Nclex review questions- cardiac health problems
Which position is best for a client with heart failure who has orthopnea? Options: Low Fowlers position Sims position High Fowler's position Trendelenburg position
Answer: high Fowlers position
A middle-age client with the history of hypertension reports having indigestion. The nurse connects the client to a cardiac monitor, which reveals 8 premature ventricular contractions per minute. What should the nurse do next? Options: Call the HCP Start an intravenous infusion Obtain a portable chest radiograph Draw blood for laboratory studies
Answer: start an intravenous infusion
Following diagnosis of angina pectoris a client reports being unable to walk up two flights of stairs without pain. What should the nurse instruct the client to do? Options: Climb the steps early in the day Rest for at least an hour before climbing the stairs Take a nitroglycerin tablet before climbing the stairs Lie down after climbing the stairs
Answer: take a nitroglycerin tablet before climbing the stairs
The nurse notice that a clients heart rate decreases from 63 to 50 bpm on the monitor. What should the nurse do first? Options: Administer the atropine 0.5 mg IV push Auscultate for abnormal heart sounds Prepare the transcutaneous pacing Take the clients BP
Answer: take the clients BP
A client receiving a loop diuretics should be encouraged to eat which foods to prevent potassium loss? Select all that apply Options: Angel food Banana Dried fruit Orange juice Peppers
Answer is: banana, dried fruit, orange juice
The nurse is assessing a client who has had a stent inserted in the coronary artery the other right for femoral artery. The client is receiving intravenous heparin sodium at 1000 units per hour. During the second post procedure check, the nurse notes that the puncture site at the groin has begun to steadily ooze blood. What should the nurse do first? Options: Don gloves and apply direct pressure over the site Observe and document the bleeding Notify the HCP Prepare protamine sulfate for intravenous administration
Answer: Don gloves and apply direct pressure over the site
The nurse is discussing medications with a client with hypertension who has a prescription for for us in my daily. Which comment by the client indicates the client needs further education? Options: I know I shouldn't drive after taking my furosemide I should be careful not to stand up too quickly when taking furosemide I should take furosemide in the morning instead of before bed I need to be sure to also take the potassium supplement that the doctor prescribed along with my medication
Answer: I know I shouldn't drive after taking my medication
The nurse is teaching client with hypertension about maintaining an exercise program. Which teaching strategy will be most helpful? Options: Give the client a written exercise program to follow Explain the exercise program to the clients spouse Offer reassurance that the client can follow the exercise program Tailor up program to meet the clients needs and abilities
Answer: Tailor a program to meet the clients needs and abilities
Which client is at greatest risk for coronary artery disease? Options: 30 to-year-old female with mitral valve prolapse who quit smoking 10 years ago A 43-year-old male with a family history of coronary artery disease and cholesterol level of 158 A 56-year-old male with an HDL level of 60 who takes atorvastatin A 65-year-old female who is obese with an LDL of 188
Answer: a 65-year-old female who is obese with an LDL of 188
Which symptoms should the nurse teach the client with unstable angina to report immediately to the healthcare provider? Options: A change in pattern of the chest pain Pain during sexual activity Pain during an argument Pain during or after a physical activity
Answer: a change in pattern of the chest pain
A client admitted for a myocardial infarction develops cardiogenic shock. And arterial line is inserted. Which prescription from the healthcare provider should the nurse verify before implementing? Options: Call for your an output less than 30 mL per hour for two consecutive hours Administer metoprolol 5 mg IV push Prepare for pulmonary artery catheter insertion Titrate dobutamine to keep systolic blood pressure greater than 100 mmHg
Answer: administer metoprolol 5 mg IV push
An adult comes into the ER with crushing the sub sternal chest pain that radiates to the shoulder and left arm. The admitting diagnoses is a cute MI Prescriptions include oxygen by nasal cannula at 4 L per minute, complete blood count, a chest radiograph, a 12 lead electrocardio gram, and 2 mg of morphine sulfate give an IV. What should the nurse do first? Options: Administer the morphine Obtain a 12 lead ECG Obtain the blood work Prescribe the chest radiograph
Answer: administer the morphine
The nurse is admitting an older adult to the hospital. The echocardiogram report revealed left ventricular enlargement. The nurse notes 2+ pitting Adema in ankles when getting the client into bed. Based on his findings, what should the nurse do first? Options: Assess respiratory status Draw blood for lab studies Insert a Foley Weigh the client
Answer: assess respiratory status
The nurse teaches a client who has recently been diagnosed with hypertension about following a low-calorie, low-fat, low sodium diet. Which menu selection would best meet the clients needs? Options: Make screen salad with blue cheese dressing, crackers, and cold cuts Ham sandwich on rye and an orange Baked chicken and apple and a slice of white Hotdogs, baked beans, and celery and carrot sticks
Answer: baked chicken, an apple, and a slice of white bread
An older adult with a history of heart failure is admitted to the emergency department with a pulmonary Adema. During admission, what should the nurse assessed first? Options: Blood pressure Skin breakdown Serum potassium levels Urine output
Answer: blood pressure
A client with chest pain is prescribed intravenous nitroglycerin. Which finding is of greatest concern for the nurse initiating the nitroglycerin drip? Options: Serim potassium is 3.5 MEQ/L Blood pressure is 88/46 mmHg ST elevation is present on the electro cardio gram Heart rate 61 bpm
Answer: blood pressure is 88/46 mmHg
Which food should the nurse teach a client with heart failure to limit one following a 2 g sodium diet? Options: Apple Canned tomato juice Whole wheat bread Hamburger
Answer: canned tomato juice
Nurse nurse has completed an assessment on a client with a decreased cardiac output. Which findings should receive the highest priority? Options: BP 110/62 mmHg, a fib with heart rate 82, bilateral Basilar crackles Confusion, urine put 15 mL over the last two hours in orthopnea SPO2 92 on a 2 L nasal cannula, respirations 20, one plus Adema of lower extremities Weight gain of 1 kg in three days, BP 130/80 mmHg, mild dyspnea with exercise
Answer: confusion, urine output 15 mL over the last two hours, orthopnea
The nurse is assessing a client with a known history of chronic heart failure. Which finding indicates poor perfusion to the tissues? Options: BP 102/60 4 mmHg Cool, pale extreme Heart rate of 104 BPM SOB when supine
Answer: cool, pale extremities
The client has been managing angina episodes with nitroglycerin. Which finding indicates that the therapeutic effect of the drug has been achieved? Options: Decrease chest pain Increased BP Decrease BP Decrease HR
Answer: decrease chest pain
Metoprolol is added to the pharmacologic therapy of a diabetic female diagnosed with stage two hypertension who has been initially treated with furosemide and ramipril. the nurse should evaluate the client for which expect a therapeutic affect? Options: Decrease in HR Lessening of fatigue Improvement in blood sugar levels Increase in urine output
Answer: decrease in heart rate
A client returned from a left heart catheterization the right groin was used for the catheter access. At which location should the nurse palpate the distal pulse on this client? Options: Anterior to the right tibia Dorsal surface of the right foot Posterior to the right knee Right midinguinal area
Answer: dorsal surface of the right foot
Which would be most helpful in coaching the client to stop smoking? Options: Review the negative affects on smoking on the body Discussed the effects of passive smoking on environmental pollution Establish the clients daily smoking pattern Explain how smoking worsens high blood pressure
Answer: establish the clients daily smoking pattern
What is the major goal of nursing care for a client with heart failure and pulmonary edema? Options: Increase cardiac out Improve respiratory status Decrease peripheral Edema Enhance comfort
Answer: increase cardiac output
Which is expected expected outcome when a client is receiving IV administration of Furosemide? Options: Increased BP Increased urine output Decreased pain Decrease premature ventricular contractions
Answer: increased urine output
A client within China is taking nifedipine. What instructions should the nurse give the client? Options: Monitor BP monthly Perform daily weights Inspect gums daily Limit intake of green leafy vegetables
Answer: inspect gums daily
The nurse is making a discharge plan with an obese client with hypertension who smokes. What is the most important long-term goal for this client? Options: Take medications as prescribed Stop smoking Make a commitment to a long-term lifestyle changes Lose weight
Answer: make a commitment to a long-term lifestyle changes
The nurse teaches a client with heart failure to take oral furosemide in the morning. What is the expected outcome for taking this drug in the morning? The client will: Options: Avoid concentrated urine Prevent the risk of falling Limit the excretion of electrolyte Obtain more sleep more
Answer: obtain more sleep more
What instructions should a nurse discharge teaching plan for the client with heart failure? Options: Maintaining a high-fiber diet Walking 2 miles every day Obtaining daily way to the same time each day Remaining sedentary for most of the day
Answer: obtaining daily weight at the same time each day
After a myocardial infarction, the hospitalized client is taught to move her legs while resting in bed. What is expected outcome of this exercise? Options: Prepare the client for ambulation Promote urinary intestinal illumination Prevent thrombophlebitis and blood clot formation Decrease the likelihood of pressure ulcer formation
Answer: prevent thrombophlebitis and blood clot formation
An older adult has chest pain and shortness of breath. The healthcare provider (HCP) prescribed nitroglycerin tablets. what should the nurse instruct the client to do? Options: Put the tablet under the tongue until it is absorbed Swallow the tablet was 120 mL of water Chew the tablet until it is dissolved Placed a tablet between the cheek and gums until it disappears
Answer: put the tablet under the tongue until it is absorbed
A client has chest pain rated at eight on a 10 point visual analog scale. The 12 lead electro cardiogram reveals ST elevation in the inferior leads, and troponin levels are elevated. What should the nurse do first? Options: Monitor daily weights and urine output Limit visitation by family and friends Provide client education on medications and diet Reduce pain and myocardial oxygen demand
Answer: reduce pain and myocardial oxygen demand
Which is the most appropriate diet for a client during the acute phase of myocardial infarction? Options: Liquids as desired Small, easily digested meals Three regular meals per day Nothing by mouth
Answer: small, easily digested meals
The client who experiences in China has been told to follow a low cholesterol diet. Which meal would be best? Options: Hamburger salad and milkshake Bakes liver green beans and coffee Spaghetti with tomato sauce salad and coffee Fried chicken green beans and skim milk
Answer: spaghetti with tomato sauce salad and coffee
Which is an expected outcome for a client on the second day of hospitalization after an MI? Options: The client continues to have severe chest pain The client can identify risk factors for MI The client participates in cardiac rehabilitation walking program The client can perform personal self-care activities without pain
Answer: the client can perform personal self-care activities without pain
A client with chronic heart failure has atrial fibrillation and is taking worth in. What should the nurse tell the client about the expected outcome of this drug? Options: This medication will decrease the extra fluid of your heart is circulating Does medication will improve the work of your heart This medication will prevent clots from forming This medication will regulate the rhythm of your heart
Answer: this medication will prevent a clot from forming
A client is to have a treadmill stress test. Prior to the test, the nurse reviews the results of the laboratory reports. The nurse should report which elevated laboratory value to the healthcare provider prior to the stress test? Options: Cholesterol level Erythrocyte sedimentation rate Prothrombin time Troponin level
Answer: troponin level
The healthcare provider prescribes continuous IV nitroglycerin infusion for the client with myocardial infarction. What should the nurse do to ensure safe administration of this drug? Options: Use of infusion pump for the medication Take the blood pressure every four hours Monitor urine output hourly Obtain serum potassium levels daily
Answer: use infusion pump for the medication
The nurse should assess the client with left sided heart failure for which findings? Select all that apply. Options: Dyspnea JVD Crackles Right upper quadrant pain Oliguria Decreased oxygen saturation levels
Answers: Dyspnea Crackles Oliguria Decreased oxygen saturation levels
Which are indications that a client with a history of left sided heart failure is developing pulmonary Adema? Select all that apply Options: Distended jugular vein's Dependent Adema Anorexia Coarse crackles Tachycardia
Answers: coarse crackles and tachycardia