Cardiac Vascular Nursing Exam Risk Assessment & Management 4

Question 1

A patient with newly diagnosed heart failure with reduced ejection fraction (HFrEF, EF 35%) has a serum potassium of 5.6 mEq/L. Which medication should be held?

Accepted Answer

Spironolactone

Answer

Spironolactone is a potassium-sparing aldosterone antagonist that is contraindicated or should be held when potassium exceeds 5.0 mEq/L due to hyperkalemia risk.

Question 2

Which electrocardiographic finding in a patient with suspected hyperkalemia (K⁺ = 7.2 mEq/L) requires the most urgent intervention?

Accepted Answer

Widened QRS complex with sine-wave pattern

Answer

A widened QRS with a sine-wave pattern indicates severe, life-threatening hyperkalemia with imminent risk of ventricular fibrillation, requiring immediate IV calcium gluconate.

Question 3

A nurse notes a patient's pulmonary artery wedge pressure (PAWP) is 24 mmHg. Which clinical condition does this most likely indicate?

Accepted Answer

Left ventricular failure with pulmonary congestion

Answer

A PAWP greater than 18 mmHg suggests elevated left ventricular end-diastolic pressure, consistent with left ventricular failure and pulmonary congestion.

Question 4

A patient undergoing risk stratification for sudden cardiac death (SCD) is found to have a QTc interval of 510 ms. Which medication in their current regimen most likely contributed to this finding?

Accepted Answer

Amiodarone

Answer

Amiodarone prolongs ventricular repolarization and is a common cause of QT prolongation, increasing the risk of torsades de pointes.

Question 5

During a carotid endarterectomy, the patient develops new onset contralateral arm weakness. What is the nurse's priority action?

Accepted Answer

Alert the surgical team immediately and prepare for emergency neurological assessment

Answer

New neurological deficits during carotid surgery indicate possible stroke or cerebral hypoperfusion and require immediate surgical team notification and neurological evaluation.

Cardiac Vascular Nursing Exam Practice Test

Cardiac Vascular Nursing Exam Practice Test

Cardiac Vascular Nursing Exam Risk Assessment & Management 4