Cardiovascular

The nurse has completed a teaching session on self-administration of sublingual nitroglycerin. Which client statement indicates that the teaching has been effective? "I can take nitroglycerin before sex so I won't develop chest pain". "I can put the nitroglycerin tablets in my daily pill dispenser with my other medications". "Side effects of nitroglycerin include flushing, throbbing headache, and hypertension". "After taking two tablets with no relief, I should call EMS."

"I can take nitroglycerin before sex so I won't develop chest pain".

The nurse is admitting a client with heart failure. What client statement indicates that fluid overload was occurring at home? "I eat six small meals a day when I am hungry." "My food tastes bland without salt." "My best time of the day is the morning." "I cut back on going up the steps during the day."

"I cut back on going up the steps during the day."

A client, who has undergone a percutaneous transluminal coronary angioplasty (PTCA), has received discharge instructions. Which statement by the client would indicate the need for further teaching by the nurse? "I should avoid taking a tub bath until my catheter site heals." "I should avoid prolonged sitting." "I should expect a low-grade fever and swelling at the site for the next week." "I should expect bruising at the catheter site for up to 3 weeks."

"I should expect a low-grade fever and swelling at the site for the next week."

A nurse working in the medical intensive care unit has a client admitted with mitral stenosis. The nurse is precepting a graduate nurse and explains the pathophysiology of the condition. What statement made by the graduate nurse will reflect an appropriate understanding of the disease process? Select all that apply. "There is a narrowing between the left atrium and left ventricle." "It is caused by a tear that leads to the lungs becoming congested." "Mitral stenosis affects the coronary blood flow and can lead to angina." "Mitral stenosis is caused by an obstruction between the right atrium and ventricle." "Increased blood flow in the left atrium causes left atrial hypertrophy."

"There is a narrowing between the left atrium and left ventricle." "Increased blood flow in the left atrium causes left atrial hypertrophy."

The nurse is caring for a client experiencing an acute MI (STEMI). The nurse anticipates the physician will prescribe alteplase. Before administering this medication, which question is most important for the nurse to ask the client? "What time did your chest pain start today?" "What is your pain level on a scale of 1 to 10?" "How many sublingual nitroglycerin tablets did you take?" "Do your parents have heart disease?"

"What time did your chest pain start today?"

A client has just arrived in the ER with a possible myocardial infarction (MI). The electrocardiogram (ECG) should be obtained within which time frame of arrival to the ER? 15 minutes 20 minutes 10 minutes 5 minutes

10 minutes

The nurse is teaching a client with suspected acute myocardial infarction about serial isoenzyme testing. When is it best to have isoenzyme creatinine kinase of myocardial muscle (CK-MB) tested? 30 minutes to 1 hour after pain 12 to 18 hours after admission 2 to 3 hours after admission 4 to 6 hours after pain

4 to 6 hours after pain

A nurse is working with a client who has been scheduled for a percutaneous coronary intervention (PCI) later in the week. What anticipatory guidance should the nurse provide to the client? A sheath will be placed over the insertion site after the procedure is finished. The client will be given vitamin K infusions to prevent bleeding following PCI. The procedure will likely be repeated in 6 to 8 weeks to ensure success. The client will remain on bed rest for 48 to 72 hours after the procedure.

A sheath will be placed over the insertion site after the procedure is finished.

A nurse reviews an ECG strip for a client who is admitted with symptoms of an acute MI. The nurse should recognize what classic ECG changes that occur with an MI? Select all that apply. T-wave hyperactivity and inversions ST-segment elevations U-wave elevations Absent P-waves Abnormal Q-waves

Abnormal Q-waves T-wave hyperactivity and inversions ST-segment elevations

The nurse is assessing a postoperative patient who had a percutaneous transluminal coronary angioplasty (PTCA). Which possible complications should the nurse monitor for? (Select all that apply.) Abrupt closure of the artery Aortic dissection Coronary artery vasospasm Arterial dissection Nerve root pressure

Abrupt closure of the artery Arterial dissection Coronary artery vasospasm

The nurse providing care for a client post PTCA knows to monitor the client closely. For what complications should the nurse monitor the client? Select all that apply. Bleeding at the insertion site Arterial occlusion Venous insufficiency Abrupt closure of the coronary artery Retroperitoneal bleeding

Abrupt closure of the coronary artery Bleeding at the insertion site Retroperitoneal bleeding Arterial occlusion

A nurse is reevaluating a client receiving IV fibrinolytic therapy. Which finding requires immediate intervention by the nurse? Altered level of consciousness Chest pain 2 of 10 (on a 1-to-10 pain scale) Presence of reperfusion dysrhythmias Minimal oozing of blood from the IV site

Altered level of consciousness

Following a percutaneous coronary intervention (PCI), a client is returned to the nursing unit with large peripheral vascular access sheaths in place. The nurse understands that which method to induce hemostasis after sheath is contraindicated? Application of a vascular closure device Application of a sandbag to the area Application of a mechanical compression device Direct manual pressure

Application of a sandbag to the area

Which method to induce hemostasis after sheath removal after percutaneous transluminal coronary angioplasty (PTCA) is most effective? Application of a vascular closure device such as Angio-Seal or VasoSeal Application of a pneumatic compression device (e.g., FemoStop) Direct manual pressure Application of a sandbag to the area

Application of a vascular closure device such as Angio-Seal or VasoSeal

The nurse understands it is important to promote adequate tissue perfusion following cardiac surgery. Which measures should the nurse complete to prevent the development of deep venous thrombosis (DVT) and possible pulmonary embolism (PE)? Select all that apply. Apply antiembolism stockings. Avoid elevating the knees on the bed. Place pillows in the popliteal space. Initiate passive exercises. Encourage the client to cross their legs.

Apply antiembolism stockings. Avoid elevating the knees on the bed. Initiate passive exercises.

The nurse is providing care for a client with pulmonary edema. Which assessment method should the nurse prioritize to monitor the respiratory status of this individual? Pulse oximetry Lung sounds Arterial blood gas (ABG) analysis Skin color assessment

Arterial blood gas (ABG) analysis

The nurse is caring for a client diagnosed with unstable angina who is receiving IV heparin. The client requires bleeding precautions. Bleeding precautions include which measure? Avoid the use of nail clippers Avoid subcutaneous injections Use an electric toothbrush Avoid continuous BP monitoring

Avoid continuous BP monitoring

The nurse is participating in the care conference for a client with ACS. What goal should guide the care team's selection of assessments, interventions, and treatments? Balancing myocardial oxygen supply with demand Decreasing energy expenditure of the myocardium Maximizing cardiac output while minimizing heart rate Increasing the size of the myocardial muscle

Balancing myocardial oxygen supply with demand

A client is brought to the emergency department via rescue squad with suspicion of cardiogenic pulmonary edema. What complication should the nurse monitor for? Select all that apply. Pulmonary embolism Nausea and vomiting Respiratory arrest Cardiac arrest Cardiac dysrhythmias

Cardiac dysrhythmias Respiratory arrest Cardiac arrest

A patient has had cardiac surgery and is being monitored in the intensive care unit (ICU). What complication should the nurse monitor for that is associated with an alteration in preload? Elevated central venous pressure Hypertension Hypothermia Cardiac tamponade

Cardiac tamponade

The OR nurse is explaining to a client that cardiac surgery requires the absence of blood from the surgical field. At the same time, it is imperative to maintain perfusion of body organs and tissues. What technique for achieving these simultaneous goals should the nurse describe? Cardiopulmonary bypass Coronary artery bypass graft (CABG) Atherectomy Percutaneous transluminal coronary angioplasty (PTCA)

Cardiopulmonary bypass

A client with chest pain arrives in the emergency department and receives nitroglycerin, morphine, oxygen, and aspirin. The health care provider diagnoses acute coronary syndrome. When the client arrives on the unit, vital signs are stable and the client does not report any pain. In addition to the medications already given, which medication does the nurse expect the health care provider to order? Digoxin Furosemide Carvedilol Nitroprusside

Carvedilol

A client is recovering in the hospital from cardiac surgery. The nurse has identified the diagnosis of risk for ineffective airway clearance related to pulmonary secretions. What intervention best addresses this risk? Administration of bronchodilators by nebulizer Client's consistent performance of deep-breathing and coughing exercises Administration of inhaled corticosteroids by metered dose inhaler (MDI) Client's active participation in the cardiac rehabilitation program

Client's consistent performance of deep-breathing and coughing exercises

A nurse has taken on the care of a client who had a coronary artery stent placed yesterday. When reviewing the client's daily medication administration record, the nurse should anticipate administering what drug? Acetaminophen Clopidogrel Dipyridamole Ibuprofen

Clopidogrel

A client is admitted for treatment of Prinzmetal angina. When developing this client's care plan, the nurse should keep in mind that this type of angina is a result of what trigger? The same type of activity that caused previous angina episodes. An unpredictable amount of activity. Activities that increase myocardial oxygen demand. Coronary artery spasm.

Coronary artery spasm.

The nurse is reviewing the laboratory results for a patient having a suspected myocardial infarction (MI). What cardiac-specific isoenzyme does the nurse observe for myocardial cell damage? Alkaline phosphatase Troponin Creatine kinase MB Myoglobin

Creatine kinase MB

The nurse is caring for a client who was admitted to the telemetry unit with a diagnosis of "rule/out acute MI." The client's chest pain began 3 hours earlier. Which laboratory test would be most helpful in confirming the diagnosis of a current MI? Myoglobin level Troponin C level Creatinine kinase-myoglobin (CK-MB) level CK-MM

Creatinine kinase-myoglobin (CK-MB) level

A nurse is caring for a client who experienced an MI. The client is ordered to received metoprolol. The nurse understands that this medication has which therapeutic effect? Decreases cholesterol level Decreases resting heart rate Increases cardiac output Decreases platelet aggregation

Decreases resting heart rate

A client is recovering from coronary artery bypass graft (CABG) surgery. During discharge preparation, the nurse should advise the client and family members to expect which common symptom that typically resolves spontaneously? Ankle edema Memory lapses Dizziness Depression

Depression

The nurse is assessing a client with acute coronary syndrome (ACS). The nurse includes a careful history in the assessment, especially with regard to signs and symptoms. What signs and symptoms are suggestive of ACS? Select all that apply. Syncope Unusual fatigue Dyspnea Hypotension Peripheral cyanosis

Dyspnea Unusual fatigue Syncope

The nursing instructor is teaching nursing students about myocardial contractility and ejection fractions. What diagnostic tests can determine client ejection fractions? Select all that apply. Echocardiogram Cardiac catheterization Positron emission tomography scan Troponin levels Magnetic resonance imaging

Echocardiogram Cardiac catheterization Magnetic resonance imaging

The nurse is caring for a client newly diagnosed with coronary artery disease (CAD). While developing a teaching plan for the client to address modifiable risk factors for CAD, the nurse will include which factor(s)? Select all that apply. Alcohol use Drug use Elevated blood pressure Obesity Decreased LDL level

Elevated blood pressure Obesity

The client has just returned to the floor after balloon valvuloplasty of the aortic valve and the nurse is planning appropriate assessments. The nurse should assess for indications of what potential complications? Select all that apply. Mitral valve damage Emboli Plaque formation Ventricular dysrhythmia Atrial-septal defect

Emboli Mitral valve damage Ventricular dysrhythmia

Which changes occur to the heart as a result of heart transplant? Heart beats faster than the natural heart No significant changes are noted in the heart Heart beats slower than the natural heart The heart takes less time to increase the heart rate in response to exercise

Heart beats faster than the natural heart

A client admitted to the coronary care unit (CCU) diagnosed with a STEMI is anxious and fearful. Which medication will the nurse administer to relieve the client's anxiety and decrease cardiac workload? IV nitroglycerin Amlodipine IV morphine Atenolol

IV morphine

A client diagnosed with a myocardial infarction (MI) has begun an active rehabilitation program. The nurse recognizes which overall goal as a focus of rehabilitation for a client who has had an MI? Return to work and the lifestyle experienced before the illness Improved quality of life Limit to the effects and progression of atherosclerosis Prevention of another cardiac event

Improved quality of life

A client diagnosed with a myocardial infarction (MI) is being moved to the rehabilitation unit for further therapy. Which statement reflects a goal of rehabilitation for the client with an MI? Limitation of the effects and progression of atherosclerosis Ability to return to work and a pre-illness functional capacity Improvement in quality of life Prevention of another cardiac event

Improvement in quality of life

An ED nurse is assessing a 71-year-old female client for a suspected MI. When planning the assessment, the nurse should be cognizant of what signs and symptoms of MI that are particularly common in female clients? Select all that apply. Indigestion Nausea Chest pain Anxiety Shortness of breath

Indigestion Nausea

A client has been recently placed on nitroglycerin. Which instruction by the nurse should be included in the client's teaching plan? Instruct the client on side effects of flushing, throbbing headache, and tachycardia. Instruct the client to place nitroglycerin tablets in a plastic pill box. Instruct the client to renew the nitroglycerin supply every 3 months. Instruct the client not to crush the tablet.

Instruct the client on side effects of flushing, throbbing headache, and tachycardia.

The nurse is caring for a client who will have coronary artery revascularization. When explaining the pre- and postoperative regimens, the nurse should address which subject? Intubation and mechanical ventilation Complications requiring graft removal Symptoms of low blood pressure Symptoms of hypovolemia

Intubation and mechanical ventilation

The nurse has been asked to teach a patient how to self-administer nitroglycerin. The nurse should instruct the patient to do which of the following? Select all of the teaching points that apply. Keep the tablets at home on the kitchen counter or bedside table so they can be reached quickly. Put some of the tablets in a small metal or plastic pillbox that can be easily carried at all times and be accessible quickly, when needed. Renew the supply every 6 months. Take the tablet in anticipation of any activity that can produce pain. Let the tablet dissolve in the mouth and keep the tongue still. The tablet can be crushed between the teeth but not swallowed. Call emergency services if, after taking three tablets (one every 5 minutes), pain persists.

Let the tablet dissolve in the mouth and keep the tongue still. The tablet can be crushed between the teeth but not swallowed. Renew the supply every 6 months. Take the tablet in anticipation of any activity that can produce pain. Call emergency services if, after taking three tablets (one every 5 minutes), pain persists

Which assessments should a nurse perform when caring for a client following a cardiac catheterization? Select all that apply. Palpate the insertion site for tenderness. Inspect the color in every extremity. Inspect pressure dressing for signs of bleeding. Palpate the pulse in different locations. Monitor BP and pulse frequently.

Monitor BP and pulse frequently. Inspect pressure dressing for signs of bleeding. Palpate the pulse in different locations.

The ED nurse is caring for a client with a suspected MI. What drug should the nurse anticipate administering to this client? Morphine Oxycodone Acetaminophen Warfarin

Morphine

Severe chest pain is reported by a client during an acute myocardial infarction. Which of the following is the most appropriate drug for the nurse to administer? Nitroglycerin transdermal patch Morphine sulfate (Morphine) Meperidine hydrochloride (Demerol) Isosorbide mononitrate (Isordil)

Morphine sulfate (Morphine)

After 2-hour onset of acute chest pain, the client is brought to the emergency department for evaluation. Elevation of which diagnostic findings would the nurse identify as suggestive of an acute myocardial infarction at this time? Troponin I C-reactive protein WBC (white blood cell) count Myoglobin

Myoglobin

The nurse reviews laboratory tests for cardiac biomarkers for a client suspected of suffering an MI. What is the earliest marker of an MI? Total creatinine kinase (CK) Creatinine kinase-myocardial band (CK-MB) Myoglobin Troponin I and T

Myoglobin

A nurse is assessing a patient who has had valvular heart disease for more than 15 years. Which signs and symptoms should the nurse expect? (Choose all that apply.) Orthopnea Paroxysmal nocturnal dyspnea Pulsus paradoxus Cough Pericardial friction rub

Paroxysmal nocturnal dyspnea Orthopnea Cough

The critical care nurse is caring for a client who has had an MI. The nurse should expect to assist with establishing what hemodynamic monitoring procedure to assess the client's left ventricular function? Arterial blood gases (ABGs) Pulmonary artery pressure monitoring (PAPM) Central venous pressure (CVP) monitoring Systemic arterial pressure monitoring (SAPM)

Pulmonary artery pressure monitoring (PAPM)

A nurse is educating a client with coronary artery disease about nitroglycerin administration. The nurse tells the client that nitroglycerin has what actions? Select all that apply. Dilates blood vessels Decreases ischemia Relieves pain Reduces myocardial oxygen consumption Decreases the urge to use tobacco

Reduces myocardial oxygen consumption Dilates blood vessels Decreases ischemia Relieves pain

A client with CAD has been prescribed a transdermal nitroglycerin patch. What instructions should the nurse provide to the client? Select all that apply. Cover the patch in plastic wrap after applying. Store the patch in its original container when not in use. Seek emergency treatment if flushing or nausea occurs. Remove the transdermal patch at night and reapply in the morning.

Remove the transdermal patch at night and reapply in the morning. Store the patch in its original container when not in use.

A client with infective endocarditis is admitted to the hospital. While obtaining a history, what should the nurse ask the client about? Select all that apply. Intravenous (IV) drug use Prosthetic cardiac valves Nasal piercing Recent urinary tract infection Renal dialysis

Renal dialysis Intravenous (IV) drug use Nasal piercing Prosthetic cardiac valves Recent urinary tract infection

A client in the ICU has a central venous pressure (CVP) line placed. The CVP reading is 10 mm Hg. To what condition does the nurse correlate the CVP reading? Right-sided heart failure Reduction in preload Left-sided heart failure Hypovolemia

Right-sided heart failure

The nurse is caring for a client presenting to the emergency department (ED) reporting chest pain. Which electrocardiographic (ECG) finding would be most concerning to the nurse? Isolated premature ventricular contractions (PVCs) Sinus tachycardia ST elevation Frequent premature atrial contractions (PACs)

ST elevation

A nurse is assigned to care for a recently admitted client who has been diagnosed with refractory angina. What symptom will the nurse expect the client to exhibit? Pain that occurs more frequently and lasts longer than the pain usually seen with stable angina Predictable and consistent pain that occurs on exertion and is relieved by rest Pain that may occur at rest, but the threshold for pain is lower than expected Severe, incapacitating chest pain

Severe, incapacitating chest pain

The nurse is reevaluating a client 2 hours after a percutaneous transluminal coronary angioplasty (PTCA) procedure. Which assessment finding may indicate the client is experiencing a complication of the procedure? Heart rate of 100 bpm Potassium level of 4.0 mEq/L Dried blood at the puncture site Urine output of 40 mL

Urine output of 40 mL

What normal change due to aging does the nurse expect in the heart of an older client? Thinning and flaccidity of the cardiac values Decreased left ventricular ejection time Decreased connective tissue in the SA and AV nodes and bundle branches Widening of the aorta

Widening of the aorta

Which nursing actions would be of greatest importance in the management of a client preparing for angioplasty? Remove hair from skin insertion sites. Inform client of diagnostic tests. Withhold anticoagulant therapy. Assess distal pulses.

Withhold anticoagulant therapy.

The nurse is obtaining a history from a client diagnosed with hypertrophic cardiomyopathy. What information obtained from the client is indicative of hypertrophic cardiomyopathy? a history of amyloidosis a history of alcoholism a long-standing history of hypertension a parent has the same disorder

a parent has the same disorder

A client reports midsternal chest pain radiating down his left arm. The nurse notes that the client is restless and slightly diaphoretic, and measures a temperature of 99.6 °F (37.6 °C); a heart rate of 102 beats/minute; regular, slightly labored respirations at 26 breaths/minute; and a blood pressure of 150/90 mm Hg. What assessment is the nurse's highest priority? body temperature cardiac output acute pain anxiety

acute pain

The nurse is caring for a ventilated client after coronary artery bypass graft surgery. What are the criterions for extubation for the client? Select all that apply. inability to speak breathing without assistance of the ventilator adequate cough and gag reflexes labile vital signs acceptable arterial blood gas values

adequate cough and gag reflexes acceptable arterial blood gas values breathing without assistance of the ventilator

The nurse is assessing a client with left-sided heart failure. What assessment finding is expected? jugular vein distention ascites pitting edema of the legs air hunger

air hunger

A client has had a 12-lead ECG completed as part of an annual physical examination. The nurse notes an abnormal Q wave on an otherwise unremarkable ECG. The nurse recognizes that this finding indicates an evolving MI. variant angina. a cardiac dysrhythmia. an old MI.

an old MI.

A client with a myocardial infarction (MI) develops pulmonary crackles and dyspnea. A chest X-ray shows evidence of pulmonary edema. What type of MI did this client have? lateral. anterior. inferior. posterior.

anterior.

The nurse is beginning discharge teaching with a client diagnosed with a myocardial infarction (MI). The nurse will include teaching on what medications? Select all that apply. atorvastatin aspirin morphine sildenafil enalapril

atorvastatin enalapril aspirin

A client is beginning to have more breathlessness with aortic stenosis. What is the treatment does the nurse anticipate for the client? balloon angioplasty cardiac graft procedure balloon valvuloplasty cardiac catheterization

balloon valvuloplasty

The nurse is caring for a client diagnosed with bacterial myocarditis. The client's heart rate is 120-130 beats per minute and blood pressure 158/89 mm Hg. What medications will the nurse administer to treat the client with myocarditis? Select all that apply. penicillin amiodarone nitroglycerin carvedilol ibuprofen

carvedilol amiodarone penicillin

The nurse is administering medications to a client with pericarditis. What medications will be commonly prescribed to treat pericarditis? Select all that apply. prednisone colchicine ibuprofen indomethacin

colchicine ibuprofen prednisone

A client who had coronary artery bypass surgery is exhibiting signs of heart failure. What medications will the nurse anticipate administering for this client? Select all that apply. inotropic agents nitroprusside diuretics digoxin amlodipine

diuretics inotropic agents digoxin

The nurse is caring for a client with coronary artery disease. What is the nurse's priority goal for the client? administer sublingual nitroglycerin decrease anxiety enhance myocardial oxygenation educate the client about his symptoms

enhance myocardial oxygenation

The nurse working in the medical intensive care unit is caring for a client admitted with mitral stenosis. What will the nurse assess is related to the pathophysiology of mitral stenosis? Select all that apply. history of endocarditis shortness of breath with activity high-pitched murmur fatigue low-pitched murmur

fatigue low-pitched murmur shortness of breath with activity history of endocarditis

The nurse is caring for a client with aortic regurgitation. What medication will the nurse administer to reduce afterload? metoprolol nitroprusside isosorbide diltiazem

nitroprusside

A client presents to the ED with a myocardial infarction. Prior to administering a prescribed thrombolytic agent, the nurse must determine whether the client has which absolute contraindication to thrombolytic therapy? prior intracranial hemorrhage shellfish allergy use of heparin recent consumption of a meal

prior intracranial hemorrhage

A client was transferring a load of firewood in the morning and experienced a heaviness in the chest and dyspnea. The client arrives in the emergency department four hours after the heaviness and the health care provider diagnoses an anterior myocardial infarction (MI). What orders will the nurse anticipate? sublingual nitroglycerin, tissue plasminogen activator (tPA), and telemetry serial liver enzyme testing, telemetry, and a lidocaine infusion morphine administration, stress testing, and admission to the cardiac care unit streptokinase, aspirin, and morphine administration

sublingual nitroglycerin, tissue plasminogen activator (tPA), and telemetry

A client has a blockage in the proximal portion of a coronary artery and decides to undergo percutaneous transluminal coronary angioplasty (PTCA). What medication will the nurse expect to administer during the procedure? ticagrelor hydrochlorothiazide metoprolol ceftriaxone

ticagrelor

An obese client describes symptoms of palpitations, chronic fatigue, and dyspnea on exertion to the cardiologist. Upon completing the examination, the cardiologist schedules a procedure to confirm the suspected diagnosis. What diagnostic procedure would the nurse expect to be prescribed? transesophageal echocardiography electrocardiography radionuclide angiography chest radiograph

transesophageal echocardiography

Which test used to diagnose heart disease is least invasive? transthoracic echocardiography cardiac catheterization magnetic resonance imaging coronary arteriography

transthoracic echocardiography

The nurse is providing discharge teaching to a client with recurrent endocarditis. What are prevention strategies will be included with the teaching? Select all that apply. use a nail clipper for fingernail care report recurrent fever lasting longer than 7 days to the health care provider use a toothpick to keep food from accumulating in the mouth body piercing can be done in a clean area notify dentist of the history of endocarditis with any planned dental procedures

use a nail clipper for fingernail care report recurrent fever lasting longer than 7 days to the health care provider notify dentist of the history of endocarditis with any planned dental procedures