Acquired Immuno Deficiency Syndrome (AIDS) - Answers and Rationale

1.     Answer D

The human immunodeficiency virus (HIV) is transmitted from mother to child via the transplacental route, but a Cesarean section delivery isn't necessary when the mother is HIV-positive. The use of birth control will prevent the conception of a child who might have HIV. It's true that a mother who is HIV-positive can give birth to a baby who is HIV-negative.

2.      Answer C

Most children infected with HIV develop symptoms within the first 9 months of life. The remainder of these infected children become symptomatic sometime before age 3. Children, with their immature immune systems, have a much shorter incubation period than adults. Options A, B, and D are incorrect.

3.    Answer B

A positive antibody test in a child younger than 18 months indicates only that the mother is infected because maternal immunoglobulin G antibodies persist in infants for 6 to 9 months and, in some cases, as long as 18 months. A positive enzyme-linked immunosorbent assay (ELISA) does not indicate true infection.

4.    Answer D

QUESTION: What does it mean if a person is HIV positive?
STRATEGY: Think about each answer choice. Is it true about AIDS?
NEEDED INFO: AIDS (acquired immunodeficiency syndrome): caused by immunodeficiency virus (HIV). Alters functioning of immune system. Transmission: contact with blood, and body fluids (semen). Test which detects presence of antibodies: enzyme-linked immunosorbent assay (ELISA). Test that confirms presence of virus: Western Blot.
CORRECT ANSWER: (D) HIV virus is considered infected and infectious (A) not true; AIDS: defined as presence of complications (such as opportunistic infections--Pneumocystis pneumonia) from HIV virus (B) not completely certain; Aids Related Complex (ARC) has symptoms (fever, drenching night sweats, weight loss, fatigue, lymphadenopathy) without opportunistic infections (C) no test determines exposure; only detects infection

5.    Answer A

While all these nursing diagnoses are appropriate for the client with AIDS, Impaired gas exchange is the priority nursing diagnosis for the client with P. carinii pneumonia. Airway, breathing, and circulation take top priority with any client. 

6.   Answer C

C: The nurse recognizes the client's pain, hopelessness, and sense of loss related to his condition and the loss of his friend and encourages him to express his feelings. Giving the client permission to talk about his feelings of sadness, loss, and hopelessness and listening to him is an important nursing intervention for the dying client. 
A: This statement diverts attention from the content of the client's statements and blocks expression of feelings. 
B: "Don't give up" is a type of pep talk that ignores the client's feelings. 
D: This statement ignores the client's needs and inhibits his expression of feelings.

7.     Answer C

The preschool child will begin to conceptualize the death process as involving physical harm. A child from birth to 2 years of age will be unable to grasp the concept of illness and death. A school-aged child will begin to understand that something is wrong. An adolescent will express fear, withdrawal, and denial.

8.     Answer A

The AIDS virus is spread by direct contact with blood or blood products and by sexual contact. Children with hemophilia are at risk for AIDS because of the factor VIII concentrate infusions they receive. These concentrates are derived from larger quantities of pooled plasma, exposing recipients to thousands of blood donors. However, current testing of blood and blood products has reduced the risk of AIDS virus transmission. 

There is no evidence that casual contact between infected and uninfected people transmits the HIV virus. 

All venipunctures for blood specimens in hospitals and clinics are performed with sterile disposable needles. Because the needles are sterile, they cannot be a source of HIV transmission.

Exposure to others in a waiting room is considered casual contact. There is no evidence that casual contact between infected and uninfected people transmits the HIV virus. 

9.     Answer A

This statement reflects values and beliefs regarding homosexuality as being bad and deserving of punishment.

There is not enough evidence presented to justify drawing this conclusion.

There is not enough evidence presented to justify drawing this conclusion.

Although this may be true, no information is given to suggest that the nursing assistant has been assigned to care for this client.

10.   Answer B

Nebulizer pieces are cleaned with warm water after each treatment and allowed to air dry. They are soaked in white vinegar and water for 30 minutes at the end of each day. Options A, C, and D are inaccurate and would damage the nebulizer equipment.

11.  Answer A

The client is in the anger or "why me" stage; encouraging the expression of feelings will help the client resolve them and move toward acceptance. 

This does not reflect on what the client said; introducing the topic of death may not be therapeutic. 

This abdicates the responsibility of talking with the client; suggesting speaking with a minister ignores the client's present concerns. 

This is judgmental, which may precipitate feelings of guilt and block the nurse-client relationship.

12.   Answer D

True infections in infants are confirmed by the detection of HIV by a p24 antigen assay, virus culture of HIV, or polymerase chain reaction. A Western blot confirms the presence of HIV antibodies. The CD4-i- count indicates how well the immune system is working. A chest x-ray evaluates the presence of other manifestations associated HIV infection such as pneumonia. 

13.   Answer B

The risk would depend on the spouse's prior behavior. 

Equipment used is disposable; the donor does not come into contact with anyone else's blood.

An individual may be infected for many weeks before testing positive for the antibodies; the individual could still transmit the virus. 

Condoms offer some protection but are subject to failure because of condom rupture or improper use; risks of infection are present with any sexual contact. " (SR 1403)

14.   Answer D

With AZT toxicity, the child would demonstrate agitation, restlessness, and insomnia, not fatigue and lethargy. 

This is usually a response to the disease rather than the therapy. 

Urinary output is unrelated to AZT toxicity; a decreased urinary output can be related to a decreased fluid intake, vomiting, and diaphoresis associated with fever.

AZT can cause life-threatening blood dyscrasias including thrombocytopenia. " 

15.   Answer C

Anergy testing determines the level of immune response an individual has to common microbes. A normal response is a local skin reaction to all the antigens injected intradermally. Absence of a response within 3 days suggests the individual is immunodeficient and can't produce a normal immune response. It doesn't imply nonexposure to the antigens, which are environmentally prevalent. Demonstration of antibodies to the antigens would be a positive skin reaction. An expected reaction to the antigens isn't considered an allergic or hypersensitive reaction. 

16.   Answer C

The most common opportunistic infection of children infected with HIV is Pneumocystis carinii pneumonia, which occurs most frequently between the ages of 3 and 6 months, when HIV status may be indeterminate. Lymphoid interstitial pneumonia is a form of chronic pneumonitis and is also characteristic of HIV infection; however, it is not the most common opportunistic infection. Although gastrointestinal disturbances and neurological abnormalities may occur in the child with HW infection, options A and B are not specific opportunistic infections noted in the HIV-infected child. 

17.   Answer B

All children have a high risk for injury because of their curiosity, inexperience, and lack of judgment. 

Children with AIDS have a dysfunction of the immune system (depressed or ineffective T cells, B cells, and immunoglobulins) and are susceptible to opportunistic infections. 

Although children with AIDS are most likely small for their ages, altered growth and development are not as life threatening as an infection. 

Although this can occur in children with AIDS, the prevention of infection is the priority.

18.   Answer C

AIDS clients must follow safer-sex practices to prevent transmission of the human immunodeficiency virus. Although avoiding the use of alcohol and illicit drugs is helpful, the most important point the nurse can make is that drug users can best avoid transmission by using clean needles and disposing of used needles. The AIDS client has no legal obligation to tell anyone about an AIDS diagnosis.

19.   Answer A

A: Pneumocystis carinii pneumonia (PCP) is an opportunistic infection that develops in patients with AIDS because the regulators of the immune system are destroyed by the HIV virus. The pathogens responsible for opportunistic infection are ubiquitous. Pneumocystis carinii pneumonia is in the air we breathe. People with intact immune systems do not become sick from this organism. Morbidity and mortality from this complication has been reduced by prophylactic drug treatment.

B: Most opportunistic infections result from secondary reactivation of previously acquired pathogens rather than from a new or primary infection. Most people become infected with Pneumocystis carinii pneumonia in the pre-school years and the child's intact immune system brings it under control. The organism remains dormant in the person's body and can be reactivated when immunodeficiency occurs.

C: The pathogen responsible for PCP is airborne and can be found in the lungs of humans and animals. Lifetime suppressive therapy with antibiotics is given to people with PCP to keep the infection under control. Helping patients comply with the antibiotic regimen is an essential part of the nursing care plan. 

D: PCP is an airborne organism. It is not acquired from unprotected sex with an infected individual.

20.   Answer D

In a client with AIDS, deterioration of the central nervous system (CNS) can lead to AIDS-related dementia. Because this type of dementia impairs cognition and judgment, it places the client at risk for injury. Although self-care deficit and dysfunctional grieving can be associated with AIDS, they don't take precedence for a client with AIDS-related dementia. Because CNS deterioration results from infection — not altered tissue perfusion — Ineffective cerebral tissue perfusion isn't an appropriate diagnosis.

21.   Answer D

Transmission of HIV can occur through breast milk, so breast-feeding should be discouraged in this case.

For practice exams please click the link below:
http://ilovenurselouie.blogspot.com/2014/07/acquired-immuno-deficiency-syndrome.html

Acquired Immuno Deficiency Syndrome (AIDS) - Practice Exam

1.     In teaching a female client who is HIV-positive about pregnancy, the nurse would know more teaching is necessary when the client says:

A.     "The baby can get the virus from my placenta."

B.     "I'm planning on starting on birth control pills."

C.    "Not everyone who has the virus gives birth to a baby who has the virus."

D.    "I'll need to have a C-section if I become pregnant and have a baby."

2.     A mother with human immunodeficiency virus (HIV) infection brings her 10-month-old infant to the clinic for a routine checkup. The physician has documented that the infant is asymptomatic for HIV infection. After the checkup the mother tells the nurse that she is so pleased that the infant will not get HIV. The most appropriate nursing response to the mother is:

A.     "I am so pleased also that everything has turned out fine."

B.     "Everything looks great, but be sure that you return with your infant next month for the scheduled visit."

C.    "Most children infected with HIV develop symptoms within the first 9 months of life, and some become symptomatic sometime before age 3."

D.    "Since symptoms have not developed, it is unlikely that your infant will develop HIV infection."

3.     A newborn infant of a mother who has human immunodeficiency virus (HIV) is tested for the presence of HIV antibodies. An enzyme-linked immunosorbent assay (ELISA) is performed, and the results are positive. A nurse interprets these results as:

A.     Positive for H1V virus.

B.     Indicating the presence of maternal infection.

C.    Indicating the absence of maternal infection.

D.    Negative for HIV virus.

4.     A 38-year-old woman visits the physician for HIV testing. The physician notifies the patient that the results are positive. The patient asks the nurse what this means. The nurse's response should be based on an understanding that:

A.     the patient has AIDS.

B.     the patient will develop AIDS within the year.

C.    the patient has been exposed to the HIV virus.

D.    the patient has been infected with the HIV virus.

5.     A client with acquired immunodeficiency syndrome (AIDS) develops Pneumocystis carinii pneumonia. Which nursing diagnosis has the highest priority for this client?

A.     Impaired gas exchange

B.     Impaired oral mucous membranes

C.    Imbalanced nutrition: Less than body requirements

D.    Activity intolerance

6.     The client, who is dying from acquired immunodeficiency syndrome (AIDS), is admitted to the inpatient psychiatric unit because he attempted suicide. His close friend recently died from AIDS. The client states to the nurse, "What's the use of living? My time is running out." What is the nurse's best response?

A.     "Let's talk about making some good use of that time."

B.     "Don't give up. There could be a cure for AIDS tomorrow."

C.    "You're in a lot of pain. What are you feeling?"

D.    "Life is precious and worth living."

7.     A nurse is caring for a 4-year-old child with a diagnosis of human immunodeficiency virus (HIV) infection. In planning care to address the psychosocial issues, the nurse would expect that this child:

A.     Is unable to grasp the concept of illness and death.

B.     Begins to understand that something is wrong.

C.    Begins to conceptualize the death process as involving physical harm.

D.    Will express fear, withdrawal, and denial.

8.     While attending a support group, the parents of a child with hemophilia become concerned because several of the families have had older children who have died from acquired immunodeficiency syndrome (AIDS). They ask the nurse how these children got the AIDS virus. The nurse bases the response on which of the following as the most likely route of transmission of AIDS to these children?

A.     Contamination of the factor VIII replacement received during bleeding episodes.

B.     Casual contact with a child testing positive for human immunodeficiency virus (HIV).

C.    Use of a contaminated needle to obtain a blood sample for type and crossmatching.

D.    Exposure in the waiting room to children with AIDS attending the same hematology clinic.

9.     A 26-year-old homosexual is diagnosed with AIDS. The primary nurse reports to the nursing team that the client wept when told of the diagnosis. One of the nursing assistants responds, "I don't feel sorry for him. He made his bed, and now he can lie in it." This comment is most likely a result of the nursing assistant's:

A.     Values and beliefs about sexual life-styles

B.     Anger and mistrust of homosexual males in general

C.    Discomfort with men who are unable to control their emotions

D.    Hostility over having to care for someone with a sexually related disease

10.   A child with acquired immunodeficiency syndrome (AIDS) is hospitalized for the treatment of Pneumocystis carinii pneumonia. The child will be receiving nebulizer treatments at home when discharged. The nurse instructs the mother regarding the maintenance of the nebulizer equipment and tells the mother to:

A.     Clean the nebulizer pieces after each treatment with one-fourth strength bleach and water.

B.     Clean the nebulizer pieces with warm water after each treatment and allow to air dry.

C.    Boil the nebulizer pieces for 15 minutes after each treatment.

D.    Clean the mouthpiece with alcohol after each use and soak in alcohol for 30 minutes at the end of each day.

11.   A client with AIDS comments to the nurse, "There are so many rotten people around. Why couldn't one of them get AIDS instead of me?" The nurse could best respond:

A.     "It seems unfair that you should be so ill."

B.     "I can understand why you're afraid of death."

C.    "Have you thought of speaking with a minister?"

D.    "I'm sure you really don't wish this on someone else."

12.   A physician prescribes laboratory studies for an infant of a woman who has human immunodeficiency virus (HIV) to determine the presence of HIV antigen. The nurse anticipates that which laboratory study will be prescribed?

A.     Western blot

B.     Chest x-ray

C.    CD4+ count

D.    p24 antigen assay

13.   The nursing staff has a team conference on AIDS and discusses the routes of transmission of the human immunodeficiency virus (HIV). The discussion reveals that an individual has no risk of exposure to HIV when that individual:

A.     Has intercourse with just the spouse

B.     Makes a donation of a pint of whole blood

C.    Limits sexual contact to those without HIV antibodies

D.    Uses a condom each time there is sexual intercourse

14.   A 1-year-old is in the pediatric unit for management of AIDS. The child is receiving zidovudine (AZT) every 6 hours. The nurse evaluates that the child is in life-threatening AZT toxicity when the child manifests:

A.     Fatigue and lethargy

B.     A progressive weight loss

C.    An increased urine output

D.    Multiple bruises on the limbs and trunk

15.   A client with human immunodeficiency virus undergoes intradermal anergy testing using Candida and mumps antigen. During the 3 days following the tests, there is no induration or evidence of reaction at the intradermal injection sites. The most accurate conclusion the nurse can make is the:

A.     client has no previous exposure to the antigens injected.

B.     results demonstrate the client has antibodies to the antigens.

C.    client is immunodeficient and won't have a skin response.

D.    client isn't allergic to the antigens and therefore doesn't react.

16.   An infant of a mother infected with human immunodeficiency virus (HIV) is seen in the clinic each month and is being monitored for symptoms indicative of HIV. The nurse assesses the infant, knowing that the most common opportunistic infection of children infected with HIV is:

A.     Gastroenteritis

B.     Meningitis

C.    Pneumocystis carinii pneumonia

D.    Lymphoid interstitial pneumonia

17.   The nursing diagnosis with the highest priority for a child with AIDS would be:

A.     Risk for injury

B.     Risk for infection

C.    Alteration in growth and development

D.    Alteration in nutrition: less than body requirements

18.   The nurse is working in a support group for clients with acquired immunodeficiency syndrome (AIDS). Which point is most important for the nurse to stress?

A.     Avoiding the use of illicit drugs and alcohol

B.     Refraining from telling anyone about the diagnosis

C.    Following safer-sex practices

D.    Telling potential sex partners about the diagnosis, as required by law

19.   A patient who has acquired immune deficiency syndrome (AIDS) develops Pneumocystis carinii pneumonia (PCP). The patient asks the nurse, "How did I get this pneumonia?" The nurse's response should be based on which of these statements about PCP?

A.     It occurs in immunosuppressed persons from proliferation of organisms that are normally present in the body.

B.     It is transmitted from close contact with an infected individual who has a suppressed immune system.

C.    It results from exposure to a carrier of the organism who has not taken appropriate precautions.

D.    It is most often acquired from unprotected sex with an infected individual.

20.   During a late stage of acquired immunodeficiency syndrome (AIDS), a client demonstrates signs of AIDS-related dementia. The nurse should give the highest priority to which nursing diagnosis?

A.     Bathing or hygiene self-care deficit

B.     Ineffective cerebral tissue perfusion

C.    Dysfunctional grieving

D.    Risk for injury

21.   The nurse has a client at 30 weeks' gestation who has tested positive for the human immunodeficiency virus (HIV). What should the nurse tell the client when she says that she wants to breast-feed her baby?

A.     Encourage breast-feeding so that she can get her rest and get healthier.

B.     Encourage breast-feeding because it's healthier for the baby.

C.    Encourage breast-feeding to facilitate bonding.

D.    Discourage breast-feeding because HIV can be transmitted through breast milk.

For answers and rationale click the link below:
http://ilovenurselouie.blogspot.com/2014/07/acquired-immuno-deficiency-syndrome_30.html

Cardiology Nursing Practice Test Part 1 - Answers and Rationale

1. Answer: C. 
Furosemide, a loop diuretic, does not alter pain. Furosemide acts on the kidneys to increase urinary output. Fluid may move from the periphery, decreasing edema. Fluid load is reduced, lowering blood pressure.

2. Answer: A

Obesity is an important risk factor for coronary artery disease that can be modified by improved diet and weight loss. Family history of coronary artery disease, male gender, and advancing age increase risk but cannot be modified.

3. Answer: B. 
A history of cerebral hemorrhage is a contraindication to tPA because it may increase the risk of bleeding. TPA acts by dissolving the clot blocking the coronary artery and works best when administered within 6 hours of onset of symptoms. Prior MI is not a contraindication to tPA. Patients receiving tPA should be observed for changes in blood pressure, as tPA may cause hypotension.

4. Answer: C. 
Exercise is important for all hospitalized patients to prevent deep vein thrombosis. Muscular contraction promotes venous return and prevents hemostasis in the lower extremities. This exercise is not sufficiently vigorous to increase physical fitness, nor is it intended to prevent bedsores or constipation.

5. Answer: D

Cardiogenic shock severely impairs the pumping function of the heart muscle, causing diminished blood flow to the organs of the body. This results in diminished brain function and confusion, as well as hypotension, tachycardia, and weak pulse. Cardiogenic shock is a serious complication of myocardial infarction with a high mortality rate.

6. Answer: D

A patient with congestive heart failure and dyspnea may have pulmonary edema, which can cause severe hypertension. Therefore, taking the patient's blood pressure should be the first action. Lying flat on the exam table would likely worsen the dyspnea, and the patient may not tolerate it. Blood draws for chemistry and ABG will be required, but not prior to the blood pressure assessment.

7. Answer D. 
Aspirin overdose can lead to metabolic acidosis and cause pulmonary edema development.

8. Answer A. 
Streptokinase is a clot busting drug and the best choice in this situation.

9. Answer B. 
Check the intake and output prior to making any decisions about patient care.

10. Answer B. 
Dizziness can be a sign of hypotension, which may be a contraindication with morphine.

11. Answer C. 
The early signs of congestive heart failure (CHF) include tachycardia, tachypnea, profuse scalp sweating, fatigue and irritability, sudden weight gain, and respiratory distress. A cough may occur in CHF as a result of mucosal swelling and irritation but is not an early sign. Pallor may be noted in the infant with CHF but is also not an early sign.

12. Answer A.The most common symptom of an MI is chest pain, resulting from deprivation of oxygen to the heart. Dyspnea is the second most common symptom, related to an increase in the metabolic needs of the body during an MI. Edema is a later sign of heart failure, often seen after an MI. Palpitations may result from reduced cardiac output, producing arrhythmias.

13. Answer B.

14. Answer D. Morphine is administered because it decreases myocardial oxygen demand. Morphine will also decrease pain and anxiety while causing sedation, but it isn’t primarily given for those reasons.

15. Answer C. 
Coronary thrombosis causes an occlusion of the artery, leading to myocardial death. An aneurysm is an out pouching of a vessel and doesn’t cause an MI. Renal failure can be associated with MI but isn’t a direct cause. Heart failure is usually the result of an MI.

16. Answer A. 
Validation of a client’s feeling is the most appropriate response. It gives the client a feeling of comfort and safety. The other three responses give the client false hope. No one can determine if a client experiencing a myocardial infarction will feel or get better and therefore, these responses are inappropriate.

17. Answer A. 
Beta-adrenergic blockers work by blocking beta receptors in the myocardium, reducing the response to catecholamines and sympathetic nerve stimulation. They protect the myocardium, helping to reduce the risk of another infarction by decreasing the workload of the heart and decreasing myocardial oxygen demand. Calcium channel blockers reduce the workload of the heart by decreasing the heart rate. Narcotics reduce myocardial oxygen demand, promote vasodilation, and decrease anxiety. Nitrates reduce myocardial oxygen consumption by decreasing left ventricular end – diastolic pressure (preload) and systemic vascular resistance.

18. Answer C. 
Arrythmias, caused by oxygen deprivation to the myocardium, are the most common complication of an MI. Cardiogenic shock, another complication of MI, is defined as the end stage of left ventricular dysfunction. Heart failure is the second most common complication because the pumping function of the heart is compromised by a myocardial infarction. Pericarditis most commonly results from a bacterial or viral infection but may occur after MI.

19. Answer B

20. Answer C

21. Answer D

22. Answer B  
Administering supplemental oxygen to the patient is the first priority.  Administer oxygen to increase SpO2 to greater than 90% to help prevent further cardiac damage.  Sublingual nitroglycerin and morphine are commonly administered after oxygen.

23. Answer C. 
High Fowler’s position facilitates breathing by reducing venous return.  Lying flat and side-lying positions worsen breathing and increase the heart’s workload.

24. Answer A. 
Kidney disease interferes with metabolism and excretion of Quinidine, resulting in higher drug concentrations in the body. Quinidine can depress myocardial excitability enough to cause cardiac arrest.

25. Answer C. 
Administer oxygen at 2 liters per minute and no more, for if the client is emphysemic and receives too high a level of oxygen, he will develop CO2 narcosis and the respiratory system will cease to function.

26. Answer is D.

When dealing with a medical emergency, the rule is airway first, then breathing, and then circulation. Starting oxygen is the priority.

27. Answer is C.
Establish an airway Establishing an airway is always the primary objective in a cardiopulmonary arrest.

28. Answer is A. 
Blood pressure 94/60 Both medications decrease the heart rate. Metoprolol affects blood pressure. Therefore, the heart rate and blood pressure must be within normal range (HR 60-100; systolic B/P over 100) in order to safely administer both medications.

29. Answer A. 
When a client has CHF, the goal is to reduce fluid accumulation. One way that this is accomplished is by sodium restriction. Ham, cheese (and most cold cuts, and potao chips are high in sodium. Daily weighing is an appropriate intervention to help the client monitor fluid overload. Most fresh fruits and vegetables are low in sodium.

30. Answer A. 
To ensure the best outcome, clients should be able to comply with instructions related to activity, diet, medications, and follow-up health care on discharge from the hospital following an MI. The remaining options indicate that the client will be successful in these areas.

31. Answer A

32. Answer C

33. Answer C

34. Answer C

35. Answer B

36. Answer A

37. Answer B. vital signs that remain near baseline indicate good cardiac reserve with exercise.

38. Answer B.  
This client's findings indicate cardiogenic shock, which occurs when the heart fails to pump properly, impeding blood supply and oxygen flow to vital organs. Cardiogenic shock also may cause cold, clammy skin and generalized weakness, fatigue, and muscle pain as lactic acid accumulates from poor blood flow, preventing waste removal. Left-sided and right-sided heart failure eventually cause venous congestion with jugular vein distention and edema as the heart fails to pump blood forward. A ruptured aneurysm causes severe hypotension and a quickly deteriorating clinical status from blood loss and circulatory collapse; this client has low but not severely decreased blood pressure. Also, in ruptured aneurysm, deterioration is more rapid and full cardiac arrest is common.

39. Answer C

40. Answer D

41. Answer C

42. Answer A

43. Answer D

44. Answer B

45. Answer D

46. Answer B

47. Answer C

48. Answer A

49. Answer C

50. Answer C

51. Answer A

52. Answer D 
Patients with pulmonary edema experience air hunger, anxiety, and agitation. Respiration is fast and shallow and heart rate increases. Stridor is noisy breathing caused by laryngeal swelling or spasm and is not associated with pulmonary edema.

53. Answer: D. 
A patient with congestive heart failure and dyspnea may have pulmonary edema, which can cause severe hypertension. Therefore, taking the patient's blood pressure should be the first action. Lying flat on the exam table would likely worsen the dyspnea, and the patient may not tolerate it. Blood draws for chemistry and ABG will be required, but not prior to the blood pressure assessment.

54. Answer D

55. Answer C

56. Answer A

58. Answer B

59. Answer D

60. Answer C

For Cardiology Nursing Practice Test Part 1. Click the link below.

http://ilovenurselouie.blogspot.com/2014/07/cardiology-nursing-practice-exam-part-1.html