practice questions

A. "The left atrium receives oxygenated blood from the lungs." B. "The left ventricle pumps blood into the body's tissues." C. "The right atrium receives deoxygenated blood from the body tissues.": The heart consists of four chambers: two atria and two ventricles. The right and left chambers are separated down the middle of the heart by the septum. The right atrium receives deoxygenated blood from the body. That blood moves into the right ventricle, which pumps it to the lungs with low resistance. The left atrium then receives the oxygenated blood from the lungs, and that blood moves to the left ventricle. The left ventricle, which is the most muscular chamber, pumps oxygen-rich blood into the systemic circulation.

A client with left-sided congestive heart failure (CHF) asks the nurse about the condition. Which responses by the nurse provides the client with an understanding of the heart function? Select all that apply. A. "The left atrium receives oxygenated blood from the lungs." B. "The left ventricle pumps blood into the body's tissues." C. "The right atrium receives deoxygenated blood from the body tissues." D. "The heart consists of a septum, five chambers, and four valves." E. "The blood flows to the left ventricle, which pumps blood into the lungs."

A) Hand tremors: Identify hand tremors as a manifestation of hyperthyroidism that can result from thyroid hormone replacement therapy. Report the finding to the provider due to possible need for a decrease in dosage of medication.

A nurse in a provider's office is assessing a client who recently began taking levothyroxine to treat hypothyroidism. Which of the following should indicate to the nurse that the client might need a decrease in the dosage of the medication? A. Hand tremors B. Bradycardia C. Pallor D. Slow speech

B) Decreased thyroid-stimulating hormone (TSH): In the presence of Graves' disease low TSH is an expected finding. The pituitary gland decreases the production of TSH when thyroid hormone levels is elevated.

A nurse in a provider's office is reviewing the health record of a client who is being evaluated for Grave's disease. The nurse should identify that which of the following laboratory results is an expected finding? A. Decreased thyrotropin receptor antibodies B. Decreased thyroid-stimulating hormone (TSH) C. Decreased free thyroxine index D. Decreased triiodothyronine

A) Diaphoresis: A client who has a blood glucose level below 70 mg/dL will exhibit manifestations of hypoglycemia. Expected findings associated with hypoglycemia include weakness, hunger, diaphoresis, nausea, shakiness and confusion.

A nurse is caring for a client who has type 1 diabetes mellitus and a capillary blood glucose reading of 48mg/dl. Which of the following findings should the nurse expect? A) Diaphoresis B) Decreased skin turgor C) Ketonuria D) Kussmaul respirations

A) Morning: The client should take furosemide, a diuretic, in the morning so that the peak action and duration of the medication occurs during waking hours.

A nurse is providing discharge instructions for a client who has a prescription for furosemide 40mg PO daily. The nurse should instruct the client to take this medication at which of the following times of day: A) Morning B) immediately after lunch C) Immediately before dinner D) Bedtime

B) I will report any changes in heart rate to my provider: B Teach the client to monitor their heart rate and report any changes to the provider

A nurse is providing teaching for a client who has a new diagnosis of hypertension and a new prescription for spironolactone 25mg/day. Which of the following statement by the client indicates an understanding of the teaching. A) I should eat a lot of fruits and vegetable, especially bananas and potatoes B) I will report any changes in heart rate to my provider C) I should replace my salt shaker on my table with salt substitute. D) I will decrease my dose of this medication when I no longer have headaches and facial redness

B. Medication should not be discontinued without the advice of the provider C. Follow-up blood TSH levels should be obtained D. Take the medication on an empty stomach: B- the provider carefully titrates the dosage of this medication. It should be increased slowly until the client reaches a euthyroid state. C- blood TSH levels are used to monitor the effectiveness of the medication. D- the medication should be taken on an empty stomach to promote absorption.

A nurse is reinforcing teaching with a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Weight gain is expected while taking this medication B. Medication should not be discontinued without the advice of the provider C. Follow-up blood TSH levels should be obtained D. Take the medication on an empty stomach E. Use fiber laxatives for constipation

D) Bicarbonate level 12 mEq/L: A client who has diabetic ketoacidosis should have a bicarbonate level that is <15 mEq/L due to the increased production of counter-regulatory hormones that lead to metabolic acidosis.

A nurse is reviewing the laboratory values of a client who has diabetic ketoacidosis. Which of the following laboratory values is consistent with diabetic ketoacidosis? A. Blood glucose 30 mg/dL B. Negative urine ketones C. Blood pH 7.38 D. Bicarbonate level 12 mEq/L

B) Eating popcorn at the movie theater D) Consuming 36oz of beer daily: B Popcorn at the movie theater contains a large quantity of sodium and fat, which increases risk for hypertension. D: Consuming more than 24oz of beer per day for a male and 12oz of beer for a female client increases the risk for hypertension

A nurse is screening a client for hypertension. The nurse should identify which of the following actions by the client increase the risk for hypertension. (Select all that apply) A) Drinking 8oz of nonfat milk daily B) Eating popcorn at the movie theater C) Walking 1 mile daily at 12min/mile pace D) Consuming 36oz of beer daily E) Getting a massage once a week

d. "I will call my doctor if my pulse rate is less than 60"

A nurse is teaching a client who has angina about a new prescription for metoprolol. Which of the following statements by the client indicates understanding of the teaching? a. "I should place the tablet under my tongue" b. "I should have my clotting time checked weekly" c. "I will report any ringing my ears" d. "I will call my doctor if my pulse rate is less than 60"

C) "I'll be sure to wear cotton socks every day.": The nurse should instruct the client to wear clean cotton socks every day to absorb moisture and reduce the risk of infection.

A nurse is teaching a client who has type 2 diabetes mellitus about foot care. Which of the following statements by the client indicates an understanding of the teaching? A. "I will apply moisturizer between my toes." B. "I will soak my feet daily." C. "I'll be sure to wear cotton socks every day." D. "I'll use a heating pad to warm my feet."

b. Call 911 immediately

A patient calls the cardiac clinic you are working at and reports that they have taken 3 sublingual doses of Nitroglycerin as prescribed for chest pain, but the chest pain is not relieved. What do you educate the patient to do next? a. Take another dose of Nitroglycerin in 5 minutes. b. Call 911 immediately c. Lie down and rest to see if that helps with relieving the pain d. Take two doses of Nitroglycerin in 5 minutes

B. Assist patient to walk several times To avoid blockage of the graft or stent, the patient should walk several times on postoperative day one and subsequent days. Having the patient's knees flexed for sitting in a chair or in bed increase the risk of venous thrombosis and may place stress on the suture lines.

A patient with critical limb ischemia had peripheral artery bypass surgery to improve circulation. What nursing care should be provided on the first postoperative day? A. Keep patient on bed rest B. Assist patient to walk several times C. Have patient sit in the chair several times D. Place patient on their side with knees flexed

B. Patient says muscle leg pain occurs with continued exercise.: Intermittent claudication is an ischemic muscle ache or pain that is precipitated by a consistent level of exercise, resolves within 10 minutes or less with rest, and is reproducible.

A patient with peripheral artery disease is seen in the primary care clinic. Which symptom reported by the patient would indicate to the nurse that the patient is experiencing intermittent claudication? A. Patient reports chest pain with strenuous activity B. Patient says muscle leg pain occurs with continued exercise C. Patient has numbness and tingling all over their toes and both feet D. Patient states the feet become red when they are in a dependent position

A. Weight loss B. Dry oral mucosa E. Decreased venous pressure: A patient with fluid volume deficit would NOT have a full bounding pulse or distended neck veins. That would be indicative of fluid volume excess.

An older woman is admitted to the unit with GI bleeding and Fluid Volume Deficit. Clinical manifestations of this are...? (select all that apply) A. Weight loss B. Dry oral mucosa C. Full bounding pulse D. Distended neck veins E. Decreased venous pressure

A) Osmosis: Osmosis is the movement of water between 2 compartments separated by a semipermeable membrane. Water moves through the membrane from an area of low solute concentration to an area of high solute concentration.

During administration of a hypertonic IV solution, the mechanism involved in equalizing the fluid concentration between ECF and the cell is? A. Osmosis B. Diffusion C. Active transport D. facilitated diffusion

A. 3 to 4 minutes: Nitroglycerin given sublingually alleviates angina pain within 3 minutes.

The nurse advises a patient that sublingual nitroglycerin should alleviate angina pain within: A. 3 to 4 minutes. B. 10 to 15 minutes. C. 30 minutes. D. 60 minutes.

C. Cerebral or pulmonary emboli Warfarin is an anticoagulant that is used to prevent thrombi from forming on the walls of the atria during atrial fibrillation. When the medication is terminated, thrombi could again form. If one or more thrombi detach from the atrial wall, they could travel as cerebral emboli from the left atrium or pulmonary emboli from the right atrium.

The nurse is caring for a patient who has been receiving warfarin (Coumadin) and diltiazem (Cardizem) as treatment for atrial fibrillation. Because the warfarin has been discontinued before surgery, the nurse should diligently assess the patient for which complication early in the postoperative period until the medication is resumed? A. Decreased cardiac output B. Increased blood pressure C. Cerebral or pulmonary emboli D. Excessive bleeding from incision or IV sites

B. Hyperlipidemia and obesity: Increased exercise without and increase in caloric intake will result in weight loss, reducing the risk associated with obesity. Exercise increases lipid metabolism and increases HDL, thus reducing CAD risk. Exercise may indirectly reduce the risk of CAD by controlling hypertension, promoting glucose metabolism in diabetes, and reducing stress.

The nurse is encouraging a sedentary patient with major risks for CAD to perform physical exercises on a regular basis. In addition to decreasing the risk factor of physical inactivity, the nurse tells the parent that exercise will directly contribute to reducing which risk factors? A. Diabetes and hypertension B. Hyperlipidemia and obesity C. Increased serum lipids and stressful lifestyle D. Hypertension and increased serum homocysteine

D. Ventricular irritability: Digoxin toxicity causes a malfunction in the sodium-potassium-pump of the cardiac cell, causing ventricular irritability and ectopic beats.

The nurse monitors the cardiac rhythm of a client with heart failure taking digoxin. Which common rhythm characteristic first alerts the nurse to digoxin toxicity? A. Tachycardia B. Premature atrial contractions C. Bradycardia D. Ventricular irritability

A. Daily ibuprofen use C. Hyperthyroidism D. Daily metformin use E. Anemia: Chronic congestive heart failure can easily exacerbate and decompensate. Exacerbations arise from infections, arrhythmias, hypertension, anemia, hyperthyroidism, inadequate diet, and use of nonsteroidal anti-inflammatory drugs. Diabetes is a known risk factor for heart failure.

The nurse questions a client with acute exacerbation of heart failure about recent medical history and medication usage. The nurse recognizes which medications or conditions may contribute to this client's exacerbation of heart failure? A. Daily ibuprofen use B. Irritable bowel syndrome C. Hyperthyroidism D. Daily metformin use E. Anemia

C) Lactated ringers: A patient with fluid volume deficit needs replacement fluid for fluid volume. The isotonic solution Lactated ringers would do this to increase fluid volume

The typical fluid replacement for fluid volume deficit is...? A. Dextran B. 0.45 NS C. Lactated ringers D. 5% Dextrose in 0.45% NS

B. The therapeutic lifestyle changes diet includes recommendations for all people, not just those with risk factors, to decrease the risk for CAD.

To which patient should the nurse teach the therapeutic lifestyle changes diet to reduce the risk of CAD? A. Patients who have had an MI B. All patients to reduce CAD risk C. Those with 2 or more risk factors for CAD D. Those with a cholesterol level > 200 mg/dl (5.2 mmol/L)

B. Endothelial changes may be caused by chemical irritants, such as hyperlipidemia or by tobacco use. B. The etiology of CAD includes atherosclerosis as the major cause. The pathophysiology of atherosclerosis development and resulting at hero as is related to endothelial injury and inflammation, which can be the result of tobacco use, hyperlipidemia, hypertension, toxins, diabetes, high homocysteine levels, and infections causing a local inflammatory response in the inner lining of the vessel wall.

What accurately describes the pathophysiology of CAD? A. Partial or total occlusion of the coronary artery occurs during the stage of raised fibrous plaque. B. Endothelial changes may be caused by chemical irritants, such as hyperlipidemia or by tobacco use. C. Collateral circulation in the coronary circulation is more likely to be present in the young patient with CAD. D. The leading theory of atherogenesis proposes that infection and fatty dietary intake are the basic underlying causes of atherosclerosis.

B. A 70 year old white male who lives a sedentary lifestyle and has a history of HTN. C. A 40 year old hispanic female who has diabetes and whose father had a stroke. D. A 53 year old white male who works a stressful job and smokes a pack of cigarettes per week: B is correct because HTN and living a sedentary lifestyle are two major risk factors for CAD. HTN causes damage to arterial walls over time. This person is also a risk because he is an older white male. C is correct because she has a history of diabetes (think sugar in the straws, it gets harder to get things through over time!) as well as having a family history of a cardiovascular condition. D is correct because those with increased stressors (such as his job) and his history of smoking as well as being an older white male, which are all risk factors for CAD.

Which of the following individuals would be considered a high risk for developing CAD? (Select all that apply) A. A 60 year old black female who exercises 2x a week with a BMI of 23. B. A 70 year old white male who lives a sedentary lifestyle and has a history of HTN. C. A 40 year old hispanic female who has diabetes and whose father had a stroke. D. A 53 year old white male who works a stressful job and smokes a pack of cigarettes per week. E. A 67 year old asian female who has a history of depression and eats high carb meals.

C- Troponin

Which test/lab would be the best when diagnosing an MI? A- LDH B- B- CK-MB C- Troponin D- AST E- Myoglobin

E - Contact the patient's HCP to report chest pain and to order an ECG to be performed: priority is to the patient's chest pain due to previous Hx and presence of other underlying symptoms such as fatigue.

Your patient is a 55 year old white male that has been admitted to the hospital 2 days ago for sudden onset of chest pain. He has since been diagnosed with ACS, HTN, CAD, and a cardiac dysrhythmia. During physical therapy the patient began to feel increased fatigue and SOB, and complains of 2/10 pain in his chest. The patient is scheduled for a cardiac stress test later today. What is the nurse's priority action? A - Administer one sublingual dose of nitroglycerine due to the patient's onset of chest pain B - Contact the patient's HCP to report chest pain and to delay the stress test C - Administer morphine to the patient for the onset of chest pain D - Assess lung sounds on the patient E - Contact the patient's HCP to report chest pain and to order an ECG to be performed