Cardiac Practice Questions

The nurse is caring for a patient newly diagnosed with heart failure. The patient is to receive a first dose of digoxin 0.125 mg IV push. An ampule containing 0.25 mg/mL is available. Calculate the number of milliliters the nurse should draw up to administer this dose. ______ mL

0.5 mL

The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles and the nurse suspects pulmonary edema. The nurse immediately asks another nurse to contact the health care provider and prepares to implement which priority interventions? Select all that apply. 1. Administering oxygen 2. Inserting a Foley catheter 3. Administering furosemide 4. Administering morphine sulfate intravenously 5. Transporting the client to the coronary care unit 6. Placing the client in a low Fowler's side-lying position

1. Administering oxygen 2. Inserting a Foley catheter 3. Administering furosemide 4. Administering morphine sulfate intravenously

The nurse should evaluate that defibrillation of a client was *most* successful if which observation was made? 1. Arousable, sinus rhythm, blood pressure (BP) 116/72 mm Hg 2. Nonarousable, sinus rhythm, BP 88/60 mm Hg 3. Arousable, marked bradycardia, BP 86/ 54 mm Hg 4. Nonarousable, supraventricular tachycardia, BP 122/60 mm Hg

1. Arousable, sinus rhythm, blood pressure (BP) 116/72 mm Hg

The nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no P waves; instead, there are fibrillatory waves before each QRScomplex. How should the nurse correctly interpret the client's heart rhythm? 1. Atrial fibrillation 2. Sinus tachycardia 3. Ventricular fibrillation 4. Ventricular tachycardia

1. Atrial fibrillation Rationale: this can be differentiated from Vfib because there are NO QRS complexes with Vfib

A client is admitted to the emergency department with chest pain that is consistent with myocardial infarction based on elevated troponin levels. Heart sounds are normal and vital signs are noted on the client's chart. The nurse should alert the health care provider because these changes are most consistent with which complication? SEE CHART IN TEXTBOOK (increasing heart rate, increasing RR, decreasing blood pressures over a period of 45 minutes) 1. Cardiogenic shock 2. Cardiac tamponade 3. Pulmonary embolism 4. Dissecting thoracic aortic aneurysm

1. Cardiogenic shock

A client has frequent bursts of ventricular tachycardia on the cardiac monitor. What should the nurse be most concerned about with this dysrhythmia? 1. It can develop into ventricular fibrillation at any time. 2. It is almost impossible to convert to a normal rhythm. 3. It is uncomfortable for the client, giving a sense of impending doom. 4. It produces a high cardiac output that quickly leads to cerebral and myocardial ischemia.

1. It can develop into ventricular fibrillation at any time.

A client's electrocardiogram strip shows atrial and ventricular rates of110 beats/minute. The PRinterval 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? 1. Sinus tachycardia 2. Sinus bradycardia 3. Sinus dysrhythmia 4. Normal sinus rhythm

1. Sinus tachycardia

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? 1. The neurovascular status is normal because of increased blood flow through the leg. 2. The neurovascular status is moderately impaired, and the surgeon should be called. 3. The neurovascular status is slightly deteriorating and should be monitored for another hour. 4. The neurovascular status is adequate from an arterial approach, but venous complications are arising.

1. The neurovascular status is normal because of increased blood flow through the leg. Rationale: after a aortoiliac bypass graft, warmness, redness, and edema are normal on the affected leg

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? 1. Muffled heart sounds 2. A rise in blood pressure 3. Jugular venous distention 4. Client expressions of dyspnea

2. A rise in blood pressure

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? 1. Hypovolemia 2. Acute kidney injury 3. Glomerulonephritis 4. Urinary tract infection

2. Acute kidney injury

The nurse is caring for a client who had a resection of an abdominal aortic aneurysm yesterday. The client has an intravenous (IV) infusion at a rate of 150 mL/hour, unchanged for the last 10 hours. The client's urine output for the last 3 hours has been 90, 50, and 28 mL (28 mL is most recent). The client's blood urea nitrogen level is 35 mg/dL (12.6 mmol/L) and the serum creatinine level is 1.8 mg/dL (159 mcmol/L), measured this morning. Which nursing action is the priority? 1. Check the urine specific gravity. 2. Call the health care provider (HCP). 3. Put the IV line on a pump so that the infusion rate is sure to stay stable. 4. Check to see if the client had a blood sample for a serum albumin level drawn.

2. Call the health care provider (HCP). Rationale: following an AAA resection, the nurse is monitoring for s/s of acute kidney failure. since these s/s are indicative of that, you would call the HCP

A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. Which finding would the nurse anticipate when auscultating the client's breath sounds? 1. Stridor 2. Crackles 3. Scattered rhonchi 4. Diminished breath sounds

2. Crackles

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? 1. Glipizide 2. Metformin 3. Repaglinide 4. Regular insulin

2. Metformin

The nurse is evaluating a client's response to cardioversion. Which assessment would be the *priority*? 1. Blood pressure 2. Status of airway 3. Oxygen flow rate 4. Level of consciousness

2. Status of airway Rationale: *ABCs*

A client with myocardial infarction is developing cardiogenic shock. Because of the risk of myocardial ischemia, what condition should the nurse carefully assess the client for? 1. Bradycardia 2. Ventricular dysrhythmias 3. Rising diastolic blood pressure 4. Falling central venous pressure

2. Ventricular dysrhythmias

A client is having frequent premature ventricular contractions. The nurse should place *priority* on assessment of which item? 1. Sensation of palpitations 2. Causative factors, such as caffeine 3. Blood pressure and oxygen saturation 4. Precipitating factors, such as infection

3. Blood pressure and oxygen saturation

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? 1. Call a code. 2. Call the health care provider. 3. Check the client's status and lead placement. 4. Press the recorder button on the electrocardiogram console.

3. Check the client's status and lead placement.

The client has developed atrial fibrillation, with a ventricular rate of 150 beats/minute. The nurse should assess the client for which associated signs and/or symptoms? 1. Flat neck veins 2. Nausea and vomiting 3. Hypotension and dizziness 4. Hypertension and headache

3. Hypotension and dizziness Rationale: this patient is experiencing uncontrolled Afib = symptomatic and HR >100 -Hypotension dizziness is from decreased CO

The nurse notes that a client with sinus rhythm has a premature ventricular contraction that falls on the T wave of the preceding beat. The client's rhythm suddenly changes to one with no P waves, no definable QRS complexes, and coarse wavy lines of varying amplitude. How should the nurse correctly interpret this rhythm? 1. Asystole 2. Atrial fibrillation 3. Ventricular fibrillation 4. Ventricular tachycardia

3. Ventricular fibrillation

The nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but more than 140 beats/minute. The nurse determines that the client is experiencing which dysrhythmia? 1. Sinus tachycardia 2. Ventricular fibrillation 3. Ventricular tachycardia 4. Premature ventricular contractions

3. Ventricular tachycardia

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*? 1. "I should notify my doctor if my feet or legs start to swell." 2. "My doctor told me to call his office if my pulse rate decreases below 60." 3. "Avoiding grapefruit juice will definitely be a challenge for me, since I usually drink it every morning with breakfast." 4. "My spouse told me that since I have developed this problem, we are going to stop walking in the mall every morning."

4. "My spouse told me that since I have developed this problem, we are going to stop walking in the mall every morning."

A client in ventricular fibrillation is about to be defibrillated. To convert this rhythm effectively, the *monophasic* defibrillator machine should be set at which energy level (in joules, J) for the first delivery? 1. 50 J 2. 120 J 3. 200 J 4. 360 J

4. 360 J -Biphasic defibrillator is 120-200

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*? 1. Anxiety level of the client and family 2. Presence of a MedicAlert card for the client to carry 3. Knowledge of restrictions on postdischarge physical activity 4. Activation status of the device, heart rate cutoff, and number of shocks it is programmed to deliver

4. Activation status of the device, heart rate cutoff, and number of shocks it is programmed to deliver

The nurse is assisting to defibrillate a client in ventricular fibrillation. After placing the pad on the client's chest and before discharge, which intervention is a *priority*? 1. Ensure that the client has been intubated. 2. Set the defibrillator to the "synchronize" mode. 3. Administer an amiodarone bolus intravenously. 4. Confirm that the rhythm is actually ventricular fibrillation.

4. Confirm that the rhythm is actually ventricular fibrillation.

The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PRinterval 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? 1. Check vital signs. 2. Check laboratory test results. 3. Notify the health care provider. 4. Continue to monitor for any rhythm change.

4. Continue to monitor for any rhythm change. Rationale: this is a normal sinus rhythm

Aclient in sinus bradycardia, with a heart rate of 45 beats/minute, complains of dizziness and has a blood pressure of 82/60 mm Hg. Which prescription should the nurse anticipate will be prescribed? 1. Administer digoxin. 2. Defibrillate the client. 3. Continue to monitor the client. 4. Prepare for transcutaneous pacing.

4. Prepare for transcutaneous pacing. Rationale: this patient is experiencing symptomatic sinus bradycardia

You're providing education to a patient who will be undergoing a heart catheterization. Which statement by the patient requires you to re-educate the patient about this procedure? A. "The brachial artery is most commonly used for this procedure." B. "A dye is injected into the coronary arteries to assess for blockages." C. "Not all patients who have a heart catheterization will need a stent placement." D. "I will not be completely asleep and will be able to breathe on my own during the procedure."

A. "The brachial artery is most commonly used for this procedure."

Which of the following patients are MOST at risk for developing endocarditis? Select-all-that-apply: A. A 25 year old male who reports using intravenous drugs on a daily basis. B. A 55 year old male who is post-opt from aortic valve replacement. C. A 63 year old female who is newly diagnosed with hyperparathyroidism and is taking Aspirin. D. A 66 year old female who recently had an invasive dental procedure performed 1 month ago and is having a fever.

A. A 25 year old male who reports using intravenous drugs on a daily basis. B. A 55 year old male who is post-opt from aortic valve replacement. D. A 66 year old female who recently had an invasive dental procedure performed 1 month ago and is having a fever.

Which of the following patients are MOST at risk for developing heart failure? Select-all-that-apply: A. A 69 year old male with a history of alcohol abuse and is recovering from a myocardial infarction. B. A 55 year old female with a health history of asthma and hypoparathyroidism. C. A 30 year old male with a history of endocarditis and has severe mitral stenosis. D. A 45 year old female with lung cancer stage 2. E. A 58 year old female with uncontrolled hypertension and is being treated for influenza.

A. A 69 year old male with a history of alcohol abuse and is recovering from a myocardial infarction. C. A 30 year old male with a history of endocarditis and has severe mitral stenosis. E. A 58 year old female with uncontrolled hypertension and is being treated for influenza.

A 30 year old female is being treated for infective endocarditis with IV antibiotics. At the beginning of the hospitalization, the patient's symptoms were severe and sudden with a high fever but are now controlled. She has no significant health history other than 2 cesarean sections in the past. She is being prepped for a central line placement so she can be discharged home with home health to continue the 4 week antibiotic regime. What is type of infective endocarditis this classified as based on the information listed? A. Acute Infective Endocarditis B. Subacute Infective Endocarditis C. Non-infective Endocarditis D. Pericarditis

A. Acute Infective Endocarditis

Keeping the patient in question 4 in mind (with the stable angina): What type of diagnostic tests will the physician most likely order (at first) for this patient to evaluate the cause of the patient's symptoms? Select-all-that-apply:* A. EKG B. Stress test C. Heart catheterization D. Balloon angioplasty

A. EKG B. Stress test

In regards to the patient with the pronounced T wave inversion, after administering the first dose of Nitroglycerin sublingual the patient's blood pressure is now 68/48. The patient is still having chest pain and T-wave inversion on the cardiac monitor. What is your next nursing intervention? A. Hold further doses of Nitroglycerin and notify the doctor immediately for further orders. B. Administer Morphine IV and place the patient in reverse Trendelenburg position. C. Administer Nitroglycerin and monitor the patient's blood pressure. D. All the options are incorrect.

A. Hold further doses of Nitroglycerin and notify the doctor immediately for further orders.

Select-all-that-apply: What are the typical signs and symptoms of infective endocarditis? A. Hyperthermia B. S4 gallop C. Enlarged Spleen D. Hyperkalemia E. Substernal pain that radiates to the back F. Heart failure G. Cardiac Murmur

A. Hyperthermia C. Enlarged Spleen F. Heart failure G. Cardiac Murmur

A patient is receiving treatment for stable coronary artery disease. The doctor prescribes the patient Plavix. What important information will you include in the patient's teaching? Select-all-that-apply: A. If you are scheduled for any planned surgical procedures, let your doctor know you are taking Plavix because this medication will need to be discontinued 5-7 days prior to the procedure. B. A normal side effect of this medication is a dry cough. C. Avoid green leafy vegetables while taking Plavix. D. Notify the doctor, immediately, if you develop bruising, problems urinating, or fever.

A. If you are scheduled for any planned surgical procedures, let your doctor know you are taking Plavix because this medication will need to be discontinued 5-7 days prior to the procedure. D. Notify the doctor, immediately, if you develop bruising, problems urinating, or fever.

24-36 hours after a myocardial infarction _____________ congregate at the site during the inflammation phase. A. Neutrophils B. Eosinophils C. Platelets D. Macrophages

A. Neutrophils

A patient is complaining of chest pain. On the bedside cardiac monitor you observe pronounce T-wave inversion. You obtain the patient's vital signs and find the following: Blood pressure 190/98, HR 110, oxygen saturation 96% on room air, and respiratory rate 20. Select-all-that-apply in regards to the MOST IMPORTANT nursing interventions you will provide based on the patient's current status: SATA A. Obtain a 12-lead EKG B. Place the patient in supine position C. Assess urinary output D. Administer Nitroglycerin sublingual as ordered per protocol E. Collect cardiac enzymes as ordered per protocol F. Encourage patient to cough and deep breath G. Administer Morphine IV as ordered per protocol H. Place patient on oxygen via nasal cannula I. No interventions are needed at this time

A. Obtain a 12-lead EKG D. Administer Nitroglycerin sublingual as ordered per protocol E. Collect cardiac enzymes as ordered per protocol G. Administer Morphine IV as ordered per protocol H. Place patient on oxygen via nasal cannula

A patient is admitted with chest pain to the ER. The patient has been in the ER for 5 hours and is being admitted to your unit for overnight observation. From the options below, what is the most IMPORTANT information to know about this patient at this time? A. Troponin result and when the next troponin level is due to be collected B. Diet status C. Last consumption of caffeine D. CK result and when the next CK level is due to be collected

A. Troponin result and when the next troponin level is due to be collected

At a clinic visit, the nurse provides dietary teaching for a patient recently hospitalized with an exacerbation of chronic heart failure. The nurse determines that teaching is successful if the patient makes which statement? A."I will limit the amount of milk and cheese in my diet." B."I can add salt when cooking foods but not at the table." C."I will take an extra diuretic pill when I eat a lot of salt." D."I can have unlimited amounts of foods labeled as reduced sodium."

A."I will limit the amount of milk and cheese in my diet."

An older adult patient with chronic heart failure (HF) and atrial fibrillation asks the nurse why warfarin has been prescribed to continue at home. What is the best response by the nurse? A."The medication prevents blood clots from forming in your heart." B."The medication dissolves clots that develop in your coronary arteries." C."The medication reduces clotting by decreasing serum potassium levels." D."The medication increases your heart rate so that clots do not form in your heart."

A."The medication prevents blood clots from forming in your heart."

Which person should the nurse identify as having the highest risk for abdominal aortic aneurysm? A.A 70-yr-old man with high cholesterol and hypertension B.A 40-yr-old woman with obesity and metabolic syndrome C.A 60-yr-old man with renal insufficiency who is physically inactive D.A 65-yr-old woman with hyperhomocysteinemia and substance abuse

A.A 70-yr-old man with high cholesterol and hypertension

A patient admitted with heart failure is anxious and reports shortness of breath. Which nursing actions would be appropriate to alleviate this patient's anxiety (select all that apply.)? A.Administer ordered morphine sulfate. B.Position patient in a semi-Fowler's position. C.Position patient on left side with head of bed flat. D.Instruct patient on the use of relaxation techniques. E.Use a calm, reassuring approach while talking to patient.

A.Administer ordered morphine sulfate. B.Position patient in a semi-Fowler's position. D.Instruct patient on the use of relaxation techniques. E.Use a calm, reassuring approach while talking to patient.

Which factor should be considered when caring for a woman with suspected coronary artery disease? A.Fatigue may be the first symptom. B.Classic signs and symptoms are expected. C.Increased risk is present before menopause. D.Women are more likely to develop collateral circulation.

A.Fatigue may be the first symptom.

The patient has a potassium level of 2.9 mEq/L, and the nurse obtains the following measurements on the rhythm strip: Heart rate of 86 with a regular rhythm, the P wave is 0.06 seconds (sec) and normal shape, the PR interval is 0.24 sec, and the QRS is 0.09 sec. How should the nurse document this rhythm? A.First-degree AV block B.Second-degree AV block C.Premature atrial contraction (PAC) D.Premature ventricular contraction (PVC)

A.First-degree AV block

When caring for a patient with infective endocarditis, the nurse will assess the patient for which vascular manifestations (select all that apply.)? A.Osler's nodes B.Janeway's lesions C.Splinter hemorrhages D.Subcutaneous nodules E.Erythema marginatum lesions

A.Osler's nodes B.Janeway's lesions C.Splinter hemorrhages

When planning emergent care for a patient with a suspected myocardial infarction (MI), what should the nurse anticipate administrating? A.Oxygen, nitroglycerin, aspirin, and morphine B.Aspirin, nitroprusside, dopamine, and oxygen C.Oxygen, furosemide (Lasix), nitroglycerin, and meperidine D.Nitroglycerin, lorazepam (Ativan), oxygen, and warfarin (Coumadin)

A.Oxygen, nitroglycerin, aspirin, and morphine

The nurse is teaching a community group about preventing rheumatic fever. What information should the nurse include? A.Prompt recognition and treatment of streptococcal pharyngitis B.Avoidance of respiratory infections in children born with heart defects C.Completion of 4 to 6 weeks of antibiotic therapy for infective endocarditis D.Requesting antibiotics before dental surgery for individuals with rheumatoid arthritis

A.Prompt recognition and treatment of streptococcal pharyngitis

While admitting a patient with pericarditis, the nurse will assess for what manifestations of this disorder? A.Pulsus paradoxus B.Prolonged PR intervals C.Widened pulse pressure D.Clubbing of the fingers

A.Pulsus paradoxus

The nurse conducts a complete physical assessment on a patient admitted with infective endocarditis. Which finding is significant? A.Regurgitant murmur at the mitral valve area B.Point of maximal impulse palpable in fourth intercostal space C.Heart rate of 94 beats/min and capillary refill time of 2 seconds D.Respiratory rate of 18 breaths/min and heart rate of 90 beats/min

A.Regurgitant murmur at the mitral valve area

The patient with chronic heart failure is being discharged from the hospital. What information should the nurse emphasize in the patient's discharge teaching to prevent progression of the disease to acute decompensated heart failure (ADHF)? A.Take medications as prescribed. B.Use oxygen when feeling short of breath. C.Only ask the physician's office questions. D.Encourage most activity in the morning when rested.

A.Take medications as prescribed.

When providing nutritional counseling for patients at risk for coronary artery disease (CAD), which foods would the nurse encourage patients to include in their diet (select all that apply.)? A.Tofu B.Walnuts C.Tuna fish D.Whole milk E.Orange juice

A.Tofu B.Walnuts C.Tuna fish

The nurse prepares to defibrillate a patient. For which dysrhythmia has the nurse observed in this patient? A.Ventricular fibrillation B.Third-degree AV block C.Uncontrolled atrial fibrillation D.Ventricular tachycardia with a pulse

A.Ventricular fibrillation

Which patient(s) are most at risk for developing coronary artery disease? Select-all-that-apply: A. A 25 year old patient who exercises 3 times per week for 30 minutes a day and has a history of cervical cancer. B. A 35 year old male with a BMI of 30 and reports smoking 2 packs of cigarettes a day. C. A 45 year old female that reports her father died at the age of 42 from a myocardial infraction. D. A 29 year old that has type I diabetes.

B. A 35 year old male with a BMI of 30 and reports smoking 2 packs of cigarettes a day. C. A 45 year old female that reports her father died at the age of 42 from a myocardial infraction. D. A 29 year old that has type I diabetes.

Patients with heart failure can experience episodes of exacerbation. All of the patients below have a history of heart failure. Which of the following patients are at MOST risk for heart failure exacerbation? A. A 55 year old female who limits sodium and fluid intake regularly. B. A 73 year old male who reports not taking Amiodarone for one month and is experiencing atrial fibrillation. C. A 67 year old female who is being discharged home from heart valve replacement surgery. D. A 78 year old male who has a health history of eczema and cystic fibrosis.

B. A 73 year old male who reports not taking Amiodarone for one month and is experiencing atrial fibrillation.

You are assisting a patient up from the bed to the bathroom. The patient has swelling in the feet and legs. The patient is receiving treatment for heart failure and is taking Hydralazine and Isordil. Which of the following is a nursing priority for this patient while assisting them to the bathroom? A. Measure and record the urine voided. B. Assist the patient up slowing and gradually. C. Place the call light in the patient's reach while in the bathroom. D. Provide privacy for the patient.

B. Assist the patient up slowing and gradually.

A 74 year old female presents to the ER with complaints of dyspnea, persistent cough, and unable to sleep at night due to difficulty breathing. On assessment, you note crackles throughout the lung fields, respiratory rate of 25, and an oxygen saturation of 90% on room air. Which of the following lab results confirm your suspicions of heart failure?* A. K+ 5.6 B. BNP 820 C. BUN 9 D. Troponin <0.02

B. BNP 820

A patient calls the cardiac clinic you are working at and reports that they have taken 3 sublingual doses of Nitroglycerin as prescribed for chest pain, but the chest pain is not relieved. What do you educate the patient to do next? A. Take another dose of Nitroglycerin in 5 minutes. B. Call 911 immediately C. Lie down and rest to see if that helps with relieving the pain D. Take two doses of Nitroglycerin in 5 minutes

B. Call 911 immediately

Select-all-that-apply: Which of the following are NOT typical signs and symptoms of pericarditis? A. Fever B. Increased pain when leaning forward C. ST segment depression D. Pericardial friction rub E. Radiating substernal pain felt in the left shoulder F. Breathing in relieves the pain

B. Increased pain when leaning forward C. ST segment depression F. Breathing in relieves the pain

You note in the patient's chart that the patient recently had a myocardial infarction due to a blockage in the left coronary artery. You know that which of the following is true about this type of blockage? A. A blockage in the left coronary artery causes the least amount of damage to the heart muscle. B. Left coronary artery blockages can cause anterior wall death which affects the left ventricle. C. Left coronary artery blockage can cause posterior wall death which affects the right ventricle. D. The left anterior descending artery is least likely to be affected by coronary artery disease.

B. Left coronary artery blockages can cause anterior wall death which affects the left ventricle.

Select all the correct statements about educating the patient with heart failure: A. It is important patients with heart failure notify their physician if they gain more than 6 pounds in a day or 10 pounds in a week. B. Patients with heart failure should receive an annual influenza vaccine and be up-to-date with the pneumonia vaccine. C. Heart failure patients should limit sodium intake to 2-3 grams per day. D. Heart failure is exacerbated by illness, too much fluid or sodium intake, and arrhythmias. E. Patients with heart failure should limit exercise because of the risks.

B. Patients with heart failure should receive an annual influenza vaccine and be up-to-date with the pneumonia vaccine. C. Heart failure patients should limit sodium intake to 2-3 grams per day. D. Heart failure is exacerbated by illness, too much fluid or sodium intake, and arrhythmias.

Which of the following are NOT typical signs and symptoms of right-sided heart failure? Select-all-that-apply: A. Jugular venous distention B. Persistent cough C. Weight gain D. Crackles E. Nocturia F. Orthopnea

B. Persistent cough D. Crackles F. Orthopnea

Which of the following EKG changes are abnormal findings that may indicate ischemia or injury to the cardiac muscle found on a 12-lead EKG? SELECT-ALL-THAT-APPLY: A. Lengthening p-waves B. ST-segment elevation C. T-wave inversion D. Tall t-waves E. QT interval narrowing F. ST-segment depression

B. ST-segment elevation C. T-wave inversion D. Tall t-waves F. ST-segment depression

You're educating a patient about the causes of a myocardial infarction. Which statement by the patient indicates they misunderstood your teaching and requires you to re-educate them? A. Coronary artery dissection can happen spontaneously and occurs more in women. B. The most common cause of a myocardial infarction is a coronary spasm from illicit drug use or hypertension. C. Patients who have coronary artery disease are at high risk for developing a myocardial infarction. D. Both A and B are incorrect.

B. The most common cause of a myocardial infarction is a coronary spasm from illicit drug use or hypertension.

The nurse provides discharge instructions for a 40-yr-old woman newly diagnosed with cardiomyopathy. Which statement indicates that further teaching is necessary? A."I will avoid lifting heavy objects." B."I can drink alcohol in moderation." C."My family will need to take a CPR course." D."I will reduce stress by learning guided imagery."

B."I can drink alcohol in moderation."

After teaching a patient with chronic stable angina about nitroglycerin, the nurse recognizes the need for further teaching when the patient makes which statement? A."I will replace my nitroglycerin supply every 6 months." B."I can take up to five tablets every 3 minutes for relief of my chest pain." C."I will take acetaminophen (Tylenol) to treat the headache caused by nitroglycerin." D."I will take the nitroglycerin 10 minutes before planned activity that usually causes chest pain."

B."I can take up to five tablets every 3 minutes for relief of my chest pain."

The nurse is doing discharge teaching with the patient who received an implantable cardioverter-defibrillator (ICD) in the left side. Which statement by the patient indicates to the nurse that further teaching is required? A."I will call the cardiologist if my ICD fires." B."I cannot fly because it will damage the ICD." C."I cannot move my left arm until it is approved." D."I cannot drive until my cardiologist says it is okay."

B."I cannot fly because it will damage the ICD."

A patient reports dizziness and shortness of breath and is admitted with a dysrhythmia. Which medication, if ordered, requires the nurse to carefully monitor the patient for asystole? A.Digoxin B.Adenosine C.Metoprolol D.Atropine sulfate

B.Adenosine

The patient had a history of rheumatic fever and has been diagnosed with mitral valve stenosis. The patient is planning to have a biologic valve replacement. What protective mechanisms should the nurse teach the patient about using after the valve replacement? A.Long-term anticoagulation therapy B.Antibiotic prophylaxis for dental care C.Exercise plan to increase cardiac tolerance D.Take β-adrenergic blockers to control palpitations.

B.Antibiotic prophylaxis for dental care

The nurse would assess a patient with complaints of chest pain for which clinical manifestations associated with a myocardial infarction (MI) (select all that apply.)? A.Flushing B.Ashen skin C.Diaphoresis D.Nausea and vomiting E.S3 or S4 heart sounds

B.Ashen skin C.Diaphoresis D.Nausea and vomiting E.S3 or S4 heart sounds

The nurse observes no P waves on the patients monitor strip. There are fine, wavy lines between the QRS complexes. The QRS complexes measure 0.08 sec (narrow), but they occur irregularly with a rate of 120 beats/min. What does the nurse determine the rhythm to be? A.Sinus tachycardia B.Atrial fibrillation C.Ventricular fibrillation D.Ventricular tachycardia

B.Atrial fibrillation

A patient returns after cardiac catheterization. Which nursing care would the registered nurse delegate to the licensed practical nurse? A.Monitor the electrocardiogram for dysrhythmias B.Check for bleeding at the catheter insertion site C.Prepare discharge teaching related to complications D.Take vital signs and report abnormal values

B.Check for bleeding at the catheter insertion site

The nurse is providing teaching to a patient recovering from a myocardial infarction. How should resumption of sexual activity be discussed? A.Delegated to the primary care provider B.Discussed along with other physical activities C.Avoided because it is embarrassing to the patient D.Accomplished by providing the patient with written material

B.Discussed along with other physical activities

The nurse prepares a discharge teaching plan for a 44-yr-old male patient who has recently been diagnosed with coronary artery disease (CAD). Which risk factor should the nurse plan to focus on during the teaching session? A.Type A personality B.Elevated serum lipids C.Family cardiac history D.Hyperhomocysteinemia

B.Elevated serum lipids

The patient is admitted with acute coronary syndrome (ACS). The ECG shows ST-segment depression and T-wave inversion. What should the nurse know that this indicates? A.Myocardia injury B.Myocardial ischemia C.Myocardial infarction D.A pacemaker is present.

B.Myocardial ischemia

The nurse is examining the electrocardiogram (ECG) of a patient just admitted with a suspected MI. Which ECG change is most indicative of prolonged or complete coronary occlusion? A.Sinus tachycardia B.Pathologic Q wave C.Fibrillatory P waves D.Prolonged PR interva

B.Pathologic Q wave

A patient with a recent diagnosis of heart failure has been prescribed furosemide. What outcome does the nurse anticipate will occur that demonstrates medication effectiveness? A.Promote vasodilation. B.Reduction of preload. C.Decrease in afterload. D.Increase in contractility

B.Reduction of preload.

The home care nurse visits a patient with chronic heart failure. Which clinical manifestations, assessed by the nurse, would indicate acute decompensated heart failure (pulmonary edema)? A.Fatigue, orthopnea, and dependent edema B.Severe dyspnea and blood-streaked, frothy sputum C.Temperature is 100.4oF and pulse is 102 beats/min D.Respirations 26 breaths/min despite oxygen by nasal cannula

B.Severe dyspnea and blood-streaked, frothy sputum

The patient has atrial fibrillation with a rapid ventricular response. What electrical treatment option does the nurse prepare the patient for? A.Defibrillation B.Synchronized cardioversion C.Automatic external defibrillator (AED) D.Implantable cardioverter-defibrillator (ICD)

B.Synchronized cardioversion

Atrial data: Rate: 70, regular Variable PR interval Independent beats Ventricular data: Rate: 40, regular Isolated escape beats Additional data: QRS: 0.04 sec / P wave and QRS complexes unrelated What is the correct interpretation of this rhythm strip? A.Sinus dysrhythmia B.Third-degree heart block C.Wenckebach phenomenon D.Premature ventricular contractions

B.Third-degree heart block

The patient had aortic aneurysm repair 6 hours ago. What priority nursing action will maintain graft patency? A.Assess output for renal dysfunction. B.Use IV fluids to maintain adequate BP. C.Use oral antihypertensives to maintain cardiac output. D.Maintain a low BP to prevent pressure on surgical site.

B.Use IV fluids to maintain adequate BP.

You're providing discharge teaching to a patient being treated for endocarditis. Which statement by the patient demonstrated they understood your teaching about this condition? A. "I will stop taking the antibiotics once my fever is gone in order to prevent antibiotic resistance." B. "I will only wash my hands with soap and water." C. "I will inform my dentist about my history of endocarditis prior to any invasive procedures." D. "I will avoid eating fish and organ meats."

C. "I will inform my dentist about my history of endocarditis prior to any invasive procedures."

A patient is being discharged home after receiving treatment for a myocardial infarction. The patient will be taking Coreg. What statement by the patient demonstrates they understood your education material about this drug? A. "I will take this medication at night." B. "I will take this medication as needed." C. "I will monitor my heart rate and blood pressure while taking this medication." D. "I will take this medication in the morning with grapefruit juice."

C. "I will monitor my heart rate and blood pressure while taking this medication."

After a myocardial infraction, at what time (approximately) do the macrophages present at the site of injury to perform granulation of the tissue? A. 24 hours B. 2 days C. 10 days D. 6 hours

C. 10 days

A patient with left-sided heart failure is having difficulty breathing. Which of the following is the most appropriate nursing intervention? A. Encourage the patient to cough and deep breathe. B. Place the patient in Semi-Fowler's position. C. Assist the patient into High Fowler's position. D. Perform chest percussion therapy.

C. Assist the patient into High Fowler's position.

A patient is hospitalized with chronic pericarditis. On assessment, you note the patient has pitting edema in lower extremities, crackles in lungs, and dyspnea on excretion. The patient's echocardiogram shows thickening of the pericardium. This is known as what type of pericarditis? A. Pericardial effusion B. Acute pericarditis C. Constrictive pericarditis D. Effusion-Constrictive pericarditis

C. Constrictive pericarditis

A patient taking Digoxin is experiencing severe bradycardia, nausea, and vomiting. A lab draw shows that their Digoxin level is 4 ng/mL. What medication do you anticipate the physician to order for this patient? A. Narcan B. Aminophylline C. Digibind D. No medication because this is a normal Digoxin level.

C. Digibind

A patient is taking Digoxin. Prior to administration you check the patient's apical pulse and find it to be 61 bpm. Morning lab values are the following: K+ 3.3 and Digoxin level of 5 ng/mL. Which of the following is the correct nursing action? A. Hold this dose and administer the second dose at 1800. B. Administer the dose as ordered. C. Hold the dose and notify the physician of the digoxin level. D. Hold this dose until the patient's potassium level is normal.

C. Hold the dose and notify the physician of the digoxin level.

The patient has developed cardiogenic shock after a left anterior descending myocardial infection. Which circulatory-assist device should the nurse expect to use for this patient? A. Cardiopulmonary bypass B.Impedance cardiography (ICG) C. Intraaortic balloon pump (IABP) D. Central venous pressure (CVP) measurement

C. Intraaortic balloon pump (IABP)

A patient with heart failure is taking Losartan and Spironolactone. The patient is having EKG changes that presents with tall peaked T-waves and flat p-waves. Which of the following lab results confirms these findings? A. Na+ 135 B. BNP 560 C. K+ 8.0 D. K+ 1.5

C. K+ 8.0

A patient recovering from a myocardial infarction is complaining of the taste of blood in their mouth. On assessment, you note there is bleeding on the anterior gums. Which medication can cause this? A. Coreg B. Cardizem C. Lovenox D. Lipitor

C. Lovenox

A patient is receiving treatment for infective endocarditis. The patient has a history of intravenous drug use and underwent mitral valve replacement a year ago. The patient is scheduled for a transesophageal echocardiogram tomorrow. On assessment, you find tender, red lesions on the patient's hands and feet. You know that this is a common finding in patients with infective endocarditis and is known as? A. Janeway Lesions B. Roth Spots C. Osler's Nodes D. Trousseau's Sign

C. Osler's Nodes

You are providing care to a patient with pericarditis. Which of the following is NOT a proper nursing intervention for this patient? A. Monitor the patient for complications of cardiac tamponade. B. Administer Ibuprofen as scheduled. C. Place the patient in supine position to relieve pain. D. Monitor the patient for pulsus paradoxus and muffled heart sounds.

C. Place the patient in supine position to relieve pain.

A patient with endocarditis has listed in their medical history "Roth Spots". You know that this is a complication of infective endocarditis and presents as? A. Non-tender spots found on the feet and hands B. Red and tender lesions found in the eyes C. Retinal hemorrhages with white centers D. Purplish spots found on the forearms and groin

C. Retinal hemorrhages with white centers

A patient reports during a routine check-up that he is experiencing chest pain and shortness of breath while performing activities. He states the pain goes away when he rests. This is known as: A. Unstable angina B. Variant angina C. Stable angina D. Prinzmetal angina

C. Stable angina

A patient is admitted with sepsis. The patient has a temperature of 104.2 'F and is experiencing chills. On assessment, you note a mitral murmur which the patient states they've never had before, and dark, small lines on the patient's fingernails. The patient has a history of IV drug use in the past. However, the patient states they are no longer using drugs. The physician suspects possible infective endocarditis. What diagnostic test do you expect the physician to order in order to confirm the presence of infective endocarditis? A. Abdominal ultrasound B. Heart catheterization C. Transesophageal echocardiogram D. White blood cell count

C. Transesophageal echocardiogram

You are providing care to a patient experiencing chest pain when coughing or breathing in. The patient has pericarditis. The physician has ordered the patient to take Ibuprofen for treatment. How will you administer this medication? A. strictly without food B. with a full glass of juice C. with a full glass of water D. with or without food

C. with a full glass of water

In caring for the patient with angina, the patient said, "While I was having a bowel movement, I started having the worst chest pain ever, like before I was admitted. I called for a nurse, then the pain went away." What further assessment data should the nurse obtain from the patient? A."What precipitated the pain?" B."Has the pain changed this time?" C."In what areas did you feel this pain?" D."What is your pain level on a 0 to 10 scale?"

C."In what areas did you feel this pain?"

A 25-yr-old patient with a group A streptococcal pharyngitis does not want to take the antibiotics prescribed. What should the nurse tell the patient to encourage the patient to take the medications and avoid complications of the infection? A."The complications of this infection will affect the skin, hair, and balance." B."You will not feel well if you do not take the medicine and get over this infection." C."Without treatment, you could get rheumatic fever, which can lead to rheumatic heart disease." D."You may not want to take the antibiotics for this infection, but you will be sorry if you do not."

C."Without treatment, you could get rheumatic fever, which can lead to rheumatic heart disease."

The nurse is monitoring the electrocardiograms of several patients on a cardiac telemetry unit. The patients are directly visible to the nurse, and all of the patients are observed to be sitting up and talking with visitors. Which patient's rhythm would require the nurse to take immediate action? A.A 62-yr-old man with a fever and sinus tachycardia with a rate of 110 beats/min B.A 72-yr-old woman with atrial fibrillation with 60 to 80 QRS complexes per minute C.A 52-yr-old man with premature ventricular contractions (PVCs) at a rate of 12 per minute D.A 42-yr-old woman with first-degree AV block and sinus bradycardia at a rate of 56 beats/min

C.A 52-yr-old man with premature ventricular contractions (PVCs) at a rate of 12 per minute

The nurse is caring for a patient who is 24 hours postpacemaker insertion. Which nursing intervention is most appropriate at this time? A.Reinforcing the pressure dressing as needed B.Encouraging range-of-motion exercises of the involved arm C.Assessing the incision for any redness, swelling, or discharge D.Applying wet-to-dry dressings every 4 hours to the insertion site

C.Assessing the incision for any redness, swelling, or discharge

A patient who had bladder surgery 2 days ago develops acute decompensated heart failure (ADHF) with severe dyspnea. Which action by the nurse would be indicated first? A.Perform a bladder scan to assess for urinary retention. B.Restrict the patient's oral fluid intake to 500 mL per day. C.Assist the patient to a sitting position with arms on the overbed table. D.Instruct the patient to use pursed-lip breathing until the dyspnea subsides.

C.Assist the patient to a sitting position with arms on the overbed table.

Postoperative care of a patient undergoing coronary artery bypass graft (CABG) surgery includes monitoring for which common complication? A.Dehydration B.Paralytic ileus C.Atrial dysrhythmias D.Acute respiratory distress syndrome

C.Atrial dysrhythmias

The nurse observes a flat line on the patient's monitor and the patient is unresponsive without pulse. What medications does the nurse prepare to administer? A.Lidocaine and amiodarone B.Digoxin and procainamide C.Epinephrine and/or vasopressin D.β-adrenergic blockers and dopamine

C.Epinephrine and/or vasopressin

The nurse assesses the right femoral artery puncture site as soon as the patient arrives after having a stent inserted into a coronary artery. The insertion site is not bleeding or discolored. What should the nurse do next to ensure the femoral artery is intact? A.Palpate the insertion site for induration. B.Assess peripheral pulses in the right leg. C.Inspect the patient's right side and back. D.Compare the color of the left and right legs.

C.Inspect the patient's right side and back.

A 72-yr-old man with a history of aortic stenosis is admitted to the emergency department. He reports severe left-sided chest pressure radiating to the jaw. Which medication, if ordered by the health care provider, should the nurse question? A.Aspirin B.Oxygen C.Nitroglycerin D.Morphine sulfate

C.Nitroglycerin Rationale: nitroglycerin should be used cautiously or avoided in patients with aortic stenosis as a significant reduction in blood pressure may occur.

A 74-yr-old man with a history of prostate cancer and hypertension is admitted to the emergency department with substernal chest pain. Which action will the nurse complete before administering sublingual nitroglycerin? A.Administer morphine sulfate IV. B.Auscultate heart and lung sounds. C.Obtain a 12-lead electrocardiogram (ECG). D.Assess for coronary artery disease risk factors.

C.Obtain a 12-lead electrocardiogram (ECG).

The nurse observes ventricular tachycardia (VT) on the patient's monitor. What evaluation made by the nurse led to this interpretation? A.Unmeasurable rate and rhythm B.Rate 150 beats/min; inverted P wave C.Rate 200 beats/min; P wave not visible D.Rate 125 beats/min; normal QRS complex

C.Rate 200 beats/min; P wave not visible

The nurse determines there is artifact on the patient's telemetry monitor. Which factor should the nurse assess for that could correct this issue? A.Disabled automaticity B.Electrodes in the wrong lead C.Too much hair under the electrodes D.Stimulation of the vagus nerve fibers

C.Too much hair under the electrodes

Cardioversion is attempted for a patient with atrial flutter and a rapid ventricular response. After the delivering 50 joules by synchronized cardioversion, the patient develops ventricular fibrillation. Which action should the nurse take immediately? A.Administer 250 mL of 0.9% saline solution IV by rapid bolus. B.Assess the apical pulse, blood pressure, and bilateral neck vein distention. C.Turn the synchronizer switch to the "off" position and recharge the device. D.Tell the patient to report any chest pain or discomfort and administer morphine sulfate.

C.Turn the synchronizer switch to the "off" position and recharge the device.

You're providing diet discharge teaching to a patient with a history of heart failure. Which of the following statements made by the patient represents they understood the diet teaching? A. "I will limit my sodium intake to 5-6 grams a day." B. "I will be sure to incorporate canned vegetables and fish into my diet." C. "I'm glad I can still eat sandwiches because I love bologna and cheese sandwiches." D. "I will limit my consumption of frozen meals."

D. "I will limit my consumption of frozen meals."

Which of the following is a late sign of heart failure? A. Shortness of breath B. Orthopnea C. Edema D. Frothy-blood tinged sputum

D. Frothy-blood tinged sputum

Which of the following tests/procedures are NOT used to diagnose heart failure? A. Echocardiogram B. Brain natriuretic peptide blood test C. Nuclear stress test D. Holter monitoring

D. Holter monitoring

What type of heart failure does this statement describe? The ventricle is unable to properly fill with blood because it is too stiff. Therefore, blood backs up into the lungs causing the patient to experience shortness of breath. A. Left ventricular systolic dysfunction B. Left ventricular ride-sided dysfunction C. Right ventricular diastolic dysfunction D. Left ventricular diastolic dysfunction

D. Left ventricular diastolic dysfunction

Lipitor is prescribed for a patient with a high cholesterol level. As the nurse, how do you educate the patient on how this drugs works on the body? A. Lipitor increases LDL levels and decreases HDL levels, total cholesterol, and triglyceride levels. B. Lipitor decreases LDL, HDL levels, total cholesterol, and triglyceride levels. C. Lipitor increases HDL levels, total cholesterol, and triglyceride levels. D. Lipitor increases HDL levels and decreases LDL, total cholesterol, and triglyceride levels.

D. Lipitor increases HDL levels and decreases LDL, total cholesterol, and triglyceride levels.

A patient with severe pericarditis has developed a large pericardial effusion. The patient is symptomatic. The physician orders what type of procedure to help treat this condition? A. Pericardiectomy B. Heart catheterization C. Thoracotomy D. Pericardiocentesis

D. Pericardiocentesis

A patient is 36 hours status post a myocardial infarction. The patient is starting to complain of chest pain when they lay flat or cough. You note on auscultation of the heart a grating, harsh sound. What complication is this patient mostly likely suffering from? A. Cardiac dissection B. Ventricular septum rupture C. Mitral valve prolapse D. Pericarditis

D. Pericarditis

A patient is on a Heparin drip post myocardial infarction. The patient has been on the drip for 4 days. You are assessing the patient's morning lab work. Which of the following findings in the patient's lab work is a potential life-threatening complication of Heparin therapy and requires intervention? A. K+ 3.7 B. PTT 65 seconds C. Hgb 14.5 D. Platelets 135,000

D. Platelets 135,000

A patient taking Lovenox is having a severe reaction. What is the antidote for this medication?* A. Activated Charcoal B. Acetylcysteine C. Narcan D. Protamine sulfate

D. Protamine sulfate

A patient reports having crushing chest pain that radiates to the jaw. You administer sublingual nitroglycerin and obtain a 12 lead EKG. Which of the following EKG findings confirms your suspicion of a possible myocardial infraction? A. absent Q wave B. QRS widening C. absent P-wave D. ST segment elevation

D. ST segment elevation

A doctor has ordered cardiac enzymes on a patient being admitted with chest pain. You know that _____________ levels elevate 2-4 hours after injury to the heart and is the most regarded marker by providers. A. Myoglobin B. CK-MB C. CK D. Troponin

D. Troponin

On physical assessment of a patient with pericarditis, you may hear what type of heart sound? A. S3 or S4 B. mitral murmur C. pleural friction rub D. pericardial friction rub

D. pericardial friction rub

The nurse performs discharge teaching for a patient with an implantable cardioverter-defibrillator (ICD). Which statement by the patient indicates to the nurse that further teaching is needed? A."The device may set off the metal detectors in an airport." B."My family needs to keep up to date on how to perform CPR." C."I should not stand next to antitheft devices at the exit of stores." D."I can expect redness and swelling of the incision site for a few days."

D."I can expect redness and swelling of the incision site for a few days."

A patient develops third-degree heart block and reports feeling chest pressure and shortness of breath. Which instructions should the nurse provide to the patient before initiating emergency transcutaneous pacing? A."The device will convert your heart rate and rhythm back to normal." B."The device uses overdrive pacing to slow the heart to a normal rate." C."The device is inserted through a large vein and threaded into your heart." D."The device delivers a current through your skin that can be uncomfortable."

D."The device delivers a current through your skin that can be uncomfortable."

The patient is being dismissed from the hospital after acute coronary syndrome and will be attending rehabilitation. What information would be taught in the early recovery phase of rehabilitation? A.Therapeutic lifestyle changes should become lifelong habits. B.Physical activity is always started in the hospital and continued at home. C.Attention will focus on management of chest pain, anxiety, dysrhythmias, and other complications. D.Activity level is gradually increased under cardiac rehabilitation team supervision and with electrocardiographic (ECG) monitoring.

D.Activity level is gradually increased under cardiac rehabilitation team supervision and with electrocardiographic (ECG) monitoring.

For which problem is percutaneous coronary intervention (PCI) most clearly indicated? A.Chronic stable angina B.Left-sided heart failure C.Coronary artery disease D.Acute myocardial infarction

D.Acute myocardial infarction

The nurse is administering a dose of digoxin to a patient with heart failure (HF). The nurse would become concerned with the possibility of digitalis toxicity if the patient reported which symptom? A.Muscle aches B.Constipation C.Pounding headache D.Anorexia and nausea

D.Anorexia and nausea

A patient was admitted for possible ruptured aortic aneurysm. No back pain was reported. Ten minutes later, the nurse notes sinus tachycardia 138 beats/min, blood pressure is palpable at 65 mm Hg, increasing waist circumference, and no urine output. How should the nurse interpret the findings? A.Tamponade will soon occur. B.The renal arteries are involved. C.Perfusion to the legs is impaired. D.Bleeding into the abdomen is likely.

D.Bleeding into the abdomen is likely.

An asymptomatic patient with acute decompensated heart failure (ADHF) suddenly becomes dyspneic. Before dangling the patient on the bedside, what should the nurse assess first? A.Urine output B.Heart rhythm C.Breath sounds D.Blood pressure

D.Blood pressure

When evaluating a patient's knowledge regarding a low-sodium, low-fat cardiac diet, the nurse recognizes additional teaching is needed when the patient selects which food? A.Baked flounder B.Angel food cake C.Baked potato with margarine D.Canned chicken noodle soup

D.Canned chicken noodle soup

A patient admitted to the emergency department 24 hours ago with complaints of chest pain was diagnosed with a ST-segment-elevation myocardial infarction (STEMI). What complication of myocardial infarction should the nurse anticipate? A.Unstable angina B.Cardiac tamponade C.Sudden cardiac death D.Cardiac dysrhythmias

D.Cardiac dysrhythmias

A patient with a long-standing history of heart failure recently qualified for hospice care. What measure should the nurse now prioritize when providing care for this patient? A.Taper the patient off his current medications. B.Continue education for the patient and his family. C.Pursue experimental therapies or surgical options. D.Choose interventions to promote comfort and prevent suffering

D.Choose interventions to promote comfort and prevent suffering

A 55-yr-old female patient develops acute pericarditis after a myocardial infarction. Which assessment finding indicates a *possible complication*? A.Presence of a pericardial friction rub B.Distant and muffled apical heart sounds C.Increased chest pain with deep breathing D.Decreased blood pressure with tachycardia

D.Decreased blood pressure with tachycardia Rationale: Cardiac tamponade is a serious complication of acute pericarditis. Signs and symptoms include narrowed pulse pressure, tachypnea, tachycardia, a decreased cardiac output, and decreased blood pressure.

On admission to the emergency department, a patient with cardiomyopathy has an ejection fraction of 10%. On assessment, the nurse notes bilateral crackles and shortness of breath. Which additional assessment finding would most indicate patient decline? A.Increased heart rate B.Increased blood pressure C.Decreased respiratory rate D.Decreased level of consciousness

D.Decreased level of consciousness

A patient experienced sudden cardiac death (SCD) and survived. Which preventive treatment should the nurse expect to be implemented? A.External pacemaker B.An electrophysiologic study (EPS) C.Medications to prevent dysrhythmias D.Implantable cardioverter-defibrillator (ICD)

D.Implantable cardioverter-defibrillator (ICD)

The patient with pericarditis is complaining of chest pain. After assessment, which intervention should the nurse expect to implement to provide pain relief? A.Corticosteroids B.Morphine sulfate C.Proton pump inhibitor D.Nonsteroidal antiinflammatory drugs

D.Nonsteroidal antiinflammatory drugs

The nurse is caring for a patient who received a mechanical aortic valve replacement two years ago. Current lab values include an international normalized ratio (INR) of 1.5, platelet count of 150,000/µL, and hemoglobin of 8.6g/dL. Which nursing action is most appropriate? A.Assess the vital signs. B.Start intravenous fluids. C.Monitor for signs of bleeding. D.Report laboratory values to the health care provider.

D.Report laboratory values to the health care provider.

After having a myocardial infarction (MI), the nurse notes the patient has jugular venous distention, gained weight, developed peripheral edema, and has a heart rate of 108 beats/min. What should the nurse suspect is happening? A.ADHF B.Chronic HF C.Left-sided HF D.Right-sided HF

D.Right-sided HF

A male patient who has coronary artery disease (CAD) has serum lipid values of low-density lipoprotein (LDL) cholesterol of 98 mg/dL and high-density lipoprotein (HDL) cholesterol of 47 mg/dL. What should the nurse include in patient teaching? A.Consume a diet low in fats. B.Reduce total caloric intake. C.Increase intake of olive oil. D.The lipid levels are normal

D.The lipid levels are normal

A patient has a history of heart failure. Which of the following statements by the patient indicates the patient may be experiencing heart failure exacerbation? A. "I've noticed that I've gain 6 lbs in one week." B. "While I sleep I have to prop myself up with a pillow so I can breathe." C. "I haven't noticed any swelling in my feet or hands lately." D. Options B and C are correct. E. Options A and B are correct. F. Options A, B, and C are all correct.

E. Options A and B are correct.

True or False: Endocarditis only affects the atrioventricular and semi-lunar valves in the heart.

False