Philadelphia University
Nursing Faculty
Academic Year 2012-2013
Second Semester
Critical Care Nursing (911410)
Second Exam
Exam Duration: One Hour
Date: 13/5/2013
Student ID
Student’s Name:..........................................................................................
Student’s University Number:....................................................................
Section Number: (1)
Examiner
Dr. Mayada Daibes
Type of questions
Multiple Choice
Questions
calculation
Total
Number of
questions
17
Assigned marks on Deserved Mark
questions
out of (20)
17
1
3
18
20
Question 1
Answer
2
3
4
5
6
7
8
9
10
Question 11
Answer
12
13
14
15
16
17
18
19
20
1
Please, answer all following questions and write down your answers in the
box above.
1.
A nurse is assessing the client with left-sided heart failure. The client states
that he needs to use three pillows under the head and chest at night to be
able to breathe comfortably while sleeping. The nurse documents that the
client is experiencing:
a.
b.
c.
d.
Orthopnea
dyspnea at rest
dyspnea on exertion
none of the above is correct
2.
First-line agents used in treating congestive heart failure:
a. dobutamine (Dobutrex)
b. ACE inhibitors
c. thiazide diuretics
d. calcium channel blockers
3.
Mechanism by which vasodilators, such as ACE Inhibitors, improve
myocardial performance in CHF:
a. increase heart rate
b. promote dieuresis
c. reduce afterload
d. reduce pulmonary blood flow
4.
Which of the following blood tests is most indicative of cardiac damage?
a. Lactate dehydrogenase
b. myoglobin
c. Troponin I
d. Creatine kinase
5.
What is the primary reason for administering morphine to a client with
myocardial infarction?
a. To sedate the client
b. To decrease the client’s pain
c. To decrease the client’s anxiety
d. To decrease oxygen demand on the client’s heart
2
6.
Which of the following classes of medications protects the ischemic
myocardium, during angina for example, by blocking catecholamines and
sympathetic nerve stimulation?
a. Beta-adrenergic blockers
b. Calcium channel blockers
c. Narcotics
d. Nitrates (Nitroglycerine)
7.
Which type of angina usually occurs at rest or with minimal formal execise
or exertion, and often occurs at night:
a. unstable angina
b. prinzmetal's or vasospastic angina
c. stable angina.
d. None of the above
8.
The PR interval of a first degree heart block :
a. constant and greater than 0.20second in duration
b. Is completely variable in duration
c. Gradually decreases in duration until a p wave appears without a QRS
complex
d. Gradually lengthens until a p wave appears without a QRS complex
9.
In which type of angina does pain occur at rest; is of new onset; is of
increasing intensity, force, or duration; is not relieved by rest; and is slow
to subside in response to NTG?
a. unstable angina
b. prinzmetal's or vasospastic angina
c. stable angina
d. none of the above is correct.
10. This cardiovascular disorder is when abnormal electrical impulses are
looping in the ventricles causing the heart to contract more than 160 beats
per minute. This results in an inadequate filling of the ventricles with blood
between beats and therefore less blood is pumped throughout the body
than during normal contractions:
a. ventricular tachycardia
b. ventricular fibrillation
c. Mitral valve stenosis.
d. Ventricular hyperatrophy.
3
11. This cardiovascular disorder happens when the heart is unable to pump
sufficient blood to maintain adequate circulation. This results in a backup
of blood and the extra pressure may cause accumulation to fluid into the
blood:
a. congestive heart failure.
b. Cardiac tamponade.
c. Endocarditis
d. Atherosclerosis.
12. When assessing a client’s ECG 12- leads stripe, who has been diagnosed to
have inferior MI, which of the leads a nurse needs to assess to check any
progress in his MI condition:
a. Lead I, aVL, III.
b. Leads II, III, aVF
c. Leads II, aVF, aVL.
d. Leads V1, V2, aVF.
Determine the arrhythmia/s in each of the following ECG stripes below:
13.
a.
b.
c.
d.
Normal sinus rhythm
Paroxysmal supraventricular Tachycardia (PSVT)
1st Degree AV block
Left Bundle Branch Block
14.
a. 2nd degree AV Block, Type II
b. 2nd degree AV Block , Type I
c. Sinus Bradycardia
d. None of the above is correct.
4
15.
a. premature atrial contractions
b. Premature ventricular contractions
c. Normal Sinuc rhythm
d. Paroxysmal supravetricular Tachycardia
16.
a. Ventricular Tachycardia
b. Ventricular Fibrillation
c. Premature Ventricular Contractions
d. Atrial Flutter.
17.
a.
b.
c.
d.
Sinus tachycardia
Supraventricular tachycardia (SVT)
Ventricular tachycardia
Atrial flutter
5
18. Mr. Hisham is a patient who has been diagnosed as having Killip grade II
heart failure. Mr. Hisham has undergone an echocardiography today. The
echocardiographer reported the following results in his report (Three
Marks):
- End-Diastolic Volume= 200 ml
- End-systolic volume = 140 ml
- Heart rate = 50 bpm
Calculate the FOLLOWING:
1. Stroke volume=
2. Cardiac output (C.O)=
3. Ejection fraction=
Best wishes
Dr. Mayada Daibes
6