Cardiovascular exam

The nurse reminds the pt that the AHA recommends a lipid study every — years 1. 2 2. 2-3 3. 4 4. 4-6

4

The pt, age 26, is hospitalized with cardiomyopathy. While obtaining a nursing history from her, the nurse recognizes that the increased incidence of cardiomyopathy in young adults who have minimal risk factors for cardiovascular disease is related to which factor 1. Cocaine use 2. Viral infections 3. Vitamin B1 deficiencies 4. Pregnancy

1

To use an external cardiac defibrillator on a pt, which action would be performed to check the cardiac rhythm 1. Applying the adhesive patch electrodes to the skin and moving away from the pt 2. Applying standard electrocardiographic monitoring leads to the pt and observing the rhythm 3. Connecting standard electrocardiographic electrodes to a transtelephonic monitoring device

1

What should a person with unstable angina avoid 1. Shoveling snow 2. Eating red meat 3. Walking outside

1

The nurse is assessing a pt and suspects the pt is experiencing thrombophlebitis in the lower leg. What symptoms would the nurse assess 1. Edema of the extremity 2. Calf is warm to the touch 3. Severe cramping 4. Pain in the effected extremity

1, 2, 4

The nurse encourages the pt who is recovering from a MI to ask the HCP to prescribe a cardiac rehabilitation series in order to learn to 1. Improve stamina 2. Strengthen muscles 3. Plan an appropriate diet 4. Select herbal remedies 5. Reduce risk of further problems 6. Understanding heart condition

1, 2, 5, 6

A pt is admitted to the medical floor with a diagnosis of HF. Which assessment findings are consistent with the medical diagnosis 1. Increase abdominal girth 2. Weight loss of 6lbs in the past 2 weeks 3. Putting edema 4. Nervous tremors 5. Nights sweats

1, 3

Following an angiogram with the insertion site of the left groin, the nurse will include in the plan of care provisions for 1. Checking pedal pulse 2. Ambulating with assistance 2 hrs after recovery 3. Checking color and warmth of left leg frequently 4. Sandbagging over insertion site 5. Placing pt in semi-Fowler's position

1, 3, 4

The nurse is providing pt teaching for a pt with Raynaud disease. Which info should be included SELECT ALL THAT APPLY 1. Avoid cold 2. Warm hands and feet with heating pad 3. Practice stress reduction techniques 4. Comply with smoking cessation 5. Limit caffeine intake

1, 3, 4, 5

The nurse points out which of the following as modifiable risks for CAD SELECT ALL THAT APPLY 1. Diabetes mellitus 2. Hereditary 3. Smoking 4. Hypertension 5. Hyperlipidemia 6. Age

1, 3, 4, 5

The home health care nurse is visiting a pt with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The pt is taking cholestyramine. Which statement made by the pt indicates the need for further teaching 1. I'll continue my nicotinic acid from the health food store 2. Walking a mile each day will help the whole process 3. Constipation and bloating might be a problem

1

The nurse assesses that the home health pt has no signs or symptoms of heart failure, but does have a history of rheumatic fever and has been recently diagnosed with diabetes mellitus. The nurse is aware that using the ACC/AHA staging, this pt would be a 1. Stage A 2. Stage B 3. Stage C 4. Stage D

1

The nurse is collecting data on a pt with a diagnosis of RSHF. The nurse would expect to note which specific characteristics of this condition 1. Dependent edema 2. Dyspnea 3. Crackles on lung auscultation

1

A nurse is assisting in the care of a pt who began having chest pain 2hr ago. Which of the following lab findings should the nurse identify as an indication the pt has sustained injury to the heart 1. Troponin T 0.8 ng/mL 2. Myoglobin 80 mcg/L 3. Creatinine kinase (MB) 100 units/L

1

A pt admitted to the ER with a possible MI has reports back from the lab. Which lab report is specific for myocardial 1. CK-MB 2. Low level of sodium 3. Elevated white count

1

A pt experienced intense chest pain, anxiety, and nausea. The admitting diagnosis is suspected MI. When providing care for the pt in the ER, the nurse must understand d what about a MI 1. It involves a critical reduction in blood supply to the myocardium 2. There is a marked increase in cardiac output 3. A sudden irregularity of cardiac contractions occurs

1

A pt has a history of angina pectoris. To decrease pain from the angina pectoris, what should the pt do 1. Take cardiac glycoside at the first symptom of cardiac pain 2. Take Nitroglycerin sublingually three times daily 3. Take Nitroglycerin sublingually prophylactically before strenuous exercise

1

A pt is admitted to the hospital with a diagnosis of HF. Recently the pt's symptoms have been getting worse as a result of arteriosclerosis. In establishing a pt care plan, what is the primary goal of treatment 1. Reduce workload of heart 2. Promote rest for heart 3. Reduce fluid retention

1

A pt is wearing a continuous cardiac monitor which begins to alarm at the nurse's station. The nurse sees no electrocardiographic complexes on the screen. The nurse would take which action first 1. Check the pt status and lead placement 2. Call the PHCP 3. Press the recorder button on the ECG console

1

A pt receives a diagnosis of angina pectoris, with no subsequent cardiac involvement. The HCP prescribed Nitroglycerin. What explanation would the nurse give to this pt about why this medication is given sublingually 1. Superficial blood vessels promote rapid absorption of the medication 2. Saliva helps break down the medication for absorption 3. The medication is too rapidly absorbed n the stomach

1

A pt, age 72, was admitted to the medical unit with a diagnosis of angina pectoris. Characteristic s/s of angina pectoris include 1. Substernal pain that radiates down left arm 2. Fatigue, shortness of breath, and dyspnea 3. Epigastric pain that radiates to the jaw

1

Amiodarone is contraindicated for patients with which condition? 1. Severe sinus node dysfunction causing bradycardia 2. AF 3. PVC's

1

During a health interview by the home health nurse, which patient complaint suggests left-sided heart failure? 1. "I have to sleep in my recliner and I have this hacking cough." 2. "I have no appetite and I have lost 3 lb in the last week." 3. "I have to urinate every 2 hours, even during the night." 4. "I go barefoot most of the time because my feet are so hot."

1

The PHCP is going to perform carotid massage on the pt with rapid rate atrial fibrillation. Which interventions would the nurse anticipate SELECT ALL THAT APPLY 1. The client would be placed on a cardiac monitor 2. The PHCP massages the carotid artery for a full minute 3. The head would be turned toward the side to be massaged 4. Rhythm strips would be obtained before, during, and after the procedure 5. Vital signs, cardiac rhythm, and level of consciousness would be monitored the procedure

1, 4, 5

The hospice nurse introduced the family to the volunteer coordinator who will assign a volunteer to the pt. What can a hospice volunteer do for a pt and caregiver 1. Bathe the pt 2. Give the family respite

2

The nurse assesses pitting edema that can be depressed approximately 1/4 in and refills in 15 seconds. The nurse would document this assessment as 1. +1 2. +2 3. +3 4. +4

2

A 24-year old man seeks medical attention for complaints of claudication in the arch of the foot. A nurse also notes superficial thrombophlebitis of the lower leg. The nurse would next assess the client for 1. Familial tendency toward peripheral vascular disease 2. Smoking history 3. Recent exposures to allergens 4. History of insect bites

2

A postcardiac surgery client with a blood urea nitrogen (BUN) level of 45 mg/dL and a serum creatinine level of 2.2 mg/dL has a total 2-hour urine output of 25 mL. The nurse understands that the client is at risk for which? 1. Hypovolemia 2. Acute kidney injury 3. Glomerulonephritis 4. UTI

2

A pt with a history of IV drug use is diagnosed with acute infective endocarditis. Which nursing intervention for this pt is most appropriate 1. Early ambulation 2. Restricted activity for several wks 3. Low-cal diet 4. Dilution of blood by increased fluid intake

2

Almodipine (Norvasc) works by 1. Slows HR 2. Blood vessel dilation

2

An 86 year old pt is receiving an intravenous infusion at 83 mL/h via an electronic infusion pump. Why is it so vital that the IV lines of older adult pt's be monitored carefully 1. These pt are at an increased risk for developing a venous infection 2. These pt's are at an increased risk for developing fluid overload of the circulatory system

2

The cardiac marker — rises 3 hrs after MI and measures myocardial contractile protein 1. INR 2. Hemoglobin 3. Troponin 1

3

The nurse had reinforced instructions to the pt with Raynaud's disease about self-management of the disease process. The nurse determines that the pt needs further teaching if the pt makes which statement 1. Taking nifedipine as prescribed will decrease spams in my blood vessels 2. Moving to a warmer climate would help

2

The nurse is monitoring a pt following cardioversion. Which observations would be highest priority to the nurse 1. Level of consciousness 2. Status of airway 3. B/P

2

The nurse is monitoring a pt who is taking propranolol. Which data collection findings would indicate a potential serious completion associated with propranolol 1. The development of complaints of insomnia 2. The development of audible expiratory wheezes

2

The nurse is planning to administer hydrochlorothiazide to a pt. Which are concerns related to the administration of this medication 1. Hyperkalemia, hypoglycemia, penicillin allergy 2. Hypokalemia, hyperglycemia, sulfa allergy 3. Hypokalemia, increased risk of osteoporosis

2

The nurse is preparing to ambulate a postoperative pt after cardiac surgery. The nurse plans to do which to enable the pt to best tolerate the ambulation 1. Provide the pt with a walker 2. Premedicate the pt with an analgesic before ambulating 3. Encourage the pt to cough and deep breathe

2

The nurse reinforces discharge instructions to a postoperative pt who is taking Warfarin Sodium. Which statement made by the pt reflects the need for further teaching 1. I will take my pills everyday at the same time 2. I will take enteric coated aspirin for my headaches because it is coated

2

The nurse reminds the pt who is on Coumadin for the treatment of atrial fibrillation that the ideal is to maintain the INR between 1. 1 and 2 2. 2 and 3 3. 3 and 4 4. 4 and 5

2

Which information should be taught to pt's starting on anticoagulant therapy for a valvular disorder SELECT ALL THAT APPLY 1. Increase the dose of aspirin for better therapy 2. Take medication at the same time everyday 3. Report to the physician cuts that do not stop bleeding with direct pressure 4. No restrictions for food or drink 5. Report for prescribed blood tests (PTT, INR, CBC, Blood sugar)

2, 3

The nurse would design teaching for a pt with Raynaud disease to include which of the following SELECT ALL THAT APPLY 1. Warming hands and feet with a heating pad 2. Using mittens in cold weather 3. Practicing stress-reducing techniques 4. Complete smoking cessation 5. Using caution when cleaning the refrigerator or freezer

2, 3, 4, 5

When assessing a pt with a possible MI, what should the nurse assess for SELECT ALL THAT APPLY 1. Pain radiating to the left arm and jaw 2. Hypertension 3. Pallor 4. Diaphoresis 5. Erratic behavior 6. Cardiac rhythm changes

2, 3, 4, 5, 6

Which pt teaching would help to prevent venous stasis SELECT ALL THAT APPLY 1. Dangle legs 2. Avoid crossing legs at the knee 3. Elevate legs when lying in bed or sitting 4. Massage extremities to help maintain blood flow 5. Wear elastic stockings when ambulating

2, 3, 5

Which statement(s) about diuretics is /are true 1. Sodium sparing 2. Mechanism for action of antihypertensive effects 3. Electrolytes must be evaluated 4. Thiazides diuretics 5. Reduce cardiovascular morbidity

2, 3, 5

What actions would the nurse expect to be used to treat HF SELECT ALL THAT APPLY 1. Digitalis 2. Diuretic agents 3. Generous fluid intake 4. ACE inhibitors, Beta-Adrenergic blockers, Nitrates 5. Oxygen therapy

2, 4, 5

The nurse caring for a pt recovering from a MI teaches which method to avoid the Valsalva's maneuver during a BM 1. Taking a deep breath and holding it 2. Pursing lips and whistling 3. Mouth breathing

3

A pt diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and shortness of breath, and the pt is visibly anxious. Which is a life-threatening complication that could be occurring 1. Pulmonary edema 2. MI 3. Pulmonary embolism

3

A pt is admitted with a possible aortic abdominal aneurysm. What is most important factor to monitor as a possible complication 1. RR 2. Body temp 3. B/P

3

A pt is diagnosed with acute MI and is receiving tissue plasminogen activator, alteplase. Which action is a priority nursing intervention 1. Monitor for kidney failure 2. Monitor psychosocial status 3. Monitor for signs of bleeding

3

A pt taking nicotinic a is for hyperlipidemia, and the nurse reinforces instructions to the pt about the medication. Which statement by the pt indicates an understanding of the instructions 1. The medication needs to be taken with meals to decrease flushing 2. Clay-colored stools are a common side effect and are not a concern 3. Ibuprofen taken 30 minutes before the nicotinic acid will decrease the flushing

3

A pt's b/p is 134/78 mmHg. The nurse records the pulse pressure as 1. 78 2. 134 3. 56

3

The nurse is assisting with caring for a pt immediately after insertion of a permanent demand pacemaker via the right subclavian vein. The nurse prevents dislodgement of the pacing catheter by implementing which intervention 1. Limiting movement and abduction of the left arm 2. Having a PT do active ROM to the right arm 3. Limiting movement and abduction of the right arm

3

The nurse is caring for a 92 year old pt with pneumonia who is receiving IV carefully monitors the flow rate of the IV infusion because rapid infusion can cause 1. Hypertension 2. Pulmonary emboli 3. HF

3

The nurse is caring for a pt on a cardiac monitor who is alone in a room at the end of the hall. The pt has a short burst of VT, followed by VF. The pt suddenly losses consciousness. Which action would the nurse take first 1. Run to get a defibrillator from the adjacent nursing unit 2. Start oxygen by cannula at 10 L/min and lower head of bed 3. Call for help and initiate CPR

3

The nurse is checking the neurovascular status of a pt who returned to the surgical nursing unit 4hrs ago after undergoing an aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission . Based on this data, the nurse would make which determination about the pt's neurovascular status 1. Slightly deteriorating 2. Moderately impaired 3. Normal

3

The nurse notes a run of three ventricular contractions (PVC) that are not preceded by a P wave. This particular arrhythmia can progress into 1. atrial fibrillation and possible emboli. 2. sinus tachycardia and syncope. 3. ventricular tachycardia and death. 4. sinus bradycardia and fatigue.

3

Explain the "Widow Maker"

The LAD is affected by becoming totally or almost completely blocked, a silent deadly HA

The pt with congestive HF who is on a diuretic drug shows a weight loss of 6.6 lb. The nurse is aware that the pt has lost — L of fluid 1. 4 2. 3 3. 2 4. 1

2

How should the nurse advise a pt with an INR of 5.8 1. Make arrangements to go to the ER immediately 2. Hold the next dose and notify HCP immediately 3. Increase fluid intake 2,000 mL/day

2

How should the nurse advise the pt with an INR of 5.8 1. Make arrangements to go to the ER immediately 2. Stop taking anticoagulant and notify HCP

2

A pt with MI suddenly becomes tachycardia, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. The nurse listens to breath sounds expecting to hear which breath sounds bilaterally 1. Rhonchi 2. Wheezes 3. Diminished breath sounds 4. Crackles

4

Heparin Sodium is prescribed for the pt. Which lab results indicates that the heparin is prescribed at a therapeutic level 1. aPTT of 55 seconds 2. INR of 2.3 3. PT of 21 seconds

1

The post surgical pt has a painful and swollen right calf that appears to be larger than the calf of the left leg. Heat is the nurse assessing for when she flexes the pt's right leg and dorsiflexes the foot 1. Pain, which would be a positive Homans' sign 2. Muscular spasm, which would be a sign of hypocalcemia

1

What are signs and symptoms of approaching death SELECT ALL THAT APPLY 1. Increased pulse rate 2. Mottled extremities 3. Increase urine output 4. Pulling at bed linens 5. Alteration in respiration

1, 3, 4, 5

The nurse in a medical unit is caring for a pt with HF. The pt suddenly develops extreme dyspnea, tachycardia, and lung crackles, and the nurse suspects pulmonary edema. The nurse immediately notifies the RN and expects which interventions to be prescribed SELECT ALL THAT APPLY 1. Administering oxygen 2. Transporting the pt to the coronary care unit 3. Inserting a Foley catheter 4. Administering furosemide 5. Placing the pt in a low-Fowler's side-laying position 6. Administering morphine sulfate intravenously

1, 3, 4, 6

The nurse outlines which of the following as conditions that would disqualify a candidate for a heart transplant SELECT ALL THAT APPLY 1. Recent malignancy 2. Dilated cardiomyopathy 3. Peptic ulcer disease 4. Diabetes type 2 5. Severe obesity 6. Inoperable coronary artery disease

1, 3, 5

A pt diagnosis of hypertension. When providing discharge teaching what should the nurse include 1. Encouragement to begin a vigorous exercise program 2. Instruction to limit sodium intake to 2 g/day 3. Education on continuing to take antihypertensive medications as prescribed

2, 3

Isosorbide Mononitrate is prescribed for a pt with angina pectoris. The pt tells the nurse that the medication is causing a headache. Which action would the nurse suggest to the pt 1. Contact the PHCP 2. Cut dose in half 3. Take the medication with food

3

The nurse takes into consideration that age-related changes affect the peripheral circulation because of 1. Hypotension 2. Poor nutrition 3. Sclerosed blood vessels

3

The pain that a person with arterial insufficiency feels on exertion, which is relieved by rest, is —— 1. Stasis ulcer 2. DVT 3. Intermittent claudication

3

What is the difference between primary and secondary hypertension 1. Secondary is related to hereditary factors 2. Secondary cannot be treated effectively 3. Secondary is caused by another disorder like renal disease

3

When caring for a pt whose HCP has ordered furosemide (Lasix), what will the nurse recognize when the medication is having the desired effect 1. The pt becomes very thirsty 2. The pt B/P is reduced 3. Production of urine is increased 4. The pt weight decreases

3, 4

After an influenza-like illness, the patient complains of chills and small petechiae in his mouth and his legs. A heart murmur is detectable. These are characteristic signs of 1. congestive heart failure. 2. heart block. 3. aortic stenosis. 4. infective endocarditis.

4

The nurse is aware that the pt will benefit from the administration of streptokinase and tissue plasminogen activators when administered how long after admission for acute MI s/s 1. First 24 hrs 2. First 72 hrs 3. In the second 6 hrs after an MI 4. First 30 mins to 1 hr

4

The nurse making a teaching plan for a pt with Buerger disease will focus on the need for 1. Weight reduction 2. Reduction of alcohol intake 3. Avoiding cold remedies 4. Cessation of smoking

4

Which assessment would lead the nurse to examine the leg closely for evidence of a stasis ulcer 1. Lack of hair and shiny appearance of the lower leg 2. Edematous, red scaly skin on medical surface of the leg 3. Lack of pedal pulse

2

Which statement would lead the nurse to offer more instruction about taking warfarin 1. I eat a banana every morning with breakfast 2. I try to eat more leafy green veggies, especially broccoli, spinach, and kale

2

What is the TEE used for SELECT ALL THAT APPLY 1. Detect thrombi before cardioversion 2. Check for cardiac arrhythmias 3. Visualize vegetation of the heart valves 4. Measure effectiveness of diuretic therapy 5. Visualize abscesses on the heart valves

1, 3, 5

What is the primary goal of pt teaching after a MI 1. Explaining disease process 2. Assisting pt in developing healthy lifestyle 3. Describing and precipitating causes and onset of pain

2

When a pt returns to the unit following cardiac catheterization, which nursing activity should follow immediately after taking vital signs 1. Providing fluids 2. Assessing peripheral pulses

2

Before administering a dose of digoxin to an assigned pt, the nurse observes that the pt's pulse rate is 52. What is the most appropriate nursing action 1. Ratify charge nurse 2. Hold the medication and notify the HCP 3. Administer the medication

2

The pt has become very dyspneic, respiration's are 32, and the pulse is 100. The pt is coughing up frothy red sputum. What should be the initial nursing interventions 1. Lay pt flat and elevate the feet to increase venous return in cardiogenic shock 2. Place pt upright with legs in dependent position to reduce the symptoms of pulmonary edema 3. Place pt in side laying position to reduce the symptoms of AF

2

What a pt is receiving heparin therapy, what would be the nurse's most appropriate action 1. Observe him for cyanosis 2. Observe emesis, urine, and stools for blood 3. Assess degree of edema in all extremities

2

What is the action of amiodarone used to treat cardiac dysthymias 1. Prolongs duration of the electrical stimulation 2. Slows rate and prolongs time between contractions

2

What is the best nursing action that will lessen the severity of a pt's orthostatic hypotension 1. Turn him from side to side every 2 hrs 2. Change his position routinely, especially from horizontal to vertical 3. Encourage him to move very slowly

2

What is the major cause of cardiac valve disease 1. Drug abuse 2. Rheumatic fever 3. Obesity

2

What is the most useful noninvasive diagnostic tool for evaluating the pt with HF 1. Coronary angiography 2. Electrocardiogram 3. Echocardiogram

3

What is the pt goal of the walking exercise program designed for the rehabilitation of a post MI pt 1. Walk 1 mile in 15 minutes without dyspnea after 12 wks 2. Jog 1/2 mile in less than 30 mins after 12 wks 3. Walk 2 miles in less than 60 mins after 12 wks

3

Which action will the nurse implement to decrease the risk of clot formation in an older pt on bed rest 1. Position pillows behind the knees 2. Limit fluid intake 3. Encourage passive leg exercises and turning

3

Which lipoprotein contributes to the development of atherosclerosis 1. VLDL 2. HDL 3. LDL

3

A 10 year old pt I'd diagnosed with rheumatic fever. Of all the manifestations seen in rheumatic fever, which is most likely to lead to permanent complications 1. Sydenham chorea 2. Erythema marginatum 3. Subcutaneous nodules 4. Carditis

4