Nokea
What is the second step in the path of blood through the coronary circulation?
- A. Right atrium
- B. Pulmonary artery
- C. Tricuspid valve
- D. Right ventricle
- E. Superior and inferior vena cava
- F. Pulmonary vein
- G. Left atrium
Correct Answer: A
Rationale: The blood travels through the vena cava to the right atrium, through the tricuspid valve to the right ventricle, through the pulmonary artery to the lungs. The pulmonary veins deliver the blood to the left atrium, then through the mitral valve to the left ventricle and out the aorta to the body.
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The plan of care for a patient recovering from hip surgery mentions prevention of deep vein thrombosis (DVT). Which aspect of the plan of care addresses this concern?
- A. Massaging the calves of the leg twice daily
- B. Explaining the need for fluid restriction after surgery
- C. Assisting the patient to change positions frequently
- D. Encouraging the patient to take the anti-embolism stockings off at night for better sleep.
Correct Answer: C
Rationale: The plan of care to prevent deep vein thrombosis should mention changing positions, dorsiflexing the feet and rotating ankles every 2 to 4 hours. Massaging the calves of the leg is contraindicated, as the massage could loosen a blood clot. There is no need to restrict fluids. Removing the stockings off at night is not an appropriate intervention, because a DVT could form.
The nurse is reinforcing instructions on a patient who will be taking digoxin. Which sign of digoxin toxicity should the nurse include?
- A. Ringing in the ears
- B. Bradycardia
- C. Headache
- D. Visual disturbance
- E. Hematuria
- F. Anorexia
Correct Answer: B,C,D,F
Rationale: Major signs of digoxin toxicity are bradycardia (HR <60), headache, visual disturbances, anorexia, as well as fatigue and arrhythmias.
What is the transesophageal echocardiogram (TEE) used for?
- A. Detect thrombi before a cardioversion.
- B. Check for cardiac arrhythmias.
- C. Detect the presence of an aneurysm
- D. Measure effectiveness of diuretic therapy.
- E. Locate obstructions in the coronary artery.
Correct Answer: A,C
Rationale: The TEE is used to check for thrombi before cardioversion, and to visualize the presence of an aneurysm.
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 patient, age 72, was admitted to the medical unit with a diagnosis of angina pectoris. Which is a characteristic signs and symptoms of angina pectoris?
- A. substernal pain that radiates down the left arm.
- B. epigastric pain that radiates to the jaw.
- C. indigestion, nausea, and eructation.
- D. fatigue, shortness of breath, and dyspnea.
Correct Answer: A
Rationale: The pain often radiates down the left inner arm to the little finger and also upward to the shoulder and jaw.