The nurse is reviewing a new prescription for propranolol (Inderal) for a patient with coronary heart disease (CHD). The nurse should call the physician and question this prescription if the patient's history includes what information?
1. taking antioxidants
2. taking simvastatin (Zocor)
3. as...
NURS 405 - Exam 1 (100% Verified Answers)
The nurse is reviewing a new prescription for propranolol (Inderal) for a patient with coronary heart disease (CHD). The nurse should call the physician and question this prescription if the patient's history includes what information?
1. taking antioxidants
2. taking simvastatin (Zocor)
3. asthma and chronic obstructive pulmonary disease (COPD)
4. bleeding disorders correct answers 3
Class II beta-blockers such as propranolol are used to reduce heart rate and myocardial contractility and in the treatment of supraventricular tachycardia. These drugs may cause bronchospasm and are contraindicated for patients with asthma, chronic obstructive pulmonary disease (COPD), or other restrictive or obstructive lung diseases. Antioxidants and simvastatin may be taken concurrently with propranolol. Bleeding disorders are not associated with propranolol use.
The nurse is reviewing an electrocardiogram (ECG) 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/minute. What should the nurse interpret these findings as indicating? 1. sinus bradycardia
2. sick sinus syndrome
3. normal heart function
4. first-degree heart block correct answers 3
All the measurements are within normal limits. The PR and QRS measurements are normal, measuring 0.12 to 0.20 second and 0.06 to 0.10 second respectively. There is not enough information to determine if the patient is experiencing sick sinus syndrome or first-degree heart block. Bradycardia is a heart rate of less than 60 beats per minute.
The patient's ECG shows the following characteristics: PR interval .08, QRS .08, and isoelectric ST segment. The nurse realizes that these characteristics indicate which finding?
1. faster than normal conduction from the SA node to the ventricles, faster than normal conduction through the ventricles, and normal ST segment
2. faster than normal conduction from the SA node to the ventricles, normal conduction through the ventricles, and normal ST segment
3. normal conduction from the SA node to the ventricles, normal conduction through the ventricles, and normal ST segment
4. normal conduction from the SA node to the ventricles, normal conduction through the ventricles, and abnormal ST segment correct answers 2
The PR interval is normally 0.12 second (up to 0.24 second is considered normal in patients over
age 65). PR intervals greater than 0.20 second indicate a delay in conduction from the SA note to
the ventricles. The normal duration of a QRS complex is from 0.06 to 0.10 second. QRS complexes greater than 0.10 second indicate delays in transmitting the impulse through the ventricular conduction system. The ST segment, the period from the end of the ARS complex to the beginning of the T wave, should be isoelectric. The ST segment, the period from the end of the ARS complex to the beginning of the T wave, should be isoelectric.
The nurse is reviewing the anatomy of the heart with a patient scheduled for a cardiac catheterization. What should the nurse explain as the primary factor that regulates blood flow through the coronary arteries?
1. blood pressure in the aorta
2. blood vessel dilation
3. low-pressure systemic circulation
4. draining of blood into the coronary sinus by the coronary veins correct answers 1.
Blood flow through the coronary arteries is primarily regulated by the aortic blood pressure. Blood vessel dilation is a secondary factor that regulates blood flow through the coronary arteries. The systemic circulation is a high-pressure circulation system. Draining of blood into the coronary sinus by the coronary veins does not regulate blood flow through the coronary arteries.
The nurse is explaining cardiac reserve to a patient recovering from a myocardial infarction. Which example should the nurse use to explain this term? 1. breathing in through the nose and out the mouth while sitting quietly
2. getting on a treadmill and gradually increasing the pace of walking
3. sitting in a chair to cool down after completing an exercise routine
4. at the end of systole, approximately 50 mL of blood remaining in the ventricles correct answers 2
The heart's ability to respond to the body's changing need for cardiac output is called cardiac reserve. Increasing the pace of walking would place demand on the heart to increase blood flow. The other actions do not place demand on the heart and therefore do not illustrate cardiac reserve.
Question 7
Type: MCSA
A patient being evaluated for cardiac pathology asks the nurse why sodium, calcium, and potassium are so important in the diet. What is the nurse's best response?
1. "Because you are on potassium supplements, it is important to monitor electrolytes."
2. "Heart rate is affected by the oxygen levels in your body, which involves the attachment of oxygen molecules to these electrolytes."
3. "The action potentials of the heart muscle cells are dependent on the diffusion of sodium, potassium, and calcium across the cell membrane."
4. "It is the pacemaker of your heart that is responsible for the heartbeat." correct answers 3
Action potentials of the cardiac muscle involve shifts in potassium, calcium, and sodium across the cell membrane. There is not enough data to justify a response about potassium supplements. Oxygen molecules attach to the hemoglobin molecule, not electrolytes. The pacemaker is responsible for the heartbeat, but this response does not address the patient's question.
The nurse is planning to calculate a patient's cardiac index (CI). What physical assessment data does the nurse need to make this calculation? 1. weight and height
2. weight only
3. weight and waist measurement
4. waist measurement and height correct answers 1
Cardiac index (CI) is the cardiac output adjusted for body size or body surface area. Body surface area is calculated using height and weight measurements. The waist measurement is not needed to calculate CI.
When auscultating the chest of a 75-year-old patient who recently experienced a myocardial infarction (MI), the nurse hears an S3 heart sound immediately following S2. Because of this finding, the nurse should assess for which other condition?
1. extension of the MI
2. renal failure
3. liver failure
4. heart failure correct answers 4
A pathologic S3 (a third heart sound that immediately follows S2, called a ventricular gallop) results from myocardial failure and ventricular volume overload such as heart failure. Manifestations of MI extension include chest pain and a return of positive laboratory findings (CPK-MB and troponin). This heart sound is not associated with renal or liver failure.
cardiac output correct answers is the stroke volume x the number of heart beats a minute
A patient is scheduled for a pericardiocentesis. Which health problem is the patient likely experiencing? 1. slow heart rhythm
2. chest pain
3. suspected damage to a heart valve
4. cardiac tamponade correct answers 4
In the case of cardiac tamponade, pericardiocentesis is considered an emergency procedure. It is done to remove fluid from the pericardial sac, which is preventing the heart from pumping blood effectively. This procedure would not be recommended for patients with chest pain, slow heart rhythm, or suspected damage to a heart valve.
The patient is being evaluated for left atrium thrombus due to a dysrhythmia. Which diagnostic test should the nurse expect to be prescribed for this patient? 1. transesophageal echocardiography (TEE)
2. pericardiocentesis
3. cardiac catheterization
4. computed tomography (CT) correct answers 1.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Mansanto. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.59. You're not tied to anything after your purchase.
