Barb is a 60yoa female referred by her physician to your phase II cardiac rehab program due to her CVD risk factor profile and a graded exercise test (GXT) that was positive for ST segment depression. A brief synopsis of Barb’s medical history, recent labs, and GXT are shown below.   Family History: mother had a CABG procedure at age 58; older sister also had a stent placed at age 60 Medications: spironolactone 50mg x 2 daily; amlodipine 100mg x 1 daily Tobacco Use: former smoker; quit 20 years ago   Height: 5′ 3”                Weight: 162lbs                      Waist Circumference: 33in Fasting Blood Glucose 110 mg/dL Urea nitrogen 10 mg/dL Creatinine 1.2 mg/dL Sodium 136 mmol/L Potassium 3.6 mmol/L Chloride 105 mmol/L Total Cholesterol 192 mg/dL Triglycerides 195 mg/dL HDL-C 44 mg/dL LDL 102 mg/dL Aspartate aminotransferase (AST) 35 U/L Alanin aminotransferase (ALT) 42 U/L HbA1C 45 mmol/mol   Graded Exercise Test: Resting HR: 80bpm            Supine BP: 138/80            Standing BP: 140/82 Time Speed (mph) Grade (%) HR BP RPE MET Symptoms (0-4 scale) ECG 1 1.7 10 89         .5mm horizontal ST dep. 2 1.7 10 92         .5mm horizontal ST dep. 3 1.7 10 109 154/84 14 4.7   .5mm horizontal ST dep. 4 2.5 12 123         1mm horizontal ST dep. 5 2.5 12 136         1mm horizontal ST dep. 6 2.5 12 152 182/84 19 7.0   1.5mm horizontal ST dep. 7 1.7 0 140         1mm horizontal ST dep. 8 1.7 0 136 166/84       .5mm horizontal ST dep. 9 1.7 0 132         .5mm horizontal ST dep. 10 1.7 0 134 152/84       .5mm horizontal ST dep. 11 Resting seated 115         .5mm horizontal ST dep. 12 Resting seated 107 136/82       NSR   What was Barb’s peak rate pressure product ?

Mrs. H is a pleasant 70yoa female who has had progressive SOB over the past few years. She currently struggles to walk more than 2 city blocks at a time and does not get out of the house often.  The patient has a modest cough and brings up about 1 tsp of creamy sputum each morning. She is a current smoker and has smoked 2 packs of cigarettes per day since she was 20.  Today is her first day in your pulmonary rehab program.   While reviewing Mrs. H’s medical chart prior to meeting her, you come across recent ABG results as shown below. What is the primary acid-base distrubance?   PaCO2: 48 PaO2: 61 HCO3-:28 SpO2: 91%

Barb is a 60yoa female referred by her physican to your phase II cardiac rehab program due to her CVD risk factor profile and a graded exercise test (GXT) that was positive for ST segment depression. A brief synopsis of Barb’s medical history, recent labs, and GXT are shown below.   Family History: mother had a CABG procedure at age 58; older sister also had a stent placed at age 60 Medications: spironolactone 50mg x 2 daily; amlodipine 100mg x 1 daily Tobacco Use: former smoker; quit 20 years ago   Height: 5′ 3”                Weight: 162lbs                      Waist Circumference: 33in Fasting Blood Glucose 110 mg/dL Urea nitrogen 10 mg/dL Creatinine 1.2 mg/dL Sodium 136 mmol/L Potassium 3.6 mmol/L Chloride 105 mmol/L Total Cholesterol 192 mg/dL Triglycerides 195 mg/dL HDL-C 44 mg/dL LDL 102 mg/dL Aspartate aminotransferase (AST) 35 U/L Alanin aminotransferase (ALT) 42 U/L HbA1C 45 mmol/mol   Graded Exercise Test: Resting HR: 80bpm            Supine BP: 138/80            Standing BP: 140/82 Time Speed (mph) Grade (%) HR BP RPE MET Symptoms (0-4 scale) ECG 1 1.7 10 89         .5mm horizontal ST dep. 2 1.7 10 92         .5mm horizontal ST dep. 3 1.7 10 109 154/84 14 4.7   .5mm horizontal ST dep. 4 2.5 12 123         1mm horizontal ST dep. 5 2.5 12 136         1mm horizontal ST dep. 6 2.5 12 152 182/84 19 7.0   1.5mm horizontal ST dep. 7 1.7 0 140         1mm horizontal ST dep. 8 1.7 0 136 166/84       .5mm horizontal ST dep. 9 1.7 0 132         .5mm horizontal ST dep. 10 1.7 0 134 152/84       .5mm horizontal ST dep. 11 Resting seated 115         .5mm horizontal ST dep. 12 Resting seated 107 136/82       NSR   Based on Barb’s GXT, what is her VO2 peak in ml/kg*min? ACSM walking equation: VO2= (0.1 x speed) + (1.8 x speed x grade) + 3.5

Mrs. H is a pleasant 70yoa female who has had progressive SOB over the past few years. She currently struggles to walk more than 2 city blocks at a time and does not get out of the house often.  The patient has a modest cough and brings up about 1 tsp of creamy sputum each morning. She is a current smoker and has smoked 2 packs of cigarettes per day since she was 20.  Today is her first day in your pulmonary rehab program   If Mrs. H had a positve screening for anxiety and depression, which of the following would NOT be an appropriate intervention for a CEP to perform.  

Mrs. H is a pleasant 70yoa female who has had progressive SOB over the past few years. She currently struggles to walk more than 2 city blocks at a time and does not get out of the house often.  The patient has a modest cough and brings up about 1 tsp of creamy sputum each morning. She is a current smoker and has smoked 2 packs of cigarettes per day since she was 20.  Today is her first day in your pulmonary rehab program.   While reviewing Mrs. H’s medical chart prior to meeting her, you come across recent ABG results as shown below. Is compensation present?   pH: 7.39 PaCO2: 48 PaO2: 61 HCO3-:28 SpO2: 91%

The nurse prepares to give Dilantin 90mg from a bottle labeled Dilantin 30mg/5ml.  The nurse gives _______ml.

A client with elevated BUN and creatinine has been prescribed digoxin for heart failure. What aspect of care is the priority regarding this client?

A client with angina is prescribed metoprolol. Following absorption of the drug, the nurse should monitor the client for what desired effect?

The nurse is educating a client with angina about the use of nitroglycerin (NTG) sublingual (SL). Which statement by the patient indicates the need for further teaching?

ATI Unit 4 Meds Affecting CV and Unit 5 Meds Affecting the Hematologic SystemInstructionsRead each question carefully. There is only one correct answer, unless the stem of the question includes directions that state otherwise. There are 64 items on the exam in which you have 90 minutes to complete the exam. There is no backtracking to complete a skipped question or to change an answer. Grades will be posted on Blackboard within one week of the exam.