MSNCB Cardiac Nursing 5

Question 1

A patient develops heparin-induced thrombocytopenia (HIT) confirmed by laboratory testing. The nurse anticipates which medication will be ordered?

Accepted Answer

Argatroban or bivalirudin as a direct thrombin inhibitor

Answer

In confirmed HIT, all heparin products are contraindicated and a direct thrombin inhibitor such as argatroban or bivalirudin must be substituted.

Question 2

A patient with aortic stenosis develops syncope, angina, and dyspnea. The nurse recognizes these symptoms indicate:

Accepted Answer

Progression to critical stenosis requiring urgent valve intervention

Answer

The classic triad of syncope, angina, and dyspnea in aortic stenosis signals critical disease with significantly reduced survival if valve replacement is not performed.

Question 3

A patient is admitted with Wolff-Parkinson-White syndrome and develops atrial fibrillation. Which medication is contraindicated in this situation?

Accepted Answer

IV diltiazem

Answer

In WPW with atrial fibrillation, AV nodal blocking agents like diltiazem, verapamil, and digoxin are contraindicated because they can accelerate conduction through the accessory pathway, causing ventricular fibrillation.

Question 4

A patient post-PCI with stent placement is being discharged. The nurse understands the most critical teaching point regarding dual antiplatelet therapy is:

Accepted Answer

Both aspirin and the P2Y12 inhibitor must be taken consistently to prevent in-stent thrombosis

Answer

Premature discontinuation of dual antiplatelet therapy after coronary stenting dramatically increases the risk of acute in-stent thrombosis, which carries very high mortality.

Question 5

When assessing a patient with right-sided heart failure, the nurse expects to find which clinical manifestations?

Accepted Answer

Peripheral edema, hepatomegaly, and jugular venous distension

Answer

Right-sided heart failure causes systemic venous congestion manifesting as peripheral edema, hepatomegaly, ascites, and jugular venous distension.

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

MSNCB Cardiac Nursing 5