Nokea
A patient has been scheduled for cardiovascular computed tomography (CT) with contrast. To prepare the patient for this test, what action should the nurse perform?
- A. Keep the patient NPO for at least 6 hours prior to the test
- B. Establish peripheral IV access
- C. Limit the patients activity for 2 hours before the test
- D. Teach the patient to perform incentive spirometry
Correct Answer: B
Rationale: An IV is necessary if contrast is to be used to enhance the images of the CT. The patient does not need to fast or limit his or her activity. Incentive spirometry is not relevant to this diagnostic test.
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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.
When hemodynamic monitoring is ordered for a patient, a catheter is inserted into the appropriate blood vessel or heart chamber. When assessing a patient who has such a device in place, the nurse should check which of the following components? Select all that apply.
- A. A transducer
- B. A flush system
- C. A leveler
- D. A pressure bag
- E. An oscillator
Correct Answer: A,B,D
Rationale: To perform hemodynamic monitoring, a CVP, pulmonary artery, or arterial catheter is introduced into the appropriate blood vessel or heart chamber. It is connected to a pressure monitoring system that has several components. Included among these are a transducer, a flush system, and a pressure bag. A pressure monitoring system does not have a leveler or an oscillator.
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 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.
A critically ill patient is admitted to the ICU. The physician decides to use intra-arterial pressure monitoring. After this intervention is performed, what assessment should the nurse prioritize in the plan of care?
- A. Fluctuations in core body temperature
- B. Signs and symptoms of esophageal varices
- C. Signs and symptoms of compartment syndrome
- D. Perfusion distal to the insertion site
Correct Answer: D
Rationale: The radial artery is the usual site selected. However, placement of a catheter into the radial artery can further impede perfusion to an area that has poor circulation. As a result, the tissue distal to the cannulated artery can become ischemic or necrotic. Vigilant assessment is thus necessary. Alterations in temperature and the development of esophageal varices or compartment syndrome are not high risks.