CEN Exam 3 Study Questions and Answers Top Rated 2024 Graded A
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1. A pt present to the ED with complaints of chest pain. The 12-lead EKG reveals ST segment elevation in leads I and aVL. The initial BP is 112/69 and decreases to a systolic of 60 mmHg following a dose of nitroglycerin 0.4mg SL. The next most appropriate intervention is to:
A. Complete a fibrino...
CEN Exam 3 Study Questions and Answers Top Rated 2024 Graded A . MUGWE [Date] [Course title] 1. A pt present to the ED with complaints of chest pain. The 12 -lead EKG reveals ST segment elevation in leads I and aVL. The initial BP is 112/69 and decreases to a systolic of 60 mmHg following a dose of nitroglycerin 0.4mg SL. The next most appropriate intervention is to: A. Complete a fibrinolytic check sheet B. Initiate a dopamine drip for blood pressure control C. Obtain a R sided EKG D. Administer a 0.9% NS bolus IV - D. Administer a 0.9% NS bolus IV Pts can be sensitive to vasodilation effects of nitroglycerin. Initial intevention is the administration of a fluid bolus for the hypotension that occurs secondary to nitroglycerin 2. A pt presents to the triage nurse complaining of a sudden onset of chest pressure that has never been experienced before. The 12 lead EKG shows ST segment elevation in leads V1-V6. This ST segment pattern is consistent with an occlusion in which coronar y artery?: A. Left anterior descending artery B. Circumflex descending artery C. Posterior descending artery D. Right coronary artery - A. Left anterior descending artery Occlusion of the LAD will show ST segment elevation in the septal (V1 -
V2), anterior (V3 -V4), and lateral (I, aVL, V5 -V6) leads 3. A 68 y/o female presents to the ED with weakness, lightheadedness and nausea. She has not felt well for the past several hours but had to complete her workday before seeking medical care. She denies the presence of chest pain or shortness of breath. The most appropriate intervention during bedside triage is to: A. Instruct the pt to chew 325mg of ASA B. Complete the triage process, including obtaining past medical history, current medications and family history C. Obtain vascular access and draw necessary lab studies specific to cardiac biomarkers D. Preform a 12 lead EKG - D. Preform a 12 lead EKG The pt is describing an atypical acute coronary syndrome (ACS) presentation. Women have a unique presentation of signs and symptoms, and their care is at risk of being delayed because of lack of early recognition. The 12 lead EKG should be completed within 10 mins of arrival at the ED 4. Which symptom points toward a diagnosis of abdominal aortic aneurysm?: A. Pulsatile mass B. Distant heart sounds C. Hypertension D. Subcutaneous emphysema - A. Pulsatile mass Although the presence of a pulsatile mass in the abdomen may not always occur in a pt with a AAA, when present, the nurse shoud be highly suspiscious of AAA and intervene immediately. Bedside ultrasound can assist in a rapid diagnosis 5. A pt arrives to the ED and collapses in front of the triage desk. The pt does not have a pulse and is not breathing. CPR is initiated and the cardiac monitor displays ventricular tachycardia. The immediate action by the ED nurse is to?: A. Administer Amniodarone (Cordarone) 150mg IV B. Synchronize cardioversion with 200 J C. Defibrillate using biphasic defibrillator with 120 -200J D. Administer Sodium Bicarbonate 1 mEq/kg - C. Defibrillate using biphasic defibrilator with 120 -200J Immediate defibrilation is the reccomended treatment for a pulseless V-tach, in conjunction with adequate CPR. Medications are added after the first defibrilation attempt. The defibrilation should be repeated every 2 mins if a palpable pulse and palatable rhythm do not return. If using a monophasic defibrillator, 360J is reccomended 6. Which emergency pt would be an ideal candidate for targeted temperature management or induced hypothermia?: A. A pt with an elevated temperature above 39.4 C (103 F) with a lactic acid level of 6.0 mmol/L B. A responsive emergency pt who achieved a return of spontaneous circulation (ROSC) following a successful resuscitation by emergency medical services personnel C. An unrepsonsive pt who arrives at the ED with ROSC following cardiopulmonary arrest D. A pt remaining in ventricular fibrillation following a cardiopulmonary arrest event - C. An unrepsonsive pt who arrives at the ED with ROSC following cardiopulmonary arrest The ideal candidate for targeted temperature management or induced hypothermia is the pt with ROSC following CPR who remains unresponsive. According to the AHA guidelines for postresusitative care, the described pt should be considered for targeted temp ma nagement immediately on arrival at the ED with optimal reduced temperature reached within 2 -3 hours of CPR 7. Which of the following demonstrates that effective cardiopulmonary resuscitation is being delivered to the pt in cardiac arrest?: A. Presence of waveform variation on the cardiac monitor B. End -tital CO2 20mmHg C. Arterial pH of 6.9 D. Decreased coronary perfusion pressure - B. End -tital CO2 20mmHg End-tital CO2 levels greater than 10mmHg during CPR efforts demonstrate adequate chest compression depth and good quailty CPR. The higher the end -tital CO2 during resuscitations, the greater the likelihood of ROSC 8. Parents arrive to the ED with their infant, who has a pulse of 30. The infant is limo and not breathing. The immediate action by the nurse would be to: A. Begin rescue breathing at a rate of 20 breaths per min B. Initiate chest compressions at a rate of 110 breaths per min C. Defibrillate with 100J D. Administer epinephrine 0.01mg/kg - B. Initiate chest compressions at a rate of 110 breaths per min Chest compressions should be started immediately because of the pulse rate less than 60 beats per min, followed by rescue breathing for a child or infant with a pulse rate of less than 60 with poor perfusion 9. A pt presents to the ED with complaints of a rapid heartbeat, which
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