CardioVascular MedSurg

A nurse concludes that the simvastatin (Zocor) being administered to a client is effective. A decrease in what clinical finding supports this conclusion? 1 International normalized ratio (INR) 2 Heart rate 3 Triglycerides 4 Blood pressure

Triglycerides

When monitoring a client for hyponatremia, what clinical findings should the nurse consider significant? (Select all that apply.) 1 Thirst 2 Confusion 3 Tachycardia 4 Pale coloring 5 Poor tissue turgor

Confusion Poor tissue turgor

What effect of anxiety makes it particularly important for the nurse to reduce the anxiety of a client with heart failure? 1 Increases the cardiac workload 2 Interferes with usual respirations 3 Produces an elevation in temperature 4 Decreases the amount of oxygen used

Increases the cardiac workload

A client with a cardiac dysrhythmia is receiving digoxin (Lanoxin) and verapamil (Calan). Because of the combined effect of these two medications, the nurse assesses the client for: 1 Physical agitation 2 Reflex stimulation 3 Myocardial depression 4 Respiratory stimulation

Myocardial depression

A nurse is responding to the needs of victims at a collapsed building. What principle guides the nurse's priorities during this disaster? 1 To save the most lives, hemorrhage necessitates immediate care. 2 Those requiring minimal care are treated first so they can help others. 3 Because the care is most complex, victims with head injuries are treated first. 4 Children receive the highest priority because they have the greatest life expectancy

Those requiring minimal care are treated first so they can help others.

A client with a history of coronary artery disease is admitted with pneumonia. The health care provider prescribes atenolol (Tenormin). What should the nurse monitor to determine the therapeutic effect of atenolol? 1 Heart rate 2 Respirations 3 Temperature 4 Pulse oximetry

heart rate

A client with peripheral arterial insufficiency tells the nurse that walking sometimes results in severe pain in the calf muscles. The nurse responds that this pain is called: 1 Rest pain 2 Intermittent claudication 3 Phantom limb sensation 4 Raynaud's phenomenon

intermittent claudication

An ECG is performed before a client is to have a cardiac catheterization, and hypokalemia is suspected. To confirm the presence of hypokalemia, the nurse expects the primary health care provider to prescribe: 1 A complete blood count 2 A serum electrolyte level 3 An arterial blood gas panel 4 An x-ray film of long bones

A serum electrolyte level

A client is scheduled to be transferred from the coronary care unit to a progressive care unit. The client asks a nurse, "Are you sure I'm ready for this move?" What does the nurse conclude the client most likely is experiencing? 1 Fear 2 Depression 3 Dependency 4 Ambivalence

Fear

A client is prescribed prolonged bed rest after surgery. Which complication does the nurse expect to prevent by teaching this client to avoid pressure on the popliteal space? 1 Cerebral embolism 2 Pulmonary embolism 3 Dry gangrene of a limb 4 Coronary vessel occlusion

Pulmonary embolism

The client is receiving multiple blood transfusions after having extensive abdominal surgery. If the client develops fever, chills, and lower back pain, and seems very nervous, what will be the nurse's first action? 1 Notify the blood bank 2 Notify the health care provider 3 Reduce the rate of the blood transfusion 4 Stop the blood and infuse normal saline

Stop the blood and infuse normal saline

A client is admitted to the postanesthesia care unit after surgery and electronic blood pressure monitoring is to be performed. The nurse should assess the client's blood pressure every: 1 3 to 5 minutes 2 10 to 15 minutes 3 20 to 30 minutes 4 40 to 60 minutes

10 to 15 minutes

A client returns from a cardiac catheterization procedure and is to remain in the supine position for four hours with the affected leg straight. The nurse explains that these measures are to prevent: 1 Orthostatic hypotension 2 Headache with disorientation 3 Bleeding at the arterial puncture site 4 Infiltration of radiopaque dye into tissue

Bleeding at the arterial puncture site

What should the nurse include in a teaching plan to help reduce the side effects associated with diltiazem (Cardizem)? 1 Lie down after meals. 2 Change positions slowly. 3 Avoid dairy products in diet. 4 Take the drug with an antacid.

Change positions slowly

A client is admitted with stage 2 hypertension. What diastolic pressure does the nurse consider to be consistent with this diagnosis? 1 80 to 89 mm Hg 2 90 to 99 mm Hg 3 Less than 79 mm Hg 4 More than 100 mm Hg

More than 100 mm Hg

A male client with aortic stenosis is scheduled for a valve replacement in two days. He tells the nurse, "I told my wife all she needs to know if I don't make it." What response is most therapeutic? 1 "Men your age do very well." 2 "You are worried about dying." 3 "I know you are concerned, but your surgeon is excellent." 4 "I'll get you a sleeping pill tonight because I know you will need it."

You are worried about dying

During a yearly physical examination a complete blood count (CBC) is performed to determine a client's hematological status. The nurse recalls that the CBC is composed of several tests, one of which is the level of: 1 Blood glucose 2 Hemoglobin (Hb) 3 C-reactive protein 4 Blood urea nitrogen (BUN)

Hemoglobin (Hb)

A male client receiving hemodialysis undergoes surgery to create an arteriovenous fistula. Before discharge, the nurse discusses care at home with the client and his wife. Which statement by the client's wife indicates that further teaching is required? 1 "I must touch the shunt several times a day to feel for the bruit." 2 "I have to take his blood pressure every day in the arm with the fistula." 3 "He will have to be very careful at night not to lie on the arm with the fistula." 4 "We really should check the fistula every day for signs of redness and swelling.

"I have to take his blood pressure every day in the arm with the fistula."

A nurse is assessing a client with a diagnosis of early left ventricular heart failure. Specific to this type of heart failure, the nurse expects the client to state: 1 "My ankles are swollen." 2 "I am tired at the end of the day." 3 "When I eat a large meal, I feel bloated." 4 "I have trouble breathing when I walk rapidly."

"I have trouble breathing when I walk rapidly."

The nurse is caring for a client with an abdominal aortic aneurysm before surgery. Which nursing care is essential preoperatively? 1 Administering supplemental oxygen 2 Maintaining a reduced blood pressure 3 Keeping the client in a supine position 4 Monitoring the peripheral vascular status

Maintaining a reduced blood pressure

A client with angina pectoris is scheduled for a stress echocardiogram. The nurse explains that the echocardiogram is a: 1 Tool used solely to determine the cause of chest pain 2 Noninvasive approach to assess cardiovascular status 3 Modality of minimal value in planning treatment for angina 4 Test that is invasive that measures the body's reaction to progressive increases in exertion

Noninvasive approach to assess cardiovascular status

A client who had a myocardial infarction receives a prescription for a beta-blocker and a nitroglycerin patch. The nurse determines that the purpose of the nitroglycerin patch is to decrease the: 1 Pulse rate, thereby strengthening cardiac contractility 2 Cardiac output, thereby reducing the cardiac workload 3 Preload of the heart, thereby reducing the cardiac workload 4 Coronary artery lumens, thereby reducing peripheral resistance

Preload of the heart, thereby reducing the cardiac workload

A nurse is preparing to teach a client to apply a nitroglycerin patch (Nitro-Dur) as prophylaxis for angina. Which instruction should the nurse include in the teaching plan? 1 Apply the patch on a distal extremity 2 Remove a previous patch before applying the next one 3 Massage the area gently after applying the patch to the skin 4 Apply a warm compress to the site before attaching the patch

Remove a previous patch before applying the next one

A nurse reviews the plan of care for a client who is recovering from the acute phase of left ventricular failure. The nurse expects which dietary restriction to be included on the plan? 1 Sodium 2 Calcium 3 Potassium 4 Magnesium

Sodium

A client has a mitral valve replacement, and the nurse provides health teaching to promote optimum health. Which statement made by the client supports the nurse's conclusion that the client needs further teaching? 1 "I should wear a MedicAlert bracelet." 2 "I will start a vigorous aerobic exercise program." 3 "I will take antibiotics when I have my teeth repaired." 4 "I should go to the doctor when I get a respiratory infection."

"I will start a vigorous aerobic exercise program."

A client admitted to the hospital has edematous ankles. What should the nurse do to best reduce edema of the lower extremities? 1 Restrict fluids. 2 Elevate the legs. 3 Apply elastic bandages. 4 Do range-of-motion exercises

Elevate the legs

A client who had a right total hip replacement three days ago reports extreme tenderness in the right calf. On examination the nurse identifies a warm area occurring on the back of the leg, extending into the popliteal space. The physical therapist has just arrived to assist the client with ambulation and exercise. What should the nurse do to best meet this client's needs? 1 Assist the therapist in ambulating the client. 2 Administer the client's prescribed analgesic. 3 Reassure the client that pain can be expected after surgery. 4 Notify the health care provider regarding the client's status.

Notify the health care provider regarding the client's status

A client who had a femoropopliteal bypass graft is receiving clopidogrel (Plavix) postoperatively. What should the nurse teach the client related to the medication? 1 Eliminate oranges from the diet 2 Eat more roughage if constipation occurs 3 Report multiple bruises on the extremities 4 Take the medication on an empty stomach

Report multiple bruises on the extremities

A nurse is caring for a client with a diagnosis of varicose veins. Which clinical findings can the nurse expect to identify when assessing this client? (Select all that apply.) 1 Discolored toenails 2 Reports of leg fatigue 3 Localized heat in a calf 4 Reddened areas on a leg 5 Tortuous veins in the legs 6 Pain in lower extremities when standing

Reports of leg fatigue Tortuous veins in the legs Pain in lower extremities when standing

A nurse is caring for a client with a diagnosis of varicose veins. Which clinical findings can the nurse expect to identify when assessing this client? (Select all that apply.) 1 Discolored toenails 2 Reports of leg fatigue 3 Localized heat in a calf 4 Reddened areas on a leg 5 Tortuous veins in the legs 6 Pain in lower extremities when standing

Reports of leg fatigue Tortuous veins in the legs Pain in lower extremities when standing

The nurse provides discharge teaching to a client who has received prescriptions for digoxin (Lanoxin), furosemide (Lasix), and a 2-gram sodium diet. The nurse evaluates that further teaching is needed when the client states: 1 "I must check my pulse every day." 2 "I can gradually increase my exercise as long as I take rest periods." 3 "I should call my health care provider if I have difficulty breathing when I am lying flat." 4 "I can use a little table salt on my food as long as I do not use it when cooking."

"I can use a little table salt on my food as long as I do not use it when cooking."

A client is to receive 0.25 mg of digoxin intramuscularly. The ampule is labeled 0.5 mg = 2 mL. How many mL should the nurse administer? Record your answer using a whole number. __________ mL

1ml

Which client is at greatest risk for the development of a venous thrombosis? 1 A 76-year-old female with a 100 pack per year smoking history and hypertension 2 A 68-year-old male on bed rest following a left hip fracture 3 A 42-year-old female with Factor V Leiden mutation on warfarin (Coumadin) 4 A 59-year-old male who is an intravenous drug user with hyperlipidemia

A 68-year-old male on bed rest following a left hip fracture

The nurse recognizes that an early finding that indicates that a client is hypertensive is: 1 An extended Korotkoff sound 2 An irregular pulse of 92 beats per minute 3 A diastolic blood pressure that remains greater than 90 mm Hg 4 A throbbing headache over the left eye when arising in the morning

A diastolic blood pressure that remains greater than 90 mm Hg

A client with a tentative diagnosis of pernicious anemia is scheduled for a Schilling test. Which body process associated with vitamin B12 is assessed with the Shilling test? 1 Storage 2 Digestion 3 Production 4 Absorption

Absorption

What should the nurse assess to determine if a client is experiencing the therapeutic effect of valsartan (Diovan)? 1 Lipid profile 2 Apical pulse 3 Urinary output 4 Blood pressure

Blood pressure

A hospitalized client puts the call light on and reports a sudden onset of chest pain that feels like a pressure or weight on the chest. The client also states, "I feel nauseated and very weak." What action should the nurse take? 1 Call the rapid response team 2 Perform a nutritional assessment 3 Discuss possible sources of stress with the client 4 Provide reassurance while helping the client to focus on pleasant topics

Call the rapid response team

A nurse identifies premature ventricular complexes (PVCs) on a client's cardiac monitor and concludes that these complexes are a sign of: 1 Atrial fibrillation 2 Cardiac irritability 3 Impending heart block 4 Ventricular tachycardia

Cardiac irritability

A client comes to the emergency department complaining of weakness and dizziness. The blood pressure is 90/60, pulse is 92 and weak, and body weight reflects a 3-pound loss in two days. The weather has been hot. The nurse concludes that the biggest concern for this client is: 1 Deficient fluid volume 2 Impaired skin integrity 3 Inadequate nutritional intake 4 Decreased participation in activities

Deficient fluid volume

A client who is receiving multiple medications for a myocardial infarction complains of severe nausea, and the client's heartbeat is irregular and slow. The nurse determines that these signs and symptoms are toxic effects of: 1 Digoxin (Lanoxin) 2 Captopril (Capoten) 3 Morphine sulfate (MS Contin) 4 Furosemide (Lasix )

Digoxin (Lanoxin)

A client with hypertension has received a prescription for metoprolol (Lopressor). Which information should the nurse include when teaching this client about metoprolol? 1 Consume alcoholic beverages in moderation 2 Do not abruptly discontinue the medication 3 Increase the medication dosage if chest pain occurs 4 Report a heart rate of less than 70 beats per minute

Do not abruptly discontinue the medication

An older client who lives alone was found unconscious on the floor at home. The client was admitted to the hospital with the diagnoses of a fractured hip, kidney failure, and dehydration. In the 24 hours since admission, the client received 1500 mL of intravenous fluid and the serum electrolyte value demonstrates hyponatremia. The nurse concludes that the element that most likely contributed to the hyponatremia is: 1 Salt intake 2 Fluid intake 3 Sodium absorption 4 Glomerular filtration

Fluid intake

The nurse is providing care for a client that had an endarterectomy one month ago. The nurse explains the reason that clopidogrel (Plavix) is being prescribed. The nurse concludes that the teaching is understood when the client says, "The medication will: 1 Limit inflammation around my incision." 2 Help prevent further clogging of my arteries." 3 Lower the slight fever I have had since surgery." 4 Reduce the discomfort I feel at the surgical incision."

Help prevent further clogging of my arteries."

A nurse is caring for a client with a diagnosis of polycythemia vera. The client asks, "Why do I have an increased tendency to develop blood clots?" Which effect of the polycythemia vera should the nurse explain increases the risk of these thromboses? 1 Elevated blood pressure 2 Increased blood viscosity 3 Fragility of the blood cells 4 Immaturity of red blood cells

Increased blood viscosity

When discussing the therapeutic regimen of vitamin B12 for pernicious anemia with a client, the nurse explains that: 1 Weekly Z-track injections provide needed control 2 Daily intramuscular injections are required for control 3 Intramuscular injections once a month will maintain control 4 Oral tablets of vitamin B12 taken daily will provide symptom contro

Intramuscular injections once a month will maintain control

For the first several hours after a cardiac catheterization, it is most essential for the nurse to: 1 Monitor the client's apical pulse and blood pressure 2 Keep the head of the client's bed elevated 45 degrees 3 Encourage the client to cough and deep breathe every two hours 4 Check the client's temperature every hour until it returns to normal

Monitor the client's apical pulse and blood pressure

A nurse is providing post-procedure care to a client who had a cardiac catheterization via a brachial artery. For the first hour after the procedure, what is the priority nursing intervention? 1 Monitor the vital signs every 15 minutes 2 Maintain the client in the supine position 3 Keep the client's lower extremities in extension 4 Administer the prescribed oxygen at 4 L/min via nasal cannula

Monitor the vital signs every 15 minutes

A nurse provides teaching regarding vitamin B12 injections to a client with pernicious anemia. The nurse concludes that the teaching was understood when the client states, "I must take the drug: 1 When feeling fatigued." 2 Until my symptoms subside." 3 Monthly, for the rest of my life." 4 During exacerbations of anemia.

Monthly, for the rest of my life."

During a routine physical examination, an abdominal aortic aneurysm is diagnosed. The client immediately is admitted to the hospital, and surgery is scheduled for the next morning. Which clinical finding should the nurse expect when performing an assessment of this client? 1 Severe radiating abdominal pain 2 Pattern of visible peristaltic waves 3 Palpable pulsating abdominal mass 4 Cyanosis with other symptoms of shock

Palpable pulsating abdominal mass

A client is admitted to the hospital for replacement of the mitral valve. The primary purpose of the nurse frequently checking the pulses in the client's legs frequently after surgery is to detect: 1 Atrial fibrillation 2 Postsurgical bleeding 3 Arteriovenous shunting 4 Peripheral thrombophlebitis

Peripheral thrombophlebitis

The nurse encourages a client with Raynaud's disease to stop smoking because it causes: 1 Pain and tingling 2 Cyanosis and necrosis 3 Peripheral vasoconstriction 4 Excessive blood oxygen content

Peripheral vasoconstriction

What should a nurse do to decrease or control the sensory and cognitive disturbances that can occur after a client has open-heart surgery? 1 Restrict family visits 2 Withhold analgesic medications 3 Plan for maximum periods of rest 4 Keep the room light on most of the time

Plan for maximum periods of rest

A nurse is caring for a client with varicose veins. Which clinical manifestations should the nurse expect with this diagnosis? (Select all that apply.) 1 Presence of ankle edema 2 Increased muscle fatigue 3 Diminished peripheral pulses 4 Report of nocturnal leg cramps 5 Leg pain with activity that diminishes with res

Presence of ankle edema Increased muscle fatigue Report of nocturnal leg cramps

Enoxaparin (Lovenox) 40 mg subcutaneously daily is prescribed for a client who had abdominal surgery. The nurse explains that the medication is given to: 1 Control expected postoperative fever 2 Provide a constant source of mild analgesia 3 Limit the inflammatory response associated with surgery 4 Provide prophylaxis against postoperative thrombus formation

Provide prophylaxis against postoperative thrombus formation

A health care provider prescribes an antihypertensive medication. Which over-the-counter medication should the nurse teach the client to avoid because it has the potential to counteract the effect of the antihypertensive? 1 Omeprazole (Prilosec) 2 Acetaminophen (Tylenol) 3 Docusate sodium (Colace) 4 Pseudoephedrine (Sudafed)

Pseudoephedrine (Sudafed)

ne week after admission to the cardiac care unit a client displays an outburst of anger and tells the nurse to get out of the room. Which is the most appropriate nursing action? 1 Administer the prescribed sedative 2 Return when the client has calmed down 3 Point out that this behavior is inappropriate 4 Notify the practitioner of the client's behavior

Return when the client has calmed down

A nurse caring for a client with a myocardial infarction is concerned that the client may develop left ventricular failure. For which clinical manifestation should the nurse assess the client? 1 Weight loss 2 Distended neck veins 3 Paroxysmal nocturnal dyspnea 4 Right upper quadrant tenderness

Right upper quadrant tenderness

A client is admitted to the hospital with chest pain and a diagnosis of myocardial infarction. The nurse expects the client to describe the chest pain as: 1 Severe, intense 2 Burning and of short duration 3 Mild, radiating toward the abdomen 4 Squeezing, relieved by Maalox

Severe, intense

A client with a 40-year history of drinking two alcoholic beverages and smoking two packs of cigarettes daily comes to the outpatient clinic with an ischemic left foot. It is determined that the cause is arterial insufficiency. The nurse concludes that the pain in the client's foot is a result of inadequate blood supply, which may be diminished further by: 1 Drinking alcohol 2 Lowering the limb 3 Smoking cigarettes 4 Consuming excessive fluid

Smoking cigarretes

A nurse in the post-anesthesia care unit is caring for a client who received a general anesthetic. Which finding should the nurse report to the health care provider? 1 Client pushes the airway out. 2 Client has snoring respirations. 3 Respirations of 16 breaths/min are shallow. 4 Systolic blood pressure drops from 130 to 90 mm Hg

Systolic blood pressure drops from 130 to 90 mm Hg

A client is admitted to the emergency department after vomiting bright red blood. After the vomiting ceases and the vital signs are stabilized, the client is transferred to a medical-surgical unit. To assess for bleeding, the nurse on the medical-surgical unit should monitor the client for: 1 Lethargy 2 Tachycardia 3 Deep breathing 4 Abdominal pain

Tachycardia

A homosexual client is diagnosed with human immunodeficiency virus (HIV). The primary nurse informed the nursing team that the client wept when told of the diagnosis. A health care team member responded by saying, "I don't feel sorry for people like that. My philosophy is that you made your bed and now you can sleep in it." What is the basis of the team member's comment? 1 Values and beliefs about sexual lifestyles. 2 Anger and mistrust of homosexuals in general. 3 Discomfort with people who are unable to control their emotions. 4 Hostility over having to care for someone with a sexually related infection.

Values and beliefs about sexual lifestyles.

A client who recently started receiving oral corticosteroids for a severe allergic reaction is instructed that the dosage will be reduced gradually until all medication is stopped at the end of two weeks. What reason should the nurse provide for this gradual reduction in dosage? 1 Discontinuing the drug too fast will cause the allergic reaction to reappear. 2 Slow reduction of the drug will prevent a physiological crisis because the adrenal glands are suppressed. 3 The health care provider is attempting to determine the minimal dose that will be effective for the allergy. 4 Sudden cessation of the drug will cause development of serious side effects, such as moon face and fluid retention

Slow reduction of the drug will prevent a physiological crisis because the adrenal glands are suppressed.

A client is admitted with a diagnosis of a ruptured spleen. The client's blood pressure is 100/60. The nurse should assess the client for an early sign of decreased arterial pressure which is: 1 Weak radial pulses 2 Warm, flushed skin 3 Lethargy with confusion 4 Increased pulse pressure

Weak radial pulses

What clinical indicators are the nurse most likely to identify when taking the admission history of a client with right ventricular failure? (Select all that apply.) 1 Edema 2 Vertigo 3 Polyuria 4 Dyspnea 5 Palpitations

Edema Dyspnea

A client asks a nurse why captopril (Capoten) was prescribed. What specific drug classification should the nurse include in the explanation to the client? 1 Diuretic 2 Sedative 3 Hypnotic 4 Antihypertensive

Antihypertensive

A client with a dysrhythmia is admitted to telemetry for observation. In the morning, the client asks for a cup of coffee. What is the nurse's best response? 1 "Hot drinks such as coffee are not good for your heart." 2 "Coffee is not permitted on the diet that was prescribed for you." 3 "You cannot have coffee. I can bring you a cup of tea if you like." 4 "Coffee has caffeine, which can affect your heart. It should be avoided."

"Coffee has caffeine, which can affect your heart. It should be avoided."

A client with hypertension is to follow a 2-gram sodium diet. Which client statement provides evidence that the nurse's dietary instructions are understood? 1 "My fluid intake should be restricted." 2 "I should limit the number of daily food servings." 3 "Salt should not be used during cooking but can be used at the table." 4 "Labels on prepackaged food products should be evaluated before purchase.

"Labels on prepackaged food products should be evaluated before purchase.

The spouse of a client who had emergency coronary artery bypass surgery asks why there is a dressing on the client's left leg. The nurse explains that: 1 This is the access site for the heart-lung machine 2 A filter is inserted in the leg to prevent embolization 3 A vein in the leg was used to bypass the coronary artery 4 The arteries in the extremities are examined during surgery

A vein in the leg was used to bypass the coronary artery

The health care provider prescribes isosorbide dinitrate (Isordil) 10 mg as needed three times a day and a nitroglycerin transdermal disk once a day for a client with chronic angina pectoris. The client asks the nurse why the isosorbide dinitrate is prescribed. The nurse's best response is, "The isosorbide dinitrate: 1 Prevents the blood from clotting." 2 Suppresses irritability in the ventricles." 3 Allows more oxygen to get to heart tissue." 4 Increases the force of contraction of the heart."

Allows more oxygen to get to heart tissue."

A health care provider prescribes ophthalmic drops for a client. What should a nurse include in the instructions for a client learning to self-administer eye drops? 1 Lie on the unaffected side for administration. 2 Instill drops onto the pupil to promote absorption. 3 Close eyes tightly after administering the eye drops. 4 Apply pressure to the nasolacrimal duct after instillation.

Apply pressure to the nasolacrimal duct after instillation.

A client is admitted to the emergency department with crushing chest pain. A diagnosis of acute coronary syndrome is suspected. The nurse expects that the client's initial treatment will include which medication? 1 Gabapentin (Neurontin) 2 Midazolam HCI (Versed) 3 Alprazolam (Xanax) 4 Aspirin (ASA)

Aspirin (ASA)

What client response indicates to the nurse that a vasodilator medication is effective? 1 Pulse rate decreases from 110 to 75 2 Absence of adventitious breath sounds 3 Increase in the daily amount of urine produced 4 Blood pressure changes from 154/90 to 126/72

Blood pressure changes from 154/90 to 126/72

When assessing a client with the diagnosis of left ventricular failure, the nurse expects to identify: 1 Crushing chest pain 2 Dyspnea on exertion 3 Jugular vein distention 4 Extensive peripheral edema

Dyspnea on exertion

When assessing a client with heart failure, the nurse asks when the client most notices an increase in symptoms. Which activity should the nurse expect will cause the client the greatest distress? 1 Getting up from bed in the morning 2 Walking to visit the next-door neighbor 3 Climbing a flight of stairs to the bedroom 4 Leaving the table immediately after a meal

Climbing a flight of stairs to the bedroom

The nurse provides discharge teaching to a client with a history of angina. The nurse instructs the client to call for emergency services immediately if the client's pain: 1 Causes mild perspiration 2 Occurs after moderate exercise 3 Continues after rest and nitroglycerin 4 Precipitates discomfort in the arms and jaw

Continues after rest and nitroglycerin

Which of the following symptoms indicates to the nurse that the client has an inadequate fluid volume? (Select all that apply.) 1 Decreased urine 2 Hypotension 3 Dyspnea 4 Dry mucous membranes 5 Pulmonary edema 6 Poor skin turgor

Decreased urine Hypotension Dry mucous membranes Poor skin turgor

The plan of care for a postoperative client who has developed a pulmonary embolus includes monitoring and bed rest. The client asks why all activity is restricted. The nurse's response is based on the principle that bed rest: 1 Prevents the further aggregation of platelets 2 Enhances the peripheral circulation in the deep vessels 3 Decreases the potential for further dislodgment of emboli 4 Maximizes the amount of blood available to damaged tissues

Decreases the potential for further dislodgment of emboli

During administration of a whole blood transfusion, the client begins to complain of shortness of breath. The nurse notes the presence of jugular venous distension, bibasilar crackles, and tachycardia. Prioritize the following nursing actions. 1. Elevate the head of the bed to 45 degrees 2. Apply oxygen via nasal cannula 3. Administer furosemide (Lasix) per provider prescription 4. Reduce the flow rate of the transfusion 5. Document findings in the client record

Elevate the head of the bed to 45 degrees Apply oxygen via nasal cannula Reduce the flow rate of the transfusion Administer furosemide (Lasix) per provider prescription Document findings in the client record

While receiving a blood transfusion, a client develops flank pain, chills, fever, and hematuria. What type of transfusion reaction does the nurse conclude that the client probably is experiencing? 1 Allergic 2 Pyrogenic 3 Hemolytic 4 Anaphylactic

Hemolytic

A client is recovering from a myocardial infarction. Before developing the client's teaching plan, it is important for the nurse to: 1 Identify the learning needs of the client 2 Determine the nursing goals for the client 3 Evaluate the community resources available to the client 4 Explore the use of group teaching for the client

Identify the learning needs of the client

A client is diagnosed with hypertension that it related to atherosclerosis. The nurse recalls that with atherosclerosis: 1 Rennin causes a gradual decrease in arterial pressure 2 Lipid plaque formation occurs within the arterial vessels 3 Mobilization of free fatty acids from adipose tissue contributes to plaque formation 4 Development of atheromas within the myocardium is characteristi

Lipid plaque formation occurs within the arterial vessels

When developing a plan of care for a client who had a cardiac catheterization via a femoral insertion site, the nurse should include: 1 Ambulating the client two hours after the procedure 2 Checking the vital signs every 15 minutes for eight hours 3 Keeping the client nothing by mouth for four hours after the procedure 4 Maintaining the supine position for a minimum of four hours

Maintaining the supine position for a minimum of four hours

When obtaining an admission history of a preoperative client, the nurse learns that the client is taking several herbal supplements. What is the priority nursing action? 1 Explain that most herbal supplements are dangerous to the body. 2 Teach the client about taking supplemental vitamins rather than herbs. 3 Obtain information on the usefulness of the herbal therapies being taken. 4 Notify the health care provider because some herbs can cause hemorrhage

Notify the health care provider because some herbs can cause hemorrhage

A nurse is caring for a client who is admitted to the hospital with a diagnosis of unstable angina. Sublingual nitroglycerin has been prescribed. What client response indicates that nitroglycerin is effective? 1 Pain subsides as a result of arteriole and venous dilation 2 Pulse rate increases because the cardiac output has been stimulated 3 Sublingual area tingles because sensory nerves are being triggered 4 Capacity for activity improves as a response to increased collateral circulation

Pain subsides as a result of arteriole and venous dilation

While caring for a client who had an open reduction and internal fixation of the hip, the nurse encourages active leg and foot exercises of the unaffected leg every two hours. The nurse explains that these exercises will help: 1 Prevent clot formation 2 Reduce leg discomfort 3 Maintain muscle strength 4 Limit venous inflammation

Prevent clot formation

A client who is recovering from an acute myocardial infarction reports not being happy about the lack of salt with meals. Recognizing that adherence to a medical regimen improves with understanding, the nurse explains that the salt must be limited to: 1 Prevent an increase in blood pressure from tissue edema. 2 Reduce the circulating blood volume via a diuretic effect. 3 Reduce the amount of edema present, which interferes with heart action. 4 Prevent further accumulation of fluid, which increases the workload of the heart.

Prevent further accumulation of fluid, which increases the workload of the heart.

A client who is suspected of having had a silent myocardial infarction has an electrocardiogram (ECG) prescribed by the health care provider. While the nurse prepares the client for this procedure, the client asks, "Why was this test prescribed?" The best reply by the nurse is, "This test will: 1 Detect your heart sounds." 2 Reflect any heart damage." 3 Help us change your heart's rhythm." 4 Tell us how much stress your heart can tolerate."

Reflect any heart damage."

The health care provider prescribes a progressive exercise program that includes walking for a client with a history of diminished arterial perfusion to the lower extremities. The nurse explains to the client that if leg cramps occur while walking, the client should: 1 Take one aspirin (ASA) twice a day 2 Stop to rest until the pain resolves 3 Walk more slowly while pain is present 4 Take one nitroglycerin tablet sublingually

Stop to rest until the pain resolves

An African American woman is diagnosed with primary hypertension. She asks, "Is hypertension a disease of African American people?" What is the nurse's best response? 1 "The prevalence of hypertension is about equal for women of all races." 2 "The higher-risk population is composed of African American men and women." 3 "The highest-risk population consists of older Caucasian American men and women." 4 "The prevalence of hypertension is greater for African American women than for African American men."

The higher-risk population is composed of African American men and women.

To prepare a client for surgery, which explanation by a nurse would be accurate related to pneumatic compression devices? 1 They help the venous blood return to the heart. 2 They will not cause discomfort, but gently massage the legs. 3 They are used instead of anticoagulant therapy. 4 They must be worn until the first time the client gets out of bed

They help the venous blood return to the heart.

A client who is immunosuppressed is receiving filgrastim (Neupogen). When the nurse evaluates the client's response to this medication, the finding that is most expected is an increase in: 1 Platelets 2 Erythrocytes 3 Thrombocytes 4 White blood cells

White blood cells

A client with small-cell lung cancer is receiving chemotherapy. A complete blood count is prescribed before each round of chemotherapy. The component of the complete blood count that the nurse is concerned about most is: 1 Red blood cells (RBCs) 2 White blood cells (WBCs) 3 Platelets 4 Hematocrit

White blood cells

When performing a physical assessment, the nurse identifies bilateral varicose veins. What does the nurse expect the client to report about the legs? 1 Burning sensations in the legs. 2 Calf pain when the feet are dorsiflexed. 3 Increased sensitivity of the legs to cold. 4 Worsening ankle edema as the day progresses

Worsening ankle edema as the day progresses

Which assessment should the nurse obtain before administering digoxin (Lanoxin) to a client? 1 Apical heart rate 2 Radial pulse on the left side 3 Radial pulse in both right and left arms 4 Difference between apical and radial pulses

Apical heart rate

The nurse observes a client collapse while walking down the hallway. The nurse rushes to the client and determines that the client is in cardiopulmonary arrest. What will the nurse do first? 1 Do a blind finger sweep 2 Begin chest compressions 3 Check for a carotid pulse 4 Perform the abdominal thrust maneuver

Check for a carotid pulse

The nurse is providing postoperative care for a client who has received a prescription for nalbuphine (Nubain) for pain. For which side effects or adverse reactions should the nurse assess this client after administering this medication? (Select all that apply.) 1 Oliguria 2 Dry mouth 3 Palpitations 4 Constipation 5 Urinary retention 6 Orthostatic hypotension

Dry mouth Palpitations Constipation Orthostatic hypotension

A nurse is administering erythropoietin (Epogen) three times a week to a client receiving chemotherapy for cancer. Which client response is considered most expected? 1 Elevated liver enzymes 2 Elevated hematocrit level 3 Increase in the white blood cell (WBC) count 4 Increase in Kaposi's sarcoma lesions

Elevated hematocrit level

A nurse attempts to give a client with chronic arterial insufficiency of the legs the prescribed dose of aspirin (ASA). The client refuses it, stating, "My legs are not painful." The nurse should: 1 Explain the reason for the medication and encourage the client to take it 2 Withhold the medication and tell the client to ask for it if the legs become uncomfortable 3 Withhold the medication at this time and return to check with the client again in 30 minutes 4 Request that the client take the medication and explain that it prevents the client from being uncomfortable in the next few hours

Explain the reason for the medication and encourage the client to take it

A nurse is collecting data from a client with varicose veins who is to have sclerotherapy. What should the nurse expect the client to report? 1 Feeling of heaviness in both legs. 2 Intermittent claudication of the legs. 3 Calf pain on dorsiflexion of the foot. 4 Hematomas of the lower extremities.

Feeling of heaviness in both legs.

The primary health care provider prescribes a transfusion of two units of packed red blood cells for a client. When caring for the patient receiving administering blood, the priority nursing intervention is to: 1 Make sure the client's family has received education 2 Warm the blood to 98° F to prevent chills 3 Make sure the blood is infused at a slow rate during the first 15 minutes 4 Draw blood samples from the client after each unit is transfused

Make sure the blood is infused at a slow rate during the first 15 minutes

A client comes to the emergency department reporting symptoms of the flu. When the health history reveals intravenous drug use and multiple sexual partners, acute retroviral syndrome is suspected, and a test for the human immunodeficiency virus (HIV) is performed. Which clinical responses are associated most commonly with this syndrome? (Select all that apply.) 1 Malaise 2 Confusion 3 Constipation 4 Swollen lymph glands 5 Oropharyngeal candidiasis

Malaise Swollen lymph glands

n older adult is brought to the emergency department after being found in the street without a coat during a snowstorm. What actions should the nurse implement? (Select all that apply.) 1 Massage extremities. 2 Obtain a rectal temperature. 3 Assess the fingers for areas of frostbite. 4 Determine client's level of consciousness. 5 Ask for client identification

Obtain a rectal temperature. Assess the fingers for areas of frostbite. Determine client's level of consciousness. Ask for client identification

A client has surgery to replace a prolapsed mitral valve. What should the nurse teach the client? 1 The signs and symptoms of pericarditis 2 The possible need for prophylactic antibiotic therapy before dental work 3 That cardiac surgery will have to be done eventually for the other valves 4 That pregnancy and childbirth are too stressful when one has this problem

The possible need for prophylactic antibiotic therapy before dental work

Knee-length elastic support stockings are prescribed for a client with varicose veins. What should the nurse teach the client about the elastic stockings? 1 Support hose should reach the middle of the knee. 2 The stockings should be applied before getting out of bed. 3 The stockings should be applied at the first sign of discomfort. 4 Elastic bandages may be substituted because they are more economical

The stockings should be applied before getting out of bed.

To prepare a client for surgery, which explanation by a nurse would be accurate related to pneumatic compression devices? 1 They help the venous blood return to the heart. 2 They will not cause discomfort, but gently massage the legs. 3 They are used instead of anticoagulant therapy. 4 They must be worn until the first time the client gets out of bed.

They help the venous blood return to the heart.

A nurse is caring for a client who was diagnosed with a myocardial infarction. While caring for the client two days after the event, the nurse identifies that the client's temperature is elevated. The nurse concludes that this increase in temperature is most likely the result of: 1 Tissue necrosis 2 Venous thrombosis 3 Pulmonary infarction 4 Respiratory infection

Tissue necrosis

A nurse is caring for a client who is a victim of trauma and is to receive a blood transfusion. How should the nurse respond when the client expresses fear that acquired immunodeficiency disease (AIDS) may be acquired as a result of the blood transfusion? 1 "The blood is treated with radiation to kill the virus." 2 "Screening for the human immunodeficiency virus (HIV) antibodies has minimized this risk." 3 "The ability to directly identify HIV has eliminated this concern." 4 "Consideration should be given to donating your own blood for transfusion."

"Screening for the human immunodeficiency virus (HIV) antibodies has minimized this risk."

A Schilling test is prescribed for a client who is suspected of having pernicious anemia. The nurse considers that the primary purpose of the Schilling test is to determine the client's ability to: 1 Store vitamin B12 2 Digest vitamin B12 3 Absorb vitamin B12 4 Produce vitamin B12

Absorb vitamin B12

A client with an inferior myocardial infarction has a heart rate of 120 beats per minute. What is the goal of the medical regimen for this client? 1 Increase left ventricular filling and improve cardiac output. 2 Decrease oxygen needs of the vital organs and prevent cardiac dysrhythmias. 3 Decrease the workload on the heart and promote maximum coronary artery filling. 4 Increase venous return to the right atrium and increase pulmonary arterial blood flow.

Decrease the workload on the heart and promote maximum coronary artery filling.

A primary health care provider prescribes atenolol (Tenormin) 20 mg by mouth four times a day for a client who has had double coronary artery bypass surgery. What information is most important for the nurse to include in the discharge teaching plan for this client? 1 Drink alcoholic beverages in moderation. 2 Avoid abruptly discontinuing the medication. 3 Increase the medication if chest pain develops. Incorrect4 Report a pulse rate less than seventy beats per minute

Avoid abruptly discontinuing the medication.

A nurse is caring for a client who is scheduled to have an abdominal perineal resection for colorectal cancer. A type and cross match is done because of a concern about blood loss. The client has type B-negative blood. The blood type that can be used for this client is: 1 A positive 2 B negative 3 O negative 4 AB positive

B negative

A client with a history of heart failure and atrial fibrillation reports a nine-pound weight gain in the last two weeks. The nurse interprets that the most likely cause of this sudden weight gain is: 1 Fluid retention 2 Urinary retention 3 Renal insufficiency 4 Abdominal distention

Fluid retention

The day after surgery a client is encouraged to ambulate. The client angrily asks the nurse, "Why am I being made to walk so soon after surgery?" The nurse explains that the primary purpose of early ambulation is to: 1 Promote healing of the incision 2 Lower the incidence of urinary tract infections 3 Use energy to help the client sleep better at night 4 Keep blood from pooling in the legs to prevent clots

Keep blood from pooling in the legs to prevent clots

A client with a history of hypertension comes to the emergency department with double vision and a blood pressure of 260/120 mm Hg. The health care provider prescribes a sodium nitroprusside (Nitropress) infusion. The nurse recalls that sodium nitroprusside decreases blood pressure by: 1 Decreasing the heart rate 2 Increasing cardiac output 3 Increasing peripheral resistance 4 Relaxing arterial smooth muscles

Relaxing arterial smooth muscles

An insulin pump is instituted for a client with type 1 diabetes. The nurse plans discharge instructions. Which short-term goal is the priority for this client? 1 "Adhere to the medical regimen." 2 "Remain normoglycemic for three weeks." 3 "Demonstrate correct use of the insulin pump." 4 "List three self-care activities that help control the diabetes."

"Demonstrate correct use of the insulin pump."

A client experiences angina and is admitted to the telemetry unit for observation. Sublingual nitroglycerin tablets are prescribed to control periodic episodes of chest pain. Which instruction should the nurse include when teaching the client about the correct use of sublingual nitroglycerine? 1 Plan to take the tablet between meals. 2 Take the tablet with a full glass of juice. 3 Dissolve the tablet in water before swallowing it. 4 Hold the tablet under the tongue until it is dissolved.

Hold the tablet under the tongue until it is dissolved.

The nurse evaluates that the client understands the teaching regarding the use of vitamin B12 injections to treat pernicious anemia when the client states, "I must take the drug: 1 When feeling fatigued." 2 Until my symptoms subside." 3 Monthly, for the rest of my life." 4 During exacerbations of anemia.

Monthly, for the rest of my life."

A client sustains multiple internal injuries in a motor vehicle accident. While performing the client's initial assessment, the nurse identifies that the client's blood pressure suddenly drops from 134/90 to 80/60 mm Hg. What most likely has caused this drop in blood pressure? 1 Reduction in the circulating blood volume 2 Diminished vasomotor stimulation to the arterial wall 3 Vasodilation resulting from diminished vasoconstrictor tone 4 Cardiac decompensation resulting from electrolyte imbalance

Reduction in the circulating blood volume

A client with varicose veins asks a nurse what is involved when ligation and stripping are performed rather than sclerotherapy. What should the nurse consider when planning a response in language the client will understand? 1 Plaque from within the veins is abraded. 2 The dilated saphenous veins are removed. 3 Superficial veins are anastomosed to deep veins. 4 An umbrella filter is placed in the large affected veins.

The dilated saphenous veins are removed.

A client is taking administering warfarin (Coumadin). The nurse recalls that the antidote for this medication is: 1 Vitamin K 2 Fibrinogen 3 Prothrombin 4 Protamine sulfate

Vitamin K

A client with chronic liver disease reports, "My gums have been bleeding spontaneously." The nurse identifies small hemorrhagic lesions on the client's face. The nurse concludes that the client needs additional: 1 Bile salts 2 Folic acid 3 Vitamin A 4 Vitamin K

Vitamin K

A client's laboratory report indicates hyperkalemia. Which responses should the nurse expect the client to exhibit? (Select all that apply.) 1 Anorexia 2 Vomiting 3 Constipation 4 Muscle weakness 5 Irregular heart rate

Vomiting Muscle weakness Irregular heart rate