Pharmacology and Diagnostic Tests in Cardiology: A Case Study, Exams of Nursing

Download Pharmacology and Diagnostic Tests in Cardiology: A Case Study and more Exams Nursing in PDF only on Docsity! NR 340 CRITICAL CARE NURSING Cardiac Concepts Latest Review Exam Q & A 2024 1. A patient with acute myocardial infarction is experiencing severe chest pain unrelieved by nitroglycerin. Which medication should the nurse anticipate administering? A. Morphine sulfate B. Atropine sulfate C. Furosemide D. Metoprolol Answer: A. Morphine sulfate Rationale: Morphine sulfate is an opioid analgesic that helps to decrease myocardial oxygen demand, reduce preload and afterload, and alleviate pain, which is crucial in the management of acute myocardial infarction. 2. During the assessment of a patient with pericarditis, the nurse expects to find which clinical manifestation? A. Jugular vein distention B. A friction rub C. Pulsus paradoxus D. Kussmaul's sign Answer: B. A friction rub Rationale: A friction rub is a classic sign of pericarditis and is caused by the inflamed layers of the pericardium rubbing against each other. 3. A nurse is caring for a patient post-cardiac catheterization. Which finding would require immediate intervention? A. A small hematoma at the catheter insertion site B. A pulse distal to the catheter insertion site C. Complaints of mild discomfort at the insertion site D. Bleeding from the catheter insertion site Answer: D. Bleeding from the catheter insertion site Rationale: Bleeding from the catheter insertion site can indicate vascular complications and requires immediate intervention to prevent significant blood loss and other complications. 4. When planning care for a patient with congestive heart failure, which goal is the priority? A. Enhance myocardial oxygenation B. Increase activity tolerance angina, which statement by the patient indicates a need for further education? A. "I will take nitroglycerin when I experience chest pain." B. "I will rest if I feel short of breath while exercising." C. "I will continue to smoke cigarettes to help me relax." D. "I will follow a low-sodium diet as recommended." Answer: C. "I will continue to smoke cigarettes to help me relax." Rationale: Smoking is a major risk factor for coronary artery disease and can exacerbate angina. Patients with chronic stable angina should be advised to quit smoking. 12. A patient with aortic stenosis reports increasing fatigue and dizziness. The nurse understands that these symptoms are most likely due to: A. Reduced cardiac output B. Pulmonary hypertension C. Peripheral edema D. Arrhythmias Answer: A. Reduced cardiac output Rationale: Aortic stenosis leads to obstruction of blood flow from the left ventricle, resulting in reduced cardiac output and symptoms such as fatigue and dizziness. 13. A nurse is caring for a patient who is receiving a beta-blocker. Which assessment finding would warrant holding the medication and notifying the physician? A. Blood pressure of 150/90 mmHg B. Heart rate of 48 bpm C. Respiratory rate of 18 breaths per minute D. Oxygen saturation of 96% Answer: B. Heart rate of 48 bpm Rationale: A heart rate of 48 bpm may indicate bradycardia, a potential side effect of beta-blockers, and warrants holding the medication and notifying the physician. 14. Which laboratory value is most important to monitor in a patient taking digoxin and diuretics? A. Sodium B. Potassium C. Calcium D. Magnesium Answer: B. Potassium Rationale: Hypokalemia can potentiate digoxin toxicity; therefore, monitoring potassium levels is crucial in patients taking digoxin and diuretics. 15. A nurse is assessing a patient with right-sided heart failure. Which finding is most characteristic of this condition? A. Pulmonary crackles B. Dependent edema C. Paroxysmal nocturnal dyspnea D. Orthopnea Answer: B. Dependent edema Rationale: Dependent edema is a classic sign of right-sided heart failure due to fluid retention and venous congestion in the systemic circulation. 1. Which of the following is a common complication in patients with acute myocardial infarction? A. Pulmonary embolism B. Disseminated intravascular coagulation C. Cardiogenic shock D. Cerebrovascular accident Answer: C. Cardiogenic shock Rationale: Cardiogenic shock is a common complication in patients with acute myocardial infarction due to the significant decrease in cardiac output and tissue perfusion. 2. What is the primary goal of treatment for a patient with decompensated heart failure? A. Improve oxygen saturation B. Decrease blood pressure C. Increase cardiac output D. Restore normal sinus rhythm Answer: C. Increase cardiac output Rationale: The primary goal of treatment for a patient with decompensated heart failure is to increase cardiac output to improve tissue perfusion. 3. Which of the following medications is commonly used in the treatment of ventricular tachycardia? A. Metoprolol B. Amiodarone C. Lisinopril D. Furosemide Answer: B. Amiodarone Rationale: Amiodarone is a commonly used antiarrhythmic medication in the treatment of ventricular tachycardia due to its effectiveness in restoring normal sinus rhythm. 4. What is the recommended treatment for a patient experiencing acute coronary syndrome with ST-segment elevation? A. Thrombolytic therapy B. Percutaneous coronary intervention (PCI) C. Coronary artery bypass grafting (CABG) D. Antiplatelet therapy Answer: B. Percutaneous coronary intervention (PCI) Rationale: Percutaneous coronary intervention (PCI) is the recommended treatment for patients experiencing acute coronary syndrome with ST-segment elevation to restore blood flow to the affected coronary artery. 5. Which of the following is a potential complication of an intra-aortic balloon pump (IABP) therapy? A. Pneumothorax B. Cardiac tamponade C. Thrombocytopenia D. Pulmonary embolism Answer: C. Thrombocytopenia Rationale: Thrombocytopenia is a potential complication of intra-aortic balloon pump (IABP) therapy due to increased platelet activation and consumption. fibrillation in patients with heart failure? A. Hypotension B. Hyperkalemia C. Left ventricular hypertrophy D. Sinus bradycardia Answer: C. Left ventricular hypertrophy Rationale: Left ventricular hypertrophy is a risk factor for the development of atrial fibrillation in patients with heart failure due to electrical remodeling and conduction abnormalities. 14. Which of the following medications is commonly used to reduce the risk of clot formation in patients with atrial fibrillation? A. Clopidogrel B. Warfarin C. Heparin D. Aspirin Answer: B. Warfarin Rationale: Warfarin is commonly used to reduce the risk of clot formation in patients with atrial fibrillation by inhibiting the synthesis of vitamin-K dependent clotting factors. 15. Which of the following hemodynamic parameters is indicative of cardiogenic shock in a patient with heart failure? A. High cardiac output B. Low systemic vascular resistance C. Low central venous pressure D. High pulmonary artery pressure Answer: D. High pulmonary artery pressure Rationale: High pulmonary artery pressure is indicative of cardiogenic shock in a patient with heart failure due to increased pulmonary congestion and right ventricular dysfunction. 16. What is the most appropriate intervention for a patient with a suspected tension pneumothorax complicating acute respiratory distress syndrome (ARDS)? A. Mechanical ventilation B. Chest tube insertion C. High-flow nasal cannula D. Positive end-expiratory pressure (PEEP) Answer: B. Chest tube insertion Rationale: Chest tube insertion is the most appropriate intervention for a patient with a suspected tension pneumothorax complicating acute respiratory distress syndrome (ARDS) to decompress the pleural space and improve oxygenation. 17. Which of the following laboratory values is indicative of sepsis- induced cardiomyopathy in a patient with severe sepsis? A. Elevated troponin B. Decreased B-type natriuretic peptide (BNP) C. Elevated white blood cell count D. Decreased serum lactate Answer: A. Elevated troponin Rationale: Elevated troponin is indicative of sepsis-induced cardiomyopathy in a patient with severe sepsis, reflecting myocardial injury and dysfunction. 18. What is the primary goal of fluid resuscitation in patients with septic shock? A. Increase urine output B. Restore intravascular volume C. Decrease blood pressure D. Improve tissue oxygenation Answer: D. Improve tissue oxygenation Rationale: The primary goal of fluid resuscitation in patients with septic shock is to improve tissue oxygenation by restoring intravascular volume and perfusion. 19. Which of the following interventions is indicated in the management of a patient with myocarditis complicating sepsis? A. Inotropic support B. Diuresis C. Mechanical ventilation D. Coronary artery bypass grafting (CABG) Answer: A. Inotropic support Rationale: Inotropic support is indicated in the management of a patient with myocarditis complicating sepsis to improve cardiac contractility and hemodynamic stability. 20. What is the most common cause of acute heart failure in patients with sepsis? A. Cardiogenic shock B. Volume overload C. Myocardial depression D. Arrhythmias Answer: C. Myocardial depression Rationale: Myocardial depression is the most common cause of acute heart failure in patients with sepsis, leading to decreased cardiac function and systemic hypoperfusion. 21. Which of the following diagnostic tests is most helpful in the evaluation of a patient with suspected acute aortic dissection? A. Chest X-ray B. Electrocardiogram (ECG) C. Transthoracic echocardiography D. Computed tomography (CT) angiography Answer: D. Computed tomography (CT) angiography Rationale: Computed tomography (CT) angiography is the most helpful diagnostic test in the evaluation of a patient with suspected acute aortic dissection due to its high sensitivity and specificity. 22. What is the primary goal of pharmacologic therapy for a patient with acute decompensated heart failure? A. Reduce cardiac preload B. Increase cardiac contractility C. Improve diastolic filling D. Decrease afterload Answer: A. Reduce cardiac preload Rationale: The primary goal of pharmacologic therapy for a patient with acute decompensated heart failure is to reduce cardiac preload by promoting diuresis and vasodilation. 23. Which of the following interventions is indicated in the management of a patient with tension pneumothorax complicating acute respiratory distress syndrome (ARDS)? Rationale: High Fowler's position helps improve oxygenation by reducing venous return and decreasing preload on the heart. Which ECG change is characteristic of an ST-elevation myocardial infarction (STEMI)? A. T-wave inversion B. Q-wave development C. ST-segment depression D. ST-segment elevation Answer: D. ST-segment elevation Rationale: ST-segment elevation is a hallmark ECG finding in STEMI, indicating myocardial injury. Which medication is commonly used to reduce myocardial oxygen demand in patients with angina pectoris? A. Aspirin B. Nitroglycerin C. Metoprolol D. Clopidogrel Answer: C. Metoprolol Rationale: Metoprolol is a beta-blocker that reduces heart rate and blood pressure, thus decreasing myocardial oxygen demand. Which hemodynamic parameter reflects the force of ventricular contraction? A. Cardiac output B. Stroke volume C. Ejection fraction D. Mean arterial pressure Answer: B. Stroke volume Rationale: Stroke volume represents the amount of blood ejected by the ventricle in each heartbeat, reflecting the force of contraction. Which type of shock is characterized by inadequate tissue perfusion despite adequate intravascular volume? A. Hypovolemic shock B. Cardiogenic shock C. Distributive shock D. Obstructive shock Answer: C. Distributive shock Rationale: Distributive shock results from systemic vasodilation leading to maldistribution of blood flow and impaired tissue perfusion. Which lab value is indicative of heart failure exacerbation in a patient with a history of chronic heart failure? A. Decreased B-type natriuretic peptide (BNP) B. Increased serum sodium levels C. Elevated serum creatinine D. Decreased troponin levels Answer: A. Decreased B-type natriuretic peptide (BNP) Rationale: BNP levels rise in response to increased ventricular stretch and volume overload in heart failure; a decrease indicates exacerbation. Which intervention is essential in the management of ventricular tachycardia (VT) with hemodynamic instability? A. Defibrillation B. Administering amiodarone C. Synchronized cardioversion D. Vagal maneuvers Answer: A. Defibrillation Rationale: Defibrillation is crucial in VT with hemodynamic instability to restore normal cardiac rhythm. Which electrolyte imbalance is commonly associated with the development of atrial fibrillation? A. Hyperkalemia B. Hypocalcemia C. Hypokalemia D. Hypernatremia Answer: C. Hypokalemia Rationale: Hypokalemia predisposes patients to atrial fibrillation due to alterations in cardiac conduction. What is the primary mechanism of action of angiotensin-converting enzyme (ACE) inhibitors in heart failure management? A. Vasodilation B. Diuresis C. Positive inotropy D. Antiarrhythmic effects Answer: A. Vasodilation Rationale: ACE inhibitors promote vasodilation, reduce afterload, and improve cardiac output in heart failure. Which diagnostic test is used to assess the structure and function of the heart through sound waves? A. Electrocardiogram (ECG) B. Cardiac catheterization C. Magnetic resonance imaging (MRI) D. Echocardiography Answer: D. Echocardiography Rationale: Echocardiography is a non-invasive test that provides detailed images of the heart's structure and function using sound waves. What is the main purpose of administering loop diuretics in patients with heart failure? D. Fatigue Answer: B. Shortness of breath Rationale: Dyspnea or shortness of breath is a common and hallmark symptom of ADHF due to pulmonary congestion. Which medication is indicated for the treatment of symptomatic bradycardia? A. Atropine B. Amiodarone C. Adenosine D. Lidocaine Answer: A. Atropine Rationale: Atropine is a vagolytic agent used to increase heart rate in symptomatic bradycardia. Which intervention is essential in the management of cardiac tamponade? A. Administering vasopressors B. Placing a chest tube C. Initiating thrombolytic therapy D. Performing pericardiocentesis Answer: D. Performing pericardiocentesis Rationale: Pericardiocentesis is the definitive treatment for cardiac tamponade by draining the pericardial fluid. Which complication can result from prolonged bed rest in patients with heart failure? A. Hypertension B. Orthostatic hypotension C. Hyperkalemia D. Hypervolemia Answer: B. Orthostatic hypotension Rationale: Prolonged bed rest can lead to orthostatic hypotension in patients with heart failure due to reduced cardiovascular compensatory mechanisms. Which factor is essential in preventing venous thromboembolism (VTE) in hospitalized patients with cardiac conditions? A. Early ambulation B. Restricting fluid intake C. Maintaining a high-fat diet D. Using pneumatic compression devices Answer: A. Early ambulation Rationale: Early ambulation helps prevent stasis and reduces the risk of VTE in hospitalized patients with cardiac conditions. Which statement is true regarding the assessment of a patient with suspected cardiac ischemia? A. Stress testing is the gold standard for diagnosis B. Echocardiography is used to confirm the presence of ischemia C. Cardiac catheterization is the initial diagnostic test D. The 12-lead ECG is the first-line tool for evaluation Answer: D. The 12-lead ECG is the first-line tool for evaluation Rationale: The 12-lead ECG is a rapid and essential tool in assessing patients with suspected cardiac ischemia to identify ST-segment changes and ischemic patterns.