CMSRN Cardiac Vascular 3

Question 1

A patient with an acute MI reports sudden, severe midscapular tearing back pain. What complication should the nurse suspect first?

Accepted Answer

Aortic dissection

Answer

Tearing or ripping back pain radiating to the interscapular region is the hallmark presentation of aortic dissection, a life-threatening emergency.

Question 2

A nurse notes a patient's cardiac monitor shows a rhythm with no P waves, irregular RR intervals, and a rate of 110 bpm. What rhythm is this?

Accepted Answer

Atrial fibrillation

Answer

Atrial fibrillation is characterized by an absence of distinct P waves, an irregularly irregular ventricular rate, and chaotic atrial activity.

Question 3

Which instruction is most important when teaching a patient about warfarin therapy?

Accepted Answer

Avoid consistent consumption of vitamin K-rich foods

Answer

Consistent vitamin K intake is essential because vitamin K antagonizes warfarin; drastic changes in dietary vitamin K can cause INR fluctuations.

Question 4

A patient's arterial blood pressure waveform shows pulsus paradoxus of 18 mmHg. What condition does this suggest?

Accepted Answer

Cardiac tamponade

Answer

Pulsus paradoxus greater than 10 mmHg (exaggerated fall in systolic BP during inspiration) is a classic sign of cardiac tamponade.

Question 5

A nurse is caring for a patient with deep vein thrombosis (DVT) of the left leg. Which intervention is contraindicated?

Accepted Answer

Massaging the affected calf to relieve discomfort

Answer

Massaging a limb with DVT can dislodge the thrombus and cause a pulmonary embolism.

CMSRN - Medical-Surgical Nursing Practice Test