Nokea
A patient recently had a cardiac catheterization via right-radial approach and now has a compression device in place. The patient reports numbness and pain in the right hand. The cardiac-vascular nurse notes a diminished pulse, with a cool and cyanotic hand. The nurse:
- A. calls the physician.
- B. performs an Allen test.
- C. reduces the pressure on the puncture site.
- D. uses the Doppler ultrasound to assess for pulse signals.
Correct Answer: C
Rationale: Reducing pressure on the puncture site is necessary to restore blood flow to the hand.
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What is a condition where the heart muscle is weakened and unable to pump blood effectively, often leading to heart failure?
- A. Cardiomyopathy
- B. Myocarditis
- C. Endocarditis
- D. Pericarditis
Correct Answer: A
Rationale: The correct answer is A: Cardiomyopathy. Cardiomyopathy refers to a condition where the heart muscle is weakened and unable to pump blood effectively, leading to heart failure. This is because the heart muscle becomes enlarged, thickened, or stiff, affecting its ability to pump blood efficiently.
Incorrect choices:
B: Myocarditis - Myocarditis is inflammation of the heart muscle, not necessarily associated with weakening of the heart muscle leading to heart failure.
C: Endocarditis - Endocarditis is inflammation of the inner lining of the heart chambers and valves, not directly related to the weakening of the heart muscle.
D: Pericarditis - Pericarditis is inflammation of the pericardium (the outer lining of the heart), and does not directly involve the weakening of the heart muscle.
A patient who underwent a percutaneous, transluminal coronary angioplasty four weeks ago has a subsequent ejection fraction of 30%. The patient returns for a follow-up visit. Examination reveals lungs that are clear on auscultation and slight pedal edema. The patient's medications are digoxin (Lanoxin), furosemide (Lasix), enalapril maleate (Vasotec), and aspirin. The patient reports a 5 lb (2.27 kg) weight gain over the past two days. The cardiac-vascular nurse's initial action is to:
- A. document the weight and reassess the patient at the next session.
- B. inquire about the patient's medication compliance.
- C. notify the patient's physician.
- D. review the patient's most recent nuclear scan.
Correct Answer: B
Rationale: Weight gain and pedal edema suggest fluid retention, so assessing medication compliance is essential.
What is a surgical procedure to create an opening in the windpipe to assist with breathing?
- A. Tracheostomy
- B. Lobectomy
- C. Thoracotomy
- D. Pleurodesis
Correct Answer: A
Rationale: The correct answer is A: Tracheostomy. This surgical procedure involves creating an opening in the windpipe to assist with breathing by bypassing any obstructions in the upper airway. It is commonly performed in cases of severe respiratory distress or when a patient requires long-term mechanical ventilation.
Choice B: Lobectomy involves surgical removal of a lobe of the lung and does not directly relate to creating an opening in the windpipe for breathing assistance.
Choice C: Thoracotomy is a surgical incision into the chest wall but is not specifically related to creating an opening in the windpipe.
Choice D: Pleurodesis is a procedure to treat recurrent pleural effusion by creating adhesions between the layers of the pleura but does not involve creating an opening in the windpipe.
What is a life-threatening condition where the heart suddenly stops beating?
- A. Cardiac arrest
- B. Myocardial infarction
- C. Heart failure
- D. Atrial fibrillation
Correct Answer: A
Rationale: The correct answer is A: Cardiac arrest. Cardiac arrest is a life-threatening emergency where the heart stops beating suddenly. This leads to the cessation of blood flow to vital organs, causing loss of consciousness and death if not treated immediately with CPR and defibrillation. Myocardial infarction (B) is a heart attack where blood flow to the heart muscle is blocked, leading to tissue damage. Heart failure (C) is a chronic condition where the heart is unable to pump blood effectively. Atrial fibrillation (D) is an irregular heartbeat that can increase the risk of stroke but is not the same as cardiac arrest.
The client on spironolactone (Aldactone) should avoid which type of food?
- A. Foods high in potassium
- B. Foods high in sodium
- C. Foods high in calcium
- D. Foods high in chloride
Correct Answer: A
Rationale: The correct answer is A: Foods high in potassium. Spironolactone is a potassium-sparing diuretic, meaning it helps the body retain potassium. Consuming foods high in potassium while on spironolactone can lead to hyperkalemia, which is an elevated level of potassium in the blood. This can result in serious health complications such as irregular heartbeats and muscle weakness. Therefore, it is crucial for clients on spironolactone to avoid foods high in potassium to prevent these adverse effects. Choices B, C, and D are incorrect because spironolactone does not specifically interact with sodium, calcium, or chloride in a way that necessitates avoiding foods high in these electrolytes.