ATI Med-Surg Cardiovascular Test Bank -Nurselytic

Correct Answer: B

Rationale: In left-sided heart failure, the pathophysiologic mechanism leading to pulmonary edema is an increase in pulmonary hydrostatic pressure (Option
B). This occurs when the left ventricle fails to effectively pump blood to the body, causing blood to back up into the pulmonary circulation. The increased pressure within the pulmonary capillaries forces fluid out into the interstitial spaces and alveoli, resulting in pulmonary edema.

Option A, increased right ventricular preload, is incorrect because left-sided heart failure primarily affects the left side of the heart, leading to pulmonary symptoms rather than right-sided symptoms.

Option C, impaired alveolar oxygen and carbon dioxide exchange, is incorrect because while pulmonary edema can impact gas exchange, it is not the primary pathophysiologic mechanism causing the edema in left-sided heart failure.

Option D, increased lymphatic flow of pulmonary extravascular fluid, is incorrect as lymphatic flow plays a role in draining excess interstitial fluid from tissues but is not the primary mechanism leading to pulmonary edema in left-sided heart failure.

Educationally, understanding the pathophysiology of pulmonary edema in heart failure is crucial for nurses and healthcare providers to recognize and manage this potentially life-threatening condition. It highlights the importance of monitoring for signs and symptoms of heart failure exacerbation and implementing interventions to reduce pulmonary congestion and improve cardiac function.

Correct Answer: A

Rationale: In this scenario, the correct action by the LPN/LVN that requires immediate intervention is option A, assisting a patient to the bathroom 30 minutes after a coronary arteriogram. This is concerning because after a coronary arteriogram, it is crucial to maintain bed rest for a specified period to prevent complications such as bleeding from the insertion site or dislodging of the clot. Moving the patient too soon can lead to serious consequences.

Option B is not the most concerning because checking a patient's blood pressure before administering nitroglycerin is a standard practice to ensure it is safe to give the medication. Option C shows appropriate action by returning a patient to bed when there is a significant increase in heart rate during ambulation, which could indicate cardiovascular compromise. Option D, bringing breakfast to a patient scheduled for an echocardiogram, is not ideal but does not pose an immediate risk to the patient's health.

In an educational context, it is essential for healthcare providers to understand the importance of following specific protocols and guidelines post-cardiac procedures to ensure patient safety and prevent complications. This scenario highlights the critical nature of timing in patient care and the need for vigilant monitoring to prevent adverse events in cardiac patients.

Correct Answer: C

Rationale: In this scenario, the correct immediate intervention is needed for the patient described in option C. This patient, who has just arrived on the unit with an acute MI and has sinus rhythm with a rate of 76, along with frequent premature ventricular contractions, requires immediate attention due to the risk of developing life-threatening arrhythmias or worsening of the myocardial infarction.

Option A may seem concerning due to atrial fibrillation, but the heart rate of 88 while at rest is not critically high and may not require immediate intervention.

Option B describes a patient with a newly implanted demand ventricular pacemaker, which is functioning within normal parameters with occasional sinus rhythm periods, making this option less urgent compared to option C.

Option D presents a patient with a first-degree heart block and a heart rate of 58, which, although lower than normal, may not warrant immediate intervention if the patient is stable and asymptomatic.

In an educational context, understanding the urgency of different cardiac rhythms is crucial in a clinical setting, especially in coronary care units where patients are at high risk for cardiovascular complications. Proper assessment and prioritization of patients based on their cardiac rhythms can significantly impact patient outcomes and guide appropriate interventions. This case highlights the importance of recognizing critical arrhythmias and responding promptly to ensure patient safety and well-being.

Correct Answer: C

Rationale: In the context of cardiovascular health, a classic sign of ischemia is chest pain or angina. Ischemia refers to inadequate blood supply to a specific part of the body, usually due to blockage or constriction of blood vessels. Chest pain is a common symptom of myocardial ischemia, where the heart muscle does not receive enough oxygen-rich blood. This can be a warning sign of an impending heart attack.

Option A: This option is incorrect because it does not provide any information related to ischemia or its classic signs.

Option B: This option is incorrect because it does not address the specific symptom associated with ischemia, which is chest pain.

Option D: This option is incorrect as it does not describe a classic sign of ischemia. It is crucial for healthcare providers to recognize classic signs of ischemia promptly to provide appropriate interventions and prevent further complications.

Educational Context: Understanding the classic signs of ischemia is essential for healthcare professionals, especially those working in cardiology or emergency care settings. Recognizing these signs promptly can lead to timely interventions and improved patient outcomes. Educators should emphasize the importance of knowing these signs through case studies, simulations, and real-life scenarios to enhance students' clinical reasoning and decision-making skills in managing cardiovascular conditions.

Correct Answer: C

Rationale: In this scenario, the correct answer is
C) Bradycardia. When administering quinidine, a nurse should observe for bradycardia in a client with a valvular disorder of the heart because quinidine is an antiarrhythmic medication that can slow down the heart rate. This adverse effect is important to monitor as it can lead to further complications in a client with a pre-existing valvular disorder.

Option
A) Ringing of the ears is not typically associated with quinidine administration but can be a side effect of other medications like aspirin or certain antibiotics. Option
B) Stiff neck is not a common adverse effect of quinidine. Option
D) Bluish discoloration of the palms is not a known side effect of quinidine and would not be a typical symptom to observe in this context.

Educationally, understanding the potential adverse effects of medications used in cardiovascular disorders is crucial for nurses to provide safe and effective care to their patients. Monitoring for these adverse effects can help prevent complications and improve patient outcomes. It is important for nurses to be knowledgeable about the medications they administer and to closely monitor patients for any signs of potential adverse reactions.