Cardio Exam

The nurse is admitting a patient with possible rheumatic fever. Which question on the admission health history focuses on a pertinent risk factor for rheumatic fever?

"Have you had a recent sore throat?"

Which statement by a patient with newly diagnosed heart failure indicates to the nurse that teaching was effective?

"I will call the clinic if my weight goes up 5 pounds in a week."

After receiving change-of-shift report, which patient admitted to the emergency department should the nurse assess first?

A 50-yr-old patient who is complaining of sudden sharp and severe upper back pain

The nurse has just finished teaching a hypertensive patient about the newly prescribed drug, ramipril (Altace). Which patient statement indicates that more teaching is needed? a. "The medication may not work well if I take aspirin." b. "I can expect some swelling around my lips and face." c. "The doctor may order a blood potassium level occasionally." d. "I will call the doctor if I notice that I have a frequent cough."

ANS: B Angioedema occurring with angiotensin-converting enzyme (ACE) inhibitor therapy is an indication that the ACE inhibitor should be discontinued. The patient should be taught that if any swelling of the face or oral mucosa occurs, the health care provider should be immediately notified because this could be life threatening. The other patient statements indicate that the patient has an accurate understanding of ACE inhibitor therapy

When planning care for a patient hospitalized with streptococcal infective endocarditis (IE), which intervention is appropriate for the nurse to include?

Arrange for placement of a long-term IV catheter.

Which action will the nurse take to evaluate the effectiveness of IV nitroglycerin for a patient with a myocardial infarction (MI)?

Ask about chest pain

Which laboratory test result will the nurse review to determine the effects of therapy for a patient being treated for heart failure?

B-type natriuretic peptide (BNP)

A patient who has chest pain is admitted to the emergency department (ED), and all the following items are prescribed. Which one should the nurse arrange to be completed first?

Electrocardiogram (ECG)

Which action will the nurse include in the plan of care for a patient who was admitted with syncopal episodes of unknown origin?

Instruct the patient to call for assistance before getting out of bed.

When the nurse is monitoring a patient who is undergoing exercise (stress) testing on a treadmill, which assessment finding requires the most rapid action by the nurse?

Newly inverted T waves on the electrocardiogram

The nurse obtains the following information from a patient newly diagnosed with elevated blood pressure. Which finding is most important to address with the patient?

No regular physical exercise

The nurse notes that a patient who was admitted with heart failure has jugular venous distention (JVD) when lying flat. Which follow-up action should the nurse take?

Observe the neck veins with the patient elevated 45 degrees.

A patient recovering from heart surgery develops pericarditis and reports level 6 (0 to 10 scale) chest pain with deep breathing. Which prescribed PRN medication will be the most appropriate for the nurse to give?

Oral ibuprofen (Motrin) 600 mg

Which patient will need the nurse to plan discharge teaching about prophylactic antibiotics before dental procedures?

Patient who had a mitral valve replacement with a mechanical valve

A registered nurse (RN) is observing a student nurse who is assessing a patient. Which action observed by the RN requires immediate intervention?

The student nurse palpates both carotid arteries simultaneously to compare pulse quality

Which assessment finding(s) indicate to the nurse that a patient with infective endocarditis has decreased cardiac output?

Urine production of 25 mL/hr

A nurse is assessing a patient who is receiving a nitroprusside (Nipride) infusion to treat cardiogenic shock. Which finding indicates that the medication is effective?

Warm, pink, and dry skin

What finding should the nurse expect during the assessment of a young adult with infective endocarditis (IE)?

a new regurgitant murmur.

The nurse is teaching a client how to apply nitroglycerin topical ointment. Which statement indicates that the client needs further education on applying nitroglycerin topical ointment?

a. "I should remove any remaining old ointment with a tissue before applying a new dose."

The nurse evaluates that discharge teaching about the management of a new permanent pacemaker. The nurse knows teaching has been effective when the patient states:

a. "I won't lift the arm on the pacemaker side until I see the health care provider."

Which question or finding indicates to the nurse that a patient with infective endocarditis had a prior risk factor?

a. "Is there a family history of endocarditis.

Which information from a patient helps the nurse confirm the previous diagnosis of chronic stable angina?

a. "The pain goes away after a nitroglycerin tablet."

The nurse is taking the BP on multiple clients. Which reading warrants the nurse notifying the HCP because the client's MAP is abnormal?

a. 98/36

A charge nurse makes assignments for the shift. Which client is best assigned to the novice nurse?

a. A client with anemia who reports shortness of breath.

A nurse cares for several clients who are being monitored by telemetry. Which client does the nurse assess first?

a. A client with rhythm changes from atrial flutter to ventricular fibrillation.

A cardiac patient's resistance to left ventricular filling has caused blood to back up into the patient's circulatory system. What health problem is likely to result?

a. Acute pulmonary edema.

A 20-year-old patient has a mandatory electrocardiogram (ECG) before participating on a college soccer team. The patient is found to have sinus bradycardia, rate 52 and BP 114/54 mm Hg. The student denies any health problems. What action by the nurse is appropriate?

a. Allow the student to participate on the soccer team.

A patient develops sinus bradycardia at a rate of 32 beats/minute, has a blood pressure (BP) of 80/42 mm Hg, and reports feeling faint. Which action should the nurse take?

a. Apply the transcutaneous pacemaker (TCP) pads.

The nurse obtains a rhythm strip on a patient who has a myocardial infarction and makes the following analysis: no visible P waves, PR interval not measurable, ventricular rate of 162, R-interval regular, QRS complex wide and distorted, and QRS duration of 0.18 second. What should the nurse plan to do next?

a. Assess patient

The RN notes the following rhythm on a patient's telemetry and charts it as: (THIS IS ECG STRIP)

a. Atrial fibrillation

The nurse and unlicensed assistive personnel (UP) on the telemetry unit are caring for four patients. Which nursing action can be delegated to the UAP?

a. Attaching ECG monitoring electrodes after a patient bathes.

The health care provider prescribes an infusion of heparin and daily partial thromboplastin time (PTT) testing for a patient with venous thromboembolism (VTE). Which action does the nurse include in the plan of care?

a. Avoid giving IM medications to prevent localized bleeding.

The nurse is administering a thrombolytic agent to a patient with an acute myocardial infarction. Which patient data indicates that the nurse should stop the drug infusion?

a. Bleeding from the gums

A client who is receiving multiple medications for a myocardial infarction reports severe nausea. Assessments reveal that the heartbeat is irregular and slow. The nurse should recognize these symptoms as toxicity related to which medication?

a. Digoxin

A patient on the telemetry unit who recently had an acute myocardial infarction (AMI) ambulates in the hospital hallway. Which data would indicate to the nurse that the patient should stop and rest?

a. Give supplemental O2 at 2 to 3 L/min via nasal cannula.

The nurse is caring for a patient who has just arrived on the telemetry unit after having cardiac catheterization. What task should the nurse delegate to a licensed practical/vocational nurse? (LPN/LVN)

a. Give the scheduled aspirin and lipid-lowering medication.

The nurse is assessing the client following cardiac surgery. Which assessment findings should be of greatest concern to the nurse?

a. Jugular vein distention, muffled heart sounds, and BP 84/48.

A client's electrocardiogram reveals an irregular rhythm of 75 bpm with a normal QRS and P wave. The nurse is caring for the client should anticipate.

a. No immediate treatment.

A client is scheduled for cardiac surgery at 0800. While completing the preoperative checklist, the nurse sees that the surgical consent form isn't signed. It's time to administer the preoperative analgesic. Which nursing immediate action takes the highest priority in this situation?

a. Notify the surgeon that the client has not signed the consent form

A patient who has chronic heart failure tells the nurse, "I was fine when I went to bed, but I woke up in the middle of the night feeling like I was suffocating!" How should the nurse document this finding?

a. Paroxysmal nocturnal dyspnea.

The nurse who works in the vascular clinic has several patients with venous insufficiency. Which patient should the nurse assign to an experienced licensed practical/vocational nurse (LPN/LVN).

a. Patient who needs wound care for a chronic venous stasis ulcer on the lower leg.

A patient who has pain due to acute pericarditis. What is an appropriate nursing intervention for this problem?

a. Place the patient in Fowler's position, leaning forward on the table

A client presents to the ED in distress and complains of "crushing" chest pain. What is the nurse's priority for assessment?

a. Prompt initiation of an ECG.

Which group of drugs with the nurse plan to include when teaching a patient who has a new diagnosis of peripheral artery disease?

a. Statins

The nurse is caring for a client who is receiving cyclosporine postoperative heart transplant. Which outcome represents a therapeutic outcome of this pharmacologic treatment?

a. The client does not experience organ rejection

Propranolol (Inderal) is prescribed for a patient diagnosed with hypertension. The nurse should consult with the health care provider before giving this drug when the patient reveals a history of:

asthma

Which assessment data collected by the nurse who is admitting a patient with chest pain suggest that the pain is caused by an acute myocardial infarction (AMI)? A. The pain increases with deep breathing B. The pain has lasted longer than 30 minutes. C. The pain is relieved after the patient takes nitroglycerin. D. The pain is reproducible when the patient raises the arms.

b. The pain has lasted longer than 30 minutes.

A patient admitted to the coronary care unit (CCU) with an ST-segment-elevation myocardial infarction (STEMI) is restless and anxious. The blood pressure is 86/40 mm Hg. And heart rate is 132 beats/min. Based on this information. Which patient problem is the priority?

decreased cardiac output

A client returns from a left heart catheterization. The right groin was used for the catheter access. In which location should the nurse palpate the distal pulse on this client?

dorsal surface of the right foot

An older adult patient who had a mitral valve replacement with a mechanical valve is taking warfarin. What should the nurse include in discharge teaching?

need for frequent laboratory blood testing.

The nurse plans discharge teaching for a patient with chronic heart failure who has prescriptions for digoxin (Lanoxin) and hydrochlorothiazide. Which instruction should the nurse include?

notify the health care provider if nausea develops.

A patient with aortic stenosis has acute pain due to decreased coronary blood flow. What would be an appropriate nursing intervention for this patient?

promote rest to decrease myocardial oxygen demand.