CH1 Practice Exam 2 Quiz
A nurse cares for a patient who has a heart rate averaging 56 beats/min with no adverse symptoms. Which activity modification would the nurse suggest to avoid further slowing of the heart rate?
"Avoid straining while having a bowel movement."
A nurse teaches a patient who experiences occasional premature atrial contractions (PACs) accompanied by palpitations that resolve spontaneously w/out treatment. Which statement would the nurse include in the patients teaching?
Minimize or abstain from caffeine
A patient has been diagnosed with hypertension but does not take the anti hypertensive meds because a lack of symptoms. What response by nurse is best?
Most people with hypertension do not have symptoms
The nurse is aware that the primary goal for hypertensive therapy is medication compliance. The nurse should be concerned when the client states?
My doctor says I don't have high blood pressure anymore
An older patient with peripheral vascular disease (PVD) is explaining the daily foot care regimen to the family practice clinic nurse. What statement may indicate a barrier to proper foot care?
My hands shake when i try to do things requiring coordination
A nurse obtains the health history of a patient who is newly admitted to the medical unit. Which statement by the patient would alert the nurse to the presence of edema?
My shoes fit tighter by the end of the day
A nurse admits a patient who is experiencing an exacerbation of heart failure. What action would the nurse take first?
Assess the patient's respiratory status.
A nurse cares for a patient who has advanced cardiac disease and states, "I am having trouble sleeping at night."
Use pillows to elevate your head and chest while you are sleeping
A preoperative nurse assesses a patient who has type 1 diabetes mellitus prior to a surgical procedure. The patients blood glucose level is 160 mg/dL. What action would the nurse take?
Document the finding in the patients chart
The normal cardiac output range is ___ to ___.
4 - 6
A nurse is caring for a patient with a DVT. What nursing assessment indicates that a priority outside has been met?
Oxygen saturation of 98%
The client has a heart rate of 80 bpm and a stroke volume of 85 mL/beat. What is the patients cardiac output in L/min?
6.8 CO = SV x HR CO = 80 x .085 = 6.8
A patient has peripheral arterial disease (PAD). What statement by the patient indicates misunderstanding about self-management activities?
"I can use a heating pad on my legs if it's set on low."
What is the mean arterial pressure of a patient with a bp of 141/68?
92 MAP= 141 + (68 x 2) / 3
A nurse cares for a patient who has a family history of diabetes mellitus. The patient states, "my father has type 1 diabetes mellitus. Will I develop this disease as well?" How should the nurse respond?
"Your risk of diabetes is higher than the general population, but it may not occur."
Which of the following blood pressures has a narrowed pulse pressure?
100/66 Narrowed pressure = <40
A nurse prepares to administer prescribed regular and NPH insulin. Place the nurses actions in the correct order to administer these medications.
3, 1, 2, 8, 7, 4, 6, 5
Systolic heart failure results when the heart cannot contract forcefully enough during systole to eject adequate amounts of blood into the circulation. Preload increases with decreased contractility, and after load increases as a result of increased peripheral resistance. The ejection fraction drops from a normal 50%-70% to less than ____% with ventricular dilation.
40
A client has a cardiac output of 3.5 L/min and a stroke volume of 64 mL/beat. What is the patient's heart rate in bpm?
55 CO = SV X HR 3.5 = 64 x X
A nurse assesses patients on a cardiac unit. Which patient would the nurse identify as being at greatest risk for the development of left-sided heart failure?
A 36-year-old woman with aortic stenosis
Which of the following parts of the ECG tracing is a deflection representing atrial depolarization and should have a consistent shape?
A = p wave
A nurse cares for a patient with diabetes mellitus who asks, "why do I need to administer more than one injection of insulin each day?"
A single dose of insulin each day would not match your blood insulin levels and your food intake pattern
Which of the following parts of the ecg tracing represents ventricular repolarization and is usually positive, rounded, and slightly asymmetric?
G
At 4:45 PM, a nurse assesses a patient with diabetes mellitus who is recovering from an abdominal hysterectomy 2 days ago. The nurse notes that the patient is confused and diaphoretic. The nurse reviews the assessment data provided in the chart below: Capillary Blood Glucose Testing (AC/HS) At 06:30—95 At 11:30—70 At 16:30—47 Dietary Intake Breakfast: 10% eaten—patient states that she is not hungry Lunch: 5% eaten—patient is nauseous; vomits once After reviewing the patient's assessment data, which action is appropriate at this time?
Administer dextrose 50% intravenously and reassess the patient
What nonpharmacologic comfort measures should the nurse include in the plan of care for a client with severe varicose veins?
Applying elastic compression stockings Elevating the legs when sitting or lying Reminding the patient to do leg exercises
A nurse assessed a patient who has a history of heart failure. Which questions would the nurse ask to assess the extent of the patients heart failure?
Are you able to walk upstairs w/out fatigue
A nurse is caring for a patient with a non-healing arterial ulcer. The physician has informed the patient about possibly needing to amputate the patient's leg. The patient is crying and upset.
Ask the patient to describe their current emotion Offer to stay w/ the patient if they desire Asses the patient for support systems/family
A patient with a history of heart failure and hypertension is in the clinic for a follow up visit. The patient is on lisinopril and warfarin. The patient reports new-onset cough. What action by the nurse is most appropriate?
Assess the patient's lung sounds and oxygenation
A nurse is caring for a patient with a history of renal insufficiency who is scheduled for a cardiac catheterization. What actions would the nurse take prior to the catheterization?
Assess blood urea nitrogen (bun) and creatinine results Administer intravenous fluids Assess for allergies to iodine
While assessing a patient on the cardiac unit, a nurse identifies the presence of an S3 gallop. What action would the nurse take next?
Assess for symptoms of left-sided heart failure.
A nurse is caring for a patient on IV infusion of heparin. What actions does this nurse include in the patients plan of care?
Assess the patient for bleeding Monitor the daily activated partial thromboplastin time (aPTT) results Use an IV pump for the infusion
The family of a neutropenic patient reports that the patient "is not acting right." What action by the nurse is the priority?
Assess the patient for infection
The nurse is assessing a patient on admission to the hospital. The patient's leg appears as shown below (red, shiny, necrotic big toe)
Assess the patient's ankle-brachial index
A patient has been diagnosed with a DVT and is to be discharged on warfarin. The patient is adamant about refusing the drug b/c, "it's dangerous."
Assess the reason behind the patients fear
A patient who is being treated for iron-deficiency anemia is prescribed ferrous sulfate tablets. The teaching plan for this patient should include which of these instructions?
Avoid taking this med with coffee Be sure to keep your iron pills out of the reach of young children You should take this medication b/w meals on an empty stomach
The nurse supervises an unlicensed assistive personnel (UAP) applying electrocardiographic monitoring. Which statement would the nurse provide to the UAP related to this procedure?
Clean the skin and clip hairs if needed
The nurse is evaluating a 3-day diet history with a patient who has an elevated lipid panel. What meal selection indicates that the patient is managing this condition well with diet?
Baked chicken breast, broccoli, tomatoes
Which of the following is included in the client preparation for a cardiac catheterization?
Client is asked about a history of allergy to iodine-based contrast agents Reviewed all preop labs and tests for abnormalities Client has not had any clear liquids in the last 2 hours or any other food/liquids in the last 6 hours Client is assessed including peripheral pulses, heart and lung sounds, and vitals Client understands the procedure and what to expect
A nurse is caring for a patient with a nonhealing arterial lower leg ulcer. What action by the nurse is best?
Consult with the wound care nurse
On the second postoperative day, the healthcare provider notes the patients hemoglobin has remained steady but the hematocrit has decreased from 48% to 46%. Which intervention is most appropriate?
Continue to monitor the patient
The nurse is caring for a client who is 70 y.o. African American, diabetic, and smokes 1 pack a day. Highest risk for?
Coronary artery disease
A nurse is assessing a patient w/ peripheral artery disease (PAD). The patient states that walking 5 blocks is possible w/out pain. What question asked next by the nurse will give the best info?
Could you walk further than that a few months ago?
A nurse teaches a patient about self-monitoring of blood glucose levels. Which statement would the nurse include in this patients teachings to prevent blood borne infections?
Do not share your monitoring equipment
A nurse teaches patient who is prescribed digoxin therapy. Which statement would the nurse include?
Do not take this med within 1 hr of an antacid
A nurse teaches a patient with diabetes mellitus about foot care. Which statements would the nurse include in this patient's teachings?
Do not walk around barefoot Trim toenails straight across with a nail clipper
During the assessment of a patient suspected of anemia secondary to a nutritional deficiency, which question is important for the healthcare provider to ask the patient?
Do you ever experience numbness or tingling in your extremities?
A nurse cares for a patient with congestive heart failure who has a regular cardiac rhythm of 128 beats/min. For which physiological alterations would the nurse assess?
Decrease in cardiac output Decrease in urine output Decrease in blood pressure
A client who is status post total knee anthroplasty (TKA) is complaining of a sudden onset of pain, swelling, warmth, tenderness, and redness in the left leg and the physician has ordered a contrast venography. The nurse is aware that the client is at risk for?
Deep vein thrombosis
A client with heart failure presents with the following on the monitor and is complaining of abdominal pain, nausea, vomiting, and blurred, yellow vision. Which of the following medications can be a cause for this presentation?
Digoxin
The nurse is aware that which of the following can cause symptoms of left ventricular heart failure and a third heart sound (s3)?
Dilated cardiomyopathy
A nurse teaches a patient with a new permanent pacemaker. Which instructions would the nurse include in this patients teaching?
Do not lift your left arm above the level of your shoulder for 8 weeks Report any pulse rates lower than your pacemaker settings Until your incision is healed, do not submerge your pacemaker. Only take showers.
The healthcare provider is reviewing a patients laboratory results and notes the hemoglobin is 9 g/dL and the hematocrit is 28%. Which of the following orders will the healthcare provider expect to implement first?
Draw blood for red blood cell indices
A nurse assesses a patient who has a 15-year history of diabetes and notes decreased tactile sensation in both feet. What action would the nurse take first?
Examine the patients feet for signs of injury
The nurse is assessing a client and notices the following in the monitor (atrial flutter). The nurse is aware that this client should be treated with meds or cardioversion when the client is?
Experiencing a BP of 62/40 Complaining of dizziness Experiencing a potassium level of 2.9
A nurse prepares a patient for a pharmacological stress echocardiogram. What actions would the nurse take when preparing this patient for the procedure?
Explain to the patient that dobutamine will stimulate exercise for this examination Give the patient nothing by mouth 3 to 6 hours before the procedure Prepare for continuous blood pressure and pulse monitoring
The nurse is assessing a client and notices the following on the monitor. The client is not complaining of weakness and nausea. The nurse is aware that this client is experiencing?
Failure to capture (pacemaker not followed by qrs capture)
A patient is being discharged on warfarin therapy. What discharge instructions is the nurse required to provide?
Follow up laboratory monitoring Possible drug-drug interactions Reason to take medication Dietary restrictions
The 22-year-old diabetic client presents as pale, confused, and dizzy. The nurse is most concerned when the clients family member states?
He was having such a good time and only had 2 shots with us at the bar
The nurse is listening to a client's heart sounds and hears an S4 atrial gallop. The nurse is aware that this occurs as blood enters the ventricles during the active filling phase at the end of ventricular diastole. The nurse suspects the client has a history of?
Hypertension or stiffened ventricle
After teaching a patient who has diabetes mellitus and proliferative retinopathy, nephropathy, and peripheral neuropathy, the nurse assesses the patients understanding. Which statement indicates correct understanding?
I should look into swimming or water aerobics to get my exercise
After teaching a patient who has an implantable cardioverter-defibrillator (ICD), a nurse assesses the patients understanding. Which statements by the patient indicates a correct understanding of the teaching?
I will avoid sources of strong electromagnetic fields
A nurse teaches a patient with diabetes mellitus who is experiencing numbness and reduced sensation. Which statement would the nurse include in this patients teaching to prevent injury?
Use a bath thermometer to test the water temperature
After teaching a patient with congestive heart failure the nurse assess the patient's understanding. Which patient statements indicate a correct understanding of the teaching related to nutritional intake?
I'll read the nutritional labels on food items for salt content Substituting fresh vegetables for canned ones will lower my salt intake I will eat oatmeal for breakfast instead of game and eggs
The healthcare provider is reviewing the medical record of a patient who reports increasing fatigue and shortness of breath when taking walks. A series of fecal occult blood tests are noted to be positive. Further testing of the patients blood is likely to reveal which of these red blood cell characteristics?
Microcytic, hypochromic
A nurse assesses a patient with diabetes mellitus who self-administers subcutaneous insulin. The nurse notes a spongy, sweeping area at the site the patient uses most frequently for insulin injection.
Instruct the patient to rotate sites for insulin injection
The nurse is assessing a client with Somogyi phenomenon. The nurse is aware that this?
Is morning hyperglycemia from the counterregulatory response to night time hypoglycemia
A nurse assesses a patient who has aortic regurgitation. In which location shown below would the nurse auscultate to best hear a cardiac murmur related to aortic regurgitation?
Location C
Which statement by the patient indicate good understanding of foot care in peripheral vascular disease?
Lotion is important to keep my feet smooth and soft I will keep my feet dry, especially b/w the toes Washing my feet in room-temp water is best
A nurse assesses patients at a health fair. Which patients would the nurse counsel to be tested for diabetes?
Male with a bmi >25 kg/m2 48-year-old woman w/ sedentary lifestyle 56-year-old African-American male 28-year-old female who gave birth to a baby weighing 9.2 ibs (4.2 kg)
The client has a blood pressure of 118/84. The nurse is aware that the pulse pressure for this client
May result from decreased stroke volume in clients with heart faikure
A nurse is assessing an obese patient in the clinic for a follow up after an episode of deep-vein thrombosis. The patient has lost 20 ibs since the last visit. What action by the nurse is best?
Measure for new compression stockings
A nurse reviews the medication list of a patient recovering from a computed tomography (CT) scan with IV contrast to rule out small bowel obstruction. Which medication would alert the nurse to contact the provider and withhold the prescribed dose?
Metformin (glucophage)
The nurse states, "this should be applied to a non-hairy, non-fatty area of your body no longer than 12-14 hours a day. You need to rotate sites, so you don't hurt your skin and a headache is expected when you are taking this."
Nitroglycerin Patch
A nurse is teaching a larger female patient about alcohol intake and how it affects hypertension. The patient asks if drinking two beers at night is an acceptable intake.
No women should only have one beer a day as a general rule
A patient is taking warfarin and asks the nurse if taking St. John's wort is acceptable. What response by the nurse is best?
No, it may interfere with the warfarin
A nurse cares for a patient who is prescribed magnetic resonance imaging (MRI) of the heart. The patients health history includes a previous heart attack and pacemaker implantation.
Notify the healthcare provider before scheduling an MRI
A student nurse is assessing the peripheral vascular system of an older adult. What action by the student would cause the faculty member to intervene?
Palpating both carotid arteries at the same time
A nurse wants to provide community service that helps meet the goals of Healthy People 2020 (HP2020) related to cardiovascular disease and stroke. What activity would best meet this goal?
Participate in blood pressure screenings at the mall
A patient has a serum ferritin level of 8 ng/mL (18 pmol/L) and microcytic red blood cells. What action by the nurse is best?
Perform a Hemoccult test on the patient's stools
The nurse is educating a client newly diagnosed with heart failure. Which foods should be avoided in a sodium restricted diet?
Salad dressings, vegetable oils, and ketchup Cold cuts, cured meats, and frozen meals Bacon, frankfurters, and sausages Mashed potatoes, and white potato mixtures
A nurse cares for a patient with atrial fibrillation who reports fatigue when completing activities of daily living. What interventions would the nurse implement to address this patient's concerns?
Schedule periods of exercise and rest during the day
A nurse reviews laboratory results for a patient with polyuria, lethargy, and blood glucose of 560 mg/dL (31.1 mmol/L). Which laboratory result would the nurse correlate with the patients polyuria?
Serum osmolarity: 375 mOsm/kg (375 mmol/kg)
A nurse evaluates laboratory results for a patient with heart failure. Which results would the nurse expect?
Serum sodium: 130 mEq/L (130 mmol/L) Hematocrit: 32.8% Microalbuminuria Proteinuria
After teaching a patient with type 2 diabetes mellitus, the nurse assesses the patients understanding. Which statement made by the patient indicates a need for additional teaching?
Since my diabetes is controlled with diet and exercise, I must be seen only if I am sick.
A nurse assesses a patient who is recovering after a left-sided cardiac catheterization. Which assessment finding requires immediate intervention?
Slurred speech and confusion
A nurse assesses a patient with atrial fibrillation. Which manifestations would alert the nurse to the possibility of a serious complication from this condition?
Speech alterations
The healthcare provider is admitting a patient with a diagnosis of iron-deficiency anemia. The patients skin and conjunctiva are pale, the tongue is smooth and red, and there are sores on the corners of the mouth. Which additional assessment findings are related?
Spoon-shaped nails
A nursing student learns about modifiable risk factors for coronary artery disease. Which factors does this include?
Stress Obesity Smoking Hypertension
The nurse is caring for a client who has a decreased arterial oxygen supply and a demand for more oxygen. The client is complaining of shortness of breath.
Tachycardia
A nurse prepares a patient for coronary artery catheterization surgery. The patient states, "I am afraid I might die." What is the nurses best response?
Tell me more about your concerns about the test
When teaching a patient recently diagnosed with type 1 diabetes mellitus, the patient states, "I will never be able to stick myself with a needle." How would the nurse respond?
Tell me what it is about the injections that are concerning you?
A patient with coronary artery disease (CAD) asks the nurse about taking fish oil supplements. What response by the nurse is best?
The best source is fish, but pills have benefits too
After teaching a patient with diabetes mellitus to inject insulin, the nurse assesses the patients understanding. Which statement made by the patient indicates a need for additional teaching?
The lower abdomen is the best location because it is closest to the pancreas.
A patient presents to the clinic reporting increasing fatigue, shortness of breath, and tachycardia. A laboratory workup reveals microcytic-hypochromic anemia.
The oxygen carrying capacity of each red blood cell is reduced
A patient is receiving ferrous sulfate to treat iron deficiency anemia. When reviewing the laboratory report, the healthcare provider notes the patients reticulocyte count has increased. How should the healthcare provider interpret these findings?
The patient is beginning to recover from the anemia
A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication should the nurse expect to find on this client's medication administration record to prevent a common complication of this condition?
Warfarin
A nurse teaches a patient who has a history of heart failure. Which statement would the nurse include in this patients discharge teaching?
Weigh yourself daily while wearing the same amount of clothing
During an admission interview with a patient who has iron-deficiency anemia, which question should the healthcare provider ask in order to assess the degree of functional impairment experienced by the patient?
What activities are difficult for you to do now that were easier 6 months ago?
A nurse teaches a patient with diabetes mellitus and a body mass index of 42 who is at high risk for coronary artery disease. Which statements related to nutrition would the nurse include in this patients teaching?
You should balance weight loss with consuming necessary nutrients
A nurse is teaching a patient with diabetes mellitus who asks, "why is it necessary to maintain my blood glucose levels no lower than about 60 mg/dL (3.3 mmol/L)?" How would the nurse respond?
Your brain needs a constant supply of glucose because it cannot store it
