front 1 a pt has an mi you should begin with giving metoprolol IV 5MG,
Q___MIN, FOR ___ DOSES | back 1 d. |
front 2 heart skipped a beat | back 2 a. |
front 3
Premature Atrial Contractions (PAC) = contraction that
originates in the ___, but not in the sinus node. In healthy persons,
isolated incidents usually are not significant | back 3 a. |
front 4 In healthy persons with premature atrial contractions, isolated
incidents usually are not significant. | back 4 a. |
front 5 to treat PAC or premature atrial contractions, | back 5 c. |
front 6 In pts w/ _____, frequent incidents of PAC may warn of or initiate more serious arrhythmias a. diabetes | back 6 c. |
front 7 Rhythm is regular… Distorted P wave … ____ may be stopped, delayed or
conducted normally | back 7 b. |
front 8 Causes in a normal heart = normal stress, physical fatigue, caffeine,
tobacco, alcohol, hypoxia, electrolyte imbalance, hyperthyroidism,
COPD, CAD | back 8 a. |
front 9 Atrioventricular (AV) conduction is evaluated by assessing the
relationship between the ____ and QRS complexes. | back 9 b. |
front 10 carvedilol is a ______ | back 10 a. |
front 11 sotalol is a _____ | back 11 a. |
front 12 metoprolol is a ______ | back 12 a. |
front 13 adenosine is a _______ | back 13 a. |
front 14
Rebound excitation causing angina pain or
MI with sudden withdrawal of beta blocker in client with
CHD | back 14 a. |
front 15 Which of the following cardiovascular conditions does NOT contraindicate the use of metoprolol? A) Moderate to severe heart failure | back 15 d. |
front 16 A nurse is reviewing an ECG of a patient who reports feeling like their heart "skipped a beat." The nurse notices premature beats with a distorted P wave. What is the most likely diagnosis? a. Ventricular fibrillation b. Premature atrial contractions (PAC) c. Sinus bradycardia d. Atrial fibrillation | back 16 b. |
front 17 A patient with frequent premature atrial contractions(PAC) is being
assessed. The nurse understands that PACs in patients with heart
disease can: | back 17 c. |
front 18 Which medication is contraindicated in peripheral vascular disease
and Raynaud’s disease? | back 18 b. |
front 19 1. A nurse is reviewing an ECG of a patient who reports feeling like their heart "skipped a beat." The nurse notices premature beats with a distorted P wave. What is the most likely diagnosis? a. Ventricular fibrillation b. Premature atrial contractions (PAC) c. Sinus bradycardia d. Atrial fibrillation | back 19 b. |
front 20 A patient with frequent premature atrial contractions (PAC) is being assessed. The nurse understands that PACs in patients with heart disease can: a. Are more commonly nothing serious if managed with moderate exercise with frequent rest periods. b. Indicate a high risk of immediate heart failure. c. Warn of or initiate more serious arrhythmias. d. Always require immediate electrical cardioversion. | back 20 c. |
front 21 During a health history interview, a patient mentions occasional
consumption of large amounts of caffeine. The nurse knows that this
can cause: | back 21 b. |
front 22 A patient's ECG shows premature atrial contractions (PAC). What treatment might the nurse anticipate for a patient with a healthy heart and isolated incidents? a. administration of IV beta-blockers. b. Lifestyle modifications and monitoring. c. Urgent cardiac catheterization. d. Starting a daily regimen of aspirin. | back 22 b. |
front 23 In educating a patient with frequent PACs about potential causes, the nurse should mention all the following except: a. Physical fatigue. b. Excessive alcohol consumption. c. High intake of fatty foods. d. Electrolyte imbalances. | back 23 c. |
front 24 When monitoring a patient with PACs, the nurse knows to assess for which potential symptom? a. A sensation of the heart skipping a beat. b. Consistent chest pain radiating to the left arm. c. A steady, unchanging heart rate. d. Severe dizziness leading to loss of consciousness. | back 24 a. |
front 25 A nurse is providing education on managing premature atrial contractions (PAC). Which lifestyle modification is least likely to be recommended? a. Reducing caffeine intake. b. Increasing physical activity. c. Avoiding tobacco use. d. Limiting alcohol consumption. | back 25 b. |
front 26 For a patient with known heart disease and frequent PACs, the nurse anticipates administration of which medication to prevent more serious arrhythmias? a. Calcium channel blockers b. Beta blockers c. Diuretics d. Antibiotics | back 26 b. |
front 27 A patient experiencing PACs asks the nurse why they feel their heart "skipping beats." The nurse explains this sensation is due to: a. An extra beat originating in the ventricles. b. A contraction that originates in the atrium, not in the sinus node. c. The heart pausing before the next normal beat. d. A rapid succession of beats from the atria. | back 27 b. |
front 28 A patient with PACs is being discharged. What advice should the nurse give to prevent future episodes? a. "Try to avoid stressful situations as much as possible." b. "It's important to limit your caffeine intake to no more than 400 mg per day." c. "You should limit physical activity to reduce heart strain." d. "Take a daily aspirin PRN up to 3 times per day.” | back 28 a. |
front 29 A nurse is reviewing a patient's EKG strip and notes the presence of wide and bizarre QRS complexes that occur earlier than expected. This finding is consistent with: A. Atrial fibrillation. B. Ventricular tachycardia. C. Premature Ventricular Contractions (PVCs). D. First-degree heart block. | back 29 c. |
front 30 A patient's EKG shows ventricular ectopic beats that are identical in shape, suggesting they are originating from the same ectopic focus. These are best described as: A. Multifocal PVCs. B. Unifocal PVCs. C. Ventricular tachycardia. D. Ventricular fibrillation. | back 30 b. |
front 31 During a telemetry reading, a nurse notices a pattern where every other heartbeat is a premature ventricular contraction. This pattern is known as: A. Ventricular bigeminy. B. Ventricular trigeminy. C. Ventricular quadrigeminy. D. A couplet of PVCs. | back 31 a |
front 32 A patient's EKG strip demonstrates a pattern where every third beat is a premature ventricular contraction. How should the nurse document this observation? A. Ventricular bigeminy. B. Ventricular trigeminy. C. A triplet of PVCs. D. Multifocal PVCs. | back 32 b. |
front 33 If a patient's EKG shows two consecutive premature ventricular contractions, the nurse recognizes this as: A. Ventricular tachycardia. B. A couplet. C. Ventricular bigeminy. D. Multifocal PVCs. | back 33 b. |
front 34 When assessing a patient with suspected hypovolemic shock, which initial symptom is most indicative of compensatory mechanisms being activated? a. Hypertension b. Increased heart rate c. Increased urine output d. Bradypnea | back 34 b. |
front 35 In hypovolemic shock, the term "third spacing" refers to fluid loss primarily through: a. Hemorrhage b. Shift of fluid to the interstitial spaces c. Increased diuresis d. Exhalation during tachypnea | back 35 b. |
front 36 Which clinical finding is a direct consequence of a significant decrease in preload due to hypovolemia? a. Decreased stroke volume & decreased CO b. Increased central venous pressure c. Hypertension d. Polyuria | back 36 a. |
front 37 For a patient presenting with symptoms of hypovolemic shock, which laboratory finding would support this diagnosis? a. Decreased lactate levels b. Increased specific gravity of urine c. Elevated hemoglobin and hematocrit d. Decreased serum sodium | back 37 b. |
front 38 The management of a patient with more than 30% volume loss due to hypovolemic shock includes: a. Immediate replacement with blood products b. Administration of diuretics to shift fluid into intracellular space c. Oral hydration therapy d. Application of a tourniquet to the extremities to conserve blood volume | back 38 a. |
front 39 A patient with hypovolemic shock is most at risk for developing: a. Hyperthermia b. Irreversible tissue damage due to lack of perfusion c. Hypoglycemia d. Polycythemia | back 39 b. |
front 40 Which intervention is least appropriate for a patient experiencing hypovolemic shock due to third spacing? a. Intravenous fluid resuscitation b. Use of vasodilators to decrease blood pressure c. Monitoring for signs of organ failure d. Administration of blood products as indicated | back 40 b. |
front 41 The first step in managing a patient with absolute hypovolemia and signs of shock should be: a. Inserting a urinary catheter to measure output b. Ensuring patent airway and supporting breathing c. Immediate initiation of enteral feeding to provide nutrition d. Providing a thermal blanket | back 41 b. |
front 42 Which diagnostic test result is expected in a patient with severe hypovolemic shock? a. Decreased hematocrit due to hemodilution b. Increased lactate indicating anaerobic metabolism c. Elevated cardiac enzymes indicative of potential lethal arrhythmia d. Decreased blood urea nitrogen (BUN) due to renal compensation | back 42 b. |
front 43 The physiological response to hypovolemic shock includes all of the following except: a. Parasympathetic nervous system activation to decrease heart rate b. Sympathetic nervous system activation to increase heart rate c. Decrease in central venous pressure due to fluid loss d. Tachypnea to increase oxygen delivery to tissues | back 43 a. |
front 44 A 44-year-old man admitted with a peptic ulcer has a nasogastric (NG) tube in place. When the patient develops sudden, severe upper abdominal pain, diaphoresis, and a firm abdomen, which action should the nurse take? a. Irrigate the NG tube. b. Check the vital signs. c. Give the ordered antacid. d. Elevate the foot of the bed. | back 44 b. |
front 45 Which assessment should the nurse perform first for a patient who just vomited bright red blood? a. Measuring the quantity of emesis b. Palpating the abdomen for distention c. Auscultating the chest for breath sounds d. Taking the blood pressure (BP) and pulse | back 45 d. |
front 46 Which order from the health care provider will the nurse implement first for a patient who has vomited 1200 mL of blood? a. Give an IV H2 receptor antagonist. b. Draw blood for typing and crossmatching. c. Administer 1000 mL of lactated Ringers solution. d. Insert a nasogastric (NG) tube and connect to suction. | back 46 c. |
front 47 A 46-year-old patient is admitted to the emergency department with
severe abdominal pain and rebound tenderness. Vital signs include
temperature 102 F (38.3 C), pulse 120, respirations 32, and blood
pressure (BP) 82/54. Which prescribed intervention should the nurse
implement first? | back 47 d. |
front 48 20-year-old female is brought to the emergency department with a knife handle protruding from the abdomen. During the initial assessment of the patient, the nurse should a. remove the knife and assess the wound. b. determine the presence of Rovsing sign. c. check for circulation and tissue perfusion. d. insert a urinary catheter and assess for hematuria. | back 48 c. |
front 49 Which patient should the nurse assess first after receiving change-of-shift report? a. 60-year-old patient whose new ileostomy has drained 800 mL over the previous 8 hours b. 50-year-old patient with familial adenomatous polyposis who has occult blood in the stool c. 40-year-old patient with ulcerative colitis who has had six liquid stools in the previous 4 hours d. 30-year-old patient who has abdominal distention and an apical heart rate of 136 beats / per min | back 49 d. |
front 50 After receiving change-of-shift report, which patient should the nurse assess first? a. Patient who is scheduled for the drain phase of a peritoneal dialysis exchange b. Patient with stage 4 chronic kidney disease who has an elevated phosphate level c. Patient with stage 5 chronic kidney disease who has a potassium level of 3.4 mEq/L L d. Patient who has just returned from having hemodialysis and has a heart rate of 124/min | back 50 d. |
front 51 nurse is caring for a patient admitted with diabetes insipidus (DI).
Which information is most important to report to the health care
provider? | back 51 a. |
front 52 the emergency department (ED) nurse receives report that a patient involved in a motor vehicle crash is being transported to the facility with an estimated arrival in 1 minute. In preparation for the patients arrival, the nurse will obtain a. hypothermia blanket. b. lactated Ringers solution. c. two 14-gauge IV catheters. d. dopamine (Intropin) infusion. | back 52 c. |
front 53 Which finding is the best indicator that the fluid resuscitation for a patient with hypovolemic shock has been effective? a. Hemoglobin is within normal limits. b. Urine output is 60 mL over the last hour. c. Central venous pressure (CVP) is normal. d. Mean arterial pressure (MAP) is 72 mm Hg. | back 53 b. |
front 54 The nurse is caring for a patient with a massive burn injury and possible hypovolemia. Which assessment data will be of most concern to the nurse? a. Blood pressure is 90 40 mm Hg. b. Urine output is 30 mL over the last hour. c. Oral fluid intake is 100 mL for the last 8 hours. d. There is prolonged skin tenting over the sternum. | back 54 a. |
front 55 Eight hours after a thermal burn covering 50% of a patients total body surface area (TBSA) the nurse assesses the patient. Which information would be a priority to communicate to the health care provider? a. Blood pressure is 95/48 per arterial line. b. Serous exudate is leaking from the burns. c. Cardiac monitor shows a pulse rate of 108. d. Urine output is 20 mL per hour for the past 2 hours. / | back 55 d. |
front 56 The nurse monitors a patient after chest tube placement for a hemopneumothorax. The nurse is most concerned if which assessment finding is observed? a. A large air leak in the water-seal chamber b. 400 mL of blood in the collection chamber c. Complaint of pain with each deep inspiration d. Subcutaneous emphysema at the insertion site | back 56 b. |