Question 1

The nurse is preparing medications for a patient experiencing an acute myocardial infarction.Which medication will dilate the patient's coronary blood vessels?

Accepted Answer

Nitroglycerin is a vasodilator that dilates the coronary blood vessels, increasing blood flow to the heart muscle and reducing the workload of the heart. It is commonly used in the treatment of acute myocardial infarction. Heparin and fibrinolytics are used to prevent or dissolve blood clots, while beta blockers are used to slow down the heart rate and reduce blood pressure.

Question 2

A patient with cardiogenic shock has an intra-aortic balloon pump (IABP).What should the nurse include when caring for this patient?

Accepted Answer

The affected leg should be kept straight at all times to prevent displacement of the intra-aortic balloon pump catheter and ensure proper functioning.

Question 3

The nurse notes that a patient with cardiomyopathy has been prescribed an angiotensin-converting enzyme inhibitor.What is the purpose of this medication?

Accepted Answer

The purpose of an angiotensin-converting enzyme (ACE) inhibitor is to reduce the afterload on the heart. ACE inhibitors work by blocking the conversion of angiotensin I to angiotensin II, which leads to vasodilation and decreased resistance in the blood vessels. This reduces the workload on the heart and can improve cardiac function in patients with cardiomyopathy. ACE inhibitors do not directly improve heart muscle contractions, reduce fluid accumulation in the lungs, or decrease sympathetic response to decreased cardiac output.

Question 4

During a home visit the nurse notes that a patient recovering from an acute myocardial infarction has not had medication prescriptions filled at the pharmacy.What should the nurse say in response to this observation?

Accepted Answer

It is important for the nurse to explain the rationale behind the medication regimen to the patient. The medications prescribed can help treat the current health problem and prevent future events, such as another acute myocardial infarction. The nurse should emphasize the importance of filling the medication prescriptions as soon as possible to ensure proper treatment. Choices A, B, and C do not address the importance of medication adherence and may lead to noncompliance.

Question 5

The nurse is preparing to obtain a pulmonary artery wedge pressure (PAWP)on a patient.What action should be taken to ensure for the patient's safety?

Accepted Answer

Inflate the balloon with 1.5 mL of air to obtain an accurate PAWP reading and ensure patient safety.

Question 6

A patient in the intensive care unit is experiencing chest pain.What assessment finding indicates that cardiogenic shock is being compensated?

Accepted Answer

Increased heart rate indicates that the body is trying to compensate for reduced cardiac output in cardiogenic shock. Hypotension, absent urine output, and mottled and cyanotic skin are all signs of decompensation and worsening shock.

Question 7

The nurse instructs a patient recovering from an acute myocardial infarction on the Life's Simple 7 actions.Which patient statement indicates that additional teaching is required?

Accepted Answer

The answer of The nurse instructs a patient recovering from...

Question 8

The nurse wants to evaluate a patient's right heart preload.Which approach should be used to obtain this measurement?

Accepted Answer

The best approach to evaluate a patient's right heart preload is by measuring the central venous pressure (CVP). CVP reflects the pressure in the right atrium and is a reflection of right heart preload. It is obtained by inserting a catheter into a central vein, such as the subclavian or jugular vein. Option A is used to zero the arterial line, which is important for accurate blood pressure measurements but not for assessing right heart preload. Option C, measuring the pulmonary artery wedge pressure (PAWP), is done to assess left ventricular preload and is not a direct measurement of right heart preload. Option D, attaching the proximal infusion port to an intravenous solution, is not a method for assessing right heart preload.

Question 9

The health-care provider wants an SvO2 level on a patient with a pulmonary artery catheter.From where should this sample be taken?

Accepted Answer

The SvO2 level is measured in the distal lumen of a pulmonary artery catheter, which is located in the pulmonary artery. This lumen is designed specifically for blood sampling and analysis. The balloon inflation lumen is used for measuring pulmonary artery pressure, the proximal injectable port is used for administering medication, and the proximal infusion port is used for monitoring central venous pressure.

Question 10

The nurse hears crackles when auscultating the lung sounds of a patient with cardiomyopathy.What should this finding indicate to the nurse?

Accepted Answer

Crackles are a common finding in patients with pulmonary edema, which can be caused by cardiomyopathy leading to fluid accumulation in the lungs. Atelectasis, pneumothorax, and stasis pneumonia are not typically associated with crackles on auscultation.

Question 11

The health-care provider wants to determine a patient's cardiac contractility.What should be used to make this determination?

Accepted Answer

The answer of The health-care provider wants to determine a...

Question 12

A patient is being evaluated for chest pain in the emergency department.Which laboratory test is the best to determine if this patient has experienced an acute myocardial infarction?

Accepted Answer

Troponin is the preferred test to diagnose acute myocardial infarction. It is a cardiac-specific biomarker that is released into the bloodstream when damage to the heart muscle occurs. Elevations in troponin levels are highly specific for myocardial injury and can be used to confirm the diagnosis of a heart attack. Prothrombin time (B), creatine kinase-MB (C), and complete blood count (D) are not as specific for heart muscle damage and are not the preferred tests for diagnosing acute myocardial infarction.

Question 13

The nurse is caring for a patient experiencing cardiogenic shock.Which medication should the nurse expect to be prescribed to improve this patient's cardiac output?

Accepted Answer

Dobutamine hydrochloride (Dobutamine) is a medication commonly used to improve cardiac output in patients experiencing cardiogenic shock. It is a synthetic catecholamine that works by stimulating beta-1 adrenergic receptors in the heart, leading to an increase in myocardial contractility and heart rate. Nitroglycerin and morphine sulfate may be used to treat chest pain and reduce myocardial oxygen demand, but they do not directly improve cardiac output. Norepinephrine (Levophed) is another medication that can be used in cardiogenic shock, but it primarily works by increasing systemic vascular resistance and blood pressure, rather than improving cardiac output.

Question 14

The nurse is reviewing the manifestations of an acute myocardial infarction with a patient diagnosed with type 2 diabetes mellitus.What should the nurse emphasize as being an atypical manifestation of this cardiac disorder?

Accepted Answer

Fatigue is an atypical manifestation of an acute myocardial infarction in a patient with type 2 diabetes mellitus.

Question 15

A patient recovering from cardiogenic shock is observed walking to the patient lounge.What should the nurse recommend to this patient?

Accepted Answer

Rest is crucial for recovery from cardiogenic shock to prevent overexertion and further cardiac stress.

Question 16

The nurse suspects that a patient in cardiogenic shock is experiencing oxygen deprivation.What would confirm the nurse's suspicion?

Accepted Answer

Metabolic acidosis upon arterial blood gas analysis would confirm the nurse's suspicion of oxygen deprivation in a patient in cardiogenic shock. This is because the low cardiac output in cardiogenic shock leads to decreased oxygenation and perfusion of tissues, ultimately leading to tissue hypoxia and anaerobic metabolism, which causes the accumulation of lactic acid and subsequent metabolic acidosis. Therefore, an arterial blood gas analysis showing metabolic acidosis would support the nurse's suspicion.

Question 17

The nurse is caring for a patient experiencing an acute myocardial infarction.Which assessment finding indicates a decrease in this patient's cardiac output?

Accepted Answer

Low urine output indicates decreased renal perfusion, which is a result of decreased cardiac output. Chest pain and ST segment elevation are typical findings in a patient experiencing an acute myocardial infarction, but do not necessarily indicate a decrease in cardiac output. Restlessness is a non-specific symptom that can occur in many conditions and is not specific to decreased cardiac output.

Question 18

A patient with dilated cardiomyopathy has developed a productive cough.What additional manifestation supports fluid overload in this patient?

Accepted Answer

Jugular vein distention is a manifestation of fluid overload in patients with dilated cardiomyopathy. It occurs due to elevated right atrial pressure, causing blood to back up into the jugular veins. Fainting, sleeplessness, and loss of appetite are not specific manifestations of fluid overload in this patient population.

Question 19

The nurse is reviewing medications prescribed for a patient with hypertrophic cardiomyopathy.Which medication should the nurse question before administering?

Accepted Answer

Digoxin can increase the contractility of the heart, which can worsen symptoms in patients with hypertrophic cardiomyopathy. It should be used with caution or avoided altogether in these patients. The other medication options are commonly used to treat hypertrophic cardiomyopathy and are appropriate for the nurse to administer.

Question 20

The nurse suspects that a patient with cardiomyopathy is experiencing heart failure.What finding did the nurse use to make this clinical decision?

Accepted Answer

SOB (shortness of breath) when supine is a common sign of heart failure in patients with cardiomyopathy. It is caused by the accumulation of fluid in the lungs when the patient is lying down. Dizziness, chest pain, and palpitations can be symptoms of cardiomyopathy, but are not specific to heart failure.

Quiz 32: Coordinating Care for Critically Ill Patients With Cardiovascular Dysfunction