Tiêu đề PB1 - NP 3 - STUDENT COPY ✅

2 | Page D. Absence of troponin elevation despite chest pain 11. Nurse Jeidy notes inconsistent response to nitroglycerin. Which data point should she prioritize to determine the underlying cause of this inconsistency? A. Patient’s adherence to prescribed medication timing and storage conditions B. Frequency and duration of angina episodes prior to medication use C. Patient’s level of anxiety and emotional triggers during angina episodes D. Presence of other comorbid conditions 12. Nurse Jeidy is evaluating another patient who reports chest pain when walking more than 2 blocks on level ground, with marker limitation of activity. Based on the Canadian Cardiovascular Society (CCS) classification, which angina class best describes this patient's condition? A. Class I B. Class II C. Class III D. Class IV Situation: Nurse Will is working in a telemetry unit at Joel Linga Hospital, monitoring multiple high risk cardiovascular patients. His responsibilities include interpreting 12 lead ECGs, responding to telemetry alerts, and managing patients with both acute and chronic cardiac arrhythmias. 13. One of Nurse Will’s patients is a 60-year-old adult with a heart rate of 48 bpm. The ECG shows a regular rhythm, normal P waves before each QRS complex, a PR interval of 0.16 seconds, and a normal QRS duration. The patient reports dizziness and lightheadedness. Which of the following best describes this rhythm and the appropriate nursing action? A. Atrial fibrillation, provide oxygen therapy B. Supraventricular Tachycardia, provide vagal stimulation and administer Adenosine (Adenocard) C. Normal sinus rhythm with physiological QRS and T wave changes, continue routine monitoring D. Sinus bradycardia, administer atropine 0.5 to 1.0 mg to block vagal stimulation 14. The patient's PR interval comprises of seven small boxes on the ECG graph. What does the this indicates? A. A normal finding B. A problem with ventricular depolarization C. A disturbance in the repolarization of the atria D. A problem with conduction from the SA node to the ventricular cells 15. A 73 year-old male with a history of ischemic heart disease now presents with palpitations and mild shortness of breath. A telemetry strip reveals a narrow QRS tachyarrhythmia with a ventricular rate of 150 bpm. The rhythm is regular, and sawtooth-like waves are noted between QRS complexes, especially visible in leads II, III, and aVF. Blood pressure is 124/78 mmHg, and the patient is alert. Which of the following is the most appropriate initial intervention? A. Immediate synchronized cardioversion at 300 J B. Administration of IV amiodarone to chemically cardiovert the rhythm C. Initiate rate control with IV diltiazem to slow AV conduction D. Administer adenosine rapid IV push and call the physician 16. A 58-year-old patient is also being monitored. The ECG reveals that the P waves precede each QRS complex until one P wave is not followed by a QRS, PR intervals progressively lengthen with each beat until a beat is dropped, The QRS complex is narrow and normal in shape. Which of the following best described this cardiac rhythm? A. First Degree AV Block B. Second Degree AV Block, Type I C. Second Degree AV Block, Type II D. Third Degree AV Block 17. A 48-year-old female complaints of intermittent chest discomfort during exertion. She requests an ECG for evaluation. Which of the following ECG findings most specifically suggests ongoing myocardial ischemia rather than infarction or other cardiac pathology? A. Development of pathologic Q waves in leads II, III, and aVF B. T wave inversion in contiguous leads during a pain episode C. Persistent ST segment elevation in anterior leads D. Widened QRS complex greater than 120 ms with bundle branch block pattern 18. While on his way home from Joel Linga Hospital, Nurse Will notices a middle aged man unconscious on the sidewalk. The man is unresponsive, pulseless, and apneic. Nurse Will initiates CPR. According to the latest AHA Basic Life Support (BLS) guidelines, which of the following best describes the correct quality of chest compressions for this adult victim? A. Push hard and fast, compressing at least 50 mm at a rate of 100-120 compressions per minute B. Push hard and fast, compressing at least 50 in at a rate of 100-120 compressions per minute C. Push hard and fast, compressing at least 2.5 cm at a rate of 80-100 compressions per minute D. Push hard and fast, compressing at least 2.5 in at a rate of 80-100 compressions per minute 19. Emergency Rescue arrives and connects the unconscious male to the cardiac monitor, which reveals an extremely irregular rhythm with no discernible QRS complexes and a ventricular rate exceeding 300 beats per minute. Which of the following best describes the underlying cardiac event and the most appropriate immediate management? A. Ventricular fibrillation; initiate immediate defibrillation and activate emergency services. B. Ventricular tachycardia; administer intravenous beta- blockers and observe. C. Asystole; begin immediate cardiopulmonary resuscitation (CPR) and prepare for transcutaneous pacing. D. Atrial fibrillation with rapid ventricular response; control ventricular rate with calcium channel blockers. Situation: Franz is a 64 year old male with history of chronic hypertension was admitted after reporting persistent pulsating sensation in his abdomen. His blood pressure is 180/100 mmHg, placing him at increased risk for rupture. After an emergency endovascular repair, Nurse Glen monitors him post operatively. 20. Franz is at risk for compromised circulation. Which physiological mechanism ensures that blood flows unidirectionally through the cardiovascular system? A. Sympathetic vasomotor tone B. Resistance gradients in tissues C. Pressure difference between arteries and veins D. Gravity-assisted circulation 21. In normal cardiovascular physiology, which of the following best describes how fluid moves across the capillary walls? A. Hydrostatic pressure at the venous end of the capillary pushes fluid into the surrounding tissues B. Osmotic pressure at the arterial end overcomes hydrostatic pressure, pulling fluid back into the capillary C. Hydrostatic pressure at the arterial end pushes fluid out into the tissues, while osmotic pressure at the venous end pulls fluid back into the capillary D. Capillary permeability is the only factor that affects movement of fluid between the capillaries and the tissues 22. Following endovascular repair of his abdominal aortic aneurysm, Franz develops localized vasospasm near the graft site, increasing vascular resistance. If arterial pressure remains unchanged, what is the most likely impact on regional blood flow to surrounding tissues? A. Flow increases B. Flow decreases C. Flow remains unchanged D. Flow reverses direction 23. Based on Poiseuille’s law, which of the following has the most significant impact on vascular resistance within the circulatory system? A. Blood vessel length B. Blood vessel radius

4 | Page C. Increased lymphocytes D. Decreased reticulocytes 40. Martina is being closely monitored. Which action is most important for the nurse to implement? A. Administering blood products as indicated to manage bleeding B. Limiting patient’s ambulatory activities C. Removing oral crusting and scabs with a soft brush q8h D. Monitoring the patient for headaches, vertigo, or confusion 41. While receiving a unit of packed RBCs, Martina develops chills and backache. Nurse Precious notes chest rash. Which of the following is an incorrect intervention? A. Returns blood bag, tubing, attached labels, and transfusion record to the nurse’s station B. Changes the IV tubing but keeps the IV line open with normal saline C. Stops the transfusion immediately D. Prepare to administer emergency medications as prescribed, and performs cardiopulmonary resuscitation if needed 42. Martina has a platelet count of 50,000/μL. What initial treatment should Nurse Precious anticipate? A. Splenectomy B. Corticosteroids C. Administration of platelets D. Immunosuppressive therapy 43. Nurse Precious is preparing Martina for a splenectomy. Which statement should be included in the pre-op teaching? A. "You will need to take aspirin daily to reduce clot risk." B. "You must receive certain vaccines at least 2–3 weeks before surgery." C. "You will not need any follow-up after the surgery." D. "This surgery guarantees a cure from ITP." 44. Martina asks, “Why can’t I take ibuprofen for my joint pain?” What is Nurse Precious’ best response? A. “Ibuprofen will cause your spleen to enlarge.” B. “It can cause your platelet count to increase too quickly.” C. “Ibuprofen interferes with platelet function and increases bleeding risk.” D. “It has no effect on platelets, but can lower your hemoglobin.” 45. After splenectomy, which lab result would Nurse Precious expect to find in Martina? A. Decreased RBCs B. Decreased WBCs C. Increased platelets D. Increased immunoglobulins Situation: You are a nurse caring for a 198 lbs. patient who presents with sudden onset dyspnea, chest pain, and hemoptysis. The patient has a history of recent total hip arthroplasty and prolonged immobility due to a long flight. The healthcare team suspects a massive pulmonary embolism. 46. Which of the following is most likely to occur as a result of thrombus obstructing a pulmonary artery or its branches in this patient? A. Increased pulmonary vascular resistance and right ventricular strain B. Decreased alveolar dead space and improved gas exchange C. Reduced pulmonary arterial pressure and enhanced right ventricular performance D. Decreased systemic blood pressure and reduced right ventricular workload 47. What should be your initial treatment for the patient with suspected pulmonary embolism? A. Administer intravenous antibiotics B. Administer supplemental oxygen C. Start immediate anticoagulation therapy D. Perform chest physiotherapy as indicated 48. Which of the following is the primary goal in the emergency management of massive pulmonary embolism (PE)? A. To reduce pulmonary vascular resistance and decrease systemic blood pressure B. To stabilize the cardiopulmonary system C. To increase heart rate and cardiac output to enhance circulation D. To correct metabolic acidosis in order to address hypoxemia 49. The patient is experiencing pleuritic chest pain. Which of the following nursing interventions is most appropriate to improve the patient's comfort and respiratory function? A. Administer supplemental oxygen and encourage deep breathing exercises B. Position the patient in a flat, supine position to reduce respiratory distress C. Provide a semi-Fowler’s position and encourage frequent repositioning D. Limit patient movement to avoid exacerbating pain and discomfort 50. The patient with massive PE now requires a slow infusion of dobutamine (Dobutrex) to manage hypotension. The recommended dosage for dobutamine is 2.5 to 10 mcg/kg/min. The desired infusion rate = 5 mcg/kg/min. How many milligrams of dobutamine should you administered per minute? A. 0.25 mg of dobutamine per minute B. 0. 35 mg of dobutamine per minute C. 0. 45 mg of dobutamine per minute D. 0. 55 mg of dobutamine per minute Situation: Keila, a patient in the ICU, was intubated and placed on mechanical ventilation. As her condition improved, the ventilator settings were gradually adjusted based on her ABG results and spontaneous breathing effort. You are the ICU nurse assigned to monitor her respiratory status and ventilator support. 51. You review Keila’s ventilator waveform and note that the airway pressure never returns to zero at end-expiration. She is breathing spontaneously, and there are no mandatory breaths delivered. What mode is being used? A. Controlled Mechanical Ventilation (CMV) B. Assist-Control Ventilation (A/C) C. Pressure Support Ventilation (PS) D. Continuous Positive Airway Pressure (CPAP) 52. The physician adjusts the ventilator to deliver a set number of breaths, but allows Keila to take spontaneous breaths of varying volumes in between. What ventilator mode is now being used? A. Pressure Support Ventilation (PS) B. Assist-Control Ventilation (A/C) C. Synchronized Intermittent Mandatory Ventilation (SIMV) D. Continuous Positive Airway Pressure (CPAP) 53. During a critical event earlier in her ICU stay, Keila was deeply sedated and unable to initiate spontaneous breaths. All her breaths were preset and machine-delivered, with no ability to trigger the ventilator. What mode was most likely used during this time? A. Assist-Control Ventilation (A/C) B. Synchronized Intermittent Mandatory Ventilation (SIMV) C. Pressure Support Ventilation (PS) D. Controlled Mechanical Ventilation (CMV) 54. Keila is being evaluated for weaning from mechanical ventilation. Which of the following values indicates she meets the vital capacity requirement for weaning? A. 8 mL/kg B. 12 mL/kg C. 18 mL/kg D. 20 mL/kg 55. You are tasked to assess Keila’s readiness to wean using Rapid Shallow Breathing Index, calculate her RSBI given respiratory rate of 33 breaths per minute, and tidal volume of 8 ml/kg. she weighs 121 lbs. A. 75 breaths/ min/ L B. 85 breaths/ min/ L