AACN practice test
which finding is most consistent with an acute elevation in left ventricular filling
pressure? - Answers -bibasilar crackles
when pressure in the LV increases suddenly, fluid is forced into the alveoli by an
increase in hydrostatic pressure
following ACS affecting the anterior wall, a patient develops SOB. Assessment reveals
moist bibasilar crackles and a moderately loud S3. a PAC is inserted and a PAOP of 22
is obtained. these findings are most indicative of - Answers -left ventricular
decompensation
this patient has a risk factor for and signs of LV failure (anterior MI). A rise in the PAOP
and S3 is reflective of increased LVED pressure. when pressure in the LV increases
suddenly, fluid is forced into the alveoli by an increase in hydrostatic pressure
a patient with AMI develops a new 4/6 holosystolic murmur and quickly progresses to
cardiogenic shock. which should the nurse anticipate? - Answers -preparation for a TEE
the new onset of a murmur with AMI is a sign of papillary muscle rupture. an
echocardiogram will diagnose this rupture
a patient with WPW is given verapamil and becomes unconscious with a wide complex
tachycardia, a weak pulse, and hypotension. what should the nurse do initially? -
Answers -prepare for synchronized cardioversion
verapamil blocked the AV node but not the pathway of WPW. the S/E of verapamil is
hypotension and the patient has become unstable. emergency synchronized
cardioversion is necessary. the patient has a pulse so defibrillation is not required, amio
is given for patients without a pulse
a patient is admitted with chest heaviness, muffled heart sounds, JVD, and hypotension
following a stab wound to the chest. for which should the nurse initially prepare the
patient? - Answers -echocardiogram
this patient is at risk for and has symptoms for cardiac tamponade. the diagnosis is
most accurately made with an echocardiogram.
in the treatment of dilated cardiomyopathy, appropriate drug therapy should be aimed at
- Answers -decreasing afterload and decreasing preload
, the patient has systolic dysfunction. chronic heart failure due to dilated cardiomyopathy
(systolic dysfunction) is managed by diuresis, afterload reduction and inotropes as
needed. increased afterload will increase cardiac workload and worsen heart failure
symptoms, as will increasing preload
a patient is admitted following aortic valve replacement. for which rhythm should the
nurse monitor for? - Answers -second degree AV block type 2
following aortic valve replacement, patients may develop an AV block due to edema,
inflammation, hemorrhage, or suturing near node
a nurse is caring for a patient admitted with myocardial ischemia. the patient has a
history of anxiety and hypothyroidism and is currently taking cyclic antidepressants. the
nurse observes a QT interval of 0.48 seconds and should monitor closely for - Answers
-torsades
torsades is a ife threatening dysrhythmia often associated with a prolonged QT interval
and can result in sudden death.
a patient is admitted complaining of crushing chest pain, which began 2 hours ago. an
ekg shows ST elevation in leads V2-V4 which is treated with a PCI procedure to the
LAD. following the procedure the patient develops oliguria and bilateral, diffuse
crackles. which hemodynamic findings should be expected at this point? - Answers -BP
80/50, CO 3.8, SVR 2200, PAP 40/24
the patient had an anterior infarction, which predisposes the development of LV
failure/cardiogenic shock. the hemodynamic data of BP 80/50, CO 3.8, SVR 2200, and
PAP 40/24 are consistent with LV failure/cardiogenic shock
a patient with a history of HTN and renal failure reports a headache that did not respond
to OTC medication. VS are BP 210/126, HR 106, RR 22. which should the nurse
anticipate? - Answers -labetalol
labetalol is beneficial in the treatment of HTN emergencies and does not have warnings
associated with renal failure. nitroprusside puts the patient at risk for cyanide toxicity.
which can be an effect of positive pressure ventilation? - Answers -decrease in CO2
respiratory alkalosis (low CO2) may result from excessive mechanical ventilation. as
pulmonary ventilation increases, excessive CO2 is exhaled
a nurse is preparing a patient with a tracheal perforation for surgery and notices sudden
hypotension, tachycardia, LOC and auscultates a loud machinery-like heart murmur
(mill wheel heart murmur). what should the nurse do initially? - Answers -place the
patient in trendelenberg with left decubitus tilt
which finding is most consistent with an acute elevation in left ventricular filling
pressure? - Answers -bibasilar crackles
when pressure in the LV increases suddenly, fluid is forced into the alveoli by an
increase in hydrostatic pressure
following ACS affecting the anterior wall, a patient develops SOB. Assessment reveals
moist bibasilar crackles and a moderately loud S3. a PAC is inserted and a PAOP of 22
is obtained. these findings are most indicative of - Answers -left ventricular
decompensation
this patient has a risk factor for and signs of LV failure (anterior MI). A rise in the PAOP
and S3 is reflective of increased LVED pressure. when pressure in the LV increases
suddenly, fluid is forced into the alveoli by an increase in hydrostatic pressure
a patient with AMI develops a new 4/6 holosystolic murmur and quickly progresses to
cardiogenic shock. which should the nurse anticipate? - Answers -preparation for a TEE
the new onset of a murmur with AMI is a sign of papillary muscle rupture. an
echocardiogram will diagnose this rupture
a patient with WPW is given verapamil and becomes unconscious with a wide complex
tachycardia, a weak pulse, and hypotension. what should the nurse do initially? -
Answers -prepare for synchronized cardioversion
verapamil blocked the AV node but not the pathway of WPW. the S/E of verapamil is
hypotension and the patient has become unstable. emergency synchronized
cardioversion is necessary. the patient has a pulse so defibrillation is not required, amio
is given for patients without a pulse
a patient is admitted with chest heaviness, muffled heart sounds, JVD, and hypotension
following a stab wound to the chest. for which should the nurse initially prepare the
patient? - Answers -echocardiogram
this patient is at risk for and has symptoms for cardiac tamponade. the diagnosis is
most accurately made with an echocardiogram.
in the treatment of dilated cardiomyopathy, appropriate drug therapy should be aimed at
- Answers -decreasing afterload and decreasing preload
, the patient has systolic dysfunction. chronic heart failure due to dilated cardiomyopathy
(systolic dysfunction) is managed by diuresis, afterload reduction and inotropes as
needed. increased afterload will increase cardiac workload and worsen heart failure
symptoms, as will increasing preload
a patient is admitted following aortic valve replacement. for which rhythm should the
nurse monitor for? - Answers -second degree AV block type 2
following aortic valve replacement, patients may develop an AV block due to edema,
inflammation, hemorrhage, or suturing near node
a nurse is caring for a patient admitted with myocardial ischemia. the patient has a
history of anxiety and hypothyroidism and is currently taking cyclic antidepressants. the
nurse observes a QT interval of 0.48 seconds and should monitor closely for - Answers
-torsades
torsades is a ife threatening dysrhythmia often associated with a prolonged QT interval
and can result in sudden death.
a patient is admitted complaining of crushing chest pain, which began 2 hours ago. an
ekg shows ST elevation in leads V2-V4 which is treated with a PCI procedure to the
LAD. following the procedure the patient develops oliguria and bilateral, diffuse
crackles. which hemodynamic findings should be expected at this point? - Answers -BP
80/50, CO 3.8, SVR 2200, PAP 40/24
the patient had an anterior infarction, which predisposes the development of LV
failure/cardiogenic shock. the hemodynamic data of BP 80/50, CO 3.8, SVR 2200, and
PAP 40/24 are consistent with LV failure/cardiogenic shock
a patient with a history of HTN and renal failure reports a headache that did not respond
to OTC medication. VS are BP 210/126, HR 106, RR 22. which should the nurse
anticipate? - Answers -labetalol
labetalol is beneficial in the treatment of HTN emergencies and does not have warnings
associated with renal failure. nitroprusside puts the patient at risk for cyanide toxicity.
which can be an effect of positive pressure ventilation? - Answers -decrease in CO2
respiratory alkalosis (low CO2) may result from excessive mechanical ventilation. as
pulmonary ventilation increases, excessive CO2 is exhaled
a nurse is preparing a patient with a tracheal perforation for surgery and notices sudden
hypotension, tachycardia, LOC and auscultates a loud machinery-like heart murmur
(mill wheel heart murmur). what should the nurse do initially? - Answers -place the
patient in trendelenberg with left decubitus tilt
