ATI LPN
Cardiovascular Disease Quiz Questions Questions
Question 1 of 5
A 30-year-old woman is admitted to the ICU for management of respiratory failure due to influenza A. She is intubated and mechanically ventilated. Ventilator settings are in the volume control continuous mandatory ventilation (assist control) with a respiratory rate of 18, tidal volume of 360 mL (6 cc/kg of ideal body weight) and an FiO2 of 0.9, and a positive end-expiratory pressure of 14 cmH2O. Her plateau pressure is 28 cmH2O. Because of difficulty with oxygenation, she is paralyzed and appropriately monitored for depth of paralytic and sedation. Medical history is otherwise unremarkable. On physical examination, the temperature is 101.8°F; blood pressure is 112/64 mmHg, pulse rate is 85 b/min, respiratory rate is 18. BMI is 29. There is no jugular venous distention. Coarse breath sounds noted bilaterally. No other physical exam findings noted. Chest radiograph shows appropriate placed endotracheal tube with diffuse patchy infiltrates throughout both lung fields. Arterial blood gas study showed pH 7.41, PaCO2 of 38 mmHg, PaO2 of 55 mmHg. Which of the following is the most appropriate next step in the management of this patient?
Correct Answer: C
Rationale: The patient has severe hypoxemia (PaO2 of 55 mmHg) despite high FiO2 (0.9) and PEEP (14 cmH2O), indicative of acute respiratory distress syndrome (ARDS) due to influenza A. Prone positioning is a well-established intervention in ARDS to improve oxygenation by enhancing ventilation-perfusion matching, supported by clinical guidelines and trials like the PROSEVA study.
Question 2 of 5
The most common causes of heart failure are
Correct Answer: A
Rationale: The most common causes of heart failure are myocardial ischemia from coronary artery disease, followed by hypertension. Dilated cardiomyopathy is less common cause of heart failure. A high-fat diet can contribute to coronary artery disease, which is a contributor to heart failure, but a high-fat diet is not one of the most common causes of heart failure.
Question 3 of 5
You are assisting a patient up from the bed to the bathroom. The patient has swelling in the feet and legs. The patient is receiving treatment for heart failure and is taking Hydralazine and Isordil. Which of the following is a nursing priority for this patient while assisting them to the bathroom?
Correct Answer: B
Rationale: Assisting slowly (B) prevents orthostatic hypotension, a risk with vasodilators like Hydralazine and Isordil, especially with edema.
Question 4 of 5
What substance prevents friction when the heart contracts?
Correct Answer: C
Rationale: The fluid in the pericardial cavity, produced by the serous pericardium, lubricates the heart, reducing friction as it contracts and expands.
Question 5 of 5
During change-of-shift report, the nurse obtains the following information about a hypertensive patient who received the first dose of nadolol(Corgard) during the previous shift. Which information indicates that the patient needs immediate intervention?
Correct Answer: C
Rationale: The most urgent concern for this patient is the wheezes, which indicate that bronchospasm(a common adverse effect of the noncardioselective b-blockers) is occurring. The nurse should immediately obtain an oxygen saturation measurement, apply supplemental oxygen, and notify the health care provider. The mild decrease in heart rate and complaint of cold fingers and toes are associated with b-receptor blockade but do not require any change in therapy. The BP reading may indicate that a change in medication type or dose may be indicated. However, this is not as urgently needed as addressing the bronchospasm.