RN COMPREHENSIVE PREDICTOR 2019 FORM B

RN COMPREHENSIVE PREDICTOR 2019 FORM B

1.The nurse is caring for a patient with fluid volume overload. Which physiological effect does the nurse most likely expect?a.Increased preload b.Increased heart rate c.Decreased afterload d.Decreased tissue perfusion

ANS: A

Preload refers to the amount of blood in the left ventricle at the end of diastole; an increase in circulating volume would increase the preload of the heart. Afterload refers to resistance; increased pressure would lead to increased resistance, and afterload would increase. A decrease in tissue perfusion would be seen with hypovolemia. A decrease in fluid volume would cause an increase in heart rate as the body is attempting to increase cardiac output.

26.A nurse is caring for a patient with continuous cardiac monitoring for heart dysrhythmias. Which rhythm will cause the nurse to intervene immediately?a.Ventricular tachycardia b.Atrial fibrillation c.Sinus rhythm d.Paroxysmal supraventricular tachycardia

ANS: A

Ventricular tachycardia and ventricular fibrillation are life-threatening rhythms that require immediate intervention. Ventricular tachycardia is a life-threatening dysrhythmia because of the decreased cardiac output and the potential to deteriorate into ventricular fibrillation or sudden cardiac death. Atrial fibrillation is a common dysrhythmia in older adults and is not as serious as ventricular tachycardia. Sinus rhythm is normal. Paroxysmal supraventricular tachycardia is a sudden, rapid onset of tachycardia originating above the AV node. It often begins and ends

spontaneously.

27.The patient is experiencing angina pectoris. Which assessment finding does the nurse expect when conducting a history and physical examination?a.Experiences chest pain after eating a heavy meal b.Experiences adequate oxygen saturation during exercise c.Experiences crushing chest pain for more than 20 minutes d.Experiences tingling in the left arm that lasts throughout the morning

ANS: A

Angina pectoris is chest pain that results from limited oxygen supply. Often pain is precipitated by activities such as exercise, stress, and eating a heavy meal and lasts 3 to 5 minutes. Symptoms of angina pectoris are relieved by rest and/or nitroglycerin. Adequate oxygen saturation occurs with rest; inadequate oxygen saturation occurs during exercise. Pain lasting longer than 20 minutes or arm tingling that persists could be a sign of myocardial infarction.

28.A nurse is teaching about risk factors for cardiopulmonary disease.Which risk factor should the nurse describe as modifiable?

• Stress
• Allergies
• Family history
• Gender

ANS: A

Young and middle-age adults are exposed to multiple cardiopulmonary risk

factors: an unhealthy diet, lack of exercise, stress, over-the-counter and

prescription drugs not used as intended, illegal substances, and smoking. Reducing these modifiable factors decreases a patient’s risk for cardiac or pulmonary diseases. A nonmodifiable risk factor is family history; determine familial risk factors such as a family history of lung cancer or cardiovascular disease. Other nonmodifiable risk factors include allergies and gender.

29.The nurse is creating a plan of care for an obese patient who is suffering

from fatigue related to ineffective breathing. Which intervention best addresses a short-term goal the patient could achieve?

a.Sleeping on two to three pillows at night b.Limiting the diet to 1500 calories a day c.Running 30 minutes every morning d.Stopping smoking immediately

ANS: A

To achieve a short-term goal, the nurse should plan a lifestyle change that the patient can make immediately that will have a quick effect. Sleeping on several pillows at night will immediately relieve orthopnea and open the patient’s airway, thereby reducing fatigue. Running 30 minutes a day will improve cardiopulmonary health, but a patient needs to build up exercise tolerance. Smoking cessation is another process that many people have difficulty doing immediately. A more realistic short-term goal would be to gradually reduce the number of cigarettes smoked. Limiting caloric intake can help a patient lose weight, but this is a gradual process and is not reasonable for a short-term goal.

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