Exam 4 Cardiac Review

The wall of each chamber is composed of cardiac muscle tissue usually referred to as the a.Pericardium b.Endocardium c. Epicardium d. Myocardium

d. Myocardium

The normal cardiac impulse that initiates mechanical contraction of the heart arises in the a. AV node b. AV bundle c. Purkinje fibers d. SA node

d. SA node

A graphic record of the heart's electrical activity is a(n) a. ECG b. EEG c. CAT scan d. MRI

a. ECG

A nurse is assisting in caring for a client in the telemetry unit who is receiving an intravenous infusion of 1000 mL 5% dextrose with 40 mEq of potassium chloride. Which occurrence observed on the cardiac monitor indicates the presence of hyperkalemia? a. Tall, peaked T waves b. ST segment depression c. Shortened PR intervals d. Shortening of the QRS complex

a. Tall, peaked T waves

A nurse is assigned to assist with caring for a client after cardiac catheterization. The nurse plans to maintain bedrest with: a. High fowler's position b. Bathroom priveleges only c. Head elevation of 45 degrees d. Head elevation of no more than 30 degrees

d. Head elevation of no more than 30 degrees

A nurse is told during shift report that a client is having occasional ventricular dysrhythmias. The nurse reviews the client's laboratory results, recalling that which electrolyte imbalance could be responsible for this development? a. Hypernatremia b. Hypochloremia c. Hypercalcemia d. Hypokalemia

d. Hypokalemia

The aorta carries blood out of which chamber? a. Right atrium b. Right ventricle c. Left atrium d. Left ventricle

d. Left ventricle

The heart has its own special covering, a lining of two layers of fibrous tissue called the a. Pericardium b. Endocardium c. Myocardium d. Exocardium

a. Pericardium

Blood pressure is measured with the aid of an apparatus known as a(n) a. Stethoscope b. Sphygmomanometer c. EKG d. MRI

b. Sphygmomanometer

Semilunar valves can be found in which blood vessel? a. Artery b. Vein c. Venule d. Arteriole

b. Vein

For a client diagnosed with pulmonary edema, the nurse establishes a goal to have the client participate in activities what reduce cardiac workload. Which of the following client activities will contribute to achieving this goal? a. Elevating the legs when in bed b. Sleeping in the supine position c. Seasoning beef with a meat tenderizer d. Using a bedside commode for stools

d. Using a bedside commode for stools

A nurse has reinforced home care instructions to a client who had a permanent pacemaker inserted. Which educational outcome has the greatest impact on the client's long-term cardiac health? a. Ability to take an accurate pulse in either the wrist or neck b. An understanding of the importance of proper microwave oven usage c. Being aware of when it is safe to resume their normal level of sexual activity d. An understanding of why vigorous arm and shoulder movement must be avoided initially

a. Ability to take an accurate pulse in either the wrist or neck

A licensed practical nurse (LPN) is assisting in caring for a client with a diagnosis of myocardial infarction (MI). The client is experiencing chest pain that is unrelieved by the administration of nitroglycerin. The registered nurse administers morphine sulfate to the client as prescribed by the health care provider. Following administration of the morphine sulfate, the LPN plans to monitor: a. Mental status b. Urinary output c. Respirations and blood pressure d. Temperature and blood pressure

c. respirations and blood pressure

A client is scheduled for a cardiac catheterization using a radiopaque dye. The nurse checks which most critical item before the procedure? a. Intake and output b. Height and weight c. Peripheral pulse rates d. Allergy to iodine or shellfish

d. Allergy to iodine or shellfish

A nurse is caring for a client who has been admitted to the hospital with a diagnoses of angine pectoris. The client is receiving oxygen via nasal cannula at 2 L/min. The client asks the nurse why the oxygen is necessary. The nurse bases the response on which of the following? a. Oxygen assists in calming the patient b. Oxygen prevents the development of any thrombus formation c. Oxygen dilates the blood vessels, supplying more nutrients to the heart muscle d. Deficient oxygen supply to the heart cells results in angina pectoris pain

d. Deficient oxygen supply to the heart cells results in angina pectoris pain

The normal ECG is composed of the following except a. P wave b. QRS Complex c. T wave d. E wave

d. E wave

A type of abnormal heart sound that may signify incomplete closing of the valves is a. A myocardial infarction b. Bradycardia c. A heart murmur d. Tachycardia

c. A heart murmur

A client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin grain 1/150 sublingually. Five minutes later, the client is still experiencing chest pain. If the blood pressure is still stable, the nurse should take with action next? a. Administer another nitroglycerin tablet b. Call for a 12 lead electrocardiogram (ECG) to be performed c. Wait for an additional 5 minutes, then give a second nitroglycerin tablet d. Apply 10 L of oxygen via nasal cannula

a. Administer another nitroglycerin tablet

A nurse is assisting in preparing a client for a cardiac catheterization. The nurse understands that it is important to check the client for a history of: a. Allergy to shellfish b. Hypertension c. Atrial fibrillation d. Cigarette smoking

a. Allergy to shellfish

A client with heart failure is scheduled to be discharged to home with digoxin (Lanoxin) and furosemide (Lasix) as ongoing prescribed medications. The nurse teaches the client to report which sign that indicates that the medications are not having the intended effect? a. Decrease in pedal edema b. High urine output during the day c. Weight gain of 2 to 3 pounds in a few days d. Cough accompanied by other signs of respiratory infection

c. Weight gain of 2 to 3 pounds in a few days

A client has just returned from the cardiac catheterization laboratory. The left femoral vessel was used as the access site. After returning the client to bed and conducting an initial assessment, the nurse assisting in caring for the client expects that the health care provider wrote a prescription for the client to remain on bedrest: a. In the high-fowlers position b. With the head of bed elevated at least 60 degrees c. With the head of bed elevated no more than 30 degrees d. With the foot of bed elevated as much as tolerated by the client

c. With the head of bed elevated no more than 30 degrees

The outer layer of the pericardium is called the a. Visceral pericardium b. Epicardium c. Parietal pericardium d. Endocardium

c. Parietal pericardium

A hospitalized client with a history of angina pectoris is ambulating in the corridor. The client suddenly complains of severe substernal chest pain. The nurse should take which action first? a. Administer sublingual nitroglycerin b. Assist the client to sit or lie down c. Apply nasal oxygen at a rate of 2 L/min d. Check the client's vital signs

b. Assist the client to sit or lie down

A nurse is caring for a client with coronary artery disease and a topical nitrate is prescribed for the client. The nurse provides medication instructions and tells the client that acetaminophen (Tylenol) is usually prescribed to be taken before the administration of the topical nitrate because: a. Headache is a common side effect of nitrates b. Fever usually accompanies coronary artery disease c. Acetaminophen potentiates the therapeutic effects of nitrates d. Acetaminophen does not interfere with platelet action as acetylsalicylic acid (Aspirin) does

a. Headache is a common side effect of nitrates

The condition in which the number of red blood cells increases beyond normal and thus increases blood viscosity is called a. Polycythemia b. Anemia c. Hemorrhage d. Hemophilia

a. Polycythemia

A nurse notes bilateral 2+ edema in the lower extremities of a client with known coronary artery disease who was admitted to the hospital 2 days ago. Based on this finding, the nurse implements which action? a. Reviews the intake and output records for the last 2 days b. Changes the time of diuretic administration from morning to evening c. Requests a sodium restriction of 1 gram per day from the healthcare provider d. Prescribes daily weights starting on the following morning

a. Reviews the intake and output records for the last 2 days

The four structures that compose the conduction system of the heart are the a. SA node, AV node, AV bundle, and Purkinje fibers b. SA node, AV node, AV bundle and chordae tendinae c. AV node, AV bundle, Purkinje fibers, and chordae tendinae d. SA node, AV node, AV bundle, and papillary muscles

a. SA node, AV node, AV bundle, and Purkinje fibers

Which blood vessels return venous blood to the right atrium? a. Superior and inferior vena cava b. Pulmonary arteries c. Pulmonary veins d. Hepatic veins

a. Superior and inferior vena cava

The client's B-type natriuretic peptide (BNP) level is 691 pg/mL. Which of the following should the nurse institute when providing care for the client? a. Take daily weights and monitor trends b. Encourage fluids to improve hydration c. Elevate the legs above the level of the heart d. Position supine with the head of the bed at 30 degrees

a. Take daily weights and monitor trends

Microscopic vessels that carry blood from small arteries to small veins are a. Arterioles b. Venules c. Capillaries d. Sinusoids

c. Capillaries

A client 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 first: a. Call a code blue b. Call the healthcare provider c. Check the client status and lead placement d. Press the recorder button on the ECG console

c. Check the client status and lead placement

A client has experienced an episode of pulmonary edema. The nurse determines that the client's respiratory status is improving if which of the following breath sounds are noted? a. Rhonchi b. Wheezes c. Crackles in the lung bases d. Crackles throughout the lung fields

c. Crackles in the lung bases

A client with a diagnosis of myocardial infarction has a new activity prescription allowing the client to have bathroom privileges. As the client stands and begins to walk, the client begins to complain of chest pain. The nurse should initially take which action? a. Assist the client back into bed b. Report the chest pain episode to the health care provider c. Tell the client to stand still and take the client's blood pressure d. Give a nitroglycerin (Nitrostat) tablet and assist the client to the bathroom

a. Assist the client back into bed

A client has a history of left-sided heart failure. The nurse would look for the presence of which of the following to determine whether the problem is currently active? a. Bilateral lung crackles b. Pedal edema bilaterally c. Jugular vein distention d. Presence of ascites

a. Bilateral lung crackles

A client is scheduled for a dipyridamole (Persantine) thallium scan. The nurse would check to make sure that the client has not had which of the following before the procedure? a. Caffeine b. Fatty meal c. Excess sugar d. Milk products

a. Caffeine

What is the term used to describe the severe chest pain that occurs when the myocardium is deprived of oxygen? a. Infarction b. Angina c. Embolism d. Stroke

b. Angina

A client with known coronary artery disease (CAD) begins to experience chest pain while getting out of bed. The nurse should take which action first? a. Get a prescription for pain medication b. Report the complaint to the health care provider c. Have the client stop and lie back down in bed d. Have the client continue to get out of bed and into a chair

c. Have the client stop and lie back down in bed

A nurse is setting up the bedside unit for a client being admitted to the nursing unit from the emergency department with a diagnosis of coronary artery disease (CAD). The nurse should place highest priority on making sure that which of the following is available at the bedside? a. Bedside commode b. Rolling shower chair c. Oxygen tubing and flowmeter d. Twelve-lead electrocardiogram (ECG) machine

c. Oxygen tubing and flowmeter

A client receiving parenteral nutrition (PN) has a history of congestive heart failure. The health care provider has prescribed furosemide (Lasix) 40 mg orally daily to prevent fluid overload. The nurse monitors which laboratory value to identify an adverse effect from this medication? a. Glucose b. Sodium c. Potassium d. Magnesium

c. Potassium

A client who is 36 hours post myocardial infarction has ambulated for the first time. The nurse determines that the client best tolerated the activity if which observation is made? a. Skin cool but slightly diaphoretic b. Dyspnea noted only at the end of the exercise c. Preactivity pulse rate 86 beats per minute, postactivity pulse rate 94 beats per minute d. Preactivity blood pressure (BP) 140/84 mm Hg, postactivity BP 110/72 mm Hg

c. Preactivity pulse rate 86 beats per minute, postactivity pulse rate 94 beats per minute

Cardiac output is determined by a. stroke volume and blood pressure b. Heart rate and blood pressure c. Stroke volume and heart rate d. Stroke volume and peripheral resistance

c. Stroke volume and heart rate

The outermost layer of the larger blood vessels is the a. Tunica media b. Tunica intima c. Tunica adventitia d. Tunica intermedia

c. Tunica adventitia

Structures that separate the chambers and permit the flow of blood in one direction only are called a. Ventricles b. Atria c. Valves d. Vessels

c. Valves

A sublingual nitroglycerin (Nitrostat) tablet administered to a client for chest pain has relieved the pain. The nurse ensures the client has which important item within easy reach before leaving the room? a. Tissues b. Call bell c. Telephone d. Cool cloth for forehead

b. Call bell

A client's serum calcium level is 7.9 mg/dL. The nurse is immediately concerned, knowing that this level could lead to: a. High blood pressure b. Stroke c. Cardiac arrest d. Urinary stone formation

c. Cardiac arrest

A nurse is monitoring a client following cardioversion. Which of the following observations would be of highest priority to the nurse? a. Blood pressure b. Status of airway c. Oxygen flow rate d. Level of consciousness

b. Status of airway

A nurse is assisting a client admitted to the hospital with pulmonary edema to prepare for discharge. The nurse would reinforce with the client the importance of complying with which of the following measures to prevent a recurrence? a. Adjust diuretic dose based on severity of peripheral edema b. Take additional digoxin (Lanoxin) if respiratory distress occurs c. Weigh self every morning before breakfast d. Sleep with the head elevated on only one pillow

c. Weigh self every morning before breakfast

A client with angina pectoris who was given a first dose of newly prescribed nitroglycerin (Nitrostat) sublingual tablet complains of slight dizziness and headache. The nurse takes which action first? a. Takes the client's blood pressure b. Tells the client not to worry about it c. Reports the findings to the health care provider d. Gives the client a dose of acetaminophen (Tylenol) prescribed as needed (PRN)

a. Takes the client's blood pressure

The nurse is caring for the client 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? a. Limiting movement and abduction of the left arm b. Limiting movement and abduction of the right arm c. Assisting the client to get out of bed and ambulate with a walker d. Having the physical therapist do active range of motion to the right arm

b. Limiting movement and abduction of the right arm

A nurse is teaching the client with angina pectoris about disease management and lifestyle changes that are necessary in order to control disease progression. Which statement by the client indicates a need for further teaching? a. "I will avoid using table salt with meals." b. "It is best to exercise once a week for an hour." c. "I will take nitroglycerin whenever chest discomfort begins." d. "I will use muscle relaxation to cope with stressful situations."

b. "It is best to exercise once a week for an hour."

A nurse is collecting data on a client with a diagnosis of angina pectoris who takes nitroglycerin for chest pain. During the admission, the client reports chest pain. The nurse immediately asks the client which of the following questions? a. "Are you having any nausea?" b. "Where is the pain located?" c. "Are you allergic to any medications?" d. "Do you have your nitroglycerin with you?"

b. "Where is the pain located?"

A client with myocardial infarction (MI) has been transferred from the coronary care unit (CCU) to the general medical unit with cardiac monitoring via telemetry. The nurse assisting in caring for the client expects to note which type of activity prescribed? a. Strict bedrest for 24 hours b. Bathroom privileges and self-care activities c. Unrestricted activites because the client is monitored d. Unsupervised hallway ambulation with distances less than 200 feet

b. Bathroom privileges and self-care activities

A client with a diagnosis of rapid rate atrial fibrillation asks the nurse why the healthcare provider is going to perform carotid massage. The nurse responds that this procedure may stimulate the: a. Vagus nerve to slow the heart rate b. Vagus nerve to increase the heart rate c. Diaphragmatic nerve to slow the heart rate d. Diaphragmatic nerve to increase the heart rate

a. Vagus nerve to slow the heart rate

A nurse is caring for a client with a diagnosis of myocardial infarction (MI). The client reports chest pain. When the administration of a sublingual nitroglycerin tablet as prescribed does not relieve the chest pain, the next nursing action is to: a. Check the blood pressure and administer another nitroglycerin tablet b. Increase the flow rate of oxygen c. Contact the healthcare provider d. Call the client's family

a. Check the blood pressure and administer another nitroglycerin tablet

A client brings the following medications to the clinic for her yearly physical. The nurse realizes which medication has been prescribed to treat heart failure? a. Digoxin (Lanoxin) b. Potassium chloride (K-Dur) c. Warfarin (Coumadin) d. Amiodarone (Cordarone)

a. Digoxin (Lanoxin)

A nurse working the 1500-2300 shift notes that a client with coronary artery disease (CAD) has a prescription for serum lipid levels to be drawn in the morning. The nurse places the client on which dietary preparation to ensure accurate test results? a. Fasting for 12 hours b. Added snack at bedtime c. Nothing per mouth (NPO) for 24 hours d. Early meal tray delivered before the laboratory test

a. Fasting for 12 hours

A client with chronic atrial fibrillation is being started on amiodarone (Cordarone) as maintenance therapy for dysrhythmia suppression. A nurse provides instructions to the client about the medication. Which statement by the client indicates a need for further instruction? a. "I will stop taking the prescribed anticoagulant after starting this new medication." b. "I will need to use sunscreen and protective clothing when outside." c. "I will periodically have blood drawn to monitor by thyroid function." d. "I will need to have routine follow-up with my ophthalmologist."

a. "I will stop taking the prescribed anticoagulant after starting this new medication."

A client complaining of chest pain has an as-needed (prn) prescription for sublingual nitroglycerin (Nitrostat). Before administering the medication to the client, the nurse should first check the client's: a. Blood pressure b. Cardiac rhythm c. Respiratory rate d. Peripheral pulses

a. Blood pressure

A client with a diagnosis of congestive heart failure is preparing for discharge to home from the hospital. The nurse determines that the client is ready for discharge to home if the client can: a. Verbally describe the daily medications, doses and times to be administered b. Get the prescriptions filled c. Be self-sufficient at home without any help d. Independently dress and put on support hose

a. Verbally describe the daily medications, doses and times to be administered

A client with angina pectoris has just been started on medication therapy with nitroglycerin (Nitrostat). In planning care for this client, the nurse would place priority on measuring: a. Vital signs b. Serum glucose c. Intake and output d. Therapeutic serum drug levels

a. Vital signs

A client with a history of angina pectoris tells the nurse that chest pain usually occurs after going up two flights of stairs or after walking four blocks. The nurse interprets that the client is experiencing which of the following types of angina? a. Stable b. Variant c. Unstable d. Intractable

a. stable

A client who has undergone a left heart catheterization using the right femoral approach is returned to the nursing unit. Thirty minutes later the client complains of numbness and tingling of the right foot. The pedal pulse is weak and the foot is pale. The nurse notifies the registered nurse immediately because these symptoms are consistent with: a.Femoral artery thrombus or hematoma b. Local allergic reaction to the contrast dye c. Right sciatic nerve damage d. Early massive infection at the catheter insertion site

a.Femoral artery thrombus or hematoma

A nurse is planning to use an external cardiac defibrillator on a client. Which one of the following actions should the nurse perform to check the cardiac rhythm? a. Holding the defibrillator paddles firmly against the chest b. Applying the adhesive patch electrodes to the skin and moving away from the client c. Connecting standard electrocardiographic electrodes to a transtelephonic monitoring device d. Applying standard electrocardiographic monitoring leads to the client and observe the rhythm

b. Applying the adhesive patch electrodes to the skin and moving away from the client

A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. A nurse listens to breath sounds, expecting to hear bilateral: a. Rhonchi b. Crackles c. Wheezes d. Diminished breath sounds

b. Crackles

A client admitted to the hospital with a diagnosis of myocardial infarction (MI) tells the nurse that the pain likely resulted from the fried chicken sandwich that the client had for lunch. The nurse responds to the client, using the knowledge that: a. Most people love high-fat diets b. Denial is a common occurrence early after MI c. The client probably wants to belittle the opinion of the staff d. The client is not motivated to learn about heart disease at this time

b. Denial is a common occurrence early after MI

A client has just completed an information session about measures to minimize the progression of coronary artery disease (CAD). The nurse determines that the client indicates and initial understanding of lifestyle alterations if the client states and intention to: a. Take daily medication for life b. Eat a diet that is low in fat and cholesterol c. Continue to smoke to keep the metabolic rate high d. Begin to exercise if diet is not sufficient to achieve weight loss

b. Eat a diet that is low in fat and cholesterol

A nurse is assisting a client who will wear a Holter monitor for continuous cardiac monitoring over the next 24 hours. The nurse takes which of the following actions to assist this client? a. Shaves the front of the chest b. Gives the client a device holder to wear around the waist c. Teaches the client to rest as much as possible during the next 24 hours d. Tells the client to cover the monitor in plastic wrap before taking a bath

b. Gives the client a device holder to wear around the waist

A nurse is caring for a client who is developing pulmonary edema. The client exhibits respiratory distress, but the blood pressure is unchanged from the client's baseline. As an immediate action before help arrives, the nurse would: a. Suction the client vigorously b. Place the client in high-fowler's position c. Begin assembling medications that are anticipated to be given d. Call the respiratory therapy department to request a ventilator

b. Place the client in high-fowler's position

A nurse is assisting in caring for a client in the telemetry unit and is monitoring the client for cardiac changes indicative of hypokalemia. Which occurrence noted on the cardiac monitor indicates the presence of hypokalemia? a. Tall, peaked T waves b. ST segment depression c. Prolonged PR interval d. Widening of the QRS complex

b. ST segment depression

Blood flow from the heart through blood vessels to all parts of the body and back to the heart is called a. Pulmonary circulation b. Systemic circulation c. Full circulation d. Cardiac circulation

b. Systemic circulation

A nurse assists in developing a plan of care for a client admitted to the hospital with an acute myocardial infarction (MI). The nurse identifies that the priority problem during the acute phase would be: a. The client's fear b. The client's pain c. The client's and family's concern d. The client's home care support systems

b. The client's pain

A nurse is assisting in developing a plan of care for a client who will be returning to the nursing unit following a cardiac catheterization via the femoral approach. Which nursing intervention will be included in the post-procedure plan of care? a. Place the client's bed in the fowler's position b. Encourage the client to increase fluid intake c. Instruct the client to perform range of motion exercises of the extremities d. Hold regularly scheduled medications for 24 hours following the procedure

b.Encourage the client to increase fluid intake

An ambulatory clinic nurse is interviewing a client who is complaining of flu-like symptoms. The client suddenly develops chest pain. Which question would best help the nurse to discriminate pain caused by a noncardiac problem? a. "Can you describe the pain to me?" b. "Have you ever had this pain before?" c. "Does the pain get worse when you breathe in?" d. "Can you rate the pain on a scale of 1-10, with 10 being the worst?"

c. "Does the pain get worse when you breathe in?"

A nurse is caring for a client on a cardiac monitor who is alone in a room at the end of the hall. The client has a short burst of ventricular tachycardia (VT) followed by ventricular fibrillation (VF). The client suddenly loses consciousness. Which intervention should the nurse do first? a. Go to the nurse's station quickly and call a code b. Run to get a defibrillator from an adjacent nursing unit c. Call for help and initiate cardiopulmonary resuscitation (CPR) d. Start oxygen by cannula at 10 L/min and lower the head of the bed

c. Call for help and initiate cardiopulmonary resuscitation (CPR)

A client has received instructions about an upcoming cardiac catheterization. The nurse determines that the client has the best understanding of the procedure if the client knows to report which of the following items? a. Warm, flushed feeling b. Pressure at the insertion site c. Chest pain d. Urge to cough

c. Chest pain

A nurse determines that which of the following clients is most likely to be a candidate for cardioversion? a. Client with junctional rhythm b. Client with ventricular fibrillation c. Client with unstable rapid atrial fibrillation d. Client with pulseless ventricular tachycardia

c. Client with unstable rapid atrial fibrillation

A nurse is collecting data on a client with a diagnosis of right-sided heart failure. The nurse would expect to note which specific characteristic of this condition? a. Dyspnea b. Hacking cough c. Dependent edema d. Crackles on lung auscultation

c. Dependent edema

A client admitted to the hospital with coronary artery disease complains of dyspnea at rest. The nurse determines that which of the following items would be of most help to the client? a. Placing an oxygen cannula at the bedside for use if needed b. Performing continuous monitoring of oxygen saturation c. Elevating the head of the bed to at least 45 degrees d.Providing a walker to aid in ambulation

c. Elevating the head of the bed to at least 45 degrees

A client is at risk for complications of heart failure. What is the nurse's priority for early detection of the most likely cause of complications with this client? a. Checking vital signs b. Reviewing serum electrolytes c. Evaluating total body fluid d. Monitoring electrocardiogram

c. Evaluating total body fluid