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The nurse admits an adult female client with a medical diagnosis of "rule out MI." The client is very frightened and expresses surprise that a woman would have heart problems. What response by the nurse will be most appropriate? - "A woman's heart is smaller and has smaller arteries that become occluded more easily." - "A woman's resting heart rate is lower than a man's." - "It takes longer for an electrical impulse to travel from the sinoatrial node to the atrioventricular node in a woman." - "The stroke volume from a woman's heart is lower than from a man's heart."

"A woman's heart is smaller and has smaller arteries that become occluded more easily."

The nurse cares for a client with diabetes who is scheduled for a cardiac catheterization. Prior to the procedure, it is most important for the nurse to ask which question? - "Are you allergic to shellfish?" - "Are you having chest pain?" - "When was the last time you ate or drank?" - "What was your morning blood sugar reading?"

"Are you allergic to shellfish?"

The nurse reviews discharge instructions with a client who underwent a left groin cardiac catheterization 8 hours ago. Which instructions should the nurse include? - "You can take a tub bath or a shower when you get home." - "Contact your primary care provider if you develop a temperature above 102°F." - "Do not bend at the waist, strain, or lift heavy objects for the next 24 hours." - "If any discharge occurs at the puncture site, call 911 immediately."

"Do not bend at the waist, strain, or lift heavy objects for the next 24 hours."

While being prepared for echocardiography, the client asks nurse why this test is necessary. What would be the nurse's best response? - "This test will find any congenital heart defects." - "This test can tell us a lot about your heart." - "Echocardiography is a way of determining the functioning of the left ventricle of your heart." - "Echocardiography will tell your doctor if you have cancer of the heart."

"Echocardiography is a way of determining the functioning of the left ventricle of your heart."

You are doing an admission assessment on a client who is having outpatient testing done for cardiac problems. What should you ask this client during your assessment? - "Have you had any episodes of dizziness or fainting?" - "Have you had any episodes when you are to nauseous?" - "Have you had any episodes of mottling in your hands?" - "Have you had any episodes of pain radiating into your lower extremities?"

"Have you had any episodes of dizziness or fainting?"

The nurse is assessing the client's cardiovascular system. The client asks the nurse why the nurse presses on the toenails. Which is the best reply by the nurse? - "I can see how quickly the blood returns to assess blood flow." - "I can tell a lot about your breathing from pressing on your toes." - "Pressing on your toenail gives me an idea about your pain tolerance." - "I can learn things about your blood coagulation by pressing on your toenail."

"I can see how quickly the blood returns to assess blood flow."

A nurse is teaching the client about the causes of fast heart rates. What client statement indicates the client requires more teaching? - "I will drink coffee with only two of my meals." - "I will cut back on my smoking and drinking alcohol." - "If I take my metoprolol daily, I will be able to control my heart rate." - "I will take my levothyroxine daily."

"I will drink coffee with only two of my meals."

The nurse is providing teaching to a client with an implanted cardiac device. Which client statement indicates that teaching has been effective? - "I will stop using the microwave oven." - "I will not place my cell phone in my chest pocket." - "I can safely have an MRI in the future if I need one." - "I will not be able to fly with a pacemaker."

"I will not place my cell phone in my chest pocket."

A nurse is performing discharge teaching with a client who has an implantable cardioverter defibrillator (ICD) placed. Which client statement indicates effective teaching? - "I'll keep a log of each time my ICD discharges." - "I can't wait to get back to my football league." - "I have an appointment for magnetic resonance imaging of my knee scheduled for next week." - "I need to stay at least 10 inches away from the microwave."

"I'll keep a log of each time my ICD discharges."

The nurse is administering a stool softener to a client who experienced a myocardial infarction. The client says, "I had a heart attack; I don't have a problem with constipation." What explanation will the nurse use to answer the client's question? - "If you strain to have a bowel movement, you can cause a drop in your heart rate that can be dangerous." - "The heart attack sets you up for limited activity, so constipation is often a problem for clients after a heart attack." - "Please talk this over with your healthcare provider for further information." - "The prescribed stool softener will decrease stress with a bowel movement and protect your heart from further injury."

"If you strain to have a bowel movement, you can cause a drop in your heart rate that can be dangerous."

Two nursing students are reading EKG strips. One of the students asks the instructor what the P-R interval represents. The correct response should be which of the following? - "It shows the time needed for the SA node impulse to depolarize the atria and travel through the AV node." - "It shows the time it takes the AV node impulse to depolarize the atria and travel through the SA node." - "It shows the time it takes the AV node impulse to depolarize the ventricles and travel through the SA node." - "It shows the time it takes the AV node impulse to depolarize the septum and travel through the Purkinje fibers."

"It shows the time needed for the SA node impulse to depolarize the atria and travel through the AV node."

The client asks the nurse what urine output has to do with cardiac function. What is the best response by the nurse? - "Poor urine output may indicate inadequate blood flow to the kidneys." - "The heart may be working too hard if there is not enough urine." - "The heart and kidneys work independently to keep the body's fluids in balance." - "High urine output may indicate poor cardiac function."

"Poor urine output may indicate inadequate blood flow to the kidneys."

A client is ordered a nitroglycerine transdermal patch for treatment of CAD and asks the nurse why the patch is removed at bedtime. Which is the best response by the nurse? - "Nitroglycerine causes headaches, but removing the patch decreases the incidence." - "You do not need the effects of nitroglycerine while you sleep." - "Removing the patch at night prevents drug tolerance while keeping the benefits." - "Contact dermatitis and skin irritations are common when the patch remains on all day."

"Removing the patch at night prevents drug tolerance while keeping the benefits."

The nursing student asks the nurse to describe the difference between sinus rhythm and sinus bradycardia on the electrocardiogram strip. What is the nurse's best reply? - "The only difference is the heart rate." - "The P waves will be shaped differently." - "The QRS complex will be smaller in sinus bradycardia." - "The P-R interval will be prolonged in sinus bradycardia."

"The only difference is the heart rate."

The nurse is assessing vital signs on a client who is 3 months status post myocardial infarction (MI). While the healthcare provider is examining the client, the client's spouse approaches the nurse and states "We are too afraid he will have another heart attack, so we just don't have sex anymore." What is the nurse's best response? - "The physiologic demands are greatest during orgasm and are equivalent to walking 3 to 4 miles per hour on a treadmill." - "It is usually better to just give up sex after a heart attack." - "Having an orgasm is very strenuous and your husband must be in excellent physical shape before attempting it." - "The medications will prevent your husband from having an erection."

"The physiologic demands are greatest during orgasm and are equivalent to walking 3 to 4 miles per hour on a treadmill."

The nurse is caring for a client scheduled for a transesophageal echocardiogram with a diagnosis of atrial fibrillation. The client's spouse asks the nurse to explain the purpose of the test. What is the nurse's best response? - "This test will show any blood clots in the heart, and help us determine if it is safe to do a cardioversion." - "This test will show the specific area causing the atrial fibrillation and what can be done to stop it." - "This test will show if the client needs a cardiac catheterization." - "This test will let the doctor know if the client is at risk for hypotension."

"This test will show any blood clots in the heart, and help us determine if it is safe to do a cardioversion."

The nursing student asks the nurse how to tell the difference between ventricular tachycardia and ventricular fibrillation on an electrocardiogram strip. What is the best response? - "Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes." - "The two look very much alike; it is difficult to tell the difference." - "The QRS complex in ventricular fibrillation is always narrow, while in ventricular tachycardia the QRS is of normal width." - "The P-R interval will be prolonged in ventricular fibrillation, while in ventricular tachycardia the P-R interval is normal."

"Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes."

The nurse is caring for a client who had a permanent pacemaker surgically placed and is now ready for discharge. What statement made by the client indicates the need for more education? - "We will be getting rid of our microwave oven so it will not affect my pacemaker." - "I will check my pulse every day and report to the doctor if the rate is below the pacemaker setting." - "I will call the doctor if my incision becomes swollen and red." - "I will avoid any large magnets that may affect my pacemaker."

"We will be getting rid of our microwave oven so it will not affect my pacemaker."

A home care nurse is visiting a left-handed client who has an implantable cardioverter-defibrillator (ICD) implanted in the left chest. The client is planning to go rifle hunting. How should the nurse respond? - "Enjoy your hunting trip." - "You can't shoot a rifle left-handed because the rifle's recoil will traumatize the ICD site." - "Being that close to a rifle might make your ICD fire." - "You'll need to take an extra dose of your antiarrhythmic before you shoot."

"You can't shoot a rifle left-handed because the rifle's recoil will traumatize the ICD site."

The nurse is caring for a client who is being discharged after insertion of a permanent pacemaker. The client, an avid tennis player, is scheduled to play in a tournament in 1 week. What is the best advice the nurse can give related to this activity? - "You will need to cancel this activity; you must restrict arm movement above your head for 2 weeks." - "You may resume all normal activity in 1 week; if you are used to playing tennis, you may proceed with this activity." - "You should avoid tennis; basketball or football would be a good substitute." - "Cancel your tennis tournament and wait until fall, then try hockey; skating is much easier on pacemakers."

"You will need to cancel this activity; you must restrict arm movement above your head for 2 weeks."

The nurse is working with a client with a new onset of atrial fibrillation during a three-month follow-up visit. The healthcare provider is planning a cardioversion, and the client asks the nurse why there is a wait for the treatment. What is the best response by the nurse? - "The doctor wants to see if your heart will switch back to its normal rhythm by itself." - "Your atrial chambers may contain blood clots now, so you must take an anticoagulant for a few weeks before the cardioversion." - "We have to allow your heart to rest for a few weeks before it is stressed by the cardioversion." - "There is a long list of clients in line to be cardioverted."

"Your atrial chambers may contain blood clots now, so you must take an anticoagulant for a few weeks before the cardioversion."

The nurse is providing discharge education for a client with angina pectoris. Which information will the nurse include when instructing the client on self-care at home? Select all that apply. - "You need to follow a low-fat, high-fiber diet." - "You can return to normal activities when you get home." - "You should keep nitroglycerin with you at all times." - "Balance rest with your regular daily activities." - "You need to avoid exercising in extreme temperatures."

- "You need to follow a low-fat, high-fiber diet." - "You can return to normal activities when you get home." - "You should keep nitroglycerin with you at all times." - "Balance rest with your regular daily activities."

The student nurse is preparing a teaching plan for a client being discharged status post MI. What should the nurse include in the teaching plan? Select all that apply. - Need for careful monitoring for cardiac symptoms - Need for carefully regulated exercise - Need for dietary modifications - Need for early resumption of prediagnosis activity - Need for increased fluid intake

- Need for careful monitoring for cardiac symptoms - Need for carefully regulated exercise - Need for dietary modifications

Age-related changes associated with the cardiac system include which conditions? Select all that apply. - increased size of the left atrium - endocardial fibrosis - increase in the number of SA node cells - myocardial thinning

- increased size of the left atrium - endocardial fibrosis

After performing an ECG on an adult client, the nurse reports that the PR interval reflects normal sinus rhythm. What is the PR interval for a normal sinus rhythm? - 0.05 and 0.1 seconds. - 0.12 and 0.2 seconds. - 0.15 and 0.3 seconds. - 0.25 and 0.4 seconds.

0.12 and 0.2 seconds.

The nurse knows that what PR interval presents a first-degree heart block? -0.24 seconds - 0.14 seconds - 0.16 seconds - 0.18 seconds

0.24

The nurse knows that what PR interval presents a first-degree heart block? - 0.24 seconds - 0.14 seconds - 0.16 seconds - 0.18 seconds

0.24 seconds

The licensed practical nurse is monitoring the waveform pattern on the cardiac monitor of the client admitted following a myocardial infarction. The nurse notes that every other beat includes a premature ventricular contraction (PVC). The nurse notes which of the following in the permanent record? - Bigeminy - Couplets - Multifocal PVCs - R-on-T phenomenon

Bigeminy

Typical candidates for a heart transplant have severe symptoms uncontrolled by medical therapy, no other surgical options, and a prognosis of less than _____ year(s) to live. - 5 to 6 - 3 to 4 - 2 to 3 - 1 to 2

1 to 2

The nurse cares for a client with clubbing of the fingers and toes. The nurse should complete which action given these findings? - Obtain an oxygen saturation level. - Assess the client's capillary refill. - Assess the client for pitting edema. - Obtain a 12-lead ECG tracing.

Obtain an oxygen saturation level.

To evaluate a client's atrial depolarization, the nurse observes which part of the electrocardiogram waveform? - P wave - PR interval - QRS complex - T wave

P wave

The nurse is performing an assessment of a clients peripheral pulses and indicates that the pulse quality is +1 on a scale of 0-4. What does this documented finding indicate? - Diminished, but cannot be obliterated with pressure. - Full, easy to palpate, and cannot be obliterated with pressure. - Difficult to palpate and is obliterated with pressure. - Strong and bounding and may be abnormal.

Difficult to palpate and is obliterated with pressure.

To be effective, percutaneous transluminal coronary angioplasty (PTCA) must be performed within what time frame, beginning with arrival at the emergency department after diagnosis of myocardial infarction (MI)? - 30 minutes - 60 minutes - 9 days - 6 to 12 months

60 minutes

The nurse assesses a client with increasing shortness of breath and peripheral edema. The healthcare provider inserts a triple lumen catheter and orders a transduced central venous pressure (CVP). What CVP reading does the nurse suspect will correlate with the client's symptoms? - 0 mmHg - 2 mmHg - 6 mmHg - 8 mmHg

8 mmHg

The following clients are in need of exercise electrocardiography. Which client would the nurse indicate as most appropriate for a drug-induced stress test? - A 48-year-old policemen with history of knee replacement 4 years ago - A 68-year-old housewife with history of osteoporosis - A 72-year-old retired janitor obtaining a cardiac baseline - A 55-year-old recovering from a fall and broken femur

A 55-year-old recovering from a fall and broken femur

The nurse is caring for a geriatric client. The client is ordered Lanoxin (digoxin) tablets 0.125mg daily for a cardiac dysrhythmia. Which of the following assessment considerations is essential when caring for this client? - Digoxin level - Cardiac output - Activity level - Dyspnea

Digoxin level

The nurse is assigned the following client assignment on the clinical unit. For which client does the nurse anticipate cardioversion as a possible medical treatment? - A new myocardial infarction client - A client with poor kidney perfusion - A client with third-degree heart block - A client with atrial arrhythmias

A client with atrial arrhythmias

The licensed practical nurse is setting up the room for a client arriving at the emergency department with ventricular arrhythmias. The nurse is most correct to place which of the following in the room for treatment? - A suction machine - A defibrillator - Cardioversion equipment - An ECG machine

A defibrillator

The nurse caring for a client who is suspected of having cardiovascular disease has a stress test ordered. The client has a co-morbidity of multiple sclerosis, so the nurse knows the stress test will be drug-induced. What drug will be used to dilate the coronary arteries? - Thallium - Ativan - Diazepam - Dobutamine

Dobutamine

A client has started to exhibit dangerous PVCs in the cardiac postoperative unit. The client has been given a bolus of lidocaine and is under continuous IV infusion, but serious side effects, including hypotension during administration, could occur. What should the nurse be ready to do? - Adjust the IV infusion. - Administer additional lidocaine. - Prepare for defibrillation. - Call for the doctor and just wait.

Adjust the IV infusion.

The nurse is working on a telemetry unit, caring for a client who develops dizziness and a second-degree heart block, Mobitz Type 1. What will be the initial nursing intervention? - Administer an IV bolus of atropine. - Send the client to the cardiac catheterization laboratory. - Prepare to client for cardioversion. - Review the client's medication record.

Administer an IV bolus of atropine.

A client with an atrial dysrhythmia has come to the clinic for a follow-up appointment and to talk with the health care provider about options to stop this dysrhythmia. What procedure could be used to treat this client? - Elective electrical cardioversion - Chemical cardioversion - Mace procedure - Elective electrical defibrillation

Elective electrical defibrillation

The nurse is caring for a client who is displaying a third-degree AV block on the EKG monitor. What is the priority nursing intervention for the client? - Assessing the client's blood pressure and heart rate frequently - Identifying the client's code level status - Maintaining the client's intravenous fluids - Alerting the healthcare provider of the third-degree heart block

Alerting the healthcare provider of the third-degree heart block

A client's Holter monitor strip reveals a heart rate with normal conduction but with a rate consistently above 105 beats/minute. What other conditions can cause this response in a healthy heart? - All options are correct. - elevated temperature - shock - strenuous exercise

All options are correct.

The nurse is assessing a patient who reports feeling "light-headed." When obtaining orthostatic vital signs, what does the nurse determine is a significant finding? - A heart rate of more than 20 bpm above the resting rate - An unchanged systolic pressure - An increase of 10 mm Hg blood pressure reading - An increase of 5 mm Hg in diastolic pressure

An increase of 10 mm Hg blood pressure reading

Which of the following medication classifications is more likely to be expected when the nurse is caring for a client with atrial fibrillation? - Diuretic - Anticoagulant - Antihypertensive - Potassium supplement

Anticoagulant

After percutaneous transluminal coronary angioplasty (PTCA), the nurse confirms that a client is experiencing bleeding from the femoral site. What will be the nurse's initial action? - Apply manual pressure at the site of the insertion of the sheath. - Review the results of the latest blood cell count, especially the hemoglobin and hematocrit. - Decrease anticoagulant or antiplatelet therapy. - Notify the health care provider.

Apply manual pressure at the site of insertion of the sheath

A nurse provides evening care for a client wearing a continuous telemetry monitor. While the nurse is giving the client a back rub, the client 's monitor alarm sounds and the nurse notes a flat line on the bedside monitor system. What is the nurse's first response? - Assess the client and monitor leads. - Administer a pericardial thump. - Call for assistance and begin CPR. - Call a code and obtain the crash cart.

Assess the client and monitor leads.

The nurse is caring for a client on a monitored telemetry unit. During morning assessment, the nurse notes abnormal ECG waves on the telemetry monitor. Which action would the nurse do first? - Call the physician with a report. - Assess the client. - Assess for mechanical dysfunction. - Reposition the client.

Assess the client.

The nurse cares for a client with a dysrhythmia and understands that the P wave on an electrocardiogram (ECG) represents which phase of the cardiac cycle? - Atrial depolarization - Early ventricular repolarization - Ventricular depolarization - Ventricular repolarization

Atrial depolarization

A client presents to the emergency department via ambulance with a heart rate of 210 beats/minute and a sawtooth waveform pattern per cardiac monitor. The nurse is most correct to alert the medical team of the presence of a client with which disorder? - Asystole - Premature ventricular contraction - Atrial flutter - Ventricular fibrillation

Atrial flutter

The nurse is monitoring a patient in the postanesthesia care unit (PACU) following a coronary artery bypass graft, observing a regular ventricular rate of 82 beats/min and "sawtooth" P waves with an atrial rate of approximately 300 beat/min. How does the nurse interpret this rhythm? - Atrial fibrillation - Atrial flutter - Ventricular tachycardia - Ventricular fibrillation

Atrial flutter

The nurse knows that electrocardiogram (ECG) characteristics of atrial fibrillation include what? - Atrial rate of 300 to 400 - Normal PR interval - Regular rhythm - P wave resent before each QRS

Atrial rate of 300 to 400

A nurse is caring for a client who's experiencing sinus bradycardia with a pulse rate of 40 beats/minute. The client's blood pressure is 80/50 mm Hg and the client reports dizziness. Which medication does the nurse anticipate administering to treat bradycardia? - Atropine - Dobutamine - Amiodarone - Lidocaine

Atropine

The nurse is providing discharge education for a client going home after cardiac catheterization. What information is a priority to include when providing discharge education? - Avoid tub baths, but shower as desired. - Do not ambulate until the healthcare provider indicates it is appropriate. - Expect increased bruising to appear at the site over the next several days. - Returning to work immediately is okay.

Avoid tub baths, but shower as desired.

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? - Potassium - B-type natriuretic peptide (BNP) - C-reactive protein (CRP) - Platelet count

B-type natriuretic peptide (BNP)

The nurse is caring for a client with an elevated blood pressure and no previous history of hypertension. At 0900, the blood pressure was 158/90 mm Hg. At 0930, the blood pressure is 142/82 mm Hg. The nurse is most correct when relating the fall in blood pressure to which structure? - Chemoreceptors - Sympathetic nerve fibers - Baroreceptors - Vagus nerve

Baroreceptors

A nurse provides morning care for a client in the intensive care unit (ICU). Suddenly, the bedside monitor shows ventricular fibrillation and the client becomes unresponsive. After calling for assistance, what action should the nurse take next? - Begin cardiopulmonary resuscitation - Prepare for endotracheal intubation - Provide electrical cardioversion - Administer intravenous epinephrine

Begin cardiopulmonary resuscitation

A client is receiving nitroglycerin ointment to treat angina pectoris. The nurse evaluates the therapeutic effectiveness of this drug by assessing the client's response and checking for adverse effects. Which vital sign is most likely to reflect an adverse effect of nitroglycerin? - Pulse rate of 84 beats/minute - Respiration 26 breaths/minute - Blood pressure 84/52 mm Hg - Temperature of 100.2° F (37.9° C)

Blood pressure 84/52 mm Hg

The nurse is caring for a client with a damaged tricuspid valve. The nurse knows that the tricuspid valve is held in place by which of the following? - Chordae tendineae - Atrioventricular tendons - Semilunar tendineae - Papillary tendons

Chordae tendineae

A nurse is caring for a client who has been admitted to have a cardioverter defibrillator implanted. The nurse knows that implanted cardioverter defibrillators are used in which clients? - Clients with recurrent life-threatening bradycardias - Clients with sinus tachycardia - Clients with ventricular bradycardia - Clients with recurrent life-threatening tachydysrhythmias

Clients with recurrent life-threatening tachydysrhythmias

A nurse assessing a client who underwent cardiac catheterization finds the client lying flat on the bed. The client's temperature is 99.8° F (37.7° C). The client's blood pressure is 104/68 mm Hg. The client's pulse rate is 76 beats/minute. The nurse detects weak pulses in the leg distal to the puncture site. Skin on the leg is cool to the touch. The puncture site is dry, but swollen. What is the most appropriate action for the nurse to take? - Document findings and check the client again in 1 hour. - Slow the I.V. fluid to prevent any more swelling at the puncture site. - Contact the health care provider and report the findings. - Encourage the client to perform isometric leg exercise to improve circulation in the legs.

Contact the health care provider and report the findings.

A nurse is caring for a client with a central venous pressure (CVP) of 4 mm Hg. Which nursing intervention is appropriate? - Call the health care provider and obtain an order for a fluid bolus. - Re-zero the equipment and take another reading. - Call the physician and obtain an order for a diuretic. - Continue to monitor the client as ordered.

Continue to monitor the client as ordered.

A client is admitted to the cardiac care unit for an electrophysiology (EP) study. What goal should guide the planning and execution of the client's care? - Ablate the area causing the dysrhythmia. - Freeze hypersensitive cells. - Diagnose the dysrhythmia. - Determine the nursing plan of care.

Diagnose the dysrhythmia.

Which dysrhythmia is common in older clients? - Sinus bradycardia - Sinus tachycardia - Sinus arrhythmia - Ventricular tachycardia

Sinus bradycardia

The clinic nurse caring for a client with a cardiovascular disorder is performing an assessment of the client's pulse. Which of the following steps is involved in determining the pulse deficit? - Count the radial pulse for 20 to 25 seconds. - Calculate the palpated volume. - Count the heart rate at the apex. - Calculate the pauses between pulsations.

Count the heart rate at the apex.

The nurse is assessing a patient with a probable diagnosis of first-degree AV block. The nurse is aware that this dysrhythmia is evident on an ECG strip by what indication? - Variable heart rate, usually fewer than 90 bpm - Irregular rhythm - Delayed conduction, producing a prolonged PR interval - P waves hidden within the QRS complex

Delayed conduction, producing a prolonged PR interval

The nurse is observing the monitor of a patient with a first-degree atrioventricular (AV) block. What is the nurse aware characterizes this block? - A variable heart rate, usually fewer than 60 bpm - An irregular rhythm - Delayed conduction, producing a prolonged PR interval - P waves hidden with the QRS complex

Delayed conduction, producing a prolonged PR interval

The nurse analyzes the electrocardiogram (ECG) strip of a stable patient admitted to the telemetry unit. The client's ECG strip demonstrates PR intervals that measure 0.20 seconds. What is the nurse's most appropriate action? - Document the findings and continue to monitor the patient - Apply oxygen via nasal cannula and obtain a 12-lead ECG - Notify the client's primary care provider of the findings - Instruct the client to bear down as if having a bowel movement

Document the findings and continue to monitor the patient

A client has been living with an internal, fixed-rate pacemaker. When checking the client's readings on a cardiac monitor the nurse notices an absence of spikes. What should the nurse do? - Double-check the monitoring equipment. - Do nothing; there is no cause for alarm. - Suggest the need for a new beta-blocker to the doctor. - Measure the client's blood pressure.

Double-check the monitoring equipment.

The client with a diagnosis of heart failure reports frequently awakening during the night with the need to urinate. What explanation will the nurse offer to explain the urination? - Edema is collected in dependent extremities during the day; at night when the client lays down, it is reabsorbed into the circulation and excreted by the kidneys. - When the client is in the recumbent position, more pressure is put on the bladder, with the result of increased need to urinate. - The blood pressure is lower when the client is recumbent, which causes the kidneys to work harder; therefore, more urine is produced. - Fluid that is held in the lungs during the day becomes part of the circulation at night, causing the kidneys to produce an increased amount of urine.

Edema is collected in dependent extremities during the day; at night when the client lays down, it is reabsorbed into the circulation and excreted by the kidneys.

A nurse is caring for a client with atrial fibrillation. What procedure would the nurse educate the patient about for termination of the dysrhythmia? - Defibrillation - Mace procedure - Pacemaker implantation - Elective cardioversion

Elective cardioversion

The nurse prepares to auscultate heart sounds. What nursing intervention will be most effective to assist with this procedure? - Explain to the client that the nurse will be listening to different areas of the chest and may listen for a long time, but that does not mean that anything abnormal is heard. - Ask the client to sit on the edge of the bed and hold breath while the nurse listens. - Insist that the family members leave the room if they must speak to each other while the nurse is auscultating heart sounds. - Ask the client to take deep breaths through the mouth while the nurse auscultates heart sounds.

Explain to the client that the nurse will be listening to different areas of the chest and may listen for a long time, but that does not mean that anything abnormal is heard.

A client presents to the emergency room with characteristics of atherosclerosis. What characteristics would the client display? - Fatty deposits in the lumen of arteries - Cholesterol plugs in the lumen of veins - Blood clots in the arteries - Emboli in the veins

Fatty deposits in the lumen of arteries

The apical impulse, formerly called the point of maximum impulse (PMI), is normally palpable at the intersection of the midclavicular line of the left chest and at the _______________ intercostal space

Fifth

The nurse is reviewing the results of the patient's echocardiogram and observes that the ejection fraction is 35%. The nurse anticipates that the patient will receive treatment for what condition? - Pulmonary embolism - Myocardial infarction - Pericarditis - Heart failure

Heart Failure

A client is admitted to the hospital with weakness. What nursing assessment indicates postural hypotension? - Heart rate increased from 85 to 110 bpm. - Systolic pressure did not change with the change in position. - Diastolic pressure went from 80 to 110 mm Hg. - Heart rate decreased from 85 to 75 bpm at the same time that the systolic pressure increased from 120 to 135 mm Hg.

Heart rate increased from 85 to 110 bpm.

The nurse reads an athletic client's electrocardiogram. What finding will be consistent with a sinus bradycardia? - PR interval of 0.24 seconds. - Heart rate of 42 beats per minute (bpm). - QR interval of 0.25 seconds. - P-to-QR ratio of 1:2.

Heart rate of 42 beats per minute (bpm).

The nurse identifies which of the following as a potential cause of premature ventricular complexes (PVCs)? - Hypokalemia - Alkalosis - Hypovolemia - Bradycardia

Hypokalemia

The nurse reviews a client's lab results and notes a serum calcium level of 7.9 mg/dL. It is most appropriate for the nurse to monitor the client for what condition? - Impaired myocardial contractility - Enhanced sensitivity to digitalis - Increased risk of heart block - Inclination to ventricular fibrillation

Impaired myocardial contractility

Which is the most important postoperative assessment parameter for a client recovering from cardiac surgery? - Inadequate tissue perfusion - Mental alertness - Blood glucose concentration - Activity intolerance

Inadequate tissue perfusion

The staff educator is teaching a class in arrhythmias. What statement is correct for defibrillation? - It is a scheduled procedure 1 to 10 days in advance. - The client is sedated before the procedure. - It is used to eliminate ventricular arrhythmias. - It uses less electrical energy than cardioversion.

It is used to eliminate ventricular arrhythmias.

he nurse is performing an assessment of the patient's heart. Where would the nurse locate the apical pulse if the heart is in a normal position? - Left 2nd intercostal space at the midclavicular line - Right 2nd intercostal space at the midclavicular line - Right 3rd intercostal space at the midclavicular line - Left 5th intercostal space at the midclavicular line

Left 5th intercostal space at the midclavicular line

A nurse is teaching a client who receives nitrates for the relief of chest pain. Which instruction should the nurse emphasize? - Repeat the dose of sublingual nitroglycerin every 15 minutes for three doses. - Store the drug in a cool, well-lit place. - Lie down or sit in a chair for 5 to 10 minutes after taking the drug. - Restrict alcohol intake to two drinks per day.

Lie down or sit in a chair for 5 to 10 minutes after taking the drug.

After a physical examination, the provider diagnosed a patient with a grade 4 heart murmur. During assessment, the nurse expects to hear a murmur that is: - Easily heard with no palpable thrill. - Quiet but readily heard. - Loud and may be associated with a thrill sound similar to (a purring cat). - Very loud; can be heard with the stethoscope half-way off the chest

Loud and may be associated with a thrill sound similar to (a purring cat).

After a physical examination, the provider diagnosed a patient with a grade 4 heart murmur. During assessment, the nurse expects to hear a murmur that is: - Easily heard with no palpable thrill. - Quiet but readily heard. - Loud and may be associated with a thrill sound similar to (a purring cat). - Very loud; can be heard with the stethoscope half-way off the chest.

Loud and may be associated with a thrill sound similar to (a purring cat).

While the nurse is preparing a client for a cardiac catheterization, the client states that they have allergies to seafood. Which of the following medications may the nurse give prior to the procedure? - Methylprednisolone - Furosemide - Lorazepam - Phenytoin

Methylprednisolone

The nurse is administering a beta blocker to a patient in order to decrease automaticity. Which medication will the nurse administer? - Diltiazem - Metoprolol - Amiodarone - Propafenone

Metoprolol

Which nursing intervention must a nurse perform when administering prescribed vasopressors to a client with a cardiac dysrhythmia? - Keep the client flat for one hour after administration - Administer every five minutes during cardiac resuscitation - Document heart rate before and after administration - Monitor vital signs and cardiac rhythm

Monitor vital signs and cardiac rhythm

The client's heart rate is observed to be 140 bpm on the monitor. The nurse knows to monitor the client for what condition? - Myocardial ischemia - A pulmonary embolism - Right-sided heart failure - A stroke

Myocardial ischemia

The nurse is assessing vital signs in a patient with a permanent pacemaker. What should the nurse document about the pacemaker? - Date and time of insertion - Location of the generator - Model number - Pacer rate

Pacer rate

The nurse is analyzing the cardiac rhythm of a client with a pacemaker and notes the QRS complex is absent after pacer spike. The nurse knows that reading can be caused by which of the following factors? - Client noncompliance - Lead wire fracture - Pacer undersensing - Loss of pacing

Pacer undersensing

The nurse is caring for a client who has premature ventricular contractions. After assessing the client, the nurse will likely need to document which sign or symptom being observed in this client? - Palpitations - Nausea - Hypotension - Fever

Palpitations

A critically ill client is admitted to the ICU. The health care provider decides to use intra-arterial pressure monitoring. After this intervention is performed, what assessment should the nurse prioritize? - Fluctuations in core body temperature - Signs and symptoms of esophageal varices - Signs and symptoms of compartment syndrome - Perfusion distal to the insertion site

Perfusion distal to the insertion site

The nurse is educating a patient at risk for atherosclerosis. What nonmodifiable risk factor does the nurse identify for the patient? - Stress - Obesity - Positive family history - Hyperlipidemia

Positive family history

The nurse is assessing a patient's blood pressure. What does the nurse document as the difference between the systolic and the diastolic pressure? - Pulse pressure - Auscultatory gap - Pulse deficit - Korotkoff sound

Pulse pressure

The clinic nurse is assessing a client's pulse before outpatient diagnostic testing. What should the nurse document when assessing the client's pulse? - Rate, quality, and rhythm - Pressure, rate, and rhythm - Rate, rhythm, and volume - Quality, volume, and rate

Rate, quality, and rhythm

It is important for a nurse to understand cardiac hemodynamics. For blood to flow from the right ventricle to the pulmonary artery, the following must occur: - The atrioventricular valves must open. - The pulmonic valve must be closed. - Right ventricular pressure must be higher than pulmonary arterial pressure. - Right ventricular pressure must decrease with systole.

Right ventricular pressure must be higher than pulmonary arterial pressure.

The nurse is assessing heart sounds in a patient with heart failure. An abnormal heart sound is detected early in diastole. How would the nurse document this? - S1 - S2 - S3 - S4

S3

The nurse is caring for a client presenting to the emergency department (ED) reporting chest pain. Which electrocardiographic (ECG) finding would be most concerning to the nurse? - ST elevation - Isolated premature ventricular contractions (PVCs) - Sinus tachycardia - Frequent premature atrial contractions (PACs)

ST elevation

The nurse observes a client during an exercise stress test (bicycle). Which finding indicates a positive test and the need for further diagnostic testing? - Dizziness and leg cramping - BP changes; 148/80 mm Hg to 166/90 mm Hg - ST-segment changes on the ECG - Heart rate changes; 78 bpm to 112 bpm

ST-segment changes on the ECG

A patient comes to the emergency department with reports of chest pain after using cocaine. The nurse assesses the patient and obtains vital signs with results as follows: blood pressure 140/92, heart rate 128, respiratory rate 26, and an oxygen saturation of 98%. What rhythm on the monitor does the nurse anticipate viewing? - Sinus bradycardia - Ventricular tachycardia - Normal sinus rhythm - Sinus tachycardia

Sinus tachycardia

A nurse is aware that the patient's heart rate is influenced by many factors. The nurse understands that the heart rate can be decreased by: - An excess level of thyroid hormone. - Stimulation of the vagus nerve. - An increased level of catecholamines. - Sympathetic nervous system stimulation.

Stimulation of the vagus nerve.

The nurse is discussing the cardiac system with a client admitted with heart failure. The client asks "What determines the heart rate?" What is the nurse's best response? - The autonomic nervous system controls the heart rate. - Preload controls the heart rate. - Stroke volume controls the heart rate. - Force of contractility controls the heart rate.

The autonomic nervous system controls the heart rate.

The client is admitted for a scheduled cardiac catheterization. On the morning of the procedure, while assessing the client's morning laboratory values, the nurse notes a blood urea nitrogen (BUN) of 34 mg/dL and a creatinine of 4.2 mg/dL. What priority reason will the nurse notify the healthcare provider? - The client is at risk for renal failure due to the contrast agent that will be given during the procedure. - These values show a risk for dysrhythmias. - The client is overhydrated, which puts him at risk for heart failure during the procedure. - The client is at risk for bleeding.

The client is at risk for renal failure due to the contrast agent that will be given during the procedure.

A nurse is preparing a client for magnetic resonance imaging (MRI) to confirm or rule out a spinal cord lesion. During the MRI scan, which action would pose a threat to the client? - The client lies still. - The client asks questions. - The client hears thumping sounds. - The client wears a watch.

The client wears a watch.

A client has been diagnosed with atrial fibrillation and has been prescribed warfarin therapy. What should the nurse prioritize when providing health education to the client? - The need to have regular blood levels drawn - The importance of taking the medication 1 hour before or 2 hours after a meal - The need to sit upright for 30 minutes after taking the medication - The importance of adequate fluid intake

The need to have regular blood levels drawn

A patient with coronary artery disease (CAD) is having a cardiac catheterization. What indicator is present for the patient to have a coronary artery bypass graft (CABG)? - The patient has compromised left ventricular function. - The patient has had angina longer than 3 years. - The patient has at least a 70% occlusion of a major coronary artery. - The patient has an ejection fraction of 65%.

The patient has at least a 70% occlusion of a major coronary artery.

The nurse documents that a client is having a normal sinus rhythm. What characteristics of this rhythm has the nurse assessed? - Heart rate between 60 and 150 beats per minute. - Impulse travels to the atrioventricular (AV) node in 0.15 to 0.5 seconds. - The ventricles depolarize in 0.5 seconds or less. - The sinoatrial (SA) node initiates the impulse.

The sinoatrial (SA) node initiates the impulse.

The patient has a heart rate of 72 bpm with a regular rhythm. Where does the nurse determine the impulse arises from? - The AV node - The Purkinje fibers - The sinoatrial node - The ventricles

The sinoatrial node

The nurse is caring for a patient with a diagnosis of pericarditis. Where does the nurse understand the inflammation is located? - The thin fibrous sac encasing the heart - The inner lining of the heart and valves - The heart's muscle fibers - The exterior layer of the heart

The thin fibrous sac encasing the heart

A patient recently diagnosed with pericarditis asks the nurse to explain what area of the heart is involved. How does the nurse best describe the pericardium to the client? - Thin fibrous sac that encases the heart. - Inner lining of the heart and valves. - Heart's muscle fibers. - Exterior layer of the heart.

Thin fibrous sac that encases the heart.

In the treatment of coronary artery disease (CAD), medications are often ordered to control blood pressure in the client. Which of the following is a primary purpose of using beta-adrenergic blockers in the nursing management of CAD? - To dilate coronary arteries - To decrease workload of the heart - To decrease homocysteine levels - To prevent angiotensin II conversion

To decrease workload of the heart

When a client who has been diagnosed with angina pectoris reports experiencing chest pain more frequently, even at rest, that the period of pain is longer, and that it takes less stress for the pain to occur, the nurse recognizes that the client is describing which type of angina? - Intractable - Variant - Unstable - Refractory

Unstable

A patient with hypertension has a newly diagnosed atrial fibrillation. What medication does the nurse anticipate administering to prevent the complication of atrial thrombi? - Adenosine - Amiodarone - Warfarin - Atropine

Warfarin

The cardiologist has scheduled a client for drug-induced stress testing. What instructions should the nurse provide to prepare the client for this test? - You will receive medication via IV administration. - You will need to wear comfortable shoes to the test. - You will begin exercising at a slow speed. - You may experience an onset of dizziness during the test.

You will receive medication via IV administration.

The nurse is proving discharge instructions for a client with a new arrhythmia. Which statement should the nurse include? - Your family and friends may want to take a CPR class. - It is not necessary to learn how to take your own pulse. - If you miss a dose of your antiarrhythmic medication, double up on the next dose. - Do not be concerned if you experience symptoms of lightheadedness and dizziness.

Your family and friends may want to take a CPR class.

The nurse is explaining the cause of angina pain to a client. What will the nurse say most directly caused the pain? - incomplete blockage of a major coronary artery - a destroyed part of the heart muscle - complete closure of an artery - a lack of oxygen in the heart muscle cells

a lack of oxygen in the heart muscle cells

Human valves, obtained from cadaver tissue donations and used for aortic and pulmonic valve replacement, are called homografts or ___________________.

allografts

An _____________ is a heart valve replacement made from a donor heart valve

allograph

The nurse is caring for a client with second-degree atrioventricular block, Type I with symptomatic bradycardia. What is the most likely medication the nurse will administer? - nadolol - diltiazem - atropine sulfate - atenolol

atropine sulfate

Prevention of aortic regurgitation is primarily based on prevention of and treatment for _____________ infections - bacterial - viral - cardiac - fungal

bacterial

The nurse accompanies a client to an exercise stress test. The client can achieve the target heart rate, but the electrocardiogram indicates ST-segment elevation. Which procedure will the nurse prepare the client for next? - cardiac catheterization - telemetry monitoring - transesophageal echocardiogram - pharmacologic stress test

cardiac catheterization

The nurse cares for a client with an intra-arterial blood pressure monitoring device. The nurse recognizes the most preventable complication associated with hemodynamic monitoring includes which condition? - hemorrhage - catheter-related bloodstream infections - air embolism - pneumothorax

catheter-related bloodstream infections

The most common valvuloplasty procedure is a _________________.

commissurotomy

What is the term for the ability of the cardiac muscle to shorten in response to an electrical impulse? - contractility - depolarization - repolarization - diastole

contractility

The nurse is caring for an elderly client with left-sided heart failure. When auscultating lung sounds, which adventitious sound is expected? - Whistling - Rhonchi - Crackles - Coarseness

crackles

Age-related changes associated with the cardiac system include - decreased size of the left atrium. - decreased elasticity of arteries. - increase in the number of SA node cells. - myocardial thinning.

decreased elasticity of arteries.

The nurse witnesses a client experiencing ventricular fibrillation. What is the nurse's priority action? - defibrillation - cardioversion - IV bolus of atropine - IV bolus of dobutamine

defibrillation

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 data is necessary to collect if the client is experiencing chest pain? - blood pressure in the left arm - pulse rate in upper extremities - description of the pain - sound of the apical pulses

description of the pain

The first symptom of mitral stenosis often is _________ on exertion as a result of pulmonary venous hypertension.

dyspnea

A client returns for a follow-up visit to the cardiologist 4 days after a trip to the ED for sudden shortness of breath and abdominal pain. The nurse realizes the client had a myocardial infarction because the results from the blood work drawn in the hospital shows: - elevated troponin levels. - decreased LDH levels. - decreased myoglobin levels. - increased C-reactive protein levels.

elevated troponin levels

Within the heart, several structures and several layers all play a part in protecting the heart muscle and maintaining cardiac function. The inner layer of the heart is composed of a thin, smooth layer of cells, the folds of which form heart valves. What is the name of this layer of cardiac tissue? - endocardium - myocardium - pericardium - epicardium

endocardium

Which area of the heart is located at the third intercostal (IC) space to the left of the sternum? - aortic area - pulmonic area - erb point - epigastric area

erb point

The nurse auscultates the apex beat at which anatomical location? - midsternum - 5 cm to the left of the lower end of the sternum - 2.5 cm to the left of the xiphoid process - fifth intercostal space, midclavicular line

fifth intercostal space, midclavicular line

The nurse cares for a client in the emergency department who has a B-type natriuretic peptide (BNP) level of 115 pg/mL. The nurse recognizes that this finding is most indicative of which condition? - heart failure - ventricular hypertrophy - pulmonary edema - myocardial infarction

heart failure

A nurse is monitoring the vital signs and blood results of a client who is receiving anticoagulation therapy. What does nurse identify as a major indication of concern? - blood pressure of 129/72 mm Hg --heart rate of 87 bpm - hemoglobin of 16 g/dL - hematocrit of 30%

hematocrit of 30%

The nurse is monitoring a client experiencing a decrease in cardiac output. What medical conditions will lead to a decrease in preload? - hemorrhage, sepsis, and anaphylaxis - myocardial infarction, fluid overload, and diuresis - fluid overload, sepsis, and vasodilation - third spacing, heart failure, and diuresis

hemorrhage, sepsis, and anaphylaxis

The nurse cares for a client in the ICU who is being monitored with a central venous pressure (CVP) catheter. The nurse records the client's CVP as 9 mm Hg and recognizes that this finding indicates the client is most likely experiencing which condition? - hypervolemia - excessive blood loss - overdiuresis - left-sided heart failure

hypervolemia

The nurse assesses a client with a heart rate of 120 beats per minute. What are the known causes of sinus tachycardia? - hypovolemia - vagal stimulation - hypothyroidism - digoxin

hypovolemia

The nurse cares for a client prescribed warfarin orally. The nurse reviews the client's prothrombin time (PT) level to evaluate the effectiveness of the medication. Which laboratory values should the nurse also evaluate? - international normalized ratio (INR) - partial thromboplastic time (PTT) - complete blood count (CBC) - Sodium

international normalized ratio (INR)

A client with a history of right-sided heart failure lives in a long-term care facility. In the daily assessment, the nurse is required to record the level of this client's peripheral edema. Which would be the main area for examination? - feet and ankles - over the sacrum - lips and earlobes - knees and elbows

knees and elbows

Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for receiving oxygenated blood from the lungs? - left atrium - left ventricle - right atrium - right ventricle

left atrium

Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to all the cells and tissues of the body? - left ventricle - left atrium - right ventricle - right atrium

left ventricle

_________________ is a deformity that usually produces no symptoms. - mitral stenosis - cardiac tamponade - pulmonary hypertension - mitral valve prolapse

mitral valve prolapse

The nurse analyzes a 6-second electrocardiogram (ECG) tracing. The P waves and QRS complexes are regular. The PR interval is 0.18 seconds long, and the QRS complexes are 0.08 seconds long. The heart rate is calculated at 70 bpm. The nurse correctly identifies this rhythm as - normal sinus rhythm. - sinus tachycardia. - junctional tachycardia. - first-degree atrioventricular block.

normal sinus rhythm.

The client returns to the clinic for a follow-up appointment following a permanent pacemaker insertion and reports tenderness and throbbing around the incision. The nurse observes mild swelling, erythema, and warmth at the pacemaker insertion site. What does the nurse suspect? - pacemaker site infection - normal postoperative healing - postoperative site hematoma - internal bleeding at pacemaker site

pacemaker site infection

The nurse is assessing a client with suspected post-pericardiotomy syndrome after cardiac surgery. What manifestation will alert the nurse to this syndrome? - pericardial friction rub - hypothermia - decreased white blood cell (WBC) count - decreased erythrocyte sedimentation rate (ESR)

pericardial friction rub

A client describes chest pain as sharp, substernal, of intermittent duration, and radiating to the arms and back. The client says the pain increases with inspiration and swallowing and is alleviated when sitting upright. What does the nurse suspect the client may be experiencing? - pericarditis - angina pectoris - panic attack - dissecting aorta

pericarditis

The most characteristic clinical manifestation of ________ is a creaky or scratchy friction rub that can be clearly heard during auscultation at the left lower sternal border. - mitral stenosis - pericarditis - aortic regurgitation - pulmonary venous hypertension

pericarditis

The balloon on the distal tip of a pulmonary artery catheter is inflated and the pressure is measured. What is the term for the measurement obtained? - central venous pressure - pulmonary artery pressure - pulmonary artery wedge pressure - cardiac output

pulmonary artery wedge pressure

The physician orders medication to treat a client's cardiac ischemia. What is causing the client's condition? - reduced blood supply to the heart - pain on exertion - high blood pressure - indigestion

reduced blood supply to the heart

The nurse is reviewing the laboratory results for a client with heart failure. Which laboratory value will the nurse report to the health care provider? - sodium 148 mEq/L - potassium 3.9 mEq/L - calcium 9.8 mg/dL - magnesium 2.5 mg/dL

sodium 148 mEq/L

During electrical cardioversion, the defibrillator is set to synchronize with the electrocardiogram (ECG) so that the electrical impulse discharges during - atrial depolarization. - ventricular depolarization. - ventricular repolarization. - the QT interval.

ventricular depolarization

The nurse working in the emergency department places a client in anaphylactic shock on a cardiac monitor and sees the cardiac rhythm shown. Which dysrythmia should the nurse document? - ventricular tachycardia - ventricular asystole - sinus rhythm - junctional rhythm - atrial fibrillation

ventricular tachycardia

Before a transesophageal echocardiogram, a nurse gives a client an oral topical anesthetic spray. When the client returns from the procedure, the nurse observes no active gag reflex. What nursing action is a priority? - insert an oral airway. - withhold food and fluids. - position the client on his side. - introduce a nasogastric (NG) tube.

withhold food and fluids