NURS 4801 Test 2 Chapter Questions Study Guide Exam And Actual Answers.
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Course
NURS 4801
Institution
NURS 4801
Which nursing action will be most useful in assisting a college student to adhere to a newly prescribed antiretroviral therapy (ART) regimen?
a.Give the patient detailed information about possible medication side effects.
b.Remind the patient of the importance of taking the medications as schedul...
NURS 4801 Test 2 Chapter Questions
Study Guide Exam And Actual Answers.
Which nursing action will be most useful in assisting a college student to adhere to a newly prescribed
antiretroviral therapy (ART) regimen?
a.Give the patient detailed information about possible medication side effects.
b.Remind the patient of the importance of taking the medications as scheduled.
c.Encourage the patient to join a support group for students who are HIV positive.
d.Check the patient's class schedule to help decide when the drugs should be taken. - Answer d.Check
the patient's class schedule to help decide when the drugs should be taken.
The best approach to improve adherence is to learn about important activities in the patient's life and
adjust the ART around those activities. The other actions also are useful, but they will not improve
adherence as much as individualizing the ART to the patient's schedule.
A patient recovering from heart surgery develops pericarditis and complains of level 6 (0 to 10
scale) chest pain with deep breathing. Which prescribed PRN medication will be the most
appropriate for the nurse to give?
a. Fentanyl 1 mg IV
b. IV morphine sulfate 4 mg
c. Oral ibuprofen (Motrin) 600 mg
d. Oral acetaminophen (Tylenol) 650 mg - Answer c. Oral ibuprofen (Motrin) 600 mg
The pain associated with pericarditis is caused by inflammation, so nonsteroidal
antiinflammatory drugs (e.g., ibuprofen) are most effective. Opioid analgesics and
acetaminophen are not very effective for the pain associated with pericarditis
To determine whether there is a delay in impulse conduction through the atria, the nurse will measure
the duration of the pts
,a. P wave
b. Q wave
c. PR interval
D QRS complex - Answer a. P wave
The P wave represents the depolarization of the atria. The PR interval represents depolarization o the
atria, atrioventricular (AV) node, bundle of His, bundle branches, and the Purkinje fibers. The QRS
represents ventricular depolarization. The Q wave is the first negative deflection following the P wave
and should be narrow and short.
The nurse needs to quickly estimate the heart rate for a patient with a regular heart rhythm. Which
method will be best to use?
a. Count the number of large squares in the RR interval and divide by 300.
b. Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS complexes.
c. Calculate the number of small squares between one QRS complex and the next and divide into 1500.
d. Use the 3-second markers to count the number of QRS complexes in 6 seconds and multiply by 10. -
Answer d. Use the 3-second markers to count the number of QRS complexes in 6 seconds and multiply
by 10.
-This is the quickest way to determine the ventricular rate for a patient with a regular rhythm. All the
other methods are accurate, but take longer.
A patient has a junctional escape rhythm on the monitor. The nurse will expect the patient to have a
heart rate of _________ beats/minute.
a. 15 to 20.
b. 20 to 40.
c. 40 to 60.
d. 60 to 100. - Answer c. 40 to 60.
-If the sinoatrial (SA) node fails to discharge, the atrioventricular (AV) node will automatically discharge
at the normal rate of 40 to 60 beats/minute. The slower rates are typical of the bundle of His and the
Purkinje system and may be seen with failure of both the SA and AV node to discharge. The normal SA
node rate is 60 to 100 beats/minute.
,The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the
following analysis: no visible P waves, PR interval not measurable, ventricular rate 162, RR interval
regular, and QRS complex wide and distorted, QRS duration of 0.18 second. The nurse interprets the
patient's cardia rhythm as
a. atrial flutter.
b. sinus tachycardia.
c. ventricular fibrillation.
d. ventricular tachycardia. - Answer d. ventricular tachycardia.
-The absence of P waves, wide QRS, rate >150 beats/minute, and the regularity of the rhythm indicate
ventricular tachycardia. Atrial flutter is usually regular, has a narrow QRS configuration, and has flutter
waves present representing atrial activity. Sinus tachycardia has P waves. Ventricular fibrillation is
irregular and does not have a consistent QRS duration.
The nurse notes that a patient's cardiac monitor shows that every other beat is earlier than expected,
has no visible P wave, and has a QRS complex that is wide and bizarre in shape. How will the nurse
document the rhythm?
a. Ventricular couplets.
b. Ventricular bigeminy.
c. Ventricular R-on-T phenomenon.
d. Multifocal premature ventricular contractions. - Answer b. Ventricular bigeminy.
-Ventricular bigeminy describes a rhythm in which every other QRS complex is wide and bizarre looking.
Pairs of wide QRS complexes are described as ventricular couplets. There is no indication that the
premature ventricular contractions (PVC's) are multifocal or that the R-on-T phenomenon is occurring.
A patient has a normal cardiac rhythm and a heart rate of 72 beats/minute. The nurse determines that
the PR interval is 0.24 seconds. The most appropriate intervention by the nurse would be to
a. notify the HCP immediately.
b. give atropine per agency dysrhythmia protocol.
c. prepare the patient for temporary pacemaker insertion.
, d. document the finding and continue to monitor the patient. - Answer d. document the finding and
continue to monitor the patient.
-First-degree atrioventricular (AV) block is asymptomatic and requires ongoing monitoring because it
may progress to more serious forms of heart block. The rate is normal, so there is no indication that
atropine is needed. Immediate notification of the HCP about asymptomatic rhythm is not necessary.
A patient who was admitted with a myocardial infarction experiences a 45-second episode of ventricular
tachycardia, then converts to sinus rhythm with a heart rate of 98 beats/minute. Which of the following
actions should the nurse take next?
a. Immediately notify the HCP.
b. Document the rhythm and continue to monitor the patient.
c. Perform synchronized cardioversion per agency dysrhythmia protocol.
d. Prepare to give IV amiodarone (Cordarone) per agency dysrhythmia protocol. - Answer d. Prepare to
give IV amiodarone (Cordarone) per agency dysrhythmia protocol.
-The burst of sustained ventricular tachycardia indicates that the patient has significant ventricular
irritability, and antidysrhythmic medication administration is needed to prevent further episodes. The
nurse should notify the HCP after the medication is started. Defibrillation is not indicated given that the
patient is currently in sinus rhythm. Documentation and continued monitoring are not adequate
responses to this situation.
After the nurse gives IV atropine to a patient with symptomatic type I, second-degree atrioventricular
(AV) block, which finding indicates that the medication has been effective?
a. Increase in the patient's heart rate.
b. Increase in strength of peripheral pulses.
c. Decrease in premature atrial contractions.
d. Decrease in premature ventricular contractions. - Answer a. Increase in the patient's heart rate.
-Atropine will increase the heart rate and conduction through the AV node. Because the medication
increases electrical conduction, not cardiac contractility, the quality of the peripheral pulses is not used
to evaluate the drug effectiveness. The patient does not have premature atrial or ventricular
contractions.
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