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VSIM HEALTH ASSESSMENT CASE -JARED GRIFFIN EXAM FULLY SOLVED -9
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VSIM HEALTH ASSESSMENT CASE -JARED GRIFFIN EXAM FULLY SOLVED -9
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VSIM HEALTH ASSESSMENT CASE -JARED GRIFFIN EXAM FULLY SOLVED #91. The life partner of a patient diagnosed with atrial fibrillation (AF) demon- strates a need for
instruction when asking the nurse, "Can you tell me why this is a problem?" What is the nurse's best
response?: The abnormal heartbeat results in poor blood flow to the heart.
Rationale:The result of the irregular, rapid heartbeats is impaired blood flow that can result in a
stroke, thromboembolism, and heart failure. Physical findings include hy- potension, and
laboratory findings can reveal hyperthyroidism. AF is most common in patients older than 60
but affects only approximately 5% of this age group.
2. The medical record states that the patient's pulse is "small and weak." Which characteristic will the
nurse expect to detect when performing a cardio- vascular assessment on this patient? (Select all that
apply.): -Diminished pulse pressure
-A prolonged systolic peak
-Slow upstroke
Rationale:Pulse characteristics of a small, weak pulse would include slow upstroke, diminished
pulse pressure, and a prolonged systolic peak. Bounding on palpation and a rapid rise and fall of
the systolic peak are associated with large, bounding pulses.
3. Preparing for an electrocardiogram (ECG) is a priority nursing intervention for which patient?
(Select all that apply.): A patient newly diagnosed with mild hypokalemia, A patient who just had
a pacemaker placed, A patient reporting, "I feel like my heart is skipping beats", A patient
experiencing diaphoresis and arm pain
Rationale:
The ECG is used to identify conduction abnormalities, cardiac arrhythmias (asso- ciated with
hypokalemia), and myocardial infarctions. It is also used to document pacemaker performance.
It is reasonable to expect that the patient recovering from the MI will be prescribed an ECG to
monitor ongoing status of heart conduction, but this does not take priority over identifying the
acute presence of cardiac dysfunction presented by the correct options.
4. The nurse is providing care for a patient whose partner says, "We're told that he occasionally has
an irregular heartbeat. Is that bad?" Which response should the nurse make to best address the
partner's concern?: It's normal to experience occasional premature beats.
Rationale:
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, VSIM HEALTH ASSESSMENT CASE -JARED GRIFFIN EXAM FULLY SOLVED #9
Occasional premature beats are normal. Frequent episodes of irregular cardiac rhythm may be
a result of a potassium imbalance or hypoxia or triggered by digoxin toxicity.
5. A nurse is discussing the evaluation of an electrocardiograph recently per- formed on a patient
with a nursing student. Which data will the nurse identify for the student as being within normal
limits? (Select all that apply.): -Heart rate is between 60 and 100 beats/min (bpm)
-The T wave is rounded and smooth -A P wave is visible before each QRS complex
Rationale:
Normal results for an ECG include a heart rate between 60 and 100 beats/min, normal sinus
rhythm, a P wave that precedes each QRS complex, a PR interval that lasts 0.12 to 0.20
seconds, a QRS complex that lasts 0.12 seconds, an ST segment less than or equal to 0.1 mV, a
T wave that is rounded, smooth, and is positive in leads I, II, V3, V4, V5, and V6. Finally, the QT
interval duration varies but usually lasts 0.36 to 0.44 seconds.
6. The nurse is preparing a patient for a cardiovascular assessment. When providing the patient with
information concerning the examination, which physical positions will the nurse indicate will be used
during the examination? (Select all that apply.): -Sitting upright while leaning forward Supine
-Left lateral
Rationale:
The positions commonly used to facilitate this assessment include supine, left lateral, and
sitting upright while leaning forward. Neither the right lateral nor prone position is useful.
7. When preparing a patient for an electrocardiograph (ECG) the nurse will include which
instructional information?
(Select all that apply.): -It is important that the patient remain as still and relaxed as possible
during the test
-The test is painless
-The patient will be asked to lie on his or her back for the length of the test, which is 5-10
minutes, -Sticky-backed electrodes will be attached directly to the skin on the patient's arms,
legs, and chest
Rationale: Instructional information regarding an ECG should include the use of sticky electrodes
being attached to the skin on the arms, legs, and chest. The importance of remaining physically
still and relaxed while lying on the back for approximately 5-10 minutes should also be
discussed. It is important that the patient
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