CMSRN Cardiac Vascular 5

Question 1

A patient on telemetry develops ventricular fibrillation. What is the immediate priority intervention?

Accepted Answer

Initiate CPR and prepare for defibrillation

Answer

Ventricular fibrillation is a pulseless rhythm requiring immediate CPR and unsynchronized defibrillation as the definitive treatment per ACLS guidelines.

Question 2

Which patient teaching point is most important for a patient discharged with a new mechanical heart valve?

Accepted Answer

Take antibiotic prophylaxis before dental procedures for life and maintain lifelong anticoagulation

Answer

Patients with mechanical heart valves require lifelong anticoagulation due to thromboembolic risk and prophylactic antibiotics before procedures that may cause bacteremia.

Question 3

A patient is receiving a dobutamine infusion for acute decompensated heart failure. The nurse notes the heart rate has increased from 88 to 122 bpm. What action is appropriate?

Accepted Answer

Notify the provider because dobutamine-induced tachycardia increases myocardial oxygen demand

Answer

Dobutamine can cause dose-related tachycardia, which increases myocardial oxygen demand and may worsen ischemia; the provider should be notified to consider dose adjustment.

Question 4

A patient with aortic stenosis asks why they feel dizzy when exercising. What is the best explanation?

Accepted Answer

The narrowed valve limits cardiac output during exertion, reducing cerebral perfusion

Answer

The stenotic aortic valve creates a fixed obstruction to outflow; during exercise, the heart cannot increase cardiac output sufficiently to meet demand, resulting in decreased cerebral perfusion and syncope or dizziness.

Question 5

Which intervention is most effective for preventing contrast-induced nephropathy in a patient with CKD undergoing cardiac catheterization?

Accepted Answer

Providing IV hydration with isotonic saline before and after the procedure

Answer

Adequate IV hydration with isotonic saline before and after contrast administration is the most evidence-based intervention for reducing contrast-induced nephropathy risk.

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN Cardiac Vascular 5