NUR 445 Final Exam Study Questions
and Correct Answers
What are some assessment findings of an uncomplicated abdominal aortic aneurysm?
✅abdominal pulsation, ischemia in extremities from thrombus formation, peripheral
pulses weak/absent; often asymptomatic
What are some assessment findings of a dissected abdominal aortic aneurysm?
✅rapid onset of severe abdominal pain or back pain, pain may migrate with pain of
extension, peripheral neuropathy or paralysis
What are some assessment findings of a ruptured abdominal aortic aneurysm?
✅sudden onset of severe abdominal, flank, or back pain, described as ripping or
tearing, syncope, hypotension, shock, sudden death
What are some assessment findings of an uncomplicated thoracic aortic aneurysm?
✅hoarseness, cough, dyspnea, wheezing, neck vein distention, heart failure, lump in
throat sensation, BP difference of >15 between arms, peripheral pulses different
between sides; often asymptomatic
What are some assessment findings of a dissected thoracic aortic aneurysm?
✅primary symptom is pain (acute onset of severe chest pain that may radiate to back);
hypertension is common, however people with ascending aortic aneurysm tend to be
normotensive or hypotensive
What are some assessment findings of a ruptured thoracic aortic aneurysm? ✅rapid
onset of severe chest, back, abdominal, or flank pain, or atypical pain in trunk;
hypotension, hematemesis, hemoptysis
What is cardiac tamponade? ✅life-threatening condition associated with excessive
mediastinal chest tube drainage, caused by bleeding in the pericardium, causing an
accumulation of intracardiac pressure, which impairs ventricular filling and decreases
CO
What is Beck's triad? ✅elevated right atrial pressure, hypotension, and muffled heart
sounds
What are some signs and symptoms of heart failure? ✅dyspnea, fatigue, limited
exercise tolerance, fluid retention, leading to pulmonary congestion and peripheral
edema
What do heart failure symptoms result from? ✅impaired ventricular function
, What are some signs and symptoms of low CVP? ✅hypovolemia, poor venous return,
hemorrhage, excess diuresis, drug-induced vasodilation, third-spacing of fluid, vomiting,
diarrhea, dehydration
What conditions are associated with low CVP? ✅hypovolemia, shock, or heart failure
What is a normal range for CVP/RAP? ✅2-6 mmHg
What is a key finding in a hypertensive urgency? ✅No target organ damage and slow
BP reduction
What are some signs and symptoms of a hypertensive urgency? ✅headache, anxiety,
epistaxis, dyspnea; may be asymptomatic
What medications can be given for a hypertensive urgency? ✅clonidine (a2 agonist),
captopril (ACE), nifedipine (CCB)
What is the treatment for a hypertensive urgency? ✅follow up as outpatient, alleviate
pain and anxiety, oral antihypertensives, gradual decrease in BP over 24-48 hrs
What are some signs and symptoms of a hypertensive emergency? ✅severe
headache, neurological deficit, vertigo, N/V, chest pain, based on targeted organ
affected
What is the treatment for a hypertensive emergency? ✅admit to ICU, administer IV
antihypertensives, treat damaged end-organ, BP reduction goals (reduce MAP by 20%
in first half hour, achieve approximate BP of 160/100 within 2-6 hours; exception is
aortic dissection, rapidly reduce systolic BP to less than 100 mmHg)
What medications can be given in a hypertensive emergency? ✅adrenergic inhibitors
(BBs), vasodilators (nitro, nicardipine), diuretics
What is a key finding in a hypertensive emergency? ✅Target organ damage and rapid
BP reduction
What is the priority assessment of v-tach? ✅synchronized cardioversion, amiodarone,
procainamide if pulse is present; start CPR, defibrillation, epinephrine, vasopressin,
treat possible cause
What are some findings on telemetry that point to v-tach? ✅absent p waves or not
associated with QRS; looks whacky
What is third degree heart block? ✅there is no relationship between the atria and the
ventricle
