CMSRN Cardiac Vascular 4

Question 1

A patient is ordered to receive adenosine 6 mg IV push for SVT. What is the correct administration technique?

Accepted Answer

Administer rapidly over 1-2 seconds followed immediately by a 20 mL NS flush

Answer

Adenosine must be pushed rapidly over 1-2 seconds and followed immediately by a rapid saline flush to reach the heart before it is metabolized in peripheral circulation.

Question 2

Which sign would differentiate a venous leg ulcer from an arterial leg ulcer?

Accepted Answer

Located near the medial malleolus with irregular borders and surrounding hyperpigmentation

Answer

Venous ulcers typically appear near the medial malleolus with irregular edges and surrounding lipodermatosclerosis or hyperpigmentation from hemosiderin deposits.

Question 3

A patient post-CABG has a chest tube output of 250 mL in the last hour. What is the priority nursing action?

Accepted Answer

Notify the surgeon and prepare for possible return to the OR

Answer

Chest tube drainage exceeding 200 mL/hr after cardiac surgery indicates excessive bleeding and requires immediate surgical notification for possible re-exploration.

Question 4

A patient with dilated cardiomyopathy is prescribed carvedilol. What is the primary reason beta-blockers are used in heart failure with reduced ejection fraction (HFrEF)?

Accepted Answer

To block harmful neurohormonal activation and remodel the ventricle over time

Answer

Beta-blockers counteract chronic sympathetic activation in HFrEF, reducing harmful neurohormonal effects and promoting reverse ventricular remodeling, improving long-term outcomes.

Question 5

Which laboratory value requires the nurse to hold a scheduled dose of digoxin and contact the provider?

Accepted Answer

Serum digoxin level of 2.8 ng/mL

Answer

The therapeutic range for digoxin is 0.5-2.0 ng/mL; a level of 2.8 ng/mL is toxic and requires holding the dose and notifying the provider.

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN Cardiac Vascular 4