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Exam (elaborations) GNRS 555-CARDIOVASCULAR
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GNRS 555-CARDIOVASCULAR REAL EXAM2024-2025 LATEST VERSION 120
QUESTIONS AND CORRECT
ANSWERS//ALRE
,Which of the following is correct about ventricular tachycardia?
a. It always comes with no pulse.
b. It is a regular rhythm.
c. It has narrow QRS.
d. It is clinically significant. - CORRECT ANSWERS-d. It is clinically significant.
Which of the following is not true about ventricular fibrillation?
a. It is always irregular.
b. It is always pulseless.
c. It is a lethal dysrhythmia.
d. Atropine is the drug of choice of ventricular fibrillation. - CORRECT ANSWERS-d.
Atropine is the drug of choice of ventricular fibrillation.
T/F: The most serious dysrhythmias of all are the ventricular ones. - CORRECT
ANSWERS-true
During assessment of a 72-year-old with ankle swelling, the nurse notes jugular venous
distention (JVD) with the head of the patient's bed elevated 45 degrees. The nurse
knows this finding indicates:
a. decreased fluid volume.
b. jugular vein atherosclerosis.
c. elevated right atrial pressure.
d. incompetent jugular vein valves. - CORRECT ANSWERS-c. elevated right atrial
pressure.
reason: The jugular veins empty into the superior vena cava and then into theright
atrium, so JVD with the patient sitting at a 45-degree anglereflects elevated right atrial
pressure. JVD is an indicator ofexcessive fluid volume (increased preload), not
decreased fluid volume.JVD is not caused by incompetent jugular vein valves or
atherosclerosis.
The nurse is caring for a patient who is receiving IV furosemide (Lasix) and morphine
for the treatment of acute decompensated heart failure (ADHF) with severe orthopnea.
When evaluating the patient response to the medications, the best indicator that the
treatment has been effective is:
a. weight loss of 2 pounds overnight.
b. hourly urine output greater than 60 mL.
c. reduction in patient complaints of chest pain.
, d. decreased dyspnea with the head of bed at 30 degrees. - CORRECT ANSWERS-d.
decreased dyspnea with the head of bed at 30 degrees.
reason: Because the patient's major clinical manifestation of ADHF is orthopnea
(caused by the presence of fluid in the alveoli), the best indicator that the medications
are effective is a decrease in dyspnea with the head of the bed at 30 degrees. The other
assessment data also may indicate that diuresis or improvement in cardiac output has
occurred but are not as specific to evaluating this patient's response.
Intravenous sodium nitroprusside (Nipride) is ordered for a patient with acute pulmonary
edema. During the first hours of administration, the nurse will need to adjust the
nitroprusside rate if the patient develops:
a. a dry, hacking cough.
b. any ventricular ectopy.
c. a systolic BP <90 mm Hg.
d. a heart rate <50 beats/minute. - CORRECT ANSWERS-c. a systolic BP <90 mm Hg.
reason: Sodium nitroprusside is a potent vasodilator, and the major adverse effect is
severe hypotension. Coughing and bradycardia are not adverse effects of this
medication. Nitroprusside does not cause increased ventricular ectopy.
A patient who has chronic heart failure tells the nurse, "I felt fine when I went to bed, but
I woke up in the middle of the night feeling like I was suffocating!" The nurse will
document this assessment information as:
a. pulsus alternans.
b. two-pillow orthopnea.
c. acute bilateral pleural effusion.
d. paroxysmal nocturnal dyspnea. - CORRECT ANSWERS-d. paroxysmal nocturnal
dyspnea.
reason: Paroxysmal nocturnal dyspnea is caused by the reabsorption of fluid from
dependent body areas when the patient is sleeping and is characterized by waking up
suddenly with the feeling of suffocation. Pulsus alternans is the alternation of strong and
weak peripheral pulses during palpation. Orthopnea indicates that the patient is unable
to lie flat because of dyspnea. Pleural effusions develop over a longer time period.
During a visit to a 72-year-old with chronic heart failure, the home care nurse finds that
the patient has ankle edema, a 2-kg weight gain, and complains of "feeling too tired to
do anything." Based on these data, the best nursing diagnosis for the patient is:
a. activity intolerance related to fatigue.
b. disturbed body image related to leg swelling.
c. impaired skin integrity related to peripheral edema.
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