Nokea
The nurse is conducting patient teaching about cholesterol levels. When discussing the patients elevated LDL and lowered HDL levels, the patient shows an understanding of the significance of these levels by stating what?
- A. Increased LDL and decreased HDL increase my risk of coronary artery disease
- B. Increased LDL has the potential to decrease my risk of heart disease
- C. The decreased HDL level will increase the amount of cholesterol moved away from the artery walls
- D. The increased LDL will decrease the amount of cholesterol deposited on the artery walls
Correct Answer: A
Rationale: Elevated LDL levels and decreased HDL levels are associated with a greater incidence of coronary artery disease.
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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).
A patient with a complex cardiac history is scheduled for transthoracic echocardiography. What should the nurse teach the patient in anticipation of this diagnostic procedure?
- A. The test is noninvasive, and nothing will be inserted into the patients body
- B. The patients pain will be managed aggressively during the procedure
- C. The test will provide a detailed profile of the hearts electrical activity
- D. The patient will remain on bed rest for 1 to 2 hours after the test
Correct Answer: A
Rationale: Before transthoracic echocardiography, the nurse informs the patient about the test, explaining that it is painless. The test does not evaluate electrophysiology and bed rest is unnecessary after the procedure.
The critical care nurse is caring for a patient who has been experiencing bradycardia after cardiovascular surgery. The nurse knows that the heart rate is determined by myocardial cells with the fastest inherent firing rate. Under normal circumstances where are these cells located?
- A. SA node
- B. AV node
- C. Bundle of His
- D. Purkinje cells
Correct Answer: A
Rationale: The heart rate is determined by the myocardial cells with the fastest inherent firing rate. Under normal circumstances, the SA node has the highest inherent rate (60 to 100 impulses per minute).
The patient has a homocysteine level ordered. What aspects of this test should inform the nurses care? Select all that apply.
- A. A 12-hour fast is necessary before drawing the blood sample
- B. Recent inactivity can depress homocysteine levels
- C. Genetic factors can elevate homocysteine levels
- D. A diet low in folic acid elevates homocysteine levels
- E. An ECG should be performed immediately before drawing a sample
Correct Answer: A,C,D
Rationale: Genetic factors and a diet low in folic acid, vitamin B6, and vitamin B12 are associated with elevated homocysteine levels. A 12-hour fast is necessary before drawing a blood sample for an accurate serum measurement. An ECG is unnecessary and recent inactivity does not influence the results of the test.
The nurse is caring for a patient who has a history of heart disease. What factor should the nurse identify as possibly contributing to a decrease in cardiac output?
- A. A change in position from standing to sitting
- B. A heart rate of 54 bpm
- C. A pulse oximetry reading of 94%
- D. An increase in preload related to ambulation
Correct Answer: B
Rationale: Cardiac output is computed by multiplying the stroke volume by the heart rate. Cardiac output can be affected by changes in either stroke volume or heart rate, such as a rate of 54 bpm. An increase in preload will lead to an increase in stroke volume. A pulse oximetry reading of 94% does not indicate hypoxemia, as hypoxia can decrease contractility. Transitioning from standing to sitting would more likely increase rather than decrease cardiac output.