ATI Targeted Med Surg 2019: Cardiovascular

A nurse is caring for a client following insertion of a permanent pacemaker. Which of the following client statements indicates a potential complication of the insertion procedure?

"I can't get rid of these hiccups" Rationale: Hiccups can indicate that the pacemaker is stimulating the chest wall, which could mean a lead wire perforation.

A nurse is caring for a client who has a history of angina and is scheduled for exercise electrocardiography at 1100. Which of the following statements by the client requires the nurse o contact the provider for possible rescheduling?

"I smoked a cigarette this morning to calm my nerves about having this procedure" Rationale: This could change the outcome or put the client at a higher risk.

A nurse is providing health teaching to a group of clients. Which of the following clients is at risk for developing peripheral arterial disease?

A client who has DM. Rationale: they have the risk for microvascular damage and progressive arterial disease.

A nurse is caring for a client who is 8 hr post-op following a coronary artery bypass graft (CABG). Which of the following findings should the nurse report?

BP 160/80 mm Hg Rationale: Increased vascular pressure can cause bleeding at the incision sites.

A nurse is reviewing the laboratory results of several male clients who have peripheral arterial disease. The nurse should plan to provide dietary teaching for the client who has which of the following laboratory values?

Cholesterol 190 mg/dL, HDL 25 mg/dL, LDL 160 mg/dL Rationale: Expected ranges are Cholesterol (<200 mg/dL) HDL (>45 mg/dL for males & >55 mg/dL for females) LDL (<130 mg/dL)

A nurse is caring for a client who has HF and is experiencing atrial fibrillation. Which of the following findings should the nurse plan to monitor for and report to the provider immediately?

Slurred speech Rationale: slurred speech indicates inadequate circulation to the brain due to an embolus. ; an irregular pulse, dependent edema, and persistent fatigue will be present but are expected and not the highest priority.

A nurse is caring for a client who is receiving heparin therapy and develops hematuria. Which of the following actions should the nurse take if the client's aPTT is 96 seconds?

Stop the heparin infusion. Rationale: the PTT is above critical value and the client is displaying sx of bleeding.

A nurse is caring for a client who is 1 hr post-op following an aortic aneurysm repair. Which of the following findings can indicate shock and should be reported to the provider?

Urine output of 20 ml/Hr Rationale: Less than 30 ml/hr is a manifestatio of shock.

A nurse is monitoring a client's ECG monitor and notes the client's rhythm has changed from normal sinus rhythm to supra-ventricular tachycardia. The nurse should prepare to assist with which of the following interventions?

Vagal stimulation Rationale: This might temporarily convert the rhythm to normal. ; atropine treats bradycardia

A nurse is caring for a client who has endocarditis. Which of the following findings should the nurse recognize as a potential complication?

Valvular disease Rationale: damage often occurs due to inflammation or infection of the endocardium.

A nurse is assessing a client who has L-sided HF. Which of the following manifestations should the nurse expect to find?

Weak peripheral pulses Rationale: related to decreased cardiac output. ; increased abdominal girth, JVD, and dependent edema is related to systemic congestion from R-sided failure.

A nurse is providing discharge teaching to a client who has HF. The nurse should instruct the client to report which of the following findings immediately to the provider?

Weight gain of 0.9kg (2lb) in 24 hr Rationale: This indicates the worsening of HF

A nurse is caring for a client who is scheduled for a coronary artery bypass graft (CABG) in 2 hr. Which of the following client statements indicates a need for further clarification by the nurse?

"I took my warfarin last night according to my usual schedule" Rationale: Should not take any anticoagulants for several days prior to surgery to prevent excessive bleeding.

A nurse is providing teaching to a client who is 2 days post-op following a heart transplant. Which of the following statements should the nurse include in the teaching?

"You might no longer be able to feel chest pain" Rationale: Lose sensation do to the denervation of the heart. ; activity tolerance should improve gradually ; need to maintain a diet that is restricted in sodium and fat ; will remain on immunosuppressants for the remainder of their life to help prevent rejection of the heart.

A nurse is assessing a client who has pulmonary edema related to HF. Which of the following findings indicates effective treatment of the client's condition?

Absence of adventitious breath sounds Rationale: It is present with fluid in the lungs, therefore the absence can indicate it is resolving.

A nurse in an emergency department is caring for a client who had an anterior MI. The client's history reveals they are 1 week post-op following an open cholecystectomy. The nurse should identify that which of the following interventions is CI?

Assisting with thrombolytic therapy Rationale: It is CI within 3 weeks after any major surgery.

A nurse in an emergency department is assessing a client who has a bradydysrhythmia. Which of the following findings should the nurse monitor for?

Confusion Rationale: It can cause decreased systemic perfusion, which leads to confusion. ; will manifest hypotension and diaphoresis.

A nurse is caring for a client who had an onset of chest pain 24 hr ago. The nurse should identify that an increase in which of the following values is diagnostic of a MI?

Creatine kinase-MB Rationale: it is specific to the myocardium, elevated levels indicate a myocardial muscle injury.

A nurse is assessing a client who has dilated cardiomyopathy. Which of the following findings should the nurse expect?

Dyspnea on exertion Rationale: expected manifestation ; weight gain is also expected

A nurse in an emergency department is caring for a client who has a BP of 254/139 mm Hg. The nurse recognizes that the client is in a hypertensive crisis. Which of the following actions should the nurse take first?

Elevate the head of the client's bed Rationale: This helps to reduce BP and promote oxygenation. ; you will need to initiate seizure precautions, tell the client to report vision changes, and start a peripheral IV, although these are not the highest priority.

A nurse is assessing a client who has a history of DVT and is receiving warfarin. Which of the following findings should indicate to the nurse that the medication is effective?

INR 2.0 Rationale: desired range is 2.0 - 3.0.

A nurse is admitting a client who has a leg ulcer and a history of DM. Which of the following focused assessments should the nurse use to help differentiate between an arterial ulcer and venous stasis ulcer?

Inquire about the presence or absence of claudication Rationale: Arterial ulcers experience claudication, where as venous ulcers do not.

A nurse is caring for a client who is being treated for HF and has a prescription for furosemide. The nurse should plan to monitor for which of the following adverse effects of the medication?

Lightheadedness Rationale: can cause a substantial drop in BP.

A nurse is planning a presentation for a group of clients who have hypertension. Which of the following lifestyle modifications should the nurse include? (Select all that apply.)

Limited alcohol intake Regular exercise program Tabacco cessation Rationale: All of these are important things to teach patients with hypertension.

A nurse is teaching a client who has a new prescription for an ACE inhibitor to treat hypertension. The nurse should instruct the client to notify their provider if they experience which of the following adverse effects of this medication?

Persistent cough Rationale: cough is an important SE of this medication and should be reported immediately so the medication can be discontinued. ; frequent urination & constipation is expected.

A nurse is preparing a client for coronary angiography. Which of the following findings should the nurse report to the provider prior to the procedure?

Previous allergic reaction to shellfish. Rationale: The contrast used for the procedure is iodine-based therefore the patient may have an allergic reaction.

A nurse is providing discharge teaching to a client who has a prescription for transdermal nitroglycerin patches. Which of the following instructions should the nurse include in the teaching?

Place the patch on an area of skin away from skin folds and joints. Rationales: you need to apply the patch to an area of intact skin with enough room for the patch to fit smoothly.

A nurse is caring for a client who was admitted for treatment of L-sided HF and is receiving IV loop diuretics and digitalis therapy. The client is experiencing weakness and an irregular HR. Which of the following actions should the nurse take first?

Review serum electrolyte values Rationale: these symptoms are consistent with a high risk for an electrolyte imbalance.