Nokea
A patient with a complex cardiac history is scheduled for transthoracic echocardiography. What should the nurse teach the patient in anticipation of this diagnostic procedure?
- A. The test is noninvasive, and nothing will be inserted into the patients body
- B. The patients pain will be managed aggressively during the procedure
- C. The test will provide a detailed profile of the hearts electrical activity
- D. The patient will remain on bed rest for 1 to 2 hours after the test
Correct Answer: A
Rationale: Before transthoracic echocardiography, the nurse informs the patient about the test, explaining that it is painless. The test does not evaluate electrophysiology and bed rest is unnecessary after the procedure.
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A nurse is preparing a patient for scheduled transesophageal echocardiography. What action should the nurse perform?
- A. Instruct the patient to drink 1 liter of water before the test
- B. Administer IV benzodiazepines and opioids
- C. Inform the patient that she will remain on bed rest following the procedure
- D. Inform the patient that an access line will be initiated in her femoral artery
Correct Answer: C
Rationale: During the recovery period, the patient must maintain bed rest with the head of the bed elevated to 45 degrees. The patient must be NPO 6 hours preprocedure. The patient is sedated to make him or her comfortable, but will not be heavily sedated, and opioids are not necessary. Also, the patient will have a peripheral IV line initiated preprocedure.
A nurse is describing the process by which blood is ejected into circulation as the chambers of the heart become smaller. The instructor categorizes this action of the heart as what?
- A. Systole
- B. Diastole
- C. Repolarization
- D. Ejection fraction
Correct Answer: A
Rationale: Systole is the action of the chambers of the heart becoming smaller and ejecting blood. This action of the heart is not diastole (relaxations), ejection fraction (the amount of blood expelled), or repolarization (electrical charging).
The nurse is caring for a patient who has a history of heart disease. What factor should the nurse identify as possibly contributing to a decrease in cardiac output?
- A. A change in position from standing to sitting
- B. A heart rate of 54 bpm
- C. A pulse oximetry reading of 94%
- D. An increase in preload related to ambulation
Correct Answer: B
Rationale: Cardiac output is computed by multiplying the stroke volume by the heart rate. Cardiac output can be affected by changes in either stroke volume or heart rate, such as a rate of 54 bpm. An increase in preload will lead to an increase in stroke volume. A pulse oximetry reading of 94% does not indicate hypoxemia, as hypoxia can decrease contractility. Transitioning from standing to sitting would more likely increase rather than decrease cardiac output.
The physician has placed a central venous pressure (CVP) monitoring line in an acutely ill patient so right ventricular function and venous blood return can be closely monitored. The results show decreased CVP. What does this indicate?
- A. Possible hypovolemia
- B. Possible myocardial infarction (MI)
- C. Left-sided heart failure
- D. Aortic valve regurgitation
Correct Answer: A
Rationale: Hypovolemia may cause a decreased CVP. MI, valve regurgitation, and heart failure are less likely causes of decreased CVP.
The nurse is doing discharge teaching with a patient who has coronary artery disease. The patient asks why he has to take an aspirin every day if he doesnt have any pain. What would be the nurses best response?
- A. Taking an aspirin every day is an easy way to help restore the normal function of your heart
- B. An aspirin a day can help prevent some of the blockages that can cause chest pain or heart attacks
- C. Taking an aspirin every day is a simple way to make your blood penetrate your heart more freely
- D. An aspirin a day eventually helps your blood carry more oxygen that it would otherwise
Correct Answer: B
Rationale: An aspirin a day is a common nonprescription medication that improves outcomes in patients with CAD due to its antiplatelet action. It does not affect oxygen carrying capacity or perfusion. Aspirin does not restore cardiac function.