MSN 377: Ch 29 Workbook Questions
B
A patient has been experiencing increasing shortness of breath and fatigue. The physician has ordered a diagnostic test in order to determine what type of heart failure the patient is having. What diagnostic test does the nurse anticipate being ordered? A. a chest x-ray B. an echocardiogram C. an electrocardiogram D. a ventriculogram
C
A patient has missed 2 doses of digitalis (Digoxin). What laboratory results would indicate to the nurse that the patient is within therapeutic range? A. 0.25 mg/mL B. 4.0 mg/mL C. 2.0 mg/mL D. 3.2 mg/mL
B
A patient in cardiogenic shock after a myocardial infarction is placed on an intra-aortic balloon pump. What does the nurse understand is the mechanism of action of the balloon pump? A. The balloon keeps the vessels open so that blood will adequately deliver to the myocardium. B. The balloon inflates at the beginning of diastole and deflates before systole to augment the pumping action of the heart. C. The balloon delivers an electrical impulse to correct dysrhythmias the patient experiences. D. The balloon will inflate at the beginning of systole and deflate before diastole to provide a long-term solution to a failing myocardium.
C
A patient in severe pulmonary edema is being intubated by the respiratory therapist. What priority action by the nurse will assist in the confirmation of the tube placement in the proper position in the trachea? A. Observe for mist in the endotracheal tube B. Listen for breath sounds over the epigastrium C. Call for a chest x-ray D. Attach a pulse oximeter probe and obtain values
C, D, E
A patient is admitted to the intensive care unit (ICU) with left-side heart failure. What clinical manifestations does the nurse anticipate finding when performing an assessment? (Select all that apply). A. jugular vein distension B. ascites C. pulmonary crackles D. dyspnea E. cough
C
A patient is seen in the emergency department (ED) with heart failure secondary to dilated cardiomyopathy. What key diagnostic test does the nurse assess to determine the severity of the patient's heart failure? A. Blood urea nitrogen (BUN) B. Complete blood count (CBC) C. B-type natriuretic peptide (BNP) D. Serum electrolytes
A
A patient seen in the clinic has been diagnosed with stage A heart failure (according to the staging classification of the ACA). What education will the nurse provide to this patient? A. Information about ACE inhibitors and risk factor reduction B. Information about diuretic therapy and risk factor reduction C. Information about beta blockers, ACE inhibitors, and diuretics D. Information about implantable cardioverter/defibrilators.
A
A patient taking an ACE inhibitor has developed a dry, hacking cough. Because of this side effect, the patient no longer wants to take that medication. What medication that has similar hemodynamic effects does the nurse anticipate the physician ordering? A. Valsartan (Diovan) B. Furosemide (Lasix) C. Metoprolol (Lopressor) D. Isosorbide dinitrate (Dilatrate)
D
The nurse hears the alarm sound on the telemetry monitor and observes a flat line. The patient is found unresponsive, without a pulse, and no respiratory effort. What is the first action by the nurse? A. Administer epinephrine 1:10,000 10 mL IV push. B. Deliver breaths with a bag-valve mask. C. Defibrillate the patient with 360 joules. D. Call for help and begin chest compressions.
B
The nurse is assessing a patient who reports no symptoms of heart failure at rest but is symptomatic with increased physical activity. Under what classification does the nurse understand this patient would be categorized? A. I B. II C. III D. IV
A
The nurse is assigned to care for a patient with heart failure. What classification of medication does the nurse anticipate administering that will improve symptoms as well as increase survival? A. ACE inhibitor B. calcium channel blocker C. diuretic D. bile acid sequestrants
D
The nurse is performing a respiratory assessment for a patient in the left-sided heart failure. What does the nurse understand is the best determinant of that patient's ventilation and oxygenation status? A. pulse oximetry B. listening to breath sounds C. end-tidal CO2 D. arterial blood gases
A
The nurse is preparing to administer hydralazine and isosorbie dinitrate (Dilatrate). When obtaining vital signs, the nurse notes that the blood pressure is 90/60. What is the priority action by the nurse? A. Hold the mediation and call the physician B. Administer the medication and check the blood pressure in 30 minutes. C. Administer a saline bolus of 250 mL and then administer the medication. D. Administer the hydrazine and hold the dinitrate.
D
The nurse observes that a patient has 2+ pitting edema in the lower extremities. What does the nurse know that the presence of pitting edema indicates regarding fluid retention? A. A weight gain of 4 lbs B. A weight gain of 6 lbs C. A weight gain of 8 lbs D. A weight gain of 10 lbs
B
The physician writes orders for a patient to receive an angiotensin II receptor blocker for treatment of heart failure. What medication does the nurse administer? A. Digoxin (Lanoxin) B. Valsartan (Diovan) C. Metolazone (Zaroxolyn) D. Carvedilol (Coreg)
