Nursing Dx & Intervention
Bio-Psycho-Social
Legal/Ethical Concerns
Safety
EBP
100
A patient asks the nurse why they received morphine during a myocardial infarction. Based on the nurses knowledge they reply the primary reason was.. A. The morphine will help you go to sleep B. The morphine will decrease any pain you are experiencing C. The morphine helps decrease the amount of oxygen demand on the heart D. The morphine will help you relax during the MI
What is C. The Morphine helps decrease the amount of oxygen demand on the heart
100
Appropriate treatment for the management of cardiogenic shock include (select all that apply). a. dobutamine to increase myocardial contractility b. vasopressors to increase systemic vascular resistance c. circulatory assist devices such as an intraaortic balloon pump d. corticosteroids to stabilize the cell wall in the infarcted myocardium e. Trendelenburg positioning to facilitate venous return and increase preload
What is A & C: Dobutamine to increase myocardial contractility, circulatory assist devices such as intraaortic balloon pump
100
Which of the following symptoms is most likely the origin of pain the nurse needs to be concerned with when the client describes discomfort as knifelike chest pain that increases in intensity with inspiration? A Cardiac B Gastrointestinal C Musculoskeletal D Pulmonary
What is D. Pulmonary
100
A nurse is preparing for the admission of a client with heart failure who is being sent directly to the hospital from the physician’s office. The nurse would plan on having which of the following medications readily available for use? A Diltiazem (Cardizem) B Digoxin (Lanoxin) C Propranolol (Inderal) D Metoprolol (Lopressor)
What is B. Digoxin
100
Which of the following would you teach a patient with HF to avoid following a 2-gram sodium Diet? A. Tomato Juice B. Whole Wheat Bread C. Apples D. Grilled Chicken
What is A. Tomato Juice
200
A patient experiencing left sided heart failure will have which symptom associated? A. palpitations B. Hypotension C. crackles D. Arrhythmia
What is C. Crackles
200
Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output? A. Angina pectoris B Cardiomyopathy C Left-sided heart failure D Right-sided heart failure
What is D. Right Sided Heart Failure
200
A patient has questions about his “full code” code status, which response by the patient shows he understands what his code status means? 1. “If I have a heart attack, they will not bring me back" 2. “They will not use chemicals to resuscitate me” 3. “They will do everything in their power to save me” 4. “They will not do compressions on me”
What is 3. They will do everything in their power to save me
200
When teaching a patient about an upcoming procedure, the nurse notes the patient does not fully understand the process of the procedure. After the nurse applies teaching, she knows it has been effective when the patient can… 1. Repeat back to the nurse, in simple terms, what was explained to him 2. Be able to perform the procedure on his friend 3. Tell his wife how great his nurse is 4. Draw a picture of the anatomy of his body
What is 1. repeat back to him in simple terms what was explained
200
Which of the following positions would be considered best practice for a patient with breathing issues with Heart Failure? A. Flat B. Side-Lying C. High Fowlers D. Semi-Fowlers
What is C. High Fowlers
300
Which of the following places a patient at risk for developing a heart condition A. Smoking only one cigarette a day. B. Taking blood pressure pills when client feels appropriate C. Eating at a fast food restaurant 6 times a week D. Exercising for 30 minutes a day
What is A, B, C: Smoking, BP bills when pt feels appropriate, eating fast food 6 times a week
300
You notice that your patient who recently had a MI seems depressed, which of the following would you encourage the patient to do. A. Call family members and friends to visit B. Join a local outreach group for others who have had MI C. Stay in bed and watch television D. Discuss any concerns or worries they may have with you or another healthcare professional
What is A,B, D: Call family/friends, join local outreach, discuss concerns with HCP
300
A patient has a signed DNR and is about to undergo cardiac surgery. He survived the surgery and is stable and has been moved from the ICU to a med-surg floor. The patient tells you, the med-surg nurse, that he wants to be a full code now. Which of the following would be the best response? A. “Okay, I’ll change it for you” B. ”Have you talked to your family about this?” C. ”No, that’s impossible” D. “We can consult with your doctor, family, and legal team to have it changed”
What is D. We can consult with your doctor, family, and legal team to have it changed
300
When administering Coreg (Carvedilol) to a patient, what is the priority nursing assessment? a. blood pressure reading to assess for hypotension b. capillary refill to assess for adequate perfusion c. respiratory assessment for bronchospasm d. assess for risk of falls
What is C. respiratory assessment for bronchospasm
300
Which evidence based practice plan would a nurse utilize before ambulating a patient in the hall 2 days post op for heart surgery? A. Deep Breathe and cough B. Provide a walker C. Pre-medicate patient with analgesic medication D. Provide encouragement that things will get better
What is C. Pre-medicate patient with analgesic medication
400
A 55-year-old client is admitted with an acute inferior-wall myocardial infarction. During the admission interview, he says he stopped taking his metoprolol (Lopressor) 5 days ago because he was feeling better. Which of the following nursing diagnoses takes priority for this client? A Anxiety B Ineffective tissue perfusion; cardiopulmonary C Acute pain D Ineffective therapeutic regimen management
What is B. Ineffective tissue perfusion/cardiopulmonary
400
A hospitalized patient with a history of chronic stable angina tells the nurse that she is having chest pain. The nurse bases their actions on the knowledge that ischemia… a. will always progress to myocardial infarction b. will be relieved by rest, nitroglycerin, or both c. indicates that irreversible myocardial damage is occurring d. is frequently associated with vomiting and extreme fatigue
What is B. Will be relieved by rest, nitro, or both
400
When caring for a patient who is about to undergo a PCTA (Percutaneous Transluminal Coronary Angioplasty), the cath lab nurse knows which of the following actions must be completed prior to the start of the procedure. Select all that apply: 1. Patient teaching 2. Assess for allergies 3. Signed consent 4. Drink 100 mL of fluid one hour before procedure 5. Obtain CXR and ECG
What is 1,2,3,5: Pt teaching, assess for allergies, digned consent, obtain CXR & ECG
400
A patient with chronic stable angina is being discharged home from a step down cardiac unit. The nurse is educating the patient and his family on what to do if he begins experiencing chest pain at home. What actions should the nurse instruct them to do? (select all that apply) a. Immediately stop doing the action that precipitated the pain b. Begin CPR c. Give the prescribed Nitroglycerin SL Q5min x 3 d. Give the prescribed Capoten (Captopril) 12.5 mg PO e. Call 911 if the pain is not relieved by the nitroglycerin
What is A,C,E: Immediately stop doing the action that precipitated pain, give nitro, call 911 if pain is unrelieved
400
What is the first intervention for a patient experiencing a MI? A. Obtain an ECG B. Administer Sublingual Nitroglycerin C. Administer Morphine D. Administer Oxygen
What is D. Administer Oxygen
M
e
n
u