Question 1

A patient is in sinus tachycardia. Which nursing interventions are appropriate?

Accepted Answer

The answer of A patient is in sinus tachycardia. Which...

Question 2

The nurse is caring for a patient with premature ventricular contractions (PVCs). What should the nurse keep in mind about this heart rhythm?

Accepted Answer

PVCs can be insignificant in individuals without heart disease, but they may indicate underlying issues in those with cardiac history.

Question 3

Sinus bradycardia (rate 56 beats per minute) is identified in a sleeping patient on telemetry. What is the priority nursing action?

Accepted Answer

Sinus bradycardia can be a normal finding in a sleeping patient because the heart rate naturally slows during sleep. The priority nursing action is to awaken the patient and see how the heart rate responds, as this can help determine if the bradycardia is a normal physiological response or if further intervention is needed.

Question 4

The nurse is preparing medications for a patient with hyperlipidemia. What information should the nurse consider when administering these medications?

Accepted Answer

Medications for hyperlipidemia include statins, which act by inhibiting an enzyme involved in the metabolism of cholesterol and thus lowering LDL levels. They do not increase LDL levels or decrease HDL levels. ACE inhibitors are not used to treat hyperlipidemia. Bile acid sequestrants may be used as adjunct therapy but are not considered first-line drugs.

Question 5

A nurse is performing cardiopulmonary resuscitation (CPR) on a patient who is in cardiac arrest. An automatic external defibrillator (AED) is available. What activity will allow the nurse to assess the patient's cardiac rhythm?

Accepted Answer

Applying adhesive patch electrodes to the chest and moving away from the patient allows the AED to analyze the patient's cardiac rhythm automatically, which is essential for determining the appropriate course of action during CPR.

Question 6

The nurse has completed teaching related to dietary management of coronary heart disease (CHD). Effective teaching is indicated by what patient statement?

Accepted Answer

Switching to soft margarines and vegetable spreads can lower a person's intake of trans fatty acids, which can help manage CHD. The other options show a lack of understanding of dietary management for CHD.

Question 7

The nurse is instructing a patient on nitroglycerin tablets prescribed to treat angina. Which statement(s) should be included in the nurse's instructions?

Accepted Answer

Nitroglycerin tablets should be taken again if angina is not relieved within five minutes, and they should be stored in their original brown bottle to protect them from light.

Question 8

The patient has a pacemaker with one pacing spike seen on the ECG before every QRS complex. There is no change in the pacemaker rhythm over time, with rest or with activity. The nurse realizes the patient has what type of pacemaker?

Accepted Answer

Asynchronous pacing is characterized by the pacemaker sending out pacing spikes at a constant rate regardless of the patient's intrinsic heart activity, which matches the description of the pacemaker behavior observed in the patient.

Question 9

What is the priority nursing intervention for a patient with a junctional escape rhythm?

Accepted Answer

The priority nursing intervention for a patient with a junctional escape rhythm is to assess the patient for symptoms associated with this rhythm. Symptoms may include dizziness, lightheadedness, shortness of breath, and fatigue. Once symptoms are identified, appropriate interventions can be initiated. While a physician may need to be contacted, this is not the priority nursing intervention. Elimination of caffeine from the diet and preparation for a pacemaker insertion may be appropriate interventions depending on the severity of symptoms and underlying cause of the rhythm.

Question 10

The nurse is notified by the cardiac monitoring technician that a patient on continuous cardiac monitoring is having frequent alarms. When the nurse enters the patient's room, the patient is in no apparent distress, is sitting in the chair and eating. Which are appropriate nursing interventions?

Accepted Answer

The appropriate nursing interventions when a patient on continuous cardiac monitoring is having frequent alarms, but is in no apparent distress, include confirming that lead wires are properly connected (A), assessing the placement of electrodes (B), removing and reapplying new electrodes if they are nonadherent (C), and assessing skin sites and moving an electrode if the skin appears irritated (D). These steps ensure that the monitoring equipment is functioning correctly and is properly attached to the patient, which can help reduce false alarms and ensure accurate monitoring. Calling for assistance (E) may not be immediately necessary if the patient is not in distress and the issue can be resolved by checking and adjusting the monitoring equipment.

Question 11

The nurse is caring for an adult patient who is admitted with chest pain that began four hours ago. Which test will be most specific in identifying acute heart damage?

Accepted Answer

Troponin is the most specific biochemical marker for identifying heart damage. CK and CK-MB are also released in heart damage, but they are not as specific as troponin. Cholesterol levels are not a specific marker for heart damage.

Question 12

A nurse is preparing a presentation on coronary heart disease (CHD) for a community women's club. Which statements should the nurse include in the presentation?

Accepted Answer

- A) Women often experience atypical symptoms during a heart attack, such as epigastric pain and nausea, which can be mistaken for heartburn.- B) Shortness of breath and fatigue are common symptoms of myocardial infarction, and these symptoms can be present in both men and women.- C) Women are more likely to have an unrecognized myocardial infarction due to atypical presentation of symptoms compared to men.

Question 13

The nurse sees this rhythm on a patient's cardiac monitor. For which rhythm should the nurse begin care?

Accepted Answer

The answer of The nurse sees this rhythm on a...

Question 14

The nurse is caring for a patient with ventricular tachycardia. Which care should the nurse prepare to provide to this patient?

Accepted Answer

Ventricular tachycardia is a potentially life-threatening condition that requires immediate assessment and intervention. Cardioversion is appropriate if the patient is symptomatic and the rhythm is sustained. Potassium channel blockers may be used to manage the arrhythmia. Defibrillation is not typically used in an awake patient unless they are pulseless. Close observation without intervention is not appropriate for this condition.

Question 15

The nurse is conducting teaching about risk factor management for cardiovascular disease (CVD) at a senior center. What is the most important information for the nurse to include?

Accepted Answer

Stopping smoking is the most important risk factor to manage for CVD, as smoking can significantly increase the risk of heart disease and stroke. While the other options (eating in moderation, exercising when able, and reducing saturated fats) are also important for CVD prevention and management, stopping smoking should be the top priority.

Question 16

A patient is prescribed atorvastatin (Lipitor). For which adverse effect should the nurse monitor this patient?

Accepted Answer

Atorvastatin can cause liver enzyme alterations, so the nurse should monitor liver function tests regularly.

Question 17

A patient received an implantable cardioverter-defibrillator (ICD). The nurse includes what instruction during discharge teaching for this patient?

Accepted Answer

It is important for the patient to be aware that if someone is in direct contact with them when the ICD discharges, they may feel a shock or tingling sensation. This is important for the safety of both the patient and their family members. The other options are incorrect or potentially harmful instructions.

Question 18

A 52-year-old obese male patient who is admitted with elevated triglycerides and a history of smoking two packs of cigarettes a day for 20 years asks about his risk for coronary artery disease. What information should the nurse provide?

Accepted Answer

The patient's history of smoking and obesity put him at increased risk for coronary artery disease, a condition that can be fatal.

Question 19

A patient reports the following symptoms to the nurse: nausea, loss of appetite, blurred and double vision, green yellow halos, vomiting and "feeling uneasy." What situation should the nurse suspect?

Accepted Answer

The symptoms reported by the patient are consistent with digoxin toxicity. Nausea, vomiting, loss of appetite, and feeling uneasy are common symptoms associated with this condition, while blurred and double vision, as well as green yellow halos, are indicative of visual disturbances that can occur with digoxin toxicity. The other options may also cause toxicity, but the symptoms reported by the patient are more consistent with digoxin.

Question 20

A patient asks about metabolic syndrome. How should the nurse respond to this patient?

Accepted Answer

Metabolic syndrome is a cluster of risk factors that increase a person's risk of heart disease, diabetes, and stroke. The risk factors include obesity, physical inactivity, high blood pressure, insulin resistance, and abnormal lipid levels. Genetic factors also play a role in the development of this syndrome.

Quiz 30: Nursing Care of Patients With Coronary Heart Disease