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Exam 4 - Perfusion Questions and Answers 100% Accurate
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Exam of 15 pages for the course Perfusion at Perfusion (Exam 4 - Perfusion)
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Exam 4 - PerfusionAfter the nurse has finished teaching a patient about the use of sublingual nitroglycerin
(Nitrostat), which patient statement indicates that the teaching has been effective?
a. I can expect some nausea as a side effect of nitroglycerin.
b. I should only take the nitroglycerin if I start to have chest pain.
c. I will call an ambulance if I still have pain after taking 3 nitroglycerin 5 minutes apart.
d. Nitroglycerin helps prevent a clot from forming and blocking blood flow to my heart. -
answerC
The emergency medical services (EMS) system should be activated when chest pain or
other symptoms are not completely relieved after 3 sublingual nitroglycerin tablets taken
5 minutes apart. Nitroglycerin can be taken to prevent chest pain or other symptoms
from developing (e.g., before intercourse). Gastric upset (e.g., nausea) is not an
expected side effect of nitroglycerin. Nitroglycerin does not impact the underlying
pathophysiology of coronary artery atherosclerosis.
Heparin is ordered for a patient with a nonST-segment-elevation myocardial infarction
(NSTEMI). What is the purpose of the heparin?
a. Heparin enhances platelet aggregation.
b. Heparin decreases coronary artery plaque size.
c. Heparin prevents the development of new clots in the coronary arteries.
d. Heparin dissolves clots that are blocking blood flow in the coronary arteries. -
answerC
Heparin helps prevent the conversion of fibrinogen to fibrin and decreases coronary
artery thrombosis. It does not change coronary artery plaque, dissolve already formed
clots, or enhance platelet aggregation.
When titrating IV nitroglycerin (Tridil) for a patient with a myocardial infarction (MI),
which action will the nurse take to evaluate the effectiveness of the medication?
a. Monitor heart rate.
b. Ask about chest pain.
c. Check blood pressure.
d. Observe for dysrhythmias. - answerB
The goal of IV nitroglycerin administration in MI is relief of chest pain by improving the
balance between myocardial oxygen supply and demand. The nurse also will monitor
, heart rate and blood pressure (BP) and observe for dysrhythmias, but these parameters
will not indicate whether the medication is effective.
A patient with ST-segment elevation in three contiguous electrocardiographic (ECG)
leads is admitted to the emergency department (ED) and diagnosed as having an ST-
segment-elevation myocardial infarction (STEMI). Which question should the nurse ask
to determine whether the patient is a candidate for thrombolytic therapy?
a. Do you have any allergies?
b. Do you take aspirin on a daily basis?
c. What time did your chest pain begin?
d. Can you rate your chest pain using a 0 to 10 scale? - answerC
Thrombolytic therapy should be started within 6 hours of the onset of the myocardial
infarction (MI), so the time at which the chest pain started is a major determinant of the
appropriateness of this treatment. The other information will also be needed, but it will
not be a factor in the decision about thrombolytic therapy.
A patient is recovering from a myocardial infarction (MI) and develops chest pain on day
3 that increases when taking a deep breath and is relieved by leaning forward. Which
action should the nurse take next?
a. Assess the feet for pedal edema.
b. Palpate the radial pulses bilaterally.
c. Auscultate for a pericardial friction rub.
d. Check the heart monitor for dysrhythmias. - answerC
The patients symptoms are consistent with the development of pericarditis, a possible
complication of MI. The other assessments listed are not consistent with the description
of the patients symptoms.
A few days after experiencing a myocardial infarction (MI) and successful percutaneous
coronary intervention, the patient states, I just had a little chest pain. As soon as I get
out of here, I'm going for my vacation as planned. Which reply would be most
appropriate for the nurse to make?
a. What do you think caused your chest pain?
b. Where are you planning to go for your vacation?
c. Sometimes plans need to change after a heart attack.
d. Recovery from a heart attack takes at least a few weeks. - answerA
When the patient is experiencing denial, the nurse should assist the patient in testing
reality until the patient has progressed beyond this step of the emotional adjustment to
MI. Asking the patient about vacation plans reinforces the patients plan, which is not
appropriate in the immediate post-MI period. Reminding the patient in denial about the
MI is likely to make the patient angry and lead to distrust of the nursing staff.
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