Cardiovascular

A nurse has completed counseling about smoking cessation with a client with coronary artery disease. The nurse determines that the client has understood the material best if the client states that:

"A smoker has twice the risk of having a heart attack than a nonsmoker."

A nurse is planning a dietary menu for a client with heart failure being treated with digoxin (Lanoxin) and furosemide (Lasix). Which of the following would be the best dinner choice from the daily menu?

Baked pollack, mashed potatoes, and carrot-raisin salad

A client is at risk for complications of heart failure. What is the nurse's priority for early detection of the most likely cause of complications with this client?

Evaluating total body fluid

A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. A nurse listens to breath sounds, expecting to hear bilateral:

Crackles

A client has experienced an episode of pulmonary edema. The nurse determines that the client's respiratory status is improving if which of the following breath sounds are noted?

Crackles in the lung bases

A client is admitted with an arterial ischemic leg ulcer. The nurse expects to note that this ulcer has which of the following typical characteristics?

Deep and painful

A nurse is collecting data on a client with a diagnosis of right-sided heart failure. The nurse would expect to note which specific characteristic of this condition?

Dependent edema

A client brings the following medications to the clinic for her yearly physical. The nurse realizes which medication has been prescribed to treat heart failure?

Digoxin (Lanoxin)

A client has an Unna boot applied for treatment of a venous stasis leg ulcer. The nurse notes that the client's toes are mottled and cool, and the client verbalizes some numbness and tingling of the foot. The nurse interprets that the boot:

Has been applied too tightly

A client with known coronary artery disease (CAD) begins to experience chest pain while getting out of bed. The nurse should take which action first?

Have the client stop and lie back down in bed.

A nurse is assigned to assist with caring for a client after cardiac catheterization. The nurse plans to maintain bedrest with:

Head elevation of no more than 30 degrees

A nurse is caring for a client with coronary artery disease, and a topical nitrate is prescribed for the client. The nurse provides medication instructions and tells the client that acetaminophen (Tylenol) is usually prescribed to be taken before the administration of the topical nitrate because:

Headache is a common side effect of nitrates.

A client seeks medical attention for intermittent episodes in which the fingers of both hands become cold, pale, and numb. The client states that they then become reddened and swollen with a throbbing, achy pain. The nurse further collects data on the client to see whether these episodes occur with:

Ingestion of coffee or chocolate

A nurse is teaching a hospitalized client who has had aortoiliac bypass grafting about measures to improve circulation. The nurse tells the client to do which of the following?

Keep the ankles uncrossed.

A hypertensive client who has been taking metoprolol (Lopressor) has been prescribed to decrease the dose of the medication. The client asks the nurse why this must be done over a period of 1 to 2 weeks. In formulating a response, the nurse incorporates the understanding that abrupt withdrawal could:

Precipitate rebound hypertension

A nurse is preparing to ambulate a postoperative client after cardiac surgery. The nurse plans to do which of the following to enable the client to best tolerate the ambulation?

Premedicate the client with an analgesic before ambulating.

Acetylsalicylic acid (Aspirin) is prescribed for a client before a percutaneous transluminal coronary angioplasty (PTCA). When the nurse takes the aspirin to the client, the client asks the nurse about its purpose. The nurse informs the client that the aspirin will:

Prevent the formation of clots.

A nurse is collecting data from a client with varicose veins. Which finding would the nurse identify as an indication of a potential complication associated with this disorder?

The client complains of leg edema, and skin breakdown has started.

A nurse determines that a client with coronary artery disease (CAD) has the necessary understanding of disease management if the client makes which statement?

"I will walk for one-half hour daily."

A nurse determines that a client with coronary artery disease (CAD) understands disease management if the client makes which of the following statements?

"I will walk for one-half hour daily."

The client's B-type natriuretic peptide (BNP) level is 691 pg/mL. Which of the following should the nurse institute when providing care for the client?

Take daily weights and monitor trends.

A nurse provides instructions to a client at risk for thrombophlebitis regarding measures to minimize its occurrence. Which statement by the client indicates an understanding of this information?

"I should avoid sitting in one position for long periods of time."

A nurse has reinforced dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions?

"I should routinely use polyunsaturated oils in my diet."

A nurse is discussing smoking cessation with a client diagnosed with coronary artery disease (CAD). Which statement would the nurse make to the client to try to motivate the client to quit smoking?

"If you quit now, your risk of cardiovascular disease will decrease to that of a nonsmoker in three to four years."

A client with coronary artery disease has selected guided imagery to help cope with psychological stress. Which statement by the client indicates the best understanding of this stress reduction measure?

"The best thing about this is that I can use it anywhere, anytime."

A client is seen in the health care provider's office for a physical examination after experiencing unusual fatigue over the last several weeks. Height is 5 feet, 8 inches, with a weight of 220 pounds. Vital signs are temperature 98.6° F oral, pulse 86 beats per minute, respirations 18 breaths per minute, and blood pressure 184/96 mm Hg. Random blood glucose is 110 mg/dL. In order to best collect relevant data, which question should the nurse ask the client first?

"When was the last time you had your blood pressure checked?"

A client who has undergone femoropopliteal bypass grafting says to the nurse, "I hope I don't have any more problems that could make me lose my leg. I'm so afraid that I'll have gone through this for nothing." The appropriate nursing response is which of the following?

"You are concerned about losing your leg?"

A postcardiac surgery client with a blood urea nitrogen (BUN) level of 45 mg/dL and a serum creatinine level of 2.2 mg/dL has a total 2-hour urine output of 25 mL. The nurse understands that the client is at risk for:

Acute Renal Failure

A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin sodium (Coumadin). The nurse is told that the client's prothrombin time is 18 seconds with a control of 11 seconds. The nurse plans to:

Administer the next dose of warfarin sodium.

A client has an inoperable abdominal aortic aneurysm (AAA). The nurse teaches the client about the need for:

Antihypertensives

A clinic nurse is obtaining cardiovascular data on a client. The nurse prepares to check the client's apical pulse and places the stethoscope in which of the following positions?

At the midclavicular line at the fifth left intercostal space

A nurse is caring for a client with a diagnosis of myocardial infarction (MI). The client reports chest pain. When the administration of a sublingual nitroglycerin tablet as prescribed does not relieve the chest pain, the next nursing action is to:

Check the blood pressure and administer another nitroglycerin tablet.

A client is diagnosed with thrombophlebitis. The nurse tells the client that which of the following will likely be prescribed?

Bedrest, with elevation of the affected extremity

A client has a history of left-sided heart failure. The nurse would look for the presence of which of the following to determine whether the problem is currently active?

Bilateral lung crackles

A nurse is providing dietary instructions to a client with congestive heart failure (CHF). The nurse determines that the client understands the instructions if the client states that which of the following food items will be avoided?

Catsup

A nurse is planning to teach a client with peripheral arterial disease about measures to limit disease progression. The nurse should include which items on a list of suggestions to be given to the client? Select all that apply.

Cut down on the amount of fats consumed in the diet. Walk each day to increase circulation to the legs. Be careful not to injure the legs or feet. Eat a well-balanced diet every day.

A client has just completed an information session about measures to minimize the progression of coronary artery disease (CAD). The nurse determines that the client indicates an initial understanding of lifestyle alterations if the client states an intention to:

Eat a diet that is low in fat and cholesterol.

A nurse monitors the laboratory data on a client at risk for coronary artery disease. A fasting blood glucose reading of 200 mg/dL is recorded on the chart. The nurse analyzes this result as:

Elevated, signaling the presence of diabetes mellitus, a risk factor of coronary artery disease

A client admitted to the hospital with coronary artery disease complains of dyspnea at rest. The nurse determines that which of the following items would be of most help to the client?

Elevating the head of the bed to at least 45 degrees

A nurse is collecting data on a client who was just admitted to the hospital with a diagnosis of coronary artery disease (CAD). The client reveals having been under a great deal of stress recently. Based on this finding, the nurse should:

Explore with the client the sources of stress in life.

A client is admitted to the hospital with a venous stasis leg ulcer. The nurse inspects the ulcer, expecting to note that the ulcer:

Has a brownish or "brawny" appearance

The client scheduled for a right femoropopliteal bypass graft is at risk for compromised tissue perfusion to the extremity. The nurse takes which action before surgery to address this risk?

Marking the location of the pedal pulses on the right leg

A nurse is checking the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission. The nurse interprets that the neurovascular status is:

Normal, caused by increased blood flow through the leg

A nurse is evaluating the effects of care for the client with deep vein thrombosis. Which of the following limb observations would the nurse note as indicating the least success in meeting the outcome criteria for this problem?

Pedal edema that is 3+

A nurse is caring for a client who is developing pulmonary edema. The client exhibits respiratory distress, but the blood pressure is unchanged from the client's baseline. As an immediate action before help arrives, the nurse would:

Place the client in high-Fowler's position.

A client receiving parenteral nutrition (PN) has a history of congestive heart failure. The health care provider has prescribed furosemide (Lasix) 40 mg orally daily to prevent fluid overload. The nurse monitors which laboratory value to identify an adverse effect from this medication?

Potassium

A student nurse is assigned to assist in caring for a client with acute pulmonary edema who is receiving digoxin (Lanoxin) and heparin therapy. The nursing instructor reviews the plan of care formulated by the student and tells the student that which intervention is unsafe?

Restricting the client's potassium intake

A nurse notes bilateral 2+ edema in the lower extremities of a client with known coronary artery disease who was admitted to the hospital 2 days ago. Based on this finding, the nurse implements which action?

Reviews the intake and output records for the last 2 days

A nurse is assisting in caring for a client in the telemetry unit and is monitoring the client for cardiac changes indicative of hypokalemia. Which occurrence noted on the cardiac monitor indicates the presence of hypokalemia?

ST-segment depression

A client's blood pressure is 100/78 mm Hg; the client has tachycardia and is cool and pale. The nurse assists the client to which position to promote tissue oxygenation?

Semi-Fowler's

A nurse is assisting in caring for a client in the telemetry unit who is receiving an intravenous infusion of 1000 mL 5% dextrose with 40 mEq of potassium chloride. Which occurrence observed on the cardiac monitor indicates the presence of hyperkalemia?

Tall, peaked T waves

A client with no history of heart disease has experienced an acute myocardial infarction and has been given thrombolytic therapy with tissue plasminogen activator (t-PA). The nurse interprets that the client is likely experiencing a complication of this therapy if which of the following occurs?

Tarry stools

In order to assess the dorsalis pedis pulse of a client diagnosed with arterial vascular disease, the nurse palpates which anatomical location? Refer to figure.

Top of the foot

A nurse has completed nutritional counseling with an overweight client about weight reduction to modify the risk for coronary artery disease. The nurse would determine the teaching as successful if the client stated that a safe weight loss goal is:

Two pounds per week

A client returns to the nursing unit after an above-the-knee amputation of the right leg. The nurse positions the client:

With the foot of the bed elevated

A client is receiving a continuous intravenous (IV) infusion of heparin in the treatment of deep vein thrombosis. The nurse is told that the client's activated partial thromboplastin time (aPTT) level is 65 seconds and that the client's baseline before the initiation of therapy was 30 seconds. The nurse identifies these results as:

Within the therapeutic range

A nurse is assisting a hospitalized client who is newly diagnosed with coronary artery disease (CAD) to make appropriate selections from the dietary menu. The nurse encourages the client to select which of the following meals?

Fresh strawberries, steamed vegetables, and baked fish

A 24-year-old man seeks medical attention for complaints of claudication in the arch of the foot. The nurse also notes superficial thrombophlebitis of the lower leg. The nurse would next check the client for:

Smoking history

For a client diagnosed with pulmonary edema, the nurse establishes a goal to have the client participate in activities that reduce cardiac workload. Which of the following client activities will contribute to achieving this goal?

Using a bedside commode for stools

A client with a diagnosis of rapid rate atrial fibrillation asks the nurse why the health care provider is going to perform carotid massage. The nurse responds that this procedure may stimulate the:

Vagus nerve to slow the heart rate

A client with a diagnosis of congestive heart failure is preparing for discharge to home from the hospital. The nurse determines that the client is ready for discharge to home if the client can:

Verbally describe the daily medications, doses, and times to be administered.

A nurse is assisting a client admitted to the hospital with pulmonary edema to prepare for discharge. The nurse would reinforce with the client the importance of complying with which of the following measures to prevent a recurrence?

Weigh self every morning before breakfast.

A licensed practical nurse (LPN) is assisting in caring for a client with a diagnosis of myocardial infarction (MI). The client is experiencing chest pain that is unrelieved by the administration of nitroglycerin. The registered nurse administers morphine sulfate to the client as prescribed by the health care provider. Following administration of the morphine sulfate, the LPN plans to monitor:

Respirations and blood pressure

A client had an aortic valve replacement 2 days ago. This morning, the client says to the nurse, "I don't feel any better than I did before surgery." The appropriate response by the nurse is:

"You are concerned that you don't feel any better after surgery?"

A nurse is setting up the bedside unit for a client being admitted to the nursing unit from the emergency department with a diagnosis of coronary artery disease (CAD). The nurse should place highest priority on making sure that which of the following is available at the bedside?

Oxygen tubing and flowmeter

A client with heart failure is scheduled to be discharged to home with digoxin (Lanoxin) and furosemide (Lasix) as ongoing prescribed medications. The nurse teaches the client to report which sign that indicates that the medications are not having the intended effect?

Weight gain of 2 to 3 pounds in a few days

A nurse working the 3:00 to 11:00 PM shift notes that a client with coronary artery disease (CAD) has a prescription for serum lipid levels to be drawn in the morning. The nurse places the client on which dietary preparation to ensure accurate test results?

Fasting for 12 hours