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The nurse is calculating a cardiac patients pulse pressure. If the patients blood pressure is 122/76 mm Hg, what is the patients pulse pressure?
- A. 46 mm Hg
- B. 99 mm Hg
- C. 198 mm Hg
- D. 76 mm Hg
Correct Answer: A
Rationale: Pulse pressure is the difference between the systolic and diastolic pressure. In this case, this value is 46 mm Hg (122 - 76 = 46).
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The nurse working on a cardiac care unit is caring for a patient whose stroke volume has increased. The nurse is aware that afterload influences a patients stroke volume. The nurse recognizes that afterload is increased when there is what?
- A. Arterial vasoconstriction
- B. Venous vasoconstriction
- C. Arterial vasodilation
- D. Venous vasodilation
Correct Answer: A
Rationale: Arterial vasoconstriction increases the systemic vascular resistance, which increases the afterload. Venous vasoconstriction decreases preload thereby decreasing stroke volume. Venous vasodilation increases preload.
The nurse is caring for a patient who is undergoing an exercise stress test. Prior to reaching the target heart rate, the patient develops chest pain. What is the nurses most appropriate response?
- A. Administer sublingual nitroglycerin to allow the patient to finish the test
- B. Initiate cardiopulmonary resuscitation
- C. Administer analgesia and slow the test
- D. Stop the test and monitor the patient closely
Correct Answer: D
Rationale: Signs of myocardial ischemia would necessitate stopping the test. CPR would only be necessary if signs of cardiac or respiratory arrest were evident.
The nurse is caring for an 82-year-old patient. The nurse knows that changes in cardiac structure and function occur in older adults. What is a normal change expected in the aging heart of an older adult?
- A. Decreased left ventricular ejection time
- B. Decreased connective tissue in the SA and AV nodes and bundle branches
- C. Thinning and flaccidity of the cardiac valves
- D. Widening of the aorta
Correct Answer: D
Rationale: Changes in cardiac structure and function are clearly observable in the aging heart. Aging results in decreased elasticity and widening of the aorta, thickening and rigidity of the cardiac valves, increased connective tissue in the SA and AV nodes and bundle branches, and an increased left ventricular ejection time (prolonged systole).
The nurse is caring for an acutely ill patient who has central venous pressure monitoring in place. What intervention should be included in the care plan of a patient with CVP in place?
- A. Apply antibiotic ointment to the insertion site twice daily
- B. Change the site dressing whenever it becomes visibly soiled
- C. Perform passive range-of-motion exercises to prevent venous stasis
- D. Aspirate blood from the device once daily to test pH
Correct Answer: B
Rationale: Gauze dressings should be changed every 2 days or transparent dressings at least every 7 days and whenever dressings become damp, loosened, or visibly soiled. Passive ROM exercise is not indicated and it is unnecessary and inappropriate to aspirate blood to test it for pH. Antibiotic ointments are contraindicated.
A patient has had a myocardial infarction and has been diagnosed as having damage to the layer of the heart responsible for the pumping action. You are aware that the damage occurred where?
- A. Endocardium
- B. Pericardium
- C. Myocardium
- D. Visceral pericardium
Correct Answer: C
Rationale: The myocardium is the layer of the heart responsible for the pumping action.