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NCLEX RN Mastery: Cardiovascular questions with complete solutions
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NCLEX RN Mastery: Cardiovascular questions with complete solutions
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NCLEX RN Mastery: Cardiovascularquestions with complete solutions
The nurse is caring for a patient that suddenly goes into uncontrolled atrial fibrillation. To determine if
the patient has an adequate stroke volume, the nurse would assess for:
widening pulse pressure
pulse deficit
Corrigan's pulse
O'Connor's pulse - correct answer ✔✔pulse deficit
Explanation
• A pulse deficit is when the apical pulse is greater than the radial pulse. This is due to a low stroke
volume in which most of the blood flow is not reaching the periphery.
• Incorrect: A widening pulse pressure would not be expected. Instead, the nurse would assess for a
narrow pulse pressure (when the difference between the systolic and diastolic pressures is less than 25%
of the systolic value).
• Incorrect: Corrigan's pulse is associated with increased stroke volume and decreased peripheral
resistance.
• Incorrect: O'Connor's pulse is not a real condition.
,A client, diagnosed with insulin-dependent diabetes and acute heart failure, was admitted to the
hospital for medical management. What are the appropriate pharmacological interventions to help
reduce myocardial workload and improve ventricular pump performance? Select all that apply.
Beta-blockers
Dobutamine IV
Morphine IV
Leukotriene modifiers
Dantrolene - correct answer ✔✔Beta-blockers
Dobutamine IV
Morphine IV
Explanation
• Morphine IV is often used for clients with acute heart failure. It is not only an anxiolytic and analgesic,
but its most important effect is venodilation, which reduces preload.
• Beta-blockers are used to inhibit the effects of the sympathetic nervous system and reduce the oxygen
needs of the myocardium.
• Dobutamine is a very useful medication for heart failure because it produces strong beta-stimulatory
effects within the myocardium. It increases heart rate, atrioventricular conduction, and myocardial
contractility.
, • Leukotriene modifiers are used in the treatment of both acute and chronic asthma. This also does not
help with workload or pump performance.
• Dantrolene is classified as a direct-acting skeletal muscle relaxant. It is currently the only specific and
effective treatment for malignant hyperthermia.
The nurse is assessing the hepatojugular reflux in a patient with congestive heart failure. To perform this
assessment technique correctly, the nurse should
lie the patient flat
compress the abdomen for 5-15 seconds
elevate the head of bed to 45 degrees
press the left upper quadrant of the abdomen - correct answer ✔✔elevate the head of bed to 45
degrees
Explanation
• The hepatojugular reflux test is used to measure jugular vein distention seen in tricuspid regurgitation,
heart failure, and other conditions.
• The nurse places the patient's head at 45 degrees.
• The nurse observes the jugular pulsations during quiet respirations, then firmly presses the right upper
quadrant or center of the abdomen for 30-60 seconds.
• The nurse then again observes the jugular pulsations during respirations. If there is a sustained rise in
the jugular vein (>3 cm), the result is positive.
A nurse is caring for a client with moderate acute decompensated heart failure. The nurse should include
which nursing intervention in the care plan?
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