Adult II Exam #2

A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but over 100. The nurse determines that the client is experiencing:

• Premature ventricular contractions

• Ventricular tachycardia

• Ventricular fibrillation

• Sinus tachycardia

A nurse is viewing the cardiac monitor in a client’s room and notes that the client has just gone into ventricular tachycardia. The client is awake and alert and has good skin color. The nurse would prepare to do which of the following?

• Immediately defibrillate.

• Prepare for pacemaker insertion.

• Administer amiodarone (Cordarone) intravenously.

• Administer epinephrine (Adrenaline) intravenously.

A client is having frequent premature ventricular contractions. A nurse would place a priority on the assessment of which of the following items?

• Blood pressure and peripheral perfusion.

• Sensation of palpitations.

• Causative factors such as caffeine.

• Precipitating factors such as infection.

The nurse devises a teaching plan for the patient with aplastic anemia. Which of the following is the most important concept to teach for health maintenance?

• Eat animal protein and dark leafy vegetables each day.

• Avoid exposure to others with acute infection.

• Practice yoga and meditation to decrease stress and anxiety.

• Get 8 hours of sleep at night and take naps during the day.

A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart rate is 64 beats per minute. The nurse assesses the cardiac rhythm as:

• Normal sinus rhythm

• Sinus bradycardia

• Sick sinus syndrome

• First-degree heart block

The nurse would instruct the client to eat which of the following foods to obtain the best supply of vitamin B12?

• Whole grains

• Green leafy vegetables

• Meats and dairy products

• Broccoli and Brussels sprouts

The nurse understands that the client with pernicious anemia will have which of the following distinguishing laboratory findings?

• Schilling’s test elevated

• Intrinsic factor, absent

• Sedimentation rate, 16 mm/hour

• RBCs 5.0 million

Atherosclerosis impedes coronary blood flow by which of the following mechanisms?

• Plaques obstruct the vein.

• Plaques obstruct the artery.

• Blood clots form outside the vessel wall.

• Hardened vessels dilate to allow blood to flow through.

A client with pernicious anemia asks why she must take vitamin B12 injections for the rest of her life. What is the nurse’s best response?

• “The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient acid.”

• “The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient intrinsic factor.”

• “The reason for your vitamin deficiency is an excessive excretion of the vitamin because of kidney dysfunction.”

• “The reason for your vitamin deficiency is an increased requirement for the vitamin because of rapid red blood cell production.”

A client is to receive epoetin (Epogen) injections. What laboratory value should the nurse assess before giving the injection?

• Hematocrit

• Partial thromboplastin time

• Hemoglobin concentration

• Prothrombin time