Alterations in Cardiac & Tissue Perfusion (Final)
The nurse initiated discharge teaching for a patient who is to be maintained on warfarin (Coumadin) after hospitalization for thrombophlebitis. Which statement by the patient indicates that further teaching is needed? A. "I should change my diet to include more green leafy vegetables." B. "I will check with my physician or pharmacist before I begin or stop any medication." C. "I should wear a Medic-Alert bracelet to indicate I am on anticoagulant therapy." D. "I will need to have my blood drawn routinely to monitor the effects of the Coumadin."
A. "I should change my diet to include more green leafy vegetables."
Which of the following conditions are reasons for having patients receive anticoagulant therapy? (Select all that apply.) A. Atrial fibrillation B. History of pulmonary emboli C. Recent hip surgery D. Hematuria E. Asthma
A. Atrial fibrillation B. History of pulmonary emboli C. Recent hip surgery
The nurse was discussing the possible adverse effects of thiazide diuretic therapy with a patient. The nurse recognized further education was needed when the patient made which statement? A. "I understand that, since I am taking this hydrochlorothiazide, I can expect my kidneys to shut down." B. "So you are saying that if my ears start to ring continuously then I need to let my doctor know." C. "I will need to get my blood work done periodically to determine if this drug is making my potassium level drop." D. "I know that I am taking this for my high blood pressure, so should expect that it will control it better once I get started on this."
A. "I understand that, since I am taking this hydrochlorothiazide, I can expect my kidneys to shut down."
The nurse is teaching a class regarding reduction of risk factors for cardiovascular disease. Which teaching statement will the nurse include? Select all that apply. A. "If you tend to get angry easily, then your risk for heart disease is higher." B. "To reduce your overall risk, it is important to keep your BMI greater than 30." C. "Do not eat more calories on a daily basis that you are able to burn." D. "Decreasing the amount that you smoke will decrease your overall cardiovascular risk." E. "Secondhand smoke creates a significant risk to others for cardiovascular disease." F. "Exercise moderately at least 2 days per week for a total of 150 minutes."
A. "If you tend to get angry easily, then your risk for heart disease is higher." C. "Do not eat more calories on a daily basis that you are able to burn." E. "Secondhand smoke creates a significant risk to others for cardiovascular disease." F. "Exercise moderately at least 2 days per week for a total of 150 minutes."
The nurse is assessing the client's heart sounds. Which instruction will the nurse provide if there is difficulty in hearing heart sounds? A. "Please roll onto your left side." B. "Lay all the way down on your back." C. "Please hold your breath while I use my stethoscope." D. "I will just take your pulse instead."
A. "Please roll onto your left side."
The nurse is preparing to discharge a client who recently experienced a STEMI. Which client statement indicates understanding of nitroglycerin use? A. "The nitroglycerin should tingle when I put it in my mouth" B. "I will keep nitroglycerin in the glove compartment of my car." C. "Since the pills are small, they won't be hard to swallow." D. "The nitroglycerin should relieve the pain immediately."
A. "The nitroglycerin should tingle when I put it in my mouth"
The nurse is teaching a client with heart failure about a newly prescribed medication, ivabradine. What teaching will the nurse include? Select all that apply. A. "Visual changes with exposure to light are expected initially." B. "Be sure to take this medication with food." C. "Call your health care provider if your pulse rate is low or irregular." D. "Use caution when driving in the sunlight." E. "Check your BP regularly and notify the health care provider if elevated."
A. "Visual changes with exposure to light are expected initially." B. "Be sure to take this medication with food." C. "Call your health care provider if your pulse rate is low or irregular." D. "Use caution when driving in the sunlight." E. "Check your BP regularly and notify the health care provider if elevated."
Which are potential causes of dilated cardiomyopathy? Select all that apply. A. Alcohol abuse B. Sedentary lifestyle C. Cigarette smoking D. Infection E. Chemotherapy F. Poor nutrition
A. Alcohol abuse D. Infection E. Chemotherapy F. Poor nutrition
Which drugs are useful in promoting circulation for clients with chronic peripheral arterial disease? Select all that apply. A. Aspirin B. Ezetimibe C. Pentoxifylline D. Clopidogrel E. Cilostazol F. Propranolol
A. Aspirin C. Pentoxifylline D. Clopidogrel E. Cilostazol
The nurse is conducting an admission assessment on a male client. Which assessment data does the nurse identify as a risk factor for cardiovascular disease? Select all that apply. A. BMI of 26 B. BP of 120/66 mm Hg C. Triglycerides 140 mg/dl D. Moderate exercise for 20 to 30 minutes weekly E. Exposure to secondhand cigarette smoke F. History of repeated streptococcal tonsillitis G. Family history of cardiovascular disease
A. BMI of 26 D. Moderate exercise for 20 to 30 minutes weekly E. Exposure to secondhand cigarette smoke G. Family history of cardiovascular disease
Before administering which class of drugs would the nurse always check the client's heart rate? A. Beta blockers B. Diuretics C. Anticoagulants D. Nonsteroidal anti-inflammatories
A. Beta blockers
The nurse reviewed the classifications of drugs that can be used to treat dysrhythmias, and knows they include which mechanism of action? (Select all that apply.) A. Beta-adrenergic blockers B. Calcium channel blockers C. Chloride channel blockers D. Sodium channel blockers E. Potassium channel blockers
A. Beta-adrenergic blockers B. Calcium channel blockers D. Sodium channel blockers E. Potassium channel blockers
Which findings would the nurse expect when assessing a client with chronic stable angina? Select all that apply. A. Chest discomfort that occurs in a pattern that is familiar to the client B. Chest discomfort that occurs with moderate to prolonged exertion C. Frequency, duration, and intensity of symptoms remain the same over several months D. Results in moderate limitation of activity E. Usually treated with rest and nitroglycerin (NTG) F. Pain lasts less than 15 minutes
A. Chest discomfort that occurs in a pattern that is familiar to the client B. Chest discomfort that occurs with moderate to prolonged exertion C. Frequency, duration, and intensity of symptoms remain the same over several months E. Usually treated with rest and nitroglycerin (NTG) F. Pain lasts less than 15 minutes
Which early symptoms indicate to the nurse that a client's HF is getting worse and pulmonary edema is developing? Select all that apply. A. Crackles in the lung bases B. Frothy, blood-tinged sputum C. Dyspnea at rest D. Cyanosis E. Disorientation F. Level of crackles rises higher in the lungs
A. Crackles in the lung bases C. Dyspnea at rest E. Disorientation
The nurse knows to watch for which symptoms of heart failure? (Select all that apply.) A. Decreased exercise tolerance B. Poor perfusion to the peripheral tissues C. Anorexia and nausea D. Edema present around the ankles E. Widening pulse pressure
A. Decreased exercise tolerance B. Poor perfusion to the peripheral tissues C. Anorexia and nausea D. Edema present around the ankles
Which is the most common and normal response by a client to a cardiovascular illness? A. Denial B. Fear C. Loss of control D. Depression
A. Denial
The nurse is providing community education regarding myocardial infarction. What teaching will the nurse include? Select all that apply. A. Denial is common reaction to chest pain. B. A myocardial infarction can occur in minutes. C. Exercise at least 20 minutes three to four times per week. D. Age is a significant risk factor in the development of CAD. E. Women are more likely to experience atypical chest pain. F. Atherosclerosis is a primary factor in the development of CAD.
A. Denial is common reaction to chest pain. D. Age is a significant risk factor in the development of CAD. E. Women are more likely to experience atypical chest pain. F. Atherosclerosis is a primary factor in the development of CAD.
For which manifestations would the nurse monitor when providing care for a client pre scribed beta-blocker therapy? Select all that apply. A. Depression B. Bradycardia C. Decreased level of consciousness D. Increased urine output E. Crackles or wheezes in the lungs F. Chest discomfort
A. Depression B. Bradycardia C. Decreased level of consciousness E. Crackles or wheezes in the lungs F. Chest discomfort
The nurse is admitting an 84-year-old client with heart failure to the emergency department with confusion, blurry vision, and an upset stomach. Which assessment data are most concerning? A. Digoxin therapy daily B. Daily metoprolol C. Furosemide twice daily D. Currently taking an antacid for upset stomach
A. Digoxin therapy daily
The nurse explains to a patient with newly diagnosed hypertension the initial therapy, which may include what drug classes? (Select all that apply.) A. Diuretics B. Beta blockers C. Aldosterone receptor antagonists D. Angiotensin II receptor blockers E. Calcium channel blockers
A. Diuretics D. Angiotensin II receptor blockers E. Calcium channel blockers
Which signs or symptoms would the nurse expect when assessing a client with chronic con strictive pericarditis? Select all that apply. A. Exertional fatigue and dyspnea B. Dependent edema C. Crackles and wheezes D. Hepatic engorgement E. Pink, frothy sputum F. Decreased appetite
A. Exertional fatigue and dyspnea B. Dependent edema D. Hepatic engorgement
Which assessment factors for a 62-year-old client would the nurse recognize as modifiable risk factors for heart disease? Select all that apply. A. History of smoking B. Age C. Obesity D. Ethnic background E. Sedentary lifestyle F. Gender
A. History of smoking C. Obesity E. Sedentary lifestyle
A client is diagnosed with left-sided heart failure. Which client assessment findings will the nurse anticipate? Select all that apply. A. Peripheral edema B. Crackles in both lungs C. Tachycardia D. Ascites E. Tachypnea F. S3 gallop
B. Crackles in both lungs C. Tachycardia E. Tachypnea F. S3 gallop
What are the priority nursing actions related to caring for an older adult client with HF who is prescribed digoxin? Select all that apply. A. Monitor the ECG strip for early signs of toxicity such as bradycardia. B. Auscultate the apical pulse heart rate and rhythm for a full minute before administering the drug. C. Observe for signs of toxicity, which are often nonspecific such as anorexia, fatigue, and blurred vision. D. Report any changes in heart rate or rhythm to the health care provider. E. Monitor serum digoxin and potassium levels. F. Check the health care provider's prescription for parameters to hold the drug.
A. Monitor the ECG strip for early signs of toxicity such as bradycardia. B. Auscultate the apical pulse heart rate and rhythm for a full minute before administering the drug. C. Observe for signs of toxicity, which are often nonspecific such as anorexia, fatigue, and blurred vision. D. Report any changes in heart rate or rhythm to the health care provider. E. Monitor serum digoxin and potassium levels. F. Check the health care provider's prescription for parameters to hold the drug.
Which assessment findings would cause the nurse to suspect cardiac tamponade in a client? Select all that apply. A. Neck vein distention B. Paradoxical pulse C. Hypertension D. Muffled heart sounds E. Tachycardia F. Petechiae
A. Neck vein distention B. Paradoxical pulse D. Muffled heart sounds E. Tachycardia
For the patient experiencing angina and ischemia, the most effective agents for relieving these conditions include which classification of drugs? (Select all that apply.) A. Nitrates B. Beta blockers C. Calcium channel blockers D. Platelet active agents E. HMG-CoA reductase inhibitors
A. Nitrates B. Beta blockers C. Calcium channel blockers
Which drugs would the nurse prepare to ad minister to a client with HF who has developed pulmonary edema? Select all that apply. A. Nitroglycerin sublingual B. Lorazepam IV C. Oxygen at 1 L/min nasal canula D. Furosemide IV E. Metoprolol IV F. Nitroglycerin IV
A. Nitroglycerin sublingual D. Furosemide IV F. Nitroglycerin IV
While reviewing the drug hydrochlorothiazide for a patient with hypertension, the nurse also checked which laboratory values before administration? (Select all that apply.) A. Potassium B. Chloride C. Sodium D. Creatinine clearance E. Alkaline phosphatase
A. Potassium B. Chloride C. Sodium D. Creatinine clearance
Which nursing interventions promote a client's compliance with antihypertensive therapy? Select all that apply. A. Provide oral and written instructions related to all prescribed medications. B. Give the client a list of resources for finding additional information on prescribed drugs. C. Stress that suddenly stopping beta blockers can cause angina or heart attack. D. Suggest that the client have a home scale for weight monitoring. E. Advocate for medications that are taken three times a day for better BP control. F. Teach clients to report unpleasant side effects to the primary health care provider.
A. Provide oral and written instructions related to all prescribed medications. C. Stress that suddenly stopping beta blockers can cause angina or heart attack. D. Suggest that the client have a home scale for weight monitoring. F. Teach clients to report unpleasant side effects to the primary health care provider.
Which are potential benefits of a client receiving the drug digoxin? A. Reduced heart rate B. Increased contractility C. Venous vasodilation D. Slowed conduction through the AV node E. Inhibition of sympathetic activity with enhanced parasympathetic activity F. Enhanced renal excretion of sodium and water
A. Reduced heart rate B. Increased contractility D. Slowed conduction through the AV node E. Inhibition of sympathetic activity with enhanced parasympathetic activity
The nurse administering enoxaparin (Lovenox) made certain to follow which safety precautions? (Select all that apply.) A. Rotate the injection site. B. Remove the air bubble from the prefilled syringe. C. Rub the site after injection to ensure distribution of the drug. D. Inject the medication in the subcutaneous tissue in the abdomen. E. Dispose of the needle and syringe in the proper sharps container.
A. Rotate the injection site. D. Inject the medication in the subcutaneous tissue in the abdomen. E. Dispose of the needle and syringe in the proper sharps container.
The nurse is caring for a client with chest pain. What assessment data would cause the nurse to suspect unstable angina? Select all that apply. A. ST changes B. Troponin T 0.6 ng/mL C. Pain lasts 15 to 25 minutes D. Increased number of angina attacks E. The intensity of the chest pain has increased
A. ST changes C. Pain lasts 15 to 25 minutes D. Increased number of angina attacks E. The intensity of the chest pain has increased
Which interventions would the nurse expect to include in the care of a client with pulmonary edema caused by HF? Select all that apply. A. Sodium restriction B. Fluid restriction C. Administration of potassium supplement D. Position client in semi-Fowler or high Fowler E. Weekly weight monitoring F. Administration of loop diuretics
A. Sodium restriction D. Position client in semi-Fowler or high Fowler F. Administration of loop diuretics
Which major self-management categories will the nurse include when teaching a client, newly diagnosed with heart failure, who is about to be discharged? Select all that apply. A. Symptoms, what to do when they get worse B. Medications C. Activity D. Heart transplants E. Weight F. Diet
A. Symptoms, what to do when they get worse B. Medications C. Activity E. Weight F. Diet
Which action increases the effectiveness of angiotensin II receptor blockers (ARBS) and angiotensin-converting enzyme inhibitors (ACEIS) in controlling hypertension for African-American clients? A. The ARB or ACEI is given with a diuretic, beta blocker, or a calcium channel blocker. B. A much higher dose of ARB or ACEI is prescribed for an African-American client. C. The ARB or ACEI is combined with rigorous lifestyle modifications. D. Clients take the ARB or ACEI around the clock on an individualized schedule.
A. The ARB or ACEI is given with a diuretic, beta blocker, or a calcium channel blocker.
What drug would the nurse expect to be prescribed for a client with hypertension and for whom lifestyle modifications have failed to control blood pressure? A. Thiazide diuretic B. Calcium channel blocker C. Angiotensin-converting enzyme inhibitor D. Beta blocker
A. Thiazide diuretic
The nurse knows that ACE inhibitors are used in heart failure for which result? A. To reduce blood pressure (i.e., afterload) B. To decrease renal flow C. To increase peripheral vascular resistance D. To cause vasoconstriction
A. To reduce blood pressure (i.e., afterload)
Which laboratory value test elevation does the nurse consider most significant in the diagnosis of a client's myocardial infarction (MI)? A. Troponin T and I B. Myoglobin C. Highly sensitive C-reactive protein D. Creatinine kinase MB
A. Troponin T and I
Which lifestyle changes would the nurse teach a client to help control hypertension? Select all that apply. A. Weight reduction if overweight or obese. B. Implement a healthy diet such as the DASH diet. C. Decrease smoking and nicotine use. D. Use relaxation techniques to decrease stress. E. Restrict sodium by not adding salt at the table. F Increase activity by use of a structured exercise program.
A. Weight reduction if overweight or obese. B. Implement a healthy diet such as the DASH diet. D. Use relaxation techniques to decrease stress. F Increase activity by use of a structured exercise program.
Which assessment findings would the nurse expect to find in a client with left heart failure? Select all that apply. A. Wheezes or crackles B. Jugular vein distention C. S, heart sound D. Paroxysmal nocturnal dyspnea E. Ascites F. Oliguria during the day
A. Wheezes or crackles C. S, heart sound D. Paroxysmal nocturnal dyspnea F. Oliguria during the day
Which statement by a client with heart failure indicates to the nurse the need for additional teaching? A. "If my heart feels like it's racing, I should call my health care provider." B. "I must weigh myself once a week and watch for signs of fluid retention." C. "I'll need periods of rest and activity and I should avoid activity after meals." D. "I'll need to consider and plan my activities for the day, and rest as needed."
B. "I must weigh myself once a week and watch for signs of fluid retention."
Which statement by a client to the nurse indicates an understanding of cigarette usage related to cardiovascular risks? A. "I don't smoke as much as I used to and I'm down to half a pack a day." B. "I need to be completely cigarette free for at least 3 years." C. "I started smoking a few years ago but I plan to quit in a year or two." D. "I smoke to relax like when I go out with friends or when I drink."
B. "I need to be completely cigarette free for at least 3 years."
The nurse is caring for a client with heart failure who is prescribed spironolactone. Which client statement requires further nursing education? A. "I may need to take this drug every other day according to lab values." B. "I need to take potassium supplements with this medication." C. "I will try my best not to use table salt on my food." D. This medication will cause me to urinate more often."
B. "I need to take potassium supplements with this medication."
For which client would the nurse question the prescription of hydrochlorothiazide? A. Client with asthma B. Client with hypokalemia C. Client with hyperkalemia. D. Client with chronic airway limitation
B. Client with hypokalemia
Which clients are at greatest risk for development of infective endocarditis? Select all that apply. A. Clients after myocardial infarction B. Clients who are IV drug users C. Clients with poor dental health D. Clients with opioid addictions E. Clients with systemic alterations in immunity F. Clients postoperative after valve replacement
B. Clients who are IV drug users C. Clients with poor dental health D. Clients with opioid addictions E. Clients with systemic alterations in immunity F. Clients postoperative after valve replacement
What is the definitive treatment for chronic constrictive pericarditis? A. Pericardiocentesis B. Surgical removal of the pericardium C. Placement of a pericardial drain D. Creation of a pericardial window
B. Surgical removal of the pericardium
What assessment findings would the nurse expect to find in a client with right heart failure? Select all that apply. A. Weight loss B. Dependent edema C. Neck vein distention D. Angina E. Hepatomegaly F. Weak peripheral pulses
B. Dependent edema C. Neck vein distention E. Hepatomegaly
The nurse is caring for a client immediately following a cardiac catheterization. Which assessment data require immediate nursing intervention? A. Blood pressure 146/70 mm Hg B. Hematoma developing at insertion site C. Client reports headache pain D. Client reports extreme thirst
B. Hematoma developing at insertion site
Which treatment best applies to the care of a client newly diagnosed with infective endocarditis? A. Long-term anticoagulant therapy with IV heparin followed by oral warfarin B. Hospitalization for initial IV antibiotics, followed by continued IV antibiotics at home C. Complete bedrest for the duration of the treatment with subcutaneous enoxaparin D. Administration of IV penicillin, followed by oral penicillin for 6 to 10 weeks
B. Hospitalization for initial IV antibiotics, followed by continued IV antibiotics at home
Which essential points would the nurse include when teaching a client with angina about nitroglycerin tablets? Select all that apply. A. If one tablet does not relieve the chest pain after 5 minutes, put two pills under your tongue. B. Keep your nitroglycerin pills with all times. you at C. The prescription should last about 7 to 8 months before a refill is needed. D. You can tell the tablets are active when you feel a tingling after placing one under your tongue. E. Keep the tablets in a glass, light-resistant container. F. If no immediate pain relief occurs, just wait because the drug will eventually take effect.
B. Keep your nitroglycerin pills with all times. you at D. You can tell the tablets are active when you feel a tingling after placing one under your tongue. E. Keep the tablets in a glass, light-resistant container.
Which client serum lipid tests suggest an in creased risk for cardiovascular disease (CVD)? Select all that apply. A. HDL 65 mg/dL B. LDL 170 mg/dL C. Triglycerides 185 mg/dL D. Total cholesterol 175 mg/dL E. VLDL 39 mg/dL F. Total cholesterol 250 mg/dL
B. LDL 170 mg/dL C. Triglycerides 185 mg/dL E. VLDL 39 mg/dL F. Total cholesterol 250 mg/dL
A 45-year-old male client having an annual physical asks the nurse about his risk for developing a myocardial infarction (MI). Which modifiable risk factors will the nurse assess to guide the client's teaching plan? Select all that apply. A. Age B. Tobacco use C. Gender D. Diet E. Family history F. Weight
B. Tobacco use D. Diet F. Weight
Which findings does the nurse expect when assessing a client with infective endocarditis? Select all that apply. A. Grating pain that is aggravated by breathing B. Osler nodes on palms of hands and soles of feet C. Splinter hemorrhages D. Janeway lesions on the hands and feet E. Anorexia and weight loss F. Pericardial friction rub
B. Osler nodes on palms of hands and soles of feet C. Splinter hemorrhages D. Janeway lesions on the hands and feet E. Anorexia and weight loss
What is the priority concept for a client who has heart failure? A. Gas exchange B. Perfusion C. Comfort D. Infection
B. Perfusion
An alert and oriented client comes to the walk in clinic with left-sided chest pain, mild short ness of breath, and diaphoresis. What is the nurse's first priority action? A. Obtain a complete cardiac history for the client. B. Place the client in semi-Fowler position with supplemental oxygen. C. Instruct the client to go immediately to the nearest full-service hospital. D. Immediately alert the health care provider and establish IV access.
B. Place the client in semi-Fowler position with supplemental oxygen.
The nurse is caring for a hospitalized client with infective endocarditis who has been receiving antibiotics for 2 days. The client is now experiencing flank pain with hematuria. What complication will the nurse suspect? A. Pulmonary embolus B. Renal infarction C. Transient ischemic attack D. Splenic infarction
B. Renal infarction
The nurse is caring for a client receiving intravenous heparin for treatment of DVT who begins to begins to vomit blood. What action should the nurse be prepared to take? A. Administer vitamin K B. Stop the infusion of heparin C. Administer an antiemetic D. Insert a nasogastric tube
B. Stop the infusion of heparin
After teaching the patient about the new prescription drug captopril, an ACE inhibitor, the nurse knew that further education was needed after the patient responded with which statement? A. "If I start to develop a cough after taking captopril, will notify my physician." B. "As I understand it, I will have to get out of bed slowly to let my blood pressure stabilize." C. "I should take captopril with food so it will not upset my stomach." D. "This drug will help control my blood pressure and treat my heart failure."
C. "I should take captopril with food so it will not upset my stomach."
A client who is receiving heparin therapy is started on warfarin. Which nursing explanation is appropriate? A "You will need both drugs long-term to provide long-term anticoagulation. B. "Warfarin is easier on your stomach so you can take it long-term." C. "It takes several days for warfarin to begin working, so both drugs are required for a short time." D. "These drugs work the same, but one is taken by mouth, so it is easier to take at home."
C. "It takes several days for warfarin to begin working, so both drugs are required for a short time."
The nurse is caring for a diabetic client who will be discharged on hydrochlorothiazide (HCTZ). What information will the nurse include in the discharge teaching? Select all that apply. A. "This drug may cause a dry, nagging cough." B. "Take this drug with a snack, right before bed." C. "Try to increase your intake of potassium in your diet." D. "This drug can affect your glucose control." E. "Increased urination is expected with this drug.
C. "Try to increase your intake of potassium in your diet." D. "This drug can affect your glucose control." E. "Increased urination is expected with this drug.
When a client admits that he or she sometimes has trouble catching his or her breath, which question would the nurse ask to obtain more information about the client's symptoms? A. "Do you have a history of any medical problems like high blood pressure?" B. "What did your health care provider tell you about your diagnosis?" C. "What was your most strenuous activity during the past week?" D. "How do you feel about being told that you have heart failure?"
C. "What was your most strenuous activity during the past week?"
The nurse is preparing to administer a calcium channel blocker to a patient with angina and will need to assess for which of the following? (Select all that apply.) A. Frequent cough B. Laboratory values for nephrotoxicity C. Baseline supine and standing blood pressure D. Laboratory values for hepatotoxicity E. History of heart failure
C. Baseline supine and standing blood pressure D. Laboratory values for hepatotoxicity E. History of heart failure
Because many sudden cardiac arrest victims die before reaching the hospital, which priority teaching point would the nurse be sure to include in a community presentation about heart disease? A. The importance of controlling alcohol consumption and smoking cessation B. Modifying risk factors and blood pressure medication compliance C. How to operate an automatic external defibrillator (AED) in the workplace D. Recognizing unstable angina and when to call for help
C. How to operate an automatic external defibrillator (AED) in the workplace
For which complication does the nurse monitor when a client with chronic stable angina (CSA) is prescribed a calcium channel blocker? A. Tachycardia B. Wheezes and crackles C. Hypotension D. Forgetfulness
C. Hypotension
What would be the nurse's best action when a client reports dizziness when changing position from sitting to standing and a sudden dry cough after starting a prescription of captopril? A. Instruct the client to change positions slowly and take an over-the-counter cough syrup. B. Tell the client to take the drug at bedtime and use over-the-counter throat lozenges. C. Notify the primary health care provider immediately about these side effects. D. Teach the client to increase fluid intake to at least 3 L/day.
C. Notify the primary health care provider immediately about these side effects.
The nurse is caring for a client with heart failure who is on oxygen at 2 L per nasal cannula with an oxygen saturation of 90%. The client states, "I feel short of breath." Which action will the nurse take first? A. Contact respiratory therapy. B. Increase the oxygen to 4 L. C. Place the client in a high-Fowler position. D. Draw arterial blood for arterial blood gas analysis.
C. Place the client in a high-Fowler position.
A patient was started on aspirin to prevent a stroke because aspirin has which effect? A. Prevents the clotting cascade from being activated B. Prevents thrombus formation C. Prevents platelet aggregation D. Decreases bleeding time
C. Prevents platelet aggregation
Which tests will the nurse teach a client are routinely done for follow-up monitoring when the client is discharged with a prescription for warfarin? A. Complete blood count and platelet count B. Partial thromboplastin time (PTT) and serum potassium C. Prothrombin time (PT) and international normalized ratio (INR) D. Serum and urine electrolyte studies
C. Prothrombin time (PT) and international normalized ratio (INR)
What is the nurse's next action 5 minutes after administering a sublingual (SL) nitroglycerin tablet to a client with chest pain? A. Apply oxygen at 2 to 4 L by nasal cannula. B. Administer morphine sulfate IV push. C. Recheck pain intensity and vital signs. D. Notify the health care provider and give a chewable aspirin.
C. Recheck pain intensity and vital signs.
What common assessment finding would the nurse expect to find in an older adult with cardiovascular disease? A. Lower leg swelling B. Pericardial friction rub C. S4 heart sound D. Change in point of maximal impulse (PMI) location
C. S4 heart sound
What does the nurse instruct a client with pericarditis to do to make him or her will feel more comfortable? A. Lie down and bend the legs at the knees. B. Sit in a semi-Fowler position with pillows under each arm. C. Sit up and lean forward. D. Lie on the side in a fetal position.
C. Sit up and lean forward.
What is the most reliable method of monitoring for fluid gain or loss in a client with heart failure? A. Check for pitting edema in dependent body parts. B. Auscultate the lungs for worsening crackles or wheezes. C. Weigh the client daily at the same time and using the same scale. D. Assess the client's skin turgor and condition of mucous membranes.
C. Weigh the client daily at the same time and using the same scale.
The nurse is assessing a client with heart failure. Which assessment data are the best indicator of fluid balance? A. Blood pressure 144/79 mm Hg B. Urine output 200 mL in the last 4 hours C. Weight increase of 9 lb in the past week D. Generalized edema in the lower extremities
C. Weight increase of 9 lb in the past week
The nurse is teaching a client with stage hypertension. Which client statement indicates understanding of dietary modifications? A. "I will reduce my sodium intake to 2500 mg per day." B. "I will restrict my intake of daily dietary lean protein." C. "I am only going to drink one cup of coffee to start my day." D. "I will drink a glass of low-fat milk with my breakfast."
D. "I will drink a glass of low-fat milk with my breakfast."
Which statement by a client with a history of hypertension and heart problems would cause the nurse to suspect development of heart failure? A. "I've had a fever frequently." B. "I noticed a very fine red rash on my chest." C. "I get a pain in my shoulder when I cough." D. "I've had to remove all of my rings for the past month."
D. "I've had to remove all of my rings for the past month."
How many cigarette pack-years has this client smoked: Smoked half a pack a day for 6 years? A. 2 pack-year B. 1 pack-year C. 2 pack-years D. 3 pack-years
D. 3 pack-years
Which early reaction is most common in clients with chest discomfort associated with un stable angina or myocardial infarction (MI)? A. Depression B. Anger C. Fear D. Denial
D. Denial
The nurse is reviewing an order for the drug hydralazine that will be administered a patient with persistent high blood pressure. The nurse recognizes this drug as which type of antihypertensive? A. Calcium channel blocker B. Beta blocker C. Central-acting alpha-2 agonist D. Direct vasodilator
D. Direct vasodilator
Which type of cardiomyopathy may present with sudden death as the first symptom? A. Dilated B. Arrhythmogenic right ventricular C. Restrictive D. Hypertrophic
D. Hypertrophic
When would the nurse be sure to hold a beta blocker drug and notify the health care provider? A. When a client states he or she woke up with a headache B. When a client's respiratory rate is 26 breaths/min on room air C. When a client is scheduled for a chest X-ray D. When a client's heart rate is less than 50 beats/min and SBP is less than 100 mm Hg
D. When a client's heart rate is less than 50 beats/min and SBP is less than 100 mm Hg