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During hemodynamic monitoring, the nurse finds that the patient has a decreased CO with unchanged pulmonary artery wedge pressures, HR, and SVR. The nurse identifies that the patient has a decrease in
- A. SV
- B. Preload
- C. Afterload
- D. Contractility
Correct Answer: D
Rationale: CO is dependent on the heart rate and stroke volume, and stroke volume is determined by preload, afterload and contractility. If CO is decreased and heart rate is unchanged, stroke volume is the variable factor.
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For what reason might the nurse be given an order to administer milrinone (Primacor)?
- A. For congestive heart failure
- B. For hypertension
- C. For cardiac arrhythmias
- D. For bradycardia
Correct Answer: A
Rationale: The correct answer is A: For congestive heart failure. Milrinone is a phosphodiesterase inhibitor used to improve cardiac output in patients with severe heart failure. It works by increasing the force of heart contractions. Therefore, it is specifically indicated for congestive heart failure to help improve cardiac function. Choices B, C, and D are incorrect because milrinone is not typically used for hypertension, cardiac arrhythmias, or bradycardia. It is important to understand the specific indications and mechanisms of action of medications to determine the appropriate use in clinical practice.
When teaching about methyldopa, it is important for the patient to know that it
- A. decreases cardiac output
- B. may produce mental confusion
- C. may produce drowsiness initially
- D. blocks the release of norepinephrine
Correct Answer: C
Rationale: Initial drowsiness is a common side effect of methyldopa.
What is the primary consideration when preparing to administer thrombolytic therapy to a patient who is experiencing an acute myocardial infarction (MI)?
- A. History of heart disease.
- B. Sensitivity to aspirin.
- C. Size and location of the MI.
- D. Time since onset of symptoms.
Correct Answer: D
Rationale: Thrombolytic therapy is most effective when administered within a few hours of symptom onset.
What structure separates the left and right sides of the heart?
- A. Interventricular septum
- B. Endocardium
- C. Epicardium
- D. Pericardium
Correct Answer: A
Rationale: The correct answer is A: Interventricular septum. This structure separates the left and right sides of the heart, forming a barrier between the two ventricles. It ensures that oxygenated and deoxygenated blood do not mix within the heart chambers. The endocardium (B) is the inner layer of the heart's chambers, the epicardium (C) is the outer layer of the heart, and the pericardium (D) is the sac surrounding the heart. These structures do not specifically separate the left and right sides of the heart.
Which medication relaxes the muscles around the airways, making it easier to breathe?
- A. Bronchodilator
- B. Corticosteroid
- C. Antihistamine
- D. Mucolytic
Correct Answer: A
Rationale: The correct answer is A: Bronchodilator. Bronchodilators work by relaxing the muscles surrounding the airways, leading to airway dilation and improved airflow. This helps in easing breathing difficulties in conditions like asthma and COPD. Corticosteroids (B) reduce inflammation, antihistamines (C) block histamine effects, and mucolytics (D) help in thinning mucus but do not directly relax airway muscles like bronchodilators do.