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N450 Exam 2 Questions With Complete Solutions
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N450 Exam 2 Questions With Complete SolutionsA patient has a diagnosis of acute myocardial infarction, and his
cardiac rhythm is sinus bradycardia with 6 to 8 premature
ventricular contractions (PVCs) per minute. The pattern that the
nurse recognizes as the most characteristic of PVCs is
An irregular rhythm.
An inverted T wave.
A wide, distorted QRS complex.
An increasingly long P-R interval. Correct Answer A wide,
distorted QRS complex.
A patient's cardiac rhythm is sinus bradycardia with a heart rate
of 34 beats/minute. If the bradycardia is symptomatic, the nurse
would expect the patient to exhibit...?
Palpitations.
Hypertension.
Warm, flushed skin.
Shortness of breath. Correct Answer shortness of breath
AACN Six Standards for establishing and maintaining a healthy
work environment are? Correct Answer Skilled communication
true collaboration
effective decision making
appropriate staffing
meaningful recognition
authentic leadership
,Acting FAST is key for a stroke. What does FAST sad for?
Correct Answer F- Face: ask the patient to smile. Droop?
A- Arms: ask patient to raise both arms.Drift?
Speech: ask patient to repeat a simple phrase. Speech slurred or
strange?
Time: If you observe signs, call 911.
Acute phase treatment: Correct Answer Fluid and Electrolyte
shifts
Fluid Therapy
Wound Care
Circulation/Escharotomy
Pain management
Nutritional Therapy
Inflammation and Healing
Immunologic Changes
Acute phase: wound care Correct Answer Cleansing and gentle
debridement
Surgical debridement - loose necrotic skin removed
Dressing changes
Open method
Multiple dressing change method (closed method)
3-14 days with antimicrobial
High risk of infection from normal flora
Skin, respiratory tract, GI tract
Topical antimicrobials:
,Silver sulfadiazine (Silvadene) or mafenide acetate
(Sulfamylon), xeroform, aquaphor, polysporin
Skin grafting:
Skin grafts taken from patient's healthy skin
Skin is meshed to cover a large wound
When open burns wounds are exposed, staff should wear
Disposable hats
Masks
Gowns
Gloves
Acute stroke treatment: Drug therapy Correct Answer
Thrombolytic therapy (recombinant tissue plasminogen activator
(rtPA)
Platelet inhibitors:
Aspirin used cautiously
Management of Blood Pressure:
Critical for first 24 hours related to risk of intracerebral
hemorrhage and any decrease in BP is indicative of neurologic
changes.
Management of body temperature:
An increase in 1 degree Celsius increases brain metabolism by
10% contributing to further brain damage.
Aspirin or acetaminophen (Tylenol)
If seizures occur:
phenytoin (Dilantin)
Pain management
Hypervolemia
Constipation
, Acute treatment and care of CVA Correct Answer Manage
respiratory status
Monitor closely for increasing neurological deficits
Increased ICP, NIH stroke scale, Glasgow coma scale
Cardiovascular system
Efficiency, fluid retention, HTN, DVT
Musculoskeletal system
Prevent joint contractures and muscular atrophy
Integumentary system
Breakdown related to loss of sensation, decreased circulation,
immobility.
Bowel and bladder control
Afib causes: Correct Answer Caused by multiple ectopic foci,
causing total disorganization of electrical activity that leads to
loss of effective atrial contraction
Key concern - causes a decrease in CO (loss of "atrial kick") and
an increased risk of stroke, just like with atrial flutter
Usually occurs with underlying heart disease. CAD, rheumatic
heart disease, cardiomyopathy, HF, pericarditis, HTN, MI and
electrolyte imbalances
Afib treatment: Correct Answer Treatment
Medications:
Rate control drugs- aim to control ventricular rate to < 100;
examples- calcium channel blockers- diltiazem, B adrenergic
blockers- metoprolol, and digoxin
Convert to sinus rhythm and maintain sinus rhythm-
amiodarone, ibutilide
Electrical cardioversion
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