NUR 417 Exam 1 (Module 1-4)

NUR 417 Exam 1 (Module 1-4)
An older adult patient who has just arrived in the emergency department has a pulse
deficit of 46 beats. Which intervention would the nurse anticipate for this patient?
1. Cardiac catheterization
2. Hourly blood pressure checks
3. Electrocardiographic monitoring
4. Emergent synchronized cardioversion
Pulse deficit is a difference between simultaneously obtained apical and radial pulses. It
indicates that there may be a cardiac dysrhythmia that would best be detected with
ECG monitoring. Frequent BP monitoring, cardiac catheterization, and emergent
cardioversion are used for diagnosis and/or treatment of cardiovascular disorders but
would not be as helpful in determining the immediate reason for the pulse deficit.
How would the nurse listen to auscultate for S3 or S4 gallops in the mitral area?
1. Use the diaphragm of the stethoscope with the patient lying flat.
2. Use the bell of the stethoscope with the patient in the left lateral position.
3. Use the diaphragm of the stethoscope with the patient in a supine position.
4. Use the bell of the stethoscope with the patient sitting and leaning forward.
Gallop rhythms generate low-pitched sounds and are most easily heard with the bell of
the stethoscope. Sounds associated with the mitral valve are accentuated by turning the
patient to the left side, which brings the heart closer to the chest wall. The diaphragm of
the stethoscope is best to use for the higher pitched sounds such as S1 and S2.
A patient is being treated for heart failure. Which laboratory test result will the nurse
review to determine the effects of the treatment?
1. Troponin
2. Homocysteine (Hcy)
3. Low-density lipoprotein (LDL)
4. B-type natriuretic peptide (BNP)
Levels of BNP are a marker for heart failure. The other laboratory results would assess
for myocardial infarction (troponin) or the risk for coronary artery disease (Hcy and
LDL).
A patient is scheduled for a cardiac catheterization with coronary angiography. What
information would the nurse provide before the procedure?