Nursing Board Exam Question in Medical and Surgical
Nursing Board Exam Review Questions in Cardiovascular System Part 3/20
(ANSWER KEY)
1. Answer: D
Ratonale: When the heart rate is above 60 beats per minute and below 10 beats per minute, digoxin therapy is deemed effective. However, if too much digoxin was administered to the client, Mobitz II heart block may be present.
2. Answer: C
Rationale: The client with left-sided heart failure usually has pulmonary congestion, orthopnea, hemoptysis and experiences dyspnea and coughing. Right sided heart failure is characterized by hepatomegaly, edema, ascites and distended neck veins. Right sided heart failure is another complication of cardiomyopathy.
3. Answer: D
Rationale: Patients with Arterial Occlusive Disease have decreased perfusion of tissues. By placing the patient in a dependent position, blood flow to the lower extremities is enhanced, and, therefore, the nursing diagnosis for this intervention would be Altered Tissue Perfusion.
4. Answer: A
Rationale: A “tet” spell is when the child is having difficulty meeting oxygen demands. The knee chest position reduces venous blood return from the lower extremities and increases vascular resistance to divert blood flow to the pulmonary artery.
5. Answer: B
Rationale: The major complication of thromboembolytic therapy is hemorrhage, and the antidote for this is Amicar, which aids in the stoppage of bleeding by inhibiting plasminogen, which inhibits thrombolysis. This drug should be available for any patient on this type of thromboembolytic therapy. Protamine Sulfate and Vitamin K are the antidotes for Heparin and Coumadin, respectively. Heparin is not correct, as it is an anticoagulant.
6. Answer: A
Rationale: Straining or bearing down activities can cause vagal stimulation that leads to bradycardia. Use of stool softeners promote easy bowel evacuation that prevents straining or the valsalva maneuver.
7. Answer: B
Rationale: Clients that present with mitral stenosis often have a history of rheumatic fever or bacterial endocarditis.
8. Answer: D
Rationale: Heartburn is a burning sensation caused by regurgitation of gastric contents that is best relieved by sleeping position, eating small meals, and not eating before bedtime.
9. Answer: A
Rationale: Polycythemia occurs as a physiological reaction to chronic hypoxemia which commonly occurs in clients with Tetralogy of Fallot. Polycythemia and the resultant increased viscosity of the blood increase the risk of thromboembolic events. Cerebrovascular accidents may occur. Signs and symptoms include sudden paralysis, altered speech, extreme irritability or fatigue, and seizures.
10. Answer: C
Rationale: PTCA (percutaneous transluminal coronary angioplasty) is performed to improve coronary artery blood flow in a diseased artery. It is performed during a cardiac catheterization. Aorta coronary bypass Graft is the surgical procedure to repair a diseased coronary artery.
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