MS Qz 3 2022

A nurse prepares to discharge a client with a cardiac dysrhythmia who is prescribed home health care services. Which priority information would be communicated to the home health nurse upon discharge?

Medication orders for home

A nurse cares for a client with right-sided heart failure. The client asks, "Why do I need to weigh myself every day?" How would the nurse respond?

"Weight is the best indication that you are gaining or losing fluid."

A nurse assesses a client who has a history of heart failure. Which question would the nurse ask to assess the extent of the client's heart failure?

"Are you still able to walk upstairs without fatigue?"

A nurse prepares to discharge a client who has heart failure. Which questions would the nurse ask to ensure this client's safety prior to discharging home? (Select all that apply.)

"Are your bedroom and bathroom on the first floor?" "What social support do you have at home?" "What spiritual beliefs may impact your recovery?"

A nurse is providing discharge teaching to a client recovering from a heart transplant. Which statement would the nurse include?

"Avoid large crowds and people who are sick."

2. A nurse cares for a client who has a heart rate averaging 56 beats/min with no adverse symptoms. Which activity modification would the nurse suggest to avoid further slowing of the heart rate?

"Avoid straining while having a bowel movement."

A nurse is teaching a client with heart failure who has been prescribed enalapril. Which statement would the nurse include in this client's teaching?

"Avoid using salt substitutes."

A nurse teaches a client with heart failure about energy conservation. Which statement would the nurse include in this client's teaching?

"Begin walking 200 feet a day three times a week."

. A nurse cares for a client recovering from prosthetic valve replacement surgery. The client asks, "Why will I need to take anticoagulants for the rest of my life?" What is the best response by the nurse?

"Blood clots form more easily in artificial replacement valves."

A nurse supervises an assistive personnel (AP) applying electrocardiographic monitoring. Which statement would the nurse provide to the AP related to this procedure?

"Clean the skin and clip hairs if needed."

The nurse asks a client who has experienced ventricular dysrhythmias about substance abuse. The client asks, "Why do you want to know if I use cocaine?" What is the nurse's best response?

"Clients who use cocaine are at risk for fatal dysrhythmias."

A nurse teaches a client who is prescribed digoxin therapy. Which statement would the nurse include in this client's teaching?

"Do not take this medication within 1 hour of taking an antacid."

A nurse cares for an older adult client with heart failure. The client states, "I don't know what to do. I don't want to be a burden to my daughter, but I can't do it alone. Maybe I should die." What is the best response by the nurse?

"I can stay if you would you like to talk more about this."

An emergency department nurse obtains the health history of a client. Which statement by the client would alert the nurse to the occurrence of heart failure?

"I get short of breath when I climb stairs."

A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure?

"I must stop halfway up the stairs to catch my breath."

After teaching a client who has an implantable cardioverter-defibrillator (ICD), a nurse assesses the client's understanding. Which statement by the client indicates correct understanding of the teaching?

"I will avoid sources of strong electromagnetic fields."

. After teaching a client who is being discharged home after mitral valve replacement surgery, the nurse assesses the client's understanding. Which client statement indicates a need for additional teaching?

"I will have my teeth cleaned by my dentist in 2 weeks.

After teaching a client with congestive heart failure (CHF), the nurse assesses the client's understanding. Which client statements indicate a correct understanding of the teaching related to nutritional intake? (Select all that apply.)

"I'll read the nutritional labels on food items for salt content." "I will eat oatmeal for breakfast instead of ham and eggs." "Substituting fresh vegetables for canned ones will lower my salt intake."

A nurse teaches a client who experiences occasional premature atrial contractions (PACs) accompanied by palpitations that resolve spontaneously without treatment. Which statement would the nurse include in this client's teaching?

"Minimize or abstain from caffeine."

A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse

"My shoes fit really tight lately."

A nurse obtains the health history of a client who is newly admitted to the medical unit. Which statement by the client would alert the nurse to the presence of edema?

"My shoes fit tighter by the end of the day."

A nurse collaborates with assistive personnel (AP) to provide care for a client with congestive heart failure. Which instructions would the nurse provide to the AP when delegating care for this client? (Select all that apply.)

"Reposition the client every 2 hours." "Accurately record intake and output." "Use the same scale to weigh the client each morning."

17. A nurse prepares a client for cardiac catheterization. The client states, "I am afraid I might die." What is the nurse's best response?

"Tell me more about your concerns about the test."

A nurse teaches a client with a new permanent pacemaker. Which instructions would the nurse include in this client's teaching? (Select all that apply.)

"Until your incision is healed, do not submerge your pacemaker. Only take showers." "Report any pulse rates lower than your pacemaker settings."

15. A nurse cares for a client who has advanced cardiac disease and states, "I am having trouble breathing while I'm sleeping at night." What is the nurse's best response?

"Use pillows to elevate your head and chest while you are sleeping."

A nurse teaches a client who has a history of heart failure. Which statement would the nurse include in this client's discharge teaching?

"Weigh yourself daily while wearing the same amount of clothing."

16. A nurse cares for a client who is recovering from a myocardial infarction. The client states, "I will need to stop eating so much chili to keep that indigestion pain from returning." What is the nurse's best response?

"What do you understand about what has happened to you?."

A nurse cares for a client with end-stage heart failure who is awaiting a transplant. The client appears depressed and states, "I know a transplant is my last chance, but I don't want to become a vegetable." How would the nurse respond?

"Would you like information about advance directives?"

After teaching a client who is recovering from a heart transplant to change positions slowly, the client asks, "Why is this important?" How would the nurse respond?

"Your new heart is not connected to the nervous system and is unable to respond to decreases in blood pressure caused by position changes."

A nurse assesses clients on a cardiac unit. Which client would the nurse identify as being at greatest risk for the development of left-sided heart failure?

A 36-year-old woman with aortic stenosis

A nurse assesses clients on a cardiac unit. Which clients would the nurse identify as at greatest risk for the development of acute pericarditis? (Select all that apply.)

A 36-year-old woman with systemic lupus erythematosus (SLE) A 42-year-old man recovering from coronary artery bypass graft surgery An 80-year-old man with a bacterial infection of the respiratory tract

A nurse is assessing clients on a medical-surgical unit. Which client would the nurse identify as being at greatest risk for atrial fibrillation?

A 50-year-old who is post coronary artery bypass graft surgery.

A nurse assesses clients on a medical-surgical unit. Which client would the nurse identify as having the greatest risk for cardiovascular disease?

A 65-year-old woman with diabetes mellitus.

A nurse assesses a client with tachycardia. Which clinical manifestation requires immediate intervention by the nurse?

Midsternal chest pain

10. A nurse assesses a client who is scheduled for a cardiac catheterization. Which assessment would the nurse complete as the priority prior to this procedure?

Allergies to iodine-based agents

A nurse assesses a client after administering the first dose of a nitrate. The client reports a headache. What action would the nurse take?

Administer PRN acetaminophen.

A nurse is caring for a client who was admitted with hypertrophic cardiomyopathy (HCM). What interprofessional care does the nurse anticipate providing? (Select all that apply.)

Administering beta blockers Preparing for a cardiac catheterization Instructing the client to avoid strenuous exercise

A nurse performs an admission assessment on a 75-year-old client with multiple chronic diseases. The client's blood pressure is 135/75 mm Hg and oxygen saturation is 94% on 2 L per nasal cannula. The nurse assesses the client's rhythm on the cardiac monitor and observes the reading shown below: What action would the nurse take first?

Ask the client what medications he or she takes.

1. A nurse is caring for a client with a history of renal insufficiency who is scheduled for a cardiac catheterization. What actions would the nurse take prior to the catheterization? (Select all that apply.)

Assess for allergies to iodine. Administer intravenous fluids. Assess blood urea nitrogen (BUN) and creatinine results.

While assessing a client on a cardiac unit, a nurse identifies the presence of an S3 gallop. What action would the nurse take next?

Assess for symptoms of left-sided heart failure.

A nurse assesses an older adult client who has multiple chronic diseases. The client's heart rate is 48 beats/min. What action would the nurse take first?

Assess the client's medications.

A nurse admits a client who is experiencing an exacerbation of heart failure. What action would the nurse take first?

Assess the client's respiratory status.

8. A nurse assesses a client 2 hours after a cardiac angiography via the left femoral artery. The nurse notes that the left pedal pulse is weak. What action would the nurse take next?

Assess the color and temperature of the left leg.

A nurse cares for a client with an intravenous temporary pacemaker for bradycardia. The nurse observes the presence of a pacing spike but no QRS complex on the client's electrocardiogram. What action would the nurse take next?

Assess vital signs and level of consciousness.

A nurse assesses a client who has mitral valve regurgitation. For which cardiac dysrhythmia would the nurse assess?

Atrial fibrillation

18. An emergency department nurse triages clients who present with chest discomfort. Which client would the nurse plan to assess first?

Client who describes intense squeezing pressure across the chest.

12. A nurse assesses a client who is recovering from a myocardial infarction. The client's blood pressure is 140/88 mm Hg. What action would the nurse take first?

Compare the results with previous blood pressure readings.

A nurse cares for a client with congestive heart failure who has a regular cardiac rhythm of 128 beats/min. For which physiologic alterations would the nurse assess? (Select all that apply.)

Decrease in cardiac output Decrease in blood pressure Decrease in urine output

A nurse assesses a client with mitral valve stenosis. What clinical sign or symptom would alert the nurse to the possibility that the client's stenosis has progressed?

Dyspnea on exertion

A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which intervention is appropriate for the nurse to perform prior to defibrillating this client?

Ensure that everyone is clear of contact with the client and the bed.

A nurse prepares to discharge a client who has heart failure. Based on national quality measures, what actions would the nurse complete prior to discharging this client? (Select all that apply.)

Ensure that the client is prescribed a beta blocker. Document a discussion about advanced directives. Care transition record transmitted to next level of care within 7 days of discharge.

A nurse assesses female client who is experiencing a myocardial infarction. Which clinical manifestation would the nurse expect?

Fatigue and shortness of breath

2. An emergency department nurse assesses a female client. Which assessment findings would alert the nurse to request a prescription for an electrocardiogram? (Select all that apply.)

Fatigue despite adequate rest Indigestion Shortness of breath

A nurse assesses a client with pericarditis. Which assessment finding would the nurse expect to find?

Friction rub at the left lower sternal border.

A nurse assesses a client who had a myocardial infarction and has a blood pressure of 88/58 mm Hg. Which additional assessment finding would the nurse expect?

Heart rate of 120 beats/min

A nurse evaluates laboratory results for a client with heart failure. Which results would the nurse expect? (Select all that apply.)

Hematocrit: 32.8% Serum sodium: 130 mEq/L (130 mmol/L) Proteinuria Microalbuminuria

The nurse is caring for a client on the medical-surgical unit who suddenly becomes unresponsive and has no pulse. The cardiac monitor shows the rhythm below:

Initiate cardiopulmonary resuscitation (CPR).

13. A nurse cares for a client who has an 80% blockage of the right coronary artery (RCA) and is scheduled for bypass surgery. Which intervention would the nurse be prepared to implement while this client waits for surgery?

Initiation of an external pacemaker

After administering the first dose of captopril to a client with heart failure, the nurse implements interventions to decrease complications. Which intervention is most important for the nurse to implement?

Instruct the client to ask for assistance when rising from bed.

A telemetry nurse assesses a client who has a heart rate of 35 beats/min on the cardiac monitor. Which assessment would the nurse complete next?

Level of consciousness

11. A nurse cares for a client who is prescribed magnetic resonance imaging (MRI) of the heart. The client's health history includes a previous myocardial infarction and pacemaker implantation. What action would the nurse take?

Notify the primary health care provider before scheduling the MRI.

A nurse prepares a client for a pharmacologic stress echocardiogram. What actions would the nurse take when preparing this client for the procedure? (Select all that apply.)

Prepare for continuous blood pressure and pulse monitoring. Give the client nothing by mouth 3 to 6 hours before the procedure. Explain to the client that dobutamine will simulate exercise for this examination.

A nurse is assessing a client with left-sided heart failure. For which clinical manifestations would the nurse assess? (Select all that apply.)

Pulmonary crackles Confusion Cough that worsens at night

A nurse assesses a client after administering a prescribed beta blocker. Which assessment would the nurse expect to find?

Pulse decreased from 100 to 80 beats/min.

3. A nurse assesses a client who is recovering after a coronary catheterization. Which assessment findings in the first few hours after the procedure require immediate action by the nurse? (Select all that apply.)

Serum potassium of 2.9 mEq/L (2.9 mmol/L) Expanding groin hematoma Rhythm changes on the cardiac monitor

A nurse administers prescribed adenosine to a client. Which response would the nurse assess for as the expected therapeutic response?

Short period of asystole

A nurse assesses a client who is recovering from a heart transplant. Which assessment findings would alert the nurse to the possibility of heart transplant rejection? (Select all that apply.)

Shortness of breath Abdominal bloating New-onset bradycardia Fatigue

A nurse assesses a client's electrocardiogram (ECG) and observes the reading shown below:

Sinus rhythm with premature ventricular contractions (PVCs)

A nurse is caring for a client with acute pericarditis who reports substernal precordial pain that radiates to the left side of the neck. Which nonpharmacologic comfort measure would the nurse implement?

Sit the client up with a pillow to lean forward on.

After assessing a client who is receiving an amiodarone intravenous infusion for unstable ventricular tachycardia, the nurse documents the findings and compares these with the previous assessment findings: Time: 08:00 Temperature: 98° F (36.7° C) Heart rate: 68 beats/min Blood pressure: 135/60 mm Hg Respiratory rate: 14 breaths/min Oxygen saturation: 96% Oxygen therapy: 2 L nasal cannula Time: 10:00 Temperature: 98.2° F (36.8° C) Heart rate: 50 beats/min Blood pressure: 132/57 mm Hg Respiratory rate: 16 breaths/min Oxygen saturation: 95%

Slow the amiodarone infusion rate.

9. A nurse assesses a client who is recovering after a left-sided cardiac catheterization. Which S/S would the nurse notify the HCP immediately

Slurred speech and confusion

A nurse is teaching a client who has premature ectopic beats. Which education would the nurse include in this client's teaching? (Select all that apply.)

Smoking cessation Stress reduction and management Adverse effects of medications

A nurse assesses a client with atrial fibrillation. Which manifestation would alert the nurse to the possibility of a serious complication from this condition?

Speech alterations

A nurse cares for a client with infective endocarditis. Which infection control precautions would the nurse use?

Standard Precautions

5. A nurse cares for a client who is recovering from a right-sided heart catheterization. For which complications of this procedure would the nurse assess? (Select all that apply.)

Thrombophlebitis Pulmonary embolism Cardiac tamponade

4. A nurse reviews a client's laboratory results. Which findings would alert the nurse to the possibility of atherosclerosis? (Select all that apply.)

Total cholesterol: 280 mg/dL (7.3 mmol/L) Triglycerides: 200 mg/dL (2.3 mmol/L) Low-density lipoprotein cholesterol: 160 mg/dL (4.1 mmol/L)

A nurse assists with the cardioversion of a client experiencing acute atrial fibrillation. What action would the nurse take prior to the cardioversion?

Turn off oxygen therapy.

1. A nurse assesses a client's electrocardiograph tracing and observes that not all QRS complexes are preceded by a P wave. How would the nurse interpret this observation?

Ventricular and atrial depolarizations are initiated from different sites.

A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication would the nurse expect to find on this client's medication administration record to prevent a common complication of this condition?

Warfarin

14. A nurse teaches a client with diabetes mellitus and a body mass index of 42 who is at high risk for coronary artery disease. Which statement related to nutrition would the nurse include in this client's teaching?

a. "You should balance weight loss with consuming necessary nutrients."

A nurse cares for a client who is on a cardiac monitor. The monitor displayed the rhythm shown below: What action would the nurse take first?

a. Assess airway, breathing, and circulation.

19. A nurse assesses a client who has aortic regurgitation. In which location in the illustration shown below would the nurse auscultate to best hear a cardiac murmur related to aortic regurgitation?

a. Location A