332 Test Prep Question

A home health nurse is seeing an elderly male client for the first time. During the physical assessment of the skin on the lower legs, the nurse notes edema, brown pigmentation in the gaiter area, pedal pulses, and a few irregularly shaped ulcers around the ankles. From these findings, the nurse knows that the client has a problem with peripheral circulation. Which of the following does the nurse suspect?

Venous Insufficiency

You are working on a telemetry unit. Your client was admitted with a cardiac event and is now on a cardiac monitor. You know a cardiac monitor reveals the heart's electrical but not its mechanical activity. How would you assess the mechanical activity of the client's heart?

palpate peripheral pulses

A client in the hospital informs the nurse he "feels like his heart is racing and can't catch his breath." What does the nurse understand occurs as a result of a tachydysrhythmia?

reduces ventricular ejection volume

When the nurse observes that the client's heart rate increases during inspiration and decreases during expiration, the nurse reports that the client is demonstrating

sinus dysrhythmias

Heparin therapy is usually considered therapeutic when the client's activated partial thromboplastin time (aPTT) is how many times normal?

2-2.5

A 1-minute electrocardiogram (ECG) tracing of a client with a regular heart rate reveals 25 small, square boxes within an RR interval. The nurse correctly identifies the client heart rate as

60

The nurse is assigned to care for a patient with heart failure. What classification of medication does the nurse anticipate administering that will improve symptoms as well as increase survival?

ACE Inhibitor

Which classification of medications plays a pivotal role in the management of HF caused by systolic dysfunction? ACE Inhibitors Beta Blockers Diuretics Digitalis

ACE Inhibitors

When starting a client on oral or I.V. diltiazem, for which potential complication should the nurse monito

AV block

The nurse understands that a client with which cardiac arrhythmia is most at risk for developing heart failure?

Atrial Fibrillation

Which patient is at highest risk for venous thromboembolism? A. 50-year-old postoperative patient B. 25-year-old patient with a central venous catheter in place to treat septicemia C. 71-year-old otherwise healthy older adult D. pregnant 30-year-old woman due in 2 weeks

B. 25 year old patient with central venous catheter in place to treat septicemia

Which observation regarding ulcer formation on the client's lower extremity indicates to the nurse that the ulcer is a result of venous insufficiency? A. Base is pale to black B. Large & superficial C. Is deep, involving the joint space D. Though superficial, very painful

B. Large & superficial

A nurse is caring for a client with a history of cardiac disease and type 2 diabetes. The nurse is closely monitoring the client's blood glucose level. Which medication is the client most likely taking?

Beta Blocker - carvedilol The nurse must monitor blood glucose levels closely in clients with type 2 diabetes who are taking beta-adrenergic blockers such as carvedilol, because beta-adrenergic blockers may mask the signs of hypoglycemia. The nurse should monitor QRS duration in clients taking procainamide and pulmonary function in clients taking amiodarone (because the drug may cause pulmonary fibrosis). Diltiazem may cause an increased PR interval or bradycardia.

Which observation regarding ulcer formation on the client's lower extremity indicates that the ulcer is a result of venous insufficiency? A. is deep, involving the joint space B. Base is pale to black C. Border of the ulcer is irregular D. Though superficial, it is very painful

C. Border of the ulcer is irregular

The nurse is teaching a patient diagnosed with peripheral arterial disease (PAD). What should be included in the teaching plan? A. Elevate the lower extremities B. Exercise is discouraged C. Keep the lower extremities in a neutral or dependent position D. PAD should no cause pain

C. Keep the lower extremities in a neutral or dependent position Blood flow to the lower extremities needs to be enhanced

The nurse is to administer morphine sulfate to a client with chest pain. What initial nursing action is required prior to administration?

Count the respiratory rate for bradypnea ^ morphine causes respiratory depression

A client is being scheduled for a stress test. The client is unable to exercise during the test. The nurse would include information about which medication used for pharmacologic stress testing?

Dipyridamole

The diagnosis of heart failure is usually confirmed by which of the following? Echocardiogram ECG X-Ray

Echocardiogram

A patient is having an angiography to detect the presence of an aneurysm. After the contrast is administered by the interventionist, the patient begins to complain of nausea and difficulty breathing. What medication is a priority to administer at this time?

Epinephrine Patient may be showing signs of an allergic reaction to the contrast dye

A 43-year-old male came into the emergency department where you practice nursing and was diagnosed with atrial fibrillation. It's now 48 hours since his admittance and the dysrhythmia persists. Which of the following medications will the client's healthcare provider most likely order?

Heparin

What is a priority nursing assessment when caring for a patient in a hypertensive crisis receiving intravenous vasodilators? A. pain B. I&O C. Vision D. Family hx

I&O Assessing fluid volume is recommended because if there is volume depletion secondary to natriuresis caused by the elevated blood pressure, then volume replace with normal saline can prevent large sudden drops in B/P when antihypertensive medications are administered

A client with heart failure asks the nurse how dobutamine affects the body's circulation. What is the nurse's best response?

Increases the force of myocardial contraction

The nurse recognizes that the treatment for a non-ST-elevation myocardial infarction (NSTEMI) differs from that for a STEMI, in that a STEMI is more frequently treated with

PCI

A client admitted to the telemetry unit has a serum potassium level of 6.6 mEq/L. Which electrocardiographic (ECG) characteristic is commonly associated with this laboratory finding?

Peaked T Waves The patient's serum potassium level is high. The T wave is an ECG characteristic reflecting repolarization of the ventricles. It may become tall or "peaked" if a patient's serum potassium level is high.

A patient in cardiogenic shock after a myocardial infarction is placed on an intra-aortic balloon pump (IABP). What does the nurse understand is the mechanism of action of the balloon pump?

The balloon inflates at the beginning of diastole and deflates before systole to augment the pumping action of the heart.

Which electrocardiogram (ECG) characteristic is usually seen when a client's serum potassium level is low?

U Wave

The registered nurse reviewed the patient's vital signs and noted a consistent pattern of heart rate recordings between 48 and 58 bpm over a 24-hour period of time. What medication will cause bradycardia?

atenolol - beta blocker

A client's electrocardiogram (ECG) tracing reveals a atrial rate between 250 and 400, with saw-toothed P waves. The nurse correctly identifies this dysrhythmia as

atrial flutter

The nurse cares for a client in the ICU diagnosed with coronary artery disease (CAD). Which assessment data indicates the client is experiencing a decrease in cardiac output?

disorientation, 20 mL of urine over the last two hours

The nurse is caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the dysrhythmia?

elective cardioversion

A client with a history of mitral stenosis is admitted to the intensive care unit (ICU) with the abrupt onset of atrial fibrillation. The client's heart rate ranges from 120 to 140 bpm. The nurse recognizes that interventions are implemented to prevent the development of

embolic stroke

A client's elevated cholesterol levels are being managed with atorvastatin daily. What is a common side effect the nurse will teach the client that will require monitoring?

increased liver enzymes

A cardiac patient with a magnesium lab result of 2.5 mEq/L would most likely evidence which of the following?

increased myocardial contractility

Following a left anterior myocardial infarction, a client undergoes insertion of a pulmonary artery catheter. Which finding most strongly suggests left-sided heart failure?

increased pulmonary artery diastolic pressure

A client with heart failure asks the nurse how dobutamine affects the body's circulation. What is the nurse's best response?

increases the force of myocardial contraction