Nokea
You have just received change-of-shift report about these patients on the coronary step down unit. Which one will you assess first?
- A. A 26-year-old with heart failure caused by congenital mitral stenosis who is scheduled for balloon valvuloplasty later today.
- B. A 45-year-old with constrictive cardiomyopathy who developed acute dyspnea and agitation about 1 hour before the shift change.
- C. A 56-year-old who had a coronary angioplasty and stent placement yesterday and has complained of occasional chest pain since the procedure.
- D. A 77-year-old who transferred from intensive care 2 days ago after coronary artery bypass grafting and has a temperature of 100.6°F.
Correct Answer: B
Rationale: Acute dyspnea and agitation suggest worsening heart failure or another urgent condition.
You may also like to solve these questions
What is a chronic condition where the airways in the lungs become damaged and widened, leading to mucus buildup and frequent infections?
- A. Bronchiectasis
- B. Chronic bronchitis
- C. Pneumoconiosis
- D. Asthma
Correct Answer: A
Rationale: The correct answer is A: Bronchiectasis. This condition involves permanent widening and damage to the airways, leading to mucus accumulation and recurrent infections. Chronic bronchitis (B) primarily involves inflammation of the bronchial tubes without permanent widening. Pneumoconiosis (C) is a group of lung diseases caused by inhaling mineral dust, not directly related to airway damage. Asthma (D) is characterized by reversible airway constriction and inflammation, not permanent widening like in bronchiectasis.
While completing a nursing admission history, you obtain this information about the patient's cardiovascular risk factors: patient's mother and two siblings have had myocardial infarctions. Patient smokes and has a 20 pack/year history of cigarette use. Her work as a mail carrier involves a lot of walking. She takes metoprolol (Lopressor) for hypertension and her blood pressure has been in the range of 130/60 to 140/85. Which interventions will be most important to include in the discharge plan? (Choose all that apply.)
- A. Refer to community programs that assist in smoking cessation.
- B. Teach about the impact of family history on cardiovascular risk.
- C. Educate about the need for a change in antihypertensive therapy.
- D. Assist in reducing the stress associated with her cardiovascular risk.
Correct Answer: A
Rationale: Smoking cessation is crucial given her history and risk factors.
Which artery supplies the anterior wall of the left ventricle, the anterior interventricular septum, the anterior papillary muscles, and apex of the heart?
- A. Left anterior descending artery
- B. Left circumflex artery
- C. Posterior descending artery
- D. Aortic artery
Correct Answer: A
Rationale: The correct answer is A: Left anterior descending artery. This artery supplies the structures mentioned due to its location and distribution in the heart. The left anterior descending artery runs along the anterior interventricular groove and provides blood flow to the anterior wall of the left ventricle, anterior interventricular septum, anterior papillary muscles, and apex of the heart. The other choices are incorrect because:
B: Left circumflex artery supplies the lateral and posterior walls of the left ventricle.
C: Posterior descending artery supplies the inferior part of the heart.
D: Aortic artery is not a specific artery that supplies the mentioned structures.
A client on a beta blocker has a blood pressure of 90/60 mm Hg. What is the nurse's priority action?
- A. Hold the beta blocker and notify the healthcare provider.
- B. Administer the beta blocker as ordered.
- C. Administer a diuretic to reduce blood pressure.
- D. Continue to monitor the client and reassess in 30 minutes.
Correct Answer: A
Rationale: The correct answer is A: Hold the beta blocker and notify the healthcare provider. A blood pressure of 90/60 mm Hg is considered low and may be a sign of hypotension, which can be a serious side effect of beta blockers. Holding the medication and notifying the healthcare provider is the priority action to prevent further complications. Administering the beta blocker (choice B) can worsen the hypotension. Administering a diuretic (choice C) may further lower the blood pressure. Continuing to monitor and reassess (choice D) is not appropriate in this situation as immediate action is needed due to the low blood pressure reading.
What is a condition where the airways become swollen and produce extra mucus, making it difficult to breathe, often associated with COPD?
- A. Chronic bronchitis
- B. Pneumonia
- C. Emphysema
- D. Tuberculosis
Correct Answer: A
Rationale: Rationale:
1. Chronic bronchitis is characterized by inflammation of the airways leading to excess mucus production.
2. It is a common symptom of COPD, obstructing airflow and causing breathing difficulties.
3. Pneumonia, emphysema, and tuberculosis do not primarily involve airway inflammation and mucus production as seen in chronic bronchitis.