Cardiovascular- Passpoint

When listening to a client's heart, the nurse hears a rumbling, low-pitched diastolic murmur with the bell. This sound is consistent with which condition?

Mitral stenosis causes a diastolic, rumbling, low-pitched murmur. Aortic stenosis, an S3 gallop, and pericardial friction rubs do not make this distinct sound

the correct landmark for obtaining an apical pulse is the

The correct landmark for obtaining an apical pulse is the left fifth intercostal space in the midclavicular line. This area is the point of maximum impulse and the location of the left ventricular apex. The left second intercostal space in the midclavicular line is where the nurse auscultates pulmonic sounds. The apical pulse isn't obtained at the midaxillary line or the seventh intercostal space in the midclavicular line.

The nurse is admitting a client with substernal chest pain. Which diagnostic tests does the nurse anticipate the client will receive to confirm or rule out a diagnosis of myocardial infarction (MI)? Select all that apply.

Troponin and myoglobin are enzymes that are released when cardiac muscle is damaged. Serum troponin levels increase within 2 to 4 hours after MI. Serum myoglobin levels increase within ½ hour to 2 hours after MI. Serum bilirubin evaluates liver function and is not altered with cardiac damage. Urinalysis and 24-hour creatinine clearance reflect kidney—not cardiac—function. An electroencephalogram evaluates the electrical activity of the brain.

Following cardiac bypass surgery, the client has been referred to a cardiac rehabilitation exercise program. The client has type 1 diabetes and has bilateral leg discomfort with walking. The client is exercising using a stationary bicycle. The nurse should evaluate the client's response to exercise by assessing the presence of which condition?

A common complication of diabetes is diabetic neuropathy. Diabetic neuropathy results from the metabolic and vascular factors related to hyperglycemia. Damage leads to sensory deficits and peripheral pain. Muscle atrophy can result from disuse, but it is not a direct consequence of diabetes. Raynaud's disease is associated with vasospasms in the hands and feet. Transient ischemic attacks involve the cerebrum.

A young adult has been diagnosed with hypertrophic cardiomyopathy. The nurse should further assess the client for which complication?

Cardiomyopathy is a broad term that includes three major forms: dilated, hypertrophic, and restrictive cardiomyopathies. The underlying etiology of hypertrophic cardiomyopathy is unknown; it is typically observed in young men but is not limited to them. Common symptoms are fatigue, low tolerance to activity related to the low ejection fraction, and shortness of breath. Angina may be observed if coronary artery disease is present. Abdominal pain and hypertension are not common.

A client has a heart rate of 170 beats/minute. The physician diagnoses ventricular tachycardia and orders lidocaine hydrochloride, an initial I.V. bolus of 50 mg followed in 5 minutes by a second 50-mg bolus, then continuous I.V. infusion at 2 mg/minute. The nurse can expect the client to begin experiencing an antiarrhythmic effect within

Lidocaine exerts its antiarrhythmic effect in 1 to 2 minutes after I.V. bolus administration. A continuous I.V. infusion will maintain lidocaine's antiarrhythmic effect for as long as the drip is used. Lidocaine provides antiarrhythmic effects for only 15 minutes after the I.V. infusion is stopped.

The nurse should assess the client with left-sided heart failure for which findings? Select all that apply.

Dyspnea, crackles, oliguria, and decreased oxygen saturation are signs and symptoms related to pulmonary congestion and inadequate tissue perfusion associated with left-sided heart failure. JVD and right upper quadrant pain along with ascites and edema are usually associated with congestion of the peripheral tissues and viscera in right-sided heart failure

Which medication should a nurse have on hand when removing a sheath after cardiac catheterization?

Removing the sheath after cardiac catheterization may cause a vasovagal response, including bradycardia. The nurse should have atropine on hand to increase the client's heart rate if this occurs. Heparin thins the blood; clients should stop taking it before the sheath removal. Protamine sulfate is an antidote to heparin, but the nurse shouldn't administer it during sheath removal. Adenosine treats tachyarrhythmias.

A client with Raynaud's phenomenon is considering having a sympathectomy. What information should the nurse give the client about this surgery? A sympathectomy is performed:

Sympathectomy is scheduled only after other treatment alternatives have been explored and have failed. Medication and stress management are beneficial strategies to prevent advancement of the disease process. If the disease is controlled by medication, there is no reason for surgery.

The nurse is assessing a client who has a long history of uncontrolled hypertension. The nurse should assess the client for damage in which area of the eye?

The retina is especially susceptible to damage in a client with chronic hypertension. The arterioles supplying the retina are damaged. Such damage can lead to vision loss. The iris, cornea, and sclera are not affected by hypertension.

The nurse is assessing a client who has a history of peripheral artery disease. The nurse observes that the left great toe is black. The nurse determines that the black color is caused by which factor?

The term gangrene refers to blackened, decomposing tissue that is devoid of circulation. Chronic ischemia and death of the tissue can lead to gangrene in the affected extremity. Injury, edema, and decreased circulation lead to infection, gangrene, and tissue death. Atrophy is the shrinking of tissue, and contraction is joint stiffening secondary to disuse. The term rubor denotes a reddish color of the skin.