NSG 420 Exam I PassP
The most common site of aneurysm formation is in the: a) Abdominal aorta, just below the renal arteries b) Ascending aorta, around the aortic arch c) Descending aorta, beyond the subclavian arteries d) Aortic arch, around the ascending and descending aorta
a) Abdominal aorta, just below the renal arteries
A client's electrocardiogram (EKG) tracing shows normal sinus rhythm followed by three premature ventricular contractions (PVCs) and a return to normal sinus rhythm. What is the priority action of the nurse? a) Assess the client's apical-radial pulse rate b) Assess the client's BP c) Administer oxygen d) Administer amiodarone
a) Assess the client's apical-radial pulse rate
Which condition most commonly results in coronary artery disease (CAD)? a) Atherosclerosis b) Diabetes mellitus c) Myocardial infarction d) Renal failure
a) Atherosclerosis
The nurse obtains a pulse rate of 116 (bpm) before administering digoxin to a client with heart failure who has been receiving digoxin for 2 weeks. What should the nurse do next? a) Evaluate the client's cardiac rhythm b) Administer the digoxin c) Withhold the digoxin and take the pulse again in 15 minutes d) Assess the client's respiratory rate
a) Evaluate the client's cardiac rhythm
A client is prescribed adenosine for treatment of supraventricular tachycardia (SVT). When should the nurse assess the client for a response to the dose of adenosine? a) After 15-20 minutes b) After 1-2 minutes c) After 30 minutes d) After 5-10 minutes
b) After 1-2 minutes
A nurse is checking laboratory values on a client who has crackles in the lower lobes, 2+ pitting edema, and dyspnea with minimal exertion. Which laboratory value does the nurse expect to be abnormal? a) Potassium b) B-type natriuretic peptide (BNP) c) C-reactive protein (CRP) d) Platelet count
b) B-type natriuretic peptide (BNP)
A client is discharged after an aortic aneurysm repair with a synthetic graft to replace part of the aorta. The nurse should instruct the client to notify the health care provider (HCP) before having which procedure? a) Blood drawn b) an IV line inserted c) Tooth extraction d) X-ray exam
c) Tooth extraction
Which of the following assessment findings are indicative of digoxin toxicity? Select all that apply: a) Dizziness b) Abdominal discomfort c) Loss of appetite d) Yellow-green halos
All are indicative of digoxin toxicity a) Dizziness b) Abdominal discomfort c) Loss of appetite d) Yellow-green halos
Which client statement should the nurse evaluate as indicating the client's correct understanding of the causes of coronary artery disease (CAD)? a) "The leading cause of CAD is atherosclerosis" b) "There are many causes of CAD" c) "Cigarette smoking is the most common cause of CAD" d) "I will need to ask my HCP about the causes of CAD"
a) "The leading cause of CAD is atherosclerosis"
The nurse is caring for a client with peripheral artery disease (PAD) who has just returned from having a percutaneous transluminal balloon angioplasty. Which finding requires immediate action from the nurse? a) A change in the intensity of the pulse from baseline b) 2/10 pain at catheterization site c) Shiny skin and a hairless appearance on the affected leg d) Presence of an ulcer on the limb of the catheterization site
a) A change in the intensity of the pulse from baseline May indicate an arterial closure
An obese white male client, age 49, is diagnosed with hypercholesterolemia. The health care provider orders a low-fat, low-cholesterol, low-calorie diet to reduce blood lipid levels and promote weight loss. This diet is crucial to the client's well-being because race, sex, and age increase risk for coronary artery disease (CAD). To determine whether the client has other major risk factors for CAD, the nurse should assess for: a) A history of diabetes mellitus b) Elevated high-density lipoprotein levels c) A history of ischemic heart disease d) Alcohol use disorder
a) A history of diabetes mellitus Diabetes mellitus, smoking, and hypertension are other major risk factors for CAD
The emergency department protocol provides for administration of alteplase (tPA) for clients with confirmed acute coronary syndrome (ACS). The nurse contacts the health care provider to clarify the order for the client with which health history? a) A-fib and a mild stroke one month ago b) MI one year ago with angioplasty c) HT, dyslipidemia, and PAD d) No history of CV disease
a) A-fib and a mild stroke one month ago tPA contraindicated for recent stroke patients- risk of bleeding
The nurse is instructing a client who is at risk for peripheral artery disease how to use knee-length elastic stockings (support hose). What instruction(s) should the nurse include in the teaching plan? Select all that apply. a) Apply the elastic stockings before getting out of bed b) Remove if swelling occurs c) Remove once every 8 hrs, elevate the feet, and reapply in 15 minutes d) Once the stockings have been pulled over the calf, roll the remaining stocking down to make a cuff e) Keep the stockings in place for 48 hours, and reapply using a clean pair
a) Apply the elastic stockings before getting out of bed c) Remove once every 8 hrs, elevate the feet, and reapply in 15 minutes
A client in the emergency department has symptoms of anxiety, a "racing heart," and dyspnea. The cardiac monitor shows sinus tachycardia with a heart rate of 122. What is the appropriate action of the nurse? a) Assess the client's vital signs and O2 sat. b) Administer a beta blocker to slow the HR c) Administer diazepam 2.5 mg IV push for anxiety d) Obtain a stat 12-lead EKG and troponin level
a) Assess the client's vital signs and O2 sat.
The nurse is developing a care plan with an older adult with hypertension and is instructing the client that hypertension can be a "silent killer." The nurse should instruct the client to report signs of which disease that is often a result of undetected high blood pressure? a) Cerebrovascular accidents b) Liver disease c) Myocardial infarction d) Pulmonary disease
a) Cerebrovascular accidents
The nurse performs an assessment on a newly-admitted client with a diagnosis of left-sided heart failure. What data should the nurse document to support this diagnosis? Select all that apply. a) Chronic cough b) Lower extremity edema c) Chest pain d) Rapid weight gain e) Flushed face f) Rapid pulse
a) Chronic cough b) Lower extremity edema d) Rapid weight gain f) Rapid pulse
The nurse is conducting a focused assessment for a client with left-sided heart failure. Which finding(s) would be concerning? Select all that apply. a) Dyspnea b) Jugular vein distention c) Crackles d) Right upper quadrant pain e) Oliguria f) Decreased O2 saturation
a) Dyspnea c) Crackles e) Oliguria f) Decreased O2 saturation
The nurse is observing the electrocardiogram (EKG) rhythm of a client with a permanent pacemaker and determines there is not a QRS complex that follows the pacemaker spike. Which follow-up action is most appropriate? a) Report to the HCP that the pacemaker is failing to capture b) Check the client's electrolyte results from the daily lab work for any changes c) Ask the client to take deep breaths and cough d) Place the client on the right side and elevate the head of the bed 30 degrees
a) Report to the HCP that the pacemaker is failing to capture
A nurse is evaluating a client who had a myocardial infarction (MI) 7 days earlier. Which outcome indicates that the client is responding favorably to therapy? The client... a) demonstrates ability to tolerate more activity w/out chest pain b) exhibits a HR within normal limits c) requests information regarding smoking cessation d) is able to verbalize the action of all prescribed meds
a) demonstrates ability to tolerate more activity w/out chest pain
A client takes hydrochlorothiazide (HCTZ) for treatment of hypertension. The nurse should instruct the client to report which effect(s)? Select all that apply. a) Muscle twitching b) Abdominal cramping c) Diarrhea d) Confusion e) Lethargy f) Muscle weakness
b) Abdominal cramping e) Lethargy f) Muscle weakness
A client is admitted to the telemetry unit following a ST segment-elevation myocardial infarction (STEMI). The electrocardiogram (EKG) tracing shows a run of sustained ventricular tachycardia. What is the first action that the nurse should take? a) Defibrillate the client b) Assess the client's airway, breathing, pulses, and LOC c) Begin CPR d) Apply the external pacemaker
b) Assess the client's airway, breathing, pulses, and LOC
A nurse just received a shift report for a group of clients on the telemetry unit. Which client should the nurse assess first? a) the client with a history of cardioversion for sustained ventricular tachycardia 2 days ago b) the client admitted with first-degree atrioventricular (AV) block whose cardiac monitor now reveals type II second-degree AV block c) the client with a history of heart failure who has bibasilar crackles and pitting edema in both feet d) the client admitted for unstable angina who underwent percutaneous coronary intervention (PCI) with stenting yesterday
b) the client admitted with first-degree atrioventricular (AV) block whose cardiac monitor now reveals type II second-degree AV block
A client has peripheral artery disease of both lower extremities. The client tells the nurse, "I've really tried to manage my condition well." Which example indicates the client is using appropriate care management strategies? The client... a) rests with legs elevated above heart level b) walks slowly but steadily for 30 minutes twice daily c) limits activity to walking around the house d) wears anti-embolism stockings at all times when out of bed
b) walks slowly but steadily for 30 minutes twice daily
A client is receiving cilostazol for peripheral artery disease causing intermittent claudication. Which statement by the client indicates to the nurse that this medication is effective? a) "I am having fewer aches and pains" b) "I no longer have headaches" c) "I am able to walk further w/out leg pain" d) "My toes are turning greyish-black in color"
c) "I am able to walk further w/out leg pain"
The nurse is caring for a client with peripheral artery disease who has recently been prescribed clopidogrel. Which statement by the client indicates that the nurse should continue giving information to the client about this medication? a) "I shouldn't be surprised if I bruise easier or my gums bleed a little when brushing my teeth." b) "It doesn't really matter if I take this medicine with or without food, whatever works best for my stomach." c) "I should stop taking my medicine if it makes me feel weak and dizzy." d) "The health care provider prescribed this medicine to make my platelets less likely to stick together and help prevent clots from forming."
c) "I should stop taking my medicine if it makes me feel weak and dizzy."
A client presents with acute onset chest pain rated as 7/10 radiating to left arm and mid-scapular region, blood pressure of 155/95 mm Hg, heart rate of 98 beats/min, respiratory rate of 22 breaths/min, and an oxygen saturation of 94%. What is the nurse's priority intervention? a) Establish IV access b) Apply supplemental O2 c) Administer sublingual nitroglycerin d) Conduct a full CV assessment
c) Administer sublingual nitroglycerin
The nurse is assessing a client who has a history of peripheral artery disease. The nurse observes that the left great toe is black. The nurse determines that the black color is caused by which factor? a) Atrophy b) Contraction c) Gangrene d) Rubor
c) Gangrene
The nurse has received a change-of-shift report about clients. Which client should the nurse assess first? a) Patient with CHF who has right upper quadrant fullness b) Patient in A-fib with a HR of 90 bpm reporting a "fluttering" feeling c) Patient with PAD just returning from an angiogram d) Patient who had coronary artery bypass surgery 2 days ago and who reports having incisional pain of 3/10
c) Patient with PAD just returning from an angiogram Important to take a baseline assessment on patients returning from an angiogram
A health care provider has scheduled a client with mitral stenosis for mitral valve replacement. Which condition may arise as a complication of mitral stenosis? a) Left-sided HF b) Myocardial ischemia c) Pulmonary hypertension d) Left ventricular hypertrophy
c) Pulmonary hypertension Mitral stenosis, or severe narrowing of the mitral valve, impedes blood flow through the stenotic valve, increasing pressure in the left atrium and pulmonary circulation. These problems may lead to low cardiac output, pulmonary hypertension, edema, and right-sided (not left-sided) heart failure.
The nurse administers amiodarone to a client with an arrhythmia. Which finding indicates the drug is having the desired effect? a) The ventricular rate is increasing b) The absent pulse is now palpable c) The number of PVCs is decreasing d) The fine V-fib changes to coarse V-fib
c) The number of PVCs is decreasing
A client with peripheral artery disease has chronic, severe bilateral pretibial and ankle edema the client is on complete bed rest. To maintain skin integrity, what should the nurse do? a) Administer pain meds b) Encourage fluid intake of 3,000 mL daily c) Turn the client every 1-2 hrs d) Maintain hygiene
c) Turn the client every 1-2 hrs
The nurse is not able to palpate the left pedal pulses of a client with peripheral artery disease. What should the nurse do first? a) Auscultate the pulses with a stethoscope b) Call the HCP c) Use a Doppler ultrasound device d) Inspect the left lower extremity
c) Use a Doppler ultrasound device
When teaching a client with newly diagnosed hypertension about the pathophysiology of this disease, the nurse states that arterial baroreceptors, which monitor arterial pressure, are located in the carotid sinus. Which other area should the nurse mention as a site of arterial baroreceptors? a) brachial artery b) radial artery c) aorta d) right ventricular wall
c) aorta
The client with peripheral artery disease reports both legs hurt when walking. What should the nurse instruct the client to do? a) Avoid walking when the pain occurs b) Rest frequently with the legs elevated c) Wear support stockings d) Enroll in a supervised exercise training program
d) Enroll in a supervised exercise training program
The client with peripheral artery disease has been prescribed diltiazem. To determine the effectiveness of this medication, the nurse should evaluate the client for which intended outcome? a) Decreased anxiety b) Better sleep c) Cooler extremities d) Improved blood flow
d) Improved blood flow
The nurse is conducting a health assessment of an older adult. The client tells the nurse about cramping leg pain that occurs when walking for 15 minutes; the pain is relieved with rest. The lower extremities are slightly cool to touch, and pedal pulses are palpable +1. What should the nurse instruct the client to do? a) Increase time spent walking b) Add more potassium to their diet c) Perform leg circles and ankle pumps d) Seek consultation from the HCP
d) Seek consultation from the HCP Pt is displaying S/S of peripheral artery disease and requires follow-up
