Questions 29

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ATI RN Custom Cardiovascular Med Surg Questions

Extract:

A nurse is caring for an adolescent in an emergency department.
Vital Signs.
2300: Medical History.
Blood pressure 120/78 mm Hg. Apical pulse rate 100/min.
Respiratory rate 20/min.
2400: Temperature 37.9° C (100.2° F). Oxygen saturation 98% on room air.
Nurses' Notes.
Blood pressure 112/64 mm Hg. Apical pulse rate 108/min.
Respiratory rate 28/min.
Temperature 38.9° C (102° F). Oxygen saturation 95% on room air.
Medical History.
History of rheumatic fever with resulting cardiac valve damage.
Nurses' Notes.
2300: Adolescent brought to emergency department by their parent.
Adolescent reports intermittent low-grade fever and anorexia.
Manifestations presented a few days after having dental work performed.
Now they are worse.
Adolescent noticed shortness of breath with exertion today.
Adolescent in semi-reclining position.
Respirations easy and unlabored while at rest.
Mild dyspnea observed when adolescent ambulated to the room.
Lung sounds clear bilaterally.
Oral mucous membranes pink with petechiae noted.
Adolescent reports diffuse joint pain as 2 on a scale of 0 to 10. 2400: Adolescent restless and sweating, sitting in high-Fowler's position.
Dyspnea noted at rest.
Adolescent reports pain in mid-chest as dull, aching, and as 2 on a scale of 0 to 10. Few coarse rales auscultated bilaterally


Question 1 of 5

A nurse is caring for an adolescent in an emergency department. Which of the following should the nurse anticipate the provider will prescribe?

Correct Answer: Obtaining blood cultures, administering antibiotics, and obtaining an echocardiogram are anticipated due to suspected endocarditis from recent dental work and symptoms like fever and dyspnea. Restricting dental hygiene and strenuous exercise are contraindicated as they could worsen the condition or are unnecessary.

Rationale:

Extract:


Question 2 of 5

A patient is admitted to the emergency department and diagnosed as having an ST-segment-elevation myocardial infarction (STEMI). Which question would the nurse ask to determine whether the patient is a candidate for thrombolytic therapy?

Correct Answer: The time of pain onset is crucial in determining eligibility for thrombolytic therapy. Thrombolytic therapy is most effective when given within a certain time frame from the onset of symptoms. Aspirin use, allergies, and pain severity are less relevant for eligibility.

Rationale:

Question 3 of 5

The nurse is providing teaching about the patient's laboratory values that increase the risk for coronary artery disease (CAD). Which of the following values should the nurse prioritize?

Correct Answer: A fasting triglyceride level of 167 mg/dL is above the desirable level of less than 150 mg/dL, indicating a higher risk for CAD. HDL is protective, LDL is near optimal, and total cholesterol is within normal range.

Rationale:

Question 4 of 5

The nurse obtains a health history from an older adult with a prosthetic mitral valve who has symptoms of infective endocarditis (IE). Which question by the nurse helps identify a risk factor for IE?

Correct Answer: Dental work can introduce bacteria into the bloodstream, which can lead to infective endocarditis, especially in individuals with prosthetic heart valves. Heart attack, immunizations, and family history are not specific risk factors for IE.

Rationale:

Question 5 of 5

Which action by the nurse will determine if therapies ordered for a patient with chronic constrictive pericarditis are effective?

Correct Answer: Jugular venous distention (JVD) is a common sign of chronic constrictive pericarditis. If JVD is not present, it may indicate that the therapies are effective. ST segment changes, sedimentation rate, and paradoxical pulse are not specific to this condition.

Rationale:

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