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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.
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The nurse assesses pitting edema that can be depressed approximately $4 \mathrm{~mm}$ and refills in 15 seconds. The nurse would document this assessment as:
- A. +1 edema.
- B. +2 edema.
- C. +3 edema.
- D. +4 edema.
Correct Answer: B
Rationale: A +2 edema can be documented if the skin can be depressed $4 \mathrm{~mm}$ and respond within 15 seconds.
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 caring for a patient recovering from a myocardial infarction (MI) administers stool softeners for which reason?
- A. Prevent enema dependence in the hospitalized patient
- B. Prevent fecal impactions which can lead to bowel obstruction
- C. Stool softeners reduce the need for laxatives once the patient is discharged
- D. Reduce the necessity to strain at the stool to lessen the effect of Valsalva's maneuver
Correct Answer: D
Rationale: Stool softeners will lessen the severity of straining and will decrease the effect of the Valsalva's maneuver on intrathoracic pressure.
The nurse notes a run of three ventricular contractions (PVC) that are not preceded by a P wave. This particular arrhythmia can progress into which complication?
- A. atrial fibrillation and possible emboli.
- B. sinus tachycardia and syncope.
- C. ventricular tachycardia and death.
- D. sinus bradycardia and fatigue.
Correct Answer: C
Rationale: PVCs are capable of progressing into ventricular tachycardia and death.
The nurse clarifies that which is the area of the heart that normally initiates electrical impulses?
- A. left ventricle.
- B. atrioventricular (AV) node.
- C. sinoatrial (SA) node.
- D. bundle of His.
Correct Answer: C
Rationale: The SA node is the master pacemaker of the heart.