Question 1

A patient of peripheral arterial disease is being released from hospital. What advice should the nurse give to the patient about foot care?

Accepted Answer

The nurse should instruct the patient to wash her feet daily, moisturize them, and wear thick socks and comfortable shoes. Other foot care measures include promptly treating fungal infections, trimming toe nails carefully to avoid cuts, avoiding walking barefoot, and have a physician or nurse exam sores and open wounds on the feet.

Question 2

The nurse calculates the ankle-brachial index (ABI) of a patient as 0.65. The patient wants to know the significance of this value. What is the correct answer given by the nurse?

Accepted Answer

An ABI of 0.65 represents a moderate degree of peripheral arterial disease. The ABI represents a ratio of the blood pressure measured in the ankle divided by the blood pressure measured in the arm. An abnormal ABI is defined as an index <0.90. Values between 0.8 and 0.9 suggest some arterial disease. Values between 0.5 and 0.8 suggest moderate arterial disease. Values less than 0.5 are suggestive of severe arterial disease.

Question 3

What are the investigations a nurse should order/perform for a patient who recently had implantation of a pacemaker?

Accepted Answer

The nurse should order an electrocardiogram and an echocardiogram, should perform a physical assessment, and look for swelling at the incision site. The nurse should also check peripheral blood flow and evaluate for the presence of cardiac pain.
Prior to patient release, clinicians should also assess the patient's heart sounds and check laboratory tests such as hematocrit, potassium levels, serum creatinine level, and cardiac enzymes. A chest x-ray should also be performed before and after pacemaker placement.

Question 4

A patient is being released after pacemaker implantation. What instruction should the nurse give the patient about follow-up?

Accepted Answer

The nurse should instruct the patient to followup with their practicing clinician 1 week after permanent pacemaker placement and then followup every 3 to 6 months to check programming and setting of the device. Elderly patients should be checked on a regular basis for risk of infection, heart sounds, and cardiac risk factors. Patients at risk for other cardiovascular complications should be monitored on regular basis.

Question 5

Which leadership style involves minimal guidance from a leader and provides little feedback to team members?

Accepted Answer

The laissez-faire leadership style involves minimal guidance from a leader, and team members receive little feedback. Laissez- faire is a French phrase that literally means "let people do as they choose." Leadership styles include autocratic, participative, laissez-faire, transactional, and transformational. Autocratic leadership uses power to influence members of a team. Participative leadership uses a democratic process for decisions among team members. Transactional leadership focuses on daily activities and is comfortable with the status quo. Transformational leadership involves a vision and commitment to meet a team's goals.

Question 6

Which of the following statements correctly represents the significance of outcome evaluation?

Accepted Answer

The significance of outcome evaluation is in evaluating the effectiveness of interventions and identifying areas that need improvement. The process is used to evaluate the patient's status, evaluate effectiveness of interventions, and identify areas of improvement. Commonly used patient outcomes include morbidity, mortality, hemodynamic parameters, laboratory values such as blood sugar, lipid levels, and prothrombin time, symptoms such as nausea, vomiting, pain, fatigue, angina, anxiety and depression, and functional status. Commonly used practicing clinician parameters include change in knowledge or skill level and compliance with patient standards. Commonly used system outcomes include service utilization, length of hospital stay, and cost of care or services. Outcome evaluation is often used to identify factors associated with complications post cardiovascular intervention.

Question 7

In which leadership style is power used to influence team members?

Accepted Answer

The autocratic leadership style uses power to influence team members. . Other leadership styles include participative, laissez-faire, transactional, and transformational. Participative leadership uses a democratic process for decisions among team members. Laissez-faire leadership involves minimal guidance from a leader and provides little feedback to team members. Transactional leadership focuses on daily activities and is comfortable with the status quo. Transformational leadership involves a vision and commitment to meet a team's goals.

Question 8

Team causes, team processes, team effectiveness, and team building are variables of which team building models?

Accepted Answer

The cognitive motivational model of team effectiveness uses team causes, team processes, team effectiveness, and team building. The traditional model of team effectiveness views the team as components of a whole. The components include team building processes and team effectiveness. The cognitive motivational model of team effectiveness views the team as a series of interdependent variables such as team causes, team processes, team effectiveness, and team building.

Question 9

A patient is wearing a Holter monitor. What instructions should the nurse give to the patient during monitoring?

Accepted Answer

While wearing a Holter monitor, patients should maintain an activity diary so that any abnormality can be linked to this activity. Conversely, the diary may demonstrate that no abnormality occurs with certain activities. Patients should continue with prescribed medications and carry out normal activities since the primary purpose of a Holter monitor is to assist in diagnosis and to determine triggers for abnormal electrocardiogram readings. The monitor should be used during the night as some cardiac abnormalities may occur during sleep.

Question 10

The nurse is assessing the tests of a patient with a diagnosis of acute right-sided heart failure. What parameter would be elevated in right-sided heart failure?

Accepted Answer

When looking at the parameters for a patient with a diagnosis of right-sided heart failure, the CVP would be elevated. The CVP describes the amount of blood that is returning to the heart and is a measure of the pressure of the blood in the thoracic vena cava.

Question 11

The nurse is evaluating the arterial blood oxygenation level on a patient who had a myocardial infarction 2 days ago. What would be the minimal oxygenation saturation level that would reflect adequate oxygen supply to the tissues?

Accepted Answer

The minimal oxygenation saturation that would reflect adequate oxygen supply to the tissues is 90%. In an arterial blood gas reading, the measurement of oxygen tension in the arterial blood (PaO2) needs to be greater than 80 mm Hg.

Question 12

You are caring for a 47-year-old female who has been admitted to the cardiac care unit. On your rounds you notice that her mean arterial blood pressure (MAP) is decreasing. What is the mean arterial blood pressure?

Accepted Answer

The MAP is a measure of the average pressure in the circulatory system. It is a means of seeing if the patients' organs are being perfuse appropriately: a MAP of at least 60 mmHg is required for organ perfusion.

Question 13

What tests should be performed to evaluate a patient after PCTA?

Accepted Answer

An electrocardiogram, echocardiogram should be performed after PCTA, as well as a physical assessment and monitoring of peripheral blood flow

Question 14

A nurse is explaining the post-operative follow-up procedure to a patient who has undergone carotid endarterectomy. Which of the following are the correct instructions?

Accepted Answer

The correct instruction for these patients is to follow-up with their practicing clinician 1 week after the procedure and then follow-up in 3 months.

Question 15

The nurse is recording blood pressure and counting pulse rate of a patient who uses cocaine. What is the expected finding in this patient?

Accepted Answer

Cocaine increases the heart rate and the blood pressure; it is a sympathomimetic. Cocaine can also cause chest pain that may mimic a myocardial infarction. Cocaine causes coronary and peripheral vasoconstriction; this results in hypertension and episodes of cardiac ischemia that may cause infarcts. In some cases, multiple infarcts may occur even if the coronary arteries are normal.

Quiz 1: Intervention