evolve PERFUSION

Question 1 of 13 The nurse is administering intravenous lidocaine [Xylocaine] to a patient with a ventricular dysrhythmia. What is the priority nursing intervention to prevent a potential complication with this drug? Monitor the electrocardiogram (ECG). Obtain a complete blood count. Instruct to report any chest pain. Keep naloxone [Narcan] at the bedside.

A

Question 13 of 13 What is the most common sustained dysrhythmia among the U.S. population? Atrial fibrillation Atrial flutter Sustained supraventricular tachycardia (SVT) Ventricular premature beats (VPBs)

A

Question 2 of 11 The nurse is teaching a patient who has had an ST-segment elevation myocardial infarction (STEMI) about home medications. Which agent represents a drug category that should be taken by all post-MI patients? Metoprolol [Lopressor] Hydrochlorothiazide (HCTZ) Diltiazem [Cardizem] Lovastatin [Mevacor]

A

Question 7 of 10 A patient with angina is being discharged with a prescription for nitroglycerin sublingual tablets. Which instruction should the nurse include? "Store the tablets in the original container and tightly close it after use." "The tablets are only good for 1 month after the container is opened." "Sublingual nitroglycerin tablets are also effective when swallowed whole." "Effects of sublingual nitroglycerin begin in 5 to 10 minutes."

A

Question 8 of 11 A patient is admitted to the emergency department with a diagnosis of ST-segment elevation myocardial infarction (STEMI). Which is the priority nursing action? Having the patient chew a 325-mg aspirin Administering meperidine [Demerol] for pain relief Giving verapamil [Calan] to lower blood pressure Preparing an insulin drip to manage complications

A

Question 9 of 10 The nurse understands patients receiving nitroglycerin are at risk for which adverse effects? Select all that apply. Headache Wheezing Dizziness Tachycardia Bradycardia

A,C,D

Question 6 of 11 The nurse in the emergency department is receiving a report on a patient diagnosed with ST-elevation myocardial infarction (STEMI). What are the common biochemical markers and symptoms for a STEMI? Select all that apply. Chest pain and electrocardiographic (ECG) changes Decreased troponin I level Elevated troponin T level Elevated creatinine kinase level Weakness and diaphoresis

A,C,D,E

Question 1 of 10 The nurse is providing discharge teaching for a patient with a new prescription for a nitroglycerin transdermal patch. Which statement by the patient indicates a need for further teaching? "I will remove my patch at bedtime each evening." "I will limit my alcohol to one drink per day." "I will not use Viagra as long as I am on nitroglycerin." "I will move slowly when changing positions."

B

Question 1 of 11 A patient is admitted to the emergency department complaining of chest pain, and the electrocardiogram (ECG) shows an evolving ST-segment elevation myocardial infarction (STEMI). What intervention should the nurse anticipate? Administer 400 mg of ibuprofen. Have the patient chew a 325-mg aspirin. Administer an ACE inhibitor within 1 week of the onset of chest pain. Provide oxygen by nasal cannula to achieve an arterial oxygen saturation of 94%.

B

Question 11 of 13 The nurse is interpreting an electrocardiogram (ECG). Which component represents the depolarization of the ventricles? P wave QRS complex ST segment T wave

B

Question 3 of 10 The nurse is caring for a patient who is receiving enteral feedings because of dysphagia. The healthcare provider prescribes isosorbide mononitrate [Imdur] 60 mg SR daily via the enteral tube. What is the most appropriate action by the nurse? Have the patient swallow the pill, because it cannot be crushed. Call the healthcare provider about an alternate form of nitrate for administration. Crush the Imdur into a fine powder, dilute it with water, and administer it via the enteral tube. Place the nitrate under the patient's tongue and let it dissolve, because the person has dysphagia.

B

Question 5 of 11 Which adverse effect is the greatest concern with thrombolytic therapy? Anaphylaxis Intracranial hemorrhage Cerebral edema Hemophilia

B

Question 7 of 13 In what part of the conduction pathway in a healthy heart is the electrical impulse delayed to provide time for the blood to fill the ventricles? Bundle of His AV node Purkinje system Internodal pathways

B

Question 8 of 10 A patient is receiving isosorbide dinitrate [Isordil] 20 mg 3 times per day for management of newly diagnosed stable angina. Which assessment finding would require an immediate nursing intervention? A change in blood pressure from 122/70 to 108/66 mm Hg An increase in the resting heart rate to 110 beats per minute from baseline rates of 68 to 72 beats per minute A headache the patient rates as a 5 on a pain scale of 0 to 10 Report of increased frequency of urination

B

Question 8 of 13 The nurse is caring for a patient receiving amiodarone [Cordarone]. Which body system should the nurse assess for serious adverse effects of this medication? Musculoskeletal Respiratory Integumentary Gastrointestinal

B

Question 9 of 13 A patient develops supraventricular tachycardia (SVT) and is hypotensive. Which medication should the nurse anticipate will be administered? Lidocaine [Xylocaine] Adenosine [Adenocard] Amiodarone [Cordarone] Phenytoin [Dilantin]

B

Question 6 of 10 Which are the main types of drugs used to prevent or relieve anginal pain? Select all that apply. Platelet inhibitors Beta blockers Nitrates Calcium channel blockers Statins

B,C,D

Question 10 of 10 Which medication combination is useful in the treatment of variant angina? Metoprolol [Lopressor] and ranolazine [Ranexa] Isosorbide dinitrate [Isordil] and metoprolol [Lopressor] Diltiazem [Cardizem] and isosorbide mononitrate [Imdur] Propranolol [Inderal] and diltiazem [Cardizem]

C

Question 10 of 11 Which drug would not be included in the treatment plan for a patient who will undergo a primary percutaneous coronary intervention (PCI)? Aspirin Heparin Diltiazem [Cardizem] Clopidogrel [Plavix]

C

Question 11 of 11 Which is the most beneficial treatment for patients experiencing an ST-segment elevation myocardial infarction (STEMI)? Oxygen administration Metoprolol [Lopressor] Reperfusion therapy Lidocaine [Xylocaine]

C

Question 12 of 13 The nurse is planning care for a patient at risk for dysrhythmias. The nurse understands that the Cardiac Arrhythmia Suppression Trial (CAST) confirmed which finding? Most atrial rhythm problems should be treated with medication. After a myocardial infarction, all dysrhythmias should be treated. Dysrhythmias should be treated only when they are symptomatically significant. Most rhythm problems result in bradydysrhythmias.

C

Question 2 of 10 The nurse is monitoring a patient receiving ranolazine [Ranexa] for angina. Which assessment finding indicates an adverse effect of this drug? Blood pressure of 90/50 mm Hg Frequent bloody stools QT prolongation on the electrocardiogram Respiratory rate of 11 breaths per minute

C

Question 3 of 13 Amiodarone [Cordarone] is prescribed for a patient with atrial fibrillation. What is the most important nursing intervention before administering this medication? Document an ophthalmic examination was performed. Explain a dermatologic evaluation is needed. Obtain baseline serum thyroid and liver function studies. Maintain NPO for transesophageal echocardiogram (TEE).

C

Question 4 of 11 Which medication is the treatment of choice for ST-segment elevation myocardial infarction (STEMI)-associated pain? Aspirin Lorazepam [Ativan] Morphine Hydromorphone hydrochloride [Dilaudid]

C

Question 5 of 10 The nurse is caring for a patient receiving nitrates for relief of angina. What pharmacodynamic action is responsible for the relief of anginal pain with nitrates? Vasoconstriction leads to improved cardiac output. Decreased force of contraction leads to decreased oxygen demand. Vasodilation leads to decreased preload, which decreases oxygen demand. Influx of calcium ions leads to relaxation of vascular smooth muscle.

C

Question 5 of 13 The nurse is caring for a patient prescribed quinidine [Quinaglute] for a supraventricular dysrhythmia. What is a common adverse effect of this drug? Constipation Urinary retention Diarrhea Blurred vision

C

Question 6 of 13 Which medication is not associated with prolongation of the QT interval? Dofetilide [Tikosyn] Sotalol [Betapace] Diltiazem [Cardizem] Dronedarone [Multaq]

C

Question 9 of 11 The nurse is preparing to administer an intravenous (IV) nitroglycerin infusion. For which patient should the nurse question the healthcare provider's prescription to administer IV nitroglycerin infusion? A patient with an inferior wall myocardial infarction (MI); blood pressure of 170/60 mm Hg A patient with an anterior wall MI who has pulmonary congestion; heart rate of 92 beats per minute A patient with a right ventricular infarction, confirmed by right-sided ECG changes A patient with chest pain unrelieved to 3 sublingual nitroglycerin tablets; took tadalafil 4 days ago

C

Question 2 of 13 What should the nurse include in the discharge teaching for a patient prescribed amiodarone [Cordarone]? Select all that apply. "Take amiodarone with grapefruit juice." "Take the medication on an empty stomach." "Wear sunblock and protective clothing when you are outdoors." "Check your pulse daily and report excessive slowing to your healthcare provider immediately." "Immediately notify your healthcare provider of shortness of breath, cough, or chest pain."

C,D,E

Question 10 of 13 In which situation is dronedarone [Multaq] contraindicated? PR intervals of 240 msec QT intervals of less than 500 msec Resting heart rate of 55 beats per minute Concomitant administration of amitriptyline [Elavil]

D

Question 3 of 11 For all patients undergoing percutaneous coronary intervention (PCI), which drug is recommended to be combined with clopidogrel [Plavix]? Heparin ACE inhibitor Alteplase [Activase] Aspirin

D

Question 4 of 10 The home health nurse observes the patient for proper use of topical nitroglycerin ointment. Which action by the patient indicates the need for further teaching? Rotates the application sites to minimize skin irritation Uses the applicator paper to measure the prescribed dose Removes ointment from a previous dose before applying the next dose Applies the prescribed ribbon of ointment to the applicator paper and places it on the chest

D

Question 4 of 13 A nurse is caring for a patient receiving dronedarone [Multaq] for treatment of atrial fibrillation. What electrocardiogram (ECG) change indicates an adverse effect of this medication? Previously upright T waves now are inverted. Previously rounded, upright P waves now are notched. ST segments previously on the baseline now are depressed. The QT-interval measurement changes from 400 msec to 520 msec.

D

Question 7 of 11 The nurse understands that ventricular fibrillation is a common cause of death after myocardial infarction (MI). Which drug should be readily available to treat ventricular fibrillation? Propranolol [Inderal] Dobutamine Valsartan [Diovan] Amiodarone [Cordarone]

D