Med Surg Exam #3 Cardiac

The patient is diagnosed with a superficial vein thrombosis. Which characteristics should the nurse know about superficial vein thrombosis? Select one: a. Typically found in the iliac, inferior, or superior vena cava b. Vein is tender to pressure and there is edema c. Embolization lungs may result in death d. Client may extend to deeper veins if untreated

d. client may extend to deeper veins if untreated

The nurses caring for a patient with a diagnosis of pericarditis. Where listeners understand the inflammation is located? Select one: a. The inner lining of the heart and valves b. The heart's muscle fibers c. The thin fibrous sack encasing the heart d. The exterior layer of the heart

c. the thin fibrous sack encasing the heart

The nurse assesses the patient with chronic biventricular heart failure for paroxysmal nocturnal dyspnea (PND) by questioning the patient regarding Select one: a. The presence of a dry, hacking cough while resting b. Frequent awakenings to void during the night c. The use of two or more pillows to help breathing during sleep d. The presence of difficulty breathing at night

c. the use of two or more pillows to help breathing during sleep

The nurse is also stating the heart sounds of the patient with mitral stenosis. The pulse rhythm is weak and irregular. What rhythm does the nurse expect to see on the electrocardiogram? Select one: a. Ventricular tachycardia b. 1st° AV block c. Sinus dysrhythmia d. Atrial fibrillation

d. atrial fibrillation

What is a significant finding in the health history of patient during an assessment of the cardiovascular system? Select one: a. Frequent viral pharyngitis b. Calcium supplementation c. Metastatic cancer d. Frequent use of recreational drugs

d. frequent use of recreational drugs

The patient clinic described shortness of breath, periods of feeling lightheaded, and feeling fatigued despite a full night sleep. The nurse obtains vital signs and also saves a systolic click. What does the nurse suspect from the assessment findings? Select one: a. Aortic stenosis b. Aortic regurgitation c. Mitral regurgitation d. Mitral valve prolapse

d. mitral valve prolapse

A nurse is obtaining a history from a patient diagnosed with hypertrophic cardiomyopathy. When information obtained from the patient is indicative of this form of cardiomyopathy? Select one: a. A long-standing history of hypertension b. A history of alcoholism c. A parent has the same disorder d. The history of amyloidosis

d. the history of amyloidosis

Match the medication affecting lipoprotein metabolism in column II with the associated classification in column I 1) Omega-3 acid ethyl esters 2) Nicotinic acid 3) Fibric acids 4) bile acid sequestrates 5) cholesterol absorption inhibitor 6) HMG-CoA Reductase inhibitor

1) Fish oil capsules 2) Niacin 3) Fenofibrate 4) Colestipol 5) Ezetimibe 6) Pravastatin

Indicate whether the following are characteristics of the first heart sound S1 or the second heart sound S2. 1) Indicates the onset of diastole 2) Loudest at pulmonic aortic areas 3) Loudest and tricuspid and mitral areas 4) Soft lub sound 5) Sharp dub sound 6) Indicates beginning of systole

1) S2 2) S2 3) S1 4) S1 5) S2 6) S1

Number in sequence the path of action potential along the conduction system of the heart Right and left atrial cells Purkinje fibers Atrioventricular node Bundle of His Ventricular cells Sinoatrial node Right and left bundle branches Internodal pathways

1) SA node 2) right and left atrial cells 3) internodal pathways 4) Atrioventricular node 5) Bundle of his 6) left and right bundle branches 7) Purkinje fibers 8) ventricular cells

Match the terminology associated with coronary atherosclerosis in column two with its function/characteristic listed in column one 1) A risk factor associated with a type a personality 2)A symptom of myocardial ischemia 3)Myocardial manifestation of coronary artery disease 4)Biochemical substances, soluble in fact, that accumulate within the blood vessel 5)The principle of blood lipid 6)A risk factor that is endocrine in origin 7)A risk factor related to weight gain 8)The functional lesion of atherosclerosis 9)A risk factor that causes pulmonary damage 10)They recommended dietary restriction that is a risk factor for heart disease 11)A lifestyle habit that is considered an modifiable risk factor for heart disease

1) Stress 2) chest pain 3) dysrhythmias 4) lipids 5) cholesterol 6) diabetes 7) obesity 8) atheroma 9) smoking 10) fat 11) inactivity

Match the description column to with a key term in column one 1) P wave 2) U wave 3) T wave 4) QT interval 5) QRS complex 6) ST segment 7) TP interval 8) PR interval

1) atrial depolarization 2) repolarization of Purkinje fibers 3) ventricular repolarization 4) normal range 0.32-0.40 5) ventricular depolarization 6) early ventricular depolarization 7) end of the T wave to the beginning of the next P wave 8) normal range 0.12-0.20

Match anatomic term in column two with its associated function in column one 1) Separates the right and left atrium 2) Since between the right ventricle in the pulmonary artery 3) Distributes venous blood to the lungs 4) Supports the heart in the mediastinum 5) Is located at the juncture of the superior vena cava in the right atrium 6) Is embedded in the right atrial of all the tricuspid valve

1) bicuspid valve 2) pulmonic valve 3) pulmonary artery 4) parietal pericardium 5) sinoatrial node 6) atrioventricular node

Match the type of ventricular heart failure listed in column two with its associated pathophysiology in column one 1) Hepatomegaly 2)Dyspnea from fluid in the alveoli 3)Pulmonary congestion predominates 4) Cough that may be blood-tinged 5) Ascites 6)Orthopnea 7)Nocturia 8)Fatigability 9)Dependent edema 10)Distended neck veins

1) right sided HF 2) left sided HF 3) left sided HF 4) left sided HF 5) right sided HF 6) left sided HF 7) right sided HF 8) left sided HF 9) right sided HF 10) right sided HF

Match the pathophysiology listed in column two with the valvular disorder listed in column one 1) Mitral stenosis 2) Aortic regurgitation 3) Aortic valve stenosis 4) Mitral regurgitation 5) Mitral valve prolapse

1) thickening and contracture of mitral valve cusps 2) characterized by a significantly wide pulse pressure 3) can be caused by rheumatoid endocarditis 4) blood flows back from the left ventricle into the left atrium during systole 5) leaflet malformation prevents complete closure during systole

Match the type of vessel insufficiency listed in column two with its associated symptoms listed in column one 1) Ulcers of lower legs and ankles 2) Cold, pale extremity 3) dependent rubor 4) Reddish blue discoloration with dependency 5) Intermittent claudication 6) Paresthesia 7) Muscle fatigue and cramping 8) Diminished or absent pulses

1) venous insufficiency 2) arterial insufficiency 3) arterial insufficiency 4) arterial insufficiency 5) arterial insufficiency 6) venous insufficiency 7) venous insufficiency 8) arterial insufficiency

The nurse returns Mr. Anderson to the supine position and measures for jugular venous distention. The finding that would indicate an abnormal increase in the volume of the venous system would be obvious distention of the vein when the patient is positioned at what angle?

45 degree

The nurse is reviewing the results of a total cholesterol level for a patient who has been taking simvastatin. What results indicate the medication is having the desired outcomes? Answer in a range Select one: a. 160 to 190 mg/dL b. 280 to 300 mg/dL c. 210 to 240 mg/dL d. 250 to 275 mg/dL

a. 160 to 190 mg/dL

The nurse is monitoring a patient who is on heparin anticoagulant therapy. What should the nurse determine the therapeutic range of international normalized ratio (INR) should be? Select one: a. 2.0 - 3.0 b. 7.0 - 8.0 c. 4.0 - 5.0 d. 5.0 - 6.0

a. 2.0-3.0

Which diagnostic test is most useful in the differentiating dyspnea related to pulmonary effects of heart failure from dyspnea related to pulmonary disease? Select one: a. B-typed natriuretic peptide levels b. Determination of blood urea nitrogen c. Cardiac catheterization d. Exercise stress testing

a. B-typed natriuretic peptide levels

Patient on the cardiac telemetry unit goes into ventricular fibrillation is unresponsive. Following initiation of the emergency call system "code blue", what is the next priority for the nurse in caring for this patient? Select one: a. Began CPR b. Get the crash cart c. Defibrillator 360 J d. Administer amiodarone IV

a. begin CPR

A patient has had an ICD inserted. What should the nurse be sure to include in the education of this patient prior to discharge? Choose all that apply Select one or more: a. Call for emergency assistance in feeling dizzy b. Record events that trigger a shock sensation c. The patient will have to schedule monthly chest x-rays to make sure the device is patent d. The patient may have a throbbing pain that is normal e. Avoid magnetic fields such as metal detection moves

a. call for emergency assistance in feeling dizzy b. record events that trigger a shock sensation e. avoid magnetic fields such as metal detection moves

Which findings is associated with a blue tinge around the lips and conjunctiva? Select one: a. Central cyanosis b. Peripheral cyanosis c. Delayed capillary filling time d. Finger clubbing

a. central cyanosis

The surgery area calls the transfer report for a 68-year-old, postmenopausal, female patient who smokes and takes hormone therapy. She is returning to the floor after a lengthy hip replacement surgery. Which factors present in this patient increase her risk for developing venous thromboembolism related to Virchow triad? Choose all that apply Select one or more: a. Estrogen therapy b. Smoking c. Prolonged immobilization d. Dehydration e. Orthopedic surgery f. IV therapy

a. estrogen therapy b. smoking c. prolonged immobilization e. orthopedic surgery f. IV therapy

A patient with PAD has a nursing diagnosis of ineffective peripheral tissue perfusion. What should be included in the teaching plan for this patient? Choose all that apply Select one or more: a. Keep legs and feet warm b. Use nicotine replacement therapy as a substitute for smoking c. Walk at least 30 minutes per day to the point of discomfort d. Apply cold compresses when the legs become swollen e. Inspect lower extremities for pulses, temperature, and any injury.

a. keep legs and feet warm c. walk at least 30 minutes per day to the point of discomfort d. apply cold compresses when the legs become swollen e. inspect lower extremities for pulses, temp, and any injury

Which arteries are the major providers of coronary circulation? Choose all that apply Select one or more: a. Left circumflex artery b. Posterior descending artery c. Right coronary artery d. Left anterior descending artery e. Left marginal artery f. Right marginal artery

a. left circumflex artery c. right coronary artery d. left anterior descending artery

When teaching the patient with PAD about modifying risk factors associated with this condition, what should the nurse emphasize? Select one: a. Modifications will reduce the risk of other atherosclerotic conditions such as stroke b. Maintenance of normal body weight is the most important factor in controlling arterial disease c. Risk reducing behaviors initiated after angioplasty can stop the progression of the disease d. Amputation is the ultimate outcome if the patient does not alter lifestyle behaviors

a. modification will reduce the risk of other atherosclerotic conditions such as stroke

What are the characteristics of arterial disease? Choose all that apply Select one or more: a. Pallor on elevation of the legs b. Ulcers over bony prominences on toes and feet c. Decreased peripheral pulses d. Pruritus e. Dull aching calf or thigh f. Thickened, Brittle nails

a. pallor on elevation of the legs b. ulcers over bony prominences on toes and feet c. decreased peripheral pulses f. thickened, brittle nails

Which characteristics of arterial's plastic disease "Raynaud's phenomenon"? Choose all that apply Select one or more: a. Precipitated by exposure to cold, caffeine, and tobacco b. May be associated with autoimmune disorders c. Involves small cutaneous arteries of the fingers and toes d. Inflammation of small and medium-sized arteries and veins e. Episodes of white, blue, and red color changes of fingertips f. Predominate in young females

a. precipitated by exposure to cold, caffeine, and tobacco b. may be associated with autoimmune disease c. involves small cutaneous arteries of the fingers and toes e. episodes of white, blue, and red color changes of fingertips

When caring for the patient with heart failure, which medications or treatments require careful monitoring of the patient's serum potassium levels to prevent further cardiac dysfunction? Select one or more: a. Spironolactone b. Metoprolol c. Furosemide d. Enalapril e. Nitroglycerin

a. spironolactone c. furosemide

What can be auscultated on the patient with cardiac valve problems? Choose all that apply Select one or more: a. Third heart sound b. Pericardial friction rub c. Cardiac murmurs d. Fourth hard sound e. Pulses alterations f. Arterial bruit

a. third heart sound c. cardiac murmurs d. fourth heart sound

The nursing student seeking assistance in hearing the patient's abnormal her son. What should the nurse tell the student to do for more effective assessment? Select one: a. Use the bell of the stethoscope of the patient leaning forward b. Use the diaphragm of the stethoscope with the patient prone c. Use the bell of the stethoscope of the patient on the right side d. Use the diaphragm of the stethoscope with the patient supine

a. use the bell of the stethoscope of the patient leaning forward

An ED nurse is assessing a 71-year-old female client for a suspected MI. When planning the assessment, the nurse should be cognizant of what signs and symptoms of MI that are particularly common in female clients? Select all that apply. Select one or more: a. Weakness b. Chest pain c. Numbness d. Shortness of breath e. Anxiety

a. weakness c. numbness

The nurse takes a baseline blood pressure measurement after the patient has rested for 10 minutes in a supine position. Which rating reflects a reduced pulse pressure? Select one: a. 140/100 mmHg b. 140/120 mmHg c. 140/110 mmHg d. 140/90 mmHg

b. 140/120 mmHg

A thoracic aneurysm is found when the patient has a routine chest x-ray. The nurse anticipates that additional diagnostic testing to determine the size and structure of the aneurysm will include which test? Select one: a. Echocardiogram b. CT scan c. Ultrasound d. Angiography

b. CT scan

The patient is admitted with pain, edema, and warm skin on her lower left leg. What test should the nurse expect to be ordered first? Select one: a. MRI b. Duplex ultrasound c. CT venography d. Complete blood count

b. Duplex ultrasound

A 2400 mg sodium diet is prescribed for a patient with chronic heart failure. The nurse recognizes that additional teaching is necessary when the patient makes which statement? Select one: a. I should limit my milk intake took 2 cups a day b. I can eat most foods as long as I do not have saw when cooking or at the table c. I can eat fresh fruits and vegetables without worrying about sodium content d. I need to read the labels on prepared foods and medicines for their sodium content

b. I can eat most foods as long as I do not have salt when cooking or at the table.

The nurse is educating a patient about the care related to a new diagnosis of mitral valve prolapse. What statement made by the patient demonstrates understanding? Select one: a. I should get a tattoo but I can get my tongue pierced b. I will avoid caffeine, alcohol, smoking c. This disorder will progress I will need a heart transplant d. I will take antibiotics before getting my teeth cleaned

b. I will avoid caffeine, alcohol, smoking

The patient with chronic heart failure has atrial fibrillation and a left ventricular ejection fraction of 18%. To decrease the risk of complications from these conditions, what drug does the nurse anticipate giving? Select one: a. Potassium supplements b. Anticoagulants c. Beta adrenergic blockers d. Diuretics

b. anticoagulants

Which initial physical assessment finding would the nurse expect to be present in a patient with acute left sided heart failure? Select one: a. Peripheral edema in cool, diaphoretic skin b. Bubbling crackles and tachycardia c. Frothy blood tinged sputum and distended jugular veins d. Hepatosplenomegaly and tachypnea

b. bubbling crackles and tachycardia

In the patient with dysrhythmia, which assessment indicates decreased cardiac output? Select one: a. Bounding pulses in a ventricular heave b. Chest pain and decreased meditation c. Abdominal distention and hepatomegaly d. Hypertension and bradycardia

b. chest pain and decreased meditation

The nurse determines treatment of harsher has been successful in the patient experiences Select one: a. Absence of chest pain and improve the level of consciousness b. Clear lung sounds and decrease heart rate c. Weight loss and diuresis d. Warm skin and less fatigue

b. clear lung sounds and decreased heart rate

Patient's rhythm strip indicates a normal HR in rhythm with normal P waves and QRS complexes, the PR interval is 0.26 seconds. What is the most appropriate action by the nurse? Select one: a. Prepare the patient for synchronized cardioversion b. Continue to assess the patient c. Repair the patient for placement of a temporary pacemaker d. Administer atropine per protocol

b. continue to assess the patient

The patient with a small AAA is not a good surgical candidate. What should the nurse teach the patient is one of the best ways to prevent expansion of the lesion? Select one: a. Comply with prescribed anticoagulant therapy b. Control hypertension with prescribed therapy c. Maintain a low calcium diet to prevent calcification of the vessels d. Avoid strenuous physical exertion

b. control hypertension with prescribed therapy

When obtaining a health history from a 72-year-old man with peripheral arterial disease of the lower extremities, the nurse asks about a history of related conditions, including Select one: a. Pulmonary embolism b. Coronary artery disease c. Venous stasis ulcers d. Venous thrombosis

b. coronary artery disease

Patient with chronic heart failure is treated with hydrochlorothiazide, digoxin, and lisinopril. To prevent the risk of digitalis toxicity with these drugs, what is the most important that the nurse monitor for this patient? Select one: a. Heart rate b. Potassium levels c. Gastrointestinal function d. Blood pressure

b. potassium levels

A surgical repair is planned for a patient who has a 5.5 cm abdominal aortic aneurysm (AAA). On physical assessment of the patient, what should the nurse expect to find? Select one: a. Weakness in the lower extremities progressing to paraplegia b. Presence of bruit in the periumbilical area c. Severe back pain with flank ecchymosis d. Hoarseness and dysphagia

b. presence of bruit in the periumbilical area

The nursing care area is very busy with new surgical patients. Which care could DRM delegate to the unlicensed assistive personnel with the patient's with VTE? Select one: a. Teach the patient call emergency medical services with signs of a pulmonary embolism b. Remind the patient to flex and extend the legs and feet every two hours c. Measure the patient for elastic compression stockings d. Assess the patient's use of herbs

b. remind the pt to flex and extend the legs and feet every 2 hours

Which conditions characterize critical limb ischemia? Choose all that apply Select one or more: a. Cold feet b. Rest pain lasting more than two weeks c. No palpable peripheral pulses d. Arterial leg ulcers e. Venous leg ulcers f. Gangrene of the leg

b. rest pain lasting more than 2 weeks d. arterial leg ulcers f. gangrene of the legs

A patient comes to the emergency department reporting chest pain after using cocaine. The nurse assesses the patient and obtain vital signs which results as follows: blood pressure 140/90, heart rate 128, respiratory rate 26, in an oxygen saturation of 90%. What rhythm on the monitor does a nurse anticipate viewing? Select one: a. Normal sinus rhythm b. Sinus tachycardia c. Ventricular tachycardia d. Sinus bradycardia

b. sinus tachycardia

When helping the patient's popliteal pulse, the nurse feels vibration at the site. How should the nurse reported this finding? Select one: a. Thready, weak pulse b. Thrill of the popliteal artery c. Bounding pulse volume d. Bruit at the artery site

b. thrill of the popliteal artery

The nurse is assessing a client with acute coronary syndrome (ACS). The nurse includes a careful history in the assessment, especially with regard to signs and symptoms. What signs and symptoms are suggestive of ACS? Select all that apply. Select one or more: a. Hypotension b. Unusual fatigue c. Dyspnea d. Syncope e. Peripheral cyanosis

b. unusual fatigue c. dyspnea d. syncope (LOC)

The nurse teaches the patient with any venous disorder that the best way to prevent venous stasis and increase venous return is to Select one: a. Sit with the legs elevated b. Walk c. Frequently rotate the ankles d. Continuously wear elastic compression stockings

b. walk

A patient with hypertension has newly been diagnosed with atrial fibrillation. What medication does the nurse anticipate administering to prevent the complications of atrial thrombi? Select one: a. Amiodarone b. Warfarin c. Adenosine d. Atropine

b. warfarin

Which statement by the patient with chronic heart failure should cause a nurse to determine that additional discharge teaching is needed? Select one: a. "I will call my health clinic if I wake up breathless at night." b. "I will look for sodium content on labels and over-the-counter medicines" c. "I should weigh myself every morning and go on a diet if I go again with more than two or 3 pounds in two days" d. "I plan to organize my house hold tasks so I don't have to constantly go up and down the stairs"

c. I should weigh myself every morning and go on a diet if I go again with more than 2 or 3 pounds in two days

Following teaching about medication for PAD, the nurse determines that additional instruction is necessary when the patient makes which statement? Select one: a. "The lisinopril I use for my blood pressure may help me walk further without pain." b. "I should take one aspirin a day to prevent clotting in my legs." c. "I will need to have frequent blood test to evaluate the effects of the warfarin I will be taking." d. "Pletal should help me increase my walking distance and help prevent class from forming in my legs."

c. I will need to have frequent blood test to evaluate the effects of the warfarin I will be taking

During the care of the patient following femoral bypass graft surgery, the nurse immediately notifies a healthcare provider if the patient experiences Select one: a. 2+ edema of the extremity and pain at the incision site b. Increasing ankle-brachial indices and serous drainage from the incision c. A loss of palpable pulses and numbness and tingling of the feet d. Fever and redness at the incision site

c. a loss of palpable pulses and numbness and tingling of the feet

The healthcare provider prescribed Spironolactone (Aldactone) for the patient with chronic heart failure. What diet modifications related to the use of this drug should the nurse include in the patient teaching? Select one: a. Decrease sodium intake and the use of salt substitutes for seasoning b. Decreased sodium intake and increase potassium intake c. Decrease both sodium and potassium intake d. Increase calcium intake and decrease sodium intake

c. decrease both sodium and potassium intake

The nurse plans long-term goals for the patient who has had a heart transplant with the knowledge that what is the most common cause of death and heart transplant patients during the first year? Select one: a. Malignant conditions b. Embolization c. Infection d. Heart failure

c. infection

The nurse is caring for a client who has been diagnosed with an elevated cholesterol level. The nurse is aware that plaque on the inner lumen of arteries is composed chiefly of what? Select one: a. White blood cells b. High-density cholesterol c. Lipids and fibrous tissue d. Lipoproteins

c. lipids and fibrous tissue

Which indirect thrombin inhibitor is only administered subcutaneously and is not in the routine coagulation tests? Select one: a. Warfarin b. Hirudin derivatives (lepirudin) c. Low molecular weight heparin d. Unfractionated heparin

c. low molecular weight heparin

Patient tells the nurse, "I was straining to have a bowel movement and felt like I was going to faint. I took my pulse and it was so slow." What does the nurse determine has most likely occurred with this patient? Select one: a. The patient may have had an aortic aneurysm b. The patient was anxious about being constipated c. The patient had a vagal response d. The patient may have had a myocardial infarction

c. the pt had a vagal response

Which characteristics describe the anticoagulation warfarin (Coumadin)? Choose all that apply Select one or more: a. May be administered orally or subcutaneously b. Dosage monitor using activated partial thromboplastin time (aPTT) c. Protamine sulfate is the antidote d. May be administered intravenously or subcutaneously e. Doses monitoring using international normalization ratio (INR) f. Vitamin K is an antidote

e. dosing monitoring using international normalized ratio (INR) f. Vitamin K is the antidote