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ex. test 1 (pn 141)
N-clex style from book Med surg nursing
| Question | Answer |
|---|---|
| The nurse caring for a pt w/ pericarditis recognizes this disorder affects which layer of the heart? a) the inner most layerb) the heart muscle layerC) the middle layerd) the outermost lyaer | D |
| A pt with mitral valve stenosis is admitted, this disorder will affect a) blood flow from teh R atrium to R ventb) blood flow from the L atrium to the L ventc) Blood flow from the R ventricle to lungsd) blood flow from the L ventricle to the body | B |
| Vetricular systole corresponds w/ which wave form on the ECG?a) P waveb) QRS complexC) T waved) S-T segment | B |
| Which of the following factors have a sig. effect of peripheral vascular ressitence? (multiple)a) # of capillariesb) length of BVc) BV diameterd) position of bodye) viscosity of bloodf) age of pt | B,C,E |
| The nurse is teaching a pt who is taking atorvastatin (lipitor) daily. what is vital to be included in the teachinga) report changes in color of skin/ scherab) take with mealsc) reduce amount of fat d) if muscle are sore, increase exercise | a |
| pt asks nurse how they can distinguish chest pain between angina and a MI, what is the response | Chest pain of angina can be relieved by rest and nitroglycerin, chest pain from an mi can't be relieved by those |
| What is the highest priority nursing Dx for a pt who has had an Percutaneous coronary vascularization | Risk for impaired tissue perfusion |
| A male client is experiancing a MI which VS are most concerning a) BP 138/84, P 72b) BP 90/50, Urinary output 20 mL/hrc) p 92, urinary output 50 mL/ hrd) bp 150/70, P 100 | b |
| a pt develops left sided heart failure; an appropriate nursing dx is a) activity intolerence b) ineffective airway clearence c) deficient fluid volume d) pain | a- left sided heart failure affects CO and the availability of blood and oxygen to meet the body's metabolic needs, as a result activity intolerance occurs |
| A pt develops right sided heart failure, what is a s/s that a nurse would find? a) pulmonary edema b) edematous legs & ankles c) decreased heart rate D) increased urinary output | b- the backwards effect of right sided heart failure affect the venous system & peripheral tissues. This increased pressure in the venous system causes peripheral edema |
| the nurse is to admin. digoxin 0.25 mg PO, the pt apical pulse is 48. what is the appropriate nursing action | hold digoxin and notify the physician. A slow apical pulse may indicate digitalis toxicity |
| A pt is discharged with mitral stenosis. Discharge teaching shouldn't include a) How to auscultate heart for murmers 2x dailyb) s/s of heart failure C) notify MD if temp is elevated >100 F for more than 2 daysd)s/s of activity intolerence | A |
| following replacement of a stenosed mitral valve w/ a mechanical heart valve; what is a high priority Nx Dx? | ineffective protection r/t anticoagulant therapy |
Created by:
jmkettel
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