Page 454 - Critical Care Nursing Demystified

FINAL EXAM QUESTIONS 439

3. A patient is experiencing signs and symptoms of left-sided heart failure. Which
of the following would be consistent with this diagnosis?
A. Ascites
B. Elevated jugular venous distention
C. Posterior tibial edema
D. Crackles

4. Which of the following assessment findings in a patient with acute coronary
syndrome would cause the nurse to withhold thrombolytic therapy? Select all
that apply.
A. ST segment myocardial infarction
B. Surgery within the past 2 months
C. Need for frequent venipunctures
D. Recent aspirin and heparin therapy
E. Recent trauma
F. Insertion of a central line
G. Being 50 to 70 years old

5. A patient has just had a pulmonary artery catheter inserted to monitor severe
heart failure. The nurse is reading the patient’s pressures and notes a pressure
of 28/0 mm Hg and a striking change from the previous pressures of 30/15. She Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
also notes the patient is starting to have ventricular dysrhythmias. Which cham-
ber has this catheter MOST LIKELY migrated to?
A. The left ventricle
B. The right atrium
C. The right ventricle
D. The left atrium

6. Your patient is to be discharged home after a heart transplant (orthotopic
method). Which of the following would you include in his teaching plan?
A. You will have to learn how to program a temporary pacemaker.
B. You will have to stay on dobutamine as long as you have a transplanted heart.
C. You will have to rise slowly in the morning as your BP may drop suddenly when
you rise.
D. You will always have two “Q” waves on your ECG.

7. A patient has been admitted to your medical unit with extreme hypertension.
On physical examination you note a pulsating mass just to the left of midline in
the upper abdominal area. Which of the following physical assessment proce-
dures is CONTRAINDICATED based on the above information?
A. Auscultation
B. Deep palpation
C. Light palpation
D. Percussion