Cardiovascular and Hematological Care Flashcards
7 cards from real CMSRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Cardiovascular and Hematological Care flashcards as text
A patient with atrial fibrillation has a ventricular rate of 140 bpm and is hemodynamically unstable. What intervention is the priority?
Answer: Perform synchronized cardioversion
Hemodynamically unstable tachyarrhythmias require immediate synchronized cardioversion to restore sinus rhythm.
Which lab value is the most specific marker for myocardial cell damage following an acute MI?
Answer: Troponin I or T
Cardiac troponin I and T are highly specific for myocardial injury and remain elevated for 7–14 days after an acute MI.
A nurse caring for a patient with deep vein thrombosis notes the INR is 4.8 on warfarin. Which action is most appropriate?
Answer: Hold warfarin and notify the provider
An INR above the therapeutic range (2–3 for DVT) increases bleeding risk and requires dose withholding and provider notification.
A patient with chronic anemia has a hemoglobin of 6.5 g/dL and reports dyspnea on minimal exertion. After transfusion is initiated, which assessment finding indicates a transfusion-related circulatory overload (TACO)?
Answer: New onset crackles and hypertension
TACO presents with pulmonary edema signs including crackles, hypertension, and respiratory distress from fluid volume overload.
When teaching a patient about dietary management of hypertension, which recommendation is most evidence-based?
Answer: Follow the DASH diet and limit sodium to <2,300 mg/day
The DASH diet combined with sodium restriction is the most evidence-based dietary approach to reducing blood pressure.
A patient with heart failure is prescribed furosemide. Which electrolyte imbalance should the nurse monitor most closely?
Answer: Hypokalemia
Loop diuretics like furosemide cause urinary potassium wasting, placing patients at risk for hypokalemia, which can precipitate dysrhythmias.
A patient is ordered to receive packed red blood cells. The nurse verifies the blood product at the bedside. Which action is essential before beginning the transfusion?
Answer: Confirm patient identity using two identifiers and compare with blood product label
Two-identifier verification of both the patient and the blood product is the critical safety step to prevent a fatal hemolytic transfusion reaction.