CV Practice Q's

The client complains of SOB when walking.

A client is being seen in the clinic to rule out (R/O) mitral valve stenosis. Which assessment data would be most significant?

Instruct the client to see his health-care provider as soon as possible

The 66 yo M client has his BP checked at a health fair. The BP is 168/98. Which action should the nurse implement first?

Teach the client how to prevent orthostatic hypotension

The HCP has ordered an ACE inhibitor for the client diagnosed with CHF. Which discharge instructions should the nurse include?

Inform the client that fluids will be increased after the procedure.

The HCP ordered a femoral angiogram for the client diagnosed with arterial occlusive disease. Which intervention should the nurse implement?

This medication should be taken in the evening.

The HCP prescribes HMG-CoA reductase inhibitor (statin) med to a client with CAD. Which should the nurse teach the client about this med?

Change position slowly when going from a lying to sitting position.

The M client diagnosed with essential HTN has been prescribed an alpha-adrenergic blocker. Which intervention should the nurse discuss with the client?

"If my chest pain is not gone with one tablet, I will will go the ER."

The M client is diagnosed with CAD and is prescribed SL nitroglycerin. Which statement indicates the client needs more teaching?

They help to prevent DVTs by movement of the blood through the veins.

The M client is diagnosed with Guillain-Barre (GB) syndrome and is the ICU on a ventilator. Which CV rationale explains implementing passive ROM exercises?

Removing compression stockings before assisting the client to bed.

The UAP is caring for the client diagnosed with chronic venous insufficiency. Which action would warrant immediate intervention from the nurse?

The 75 y/o client scheduled for a cardiac catherization.

The charge nurse is making assignments for clients on a cardiac unit. Which client should the charge nurse assign to a new graduate nurse?

The client with an apical pulse rate of 116, a resp rate of 26, and a BP of 94/62

The charge nurse is making shift assignments for the medical floor. Which client should be assigned to the most experienced RN?

"You have a hardening of your arteries that decreases the oxygen to your legs."

The client asks the nurse, "My doctor just told me that atherosclerosis is why my legs hurt when I walk. What does that mean?" Which response by the nurse would be the best response?

Monitor the client's potassium level and assess the client's intake of bananas and orange juice.

The client diagnosed with CHF is complaining of leg cramps at night. Which nursing interventions should be implemented?

Check the PTT and PR/INR

The client diagnosed with a DVT is on a heparin drip at 1400 units/hr, and Coumadin 5mg daily. Which intervention should the nurse implement first?

-Instruct the client to stay in bed and not ambulate -Encourage fluids and a diet high in roughage -Monitor IV site every 4 hrs and PRN

The client diagnosed with a DVT is placed on a medical unit. Which nursing interventions should be implemented? Select all that apply.

Assess the client's leg dressing every 4 hours.

The client diagnosed with arterial occlusive disease is 1 day postop right femoral-popliteal bypass. Which intervention should the nurse implement?

"Damage can be occurring to your heart and kidneys even if you feel great."

The client diagnosed with essential HTN asks the nurse, "I don't know why the doctor is worried about my blood pressure. I feel just great." Which statement by the nurse would be the most appropriate response?

"There is no specific cause for HTN, but there are many known risk factors."

The client diagnosed with essential HTN asks the nurse, "Why do I have high BP?" Which response by the nurse would be most appropriate?

The client has a weight gain of 2 kg within 1 to 2 days.

The client diagnosed with essential HTN is taking a loop diuretic daily. Which assessment data would require immediate intervention by the nurse?

Assess the client for cardiac complications

The client diagnosed with pericarditis is complaining of increased pain. Which intervention should the nurse implement first?

Smoking cigarettes.

The client diagnosed with peripheral vascular disease is overweight, has smoked 2 packs of cigarettes a day for 20 yrs, and sits behind a desk all day. What is the strongest factor in the development of atherosclerotic lesions?

"Did you have rheumatic fever as a child?"

The client is admitted to the medical unit to rule out carditis. Which question should the nurse ask the client during the admission interview to support this diagnosis?

Apical pulse rate of 110 and 4+ pitting edema of feet

The client is admitted to the telemetry unit diagnosed with acute exacerbation of CHF. Which signs/symptoms would the nurse expect to find when assessing this client?

Inform the client to limit fat intake and which foods have a higher fat content.

The client is at risk for a MI due to decreased tissue perfusion as a result of atherosclerosis. Which instructions can the nurse provide the client to reduce the risk?

International normalized ratio (INR)

The client is being admitted with Coumadin toxicity. Which lab data should the nurse monitor?

Muffled heart sounds.

The client is diagnosed with acute pericarditis. Which sign/symptom warrant immediate attention by the nurse?

Increased chest pain with inspiration.

The client is diagnosed with pericarditis. Which are the most common signs/symptoms the nurse would expect to find when assessing the client?

Wear graduated compression hose.

The client is employed in a job that requires extensive standing. Which intervention should the nurse include when discussing how to prevent varicose veins?

Assess the client's neurovascular status.

The client is scheduled for a right femoral cardiac catherization. Which nursing intervention should the nurse implement after the procedure?

Stay with the client and call the Rapid Response Team (RRT)

The client on the telemetry unit diagnosed with a thromboembolism is complaining of chest pain and anxiety. Which action should the nurse implement first?

Assess the client for ecchymotic areas and bleeding.

The client prescribed rivaroxaban (Xarelto), an anticoagulant, is complaining of dark, tarry stool. Which should the nurse implement first?

The nurse should measure the calf and palpate the calf for warmth.

The client presents to the outpatient clinic complaining of calf pain. The client reports returning from an airplane trip the previous day. Which should the nurse assess first?

Explain this results from the medication.

The client receiving low molecular weight heparin (LMWH) subcutaneously to prevent DVT following hip replacement surgery complains to the nurse that there are small purple hemorrhagic areas on the upper abdomen. Which action should the nurse implement?

Explain that the client needs to lower the cholesterol level.

The client tells the nurse that his cholesterol level is 240 mg/dL. Which action should the nurse implement?

"Chest pain is caused by decreased oxygen to the heart muscle."

The client with CAD asks the nurse, "Why do I get chest pain?" Which statement would be the most appropriate response by the nurse?

Instruct the client to keep a diary of activity, especially when having chest pain.

The client with CAD is prescribed a Holter monitor. Which intervention should the nurse implement?

Instruct the client to take the medication with food.

The client with pericarditis is prescribed a NSAID. Which teaching instruction should the nurse discuss with the client?

"You have incompetent valves in your legs."

The client with varicose veins asks the nurse, "What caused me to have these?" Which statement by the nurse would be most appropriate?

"Are you sexually active?"

The elderly client has CAD. Which question should the nurse ask the client during the client teaching?

ACE inhibitors prevent vasoconstriction and sodium and water retention.

The health-care provider prescribes an ACE inhibitor for the client diagnosed with essential HTN. Which statement is the most appropriate rationale for administering this med?

The client takes vitamin E OTC medication.

The home health nurse is admitting a client diagnosed with a DVT. Which action by the client warrants immediate intervention by the nurse?

The UAP begins to massage and rub lotion into the client's calf.

The nurse and an UAP are bathing a bedfast client. Which action by the UAP warrants immediate intervention?

Help position the client who is having a portable x-ray done.

The nurse and an UAP are caring for 4 clients on a telemetry unit. Which nursing task would be best for the nurse to delegate to the UAP?

Elevate the foot of the client's bed.

The nurse and an UAP are caring for a 64 yo client who is 4 hours postop bilateral-femoral-popliteal bypass surgery. Which nursing task should be delegated to the UAP?

Assist the client to a sitting position.

The nurse enters the room of the client diagnosed with CHF. The client is lying in bed gasping for breath, is cool and clammy, and has buccal cyanosis. Which intervention would the nurse implement first?

The client with arterial occlusive disease who cannot move the foot.

The nurse has just received the AM shift report. Which client would the nurse assess first?

Swelling in the calf, warmth, and tenderness.

The nurse identifies the concept of clotting for a client diagnosed with a deep vein thrombosis. Which clinical manifestation support the diagnosis?

The client has a brownish purple area on the lower legs.

The nurse is admitting a client diagnosed with peripheral vascular disease. Which data support a diagnosis of venous insufficiency?

An elevated B-type natriuretic peptide (BNP)

The nurse is assessing the client diagnosed with CHF. Which lab data would indicate that the client is in severe CHF?

The client is able to preform ADLs without dyspnea.

The nurse is assessing the client diagnosed with CHF. Which signs/symptoms would indicate that the medical tx has been effective?

Hairless skin of the legs.

The nurse is assessing the client diagnosed with long-term arterial occlusive disease. Which assessment data support the diagnosis?

The UAP informed the nurse the client is complaining of chest pain.

The nurse is caring for a client diagnosed with deep vein thrombosis. Which info reported to the nurse by the UAP requires immediate intervention?

-The client complains of chest pain on inspiration and has become restless -The client's platelet count on admission was 420(10^3) and now is 200 (10^3) -The client has developed skin lesions at the IV site

The nurse is caring for a client who is receiving heparin therapy IV. Which assessment data would indicate to the nurse the client is developing heparin-induced thrombocytopenia (HIT)? Select all that apply.

Explain the need to rise slowly from a lying or sitting position.

The nurse is caring for a male client diagnosed with essential HTN. Which info regarding antihypertensive meds should the nurse teach?

Assist feeding the client diagnosed with CHF.

The nurse is caring for clients of a telemetry floor. Which nursing task would be most appropriate to delegate to a UAP?

The client who is 4 days postop abdominal surgery and is complaining of L calf pain when ambulating.

The nurse is caring for clients on a surgical floor. Which client should be assessed first?

-Assess for paresthesia -Assess for pedal pulses -Assess for paralysis -Assess for pallor -Assess for polar (temp)

The nurse is completing a neurovascular assessment on the client with chronic venous insufficiency. What should be included in this assessment? Select all that apply.

-Tell the client to make sure the cuff is placed over the artery -Teach the client to notify HCP is BP is >160/100 -Instruct the client about orthostatic hypotension -Encourage the client to keep a record of the blood pressure readings -Explain that even when the blood pressure is within normal limits the medication should still be taken

The nurse is demonstrating the use of BP sphygmomanometer to a client newly diagnosed with HTN. Which should the nurse teach the client? Select all that apply.

-Teach the client how to count the radial pulse when taking digoxin, a cardiac glycoside -Instruct the client to remove the saltshaker from the dinner table.

The nurse is developing a discharge-teaching plan for the client diagnosed with CHF. Which interventions should be included in the plan? Select all that apply.

The client will have an audible S1 and S2 with no S3 heard by end of shift.

The nurse is developing a nursing care plan for a client diagnosed with CHF. A nursing diagnosis of "decreased cardiac output related to inability of the heart to pump effectively" is written. Which short-term goal would be best for the client?

Avoid green, leafy vegetables and notify the HCP or red or brown urine.

The nurse is discharging a client diagnosed with DVT from the hospital. Which discharge instructions should be provided to the client?

Stop the activity immediately and rest.

The nurse is discussing angina with a client who is diagnosed with CAD. Which action should the client take first when experiencing angina?

Do not walk outside if it is less than 40 degrees F

The nurse is discussing the importance of exercise with the client diagnosed with CAD. Which intervention should the nurse implement?

Exercise promotes the development of collateral circulation.

The nurse is discussing the importance of exercising with a client who is diagnosed with coronary artery disease. Which statement best describes the scientific rationale for encouraging 30 min of walking daily to help prevent complications of atherosclerosis?

A normal HDL is good because it has a protective action in the body.

The nurse is discussing the pathophysiology of atherosclerosis with a client who has a normal HDL level. Which info should the nurse discuss with the client concerning HDLs?

Teach the client to walk in well-fitting shoes on level ground.

The nurse is planning care for a client diagnosed with arterial occlusive disease. Which exercise instructions would the nurse teach the client?

The client has an apical pulse of 56.

The nurse is preparing to administer a beta blocker to the client diagnosed with CAD. Which ax data would cause the nurse to question administering the medication?

Diabetes speeds the atherosclerosis process by thickening the basement membrane of both large and small vessels.

The nurse is teaching a class of atherosclerosis. Which statement describes the scientific rationale as to why diabetes is a risk factor for developing artherosclerosis?

Discuss sedentary lifestyle and smoking cessation.

The nurse is teaching a class on arterial essential HTN. Which modifiable risk factors would the nurse include when preparing this presentation?

Stress.

The nurse is teaching a class on coronary artery disease. Which modifiable risk factor should the nurse discuss when teaching about artherosclerosis?

Take the medication even when feeling better.

The nurse is teaching a class to clients diagnosed with HTN. Which should the nurse teach the clients?

-Wash legs and feet daily in warm water. -Apply moisturizing cream to feet. -Do not wear any type of knee stocking. -Wear clean white cotton socks.

The nurse is teaching the client diagnosed with arterial occlusive disease. Which interventions should the nurse include in the teaching? Select all that apply.

-Keep a constant amount of green, leafy vegetables in the diet. -Inform the client to notify HCP if having dark, tarry stools.

The nurse is teaching the client diagnosed with deep vein thrombosis and prescribed warfarin. Which should the nurse teach the client? Select all that apply.

Walk at least 30 min a day of flat surfaces.

The nurse is teaching the client recently diagnosed with essential HTN. Which instruction should the nurse provide when discussing heart healthy exercise?

Complete the neurovascular assessment.

The nurse is unable to assess the pedal pulse in client diagnosed with arterial occlusive disease. Which intervention should the nurse implement first?

The client diagnosed with DVT who is complaining of chest pain.

The nurse just received the AM shift report. Which client should the nurse assess first?

Baked chicken, baked potato, and skim milk.

The nurse knows the client understands the teaching concerning a low-fat, low-cholesterol diet when the client selects which meal?

The client diagnosed with MI who has an audible S3 heart sound.

The nurse on the telemetry unit has just received the AM shift report. Which client should the nurse assess first?

"His legs are deprived of oxygen during periods of inactivity."

The wife of a client with arterial occlusive disease tells the nurse, "My husband says he is having rest pain. What does that mean?" Which statement by the nurse would be most appropriate?

Flex the leg muscles and change the leg positions frequently.

Which actions should the surgical scrub nurse take to prevent personally developing a DVT?

Clopidogrel

Which arterial anticoagulant medication would the nurse anticipate being prescribed for a client diagnosed with arterial occlusive disease?

-Intermittent claudication. -Venous stasis ulcers.

Which assessment data would cause the nurse to suspect the client has atherosclerosis?

A superficial pink open area on the medial part of the ankle.

Which assessment data would support that the client has a venous stasis ulcer?

Brown discolored skin.

Which assessment data would the nurse expect to find in the client diagnosed with chronic venous insufficiency?

The client diagnosed with DVT who complains of pain on inspiration.

Which assessment data would warrant immediate intervention by the nurse?

The client has numbness and tingling.

Which assessment data would warrant immediate intervention in the client diagnosed with arterial occlusive disease?

Impaired skin integrity.

Which client problem would be priority in a client diagnosed with arterial occlusive disease who is admitted to the hospital with a foot ulcer?

-Encourage a low-fat, low-cholesterol diet. -Instruct the client to walk 30 minute a day -Refer to a counselor for stress reduction techniques -Teach the client to increase fiber in the diet

Which client teaching should the nurse implement for the client diagnosed with CAD? Select all that apply.

A Caucasian F who is a nurse.

Which client would be most at risk for developing varicose veins?

Bleeding from any site.

Which complication of anticoagulant therapy should the nurse teach the client to report to the HCP?

Instruct the client to walk daily for at least 30 min.

Which instruction should the nurse include when providing discharge instructions to a client diagnosed with peripheral arterial disease?

Assess the client's serum potassium level

Which intervention should the nurse implement when administering a loop diuretic to a client diagnosed with CAD?

-Include the significant other in the discussion. -Stop smoking or using any type of tobacco products.

Which interventions should the nurse discuss with the client diagnosed with atherosclerosis? Select all that apply.

An antiplatelet medication.

Which medication should the nurse expect the HCP to order for a client diagnosed with arterial occlusive disease?

-Elevate the legs while sitting -Wear antiembolism compression stockings -Avoid injury to lower limbs -Trim the toenails straight across

Which should the nurse include in the plan of care for a client diagnosed with venous stasis ulcers? Select all that apply.

"I should bake or grill any meats I eat."

Which statement by the client diagnosed with CAD indicates that the client understands the discharge teaching concerning diet?