AH Exam #4 Review Q's, Quiz Q's (CH 30 & 31)

The nurse is teaching a class regarding reduction of risk factors for cardiovascular disease. Which teaching statement will the nurse include? Select all that apply. A. "If you tend to get angry easily, then your risk for heart disease is higher." B. "To reduce your overall risk, it is important to keep your BMI greater than 30." C. "Do not eat more calories on a daily basis that you are able to burn." D. "Decreasing the amount that you smoke will decrease your overall cardiovascular risk." E. "Secondhand smoke creates a significant risk to others for cardiovascular disease." F. "Exercise moderately at least 2 days per week for a total of 150 minutes."

A, C, E, F A. "If you tend to get angry easily, then your risk for heart disease is higher." C. "Do not eat more calories on a daily basis that you are able to burn." E. "Secondhand smoke creates a significant risk to others for cardiovascular disease." F. "Exercise moderately at least 2 days per week for a total of 150 minutes."

The nurse is assessing the client's heart sounds. Which instruction will the nurse provide if there is difficulty in hearing heart sounds? A. "Please roll onto your left side." B. "Lay all the way down on your back." C. "Please hold your breath while I use my stethoscope." D. "I will just take your pulse instead."

A. "Please roll onto your left side."

Which statement made by the client on the way to the catheterization laboratory requires an immediate action by the nurse? A. "My allergies are bothering me, so I took some Benadryl last night before bed." B. "I was nervous last night, but I still remembered to take my warfarin." C. "I sure am hungry. I haven't had anything to eat since I went to bed last night." D. "I don't know what I will do if they find a blockage in my heart."

B. "I was nervous last night, but I still remembered to take my warfarin."

While suctioning a client with a tracheostomy, the client becomes diaphoretic and nauseous and the heart rate decreases to 37 beats/min. What is the priority nursing action? A. Continue to clear the airway. B. Stop suctioning the patient. C. Administer atropine. D. Call the health care provider immediately.

B. Stop suctioning the patient.

The primary health care provider prescribes warfarin for a client with atrial fibrillation. Which client statement indicates that additional education is needed? A. "I need to go to the clinic once a week to have my blood level checked." B. "If my stools turn black, I will be sure to call my primary health care provider." C. "I'm glad I don't need to change my diet. Salads are my favorite food." D. "I need to stop taking my herbal supplement."

C. "I'm glad I don't need to change my diet. Salads are my favorite food."

A client in the telemetry unit is on a cardiac monitor. The monitor technician alerts the nurse that there are no ECG complexes, and the alarm is sounding. What is the first action by the nurse? A. Suspend the alarm. B. Call the emergency response team. C. Press the record button to get an ECG strip. D. Assess the client and check lead placement.

D. Assess the client and check lead placement.

The nurse is caring for a client with heart rate of 143 beats/min. For which manifestations does the nurse observe? Select all that apply. a. Palpitations b. Increased energy c. Chest discomfort d. Flushing of the skin e. Hypotension

a, c, e a. Palpitations c. Chest discomfort e. Hypotension

The nurse is caring for a client who has developed a bradycardia. Which possible causes does the nurse investigate? Select all that apply. a. Bearing down for a bowel movement b. Possible inferior wall myocardial infarction (MI) c. Client stating that he just had a cup of coffee d. Client becoming emotional when visitors arrived e. Diltiazem (Cardizem) administered 1 hour ago

a. Bearing down for a bowel movement b. Possible inferior wall myocardial infarction (MI) e. Diltiazem (Cardizem) administered 1 hour ago

A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The patient asks the nurse why he has to be on two medications. The nurse's response is based on which rationale? a. heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels. b. the oral and injection forms work synergistically. c. the combination of heparin and an oral anticoagulant result in fewer adverse effects that heparin used alone. d. the warfarin is used to reach an adequate level of anticoagulation when heparin alone is unable to do so.

a. heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach adequate levels.

A nurse cares for a client with an intravenous temporary pacemaker for bradycardia. The nurse observes the presence of a pacing spike but no QRS complex on the clients electrocardiogram. Which action should the nurse take next? a. Administer intravenous diltiazem (Cardizem). b. Assess vital signs and level of consciousness. c. Administer sublingual nitroglycerin. d. Assess capillary refill and temperature.

b. Assess vital signs and level of consciousness.

Which risk factors are known to contribute to atrial fibrillation? Select all that apply. a. Use of beta-adrenergic blockers b. Excessive alcohol use c. Advancing age d. High blood pressure e. Palpitations

b. Excessive alcohol use c. Advancing age d. High blood pressure

A nurse is assessing clients on a medical-surgical unit. Which client should the nurse identify as being at greatest risk for atrial fibrillation? a. a 45 year old who takes an aspirin daily b. a 50 year old who is post coronary artery bypass graft surgery c. a 78 year old who had a carotid endarterectomy d. an 80 year old with chronic obstructive pulmonary disease

b. a 50 year old who is post coronary artery bypass graft surgery. Atrial fibrillation occurs commonly in clients with cardiac disease and is a common occurrence after coronary artery bypass graft surgery. The other conditions do not place these clients at higher risk for atrial fibrillation.

A patient is being discharged on anticoagulant therapy. The nurse will include in the patient-education conversation that it is important to avoid herbal products that contain which substance? a. saw palmetto b. ginkgo c. soy d. valerian

b. ginkgo

A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to the possibility of a serious complication from this condition? a. sinus tachycardia b. speech alterations c. fatigue d. dyspnea with activity

b. speech alterations Clients with atrial fibrillation are at risk for embolic stroke. Evidence of embolic events includes changes in mentation, speech, sensory function, and motor function.

The nurse assesses a patient's ECG tracing and observes that not all QRS complexes are preceded by a P wave. How would the nurse interpret this observation? a. The patient's chest leads are not making sufficient contact with the skin. b. Ventricular and atrial depolarization are initiated from different sites. c. Ventricular tachycardia is overriding the normal atrial rhythm. d. The patient has hyperkalemia causing irregular QRS complexes.

b. ventricular and atrial depolarizations are initiated from different sites.

A patient who has been anticoagulated with warfarin (Coumadin) has been admitted got gastrointestinal bleeding. The history and physical examination indicate that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive which antidote? a. potassium chloride b. vitamin k c. vitamin e d. protamine sulfate

b. vitamin k

Which waveform indicates proper function of the sinoatrial (SA) node? a. the QRS complex is present. b. the PR interval is 0.24 second. c. a P wave precedes every QRS complex. d. the ST segment is elevated.

c. a P wave precedes every QRS complex.

The nurse caring for a patient who has a heart rate averaging 56 beats/minute with no adverse symptoms would suggest which activity modification to avoid further slowing of the heart rate? a. avoid strenuous exercise such as running. b. limit your intake of caffeinated drinks to one a day. c. avoid straining while having a bowel movement. d. make certain that your bath water is warm.

c. avoid straining while having a bowel movement.

A client who had open abdominal surgery 4 hours ago reports feeling weak and dizzy. The client's current blood pressure has decreased to 98/50, and pulse rate is 108. What is the nurse's best action at this time? a. document the vital signs, and continue to monitor the patient b. remind the client to stay in bed if feeling weak and dizzy c. call the health care provider immediately d. increase the client's IV rate to restore fluid volume

c. call the health care provider immediately

A nurse is supervising a UAP applying ECG monitoring. Which statement would the nurse provide to the UAP related to this procedure? a. "add gel to the electrodes prior to applying them." b. "place the electrode on the posterior chest." c. "clean the skin and clip the hairs if needed." d. "turn off the oxygen prior to monitoring the patient."

c. clean the skin and clip the hairs if needed.

A telemetry nurse assesses a patient who has a heart rate of 35 beats/minute. Which assessment would the nurse complete next? a. avoid strenuous exercise such as running. a. pulmonary auscultation b. mobility and gait stability c. level of consciousness d. pulse strength and amplitude

c. level of consciousness

The nurse assesses a patient with tachycardia. Which clinical manifestation requires immediate intervention by the nurse? a. P wave touching the T wave b. increased urine output c. midsternal chest pain d. mild orthostatic hypotension

c. midsternal chest pain

A client's rhythm strip shows a heart rate of 116 beats/min, one P wave occurring before each QRS complex, a PR interval measuring 0.16 second, and a QRS complex measuring 0.08 second. How does the nurse interpret this rhythm strip? a. normal sinus rhythm b. sinus bradycardia c. sinus tachycardia d. sinus rhythm with premature ventricular contractions

c. sinus tachycardia

A patient has been instructed to take one enteric-coated low-dose aspirin a day as part of therapy to prevent strokes. The nurse will provide which instruction when providing patient teaching about this medication. a. low dose aspirin therapy rarely causes problems with bleeding. b. aspirin needs to be taken on an empty stomach to ensure maximal absorption. c. take the medication with 6-8 ounces of water and with food. d. coated tablets may be crushed if necessary for easier swallowing.

c. take the medication with 6-8 ounces of water and with food.

The professional nurse is supervising a nursing student performing a 12-lead electrocardiogram (ECG). Under which circumstance does the nurse correct the student? a. the client is semi-recumbent in bed. b. chest leads are placed as for the previous ECG. c. the client is instructed to breathe deeply through the mouth. d. the client is instructed to lie still.

c. the client is instructed to breathe deeply through the mouth.

In teaching clients at risk for bradydysrhythmias, what information does the nurse include? a. "Avoid potassium-containing foods." b. "Stop smoking and avoid caffeine." c. "Take nitroglycerin for a slow heartbeat." d. "Use a stool softener."

d. "use a stool softener."

A client with in the telemetry unit is on a cardiac monitor. The monitor technician notices there are no ECG complexes and the alarm sounds. What is the first action by the nurse? a. begin CPR immediately b. call the emergency response team c. Press the record button to get an ECG strip d. Assess the client and check lead placement

d. Assess the client and check lead placement

A patient is receiving heparin therapy as part of the treatment for a pulmonary embolism. The nurse monitors the results of which lab test to check the drug's effectiveness? a. bleeding times b. vitamin k levels c. prothrombin/international normalized ratio (PT/INR) d. activated partial prothrombin time (aPTT)

d. activated partial prothrombin time (aPTT)