Cardiac/Urinary NCLEX review questions
Which condition(s) indicates target organ damage from untreated/undertreated hypertension? Select all that apply. a. heart failure b. stroke c. hyperlipidemia d. retinal damage e. diabetes
a, b, d
Which statements are true when the nurse is measuring blood pressure (BP)? Select all that apply a. the client should sit quietly while BP is being measured b. the client's BP should be measure 1 hour before consuming alcohol c. the client's arm should be positioned at the level of the heart d. using a BP cuff that is too large will give a higher BP measurement e. using a BP cuff that is too small with give a higher BP measurement
a, c, e
The nurse reviews discharge instructions with a client who underwent a left groin cardiac catheterization 8 hours ago. Which instructions should the nurse include? a. "do not bend at the waist, strain, or lift heavy objects for the next 24 hours" b. "contact your primary care provider if you develop a temperature above 102 F" c. "if any discharge occurs at the puncture site, call 911 immediately" d. "you can take a tub bath or a shower when you get home"
a. "do not bend at the waist, strain, or lift heavy objects for the next 24 hours"
According to the DASH diet, how many servings of vegetables should a person consume each day? a. 4 or 5 b. 2 or fewer c. 2 or 3 d. 7 or 8
a. 4 or 5
Which symptom is an early warning sign of acute coronary syndrome (ACS) and heart failure (HF)? a. fatigue b. change in level of consciousness c. weight gain d. hypotension
a. fatigue
The nurse auscultates the apex beat at which anatomical location? a. fifth intercostal space, midclavicular line b. midsternum c. 2.5 cm to the left of the xiphoid process d. 5 cm to the left of the lower end of the sternum
a. fifth intercostal space, midclavicular line
The nurse cares for a client in the emergency department who has a B-type natriuretic peptide (BNP) level of 115 pg/mL. The nurse recognizes that this finding is most indicative of which condition? a. heart failure b. ventricular hypertrophy c. pulmonary edema d. myocardial infarction
a. heart failure
During the auscultation of a client's heart sounds, the nurse notes an S4. The nurse recognizes that an S4 is associated with which condition? a. hypertensive heart disease b. heart failure c. diseased heart valves d. turbulent blood flow
a. hypertensive heart disease
The nurse auscultates the PMI (point of maximal impulse) at which anatomic location? a. left midclavicular line, fifth intercostal space b. 2.5 cm to the left of the xiphoid process c. 3 cm to the right of the sternum d. 5 cm to the left of the lower end of the sternum
a. left midclavicular line, fifth intercostal space
The nurse observes a client during an exercise stress test (bicycle). Which finding indicates a positive test and the need for further diagnostic testing? a. dizziness and leg cramping b. ST-segment changes on the ECG c. heart rate changes; 78 bpm to 112 bpm d. BP changes; 148/80 mmHg to 166/90 mmHg
b. ST-segment changes on the ECG
The nurse prepares to apply ECG electrodes to a male client who requires continuous cardiac monitoring. Which action should the nurse complete to optimize skin adherence and conduction of the heart's electrical current? a. clean the client's chest with alcohol prior to application of the electrodes b. clip the client's chest hair prior to applying the electrodes c. once the electrodes are applied, change them every 72 hours d. apply baby powder to the client's chest prior to placing the electrodes
b. clip the client's chest hair prior to applying the electrodes
What is the term for the ability of the cardiac muscle to shorten in response to an electrical impulse? a. depolarization b. contractility c. diastole d. repolarization
b. contractility
Which area of the heart is located at the third intercostal (IC) space to the left of the sternum? a. pulmonic area b. erb point c. epigastric area d. aortic area
b. erb point (APE to MAN)
Which term describes a situation in which blood pressure is very elevated but there is no evidence of impending or progressive target organ damage? a. hypertensive emergency b. hypertensive urgency c. primary hypertension d. secondary hypertension
b. hypertensive urgency
When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true? a. pressures may vary 10 mm Hg or more between arms b. pressures should not differ more than 5 mm Hg between arms c. pressures may vary, with the higher pressure found in the left arm d. pressures must be equal in both arms
b. pressures should not differ more than 5 mm Hg between arms
Choose the statements that correctly match the hypertensive medication with its side effect. Select all that apply. a. with ACE inhibitors, assess for bradycardia b. beta-blockers may cause sedation c. with thiazide diuretics, monitor serum potassium concentration d. cough is a common side effect of adrenergic inhibitors e. direct vasodilators may cause headache and tachycardia
c, e
The nurse cares for a client with diabetes who is scheduled for a cardiac catheterization. Prior to the procedure, it is most important for the nurse to ask which question? a. "when was the last time you ate or drank?" b. "are you having chest pain?" c. "are you allergic to shellfish?" d. "what was your morning blood sugar reading?"
c. "are you allergic to shellfish?"
The nurse is caring for a client newly diagnosed with hypertension. Which statement by the client indicates the need for further teaching? a. "when getting up from the bed, I will sit for a short period before standing up" b. "I think I'm going to sign up for a yoga class twice a week to help reduce my stress" c. "if I take my blood pressure and it is normal, I don't have to take my blood pressure pills" d. "I will consult a dietician to help get my weight under control"
c. "if I take my blood pressure and it is normal, I don't have to take my blood pressure pills"
For both outpatients and inpatients scheduled for diagnostic procedures of the cardiovascular system, the nurse performs a thorough initial assessment to establish accurate baseline data. Which data is necessary to collect if the client is experiencing chest pain? a. blood pressure in the left arm b. pulse rate in upper extremities c. description of the pain d. sound of the apical pulses
c. description of the pain
a 66-year-old client presents to the emergency department reporting severe headache and mild nausea for the past 6 hours. Upon assessment, the client's BP is 210/120 mm Hg. The client has a history of hypertension and takes 1.0 mg clonidine twice daily. Which question is most important for the nurse to ask the client next? a. "are you having chest pain or shortness of breath?" b. "do you have a dry mouth or nasal congestion?" c. "did you take any medication for your headache?" d. "have you taken your prescribed clonidine today?"
d. "have you taken your prescribed clonidine today?"
Officially, hypertension is diagnosed when the client demonstrates a systolic blood pressure greater than _____ mm Hg and a diastolic blood pressure greater than ____ mm Hg over a sustained period. a. 120, 70 b. 110, 60 c. 130, 80 d. 140, 90
d. 140, 90
The nurse is teaching a client diagnosed with hypertension about the DASH diet. How many servings of meat, fish, poultry should the client consume per day? a. 4 or 5 b. 2 or 3 c. 7 or 8 d. 2 or fewer
d. 2 or fewer
Which term describes the ability of the heart to initiate an electrical impulse? a. contractility b. excitability c. conductivity d. automaticity
d. automaticity
What is a harsh grating sound caused by abrasion of the pericardial surfaces during the cardiac cycle? a. opening snap b. ejection click c. murmur d. friction rub
d. friction rub
Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage? a. secondary hypertension b. primary hypertension c. hypertensive urgency d. hypertensive emergency
d. hypertensive emergency
The nurse cares for a client prescribed warfarin orally. The nurse reviews the client's prothrombin time (PT) level to evaluate the effectiveness of the medication. Which laboratory values should the nurse also evaluate? a. partial thromboplastic time (PTT) b. sodium c. complete blood count (CBC) d. international normalized ratio (INR)
d. international normalized ratio (INR)
A systolic blood pressure of 135 mm Hg would be classified as a. stage 2 hypertension b. stage 1 hypertension c. normal d. prehypertension
d. prehypertension
What does decrease pulse pressure reflect? a. tachycardia b. elevated stroke volume c. reduced distensibility of the arteries d. reduced stroke volume
d. reduced stroke volume
Which term is refers to hypertension in which blood pressure that is controlled with therapy becomes uncontrolled (abnormally high) when the therapy is discontinued? a. secondary b. rebound c. primary d. essential
b. rebound
The nurse is caring for a client newly diagnosed with secondary hypertension. Which condition contributes to the development of secondary hypertension? a. calcium deficit b. renal disease c. acid-based imbalance d. hepatic function
b. renal disease
Central venous pressure is measured in which heart chamber? a. left atrium b. right atrium c. right ventricle d. left ventricle
b. right atrium
A blood pressure (BP) of 140/90 mm Hg is considered to be a. prehypertension b. hypertensive emergency c. hypertension d. normal
c. hypertension
During the auscultation of heart, what is revealed by an atrial gallop? a. heart failure b. turbulent blood flow c. hypertensive heart disease d. disease heart valves
c. hypertensive heart disease
It is appropriate for the nurse to recommend smoking cessation for clients with hypertension because nicotine a. decreases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood b. decreases circulating blood volume c. increase the heart rate, constricts arterioles, and reduces the heart's ability to eject blood d. increases the heart rate, constricts arterioles, and increase the heart's ability to eject blood
c. increase the heart rate, constricts arterioles, and reduces the heart's ability to eject blood
The nurse understands that client education related to antihypertensive medication should include which of the following? a. inform client that recommended lifestyle changes are not necessary b. inform client if a dosage of medication is missed, to double the next scheduled dose c. inform client to avoid over-the-counter cold and sinus medications d. inform client to discontinue antihypertensives once blood pressure is normal
c. inform client to avoid over-the-counter cold and sinus medications
The nurse cares for a client with clubbing of the fingers and toes. The nurse should complete which action given these findings? a. assess the client's capillary refill b. assess the client for pitting edema c. obtain an oxygen saturation level d. obtain a 12-lead ECG tracing
c. obtain an oxygen saturation level
It is important for the nurse to encourage the client to rise slowly from a sitting or lying position because gradual changes in position a. help reduce the blood pressure to resupply oxygen to the brain b. provide time for the heart to reduce the rate of contraction to resupply oxygen to the brain c. help reduce the required by the heart to resupply oxygen to the brain d. provide time for the heart to increase the rate of contraction to resupply oxygen to the brain
d. provide time for the heart to increase the rate of contraction to resupply oxygen to the brain
A 35-year-old client has been diagnosed with hypertension. The client is a stock broker, smokes daily, and has diabetes. During a follow-up appointment, the client states that regular visits to the doctor just to check blood pressure (BP) are cumbersome and time consuming. As the nurse, which aspect of client teaching would you recommend? a. administering glycemic control b. discussing methods for stress reduction c. advising smoking cessation d. purchasing a self-monitoring BP cuff
d. purchasing a self-monitoring BP cuff
A diastolic blood pressure of 90 mm Hg is classified as a. normal b. prehypertension c. stage 2 hypertension d. stage 1 hypertension
d. stage 1 hypertension
A student nurse prepares to assess a client for postural blood pressure changes. Which action indicates the student nurse needs further education? a. letting 30 seconds elapse after each position change before measuring BP and HR b. obtaining the supine measurements prior to the sitting and standing measurements c. taking the client's BP with the client sitting on the edge of the bed, feet dangling d. position the client supine for 10 minutes prior to taking the initial BP and HR
a. letting 30 seconds elapse after each position change before measuring BP and HR
The nurse teaches the client which guidelines regarding lifestyle modifications for hypertension? a. maintain adequate dietary intake of fruits and vegetables b. limit aerobic physical activity to 15 minutes, three times per week c. stop alcohol intake d. reduce smoking to no more than 4 cigarettes per day
a. maintain adequate dietary intake of fruits and vegetables
when the balloon on the distal tip of a pulmonary artery catheter is inflated and a pressure is measured, the measurement obtained is referred to as which of the following? a. pulmonary artery wedge pressure b. pulmonary artery pressure c. central venous pressure d. cardiac output
a. pulmonary artery wedge pressure
The nurse uses which term for the normal pacemaker of the heart? a. sinoatrial (SA) node b. purkinje fibers c. bundle of his d. atrioventricular (AV)node
a. sinoatrial (SA) node
Which term describes the amount of blood ejected per heartbeat? a. stroke volume b. cardiac output c. ejection fraction d. afterload
a. stroke volume
During auscultation of the lungs, what would a nurse note when assessing a client with left-sided heart failure? a. wheezes with wet lung sounds b. laborious breathing c. high-pitched sounds d. stridor
a. wheezes with wet lung sounds
According to the classification of hypertension diagnosed in older adults, hypertension that can be attributed to an underlying cause is termed a. primary b. secondary c. isolated systolic d. essential
b. secondary
The nurse is caring for a client prescribed bumetanide for the treatment of stage 2 hypertension. Which finding indicates the client is experiencing an adverse effect of the medication? a. urine output of 90 mL 1 hour after medication administration b. blood glucose value of 160 mg/dL c. serum potassium value of 3.0 mEq/L d. electrocardiogram (ECG) tracing demonstrating peaked T waves
c. serum potassium value of 3.0 mEq/L
The nurse correctly identifies which data as an example of blood pressure and heart rate measurements in a client with postural hypotension? a. supine: BP 114/82, HR 90; sitting: BP 110/76, HR 95; standing: BP 108/74, HR 98 b. supine: BP 140/78, HR 72; sitting: BP 145/78, HR 74; standing: BP 144/78, HR 74 c. supine: BP 120/70, HR 70; sitting: BP 100/55, HR 90; standing: BP 98/52, HR 94 d. supine: BP 130/70, HR 80; sitting: BP 128/70, HR 80; standing: BP 130/68, HR 82
c. supine: BP 120/70, HR 70; sitting: BP 100/55, HR 90; standing: BP 98/52, HR 94
The nurse understands that an overall goal of hypertension management is that a. the client maintains a normal blood pressure reading b. there are no reports of sexual dysfunction c. there is no indication of target organ damage d. there is no report of postural hypotension
c. there is no indication of target organ damage
