Cardiac/Vascular Nurse Exam Secrets Study Guide (38 page)

52. The jugular venous pulse can be used to assess:

a. right atrial function.

b. left atrial function.

c. right ventricular function.

d. left ventricular function.

53. A nursing team leader delegates a task to an unlicensed assistant. Who is responsible for the patient outcome of this task?

a. The unlicensed assistant who completes the task

b. Both the team leader and the unlicensed person who complete the task

c. The team leader who delegates the task

d. The administrative staff

54. Which support system listed below includes organizations or agencies that provide goods and services?

a. Formal

b. Semiformal

c. Informal

d. Family

55. The best way to elicit information about a patient’s pain is to say which of the following?

a. “Will you describe your pain for me?”

b. “Are you having pain?”

c. “What kind of pain are you having?”

d. “Rate your pain on a scale of 1 to 10.”

56. Endothelial dysfunction is associated with:

a. cardiac dysrhythmias.

b. cardiac arrest.

c. hypertension.

d. vasodilation.

57. The “5 rights of delegation” include which of the following?

a. Right time, right place, right person, right direction, and right evaluation

b. Right person, right place, right time, right assignment, and right supervision

c. Right task, right time, right circumstance, right place, and right supervision

d. Right task, right circumstance, right person, right direction, and right supervision

58. The most effective handout for patients is a:

a. poster-type handout with drawings and minimal text.

b. copy of a PowerPoint presentation.

c. copy of a newspaper article.

d. minimized copy of a large poster with much text.

59. A patient is very confused and disoriented and insists that the sound of an ambulance siren is someone screaming. The best response by the nurse to a confused and disoriented patient would be which of the following?

a. “No one is screaming.”

b. “That sound was an ambulance siren.”

c. “Would you like me to turn on the television for you?”

d. “She has stopped screaming now, so everything is okay.”

60. The goal of an exercise stress test is to raise the heart rate to what percentage predicted for age and gender?

a. 200%

b. 50%

c. 80%–90%

d. >100%

61. Janeway lesions, splinter hemorrhages, and Roth’s spots are immunological responses associated with:

a. endocarditis.

b. pericarditis.

c. myocarditis.

d. aortic valve dysfunction.

62. The best determinant of the effectiveness of patient education is the:

a. patient’s satisfaction.

b. patient’s ability to demonstrate procedure.

c. patient’s ability to explain procedure and demonstrate understanding.

d. patient’s behavior modification and compliance rates.

63. Which of the following treatments is considered appropriate palliative care?

a. Chemotherapy for cancer

b. Intubation with mechanical ventilation for respiratory failure

c. Radiotherapy to relieve pain associated with bone cancer

d. Total parenteral nutrition for patients who cannot eat.

64. Electrocardiograph changes characteristic of hypokalemia include:

a. tall peaked T waves with widening and increased amplitude of QRS and prolongation of the QT interval.

b. a U wave more than 1 mm high after the T wave, AV block, and flat or inverted T waves.

c. dysrhythmias with prolonged PR and QT intervals and broad flat T waves.

d. nonspecific changes.

65. Which of the following clinical situations is characterized by marked elevations in blood pressure that can result in severe organ damage if left untreated?

a. Aortic aneurysm

b. Primary hypertension

c. Secondary hypertension

d. Hypertensive crisis

66. The Patients’ Bill of Rights includes which of the following “rights”?

a. Affordable health care

b. Pain control

c. Right to sue

d. Access to latest medical technology

67. The metabolic syndrome is characterized by:

a. abdominal obesity, decreased triglyceride level, increased high-density lipoprotein (HDL) level, and hypertension.

b. Hypertension, abdominal obesity, and increased HDL level.

c. Abdominal obesity, increased triglycerides, decreased HDL level, elevation of blood pressure, and increased fasting blood glucose.

d. Hypotension, decreased fasting blood glucose, increased triglycerides, and decreased HDL level.

68. According to the Nursing Code of Ethics of the American Nurses Association, nurses must support a patient’s autonomy and self-determination. Thus, if a 24-year old Asian woman states a treatment preference but plans to leave the decision to family members, the nurse should:

a. try to convince the patient to assert herself.

b. recognize that cultural values regarding individualism vary and respect the patient’s right to be guided by family.

c. tell the family that the patient should be the one to make the decision.

d. ask the ethics committee to intervene so that the patient is properly treated.

69. A patient has an atrioventricular (AV) block in which there are more P waves than QRS complexes with no clear relationship between them and an atrial rate two to three times the pulse rate; there is also an irregular PR interval. What type of AV block is this patient likely to have?

a. First-degree AV block

b. Second-degree AV block, Mobitz type I

c. Second-degree AV block, Mobitz type II

d. Third-degree AV block

70. Which of the following clinical situations complies with the guidelines of the American Medical Association for informed consent?

a. A patient with an aortic aneurysm is provided a list of treatment options.

b. A patient with an arrhythmia is told that the only option is cardioversion.

c. A preoperative patient is advised that there is nothing to worry about as valve repair poses little risk.

d. A health care provider withholds information about a patient’s condition to prevent causing the patient anxiety.

71. Cor pulmonale is characterized by changes in the:

a. left atria.

b. left ventricle.

c. right atria.

d. right ventricle.

72. The primary reason for completing professional development courses is to:

a. comply with state requirements for licensure.

b. remain current in the field of nursing.

c. meet institutional requirements for employment.

d. fulfill requirements for a salary increase.

73. A good strategy for helping patients overcome feelings of low self-esteem related to chronic illness and loss of autonomy is to:

a. praise patients constantly for any activities.

b. tell patients that there is no reason to be depressed.

c. provide opportunities for patients to make decisions.

d. avoid talking to patients about their feelings.

74. In renovascular disease, activation of the renin-angiotensin-aldosterone system results in:

a. increased blood pressure.

b. reduced blood pressure.

c. increased sodium and chloride excretion.

d. increased urinary output.

75. Cognitive changes associated with aging affect learning in which of the following ways?

a. Patients are better able to focus attention because their lives have fewer distractions (kids, jobs).

b. Explicit memories (facts) decline, but implicit memories (skills) often stay the same.

c. Older adults have the same ability to learn as young adults.

d. Patients have less difficulty with complex tasks.

76. What adverse effects are related to immunosuppression with high doses of tacrolimus after a heart transplant?

a. Facial dysmorphism

b. Hypertension

c. Hirsutism and acne

d. Nephrotoxicity

77. Which of the following strategies can help a patient whose appearance is altered by surgery come to terms with this change?

a. Show no revulsion or negative feelings about the changed appearance.

b. Provide personal care rather than having patients engage in self-care.

c. Encourage patients to avoid looking at the altered body part.

d. Tell patients how lucky they are that they are recovering.

78. The automatic implantable cardioverter defibrillator (AICD) delivers which of the following impulses?

a. Continuous (asynchronous) electrical impulses to control pulse rate

b. Dual-chamber sequential electrical impulses

c. On-demand (synchronous) electrical impulses when the pulse increases to a preset rate

d. On-demand electrical impulses when the pulse rate decreases to a preset rate

79. An episode of syncope associated with exertional exercise is a manifestation of:

a. aortic regurgitation

b. aortic stenosis.

c. mitral valve prolapse.

d. endocarditis.

80. When a nurse interviews a 40-year old Chinese woman, she notes that the woman seems relaxed and answers all questions, but she does not make eye contact. This probably indicates:

a. respect.

b. fear.

c. depression.

d. dishonesty.

81. The nurse teaches a patient to manage his tracheostomy, using written directions and a video; however, the patient picks up the pieces of equipment and tries to figure them out without consulting the written directions or the video. This patient’s learning style is called:

a. auditory.

b. visual.

c. kinesthetic.

d. mixed.

82. A patient with a dissecting descending thoracic aortic aneurysm will most likely complain of:

a. severe, dull pain that builds in intensity in the anterior chest and nausea and vomiting.

b. severe, tearing, knife-like pain that builds in intensity in the anterior chest and nausea and vomiting.

c. dull, aching pain posteriorly below the scapula and nausea and vomiting.

d. severe, intense, tearing, knife-like pain posteriorly between the scapulae and nausea and vomiting.

83. An expected outcome for patients with hyperlipidemia who have been taught about diet includes which of the following?

a. The patient can explain the difference between low-density and high-density lipoproteins.

b. The patient can list foods that contain saturated and non-saturated fats

c. The patient plans to stop using olive oil for cooking.

d. The patient’s goal is to increase triglycerides to 200 or more.

84. A patient who is receiving digoxin (Lanoxin) and furosemide (Lasix) daily is also prescribed tetracycline for rosacea and subsequently develops nausea, vomiting, and tachycardia. The most likely cause is:

a. digitalis toxicity.

b. allergic response to tetracycline.

c. drug interaction between furosemide and tetracycline.

d. superinfection.

85. A legal document that specifically designates someone to make decisions regarding medical and end-of-life care if a patient is mentally incompetent is:

a. an advance directive.

b. a do-not-resuscitate order.

c. a durable power of attorney.