Nokea
Mrs. Payer's care plan during the acute phase following MI should include attention to such psychologic aspects as fear, stress, and hopefulness. Therapeutic goals from the time of admission must be geared to
- A. acceptance
- B. rehabilitation
- C. slowing down
- D. dependence
Correct Answer: A
Rationale: Acceptance facilitates adaptation to illness.
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If Mrs. Jones has a temporary pacemaker and the pacemaker intermittently fails to capture or sense, increasing the output temporarily restores function. Failure to capture or sense appropriately is most often due to
- A. Prior emergency defibrillation for ventricular failure
- B. Dislodgment of pacing electrode from right ventricle
- C. Occurrence of frequent ectopic beats from right ventricle
- D. Perforation to the right ventricle by pacing electrode
Correct Answer: B
Rationale: Dislodgment affects proper pacemaker function.
What is a condition where the heart is unable to pump blood effectively, leading to a buildup of fluid in the lungs and other parts of the body?
- A. Heart failure
- B. Cardiomyopathy
- C. Myocardial infarction
- D. Pulmonary edema
Correct Answer: A
Rationale: Rationale for Correct Answer (A): Heart failure is the correct answer because it is a condition where the heart is unable to pump blood effectively, leading to fluid buildup in the lungs and other parts of the body. This occurs due to the heart's inability to adequately circulate blood, causing congestion and fluid retention. Symptoms include shortness of breath, fatigue, and swelling. Treatment aims to improve heart function and manage symptoms.
Summary of Incorrect Choices:
B (Cardiomyopathy): Cardiomyopathy is a disease of the heart muscle, which can lead to heart failure, but it is not the specific condition described in the question.
C (Myocardial infarction): Myocardial infarction, commonly known as a heart attack, results from a blockage in a coronary artery causing damage to the heart muscle, but it does not directly lead to fluid buildup in the lungs and body.
D (Pulmonary edema): Pulmonary edema is a condition characterized by fluid
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.
To detect and treat the most common complication of MI, what should the nurse do?
- A. Measure hourly urine output
- B. Auscultate the chest for crackles
- C. Use continuous cardiac monitoring
- D. Take vital signs every 2 hours for the first 8 hours
Correct Answer: C
Rationale: Continuous monitoring detects dysrhythmias.
What is a condition where the blood flow to the brain is temporarily blocked, often referred to as a mini-stroke?
- A. Transient ischemic attack (TIA)
- B. Stroke
- C. Aneurysm
- D. Myocardial infarction
Correct Answer: A
Rationale: The correct answer is A: Transient ischemic attack (TIA). A TIA is a temporary blockage of blood flow to the brain, causing stroke-like symptoms that typically resolve within 24 hours. This is distinct from a full-blown stroke (choice B) which results in permanent damage. Aneurysm (choice C) is a bulge in a blood vessel, not a blockage. Myocardial infarction (choice D) is a heart attack, not related to brain blood flow. In summary, TIA best fits the description of a temporary blockage of blood flow to the brain, making it the correct choice.