Question 6081)
When planning emergent care for a patient with a suspected MI, what should the nurse anticipate administering ?
A. Oxygen, nitroglycerin, aspirin and morphine
B. Oxygen, furosemide (lasix), nitroglycerin and meperidine
C. Aspirin, nitroprusside (Nipride), dopamine (intropin), and oxygen
D. Nitroglycerin, lorazepam (Ativan), oxygen and warfarin (Coumadin)
Answer: A
Explanation: Oxygen,nitroglycerin, aspirin and morphine. The American Heart Association's guidelines for emergency care of the patient with chest pain include the administration of oxygen, nitroglycerin, aspirin and morphine. These interventions serve to relieve chest pain, improve oxygenation, decrease myocardial workload and prevent further platelet aggregation. The other medications my be used later in the patient's treatment.
Question 6082)
One week after being hospitalized for an acute myocardial infarction, a patient reports loss of appetite and feeling nauseated which of the following prescribed medication next dose should be withheld?
A. Digoxin
B. Furosemide
C. Propranolol
D. Spironolactone
Answer: A
Explanation: Opioids decrease peristalsis, which may precipitate constipation, straining at stool should be avoided to prevent the Valsalva maneuver, which increases demands on the heart.
Question 6083)
The patient with CHF is placed in a High Fowler's position. What is the rationale for placing the patient in this position?
A. To increase the volume of blood returning to heart
B. To increase cardiac output and stroke volume
C. To reduce the volume of blood returning to heart
D. To reduce ankle edema and prevent dysrhythmia
Answer: C
Explanation: To reduce the volume of blood returning to heart
Question 6084)
Which among the following clinical indicator is most likely to be assessed when taking the admission history of a patient with right ventricular failure?
A. Dyspnea
B. Vertigo
C. Polyuria
D. Palpitation
Answer: A
Explanation: Dyspnea due to heart failure from other causes of dyspnea. If myocardial infarction is suspected, various cardiac markers may be used. BNP is a better indicator than N-terminal pro-BNP (NTproBNP) for the diagnosis of symptomatic heart failure and left ventricular systolic dysfunction.
Question 6085)
Which of the following symptoms is most commonly associated with lift sided heart failure?
A. Crackles
B. Arrhythmias
C. Hepatic engorgement
D. Hypotension
Answer: A
Explanation: Pulmonary edema may cause crackling sounds in your lungs. People with congestive heart failure (CHF) often have pulmonary edema. CHF occurs when the heart cannot pump blood effectively.
Question 6086)
The inability of the left ventricle to fill or pump sufficient blood to meet the needs of the tissues for oxygen and nutrients is:
A. Decompensated heart failure
B. Congestive heart failure
C. Left ventricular failure
D. Right ventricular failure
Answer: C
Explanation: Left-sided heart failure (left ventricular failure): inability of the left ventricle to fill or pump sufficient blood to meet the needs of the tissues for oxygen and nutrients, traditional term used to describe patient's symptoms of heart failure
Question 6087)
What is MOST effective at removing the corona virus from your hands
A. Alcohol-based hand sanitiser
B. Soap and water
C. Sodium Hypochlorite
D. Chlorhexitidine
Answer: B
Explanation: Soap and water Soap loosens the lipids in the virus membrane, causing its structure to collapse and making the virus inactive. Alcohol-based hand sanitiser is still useful for removing the virus if soap and warm water is unavailable, but it is not as effective
Question 6088)
The nurse says, "If you do not let me do this dressing change, I will not let you eat dinner with the other residents in the dining room." What legal term is related to this statement?
A. Battery
B. Assault
C. Negligence
D. Malpractice
Answer: B
Explanation: This statement is an unjust threat. Assault is the threat to harm another person without cause
Question 6089)
A patient who is receiving mechanical ventilation is anxious and is "fighting" the ventilator. Which action should the nurse take FIRST?
A. Ventilate the patient with a manual resuscitation bag.
B. erbally coach the patient to breathe with the ventilator.
C. Sedate the patient with the ordered PRN lorazepam (Ativan).
D. Increase the rate for the ordered propofol (Diprivan) infusion.
Answer: B
Explanation: The initial response by the nurse should be to try to decrease the patient's anxiety by coaching the patient about how to coordinate respirations with the ventilator. The other actions also may be helpful if the verbal coaching is ineffective in reducing the patient's anxiety.
Question 6090)
With which placental anomaly is the placenta deeply attached to the uterus?
A. Battledore placenta
B. Placenta succenturiata
C. lacenta accreta
D. Placenta circumvallata
Answer: C
Explanation: A --- battledore placenta occurs when cord inserts at the placental margin instead of centrally B---- Placenta Sucenturiata is a Placenta w/ 1 or more accessory lobes connected to the main placenta via blood vessels (Causes uterine bleeding due to retentions) D----Placenta Circumvallata, the Placenta's fetal side is partially covered w/chorion --> Making delivery a little difficult Abnormal Attachment of the Placenta to the uterus 1. Accreta: "Against the myometrium" 2. Increta: "Into the myometrium" 3. Percreta: "Perforates out into the serosa" .. and can attach to the bladder What is the presentation of placenta accreta? A woman who has a normal 1st and 2nd stage of labor but the placenta does not deliver. The woman usually has C-section or myomectomy, creating a uterine scar where the placenta implanted. What are the risk factors for placenta accreta? - prior C section - CURRENT (not necessarily prior) placenta previa - prior myomectomy - fetal Down syndrome - advanced maternal age Which placental position, posterior or anterior, is associated with a greater risk of placenta accreta? Anterior placenta = greater risk of accreta Mnemonic: "A" is for "Accreta" Does numerous C-sections increase the risk of accreta, or is your risk stable following the first C-section onward? It increases with every C-section
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