Nokea
Which of the following approaches to preventing a recurrence of sudden cardiac death is the most common?
- A. Long-term Aspirin therapy
- B. Implantable cardioverter-defibrillator
- C. Administration of amiodarone
- D. Continuous Holter monitoring
Correct Answer: B
Rationale: The most common approach to preventing a recurrence is the use of an implantable cardioverter-defibrillator (ICD). Research has shown survival rates are better with an ICD than with drug therapy alone. Drug therapy with amiodarone may be used in conjunction with an ICD to decrease episodes of ventricular dysrhythmias. Continuous monitoring will not prevent a recurrence. Aspirin will not prevent a recurrence of SCD.
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The nurse will suspect that the patient with stable angina is experiencing an adverse effect of the prescribed metoprolol if which of the following findings are assessed?
- A. The patient is restless and agitated.
- B. The blood pressure is 190/110 mm Hg.
- C. The patient complains about feeling anxious.
- D. The cardiac monitor shows a heart rate of 45.
Correct Answer: D
Rationale: Patients taking β-adrenergic blockers should be monitored for bradycardia. Because this category of medication inhibits the sympathetic nervous system, restlessness, agitation, hypertension, and anxiety will not be adverse effects.
Following an acute myocardial infarction, a patient ambulates in the hospital hallway. When the nurse is evaluating the patient's response, which of the following assessment data would indicate that the exercise level should be decreased?
- A. BP changes from 118/60 to 126/68 mm Hg.
- B. Oxygen saturation drops from 100% to 98%.
- C. Heart rate increases from 66 to 90 beats/minute
- D. Respiratory rate goes from 14 to 22 breaths/minute.
Correct Answer: C
Rationale: A change in heart rate of more than 20 beats or more indicates that the patient should stop and rest. The increases in BP and respiratory rate, and the slight decrease in oxygen saturation, are normal responses to exercise.
The nurse is caring for a patient who has survived a sudden cardiac death (SCD) event and has no evidence of an acute myocardial infarction. After the patient has recovered, which of the following information should the nurse teach the patient?
- A. That sudden cardiac death events rarely reoccur
- B. About the purpose of outpatient Holter monitoring
- C. How to self-administer low-molecular-weight heparin
- D. To limit activities after discharge to prevent future events
Correct Answer: B
Rationale: Holter monitoring is used to determine whether the patient is experiencing dysrhythmias such as ventricular tachycardia during normal daily activities. SCD is likely to recur. Heparin will not have any effect on the incidence of SCD, and SCD can occur even when the patient is resting.
Which of the following causes is the most common cause for sudden cardiac death?
- A. Ventricular tachycardia
- B. Aortic stenosis
- C. Hypertrophic cardiomyopathy
- D. Angina
Correct Answer: A
Rationale: Acute ventricular dysrhythmias (e.g., ventricular tachycardia, ventricular fibrillation) cause the majority of cases of SCD. Less commonly, SCD occurs because of a primary left ventricular outflow obstruction (e.g., aortic stenosis, hypertrophic cardiomyopathy) or extreme slowing of the heart (bradycardia).
The nurse is providing teaching to a patient about use of sublingual nitroglycerin. Which of the following patient statements indicates that the teaching has been effective?
- A. I will put the nitroglycerin tablet under my tongue if I get chest pain.
- B. I like fresh salmon and I will plan to eat it more often.
- C. I will miss being able to eat peanut butter sandwiches.
- D. I can have a cup of coffee with breakfast if I want one.
Correct Answer: A
Rationale: Sublingual nitroglycerin is taken by placing the tablet under the tongue to relieve chest pain. The other statements relate to dietary preferences and do not indicate understanding of nitroglycerin use.