Health Alt. Cardiac

Which parameter would the nurse assess in a client with right-sided heart failure? Select all that apply. One, some, or all responses may be correct. 1 Fluid volume 2 Lung sounds 3 Mental status 4 Respiratory rate 5 Peripheral pulses

1 Fluid volume

A client is admitted to the hospital for an acute episode of angina pectoris. Which parameter is the priority for the nurse to monitor? 1.Pulse and blood pressure 2.Temperature and chest pain 3.Food tolerance and urinary output 4.Right upper quadrant pain and fatigue

1.Pulse and blood pressure

When a client with heart failure reports a 9-pound (4-kilogram) weight gain in the past 2 weeks, which assessment is the priority? 1 Palpate the abdomen. 2 Check for ankle edema. 3 Auscultate breath sounds. 4 Ask about dietary salt intake

3 Auscultate breath sounds.

A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is scheduled for cardiac catheterization. Which medication would need to be withheld for 24 hours before the procedure and for 48 hours after the procedure? 1. Regular insulin 2. Glipizide (Glucotrol) 3. Repaglinide (Prandin) 4. Metformin (Glucophage)

4. Metformin (Glucophage)

A client admitted to the hospital with coronary artery disease complains of dyspnea at rest. The nurse caring for the client uses which item as the best means to monitor respiratory status on an ongoing basis? 1. Apnea monitor 2.Oxygen flowmeter 3.Telemetry cardiac monitor 4.Oxygen saturation monitor

4.Oxygen saturation monitor

The nurse is preparing to administer a nitroglycerin patch to a patient. When providing teaching about the use of the patch, what should the nurse include? Avoid drugs to treat erectile dysfunction. Increase diet intake of high-potassium foods. Take an over-the-counter H2-receptor blocker. Avoid nonsteroidal antiinflammatory drugs (NSAIDS).

Avoid drugs to treat erectile dysfunction.

A patient who has a history of heart failure and chronic obstructive lung disease is admitted with severe dyspnea. Which value would the nurse expect to be elevated if the cause of dyspnea was cardiac related? Serum potassium Serum homocysteine High-density lipoprotein B-type natriuretic peptide (BNP)

B-type natriuretic peptide (BNP)

What is the priority assessment by the nurse caring for a patient receiving IV nesiritide (Natrecor) to treat heart failure? Urine output Lung sounds Blood pressure Respiratory rate

Blood pressure

The nurse plans to have whihc medication available for immediate use to treat ventricular tachycardia? A. Digoxin B. Acebutolol C. Amiodraone D. Verapamil

C. Amiodraone

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

Cerebral or pulmonary emboli

A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. Which findings would the nurse anticipate when auscultating the client's breath sounds?

Crackles

The nurse observes a flat line on the patient's monitor and the patient is unresponsive without pulse. What medications does the nurse prepare to administer? Lidocaine or amiodarone Digoxin and procainamide Epinephrine or vasopressin β-Adrenergic blockers and dopamine

Epinephrine or vasopressin

When a client is admitted with right ventricular failure, which clinical manifestation would the nurse expect to find? Chest pain Bradypnea Bradycardia Peripheral edema

Peripheral edema

Which anatomic feature of the heart directly stimulates ventricular contractions? SA node AV node Bundle of His Purkinje fibers

Purkinje fibers

The nurse observes ventricular tachycardia (VT) on the patient's monitor. What evaluation made by the nurse led to this interpretation? Unmeasurable rate and rhythm Rate 150 beats/min; inverted P wave Rate 200 beats/min; P wave not visible Rate 125 beats/min; normal QRS complex

Rate 200 beats/min; P wave not visible

A patient is being admitted for valve replacement surgery. Which assessment finding is indicative of aortic valve stenosis? Pulse deficit Systolic murmur Distended neck veins Splinter hemorrhages

Systolic murmur

Which finding in a client who had coronary artery bypass graft (CABG) surgery 1 day previously is most important for the nurse to communicate to the health care provider? Temperature of 102°F (38.9°C) 7/10 incisional pain (0 to 10 scale) Sinus rhythm with PR interval of 0.22 seconds 120 mL of blood in the chest tube collection chamber

Temperature of 102°F (38.9°C)

The patient reports tenderness when she touches her leg over a vein. The nurse assesses warmth and a palpable cord in the area. The nurse knows the patient needs treatment to prevent which consequence? Pulmonary embolism Pulmonary hypertension Postthrombotic syndrome Venous thromboembolism

Venous thromboembolism

The nurse provides discharge instructions for a 40-yr-old woman newly diagnosed with cardiomyopathy. Which statement indicates that further teaching is necessary? "I will avoid lifting heavy objects." "I can drink alcohol in moderation." "My family will need to take a CPR course." "I will reduce stress by learning guided imagery."

"I can drink alcohol in moderation."

The nurse performs discharge teaching for a patient with an implantable cardioverter-defibrillator (ICD). Which statement by the patient indicates that further teaching is needed? "The device may set off the metal detectors in an airport." "My family needs to keep up to date on how to perform CPR." "I should not stand next to antitheft devices at the exit of stores." "I can expect redness and swelling of the incision site for a few days."

"I can expect redness and swelling of the incision site for a few days."

The nurse teaches a 28-yr-old man newly diagnosed with hypertension about lifestyle modifications to reduce his blood pressure. Which patient statement requires reinforcement of teaching? "I will avoid adding salt to my food during or after cooking." "If I lose weight, I might not need to continue taking medications." "I can lower my blood pressure by switching to smokeless tobacco." "Diet changes can be as effective as taking blood pressure medications."

"I can lower my blood pressure by switching to smokeless tobacco."

After teaching a patient with chronic stable angina about nitroglycerin, the nurse recognizes the need for further teaching when the patient makes which statement? "I will replace my nitroglycerin supply every 6 months." "I can take up to 5 tablets every 3 minutes for relief of my chest pain." "I will take acetaminophen (Tylenol) to treat the headache caused by nitroglycerin." "I will take the nitroglycerin 10 minutes before planned activity that usually causes chest pain."

"I can take up to 5 tablets every 3 minutes for relief of my chest pain."

After the nurse has finished teaching a 50-year-old female client about symptoms of coronary artery disease in women, which statement indicates that the teaching has been effective? 1 "I don't need to worry about symptoms like chest pain or pressure." 2 "I will call my health care provider about any unusual fatigue." 3 "Women have less risk of death from heart disease than men." 4 "Bad cholesterol levels are usually higher in women than in men."

"I will call my health care provider about any unusual fatigue."

At a clinic visit, the nurse provides dietary teaching for a patient recently hospitalized with an exacerbation of chronic heart failure. The nurse determines that teaching is successful if the patient makes which statement? "I will limit the amount of milk and cheese in my diet." "I can add salt when cooking foods but not at the table." "I will take an extra diuretic pill when I eat a lot of salt." "I can have unlimited amounts of foods labeled as reduced sodium."

"I will limit the amount of milk and cheese in my diet."

The nurse teaches a patient with high cholesterol about natural lipid-lowering therapies. The nurse determines further teaching is necessary when the patient makes which statement? "Omega-3 fatty acids are helpful in reducing triglyceride levels." "I should check with my physician before I start taking any herbal products." "Herbal products do not go through as extensive testing as prescription drugs do." "I will take garlic instead of my prescription medication to reduce my cholesterol."

"I will take garlic instead of my prescription medication to reduce my cholesterol."

A 44-yr-old man is diagnosed with hypertension and receives a prescription for benazepril (Lotensin). After providing teaching, which statement by the patient indicates correct understanding? "If I take this medication, I will not need to follow a special diet." "It is normal to have some swelling in my face while taking this medication." "I will need to eat foods such as bananas and potatoes that are high in potassium." "If I develop a dry cough while taking this medication, I should notify my doctor."

"If I develop a dry cough while taking this medication, I should notify my doctor."

In caring for the patient with angina, the patient said, "While I was having a bowel movement, I started having the worst chest pain ever, like before I was admitted. I called for a nurse, then the pain went away." What further assessment data should the nurse obtain from the patient? "What precipitated the pain?" "Has the pain changed this time?" "In what areas did you feel this pain?" "What is your pain level on a 0 to 10 scale?"

"In what areas did you feel this pain?"

The patient tells the nurse that he does not understand how there can be a blockage in the left anterior descending artery (LAD), but there is damage to the right ventricle. What is the best response by the nurse? "One coronary vessel curves around and supplies the entire heart muscle." "The LAD supplies blood to the left side of the heart and part of the right ventricle." "The right ventricle is supplied during systole primarily by the right coronary artery." "It is actually on the right side of the heart, but we call it the left anterior descending vessel."

"The LAD supplies blood to the left side of the heart and part of the right ventricle."

A patient develops third-degree heart block and reports feeling chest pressure and shortness of breath. Which instructions should the nurse provide to the patient before initiating emergency transcutaneous pacing? "The device will convert your heart rate and rhythm back to normal." "The device uses overdrive pacing to slow the heart to a normal rate." "The device is inserted through a large vein and threaded into your heart." "The device delivers a current through your skin that can be uncomfortable."

"The device delivers a current through your skin that can be uncomfortable."

An older adult patient with chronic heart failure (HF) and atrial fibrillation asks the nurse why warfarin (Coumadin) has been prescribed to continue at home. What is the best response by the nurse? "The medication prevents blood clots from forming in your heart." "The medication dissolves clots that develop in your coronary arteries." "The medication reduces clotting by decreasing serum potassium levels." "The medication increases your heart rate so that clots do not form in your heart."

"The medication prevents blood clots from forming in your heart."

A postoperative patient asks the nurse why the provider ordered daily administration of enoxaparin (Lovenox). Which reply by the nurse is accurate? "This medication will help prevent breathing problems after surgery, such as pneumonia." "This medication will help lower your blood pressure to a safer level, which is very important after surgery." "This medication will help prevent blood clots from forming in your legs until your level of activity, such as walking, returns to normal." "This medication is a narcotic pain medication that will help take away any muscle aches caused by positioning on the operating room table."

"This medication will help prevent blood clots from forming in your legs until your level of activity, such as walking, returns to normal."

A patient with varicose veins has been prescribed compression stockings. Which nursing instruction would be appropriate? "Try to keep your stockings on 24 hours a day, as much as possible." "While you're still lying in bed in the morning, put on your stockings." "Dangle your feet at your bedside for 5 minutes before putting on your stockings." "Your stockings will be most effective if you can remove them several times a day."

"While you're still lying in bed in the morning, put on your stockings."

A 25-yr-old patient with a group A streptococcal pharyngitis does not want to take the antibiotics prescribed. How should the nurse respond? "You will not feel well if you do not take the medicine and get over this infection." "Once you have been treated for a group A streptococcal infection, you will not get it again." "Without treatment, you could get rheumatic fever, which can lead to rheumatic heart disease." "You may not want to take the antibiotics for this infection, but you will be sorry if you do not."

"Without treatment, you could get rheumatic fever, which can lead to rheumatic heart disease."

Which instruction by the nurse to a patient who is about to undergo Holter monitoring is accurate? "You may remove the monitor only to shower or bathe." "You should connect the monitor whenever you feel symptoms." "You should refrain from exercising while wearing this monitor." "You will need to keep a diary of your activities and symptoms."

"You will need to keep a diary of your activities and symptoms."

Which assessment finding of a client with heart failure would prompt the nurse to contact the health care provider? Select all that apply. One, some, or all responses may be correct. 1 Fatigue 2 Orthopnea 3 Pitting edema 4 Dry hacking cough 5 4-pound weight gain

1 Fatigue 2 Orthopnea 3 Pitting edema 4 Dry hacking cough 5 4-pound weight gain

Which action would the nurse perform when a client is in ventricular fibrillation? Select all that apply. One, some, or all responses may be correct. 1 Initiating CPR 2 Assessing the EKG 3 Using a defibrillator 4 Obtaining electrolytes 5 Administering epinephrine

1 Initiating CPR 2 Assessing the EKG 3 Using a defibrillator 4 Obtaining electrolytes 5 Administering epinephrine

When a client with heart failure is seen in the clinic with new onset ankle edema, the nurse would question the client about which lifestyle factors that may have contributed to the ankle swelling? Select all that apply. One, some, or all responses may be correct. 1 Intake of salty foods 2Dietary fat intake 3 Medication compliance 4 Family stresses 5 Recent travel

1 Intake of salty foods 3 Medication compliance 5 Recent travel

Which intervention would the nurse perform when caring for a client in the emergency department reporting chest pain? Select all that apply. One, some, or all responses may be correct. 1 Providing oxygen 2 Assessing vital signs 3 Obtaining a 12-lead EKG 4 Drawing blood for cardiac enzymes 5 Auscultating heart sounds 6 Administering nitroglycerin

1 Providing oxygen 2 Assessing vital signs 3 Obtaining a 12-lead EKG 4 Drawing blood for cardiac enzymes 5 Auscultating heart sounds 6 Administering nitroglycerin

Which clinical manifestations are more likely to occur in women with coronary artery disease compared with men? Select all that apply. One, some, or all responses may be correct. 1 Severe fatigue 2 Sense of unease 3 Substernal chest pain 4 Shortness of breath 5 Pain radiating down the left arm

1 Severe fatigue 2 Sense of unease 4 Shortness of breath

Which information would be used to determine the cause of premature atrial contractions (PACs) observed on a client's EKG? Select all that apply. One, some, or all responses may be correct. 1 Stress level 2 Tobacco use 3 Caffeine intake 4 Electrolyte levels 5 Home medications

1 Stress level 2 Tobacco use 3 Caffeine intake 4 Electrolyte levels 5 Home medications

Which clinical finding is the nurse most likely to identify when completing a history and physical assessment of a client with complete heart block? 1 Syncope 2 Headache 3 Tachycardia 4 Hemiparesis

1 Syncope

Which modifiable risk factor would the nurse include in a community presentation on cardiovascular risk factors? Select all that apply. One, some, or all responses may be correct. 1 Weight 2 Inactivity 3 Cholesterol 4 Tobacco use 5 Homocysteine

1 Weight 2 Inactivity 3 Cholesterol 4 Tobacco use 5 Homocysteine

Potassium chloride intravenously is prescribed for a client with hypokalemia. Which actions should the nurse take to plan for preparation and administration of the potassium? Select all that apply. 1. Obtain an intravenous (IV) infusion pump. 2. Monitor urine output during administration 3.Prepare the medication for bolus administration. 4. Monitor the IV site for signs of infiltration or phlebitis. 5. Ensure that the medication is diluted in the appropriate volume of fluid. 6.Ensure that the bag is labeled so that it reads the volume of potassium in the solution.

1. Obtain an intravenous (IV) infusion pump. 3. Prepare the medication for bolus administration. 4. Monitor the IV site for signs of infiltration or phlebitis. 5. Ensure that the medication is diluted in the appropriate volume of fluid. 6.Ensure that the bag is labeled so that it reads the volume of potassium in the solution.

When computing a heart rate from the electrocardiography (ECG) tracing, the nurse counts 15 of the small blocks between the R waves of a patient whose rhythm is regular. What does the nurse calculate the patient's heart rate to be? 60 beats/min 75 beats/min 100 beats/min 150 beats/min

100 beats/min

A patient with a history of chronic hypertension is being evaluated in the emergency department for a blood pressure of 200/140 mm Hg. Which patient assessment question is the priority? Is the patient pregnant? Does the patient need to urinate? Does the patient have a headache or confusion? Is the patient taking antiseizure medications as prescribed?

Does the patient have a headache or confusion?

When the patient is being examined for venous thromboembolism (VTE) in the calf, what diagnostic test should the nurse expect to teach the patient about first? Duplex ultrasound Contrast venography Magnetic resonance venography Computed tomography venography

Duplex ultrasound

A patient admitted to the emergency department 24 hours ago with reports of chest pain was diagnosed with a ST-segment-elevation myocardial infarction (STEMI). What complication of myocardial infarction should the nurse anticipate? Dysrhythmias Unstable angina Cardiac tamponade Sudden cardiac death

Dysrhythmias

The nurse prepares a discharge teaching plan for a patient who has recently been diagnosed with coronary artery disease (CAD). Which priority risk factor should the nurse plan to focus on during the teaching session? Type A personality Elevated serum lipids Family cardiac history High homocysteine levels

Elevated serum lipids

A client with atrial fibrillation who is receiving maintenance therapy of warfarin sodium (Coumadin) has a prothrombin time (PT) of 35 seconds. On the basis of the prothrombin time, the nurse anticipates which prescription? 1. Adding a dose of heparin sodium 2. Holding the next dose of warfarin 3. Increasing the next dose of warfarin 4. Administering the next dose of warfarin

2. Holding the next dose of warfarin

Intravenous heparin therapy is prescribed for a client. While implementing this prescription, the nurse ensures that which medication is available on the nursing unit? 1. Vitamin K 2. Protamine sulfate 3. Potassium chloride 4. Aminocaproic acid

2. Protamine sulfate

A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats/minute. The PR interval is 0.14 second, the QRS complex measures 0.08 second, and the PP and RR intervals are regular. How should the nurse correctly interpret this rhythm? 1. Sinus dysrhythmia 2. Sinus tachycardia 3. Sinus bradycardia 4. Normal sinus rhythm

2. Sinus tachycardia

The nurse is preparing discharge instructions for a client with Raynaud's disease. The nurse should plan to provide which instruction to the client? 1. Use nail polish to protect the nail beds from injury. 2. Stop smoking because it causes cutaneous vasospasm. 3. Wear gloves for all activities involving use of both hands. 4. Always wear warm clothing even in warm climates to prevent vasoconstriction.

2. Stop smoking because it causes cutaneous vasospasm.

The nurse is developing a plan of care for a client with varicose veins in whom skin breakdown occurred over the varicosities as a result of secondary infection. Which is a priority intervention? 1.Keep the legs aligned with the heart. 2.Elevate the legs higher than the heart. 3.Clean the skin with alcohol every hour. 4.Position the client onto the side every shift.

2.Elevate the legs higher than the heart.

Which response by the nurse is best when a client who has had an ST-segment elevation myocardial infarction (STEMI) asks about the resumption of sexual activity? 1 "You can safely resume sexual activities when you are no longer fearful of sexual intimacy." 2 "You will be able to discuss sexual activity with the health care provider before discharge." 3 "Sexual activities can be safely resumed after an exercise stress test with no heart symptoms." 4 "Many clients wait a few weeks after myocardial infarction before having any sexual activity."

3 "Sexual activities can be safely resumed after an exercise stress test with no heart symptoms."

Where will the nurse place the V1 lead when obtaining a 12-lead electrocardiogram? 1 Fifth intercostal space, left midaxillary line 2 Second intercostal space, left sternal border 3 Fourth intercostal space, right sternal border 4 Fifth intercostal space, left midclavicular line

3 Fourth intercostal space, right sternal border Positions for these 6 leads are as follows: V1: fourth intercostal space, right sternal border; V2: fourth intercostal space, left sternal border; V3: halfway between V2 and V4; V4: fifth intercostal space, left midclavicular line; V5: fifth intercostal space, left anterior axillary line; V6: fifth intercostal space, left midaxillary line.

The nurse in the medical unit is reviewing the laboratory test results for a client who has been transferred from the intensive care unit. The nurse notes that a cardiac troponin T level assay was performed while the client was in the intensive care unit. The nurse determines that this test was performed to assist in diagnosing which condition? 1.Heart failure 2.Atrial fibrillation 3.Myocardial infarction 4.Ventricular tachycardia

3.Myocardial infarction

The nurse is watching the cardiac monitor and notices that a client's rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but more than 140 beats per minute. The nurse determines that the client is experiencing which dysrhythmia? 1.Sinus tachycardia 2.Ventricular fibrillation 3.Ventricular tachycardia 4.Premature ventricular contractions

3.Ventricular tachycardia

The nurse is caring for a client who has just had implantation of an automatic internal cardioverter-defibrillator. The nurse immediatelywould assess which item based on priority? 1. Anxiety level of the client and family 2. Presence of a Medic-Alert card for the client to carry 3. Knowledge of restrictions of postdischarge physical activity 4. Activation status of the device, heart rate cutoff, and number of shocks it is programmed to deliver

4. Activation status of the device, heart rate cutoff, and number of shocks it is programmed to deliver

The nurse is performing an admission assessment on a client with a diagnosis of Raynaud's disease. How should the nurse assess for this disease? 1. Checking for a rash on the digits 2. Observing for softening of the nails or nail beds 3. Palpating for a rapid or irregular peripheral pulse 4. Palpating for diminished or absent peripheral pulses

4. Palpating for diminished or absent peripheral pulses

A client in sinus bradycardia, with a heart rate of 45 beats/minute, complains of dizziness and has a blood pressure of 82/60 mm Hg. Which prescription shouldthe nurse anticipate will be prescribed? 1. Administer digoxin. 2. Defibrillate the client. 3. Continue to monitor the client. 4. Prepare for transcutaneous pacing.

4. Prepare for transcutaneous pacing.

A client being treated for heart failure is administered intravenous bumetanide. Which outcome indicates the medication has achieved the expected effect? 1. Cough becomes productive of frothy pink sputum 2. The serum potassium level changes from 3.8 to 3.1mEq/L 3. B-natriuretic peptide (BNP) factor increases from 200 tp 262pg/ml 4. Urine output increases from 10ml/hr to greater than 50ml/hr

4. Urine output increases from 10ml/hr to greater than 50ml/hr

A client is receiving a continuous intravenous infusion of heparin sodium to treat deep vein thrombosis. The clients activated partial thromboplastin (aPTT) time is 65 seconds. The licensed practical nurse reviews the laboratory results with the registered nurse, anticipating which action is needed? 1.) discontinuing the heparin infusion 2) increasing the rate of the heparin infusion 3) decreasing the rate of the heparin infusion 4.) Leaving the rate of the heparin infusion as is

4.) Leaving the rate of the heparin infusion as is

A client is having frequent premature ventricular contractions. The nurse should place priority on assessment of which item?1.Sensation of palpitations 2.Causative factors, such as caffeine 3.Precipitating factors, such as infection 4.Blood pressure and oxygen saturation

4.Blood pressure and oxygen saturation

The ambulatory care nurse is working with a client who has been diagnosed with Prinzmetal's (variant) angina. What should the nurse plan to teach the client about this type of angina? 1.It is most effectively managed by β-blocking agents. 2.It has the same risk factors as stable and unstable angina. 3.It can be controlled with a low-sodium, high-potassium diet. 4.Generally it is treated with calcium-channel-blocking agents

4.Generally it is treated with calcium-channel-blocking agents

A client is being discharged from the hospital after being treated for infective endocarditis. The nurse should provide the client with which discharge instruction? 1.Take antibiotics until the chest pain is fully resolved. 2.Take acetaminophen (Tylenol) if the chest pain worsens. 3.Use a firm-bristle toothbrush and floss vigorously to prevent cavities. 4.Notify all health care providers (HCP) of the history of infective endocarditis before any invasive procedures.

4.Notify all health care providers (HCP) of the history of infective endocarditis before any invasive procedures.

A client in sinus bradycardia, with a heart rate of 45 beats per minute and blood pressure of 82/60 mm Hg, reports dizziness. Which intervention should the nurse anticipate will be prescribed? 1.Administer digoxin. 2.Defibrillate the client. 3.Continue to monitor the client. 4.Prepare for transcutaneous pacing.

4.Prepare for transcutaneous pacing.

Which person would the nurse identify as having the highest risk for coronary artery disease (CAD)? A 60-yr-old man with low homocysteine levels A 45-yr-old man with a high-stress job who is depressed A 54-yr-old woman vegetarian with increased high-density lipoprotein (HDL) levels A 62-yr-old woman who has a sedentary lifestyle and body mass index (BMI) of 23 kg/m2

A 45-yr-old man with a high-stress job who is depressed

Which patient is at greatest risk for sudden cardiac death (SCD)? A 52-yr-old black man with left ventricular failure A 62-yr-old obese man with diabetes and high cholesterol A 42-yr-old white woman with hypertension and dyslipidemia A 72-yr-old Native American woman with a family history of heart disease

A 52-yr-old black man with left ventricular failure

The nurse is monitoring the electrocardiograms of several patients on a cardiac telemetry unit. The patients are directly visible to the nurse, and all the patients are observed to be sitting up and talking with visitors. Which patient's rhythm would require the nurse to take immediate action? A 62-yr-old man with a fever and sinus tachycardia with a rate of 110 beats/min A 72-yr-old woman with atrial fibrillation with 60 to 80 QRS complexes per minute A 52-yr-old man with premature ventricular contractions (PVCs) at a rate of 12 per minute A 42-yr-old woman with first-degree AV block and sinus bradycardia at a rate of 56 beats/min

A 52-yr-old man with premature ventricular contractions (PVCs) at a rate of 12 per minute

Which person would the nurse identify as having the highest risk for abdominal aortic aneurysm? A 70-yr-old man with high cholesterol and hypertension A 40-yr-old woman with obesity and metabolic syndrome A 60-yr-old man with renal insufficiency who is physically inactive A 65-yr-old woman with high homocysteine levels and substance use

A 70-yr-old man with high cholesterol and hypertension

The nurse is performing an admission assessment on a client with a diagnosis of angina pectoris who takes nitroglycerin for chest pain at home. During the assessment the client complains of chest pain. The nurse should immediately ask the client which question? A. "Where is the pain located?" B. "Are you having any nausea?" C. "Are you allergic to any medications?" D. "Do you have your nitroglycerin with you?"

A. "Where is the pain located?"

The nurse is caring for a client hospitalized for heart failure exacerbation and suspects the client may be entering a state of shock. The nurse knows that which intervention is the priority for this client? A. Administration of digoxin B. Adiminstration of whole blood C. Administration of intravenous fluids D. Administration of packed red blood cells

A. Administration of digoxin

A nurse is caring for a patient immediately following a transesophageal echocardiogram (TEE). Which assessments are appropriate for this patient? (Select all that apply.) Assess for return of gag reflex. A. Assess groin for hematoma or bleeding. B. Monitor vital signs and oxygen saturation. C. Position patient supine with head of bed flat. D. Assess lower extremities for circulatory compromise.

A. Assess for return of gag reflex. B. Monitor vital signs and oxygen saturation.

A client is having a cardia catheterization using iodine agent. Whcih assessment is most critical before the procedure? A. Previous Allergy to contrast agents B. Height and Weight C. Baseline Peripheral pulse rates D. Intake and output

A. Previous Allergy to contrast agents

The nurse has obtained this rhythm strip from her patient's monitor. What should the nurse document this rhythm indicates? A. Sinus tachycardia B. Sinus bradycardia C. Ventricular fibrillation D. Ventricular tachycardia

A. Sinus tachycardia

The nurse assessed client for which manifestation that differentaties pericarditis from other cardiopulmonary problems? A. pericardial friction rub B. anterior chest pain C. weakness and irritablitiy D. Chest pain that worsens on inspiration

A. pericardial friction rub

A nurse is caring for a patient with a diagnosis of deep venous thrombosis (DVT). The patient has an order to receive 30 mg enoxaparin (Lovenox). Which injection site should the nurse use to administer this medication safely? Buttock, upper outer quadrant Abdomen, anterior-lateral aspect Back of the arm, 2 in away from a mole Anterolateral thigh, with no scar tissue nearby

Abdomen, anterior-lateral aspect

A 39-yr-old woman with a history of smoking and oral contraceptive use is admitted with a venous thromboembolism (VTE) and prescribed unfractionated heparin. What laboratory test should the nurse review to evaluate the expected effect of the heparin? Platelet count Activated clotting time (ACT) International normalized ratio (INR) Activated partial thromboplastin time (aPTT)

Activated partial thromboplastin time (aPTT)

The patient is being dismissed from the hospital after acute coronary syndrome (ACS) and will be attending rehabilitation. What information would be taught in the early recovery phase of rehabilitation? Therapeutic lifestyle changes should become lifelong habits. Physical activity is always started in the hospital and continued at home. Attention will focus on managing chest pain, anxiety, dysrhythmias, and other complications. Activity level is gradually increased under cardiac rehabilitation team supervision and monitoring.

Activity level is gradually increased under cardiac rehabilitation team supervision and monitoring.

For which problem is percutaneous coronary intervention (PCI) most clearly indicated? Chronic stable angina Left-sided heart failure Coronary artery disease Acute myocardial infarction

Acute myocardial infarction

A patient reporting dizziness and shortness of breath is admitted with a dysrhythmia. Which medication, if ordered, requires the nurse to carefully monitor the patient for asystole? Digoxin Adenosine Metoprolol Atropine sulfate

Adenosine

A patient admitted with heart failure is anxious and reports shortness of breath. Which nursing actions would be appropriate to alleviate this patient's anxiety? (Select all that apply.) Administer ordered morphine sulfate. Position patient in a semi-Fowler's position. Position patient on left side with head of bed flat. Instruct patient on the use of relaxation techniques. Use a calm, reassuring approach while talking to patient.

Administer ordered morphine sulfate. Position patient in a semi-Fowler's position. Instruct patient on the use of relaxation techniques. Use a calm, reassuring approach while talking to patient.

The nurse is reviewing the laboratory test results for a patient whose warfarin (Coumadin) therapy was stopped before surgery. On postoperative day 2, the international normalized ratio (INR) result is 2.7. Which action by the nurse is most appropriate? Hold the daily dose of warfarin. Administer the daily dose of warfarin. Teach the patient signs and symptoms of bleeding. Call the health care provider to request an increased dose of warfarin.

Administer the daily dose of warfarin.

The nurse determines that a patient's pedal pulses are absent. What factor could contribute to this finding? Atherosclerosis Hyperthyroidism Atrial dysrhythmias Arteriovenous fistula

Atherosclerosis

Postoperative care of a patient undergoing coronary artery bypass graft (CABG) surgery includes monitoring for which common complication? Dehydration Paralytic ileus Atrial dysrhythmias Acute respiratory distress syndrome

Atrial dysrhythmias

The nurse observes no P waves on the patients monitor strip. There are fine, wavy lines between the QRS complexes. The QRS complexes measure 0.08 seconds (narrow), but they occur irregularly with a rate of 120 beats/min. What does the nurse determine the rhythm to be? Sinus tachycardia Atrial fibrillation Ventricular fibrillation Ventricular tachycardia

Atrial fibrillation

The nurse is doing discharge teaching with the patient who received an implantable cardioverter-defibrillator (ICD) in the left side. Which statement by the patient indicates that further teaching is required? A. "I will call the cardiologist if my ICD fires." B. "I cannot fly because it will damage the ICD." C. "I cannot move my left arm until it is approved." D. "I cannot drive until my cardiologist says it is okay."

B. "I cannot fly because it will damage the ICD."

An electrocardiogram shows that the venticular rhythm is irregular and there are no discemilbe P waves, this is: A. First- degree AV block B. Atrial fib C. Atrial flutter D. Thrid- degree AV block

B. Atrial fib

The nurse is monitoring a client who is taking propranolol. Which data collection finding would indicate a potential serious complication associated with propranolol? A. Report of infrequent insominia B. Development of expiratory wheezes C. A baseline of 150/80 mm Hg after 2 doses of medication D. A baseline resting heart reate of 88 beats per minute followed by a resting heart rate of 72 beats per minute after 2 doses of the medication

B. Development of expiratory wheezes

The nurse is caring for a client with acute pericarditis. Which clinical finding would require immediate intervention by the nurse? A. Client reports chest pain that is worse with deep insiration B. Distant heart tones and JVD C. ECG showing ST segment elevations in all leads D. Pericardial friction rub ausculatated at the left sternal border

B. Distant heart tones and JVD

A client complains of calf tenderness, and thrombophlebitis is suspected. The nurse should next assess which finding? A. Bilateral edema B. Increased calf circumference C. Coolness and pallor of the affected limb D. Diminised distal peripheral pulses

B. Increased calf circumference

What is the first priority of a patient with a suspected acute aortic dissection? A. reduce anxiety B. control blood pressure C. monitor chest pain D. increase myocardial contractility

B. control blood pressure

The nurse is caring for a patient admitted with a history of hypertension. The patient's medication history includes hydrochlorothiazide daily for the past 10 years. Which parameter would indicate the optimal intended effect of this drug therapy? BP 128/78 mm Hg Weight loss of 2 lb Absence of ankle edema Output of 600 mL per 8 hours

BP 128/78 mm Hg

A patient was admitted for possible ruptured aortic aneurysm. Ten minutes later, the nurse notes sinus tachycardia 138 beats/min, blood pressure is palpable at 65 mm Hg, increasing waist circumference, and no urine output. How should the nurse interpret the findings? Tamponade will soon occur. The renal arteries are involved. Perfusion to the legs is impaired. Bleeding into the abdomen is likely.

Bleeding into the abdomen is likely.

An asymptomatic patient with acute decompensated heart failure (ADHF) suddenly becomes dyspneic. Before dangling the patient on the bedside, what should the nurse assess first? Urine output Heart rhythm Breath sounds Blood pressure

Blood pressure

The nurse is caring for a patient admitted with chronic obstructive pulmonary disease (COPD), angina, and hypertension. Before administering the prescribed daily dose of atenolol 100 mg PO, the nurse assesses the patient carefully. Which adverse effect is this patient at risk for given the patient's health history? Hypocapnia Tachycardia Bronchospasm Nausea and vomiting

Bronchospasm

The nurse admits a 73-yr-old male patient with dementia for treatment of uncontrolled hypertension. The nurse will closely monitor for hypokalemia if the patient receives which medication? Clonidine (Catapres) Bumetanide (Bumex) Amiloride (Midamor) Spironolactone (Aldactone)

Bumetanide (Bumex)

The nurse in the medical unit is assigned to provide discharge teaching to a client with a diagnosis of angina pectoris. The nurse is discussing lifestyle changes that are needed to minimize the effects of the disease process. The client continually changes the subject during the teaching session. The nurse interprets that this client's behavior is most likely related to which problem? A. Anxiety related to the need to make lifestyle changes B. Boredom resulting from having already learned the material C. An attempt to ignore or deny the need to make lifestyle changes D. Lack of understanding of the material provided at the teaching session and embarrassment about asking questions

C. An attempt to ignore or deny the need to make lifestyle changes

A client develops a fib and ventricular rate of 140 and signs of decreased CO. What medication would be used 1St A. atropine sulfate B. Lidocaine C. Metoprolol D. Warfarin

C. Metoprolol

The nurse should suspect myocaridal injury or infarction if whihc lab value comes back elevated? A. Creatine kinase B. C-reactive protien C. Troponin D. Myoglobin

C. Troponin

The nurse recognizes additional teaching is needed when the patient prescribed a low-sodium, low-fat cardiac diet selects which food? Baked flounder Angel food cake Canned chicken noodle soup Baked potato with margarine

Canned chicken noodle soup

A patient is scheduled for a heart transplant. What is a major cause of death beyond the first year after a heart transplant? Infection Acute rejection Immunosuppression Cardiac vasculopathy

Cardiac vasculopathy

A patient with a long-standing history of heart failure recently qualified for hospice care. What measure should the nurse now prioritize when providing care for this patient? Taper the patient off his current medications. Continue education for the patient and his family. Pursue experimental therapies or surgical options. Choose interventions to promote comfort and prevent suffering.

Choose interventions to promote comfort and prevent suffering.

Which client would be at an increased risk for coronary artery disease (CAD)? Select all that apply. One, some, or all responses may be correct. 1 Client with total cholesterol 175 mg/dL and LDL cholesterol 80 mg/dL 2 Client with total cholesterol 190 mg/dL and HDL cholesterol 40 mg/dL 3 Client with total cholesterol 200 mg/dL and HDL cholesterol 45 mg/dL 4 Client with total cholesterol 250 mg/dL and LDL cholesterol 120 mg/dL 5 Client with total cholesterol 160 mg/dL and LDL cholesterol 125 mg/dL

Client with total cholesterol 250 mg/dL and LDL cholesterol 120 mg/dL Major risk factors for CAD include elevated serum lipid levels. A total cholesterol greater than 200 mg/dL, LDL cholesterol greater than 130 mg/dL, and HDL cholesterol less than 40 mg/dL increase a client's risk for CAD. Therefore, the client with a total cholesterol of 250 mg/dL is at an increased risk for CAD. Laboratory values of total cholesterol 175 mg/dL and LDL cholesterol 80 mg/dL; total cholesterol 190 mg/dL and HDL cholesterol 40 mg/dL; total cholesterol 200 mg/dL and HDL cholesterol 45 mg/dL; and total cholesterol 160 mg/dL and LDL cholesterol 125 mg/dL are all within normal limits and do not indicate that the client is at increased risk for CAD.

Which assessment findings of the left lower extremity would the nurse identify as consistent with arterial occlusion? (Select all that apply.) Edematous Cold and mottled Reports of paresthesia Pulse not palpable with Doppler Warmer than right lower extremity Capillary refill less than 3 seconds

Cold and mottled Reports of paresthesia Pulse not palpable with Doppler

The nurse is caring for a patient who received a mechanical aortic valve replacement 2 years ago. Current lab values include an international normalized ratio (INR) of 1.5, platelet count of 150,000/µL, and hemoglobin of 8.6g/dL. Which nursing action is most appropriate? Assess the vital signs. Start intravenous fluids. Monitor for signs of bleeding. Contact the health care provider.

Contact the health care provider.

A patient who has myocarditis now has fatigue, weakness, palpitations, and dyspnea at rest. The nurse assesses pulmonary crackles, edema, and weak peripheral pulses. Sinoatrial tachycardia is evident on the cardiac monitor. The Doppler echocardiography shows dilated cardiomyopathy. What should collaborative care accomplish to improve cardiac output and quality of life? Decrease preload and afterload. Relieve left ventricular outflow obstruction. Improve diastolic filling and the underlying disease process. Improve ventricular filling by reducing ventricular contractility.

Decrease preload and afterload.

A 55-yr-old female patient develops acute pericarditis after a myocardial infarction. Which assessment finding indicates a possible complication? Presence of a pericardial friction rub Distant and muffled apical heart sounds Increased chest pain with deep breathing Decreased blood pressure with tachycardia

Decreased blood pressure with tachycardia

The nurse is caring for a patient with a recent history of deep vein thrombosis (DVT) who is scheduled for an emergency appendectomy. Vitamin K is ordered for immediate administration. The international normalized ratio (INR) value is 1.0. Which nursing action is most appropriate? Administer the medication as ordered. Hold the medication and record in the electronic medical record. Hold the medication until the lab result is repeated to verify results. Administer the medication and seek an increased dose from the health care provider.

Hold the medication and record in the electronic medical record.

The nurse teaches a patient with hypertension that uncontrolled hypertension may damage organs in the body primarily by which mechanism? Hypertension promotes atherosclerosis and damage to the walls of the arteries. Hypertension causes direct pressure on organs, resulting in necrosis and scar tissue. Hypertension causes thickening of the capillary membranes, leading to hypoxia of organ systems. Hypertension increases blood viscosity, which causes intravascular coagulation and tissue necrosis distal to occlusions.

Hypertension promotes atherosclerosis and damage to the walls of the arteries.

What should the nurse recognize as an indication for the use of dopamine in the care of a patient with heart failure? Acute anxiety Hypotension and tachycardia Peripheral edema and weight gain Paroxysmal nocturnal dyspnea (PND)

Hypotension and tachycardia

Which type of shock would the nurse monitor for in a client with a ruptured abdominal aortic aneurysm? Obstructive Neurogenic Cardiogenic Hypovolemic

Hypovolemic

A patient with a history of myocardial infarction is scheduled for a transesophageal echocardiogram to visualize a suspected clot in the left atrium. What information should the nurse include when teaching the patient about this diagnostic study? IV sedation may be administered to help the patient relax. Food and fluids are restricted for 2 hours before the procedure. Ambulation is restricted for up to 6 hours before the procedure. Contrast medium is injected into the esophagus to enhance images.

IV sedation may be administered to help the patient relax.

A patient experienced sudden cardiac death (SCD) and survived. Which treatment should the nurse expect to be implemented to prevent an SCD recurrence at home? External cardiac pacemaker An electrophysiologic study (EPS) Medications to prevent dysrhythmias Implantable cardioverter-defibrillator (ICD)

Implantable cardioverter-defibrillator (ICD)

A patient is prescribed diltiazem (Cardizem) for Raynaud's phenomenon. Which assessment finding would indicate to the nurse that the medication is effective? Improved skin turgor Decreased cardiac rate Improved finger perfusion Decreased mean arterial pressure

Improved finger perfusion

The patient has heart failure (HF) with an ejection fraction of less than 40%. What core measures should the nurse expect to include in the plan of care for this patient? (Select all that apply.) Left ventricular function is documented Controlling dysrhythmias will eliminate HF Prescription for digoxin (Lanoxin) at discharge Prescription for angiotensin-converting enzyme inhibitor at discharge Education materials about activity, medications, weight monitoring, and what to do if symptoms worsen

Left ventricular function is documented Prescription for angiotensin-converting enzyme inhibitor at discharge Education materials about activity, medications, weight monitoring, and what to do if symptoms worsen

The patient has chronic venous insufficiency and a venous ulcer. The unlicensed assistive personnel (UAP) decides to apply compression stockings because that is what patients "always" have ordered. Which assessment finding would indicate the application of compression stockings could harm the patient? Leg pain at rest High blood pressure Dry, itchy, flaky skin Elevated blood glucose

Leg pain at rest

The nurse is teaching a women's group about ways to prevent hypertension. What information should the nurse include? (Select all that apply.) Lose weight. Limit beef consumption. Limit sodium and fat intake. Increase fruits and vegetables. Exercise 30 minutes most days.

Limit beef consumption. Limit sodium and fat intake. Increase fruits and vegetables. Exercise 30 minutes most days.

The nurse is administering a dose of Digitalis (digoxin) to a patient with heart failure (HF). The nurse would become concerned with the possibility of digitalis toxicity if the patient reported which symptom? Muscle aches Constipation Loss of appetite Pounding headache

Loss of appetite

The blood pressure of an older adult patient admitted with pneumonia is 160/70 mm Hg. What is an age-related change that contributes to this finding? Stenosis of the heart valves Decreased adrenergic sensitivity Increased parasympathetic activity Loss of elasticity in arterial vessels

Loss of elasticity in arterial vessels

The nurse is providing care for a patient who has decreased cardiac output due to heart failure. As a basis for planning care, what should the nurse understand about cardiac output (CO)? CO is calculated by multiplying the patient's stroke volume by the heart rate. CO is the average amount of blood ejected during one complete cardiac cycle. CO is determined by measuring the electrical activity of the heart and the heart rate. CO is the patient's average resting heart rate multiplied by the mean arterial blood pressure.

O is calculated by multiplying the patient's stroke volume by the heart rate.

A 74-yr-old man with a history of prostate cancer and hypertension is admitted to the emergency department with substernal chest pain. Which priority action will the nurse complete before administering sublingual nitroglycerin? Administer morphine sulfate IV. Auscultate heart and lung sounds. Obtain a 12-lead electrocardiogram (ECG). Assess for coronary artery disease risk factors.

Obtain a 12-lead electrocardiogram (ECG).

When caring for a patient with infective endocarditis, the nurse will assess the patient for which vascular manifestations? (Select all that apply.) Osler's nodes Janeway's lesions Splinter hemorrhages Subcutaneous nodules Erythema marginatum lesions

Osler's nodes Janeway's lesions Splinter hemorrhages

When planning emergent care for a patient with a suspected myocardial infarction (MI), what should the nurse anticipate administering? Oxygen, nitroglycerin, aspirin, and morphine Aspirin, nitroprusside, dopamine, and oxygen Oxygen, furosemide (Lasix), nitroglycerin, and meperidine Nitroglycerin, lorazepam (Ativan), oxygen, and warfarin (Coumadin)

Oxygen, nitroglycerin, aspirin, and morphine

Which assessment finding would alert the nurse that a postoperative patient is not receiving the beneficial effects of enoxaparin (Lovenox)? Crackles bilaterally in the lung bases Pain and swelling in a lower extremity Absence of arterial pulse in a lower extremity Abdominal pain with decreased bowel sounds

Pain and swelling in a lower extremity

Which action should the nurse implement with auscultation during a patient's cardiovascular assessment? Position the patient supine. Ask the patient to hold their breath. Palpate the radial pulse while auscultating the apical pulse. Use the bell of the stethoscope when auscultating S1 and S2.

Palpate the radial pulse while auscultating the apical pulse.

A patient was just diagnosed with acute arterial ischemia in the left leg secondary to atrial fibrillation. Which early clinical manifestation must be reported to the provider to save the patient's limb? Paralysis Cramping Paresthesia Referred pain

Paresthesia

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

Patient says muscle leg pain occurs with continued exercise.

An 80-yr-old patient with uncontrolled type 1 diabetes is diagnosed with aortic stenosis. When conservative therapy is no longer effective, the nurse knows that the patient will need to do or have what done? Aortic valve replacement Have a pacemaker inserted Open commissurotomy (valvulotomy) procedure Percutaneous transluminal balloon valvuloplasty (PTBV) procedure

Percutaneous transluminal balloon valvuloplasty (PTBV) procedure

The nurse is preparing to administer a scheduled dose of enoxaparin (Lovenox) 30 mg subcutaneously. What should the nurse do to administer this medication correctly? Remove the air bubble in the prefilled syringe. Aspirate before injection to prevent IV administration. Rub the injection site after administration to enhance absorption. Pinch the skin between the thumb and forefinger before inserting the needle.

Pinch the skin between the thumb and forefinger before inserting the needle.

A patient informs the nurse of experiencing syncope. Which prioitiy nursing action should the nurse anticipate in the patient's subsequent diagnostic workup? Preparing to assist with a head-up tilt-test Assessing the patient's knowledge of pacemakers Administering an IV dose of a β-adrenergic blocker Teaching the patient about antiplatelet aggregators

Preparing to assist with a head-up tilt-test

A patient has received a bolus dose and an infusion of alteplase (Activase) for an ST-segment elevation myocardial infarction (STEMI). Which patient assessment would determine the effectiveness of the medication? Presence of chest pain Blood in the urine or stool Tachycardia with hypotension Decreased level of consciousness

Presence of chest pain

The nurse is teaching a community group about preventing rheumatic fever. What information should the nurse include? Prompt recognition and treatment of streptococcal pharyngitis Avoiding respiratory infections in children born with heart defects Completion of 4 to 6 weeks of antibiotic therapy for infective endocarditis Requesting antibiotics before dental surgery for individuals with rheumatoid arthritis

Prompt recognition and treatment of streptococcal pharyngitis

The nurse is caring for a preoperative patient who has an order for vitamin K by subcutaneous injection. The nurse should verify that which laboratory study is abnormal before administering the dose? Hematocrit (Hct) Hemoglobin (Hgb) Prothrombin time (PT) Activated partial thromboplastin time (aPTT)

Prothrombin time (PT)

The nurse is caring for a patient with hypertension who is scheduled to receive a dose of metoprolol (Lopressor). The nurse should withhold the dose and consult the prescribing provider for which vital sign taken just before administration? O2 saturation 93% Pulse 48 beats/min Respirations 24 breaths/min Blood pressure 118/74 mm Hg

Pulse 48 beats/min

While admitting a patient with pericarditis, the nurse will assess for what manifestations of this disorder? Pulsus paradoxus Prolonged PR intervals Widened pulse pressure Clubbing of the fingers

Pulsus paradoxus

What medications should the nurse expect to include in the teaching plan to decrease the risk of cardiovascular events and death for patients with PAD? (Select all that apply.) Ramipril (Altace) Cilostazol (Pletal) Simvastatin (Zocor) Clopidogrel (Plavix) Warfarin (Coumadin) Aspirin (acetylsalicylic acid)

Ramipril (Altace) Simvastatin (Zocor) Clopidogrel (Plavix) Aspirin (acetylsalicylic acid)

The nurse observes that phlebitis has developed at a patient's peripheral IV site over the past several hours. Which intervention should the nurse implement first? Remove the patient's IV catheter. Apply an ice pack to the affected area. Decrease the IV rate to 20 to 30 mL/hr. Administer prophylactic anticoagulants.

Remove the patient's IV catheter.

When teaching a patient about dietary management of stage 1 hypertension, which instruction is appropriate? Increase water intake. Restrict sodium intake. Increase protein intake. Use calcium supplements.

Restrict sodium intake.

After having a myocardial infarction (MI), the nurse notes the patient has jugular venous distention, gained weight, developed peripheral edema, and has a heart rate of 108 beats/min. What should the nurse suspect is happening? Chronic HF Left-sided HF Right-sided HF Acute decompensated HF

Right-sided HF

The nurse prepares to administer digoxin 0.125 mg to a patient admitted with influenza and a history of chronic heart failure. What should the nurse assess before giving the medication? Prothrombin time Urine specific gravity Serum potassium level Hemoglobin and hematocrit

Serum potassium level

The home care nurse visits a patient with chronic heart failure. Which assessment findings would indicate acute decompensated heart failure (pulmonary edema)? Fatigue, orthopnea, and dependent edema Severe dyspnea and blood-streaked, frothy sputum Temperature is 100.4° F and pulse is 102 beats/min Respirations 26 breaths/min despite oxygen by nasal cannula

Severe dyspnea and blood-streaked, frothy sputum

What position should the nurse place the patient in to auscultate for signs of acute pericarditis? Supine without a pillow Sitting and leaning forward Left lateral side-lying position Head of bed at a 45-degree angle

Sitting and leaning forward

A 67-yr-old woman with hypertension is admitted to the emergency department with a blood pressure of 234/148 mm Hg and was started on nitroprusside (Nitropress). After 1 hour of treatment, the mean arterial blood pressure (MAP) is 55 mm Hg. Which nursing action is a priority? Start an infusion of 0.9% normal saline at 100 mL/hr. Maintain the current administration rate of the nitroprusside. Request insertion of an arterial line for accurate blood pressure monitoring. Stop the nitroprusside infusion and assess the patient for potential complications.

Stop the nitroprusside infusion and assess the patient for potential complications.

The patient has atrial fibrillation with a rapid ventricular response. What electrical treatment option does the nurse prepare the patient for? Defibrillation Synchronized cardioversion Automatic external defibrillator (AED) Implantable cardioverter-defibrillator (ICD)

Synchronized cardioversion

Which information should the nurse consider when planning care for older adult patients with hypertension? (Select all that apply.) Systolic blood pressure increases with aging. White coat syndrome is prevalent in older patients. Volume depletion contributes to orthostatic hypotension. Blood pressures should be maintained near 120/80 mm Hg. Blood pressure drops 1 hour after eating in many older patients. Older patients require higher doses of antihypertensive medications.

Systolic blood pressure increases with aging. White coat syndrome is prevalent in older patients. Volume depletion contributes to orthostatic hypotension. Blood pressures should be maintained near 120/80 mm Hg. Blood pressure drops 1 hour after eating in many older patients.

What age-related cardiovascular changes should the nurse assess for when providing care to an older adult patient? (Select all that apply.) Systolic murmur Diminished pedal pulses Increased maximal heart rate Decreased maximal heart rate Increased recovery time from activity

Systolic murmur Diminished pedal pulses Decreased maximal heart rate Increased recovery time from activity

A patient comes into the hospital with suspected pulmonary embolism which medication would be used to dissolve the clot? Warfarin Lovenox Heparin TNKase

TNKase

The UAP is taking orthostatic vital signs. In the supine position, the blood pressure (BP) is 130/80 mm Hg, and the heart rate (HR) is 80 beats/min. In the sitting position, the BP is 140/80, and the HR is 90 beats/min. Which action should the nurse instruct the UAP to take next? Repeat BP and HR in this position. Record the BP and HR measurements. Take BP and HR with patient standing. Return the patient to the supine position.

Take BP and HR with patient standing.

The patient with chronic heart failure is being discharged from the hospital. What information should the nurse emphasize in the patient's discharge teaching to prevent progression of the disease to acute decompensated heart failure (ADHF)? Take medications as prescribed. Use oxygen when feeling short of breath. Direct questions only to the health care provider. Encourage most activity in the morning when rested.

Take medications as prescribed.

A patient returns to the unit after a cardiac catheterization. Which nursing care would the registered nurse delegate to the unlicensed assistant personnel (UAP)? Take vital signs and report any abnormal values. Check for bleeding at the catheter insertion site. Prepare discharge teaching related to complications. Monitor the electrocardiogram for S-T segment changes.

Take vital signs and report any abnormal values.

What is a priority nursing intervention in the care of a patient with a diagnosis of chronic venous insufficiency (CVI)? Applying topical antibiotics to venous ulcers Maintaining the patient's legs in a dependent position Administering oral and/or subcutaneous anticoagulants Teaching the patient the correct use of compression stockings

Teaching the patient the correct use of compression stockings

A male patient with coronary artery disease (CAD) has a low-density lipoprotein (LDL) cholesterol of 98 mg/dL and high-density lipoprotein (HDL) cholesterol of 47 mg/dL. What information should the nurse include in patient teaching? Consume a diet low in fats. Reduce total caloric intake. Increase intake of olive oil. The lipid levels are normal.

The lipid levels are normal.

Cardioversion is attempted for a patient with atrial flutter and a rapid ventricular response. After delivering 50 joules by synchronized cardioversion, the patient develops ventricular fibrillation. Which action should the nurse take immediately? Administer 250 mL of 0.9% saline solution IV by rapid bolus. Assess the apical pulse, blood pressure, and bilateral neck vein distention. Turn the synchronizer switch to the "off" position and recharge the device. Ask the patient if there is any chest pain or discomfort and administer morphine sulfate.

Turn the synchronizer switch to the "off" position and recharge the device.

The patient had aortic aneurysm repair 6 hours ago. What priority nursing action will maintain graft patency? Assess output for renal dysfunction. Use IV fluids to maintain adequate BP. Use oral antihypertensives to maintain cardiac output. Maintain a low BP to prevent pressure on surgical site.

Use IV fluids to maintain adequate BP.

The nurse prepares to defibrillate a patient. Which dysrhythmia has the nurse observed in this patient? Ventricular fibrillation Third-degree AV block Uncontrolled atrial fibrillation Ventricular tachycardia with a pulse

Ventricular fibrillation

Important teaching for the patient scheduled for a radiofrequency catheter ablation procedure includes explaining that a. ventricular bradycardia may be induced and treated during the procedure. b. catheter will be placed in both femoral arteries to allow double catheter use. c. the procedure will destroy areas of the conduction system that are causing rapid heart rhythms d. general anestetic will be given to prevent the awareness of any sudden cardia death experiences

c. the procedure will destroy areas of the conduction system that are causing rapid heart rhythms

A 62-yr-old Hispanic male patient with diabetes has been diagnosed with peripheral artery disease (PAD). The patient smokes and has a history of gout. To prevent complications, which factor is priority in patient teaching? Gender Smoking Ethnicity Comorbidities

Smoking

The nurse is examining the electrocardiogram (ECG) of a patient just admitted with a suspected myocardial infarction (MI). Which ECG change is most indicative of prolonged or complete coronary occlusion? Sinus tachycardia Pathologic Q wave Fibrillatory P waves Prolonged PR interval

Pathologic Q wave

When providing dietary teaching to a patient with hypertension, the nurse would teach the patient to restrict intake of which meat? Broiled fish Roasted duck Roasted turkey Baked chicken breast

Roasted duck

A nurse is reinforcing instructions to a hospitalized client with heart block about the fundamental concepts regarding the cardiac rhythm. The nurse explains to the client that the normal site in the heart responsible for initiating electrical impulses is which site?

SA Node

In caring for a patient admitted with poorly controlled hypertension, which laboratory test result should the nurse understand as indicating the presence of target organ damage? Serum uric acid of 3.8 mg/dL Serum creatinine of 2.6 mg/dL Serum potassium of 3.5 mEq/L Blood urea nitrogen of 15 mg/dL

Serum creatinine of 2.6 mg/dL

A patient with a recent diagnosis of heart failure has been prescribed furosemide (Lasix). What outcome would demonstrate medication effectiveness? Promote vasodilation. Reduction of preload. Decrease in afterload. Increase in contractility.

Reduction of preload.

The nurse conducts a complete physical assessment on a patient admitted with infective endocarditis. Which finding is significant? Regurgitant murmur at the mitral valve area Point of maximal impulse palpable in fourth intercostal space Heart rate of 94 beats/min and capillary refill time of 2 seconds Respiratory rate of 18 breaths/min and heart rate of 90 beats/min

Regurgitant murmur at the mitral valve area

What is an appropriate explanation for the nurse to give to a patient about the purpose of intermittent pneumatic compression devices after a surgical procedure? The devices keep the legs warm while the patient is not moving much. The devices maintain the blood flow to the legs while the patient is on bed rest. The devices keep the blood pressure down while the patient is stressed after surgery. The devices provide compression of the veins to keep the blood moving back to the heart.

The devices provide compression of the veins to keep the blood moving back to the heart.

Which statement best describes the electrical activity of the heart represented by measuring the PR interval on the electrocardiogram (ECG)? The length of time it takes to depolarize the atrium. The length of time it takes for the atria to depolarize and repolarize. The length of time for the electrical impulse to travel from the sinoatrial (SA) node to the Purkinje fibers. The length of time it takes for the electrical impulse to travel from the sinoatrial (SA) node to the atrioventricular (AV) node.

The length of time for the electrical impulse to travel from the sinoatrial (SA) node to the Purkinje fibers.

While auscultating the patient's heart sounds with the bell of the stethoscope, the nurse hears a ventricular gallop. How should the nurse document what is heard? Diastolic murmur Third heart sound (S3) Fourth heart sound (S4) Normal heart sounds (S1, S2)

Third heart sound (S3)

Which foods would the nurse encourage patients at risk for coronary artery disease (CAD) to include in their diets? (Select all that apply.) Tofu Walnuts Tuna fish Whole milk Orange juice

Tofu Walnuts Tuna fish

The nurse determines there is artifact on the patient's telemetry monitor. Which factor should the nurse assess for that could correct this issue? Disabled automaticity Electrodes in the wrong lead Too much hair under the electrodes Stimulation of the vagus nerve fibers

Too much hair under the electrodes

A patient presents to the emergency department reporting chest pain for 3 hours. What component of the blood work is most clearly indicative of a myocardial infarction (MI)? CK-MB Troponin Myoglobin C-reactive protein

Troponin

The nurse is performing an assessment for a patient with fatigue and shortness of breath. Auscultation reveals a heart murmur. What does this assessment finding indicate? Increased viscosity of the patient's blood Turbulent blood flow across a heart valve Friction between the heart and the myocardium A deficit in conductivity impairs normal contractility

Turbulent blood flow across a heart valve

The nurse is admitting a preoperative patient with a suspected abdominal aortic aneurysm (AAA). The medication history reveals that the patient has been taking warfarin (Coumadin) daily. Based on this history and the patient's admission diagnosis, the nurse should prepare to administer which medication? Vitamin K Cobalamin Heparin sodium Protamine sulfate

Vitamin K

When teaching a client with atrial fibrillation about a new prescription for warfarin, the nurse will include information about which vitamin? Vitamin K Vitamin D Vitamin B1 Vitamin B12

Vitamin K

The nurse is preparing to administer digoxin to a patient with heart failure. In preparation, laboratory results are reviewed with the following findings: sodium 139 mEq/L, potassium 5.6 mEq/L, chloride 103 mEq/L, and glucose 106 mg/dL. What is the priority action by the nurse? Withhold the daily dose until the following day. Withhold the dose and report the potassium level. Give the digoxin with a salty snack, such as crackers. Give the digoxin with extra fluids to dilute the sodium level.

Withhold the dose and report the potassium level.

A nurse is preparing to teach a group of women in a community volunteer group about heart disease. What should the nurse include in the teaching plan? Women are less likely to delay seeking treatment than men. Women are more likely to have noncardiac symptoms of heart disease. Women are often less ill when presenting for treatment of heart disease. Women have more symptoms of heart disease at a younger age than men.

Women are more likely to have noncardiac symptoms of heart disease

On admission to the emergency department, a patient with cardiomyopathy has an ejection fraction of 10%. On assessment, the nurse notes bilateral crackles and shortness of breath. Which additional assessment finding would most indicate patient decline? Increased heart rate Increased blood pressure Decreased respiratory rate Decreased level of consciousness

Decreased level of consciousness

The nurse supervises an unlicensed assistant personnel (UAP) who is taking the blood pressure of an obese patient admitted with heart failure. Which action by the UAP will require the nurse to intervene? Deflating the blood pressure cuff at a rate of 8 to 10 mm Hg/sec Waiting 2 minutes after position changes to take orthostatic pressures Taking the blood pressure with the patient's arm at the level of the heart Taking a forearm blood pressure if the largest cuff will not fit the patient's upper arm

Deflating the blood pressure cuff at a rate of 8 to 10 mm Hg/sec

Which aspect of the heart's action does the QRS complex on the ECG represent? Depolarization of the atria Repolarization of the ventricles Depolarization from atrioventricular (AV) node throughout ventricles The length of time it takes for the impulse to travel from the atria to the ventricles

Depolarization from atrioventricular (AV) node throughout ventricles

The nurse is teaching a patient recovering from a myocardial infarction. How should resumption of sexual activity be discussed? Delegated to the primary care provider Discussed along with other physical activities Avoided because it is embarrassing to the patient Accomplished by providing the patient with written material

Discussed along with other physical activities

Which assessment finding should be considered when caring for a woman with suspected coronary artery disease? Fatigue may be the first symptom. Classic signs and symptoms are expected. Increased risk is present before menopause. Women are more likely to develop collateral circulation.

Fatigue may be the first symptom.

The patient has a potassium level of 2.9 mEq/L, and the nurse obtains the following measurements on the rhythm strip: Heart rate of 86 with a regular rhythm, the P wave is 0.06 seconds (sec) and normal shape, the PR interval is 0.24 seconds, and the QRS is 0.09 seconds. How should the nurse document this rhythm? First-degree AV block Second-degree AV block Premature atrial contraction (PAC) Premature ventricular contraction (PVC)

First-degree AV block

An older adult with dementia has a venous ulcer related to chronic venous insufficiency. The nurse should provide teaching on which type of diet for this patient and his caregiver? Low-fat diet High-protein diet Calorie-restricted diet High-carbohydrate diet

High-protein diet

A female patient with type 1 diabetes has chronic stable angina controlled with rest. She states that over the past few months, she has required increasing amounts of insulin. What goal should the nurse use in planning care to prevent cardiovascular disease progression? Exercise almost every day. Avoid saturated fat intake. Limit calories to daily limit. Keep Hgb A1C less than 7%.

Keep Hgb A1C less than 7%.

The nurse is caring for a newly admitted patient with vascular insufficiency. The patient has a new order for enoxaparin (Lovenox) 30 mg subcutaneously. What should the nurse do to correctly administer this medication? Spread the skin before inserting the needle. Leave the air bubble in the prefilled syringe. Use the back of the arm as the preferred site. Sit the patient at a 30-degree angle before administration.

Leave the air bubble in the prefilled syringe.

Which patients are most at risk for developing endocarditis? (Select all that apply.) Older woman with histoplasmosis Man with reports of chest pain and dyspnea Man who is homeless with history of IV drug use Patient with end-stage renal disease on peritoneal dialysis Adolescent with exertional palpitations and clubbing of fingers Female with peripheral intravenous site for medication administration

Man who is homeless with history of IV drug use Patient with end-stage renal disease on peritoneal dialysis

The patient is admitted with acute coronary syndrome (ACS). The ECG shows ST-segment depression and T-wave inversion. What should the nurse know that this indicates? Myocardia injury Myocardial ischemia Myocardial infarction Normal pacemaker function.

Myocardial ischemia

When teaching how lisinopril (Zestril) will help lower the patient's blood pressure, which mechanism of action should the nurse explain? Blocks β-adrenergic effects. Relaxes arterial and venous smooth muscle. Inhibits conversion of angiotensin I to angiotensin II. Reduces sympathetic outflow from central nervous system.

Inhibits conversion of angiotensin I to angiotensin II.

The nurse in the recovery room assesses the right femoral artery puncture site after the patient had a stent inserted into a coronary artery. The insertion site is not bleeding or discolored. What should the nurse do next to ensure the femoral artery is intact? Palpate the insertion site for induration. Assess peripheral pulses in the right leg. Inspect the patient's right side and back. Compare the color of the left and right legs.

Inspect the patient's right side and back.

Which antilipemic medications should the nurse question for a patient who has cirrhosis of the liver? (Select all that apply.) Niacin Cholestyramine Ezetimibe (Zetia) Gemfibrozil (Lopid) Atorvastatin (Lipitor)

Niacin Ezetimibe (Zetia) Gemfibrozil (Lopid) Atorvastatin (Lipitor

A 72-yr-old man with a history of aortic stenosis is admitted to the emergency department. He reports severe left-sided chest pressure radiating to the jaw. Which medication, if ordered by the health care provider, should the nurse question? Aspirin Oxygen Nitroglycerin Morphine sulfate

Nitroglycerin

The patient with pericarditis is reporting chest pain. After assessment, which intervention should the nurse expect to implement to provide pain relief? Corticosteroids Morphine sulfate Proton pump inhibitor Nonsteroidal antiinflammatory drugs

Nonsteroidal antiinflammatory drugs

The nurse is evaluating the condition of a client after pericardiocentesis performed to treat cardiac tamponade. Which observation would indicate that the procedure was successful? 1. Muffled heart sounds 2. A rise in blood pressure 3. Jugular venous distention 4. Client expressions of dyspnea

2. A rise in blood pressure

The nurse is monitoring a client who is taking digoxin for adverse effects. Which findings are characteristic of digoxin toxicity? Select all that apply: 1. Tremors 2. Diarrhea 3. Irritability 4. Blurred vision 5. Nausea and vomiting

2. Diarrhea 4. Blurred vision 5. Nausea and vomiting

The charge nurse is assisting with a non emergent cardioversion for a client with supraventricular tachycardia. Which action by the primary nurse would cause the charge nurse to intervene? 1. Administers a one time dose of IV midazolam 2. Disengages the "sync" function on the defibrillator 3. Places defibrillator pads on the upper right and lower left chest 4. Turns off the client oxygen and moves it away from the bed

2. Disengages the "sync" function on the defibrillator

Which foods will the nurse discuss when teaching a client who has a new prescription for warfarin? 1 Dairy products 2 High-fiber fruits 3 Green leafy vegetables 4 Whole-grain breads and cereals

3 Green leafy vegetables

What should the nurse teach the patient who has had a valve replacement with a biologic valve? Long-term anticoagulation therapy Antibiotic prophylaxis for dental care Exercise plan to increase cardiac tolerance β-Adrenergic blockers to control palpitations

Antibiotic prophylaxis for dental care

The nurse would assess a patient with reports of chest pain for which clinical manifestations associated with a myocardial infarction (MI)? (Select all that apply.) Flushing Ashen skin Diaphoresis Nausea and vomiting S3 or S4 heart sounds

Ashen skin Diaphoresis Nausea and vomiting S3 or S4 heart sounds

Despite a high dosage, a male patient who is taking nifedipine (Procardia XL) for antihypertensive therapy continues to have blood pressures over 140/90 mm Hg. What should the nurse do next? Assess his adherence to therapy. Ask him to make an exercise plan. Teach him to follow the DASH diet. Request a prescription for a thiazide diuretic.

Assess his adherence to therapy.

Which dietary choice reflects the recommendations of the Dietary Approaches to Stop Hypertension (DASH) diet? Select all that apply. One, some, or all responses may be correct. 1 Salami 2 Pickles Correct3 Salmon 4 French fries 5 Canned soup

3 Salmon

When taking the health history for a client admitted with heart failure, which assessment finding will the nurse expect the client to report? 1 Losing weight over the past week 2 Tingling in the upper extremities 3 Using several pillows at night to sleep 4 Wheezing when exposed to dust or pollen

3 Using several pillows at night to sleep

How can the nurse describe heart failure to a client? 1 A cardiac condition caused by inadequate circulating blood volume 2 An acute state in which the pulmonary circulation pressure decreases 3 An inability of the heart to pump blood in proportion to metabolic needs 4 A chronic state in which the systolic blood pressure drops below 90 mm Hg

3. An inability of the heart to pump blood in proportion to metabolic needs

The nurse develops a plan of care for a client with deep vein thrombosis. Which client position or activity in the plan should be included? 1. Out-of-bed activities as desired 2. Bed rest with the affected extremity kept flat 3. Bed rest with elevation of the affected extremity 4. Bed rest with the affected extremity in a dependent position

3. Bed rest with elevation of the affected extremity

A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A nurse sees no electrocardiographic complexes on the screen. Which is the priority action of the nurse? 1. Call a code. 2. Call the health care provider. 3. Check the client's status and lead placement. 4. Press the recorder button on the electrocardiogram console.

3. Check the client's status and lead placement.

The nurse is caring for a patient who is 24 hours after pacemaker insertion. Which nursing intervention is appropriate at this time? Reinforcing the pressure dressing as needed Encouraging range-of-motion exercises of the involved arm Assessing the incision for any redness, swelling, or discharge Applying wet-to-dry dressings every 4 hours to the insertion site

Assessing the incision for any redness, swelling, or discharge

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

Assist patient to walk several times.

A patient who had bladder surgery 2 days ago develops acute decompensated heart failure (ADHF) with severe dyspnea. Which action by the nurse would be indicated first? Review urinary output for the previous 24 hours. Restrict the patient's oral fluid intake to 500 mL/day. Assist the patient to a sitting position with arms on the overbed table. Teach the patient to use pursed-lip breathing until the dyspnea subsides.

Assist the patient to a sitting position with arms on the overbed table.

The nurse is admitting a patient who is scheduled to undergo a cardiac catheterization. What allergy information is most important for the nurse to assess and document before this procedure? A. Iron B. Iodine C. Aspirin D. Penicillin

B. Iodine

An arterial blood gas report indicates that pH is 7.25, Pco2 is 60 mm Hg, and HCO3 is 26 mEq/L (26 mmol/L). Which client is most likely to exhibit these blood gas results? 1 A client with pulmonary fibrosis 2 A client with uncontrolled type 1 diabetes 3 A client who has been vomiting for 3 days 4 A client who takes sodium bicarbonate for indigestion

1 A client with pulmonary fibrosis

After a cardiac catheterization, a client's urinary output is 3 times the client's fluid intake. What is the likely cause of the high urinary output? 1 An expected effect of the dye used with the procedure 2 Increased cardiac output as a result of the procedure 3 Improvement of urinary functioning after the catheterization 4 A result of the prescribed intravenous (IV) rate of 50 mL/h

1 An expected effect of the dye used with the procedure

Which action would the nurse include in the plan of care for a client admitted with heart failure who has gained 20 pounds in 3 weeks? Select all that apply. One, some, or all responses may be correct. 1 Diuretics 2 Low-salt diet 3 Daily weight checks 4 Fluid restriction 5 Intake and output 6 Oxygen administration

1 Diuretics 2 Low-salt diet 3 Daily weight checks 4 Fluid restriction 5 Intake and output 6 Oxygen administration

The nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no P waves; instead, there are fibrillatory waves before each QRS complex. How should the nurse interpret the client's heart rhythm?1.Atrial fibrillation 2.Sinus tachycardia 3.Ventricular fibrillation 4.Ventricular tachycardia

1.Atrial fibrillation

A client has frequent bursts of ventricular tachycardia on the cardiac monitor. What should the nurse be most concerned about with this dysrhythmia? 1.It can develop into ventricular fibrillation at any time. 2.It is almost impossible to convert to a normal rhythm. 3.It is uncomfortable for the client, giving a sense of impending doom. 4.It produces a high cardiac output with cerebral and myocardial ischemia.

1.It can develop into ventricular fibrillation at any time.

The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles and the nurse suspects pulmonary edema. The nurse immediately asks another nurse to contact the health care provider and prepares to implement which priority interventions? Select all that apply. 1. Administering oxygen 2. Inserting a Foley catheter 3. Administering furosemide (Lasix) 4. Administering morphine sulfate intravenously 5. Transporting the client to the coronary care unit 6. Placing the client in a low Fowler's side-lying positio

1. Administering oxygen 2. Inserting a Foley catheter 3. Administering furosemide (Lasix) 4. Administering morphine sulfate intravenously

The nurse is assessing a client newly diagnosed with mild hypertension. Which assessment finding should the nurse expect? 1. Asymptomatic 2. Shortness of breath 3. Visual disturbances 4. Frequent nosebleeds

1. Asymptomatic

When caring for a client who presents to the emergency department with an ST-segment-elevation myocardial infarction (STEMI), which laboratory result will the nurse expect? 1 Decreased white blood cell count 2 Elevated serum troponins I and T 3 Decreased creatine kinase-MB (CK-MB) 4 Decreased B-type natriuretic peptide (BNP)

2 Elevated serum troponins I and T

The nurse is evaluating a client's response to cardioversion. Which observation would be of highest priorityto the nurse?1. Blood pressure 2. Status of airway 3. Oxygen flow rate 4. Level of consciousness

2 Status of airway

When discharging a client who has had insertion of a coronary artery stent, the nurse will instruct the client to seek immediate medical attention for which signs and symptoms? Select all that apply. One, some, or all responses may be correct. 1 Dyspnea with vigorous exertion 2 Unexplainable profuse diaphoresis 3 Indigestion not relieved by antacids 4 Fatigue the day after a rigorous walk 5 Acute chest pain after rigorous exercise 6 Continued chest pain after nitroglycerin use

2 Unexplainable profuse diaphoresis 3 Indigestion not relieved by antacids 5 Acute chest pain after rigorous exercise 6 Continued chest pain after nitroglycerin use

A client with a diagnosis of angina pectoris is hospitalized for an angioplasty. The client returns to the nursing unit after the procedure, and the nurse provides instructions to the client regarding home care measures. Which statement, if made by the client, indicates an understanding of the instructions? 1."I need to cut down on cigarette smoking." 2."I am so relieved that my heart is repaired." 3."I need to adhere to my dietary restrictions." 4."I am so relieved that I can eat anything I want to now."

3."I need to adhere to my dietary restrictions."

The registered nurse (RN) is educating a new RN about the use of oxygen for clients with angina pectoris. Which statement by the new nurse indicates that the teaching has been effective?1."Oxygen has a calming effect." 2."Oxygen will prevent the development of any thrombus." 3."The pain of angina pectoris occurs because of a decreased oxygen supply to heart cells." 4."Oxygen dilates the blood vessels so that they can supply more nutrients to the heart muscle."

3."The pain of angina pectoris occurs because of a decreased oxygen supply to heart cells."

Which finding for a client with acute coronary syndrome who is walking in the hallway will be most important to communicate to the health care provider? 1 Client has a premature atrial contraction while ambulating. 2 Client expresses anxiety about ambulating alone at home. 3 Pulse rate increases from 68 beats/minute to 80 beats/minute with ambulation. 4 Blood pressure drops from 130/72 mm Hg to 122/60 mm Hg with ambulation.

4 Blood pressure drops from 130/72 mm Hg to 122/60 mm Hg with ambulation.

A client with a diagnosis of myocardial infarction asks the nurse, "What is causing the pain I am having?" Which explanation would the nurse give? 1 Compression of the heart muscle 2 Release of myocardial isoenzymes 3 Rapid vasodilation of the coronary arteries Correct4 Inadequate oxygenation of the myocardium

4 Inadequate oxygenation of the myocardium

Which would the nurse do to help alleviate the distress of a client with heart failure and pulmonary edema? 1 Encourage frequent coughing. 2 Elevate the client's lower extremities. 3 Prepare for modified postural drainage. 4 Place the client in the orthopneic position.

4 Place the client in the orthopneic position.