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What is a chronic condition where the heart muscle becomes weakened and enlarged, reducing its ability to pump blood effectively?
- A. Dilated cardiomyopathy
- B. Hypertrophic cardiomyopathy
- C. Myocarditis
- D. Pericarditis
Correct Answer: A
Rationale: The correct answer is A: Dilated cardiomyopathy. This is a chronic condition characterized by the heart muscle becoming weakened and enlarged, leading to reduced pumping efficiency. This results in symptoms like shortness of breath, fatigue, and swelling. The other choices are incorrect because:
B: Hypertrophic cardiomyopathy is characterized by thickening of the heart muscle, not weakening and enlargement.
C: Myocarditis is inflammation of the heart muscle, not specifically causing heart muscle weakening and enlargement.
D: Pericarditis is inflammation of the pericardium (outer lining of the heart), not directly affecting heart muscle function.
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If Mrs. Jones has a temporary pacemaker and the pacemaker intermittently fails to capture or sense, increasing the output temporarily restores function. Failure to capture or sense appropriately is most often due to
- A. Prior emergency defibrillation for ventricular failure
- B. Dislodgment of pacing electrode from right ventricle
- C. Occurrence of frequent ectopic beats from right ventricle
- D. Perforation to the right ventricle by pacing electrode
Correct Answer: B
Rationale: Dislodgment affects proper pacemaker function.
From where do these originate, behind the cusps of the aortic valve, in an area known as Valsalva's sinus?
- A. Pulmonary valve
- B. Aortic valve
- C. Tricuspid valve
- D. Mitral valve
Correct Answer: B
Rationale: Rationale: The correct answer is B - Aortic valve. This is because Valsalva's sinus is located behind the cusps of the aortic valve. The sinuses of Valsalva are pouch-like dilations found at the root of the aorta, just above the aortic valve. These sinuses are important in preventing backflow of blood into the heart during diastole. The other choices, A, C, and D, are incorrect because they do not originate from Valsalva's sinus. The pulmonary valve is located in the pulmonary artery, the tricuspid valve is between the right atrium and right ventricle, and the mitral valve is between the left atrium and left ventricle.
The client is on nitroglycerin and reports chest pain. What is the nurse's priority action?
- A. Administer nitroglycerin as ordered.
- B. Administer morphine as ordered.
- C. Administer aspirin as ordered.
- D. Notify the healthcare provider immediately.
Correct Answer: D
Rationale: The correct answer is D: Notify the healthcare provider immediately. When a client on nitroglycerin reports chest pain, it could indicate a worsening condition or potential myocardial infarction. The nurse's priority is to notify the healthcare provider promptly for further assessment and intervention. Administering nitroglycerin (choice A) may not address the underlying cause of the chest pain. Administering morphine (choice B) may mask symptoms and delay appropriate treatment. Administering aspirin (choice C) is important in chest pain management but does not take priority over notifying the healthcare provider for further evaluation and guidance.
A patient recently had a cardiac catheterization via right-radial approach and now has a compression device in place. The patient reports numbness and pain in the right hand. The cardiac-vascular nurse notes a diminished pulse, with a cool and cyanotic hand. The nurse:
- A. calls the physician.
- B. performs an Allen test.
- C. reduces the pressure on the puncture site.
- D. uses the Doppler ultrasound to assess for pulse signals.
Correct Answer: C
Rationale: Reducing pressure on the puncture site is necessary to restore blood flow to the hand.
The client on warfarin has an INR of 5.5. What is the priority nursing action?
- A. Administer vitamin K as an antidote.
- B. Hold the next dose of warfarin.
- C. Increase the dose of warfarin.
- D. Administer fresh frozen plasma.
Correct Answer: A
Rationale: The correct answer is A: Administer vitamin K as an antidote. An INR of 5.5 indicates the client is at risk for bleeding due to excessive anticoagulation from warfarin. Administering vitamin K helps reverse the effects of warfarin and lowers the INR back to the therapeutic range. Holding the next dose of warfarin (B) is important but not the priority over administering the antidote. Increasing the dose of warfarin (C) would worsen the situation. Administering fresh frozen plasma (D) is not a standard treatment for high INR levels due to warfarin.