Practice Questions from Kelly

2. The nurse on the intermediate care unit received change-of-shift report on four patients with hypertension. Which patient should the nurse assess first? A) 43-year-old with a (blood pressure (BP) of 160/92 who is complaining of chest pain B) 52-year-old with a BP of 212/90 who has intermittent claudication C) 50-year-old with a BP of 190/104 who has a creatinine of 1.7 mg/dL D) 48-year-old with a BP of 172/98 whose urine shows microalbuminuria

A) 43-year-old with a (blood pressure (BP) of 160/92 who is complaining of chest pain

18. Based on the Joint Commission Core Measures for patients with heart failure, which topics should the nurse include in the discharge teaching plan for a patient who has been hospitalized with chronic heart failure (select all that apply)? A) How to take and record daily weight B) Importance of limiting aerobic exercise C) Date and time of follow-up appointment D) Symptoms indicating worsening heart failure E) Actions and side effects of prescribed medications

A) How to take and record daily weight C) Date and time of follow-up appointment D) Symptoms indicating worsening heart failure E) Actions and side effects of prescribed medications

17. Which assessment finding in a patient admitted with acute decompensated heart failure (ADHF) requires the most immediate action by the nurse? A) Oxygen saturation of 88% B) Weight gain of 1 kg (2.2 lb) C) Heart rate of 106 beats/minute D) Urine output of 50 mL over 2 hours

A) Oxygen saturation of 88%

3. The nurse is reviewing the laboratory test results for a patient who has recently been diagnosed with hypertension. Which result is most important to communicate to the health care provider? A) Serum creatinine of 2.8 mg/dL B) Serum potassium of 4.5 mEq/L C) Serum hemoglobin of 14.7 g/dL D) Blood glucose level of 96 mg/dL

A) Serum creatinine of 2.8 mg/dL

4. A patient with a history of hypertension treated with a diuretic and an angiotensin-converting enzyme (ACE) inhibitor arrives in the emergency department complaining of a severe headache and nausea and has a blood pressure (BP) of 238/118 mm Hg. Which question should the nurse ask first? A) "Did you take any acetaminophen (Tylenol) today?" B) "Have you been consistently taking your medications?" C) "Have there been any recent stressful events in your life?" D) "Have you recently taken any antihistamine medications?"

B) "Have you been consistently taking your medications?"

26. Which actions could the nurse delegate to unlicensed assistive personnel (UAP) who are providing care for a patient who is at risk for venous thromboembolism? A) Monitor for any bleeding after anticoagulation therapy is started. B) Apply sequential compression device whenever the patient is in bed. C) Ask the patient about use of herbal medicines or dietary supplements. D) Instruct the patient to call immediately if any shortness of breath occurs.

B) Apply sequential compression device whenever the patient is in bed.

12 Which patient at the cardiovascular clinic requires the most immediate action by the nurse? A) Patient with type 2 diabetes whose current blood glucose level is 145 mg/dL B) Patient with stable angina whose chest pain has recently increased in frequency C) Patient with familial hypercholesterolemia and a total cholesterol of 465 mg/dL D) Patient with chronic hypertension whose blood pressure today is 172/98 mm Hg

B) Patient with stable angina whose chest pain has recently increased in frequency

8. Which assessment data collected by the nurse who is admitting a patient with chest pain suggest that the pain is caused by an acute myocardial infarction (AMI)? A) The pain increases with deep breathing. B) The pain has lasted longer than 30 minutes. C) The pain is relieved after the patient takes nitroglycerin. D) The pain is reproducible when the patient raises the arms.

B) The pain has lasted longer than 30 minutes.

5. The nurse is assessing a patient who has been admitted to the intensive care unit (ICU) with a hypertensive emergency. Which finding is most important to report to the health care provider? A) Urine output over 8 hours is 250 mL less than the fluid intake. B) The patient cannot move the left arm and leg when asked to do so. C) Tremors are noted in the fingers when the patient extends the arms. D) The patient complains of a headache with pain at level 8/10 (0 to 10 scale).

B) The patient cannot move the left arm and leg when asked to do so.

20. The nurse identifies the nursing diagnosis of decreased cardiac output related to valvular insufficiency for the patient with infective endocarditis (IE) based on which assessment finding(s)? A) Fever, chills, and diaphoresis B) Urine output less than 30 mL/hr C) Petechiae on the inside of the mouth and conjunctiva D) Increase in heart rate of 15 beats/minute with walking

B) Urine output less than 30 mL/hr

19. During the assessment of a 25-year-old patient with infective endocarditis (IE), the nurse would expect to find? A) substernal chest pressure. B) a new regurgitant murmur. C) a pruritic rash on the chest. D) involuntary muscle movement.

B) a new regurgitant murmur.

16. A patient with a history of chronic heart failure is admitted to the emergency department (ED) with severe dyspnea and a dry, hacking cough. Which action should the nurse do first? A) Auscultate the abdomen. B) Check the capillary refill. C) Auscultate the breath sounds. D) Assess the level of orientation.

C) Auscultate the breath sounds.

10. Heparin is ordered for a patient with a non?ST-segment-elevation myocardial infarction (NSTEMI). What is the purpose of the heparin? A) Heparin enhances platelet aggregation. B) Heparin decreases coronary artery plaque size. C) Heparin prevents the development of new clots in the coronary arteries. D) Heparin dissolves clots that are blocking blood flow in the coronary arteries.

C) Heparin prevents the development of new clots in the coronary arteries.

22. A 21-year-old woman is scheduled for percutaneous transluminal balloon valvuloplasty to treat mitral stenosis. Which information should the nurse include when explaining the advantages of valvuloplasty over valve replacement to the patient? A) Biologic valves will require immunosuppressive drugs after surgery. B) Mechanical mitral valves need to be replaced sooner than biologic valves. C) Lifelong anticoagulant therapy will be needed after mechanical valve replacement. D) Ongoing cardiac care by a health care provider is not necessary after valvuloplasty.

C) Lifelong anticoagulant therapy will be needed after mechanical valve replacement.

25 Which assessment finding for a patient who has been admitted with a right calf venous thromboembolism (VTE) requires immediate action by the nurse? A) Erythema of right lower leg B) Complaint of right calf pain C) New onset shortness of breath D) Temperature of 100.4° F (38° C)

C) New onset shortness of breath

6. The registered nurse (RN) is caring for a patient with a hypertensive crisis who is receiving sodium nitroprusside (Nipride). Which nursing action can the nurse delegate to an experienced licensed practical/vocational nurse (LPN/LVN)? A) Titrate nitroprusside to decrease mean arterial pressure (MAP) to 115 mm Hg. B) Evaluate effectiveness of nitroprusside therapy on blood pressure (BP). C) Set up the automatic blood pressure machine to take BP every 15 minutes. D) Assess the patient's environment for adverse stimuli that might increase BP.

C) Set up the automatic blood pressure machine to take BP every 15 minutes.

14. A patient who has chronic heart failure tells the nurse, "I was fine when I went to bed, but I woke up in the middle of the night feeling like I was suffocating!" The nurse will document this assessment finding as? A) orthopnea. B) pulsus alternans. C) paroxysmal nocturnal dyspnea. D) acute bilateral pleural effusion.

C) paroxysmal nocturnal dyspnea.

15. The nurse working on the heart failure unit knows that teaching an older female patient with newly diagnosed heart failure is effective when the patient states that? A) she will take furosemide (Lasix) every day at bedtime. B) the nitroglycerin patch is applied when any chest pain develops. C) she will call the clinic if her weight goes from 124 to 128 pounds in a week. D) an additional pillow can help her sleep if she is feeling short of breath at night.

C) she will call the clinic if her weight goes from 124 to 128 pounds in a week.

21. When caring for a patient with mitral valve stenosis, it is most important that the nurse assess for? A) diastolic murmur. B) peripheral edema. C) shortness of breath on exertion. D) right upper quadrant tenderness.

C) shortness of breath on exertion.

24. Which topic should the nurse include in patient teaching for a patient with a venous stasis ulcer on the left lower leg? A) Need to increase carbohydrate intake B) Methods of keeping the wound area dry C) Purpose of prophylactic antibiotic therapy D) Application of elastic compression stockings

D) Application of elastic compression stockings

11. When caring for a patient with acute coronary syndrome who has returned to the coronary care unit after having angioplasty with stent placement, the nurse obtains the following assessment data. Which data indicate the need for immediate action by the nurse? A) Heart rate 102 beats/min B) Pedal pulses 1+ bilaterally C) Blood pressure 103/54 mm Hg D) Chest pain level 7 on a 0 to 10 point scale

D) Chest pain level 7 on a 0 to 10 point scale

1. Which information should the nurse include when teaching a patient with newly diagnosed hypertension? A) Increasing physical activity will control blood pressure (BP) for most patients. B) Most patients are able to control BP through dietary changes. C) Annual BP checks are needed to monitor treatment effectiveness. D) Hypertension is usually asymptomatic until target organ damage occurs.

D) Hypertension is usually asymptomatic until target organ damage occurs.

13. The nurse is caring for a patient who is receiving IV furosemide (Lasix) and morphine for the treatment of acute decompensated heart failure (ADHF) with severe orthopnea. Which clinical finding is the best indicator that the treatment has been effective? A) Weight loss of 2 pounds in 24 hours B) Hourly urine output greater than 60 mL C) Reduction in patient complaints of chest pain D) Reduced dyspnea with the head of bed at 30 degrees

D) Reduced dyspnea with the head of bed at 30 degrees

9. Which information given by a patient admitted with chronic stable angina will help the nurse confirm this diagnosis? A) The patient states that the pain "wakes me up at night." B) The patient rates the pain at a level 3 to 5 (0 to 10 scale). C) The patient states that the pain has increased in frequency over the last week. D) The patient states that the pain "goes away" with one sublingual nitroglycerin tablet.

D) The patient states that the pain "goes away" with one sublingual nitroglycerin tablet.

7. When developing a teaching plan for a 61-year-old man with the following risk factors for coronary artery disease (CAD), the nurse should focus on the? A) family history of coronary artery disease. B) increased risk associated with the patient's gender. C) increased risk of cardiovascular disease as people age. D) elevation of the patient's low-density lipoprotein (LDL) level.

D) elevation of the patient's low-density lipoprotein (LDL) level.

23. A 73-year-old patient with chronic atrial fibrillation develops sudden severe pain, pulselessness, pallor, and coolness in the right leg. The nurse should notify the health care provider and immediately? A) apply a compression stocking to the leg. B) elevate the leg above the level of the heart. C) assist the patient in gently exercising the leg. D) keep the patient in bed in the supine position.

D) keep the patient in bed in the supine position.