UNIT3-NCLEX

Which electrolyte does not play a major role in cardiovascular performance? 1. Magnesium 2. Chloride 3. Potassium 4. Calcium

2. Chloride

During the first several hours after a cardiac catheterization, it would be most essential for nurse Cherry to... 1. Elevate clients bed at 45° 2. Instruct the client to cough and deep breathe every 2 hours 3. Frequently monitor client's apical pulse and blood pressure 4. Monitor clients temperature every hour

3. Blood pressure is monitored to detect hypotension which may indicate shock or hemorrhage. Apical pulse is taken to detect dysrhythmias related to cardiac irritability

A nurse is reviewing an ECG reading and notes an increased U wave with a depressed ST. The nurse interprets this reading as what electrolyte imbalance? 1. Hypocalcemia 2. Hypercalcemia 3. Hypokalemia 4. Hyperkalemia

3. Increased U waves with a depressed ST and flat, inverted T waves are normally found in hypokalemia.

a nurse on a cardiac unit is caring for a client who is on telemetry. the nurse recognizes the client's heart rate is 46/min and notifies the provider. the nurse should anticipate that which of the following management strategies will be used for this client? a. defibrillation b. pacemaker insertion c. synchronized cardioversion d. administration of IV lidocaine

B

a nurse is assessing a client who has a left-sided heart failure. which of the following manifestations should the nurse expect to find? A. increased abdominal girth B. weak peripheral pulses C. jugular venous neck distention D. dependent edema

B. weak peripheral pulses -weak peripheral pulses are related to decreased cardiac output resulting from left-sided heart failure

dietary modifications during the first 24 to 48 hours after myocardial infarction include: a. low intake of saturated fat b. high fruit and vegetable intake c. low energy intake d. high fluid intake

C

one controllable risk factor for coronary heart disease is a. genetics b.family history c. gender d. smoking

D. SMOKING

A nurse is providing preoperative teaching to a patient who will undergo cardiac catheterization. Which of the following statements indicates further teaching? 1. "I shouldn't take my digoxin before catheterization." 2. "I will be under general anesthesia." 3. "I shouldn't eat anything after midnight." 4. "Coughing is normal during the procedure."

2. Local anesthesia is given so that the patient may report chest pain or pressure on the site

A patient has been prescribed losartan (Cozaar) for hypertension. What patient teaching points will the nurse include about this drug? A. "Report onset of a cough or fever to health care provider." B. "Limit fluid intake to decrease urinary output." C. "Monitor blood pressure once a week." D. "Take the drug late in the day to prevent sleepiness."

A

a nurse is planning a presentation about hypertension for a community women's group. which of the following modifications should the nurse include? (select all that apply) A. limit alcohol intake B. regular exercise program C. decreased magnesium intake D. reduced potassium intake E. smoking cessation

A. limited alcohol intake B. regular exercise program E. smoking cessation clients who have hypertension should limit alcohol intake, a regular exercise program will help reduce blood pressure, low magnesium intake is associated with hypertension, low potassium intake is associated with hypertension, smoking exacerbates hypertension

A nurse is performing a cardiac assessment on a client. Identify the area the nurse should inspect when evaluating the point of maximal impulse.

APEX

A nurse is preparing to discharge a patient newly prescribed warfarin (Coumadin). While assessing the patient's knowledge of the drug, what would indicate that the patient needs further instruction concerning drug therapy? A. "I love to eat homegrown tomatoes in the summer." B. "I take aspirin for my arthritis." C. "I walk 2 miles a day." D. "I drink a glass of wine about once a week."

B

A nurse is completing discharge teaching to a client who has heart failure and is encouraged to increase potassium in his diet. Which of the following statements by the client indicates understanding of the teaching? A. "I will consume more white rice." B. "I will eat more baked potatoes." C. "I will drink more grape juice." D. "I will use more powdered cocoa mixes."

B. "I will eat more baked potatoes."

A nurse is providing teaching to a patient who has been experiencing unstable angina. What will the nurse's explanation of this condition include? A. A coronary vessel has become completely occluded and is unable to deliver blood to your heart. B. The pain is caused by a spasm of a blood vessel, not just from the vessel narrowing. C. There is serious narrowing of a coronary artery that is causing a reduction in oxygen to the heart. D. Your body's response to a lack of oxygen in the heart muscle is pain.

C

a blood pressure of 135/85 mm Hg would be classified as a. normal b. prehypertension c. stage 1 hypertension d. stage 2 hypertension

C

medical nutrition therapy for congestive heart failure usually includes a.increased fluid intake b. decreased protein intake c. sodium restriction d. potassium restriction

C

nutritional therapy for hypertension includes: a. high sodium intake b. low protein intake c. high calcium and potassium intake d. low fat and cholesterol intake

C

a nurse is caring for a client who presents to the emergency department with a blood pressure of 254/139 mm/Hg. the nurse recognizes that the client is in a hypertensive crisis. which of the following actions should the nurse take first? A. obtain blood samples for laboratory testing B. tell the client to report vision changes C. place the head of the bed at 45 degrees D. initiate an IV

C. place the head of the bed at 45 degrees the first action the nurse should take when using the airway, breathing, circulation approach to client care is to place the head of the client's bed at 45 degrees. this improves respiratory status and promotes venous return to reduce workload on the heart.

A 6-year-old child weighing 60 pounds has been prescribed oral digoxin (Lanoxin) 30 mcg/kg as a loading dose. How many milligram will she be given? A. 0.218 mg B. 0.418 mg C. 0.618 mg D. 0.818 mg

D

A patient is admitted to the intensive care unit in shock with hypotension. What is an appropriate nursing diagnosis for this patient? A. Impaired gas exchange B. Deficient fluid volume C. Risk for shock D. Ineffective peripheral tissue perfusion

D

according to the TLC (therapeutic lifestyle change) diet recommendations, most dietary fat should be: a. trans fat b. saturated fat c. polyunsaturated fat d. monounsaturated fat

D

a nurse in a cardiac unit is assisting with the admission of a client who is to undergo hemodynamic monitoring. which of the following actions should the nurse anticipate performing? a. administer large volumes of IV fluids b. assist with insertion of pulmonary artery catheter c. obtain doppler pulses of the extremities. d. gather supplies for insertion of a peripheral IV catheter

b a pulmonary artery catheter and pressure-monitoring system are inserted for hemodynamic monitoring of a client.

the nurse is caring for a pt in the ICU diagnosed with coronary artery disease (CAD). which of the following assessment data indicates the pt is experiencing a decrease in cardiac output? a. BP 108/60 mm Hg, ascites, and crackles b. disorientation, 20 mL of urine over the last 2 hrs c. reduced pulse pressure and heart murmur d. elevated jugular venous distention (JVD) and postural changes in BP

b assessment findings associated with reduced cardiac output include reduced pulse pressure, hypotension, tachycardia, reduced uring output, lethargy, or disorientation

The nurse is conducting a physical examination of a 7 yo girl prior to a cardiac catheterization. the nurse knows to pay particular attention to assessing the child's pedal pulses. how can the nurse best facilitate their assessment after the procedure? a. mark the location of the child's peripheral pulses with an indelible marker b. mark the child pedal pulses with an indelible marker, then document c. document the location and quality of the pedal pulses d. assess the location and quality of the child's peripheral pulses

b the nurse should pay particular attention to assessing the childs peripheral pulses, including pedal pulses. using an indelible pen, the nurse should mark the location of the childs pedal pulses as well as document the location and quality in the childs medical records.

a nurse is caring for a client following peripheral bypass graft of the left lower extremity. which of the following client findings pose an immediate concern? select all that apply a. trace of bloody drainage on dressing b. capillary refill of affected limb of 6 seconds c. mottled appearance of the limb d. throbbing pain of affected limb that is decreased following IV bolus analgesic e. pulse of 2+in the affected limb

b c capillary refill greater than 2 to 4 seconds is outside the expected reference range and should be reported to the provider mottled appeariance of the affected extremity is an unexpected finding and should be reported to the provider

a nurse is presenting a community education program on recommended lifestyle changes to prevent angina and myocardial infarction. which of the following changes should the nurse recommend be made first? a. diet modification b. relaxation exercises c. smoking cessation d. taking omega-3 capsules

c according to the airway, breathing, and circulation (ABC) priority-setting framework, adequate oxygenation is the priority. nicotine causes vasoconstriction, elevates blood pressure, and narrows coronary arteries. therefore, smoking cessation should be the first recommended lifestyle change.

which of the following terms is used to describe the ability of the heart to initiate an electrical impulse? a. excitability b. conductivity c. automaticity d. contractility

c automaticity is the ability of specialized electrical cells of the cardiac conduction system to inititiate an electrical impulse. contractility refers to the ability of the specialized electrical cells of the cardiac conduction system to contract in response to an electrical impulse. conductivity refers to the ability of the specialized electrical cells of the cardiac conduction system to transmit an electrical impulse from one cell to another. excitability refers to the ability of the specialized electrical cells of the cardiac conduction system to respond to an electrical impulse.

a nurse is caring for a client following an angioplasty that was inserted through the femoral artery. while turning the client, the nurse discovers blood underneath the client's lower back. the nurse should suspect: a. retroperitoneal bleeding b. cardiac tamponade c. bleeding from the incisional site d. heart failure

c bleeding is occuring from the incision site and then draining under the client. the nurse should assess the incision for hematoma, apply pressure, monitor the client, and notify the provider

for both outpatients and inpatients scheduled for diagnostic procedures of the cardiovascular system, the nurse performs a thorough initial assessment to establish accurate baseline data. which of the following data is necessary to collect if the patient is experiencing chest pain? a. pulse rate in upper extremities b. blood pressure in the left arm c. description of the pain d. sound of the apical pulses

c if the patient is experiencing chest pain, a history of its location, frequency, and duration is necessary, as is a description of the pain, if it radiates to a particular area, what precipitates its onset, and what brings relief. the nurse weighs the patient and measures vital signs. the nurse may measure BP in both arms and compare findings. the nurse assesses apical and radial pulses, noting rate, quality, and rhythm. the nurse also checks peripheral pulses in the lower extremities.

a nurse on a cardiac unit is reviewing the laboratory findings of a client who has a diagnosis of myocardial infarction (MI) and reports that his dyspnea began 2 weeks ago. which of the following cardiac enzymes would confirm the infarction occurred 14 days ago? a. CK-MB b. troponin I c. troponin T d. myoglobin

c the troponin T level will still be evident 14 to 21 days following an MI

a nurse is completing the admission assessment of a client who will undergo peripheral bypass graft surgery on the left leg. which of the following is an expected finding? a. rubor of the affected leg when elevated b. 3+ dorsal pedal pulse in left foot c. thin, peeling toenails of left foot d. report of intermittent claudication in the affected leg

d a client who has peripheral artery disease may report that numbness or burning pain in the extremity ceases with rest (intermittent claudication)

the nurse is observing a pt during an exercise stress test (bicycle). which of the following findings indicates a positive test and the need for further diagnostic testing. a. heart rate changes; 78 bpm to 112 bpm. b. BP changes; 148/80 mm Hg to 166/90 mm Hg c. dizziness and leg cramping d. ST-segment changes on the ECG

d during the test, the following are monitored: 2 or more ECG leads for heart rate, rhythm, and ischemic changes; BP; skin temp; physical appearance; perceived exertion; and symptoms, including chest pain, dyspnea, dizziness, leg cramping, and fatigue. the test is terminated when the target heart rate is achieved or if the pt experiences signs of myocardial ischemia. further diagnostic testing, such as cardiac catheterization, may be warranted if the pt develops chest pain, extreme fatigue, a decrease in BP or pulse rate, serious dysrhythmias or ST-segment changes on the ECG during the stress test. the other findings would not warrant the testing to be stopped.

the nurse is caring for a pt with diabetes who is scheduled for a cardiac catheterization. prior to the procedure, it is most important for the nurse to ask which of the following questions? a. "what was your morning blood sugar reading?" b. "are you having chest pain?" c. "when was the last time you ate or drank?" d. "are you allergic to shellfish?

d radiopaque contrast agents are used to visualize the coronary arteries. some contrast agents contain iodine, and the pt is assessed before the procedure for the previous reactions to contrast agents or allergies to iodine-containing substances (seafood). if the pt has a suspected or known allergy to the substance, antihistamines or methylprednisolone (solu medrol) may be administered before the procedure. although the other questions are impt to ask the pt, it is most impt to ascertain if the pt has an allergy to shellfish.

A nurse is reviewing a patient's chart. Which lab finding would reveal to the nurse that the patient has an MI? (Select all that apply) 1. CK-MB 2. CK-MM 3. CK-BB 4. Troponins 5. Creatinine

1, 4

Before undergoing cardiac catherization, it is important for the nurse to ask the patient if they have any allergies to: 1. Shellfish 2. Egg 3. Avocados 4. Peanuts

1. Allergy to shellfish indicates a risk to radioplaque dyes and iodine. An antihistamine and corticosteroid are given prior to the procedure.

A nurse is providing teaching to a patient scheduled for a stress test. The patient understands instruction when he states: 1. "I shouldn't use my Verapamil before the test." 2. "It is important that I have a large meal before the test." 3. "I'm allowed to drink my coffee on the day of the test." 4. "I'm going to take a long hot shower after the test."

1. Calcium channel blockers, like Verapamil should be withheld before the test to allow the heart rate to increase during the test

A client has been diagnosed with hypertension. The nurse priority nursing diagnosis would be: 1. Ineffective health maintenance 2. Impaired skin integrity 3. Deficient fluid volume 4. Pain

1. Managing hypertension is the priority for the client with hypertension. Clients with hypertension frequently do not experience pain, deficient volume, or impaired skin integrity. It is the asymptomatic nature of hypertension that makes it so difficult to treat.

An ER nurse is reviewing the charts of several patients. Which of the following patients would the nurse interpret as having an angina? 1. A 39-year-old female patient complaining of indigestion, discomfort, and states that she feels like she has to "catch her breath." 2. A 51-year-old male patient who states "It hurts when I breathe!" 3. A 42-year-old female patient complaining of pain traveling up and down her chest 4. A 27-year old male patient complaining of a dull ache on his chest, palpitations, and numbness in his fingertips

1. As opposed to men, women have atypical signs of an angina pectoris. Signs and symptoms include, dyspnea, stabbing chest pain, indigestion, fatigue, nausea and vomiting.

Which of the following is an expected outcome? During the second day of hospitalization of the client after a Myocardial Infarction. 1. Able to perform self-care activities without pain 2. Severe chest pain 3. Can recognize the risk factors of Myocardial Infarction 4. Can Participate in cardiac rehabilitation walking program

1. Able to perform self-care activities without pain By the 2nd day of hospitalization after suffering a Myocardial Infarction, Clients are able to perform care without chest pain

Mang Jose with rheumatoid arthritis states, "the only time I am without pain is when I lie in bed perfectly still". During the convalescent stage, the nurse in charge with Mang Jose should encourage: 1. Active joint flexion and extension 2. Continued immobility until pain subsides 3. Range of motion exercises twice daily 4. Flexion exercises three times daily

1. Active joint flexion and extension Active exercises, alternating extension, flexion, abduction, and adduction, mobilize exudates in the joints relieves stiffness and pain.

What would be the primary goal of therapy for a client with pulmonary edema and heart failure? 1. Enhance comfort 2. Increase cardiac output 3. Improve respiratory status 4. Peripheral edema decreased

2. Increase cardiac output The primary goal of therapy for the client with pulmonary edema or heart failure is increasing cardiac output. Pulmonary edema is an acute medical emergency requiring immediate intervention.

Nurse hazel receives emergency laboratory results for a client with chest pain and immediately informs the physician. An increased myoglobin level suggests which of the following? 1. Liver disease 2. Myocardial damage 3. Hypertension 4. Cancer

2. Myocardial damage Detection of myoglobin is a diagnostic tool to determine whether myocardial damage has occurred.

A nurse is interviewing a 56-year-old patient who states that after sleeping for two hours, he feels like he's suffocating. He also says that "Once I sit up and dangle my legs off the bed, I feel better." The nurse interprets these findings as: 1. Orthopnea 2. Anxiety 3. Insomnia 4. Paroxysmal nocturnal dyspnea

4. PND occurs when the patient lies down for a few hours and is awakened with shortness of breath. Reclining and dangling the legs off the bed relieves their dyspnea.

The patient is being discharged with warfarin (Coumadin). What labs should be routinely monitored for this patient? 1. Serum lipid panel 2. PTT 3. CBC 4. PT and INR

4. PT (prothrombin time) and INR (international normalized ratio) are monitored for the therapeutic effects of the anticoagulant

A nurse in the telemetry unit is caring for a patient who has a weak pulse that changes to a strong pulse. The nurse would document this finding as: 1. Paradoxical pulse 2. Gallop 3. Hyperkinetic pulse 4. Pulsus alternans

4. Pulsus alternans is where a weak pulse alternates with a stronger one.

A patient is admitted to the cardiac unit with a diagnosis of a myocardial infarction (MI). The nurse notes that the patient is having regular premature ventricular contractions (PVCs). Why would the nurse be concerned? A.Blood is not efficiently pumped from the heart with PVCs. B. Healing of the myocardium will be disrupted. C. PVCs usually cause severe pain. D. PVCs make it difficult to make a definitive diagnosis.

A

a nurse is admitting a client who has a suspected myocardial infarction (MI) and a hirtory of angina. which of the following findings will help the nurse distinguish angina from an MI? a. angina can be relieved with rest and nitroglycerin b. the pain of an MI resolves in less than 15 min c. the type of activity that causes an MI can be identified d. angina can occur for longer than 30 min

A

a nurse is caring for a client who experienced defibrillation. which of the following should be included in the documentation of this procedure? select all that apply a. follow up ECG b. energy settings used c. IV fluid intake d. urinary output e. skin condition under electrodes

A, B, E

helpful seasonings to use in a sodium restricted diet include which of the following? select all that apply a. lemon juice b. soy sauce c. herbs and spices d. seasoned salt

A, C

A nurse is caring for a client who has heart failure and asks how to limit fluid intake to 2,000 mL/day. Which of the following is an appropriate response by the nurse? A. "Pour the amount of fluid you drink into an empty 2 liter bottle to keep track of how much you drink." B. "Each glass contains 8 ounces. There are 30 milliliters per ounce, so you can have a total of 8 glasses or cups of fluid each day." C. "This is the same as 2 quarts, or about the same as two pots of coffee." D. "Take sips of water or ice chips so you will not take in too much fluid."

A. "Pour the amount of fluid you drink into an empty 2 liter bottle to keep track of how much you drink."

prehypertension is defined as a blood pressure of _____/______ a. less that 120 and less than 80 b. 120 to 139 and 80 to 89 c. 140 to 159 and 90 to 99 d. more than 160 and more than 100

B

a low cholesterol diet restricts which of the following foods? select all that apply a. fish b. liver c. butter d. nonfat milk

B, C

a nurse is providing health teaching for a group of clients. which of the following clients is at risk for developing peripheral arterial disease? A. a client who has hypothyroidism B. a client who has diabetes mellitus C. a client whose daily caloric intake consists of 25% fat D. a client who consumes 2 bottles of beer a day

B. a client who has diabetes mellitus diabetes mellitus places the client at risk for microvascular damage and progressive peripheral arterial disease.

a client who has a new diagnosis of hypertension has a prescription for an ACE inhibitor. the nurse instructs the client about adverse effects of the medication. the client demonstrates an understanding of the teaching by stating that he will notify his provider if he experiences which of the following? A. tendon pain B. persistent cough C. frequent urination D. constipation

B. persistent cough a persistent cough is an adverse effect of ACE inhibitors, and the client should discontinue the medication if it occurs.

a nurse is monitoring a client following coronary artery bypass graft surgery. which of the following findings can indicate cardiac tamponade? A. sternal instability B. increased WBC count C. blood pressure 140/82 mm/Hg on inspiration and 154/90 mm/Hg on expiration D. sinus rhythm with occasional premature atrial contractions and heart rate 88/min

C. blood pressure 140/82 mm/Hg on inspiration and 154/90 mm/Hg on expiration pulsus paradoxus, when the systolic blood pressure is 10 mm/Hg or higher on expiration than on inspiration, is an indicator of cardiac tamponade.

a nurse is reviewing the laboratory results of several clients who have peripheral arterial disease. the nurse should plan to provide dietary teaching for the client who has which of the following laboratory values? A. cholesterol 180 mg/dL, HDL 70 mg/dL, LDL 90mg/dL B. cholesterol 185 ml/dL, HDL 50 mg/dL, LDL 120 mg/dL C. cholesterol 190 mg/dL, HDL 25 mg/dL, LDL 160 mg/dL D. cholesterol 195 mg/dL, HDL 55 mg/dL, LDL 125 mg/dL

C. cholesterol 190 mg/dL, HDL 25 mg/dL, LDL 160 mg/dL the expected reference range of cholesterol is less that 200 mg/dL, HDL above 40 mg/dL, and LDL less that 100 mg/dL

a nurse is admitting a client who has a leg ulcer and a history of diabetes mellitus. the nurse should use which of the following focused assessments to help differentiate between an arterial ulcer and a venous stasis ulcer? A. explore the client's family history of peripheral vascular disease B. note the presence or absence of pain at the ulcer site C. inquire about the presence or absence of claudication D. ask if the client has had a recent infection

C. inquire about the presence or absence of claudication knowing if the client is experiencing claudication helps differentiate venous from arterial ulcers. clients who have arterial ulcers experience claudication, but those who have venous ulcers do not.

A 54-year-old man has a myocardial infarction, resulting in left-sided heart failure. The nurse caring for the man is most concerned that he will develop edema in what area of the body? a. abdominal b. liver c. peripheral d. pulmonary

D

A 76-year-old patient is receiving IV heparin 5,000 units every 8 hours. An activated thromboplastin time (aPTT) is drawn 1 hour before the 8:00 AM dose; the aPTT is at 3.5 times the control value. What is the nurse's priority action? A. Give a larger dose to increase the aPTT. B. Give the dose as ordered and chart the results. C. Check the patient's vital signs prior to administering the dose. D. Hold the dose and call the result to the physician.

D

the ___ supplies blood to the heart a. pulmonary arteries b. coronary sinus c. pulmonary veins d. coronary arteries

D

the ____ returns the heart's blood supply to the general circulation. a. coronary arteries b. pulmonary veins c. pulmonary arteries d. coronary sinus

D

the best way to prevent coronary heart disease is to: a. limit intake of high-cholesterol foods b. become aware of the fat content of foods c. obtain thorough annual physical examinations d. develop a heart-healthy lifestyle during childhood

D

A nurse is orienting a newly licensed nurse on the care of a client who is receiving hemodynamic monitoring. Which of the following statements by the newly licensed nurse indicates the teaching was effective? A. "Air should be instilled into the monitoring system." B. "The client should be in the prone position." C. "The transducer should be level with the 2nd intercostal space" D. "A chest X-ray is needed to verify placement."

D. A chest x-ray is obtained to confirm proper placement of the lines

A nurse is teaching a client the importance of remaining still following angiography. Which of the following is an appropriate statement by the nurse? A. "Moving in bed raises your blood pressure." B. "Too much activity increases your risk for infection." C. "Moving in bed increases your risk of a complication due to anesthesia." D. "Too much activity places you at risk for bleeding."

D. Following angiography, it is important that the client lie still due to the increased risk for bleeding at the insertion site.

A nurse is reviewing the medical record of a client who is receiving heparin therapy for treatment of deep-vein thrombosis. Which of the following interventions should the nurse anticipate taking if the client's aPTT is 96 seconds? A. increase the heparin infusion flow rate by 2mL/hr B. continue to monitor the heparin infusion as prescribed C. request a prothrombin time (PT) D. stop the heparin infusion.

D. Stop the heparin infusion - The aPTT level is above the therapeutic range of 1.5 to 2 times the control value. The nurse should discontinue the heparin infusion immediately and notify the provider to prevent harm to the client.

a nurse is preparing a client for a coronary angiography. the nurse should report which of the following findings to the provider prior to the procedure? A. hemoglobin 14.4 g/dL B. history of peripheral arterial disease C. urine output 200 mL/4hr D. previous allergic reaction to shellfish

D. previous allergic reaction to shellfish the contrast medium used is iodine-based. clients who have a history of allergic reaction to shellfish often react to iodine and might need a steroid or antihistamine.

the ability of the cardiac muscle to shorten in response to an electrical impulse is termed which of the following? a. contractility b. diastole c. repolarization d. depolarization

a contractility is the ability of the cardiac muscle to shorten in response to an electrical impulse. depolarization is the electrical activation of a cell caused by the influx of sodium into the cell while the potassium exits the cell. repolarization is the return of the cell to the resting state, caused by reentry of potassium into the cell while sodium exits the cell. diastole is the period of ventricular relaxation resulting in ventricular filling.

a nurse is caring for a client and reviewing a new prescription for an afterload-reducing mediation. the nurse should recognize that this medication is administered for which of the following types of shock? a. cardiogenic b. obstructive c. hypovolemic d. distributive

a reducing afterload will allow the heart to pump more effectively, which is needed for the client who has cardiogenic shock.

a nurse is caring for a client who has chronic venous insufficiency. the provider prescribed thigh-high compression stockings. the nurse should instruct the client to a. massage both legs firmly with lotion prior to applying the stockings. b. apply the stockings in the morning upon awakening and before getting out of bed c. roll the stockings down to the knees if they will not stay up on the thighs. d. remove the stockings while out of bed for 1 hr, four times a day to allow the legs to rest

b applying stockings in the morning upon awakening and before getting out of bed reduces venous stasis and assists in the venous return of blood to the heart. legs are less edematous at this time.

a harsh grating sound caused by abrasion of the pericardial surfaces during the cardiac cycle is termed which of the following? a. murmur b. friction rub c. opening snap d. ejection click

b in pericarditis, a harsh, grating sound that can be heard in both systole and diastole is called a friction rub. a murmur is created by the turbulent flow of blood. a cause of the turbulence may be a critically narrowed valve. an opening snap is caused by high pressure in the left atrium with abrupt displacement of a rigid mitral valve. an ejection clich is caused by very high pressure within the ventricle, displacing a rigid calcified aortic valve.

a nurse s caring for a client who has heart failure and reports increased shortness of breath. the nurse increases the oxygen per protocol. which of the following actions should the nurse take first? a. obtain the client's weight b. assist the client into high fowlers position c. auscultate lungs sounds. d. check oxygen saturation with pulse oximeter.

b using the airway, breaking, and circulation (ABC) priority-setting framework, the first action is to assist the client into high fowlers position. this will decrease venous return to the heart (preload) and help relieve lung congestion

a nurse is caring for a client who is admitted to the emergency department with a blood pressure of 266/147 mm Hg. the client reports a headache and states that she is seeing double. the client states that she ran out of her diltiazem (cardizem) 3 days ago, and she has not been able to purchase more. which of the following nursing interventions should the nurse expect to perform first? a. administer acetaminophin for headache. b. provide teaching in regard to the importance of not abruptly stopping antihypertensive c. obtain IV access and prepare to administer an IV antiypertension d. call social services for a referral for financial assistance in obtaining prescribed medication.

c the greatest risk to the client is injury due to a blood pressure of 266/147 mm Hg, which can be life threatening and should be lowered as soon as possible. obtaining IV access will permit administration of an IV hypertensive, which will act more rapidly than by the oral route

a nurse is caring for a client who is 4 hr postop following coronary artery bypass grafting (CABG) surgery. he is able to inspire 200 mL with the incentive spirometer, then refuses to cough because he is tired and it hurts too much. which of the following is an appropriate nursing intervention? a. allow the client to rest, and return in 1 hr. b. administer IV bolus analgesic, and return in 15 min. c. document the 200 mL as an appropriate inspired volume. d. tell the client that he must try to cough if he does not want to get pneumonia

b providing adequate analgesia and returning in 15 min will reduce pain and improve coughing effectiveness

a nurse in the emergency department is caring for a client who had an anterior myocardial infarction. the client's history reveals she is 1 week postoperative open cholecystectomy. the nurse should recognize that which of the following interventions is contraindicated? A. administering IV morphine sulfate. B. administering oxygen at 2 L/min via nasal cannula C. helping the client to the bedside commode D. assisting with thrombolytic therapy

D. assisting with thrombolytic therapy -the nurse should recognize that major surgery within the previous 3 weeks is a contraindication for thrombolytic therapy

a nurse is caring for a client who has a new diagnosis of hypertension and a new prescription for spironolactone (aldactone) 25 mg/day. which of the following statements by the client indicates a need for further teaching? a. "i should eat a lot of fruits and vegetables, especially bananas and potatoes." b. "i will report any changes in heart rate or rhythm" c. "i should use a salt substitute that is low in potassium" d. " i will continue to take this medication even if i am feeling better."

a potatoes and bananas are high inpotassium, and spironolactone is a potassium-sparing didduretic. consuming these foods can lead to hyperkalemia

a nurse is caring for a 72 yr old client who is to under go a percutaneous balloon valvuloplasty. the client's daughter asks the nurse to explain the expected outcome of this procedure. which of the following is an appropriate response by the nurse? a. "this will improve blood flow in your mother's coronary arteries." b." this will permit your mother to resume her activities of daily living." c."this will prolong your mothers life" d."this will reverse the effects to the damaged area."

b surgery is indicated for older adult clients when clinical manifestations interfere with activities of daily living.

the nurse is caring for a pt prescribed warfarin (coumadin) orally. the nurse reviews the pts prothrombin time (PT) level to evaluate the effectiveness of the medication. the nurse should also evaluate which of the following lab values? a. sodium b. international normalized ratio (INR) c. complete blood count (CBC) d. Partial thromboplastic time (PTT)

b the INR, reported with the PT, provides a standard method for reporting PT levels and eliminates the variation of PT results from dif labs. the INR, rather than the PT alone, is used to monitor the effectiveness of warfarin. the therapeutic range for INR is 2-3.5, although specific ranges vary based on diagnosis. the other lab values are not used to evaluate the effectiveness of coumadin.

the child has returned to the nurse's unit following a cardiac catheterization. the insertion site is located at the right groin. peripheral pulses were easily palpated in bilateral lower extremities prior to the procedure. which of the following findings should be reported to the childs physician? (Select all that apply) a. the right groin is soft without edema b. the childs right foot is cool with a pulse assessed only with the use of a doppler c. the child has a temp of 102.4 d. the child is complaining of nausea e. the child has a runny nose

b c d the following information should be reported to the physician following a cardiac catheterization because they are indicative of possible complications: negative changes to the child's peripheral vascular circulatory status (cool foot with poor pulse), a fever over 100.4, and nausea or vomiting.

a nurse is screening a client for hypertension. which of the following actions by the client increase his risk for hypertension? select all that apply a. drinking 8 oz of nonfat milk daily b. eating popcorn at the movie theater c. walking 1 mile daily at 12 min/mile pace d. consuming 36 oz of beer daily e. getting a masasge once a week

b d popcorn at a movie theater contains a large quantify of sodium and fat, which increases the risk for hypertension consuming more than 24 oz of beer per day can contribute to weight gain, which increases the risk for hypertension

the nurse is caring for a pt in the ED who has a B-type natriuretic peptide (BNP) level of 115 pg/mL. the nurse understands that this finding is most suggestive of which of the following. a. pulmonary edema b. ventricular hypertrophy c. heart failure d. myocardial infarction

c a BNP level greater than 100 pg/mL is suggestive of HF. Because this serum lab test can be quickly obtained, BNP levels are useful for prompt diagnosis of HF in settings such as the ED. elevations in BNP can occur from a number of other conditions such as pulmonary embolus, myocardial infarction (MI), and ventricular hypertrophy. therefore, the clinician correlates BNP levels with abdnormal physical assessment findings and other diagnostic tests before making a definitive diagnosis of HF.

the nurse is caring for a pt in the ICU who is being monitored with a central venous pressure (CVP) catheter. the nurse records the pts CVP as 8 mm Hg. the nurse understands that this finding indicates the pt is experiencing which of the following? a. left sided heart failure (HF) b. excessive blood loss c. hypervolemia d. overdiuresis

c the normal CVP is 2 to 6 mm Hg. a CVP greater than 6 mm Hg indicates an elevated right ventricular preload. many problems can cause an elevated CVP, but the most common is hypervolemia (excessive fluid circulating in the body) or right sided HF. in contrast, a low CVP (<2mm Hg) indicates reduced right ventricular preload, which is most often from hypovolemia.

the nurse is preparing to apply ECG electrodes to a male pt who requires continuous cardiac monitoring. which of the following should the nurse complete to optimize skin adherence and conduction of the heart's electrical current. a. once the electrodes are applied, change them q72 hr b. clean the pts chest with alcohol prior to application of electrodes c. apply baby powder to the pts chest prior to placing the electrodes d. clip the pts chest hair prior to applying the electrodes

d the nurse should complete the following actions when applying cardiac electrodes: clip(do not shave) hair from around the electrode site, if needed; if the pts diaphoretic (sweaty), apply a small amount of benzoin to the skin, avoiding the area under the center of the elctrode; debride the skin surface of dead cells with soap and water and dry well (or as recommended by the manufacturer). change the electrodes q 24 - 48 hrs ( or as recommended by the manufacturer); examine the skin for irritation and apply the electrodes to diff locations.

a nurse is caring for a client who has a history of deep vein thrombosis and is receiving warfarin. which of the following client findings provides the nurse with the best evidence regarding the effectiveness of the warfarin therapy? A. hemoglobin 14 g/dL B. minimal bruising of extremities C. reduced circumference of affected extremity D. INR 2.5

D. INR 2.5 the nurse should determine that an INR of 2.5 is within the desired therapeutic range and is the best evidence of effective warfarin therapy.

decreased pulse pressure reflects which of the following? a. reduced stroke volume b. reduced distensibility of the arteries c. elevated stroke volume d. tachycardia

a decreased pulse pressure reflects reduced stroke volume and ejection velocity or obstruction to blood flow during systole. increased pulse pressure would indicate reduced distensibility of the arteries, along with bradycardia.

a nurse is assessing the skin of 12 yo with suspected right ventricular heart failure. which of the following findings would the nurse expect to note? a. edema of the lower extremities b. edema of the face c. edema in the presacral region d. edema of the hands

a edema of the lower extremities is characteristic of right ventricular heart failure in older children. in infants, peripheral edema occurs first in the face, then the presacral region, and the extremities.

a nurse is caring for a client who has heart failure and is experiencing atrial fibrillation. the nurse should plan to monitor for and report which of the following findings to the provider immediately? A. slurred speech B. irregular pulse C. dependent edema D. persistent fatigue

A. slurred speech the greatest risk to this client is injury from an embolus caused by the atrial fibrillation. slurred speech can indicate inadequate circulation to the brain because of an embolus. the nurse should report this finding to the provider immediately.

a nurse is reviewing the health record of a client who is being evaluated for possible valvular heart disease. the nurse should recognize which of the following data as risk factors for this condition? select all that apply a. surgical repair of an atrial septal defect at age 2 b. measles infection during childhood c. hypertension for 5 yrs d. weight gain of 10 lb in the past year e. diastolic murmur present

a c e a history of congenital malformations is a risk factor for valvular heart disease hypertension places a client at risk for valvular heart disease. a murmur indicates turbulent blood flow, which is often due to valvular heart disease.

the nurse is reviewing discharge instructions with a pt who underwent a left groin cardiac catheterization 8 hrs ago. which of the following instructions should the nurse include? a. "if any discharge occurs at the puncture site, call 911 immediately." b."you can take a tub bath or shower when you get home." c."do not bend at the waist, strain, or lift heavy objects for the next 24 hrs." d. "contact your primary care provider if you develop a temp above 102."

c the nurse should instruct the pt to complete the following: if the artery of the groin was used, for the next 24 hrs, do not bend at the waist, strain, or lift heavy objects; the priary provider should be contacted if any of the following occur: swelling, new bruising or pain from your procedure puncture site, temp of 101 or more. If bleeding occurs, lie down (groin approach) and apply firm pressure to the puncture site for 10 min. notify the primary provider as soon as possible and follow instructions. if there is a large amount of bleeding, call 911. the pt should not drive to the hospital.

Nurse Trisha teaches a client with heart failure to take oral Furosemide in the morning. The reason for this is to help 1. Retard rapid drug absorption 2. Excrete excessive fluids accumulated at night 3. Prevents sleep disturbances during night 4. Prevention of electrolyte imbalance

3. Prevents sleep disturbances during night When diuretics are taken in the morning, client will void frequently during daytime and will not need to void frequently at night.

A patient who is being hemodynamically monitored has an increased RA pressure. How does the nurse interpret this finding? 1. Pulmonary rupture 2. Hypovolemia 3. Right ventricular failure 4. Afterload reduction

3. Right ventricular failure Normal RA ranges between 1-8 mm Hg. An increased RA indicates right ventricular failure whereas a low RA indicates hypovolemia

Which of the following should the nurse teach the client about the signs of digitalis toxicity? 1. Increased appetite 2. Elevated blood pressure 3. Skin rash over the chest and back 4. Visual disturbances such as seeing yellow spots

4

a type of protein that may help prevent coronary heart disease is a. soy protein b. milk protein c. oat protein d. bean protein

A

which of the following foods may be used freely on a low sodium diet? a. fruits b. milk c. cured meat d. canned vegetables

A

A nurse is caring for a client who is receiving hemodynamic monitoring readings: PAS 34 mm Hg, PAD 21 mm Hg, PAWP 16 mm Hg, CVP 12 mm Hg. For which of the following is the client at risk? (Select all that apply) A. Heart Failure B. Cor pulmonale C. Hypovolemic shock D. Pulmonary hypertension E. Peripheral edema

A, B, D, E

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

d the client is advised to notify the provider if bradycardia occurs

A client suffered from a lower leg injury and seeks treatment in the emergency room. There is a prominent deformity to the lower aspect of the leg, and the injured leg appears shorter that the other leg. The affected leg is painful, swollen and beginning to become ecchymotic. The nurse interprets that the client is experiencing: 1. Fracture 2. Strain 3. Sprain 4. Contusion

1. fracture Common signs and symptoms of fracture include pain, deformity, shortening of the extremity, crepitus and swelling.

Which of the following is the correct definition of a stroke volume? 1. The volume of blood stretching the left ventricle at the end of diastole 2. The volume of blood ejected by the left ventricle during each contraction 3. The pressure against which the ventricles has to eject blood through the semilunar valves 4. The volume of blood pumped from the left ventricle in one minute

2. The volume of blood ejected by the left ventricle during each contraction

a nurse is providing discharge teaching for a client who has prescription for the transdermal nitroglycerin patch. which of the following instructions should the nurse include in the teaching? A. apply the new patch to the same site as the previous patch B. place the patch on an area of skin away from skin folds and joints C. keep the patch on 24hr per day D. replace the patch at the onset of angina

B. place the patch on an area of skin away from skin folds and joints the client should apply the patch to an area of skin that is not prone to movement or wrinkling

if a person is taking calcium channel-blocking medication, he/she should avoid a. soy products b. milk products c. grapefruit juice d. tomato juice

C.

A 64 year old male client with a long history of cardiovascular problem including hypertension and angina is to be scheduled for cardiac catheterization. During pre cardiac catheterization teaching, Nurse Cherry should inform the client that the primary purpose of the procedure is 1. To determine the existence of CHD 2. To visualize the disease process in the coronary arteries 3. To obtain the heart chambers pressure 4. To measure oxygen content of different heart chambers

2. To visualize the disease process in the coronary arteries The lumen of the arteries can be assessed by cardiac catheterization. Angina is usually caused by narrowing of the coronary arteries.

A male client's left tibia was fractured in an automobile accident, and a cast is applied. To assess for damage to major blood vessels from the fracture tibia, the nurse in charge should monitor the client for: 1. Swelling of the left thigh 2. Increased skin temperature of the foot 3. Prolonged reperfusion of the toes after blanching 4. Increased blood pressure

3. Damage to blood vessels may decrease the circulatory perfusion of the toes, this would indicate the lack of blood supply to the extremity.

A nurse is reviewing a new prescription to administer 0.9% NaCl IV at 50 ml/hr to a client who is receiving hemodynamic monitoring and has an indwelling IV catheter in the left hand. Which of the following sites can be used for administering this solution? (Select all that apply) A. Peripheral saline lock B. Port on the arterial line C. Port on proximal (CVP) lumen of pulmonary artery (PA) catheter D. Port on distal lumen of PA catheter E. Balloon inflation port

A, C A. IV fluid administration can occur via a lock on a peripheral IV catheter C. The proximal (CVP) lumen of a PA catheter is used for hemodynamic monitoring and can also be used for IV fluid administration.

A nurse is teaching a client who has heart failure about the need to limit sodium in the diet to 2,000 mg daily. Which of the following foods should be consumed in limited quantities? (Select all that apply.) A. Cheddar cheese, 2 oz B. Hot dog C. Canned tuna, 3 oz D. Roast chicken breast, 3 oz E. Baked ham, 3 oz

A. Cheddar cheese, 2 oz B. Hot dog C. Canned tuna, 3 oz E. Baked ham, 3 oz

a nurse is providing discharge teaching for a client who has heart failure. the nurse should instruct the client to report which of the followings immediately to the provider? A. weight gain of 0.9 kg (2lb) in 24 hr B. increase of 10 mm Hg in systolic blood pressure C. dyspnea with exertion D. dizziness when rising quickly

A. weight gain of 0.9 kg (2 lb) in 24 hr when using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is a weight gain of 0.5-0.9 kg (1-2 lb) in 1 day. this weight gain is an indication of fluid retention resulting from worsening heart failure. the client should report this finding immediately.

A nurse is caring for a client following a coronary artery bypass graft (CABG). Hemodynamic monitoring has been initiated. Which of the following actions by the nurse facilitate correct monitoring readings? (Select all that apply) A. Place the client in high-Fowler's position B. Level transducer to phlebostatic axis C. Zero transducer to room air D. Observe trends in readings E. Compare readings to physical assessment

B, C, D, E B. The level of the transducer should be at the phlebostatic axis (right atrium) to ensure an accurate reading is obtained C. The transducer is zeroed to room air to ensure an accurate reading is obtained. Hemodynamic pressure lines should be calibrated to read atmospheric pressure as zero. D. The trend of the client's pressure reading assists in providing appropriate medical treatment E. Readings are compared to the client's physical assessment findings to evaluate the client's condition and the appropriate treatment provided.

a nurse is caring for a client in the first 8 hr following coronary artery bypass graft (CABG) surgery. which of the following client findings should the nurse report to the provider? A. mediastinal drainage 100mL/hr B. blood pressure 160/80 mm Hg C. Temperature 37.1 (98.9) D. Potassium 3.8 mEq/L

B. blood pressure 160/80 mm Hg the nurse should report an elevated blood pressure following a CABG procedure because increased vascular pressure can cause bleeding at the incision sites.

a nurse is caring for a client who is being treated for heart failure and has prescriptions for digoxin and furosemide. the nurse should plan to monitor for which of the folling as an adverse effect of these medications? A. shortness of breath B. lightheadedness C. dry cough D. metallic taste

B. lightheadedness furosemide can cause a substsantial drop in blood pressure, resulting in lightheadedness

a nurse is caring for a client who is scheduled for a coronary artery bypass graft (CABG) in 2 hr. which of the following client statements indicates a need for further clarification by the nurse? A. "my arthritis is really bothering me because i haven't taken my aspirin in a week." B. "my blood pressure shouldn't be high because i took my blood pressure medication this morning." C. "i took my warfarin last night according to my usual schedule." D. "i will check my blood sugar because i took a reduced dose of insulin this morning."

C. "i took my warfarin last night according to my usual schedule." clients scheduled for a CABG should not take anticoagulants, such as warfarin, for 5 to 7 days prior to the surgery to prevent excessive bleeding.

a nurse is caring for a client who had an onset of chest pain 24 hr ago. the nurse should recognize that an increase in which of the following diagnostic of a myocardial infarction (MI)? A. myoglobin B. c-reactive protein C. creatine kinase- MB D. homocysteine

C. creatine kinase- MB creatine kinase-MB is the isoenzyme specific to the myocardium and is elevated when that muscle is injured.

a nurse is caring for a client who has a history of angina and is scheduled for a stress test at 1100. which of the following statements by the client requires the nurse to contact the provider for possible rescheduling? A. "I am still hungry after the bowl of cereal I ate at 7 am" B. "i didn't take my heart pills this morning because my doctor told me not to" C. "I have had chest pain a couple of times since i saw my doctor in the office last week" D. "i smoked a cigarette this morning to calm my nerves about having this procedure."

D. "I smoked a cigarette this morning to calm my nerves about having this procedure." smoking prior to the test can change the outcome and places the client at additional risk, so the test should be rescheduled.

a nurse is caring for a client in a clinic who asks the nurse why her provider prescribed 1 aspirin per day. which of the following is an appropriate response by the nurse? a. "aspirin reduces the formation of blood clots that could cause a heart attack" b "aspirin relieves the pain due to myocardial ischemia." c. aspirin dissolves clots that are forming in your coronary arteries" d. "aspirin relieves headaches that are caused by other medications.

a aspirin decreased platelet aggregation that can cause a myocardial infarction

the nurse is caring for a pt who has undergone peripheral arteriography. how should the nurse assess the adequacy of peripheral circulation? a. by checking peripheral pulses b. by observing the pt for bleeding c. by hemodynamic monitoring d. by checking for cardiac dysrhythmias

a peripheral arteriography is used to diagnose occlusive arterial disease in smaller arteries. the nurse observes the pt for bleeding and cardiac dysrhythmias and assesses the adequacy of peripheral circulation by frequently checking the peripheral pulses. hemodynamic monitoring is used to assess the volume and pressure of blood in the heart and vascular system.

a nurse is caring for a client who has severe peripheral arterial disease (PAD). the nurse should expect that the client will sleep most comfortably in which of the following positions? a. with the affected limb hanging from the bed b. with the affected limb elevated on pillows c. with the head of the bed raised d. in a side lying, recumbent position

a the client will prefer sleeping with the affected extremity in a dependent position because this relieves pain

age-related changes associated with the cardiac system include which of the following? select all that apply. a. increased size of left atrium b. endocardial fibrosis c. myocardial thinning d. increase in the number of SA node cells

a b age-related changes associated with the cardiac system include endocardial fibrosis, increased size of the left atrium, decreased number of SA node cells, and myocardial thickening.

a nurse is teaching a client who has a new prescription for clopidogrel (plavix). which of the following should be included in the teaching? select all that apply a. effects may not be apparent for several weeks b. monitor for the presence of black, tarry stools c. instruct the client to use an electric razor d. schedule a weekly PT test e. advise the client about food sources containing vitamin K

a b therapeutic benefits may not occur for several weeks when taking plavix evidence of GI bleedings, such as abdominal pain, coffee-groung emesis, or black, tarry stools should be monitored and reported to the provider

a nurse is performing a physical assessment of a client who has chronic peripheral arterial disease (PAD). which of the following is an expected finding? a. edema around the clients ankles and feet b. ulceration around the clients medial malleoli c. scaling eczema of the client's lower legs with stasis dermatitis d. pallor on elevation of the clients limbs and rubor when his limbs are dependent

d in a clinet who has chronis PAD, pallor is seen in the extremities when the limbs are elevated, and rubor occurs when they are lowered

a nurse educator is reviewing the use of cariopulmonary bypass during surgery for coronary artery bypass grafting with a group of nurses. which of the following should be included in the discussion? select all that apply a. the client's demand for oxygen is lowered b. motion of the heart ceases c. rewarming of the client takes place d. the clients metabolic rate is increased e. blood flow to the heart is stopped

a b c the use of cardiopulmonary bypass reduces the client's deman for oxygen, which reduces the risk of inadequate oxygenation of vital organs motion of the heart ceases during cardiopulmonary bypass to allow for placement of the graft near the affected coronary artery the core body temperature is lowered for the procedure, and rewarming then occurs through heat exchanges on the cardiopulmonary bypass machine

a nurse educator is reviewing expected findings in a client who has right-sided valvular heart disease with a group of nurses. which of the following should be included in the discussion? select all that apply] a. dyspnea b. client report of fatigue c. bradycardia d. pleural friction rub e. peripheral edema

a b e dyspnea is a clinical manifestation of right-sided valvular heart disease a client's report of fatigue is a client manifestation of right sided valvular disease peripheral edema is a clinical manifestation of right sided valvular heart disease

a nurse is completing the admission assessment of a client who has suspected pulmonary edema. which of the following are expected findings? select all that apply a. tachypnea b. persistent cough c. increased urinary output d. thick, yellow sputum e. orthopnea

a b e tachypnea is an expected finding in a client who has pulmonary edema a persistent cough with pink, frothy sputum is an expected finding in a client who has pulmonary edema orthopnea is an expected finding in a client who has pulmonary edema

a nurse in an urgent care clinic is obtaining a history from a client who has type 2 diabetes melitus and a recent diagnosis of hypertension. this is the second time in two weeks that the client experienced hyopglycemia. which of the following data should the nurse report to the provider? a. takes psyllium hydrophilic muccilloid (metamucil) daily b. drinks skim milk daily c. takes metoprolol (lopressor) daily d. drinks grapefruit juice daily

c lopressor can mask the effects of hypoglycemia in clients with diabetes mellitus. this should be reported to the provider

a nurse is caring for a client who has a deep-vein thrombosis (DVT) and has been taking unfractionated heparin for 1 week. two days ago, the provider also prescribed warfarin (coumadin.) the cilent questions the nurse about receiving both heparin and warfarin at the same time. which of the following is an appropriate response by the nurse? a. "i will remind your provider that you are already receiving heparin." b. "laboratory findings indicated that two anticoagulants were needed.' c."it takes three or four days before the effects of warfarin are achieved and the heparin can be discontinued." d."only one of these medications is being given to treat your DVT

c warfarin depresses synthesis of clotting factors but does not have effect on clotting factors that are present. therefore, it takes 3 to 4 days before the clotting factors that are present decay and the therapeutic effects of warfarin occur.