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A critical care nurse is caring for a patient with a pulmonary artery catheter in place. What does this catheter measure that is particularly important in critically ill patients?
- A. Pulmonary artery systolic pressure
- B. Right ventricular afterload
- C. Pulmonary artery pressure
- D. Left ventricular preload
Correct Answer: D
Rationale: Monitoring of the pulmonary artery diastolic and pulmonary artery wedge pressures is particularly important in critically ill patients because it is used to evaluate left ventricular filling pressures (i.e., left ventricular preload). This device does not directly measure the other listed aspects of cardiac function.
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The physician has ordered a high-sensitivity C-reactive protein (hs-CRP) drawn on a patient. The results of this test will allow the nurse to evaluate the role of what process that is implicated in the development of atherosclerosis?
- A. Immunosuppression
- B. Inflammation
- C. Infection
- D. Hemostasis
Correct Answer: B
Rationale: High-sensitivity CRP is a protein produced by the liver in response to systemic inflammation. Inflammation is thought to play a role in the development and progression of atherosclerosis.
The cardiac care nurse is reviewing the conduction system of the heart. The nurse is aware that electrical conduction of the heart usually originates in the SA node and then proceeds in what sequence?
- A. SA node to bundle of His to AV node to Purkinje fibers
- B. SA node to AV node to Purkinje fibers to bundle of His
- C. SA node to bundle of His to Purkinje fibers to AV node
- D. SA node to AV node to bundle of His to Purkinje fibers
Correct Answer: D
Rationale: The normal electrophysiological conduction route is SA node to AV node to bundle of His to Purkinje fibers.
A resident of a long-term care facility has complained to the nurse of chest pain. What aspect of the residents pain would be most suggestive of angina as the cause?
- A. The pain is worse when the resident inhales deeply
- B. The pain occurs immediately following physical exertion
- C. The pain is worse when the resident coughs
- D. The pain is most severe when the resident moves his upper body
Correct Answer: B
Rationale: Chest pain associated with angina is often precipitated by physical exertion. The other listed aspects of chest pain are more closely associated with noncardiac etiologies.
A lipid profile has been ordered for a patient who has been experiencing cardiac symptoms. When should a lipid profile be drawn in order to maximize the accuracy of results?
- A. As close to the end of the day as possible
- B. After a meal high in fat
- C. After a 12-hour fast
- D. Thirty minutes after a normal meal
Correct Answer: C
Rationale: Although cholesterol levels remain relatively constant over 24 hours, the blood specimen for the lipid profile should be obtained after a 12-hour fast.
The nurse is performing an intake assessment on a patient with a new diagnosis of coronary artery disease. What would be the most important determination to make during this intake assessment?
- A. Whether the patient and involved family members understand the role of genetics in the etiology of the disease
- B. Whether the patient and involved family members understand dietary changes and the role of nutrition
- C. Whether the patient and involved family members are able to recognize symptoms of an acute cardiac problem and respond appropriately
- D. Whether the patient and involved family members understand the importance of social support and community agencies
Correct Answer: C
Rationale: During the health history, the nurse needs to determine if the patient and involved family members are able to recognize symptoms of an acute cardiac problem, such as acute coronary syndrome (ACS) or HF, and seek timely treatment for these symptoms. Each of the other listed topics is valid, but the timely and appropriate response to a cardiac emergency is paramount.