1.
. As a part of the nursing process, the nurse will evaluate for therapeutic effects of digoxin therapy for the treatment of heart failure. Desired outcomes would include:CHECK ALL THAT APPLY:_____Apical heart rate greater than or equal to 100 beats/minute_____Increased urinary output_____Diminished peripheral pulses_____Decreased dyspnea and pulmonary crackles_____Improved activity tolerance
2.
Mrs. Smith requires and IV bolus of Cardizem 0.25 mg/kg. She weighs 125 pounds (58.8 killograms). What is the total bolus dose (mg) and how much will you give (cc)? Ampule contains 5 mg/cc.
3.
Nitroglycerine drip is to be started at 5 mcg/min. Bag contains 25/250cc. Find cc/hr.
4.
Dopamine drip is ordered at 2 mcg/kg/min. Patient weighs 180 lbs. Bag contains 400mg/250cc. Find cc/hr.
5.
An asmatic patient's rythym has gone into SVT. After assessing you determine that he is stable. Which of the following would you not do?
Correct Answer
D. Give Adenosine 6 mg rapid IV push over 1-3 seconds, with rhythm strip running continuously.
Explanation
Giving Adenosine 6 mg rapid IV push over 1-3 seconds, with rhythm strip running continuously is the correct answer because adenosine is contraindicated in patients with asthma or other reactive airway diseases due to its potential to cause bronchospasm. Since the patient is stable, it is not necessary to give adenosine in this situation.
6.
The monitor tech informs you that your patient is in SVT. You assess and find he is having chest pain, SOB, Decreased BP and decreased LOC. Your immediate response is:
Correct Answer
D. All the above
Explanation
In this scenario, the patient is experiencing symptoms of SVT (supraventricular tachycardia) such as chest pain, shortness of breath, decreased blood pressure, and decreased level of consciousness. These symptoms indicate that the patient's condition is unstable and requires immediate intervention. Therefore, the appropriate response would be to prepare for cardioversion, notify the physician if time allows, and have all the necessary equipment available including IV access, CRT cart, O2 source, and suction. This comprehensive approach ensures that the patient can receive prompt and effective treatment to stabilize their condition.
7.
Your patient is in VT and stable. What is your next step?
Correct Answer
D. Administer Lidocaine bolus 1-1.5 mg/kg then start Lidocaine drip.
Explanation
The correct answer is to administer a Lidocaine bolus followed by a Lidocaine drip. This is the appropriate next step for a stable patient in ventricular tachycardia (VT). Lidocaine is an antiarrhythmic medication commonly used to treat VT. Administering a bolus of 1-1.5 mg/kg can help to rapidly control the arrhythmia, and starting a Lidocaine drip afterwards can help to maintain sinus rhythm and prevent recurrence of VT. Calling the physician and monitoring the patient may be necessary, but the immediate action to take is to administer Lidocaine.
8.
The nurse is scheduled to administer a dose of digoxin (Lanoxin) to an adult client with atrial fibrillation. The client has a potassium level of 4.6 mEq/L. The nurse interprets that the:
Correct Answer
D. Dose should be administered as ordered
Explanation
The nurse interprets that the dose of digoxin should be administered as ordered because the client's potassium level of 4.6 mEq/L is within the normal range. Digoxin is a medication used to treat atrial fibrillation, and it is important to administer it as prescribed to maintain the client's heart rhythm. There is no indication that the client needs a dose of potassium before receiving digoxin or that the dose should be withheld and the healthcare provider notified. Therefore, the correct action is to administer the digoxin as ordered.
9.
The Cardiac Action of Nesiritide (Natrecor) is:
Correct Answer
B. Causes vasodilation. Mild diruetic effect.
Explanation
The correct answer for this question is that Nesiritide (Natrecor) causes vasodilation and has a mild diuretic effect. This means that it helps to widen the blood vessels, which can help to decrease blood pressure and improve blood flow. Additionally, it promotes the excretion of salt and water from the body, which can help to reduce fluid buildup and relieve symptoms of fluid overload.
10.
The Cardiac Action of Lidocaine is:
Correct Answer
A. Increases electrical stimulation threshold of ventricle, stabilizes cell membrane, decreases automaticity
Explanation
Lidocaine increases the electrical stimulation threshold of the ventricle, meaning that it requires a stronger electrical signal to initiate a response. It also stabilizes the cell membrane, preventing abnormal electrical activity. Additionally, lidocaine decreases automaticity, which refers to the heart's ability to generate electrical impulses on its own. These actions help to prevent abnormal heart rhythms and maintain a regular heart rate.
11.
Indications for Diltiazem (Cardizem) include:
Correct Answer
C. Atrial flutter or Atrial Fibrillation with rapid ventricular response.
Explanation
Diltiazem (Cardizem) is indicated for the treatment of atrial flutter or atrial fibrillation with rapid ventricular response. These conditions involve irregular and rapid heart rhythms that can lead to decreased cardiac output. Diltiazem is a calcium channel blocker that helps to slow down the heart rate and improve the heart's pumping ability. It is not indicated for the treatment of malignant ventricular ectopy or unstable or chronic angina, as these conditions require different treatment approaches.
12.
Which of the following is the correct way to titrate Nitroglycerine (Nitrate)?
Correct Answer
C. Titrate by 5 mcg/min every 5 minutes.
13.
Your patient is in pulseless Vtach. Which of the following do you do?
Correct Answer
E. All the above.
Explanation
In the given scenario of a patient in pulseless Vtach (ventricular tachycardia), it is crucial to take immediate action to save the patient's life. Calling Code Blue is necessary to alert the medical team and ensure a rapid response. Beginning CPR helps maintain blood circulation and oxygenation until further interventions can be performed. Defibrillation is essential to restore the heart's normal rhythm, and the recommended energy levels are 360 joules (monophasic) or 200 joules (biphasic). Checking the monitor for rhythm changes is important to assess the effectiveness of the interventions and guide further treatment. Therefore, all the mentioned actions are necessary in this critical situation.
14.
When rates are changed on Cardiac Drips, vital signs should:
Correct Answer
B. Be repeated as indicated under "initial monitoring".
Explanation
When rates are changed on Cardiac Drips, vital signs should be repeated as indicated under "initial monitoring". This means that after the rates are adjusted, the patient's vital signs should be checked again to ensure that the changes in medication dosage are having the desired effect and not causing any adverse reactions. This is important for patient safety and to monitor the effectiveness of the cardiac drip treatment. Checking vital signs allows healthcare professionals to make any necessary adjustments to the medication dosage and ensure that the patient's condition is stable.
15.
Which of the following is the most important to closely observe with patients on cardiac drips?
Correct Answer
C. Decreased renal function
Explanation
When patients are on cardiac drips, it is crucial to closely observe their renal function. Cardiac drips are medications administered intravenously to manage cardiac conditions, and they can put a strain on the kidneys. Monitoring renal function is important because these medications can potentially cause kidney damage or worsen existing renal issues. By closely observing renal function, healthcare professionals can detect any decline in kidney function early on and take appropriate measures to prevent further complications. This helps ensure the safety and well-being of the patient while receiving cardiac drips.