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NCLEX Cardiac Critical Care Questions
and Answers Rated A+
The nurse is caring for an adult pt who is admitted with chest pain that began four hours ago. Which test will be most specific in identifying acute heart damage?
- troponin
- CPK
- CK-MB
- cholesterol ✔✔Answer: 1
Rationale 1: Troponin is primarily located in cardiac muscle & can indicate myocardial infarction or unstable angina. Troponin elevates at two to four hours after myocardial infarction.
Rationale 2,3: CPK & CK-MB will elevate with myocardial damage, but will take longer to rise & are not as specific as troponin.
Rationale 4: Cholesterol level is not helpful in diagnosis of myocardial damage.
The nurse realizes that the pt in the critical care area with ventricular tachycardia will require which action? Select all that apply.
- immediate assessment & probable emergency intervention by the nurse
- cardioversion, if sustained & symptomatic
- probable administration of a potassium channel blocker
- close observation for one hour prior to calling the physician
- defibrillation to convert the rhythm in the awake pt ✔✔Correct Answer: 1,2,
Rationale 1: The nurse should immediately assess the pt to see how the potentially life- threatening rhythm is being tolerated.
Rationale 2: The nurse should be prepared to cardiovert the pt in ventricular tachycardia with a pulse according to standing prescriptions. The nurse in critical care needs to be aware of standing prescriptions for each pt prior to an emergent event & needs to have the necessary emergency equipment & meds ready.
Rationale 3: Class III antidysrhythmic meds (potassium channel blockers) are typically administered.
Rationale 4: Observation prior to calling a physician is not an appropriate action when a potentially life-threatening rhythm is identified.
Rationale 5: Defibrillation is only conducted in ventricular tachycardia when the pt is pulseless; otherwise, time is taken to synchronize for cardioversion.
Which is the priority nursing intervention for a pt with a junctional escape rhythm?
- Assess the pt for symptoms associated with this rhythm.
- Contact the physician immediately for emergency orders.
- Eliminate caffeine from the diet.
- Prepare for a pacemaker insertion. ✔✔Answer: 1
Determine the cardiac output (CO) of a pt whose stroke volume (SV) is 80 mL/beat & whose heart rate (HR) is 75 beats/minute. Round to the nearest whole number & place the answer
below. _______ ✔✔Answer: 6000
Rationale : Cardiac output is the amount of blood pumped by the ventricles into the pulmonary & systemic circulations in one minute. It is determined by multiplying the stroke volume by the heart rate (SV × HR = CO). Multiplying 80 mL/beat by 75 beats/minute equals 6000 mL.
A nurse is administering a dopamine infusion at a moderate dose to a client who has severe HF. Which of the following is an expected effect?
- Lowered heart rate
- Increased myocardial contractility
- Decreased conduction through the AV node
D. Vasoconstriction of the renal blood vessels ✔✔2. Increased myocardial contractility -- thus
increasing CO
