NCLEX Cardiac

The nurse is giving discharge instructions to the client with varicose veins. The nurse realizes there is a need for further teaching when the client makes which statement?

"I need to sit as much as possible with my legs elevated."

The nurse reinforces 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."

The nurse determines that a client with coronary artery disease (CAD) needs further teaching about disease management if the client makes which statement?

"I will avoid walking for exercise."

The nurse determines that a client with coronary artery disease (CAD) understands disease management if the client makes which statement?

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

While the nurse is involved in preparing a client for a cardiac catheterization, the client says, "I don't want to talk with you. You're only the nurse. I want my doctor." Which response by the nurse would be therapeutic?

"So you're saying that you want to talk to your health care provider?"

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 would 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." Which is an appropriate nursing response?

"You are concerned about losing your leg?"

The nurse is caring for a client in the cardiac care unit with heart disease. The nurse knows that the direction of blood flows through the heart and lungs in which order? Please arrange the blood flow in the direction of flow. All options must be used.

1) 4 2) 3 3) 5 4) 1 5) 2 6) 6

A client with hypertension has been prescribed a low-sodium diet. The nurse reinforcing instructions about foods that are allowed would include which foods in a list provided to the client? Select all that apply.

1) Fresh Tomato 5) Summer Squash

The primary health care provider is discharging a client with a diagnosis of chronic heart failure. Which health maintenance instructions would the nurse reinforce in the discharge teaching plan? Select all that apply.

1) Obtain annual influenza vaccination. 3) Avoid adding salt to foods or in cooking 4) Report a weight gain of 3 or more pounds in a week.

The nurse is caring for a client with left-sided heart failure. Which clinical signs are most important for the nurse to communicate to the primary health care provider? Select all that apply.

1) Pink-tinged frothy sputum 2) increased respiratory rate 5) auscultation of crackles throughout the lungs

A client with left-sided heart failure has been admitted to the hospital. The nurse is reviewing the medical record and notes which signs and symptoms? Select all that apply.

1. Orthopnea 3. Sleep apnea 5. Pink frothy sputum

A client is being discharged from the hospital on warfarin for venous thromboembolism (VTE) prevention. Which instructions would the nurse reinforce in the client's teaching plan? Select all that apply.

1. Wear a medic alert bracelet 2. Check urine and stool for blood 3. Notify your dentist before an appointment

A client asks the nurse about metabolic syndrome and what it means. The teaching plan would include which characteristics that define metabolic syndrome? Select all that apply.

2) Blood pressure is elevated with systolic values greater than 130 mm Hg and diastolic values greater than 85 mm Hg. 4)The client has abdominal obesity with a waist greater than 40 inches in males and greater than 35 inches in females.

The nurse is checking the apical heart rate of a client with a complaint of angina. The nurse places the stethoscope in which anatomical area? Refer to figure.

4

A client with a diagnosis of myocardial infarction has a new activity prescription allowing the client to have bathroom privileges. As the client stands and begins to walk, the client begins to complain of chest pain. The nurse would take which action?

Assist the client to get back into bed

A hospitalized client with a history of angina pectoris is ambulating in the corridor. The client suddenly complains of severe substernal chest pain. The nurse would take which action first?

Assist the client to sit or lie down.

The 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 position?

At the mid-clavicular line at the fifth left intercoastal space

The nurse has provided discharge instructions to a client being placed on long-term anticoagulant therapy with warfarin sodium. The nurse reminds the client to do which?

Avoid taking products containing acetylsalicylic acid (aspirin).

The nurse is reinforcing instructions to a client with angina pectoris about measures to reduce recurrence of chest pain. The nurse would stress to the client the importance of taking which measure?

Avoiding exposure to either very hot or very cold weather

A client is admitted with chest pain related to atrial fibrillation. Based on her blood glucose reading, metformin is prescribed for the client. As the nurse reviews the client's chart and prescriptions, which finding would require the nurse to verify the metformin prescription? Refer to chart.

Creatinine result

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

Evaluating total body fluid

A client is scheduled for a dipyridamole thallium scan. The nurse would check to make sure that the client has not consumed which substance before the procedure?

Caffeine

A client is wearing a continuous cardiac monitor, which begins to alarm at the nurse's station. The nurse sees no electrocardiographic complexes on the screen. The nurse would do which action first?

Check the client status and lead placement.

A female client complains of an "odd, left-sided, twinge-like pain" along the anterior axillary line and states she has had this feeling for the past 3 days. Which is the initial action?

Determine if the pain is cardiac in origin

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

Digoxin

The nurse is caring for a client with a new onset of atrial fibrillation. Which prescribed treatments would the nurse expect? Select all that apply.

Digoxin Warfarin Electrical Cardioversion

The 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 meal?

Fresh strawberries, steamed vegetables, and baked fish

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 and Raynaud's disease is diagnosed. Which factor would precipitate these episodes?

Ingestion of coffee or chocolate

A client in a long-term care facility who has a history of angina pectoris wants to go for a short walk outside with a family member. It is a sunny but chilly December day. The nurse would perform which intervention to care for this client in a holistic manner?

Instruct the family member to dress the client warmly before going outside.

The nurse has given simple instructions on preventing some of the complications of bed rest to a client who experienced a myocardial infarction. The nurse would intervene if the client were performing which of these contraindicated activities?

Isometric exercises of the arms and legs

The nurse is caring for a client diagnosed with Buerger's disease. Which finding would the nurse determine is a potential complication associated with this disease?

Numbness and tingling in the legs

The 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 would place highest priority on making sure that which is available at the bedside?

Oxygen tubing and flowmeter

The nurse is using a stethoscope to listen to a client's heart and hears this sound. (Refer to audio.) To assist in identifying the sound, the nurse would take which initial and best action?

Palpate the carotid pulse for a pulsation

The nurse is caring for a client who has a malignant lung neoplasm and has developed cardiopulmonary complications. On auscultation, the nurse hears these breath sounds over the left lower sternal border (over the apical area) and interprets the sounds as which? (Refer to audio.)

Pericardial friction rub

A hypertensive client who has been taking metoprolol 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 affect the client in which way?

Precipitate rebound hypertension

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

Premedicate the client with an analgesic before ambulating.

A client is scheduled for a cardiac catheterization using a radiopaque dye. The nurse checks which most critical item before the procedure?

Prior reaction to contrast media

A client has been diagnosed with Prinzmetal's angina. The nurse reviews the medical record and notes which accompanying characteristics? Select all that apply.

Prolonged severe pain Happens at the same time each day

The nurse is planning measures to decrease the incidence of chest pain for a client with angina pectoris. The nurse would do which intervention to effectively accomplish this goal?

Provide a quiet and low-stimulus environment.

A student nurse is assigned to assist in caring for a client with acute pulmonary edema who is receiving digoxin 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

The 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 would implement which action?

Review the intake and output records for the last 2 days.

The 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

The 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.

The nurse is assisting in the care of a client diagnosed with rheumatic heart disease. The nurse would reinforce instructions to the client to notify the dentist before dental procedures for which reason?

The client requires prophylactic antibiotics before treatment.

A client who is 36 hours post-myocardial infarction has ambulated for the first time. The nurse determines that the client best tolerated the activity if which observation is made?

The preactivity pulse rate is 86 beats per minute; the postactivity pulse rate is 94 beats per minute.

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

Weight gain of 2 to 3 pounds in a few days

A client has just returned from the cardiac catheterization laboratory. The left femoral vessel was used as the access site. After returning the client to bed, the nurse places a sign above the bed stating that the client would remain on bed rest and in which position?

With the head of the bed elevated no more than 15 degrees

The nurse is caring for a client who had a total knee replacement. Postoperatively, the nurse monitors for which highest priority assessment?

calf pain

A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and shortness of breath, and the client is visibly anxious. Which is a life-threatening complication that could be occurring?

pulmonary embolism