Nokea
It would be correct for the nurse to identify which cardiac dysrhythmias can reduce cardiac output. Select all that apply.
- A. Supraventricular tachycardia
- B. Sinus bradycardia
- C. Ventricular tachycardia
- D. Mobitz type II heart block
- E. Isolated premature atrial contraction (PAC)
Correct Answer: A,B,C,D
Rationale: Supraventricular tachycardia reduces filling time, lowering cardiac output. Sinus bradycardia decreases heart rate, reducing output. C: Correct - Ventricular tachycardia impairs effective pumping. D: Correct - Mobitz type II can cause missed beats, reducing output. E: Incorrect - Isolated PACs typically do not significantly affect cardiac output.
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The following scenario applies to the next 6 items
The client is a 72-year-old male who presents to the emergency department with increasing
shortness of breath over the past two days that gets worse when he is lying flat in bed at night.
Item 1 of 6
History And Physical Nurses' Notes Flow Sheet
0700: The client is a 72-year-old male who presents to the emergency department with increasing shortness of breath over the past two days that gets worse when he is lying flat in bed at night. He states, "I feel like I can't catch my breath," and he had to sleep in a recliner. He reports a 4 lb weight gain over the last week and increasing fatigue. The client is alert and oriented but is using his accessory muscles to breathe. He reports feeling short of breath, orthopnea, and paroxysmal nocturnal dyspnea. He has bilateral pedal edema (+2), bilateral crackles heard upon auscultation, and jugular vein distention noted on his assessment. The
the client has a medical history of hypertension, coronary artery disease, and a prior myocardial infarction. He was diagnosed with heart failure with reduced ejection fraction (HFrEF) two years ago. Current home medications include lisinopril, metoprolol succinate, furosemide, and atorvastatin.
The client reporting …………… and …………….would indicate improvement in their condition.
- A. Ambulation tolerance
- B. Edema after activity
- C. Weight loss
- D. Sleeping in bed
- E. High sodium intake
Correct Answer: A,D
Rationale: A: Improved ambulation tolerance indicates better functional capacity. D: Sleeping in bed (without orthopnea) suggests reduced pulmonary congestion. B, C, E: Edema, weight loss, and high sodium intake do not necessarily indicate improvement.
The nurse is reviewing laboratory data for a client suspected of having a myocardial infarction. The nurse anticipates that the CK-MB isoenzyme will peak within how many hours?
- A. 3 to 6 hours
- B. 1 to 2 hours
- C. 48 to 72 hours
- D. 18 hours
Correct Answer: D
Rationale: CK-MB peaks around 18 hours after a myocardial infarction, indicating myocardial damage.
The nurse is caring for a client with the below tracing on the electrocardiogram (ECG). The client reports dyspnea and dizziness. The nurse should obtain a prescription for which medication? See the image below.
- A. Diltiazem
- B. Amiodarone
- C. Labetalol
- D. Atropine
Correct Answer: B
Rationale: Amiodarone is used for ventricular arrhythmias (e.g., ventricular tachycardia), which may cause dyspnea and dizziness.
A hypertensive client was prescribed antihypertensive medication. The client tells a clinic nurse that she prefers to take an herbal supplement to help lower her blood pressure. Which is the most appropriate response from the nurse?
- A. Tell the client that herbal supplements are unsafe and should be avoided
- B. Encourage the client to discuss the use of herbal supplements with her attending health care provider (HCP)
- C. Teach the client how to take her blood pressure and ask her to monitor it every fifteen minutes
- D. Tell the client that if she takes the herbal supplement, it will require the nurses to monitor her blood pressure closely
Correct Answer: B
Rationale: Herbal supplements can interact with medications, so discussing with the HCP ensures safety and efficacy.
The nurse has instructed a client who is scheduled to have a transesophageal echocardiogram (TEE). Which of the following statements by the client would indicate a correct understanding of the teaching?
- A. I will need to take antibiotics for one week following this test.
- B. This test will determine if I have any blood clots in my heart.
- C. I will receive general anesthesia for this procedure.
- D. I may feel a flushing sensation when the contrast dye is given.
Correct Answer: B
Rationale: TEE is used to detect intracardiac thrombi, such as in atrial fibrillation, making this statement correct.