Cardiovascular System

1. A patient is transferred from intensive care. She is morbidly obese. According to the patient’s medical records, her current weight is 162 kg, but the date of her last weighing is unknown. Her hygiene is deficient, and a strong odor emanates from her abdominal folds. A request is made for a bed designed for an obese person since it is otherwise impossible the patient in order to perform care, change her position, and proceed to take care of her hygiene. The change of bed requires six helpers and two transfer slings. The surface to be used for mobilizing the patient is now acceptable and safe. During the evening, while making the rounds, the LPN discovers the patient in a semi-conscious state, her bed flipped on its side. Which of the following interventions would not be appropriate in this situation? *
2. A 58-year-old patient is placed under heparin by her physician to minimize postoperative complications following a bowel resection. Two days after the surgery, the patient is still feeling confused and agitated, which causes active bleeding of the wound. Moreover, the patient is experiencing nausea due to the many narcotics she’s been taking to reduce her pain. She eats very little, and her haemoglobin has dropped to 80 g/L. the LPN has changed the patient’s soiled dressing several times during her shift. She immediately notifies the nurse of her observations, and interventions. Given the patient’s condition, which of the following interventions should be done in postoperative care? *
3. Mr. Daniel Moreau, a 62-year-old man with a history of type 2 diabetes and hyperlipidemia, arrives at the emergency department complaining of intense chest pressure that began 25 minutes ago while he was shoveling snow. He describes the pain as “an elephant sitting on my chest,” radiating to his left arm and jaw. His skin is pale and clammy, and he appears extremely anxious. His vital signs show a BP of 92/58, pulse at 124 bpm, respirations at 28, SpO₂ at 90% on room air, and temperature at 36.7°C. The physician quickly evaluates him and orders oxygen therapy, a 12-lead ECG, cardiac enzymes, and insertion of an IV line with normal saline. As the LPN prepares to intervene, Mr. Moreau suddenly reports worsening shortness of breath and begins clutching his chest. Which intervention should take priority? *
4. Mrs. Hélène Caron, a 78-year-old woman with known CHF and atrial fibrillation, is brought to the medical ward after suddenly developing severe shortness of breath overnight. She is sitting upright in bed, gasping for air, with frothy sputum at her lips. Her lungs reveal crackles in both lower lobes. Her vital signs are BP 168/98, pulse 132 irregular, respirations 34, SpO₂ 85% on room air, temperature 36.4°C. The physician orders furosemide IV STAT, oxygen at 4 L/min by nasal cannula, and continuous cardiac monitoring. The LPN enters the room and sees the patient increasingly restless, with cyanosis around her lips. Which intervention should take priority? *
5. Mr. Samuel Lefebvre, 55 years old, returns to the cardiology unit after a coronary angiography through the right femoral artery. He has a dressing over the puncture site, and the physician has ordered bedrest for four hours, frequent vital signs, and monitoring of the limb. Two hours later, the LPN notices the patient grimacing, reporting new groin pain. His vital signs show BP 98/60, pulse 118, respirations 22, SpO₂ 95%. When the LPN lifts the sheet, she sees that the dressing is saturated with blood and a hematoma is forming. Which intervention should take priority? *
6. Mrs. Rosa Martinez, a 70-year-old woman with hypertension, comes to the clinic complaining of palpitations and dizziness. She says her heart feels “like a bird in a cage.” Her BP is 108/64, pulse 156 irregular, respirations 20, SpO₂ 97%. The physician diagnoses atrial fibrillation with rapid ventricular response and prescribes an urgent ECG, blood work, and IV access. While the LPN prepares to intervene, the patient becomes visibly confused. Which intervention should take priority? *
7. Mr. Lionel Paquette, age 59, arrives with severe headache, blurred vision, and a nosebleed after forgetting to take his blood pressure medications. His BP is 232/118, pulse 90, respirations 20, temperature 36.5°C. He is clutching his head and repeatedly states that he feels like it’s going to “explode.” The physician orders antihypertensive medication IV, continuous BP monitoring, and an ECG. As the LPN enters, Mr. Paquette grips the rails and says the headache is intensifying rapidly. Which intervention should take priority? *
8. Ms. Karine Boucher, 45, recovering from a hysterectomy, suddenly develops intense shortness of breath while trying to stand from sitting position. She is visibly panicked, holding her chest, and gasping for air. Her BP is 84/50, pulse 132, respirations 38, SpO₂ 82% on room air. The physician is called and orders oxygen, cardiac monitoring, and STAT blood gases. The LPN arrives to find the patient increasingly cyanotic. Which intervention should take priority? *
9. Mr. Luc Tremblay, age 34, comes to the emergency department reporting sharp chest pain that worsens when lying down and improves when leaning forward. He recently had a viral infection. His BP is 118/74, pulse 102, respirations 22, SpO₂ 95%. The physician suspects pericarditis and orders analgesics, ECG, and cardiac enzymes. The LPN notices the patient now grimacing in pain and clutching his chest. Which intervention should take priority? *
10. Mrs. Émilie Proulx, 82, with chronic heart failure, is admitted for weight gain and increasing leg edema over the past three days. She reports shortness of breath when lying flat and needing three pillows to sleep. Vital signs are BP 152/88, pulse 96, respirations 24, SpO₂ 94%. The physician orders daily weights, I&O monitoring, and furosemide PO. The LPN enters and notices that the patient’s legs are significantly more swollen than this morning. Which intervention should take priority? *
11. Mr. Henri Dubois, age 77, collapses briefly in the hallway while visiting his wife. He regains consciousness quickly but appears pale and weak. He reports feeling dizzy all morning. His BP is 94/60, pulse 52, respirations 18, SpO₂ 96%. Staff notes he has a known history of severe aortic stenosis. The physician orders cardiac monitoring and IV saline. The LPN accompanies the patient to a stretcher, noticing he still seems unstable.
Which intervention should take priority? *
12. Mr. Patrice Gagnon, 66, is recovering from CABG surgery. Four hours post-op, he becomes restless and repeatedly tries to sit up. His BP has dropped from 120/68 to 88/50, pulse increased to 118, respirations 26, SpO₂ at 93%. His chest drain shows increased sanguineous output. The physician has ordered hourly vital signs and monitoring of drainage. The LPN recognizes his agitation is worsening. Which intervention should take priority? *
13. Ms. Aisha Malik, age 52, arrives with fatigue, shortness of breath, and new chest discomfort. She reports heavy menstrual bleeding for months. Her BP is 98/58, pulse 120, respirations 24, SpO₂ 93%. Labs show hemoglobin of 68 g/L. The physician orders oxygen, IV access, and crossmatch for transfusion. The LPN enters and finds the patient clutching her chest. Which intervention should take priority? *
14. Mr. Andrew Collins, 48, comes to the emergency clinic feeling “strange heartbeats.” He appears anxious with occasional facial flushing. His BP is 126/84, pulse 88 but irregular, respirations 20, SpO₂ 98%. The ECG technician hands the LPN a tracing showing ventricular bigeminy. The physician orders electrolyte tests and continuous monitoring. The LPN enters and notes the patient is becoming dizzy. Which intervention should take priority? *
15. Mrs. Lorraine Côté, 58, admitted for a DVT, suddenly reports difficulty breathing and sharp chest pain. She looks frightened and her skin appears pale. Her BP is 100/62, pulse 110, respirations 30, SpO₂ 89% on room air. The physician is notified and orders oxygen, ECG, and blood gases. The LPN returns to find the patient increasingly breathless. Which intervention should take priority? *
16. Mr. Julien Roy, 72, arrives confused and dizzy after mistakenly doubling his dose of metoprolol. His BP is 86/54, pulse 38, respirations 18, SpO₂ 97%. He repeatedly says he feels like he might faint. The physician orders atropine, ECG, and IV access. The LPN notices his pulse is dropping further. Which intervention should take priority? *
17. Ms. Audrey Lambert, 33, receives IV contrast for a CT scan and quickly develops chest tightness, difficulty breathing, and swelling around her eyes. Her BP is 70/40, pulse 140, respirations 36, SpO₂ 86%. The physician orders epinephrine IM STAT, oxygen, and IV fluids. The LPN sees the patient becoming increasingly cyanotic. Which intervention should take priority? *
18. Mr. Benoît Savard, 69, admitted for GI bleeding, becomes suddenly pale and diaphoretic. His BP is 78/46, pulse 136, respirations 28, SpO₂ 92%. His new stool is dark and bloody. The physician orders two large-bore IVs, fluid bolus, and STAT hemoglobin. The LPN notices his mental status is declining. Which intervention should take priority? *
19. Ms. Sophie Nguyen, 56, is admitted with sudden left leg pain. Her leg is pale, cold, and pulseless below the knee. Vital signs: BP 130/74, pulse 104, respirations 22, SpO₂ 97%. The physician suspects an arterial occlusion and orders heparin IV. The LPN sees the patient grimacing as the pain intensifies. Which intervention should take priority? *
20. Mr. Jean-Marc Pelletier, 49, with a history of valve repair, has chills, fever, and new chest discomfort. His BP is 118/66, pulse 108, respirations 20, temp 38.9°C. The physician suspects endocarditis and orders blood cultures and IV antibiotics. The LPN notes his temperature continues to rise. Which intervention should take priority? *
21. Mrs. Giselle Aubin, 81, recently started a new antihypertensive medication. When rising to go to the bathroom, she becomes dizzy and nearly faints. Her BP lying is 134/72, sitting 102/60, standing 84/54. She appears weak and shaky. The physician orders fall precautions and hydration. The LPN helps her back to bed. Which intervention should take priority? *
22. Mr. Marco DeLuca, 64, with known stable angina, arrives with chest discomfort. He took one nitroglycerin tablet at home with slight relief but the pain returned. His BP is 110/70, pulse 96, respirations 22, SpO₂ 95%. The physician orders an ECG, oxygen, and nitroglycerin q5min × 3. As the LPN prepares the medication, the patient reports the pain is worsening. Which intervention should take priority? *