NUR 099 (Nursing Seminar 1)

STUDENT ANSWER SHEET BS NURSING / FOURTH YEAR

Session # 21

LESSON TITLE: CARDIOLOGY PART 3 Materials:

LEARNING OUTCOMES: Book, pen and notebook, index card/class list
Upon completion of this lesson, the nursing student can:

1. Understand and assess the clinical manifestations of

myocardial infarction and heart failure;
2. Learn how to formulate a nursing diagnosis and a plan of References: Brunner & Suddarth’s Textbook on
care for patients with these cardiac diseases; Medical-Surgical Nursing 14th Edition; Janice L.
3. Manage the signs and symptoms of these diseases and Hinkle PhD, RN, CNRN; Kerry H. Cheever RN,
promote the well-being of the patients. CNRN

LESSON PREVIEW/REVIEW: (5 minutes)

MAIN LESSON (55 minutes):

I. Myocardial infarction
a. Assessment
b. Pathophysiology
c. Diagnostic procedures
d. Nursing management and evaluation
II. Hypertension
a. Assessment
b. Pathophysiology
c. Diagnostic procedures
d. Nursing management and evaluation

CHECK FOR UNDERSTANDING (25 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed. You
are given 25 minutes for this activity:

MULTIPLE CHOICE

Situation 7: A 56-year old male client named Happy Hogan is brought to the emergency department because of severe
chest pain not relieved by nitroglycerine. He has a history of angina pectoris. The attending physician diagnosed him to
have myocardial infarction. He is attended to by Nurse May.

1 The immediate nursing intervention in the diagnosis of myocardial infarction would be

a. Oxygen administration as ordered by the physician
b. Administration of morphine sulfate
c. Preparing for the immediate surgery of the patient
d. Administration of nitroglycerine

ANSWER: ________
RATIO:___________________________________________________________________________________________
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 2 During the diagnosis of myocardial infarction the doctor has noted that the endocardial muscles are affected. The
nurse must know that this classification of MI is
a. Transmural infarct
b. Subendocardial infarct
c. Intramural infarct
d. Intermural infarct

ANSWER: ________
RATIO:___________________________________________________________________________________________
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3 The client’s creatine-phosphokinase MB (CPK-MB) is monitored. The nurse must know that the peak usually is
achieved within how many hours after a myocardial infarction?
a. 3-6 hours
b. 12-18 hours
c. 3-4 days
d. 5-7 days

ANSWER: ________
RATIO:___________________________________________________________________________________________
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4 In the ECG reading interpretation, the nurse has noted a T-wave depression. Nurse May must this as
a. Zone of ischemia
b. Zone of injury
c. Zone of infarction
d. Zone of occlusion

ANSWER: ________
RATIO:___________________________________________________________________________________________
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5 Aside from relieving pain from MI, morphine sulfate is administered since it causes what to the coronary arteries?
a. Vasodilation
b. Vasoconstriction
c. Vasospasms
d. Thrombolytic

ANSWER: ________
RATIO:___________________________________________________________________________________________
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6 One of the discharge teachings to Happy is to prevent constipation from occurring since straining during a bowel
movement can cause
a. Heart failure
b. Arteriosclerosis
c. Cardiac arrhythmias
d. Hypertension

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ANSWER: ________
RATIO:___________________________________________________________________________________________
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7 In order to prevent constipation, nurse May must instruct Happy to

a. Increase fiber in the diet
b. Increase sodium in the diet
c. Increase vitamin K in the diet
d. Increase fluid intake

ANSWER: ________
RATIO:___________________________________________________________________________________________
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8 Great sources of vitamin K would be found in

a. Citrus fruits
b. Meats
c. Cereals
d. Green, leafy vegetables

ANSWER: ________
RATIO:___________________________________________________________________________________________
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9 Which of the following drugs would be beneficial in dissolving the thrombus that has caused a blockage in
Happy’s coronary artery?
a. Aspirin
b. Heparin sodium
c. Warfarin
d. Alteplase

ANSWER: ________
RATIO:___________________________________________________________________________________________
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10 If Happy is not relieved by drug and oxygen therapy for myocardial infarction the Nurse May must
a. Prepare the patient for emergency surgery
b. Increase the delivery of oxygen
c. Suggest to the physician to increase the dose of the drugs
d. Reassess the patient’s ECG readings

ANSWER: ________
RATIO:___________________________________________________________________________________________
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11 One of the drugs prescribed by the physician is furosemide (Lasix). When giving this drug to Happy, nurse May
should monitor the patient’s
a. Intake and output

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 b. Body temperature
c. Level of pain
d. Respiratory rate

ANSWER: ________
RATIO:___________________________________________________________________________________________
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12 In the administration of morphine sulfate, the nurse must monitor for the adverse effect of the drug which is
a. Respiratory depression
b. Hypotension
c. Oliguria
d. Increased temperature

ANSWER: ________
RATIO:___________________________________________________________________________________________
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13 Upon discharge which of the following patient response would require further teaching by the nurse?
a. “I will increase my fiber intake to prevent constipation.”
b. “I will minimize my intake of sodium.”
c. “I will report signs of bleeding in my anticoagulant therapy.”
d. “I will take aspirin on an empty stomach.”

ANSWER: ________
RATIO:___________________________________________________________________________________________
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14 Which of the following phases of cardiac rehabilitation would include long-term maintenance of what was
performed in the first 3 phases?
a. Phase I
b. Phase II
c. Phase III
d. Phase IV

ANSWER: ________
RATIO:___________________________________________________________________________________________
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15 In the phase III of cardiac rehabilitation, the patient is undergoing

a. In-patient treatment
b. Exercise and education program
c. Immediate post-discharge period
d. Long term maintenance

ANSWER: ________
RATIO:___________________________________________________________________________________________
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Situation: A 22-year old female patient named Sasha Braus has been rushed to the hospital with a chief complaint of
dyspnea. Nurse Armin assigned at the ER assessed Sasha and has observed for crackles upon auscultation, pink-frothy
sputum, and has a pre-existing disease of ventricular septal defect. The attending physician has diagnosed the patient to
have heart failure.

16 Based on Nurse Armin’s assessment findings, the patient is experiencing which type of heart failure?
a. Right-sided heart failure
b. Left-sided heart failure
c. Bilateral heart failure
d. End-stage heart failure

ANSWER: ________
RATIO:___________________________________________________________________________________________
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17 The doctor has prescribed a cardiac glycoside known as digoxin (Lanoxin). What is NOT an action of this drug?
a. Increases force of contraction of the heart
b. Rate of heart is decreased
c. Negative dromotropic effect
d. Heart rate is increased

ANSWER: ________
RATIO:___________________________________________________________________________________________
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18 Sasha asks the nurse why she should be in sodium restriction. Nurse Armin must reply which of the following
statements?
a. “You salt intake is limited since sodium will cause water to be retained in your blood which can increase
the workload of your heart.”
b. “Sodium is restricted because it causes your heart to pump ineffectively.”
c. “Sodium is taken in limited amounts since it can excite the nerves of the heart.”
d. “Salt is reduced to increase the potassium levels of your blood.”

ANSWER: ________
RATIO:___________________________________________________________________________________________
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19 When administering furosemide (Lasix) to Sasha, nurse Armin must watch out for which of the following?
a. Hypokalemia
b. Hyperkalemia
c. Hypernatremia
d. Hypocalcemia

ANSWER: ________
RATIO:___________________________________________________________________________________________
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20 Nurse Armin must also determine the difference between right-sided and left-sided heart failure. The signs and
symptoms of right-sided heart failure would NOT include which of the following?

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 a. Distended jugular veins
b. Hepatomegaly
c. Pulmonary edema
d. Ascites

ANSWER: ________
RATIO:___________________________________________________________________________________________
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21 After the administration of digoxin (Lanoxin) to Sasha, the nurse must watch out for
a. Blurred vision
b. Yellow halos around lights
c. Photophobia
d. Nausea and vomiting

ANSWER: ________
RATIO:___________________________________________________________________________________________
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22 Nurse Armin must advise Sasha to avoid which of the following substances?
a. Nicotine
b. Alcohol
c. Caffeine
d. All of these

ANSWER: ________
RATIO:___________________________________________________________________________________________
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23 When administering furosemide (Lasix) to a patient with heart failure nurse Armin must advise Sasha to eat fruits
that are high in
a. Chloride
b. Potassium
c. Calcium
d. Sodium

ANSWER: ________
RATIO:___________________________________________________________________________________________
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24 Sasha tells that nurse that she always feels exhausted whenever she walks to and from the toilet whenever she
has the urge to urinate. The appropriate nursing diagnosis for her would be
a. Risk for decreased cardiac output
b. Activity intolerance
c. Acute pain
d. Ineffective tissue perfusion

ANSWER: ________
RATIO:___________________________________________________________________________________________
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 25 In order to truly eradicate Sasha’s heart failure, the doctor must
a. Advise the patient to be on cardiac glycosides and diuretics for life
b. Refer the patient to a surgeon who can correct her ventricular septal defect
c. Totally restrict sodium from her diet until she gets better
d. Modify her lifestyle

ANSWER: ________
RATIO:___________________________________________________________________________________________
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LESSON WRAP-UP (10 minutes)

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.
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LESSON WRAP-UP (10 minutes)

You will now mark (encircle) the session you have finished today in the tracker below. This is simply a visual to help you
track how much work you have accomplished and how much work there is left to do.

You are done with the session! Let’s track your progress.

AL Strategy: Turn and Talk

1. The instructor will pose one question to the class.
2. The students will begin to discuss their answers to their seatmate (with observance of social distancing) on a set
allotted time.
3. When the time is up, the instructor will randomly ask the students to share their thoughts and ideas from their partners’
discussion in the class.

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