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This is a procedure where a small mesh tube is inserted into an artery to keep it open and improve blood flow.
- A. Stent placement
- B. Angioplasty
- C. Bypass surgery
- D. Coronary artery bypass graft (CABG)
Correct Answer: A
Rationale: The correct answer is A: Stent placement. Stent placement involves inserting a mesh tube into an artery to keep it open and improve blood flow. This procedure is minimally invasive compared to bypass surgery (C) and CABG (D), which involve rerouting blood flow. Angioplasty (B) is related but specifically refers to widening the artery using a balloon catheter, not inserting a mesh tube like in stent placement. Therefore, A is the best choice for the given procedure.
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What is the term for the amount of blood ejected by the left ventricle into the aorta per beat, determined by preload, contractility, and afterload?
- A. Stroke volume
- B. Cardiac output
- C. End-diastolic volume
- D. Ejection fraction
Correct Answer: A
Rationale: The correct answer is A: Stroke volume. Stroke volume is the amount of blood ejected by the left ventricle into the aorta per beat. Preload (end-diastolic volume), contractility, and afterload influence stroke volume. Cardiac output (B) is the total volume of blood pumped by the heart per minute. End-diastolic volume (C) is the volume of blood in the ventricle before contraction. Ejection fraction (D) is the percentage of blood ejected from the ventricle during systole.
A client on a beta blocker has a blood pressure of 90/60 mm Hg. What is the nurse's priority action?
- A. Hold the beta blocker and notify the healthcare provider.
- B. Administer the beta blocker as ordered.
- C. Administer a diuretic to reduce blood pressure.
- D. Continue to monitor the client and reassess in 30 minutes.
Correct Answer: A
Rationale: The correct answer is A: Hold the beta blocker and notify the healthcare provider. A blood pressure of 90/60 mm Hg is considered low and may be a sign of hypotension, which can be a serious side effect of beta blockers. Holding the medication and notifying the healthcare provider is the priority action to prevent further complications. Administering the beta blocker (choice B) can worsen the hypotension. Administering a diuretic (choice C) may further lower the blood pressure. Continuing to monitor and reassess (choice D) is not appropriate in this situation as immediate action is needed due to the low blood pressure reading.
What is a chronic condition where the heart is unable to pump blood efficiently, leading to fluid buildup in the lungs and other parts of the body?
- A. Heart failure
- B. Cardiomyopathy
- C. Pericarditis
- D. Aortic stenosis
Correct Answer: A
Rationale: Step 1: Heart failure is a chronic condition where the heart is unable to pump blood efficiently.
Step 2: This inefficiency leads to fluid buildup in the lungs (pulmonary congestion) and other parts of the body.
Step 3: Cardiomyopathy is a broad term for diseases that affect the heart muscle but may not necessarily result in heart failure.
Step 4: Pericarditis is inflammation of the pericardium, the sac surrounding the heart, not directly related to heart pumping efficiency.
Step 5: Aortic stenosis is a condition where the aortic valve narrows, affecting blood flow from the heart but not necessarily leading to heart failure.
What is a condition where the heart's mitral valve does not close properly, causing blood to leak backward into the left atrium?
- A. Mitral valve prolapse
- B. Aortic stenosis
- C. Mitral stenosis
- D. Tricuspid regurgitation
Correct Answer: A
Rationale: Mitral valve prolapse is the correct answer because it is a condition where the mitral valve doesn't close properly, leading to blood leakage into the left atrium during the heart's contraction. This results in a characteristic systolic click on auscultation. Aortic stenosis (B) involves narrowing of the aortic valve, not the mitral valve. Mitral stenosis (C) refers to a narrowing of the mitral valve, not improper closure. Tricuspid regurgitation (D) is when the tricuspid valve doesn't close properly, causing blood to leak backward into the right atrium, not the left atrium.
You have just received change-of-shift report about these patients on the coronary step down unit. Which one will you assess first?
- A. A 26-year-old with heart failure caused by congenital mitral stenosis who is scheduled for balloon valvuloplasty later today.
- B. A 45-year-old with constrictive cardiomyopathy who developed acute dyspnea and agitation about 1 hour before the shift change.
- C. A 56-year-old who had a coronary angioplasty and stent placement yesterday and has complained of occasional chest pain since the procedure.
- D. A 77-year-old who transferred from intensive care 2 days ago after coronary artery bypass grafting and has a temperature of 100.6°F.
Correct Answer: B
Rationale: Acute dyspnea and agitation suggest worsening heart failure or another urgent condition.