Cardiac Vascular 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 Cardiac Vascular flashcards as text
A patient on telemetry develops ventricular fibrillation. What is the immediate priority intervention?
Answer: Initiate CPR and prepare for defibrillation
Ventricular fibrillation is a pulseless rhythm requiring immediate CPR and unsynchronized defibrillation as the definitive treatment per ACLS guidelines.
Which patient teaching point is most important for a patient discharged with a new mechanical heart valve?
Answer: Take antibiotic prophylaxis before dental procedures for life and maintain lifelong anticoagulation
Patients with mechanical heart valves require lifelong anticoagulation due to thromboembolic risk and prophylactic antibiotics before procedures that may cause bacteremia.
A patient is receiving a dobutamine infusion for acute decompensated heart failure. The nurse notes the heart rate has increased from 88 to 122 bpm. What action is appropriate?
Answer: Notify the provider because dobutamine-induced tachycardia increases myocardial oxygen demand
Dobutamine can cause dose-related tachycardia, which increases myocardial oxygen demand and may worsen ischemia; the provider should be notified to consider dose adjustment.
A patient with aortic stenosis asks why they feel dizzy when exercising. What is the best explanation?
Answer: The narrowed valve limits cardiac output during exertion, reducing cerebral perfusion
The stenotic aortic valve creates a fixed obstruction to outflow; during exercise, the heart cannot increase cardiac output sufficiently to meet demand, resulting in decreased cerebral perfusion and syncope or dizziness.
Which intervention is most effective for preventing contrast-induced nephropathy in a patient with CKD undergoing cardiac catheterization?
Answer: Providing IV hydration with isotonic saline before and after the procedure
Adequate IV hydration with isotonic saline before and after contrast administration is the most evidence-based intervention for reducing contrast-induced nephropathy risk.
A patient presents with an INR of 8.2 and active gum bleeding while on warfarin. Which treatment is most appropriate?
Answer: Hold warfarin and administer oral or IV vitamin K
For supratherapeutic INR with bleeding, holding warfarin and administering vitamin K (with FFP for significant bleeding) reverses anticoagulation by restoring clotting factor synthesis.
A patient with hypertension has a blood pressure of 198/114 mmHg with complaints of headache and blurred vision but no end-organ damage. This is classified as which condition?
Answer: Hypertensive urgency
Hypertensive urgency is severely elevated BP (>180/120 mmHg) without acute end-organ damage; it is managed with oral antihypertensives and gradual BP reduction over 24-48 hours.