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CNCM 418 > Altered Tissue Perfusion > Flashcards

Altered Tissue Perfusion Flashcards

1
Q
  1. A patient recently had a myocardial infarction and angiogram shows blockage in the left anterior descending (LAD) artery. You know that which of the following is true about this type of blockage?

A. The left anterior descending artery is least likely to be affected by coronary artery disease.
B. A blockage in the left coronary artery causes the least amount of damage to the heart muscle.
C. Left coronary artery blockage can cause posterior wall death which affects the right ventricle.
D. Left anterior descending artery blockages can cause anterior wall death which affects the left ventricle.

A

D. Left anterior descending artery blockages can cause anterior wall death which affects the left ventricle.

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2
Q
  1. A triage nurse received a patient with chief complaint of chest pain. You obtained a 12-lead EKG and identified the following ST elevations. What area of the heart does this represent?

A. Anterior
B. Septal
C. Lateral
D. Inferior

A

C. Lateral

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3
Q
  1. On an 12-lead ECG, the inferior view of the heart is represented with the following leads? *

A. I, AVL, V5, V6
B. II, III, AVF
C. V1, V2
D. V3, V4

A

B. II, III, AVF

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4
Q
  1. A patient being admitted with chest pain was given a cardiac enzyme test. Base on your initial interview the onset of chest pain started 3-4 hours ago. What is the most regarded marker and more specific for heart damage?

A. Myoglobin
B. Troponin I & T
C. CKMB
D. LDH

A

B. Troponin I & T

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5
Q
  1. Which of the following are typical signs and symptoms of left-sided heart failure? Select-all-that-apply:

A. Persistent cough
B. Peripheral edema
C. Crackles
D. Pulmonary edema
E. Ascites
F. Jugular venous distention

A

A. Persistent cough
C. Crackles
D. Pulmonary edema

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6
Q
  1. A 65 year old male presents to the ER with complaints of dyspnea, persistent cough, and unable to sleep at night due to difficulty breathing. Which of the following lab results confirm your suspicions of heart failure?

A. BNP 820
B. BUN 9
C. Troponin <0.02
D. K+ 5.6

A

A. BNP 820

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7
Q
  1. Which of the following diagnostic test/procedure is the most common test used to diagnosed cardiomyopathy?

A. Holter monitoring
B. Angiogram
C. Echocardiogram
D. Nuclear stress test

A

C. Echocardiogram

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8
Q
  1. The ventricle is unable to increase cardiac output because of the thickening of the heart muscle that obstruct blood flow. Therefore, blood backs up into the lungs causing the patient to experience shortness of breath. What type of heart failure does this statement describe?

A. Hypertrophic cardiomyopathy (HCM)
B. Dilated cardiomyopathy (DCM)
C. Restrictive cardiomyopathy (RCM)

A

A. Hypertrophic cardiomyopathy (HCM)

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9
Q
  1. A patient with left-sided heart failure is having difficulty of breathing. Which of the following is the most appropriate nursing intervention?

A. Perform chest percussion therapy.
B. Assist the patient in Semi-Fowler’s position.
C. Place the patient into High Fowler’s position.
D. Encourage the patient to cough and deep breathe.

A

C. Place the patient into High Fowler’s position.

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10
Q
  1. Which of the following is a late sign of heart failure?

A. Edema
B. Fatigue
C. Shortness of breath
D. Frothy-blood tinged sputum

A

D. Frothy-blood tinged sputum

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11
Q
  1. A patient with heart failure is taking Spironolactone. The patient is having EKG changes that presents with tall peaked T-waves. Which of the following lab results confirms these findings?

A. K+ 8.0
B. K+ 1.5
C. BNP 560
D. Na+ 135

A

A. K+ 8.0

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12
Q
  1. A patient reports having crushing chest pain that radiates to the jaw, neck and left arm. You administer sublingual nitroglycerin, hook to O2 support and obtain a 12 lead EKG. Which of the following EKG findings confirms your suspicion of a possible myocardial infraction?

A. QRS widening
B. Absent Q wave
C. ST segment elevation and marked Q wave
D. Absent P-wave

A

C. ST segment elevation and marked Q wave

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13
Q
  1. A patient is receiving treatment for an acute myocardial infarction. The nurse is closely monitoring the patient for signs and symptoms associated with cardiogenic shock. Which value below is associated with cardiogenic shock?

A. Troponin <0.01 ng/mL
B. Cardiac index 1.5 L/min/m2
C. Pulmonary capillary wedge pressure (PCWP) 10 mmHg
D. Central venous pressure (CVP) 4 mmHg

A

B. Cardiac index 1.5 L/min/m2

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14
Q
  1. After administering IV Nitroglycerine at 10mcg/min, the patient’s blood pressure decrease to 65/46. The patient is still having chest pain. What is your next nursing intervention?

A. Hold IV Nitroglycerin and notify the doctor immediately.
B. Continue IV Nitroglycerin and monitor the patient’s blood pressure.
C. Administer Morphine IV as ordered and observe.
D. All of the options are correct.

A

A. Hold IV Nitroglycerin and notify the doctor immediately.

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15
Q
  1. A patient who has cardiogenic shock is experiencing labored breathing and low oxygen levels. The x-ray results show pulmonary edema. The physician orders Furosemide 40mg IV. What finding would require immediate nursing action?

A. Heart rate 110 bpm
B. Potassium 1.8 mEq/L
C. Urinary output 45 mL/hr
D. Blood pressure 98/54

A

B. Potassium 1.8 mEq/L

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16
Q
  1. A patient diagnose with heart failure is taking Digoxin for one week. He is experiencing severe bradycardia, nausea, vomiting, and seeing yellowish- green halos around the lights. A lab result shows that the Digoxin level is 4 ng/mL. What medication do you anticipate the physician to order for this patient?

A. Aminophylline
B. Narcan
C. Activated charcoal
D. Digibind or Digoxin immune fab

A

D. Digibind or Digoxin immune fab

17
Q
  1. These drugs are used as first-line treatment of heart failure. They work by allowing more blood to flow to the heart which decreases the work load of the heart and allows the kidneys to secrete sodium.

A. Vasodilators
B. Beta-blockers
C. Angiotensin II receptor blockers
D. Angiotensin-converting-enzyme (ACE) inhibitors

A

D. Angiotensin-converting-enzyme (ACE) inhibitors

18
Q
  1. An initial daily dosage of 100 mg of Aldactone (Spironolactone) is administered for five days to your patient with congestive heart failure. Which of the following is a common side effect of Spironolactone?

A. Dry cough
B. Renal failure
C. Hypokalemia
D. Hyperkalemia

A

D. Hyperkalemia

19
Q
  1. ACE inhibitors work to decrease the workload on the heart by blocking the conversion of Angiotensin I to Angiotensin II to prevent vasoconstriction. Thus, relaxes the blood vessels and decreases blood pressure. *

True
False

A

True

20
Q
  1. Which of the following is contraindicated to fibrinolytic therapy? Select- all-that-apply.

Intracranial hemorrhage within 3 months
Bleeding disorders
Suspected aortic dissection
Closed head and facial trauma

A

ALL OF THE ABOVE

21
Q
  1. Which medication is administered to a patient with atrial fibrillation to prevent blood from clotting?

A. Morphine Sulfate
B. Betablockers
C. Diuretics
D. Anticoagulant

A

D. Anticoagulant

22
Q
  1. Dobutamine IV infusion at 5mcg/kg/min is started for the patient with heart failure because of the following reason:

A. To decrease afterload, preload, BP and increase CO
B. To decrease intravascular and extravascular fluid volume
C. To increase myocardial contractility, stroke volume, heart rate and decrease SVR
D. To increase myocardial contractility and decrease heart rate

A

C. To increase myocardial contractility, stroke volume, heart rate and decrease SVR

23
Q
  1. A procedure of which a technique is used to dilate an area of arterial blockage with the help of a catheter that has an inflatable small sausage balloon at its tip.

A. Coronary Artery Bypass Graft
B. Angiogram
C. Percutaneous Transluminal Coronary Angioplasty
D. Fibrinolytic therapy

A

C. Percutaneous Transluminal Coronary Angioplasty

24
Q
  1. A pacing device that is an electronic, battery-powered device that is surgically implanted under the skin.

A. Mechanical assist device
B. Biventricular pacing
C. Cardiac monitor
D. Automated external defibrillator

A

B. Biventricular pacing

25
Q
  1. A surgical procedure that involves taking a blood vessel from another part of the body (usually the chest, leg or arm) and attaching it to the aorta and to the coronary artery below the narrowed area or blockage.

A. Cardiac transplantation
B. Coronary Artery Bypass Graft (CABG)
C. Surgical septal myectomy
D. Septal ablation

A

B. Coronary Artery Bypass Graft (CABG)

CNCM 418 (5 decks)

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