Nokea
A patient, age 72, was admitted to the medical unit with a diagnosis of angina pectoris. Which is a characteristic signs and symptoms of angina pectoris?
- A. substernal pain that radiates down the left arm.
- B. epigastric pain that radiates to the jaw.
- C. indigestion, nausea, and eructation.
- D. fatigue, shortness of breath, and dyspnea.
Correct Answer: A
Rationale: The pain often radiates down the left inner arm to the little finger and also upward to the shoulder and jaw.
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What do dark or 'cold' spots on a thallium scan indicate?
- A. Tissue with adequate blood supply
- B. Dilated vessels
- C. Areas of neoplastic growth
- D. Tissue that has inadequate perfusion
Correct Answer: D
Rationale: Thallium scans show adequate perfused areas by the collection of thallium. Dark spots or 'cold spots' indicate tissues that have inadequate perfusion.
The nurse would reinforce teaching for a patient with Raynaud disease to include which teaching point?
- A. Warming hands and feet with a heating pad
- B. Using mittens in cold weather
- C. Practicing stress-reducing techniques
- D. Complete smoking cessation
- E. Using caution when cleaning the refrigerator or freezer
Correct Answer: B,C,D,E
Rationale: Nursing interventions include patient teaching in techniques for stress reduction, avoiding exposure to cold, and techniques for smoking cessation.
The nurse notes a run of three ventricular contractions (PVC) that are not preceded by a P wave. This particular arrhythmia can progress into which complication?
- A. atrial fibrillation and possible emboli.
- B. sinus tachycardia and syncope.
- C. ventricular tachycardia and death.
- D. sinus bradycardia and fatigue.
Correct Answer: C
Rationale: PVCs are capable of progressing into ventricular tachycardia and death.
During a health interview by the home health nurse, which patient report suggests left-sided heart failure?
- A. I have to sleep in my recliner and I have this hacking cough.'
- B. I have no appetite and I have lost $3 \mathrm{lb}$ in the last week.'
- C. I have to urinate every 2 hours, even during the night.'
- D. I go barefoot most of the time because my feet are so hot.'
Correct Answer: A
Rationale: Left ventricular failure is often among the first of signs and symptoms of decreased cardiac output. The second is pulmonary congestion. Signs and symptoms of this condition include dyspnea, orthopnea, pulmonary crackles, hemoptysis, and cough.
The nurse is reinforcing instructions on a patient who will be taking digoxin. Which sign of digoxin toxicity should the nurse include?
- A. Ringing in the ears
- B. Bradycardia
- C. Headache
- D. Visual disturbance
- E. Hematuria
- F. Anorexia
Correct Answer: B,C,D,F
Rationale: Major signs of digoxin toxicity are bradycardia (HR <60), headache, visual disturbances, anorexia, as well as fatigue and arrhythmias.