Ch. 25 Cardiac

the nurse is reviewing the results of the patient's echocardiogram and observes that the ejection fraction is 35%. the nurse anticipates that the patient will receive treatment for what condition? a. pulmonary embolism b. myocardial infarction c. pericarditis d. heart failure

d. heart failure

the nurse is performing an assessment of the patient's heart. where would the nurse locate the apical pulse if the heart is in a normal position? a. left 2nd intercostal space at the mid-clavicular line b. right 2nd intercostal space at the mid-clavicular line c. right 3rd intercostal space at the mid-clavicular line d. left 5th intercostal space at the mid-clavicular line

d. left 5th intercostal space at the mid-clavicular line

the nurse is assessing a patient's electrocardiogram (ECG). what phase does the nurse determine is the resting phase before the next depolarization? a. phase 1 b. phase 2 c. phase 3 d. phase 4

d. phase 4

The client states, "My doctor says that because I am now taking this water pill, I need to eat more foods that contain potassium. Can you give me some ideas about what foods would be good for this?" The nurse's appropriate response is which of the following? a. Apricots, dried peas and beans, dates b. Asparagus, blueberries, green beans c. Cranberries, apples, popcorn d. Bok choy, cooked leeks, alfalfa sprouts

a. Apricots, dried peas and beans, dates

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. "Are you allergic to shellfish?" b. "Are you having chest pain?" c. "When was the last time you ate or drank?" d. "What was your morning blood sugar reading?"

a. "Are you allergic to shellfish?"

A client recovering from a myocardial infarction asks why he needs to take a stool softener. He says, "I had a heart attack; I don't have a problem with constipation." Which explanation should the nurse use to answer the client's question? a. "If you strain to have a bowel movement, you can cause a drop in your heart rate that can be dangerous." b. "Hospital food causes constipation." c. "Your doctor ordered this stool softener for you." d. "Everyone who has a heart attack takes stool softeners."

a. "If you strain to have a bowel movement, you can cause a drop in your heart rate that can be dangerous."

The nurse is providing discharge education for the client going home after a cardiac catheterization. Which of the following would be important information to give this client? a. Avoid tub baths, but shower as desired. b. Do not ambulate until the physician indicates it is appropriate. c. Expect bruising to appear at the site. d. Returning to work immediately is okay.

a. Avoid tub baths, but shower as desired.

The nurse is taking a health history from a client admitted with the medical diagnosis of cardiovascular disease (CVD). Identify which of the following symptoms indicate CVD. a. Chest pain, weight gain, fatigue b. Dizziness, rash, extra-ocular eye movements c. Fatigue, ecchymosis, confusion d. Petechiae, ascites, constipation

a. Chest pain, weight gain, fatigue

The nurse practitioner inspects the patient's skin during a physical examination. She is looking for any abnormalities, especially skin findings associated with cardiovascular disease. The nurse notes a bluish tinge in the buccal mucosa and the tongue. She knows this is probably due to: a. Congenital heart disease. b. Blood leaking outside the blood vessels. c. Intermittent arteriolar vasoconstriction. d. Peripheral vasoconstriction.

a. Congenital heart disease.

Which of the following would be an indication for a transesophageal echocardiography (TEE)? a. Determination of atrial thrombi b. Determination of electrical activity of the heart. c. Evaluation of the response of the cardiovascular system to increased oxygen demands. d. Evaluation of myocardial perfusion at rest and after exercise.

a. Determination of atrial thrombi

The nurse is caring for a geriatric client. The client is ordered Lanoxin (digoxin) tablets 0.125mg daily for a cardiac dysrhythmias. Which of the following assessment considerations is essential when caring for this age-group? a. Digoxin level b. Cardiac output c. Activity level d. Dyspnea

a. Digoxin level

A patient's gradual decline in activity tolerance and increased shortness of breath have prompted her health care provider to assess the structure and size of her heart. Which of the following diagnostic tests is most likely to yield these assessment data? a. Echocardiography b. Electrocardiography (ECG) c. Cardiac catheterization d. Angiography

a. Echocardiography

The nurse prepares to auscultate heart sounds. Which nursing interventions would be most effective to assist with this procedure? a. Explain to the client that the nurse will be listening to different areas of the chest and may listen for a long time, but that does not mean that anything abnormal is heard. b. Ask the client to sit on the edge of the bed and hold his breath while the nurse listens. c. Insist that the family members leave the room if they must speak to each other while the nurse is auscultating heart sounds. d. Ask the client to take deep breaths through his mouth while the nurse auscultates heart sounds.

a. Explain to the client that the nurse will be listening to different areas of the chest and may listen for a long time, but that does not mean that anything abnormal is heard.

The nurse instructor is teaching a group of nursing students about adventitious heart sounds. The instructor explains that auscultation of the heart requires familiarization with normal and abnormal heart sounds. What would the instructor tell these students a ventricular gallop indicates in an adult? a. Heart failure b. Hypertensive heart disease c. Normal functioning d. Pericarditis

a. Heart failure

A patient is admitted to a hospital to confirm a diagnosis of postural hypotension. The nurse assesses the patient's blood pressure every 4 hours. Which of the following is an indicator of postural hypotension that occurs when the patient moves from a lying to a sitting or standing position? a. Heart rate increased from 85 to 110 bpm. b. Systolic pressure did not change with the change in position. c. Diastolic pressure went from 80 to 110 mm Hg. d. Heart rate decreased from 85 to 75 bpm at the same time that the systolic pressure increased from 120 to 135 mm Hg.

a. Heart rate increased from 85 to 110 bpm.

The cardiologist has scheduled a client for drug-induced stress testing. What instructions should the nurse provide to prepare the client for this test? a. You will receive medication via IV administration. b. You will need to wear comfortable shoes to the test. c. You will begin exercising at a slow speed. d. You may experience an onset of dizziness during the test.

a. You will receive medication via IV administration.

the nurse is assessing a patient who complains of feeling "light-headed". when obtaining orthostatic vital signs, what does the nurse determine is a significant finding? a. a heart rate of 20 bpm above the resting rate b. an unchanged systolic pressure c. an increase of 10mmHg blood pressure reading d. an increase of 5mmHg in diastolic pressure

a. a heart rate of 20 bpm above the resting rate

Age-related changes associated with the cardiac system include a. decreased size of the left atrium. b. endocardial fibrosis. c. increase in the number of SA node cells. d. myocardial thinning.

b. endocardial fibrosis.

a patient had a cardiac catheterization and is now in the recovery area. what nursing interventions should be included in the plan of care? (SAA) a. assessing the peripheral pulses in the affected extremity b. checking the insertion site for hematoma formation c. evaluating temperature and color in the affected extremity d. assisting the patient to the bathroom after the procedure e. assessing vital signs every 8 hours

a. assessing the peripheral pulses in the affected extremity b. checking the insertion site for hematoma formation c. evaluating temperature and color in the affected extremity

Which term describes the ability of the heart to initiate an electrical impulse? a. automaticity b. contractility c. conductivity d. excitability

a. automaticity

Following a myocardial infarction, a client develops an arrhythmia and requires a continuous infusion of lidocaine. To monitor the effectiveness of the intervention, the nurse should focus primarily on the client's: a. electrocardiogram (ECG). b. urine output. c. creatine kinase (CK) and troponin levels. d. blood pressure and heart rate.

a. electrocardiogram (ECG).

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

a patient's heart rate is observed to be 140 bpm on the monitor. the nurse knows that the patient is at risk for what complication? a. myocardial ischemia b. a pulmonary embolism c. right sided heart failure d. a stroke

a. myocardial ischemia

the nurse is assessing a patient's blood pressure. what does the nurse document as the difference between the systolic and diastolic pressure? a. pulse pressure b. auscultatory gap c. pulse deficit d. korotkoff sound

a. pulse pressure

Central venous pressure is measured in which heart chamber? a. right atrium b. left atrium c. left ventricle d. right ventricle

a. right atrium

Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to the lungs to be oxygenated? a. right ventricle b. left ventricle c. right atrium d. left atrium

a. right ventricle

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 120/70 mm Hg, HR 70 bpm; sitting: BP 100/55 mm Hg, HR 90 bpm; standing: BP 98/52 mm Hg, HR 94 bpm b. supine: BP 130/70 mm Hg, HR 80 bpm; sitting: BP 128/70 mm Hg, HR 80 bpm; standing: BP 130/68 mm Hg, HR 82 bpm c. supine: BP 140/78 mm Hg, HR 72 bpm; sitting: BP 145/78 mm Hg, HR 74 bpm; standing: BP 144/78 mm Hg, HR 74 bpm d. supine: BP 114/82 mm Hg, HR 90 bpm; sitting: BP 110/76 mm Hg, HR 95 bpm; standing: BP 108/74 mm Hg, HR 98 bpm

a. supine: BP 120/70 mm Hg, HR 70 bpm; sitting: BP 100/55 mm Hg, HR 90 bpm; standing: BP 98/52 mm Hg, HR 94 bpm

the nurse is caring for a patient with pedicarditis. where does the nurse understand the inflammation is located? a. the thin fibrous sac encasing the heart b. the inner lining of the heart and valves c. the heart's muscle fibers d. the exterior layer of the heart

a. the thin fibrous sac encasing the heart

A nurse is preparing a client for cardiac catheterization. The nurse knows that she must provide which nursing intervention when the client returns to his room after the procedure? a. Withhold analgesics for at least 6 hours after the procedure. b. Assess the puncture site frequently for hematoma formation or bleeding. c. Inform the client that he may experience numbness or pain in his leg. d. Restrict fluids for 6 hours after the procedure.

b. Assess the puncture site frequently for hematoma formation or bleeding.

During assessment of a 63-year-old retired mechanic, the nurse notes and documents an S3 heart sound. The nurse knows that this sound is an abnormal sound suggestive of: a. Congenital heart disease. b. Heart failure. c. Aortic stenosis. d. Coronary artery disease.

b. Heart failure.

the nurse is administering a beta blocker to a patient in order to decrease automaticity. which medication will the nurse administer? a. Cardizem b. Lopressor c. Cordarone d. Rythmol

b. Lopressor

Your client is going to have a stress test. What radionuclide would most likely be used to diagnose ischemic heart disease during this test? a. Techtonium-89-r b. Thallium-201 c. Technetium-99m d. Transmnium-105

b. Thallium-201

The nurse cares for a client with an intra-arterial blood pressure monitoring device. The nurse recognizes the most preventable complication associated with hemodynamic monitoring includes which condition? a. hemorrhage b. catheter-related bloodstream infections c. air embolism d. pneumothorax

b. catheter-related bloodstream infections

a patient tells the nurse, "i was straining to have a bowel movement and felt like i was going to faint. i took my pulse and it was so slow." what does the nurse understand occurred with this patient? a. the patient may have had a myocardial infarction b. the patient had a vagal response c. the patient was anxious about being constipated d. the patient may have an abdominal aortic aneurysm

b. the patient had a vagal response

the nurse observes a CNA obtaining blood pressure reading with a cuff that is too small for the patient. the nurse informs the CNA that using a cuff that is too small can affect the reading results in what way? a. the results will be falsely decreased b. the results will be falsely elevated c. it will give an accurate reading d. it will be significantly different with each reading

b. the results will be falsely elevated

Your students are studying various laboratory tests, such as blood chemistries, that may be used as part of the diagnostic analysis for a client with a cardiovascular disorder. What do hyperglycemia and hypertriglyceridemia indicate? a. coronary artery disease b. uncontrolled diabetes mellitus c. fluid retention and hypertension d. atherosclerotic heart disease

b. uncontrolled diabetes mellitus

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. "You can take a tub bath or a shower when you get home." b. "Contact your primary care provider if you develop a temperature above 102°F." c. "Do not bend at the waist, strain, or lift heavy objects for the next 24 hours." d. "If any discharge occurs at the puncture site, call 911 immediately."

c. "Do not bend at the waist, strain, or lift heavy objects for the next 24 hours."

Your client is being prepared for echocardiography when they ask you why they need to have this test. What would be your best response? a. "This test will find any congenital heart defects." b. "This test can tell us a lot about your heart." c. "Echocardiography is a way of determining the functioning of the left ventricle of your heart." d. "Echocardiography will tell your doctor if you have cancer of the heart."

c. "Echocardiography is a way of determining the functioning of the left ventricle of your heart."

The health care provider documents that the patient's pulse quality is a +1 on a scale of 0 to 4. The nurse knows that this describes a pulse that is: a. Diminished, but cannot be obliterated. b. Full, easy to palpate, and cannot be obliterated. c. Difficult to palpate and is obliterated with pressure. d. Strong and bounding and may be abnormal.

c. Difficult to palpate and is obliterated with pressure.

Which area of the heart that is located at the third intercostal space to the left of the sternum? a. aortic area b. pulmonic area c. Erb point d. epigastric area

c. Erb point

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. BP changes; 148/80 mmHg to 166/90 mmHg c. ST-segment changes on the ECG d. Heart rate changes; 78 bpm to 112 bpm

c. ST-segment changes on the ECG

a 52 year old female patient is going through menopause and asks the nurse about estrogen replacement for its cardioprotective benefits. what is the best response by the nurse? a. that's a great idea. you don't want to have a heart attack. b. current research determines that the replacement of estrogen will protect a woman after she goes into menopause c. current evidence indicates that estrogen is ineffective as a cardioprotectant. estrogen is actually potentially harmful and is no longer a recommended therapy d. you need to research it and determine what you want to do

c. current evidence indicates that estrogen is ineffective as a cardioprotectant. estrogen is actually potentially harmful and is no longer a recommended therapy.

the nurse is educating a patient at risk for atherosclerosis. what non-modifiable risk factors does the nurse identify for the patient? a. stress b. obesity c. positive family history d. hyperlipidemia

c. positive family history

the nurse is assessing heart sounds in a patient with heart failure. an abnormal heart sound is detected early in diastole. how would the nurse document this? a. s1 b. s2 c. s3 d. s4

c. s3

the patient has a heart rate of 72 bpm with a regular rhythm. where does the nurse determine the impulse arises from? a. AV node b. purkinje fibers c. sinoatrial node d. the ventricles

c. sinoatrial node

Which term describes the amount of blood ejected per heartbeat? a. cardiac output b. ejection fraction c. stroke volume d. afterload

c. stroke volume

The following clients are in need of exercise electrocardiography. Which client would the nurse indicate as most appropriate for a drug-induced stress test? a. A 48-year-old policemen with history of knee replacement 4 years ago b. A 68-year-old housewife with history of osteoporosis c. A 72-year-old retired janitor obtaining a cardiac baseline d. A 55-year-old recovering from a fall and broken femur

d. A 55-year-old recovering from a fall and broken femur

The nurse is conducting a head-to-toe assessment of a patient at the beginning of a shift. The nurse has palpated the patient's radial pulse for 1 minute to determine the patient's heart rate and has detected an irregular rhythm. How should the nurse follow-up this assessment finding? a. Continue to palpate the patient's radial pulse for one more minute in order to gauge the severity of the arrhythmia. b. Palpate the patient's right and left radial pulses simultaneously to compare the symmetry of the patient's rate and rhythm. c. Reposition the patient, wait 3 to 5 minutes and then reassess the patient's radial pulse. d. Auscultate the patient's apical pulse while simultaneously palpating the patient's radial pulse.

d. Auscultate the patient's apical pulse while simultaneously palpating the patient's radial pulse.

A nurse is caring for a client with a central venous pressure (CVP) of 4 mm Hg. Which nursing intervention is appropriate? a. Call the physician and obtain an order for a fluid bolus. b. Rezero the equipment and take another reading. c. Call the physician and obtain an order for a diuretic. d. Continue to monitor the client as ordered.

d. Continue to monitor the client as ordered.

The nurse caring for a client who is suspected of having cardiovascular disease has a stress test ordered. The client has a co-morbidity of multiple sclerosis, so the nurse knows the stress test will be drug-induced. What drug will be used to dilate the coronary arteries? a. Thallium b. Ativan c. Diazepam d. Dobutamine

d. Dobutamine

A nurse working in a cardiac step-down unit understands that the following drugs can affect the contractility of the heart. The nurse recognizes that contractility is depressed by which of the following drugs? a. Lanoxin b. Intropin c. Dubotrex d. Lopressor

d. Lopressor

You are evaluating the expected outcomes on a client who is recovering from a cardiac catheterization. What is an expected outcome that you would evaluate? a. The client and family understands the client's CV diagnosis. b. The client and family understands the need for medication. c. The client and family understands the need to restrict activity for 72 hours. d. The client and family understands the discharge instructions.

d. The client and family understands the discharge instructions.

The instructor is teaching a pre-nursing anatomy and physiology class. The class is studying the cardiovascular system. What does the instructor tell the class safeguards the heart from infectious microorganisms? a. The inner layer of the endocardium b. The outer layer or the epicardium c. The serous epicardium d. The parietal pericardium

d. The parietal pericardium

In caring for a client with vasovagal syncope, the nurse should know that the associated temporary loss of consciousness is most commonly related to: a. vestibular dysfunction b. sudden vascular fluid shifting c. postural hypotension d. bradyrhythmia

d. bradyrhythmia