Nokea
What do dark or 'cold' spots on a thallium scan indicate?
- A. Tissue with adequate blood supply
- B. Dilated vessels
- C. Areas of neoplastic growth
- D. Tissue that has inadequate perfusion
Correct Answer: D
Rationale: Thallium scans show adequate perfused areas by the collection of thallium. Dark spots or 'cold spots' indicate tissues that have inadequate perfusion.
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The nurse caring for a patient recovering from a myocardial infarct who is on remote telemetry recognizes the need for added instruction when the patient makes which statement?
- A. I can ambulate in the hallway with this gadget on.'
- B. I always take off the telemetry device when I shower.'
- C. My EKG is being watched by one of the nurses in CCU on the home unit.'
- D. I am able to sleep just fine with this device on.'
Correct Answer: B
Rationale: Remote telemetry allows the patient to be on a separate unit, but be monitored in a central location. The patients can be ambulatory and can sleep with the monitor on. They should not remove the monitor to shower.
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.
The pain that a person with arterial insufficiency feels on exertion, which is relieved by rest, is
Correct Answer: intermittent claudication
Rationale: Intermittent claudication is a pain caused by ischemia when a person with arterial insufficiency exerts to the point that the tissues have inadequate oxygen-rich blood. The pain is relieved by rest.
The nurse reminds the patient that the American Heart Association recommends a lipid study how frequently?
- A. Every 2 years
- B. Every 2 to 3 years
- C. At least every 4 years
- D. Every 4 to 6 years
Correct Answer: D
Rationale: The American Heart Association recommends a lipid study every 4 to 6 years for all Americans over the age of 20.
The nurse outlines which as a condition that would disqualify a candidate for a heart transplant?
- A. Recent malignancy
- B. Dilated cardiomyopathy
- C. Peptic ulcer disease
- D. Diabetes type 2
- E. Severe obesity
- F. Inoperable coronary artery disease
Correct Answer: A,C,E
Rationale: Contraindications for candidacy for cardiac transplant include recent malignancy, active peptic ulcer disease, severe obesity, diabetes type 1 with end-organ damage. Dilated cardiomyopathy and inoperable coronary artery disease are indications for transplant.