Cardiovascular showdown review

Troponin levels rise in 3 to 6 hours from onset of symptoms and usually peak within 12 hours, but can remain in circulation for up to how many days?

12 days

The nurse understands that before the electrical impulse can reach the bundle of His, it first has to pass through the:

AV node

Which of the follow is an invasive diagnostic procedure used to assess the vascular system

Angiogram

A nurse is reinforcing teaching with a newly licensed nurse about reading a client's ECG tracing. The nurse should include in the teaching that the P wave represents which of the following cardiac electrical activities

Atrial depolarization

Initial treatment of asystole and pulseless electrical activity is

CPR

A nurse is assisting with the care of a client 2 hr postoperative following a cardiac catheterization. Which of the following actions should the nurse take?

Check the client's distal pulses in both legs.

A nurse is collecting data from a client who has atrial fibrillation. When documenting the quality of the client's pulse, which of the following terms should the nurse use?

Irregular

There is an increased risk for bleeding when the client receiving heparin is also taking which of the following?

NSAIDS

A nurse is assisting with the care of a client who is receiving heparin by IV infusion. Which of the following medications should the nurse have available in the event of an overdose?

Protamine

A nurse in a provider's office is collecting data from a client who takes furosemide daily for heart failure. Which of the following findings is a manifestation of hypokalemia?

Reports of fatigue

A nurse is reinforcing teaching with a client who wants to increase her daily intake of omega-3 fatty acids. Which of the following foods should the nurse suggest the client increase?

Soybean oil

A nurse is reinforcing discharge teaching for a client who is postoperative following the insertion of a permanent pacemaker. Which of the following instructions should the nurse include?

You should hold your cell phone on the side opposite the pacemaker

A nurse is reinforcing teaching with a client who is scheduled for an ECG. Which of the following instructions should the nurse include

You will need to lie still on your left side during this test.

A heart rate of 60 bpm or less is defined as:

bradycardia

he nurse knows that if the patient is unable to physically perform a treadmill stress test, they will most likely undergo a chemical stress test using which of the following medications to stimulate cardiac exertion?

dobutamine

The use of catheters with multiple electrodes inserted through the femoral vein to record the heart's electrical activity and stimulate dysrhythmias refers to what kind of procedure?

electrophysiology studies

A nurse is reviewing the laboratory values for a client who has heart failure and is taking bumetanide. For which of the following results should the nurse notify the provider?

potassium 2.3 mEq/L

Heparin is given intravenously for immediate response for

pulmonary embolism

A serious risk with a diagnosis of deep vein thrombosis is the development o

pulmonary embolus

Which heart sound is normal is children and young adults but is pathologic if it is heard after the age of 30?

s3

Which of the following drugs may be administered after a heart attack to dissolve thrombi?

t-PA (thrombolytic)

Each small square on an EKG strip represents ______ seconds on the strip

0.04 seconds

In order to interpret EKGs correctly, the nurse must be knowledgable of time frames for each interval being measured. The nurse knows the time indicating a normal QRS complex is:

0.06-0.12 seconds

When providing discharge teaching on nitroglycerin, you can document a successful teach back when the patient verbalizes she can take up to _____ nitroglycerin tabs followed by calling 911 if pain is not relieved.

3

The normal cardiac output is

4-8 L/min

When teaching the patient about prescribed sublingual nitroglycerin, the nurse informs the patient that if the pain is not relieved, the dose can be repeated after how many minutes?

5

Before each dose of digoxin, the apical pulse is counted for 1 full minute; the drug is withheld, and the health care provider is notified if the pulse is below:

60 bpm

Which of the following is the normal rate for the sinoatrial node?

60 to 100 beats per minute

A nurse is reviewing the morning laboratory results of electrolytes for four clients who are receiving digoxin. Which of the following clients should the nurse identify as being at risk for developing digoxin toxicity?

A client taking furosemide for chronic hypertension

A nurse administered nitroglycerin sublingually to a client who has angina pectoris and experienced chest pain. The client states that his chest pain is relieved but now he has a headache. Which of the following responses by the nurse is appropriate?

A headache is a common adverse effect of this medication, but it will probably occur less often over time."

When caring for a patient after a cardiac catheterization with coronary angiography, which of the following findings would be of most concern to the nurse?

Absence of pulses below the catheter insertion site

Which of the following assessments would indicate a side effect of digoxin (Lanoxin) is occuring and requires follow up?

Anorexia

A nurse is reinforcing teaching with a client who has a new prescription for transdermal nitroglycerin for angina pectoris. Which of the following instructions should the nurse include?

Apply a new patch each day.

The nurse is caring for a patient whose EKG monitor shows a total absence of electrical impulse and unable to palpate a pulse. The nurse recognizes the patient is experiencing which rhythm?

Asystole

A nurse is assisting with collecting data on a client who is on a continuous ECG monitor. The client's ECG tracing shows no identifiable P waves and an irregular ventricular rate. The nurse should recognize the client is experiencing which of the following cardiac dysrhythmias?

Atrial fibrillation

A nurse is reinforcing teaching with a client about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following food choices reflects the client's understanding of these dietary instructions?

Beans

The nurse is preparing discharge instructions on a patient started on warfarin for atrial fibrillation. The nurse evaluates that the patient understands discharge education when stating she will contact her doctor if:

Bowel movements become black in color

Which of the following is the function of the cornoary arteries?

Bring oxygenated blood to the myocardium

As the nurse examines a patient for decreased circulation in the lower extremities, which of the following findings would indicate adequate circulation?

Capillary refill less than 3 seconds

The nitrates given for anginal pain are used to dilate which of the following vessels?

Coronary arteries

A nurse is checking the apical pulse of a client who is taking several antidysrhythmic medications. Which of the following actions should the nurse take

Count the apical pulsations for a full minute

for the patient with heart failure receiving furosemide, the nurse evaluates the medication as being effective if which of the following effects occurs?

Crackles in lungs diminish

A nurse is collecting data from a client who reports a sudden onset of shortness of breath, fatigue, and dizziness. Electrocardiography indicates the client is experiencing atrial fibrillation. Which of the following medications should the nurse expect to administer?

Digoxin

The nurse is providing discharge education to the patient after being started on lisinopril. It is important to include which of the following is a common side effect of this medication and should be reported to your primary care provider?

Dry, nagging cough

A nurse is reinforcing teaching with an older adult client who has had a newly inserted permanent pacemaker. Which of the following manifestations should the nurse include in the teaching as a pacemaker malfunction that the client should report to the provider?

Fatigue

After hospitalization for a myocardial infarction, a patient is placed on a low-sodium diet. In discussing foods allowed on this diet, the nurse should inform the patient that this list includes which of the following

Fresh vegetables

A nurse is assisting with the plan of care for a client immediately following a cardiac catheterization with coronary angiography. An arterial closure device was used to close the access site. Which of the following interventions should the nurse recommend?

Have the client rest in bed for 2 hr

A nurse in a provider's office is collecting data from a client who reports dyspnea and fatigue. The nurse determines that the client also has tachycardia and edema. Which of the following disorders should the nurse suspect?

Heart failure

A patient with a deep vein thrombus asks the nurse whether the drug will dissolve the clot in her leg. The best response by the nurse is

Heparin prevents further growth of the clot or formation of new clots where the circulation is slowed

Evaluaton of an ECG responses to normal activity over a period of a day or two is perfomred with

Holter monitor

when administering spironolactone (Aldactone), the nurse monitors the client for which of the following electrolyte imbalances?

Hyperkalemia

A nurse is reinforcing teaching with a client who is scheduled for an exercise ECG stress test. Which of the following comments should indicate to the nurse that the client requires further instructions?

I will expect to feel chest pain during this test

A nurse is reinforcing discharge teaching for a client who will be taking warfarin (Coumadin) at home. Which of the following statements indicates that the client understands the effects of this medication?

I'll use my electric razor for shaving.

A nurse is reinforcing teaching for a client who has a new prescription for sublingual nitroglycerin. Which of the following instructions should the nurse include?

If your mouth is dry, take a sip of water before putting the tablet under your tongue."

discharge teaching for a patient with heart failure should include which of the following instructions?

Inform the physician if you gain more than 3 to 5lbs in one week

Beta-adrenergic blockers lower BP by which of the following?

Inhibiting cardiac stimulation

A nurse is preparing to administer heparin subcutaneously to a client. Which of the following is an appropriate action by the nurse?

Inject the medication into the abdomen 1-2 inches from the umbilicus

A nurse is assisting with the plan of care for a client who has a new deep-vein thrombosis (DVT) in his leg. Which of the following interventions should the nurse include in the plan?

Keep the client's affected leg elevated.

The nurse understands that pain associated with coronary artery disease occurs from which of the following?

Lack of sufficient oxygen to the myocardium

Which of the following chambers of the heart is largest, has the highest pressure, and has the thickest myocardium

Left ventricle

A nurse is reinforcing teaching with a client who has a new prescription for sublingual nitroglycerine. Which of the following instructions should the nurse include in the teaching?

Lie down upon onset of chest pain

A nurse is caring for a client who recently had surgery for insertion of a permanent pacemaker. Which of the following orders should the nurse question?

MRI of the chest

The nurse caring for a patient immediately following a transesophageal echocardiogram (TEE) should consider which of these actions the highest priority?

Maintain NPO until gag reflex has returned

A nurse is measuring a client for knee-high antiembolic stockings to help prevent venous stasis. Which of the following actions should the nurse take?

Measure from the client's heel to the popliteal space.

A nurse is assisting in the plan of care for a client who is receiving digoxin to treat heart failure. Which of the following actions should the nurse plan to take?

Monitor the client for nausea, vomiting, and anorexia

A nurse is collecting data from a client who has heart failure and takes chlorothiazide. Which of the following findings should the nurse identify as indicating hypokalemia?

Muscle weakness

A nurse is assisting in the plan of care for a client who has a suspected myocardial infarction. Which of the following medication should the nurse plan to administer first?

Oxygen

The segment measured from the beginning of the P wave to the beginning of the QRS is referred to as the __________ interval.

PR interval

A nurse in an outpatient clinic is collecting data from a client who tells the nurse, "I have pain in my legs when I begin to walk, but the pain stops when I stop walking." Which of the following conditions should the nurse suspect?

Peripheral vascular problems in both legs

Which of the following statements by a patient demonstrates to the nurse that the patient understands when to replace nitroglycerin tablets

Pills no longer cause tingling sensation under tongue.

A nurse is caring for a client who has thrombophlebitis and is receiving a continuous heparin infusion. Which of the following medications should the nurse have available to reverse heparin's effects?

Protamine sulfate

A nurse is caring for a client who has a new prescription for warfarin. The nurse should use the results of which of the following diagnostic tests to monitor the effect of this therapy?

Prothrombin time (PT)

The ventricles contract when the electrical impulse reaches the:

Purkinje fibers

Which of the following waveforms represents the ventricular contraction on the EKG?

QRS complex

A nurse is reinforcing teaching with a newly licensed nurse about reading a client's ECG tracing. The nurse should include in the teaching that which of the following ECG components represent the time it takes for ventricular depolarization and repolarization?

QT interval

A nurse is caring for a client who has a serum potassium level of 5.5 mEq/L. The provider prescribes polystyrene sulfonate. Which of the following ECG results should indicate to the nurse that the medication has been effective?

Reduction of T wave amplitude

A nurse is preparing to administer digoxin to a client who has heart failure. For which of the following findings should the nurse withhold the medication and report to the provider?

Report of blurred vision

Which of the following diagnostic procedures does the nurse understand measures the pressures in the cardiac chambers?

Right side cardiac catheterization

When auscultating the heart, the nurse knows that which heart sound corresponds with the closing of the atrioventricular valves.

S1

A patient with chest pain that is unrelieve by nitroglycerin is admitted to the coronary care unit for observation and diagnosis. While the patient is on telemetry, the nurse would be most concerned with the prescence of

ST segment elevation

The patient is being discharged home on furosemide (Lasix). The nurse evaluates that the patient correctly understands the discharge instructions when they state they which of the following lab results will be monitored as ordered?

Serum potassium

Before a cardiac catheterization, it is essential that the nurse ask a patient if the patient is allergic to which of the following?

Shellfish

A nurse is collecting data from a client who has left-sided heart failure. Which of the following findings should the nurse expect?

Shortness of breath while lying down

The nurse understands that rhythms arising from the primary pacing node of the heart are referred to as which of the following?

Sinus rhythms

A nurse is collecting data from a client who is to start taking digoxin for heart failure. The nurse should instruct the client to avoid taking which of the following herbal supplements?

St. John's wort

The nurse is monitoring a client following a cardioversion. Which observation should be the highest of priority to the nurse?

Status of airway

A patient is being taught the action of digoxin, which is has inotropic effects. The nurse defines an inotropic agent as a medication that has which of the following actions?

Strengthens heart contraction

Which of the following waveforms represents the resting state of the ventricle on the EKG?

T wave

The coronary arteries are embedded within the epicardium

TRUE

A nurse is assisting with the care of a client who was admitted to the telemetry unit after he experienced chest pain, dyspnea and diaphoresis. Which of the following ECG findings is a manifestation of acute myocardial infarction?

The ST segment is above the isoelectric line.

A nurse is reinforcing teaching with an older adult client who has been newly diagnosed with a heart murmur. Which of the following statements should the nurse make?

This indicates turbulent blood flow through a valve.

Stimulation of the sympathetic nervous system results in all of the follow expect

Vasodilation

The heart receives blood returning from the body through which of the following?

Vena Cava

A nurse is collecting data about a client's cardiac functioning. The nurse auscultates an S3 sound. Which of the following causes should the nurse suspect?

Ventricular gallop

A nurse is caring for a client who is receiving warfarin therapy to prevent a deep vein thrombosis. Which of the following medications should the nurse have available in the event of an overdose?

Vitamin K

A nurse is collecting data from a client who is taking warfarin and has an elevated PT/INR. Which of the following medications should the nurse anticipate administering?

Vitamin K

A nurse is reinforcing teaching about warfarin with a client who has a new onset of atrial fibrillation. Which of the following statements should the nurse include in the teaching?

Warfarin helps prevent strokes in clients who have atrial fibrillation

A nurse is reinforcing teaching for a client who has a new prescription for warfarin. Which of the following information should the nurse include?

a. The client should use an electric razor while on this medication

A nurse is collecting data from an older adult client who has been taking digoxin for the past several months. For which of the following manifestations of digoxin toxicity should the nurse monitor?

anorexia

The nurse is caring for patient in ventricular tachycardia who is hemodynamically stable. Which of the following is the initial treatment for this dysrhythmia?

antiarrhythmic IV such as amiodarone

After the insertion of a intracoronary stent, the nurse will provide discharge education on what newly prescribed medication?

antiplatelet such as clopidogrel

Beta-blockers are used with caution in patients with:

asthma

during a cardioversion, a shock that is delivered during ventricular relaxation (T wave) can initiate:

atrial fibrillation

A patient with a sinus node dysfunction has a permanent pacemaker inserted. Before discharge, the nurse teaches the patient to

avoid high voltage electrical generators

The diagnostic lab test that relates closely and shows higher results for increased severity in heart failure patients is:

b-type natriuretic peptide (BNP)

Cardiac output is best defined as the amount of ___________________________.

blood ejected by the heart each minute.

A nurse is collecting data about a client's circulatory system. Which of the following pulse sites should the nurse avoid checking bilaterally at the same time?

carotid

The first branches of the systemic circulation are the:

coronary arteries

The process in which the cardiac cell becomes stimulated and the cell loses it's internal negativity is referred to as

depolarization

An abnormal accumulation of fluid in a tissue is referred to as

edema

The nurse understands one of the priorities of patients with atrial fibrillation is anticoagulants because they are at highest risk for:

embolization

Following a transesophageal echocardiogram, it is important to monitor all of the following except?

groin site

When administering nitrates for angina, the nurse monitors the client for which common adverse reaction?

headache

Teaching to include dietary sources of potassium is indicated for the hypertensive patient taking

hydrochlorothiazide

Which electrolyte imbalance would the patient taking a loop or thiazide diuretic most likely develop?

hypokalemia

A patient on the cardiac telemetry unit goes unresponsive and is noted to be in ventricular fibrillation on the monitor. Following the intimation of the emergency call system, the next priority for the nurse is to

initiate CPR

Which structure of the heart receives blood saturated with oxygen from the pulmonary veins?

left atrium

A ___________ is the sound produced by turbulent blood flow across the valves creating a "whooshing" sound.

murmur

A patient asks the nurse what a diagnosis of heart failure means. Which of the following is the nurse's best response

our heart is no longer pumping as efficiently as it once did.

Before starting a female patient on an ACE inhibitor, what should the patient be assessed for

positive pregnancy test

You receive a critical PTT lab results on your patient receiving heparin of 156 seconds. The nurse calls to notify the provider and should anticipate receiving orders for the heparin's antidote which is:

protamine sulfate

During the repair of an abdominal aneurysm, the aorta is clamped for a period of time. This poses a risk for:

renal failure

African Americans develop hypertension at a younger age and an increased mortality rate related to hypertension than Caucasians.

true

Parasympathetic nervous system stimulation results in slowing of the heart rate, slowing of conduction through the AV node, and decreased strength of contractility.

true

Which of the following prevents the backflow of blood into veins?

valves

Nurses should teach patients with PVD to stop smoking because smoking causes

vasoconstriction

The internal cardiac defibrillator (ICD/AICD) is used to treat patients with life-threatening recurrent:

ventricular arrhythmias

The nurse suspects a client is experiencing digoxin toxicity. Which of the following symptoms would the client have reported to make the nurse suspicious of toxic reaction?

visual disturbance such as a halo

To monitor the severity of a patient's heart failure, which of the following information is the most appropriate for the nurse to gather daily?

weight