c. ) PR interval
d. ) QRS interval
d.) QRS interval
The nurse prepares to administer which prescribed medication to the patient with shortness of breath and a heart rhythm of 46 beats per minute?
a. ) Atropine sulfate
b. ) Atenolol
c. ) Diltiazem
d. ) Adenosine
a.) Atropine sulfate
The nurse provides care to a patient who is prescribed IV adenosine. Which is the priority nursing action before administering the medication?
a. ) Monitoring respirations
b. ) Palpating the patient’s pulse
c. ) Teaching the patient to avoid caffeine intake
d. ) Ensuring a transcutaneous pacemaker is available
d.) Ensuring a transcutaneous pacemaker is available
The nurse is preparing to defibrillate a patient and selects which setting before the first shock?
a. ) 50 J
b. ) 100 J
c. ) 150 J
d. ) 200 J
d.) 200 J
Once ventricular fibrillation has been confirmed in a patient, which action is the priority?
a. ) Assessing vital signs
b. ) Opening the airway
c. ) Beginning rescue breathing
d. ) Starting chest compressions
d. ) Starting chest compressions
d.) Starting chest compressions
A patient becomes unresponsive without a palpable pulse despite showing bradycardia on the rhythm strip. What action should the nurse take immediately? (Select all that apply)
a. ) Auscultating heart sounds
b. ) Beginning cardiac compressions
c. ) Adjusting cardiac monitor leads
d. ) Obtaining blood samples for electrolytes
e. ) Placing epinephrine at the bedside
b. ) Beginning cardiac compressions
e. ) Placing epinephrine at the bedside
What is the order of electrical impulse through the heart?
1) SA node fires
2) Impulse spreads through the atrial myocardium
3) Impulse travels to the AV node
4) Impulse leaves the AV node through the bundle of His
5) Impulse travels through the bundle branches
6) Impulse extends into the ventricular tissue through the purkinje fibers
What are some major risk factors for cardiovascular disease?
Family history of cardiovascular disease
Diabetes mellitus
Chronic renal disease
Hypertension
Dyslipidemia
What are some examples of modifiable risk factors?
Weight
Dietary habits
Alcohol consumption
Smoking
The nurse is performing an assessment on a client and comes up with a blood pressure reading of 140/95. The client then states, “my blood pressure has been higher than that the last two times I have checked it”. Upon further evaluation, the nurse finds this to be true and knows that the client is experiencing what?
a) Stage 1 hypertension
b) Stage 2 hypertension
c) Nothing, this blood pressure reading is normal.
b) Stage 2 hypertension
What is the purpose of a transesophageal echocardiogram (TEE)?
This exam can allow doctors to get a clearer and better picture of the heart. This is most commonly used to see specific structures of the heart or to visualize clots in the heart chambers.


