MIDTERMS MS3

Which of these are problems associated with the cardio-vascular system? A. COPD, DVT and angina B. DVT, angina and CHD C. DVT, CHD and Crohns Disease D. Rickets, Scurvey and Hyperthyroidism

B

A nurse is caring for a client who develops a ventricular fibrillation rhythm. The client is unresponsive, pulseless, and apneic. Which of the following actions is the nurse's priority? A. Defibrillation B. Airway management C. Amiodarone administration D. Epinephrine administration

A

Aminophylline was ordered for acute asthmatic attack. The mother is asking for the drug's indication. The nurse is correct if she says: A. Relax smooth muscles of the bronchial airway B. Suppress cough C. Promote expectoration Prevent thickening of secretions

A

Commonly referred to as "chest pains", the heart is receiving an insufficient amount of blood during stressful situations or exercise A. ischemia B. angina pectoralis C. atherosclerosis

A

Disease that occurs when deposits of fatty substances form along the walls of the arteries. A. Atherosclerosis B. Heart Failure C. Myocardial Infarction D. Claudication

A

Does hypertension weaken the heart? A. Yes, the workload of the heart is double due to hypertension B. Yes, only when is it severe C. No, it only blocks the arteries D. Yes, hypertension stops the blood supply to the heart

A

Heart disease has genetic triggers, if either of your parents has suffered from a heart attack or stroke, you are at a high risk of suffering from heart diseases as well. A. True B. False C. Maybe

A

Heart valve leakage can develop gradually over time or can occur all of a sudden. While diseases like rheumatic heart disease, Marfan syndrome often lead to this condition, endocarditis or the valve infection or high blood pressure may also contribute to the condition. A. True B. False

A

High blood pressure and high cholesterol levels can lead to coronary heart disease. A. True B. False C. Maybe

A

In shock, which of the following statements is true relative to oxygen consumption (VO2) A. Oxygen demand exceeds oxygen delivery B. Oxygen delivery and oxygen demand are determined by stroke volume C. Because DO2 is greater than VO2 in shock situations, anaerobic metabolism results in formation of lactate D. As long as VO2 is greater than DO2, anaerobic metabolism will be minimal and blood lactate levels will remain normal

A

In which instance would you be most likely to administer a vasopressor or inotropic drug to an animal in shock? A. When hypotension persists despite restoration of normal blood volume, and thus vascular tone or cardiac function is suspected to be the problem B. Vasopressors are usually the first choice to fix deficits in blood volume C. Usually, inotropes would be started when hypotension persists after 24-48 hours of administering maintenance fluid volumes D. Usually, inotropes and vasopressors are only administered AFTER shock is resolves, as earlier administration might lead to cardiac arrhythmias or systemic hypertension

A

Lack of proper supply of oxygen can interfere with the electrical impulses of the heart, causing abnormal heart rhythms. A. True B. False C. Maybe

A

Management of ARDS is usually only supportive. There is little we can do to reverse the process. A. True B. False

A

Men have a higher risk of suffering from a heart attack than women. Women s risk of having heart trouble increases after menopause but still is not as high as men. However, the symptoms of a heart attack are more subtle in the case of women and hence have a higher probability of going unnoticed. A. True B. False

A

Nausea and tiredness without any apparent cause can also indicate a heart attack. A. True B. False C. Maybe

A

Shock from anaphylaxis is a result of which type of shock? A. Distributive A. Hypovolemic B. Obstructive C. Cardiogenic

A

The acute nursing management of a client with CHF will include all of the following goals except... A. A decrease in myocardial contractility B. An increase in cardiac output C. An elevation in renal blood flow D. A reduction in the heart's workload

A

The nurse is teaching a client who has a new prescription for sublingual nitroglycerin. Which of the following must be emphasized? A. Carry the nitroglycerine with you at all times B. Rest in bed for an hour after taking medication C. Take the medication at the same time each day D. Keep the medication bottle in the refrigerator

A

The nurse, recognizing that digitalis preparations promote diuresis, should evaluate clients for a depletion of: A. Potassium B. Calcium C. Phosphate D. Sodium

A

A client has been admitted for acute asthma exacerbation and placed in High-Fowler's position. The nurse knows this position is best it: A. Allows for chest physiotherapy B. Facilitates maximal ventilation C. Is required for the aerosol treatments to work D. Is the position for the chest x-ray

B

A client has the following ABG values pH 7.52, PaO2 50mmHg, HgPaCO2 28 mmHg, HgHCO3 24 mEq/L. Based on the client's PaO2, which of these conclusions would be accurate? A. The oxygen level is low but poses no risk for the client B. The client is severely hypoxic C. The client's PaO2 level is within the normal range D. The client requires oxygen therapy with very low oxygen concentration

B

A client with ARDS is showing signs of increased dyspnea. The nurse reviews a report a ABGs that arrived: pH 7.35; PaCO2 25mm, HgHCO3 22 mEq/L PaO2 95 mmHg. Which finding should the nurse report to the physician? A. Ph B. PaCO2 C. HCO3 D. PaO2

B

A client with bronchial asthma has difficulty breathing because of: A. A too rapid expulsion of air B. Spasms of the bronchi, that trap the air C. An increase in the vital capacity of the lungs D. Hyperventilation due to an anxiety reaction

B

A nurse is assessing a female client with multiple trauma who is at risk of developing acute respiratory distress syndrome. The nurse assesses for which earliest sign of acute respiratory distress syndrome? A. Inspiratory crackles B. Increased respiratory rate C. Bilateral wheezing D. Intercostal retractions

B

A patient is in anaphylactic shock. The patient has a severe allergy to peanuts and mistakenly consumed an eggroll containing peanut ingredients during her pm snack. The patient is given Epinephrine intramuscularly. As the nurse, you know this medication will have what effect in the body? A. It will prevent a recurrent attack B. It will help dilate the airways C. It will help block the effects of histamine in the body D. It will cause vasoconstriction and decrease the bp

B

All are predisposing factors of ARDS except? A. Sepsis B. Status asthmaticus C. Fat embolism D. Multiple blood transfusions

B

As adult is admitted with early left-sided congestive heart failure. Which symptom should the nurse expect to find? A. Bradycardia B. Rales C. Liver engorgement D. vein distention

B

Cause of pulmonary edema in ARDS is? A. Increased hydrostatic pressure B. Increased vascular permeability C. Physiological D. Lymphatic obstruction

B

In patient with severe anaphylactic reaction, A. Bronchospasm is the most dangerous feature B. An aura may precede acute reaction if patient is awake C. Pulmonary edema is common clinical finding D. Previous exposure to the triggering drug is necessary

B

In shock, the pulse pressure will A. Widen B. Narrow C. Become thready D. Remain unchanged

B

Is an aneurysm caused by hypertension? A. No B. Yes C. An aneurysm occurs only because of hypertension D. There is no evidence

B

The client is taking Digoxin and Furosemide at the same time; the nurse's knowledge of drug-to-drug interaction alerts her for possible effect of which electrolyte imbalance? A. hyponatremia B. hypokalemia C. hypocalcemia D. hypophosphatemia

B

The following interventions are ordered by the health care provider for a patient who has respiratory distress and syncope after eating strawberries. Which will the nurse complete first? A. Administer diphenhydramine B. Give epinephrine C. Start continuous ECG monitoring D. Draw blood for complete blood count (CBC)

B

What are the common causes of coronary heart disease? A. Damage to the outer wall of the heart B. Damage to the inner wall of the heart C. Rupture of the capillary vessels D. None of the above

B

When the doctor suspects that people have sepsis or septic shock, which of the following steps must be done immediately? A. Do a blood culture and sensitivity testing B. Treat them with antibiotics C. Remove any medical devices that may have started the infection D. Give them fluids intravenously

B

Which data collected by the nurse caring for a patient who has cardiogenic shock indicate that the patient may be developing multiple organ dysfunction syndrome (MODS) A. The patient's extremities are cool and pulses are weak B. The patient's serum creatinine level is elevated C. The patient complains of intermittent chest pressure D. The patient has bilateral crackles throughout lung fields

B

A black male client with asthma seeks emergency care for acute respiratory distress. Because of this client's dark skin, the nurse should assess for cyanosis by inspecting the: A. Lips B. Fingernail C. Mucous membranes D. Pina

C

A client's chest tube is to be removed by the physician. Which of the following items should the nurse have ready to be placed directly over the wound when the chest tube is removed? A. Fine-mesh gauze dressing B. Montgomery strap C. Petroleum gauze dressing D. Butterfly dressing

C

A nurse is caring for a client who came to the emergency department reporting chest pain. The provider suspects a myocardial infarction. While waiting for the troponin levels report, the client asks what this blood test will show. Which of the following explanations should the nurse provide the client? A. Troponin is an enzyme that indicates damage to brain, heart, and skeletal muscle tissues B. Troponin is a lipid whose levels reflect the risk for coronary artery disease C. Troponin is a heart muscle protein that appears in the bloodstream when there is damage to the heart D. Troponin is a protein that helps transport oxygen throughout the body

C

A patient is admitted to the emergency department (ED) for shock of unknown etiology. The first action by the nurse should be to A. obtain the blood pressure B. check the level of orientation C. administer supplemental oxygen D. obtain a 12-lead electrocardiogram

C

A patient with massive trauma and possible spinal cord injury is admitted to ER. Which findings by the nurse will help confirm a diagnosis of neurogenic shock? A. Cool, clammy skin B. Inspiratory crackles C. Apical heart rate of 48/bpm D. Temp. 38.4 degree Celsius

C

A specific blood test to confirm an acute myocardial infarction is? A. Lipid profile B. Cardiac Enzyme C. Full Blood Count D. Serum Electrolyte

C

Adrenergic drugs, such as epinephrine are given during shock for what primary reason? A. to prevent spasm and constriction of peripheral vessels B. to increase tone and motility of GIT C. to increase cardiac output by increase rate and strength of myocardial activity D. to prevent cardiac dysrhythmias

C

After activity, a client state that anginal pain increases. The nurse should realize that angina pectoris is a sign of: A. Coronary thrombosis B. Mitral insufficiency C. Myocardial ischemia D. Myocardial infarction

C

After receiving 1Liter of Normal Saline, the CVP for a patient who has septic shock is 10 mmHg, but BP is still 82/40 mmHg. The nurse will anticipate the administration of A. Nitroglycerine B. Drotrecogin alpha C. Norepinephrine D. Sodium nitroprusside

C

All are true about ARDS except? A. Ground glass mottling in X-Ray chest B. Cyanosis C. Increased surfactant D. Widespread atelectasis

C

Baroreceptors monitor blood pressure and help us to respond to shocks. These are found in the: A. Brain and spinal cord B. Brain and ventricular muscle tissue C. Carotid arteries and aortic arch D. Abdominal aorta

C

Blood levels of angiotensin and renin are increase during shock. What clinical findings would the nurse assess for because of these blood levels? A. peripheral vasodilation B. increase respiratory rate C. peripheral vasoconstriction D. decrease respiratory rate

C

Cardiac enzyme studies are helpful in diagnosing an MI. These studies are most indicative of: A. cardiac necrosis B. location of MI C. cardiac ischemia D. size of the infarct

C

Cause of pulmonary edema in ARDS is? A. Physiological B. Increased hydrostatic pressure C. Increased vascular permeability D. Lymphatic obstruction

C

Chest tube has been inserted in a client with a pneumothorax. The nurse should evaluate the effectiveness of the chest tube A. To promote formation of lung scar tissue B. To insert antibiotics into the pleural space C. To remove air and fluid D. For administration of oxygen

C

Clients are encouraged to perform deep breathing exercises after surgery. The reason for this is that deep breathing exercises helps to: A. Expand the residual volume B. Increase blood volume C. Decrease partial pressure of oxygen D. Counteract respiratory acidosis

C

Conceptually, the goal of shock resuscitation is to: A. Get the blood pressure back to normal B. Let the blood pressure drop because elevating may cause bleeding C. Try to restore some perfusion without elevating the BP too much D. Resuscitate until the pulse oximeter reads at least 94%

C

Evaluation of the effectiveness of cardiac nitrates is based on: A. Improved cardiac output B. Dilation of superficial blood vessels C. Relief of anginal pain D. A decrease in blood pressure

C

Following Irreversible shock, a client develops deficiency of ADH. Normally secretion of ADH causes: A. serum osmolality to increase B. urine concentration to decrease C. Tubular reabsorption of water to increase D. GFR to decrease

C

For the hypovolemic shock to occur, the patient would need to lose ____________ of their blood volume. A. <30% B. >10% C. >15% D. >25%

C

For which of the following procedures would the nurse anticipate preparing the client who develops a large pleural effusion? A. Paracentesis B. Bronchoscopy C. Thoracentesis D. Chest tube insertion

C

Heart attack modifiable risk factors that can be controlled are: A. Race B. Age C. Diet and Lifestyle D. Genetic structure

C

Prevent heart disease by eating. A. Saturated fats B. Processed food C. Fruits, vegetables, and fiber D. Salt

C

The correct pathway that an erythrocyte would travel during systemic circulation is: A. Arteriole--aorta--vein--venule—capillary B. Capillary--venule--vein--artery—aorta C. Aorta--arteriole--capillary--venule—vein D. Venule--vein--capillary--arteriole—aorta

C

The muscular layer of the heart that is responsible for pumping is the: A. Endocardium B. Epicardium C. Myocardium

C

The nurse interprets which finding as an early sign of acute ARDS in a client at risk? A. Metabolic acidosis B. Elevated carbon dioxide level C. Hypoxia not responsive to oxygen therapy D. Sever, unexplained electrolyte imbalance

C

The nurse is administering diltiazem (Cardizem) to a client. Prior to administration, it is important for the nurse to assess which parameter? A. Temperature B. Vision C. Blood pressure D. Breath sound

C

The nurse is caring for a patient with acute DIC. Which clinical manifestation should the nurse recognize is caused by this condition? A. Bradypnea B. Polyuria C. Ozzing from the IV access site D. Hypertension

C

When a client is admitted to the coronary care unit with a diagnosis of acute pulmonary edema, the nurse should be prepared for: A. Postural drainage B. Inhalation therapy C. Dry tourniquet D. Wet phlebotomy

C

When a client is experiencing hypovolemic shock with decreased tissue perfusion, the nurse recognizes that the body initially attempts to compensate by: A. Producing more RBC's B. Producing less ADH C. Maintaining peripheral vasoconstriction D. Decreasing mineralocorticoid production

C

When assessing a client with a sucking stab wound of the chest, the nurse should be concerned primarily with the: A. Blood pressure and pupillary response B. Amount of serosanguineous drainage C. Quality and depth of respirations D. Degree and level of pain

C

Which finding is the best indicator that the fluid resuscitation for a 90-kg patient with hypovolemic shock has been effective? A. Hemoglobin is within normal limits B. Central venous pressure (CVP) is normal C. Urine output is 75 mL over the past hour D. Mean arterial pressure (MAP) is 72 mm Hg.

C

Which goal of treatment for a patient with disseminated intravascular coagulation should the nurse consider most important? A. Decreasing the number of platelets in the circulation B. Increasing thrombin levels C. Supporting and resuscitating the circulatory system D. Resolving bacterial infection

C

Which of the ff. enzyme studies confirm a diagnosis of MI? A. SGPT B. LDH C. Troponin-T D. SGOT

C

Which of the following is the most common situation leading to ARDS? A. Head injury B. 1st degree burn C. Multiple bone fractures D. Near choking

C

Which of the following is true for vital signs in the shock patient? A. The pulse will increase, and the respirations will decrease B. The pulse will decrease, and the respirations will increase C. The pulse will increase, and the respirations will increase D. The pulse will decrease, and the respirations will increase

C

Which of the following would be included in the plan of care for the client with ARDS? A. Keeping client in prone position B. Assessing the client for fluid volume deficit C. Monitoring ABGs levels and cardiac status D. Administering oxygen at a rate of 2L/minute by nasal cannula

C

Which of these options can aptly describe liver problem? A. Permanent liver damage B. Enlargement of the liver C. Disturbance in the liver function D. None of above

C

You are providing care to a patient in anaphylactic shock. What is not a typical medical treatment for this condition, and if ordered the nurse should ask for an order clarification? A. IV diphenhydramine B. Epinephrine C. IV furosemide D. Costicosteroids E. Isotonic intravenous fluids

C

A nurse is taking pulmonary artery catheter measurements of a male client with acute respiratory distress syndrome. The pulmonary capillary wedge pressure reading is 12mm Hg. The nurse interprets that this reading is: A. Low and unexpected B. High and expected C. Uncertain and unexpected D. Normal and expected

D

All are true about ARDS except? A. Pulmonary hypertension B. Normal PCWP C. Hypoxemia D. Low protein pulmonary edema

D

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? A. Decrease the rate for the 5% dextrose in normal saline (D5/.9 NS) infusion B. Decrease the rate for the nitroglycerin infusion C. Increase the rate for the dopamine infusion D. Increase the rate for the sodium nitroprusside infusion

D

Assessment of a client diagnosed with congestive heart failure reveals moderate dyspnea, clammy and very pale skin, and cough producing frothy, blood-tinged sputum. Based on these findings, the nurse suspects that the client is experiencing which of the following? A. Endocarditis B. Angina C. Myocardial Infarction D. Pulmonary edema

D

Before administering digoxin (Lanoxin) to a client, which of the following nursing assessments is a priority? A. Check for bowel sounds B. Auscultate breath sounds C. Measure the blood pressure D. Monitor the heart rate

D

Common symptoms of a heart attack are A. Nausea B. Fatigue C. Chest pain D. All of the above

D

For the client experiencing a cardiac arrest, which of the following interventions should be performed first? A. Assess client's blood pressure B. Auscultate heart sounds C. Assist with defibrillation D. Establish a patent airway

D

Hypertension can damage the heart in a very short span. A. It varies from person to person B. Yes, even a year is enough for the damage C. No, it takes long more years before the damage occurs D. It takes a couple of years or more

D

Secondary factors that increase the risk for ARDS include? A. Chronic alcohol abuse B. Chronic lung disease C. Low serum pH D. All of the above

D

Sepsis is a body wide response to which of the following conditions? A. Hospital-acquired infection B. A lung infection C. A urinary tract infection D. Bacteria in the blood

D

The nurse is caring for a client with a myocardial infarction. Which finding requires the nurse's immediate action? A. Dizziness spells B. Periorbital edema C. Lethargy D. Difficulty of breath

D

The nurse takes his BP in a lying and sitting position. She understands that this is a test for: A. Vascular insufficiency B. CNS depression C. Malignant HPN D. Orthostatic hypotension

D

The nurse would suspect ARDS in the client diagnosed with hypovolemic shock secondary to multiple traumas when the client exhibits which of the following? A. Greenish, tenacious sputum and tachypnea B. Increased breath sounds with increased chest expansion C. PaCO2 of 65 mmHg with a PaO2 of 85 mmHg D. PaO2 of 62 mmHg after 2 hours of oxygen at 10L/minute

D

This chamber of the heart is much thicker than the others because it pumps to the entire body: A. Right atrium B. Right ventricle C. Left atrium D. Left ventricle

D

What part of the intrinsic conduction system starts the heart beat? A. The atrioventricular node B. The Bundle of His C. The Perkinje fibers D. The sino-atrial node

D

When assessing a client with angina, which of the following is considered a common precipitating factor for pain? A. Exposure to cold B. Drinking light alcohol occasionally C. Eating small meals frequently D. Cigarette smoking

D

Which assessment information is most important for the nurse to obtain when evaluating whether treatment of a patient with anaphylactic shock has been effective? A. heart rate B. Blood pressure C. Orientation D. Oxygen saturation

D

Which of the following is not a major mechanism for lack of oxygen delivery to tissues? A. Inadequate blood volume B. Inadequate cardiac performance C. Inadequate vascular tone D. Increased coronary perfusion

D

Which of the following would be important to include in the discharge teaching plan for the client diagnosed with pulmonary embolism? A. Reduce walking to necessary activities around the house B. Soak feet nightly in warm water to increase circulation C. Avoid bending when attempting to pick up objects D. Maintain peripheral circulation with leg exercises

D

Which of these are the signs of coronary heart disease? A. Block coronary artery B. Pressure in the chest C. Shortness of breath D. All of the above E. A & C F. B & C

D

Which processes usually regulate the urine output when blood pressure drops? A. Anti-diuretic hormone and insulin B. Insulin and growth hormone C. Valsalva maneuver and cpr D. Renin-angiotensin-aldosterone system and anti-diuretic hormone

D

Will you get a heart disease if you have hypertension? A. Only when left uncontrolled B. Yes, when your BP remains higher C. It is not the case D. A & B

D

Latex allergy may present with A. Urticaria B. Bronchospasm C. Pulmonary edema D. Pruritis E. All of the above

E

Signs of hypovolemic shock include: A. Passing out B. Sweating a lot C. Feeling anxious D. Higher breathing than normal E. All of the above F. A & B

E