Question 1

Which vitamin is essential in the process of coagulation?

Accepted Answer

Rationale 1: Vitamin A is involved with epithelialization.
Rationale 2: Vitamin K is required for the liver to make four of the clotting factors.
Rationale 3: Vitamin C is required for synthesis of collagen.
Rationale 4: Vitamin D is required for calcium absorption.

Question 2

The nurse is caring for a client with a stroke volume of 54 ml/beat and a heart rate of 72 beats per minute. The nurse calculates that the client's cardiac output is ___ L/min.

Accepted Answer

3.9

Question 3

The nurse asks a group of nursing students to name examples of positive inotropic agents. Which answers by the students indicate understanding of the content?

Accepted Answer

Rationale 1: Epinephrine is an example of a positive inotropic agent.
Rationale 2: Norepinephrine is an example of a positive inotropic agent.
Rationale 3: Dopamine is an example of a positive inotropic agent.
Rationale 4: Quinidine is an example of a negative inotropic agent.
Rationale 5: Propranolol is an example of a negative inotropic agent.

Question 4

A nurse administers an IV antihypertensive medication, causing an immediate reduction in blood pressure. The baroreceptors respond by attempting to return blood pressure back to normal by accelerating the heart rate. Which term will the nurse use when documenting this phenomenon?

Accepted Answer

Rationale 1: Reflex tachycardia is an accelerated heart rate in response to a sudden drop in blood pressure.
Rationale 2: Ventricular tachycardia occurs when the ventricles of the heart beat greater than 100 beats per minute.
Rationale 3: Re-entry tachycardia is caused by abnormal conduction pathways in the myocardium.
Rationale 4: Supraventricular tachycardia is a rapid heartbeat when the heart rate is generated either in the atria or in the atrioventricular node.

Question 5

The nurse is teaching a community group about the role that cholesterol plays in the development of high blood pressure and atherosclerosis. In order to decrease this risk, the nurse recommends that clients maintain a low density lipoprotein (LDL) level less than _____ mmol/L.

Accepted Answer

The answer of The nurse is teaching a community group...

Question 6

The nurse is providing teaching to a client who has been placed on oral cholestyramine for management of a lipid disorder. Which statement by this client indicates the need for further teaching about this drug?

Accepted Answer

Rationale 1: Cholestyramine has a strong potential for delaying absorption of other drugs from the gastrointestinal tract, and so should be taken 1 hour after or 4 hours before other oral medications.
Rationale 2: Failure to mix cholestyramine powder with an adequate volume of water can lead to gastrointestinal obstruction.
Rationale 3: Cholestyramine can interfere with vitamin absorption, so vitamin supplementation might be needed.
Rationale 4: The interaction between cholestyramine and warfarin produces an increased risk of bleeding by lowering vitamin K levels, so the dose of warfarin the client is taking might need to be lowered.

Question 7

A client is being discharged home with nitrostat to take as needed for his angina. Which of the following statement by the client indicate more teaching is required regarding this drug?

Accepted Answer

Rationale 1. Nitroglycerin can cause headaches that should resolve after a few doses, the headaches that are severe and do not resolve should be reported to the physician.
Rationale 2. This is the correct method of taking Nitrostat.
Rationale 3. The nitro tablets should be kept in their original container and not be exposed to light or temperature extremes.
Rationale 4. Only two doses, one tablet 5 minutes apart should be taken for chest pain. If pain is still present, the client should call 911.
Rationale 5. Over time, the nitro tablets will lose potency, the prescription should be renewed every 6 months.

Question 8

Nursing students are completing an orientation to a cardiac care floor, and are reviewing th actions of several drugs used to treat angina. What statement by a student accurately describes the specific effect that the dilating of smooth muscle of veins has on the client with angina?

Accepted Answer

Rationale 1. Myocardial oxygen demand is reduced by reducing blood volume return to the heart.
Rationale 2. While this is considered a secondary action of nitrates, it is not due to the dilation of veins, it is due to the dilation of the coronary arteries.
Rationale 3. With venous vasodilation, the amount of blood returning to the heart (preload) is reduced, and the chambers contain a smaller volume. With less blood for the ventricles to pump, cardiac output is reduced and the workload of the heart is decreased, thereby lowering myocardial oxygen demand.
Rationale 4. This is not an effect of nitrates.
Rationale 5. Nitrates do not have an effect on the contractility of the heart.

Question 9

A client is evaluated in the emergency room for thrombolytic therapy following a stroke. When completing a thorough health history, what does the nurse learn that precludes this client from receiving thrombolytics?

Accepted Answer

Rationale 1. This is not a contraindication to thrombolytic therapy
Rationale 2. This is not a contraindication to thrombolytic therapy
Rationale 3. This is not a contraindication to thrombolytic therapy
Rationale 4. Assess for conditions that would be contraindicated, including recent trauma or surgery/ biopsy, GI bleeding, postpartum (within 10 days), cerebral hemorrhage, bleeding disorders, and thrombocytopenia, because thrombolytics would place the client at risk for increased bleeding.

Question 10

The nurse is caring for a newly admitted client who is suspected of having an MI. What timeframe would thrombolytics no longer be considered to be therapeutic for treatment of MI?

Accepted Answer

Rationale:Thrombolytics are most effective when administered from 20 minutes to 12 hours after the onset of MI symptoms. Ideally, the time from presentation in the emergency department to administration of the thrombolytic agent should be 30 minutes or less. Research has demonstrated little or no therapeutic benefit if the drugs are administered 24 hours or more after the MI onset.
Rationale Thrombolytics are most effective when administered from 20 minutes to 12 hours after the onset of MI symptoms. Ideally, the time from presentation in the emergency department to administration of the thrombolytic agent should be 30 minutes or less. Research has demonstrated little or no therapeutic benefit if the drugs are administered 24 hours or more after the MI onset.
Rationale Thrombolytics are most effective when administered from 20 minutes to 12 hours after the onset of MI symptoms. Ideally, the time from presentation in the emergency department to administration of the thrombolytic agent should be 30 minutes or less. Research has demonstrated little or no therapeutic benefit if the drugs are administered 24 hours or more after the MI onset.
Rationale Thrombolytics are most effective when administered from 20 minutes to 12 hours after the onset of MI symptoms. Ideally, the time from presentation in the emergency department to administration of the thrombolytic agent should be 30 minutes or less. Research has demonstrated little or no therapeutic benefit if the drugs are administered 24 hours or more after the MI onset.

Question 11

A client prescribed 81 mg of aspirin (ASA) daily following a myocardial infarction (MI) asks the nurse why the baby dose of ASA is prescribed. Which response by the nurse is the most appropriate?

Accepted Answer

Rationale 1: The low dose of ASA (75-150 mg) used for maintenance therapy reduces the common side effects of GI distress and bleeding.
Rationale 2: Although this dose of ASA is all the client needs right now, this answer does not provide the best explanation. 
Rationale 3: A lower dose is not given for economical reasons.
Rationale 4: High doses of ASA do prevent recurrent MI, although they have more side effects.

Question 12

Considering that a goal of treatment for clients with angina is to reduce the incidence of anginal episodes, what is considered a first line drug int the treatment of chronic angina?

Accepted Answer

Rationale 1. Reteplase is a thrombolytic used for the treatment of MI, it is not a long term drug used for the treatment of angina.
Rationale 2. ASA is given long term for clients after an MI to reduce platelet aggregation.
Rationale 3. Nitrostat is a sublingual nitrate used for as needed treatment of angina pain, not for reducing the incidence of angina
Rationale 4. Because of their ability to reduce the workload of the heart by slowing heart rate (negative chronotropic effect) and reducing contractility (negative inotropic effect), beta blockers are used to decrease the frequency and severity of angina attacks caused by exertion.

Quiz 19: Review of the Cardiovascular System