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Cardio
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Cardio
2/11/14 10:33 AM
d. Has the same mechanism of action as Heparin, and the crossover time is
needed for the serum level of warfarin to be therapeutic.
10. A 60-year-old male client comes into the emergency department
with complaints of crushing chest pain that radiates to his shoulder
and left arm. The admitting diagnosis is acute myocardial infarction.
Immediate admission orders include oxygen by NC at 4L/minute,
blood work, chest x-ray, an ECG, and 2mg of morphine given
intravenously. The nurse should first:
a. Administer the morphine
b. Obtain a 12-lead ECG
c. Obtain the lab work
d. Order the chest x-ray
11. When administered a thrombolytic drug to the client
experiencing an MI, the nurse explains to him that the purpose of
this drug is to:
a. Help keep him well hydrated
b. Dissolve clots he may have
c. Prevent kidney failure
d. Treat potential cardiac arrhythmias.
12. When interpreting an ECG, the nurse would keep in mind which
of the following about the P wave? Select all that apply.
a. Reflects electrical impulse beginning at the SA node
b. Indicated electrical impulse beginning at the AV node
c. Reflects atrial muscle depolarization
d. Identifies ventricular muscle depolarization
e. Has duration of normally 0.11 seconds or less.
13. A client has driven himself to the ER. He is 50 years old, has a
history of hypertension, and informs the nurse that his father died of
a heart attack at 60 years of age. The client is presently complaining
of indigestion. The nurse connects him to an ECG monitor and begins
administering oxygen at 2 L/minute per NC. The nurses next action
would be to:
a. Call for the doctor
b. Start an intravenous line
c. Obtain a portable chest radiograph
d. Draw blood for laboratory studies
14. The nurse receives emergency laboratory results for a client with
chest pain and immediately informs the physician. An increased
myoglobin level suggests which of the following?
a. Cancer
b. Hypertension
c. Liver disease
d. Myocardial infarction
15. When teaching a client about propranolol hydrochloride, the
nurse should base the information on the knowledge that
propranolol hydrochloride:
a. Blocks beta-adrenergic stimulation and thus causes decreased heart rate,
myocardial contractility, and conduction.
b. Increases norepinephrine secretion and thus decreases blood pressure
and heart rate.
c. Is a potent arterial and venous vasodilator that reduces peripheral
vascular resistance and lowers blood pressure.
d. Is an angiotensin-converting enzyme inhibitor that reduces blood pressure
by blocking the conversion of angiotensin I to angiotensin II.
16. The most important long-term goal for a client with hypertension
would be to:
a. Learn how to avoid stress
b. Explore a job change or early retirement
c. Make a commitment to long-term therapy
d. Control high blood pressure
17. Hypertension is known as the silent killer. This phrase is
associated with the fact that hypertension often goes undetected
until symptoms of other system failures occur. This may occur in the
form of:
a. Cerebrovascular accident
b. Liver disease
c. Myocardial infarction
d. Pulmonary disease
18. During the previous few months, a 56-year-old woman felt brief
twinges of chest pain while working in her garden and has had
frequent episodes of indigestion. She comes to the hospital after
experiencing severe anterior chest pain while raking leaves. Her
Cardio Answers
2/11/14 10:33 AM
value, the therapeutic range for this individual would be 16.5 to 22 seconds.
Therefore the result is within therapeutic range.
9. ANSWER B. Warfarin works in the liver and inhibits synthesis of four
vitamin K-dependent clotting factors (X, IX, VII, and II), but it takes 3 to 4
days before the therapeutic effect of warfarin is exhibited.
10. ANSWER A. Although obtaining the ECG, chest x-ray, and blood work
are all important, the nurses priority action would be to relieve the crushing
chest pain.
11. ANSWER B. Thrombolytic drugs are administered within the first 6
hours after onset of a MI to lyse clots and reduce the extent of myocardial
damage.
12. ANSWERS A, C, E. In a client who has had an ECG, the P wave
represents the activation of the electrical impulse in the SA node, which is
then transmitted to the AV node. In addition, the P wave represents atrial
muscle depolarization, not ventricular depolarization. The normal duration of
the P wave is 0.11 seconds or less in duration and 2.5 mm or more in
height.
13. ANSWER B. Advanced cardiac life support recommends that at least
one or two intravenous lines be inserted in one or both of the antecubital
spaces. Calling the physician, obtaining a portable chest radiograph, and
drawing blood are important but secondary to starting the intravenous line.
14. ANSWER D. Detection of myoglobin is one diagnostic tool to determine
whether myocardial damage has occurred. Myoglobin is generally detected
about one hour after a heart attack is experienced and peaks within 4 to 6
hours after infarction (Remember, less than 90 mg/L is normal).
15. ANSWER A. Propranolol hydrochloride is a beta-adrenergic blocking
agent. Actions of propranolol hydrochloride include reducing heart rate,
decreasing myocardial contractility, and slowing conduction.
16. ANSWER C. Compliance is the most critical element of hypertensive
therapy. In most cases, hypertensive clients require lifelong treatment and
their hypertension cannot be managed successfully without drug therapy.
Stress management and weight management are important components of
hypertension therapy, but the priority goal is related to compliance.
17. ANSWER A. Hypertension is referred to as the silent killer for adults,
because until the adult has significant damage to other systems, the
hypertension may go undetected. CVAs can be related to long-term
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