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Free NCLEX-RN Exam Braindumps (page: 33)

Page 32 of 431
PDF with 862 Questions

To appropriately monitor therapy and client progress, the nurse should be aware that increased myocardial work and O2 demand will occur with which of the following?

  1. Positive inotropic therapy
  2. Negative chronotropic therapy
  3. Increase in balance of myocardial O2 supply and demand
  4. Afterload reduction therapy

Answer(s): A

Explanation:

(A) Inotropic therapy will increase contractility, which will increase myocardial O2 demand. (B) Decreased heart rate to the point of bradycardia will increase coronary artery filling time. This should be used cautiously because tachycardia may be a compensatory mechanism to increase cardiac output. (C) The goal in the care of the MI client with angina is to maintain a balance between myocardial O2 supply and demand. (D) Decrease in systemic vascular resistance by drug therapy, such as IV nitroglycerin or nitroprusside, or intra-aortic balloon pump therapy, would decrease myocardial work and O2 demand.



To appropriately monitor therapy and client progress, the nurse should be aware that increased myocardial work and O2 demand will occur with which of the following?

  1. Positive inotropic therapy
  2. Negative chronotropic therapy
  3. Increase in balance of myocardial O2 supply and demand
  4. Afterload reduction therapy

Answer(s): A

Explanation:

(A) Inotropic therapy will increase contractility, which will increase myocardial O2 demand. (B) Decreased heart rate to the point of bradycardia will increase coronary artery filling time. This should be used cautiously because tachycardia may be a compensatory mechanism to increase cardiac output. (C) The goal in the care of the MI client with angina is to maintain a balance between myocardial O2 supply and demand. (D) Decrease in systemic vascular resistance by drug therapy, such as IV nitroglycerin or nitroprusside, or intra-aortic balloon pump therapy, would decrease myocardial work and O2 demand.



Assessment of the client with pericarditis may reveal which of the following?

  1. Ventricular gallop and substernal chest pain
  2. Narrowed pulse pressure and shortness of breath
  3. Pericardial friction rub and pain on deep inspiration
  4. Pericardial tamponade and widened pulse pressure

Answer(s): C

Explanation:

(A) No S3 or S4 are noted with pericarditis. (B) No change in pulse pressure occurs. (C) The symptoms of pericarditis vary with the cause, but they usually include chest pain, dyspnea, tachycardia, rise in temperature, and friction rub caused by fibrin or other deposits. The pain seen with pericarditis typically worsens with deep inspiration. (D) Tamponade is not typically seen early on, and no change in pulse pressure occurs.



Assessment of the client with pericarditis may reveal which of the following?

  1. Ventricular gallop and substernal chest pain
  2. Narrowed pulse pressure and shortness of breath
  3. Pericardial friction rub and pain on deep inspiration
  4. Pericardial tamponade and widened pulse pressure

Answer(s): C

Explanation:

(A) No S3 or S4 are noted with pericarditis. (B) No change in pulse pressure occurs. (C) The symptoms of pericarditis vary with the cause, but they usually include chest pain, dyspnea, tachycardia, rise in temperature, and friction rub caused by fibrin or other deposits. The pain seen with pericarditis typically worsens with deep inspiration. (D) Tamponade is not typically seen early on, and no change in pulse pressure occurs.






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