NCM 112 Oxygenation Evaluation Exam
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Questions and Answers

What is the primary treatment for a patient with a confirmed occlusion of a blocked artery upon arrival at the facility?

  • Percutaneous coronary intervention (PCI) (correct)
  • Balloon angioplasty
  • Medications to dissolve the clot
  • Coronary artery bypass grafting (CABG)

When educating a patient prescribed spironolactone for chronic heart failure, what dietary changes should be emphasized?

  • Maintain a high carbohydrate diet
  • Limit fluid intake to two liters daily
  • Increase sodium intake and decrease potassium intake
  • Decrease sodium intake and increase potassium intake (correct)

What is the most common cause of death in heart transplant patients during the first year?

  • Infection (correct)
  • Rejection of the transplanted organ
  • Malignancies
  • Cardiac complications

Which assessment finding is most indicative of right-sided heart failure?

<p>Distended neck veins (B)</p> Signup and view all the answers

Which statement regarding cardiopulmonary bypass during coronary artery bypass grafting should be excluded from discussion?

<p>The client's metabolic rate is decreased (D)</p> Signup and view all the answers

Which symptoms would indicate a deep vein thrombosis (DVT) if reported by a client?

<p>Pain behind the knee with dorsiflexion of foot (A), Sudden swelling of one leg with dependent edema (B)</p> Signup and view all the answers

Which signs may be observed in a patient with right-sided heart failure?

<p>Jugular venous distention (JVD) (A)</p> Signup and view all the answers

How should the effects of Coumadin treatment in a patient with deep vein thrombosis be evaluated?

<p>Prothrombin time (PT) (C)</p> Signup and view all the answers

What is the best prevention technique for deep vein thrombosis (DVT) in a client scheduled for outpatient bariatric surgery?

<p>Early ambulation (B)</p> Signup and view all the answers

Which finding is indicative of a client developing fluid overload?

<p>Pulmonary crackles that clear with deep breathing (C)</p> Signup and view all the answers

Which medication should be withheld for 24 hours before and 48 hours after cardiac catheterization?

<p>Metformin (A)</p> Signup and view all the answers

In caring for a patient with heart failure who suddenly develops dyspnea and tachycardia, what is the priority intervention?

<p>Administering oxygen (A), Administering morphine sulfate intravenously (B), Transporting the client to the coronary care unit (C)</p> Signup and view all the answers

What should the nurse prioritize in the management of a patient admitted with acute myocardial infarction?

<p>Obtain a 12-lead ECG (A)</p> Signup and view all the answers

Which ECG characteristic is indicative of myocardial ischemia?

<p>Elevated ST segment (C)</p> Signup and view all the answers

What should the nurse instruct a patient with varicose veins regarding the use of compression stockings?

<p>Try to keep them on 24 hours a day as much as possible (D)</p> Signup and view all the answers

What is the therapeutic range for aPTT in a patient receiving continuous IV Heparin?

<p>1.5-2.5 times the normal value range (D)</p> Signup and view all the answers

What should the nurse recognize when leads I, II, and III differ on the cardiac rhythm strip?

<p>The electrical current view changes with lead placement. (B)</p> Signup and view all the answers

Which medication has been shown to improve heart failure in African American patients with hypertension and angina?

<p>Hydralazine (A)</p> Signup and view all the answers

In which position should a nurse place a patient exhibiting signs of pulmonary edema?

<p>High Fowlers position (A)</p> Signup and view all the answers

What finding is most concerning during the assessment of a patient with severe anemia?

<p>Dyspnea at rest (B)</p> Signup and view all the answers

After a pericardiocentesis, which complication should the nurse monitor for?

<p>Pneumothorax (A)</p> Signup and view all the answers

Which statement indicates that a patient needs more teaching regarding medications for peripheral artery disease (PAD)?

<p>I should take one aspirin a day to prevent clotting in my legs. (C)</p> Signup and view all the answers

What first test should nurse Gian expect to be ordered for a patient with pain and edema in one leg?

<p>Duplex ultrasound (A)</p> Signup and view all the answers

What is nurse Timothy's best response to a patient asking if heparin will dissolve their leg clot?

<p>Heparin prevents growth of clots or formation of new clots. (A)</p> Signup and view all the answers

What pathologic change would be most evident in the ECG?

<p>QRS complex (A)</p> Signup and view all the answers

What is the primary effect of β-adrenergic blockers like atenolol on blood pressure?

<p>Decrease CO by reducing rate and strength of the heart (B)</p> Signup and view all the answers

What assessment datum should be collected to suspect digoxin toxicity in a patient?

<p>Potassium level (B)</p> Signup and view all the answers

When should early scar tissue in the myocardium lead to an unstable heart wall after an MI?

<p>4 to 10 days after MI (B)</p> Signup and view all the answers

Who should be taught the Therapeutic Lifestyle Changes diet to reduce CAD risk?

<p>Individuals with two or more risk factors (A)</p> Signup and view all the answers

Why is it crucial to rapidly treat unstable angina in patients reporting chest pain?

<p>It can cause complete thrombosis of the vessel lumen. (C)</p> Signup and view all the answers

What is the primary intervention for managing venous leg ulcers effectively?

<p>Graduated compression stockings (C)</p> Signup and view all the answers

What should be monitored to prevent digitalis toxicity in a patient on hydrochlorothiazide, digoxin, and lisinopril?

<p>Potassium levels (D)</p> Signup and view all the answers

What should be included in discharge teaching for a patient with a permanent pacemaker?

<p>Use mild analgesics for chest spasms. (D)</p> Signup and view all the answers

In a patient with sickle cell disease, what action is crucial when experiencing upper respiratory infections?

<p>Seek early medical intervention. (C)</p> Signup and view all the answers

What preventive measure should a patient with endocarditis take regarding medical procedures?

<p>Obtain prophylactic antibiotic therapy. (B)</p> Signup and view all the answers

What initial treatment is anticipated for a patient with ITP and a platelet count of 50,000/µl?

<p>Corticosteroids (B)</p> Signup and view all the answers

What complication should a nurse monitor for after pacemaker implantation?

<p>Bradycardia (B)</p> Signup and view all the answers

What statement by a client with variant angina indicates the need for further teaching?

<p>My spouse told me that since I have developed this problem, we are going to stop walking in the mall every morning. (C)</p> Signup and view all the answers

What does decreased central venous pressure (CVP) indicate in an acutely ill patient?

<p>Possible hypovolemia (A)</p> Signup and view all the answers

What goal should be prioritized during the acute postoperative period following AAA repair?

<p>IV fluids are administered at a rate to maintain urine output of 100 mL/hour. (C)</p> Signup and view all the answers

What complication should the nurse prevent when there is an increased quantity of fluid in the pericardial sac?

<p>Cardiac tamponade (D)</p> Signup and view all the answers

What is an additional function of pulmonary artery pressure monitoring systems besides assessing left ventricular function?

<p>Assessing the patient's response to fluid and drug administration. (B)</p> Signup and view all the answers

Which characteristic is NOT associated with vasospastic disease (Raynaud's phenomenon)?

<p>Associated with inflammation of large arteries (A)</p> Signup and view all the answers

Which aneurysm is characterized as a circumferential dilation of the artery?

<p>Fusiform aneurysm (D)</p> Signup and view all the answers

What observation might indicate graft thrombosis after AAA repair?

<p>Decreased pulses and cool, painful extremities below the level of repair. (A)</p> Signup and view all the answers

Flashcards

Treatment for blocked artery (within 90 minutes)?

Percutaneous coronary intervention (PCI)

Diet modification for spironolactone?

Decrease sodium intake, increase potassium intake.

Common cause of heart transplant death (first year)?

Infection

Assessment finding for right-sided heart failure?

Distended neck veins

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Signs of deep vein thrombosis (DVT)?

Sudden swelling of one leg with dependent edema, numbness of legs with diaphoresis, pain behind the knee with dorsiflexion of foot.

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Right-sided heart failure signs?

Bilateral ankle edema, Jugular venous distention (JVD), Enlarged liver

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Preventing thrombophlebitis on bedrest?

Elevate knee gatch, encourage ankle exercises, use sequential compression devices, prevent dehydration, elevate feet/legs above heart.

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Preventing DVT in outpatient bariatric surgery

Early ambulation is crucial in preventing deep vein thrombosis (DVT).

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Test for Coumadin (deep vein thrombosis)?

Prothrombin time (PT)

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Fluid overload symptom

Pulmonary crackles that clear with deep breathing signal potential fluid overload.

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Medications to withhold before cardiac catheterization

Metformin must be withheld for 24 hours before and 48 hours after cardiac catheterization.

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Priority interventions for acute heart failure

Administering oxygen, transporting to the coronary care unit, administering morphine, and placing the patient in a low Fowler's position are priority interventions.

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Priority assessment for acute myocardial infarction (MI)

Obtain a 12-lead electrocardiogram (ECG) as a priority in a suspected MI.

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ECG characteristic of myocardial ischemia

An elevated ST segment on an ECG indicates myocardial ischemia.

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Pain relief for cardiac tamponade

Administering morphine sulfate as ordered is the initial action to relieve pain.

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Pericarditis chest pain characteristic

Pericarditis causes sharp chest pain that worsens with deep breathing.

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Decreased CVP indicates

Possible hypovolemia (low blood volume).

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Post-AAA repair goal

Maintain urine output at 100 mL/hour by adjusting IV fluids.

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Pericardial fluid increase risk

Cardiac tamponade (pressure on the heart).

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Pulmonary artery monitoring use

Assess left ventricular function and response to fluids/drugs.

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Raynaud's phenomenon cause

Cold, caffeine, tobacco, autoimmune disorders affect small arteries.

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Fusiform aneurysm characteristic

Uniform, circumferential widening of the artery.

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Graft thrombosis symptom

Decreased pulses, coolness, pain below repair site.

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Iron supplement instruction

Increase fluid and fiber intake to prevent constipation.

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HF improvement in AA

Hydralazine shows improvement in heart failure for African American patients with hypertension and angina.

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HF patient position

Patients with heart failure exhibiting pulmonary edema are best positioned in a high Fowlers position to improve circulation.

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Severe Anemia concern

Dyspnea at rest is the most concerning finding during a physical assessment of a patient with severe anemia.

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Post-pericardiocentesis complication

Pneumothorax is a potential complication to monitor for after a pericardiocentesis procedure.

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Incorrect PAD medication statement

The statement, "I should take one aspirin a day to prevent clotting in my legs" indicates a need for further instruction regarding PAD.

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Hemophilia sport activity

Swimming is a suitable sport activity for a 10-year-old child with hemophilia.

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VTE risk factors in post-op

Smoking, estrogen therapy, orthopedic surgery, and prolonged immobilization increase the risk of venous thromboembolism (VTE) in post-menopausal women.

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Initial VTE diagnosis test

Duplex ultrasound is an initial diagnostic test for patients experiencing pain, edema, and warm skin on a leg.

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What ECG component shows pathologic change?

The QRS complex reflects ventricular depolarization, so any abnormalities in this wave would indicate problems with ventricular function.

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How do beta-blockers affect blood pressure?

Beta-blockers like atenolol lower blood pressure by decreasing heart rate and contractility, and inhibiting renin release, which reduces vasoconstriction.

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Elevated Troponin: Angina or MI?

Increased serum troponin levels, particularly 4 to 6 hours after onset, are specific to myocardial infarction (MI) damage, not unstable angina.

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What assessment is crucial in suspected Digoxin toxicity?

Digoxin toxicity can lead to dangerously high potassium levels (hyperkalemia), so monitoring potassium levels is critical.

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What is the goal during hypertensive crisis?

The initial goal in a hypertensive crisis is to quickly reduce blood pressure, ideally to a normal level within 2-3 hours.

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Unstable angina treatment priority

Rapid treatment is crucial because plaque rupture can cause complete vessel blockage leading to a heart attack.

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Venous leg ulcer treatment

Graduated compression stockings are the most important treatment for venous leg ulcers.

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Digitalis toxicity prevention in CHF

Monitoring potassium levels is vital when treating chronic heart failure with drugs like digoxin, as this helps avoid digoxin toxicity.

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Pacemaker patient discharge teaching

Teach patients to use mild analgesics to control chest spasms from pacing.

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Sickle cell disease discharge teaching

Teach patients to seek prompt medical attention for upper respiratory infections to avoid complications.

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Endocarditis recurrence prevention

Obtaining prophylactic antibiotics before invasive medical or dental procedures helps prevent endocarditis recurrence.

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ITP initial treatment

Corticosteroids are a common initial treatment for immune thrombocytopenic purpura (ITP).

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Cardiac dysrhythmia goal

Maintaining adequate cardiac output (heart's pumping ability) is the primary goal for patients with cardiac dysrhythmias.

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Study Notes

Evaluation Examination Study Notes

  • Content: This document appears to be an evaluation examination, specifically on oxygenation, for a nursing program (NCM 112). The questions cover various aspects of patient care, including assessment, diagnosis, treatment, and monitoring.

Exam Questions (Page 1 - 16)

  • Content: Multiple-choice questions addressing patient care in different scenarios, cardiovascular health, and other relevant topics. Multiple-answer format questions are also present.
  • Questions: Covered topics include cardiac catheterizations, dysrhythmias, heart failure, cardiac monitoring, diagnostic tests, and various other clinical scenarios. Questions also relate to patient education and understanding of disease processes. Additional questions include topics such as hypertension, angina, and other cardiovascular conditions and their management. Some questions describe specific patient case studies and assessment tools, like ECG results, to assess the patient's health.
  • Format: Each question is presented with a series of possible answers, requiring selection of the correct one or ones.

Exam Questions (Page 9 - 16)

  • Content: Continuation of the exam material, focusing on patient care, medical diagnoses, and physiological concepts. Covers a wide range of topics in patient care and physiological concepts. Questions deal with a variety of illnesses and medical conditions and examine a student's knowledge across several physiological and diagnostic areas.
  • Format: Multiple-choice questions, and some possible multiple-answer format questions.

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Description

Test your knowledge and skills on oxygenation and patient care in the nursing program NCM 112. This evaluation includes multiple-choice and multiple-answer questions covering topics such as cardiac health, diagnostic tests, and patient management scenarios. Prepare effectively for your nursing exams with this comprehensive assessment.

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