NCLEX Cardio
The nurse employed in a cardiac unit determines that which client is the least likely to have an implanted cardioverter-defibrillator (ICD) inserted?
A client with an episode of cardiac arrest related to myocardial infarction
The nurse is evaluating the condition of a client after pericardiocentesis performed to treat cardiac tamponade. Which observation would indicate that the procedure was effective?
A rise in blood pressure
The nurse who is auscultating a 56-year-old client's apical heart rate before administering digoxin notes that the heart rate is 52 beats/min. The nurse should make which interpretation of this information?
Abnormal, requiring further assessment
The nurse is caring for a client who has just had implantation of an automatic internal cardioverter-defibrillator. The nurse should assess which item based on priority?
Activation status and settings of the device
The nurse is caring for a client who has just had implantation of an automatic internal cardioverter-defibrillator. The nurse should assess which item based on priority?
Activation status of the device, heart rate cutoff, and number of shocks it is programmed to deliver
A client who had cardiac surgery 24 hours ago has had a urine output averaging 20 mL/hour for 2 hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for the subsequent hour was 25 mL. Daily laboratory results indicate that the blood urea nitrogen level is 45 mg/dL (16 mmol/L) and the serum creatinine level is 2.2 mg/dL (194 mcmol/L). On the basis of these findings, the nurse would anticipate that the client is at risk for which problem?
Acute kidney injury
The nurse is evaluating a client's response to cardioversion. Which assessment would be the priority?
Airway patency
A client has been experiencing difficulty with completion of daily activities because of underlying cardiovascular disease, as evidenced by exertional fatigue and increased blood pressure. Which observation by the nurse best indicates client progress in meeting goals for this problem?
Ambulates 10 feet (3 meters) farther each day
A client with myocardial infarction is experiencing new, multiform premature ventricular contractions and short runs of ventricular tachycardia. The nurse plans to have which medication available for immediate use to treat the ventricular tachycardia?
Amiodarone
A home care nurse is visiting a client to provide follow-up evaluation and care of a leg ulcer. On removing the dressing from the leg ulcer, the nurse notes that the ulcer is pale and deep and that the surrounding tissue is cool to the touch. The nurse should document that these findings identify which type of ulcer?
An arterial ulcer
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?
An attempt to ignore or deny the need to make lifestyle changes
The nurse is providing instructions to a client with a diagnosis of hypertension regarding high-sodium items to be avoided. The nurse instructs the client to avoid consuming which item?
Antacids
Endovenous laser treatment (EVLT) is done on a client with varicose veins. Which interventions should the nurse include in the postprocedure plan of care?
Assess color and temperature of the affected limb to determine vascular status.
Which is the priority assessment in the care of a client who is newly admitted to the hospital for acute arterial insufficiency of the left leg and moderate chronic arterial insufficiency of the right leg?
Assess peripheral pulses with an ultrasonic Doppler device.
The nurse is assessing a client newly diagnosed with mild hypertension. Which assessment finding should the nurse expect?
Asymptomatic
A client's electrocardiogram shows that the ventricular rhythm is irregular and there are no discernible P waves. The nurse recognizes that this pattern is associated with which condition?
Atrial fibrillation
The nurse notes that a client's cardiac rhythm shows absent P waves, no PR interval, and an irregular rhythm. How should the nurse interpret this rhythm?
Atrial fibrillation
A client with a history of hypertension has been prescribed triamterene. The nurse determines that the client understands the effect of this medication on the diet if the client states to avoid which fruit?
Bananas
A client with myocardial infarction (MI) has been transferred from the coronary care unit (CCU) to the general medical unit. What activity level should the nurse encourage for the client immediately after transfer?
Bathroom privileges and self-care activities
A client is at risk for vasovagal attacks that cause bradydysrhythmias. The nurse would tell the client to avoid which actions to prevent this occurrence? Select all that apply.
Bearing down during a bowel movement Simulating a gag reflex when brushing the teeth Raising the arms above the head Applying pressure on the eyes
A client with a complete heart block has had a permanent demand ventricular pacemaker inserted. The nurse assesses for proper pacemaker function by examining the electrocardiogram (ECG) strip for the presence of pacemaker spikes at what point?
Before each QRS complex
A client has been admitted with left-sided heart failure. When planning care for the client, interventions should be focused on reduction of which specific problem associated with this type of heart failure?
Bilateral lung crackles
The nurse is providing postoperative care for a client who had a percutaneous insertion of an inferior vena cava filter and was on heparin therapy before surgery. The nurse should be most concerned about monitoring for which potential complications?
Bleeding and infection
The nurse is performing a cardiovascular assessment on a client. Which parameter would the nurse assess to gain the best information about the client's left-sided heart function?
Breath sounds
The client who is beginning an exercise program asks the nurse why his heart "feels like it's pounding" when he is exercising vigorously. The nurse provides education to the client about increased cardiac response based on which physiological concept?
Cardiac output is the body's attempt to meet metabolic demands.
A chaotic small, irregular, disorganized cardiac pattern suddenly appears on a client's cardiac monitor. Which is the nurse's first action?
Check the client and the chest leads.
A client is wearing a continuous cardiac monitor, which begins to sound its alarm. The nurse sees no electrocardiographic complexes on the screen. Which is the priority nursing action?
Check the client's status and lead placement.
A client is scheduled for a cardiac catheterization to diagnose the extent of coronary artery disease. The nurse places highest priority on telling the client to report which sensation during the procedure?
Chest pain
The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 seconds, and QRS complexes measure 0.06 seconds. The overall heart rate is 64 beats/minute. Which action should the nurse take?
Continue to monitor for any rhythm change.
The nurse is concerned about the adequacy of peripheral tissue perfusion in the post-cardiac surgery client. Which action should the nurse include within the plan of care for this client?
Cover the legs lightly when sitting in a chair.
A client has experienced an episode of pulmonary edema. The nurse determines that the client's respiratory status is improving after this episode if which breath sounds are noted?
Crackles in the bases
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?
Elevate the legs higher than the heart.
The nurse is planning care for a client with deep vein thrombosis of the right leg. Which interventions would the nurse anticipate the physician to most likely prescribe? Select all that apply.
Elevation of the right leg Administration of acetaminophen Application of moist heat to the right leg Monitoring for signs of pulmonary embolism
A client with an acute respiratory infection is admitted to the hospital with a diagnosis of sinus tachycardia. Which nursing action should be included in the client's plan of care?
Eliminating sources of caffeine from meal trays
The nurse is conducting a health history of a client with a primary diagnosis of heart failure. Which conditions reported by the client could play a role in exacerbating the heart failure? Select all that apply.
Emotional stress Atrial fibrillation Nutritional anemia Recent upper respiratory infection
The primary health care provider prescribes limited activity (bed rest and bathroom only) for a client who developed deep vein thrombosis (DVT) after surgery. What interventions should the nurse plan to include in the client's plan of care? Select all that apply.
Encourage increased oral intake of water daily. Place thigh-length elastic stockings on the client. Encourage coughing with deep breathing.
The nurse is caring for a client who is on strict bed rest and creates a plan of care with goals related to the prevention of deep vein thrombosis and pulmonary emboli. Which nursing action is most helpful in preventing these disorders from developing?
Encouraging active range-of-motion exercises
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?
Generally it is treated with calcium channel-blocking agents.
The nurse is performing a health screening on a 54-year-old client. The client has a blood pressure of 118/78 mm Hg, total cholesterol level of 190 mg/dL (4.9 mmol/L), and fasting blood glucose level of 184 mg/dL (10.2 mmol/L). The nurse interprets this to mean that the client has which modifiable risk factor for coronary artery disease (CAD)?
Glucose intolerance
The nurse is assessing a client with an abdominal aortic aneurysm. Which assessment finding by the nurse is unrelated to the aneurysm?
Hyperactive bowel sounds in the area
The nurse is caring for a client with cardiac disease who has been placed on a cardiac monitor. The nurse notes that the client has developed atrial fibrillation and has a rapid ventricular rate of 150 beats/minute. The nurse should next assess the client for which finding?
Hypotension
A client has developed uncontrolled atrial fibrillation with a ventricular rate of 150 beats/min. What manifestation should the nurse observe for when performing the client's focused assessment?
Hypotension and dizziness
The nurse assesses the sternotomy incision of a client on the third day after cardiac surgery. The incision shows some slight puffiness along the edges and is non-reddened, with no apparent drainage. The client's temperature is 99º F (37.2º C) orally. The white blood cell count is 7500 mm3 (7.5 × 109/L). How should the nurse interpret these findings?
Incision is slightly edematous but shows no active signs of infection.
A client complains of calf tenderness, and thrombophlebitis is suspected. The nurse should next assess the client for which finding?
Increased calf circumference
The nurse is listening to a cardiologist explain the results of a cardiac catheterization to a client and family. The cardiologist tells the client that a blockage is present in the large blood vessel that supplies the anterior wall of the left ventricle. The nurse determines that the blockage is located in which area?
Left anterior descending coronary artery (LAD)
A hospitalized client has been diagnosed with heart failure as a complication of hypertension. In explaining the disease process to the client, the nurse identifies which chamber of the heart as primarily responsible for the symptoms?
Left ventricle
The nurse is giving discharge instructions to a client who has just undergone vein ligation and stripping. The nurse evaluates that the client understands activity and positioning limitations if the client states that which action is appropriate to do?
Lie down with the legs elevated and avoid sitting.
The nurse is caring for a client immediately after insertion of a permanent demand pacemaker via the right subclavian vein. Which activity will assist with preventing dislodgement of the pacing catheter?
Limiting both movement and abduction of the right arm
The nurse is performing an assessment on a client with a diagnosis of left-sided heart failure. Which assessment component would elicit specific information regarding the client's left-sided heart function?
Listening to lung sounds
The nurse is developing a plan of care for a client who will be admitted to the hospital with a diagnosis of deep vein thrombosis (DVT) of the right leg. The nurse would include which intervention in the plan?
Maintain activity level as prescribed.
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?
Metformin
The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 seconds, and QRS complexes measure 0.06 seconds. The overall heart rate is 64 beats per minute. Which action should the nurse take?
Monitor for any rhythm change.
The nurse is teaching a client with cardiomyopathy about home care safety measures. The nurse should address with the client which most important measure to ensure client safety?
Moving slowly from a sitting to a standing position
The nurse is monitoring a client with acute pericarditis for signs of cardiac tamponade. Which assessment finding indicates the presence of this complication?
Muffled or distant heart sounds
The nurse in the medical unit is reviewing the laboratory test results for a client who has been transferred from the intensive care unit (ICU). The nurse notes that a cardiac troponin T assay was performed while the client was in the ICU. The nurse determines that this test was performed to assist in diagnosing which condition?
Myocardial infarction
The nurse is assessing an electrocardiogram (ECG) rhythm strip for a client. The PP and RR intervals are regular. The PR interval is 0.14 second, and the QRS complexes measure 0.08 second. The overall heart rate is 82 beats/min. The nurse should report the cardiac rhythm to be which rhythm?
Normal sinus rhythm
A client is being discharged from the hospital after being treated for infective endocarditis. The nurse should provide the client with which discharge instruction?
Notify all primary health care providers (PHCPs) of the history of infective endocarditis before any invasive procedures.
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?
Oxygen saturation monitor
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?
Palpating for diminished or absent peripheral pulses
A client is admitted to the hospital with a diagnosis of pericarditis. The nurse should assess the client for which manifestation that differentiates pericarditis from other cardiopulmonary problems?
Pericardial friction rub
Spironolactone is prescribed for a client with heart failure. In providing dietary instructions to the client, the nurse identifies the need to avoid foods that are high in which electrolyte?
Potassium
A client with pulmonary edema has been receiving diuretic therapy. The client has a prescription for additional furosemide in the amount of 40 mg intravenous push. Knowing that the client will also be started on digoxin, which laboratory result should the nurse review as the priority?
Potassium level
Which laboratory test results may be associated with peaked or tall, tented T waves on a client's electrocardiogram (ECG)?
Potassium level of 6.8 mEq/L (6.8 mmol/L)
Cardiac monitoring leads are placed on a client who is at risk for premature ventricular contractions (PVCs). Which heart rhythm will the nurse anticipate in this client if PVCs are occurring?
Premature beats followed by a compensatory pause
The nurse is preparing to ambulate a client on the third day after cardiac surgery. What should the nurse plan to do to enable the client to best tolerate the ambulation?
Premedicate the client with an analgesic.
A client is scheduled for a cardiac catheterization using an iodine agent. Which assessment is most critical before the procedure?
Previous allergy to contrast agents
The nurse is caring for a postoperative client who has lost a significant amount of blood because of complications during a surgical procedure. Which assessment finding would be indicative of further fluid volume deficit?
Pulse rate increases from 100 beats/min to 136 beats/min
The nurse is caring for a client with a diagnosis of myocardial infarction (MI) and is assisting the client in completing the diet menu. Which beverage should the nurse instruct the client to select from the menu?
Raspberry juice
A client is having a follow-up primary health care provider (PHCP) office visit after vein ligation and stripping. The client describes a sensation of "pins and needles" in the affected leg. Which would be an appropriate action by the nurse based on evaluation of the client's comment?
Report the complaint to the PHCP.
A client recovering from an exacerbation of left-sided heart failure is experiencing activity intolerance. Which change in vital signs during activity would be the best indicator that the client is tolerating mild exercise?
Respiratory rate increased from 16 to 19 breaths per minute
The nurse notes bilateral 2+ edema in the lower extremities of a client with myocardial infarction who was admitted 2 days ago. Based on this observation, what should the nurse plan to do first?
Review intake and output records for the last 2 days.
The nurse identifies that a client is having occasional premature ventricular contractions (PVCs) on the cardiac monitor. The nurse reviews the client's laboratory results and determines that which result would be consistent with the observation?
Serum potassium level of 2.8 mEq/L (2.8 mmol/L)
The post-myocardial infarction client is scheduled for a technetium-99m ventriculography (multigated acquisition [MUGA] scan). The nurse ensures that which item is in place before the procedure?
Signed informed consent
The 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?
Sinoatrial (SA) node
A client's electrocardiogram (ECG) strip shows atrial and ventricular rates of 70 complexes/minute. The PR interval is 0.16 second, the QRS complex measures 0.06 second, and the PP interval is slightly irregular. How should the nurse report this rhythm?
Sinus dysrhythmia
A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats per minute. The PR interval is 0.14 seconds, the QRS complex measures 0.08 seconds, and the PP and RR intervals are regular. How should the nurse interpret this rhythm?
Sinus tachycardia
A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats/minute. The PR interval is 0.14 seconds, the QRS complex measures 0.08 seconds, and the PP and RR intervals are regular. How should the nurse correctly interpret this rhythm?
Sinus tachycardia
A client has been diagnosed with thromboangiitis obliterans (Buerger's disease). The nurse is identifying measures to help the client cope with lifestyle changes needed to control the disease process. The nurse plans to refer the client to which member of the health care team?
Smoking cessation program
The nurse is evaluating a client's cardiac rhythm strip to determine if there is proper function of the VVI mode pacemaker. Which denotes proper functioning?
Spikes occur before QRS complexes when intrinsic ventricular beats do not occur.
The nurse is assessing the client's condition after cardioversion. Which observation should be of highest priority to the nurse?
Status of airway
The nurse is evaluating a client's response to cardioversion. Which assessment would be the priority?
Status of airway
The nurse is preparing discharge instructions for a client with Raynaud's disease. The nurse should plan to provide which instruction to the client?
Stop smoking because it causes cutaneous blood vessel spasm.
A client with no history of heart disease has experienced acute myocardial infarction and has been given thrombolytic therapy with tissue plasminogen activator. What assessment finding should the nurse identify as an indicator that the client is experiencing complications of this therapy?
Tarry stools
The cardiologist has written a prescription for a client to have an echocardiogram. Which action should the nurse take to prepare the client for the procedure?
Tells the client that the procedure is painless and takes 30 to 60 minutes
The nurse reading the operative record of a client who had cardiac surgery notes that the client's cardiac output immediately after surgery was 3.2 L/min. Evaluation of the cardiac output results leads the nurse to make which conclusion?
The cardiac output is below the normal range.
After instruction on the application of antiembolism stockings, the nurse determines that the client requires further teaching if which of these actions is performed?
The client bunches up the stockings for easier application.
A client's total cholesterol level is 344 mg/dL (8.6 mmol/L), low-density lipoprotein cholesterol (LDL-C) level is 164 mg/dL (4.25 mmol/L), and high-density lipoprotein cholesterol (HDL-C) level is 30 mg/dL (1.2 mmol/L). Based on analysis of the data, how should the nurse direct client teaching?
The client is at high risk for cardiovascular disease, and measures to modify all identified risk factors should be taught.
A client is scheduled for elective cardioversion to treat chronic high-rate atrial fibrillation. Which finding indicates that further preparation is needed for the procedure?
The client is wearing a nasal cannula delivering oxygen at 2 L/min.
A client who has been exercising in a gymnasium stops to measure his pulse and places his fingers over both carotid arteries simultaneously. The nurse exercising nearby is correct when cautioning the client to check the pulse on only one side, primarily for which reason?
The heart rate and blood pressure could drop.
The nurse is assessing the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission. How should the nurse correctly interpret the client's neurovascular status?
The neurovascular status is normal because of increased blood flow through the leg.
The nurse is assessing the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable. How should the nurse interpret the client's neurovascular status?
The neurovascular status is normal because of increased blood flow through the leg.
The nurse working in a long-term care facility is assessing a client who is experiencing chest pain. The nurse should interpret that the pain is most likely caused by myocardial infarction (MI) on the basis of what assessment finding?
The pain has not been relieved by rest and nitroglycerin tablets.
The nurse is assigned the care of a client with a diagnosis of heart failure who is receiving intravenous doses of furosemide. The client is attached to cardiac telemetry, and the nurse is monitoring the client's cardiac status. The nurse notes that the client's cardiac rhythm has changed to this pattern. The nurse determines that the most likely cause of this cardiac rhythm in the client is which problem? Refer to figure.
The presence of hypokalemia
A client has received antidysrhythmic therapy for the treatment of premature ventricular contractions (PVCs). The nurse evaluates this therapy as most effective if which finding is noted with regard to the PVCs?
They decrease to a frequency of less than 6 per minute.
The nurse monitors the client for which condition as a complication of polycythemia vera?
Thrombosis
A client is seen in the emergency department for complaints of chest pain that began 3 hours ago. The nurse should suspect myocardial injury or infarction if which laboratory value comes back elevated?
Troponin
The nurse is instructing the post-cardiac surgery client about activity limitations for the first 6 weeks after hospital discharge. The nurse should include which item in the instructions?
Use the arms for balance, not weight support, when getting out of bed or a chair.
The nurse is developing a plan of care for a client recovering from pulmonary edema. The nurse establishes a goal to have the client participate in activities that reduce cardiac workload. The nurse should identify which client action as contributing to this goal?
Using a bedside commode
A client who has had a myocardial infarction asks the nurse why she should not bear down or strain to ensure having a bowel movement. The nurse provides education to the client based on which physiological concept?
Vagus nerve stimulation causes a decrease in heart rate and cardiac contractility.
An emergency room nurse is performing a cardiovascular assessment on a client. During auscultation of the heart sounds, the nurse hears these abnormal sounds. The nurse suspects that the client has which condition?
Ventricular hypertrophy
A client is attached to a cardiac monitor, and the nurse notes the presence of this cardiac rhythm on the monitor. The nurse quickly assesses the client, knowing that this rhythm is indicative of which rhythm? Refer to figure
Ventricular tachycardia (VT)
The nurse is planning to teach a client with peripheral arterial disease about measures to limit disease progression. Which items should the nurse include on a list of suggestions for the client? Select all that apply.
Walk each day to increase circulation to the legs. Cut down on the amount of fats consumed in the diet. Be careful not to injure the legs or feet.
A client with coronary artery disease is scheduled to have a diagnostic exercise stress test. Which instruction should the nurse plan to provide to the client about this procedure?
Wear loose clothing with a shirt that buttons in front.
A client recovering from pulmonary edema is preparing for discharge. What should the nurse plan to teach the client to do to manage or prevent recurrent symptoms after discharge?
Weigh self on a daily basis.
The registered nurse (RN) is orienting a new RN assigned to the care of a client with a cardiac disorder and is told that the client has an alteration in cardiac output. After educating the new RN about cardiac output, which statement made by the new RN indicates the need for further instruction?
"A cardiac output of 2 L/min is normal."
A client seeks treatment in a vascular surgeon's office for unsightly varicose veins, and radiofrequency ablation (RFA) is recommended. Before leaving the examining room, the client says to the nurse, "Can you tell me again how this is done?" Which statement should the nurse make?
"A heating element is used to occlude the vein."
A client with iron deficiency anemia complains of feeling fatigued almost all of the time. The nurse should respond with which statement?
"Adequate amounts of hemoglobin are needed to carry oxygen for tissue metabolism."
The nurse has just completed education on myocardial infarction (MI) to a group of new nurses. Which statement made by one of the nurses indicates that the teaching has been effective?
"Chest pain is caused by tissue hypoxia in the myocardium."
The nurse educator is teaching the new registered nurse (RN) how to care for clients with a decrease in blood pressure. Which statement by the new RN indicates the need for further instruction?
"Decreased myocardial blood flow is not a concern."
A client with no history of cardiovascular disease comes to the ambulatory clinic with flu-like symptoms. The client suddenly complains of chest pain. Which question should best help the nurse discriminate pain caused by a noncardiac problem?
"Does the pain get worse when you breathe in?"
The registered nurse (RN) is educating a new nurse about aortic regurgitation. Which statement by the new nurse indicates that the teaching has been effective?
"Failure of the aortic valve to close completely allows blood to flow retrograde through the aorta to the left ventricle."
The nurse has provided self-care activity instructions to a client after insertion of an implanted cardioverter-defibrillator (ICD). The nurse determines that further instruction is needed if the client makes which statement?
"I can perform activities such as swimming, driving, or operating heavy equipment as I need to."
The home health nurse makes a home visit to a client who has an implanted cardioverter-defibrillator (ICD) and reviews the instructions concerning pacemakers and dysrhythmias with the client. Which client statement indicates that further teaching is necessary?
"I can stop taking my antidysrhythmic medicine now because I have a pacemaker."
The nurse is trying to determine the ability of the client with myocardial infarction (MI) to manage independently at home after discharge. Which statement by the client is the strongest indicator of the potential for difficulty after discharge?
"I don't have anyone to help me with doing heavy housework at home."
The home health nurse visits a client recovering after an episode of cardiogenic shock secondary to an anterior myocardial infarction (MI) and provides home care instructions to the client. Which statement by the client indicates an understanding of these home care measures?
"I have planned periods of rest at 10:00 a.m. and 3:00 p.m. daily."
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?
"I need to adhere to my dietary restrictions."
The home care nurse is providing instructions to a client with an arterial ischemic leg ulcer about home care management and self-care management. Which statement, if made by the client, indicates a need for further instruction?
"I need to be sure that I elevate my leg above the level of my heart for at least an hour every day.
The home health nurse is visiting a client who has had a mechanical valve replacement for severe mitral valve stenosis. Which statement by the client reflects an understanding of specific postoperative care after this surgery?
"I need to throw away my straight razor and buy an electric razor."
A client is scheduled to undergo cardiac catheterization for the first time, and the nurse provides instructions to the client. Which client statement indicates an understanding of the instructions?
"I probably will feel tired after the test from lying on a hard x-ray table for a few hours."
The nurse has provided dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions?
"I should use polyunsaturated oils in my diet."
A client who had coronary artery bypass surgery states to the home health nurse, "I get so frustrated. I can't even do my gardening." The nurse then assesses the client for activity level since the surgery. Which client statement indicates a need for further teaching?
"I try to walk immediately after lunch, after I've finished my morning housecleaning."
The home care nurse has taught a client with a problem of inadequate cardiac output about helpful lifestyle adaptations to promote health. Which statement by the client best demonstrates an understanding of the information provided?
"I will eat enough daily fiber to prevent straining at stool."
A client is admitted to the visiting nurse service for assessment and follow-up after being discharged from the hospital with new-onset heart failure (HF). The nurse teaches the client about the dietary restrictions required with HF. Which statement by the client indicates that further teaching is needed?
"I'm going to have a ham and cheese sandwich and potato chips for lunch."
The nurse is discussing smoking cessation with a client diagnosed with coronary artery disease (CAD). Which statement should the nurse make to try to motivate the client to quit smoking?
"If you quit now, your risk of cardiovascular disease will decrease to that of a nonsmoker in 3 to 4 years."
A client with a diagnosis of varicose veins is scheduled for treatment by sclerotherapy and is receiving education about the procedure from the nurse. Which statement by the client indicates that the teaching has been effective?
"It involves injecting an agent into the vein to damage the vein wall and close it off."
The nurse is teaching the client with angina pectoris about disease management and lifestyle changes that are necessary to control disease progression. Which statement by the client indicates a need for further teaching?
"It is best to exercise once a week for 1 hour."
An ambulatory care nurse measures the blood pressure of a client and finds it to be 156/94 mm Hg. Which statement indicates that the client needs additional education?
"It is important that I limit protein intake."
The registered nurse (RN) is educating a new nurse on mitral stenosis. Which statement by the new nurse indicates that the teaching has been effective?
"Left atrium to left ventricle narrowing will impede flow of blood."
The nurse educator is lecturing new registered nurses (RNs) about serum calcium levels. Which statement by one of the new RNs indicates that teaching has been effective?
"Low calcium levels can lead to cardiac arrest."
The nurse determines that a client requires further teaching after permanent pacemaker insertion if which statement is made?
"My pulse rate should be less than what my pacemaker is set at."
A client with variant angina is scheduled to receive an oral calcium channel blocker twice daily. Which statement by the client indicates the need for further teaching?
"My spouse told me that since I have developed this problem, we are going to stop walking in the mall every morning."
The nurse has completed an educational course covering first-degree heart block. Which statement by the nurse indicates that teaching has been effective?
"Prolonged, equal PR intervals indicate first-degree heart block."
The new registered nurse (RN) is orienting on the cardiac unit. Which statement by the new RN indicates an understanding of an early indication of fluid volume deficit due to blood loss?
"Pulse rate will increase."
The nurse is listening to a lecture on Advanced Cardiac Life Support (ACLS). The instructor is discussing electrocardiographic (ECG) changes caused by myocardial ischemia. Which statement by the nurse indicates that teaching has been effective?
"ST segment elevation or depression can indicate ischemia."
The nurse is listening to a lecture about angina. Which statement by the nurse indicates that the teaching has been effective?
"Stable angina is chronic."
The registered nurse (RN) is listening to a lecture on pulmonary edema. Which statement by the RN indicates that the teaching has been effective?
"The client will experience extreme anxiety."
The nurse is reviewing the procedure for performance of an electrocardiogram (ECG). Which action by the nurse indicates understanding of the correct position for the V1 lead when performing a 12-lead electrocardiogram?
"The lead should be placed on the fourth intercostal space right sternal border."
A nursing instructor asks a nursing student to describe the structure and function of the coronary arteries. Which response by the student indicates a need for further teaching on the anatomy and physiology of the heart?
"The left coronary artery supplies the right atrium and right ventricle with blood."
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?
"The pain of angina pectoris occurs because of a decreased oxygen supply to heart cells."
A nursing student who is researching a medication at the nurses' station asks the registered nurse (RN) what the function of an alpha-adrenergic receptor is, and where the receptors are primarily found. The RN educates the nursing student. Which statement by the nursing student indicates that teaching has been effective?
"The peripheral arteries and veins; when stimulated they cause vasoconstriction."
A client with rapid-rate atrial fibrillation asks the nurse why the cardiologist is going to perform carotid sinus massage. The nurse educates the client about the treatment. Which statement by the client indicates that the teaching has been effective?
"The vagus nerve slows the heart rate."
The nurse is participating in a class on rhythm strip interpretation. Which statement by the nurse indicates an understanding of a PR interval of 0.20?
"This is a normal finding."
The nurse is educating the client about variant angina. Which statement by the client indicates that the teaching has been effective?
"Variant angina occurs at the same time each day."
The new registered nurse (RN) is reviewing cardiac rhythms with a mentor. Which statement by the new RN indicates that teaching about ventricular fibrillation has been effective?
"Ventricular fibrillation does not have P waves or QRS complexes."
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?
"Where is the pain located?"
A client calls the nurse at the clinic and reports that ever since the vein ligation and stripping procedure was performed, she has been experiencing a sensation as though the affected leg is falling asleep. The nurse should make which response to the client?
"Your primary health care provider needs to be contacted to report this problem."
The nurse is assessing a client's legs for the presence of edema. The nurse notes that the client has mild pitting with slight indentation and no perceptible swelling of the leg. How should the nurse define and document this finding?
1+ edema
The nurse is assisting in the care of a client scheduled for cardioversion. The nurse plans to set the defibrillator to which starting energy range level, depending on the specific emergency health care provider (HCP) prescription?
120 joules
