WorksheetsNRSG 411 - Perfusion
Total questions: 27
Worksheet time: 29mins
A patient is receiving a drug that decreases afterload. To evaluate the patient’s response to this drug, what is most important for the nurse to assess?
Heart Rate
Lung Sounds
Blood Pressure
Jugular Vein Distention
Surgical closure of the ductus arteriosus would result in which of the following?
Stop the loss of unoxygenated blood to the systemic circulation
Decrease the edema in the legs and feet
Increase the oxygenation of blood
Prevent the return of oxygenated blood to the lungs
A young child with tetralogy of Fallot may assume a posturing position as a compensatory mechanism. The position automatically assumed by the child is:
Low Folwer's
Prone
Squatting
Supine
Which is considered a mixed cardiac defect?
Transposition of the Great Arteries
Patent Ductus Arteriosus
Atrial Septal Defect
Pulmonic Stenosis
Nursing care of the infant or child with congestive heart failure would include:
forcing fluids appropriate to age
monitoring respirations during active periods
organizing activities to allow for uninterrupted sleep
giving larger feedings less often to conserve energy
Nurses counseling parents regarding the home care of the child with a cardiac defect before corrective surgery should stress the:
importance of reducing caloric intake to decrease cardiac demands.
importance of relaxing discipline and limit-setting to prevent crying.
need to be extremely concerned about cyanotic spells.
desirability of promoting normalcy within the limits of the child’s condition.
The nurse applies the cardiac monitor to a patient in the ER complaining of dizziness, shortness of breath and feeling "horrible". Upon finding this rhythm, the nurse chooses what priority action to take?
Start chest compressions
Prepare to defibrillate
Start an IV with 3 way stop-cock
complete a health history
A patient is brought to the ER by ambulance after having a syncopal episode. The nurse notes right-sided facial droop, weak hand grasp of the right hand, and garbled speech. Which of the following actions does the nurse take? Select all that apply.
assess neurological status using the NIH stroke scale
start a large bore IV and apply oxygen as needed
attempt to have patient stand to assess leg strength
Give patient drink of water and monitor for s/s aspiration
alert radiology for need of stat CT scan of the head
The mother of an infant born with Tetralogy of Fallot calls you to the infants room voicing that her lips are blue. What priority action does the nurse take?
start CPR by giving 15 compressions and 1 breath
pick up the infant and hold upright
look to intubate the infant as soon as possible
push infants bent legs toward chest
The nurse in a telemetry unit notes a patient rhythm changes from NSR to this rhythm. What priority action does the nurse take first?
Apply oxygen via non-rebreather
Call a code blue to patient room
Assess patient for changes in condition
Nothing as this is normal
The nurse reads that the previous shift nurse documented the patient had a pulse deficit. The nurse interprets this to mean which of the following?
a large gap between systolic B/P and diastolic BP
the apical pulse is faster than the radial pulse
the apical pulse is less than 60 beats per minute
a drop in the systolic BP when standing
The nurse is admitting a patient who suffered a ischemic right hemisphere CVA to the rehab unit. Which of the following assessment findings does the nurse anticipate to see? Select all that apply
poor vision in the right eye
left-sided neglect
cautious, plodding behaviors
communication deficits
risk for aspiration
The nurse recognizes which of the following stroke patients as being a good candidate for thrombolytic therapy.
63 y/o female whose husband voices she was making supper 1 hour ago when she suddenly developed right sided paralysis, CT scan shows hemorrhagic are in brain
54 y/o male whose brother voices he found him lying on the floor of his house 20 minute ago, remains unconscious at this time, CT scan shows left hemisphere ischemic CVA
60 y/o male patient whose family voiced he started garbling his speech and having facial droop while out for supper 45 minutes ago, he has a history of A Fib, CT shows ischemic CVA of right hemisphere
58 y/o female who was reported to have sudden onset of right sided weakness and facial droop less than 30 minutes ago, has a history of MVC with head trauma 8 weeks ago, CT scan shows ischemic CVA
65 y/o female with syncopal episode 30 minutes ago witnesses by friends, left sided vision trouble, left sided facial droop, no arm or leg weakness, history of HTN, b/p now 139/84, CT scan with no acute changes noted
The nurse receives an order to initiate tPA therapy for a patient brought to the emergency department with s/s of CVA. Which of the following findings causes the nurse to questions this order?
Witness reports of onset of symptoms started 2 hours ago
history of chronic a fib with anticoagulant therpay
Continual worsening of stroke-like symptoms
cardiac catheterization for chest pain 3 days ago
A patient is receiving spironolactone (Aldactone) twice daily due to history of heart failure. The nurse will monitor the patient’s telemetry for which of the following?
peaked P waves
peaked T waves
narrow QRS complexes
ST segment depression
The home care nurse visits a patient with chronic heart failure who is taking digoxin (Lanoxin), metoprolol (Lopressor) and furosemide (Lasix). The patient complains of nausea, vomiting, and general malaise over the last 3 days. Which action will the nurse take first?
Perform a dipstick urine test for protein and specific gravity.
Assess the patient's apical pulse rate and rhythm.
Instruct the patient to eat foods high in potassium.
Ask the patient to see their daily weight recordings.
A patient with left-sided heart failure is prescribed oxygen at 4 L/min per nasal cannula, furosemide (Lasix), spironolactone (Aldactone), and enalapril (Vasotec). Which assessment should the nurse complete to best evaluate the patient’s response to these drugs?
Observe skin turgor
Auscultate lung sounds
Measure blood pressure
Review intake and output
The nurse takes blood pressures at a health fair. The nurse identifies which person as most at risk for developing hypertension?
A 52-year-old male who smokes and has a parent with hypertension
A 30-year-old female advertising agent who is unmarried and lives alone
A 68-year-old male who uses herbal remedies to treat an enlarged prostate gland
A 43-year-old female who travels extensively for work and exercises only on weekends
A patient’s blood pressure has not responded consistently to prescribed drugs for hypertension. What is the first cause of this lack of responsiveness the nurse should explore?
Progressive target organ damage.
The possibility of drug interactions.
The patient not adhering to therapy.
The patient’s possible use of recreational drugs.
A patient with stage 2 hypertension who is taking hydrochlorothiazide (HydroDiuril) and lisinopril (Prinivil) has prazosin (Minipress) added to the medication regimen. What is most important for the nurse to teach the patient to do?
Weigh every morning to monitor for fluid retention
Change position slowly and avoid prolonged standing
Use sugarless gum or candy to help relieve dry mouth
Take the pulse daily to note any slowing of the heart rate
Which initial physical assessment finding would the nurse expect to be present in a patient with acute left-sided heart failure?
Bubbling crackles and tachycardia
Hepatosplenomegaly and tachypnea
Peripheral edema and cool, diaphoretic skin
Frothy blood-tinged sputum and distended jugular veins
The nurse assesses the patient with chronic biventricular heart failure for paroxysmal nocturnal dyspnea (PND) by questioning the patient regarding
the presence of difficulty breathing at night.
frequent awakening to void during the night.
the presence of a dry, hacking cough when resting.
the use of two or more pillows to help breathing during sleep.
The nurse reviews the following vital signs recorded by an unlicensed assistive personnel (UAP) on a patient with acute decompensated heart failure: BP 98/60, HR 102 bpm, RR 24, Temp 98.2°F (36.7° C), SpO2 84% on 2 L/min via nasal cannula. What is the first action the nurse will take?
Initiate IV fluids.
Order ABG's
Elevate HOB
Increase O2 flow
A patient with chronic heart failure has atrial fibrillation and a left ventricular ejection fraction (LVEF) of 18%. To decrease the risk of complications from these conditions, what drug does the nurse anticipate giving?
Diuretics
Anticoagulants
β-Adrenergic blockers
Potassium supplements
When caring for the patient with heart failure, which medications or treatments require careful monitoring of the patient’s serum potassium level to prevent further cardiac dysrhythmia/dysfunction (select all that apply)?
Spironolactone (Aldactone)
Inamrinone (Inocor)
Furosemide (Lasix)
Metoprolol CR/XL (Toprol XL)
Enalapril (Vasotec)
While teaching women about the risks and incidence of CAD, what does the nurse emphasize?
Smoking is not as significant a risk factor for CAD in women as it is in men.
Women seek treatment sooner than men when they have symptoms of CAD.
Estrogen replacement therapy in postmenopausal women decreases the risk for CAD.
Increasing exercise and eating healthy have a significant value in preventing and treating CAD.
Which serum lipid elevation, along with elevated LDL, is strongly associated with CAD?
Apolipoproteins
Fasting triglycerides
Total serum cholesterol
High-density lipoprotein (HDL)
