Excelsior College- Life Span 1 Quiz 1 NoAnswers

1. When assessing heart sounds in an older adult patient, the RN hears a sound during early diastole. How should the RN document this finding? a. S1 b. S4 c. S3 d. S2

c. S3

Notes for question 1 r/t internal radiation therapy

-Brachytherapy is another name for internal radiation therapy -keep pt on bedrest in a supine or flat position to prevent accidental displacement of the radiation insert. -if they fall out by accident, pick them up using long forceps and put them in an appropriate radioactive container.

1. A patient in rapid atrial flutter weighs 220 pounds. The patient is prescribed diltiazem 0.25mg per kilogram. How many mg of diltiazem will be administered to this patient?

Answer: 25mg

1. Which statement made by the patient with a new implantable cardiac device demonstrates to the RN that patient teaching has been effective? a. I should leave the dressing on my incision until I see my doctor. b. I will avoid using the microwave. c. I need to exercise both arms every day. d. I can resume driving when my doctor tells me

D. I can resume driving when my doctor tells me

What are the different types of internal beam radiation?

Interstitial brachytherapy, Intracavitary brachytherapy, and Episcleral brachytherapy

1. Which lab value indicates to the nurse that the client is using Simvastatin as prescribed? a. Triglycerides 250 mg/dl b. Total cholesterol 300 mg/dl x c. LDL cholesterol 70 mg/dl d. HDL cholesterol 30 mg/dl

c. LDL cholesterol 70 mg/dl

What are acute side effects of radiation?

Skin irritation/damage at exposed sites, damage to salivary glands, fatigue, hair loss, N +/- V

1. During a community screening for coronary artery disease, the RN determines that which assessment data indicates the participant that is at greatest risk? a. 55 year old African American male with a bp of 170/90 b. 40 year old Caucasian male with a serum cholesterol of 300 mg/dl c. 55 year old Caucasian female whose step father has a hx of myocardial infarction d. 40 year old African American female with a bmi of 24

a. 55 year old African American male with a bp of 170/90

The nurse observes this dysrhythmia, prioritize the interventions by placing each step in the correct order. (ventricular tachycardia) a. Administer epinephrine b. Assess for a palpable pulse c. Begin chest compressions d. Defibrillate the client e. Administer amiodarone

a. Administer epinephrine 4 b. Assess for a palpable pulse 1 c. Begin chest compressions 2 d. Defibrillate the client 3 e. Administer amiodarone 5

1. Which interventions would be appropriate to decrease alarm fatigue? Select all that apply. a. Customize alarm parameters for each patient b. Cleanse the skin with soap and water before applying device. c. Keep all alarms off when providing direct patient care. d. Place the monitoring device on an area with minimal patient movement. e. Monitor only patients with a clinical indication for monitoring.

a. Customize alarm parameters for each patient b. Cleanse the skin with soap and water before applying device. c. Keep all alarms off when providing direct patient care. d. Place the monitoring device on an area with minimal patient movement. e. Monitor only patients with a clinical indication for monitoring.

1. Which nursing intervention is a priority for the client immediately after the placement of a permanent pacemaker? a. Initiate continuous ECG monitoring. b. Administer a non-opioid analgesic c. Immobilize the arm on the side of the pacemaker d. Transport to medical imaging for a chest x-ray

a. Initiate continuous ECG monitoring.

1. Which intervention should the nurse implement when preparing a patient with a new cardiac dysrhythmia for discharge to home? a. Teach the patient about the effects of the dysrhythmia b. Assess the patient for dyspnea with exertion c. Auscultate breath sounds bilaterally d. Administer medication to maintain a heart rate of 80 bpm

a. Teach the patient about the effects of the dysrhythmia

A patient presents to the Emergency Room following a myocardial infarction. What would be the expected findings upon presentation (select all that apply)? a. cyanotic nail beds b. warm dry skin c. cool skin d. decreased urinary output

a. cyanotic nail beds c. cool skin d. decreased urinary output

Beta-adrenergic blockers, such as Inderal and Lopressor (metoprolol), require instructions to the patient before administration. What instructions would you give (select all the apply)? a. do not discontinue abruptly b. watch for shortness of breath c. check apical pulse daily d. report a decrease in heart rate. take with a meal or just after a meal

a. do not discontinue abruptly b. watch for shortness of breath c. check apical pulse daily e. take with a meal or just after a meal

Patient teaching is done by the Registered Nurse before the patient is discharged. When a patient has been prescribed Inderal (propranolol), and is post-menopausal, what information and instruction should be included? a. it can produce insomnia in conjunction with mental depression b. it can produce asthma like conditions c. it can produce hormones that may reverse menopause d. it can produce symptoms of hyperglycemia

a. it can produce insomnia in conjunction with mental depression

Evaluating fluid loss with diuretic use should be done by (select all the apply): a. measuring peripheral edema b. daily weights c. daily blood work d. assessing breath sounds

a. measuring peripheral edema b. daily weights d. assessing breath sounds

Central alpha agonists, such as Aldomet (methyldopa) or Catapress, can cause a side effect that often results in non-compliance by the patient. The side effect that is often under assessed by nurses would be: a. sexual dysfunction b. dry mouth c. fatigue d. light headedness

a. sexual dysfunction

1. The patient who is one day postoperative after a right lower lobe lobectomy has a rhythm on the telemetry that is regular, with a P wave in front of each QRS complex and the rate is 112 beats per minute. The blood pressure is 126/80. Which interventions will the RN implement? Select all that apply. a. Obtain temporal artery temperature b. Calculate 24 hour intake and output c. Assess the patient for pain d. Notify health care provider e. Prepare for cardioversion

b. Calculate 24 hour intake and output

1. The nurse assesses erratic electrical activity on the telemetry reading while the client is talking to the nurse over the intercom. Which task should the nurse ask the UAP to implement? a. Sit and watch the telemetry monitor b. Check the client's telemetry leads c. Call for a rapid medical response d. Turn of the telemetry monitor

b. Check the client's telemetry leads

1. Which information should the nurse include when educating the client about Simvastatin? a. Take simvastatin in the morning before breakfast b. Contact the health care provider for muscle aches or dark urine c. Simvastatin is being prescribed to lower HDL cholesterol d. Include citrus fruits, especially grapefruit in the diet

b. Contact the health care provider for muscle aches or dark urine

1. A client with a new cardiac dysrhythmia reports episodes of palpitations and lightheadedness and is hypotensive. Which outcome is best for the client at this time? a. Express a positive attitude about living with the dysrhythmia. b. Demonstrate decreased episodes of the dysrhythmia. c. Describe the medication regimen and its rationale. d. Explain the dysrhythmia and its side effects.

b. Demonstrate decreased episodes of the dysrhythmia.

1. Which assessment findings in the client with atrial fibrillation support a nursing diagnosis of decreased cardiac output? a. Anxiety and shortness of breath b. Pulmonary edema and hypotension c. Palpitations and chest pain d. Left sided hemiparesis and slurred speech

b. Pulmonary edema and hypotension

1. Following the verbal hand off report, which patient should the rn assess first? a. The patient that reports left shoulder discomfort after the insertion of a permanent pacemaker b. The patient with palpitations, dizziness, and shortness of breath c. The patient that reports soreness of the chest after an elective cardioversion d. The patient with a heart rate of 60 who is prescribed metoprolol

b. The patient with palpitations, dizziness, and shortness of breath

Factors that alter cardiac output or peripheral vascular resistance will alter blood pressure. Thus, blood pressure is __________ when the cardiac output is __________ and the peripheral resistance is _________. a. decreased, decreased, increased b. elevated, elevated, increased c. decreased, elevated, increased d. elevated, decreased, decreased

b. elevated, elevated, increased

1. Which medication should the RN administer first when the patient with syncope reports feeling shaky, has a blood pressure of 70/40 and a regular heart rate of 40? a. Amiodarone b. Diltiazem c. Atropine d. Epinephrine

c. Atropine tx bradycardia FYI: a. Amiodarone x treats arrythmias b. Diltiazem x treats high bp and chest pain

1. The nurse is admitting a client with no previous cardiac history who has been in persistent atrial fibrillation for more than two days. What medical order would the nurse question? a. Prepare for transesophageal echocardiogram b. Administer heparin by continuous infusion c. Prepare for ablation of the atrioventricular node d. Administer diltiazem by continuous infusion.

c. Prepare for ablation of the atrioventricular node

Hypertension is a prolonged elevation of systolic and diastolic blood pressure greater than 140/90. To diagnose this condition: a. it is necessary to exercise right before the reading b. it is necessary to rest overnight before the reading c. it is necessary to have at least three readings, done on separate occasions, after resting for 5 minutes d. it is necessary to have at least five readings, done at the same time of day, after resting for 10 minutes

c. it is necessary to have at least three readings, done on separate occasions, after resting for 5 minutes

1. Which assessment would cause the nurse to temporarily stop an elective cardioversion? a. The conduction pads are placed anterior posteriorly b. The defibrillator is set to the synchronized mode c. The client has been taking warfarin for three weeks d. The client has a medication patch on the left chest wall

d. The client has a medication patch on the left chest wall

Primary hypertension, which accounts for 90% of all cases, is also called: a. elevated hypertension b. vascular hypertension c. pulmonary hypertension d. essential hypertension

d. essential hypertension

If a patient is receiving furosemide (Lasix) 40 mgs. day, what sign would indicate that the patient may be having an electrolyte imbalance? a. reduction in edema b. potassium lab result of 4.5 mEq/L c. increase in urination d. muscle weakness

d. muscle weakness

Some non-modifiable risk factors for hypertension are _______ and _________. Some modifiable risk factors are __________ and __________ .a. alcohol use, obesity, race and sex b. steroid use, tobacco use, race, age c. stress, age, tobacco use, alcohol use d. race, sex, oral contraceptives, obesity

d. race, sex, oral contraceptives, obesity