Question 1

When the patient is being monitored for cardiogenic shock with one of the devices like extracorporeal life support, left ventricular assist device, or intraaortic balloon pump, what lab value must be monitored to prevent these devices from becoming clotted?

Accepted Answer

To prevent the extracorporeal life support, left ventricular assist device, or intraaortic balloon pump from becoming clotted, the PT and INR must be monitored as these laboratory values reflect the tendency of the blood to clot.

Question 2

An intensive care nurse answers a rapid response call for a 54-year-old female patient on the pre-surgery floor who is scheduled to have a left partial knee replacement later today. When the nurse arrives, she notes the ashen color of the woman's face and profuse sweating. The monitor shows a blood pressure of 170/90, a heart rate of 122 and an oxygen saturation of 92% on 1 liter of oxygen. The admitting nurse states that the woman had been complaining of nausea. What is the most likely cause of the patient's condition?

Accepted Answer

The most likely cause of the patient's condition is the myocardial infarction. Many people who have a myocardial infarction experience symptoms such as indigestion or "just not feeling well." Because of the peripheral vasoconstriction occurring in the body, the skin will look pale or ashen. An increase in circulating catecholamines is a response to the stress of the infarction and is the cause of the tachycardia, anxiety and palpitations.

Question 3

What is the major difference in the clinical presentation of acute myocardial infarction (AMI) compared to angina?

Accepted Answer

The major difference in the clinical presentation of AMI and angina is that the chest pain is not quickly relieved by rest or nitroglycerin.

Question 4

When an ischemic event happens, when does myocardial cell death begin?

Accepted Answer

During an ischemic event, myocardial cell death begins 20 minutes after ischemia. The damage is still reversible at this point- it becomes irreversible after approximately 3-4 hours of ischemia.

Question 5

Which cardiac enzyme is only found in cardiac cells and is indicative of an acute myocardial infarction when elevated?

Accepted Answer

Troponin is a protein found in cardiac cells and is used as an indicator of myocardial infarction. When it is elevated it is a positive indication some level of acute myocardial infarction.

Question 6

The cardiologist is writing orders to start an amiodarone infusion. Which of the following arrhythmias would an amiodarone drip be the most appropriate for?

Accepted Answer

An amiodarone drip would be the most appropriate drug for a patient with the diagnosis of uncontrolled atrial fibrillation. Amiodarone treats ventricular and supraventricular arrhythmias.

Question 7

Which of the following tests can differentiate between systolic and diastolic dysfunction in heart failure?

Accepted Answer

The test that can differentiate between systolic and diastolic dysfunction in heart failure is the echocardiogram. The echocardiogram is considered to be the gold standard in diagnostic tests for heart failure. Not only does it reflect the difference between systolic and diastolic function in heart failure, it can determine the ventricular wall size and motion.

Question 8

Which of the following is not a method of self-monitoring technique?

Accepted Answer

Relaxation techniques can be used to reduce stress, but they are not used for self-monitoring. Self-monitoring techniques include lifestyle modifications, reducing exposure to stressful situations, alteration of thinking, and modification of reaction.

Question 9

Which of the following methods of stress reduction uses repetitive verbal phases and concentrating on sensation for deep relaxation?

Accepted Answer

Autogenic training is a technique that is used for deep relaxation, and it involves the use of repetitive verbal phases and concentrating on sensations. Cognitive restructuring involves the use of the mind to alter the stress response. Imagery is another method for stress reduction. Additionally, progressive muscle relaxation reduces stress by interfering with the sympathetic nervous system. Meditation is a process that leads to deep relaxation through use of mantras and concentration.

Quiz 2: Problems