Question 1

A patient is admitted with the diagnosis of unstable angina.The nurse knows that the physiological mechanism present is most likely which of the following?

Accepted Answer

A)  Complete occlusion of a coronary artery 
B)  Fatty streak within the intima of a coronary artery 
C)  Partial occlusion of a coronary artery with a thrombus 
D)  Vasospasm of a coronary artery 
A)  Complete occlusion of a coronary artery 
B)  Fatty streak within the intima of a coronary artery 
C)  Partial occlusion of a coronary artery with a thrombus 
D)  Vasospasm of a coronary artery C

Question 2

Which nursing interventions would be appropriate after angioplasty?

Accepted Answer

A)  Elevate the head of the bed by 45 degrees for 6 hours. 
B)  Assess pedal pulses on the involved limb every 15 minutes for 1 to 2 hours. 
C)  Monitor the vascular hemostatic device for signs of bleeding. 
D)  Instruct the patient to bend his or her knee every 15 minutes while the sheath is in place. 
E)  Maintain NPO status for 12 hours. 
A)  Elevate the head of the bed by 45 degrees for 6 hours. 
B)  Assess pedal pulses on the involved limb every 15 minutes for 1 to 2 hours. 
C)  Monitor the vascular hemostatic device for signs of bleeding. 
D)  Instruct the patient to bend his or her knee every 15 minutes while the sheath is in place. 
E)  Maintain NPO status for 12 hours. B,C

Question 3

A patient presents to the emergency department (ED)with chest pain that he has had for the past 2 hours.The patient is nauseated and diaphoretic,with dusky skin color.The electrocardiogram shows ST elevation in leads II,III,and aVF.Which therapeutic intervention would the nurse question?

Accepted Answer

A)  Emergent pacemaker insertion 
B)  Emergent percutaneous coronary intervention 
C)  Emergent thrombolytic therapy 
D)  Immediate coronary artery bypass graft surgery 
A)  Emergent pacemaker insertion 
B)  Emergent percutaneous coronary intervention 
C)  Emergent thrombolytic therapy 
D)  Immediate coronary artery bypass graft surgery A

Question 4

Acute myocardial infarction (AMI)can be classified as which of the following?

Accepted Answer

A)  Angina 
B)  Nonischemic 
C)  Non-Q wave 
D)  Q wave 
E)  Frequent PVCs 
A)  Angina 
B)  Nonischemic 
C)  Non-Q wave 
D)  Q wave 
E)  Frequent PVCs

Question 5

A patient is having a cardiac evaluation to assess for possible valvular disease.Which study best identifies valvular function and measures the size of the cardiac chambers?

Accepted Answer

A)  12-lead electrocardiogram 
B)  Cardiac catheterization 
C)  Echocardiogram 
D)  Electrophysiology study 
A)  12-lead electrocardiogram 
B)  Cardiac catheterization 
C)  Echocardiogram 
D)  Electrophysiology study

Question 6

Identify the priority interventions for managing symptoms of an acute myocardial infarction (AMI)in the ED.

Accepted Answer

A)  Administration of morphine 
B)  Administration of nitroglycerin (NTG) 
C)  Dopamine infusion 
D)  Oxygen therapy 
E)  Transfusion of packed red blood cells 
A)  Administration of morphine 
B)  Administration of nitroglycerin (NTG) 
C)  Dopamine infusion 
D)  Oxygen therapy 
E)  Transfusion of packed red blood cells

Question 7

A patient has been diagnosed with Marfan syndrome.What information does the nurse plan to teach the patient about this condition?

Accepted Answer

A)  It is an autosomal dominant inherited disorder of connective tissue. 
B)  It is caused by a random genetic mutation and is not familial. 
C)  There are no drugs that help control the cardiac symptoms of the disease. 
D)  Contact sports are permitted if precautions against concussion are taken. 
A)  It is an autosomal dominant inherited disorder of connective tissue. 
B)  It is caused by a random genetic mutation and is not familial. 
C)  There are no drugs that help control the cardiac symptoms of the disease. 
D)  Contact sports are permitted if precautions against concussion are taken.

Question 8

The nurse is providing care to a patient on fibrinolytic therapy.Which statement from the patient warrants further assessment and intervention by the critical care nurse?

Accepted Answer

A)  "I have an incredible headache!" 
B)  "There is blood on my toothbrush!" 
C)  "Look at the bruises on my arms!" 
D)  "My arm is bleeding where my IV is!" 
A)  "I have an incredible headache!" 
B)  "There is blood on my toothbrush!" 
C)  "Look at the bruises on my arms!" 
D)  "My arm is bleeding where my IV is!"

Question 9

The patient is admitted with recurrent supraventricular tachycardia that the cardiologist believes to be related to an accessory conduction pathway or a reentry pathway.The nurse anticipates which procedure to be planned for this patient?

Accepted Answer

A)  Implantable cardioverter-defibrillator placement 
B)  Permanent pacemaker insertion 
C)  Radiofrequency catheter ablation 
D)  Temporary transvenous pacemaker placement 
A)  Implantable cardioverter-defibrillator placement 
B)  Permanent pacemaker insertion 
C)  Radiofrequency catheter ablation 
D)  Temporary transvenous pacemaker placement

Question 10

Which comment by the patient indicates a good understanding of a diagnosis of coronary heart disease?

Accepted Answer

A)  "I had a heart attack because I work too hard, and it puts too much strain on my heart." 
B)  "The pain in my chest gets worse each time it happens. I think that there is more damage to my heart vessels as time goes on." 
C)  "If I change my diet and exercise more, I should get over this and be healthy." 
D)  "What kind of pills can you give me to get me over this and back to my lifestyle?" 
A)  "I had a heart attack because I work too hard, and it puts too much strain on my heart." 
B)  "The pain in my chest gets worse each time it happens. I think that there is more damage to my heart vessels as time goes on." 
C)  "If I change my diet and exercise more, I should get over this and be healthy." 
D)  "What kind of pills can you give me to get me over this and back to my lifestyle?"

Question 11

The patient's spouse is feeling overwhelmed about cooking different dinners for the patient and the rest of the family to satisfy a cholesterol-reducing diet.Which response by the nurse is best?

Accepted Answer

A)  "It will be worth it to have a healthy spouse, won't it?" 
B)  "The low-cholesterol diet is one from which everyone can benefit." 
C)  "As long as you change at least a few things in the diet, it will be okay." 
D)  "You can go on the diet with him, and then let the children eat whatever they want." 
A)  "It will be worth it to have a healthy spouse, won't it?" 
B)  "The low-cholesterol diet is one from which everyone can benefit." 
C)  "As long as you change at least a few things in the diet, it will be okay." 
D)  "You can go on the diet with him, and then let the children eat whatever they want."

Question 12

Which statements are true regarding the symptoms of an AMI?

Accepted Answer

A)  Dysrhythmias are common occurrences. 
B)  Men have more atypical symptoms than women. 
C)  Midsternal chest pain is a common presenting symptom. 
D)  Some patients are asymptomatic. 
E)  Patients may complain of jaw or back pain. 
A)  Dysrhythmias are common occurrences. 
B)  Men have more atypical symptoms than women. 
C)  Midsternal chest pain is a common presenting symptom. 
D)  Some patients are asymptomatic. 
E)  Patients may complain of jaw or back pain.

Question 13

The patient is admitted with an acute myocardial infarction (AMI).Three days later the nurse is concerned that the patient may have a papillary muscle rupture.Which assessment data may indicate a papillary muscle rupture?

Accepted Answer

A)  Gallop rhythm 
B)  New murmur 
C)  S1 heart sound 
D)  S3 heart sound 
A)  Gallop rhythm 
B)  New murmur 
C)  S1 heart sound 
D)  S3 heart sound

Question 14

A patient presents to the ED complaining of severe substernal chest pressure radiating to the left shoulder and back that started about 12 hours ago.The patient delayed coming to the ED,hoping the pain would go away.The patient's 12-lead ECG shows ST-segment depression in the inferior leads.Troponin and CK-MB are both elevated.What does the nurse understand about thrombolysis in this patient?

Accepted Answer

A)  The patient is not a candidate for thrombolysis. 
B)  The patient's history makes him a good candidate for thrombolysis. 
C)  Thrombolysis is appropriate for a candidate having a non-Q wave MI. 
D)  Thrombolysis should be started immediately. 
A)  The patient is not a candidate for thrombolysis. 
B)  The patient's history makes him a good candidate for thrombolysis. 
C)  Thrombolysis is appropriate for a candidate having a non-Q wave MI. 
D)  Thrombolysis should be started immediately.

Question 15

A 72-year-old woman is brought to the ED by her family.The family states that she's "just not herself." Her respirations are slightly labored,and her heart monitor shows sinus tachycardia (rate 110 beats/min)with frequent premature ventricular contractions (PVCs).She denies any chest pain,jaw pain,back discomfort,or nausea.Her troponin levels are elevated,and her 12-lead electrocardiogram (ECG)shows elevated ST segments in leads II,III,and aVF.The nurse knows that these symptoms are most likely associated with which diagnosis?

Accepted Answer

A)  Hypokalemia 
B)  Non-Q wave MI 
C)  Silent myocardial infarction 
D)  Unstable angina 
A)  Hypokalemia 
B)  Non-Q wave MI 
C)  Silent myocardial infarction 
D)  Unstable angina

Question 16

The provider prescribes a pharmacological stress test for a patient with activity intolerance.The nurse would anticipate that the drug of choice would be

Accepted Answer

A)  dopamine. 
B)  dobutamine. 
C)  adenosine. 
D)  atropine. 
A)  dopamine. 
B)  dobutamine. 
C)  adenosine. 
D)  atropine.

Question 17

A patient is having a stent and asks why it is necessary after having an angioplasty.Which response by the nurse is best?

Accepted Answer

A)  "The angioplasty was a failure, and so this procedure has to be done to fix the heart vessel." 
B)  "The stent is inserted to enhance the results of the angioplasty, by helping to keep the vessel open and prevent it from closing again." 
C)  "This procedure is being done instead of using clot-dissolving medication to help keep the heart vessel open." 
D)  "The stent will remove any clots that are in the vessel and protect the heart muscle from damage." 
A)  "The angioplasty was a failure, and so this procedure has to be done to fix the heart vessel." 
B)  "The stent is inserted to enhance the results of the angioplasty, by helping to keep the vessel open and prevent it from closing again." 
C)  "This procedure is being done instead of using clot-dissolving medication to help keep the heart vessel open." 
D)  "The stent will remove any clots that are in the vessel and protect the heart muscle from damage."

Question 18

An essential aspect of teaching that may prevent recurrence of heart failure is

Accepted Answer

A)  notifying the provider if a 2-lb weight gain occurs in 24 hours. 
B)  compliance with diuretic therapy. 
C)  taking nitroglycerin if chest pain occurs. 
D)  assessment of an apical pulse. 
A)  notifying the provider if a 2-lb weight gain occurs in 24 hours. 
B)  compliance with diuretic therapy. 
C)  taking nitroglycerin if chest pain occurs. 
D)  assessment of an apical pulse.

Question 19

The patient tells the nurse,"I didn't think I was having a heart attack because the pain was in my neck and back." The nurse explains:

Accepted Answer

A)  "Pain can occur anywhere in the chest, neck, arms, or back. Don't hesitate to call the emergency medical services if you think it's a heart attack." 
B)  "For many people chest pain from a heart attack occurs in the center of the chest, behind the breastbone." 
C)  "The sooner the patient can get medical help, the less damage is likely to occur in case of a heart attack." 
D)  "You need to make sure it's a heart attack before you call the emergency response personnel." 
E)  "Often symptoms can be treated with nitroglycerin, so be sure to take several before calling 911." 
A)  "Pain can occur anywhere in the chest, neck, arms, or back. Don't hesitate to call the emergency medical services if you think it's a heart attack." 
B)  "For many people chest pain from a heart attack occurs in the center of the chest, behind the breastbone." 
C)  "The sooner the patient can get medical help, the less damage is likely to occur in case of a heart attack." 
D)  "You need to make sure it's a heart attack before you call the emergency response personnel." 
E)  "Often symptoms can be treated with nitroglycerin, so be sure to take several before calling 911."

Question 20

The nurse is assessing a patient with left-sided heart failure.Which symptom would the nurse expect to find?

Accepted Answer

A)  Dependent edema 
B)  Distended neck veins 
C)  Dyspnea and crackles 
D)  Nausea and vomiting 
A)  Dependent edema 
B)  Distended neck veins 
C)  Dyspnea and crackles 
D)  Nausea and vomiting

A patient is admitted with the diagnosis of unstable angina.The nurse knows that the physiological mechanism present is most likely which of the following?

Which nursing interventions would be appropriate after angioplasty?

A patient presents to the emergency department (ED)with chest pain that he has had for the past 2 hours.The patient is nauseated and diaphoretic,with dusky skin color.The electrocardiogram shows ST elevation in leads II,III,and aVF.Which therapeutic intervention would the nurse question?

Acute myocardial infarction (AMI)can be classified as which of the following?

A patient is having a cardiac evaluation to assess for possible valvular disease.Which study best identifies valvular function and measures the size of the cardiac chambers?

Identify the priority interventions for managing symptoms of an acute myocardial infarction (AMI)in the ED.

A patient has been diagnosed with Marfan syndrome.What information does the nurse plan to teach the patient about this condition?

The nurse is providing care to a patient on fibrinolytic therapy.Which statement from the patient warrants further assessment and intervention by the critical care nurse?

The patient is admitted with recurrent supraventricular tachycardia that the cardiologist believes to be related to an accessory conduction pathway or a reentry pathway.The nurse anticipates which procedure to be planned for this patient?

Which comment by the patient indicates a good understanding of a diagnosis of coronary heart disease?

The patient's spouse is feeling overwhelmed about cooking different dinners for the patient and the rest of the family to satisfy a cholesterol-reducing diet.Which response by the nurse is best?

Which statements are true regarding the symptoms of an AMI?

The patient is admitted with an acute myocardial infarction (AMI).Three days later the nurse is concerned that the patient may have a papillary muscle rupture.Which assessment data may indicate a papillary muscle rupture?

The provider prescribes a pharmacological stress test for a patient with activity intolerance.The nurse would anticipate that the drug of choice would be

A patient is having a stent and asks why it is necessary after having an angioplasty.Which response by the nurse is best?

An essential aspect of teaching that may prevent recurrence of heart failure is

The patient tells the nurse,"I didn't think I was having a heart attack because the pain was in my neck and back." The nurse explains:

The nurse is assessing a patient with left-sided heart failure.Which symptom would the nurse expect to find?

Overview of Critical Care Nursing

Patient and Family Response to the Critical Care Experience

Ethical and Legal Issues in Critical Care Nursing

End-Of-Life Care and Palliative Care in Critical Care Settings

Comfort and Sedation

Nutritional Support

Dysrhythmia Interpretation and Management

Hemodynamic Monitoring

Ventilatory Assistance

Rapid Response Teams and Code Management

Organ Donation

Shock,sepsis,and Multiple Organ Dysfunction Syndrome

Nervous System Alterations

Acute Respiratory Failure

Acute Kidney Injury

Hematological and Immune Disorders

Gastrointestinal Alterations

Endocrine Alterations

Trauma and Surgical Management

Burns

Filters

Exam 13: Cardiovascular Alterations

A patient is admitted with the diagnosis of unstable angina.The nurse knows that the physiological mechanism present is most likely which of the following?

Which nursing interventions would be appropriate after angioplasty?

A patient presents to the emergency department (ED)with chest pain that he has had for the past 2 hours.The patient is nauseated and diaphoretic,with dusky skin color.The electrocardiogram shows ST elevation in leads II,III,and aVF.Which therapeutic intervention would the nurse question?

Acute myocardial infarction (AMI)can be classified as which of the following?

A patient is having a cardiac evaluation to assess for possible valvular disease.Which study best identifies valvular function and measures the size of the cardiac chambers?

Identify the priority interventions for managing symptoms of an acute myocardial infarction (AMI)in the ED.

A patient has been diagnosed with Marfan syndrome.What information does the nurse plan to teach the patient about this condition?

The nurse is providing care to a patient on fibrinolytic therapy.Which statement from the patient warrants further assessment and intervention by the critical care nurse?

The patient is admitted with recurrent supraventricular tachycardia that the cardiologist believes to be related to an accessory conduction pathway or a reentry pathway.The nurse anticipates which procedure to be planned for this patient?

Which comment by the patient indicates a good understanding of a diagnosis of coronary heart disease?

The patient's spouse is feeling overwhelmed about cooking different dinners for the patient and the rest of the family to satisfy a cholesterol-reducing diet.Which response by the nurse is best?

Which statements are true regarding the symptoms of an AMI?

The patient is admitted with an acute myocardial infarction (AMI).Three days later the nurse is concerned that the patient may have a papillary muscle rupture.Which assessment data may indicate a papillary muscle rupture?

The provider prescribes a pharmacological stress test for a patient with activity intolerance.The nurse would anticipate that the drug of choice would be

A patient is having a stent and asks why it is necessary after having an angioplasty.Which response by the nurse is best?

An essential aspect of teaching that may prevent recurrence of heart failure is

The patient tells the nurse,"I didn't think I was having a heart attack because the pain was in my neck and back." The nurse explains:

The nurse is assessing a patient with left-sided heart failure.Which symptom would the nurse expect to find?

Overview of Critical Care Nursing

Patient and Family Response to the Critical Care Experience

Ethical and Legal Issues in Critical Care Nursing

End-Of-Life Care and Palliative Care in Critical Care Settings

Comfort and Sedation

Nutritional Support

Dysrhythmia Interpretation and Management

Hemodynamic Monitoring

Ventilatory Assistance

Rapid Response Teams and Code Management

Organ Donation

Shock,sepsis,and Multiple Organ Dysfunction Syndrome

Nervous System Alterations

Acute Respiratory Failure

Acute Kidney Injury

Hematological and Immune Disorders

Gastrointestinal Alterations

Endocrine Alterations

Trauma and Surgical Management

Burns

Filters