CEN Ch apter 9 Review Questions with

CEN Ch apter 9 Review Questions with Correct Answers 100% Verified Latest Updated 2024 A patient presents who has experienced chest pain but now is pain free. EKGs have been repeated twice, and troponin levels repeated at 4-hour intervals are within normal limits. The patient has no

significant risk factors for heart disease. The nurse anticipates:

• admission to the ICU to rule out MI
• admission to cardiac catheterization lab for evaluation of coronary anatomy
• that the patient will be discharged home, with instructions for close follow-up with their PCP because

the risk of an adverse coronary event is low

• admission to the telemetry unit to rule out MI - Correct Answer C. that the patient will be discharged

home, with instructions for close follow-up with their PCP because the risk of an adverse coronary event is low A patient who became unconscious during ascent while scuba diving arrives via EMS. The patient is unconscious and hypotensive. What is the most appropriate position in which to place this patient during their examination by the physician?

• left lateral decubitus, head down
• right lateral decubitus, head down
• left lateral decubitus, head up
• supine - Correct Answer A. left lateral decubitus, head down

Positioning the patient in a left lateral decubitus, head down position prevents air from traveling through the right side of the heart into the pulmonary arteries, leading to a possible right ventricular outflow obstruction.In which patient would the nurse question an order for morphine sulfate?

• a patient with aortic dissection 1 / 4

• a patient with a STEMI
• a patient with unstable angina
• a patient with NSTEMI - Correct Answer D. a patient with NSTEMI

An increase in mortality has been associated with the use of morphine sulfate in patients with NSTEMI.Investigators from the CRUSADE registry looked at over 50,000 patients with NSTEMI and found that those patients receiving morphine had a 48% greater risk of death Following the administration of 2L IV crystalloids, the emergency nurse begins to administer IV dobutamine to a patient who has been diagnosed with a right ventricular infarction. The emergency nurse identifies that this medication has been effective when the patient demonstrates which of the following?

• bradycardia
• increase in BP
• presence of distended neck veins
• onset of atrial fibrillation - Correct Answer B. increase in BP

Patients who experience an RVI are preload dependent and require additional fluids to increase their BP.If the patient's BP does not respond to the additional fluid administration, the administration of dobutamine is indicated to increase the patient's cardiac output, thereby increasing the BP.The nurse has instituted applied oxygen and is to reduce the patient's heart rate and BP. Which of the following findings would be expected after applying oxygen, initiating two large-claiber IV lines , and administering IV beta-blockers?

• difference of >20 mm Hg BP when comparing in both arms
• chest pain radiating to the left shoulder
• orthopnea and jugular venous distention
• petechial lesions on the patient's palms or soles - Correct Answer A. difference of >20 mm Hg BP

when comparing in both arms 2 / 4

Difference of >20 mm Hg BP in both arms is suggestive of aortic dissection. Treatment for aortic dissection includes the insertion of two large-caliber IV lines, application of oxygen, and administration of beta-blockers to reduce the patient's heart rate and BP.A 3-month-old infant weighing 11 lbs (5 kg) arrives at the emergency department in full cardiopulmonary arrest. The monitor shows VF. Good-quality CPR is being performed, and the infant has been defibrillated once. Which medication should be administered next?

• epi 0.05 mg IV/IO
• atropine 0.1 mg IV/IO
• Amiodarone 25 mg IV/IO
• sodium bicarbonate 5 mEq IV - Correct Answer A. epi 0.05 mg IV/IO

A patient in cardiopulmonary arrest remains in VF despite having been defibrillated 6 times, receiving good quality CPR, and the administration of epinephrine and amiodarone. ABGs reveal a pH of 7.02, PO2 96, and pCO2 40. What medication order should the emergency nurse anticipate next for this patient?

• adenocard 6 mg
• calcium chloride 1 gram
• vasopressin 40 units
• sodium bicarbonate 1 mEq/kg - Correct Answer D. sodium bicarbonate 1 mEq/kg

A patient presents via EMS in cardiopulmonary arrest. Chest compressions and bag-mask ventilation are being performed. The cardiac monitor shows VT. While the defibrillator is charging for defibrillation, the

nurse should ensure that:

• no one is touching the patient
• high-quality CPR is continued
• oxygen delivery via NC continues at 6L
• the defibrillator pads have been placed on the patient - Correct Answer B. high-quality CPR is

continued 3 / 4

A teenaged patient presents to triage stating that they have the sensation that their heart is jumping out of their chest for the past several hours. The patient denies routine drug use and states that they have been studying for end-of-the-semester final exams for the past 3 days and took a pill to help him study.You are able to feel a radial pulse that is approximately 140 beats/minute. Which of the following dysrhythmias would be expected?

A. SVT

• VT
• at fib
• SR with PACs - Correct Answer A. SVT

The emergency nurse is participating in the treatment of a patient in cardiopulmonary arrest. CPR is ongoing, an advanced airway is present, and vascular access has been obtained. The monitor shows an organized rhythm, but no palpable pulse is detected. In addition to evaluating the "He and Ts" as causes of PEA, the nurse anticipates the use of what device or procedure to better evaluate for potentially reversible causes of PEA?

A. EKG

• point of care US
• bedside CXR
• glucometer - Correct Answer B. point of care US

can quickly aid in identification of mechanical causes of PEA. A collapsed right ventricle suggests an inflow obstruction (i.e., tamponade, pneumothorax, or hyperinflation), whereas a dilated right ventricle indicates outflow obstruction (i.e., pulmonary embolism).Echocardiography determines that a patient has infective endocarditis with bacterial or fungal growth isolated to the tricuspid valve. In addition to a heart murmur, what other pertinent signs or symptoms would the emergency department nurse include in the assessment related to this finding?

• blood-tinged frothy sputum
• jugular vein distension
• sharp, piercing chest pain that decreases when leaning forward
• / 4