Nokea
In urgent situations of supraventricular tachycardia (SVT) when symptoms of severe heart failure have already occurred, the initial management is
- A. adenosine by rapid intravenous push
- B. DC cardioversion
- C. verapamil
- D. digoxin
Correct Answer: B
Rationale: DC cardioversion is the preferred initial management in hemodynamically unstable SVT.
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A client with acquired immunodeficiency syndrome (AIDS) has impaired gas exchange from a respiratory infection. Which assessment finding warrants immediate intervention by the nurse?
- A. Elevated temperature
- B. Generalized weakness
- C. Diminished lung sounds
- D. Pain when swallowing
Correct Answer: D
Rationale: Pain when swallowing could indicate an opportunistic infection such as candidiasis, which requires prompt treatment.
An emergency department nurse triages clients who present with chest discomfort. Which client should the nurse plan to assess first?
- A. A 42-year-old female who describes her pain as a dull ache with numbness in her fingers
- B. A 49-year-old male reports moderate pain that is worse on inspiration
- C. A 53-year-old female reports substernal pain that radiates to her abdomen
- D. A 58-year-old male describes his pain as an intense stabbing that spreads across his chest
Correct Answer: D
Rationale: Intense stabbing chest pain that spreads across the chest is highly suggestive of an acute cardiac event, such as a myocardial infarction, and requires immediate assessment.
Mechanisms of dyspnea in left heart disease include all, except
- A. PVH and decreased lung compliance
- B. Respiratory muscle fatigue
- C. Elevated LV End diastolic pressure leads to decreased antegrade coronary blood flow
- D. Reverse 'Bernheim' effect
Correct Answer: C
Rationale: Elevated LV end-diastolic pressure does not typically lead to decreased antegrade coronary blood flow.
The nurse is conducting a staff in-service on congenital heart defects. Which structural defect constitutes tetralogy of Fallot?
- A. Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
- B. Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
- C. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy
- D. Pulmonic stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy
Correct Answer: A
Rationale: Tetralogy of Fallot has these four characteristics: pulmonic stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. There is pulmonic stenosis but not atrial stenosis in tetralogy of Fallot. Right ventricular hypertrophy, not left ventricular hypertrophy, is present in tetralogy of Fallot. Tetralogy of Fallot has right ventricular hypertrophy, not left ventricular hypertrophy, and an atrial septal defect, not aortic hypertrophy.
Isovolumic contraction phase of ventricular systole occurs during which of the following phases of central venous pressure, approximately
- A. From nadir of y descent to peak of a wave
- B. From peak of a wave to trough of x wave
- C. From trough of x wave to peak of c wave
- D. From peak of c wave to trough of x' descent
Correct Answer: C
Rationale: Isovolumic contraction occurs from the trough of the x wave to the peak of the c wave.