NCM 112: Oxygenation Evaluation Examination (Set 1) PDF

# NCM 112: OXYGENATION ## EVALUTION EXAMINATION (Set 1) **Directions:** Write your Name, year and section on the provided space given above. Read each question and choices carefully, choose and ENCIRCLE the letter of the correct answer. Use only black or blue inked ball pen, and NO ERASURES ALLOWED...

# NCM 112: OXYGENATION ## EVALUTION EXAMINATION (Set 1) **Directions:** Write your Name, year and section on the provided space given above. Read each question and choices carefully, choose and ENCIRCLE the letter of the correct answer. Use only black or blue inked ball pen, and NO ERASURES ALLOWED. 1. When caring for a patient after a cardiac catheterization with coronary angiography, which finding should be of most concern to the nurse? - Absence of pulses distal to the catheter insertion site. 2. Nurse Bianca Kelly is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but more than 140 beats/minute The nurse determines that the client is experiencing which dysrhythmia? - Ventricular tachycardia 3. Which of the following is a significant finding in the health history of a patient during an assessment of the cardiovascular system? - Metastatic cancer 4. Student nurse Rimskie is seeking assistance in hearing the patient's abnormal heart sounds. What should the nurse tell the student to do for a more effective assessment? - Use the bell of the stethoscope with the patient leaning forward. 5. What accurately describes electrocardiographic (ECG) monitoring? - If the sinoatrial (SA) node fails to discharge an impulse or discharges very slowly, a secondary pacemaker in the AV node can discharge at a rate of 30 to 40 times per minute. 6. A patient is scheduled for exercise nuclear imaging stress testing. Nurse Riztella explains to the patient that this test involves: - Exercising on a treadmill or stationary bicycle with continuous ECG monitoring to detect ischemic changes in the heart during exercise. 7. A client has frequent bursts of ventricular tachycardia on the cardiac monitor. What should nurse Ivette be most concerned about with this dysrhythmia? - It can develop into ventricular fibrillation at any time. 8. Nurse Zablan determines that treatment of heart failure has been successful when the patient experiences: - Clear lung sounds and decreased Heart Rate. 9. Nurse Francine Mae is caring for a patient immediately following a transesophageal echocardiogram (TEE) should consider which action the highest priority? - Monitor the ECG. 10. Which method is used to evaluate the ECG responses to normal activity over a period of 1 or 2 days? - Event monitor or loop recorder 11. Which statement indicates the patient is experiencing anger as the psychologic response to his acute MI? - "What's going to happen if I have another heart attack?" 12. Coronary circulation is the movement of blood throughout the vessels that supply the myocardium. Which of the following arteries are the major providers of coronary circulation? Select all that apply (Left main coronary artery, Right coronary artery, Left anterior descending artery, Posterior descending artery). - 1, 2, 4, and 6 13. A female patient has a total cholesterol level of 232 mg/dL (6.0 mmol/L) and a high-density lipoprotein (HDL) of 65mg/dL (1.68 mmol). Another patient has a total cholesterol level of 200 mg/dl (5.17 mmol/L) and an HDL of 32 mg/dL (0.83 mmol/L). Based on these findings, which patient has the highest cardiac risk? - The man, because his cholesterol-to-HDL ratio is higher. 14. The acronym FACES is used to help teach patients to identify early symptoms of heart failure. What does this acronym mean? - Fatigue, limitation of activities, chest congestion/cough, edema, shortness of breath. 15. A thoracic aortic aneurysm is found when a patient has a routine chest x-ray. Nurse Arrianne anticipates that additional diagnostic testing to determine the size and structure of the aneurysm will include which test? - Computed tomography (CT) scan 16. Increases in which blood studies are diagnostic for acute coronary syndrome (ACS)? Select all that apply (Copeptin, Creatine kinase (CK-MM) Cardiac troponin T (cTnT). Type natriuretic peptide (BNP). High-sensitivity C-reactive protein (hs-CRP), Lipoprotein-associated phospholipase A2) - 2, 3, and 5 17. The patient diagnosed with secondary hypertension asks why it is called secondary and not primary. What is the best explanation by nurse Justine to provide? - Has a specific cause, such as renal disease that often can be treated by medicine or surgery. 18. A 38-yr-old man is treated for hypertension for the first time. He has been taking hydrochlorothiazide and metoprolol (Lopressor) for four months after his last clinic visit, but he admits he has not been taking his medication regularly. What is the most important response to this patient? - "You probably would not need to take medications for hypertension if you would exercise more and stop smoking." 19. What drugs are commonly associated with CAD? - Apolipoproteins and Fasting Triglycerides 20. Which treatment is used for the patient with a confirmed occlusion of the blocked artery within 90 minutes of arrival to the facility? - Percutaneous coronary intervention (PCI) 21. The health care provider prescribes spironolactone (Aldactone) for the patient with chronic heart failure. What diet modifications related to the use of this drug should nurse Balingit include in the patient teaching? - Decrease sodium intake and increase potassium intake. 22. The nurse plans long-term goals for the patient who has had a heart transplant with the knowledge that what is the most common cause of death in heart transplant patients during the first year? - Infection 23. The nurse is assessing a patient who is known to have right-sided HF. What assessment finding is most consistent with this patients diagnosis? - Distended neck veins 24. Nurse Lacandola is reviewing the use of cardiopulmonary bypass during surgery for coronary artery bypass grafting with a group of nurses. Which of the following statements should the nurse exclude in the discussion? - The client's metabolic rate is increased" 25. Nurse Cesario should recognize the signs of deep vein thrombosis (DVT) if a client reports. Select all that apply (Leg feeling cool with no pain., Numbness of legs with diaphoresis., Sudden swelling of one leg with dependent edema., Dizziness and blurred vision., Pain behind the knee with dorsiflexion of foot.) - 2, 3, and 5 26. What signs will a nurse observe in a client who is experiencing right-sided heart failure? Select all that apply (Bilateral ankle edema, Jugular venous distention (JVD)., Crackles on auscultation., Enlarged liver). - 1, 2, 4, and 5 27. Identify the appropriate actions in the prevention of thrombophlebitis in a client on bedrest. Select all that apply (Elevate the knee gatch of the bed, Encourage exercises that dorsiflex and plantar flex the ankle. Apply sequential compression devices bilaterally, Prevent dehydration, Periodically elevate the feet and lower legs above level of heart, Apply warm, moist packs bilaterally to lower legs.) - 1, 3, 4, and 6 28. Nurse Carina should evaluate the effects of coumadin, used in the treatment of deep vein thrombosis, by looking at the results of which laboratory tests? - Prothrombin time (PT) 29. Nurse Marc gets a report that a client will be admitted with an ejection fraction of 58%. Which history and physical finding should the nurse anticipate? - Crackles in the lung bases that clear with deep breathing. 30. A client is scheduled for outpatient bariatric surgery. Deep vein thrombosis (DVT) is best prevented by: - Early ambulation 31. Which finding is consistent with a client developing fluid overload? - Pulmonary crackles that clear with deep breathing 32. A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is scheduled for cardiac catheterization. Which medication would need to be withheld for 24 hours before the procedure and for 48 hours after the procedure? - Metformin 33. The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles and the nurse prepares to contact the health care provider and prepares for the intervention which priority interventions ? Select all that apply (Administering oxygen, Transporting the client to the coronary care unit, Administering morphine sulfate intravenously, Transporting the client to the coronary care unit, Placing the client in a low Fowler's side-lying position). - 1, 2, 3, 4, and 6 34. A 60-year-old male client comes into the emergency department with complaints of crushing substernal chest pain that radiates to his shoulder and left arm. The admitting diagnosis is acute myocardial infarction (MI). Which of the following admission orders should nurse Cuevas prioritize? - Obtain a 12-lead ECG 35. A client comes to the emergency department complaining of chest pain. An electrocardiogram (ECG) reveals myocardial ischemia and an anterior-wall myocardial infarction (MI). Which ECG characteristic indicates myocardial ischemia? - Elevated ST segment 36. A patient with cardiac tamponade complains of severe chest pain. Nurse Rick's first action to relieve the pain is by? - Administering Morphine Sulfate as ordered. 37. Patients often confuse the chest pains caused by pericarditis from angina pectoris. Nurse Capanang must explain that the chest pain caused by pericarditis is characterized by which of the following? - Sharp chest pain aggravated by deep breathing. 38. The physician prescribed the patient to use compression stockings. How should nurse Christine instruct the patient with varicose veins to utilize compression stockings? - "Try to keep your stockings on 24 hours a day, as much as possible." 39. The patient is receiving continuous IV Heparin. For this medication to have a therapeutic effect on the patient, the aPTT should be? - 1.5-2.5 times the normal value range. 40. A client with myocardial infarction is developing cardiogenic shock. Because of the risk of myocardial ischemia, what condition should nurse Sanchez carefully assess the client for? - Rising diastolic blood pressure # NCM 112: OXYGENATION ## EVALUTION EXAMINATION (Set 2) **Directions:** Write your Name, year and section on the provided space given above. Read each question and choices carefully, choose and ENCIRCLE the letter of the correct answer. Use only black or blue inked ball pen, and NO ERASURES ALLOWED. 1. What early manifestations is the patient with primary hypertension likely to report? - Dizziness and vertigo 2. What describes the SA node's ability to discharge an electrical impulse spontaneously? - Automaticity 3. Nurse Marcos and patient Trisha Dawn set a patient outcome that at the time of discharge after an MI the patient will be able to tolerate moderate-energy activities that are similar to which activity? - Walking at 5 mph 4. The patient has hypertension and just experienced an MI. Which type of medication should nurse Lavetoria expect to be added to decrease the workload on his heart? - B-adrenergic blocker 5. Interprofessional care of the patient with NSTEMI differs from that of a patient with STEMI in that NSTEMI is more frequently initially treated with what? - Percutaneous coronary intervention (PCI) 6. Nurse Neil Christian is aware that the most common organ damage in hypertension is related to? - Atherosclerotic changes in vessels that supply the organs. 7. A patient with a small AAA is not a good surgical candidate. What should nurse Lacson teach the patient that one of the best ways to prevent expansion of the lesion? - Control hypertension with prescribed therapy. 8. Which effects contribute to making nitrates the first-line therapy for the treatment of angina? Select all that apply (Decrease preload, Decrease afterload, Dilate coronary arteries. Decrease heart rate, Prevent thrombosis of plaques, Decrease myocardial contractility.) - 1, 2, 3, 4, and 5 9. A patient with stage 2 hypertension who is taking chlorothiazide (Diuril) and terazosin (Hytrin) has a new medication added to the medication regimen. What is most important for nurse Kryatch to teach the patient? - Weigh every morning to monitor for fluid retention. 10. When caring for a client with chronic occlusive arterial disease what precautions should nurse Catapang identify for development of ulceration and gangrenous tissues? - Trauma from mechanical, chemical, or thermal 11. The patient's PR interval comprises six small boxes on the ECG strip. What does this indicate? - A disturbance in the repolarization of the atria. 12. What should nurse Aljon emphasize when teaching a patient who is newly prescribed clonidine (Catapres)? - The drug should never be stopped abruptly. 13. A 58-yr-old patient is in a cardiac rehabilitation program. The nurse teaches the patient to stop exercising if what occurs? - Pain or dyspnea develop. 14. Which patient is most likely to be in the fibrous stage of development of coronary artery disease (CAD)? - Age 50, rapid onset of disease with hypercholesterolemia 15. Nurse Bernardino is encouraging a sedentary patient with major risks for CAD to perform physical exercise on a regular basis. In addition to decreasing the risk factor of physical inactivity, the nurse tells the patient that exercise will also directly contribute to reducing which risk factors? - Hyperlipidemia and obesity 16. Nurse John Gabriel is conducting patient teaching about cholesterol levels. When discussing the patients elevated LDL and lowered HDL levels, the patient shows an understanding of the significance of these levels by stating what? - Increased LDL and decreased HDL increase my risk of coronary artery disease. 17. Myocardial ischemia occurs because of increased oxygen demand and decreased oxygen supply. What factors and disorders result in increased oxygen demand? Select all that apply (Hypovolemia or anemia, Increased cardiac workload with aortic stenosis, Narrowed coronary arteries from atherosclerosis, Angina in the patient with atherosclerotic coronary arteries, Left ventricular hypertrophy caused by chronic hypertension, Sympathetic nervous system stimulation by drugs, emotions, or exertion.) - 2, 4, 5, and 6 18. What should nurse Chan reading the monitor strip call a rhythm with a regular PR interval but a blocked QRS complex? - Type II second-degree AV block 19. The nurse monitors the patient receiving treatment for acute decompensated heart failure with the knowledge that marked hypotension is most likely to occur with the IV administration of which medication? - Nitroprusside 20. Paula Santos the triage nurse in the ED is performing a rapid assessment of a man with complaints of severe chest pain and shortness of breath. The patient is diaphoretic, pale, and weak. When the patient collapses, what should the nurse do first? - Check for a carotid pulse 21. A client with variant angina is scheduled to receive an oral calcium channel blocker twice daily. Which statement by the client indicates the need for further teaching? - "My spouse told me that since I have developed this problem, we are going to stop walking in the mall every morning." 22. The physician has placed a central venous pressure (CVP) monitoring line in an acutely ill patient so right ventricular function and venous blood return can be closely monitored. The results show decreased CVP. What does this indicate? - Possible hypovolemia 23. During the patient's acute postoperative period following repair of an AAA, nurse Miranda should ensure that which goal is achieved? - IV fluids are administered at a rate to maintain urine output of 100 mL/hour. 24. Diagnostic imaging reveals that the quantity of fluid in a clients pericardial sac is dangerously increased. The nurse should collaborate with the other members of the care team to prevent the development of what complication? - Cardiac tamponade 25. Ambrocio the critical care nurse is caring for a patient with a pulmonary artery pressure monitoring system. Nurse is aware that pulmonary artery pressure monitoring is used to assess left ventricular function. What is an additional function of pulmonary artery pressure monitoring systems? - To assess the patient's response to fluid and drug administration. 26. What are characteristics of vasospastic disease (Raynaud's phenomenon)? Select all that apply. (Predominant in young females, May be associated with autoimmune disorders, Precipitated by exposure to cold, caffeine, and tobacco, Involves small cutaneous arteries of the fingers and toes, Inflammation of small and medium-sized arteries and veins, Episodes involve white, blue, and red color changes of fingertips). - 1, 2, 3, 4, 5, and 6 27. Which aneurysm is uniform in shape and a circumferential dilation of the artery? - Fusiform aneurysm 28. Which observation should indicate to nurse Tubangui the presence of the complication of graft thrombosis after AAA repair? - Decreased pulses and cool, painful extremities below the level of repair. 29. When teaching the patient about a new prescription for oral iron supplements, what does the nurse instruct the patient to do? - Increase fluid and dietary fiber intake. 30. Nursing interventions for the patient with aplastic anemia are directed toward the prevention of which complications? - Hemorrhage and infection 31. A client with episodes of a cardiac dysrthymias is to wear a Holter monitor for 24 hours. When planning teaching for this client, what information should the nurse include about the monitor? The monitor: - Will record tracings of abnormal cardiac rhythms during ADL's 32. Nurse Rebolledo is teaching a group of clients with PVD's to stop smoking. Which physiologic effect of nicotine should the nurse explain to the group? - Constriction of the peripheral vessels, increasing the force of flow. 33. Nurse Masangcay is evaluating the condition of a client after pericardiocentesis performed to treat cardiac tamponade. Which observation would indicate that the procedure was effective ? - Muffled heart sounds 34. Identify the cardiac rhythms using the systematic approach to assessing cardiac rhythms (Multiple Choice) – H. Sinus bradycardia – I. Premature Atrial Complex (PAC) – L. Normal sinus rhythm - F. Premature Ventricular Contractions (PVC) # NCM 112: OXYGENATION ## EVALUTION EXAMINATION (Set 3) **Directions:** Write your Name, year and section on the provided space given above. Read each question and choices carefully, choose and ENCIRCLE the letter of the correct answer. Use only black or blue inked ball pen, and NO ERASURES ALLOWED. 1. Patients diagnosed with hypertension usually received medications that blocks a substance in the body that causes blood vessels to tighten. A patient asks nurse Caria Jaymee about valsartan (Diovan), the new medication prescribed for blood pressure. What is the best explanation the nurse can use to explain the action of this medication? - Decreases extracellular fluid volume by increasing Na and Cl- excretion with water. 2. Carreon the cardiac care nurse is reviewing the conduction system of the heart. The nurse is aware that electrical conduction of the heart usually originates in the SA node and then proceeds in what sequence? - SA node to AV node to bundle of His to Purkinje fibers. 3. Dietary teaching that includes eating dietary sources of potassium is indicated for the hypertensive patient taking which drug? - Spironolactone 4. Nurse Del Mundo in the Coronary Care Unit is caring for a patient with HF who has developed an intracardiac thrombus. This creates a high risk for what sequela? - Stroke. 5. What accurately describes the pathophysiology of CAD? - The leading theory of atherogenesis proposes that infection and fatty dietary intake are the basic underlying causes of atherosclerosis. 6. During a routine health examination, a 48-yr-old patient is found to have a total cholesterol level of 224 mg/dL (5.8 mmol/L) and an LDL level of 140 mg/dL (3.6 mmol/L). What does nurse Capiral teach the patient based on the Therapeutic Lifestyle Changes diet? Select all that apply (Use fat-free milk, Abstain from alcohol use, Reduce red meat in the diet., Eliminate intake of simple sugars, Avoid egg yolks and foods prepared with whole eggs.) - 2, 3, 4, and 5 7. Nurse Clemente is aware that the most common causes of pain that occurs with myocardial ischemia is? - Lactic acid accumulation during anaerobic metabolism 8. The patient has used sublingual nitroglycerin (NTG) and various long-acting nitrates but now has an ejection fraction of 38% and is considered at a high risk for a cardiac event. Which medication would first be added for vasodilation and to reduce ventricular remodeling? - Metoprolol (Lopressor) 9. A patient who is postoperative following repair of an AAA has been receiving IV fluids at 125 ml/hour continuously for the last 12 hours. Urine output for the last 4 hours has been 60 ml, 42 mL, 28 mL, and 20 mL, respectively. What is the priority action that nurse Dustin should take? - Contact the HCP and report the decrease in urine output. 10. A patient with a complex cardiac history is scheduled for transthoracic echocardiography. What should nurse Nacana teach the patient in anticipation of this diagnostic procedure? - The test is noninvasive, and nothing will be inserted into the patient's body. 11. Nurse Fritzie is aware that the common causes of the anemia of sickle cell disease is? - Intracellular hemolysis of sickled RBCs. 12. Laboratory studies are performed for a child suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia? - RBC that are microcytic and hypochromic. 13. When teaching an older adult with CAD how to manage the treatment program for angina, which guidelines does the nurse use to teach the patient? - To exercise only twice a week to avoid unnecessary strain on the heart. 14. To detect and treat the most common complication of MI, What should nurse Taguines do? - Use continuous cardiac monitoring. 15. What is the pathophysiologic mechanism that results in the pulmonary edema of left-sided heart failure? - Increased pulmonary hydrostatic pressure. 16. Nurse Balagot is caring for a patient who has had an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. How should the nurse best respond? - Recognize that the view of the electrical current changes in relation to the lead placement. 17. Which medication shows improvement in HF for African American patients for hypertension and angina? - Hydralazine 18. A patient admitted to the medical unit with HF is exhibiting signs and symptoms of pulmonary edema. The nurse is aware that positioning will promote circulation. How should the nurse best position the patient? - In a high Fowlers position. 19. During the physical assessment of the patient with severe anemia, which finding is of the most concern to nurse? - Dyspnea at rest. 20. The patient with acute pericarditis is having a pericardiocentesis. Postoperatively, what complication should the nurse monitor the patient for?. - Pneumothorax 21. Following teaching about medications for PAD, nurse Jon Carlos determines that additional instruction is necessary when the patient makes which statement? - "I should take one aspirin a day to prevent clotting in my legs." 22. The nurse is providing home care instructions to the parents of a 10-year-old child with hemophilia. Which sport activity should the nurse suggest for this child? - Swimming. 23. The surgery area calls the transfer report for a 68-year-old, postmenopausal, female patient who smokes and takes hormone therapy. She is returning to the clinical unit after a lengthy hip replacement surgery. Which factors present in this patient increase her risk for developing venous thromboembolism (VTE) related to Virchow's triad? Select all that apply. (Smoking, IV therapy, Dehydration, Estrogen therapy, Orthopedic surgery. Prolonged immobilization). - 1, 2, 4, 5, and 6 24. The patient comes to the physician's office with pain, edema, and warm skin on her lower left leg. What test should nurse Gian expect to be ordered first ? - Duplex ultrasound. 25. The patient with VTE is receiving therapy with heparin and asks the nurse whether the drug will dissolve the clot in her leg. What is the best response by nurse Timothy? - “The purpose of the heparin is to prevent growth of the clot or formation of new clots where the circulation is slowed." 26. A patient with VTE is to be discharged on long-term warfarin (Coumadin) therapy and is taught about prevention and continuing treatment of VTE. The nurse determines that discharge teaching for the patient has been effective when the patient makes which statement? - "I should avoid all dark green and leafy vegetables while I am taking Coumadin." 27. Nurse Ronald James overseeing care in the ICU reviews the shift report on four patients. The nurse recognizes which patient to be at greatest risk for the development of cardiogenic shock? The patient: - Admitted following an MI. 28. A patient with a hemoglobin (Hgb) level of 7.8 g/dL (78 g/L) has cardiac palpitations, a heart rate of 102 bpm, and an increased reticulocyte count. Considering the severity of anemia, what other manifestation would nurse Luchan expect the patient to exhibit? - Dyspnea 29. What is a nursing intervention that is indicated for the patient during a sickle cell crisis? - Administration of large doses of continuous opioid analgesics. 30. A client has been admitted to the coronary care unit with a myocardial infarction. Which nursing diagnosis should have priority? - Pain related to ischemia. 31. Which statement is not accurately describing thrombocytopenia? - TTP is characterized by decreased platelets, decreased RBCs, and enhanced aggregation of platelets. 32. A patient with HF is placed on a low-sodium diet. Which statement by the patient indicates that nurse Katrina's nutritional teaching plan has been effective? - “I will have a baked potato with broiled chicken for dinner.” 33. The cardiac monitor alarm alerts the critical care nurse that the patient is showing no cardiac rhythm on the monitor. Nurse Reniel rapid assessment suggests cardiac arrest. In providing cardiac resuscitation documentation, how will the nurse describe this initial absence of cardiac rhythm? - Asystole 34. An adult patient has been diagnosed with iron-deficiency anemia. What nursing diagnosis is most likely to apply to this patient’s health status? - Risk for infection related to tissue hypoxia. 35. Nurse Jiwani is reviewing the medication administration record of a patient diagnosed with systolic left-sided heart failure. What medication should the nurse anticipate administering to this patient? - A calcium channel blocker. # NCM 112: OXYGENATION ## EVALUTION EXAMINATION (Set 4) **Directions:** Write your Name, year and section on the provided space given above. Read each question and choices carefully, choose and ENCIRCLE the letter of the correct answer. Use only black or blue inked ball pen, and NO ERASURES ALLOWED. 1. The nursing educator is presenting a case study of an adult patient who has abnormal ventricular depolarization. This pathologic change would be most evident in what component of the ECG? - QRS complex 2. Nurse Sheena Mae is correct if she states that the primary BP effect of β-adrenergic blockers such as atenolol (Tenormin) is? - Decrease CO by decreasing rate and strength of the heart and renin secretion by the kidneys. 3. In the patient with chest pain, which results can differentiate unstable angina from an MI? - Serum troponin levels increased 4 to 6 hours after the onset. 4. Nurse Gamboa is caring for a 68-year-old patient the nurse suspects has digoxin toxicity. In addition to physical assessment, the nurse should collect what assessment datum? - Potassium level 5. What is included in the correct technique for BP measurements? - Always take the BP in both arms. 6. At what point in the healing process of the myocardium following an infarct does early scar tissue result in an unstable heart wall? - 4 to 10 days after MI 7. During treatment of a patient with a BP of 222/148 mm Hg and confusion, nausea, and vomiting, the nurse initially titrates the medications to achieve which goal? - Lower the BP to the patient’s normal within the second to third hour. 8. To which patients should the nurse teach the Therapeutic Lifestyle Changes diet to reduce the risk of coronary artery disease (CAD)? - Individuals with two or more risk factors for CAD. 9. A 62-yr-old woman has prehypertension (BP 138/88 mm Hg) and smokes a pack of cigarettes per day. She has no symptoms of CAD, but a recent LDL level was 154 mg/dL (3.98 mmol/L). Based on these findings, nurse Celis would expect that which treatment plan would be used first for this patient? - Diet therapy and smoking cessation 10. Nurse Jarmina is caring for a patient admitted with unstable angina. The laboratory result for the initial troponin I is elevated in this patient. The nurse should recognize what implication of assessment finding? - This is an accurate indicator of myocardial injury 11. What types of angina can occur in the absence of CAD? Select all that apply (Silent ischemia, Nocturnal angina, Prinzmetal's angina, Microvascular angina, Chronic stable angina) - 2, 3, and 5 12. Nurse Jansen teaches the patient with any venous disorder that the best way to prevent venous stasis and increase venous return is to: - Continuously wear elastic compression stockings. 13. When a patient reports chest pain, why must unstable angina be identified and rapidly treated? - Rupture of unstable plaque may cause complete thrombosis of the vessel lumen. 14. What is the most important measure in the treatment of venous leg ulcers? - Graduated compression stockings 15. A patient with chronic heart failure is treated with hydrochlorothiazide, digoxin, and lisinopril. To prevent the risk of digitalis toxicity with these drugs, what is most important that the nurse monitor for this patient? - Potassium levels 16. A patient with a sinus node dysfunction has a permanent pacemaker inserted. Before discharge, what should nurse Mamaradio include when teaching the patient? - Use mild analgesics to control the chest spasms caused by the pacing current. 17. During discharge teaching of a patient with newly diagnosed sickle cell disease, what should nurse Caybayab teach the patient to do? - Seek early medical intervention for upper respiratory infections. 18. When instructing a patient with endocarditis how to prevent recurrence of the infection, what should nurse Magdangal teach the patient? - Obtain prophylactic antibiotic therapy before certain invasive medical or dental procedures. 19. A patient has a platelet count of 50,000/µl and is diagnosed with ITP. What does nurse Gagarin anticipate that initial treatment will include? - Corticosteroids 20. Nurse Sid is writing a plan of care for a patient with a cardiac dysrhythmia. What would be the most appropriate goal for the patient? - Maintain adequate cardiac output. 21. A patient has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should nurse Angelou most closely assess this patient? - Bradycardia 22. A patient with mitral stenosis exhibits new symptoms of a dysrhythmia. Based on the pathophysiology of this disease process, nurse Raphael Angelo would expect the patient to exhibit what heart rhythm? - Atrial fibrillation 23. Nurse Soliman analyzes the laboratory results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child? - Partial thromboplastin time (PTT) 24. Which assessment would be most appropriate for a patient who is receiving a loop diuretic for HF? - Assess the patient for hyperkalemia. 25. Nurse Aryhen is caring for an adult patient with HF who is prescribed digoxin. When assessing the patient for adverse effects, the nurse should assess for which of the following signs and symptoms? - Bradycardia 26. The nurse is preparing a client with a deep vein thrombosis (DVT) for a Venous Doppler evaluation. Which of the following would be necessary for preparing the client for this test? - No special preparation is necessary. 27. A client is admitted with infective endocarditis (IE). Which finding would alert the nurse to a complication of this condition? - Hemorrhage 28. The nurse explains an autograft to a client scheduled for excision of a skin tumor. The nurse knows the client understands the procedure when the client says, "I will receive tissue from: " – "My thigh." 29. Nurse Bulanadi is admitting a 27 years-old who vomited 9 times in the past 6 hours should observe for signs of which overall imbalance? - Some increase in the serum hemoglobin. 30. Nurse Kem-J is developing a meal plan that would provide the maximum possible amount of iron for a patient with anemia. Which dinner menu would be best? - Ground beef patty, lima beans, wheat roll, raisins, milk. 31. Which manifestation is an indication that a patient is having hypertensive emergency? - A systolic BP >180 mm Hg and a diastolic BP >110 mm Hg. 32. While obtaining patient histories, which patient does nurse Cart Julius identify as having the highest risk for CAD? - An obese Hispanic man, age 65, with a cholesterol level of 195 mg/dL, and a BP of 128/76 mm Hg. 33. Which characteristics describe unstable angina? Select all that apply (Usually precipitated by exertion, New onset angina with minimal exertion, Occurs only when the person is recumbent, Characterized by increased duration or severity, Usually occurs in response to coronary artery spasm.) - 1, 2, 4, and 5 34. Which rhythm pattern finding is indicative of PVCs? - Continuous wide QRS complexes with a ventricular rate of 160 bpm. 35. What action is included in the nurse’s responsibilities in preparing to administer defibrillation? - Setting the defibrillator to deliver 50 joules. # NCM 112: OXYGENATION ## EVALUTION EXAMINATION (Set 4) **Directions:** Write your Name, year and section on the provided space given above. Read each question and choices carefully, choose and ENCIRCLE the letter of the correct answer. Use only black or blue inked ball pen, and NO ERASURES ALLOWED. 1. The nursing educator is presenting a case study of an adult patient who has abnormal ventricular depolarization. This pathologic change would be most evident in what component of the ECG? - QRS complex 2. Nurse Sheena Mae is correct if she states that the primary BP effect of β-adrenergic blockers such as atenolol (Tenormin) is? - Decrease CO by decreasing rate and strength of the heart and renin secretion by the kidneys. 3. In the patient with chest pain, which results can differentiate unstable angina from an MI? - Serum troponin levels increased 4 to 6 hours after the onset. 4. Nurse Gamboa is caring for a 68-year-old patient the nurse suspects has digoxin toxicity. In addition to physical assessment, the nurse should collect what assessment datum? - Potassium level 5. What is included in the correct technique for BP measurements? - Always take the BP in both arms. 6. At what point in the healing process of the myocardium following an infarct does early scar tissue result in an unstable heart wall? - 4 to 10 days after MI. 7. During treatment of a patient with a BP of 222/148 mm Hg and confusion, nausea, and vomiting, the nurse initially titrates the medications to achieve which goal? - Lower the BP to the patient’s normal within the second to third hour. 8. To which patients should the nurse teach the Therapeutic Lifestyle Changes diet to reduce the risk of coronary artery disease (CAD)? - Individuals with two or more risk factors for CAD