MSNCB Cardiac Nursing 4

Question 1

A patient presents with sudden-onset tearing chest pain radiating to the back. Blood pressure in the right arm is 160/90 mmHg and in the left arm is 110/70 mmHg. The nurse suspects:

Accepted Answer

Aortic dissection with involvement of subclavian artery

Answer

Tearing chest pain radiating to the back with a blood pressure differential greater than 20 mmHg between arms is classic for aortic dissection.

Question 2

When interpreting a 12-lead ECG, which finding is most indicative of left ventricular hypertrophy?

Accepted Answer

S wave in V1 plus R wave in V5 or V6 greater than 35 mm

Answer

The Sokolow-Lyon criteria for LVH requires the S wave in V1 plus R wave in V5 or V6 to exceed 35 mm.

Question 3

A patient with heart failure and an ejection fraction of 25% is being evaluated for cardiac resynchronization therapy (CRT). The primary goal of CRT is to:

Accepted Answer

Coordinate ventricular contraction to improve cardiac output

Answer

CRT uses biventricular pacing to resynchronize left and right ventricular contractions, improving cardiac output in patients with ventricular dyssynchrony.

Question 4

A patient with chronic heart failure is started on spironolactone. The nurse monitors most closely for:

Accepted Answer

Hyperkalemia, especially if also taking an ACE inhibitor

Answer

Spironolactone is a potassium-sparing diuretic; when combined with ACE inhibitors (which also retain potassium), dangerous hyperkalemia can develop.

Question 5

A patient in the cardiac ICU has a pulmonary artery catheter. The nurse notes a PCWP of 22 mmHg. This finding indicates:

Accepted Answer

Elevated left ventricular end-diastolic pressure

Answer

A PCWP above 18 mmHg reflects elevated left ventricular end-diastolic pressure, indicating left heart congestion and volume overload.

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

MSNCB Cardiac Nursing 4