Nokea
The patient has become very dyspneic, respirations are 32, and the pulse is 100. The patient is coughing up frothy red sputum. What should be the initial nursing intervention?
- A. Lay the patient flat to reduce hypotension and the symptoms of cardiogenic shock.
- B. Place patient in side-lying position to reduce the symptoms of atrial fibrillation.
- C. Place patient upright with legs in dependent position to reduce the symptoms of pulmonary edema.
- D. Lay the patient flat and elevate the feet to increase venous return in cardiogenic shock.
Correct Answer: C
Rationale: Signs and symptoms of pulmonary edema are restlessness; vague uneasiness; agitation; disorientation; diaphoresis; severe dyspnea; tachypnea; tachycardia; pallor or cyanosis; cough producing large quantities of blood-tinged, frothy sputum; audible wheezing and crackles; and cold extremities. The legs in a dependent position will decrease venous return and ease the pulmonary edema.
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The nurse is aware that the symptoms of an impending myocardial infarction (MI) differ in women because acute chest pain is not present. Women are frequently misdiagnosed as having which disorder?
- A. hepatitis A.
- B. indigestion.
- C. urinary infection.
- D. menopausal complications.
Correct Answer: B
Rationale: Indigestion, gallbladder attack, anxiety attack, and depression are frequent misdiagnoses for women having an MI.
What is the difference between primary and secondary hypertension?
- A. Secondary hypertension is caused by another disorder like renal disease.
- B. Secondary hypertension is related to hereditary factors.
- C. Secondary hypertension cannot be treated effectively.
- D. Secondary hypertension is no real threat to health.
Correct Answer: A
Rationale: Secondary hypertension is a consistently elevated blood pressure that is caused by another disorder, such as renal disease, diabetes, or Cushing syndrome.
The nurse is treating a patient who had a pacemaker inserted 8 years ago for the correction of atrial fibrillation. Which diagnostic test may no longer be available to the patient because of this older model implanted device?
- A. MRI
- B. CT scan
- C. Thallium scan
- D. PET
Correct Answer: A
Rationale: Patients who have pacemakers placed in the last several years can have MRI testing without difficulty. A model that has been in place for some time might be affected by the large magnets in the MRI cabinet. In either case, the patient should always report the use of a pacemaker before having an MRI.
A 70 year female patient arrives to the emergency department, reporting nausea, vomiting, fatigue and abdominal discomfort. The health care provider requests myocardial infarction (MI) protocols to begin. For which reason is this protocol beginning?
- A. The provider is concerned a lawsuit could occur due to missed diagnosis.
- B. Women tend to have less classic symptoms of a myocardial infarction.
- C. Women are more likely to die from breast or cervical cancer than an MI.
- D. The troponin I level is not as accurate for females as it is in male patients.
Correct Answer: B
Rationale: Women experiencing an MI tend to experience symptoms that are unrelated to chest pain: nausea, vomiting, fatigue, indigestion, shortness of breath, and upper back or abdominal discomfort.
The nurse explains that the heart has the ability to contract in a rhythmic pattern that is called
Correct Answer: automaticity
Rationale: Automaticity is the special ability of the myocardium to contract in a rhythmic pattern.