Adult III: Exam III Practice Questions

A patient with sleep apnea was informed of the risk of cardiovascular disease. What is the nurse’s best explanation to the patient?

A. Sleep apnea causes periods of low PaO2 and elevated PaCO2, which cause vessels to constrict, increasing the stress on the heart and risk of heart disease.

B. Sleep apnea causes periods of low PaCO2 and hypoventilation that may lead to stress on the heart by causing vessels to dilate.

C. Increased heart rate may occur with sleep apnea, increasing the work of the heart and dysfunction.

D. Sleep apnea reduces circulating oxygen, requiring the heart to beat faster to deliver oxygen to the body, which creates stress on the heart.

A. Sleep apnea causes periods of low PaO2 and elevated PaCO2, which cause vessels to constrict, increasing stress on the heart and the risk of heart disease. Chemoreceptors are sensitive to changes in partial pressure of arterial oxygen (PaO2), partial pressure of arterial carbon dioxide (PaCO2), and pH blood levels. Chemoreceptors stimulate the vasomotor center in the medulla; this center controls vasoconstriction (decreased PaO2 and/or increased PaCO2 and decreased pH) and vasodilation (increased PaO2 and/or decreased PaCO2 and increased pH)

A patient reports chest tightness with strenuous exercise that is increasing in frequency. How does the nurse interpret this symptom as part of the assessment?

A. Quality

B. Region/Radiation

C. Severity

D. Provocation

D. P stands for provocation. The fact that the chest pain is associated with strenuous activity suggests it is associated with provocation

The patient’s echocardiography test showed a 58% left ventricular ejection fraction (LVEF). The nurse understands this result to be:

A. Abnormally high

B. Abnormally low

C. Inconclusive

D. Within normal limits

D. The LVEF is the percentage of blood ejected from the left ventricle during systole, normally 55% to 60%

During an assessment of a patient admitted with new-onset angina, the patient suddenly complains of chest pain, and ST-segment elevation is noted on the bedside monitor. The nurse anticipates the patient is experiencing which type of angina?

A. Exercise-induced

B. Prinzmetal’s

C. Smoking-induced

D. Stable

B. Variant, or Prinzmetal’s, angina is caused by coronary artery spasms. It often occurs at rest and without other precipitating factors. The electrocardiogram (ECG) shows a marked ST elevation (usually seen only in acute myocardial infarction [AMI]) during the episode

Discharge medications post coronary stent placement for a male patient included a beta-blocker agent, P2Y12 inhibitor agent, aspirin, and NTG sublingual for chest pain. Which element of the patient’s medication history requires further education after coronary stent placement?

A. Phosphodiesterase type 5 inhibitors for erectile dysfunction

B. Statin therapy for hyperlipidemia

C. Acetaminophen for arthritic pain

D. Nicotine patch for smoking cessation

A. The patient needs to be informed of contraindications for taking NTG if a phosphodiesterase type 5 inhibitor was taken

A patient is admitted with exacerbated left-sided HF with reduced ejection fraction (HFrEF). The patient reports increased fatigue, weight gain, and shortness of breath. What priority interventions does the nurse anticipate?

A. 12-lead ECG and electrolyte laboratory analysis

B. Troponin and coagulation laboratory analysis

C. Place the patient in semi-Fowler’s position and administer diuretic

D. Weigh the patient and administer diuretic

C. Place the patient in semi-fowlers position and administer a diuretic