Med Surg 38, 41, 42, 31, 32, 33, 34, 35
The nurse observes a student nurse who is administering thrombolytic therapy to a patient three hours after the patient's report of chest pain. Which action performed by the student nurse indicates the need for the nurse to intervene?
Reducing the dose of the thrombolytic during episodes of chest pain
Which characteristic is typical of the pain related to chronic stable angina?
Relieved by rest, nitroglycerin, or both
A nurse is preparing a patient for a transesophageal echocardiogram (TEE). Which intervention would the nurse perform?
Remove dentures and place a bite block in the mouth.
Which action does the T wave in a patient's electrocardiogram (ECG) represent?
Repolarization of the ventricles
The nurse is preparing to measure the BP of a patient who is lying down on a bed. Which technique should the nurse use?
Rest the patient's arm on a pillow during the BP measurement.
A 22-year-old healthy adult with a family history of hypertension asks the nurse about how to reduce the risk of developing high BP. Which recommendations would the nurse give? Select all that apply.
Restrict sodium intake to less than or equal to 2300 mg/day. Eat fish, such as salmon and catfish, at least two times per week.
Which instruction is important for the nurse to provide to a patient about the management of stage 1 hypertension?
Restrict sodium intake.
Which response in heart failure is triggered by the renin-angiotensin-aldosterone system (RAAS)?
Retention of sodium and water
A patient is experiencing cheilosis. The nurse suspects that which is the cause of the patient's condition?
Riboflavin deficiency
In what order does blood flow through the heart?
Right atrium Right ventricle Lungs Left atrium Mitral valve Left ventricle
Which artery supplies the atrioventricular (AV) node and the bundle of His in most people?
Right coronary artery
The nurse is performing a focused abdominal assessment of a hospitalized patient. To palpate the patient's liver, where does the nurse palpate the patient's abdomen?
Right upper quadrant
The nurse suspects that a patient is experiencing myocardial infarction (MI). Which component of the patient's electrocardiogram (ECG) is important for the nurse to analyze to make this determination?
ST segment
Which information would the nurse include when teaching a patient about risk factors related to Prinzmetal's angina?
smoking
A patient with a history of asthma presents to the emergency department with wheezing, chest pain, and shortness of breath. Which type of medication listed in the patient's medication profile may be responsible for the patient's symptoms?
β-adrenergic blocker
Which cells of the islets of Langerhans secrete amylin?
β-cells
Which observation on a patient's telemetry electrocardiogram (ECG) monitor is a cause for concern?
Prolonged QT interval
Which mechanism of hypertension causes target organ damage?
Promotion of atherosclerosis and damage to the walls of the arteries
The nurse provides education to a patient who receives a prescription for sublingual nitroglycerin for treatment of angina. Which statement made by the patient indicates the need for further teaching?
"After the bottle is open, the tablets should be replaced every 12 months."
Which statement by a patient diagnosed with chronic stable angina indicates understanding of the disease process?
"Anginal pain is caused by an increased demand or a decreased supply of oxygen."
A patient with chronic stable angina has received a prescription for sublingual (SL) nitroglycerin. Which information would the nurse include in the patient's teaching about the side effect of orthostatic hypotension?
"Avoid sudden changes in position after taking the medication to prevent falls."
The nurse provides education about a 2-g sodium diet to a patient with heart failure. Which statement made by the patient indicates the need for further teaching?
"Bread is a good food choice because it has a very low salt content."
A patient with hypertension has been prescribed an antihypertensive medication. During a follow-up visit, the patient asks if the medication can be stopped because the BP is now within the normal range. Which response would the nurse provide?
"Continue the medication unless your health care provider advises discontinuing it."
A nurse provides discharge teaching to a patient prescribed nitroglycerin sublingual tablets for the treatment of chronic stable angina. Which statement made by the patient indicates the need for further teaching?
"I will put the bottle in my pant pocket before I leave the house."
A female patient with chronic hypertension is admitted to the emergency department with a sudden rise in BP. Which question is the priority for the nurse to ask the patient?
"Do you have a headache or confusion?"
The nurse is assessing a patient who has suspected cardiac failure. Which questions would the nurse ask related to the patient's sleep-rest pattern? Select all that apply.
"Do you need to sleep upright in a chair?" "How many pillows do you need to sleep at night?"
The nurse is performing a health history on a patient with cardiovascular disease. Which questions reflect the Health Perception-Health Management functional health pattern? Select all that apply.
"Do you use recreational drugs?", "Do you drink alcoholic beverages? How often?", "How many years have you smoked, and how many packs a day?"
Which suggestion would the nurse provide to a patient with a waist circumference of 42 inches?
"Exercise regularly to maintain ideal weight."
Which question would the nurse ask to assess a patient for orthopnea?
"How many pillows do you use for sleeping at night?"
The nurse provides medication teaching to a patient who has been prescribed sublingual (SL) nitroglycerin (NTG) tablets. Which statement made by the patient indicates the need for further education?
"I can continue taking tablets until the pain goes away, each five minutes apart."
Which statement about nitroglycerin, made by a patient with chronic stable angina, indicates a need for further teaching?
"I can take up to five tablets every three minutes for relief of my chest pain."
A nurse provides education to a patient with hypertension related to lifestyle modifications to reduce overall cardiovascular risk. Which statement made by the patient indicates effective learning? Select all that apply.
"I should exercise for at least 30 minutes daily." "I should achieve and maintain a healthy weight." "I should restrict my salt intake to less than or equal to 1500 mg/day."
The nurse provides education to a patient about the Dietary Approaches to Stop Hypertension (DASH) diet. Which statement made by the patient indicates an understanding of the teaching?
"I should include four to five servings of fruits and vegetables daily."
The nurse is teaching a patient with chronic stable angina about the use of nitroglycerin (NTG). Which statement by the patient indicates effective learning?
"I should take a tablet five minutes before an activity that is known to cause angina."
A patient who survived an episode of sudden cardiac death (SCD) is recovering in the intensive care unit (ICU). Which intervention would the nurse anticipate to prevent a recurrence?
Implantable cardioverter-defibrillator (ICD)
Which statement made by the patient scheduled for a transesophageal echocardiogram (TEE) indicates the need for more instruction?
"I will be able to have lunch as soon as the test is finished."
The nurse provides information to a patient about ways to decrease risk factors for coronary artery disease (CAD). Which statement by the patient indicates understanding of the teaching?
"I will change my lifestyle to alter patterns and decrease my stress."
Which statement by an 84-year-old patient with coronary artery disease (CAD) indicates understanding of teaching about physical activity?
"I will use longer rest periods between exercise sessions."
A patient with angina states, "I walked to the bathroom. While I was having a bowel movement, I started having the worst chest pain ever. It was similar to the pain I had at home. The pain went away rather quickly." Which further subjective assessment data would the nurse obtain?
"In what location did you feel the pain?"
The nurse assesses that a patient with acute decompensated heart failure (ADHF) experiences dyspnea. Which is the priority nursing action?
Provide supplemental oxygen.
A patient with a myocardial infarction is preparing for discharge following successful treatment. Which information is important for the nurse to include in the discharge teaching related to elimination?
"It is important to avoid straining during bowel movements."
The registered nurse is reviewing a wireless electrocardiogram (ECG) monitoring system with a nursing student. Which statement made by the student indicates the need for further teaching?
"It will not record the post-event portion of the ECG." Incorrect2
Which instruction would the nurse give to a patient who is scheduled for Holter monitoring?
"Keep a diary of all activities and symptoms."
Which instruction would the nurse give to the patient who is predisposed to coronary artery disease (CAD)? Select all that apply.
"Limit concentrated fruit juice." "Choose foods such as buckwheat and oats."
Which statement made by the student nurse indicates effective learning about cardiovascular disease?
"Nicotine stimulates catecholamine release."
A patient is recovering from an uncomplicated myocardial infarction (MI). Which instructions will the nurse include about physical activity?
"Physical activity should be regular, rhythmic, and repetitive."
A patient states, "I have episodes of sharp and stabbing chest pain that last 10 minutes when I am restocking shelves at work." The patient is diagnosed with chronic stable angina. Which instruction would the nurse give to the patient to prevent anginal pain while at work?
"Take nitroglycerin (NTG) 5 to 10 minutes before restocking the shelves."
The nurse plans care for an older patient who experiences constipation. Which gastrointestinal organ is responsible for secreting mucous to lubricate the bowel mucosa?
Large intestine
Which advice regarding modifiable risk factors would the nurse give to a patient who has a BP of 150/100 mm Hg? Select all that apply.
"Reduce salt in your diet. "Increase daily physical activity."
Which statement made by the nurse indicates effective understanding of diagnostic studies used for acute coronary syndrome?
"Serum cardiac markers are proteins that are released from necrotic heart muscle."
A patient is diagnosed with left-sided heart failure. Which assessment finding would the nurse expect?
Orthopnea
The nurse provides information about thrombolytic therapy to a group of student nurses. Which statement made by a student nurse indicates the need for further teaching?
"Significant head trauma within the past three months is a relative contraindication."
A patient phones a health care provider's office and states, "I am having severe chest tightness that won't go away even when I lie down." In addition to contacting emergency responders, which instruction would the nurse provide to the patient?
"Take chewable aspirin. The total dose should be 325 mg."
Which term is used to describe difficulty breathing when lying down?
Orthopnea
A patient with acute coronary syndrome (ACS) receives a prescription for niacin to treat hyperlipidemia. The nurse observes another care provider giving information about the medication to the patient. Which item included in the education would the nurse question?
"Take the drug on an empty stomach."
The patient reports being confused about how there can be a blockage in the left anterior descending artery (LAD) although there is damage to the right ventricle. Which explanation would the nurse give?
"The LAD supplies blood to the left side of the heart and part of the right ventricle."
Which statement made by the student nurse indicates effective learning about Prinzmetal's angina?
"The pain may be relieved by moderate exercise."
A patient is admitted to the hospital with chronic stable angina. Which information would the nurse teach the patient about pain associated with the diagnosis?
"The pain may last for a few minutes and stop when the precipitating factor is resolved."
The nurse teaches a student nurse about acute pericarditis. Which statement made by the student nurse indicates effective learning?
"The patient's pain can be relieved by sitting in the forward position."
A patient is diagnosed with primary hypertension and asks the nurse what caused the condition. Which response would the nurse give?
"There is no identified cause."
The nurse provides education to a 68-year-old patient who is experiencing orthostatic hypotension. Which statement made by the patient indicates the need for further teaching?
"This may be caused by my BP medications, which I should stop taking."
Which statement made by the student nurse indicates effective learning about microvascular angina?
"This type of angina is more common in women during activities of daily living."
A patient presents to the emergency department (ED) with chest pain. Which question would the nurse ask first?
"Where is your discomfort located?
A patient with cardiovascular disease is scheduled for a triglyceride test. Which preprocedural instructions would the nurse give? Select all that apply.
"You are permitted to drink water before the test." "Avoid consuming alcohol for 24 hours before the test."
A patient with a history of angina is being treated with nitrates and β-adrenergic receptor blockers (β-blockers). Which important information would the nurse give to the patient regarding sexuality?
"You cannot take erectile dysfunction (ED) drugs like sildenafil."
For which complication would the nurse monitor the patient taking amitriptyline?
Orthostatic hypotension
Which therapy would the nurse anticipate administering for emergency care of a patient with a suspected myocardial infarction (MI)?
Oxygen, nitroglycerin, aspirin, and morphine
How many seconds does it take for the ventricular conduction system to deliver an electrical impulse? Use a leading zero, if applicable. Record the answer to the second decimal place. __ second(s)
0.12
A patient with a diagnosis of unstable angina is admitted to the intensive care unit. Which drug therapies will the nurse anticipate to be prescribed? Select all that apply.
1, 2, 3
Which instructions would the nurse provide to a patient who receives a prescription for isosorbide mononitrate? Select all that apply.
1,2,5
Which instructions would the nurse provide to a patient who takes short-acting nitroglycerin? Select all that apply.
1,2,5
Which systolic BP (SBP) measurement correlates with stage 1 hypertension?
132 mm Hg
A patient with acute decompensated heart failure (ADHF) experiences severe pulmonary edema. Which intervention will increase oxygenation and decrease preload for this patient?
Providing bilevel positive airway pressure (BiPAP)
Which condition is the most probable cause of death in a patient during the first year after heart transplantation?
Acute rejection
Which drug breaks up the fibrin meshwork in blood clots?
Alteplase
A patient who has recently had a myocardial infarction experiences mild chest pain during inspiration, while coughing, and while performing daily activities. Sitting in a forward position relieves the pain. Which complication would the nurse suspect the patient is experiencing?
Pericarditis
A patient with stable angina receives a prescription for isosorbide dinitrate. Which medication information would the nurse provide to the patient? Select all that apply.
2,4
The nurse is caring for a patient who survived sudden cardiac death (SCD) caused by a lethal ventricular dysrhythmia. Which tests will likely be prescribed to monitor the effectiveness of drug treatment? Select all that apply.
24-hour Holter monitoring Implantable cardiac monitor Signal-averaged electrocardiogram (ECG) Electrophysiologic study (EPS) under fluoroscopy
A patient with a long history of heart failure qualifies for hospice care. Which goal would the nurse identify?
Providing comfort and relieving suffering
What is the most likely reason for the development of orthopnea in a patient with pulmonary edema?
Pulmonary congestion
Which assessment finding would the nurse expect from patient with left-sided heart failure?
Pulmonary congestion
Which finding would the nurse monitor in the patient who has left-sided heart failure?
Pulmonary congestion
A patient with a history of acute decompensated heart failure (ADHF) reports blood-tinged sputum, a productive frothy cough, and a rapid heart rate. Which condition is consistent with these clinical manifestations?
Pulmonary edema
The BP of a patient is 90/60 mm Hg. What should the nurse document as the patient's pulse pressure? Record the answer using a whole number. ________ mm Hg
30
Which respiratory rate would the nurse anticipate when assessing a patient who is developing pulmonary edema?
32 to 36 breaths/min
A patient with a history of left-sided heart failure arrives in the emergency department reporting extreme shortness of breath and a persistent cough with pink, frothy sputum. On auscultation of the heart, the nurse notes an S3 gallop. Which condition is a likely cause of these symptoms?
Pulmonary edema
Which cause of fatigue is associated with heart failure?
Anemia
Which manifestations are related to target organ disease from hypertension? Select all that apply.
Aneurysm Proteinuria Transient ischemic attack
If a patient's BP is 120/80 mm Hg, what is the patient's pulse pressure? Fill in the blank using a whole number. __ mm Hg
40
A patient's heart rate is 72 beats/min. If 0.070 L of blood is ejected from the patient's ventricle with every heartbeat, what cardiac output value would the nurse document in the patient's medical record? Record the answer using a whole number. ___________ L/min
5.0
What is the ventricular rate on the following electrocardiogram (ECG) tracing? Record the answer using a whole number rounded to the nearest 10 beats/min.
60
A patient's BP is 90/50. What is the patient's mean arterial pressure (MAP)? Record the answer by rounding to the nearest whole number. ____
63
Which statement by an 84-year-old patient with coronary artery disease (CAD) indicates understanding of teaching about physical activity?
70% block in right coronary artery
A patient's systolic BP (SBP) is 100 mm Hg and diastolic BP (DBP) is 70 mm Hg. What number will the nurse document as the patient's mean arterial pressure? Record the answer using a whole number. ________ mm Hg
80
A patient's systolic BP is 120 mm Hg, and the diastolic pressure is 60 mm Hg. Which value is the mean arterial pressure (MAP)?
80 mm Hg
Which term is used for the property of heart cells to initiate an impulse spontaneously and continuously?
Automaticity
Which patient condition is likely the cause of a heart murmur?
A damaged valve
The nurse receives information about the assigned patients during shift report. Which patient would the nurse assess first?
A patient who reports a severe headache and has begun vomiting
Which objective data would the nurse expect to see in the health record when taking care of a patient with a diagnosis of acute coronary syndrome (ACS)?
A rise in troponin levels
Which vessel carries oxygenated blood from the lungs to the heart?
Pulmonary vein
A normal splitting of S2 is best heard in which auscultatory area on the diagram?
Pulmonic
Which clinical manifestation does the nurse expect to observe in a patient with ascites?
Accumulation of fluid within the abdominal cavity
Which effects of nitroglycerin benefit a patient with acute decompensated heart failure (ADHF)? Select all that apply.
Reduces preload Dilates the coronary arteries Increases myocardial oxygen supply
A patient who is being discharged from the hospital after acute coronary syndrome will be participating in cardiac rehabilitation. Which information will the nurse provide about the early recovery phase of rehabilitation?
Activity level is increased gradually with supervision and with electrocardiogram (ECG) monitoring.
For which problem is percutaneous coronary intervention (PCI) initially indicated?
Acute myocardial infarction
A patient who is wheelchair-bound is scheduled for a multigated acquisition (MUGA) scan to aid in the diagnosis of coronary artery disease (CAD). Which revisions in the test procedure will the nurse anticipate?
Adenosine will be administered IV.
Which condition is an absolute contraindication for cardiac transplantation?
Advanced cerebral vascular disease not amenable to correction
Which is a correct term for the development of arterial anastomoses?
Angiogenesis
A patient being treated for acute decompensated heart failure (ADHF) presents with intractable cough. The nurse reviews the patient's medication profile and suspects that which drug is related to the assessment finding?
Angiotensin-converting enzyme (ACE) inhibitor
Which type of medication may be prescribed for a patient with an ejection fraction (EF) of 25%?
Angiotensin-converting enzyme (ACE) inhibitor
Which location would the nurse assess for edema caused by a cardiac condition?
Ankle
Which drug class includes clopidogrel?
Antiplatelet agent
Which conditions are accompanied by a thready pulse? Select all that apply.
Aortic valve disease Peripheral arterial disease
Which is the function of the hormone ghrelin?
Appetite stimulation
A patient asks the nurse, "How can I use my smart phone to help control my hypertension?" Which smart-phone functions will the nurse recommend to help manage the patient's BP? Select all that apply.
Appointment tracking Maintaining a drug history Generating a report for the patient's health care provider Tracking variables, including time of day and medications taken
Which drug acts by direct inhibition of the clotting factor thrombin?
Argatroban
A patient on a cardiac unit is shivering. Which finding would the nurse expect to see on the patient's electrocardiogram (ECG) tracing?
Artifact
Which clinical manifestations in a patient with chest pain are associated with myocardial infarction (MI)? Select all that apply.
Ashen skin Diaphoresis S3 or S4 heart sounds Nausea and vomiting
Which type of dysrhythmia is associated with a fever?
Sinus tachycardia
A patient reports heaviness and burning sensation in the substernal and retrosternal region. Which assessment finding would indicate sympathetic nervous system stimulation?
Ashen, clammy, and cool skin
A patient with pericarditis is admitted to the hospital. In which patient position would the nurse assess for a pericardial friction rub?
Ask the patient to sit and lean forward.
Which drug prevents platelet aggregation by inhibiting cyclooxygenase?
Aspirin
A male patient who takes nifedipine to treat hypertension continues to have BP readings over 140/90 mm Hg. Which action would the nurse take first?
Assess the patient's adherence to therapy.
A patient is diagnosed with venous thromboembolism. Which assessment finding would the nurse expect?
Asymmetry in limb circumference
The nurse monitoring the electrocardiogram (ECG) of a patient with hyperthyroidism observes regular, sawtooth-shaped flutter waves with an atrial rate of 250 beats/minute. Which term would the nurse use to document this pattern?
Atrial Flutter
What does the P wave in this figure represent?
Atrial depolarization
The nurse is providing postoperative care to a patient who underwent coronary artery bypass graft (CABG) surgery. For which common complication would the nurse monitor the patient?
Atrial dysrhythmias
A patient has an atrial rate of 450 beats per minute and a ventricular rate of 150 beats per minute. Which condition is the patient likely experiencing?
Atrial fibrillation
A patient's electrocardiogram (ECG) now shows no P waves, fine and wavy lines between the QRS complexes, QRS complexes that measure 0.08 sec, and QRS complexes that occur irregularly with a rate of 120 beats/minute. Which interpretation of the rhythm would the nurse make?
Atrial fibrillation
Which cardiac activity is absent when a permanent pacemaker fails to capture?
Atrial or ventricular contraction
When assessing a patient's abdomen, which technique does the nurse use?
Auscultate the abdomen before palpation.
A patient is diagnosed with paroxysmal nocturnal dyspnea. Which clinical manifestation would the nurse expect the patient to report?
Awakening with a feeling of suffocation
Which assessment would the nurse make to monitor a patient for an adverse effect of amitriptyline?
BP after standing up
Which heart rate would the nurse expect in a patient with paroxysmal supraventricular tachycardia (PSVT)?
Between 151 and 220 beats/min
Which gastrointestinal secretion helps to absorb fatty acids and fat-soluble vitamins?
Bile
The nurse provides care to a patient who undergoes intracoronary stent placement along with balloon angioplasty. Which drugs are expected to be used during the procedure to prevent platelet aggregation within the stent? Select all that apply.
Bivalirudin Eptifibatide
Which mechanism of action makes atenolol beneficial to a patient with hypertension?
Blocks β-adrenergic receptors
The nurse provides education to a patient who is scheduled for a serum test for triglycerides and lipoproteins. Which information would the nurse include?
Blood can be drawn in a nonfasting or a fasting state.
Which findings would indicate to the nurse that a patient is experiencing prolonged oxygen deficiency? Select all that apply.
Bluish or purplish tinge in the central areas of the tongue Obliteration of the normal angle between the base of the nail and the skin
Which artery is recommended for checking a patient's BP?
Brachial
Which finding in the medical record of a patient with heart failure (HF) is not consistent with the patient's diagnosis?
Bradycardia
A patient receives morphine sulfate to relieve chest pain. For which adverse effects would the nurse monitor the patient? Select all that apply.
Bradypnea, Hypotension
The nurse provides a list of health-promoting regular physical activity examples to a patient with coronary artery disease (CAD). Which activity would the nurse include on the list?
Brisk walking (3 to 4 miles per hour)
Which gland secretes an alkaline fluid that contains bicarbonate?
Brunner's gland
Which blood component is a marker of inflammation reflecting an increased risk of cardiovascular disease?
C-reactive protein (CRP)
A patient who is black is hospitalized for the treatment of hypertension. Which type of medication has been shown to provide better control for black individuals?
Calcium channel blockers
When examining a patient's mouth, the nurse notes white curdlike lesions surrounded by erythematous mucosa. Which condition does the nurse suspect?
Candidiasis
Which portion of the vascular system exchanges cellular nutrients and metabolic end products?
Capillary vessels
A patient with a history of diabetes is diagnosed with chronic stable angina. Which drug that decreases endothelial dysfunction would the nurse expect to teach to this patient?
Captopril
Which drug may prevent or limit ventricular remodeling?
Captopril
The nurse is caring for a patient 24 hours after the patient was diagnosed with ST-segment-elevation myocardial infarction (STEMI). For which complication of myocardial infarction (MI) would the nurse monitor this patient?
Cardiac dysrhythmias
Which are the major factors that influence BP? Select all that apply.
Cardiac output Systemic vascular resistance
Which intervention may be included in the collaborative plan of care for a patient with chronic heart failure?
Cardiac resynchronization therapy (CRT)
The nurse auscultates a new murmur at the cardiac apex in a patient who has had a myocardial infarction. Which treatment strategies would the nurse expect may be included in the patient's collaborative care plan? Select all that apply.
Cardiac surgery with mitral valve repair Intraaortic balloon pump (IABP) therapy
While auscultating a patient's heart, the nurse hears turbulent sounds between normal heart sounds. Which complication would the nurse suspect?
Cardiac valve disorder
Which condition may be present if the nurse hears a patient's S4 heart sound?
Cardiomyopathy
The nurse provides medication education to a patient with heart failure. The nurse explains that the drug's mechanism of action is to reverse ventricular remodeling and to decrease cardiac workload by inhibiting catecholamines. The nurse is referring to which drug?
Carvedilol
The registered nurse observes a student nurse who is administering transdermal controlled-release nitroglycerin (NTG) to a patient. Which action performed by the student nurse indicates the need for further teaching?
Changes the transdermal patch every 24 hours
A patient is suspected of having heart failure. Which diagnostic tests are commonly used to make this diagnosis? Select all that apply.
Chest x-ray Echocardiogram Electrocardiogram (ECG)
During an admission assessment, a patient states, "I had been having episodes of abdominal pain, so I had a surgery in which they made an opening into my common bile duct to remove stones." The nurse documents a history of which surgery?
Choledocholithotomy
Which substance stimulates secretion during the intestinal phase of gastric secretion?
Chyme
The nurse is reviewing the use of defibrillation and synchronized cardioversion with students. Which information would the nurse provide?
Defibrillation is the treatment of choice for ventricular fibrillation.
Which part of the heart's beat is represented by the QRS complex on a patient's electrocardiogram (ECG)?
Depolarization from the atrioventricular (AV) node through the ventricles
A patient is admitted to the hospital with heart failure. Following an assessment, the health care provider classifies the patient as New York Heart Association (NYHA) II. Which patient profile matches this classification?
Comfortable at rest but fatigue with ordinary physical activity
In which stage of arterial disease does the plaque rupture in the artery?
Complicated lesion Incorrect4
A patient who has angina is being seen in a health care provider's office. While in the office, the patient experiences chest pain and takes a total of three nitroglycerin tablets, five minutes apart. The patient's chest pain is not relieved. Which is the nurse's priority action?
Contact the emergency medical services (EMS).
A patient has the following electrocardiogram (ECG) tracing. Which action would the nurse take?
Continue to monitor the patient.
A patient is prescribed an angiotensin-converting enzyme (ACE) inhibitor for the treatment of heart failure (HF). Which mechanism will this medication block?
Conversion of angiotensin I to angiotensin II
A patient's diagnostic results indicate three-vessel coronary artery disease and the presence of cardiac-specific troponin I (cTnI) and cardiac-specific troponin T (cTnT) markers. Which intervention is the provider likely to recommend to the patient?
Coronary artery bypass grafting (CABG)
A patient taking atorvastatin reports a recent onset of muscle weakness and pain. Which laboratory studies will the nurse anticipate scheduling?
Creatine kinase isoenzymes
The nurse provides information to a patient about preventing coronary artery disease (CAD) by maintaining healthy serum low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels. Which goals would the nurse emphasize?
Decreased LDLs; increased HDLs
A patient reports a sudden onset of dizziness. The nurse records the following electrocardiogram (ECG) tracing. Which condition is the likely cause of the dizziness?
Decreased cardiac output
Which physiologic change of aging increases the risk of a 75-year-old patient experiencing a sinus dysrhythmia?
Decreased number of pacemaker cells in the SA node
Which condition related to heart failure causes fatigue?
Decreased oxygenation of the tissues
Which primary manifestation results from the decreased filling of the cardiac ventricles associated with diastolic failure?
Decreased stroke volume and cardiac output (CO)
Which changes in vital signs indicate that a patient who has just stood up is experiencing postural hypotension?
Decreased systolic BP, decreased diastolic BP, and/or increased HR
Which action does flecainide have on the heart?
Decreases impulse conduction
Which action does the QRS complex represent in an electrocardiogram?
Depolarization of both ventricles
Which other assessment finding would the nurse expect in a patient who reports substernal pain radiating to the neck that occurs for a few minutes when exercising?
Depression of the ST segment
A patient has been prescribed atenolol. Which condition should the nurse question the patient about before administering the drug?
Diabetes mellitus
Which drugs act by decreasing the contractility of the heart? Select all that apply.
Diltiazem Carvedilol
Which intervention would the nurse plan for a patient who smokes cigarettes and is predisposed to developing coronary artery disease?
Discuss medication to help with tobacco cessation.
The nurse is providing teaching to a patient recovering from a myocardial infarction (MI). In which way would the nurse plan for resumption of sexual activity to be discussed?
Discussed along with other physical activities
Which findings will the nurse likely observe when a patient has right-sided heart failure (HF)? Select all that apply.
Distended neck veins Enlarged cardiac muscle Engorged or enlarged liver
A patient is diagnosed with pulmonary edema. Which type of medication would the nurse anticipate being prescribed?
Diuretic
Which type of drug therapy is used to treat volume overload in patients with acute decompensated heart failure (ADHF)?
Diuretics
A patient being treated for peripheral vascular disease reports erectile dysfunction (ED). Which medication classifications listed in the patient's health record may be contributing to the condition? Select all that apply.
Diuretics β-Adrenergic receptor blockers (β-blockers)
Which instruction would the nurse provide to a patient who is scheduled for exercise testing?
Do not take β-adrenergic receptor blockers (β-blockers) 24 hours before the test.
Which medication is a selective β-agonist that does not increase systemic vascular resistance (SVR) and is preferred for the short-term treatment of acute decompensated heart failure (ADHF)?
Dobutamine
A patient diagnosed with acute decompensated heart failure (ADHF) presents with edema of the legs, dyspnea, and fatigue. Which medications would the nurse expect to be included in the patient's immediate treatment plan? Select all that apply.
Dopamine Furosemide Morphine sulfate Sodium nitroprusside
Which medication listed in a patient's health record is a potential cause of the patient's cardiomyopathy?
Doxorubicin
The nurse is caring for a patient one month after the patient had a myocardial infarction. The patient is hospitalized with a three-day history of chest pain, joint pain, and a body temperature of 101° F (38.3° C). The patient's lab results include a white blood cell count of 15,000/mcL and an erythrocyte sedimentation rate of 30 mm/hr. Which condition would the nurse suspect?
Dressler syndrome
Which common adverse effect of promethazine would the nurse explain to the patient?
Drowsiness
A patient admitted to the emergency department with pain, dyspnea, and lower extremity edema is diagnosed with diastolic heart failure. Which finding supports the diagnosis of diastolic heart failure?
Ejection fraction (EF) of 55%
Which clinical manifestations would the nurse expect to observe in a patient who is diagnosed with acute decompensated heart failure (ADHF) and pulmonary edema? Select all that apply.
Dyspnea Rapid heart rate Frothy, blood-tinged sputum
A nurse teaches a patient about strategies to prevent angina caused by coronary artery disease. The nurse tells the patient to rest for one to two hours after a heavy meal. What is the rationale for this instruction?
Eating a heavy meal would divert more blood to the gastrointestinal system.
A patient develops unexplained heart failure (HF) that remains unresponsive to usual therapy. For which diagnostic test would the nurse prepare the patient?
Echocardiogram
The nurse is caring for a patient with right-sided heart failure. Which assessment findings would the nurse expect? Select all that apply.
Edema Ascites Anasarca
An echocardiogram for a patient indicates enlarged ventricles of the heart. Which condition could be the cause of the cardiac dilation?
Elevated pressure in the ventricles
A patient with cardiovascular disease who is sitting at a 45-degree angle has distended neck veins. Which condition is a likely cause of this finding?
Elevated right atrial pressure
An acutely ill patient develops unexplained, new-onset heart failure (HF) that is unresponsive to usual care. Which diagnostic procedure is likely to take place during heart catheterization?
Endomyocardial biopsy (EMB)
A patient is being admitted to the hospital with abdominal pain. Which information does the nurse include when obtaining the patient's gastrointestinal (GI) history? Select all that apply.
Hemorrhoids, Lactose intolerance, Abdominal distention, Nausea and vomiting
The nurse is caring for a patient with hypertension. Which vital sign taken just before the scheduled administration of esmolol would lead the nurse to withhold the dose and consult the prescribing health care provider?
Pulse 48
Which muscle guards the exit from the stomach?
Pyloric sphincter muscle
The registered nurse observes another health care provider caring for a patient who is undergoing transesophageal echocardiograph studies. Which action by the provider needs correction?
Ensures that the patient's dentures fit snugly
Which enzyme causes activation of trypsinogen to trypsin?
Enterokinase
A patient in asystole is likely to receive which drug treatment?
Epinephrine
Drug-eluting stents (DES) are coated with which drugs? Select all that apply.
Everolimus Zotarolimus
Which factors contribute to artifact on a patient's telemetry monitor?
Excessive hair under the electrode pads
An elderly patient presents to a clinic for a routine physical examination. The nurse reviews the patient's medical record and notes a slow, progressive increase in systolic BP (SBP). Which action would the nurse take?
Explain to the patient that this is a normal age-related change.
A patient with chronic heart failure (HF) reports disturbed sleep as a result of the urge to urinate frequently. Which condition associated with HF is most likely causing the patient's nocturia?
Extravascular fluid being reabsorbed from the interstitial spaces
The nurse is caring for a patient with liver impairment. Which prescription would the nurse question?
Ezetimibe
For which patient conditions is coronary revascularization with coronary artery bypass graft (CABG) surgery recommended? Select all that apply.
Failed medical management Correct3 Left main coronary artery or three-vessel disease Correct4 Not candidates for percutaneous coronary intervention (PCI) Correct5 Failed PCI with continued chest pain
Which symptoms in a 55-year-old female patient would the nurse recognize as possibly indicating unstable angina?Fatigue, indigestion, and shortness of breath
Fatigue, indigestion, and shortness of breath
Angiogenesis
Fatty deposits on the walls of the coronary arteries
Which situation is indicated by the presence of bilateral fine crackles in a patient with acute decompensated heart failure (ADHF)?
Fluid in the alveoli
A nurse assesses a patient whose angiogram revealed an 80% blockage of the left circumflex artery and 70% blockage of the right coronary artery. The patient does not show any symptoms of coronary ischemia. Which reason explains this finding?
Formation of collateral circulation
A patient diagnosed with heart failure experiences fatigue. Which factor causes the fatigue?
Impaired perfusion to vital organs
Which microorganism causes Vincent's infection?
Fusiform bacteria
Which drug reduces triglycerides by decreasing the hepatic synthesis and secretion of very-low-density lipoproteins (VLDLs)?
Gemfibrozil
Which information would the nurse include in the dietary education for a patient with heart failure (HF)?
Guidelines for a low-sodium diet
Paroxysmal nocturnal dyspnea is indicative of which more serious problem?
Heart failure
A patient's baseline heart rate is 85 beats/min. Which heart rate would indicate sympathetic nervous system stimulation in this patient?
Heart rate of 110 beats/min
Which effects of aging would the nurse consider in planning care for an 80-year-old person? Select all that apply.
Heart valves become thicker. The number of pacemaker cells in the SA node decreases. There is a decreased response to physical and emotional stress.
The nurse is providing information about potential complications to a patient who is scheduled for a transesophageal echocardiography (TEE). Which information would the nurse include? Select all that apply.
Hemorrhage Dysrhythmias Transient hypoxemia
A patient experienced sudden cardiac death (SCD) while hospitalized and survived. Which treatment would likely be prescribed to avoid a recurrence?
Implantable cardioverter-defibrillator (ICD)
A patient presents to an emergency department with angina. Which parameters in the laboratory report would indicate myocardial infarction? Select all that apply.
High troponin level Increased creatinine kinase (CK-MB) level
A patient newly diagnosed with heart failure is being discharged from the hospital. Which health care team member frequently works with protocols set up with the patient's health care provider to identify problems and start interventions?
Home health nurse
Which primary causes of heart failure are linked to specific genes and gene mutations? Select all that apply.
Hypertension Cardiomyopathy Coronary artery disease (CAD)
A patient's BP reading is 142/91 mm Hg. How should the nurse classify the BP?
Hypertension, stage 2
Which condition increases a patient's risk for digoxin toxicity?
Hypokalemia
Which condition would the nurse suspect if a U wave is present on a patient's electrocardiogram?
Hypokalemia
The patient has a prescription for promethazine 25 mg. Which is the preferred route of administration?
IM
A patient with Prinzmetal's angina who takes a short-acting nitrate reports feeling dizzy while changing positions. Which prescription would the nurse anticipate?
IV fluid bolus
A patient is admitted with acute decompensated heart failure. Which part of the treatment plan will increase fatigue in this patient?
IV furosemide 40 mg every six hours
Which treatment would the nurse expect to be prescribed for a patient after heart transplantation?
Immunosuppressive therapy
A patient with angina states, "I walked to the bathroom. While I was having a bowel movement, I started having the worst chest pain ever. It was similar to the pain I had at home. The pain went away rather quickly." Which further subjective assessment data would the nurse obtain?
In what location did you feel the pain?"
Which characteristic feature of diastolic failure would the nurse explain to a patient?
Inability of the ventricles to relax and fill
Which information will the nurse include when educating an older adult patient about physical activity to reduce the risk for coronary artery disease? Select all that apply.
Include longer warm-up periods Plan indoor exercise on hot summer days.
The nurse provides health promotion teaching to a patient recently diagnosed with coronary artery disease (CAD). Which information would the nurse include? Select all that apply.
Include longer warm-up periods. Plan indoor exercise on hot summer days.
In addition to troponin levels, which laboratory result in a patient's health record is most indicative of myocardial infarction?
Increased creatine kinase-MB (CK-MB)
Which effect would be expected from a medication that acts to increase chronotropy?
Increased heart rate
A patient with angina is prescribed a calcium channel blocker. Upon reviewing the medication history, the nurse finds that the patient is on digoxin. For which complication would the nurse monitor?
Increased serum digoxin level
A patient has not reached goal BP despite taking full doses of an appropriate three-drug therapy regimen, including a diuretic. Which finding in the patient history is the likely cause of resistant hypertension?
Increasing obesity
Which complication is the major risk of death for a patient six months after receiving a heart transplant?
Infection
A patient at risk for cardiovascular disease has splinter hemorrhages. Which condition is consistent with this finding?
Infective endocarditis
In which location would a myocardial infarction (MI) occur due to blockage of the right coronary artery?
Inferior wall
The nurse provides information to a group of nursing students about measuring BP in older patients. Which information would the nurse include in the teaching?
Inflate the cuff 20 to 30 mm Hg after the radial pulse disappears.
A patient with hypertension receives a prescription for lisinopril. Which mechanism of action would the nurse expect from this medication?
Inhibits conversion of angiotensin I to angiotensin II
Which response occurs after a rupture on the endothelial surface of an artery?
Initiates coagulation cascade
The nurse provides postprocedural care to a patient admitted to an inpatient unit after cardiac catheterization. Which assessment is the highest priority?
Inspecting the procedure puncture site
While auscultating a patient's heart, the nurse hears turbulent sounds between normal heart sounds. Which complication would the nurse suspect?
Inspecting the procedure puncture site
The nurse is reviewing a plan of care for emergency treatment of a patient with chest pain. Which item listed on the plan would the nurse question?
Instruct the patient to do coughing and deep-breathing exercises.
Which artery is most commonly used for coronary bypass grafts?
Internal mammary
Which cells protect the mucosa of the small intestine?
Intestinal goblet cells
Which intervention would most improve the hemodynamic stability of a patient with worsening acute decompensated heart failure (ADHF)?
Intraaortic balloon pump (IABP)
Which gastrointestinal secretion is essential for cobalamin absorption in the ileum?
Intrinsic factor
The nurse is interviewing a patient with chronic constipation. The nurse finds that the patient performs a Valsalva maneuver to facilitate passing of feces. How is this maneuver helpful in aiding the elimination process?
It increases intraabdominal pressure.
For which reason would a patient with acute coronary syndrome (ACS) be scheduled for an off-pump coronary artery bypass (OPCAB) surgery rather than a traditional surgical approach?
It is associated with less blood loss and less renal dysfunction.
The nurse is providing information about cardiac output to a group of nursing students. Which information about calculating cardiac output should be included?
It is calculated by multiplying the patient's stroke volume by the heart rate.
Which is a disadvantage of a centralized monitoring system?
It requires continuous observation of patients' electrocardiograms (ECGs).
Which assessment finding is consistent with right-sided heart failure (HF)?
Jugular venous distention (JVD)
After a patient has undergone an esophagogastroduodenoscopy (EGD), which is the nursing priority?
Keep the patient NPO until the gag reflex returns.
Which area is the site of impaired blood flow for a patient who has a mitral valve disorder?
Left atrium and left ventricle
A nurse is caring for a patient with pleural effusion who has S3 and S4 heart sounds, crackles, and an increased heart rate. Which condition is likely affecting the patient?
Left-sided heart failure
Which instructions would the nurse include in the discharge teaching for a patient with orthostatic hypotension from carvedilol? Select all that apply.
Lie down or sit if dizziness occurs. Do not stand still for prolonged periods. Rise slowly from a supine to a sitting position. Perform leg exercises to increase venous return.
The nurse provides discharge teaching to a female patient who was newly diagnosed with primary hypertension. Which instruction would be included?
Limit the intake of alcohol to no more than one drink per day.
Which techniques will the nurse use while assessing a patient's heart sounds? Select all that apply.
Listen for friction rubs with the patient upright and leaning forward., Use the diaphragm of the stethoscope to listen to S1 and S2 sounds., Listen for S3 and S4 sounds with the bell of the stethoscope.
Which drugs act by causing either direct or indirect vasodilation? Select all that apply.
Losartan Morphine
The BP of a 71-year-old patient admitted with pneumonia is 160/70 mm Hg. Which age-related change contributes to this finding?
Loss of elasticity in arterial vessels
A patient is diagnosed with gastroesophageal reflux. The nurse recalls that reflux of gastric contents into the esophagus is normally prevented by which structure?
Lower esophageal sphincter (LES)
An older adult presents to the emergency department with recent weight gain, pitting edema to the bilateral lower extremities, and distended neck veins. Which other assessment findings would the nurse expect? Select all that apply.
Lower extremity cyanosis Third heart sound (S3) upon auscultation Displaced point of maximal impulse (PMI)
The nurse assesses a patient with cardiac problems and finds that one calf is larger than the other. Which conditions are possible explanations for this finding? Select all that apply.
Lymphedema, Varicose veins, venous thromboembolism
A patient with coronary artery disease (CAD) is being seen in an outpatient health care setting for a routine examination. The patient states, "Over the past few months, I have needed increased amounts of insulin to control my type 1 diabetes mellitus." Which goal would the nurse include in the patient's plan of care, aimed at preventing the progression of CAD?
Maintain a Hb A1C level of less than 7%.
Which is the function of the hormone gastrin?
Maintaining lower esophageal sphincter tone
A patient diagnosed with acute ischemic stroke is receiving IV antihypertensive drugs. Which interventions would the nurse perform for this patient? Select all that apply.
Measure hourly urine output. Perform frequent neurologic checks. Titrate drug according to mean arterial pressure (MAP) or BP as prescribed.
A patient's apical heart rate is 45 beats/minute. Which scheduled medication would the nurse withhold?
Metoprolol
Which medication should be used with caution in patients with diabetes because the drug may depress the tachycardia associated with hypoglycemia?
Metoprolol
Which type of angina occurs in the absence of significant coronary artery disease (CAD)?
Microvascular
A patient is admitted to the hospital with a diagnosis of acute decompensated heart failure (ADHF). The health care provider prescribes a continuous IV infusion of sodium nitroprusside. Which is the priority nursing intervention?
Monitor BP.
The nurse is caring for a patient admitted to the intensive care unit with heart failure. The patient is prescribed IV sodium nitroprusside. Which actions would the nurse take when administering the medication? Select all that apply.
Monitor arterial BP. Ensure a slow rate of administration. Record baseline BP and continuously throughout the administration.
The nurse is caring for a patient having a myocardial infarction. The health care provider prescribes an IV infusion of alteplase. Which intervention would the nurse include during the administration of this medication?
Monitor for changes in neurologic status.
The nurse is preparing an initial care plan for a patient who presents with chest pain. Which is the priority nursing intervention?
Monitoring the patient's cardiac rhythm
A patient hospitalized with heart failure (HF) often experiences dyspnea and reports feeling very anxious during the dyspneic episodes. Which medication may be prescribed short term for anxiety reduction and preload reduction?
Morphine
A patient who has received a maximum dose of nitroglycerin continues to report chest pain. Which medication would the nurse anticipate administering to this patient next?
Morphine sulfate
The nurse provides health promotion teaching to a patient recently diagnosed with coronary artery disease (CAD). Which information would the nurse include? Select all that apply.
Reduce total fat intake. Increase complex carbohydrates in the diet. Perform moderate physical activity at least 30 minutes five days a week. Dietary modifications
The nurse is assessing a patient for orthostatic hypotension. First, the nurse measured the BP and heart rate (HR) with the patient in the supine position. Which action would the nurse take next?
Move the patient to a sitting position and measure the BP and HR within two minutes.
The nurse assesses a patient who has been diagnosed with papillary muscle dysfunction. Which observation supports the patient's diagnosis?
Murmur at the cardiac apex
The nurse assesses a patient with diabetes who reports shortness of breath, neck pain, and hypoglycemic symptoms. The patient's BP is 130/86 mm Hg, heart rate is 102 beats/min, respiratory rate is 24 breaths/min, and the finger-stick blood glucose is 136 mg/dL. Which condition would the nurse suspect?
Myocardial infarction (MI)
A patient with chronic stable angina asks the nurse about the origin of the pain. Which condition would the nurse explain as the cause of the pain?
Myocardial ischemia
The nurse reviews the following electrocardiogram (ECG) tracing. Which condition is the likely cause of these findings?
Myocardial ischemia
A patient reports episodic chest pain lasting a few minutes that is provoked by exertion and relieved within 10 minutes upon resting. Which cause of the patient's symptoms would the nurse suspect?
Myocardial ischemia due to coronary artery disease
Which conditions are primary causes of heart failure? Select all that apply.
Myocarditis Coronary artery disease
Cardiac biomarker levels are being evaluated for a patient who is suspected of having a myocardial infarction (MI). Which biomarker lacks specificity for diagnosing an MI?
Myoglobin
The patient's health history indicates that the patient was taking ondansetron at home before admission. Which symptom would the nurse ask about to determine the effectiveness of the medication?
Nausea
A patient tells the nurse, "Recently, each time I run on a treadmill machine, I get chest pain. The pain goes away when I rest." Which medication is likely to be prescribed for use before the patient exercises?
Nitroglycerin
A patient with hypertension receives a prescription for chlorothiazide. Which item would the nurse instruct the patient to limit?
Nonsteroidal antiinflammatory drugs (NSAIDs)
A patient with a heart rate of 180 beats/minute has a regular heart rhythm, normal P waves, and normal PR intervals. Which QRS complex shape would the nurse expect to see on the patient's electrocardiogram (ECG) tracing?
Normal
A patient with a history of unstable angina reports a sudden onset of retrosternal chest heaviness and tightness, fatigue, shortness of breath, and nausea. Which actions would the nurse take? Select all that apply.
Obtain a 12-lead electrocardiogram (ECG). Administer sublingual nitroglycerin.
Symptomatic second-degree heart block type 2 can be managed with which procedure?
Pacemaker insertion
The nurse is preparing to take a new patient's BP using a sphygmomanometer and a stethoscope. Which action should the nurse take?
Palpate the brachial pulse and inflate the cuff until the pulse ceases.
Which technique would the nurse use to assess for the presence of a pulse deficit?
Palpate the radial pulse while auscultating the apical pulse.
The nurse is providing care to a patient who underwent an endoscopic retrograde cholangiopancreatography (ERCP) examination. Which is the most common postprocedure complication?
Pancreatitis
The nurse hears a new murmur at the cardiac apex of a patient with a myocardial infarction (MI). Which complication would the nurse suspect?
Papillary muscle dysfunction
Which term would the nurse use to document a patient's report of awakening during the night with sudden shortness of breath?
Paroxysmal nocturnal dyspnea
The nurse is examining the electrocardiogram (ECG) of a patient who has just been admitted with a suspected myocardial infarction (MI). Which ECG change is most indicative of prolonged or complete coronary occlusion?
Pathologic Q wave
The nurse is teaching an older patient with hypertension about developing an exercise program. Which instructions would the nurse include?
Perform muscle-strengthening activities twice a week.
Which patient would experience symptom relief with the administration of nitroglycerin?
Patient 1
A nurse reviews the medical records of four patients with cardiovascular disease. Which patient is likely to have jugular venous distention?
Patient 2
The nurse reviews the medical records of four patients with chest pain. Which patient would likely benefit from nitroprusside and intraaortic balloon pump (IABP) therapy?
Patient 3
Which patient is at the highest risk of developing coronary artery disease (CAD)?
Patient D: 56-year-old black female with a cholesterol level of 300 mg/dL
When reviewing the gastrointestinal (GI) system, the nurse recalls that protein digestion begins with the release of which substance from chief cells?
Pepsinogen
Diagnostic tests confirm that a patient is experiencing a ST-segment-elevation myocardial infarction (STEMI). For which first line of treatment will the nurse prepare the patient?
Percutaneous coronary intervention (PCI)
A patient who takes amphetamines reports cyclic, short bursts of pain in the chest during the day and late at night. Which recommendation would the nurse make?
Perform moderate exercise during the attack.
The nurse is caring for a patient two days after the patient experienced a myocardial infarction. For which complications will the nurse monitor the patient? Select all that apply.
Pericarditis Correct2 Heart failure Correct3 Dysrhythmia Cardiogenic shock
Which assessment findings would the nurse expect when assessing a patient with right-sided heart failure? Select all that apply.
Peripheral cyanosis Jugular vein distention Pitting edema of the lower extremities
A patient is recovering from an uncomplicated myocardial infarction (MI). Which instructions will the nurse include about physical activity?
Persistent cough
A patient with ventricular dysfunction receives a prescription for an angiotensin-converting enzyme (ACE) inhibitor. The nurse should monitor the patient for which indication of medication intolerance?
Persistent cough
The nurse provides basic exercise guidelines for a patient who is being discharged following acute coronary syndrome (ACS). Which guidelines following the FITT formula would the nurse recommend?
Physical activity that is regular, rhythmic, and repetitive
The nurse provides basic exercise guidelines for a patient who is being discharged following acute coronary syndrome (ACS). Which guidelines following the FITT formula would the nurse recommend? Physical activity that is regular, rhythmic, and repetitive
Physical activity that is regular, rhythmic, and repetitive
Which clinical manifestation occurs with left-sided heart failure (HF) but not with right-sided HF?
Pink sputum
A patient with a history of pheochromocytoma presents to the emergency department with a BP of 246/144 mm Hg. The health care provider prescribes an antihypertensive medication by continuous IV infusion. Which interventions will the nurse plan? Select all that apply.
Place the patient on bed rest. Monitor the urine output hourly. Monitor the electrocardiogram (ECG) for dysrhythmias. Titrate the infusion according to mean arterial pressure (MAP) or BP as prescribed.
Which characteristic describes a complicated coronary artery lesion?
Platelet aggregation and adhesion
A patient is admitted to the hospital with heart failure (HF). The nurse should monitor the patient for which complications? Select all that apply.
Pleural effusion Correct2 Dysrhythmias Correct3 Hepatomegaly Correct4 Renal failure
A patient experiences anginal pain. Which intervention would the nurse use?
Position the patient upright and give supplemental oxygen.
The nurse reviews a patient's electrocardiogram (ECG) tracing and notes a heart rate of 82 and an irregular rhythm. Which interpretation of the findings would the nurse make?
Premature atrial contractions
The nurse performing a cardiovascular assessment on an 85-year-old patient expects which age-related finding?
Presence of S4 2
Which type of angina occurs as a result of coronary vasospasm?
Prinzmetal's angina
Which action would the nurse take to assess a patient for jugular venous distention?
Raise the patient to about 45 degrees.
A patient with chronic stable angina shows a prolonged QT interval on the electrocardiogram (ECG) monitor. Which medication on the list of drugs prescribed for the patient would the nurse question?
Ranolazine
Which type of pulse would the nurse expect when assessing a patient who is anxious?
Rapid
A patient is prescribed a statin drug to decrease levels of low-density lipoproteins and triglycerides. For which symptoms would the nurse teach the patient to observe? Select all that apply.
Rash muscle pain Muscle weakness Gastrointestinal disturbances
A patient with a recent diagnosis of heart failure (HF) has been prescribed furosemide. Which physiologic effect would the nurse expect this medication to have?
Reduce preload
The nurse provides health promotion teaching to a patient recently diagnosed with coronary artery disease (CAD). Which information would the nurse include? Select all that apply.
Reduce total fat intake. Increase complex carbohydrates in the diet. Perform moderate physical activity at least 30 minutes five days a week.
The nurse observes that blanching of a patient's nail beds continues for three seconds after the release of pressure. Which condition is the potential cause of this finding?
Reduced arterial capillary perfusion
Which area of the body would best show accumulation of edema in a patient with heart failure (HF) who spends most of the time in bed?
Sacrum
A patient is scheduled for coronary artery bypass graft (CABG) surgery. Which type of graft, if used, would require postoperative antiplatelet and statin therapy to improve graft patency?
Saphenous vein graft
During a physical examination, where would a nurse auscultate for the patient's aortic area?
Second intercostal space to the right of the sternum
A patient is suspected of having acute pancreatitis after presenting to the emergency department with severe abdominal pain. The nurse identifies that which important diagnostic laboratory value peaks in 24 hours and then returns to normal in 48 to 72 hours?
Serum amylase
Which laboratory test result indicates the presence of target organ damage in a patient with hypertension?
Serum creatinine of 2.6 mg/dL
Which common side effects of antihypertensive medications would the nurse explain to a patient with a new diagnosis of hypertension? Select all that apply.
Sexual problems Orthostatic hypotension
A patient with diabetes shows no symptoms of angina, but Holter monitoring reveals changes in electrocardiography (ECG). The nurse suspects what condition?
Silent ischemia
Which lipid-lowering medication has adverse effects including muscle pain, elevated liver enzymes, and elevated creatine kinase levels?
Simvastatin
Which structure initiates the action potential in the heart?
Sinoatrial node
Which statement made by the student nurse indicates the need for additional teaching about electrocardiograms (ECGs)?
Six bipolar leads (V1 through V6) measure the electrical forces in the horizontal plane.
A patient with acute decompensated heart failure (ADHF) develops hypotension and thiocyanate toxicity after 48 hours of prescribed drug therapy. The nurse suspects that which medication is responsible for this condition?
Sodium nitroprusside
A patient with valvular heart disease has not experienced any symptoms of heart failure (HF). How would the nurse classify this patient according to the American College of Cardiology/American Heart Association (ACC/AHA) stages of HF?
Stage B
A patient reporting ear pain and absence of saliva has oral erythema and mouth ulcers. Which microorganism is the likely cause?
Staphylococcus
When a patient reports foul-smelling stool, which condition does the nurse suspect?
Steatorrhea
Which statement is accurate regarding the role of the autonomic nervous system in impulse formation?
Stimulation of the vagus nerve causes a decreased rate of firing of the sinoatrial (SA) node.
A patient is admitted to the intensive care unit in stable condition with a diagnosis of myocardial infarction. Which common medications will be used to treat this condition? Select all that apply.
Stool softeners Dual antiplatelet therapy IV nitroglycerin Low -molecular-weight heparin (LMWH)
A patient is hospitalized following a three-day history of heart palpitations and dizziness. The patient's electrocardiogram (ECG) shows the following rhythm. For which condition is this patient at risk?
Stroke
A patient presents to the emergency department with acute decompensated heart failure (ADHF) and indications of alveolar edema. Which assessment findings would the nurse expect? Select all that apply.
Tachypnea Correct2 Decreased PaO2 Correct3 Increased PaCO2
A patient who underwent cardiac transplantation exhibits signs of acute rejection. Which medication is often used to prevent this type of response?
Tacrolimus
The nurse is preparing a presentation related to the complications of hypertension. Which information will the nurse include? Select all that apply.
Stroke as a result of atherosclerosis Blurring of vision or loss of vision secondary to retinal damage
The nurse is preparing a presentation related to the complications of hypertension. Which information will the nurse include? Select all that apply.
Stroke as a result of atherosclerosis Blurring of vision or loss of vision secondary to retinal damage
A patient is diagnosed with heart failure. Which factors may influence the patient's cardiac output (CO)? Select all that apply.
Stroke volume Ventricular filling Myocardial contractility
A patient is diagnosed with heart failure. Which factors may influence the patient's cardiac output (CO)? Select all that apply.
Stroke volume Ventricular filling Myocardial contractility
A patient receives instructions about monitoring BP levels at home. Which information would the nurse teach the patient about measuring the BP in a supine position?
Support the arm with a pillow during measurement. 3
Which compensatory mechanism of heart failure (HF) results in increased heart rate, increased myocardial contractility, and peripheral vasoconstriction?
Sympathetic nervous system (SNS) activation
A patient with paroxysmal supraventricular tachycardia (PSVT) who is receiving IV adenosine becomes hemodynamically unstable. Which intervention would the nurse expect to be included in the patient's immediate treatment plan?
Synchronized cardioversion
Which condition causes the symptoms of right-sided heart failure?
Systemic venous congestion
A patient's diagnostic results reveal an ejection fraction (EF) of 32%. Which conditions may be indicated by this finding? Select all that apply.
Systolic failure Mixed systolic and diastolic failure
Which effects of aging on the cardiovascular system would the nurse anticipate when providing care for older adults? Select all that apply.
Systolic murmur Diminished pedal pulses Decreased cardiac reserve Increased recovery time from activity
Which symptoms would the nurse expect to find when assessing the cardiovascular system of an 83-year-old patient? Select all that apply.
Systolic murmur Diminished pedal pulses Increased systolic BP Difficulty in isolating the apical pulse
Which interventions are aimed at preventing the primary causes of heart failure (HF)? Select all that apply.
Taking BP medication as prescribed Initiating lifestyle changes to avoid coronary artery disease (CAD)
A patient asks the nurse about resuming sexual activity after acute coronary syndrome (ACS). Which information would the nurse include in the patient's teaching plan?
Taking a prophylactic nitrate may decrease chest pain during sexual activity.
The nurse is providing discharge education for a patient with moderate heart failure. Which activity instruction would the nurse recommend to be included in the plan of care?
Taking frequent rest breaks during activities
Which drug prevents the binding of fibrinogen to platelets, thereby preventing platelet aggregation?
Tirofiban
The nurse observes another health care provider taking the BP of an older patient. The cuff is inflated to 180 mm Hg. The care provider records the systolic BP (SBP) as 180 mm Hg. For which reason is the BP measurement likely to be inaccurate?
The SBP could be underestimated if an auscultatory gap is present.
Which statement describes cardiac reserve?
The ability to respond to health and illness demands by altering cardiac output
Which interpretation would the nurse make after assessing a patient and identifying murmurs?
The cardiac valves are affected.
For which reason would the nurse instruct an elderly patient to avoid taking enalapril with meals?
The drug may worsen postprandial hypotension
The nurse is teaching a group of nursing students about the anatomic characteristics of the heart. Which information would the nurse include?
The left ventricle is thicker to pump the blood into the systemic circulation.
Which statement describes the electrical activity represented by the PR interval on an electrocardiogram (ECG)?
The length of time for the electrical impulse to travel from the sinoatrial (SA) node to the Purkinje fibers
The nurse encourages the patient diagnosed with chronic heart failure to obtain physical and emotional rest. Which rationale would the nurse give for this recommendation?
To decrease the need for additional oxygen
A male patient who has coronary artery disease (CAD) has serum values of low-density lipoprotein (LDL) cholesterol 98 mg/dL, and high-density lipoprotein (HDL) cholesterol 47 mg/dL. Which information would the nurse include in patient teaching?
The lipid levels are normal.
As treatment for hypertensive crisis, a patient has received sodium nitroprusside for three days. For which reason would the nurse plan to monitor the patient's thiocyanate levels?
The medication is metabolized to cyanide, then thiocyanate.
The nurse is performing an assessment on a patient who presented to the emergency department with a report of chest pain. Which assessment data would indicate that the patient has stable angina?
The pain developed when the patient was jogging and subsided after the patient rested.
Which conditions are possible causes of the artifact in a patient's electrocardiogram (ECG) tracing? Select all that apply.
The patient is shivering. Electrical interference is present. The leads and electrodes are not secure.
Which is considered decisional capacity for informed consent related to treatment decisions?
The patient must be able to communicate his or her decisions.
Which factor leads to total occlusion of a coronary artery?
Thrombus formation in the arterial wall
A patient with hyperlipidemia has been prescribed niacin. For which reason would the nurse administer aspirin 30 minutes before administering niacin?
To prevent skin flushing
For which reason would a patient be prescribed low-molecular-weight heparin (LMWH) after a stent placement?
To prevent thrombosis formation within the stent
For which reason would an everolimus coating be used in a coronary stent?
To reduce the risk of overgrowth for the intimal lining within the stent
Which drug prevents platelet aggregation by inhibiting cyclooxygenase?
To reduce the risk of overgrowth for the intimal lining within the stent
Which is the function of F cells of the islets of Langerhans?
To secrete pancreatic polypeptide
Which findings in a patient's medical history are major modifiable risk factors for coronary artery disease (CAD)? Select all that apply.
Tobacco use BP of 150/92 mm Hg Waist circumference 42 inches
When providing nutritional counseling for patients at risk for coronary artery disease (CAD), which dietary selections should the nurse encourage to include in their meal planning? Select all that apply.
Tofu Walnuts Flaxseed
The nurse is caring for a patient with chronic stable angina who has a history of a stroke. Which prescription would the nurse question?
Vorapaxar
A patient who has been taking clonidine for 10 years tells the nurse, "I decided to quit taking the medication a few days ago." For which manifestation would the nurse monitor this patient?
Tremors
A patient presents to the emergency department reporting chest pain. Which component of the patient's blood work would most specifically indicate an acute myocardial infarction (MI)?
Troponin
A patient tells the nurse, "I had severe chest pain six days ago." Which cardiac biomarker will be most helpful in determining whether the patient had a myocardial infarction at the time the patient experienced chest pain?
Troponin
Which blood studies would the nurse expect to see prescribed in a focused evaluation of a patient with cardiac disease? Select all that apply.
Troponin Homocysteine C-reactive protein
Which finding in a patient's laboratory reports supports a conclusion that the patient is at high risk for myocardial injury?
Troponin I value of 3.5 ng/mL
Which abnormality is likely to result in a heart murmur?
Turbulent blood flow across a heart valve
The nurse reviews the assessment findings of a patient with acute decompensated heart failure (ADHF) and notes a pulmonary artery wedge pressure (PAWP) of 28 mm Hg, an intake of 1000 mL more than the output in 24 hours, and resistance to diuretics. The nurse anticipates a prescription for which clinical intervention?
Ultrafiltration (UF)
Which type of angina increases in frequency, duration, and severity over time?
Unstable angina
During the abdominal examination of a healthy patient, which actions does the nurse take? Select all that apply.
Use warm hands., Raise the head of the bed slightly., Ask the patient to breathe slowly through the mouth. Instruct the patient to assume the supine position with knees flexed.
A patient's history includes an ejection fraction of 30%, diabetes, reports of stabbing chest pain that is relieved upon rest, and prescription for captopril. If the patient is intolerant of captopril, which medication would the nurse expect will be prescribed?
Valsartan
The nurse observes a bluish tinge around the ears of a patient with cardiovascular disease. Which condition is likely to be present?
Vasoconstriction
A nurse is caring for a patient who smokes tobacco and has a two-year history of using oral contraceptives. Based on the history, the patient would be assessed for which condition?
Venous thromboembolism
Which compensatory mechanisms are initially effective in maintaining adequate cardiac output (CO) in heart failure? Select all that apply.
Ventricular dilation Ventricular hypertrophy Activation of the sympathetic nervous system (SNS)
Which compensatory mechanisms are initially effective in maintaining adequate cardiac output (CO) in heart failure? Select all that apply.
Ventricular dilation Ventricular hypertrophy Activation of the sympathetic nervous system (SNS)
Which time period does the T wave in an electrocardiogram (ECG) represent?
Ventricular repolarization
A patient reports cyclic and short bursts of pain in the chest during the day and night that are relieved by mild exercise. Which medication would the nurse anticipate will be prescribed?
Verapamil
The nurse recognizes that which test is used to assess areas of the gastrointestinal tract not accessible by an upper and lower endoscopy?
Video capsule endoscopy (VCE) Incorrect4
Which sources of polyunsaturated fat would the nurse include in a teaching plan for a patient with coronary artery disease (CAD)? Select all that apply.
Walnuts Soybeans
Which drug produces an anticoagulant effect by interfering with hepatic synthesis of vitamin K-dependent clotting factors?
Warfarin
Which medication is used to manage a complication of atrial fibrillation?
Warfarin
Which classification of acute decompensated heart failure includes a normal cardiac output (CO), increased pulmonary artery wedge pressure (PAWP), dyspnea, edema, and orthopnea?
Wet-warm
Which question would the nurse ask the older patient regarding risk factors for coronary artery disease (CAD)?
What is your body mass index (BMI) number?
The community health nurse is planning health promotion teaching to prevent coronary artery disease (CAD). Which population has the highest incidence of CAD?
White male
Which assessment data is a nonmodifiable risk factor for coronary artery disease?
White male
Which manifestation would the nurse expect in an elderly patient with arterial stiffening?
Widened pulse pressure
A patient is scheduled for cardiac catheterization with coronary angiography. Which primary purpose for the procedure would the nurse explain to the patient?
assessing the presence of arterial blockages
Which condition causes cor pulmonale?
pulmonary disease
