CMSRN Cardiovascular and Hematological Care 5

Question 1

A patient with a pacemaker has a paced rhythm on the monitor, but the nurse notes the patient's heart rate is 38 bpm and symptoms of dizziness. What does this indicate?

Accepted Answer

Pacemaker failure to capture

Answer

Failure to capture occurs when the pacemaker delivers a stimulus but the myocardium does not depolarize, resulting in bradycardia despite paced spikes.

Question 2

Which intervention is most important when caring for a patient receiving thrombolytic therapy for acute MI?

Accepted Answer

Avoid all arterial and venous punctures at non-compressible sites

Answer

Thrombolytics cause systemic fibrinolysis; avoiding punctures at non-compressible sites reduces the risk of uncontrolled hemorrhage.

Question 3

A patient with polycythemia vera is at highest risk for which complication?

Accepted Answer

Thromboembolism

Answer

The elevated red blood cell mass in polycythemia vera increases blood viscosity, dramatically raising the risk of arterial and venous thrombosis.

Question 4

A nurse administers digoxin to a patient with heart failure. Before administration, the apical pulse is 52 bpm. What should the nurse do?

Accepted Answer

Hold the dose and notify the provider

Answer

Digoxin is typically held and the provider notified if the apical pulse is below 60 bpm due to its negative chronotropic effect, which can worsen bradycardia.

Question 5

A patient receiving IV vancomycin develops sudden flushing, erythema, and hypotension during the infusion. This reaction is most consistent with:

Accepted Answer

Red man syndrome

Answer

Red man syndrome is a non-immune infusion reaction to vancomycin characterized by flushing and hypotension, prevented by slowing the infusion rate.

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN - Medical-Surgical Nursing Practice Test

CMSRN Cardiovascular and Hematological Care 5