oxygenat

The client receives morphine sulfate IV soon after admission. When evaluating the client's response to the medication, the nurse should assess its effect on her? a. Nausea b. Crackles c. Cyanosis d. Anxiety

d. Anxiety

Francis who is hospitalized following a myocardial infarction asks the nurse why he is taking morphine. The nurse explains that morphine: a. Decrease anxiety and restlessness c. Dilates coronary blood vessels b. Prevents shock and relieves pain d. Helps prevent fibrillation of the heart

b. Prevents shock and relieves pain

9. You assess a patient for postural hypotension and recognize the following are normal postural responses except: a. An unchanged systolic pressure c. An increase of 10 mm Hg in the reading b. A heart rate of 5-20 bpm above the resting rate d. An increase of 5 mm Hg in diastolic pressure

c. An increase of 10 mm Hg in the reading

17. A client is scheduled to undergo percutaneous transluminal coronary angioplasty (PTCA). Which statement by the nurse best explains the procedure to the client? a. "PTCA involves opening a blocked artery with an inflatable balloon located on the end of a catheter." b. "PTCA involves cutting away blockages with a special catheter." c. "PTCA involves passing a catheter through the coronary arteries to find blocked arteries." d. "PTCA involves inserting grafts to divert blood from blocked coronary arteries

a. "PTCA involves opening a blocked artery with an inflatable balloon located on the end of a catheter."

43. After his attack, Mr. Packman told you, "My father died of a heart attack when he was 60, and I suppose I will too." Which of the following responses would be the most appropriate? a. "Tell me more of what you're feeling." b. "Are you thinking that you won't recover from this illness?" c. "You have a fine doctor. Everything will be all right soon." d. "Would you agree that this would be very unlikely?"

a. "Tell me more of what you're feeling."

It is the second day of hospitalization of a client following a Myocardial Infarction. Which of the following is an expected outcome? a. Able to perform self-care activities without pain c. Can recognize the risk factors of Myocardial Infarction b. Severe chest pain d. Can participate in cardiac rehabilitation walking program

a. Able to perform self-care activities without pain

During rescue breathing, if the chest wall fails to rise with each inflation, the most likely reason is that the: a. Airway is not clear c. Inflations are being given at too rapid rate b. Victim is beyond resuscitation d. Rescuer is using inadequate force for cardiac massage

a. Airway is not clear

During nursing assessment, the client says, "I don't really know why I'm here; I feel fine and haven't had any symptoms." The nurse would recognize the importance of explaining to the client that symptoms of hypertension a. Are seldom present c. Occur only with malignant hypertension b. Signify a high risk of stroke d. Appear after irreversible kidney damage has occurred

a. Are seldom present

A child with heart disease starts on oral digoxin (Lanoxin). When preparing to administer the medication, which of the following should the nurse do first? a. Check the last serum electrolyte results for the child. b. Verify the dosage with a pharmacist who is working that day. c. Ask the mother if she is willing to administer the medication. d. Teach the mother how to measure the child's heart rate.

a. Check the last serum electrolyte results for the child.

33. Ms. Almaden heard from the other patient that her chest pain might be a crescendo angina. How will you explain that her pain is different from crescendo angina? You will tell her that: a. Crescendo angina occurs more frequently and last longer b. Crescendo angina is severe that she will be incapacitated c. Crescendo angina is a pain that occurs at rest d. Crescendo angina is symptoms free

a. Crescendo angina occurs more frequently and last longer

27. When obtaining the history of a client admitted with Endocarditis, which information from the client interview would the nurse consider as significant? a. Dental surgery in the recent past c. History of marijuana use b. History of coronary artery disease (CAD) d. Prolonged use of steroid therapy

a. Dental surgery in the recent past

10. You check the client's chart and see on the assessment data that the client's pulse strength is "left radial+2." Based on 0-4 rating scale, this means: a. Diminished pulse and cannot be obliterated b. Pulse is weak, thready, difficult to palpate and obliterated with pressure c. Full pulse, easy to palpate, weak and thread d. Strong and bounding pulse, may be abnormal

a. Diminished pulse and cannot be obliterated

The industrial health nurse monitor the client's BP as he begins therapy of methyldopa (Aldomet) and hydrochlorothiazide (hydroDIURIL). The nurse would know that the client must be monitored carefully during the first days of therapy because methyldopa frequently causes: a. Drowsiness c. Nausea and facial flushing, tremors and incoordination b. Inability to concentrate d. Hyperexcitability and aggression

a. Drowsiness

25. Which signs and symptoms are present with a diagnosis of pericarditis? a. Fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR) b. Low urine output secondary to left ventricular dysfunction c. Lethargy, anorexia, and heart failure d. Pitting edema, chest discomfort, and nonspecific ST-segment

a. Fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR)

38. What would be your priority nursing diagnosis during the first 24 hours following an MI? a. Impaired gas exchange b. High risk for infection c. Fluid volume deficit d. Constipation

a. Impaired gas exchange

The major goal of therapy for this client would be to: a. Increase cardiac output. c. Decrease peripheral edema. b. Improve respiratory status. d. Enhance comfort.

a. Increase cardiac output.

During the CPR, the xyphoid process at the lower end of the sternum should not be deeply compressed when performing external cardiac compression, due to the danger of lacerating the victim's: a. Liver b. Lung c. Stomach d. diaphragm

a. Liver

4. Cardiac output must be responsive to changes in the metabolic demand. You know that cardiac output can be determined by: a. Measuring the amount of blood ejected per heartbeat and multiplying it to the client's heart rate. b. Summing up the stroke volume with the client's heart rate c. Getting the heart rate of the client and the client's stroke volume and BP d. Getting the BP of the client multiply to the client's heart rate

a. Measuring the amount of blood ejected per heartbeat and multiplying it to the client's heart rate.

The client continues to have episodic chest pain during the first 8 hours, despite morphine administration. He is started on continuous intravenous NTG (Tridil) infusion. Essential nursing action would include: a. Obtaining an infusion pump for the medication c. Monitoring urine output hourly b. Monitoring the blood pressure hourly d. Obtaining serum potassium levels daily.

a. Obtaining an infusion pump for the medication

. Kate who has undergone mitral valve replacement suddenly experiences continuous bleeding from the surgical incision during postoperative period. Which of the following pharmaceutical agents should Nurse Mitch administer to her? a. Protamine Sulfate b. Quinidine Sulfate c. Vitamin C d. Coumadin

a. Protamine Sulfate

. If Mr. Packman develops cardiogenic shock, which characteristic sign should the nurse expect to observe? a. Pulmonary crackles b. Bradycardia c. Elevated blood pressure d. Fever

a. Pulmonary crackles

. After the test, you instructed Mr. Nar Ding to: a. Rest for a time b. Avoid stimulants c. Avoid extreme temperature changes d. Do all of the above

a. Rest for a time

Based on the analysis of the client's atrial fibrillation, the nurse should prepare the client for which treatment protocol? a. Diuretic therapy. b. Pacemaker implantation. c. Anticoagulation therapy. d. Cardiac catheterization.

c. Anticoagulation therapy.

11. A nurse is explaining the anatomy and physiology of the heart to a group of adults participating in a wellness program. When a participant asks for an explanation of the purpose of the superior vena cava, the nurse provides which of the following information? a. Returns blood from the body area above the diaphragm b. Returns blood from the body below the diaphragm c. Drains blood from the heart d. Receives freshly oxygenated blood from the lungs through the pulmonary veins

a. Returns blood from the body area above the diaphragm

Which of the following may predispose an individual to ventricular fibrillation based from the situation? a. Severe myocardial damage b. Electrolyte imbalances c. Hypothermia d. Hypoxia

a. Severe myocardial damage

32. After beginning an IV access and giving one aspirin to chew, the nurse administers a prescribed sublingual NTG tablet to the client and starts oxygen by nasal cannula at 4L per minute. Within 30 minutes, the client states that his pain is relieved. What type of angina pectoris Ms. Almaden is experiencing? a. Stable angina b. Unstable angina c. Refractory angina d. Prinzmetal's angina

a. Stable angina

1. The pumping action of the heart is accomplished by the rhythmic contraction and relaxation of its muscular wall. What change occurs during systole? a. The chambers of the heart become smaller as the blood is ejected b. The heart chambers fill with blood in preparation for subsequent ejection. c. The heart chamber of the heart becomes bigger as it receives blood d. The myocardium becomes thinner as it blood enter the chamber.

a. The chambers of the heart become smaller as the blood is ejected

A client with heart disease is on a continuous telemetry monitor and has developed sinus bradycardia. In determining the possible cause of the bradycardia, the nurse assesses the client's medication record. Which medication is most likely the cause of the bradycardia? a. propanolol (Inderal). b. captopril (Capoten). c. furosemide (Lasix). d. dobutamine (Dobutrex).

a. propanolol (Inderal).

. During the initial interview of the client, you would most likely learn that the client's childhood health history included: a. Chicken pox b. Poliomyelitis c. Rheumatic fever d. Meningitis

c. Rheumatic fever

Milagrosa undergoes a mitral valve replacement. Postoperatively, she develops multiple premature ventricular contractions. The physician orders lidocaine hydrochloride infusion at 2 mg/min. The IV bag contains 2 g of lidocaine in 500 ml of dextrose 5% in water. If the equipment used for administering the drug and solution indicates that 60 micro drops are equal to 1 ml, how many micro drops would provide 2 mg of lidocaine each minute? a. 15 b. 30 c. 45 d. 60

b. 30

23. A client is prescribed captopril (Capoten) to treat his hypertension. This drug is classified as: a. Calcium channel blocker b. ACE inhibitor c. Beta blocker d. Vasodilator

b. ACE inhibitor

The nurse notes that the only ECG for a 55-year-old male client scheduled for surgery in two hours is dated two years ago. The client reports that he has a history of "heart trouble," but has no problems at present. Hospital protocol requires that those over 50 years of age have a recent ECG prior to surgery. What nursing action is best for the nurse to implement? a. Ask the client what he means by "heart trouble." c. Notify surgery that the ECG is over two years old. b. Call for an ECG to be performed immediately. d. Notify the client's surgeon immediately.

b. Call for an ECG to be performed immediately.

Mrs. Gomez, a 78 year old client, is admitted with a diagnosis of mild chronic heart failure. The nurse expects to hear this sound when listening to client's lungs: a. Stridor b. Crackles c. Wheezes d. Friction rubs

b. Crackles

This client requires careful skin care, primarily because an edematous client is prone to develop: a. Itchy skin b. Decubitus ulcers c. Electrolyte imbalance d. Distention of weakened veins

b. Decubitus ulcers

12. When do coronary arteries primarily receive blood flow? a. During inspiration b. During diastole c. During expiration d. During systole

b. During diastole

Among the following signs and symptoms, which would most likely be present in a client with mitral regurgitation? a. Altered level of consciousness c. Increase creatine phospholinase concentration b. Exceptional Dyspnea d. Chest pain

b. Exceptional Dyspnea

5. Heart rate is stimulated by the following except: a. Increased level of the catecholamine c. The vagus nerve b. Excess thyroid hormone d. The sympathetic system

b. Excess thyroid hormone

16. After teaching a group of adults about modifiable risk factors for coronary artery disease (CAD), the community health nurse knows that the group needs additional teaching if which finding is identified as one of these factors? a. Cigarette smoking b. Family history c. Hypercholesterolemia d. Hypertension

b. Family history

What would be the primary goal of therapy for a client with pulmonary edema and heart failure? a. Enhance comfort c. Improve respiratory status b. Increase cardiac output d. Peripheral edema decreased

b. Increase cardiac output

The doctor has prescribed nitroglycerin to a client with angina. The patient also has closed-angle glaucoma. The nurse contacts the physician to discuss the potential problem, which is: a. Decrease intraocular pressure. c. Hypotension b. Increase intraocular pressure. d. Hypertension.

b. Increase intraocular pressure

19. A client is experiencing an acute myocardial infarction (MI) and I.V. morphine is prescribed. Morphine is given because it: a. Eliminates pain, reduces cardiac workload, and increases myocardial contractility b. Lowers resistance, reduces cardiac workload, and decreases myocardial oxygen demand c. Raises the blood pressure, lowers myocardial oxygen demand, and eliminates pain d. Increases venous return, lowers resistance, and reduces cardiac workload.

b. Lowers resistance, reduces cardiac workload, and decreases myocardial oxygen demand

35. Instructions should be given to the client before she goes home which includes all of the following, except? a. Carry the medication at all times and stored in a dark glass bottle. b. NTG should not be taken in anticipation of any activity that may produce pain. c. NTG is highly volatile and is inactivated by heat, moisture, air, light, and time. d. Renew the NTG supply every 6 months

b. NTG should not be taken in anticipation of any activity that may produce pain.

13. Atherosclerosis impedes coronary blood flow by which of the following mechanisms? a. Plaques obstruct the vein c. Blood clots form outside the vessel wall b. Plaques obstruct the artery d. Hardened vessels dilate to allow blood to flow through

b. Plaques obstruct the arter

37. Everyone who is involved in the care of a patient should work collaboratively to achieve a better outcome. As you attend to Mr. Packman, what should be your collaborative intervention that should be implemented first? a. Prevent further myocardial damage c. Prevent respiratory dysfunction b. Relief pain or ischemic signs and symptoms d. Maintain adequate tissue perfusion

b. Relief pain or ischemic signs and symptoms

After Milagrosa experiences some initial excitation, the nurse would judge that she is demonstrating a typical toxic reaction to lidocaine hydrochloride when she complains of: a. Palpitations b. Tinnitus c. Urinary frequency d. Lethargy

b. Tinnitus

You provide drug teaching about the action of morphine sulfate to Mr. Packman in relation to his MI. You identify that no further teaching is required if he states that the primary reason of morphine administration is: a. To reduce his anxiety so oxygen demand will be minimized c. To dilate his blood vessel b. To control his pain d. To reduce the workload of the heart

b. To control his pain

A 64 year old male client, with a long history of cardiovascular problem including hypertension and angina, is to be scheduled for cardiac catheterization. During pre cardiac catheterization teaching, Nurse Mimi should inform the client that the primary purpose of the procedure is: a. To determine the existence of CHD c. To obtain the heart chambers pressure b. To visualize the disease process in the coronary arteries d. To measure oxygen content of different heart chambers

b. To visualize the disease process in the coronary arteries

A client is scheduled for insertion of an inferior vena cava (IVC) filter. Nurse Patricia consults the physician about withholding which regularly scheduled medication on the day before the surgery? a. Potassium Chloride b. Warfarin Sodium c. Furosemide d. Docusate

b. Warfarin Sodium

8. How are you going to assess a client with postural hypotension? Arrange the following in order of execution. i. Position the client supine and flat ii. Do not remove the BP cuff between position changes but check to see if the BP is still correctly placed iii. Supine measurements should be measured before checking the upright position iv. Assess BP changes with client sitting on the edge of the bed with feet dangling and standing v. Record HR and BP a. i, ii, iii, iv, v b. i, iii, ii, iv, v c. i, iii, ii, v, iv d. ii, i, iii, iv, v

b. i, iii, ii, iv, v

When performing external chest compression on your patient during CPR, you will depress the sternum by: a. ½" to 1" b. 1" to 1 ½" c. 1 ½" to 2" d. 2" to 2 ½"

c. 1 ½" to 2"

21. A client is admitted to the coronary care unit with a suspected diagnosis of acute myocardial infarction. To help confirm the diagnosis, the physician orders serial enzyme tests. Increased serum levels of the isoenzyme creatinine kinase of myocardial muscle (CK-MB), found only in cardiac muscle, can be detected how soon after the onset of chest pain? a. 30 minutes to 1 hour b. 2 to 3 hours c. 4 to 8 hours d. 12 to 18 hours

c. 4 to 8 hours

3. Automaticity refers to: a. Ability to transmit an electrical impulse from one cell to another b. Ability to respond to electrical impulse c. Ability to initiate an electrical impulse d. Ability to automatically respond to electrical impulse

c. Ability to initiate an electrical impulse

Which of the following would be a priority nursing diagnosis for the client with CHF and pulmonary edema? a. High risk for infection related to stasis of secretions in alveoli. b. Impaired skin integrity related to edema and pressure. c. Activity intolerance related to imbalance between oxygen supply and demand. d. Constipation related to immobility.

c. Activity intolerance related to imbalance between oxygen supply and demand.

The nurse teaches the client about his dietary restrictions, a low calorie, and low fat, low sodium diet. Which of the following menu selections would best meet his needs? a. Mixed green salad with blue cheese dressing crackers and cold cuts b. Ham sandwich on rye bread and an orange c. Baked chicken and apple and slice of white bread d. Hotdogs, baked beans and celery and carrot sticks

c. Baked chicken and apple and slice of white bread

29. An 84-year-old male is returning from the operating room (OR) after inguinal hernia repair. The nurse notes that he has fluid volume excess from the operation and is at risk for left-sided heart failure. Which of the following signs and symptoms indicates left-sided heart failure? a. Jugular vein distention b. Right upper quadrant pain c. Bibasilar fine crackles d. Dependent edema

c. Bibasilar fine crackles

31. Which outcome is the best indicator that digoxin has been effective? a. Increased systolic and diastolic pressures c. Decreased pulse rate and increased urinary output b. Unlabored respirations and increased urinary output d. Increased BP and decreased pulse rate

c. Decreased pulse rate and increased urinary output

28. Which clinical manifestation indicates the development of right-sided heart failure in a client with COPD? a. Increased barrel chest b. Diminished heart sounds c. Dependent ankle edema d. Pink, frothy sputum

c. Dependent ankle edema

A client with a history of hypertension, myocardial infarction, and heart failure is admitted to the surgical intensive care unit after coronary artery bypass surgery graft (CABG). The nurse determines the client's serum potassium level is 4.5mEq/L. What action should the nurse implement? a. Notify the healthcare provider. c. Document the finding as the only action. b. Decrease the IV solution flow rate. d. Administer potassium replacement as prescribed.

c. Document the finding as the only action.

A client is admitted to the medical intensive care unit with a diagnosis of myocardial infarction. The client's history indicates that the infarction occurred ten hours ago. Which laboratory test result should the nurse expect this client to exhibit? a. Elevated LDH. b. Elevated serum amylase. c. Elevated CK-MB. d. Elevated hematocrit

c. Elevated CK-MB.

20. A client comes to the emergency department complaining of chest pain. An electrocardiogram (ECG) reveals myocardial ischemia and an anterior-wall myocardial infarction (MI). Which ECG characteristic indicates myocardial ischemia? a. Prolonged PR interval b. Absent Q wave c. Elevated ST segment d. Widened QRS complex

c. Elevated ST segment

The client realizes the importance of quitting smoking, and the nurse develops a plan to help him achieve his goal. Which of the following nursing interventions should be the initial step in this plan? a. Review the negative effects of smoking on the body. b. Discuss the effects passive smoking on environmental pollution. c. Establish the client's daily smoking pattern. d. Explain how smoking worsens high blood pressure.

c. Establish the client's daily smoking pattern

During the first several hours after a cardiac catheterization, it would be most essential for Nurse Mimi to: a. Elevate client's bed at 45° b. Instruct the client to cough and deep breathe every 2 hours c. Frequently monitor client's apical pulse and blood pressure d. Monitor client's temperature every hour

c. Frequently monitor client's apical pulse and blood pressure

26. Which signs and symptoms would alert the nurse to the possibility of a major complication in a client with pericarditis? a. Chest pain and diaphoresis c. Hypotension and muffled heart sounds b. Dyspnea and copious blood-tinged, frothy sputum d. Tachycardia and oliguria

c. Hypotension and muffled heart sound

A client who has been diagnosed of hypertension is being taught to restrict intake of sodium. The nurse knows that the teachings are effective if the client states that: a. I can eat celery sticks and carrots c. I can eat shredded wheat cereal b. I can eat broiled scallops d. I can eat spaghetti on rye bread

c. I can eat shredded wheat cereal

7. You know that there are factors that may bring changes in the cardiac structure associated with aging which includes all of the following except: a. Elongation of the aorta c. Increased sensitivity to baroreceptors b. Endocardial fibrosis d. Increased size of left atrium

c. Increased sensitivity to baroreceptors

As she recovers, the client asks the nurse to adjust the bed so that her knees will be supported in a flexed position and she will not "slide down" in bed. You should explain to the patient that the position requested is contraindicated, primarily because: a. It places her feet in a dropped position c. It causes stagnation of blood in her legs and feet b. It causes her knees to freeze d. It places pressure on the nerves under her knees

c. It causes stagnation of blood in her legs and feet

The nurse is planning care to prevent complication for a client with multiple myeloma. Which intervention is most important for the nurse to include? a. Safety precautions during activity. c. Maintain a fluid intake of 3 to 4 L per day. b. Assess for changes in size of lymph nodes. d. Administer narcotic analgesic around the clock.

c. Maintain a fluid intake of 3 to 4 L per day.

In reducing the risk of endocarditis, good dental care is an important measure. To promote good dental care in a client with mitral stenosis, teaching plan should include proper use of: a. Dental floss b. Electric toothbrush c. Manual toothbrush d. Irrigation device

c. Manual toothbrush

The physician orders pulmonary artery pressure monitoring including PCWP with a pulmonary catheter. The purpose of this is to help assess the: a. Degree of coronary stenosis c. Pressure from fluid within the left ventricle b. Blood pressure within the right ventricle d. Oxygen and carbon dioxide pressure in the blood

c. Pressure from fluid within the left ventricle

Nurse Trisha teaches a client with heart failure to take oral Furosemide in the morning. The reason for this is to help: a. Retard rapid drug absorption c. Prevent sleep disturbances during the night b. Excrete excessive fluids accumulated at night d. Prevention of electrolyte imbalance

c. Prevent sleep disturbances during the night

15. What position should the nurse place the head of the bed in to obtain the most accurate reading of jugular vein distention? a. High fowler's b. Raised 10 degrees c. Raised 30 degrees d. Supine position

c. Raised 30 degrees

In which of the following positions should the nurse place the client? a. Semi-sitting (low Fowler's position) c. Sitting nearly upright (high Fowler's position) b. Lying on her right side (Sims' position) d. Lying on her back with her head lowered (Trendelenburg's position)

c. Sitting nearly upright (high Fowler's position)

22. Which of the following blood tests is most indicative of cardiac damage? a. Lactate dehydrogenase b. 2 to 3 hours c. Troponin Ix d. Creatine kinase (CK)

c. Troponin Ix

18. As initial step in treating a client with angina, the physician prescribes nitroglycerin tablets, 0.3 mg given sublingually. This drug's principal effects are produced by: a. Antispasmodic effects on the pericardium c. Vasodilation of peripheral vasculature b. Causing an increased myocardial oxygen d. Improved conductivity in the myocardium

c. Vasodilation of peripheral vasculature

A 77-year-old female client is admitted to the hospital. She is confused, has no appetite, is nauseated and vomiting, and is complaining of headache. Her pulse rate is 43 beats per minute. Which question is a priority for the nurse to ask this client or her family on admission? a. "Does the client have her own teeth or dentures?" c. "Does the client takes nitroglycerin?" b. Does the client takes aspirin and if so, how much?" d. "Does the client takes digitalis?"

d. "Does the client takes digitalis?"

34. Nitroglycerine is prescribed to your patient. As part of the discharge planning, you will provide health teachings on the proper use of NTG. Which statement by the client will help you determine that additional health teaching is needed? a. "I should place my NTG tablet on my buccal pouch." b. "I should crush NTG tablet if the pain is severe." c. "My mouth should be moist" d. "I should keep my tongue still and swallow my saliva as NTG tablet dissolves."

d. "I should keep my tongue still and swallow my saliva as NTG tablet dissolves."

Lifestyle modification for Manny Packman during convalescence and healing period is necessary for faster recovery. Which of the following statements of the client needs further teaching? a. "I should avoid any activity that may cause me fatigue." b. "I should see to it that I will take a bath with warm water." c. "I should lose weight and stop smoking." d. "I should keep myself active by engaging into strenuous sports."

d. "I should keep myself active by engaging into strenuous sports."

6. One student nurse asks you how to determine the stroke volume of the heart. You will answer the question, knowingly that stroke volume is determined by: a. The degree of cardiac muscle strength b. The intrinsic contractility of the cardiac muscle c. The pressure gradient against which the muscle ejects blood during contraction d. All of the above factors

d. All of the above factors

2. Cardiac conduction system generates and transmits electrical impulses that stimulate contraction of the myocardium. Impulses come from two specialized electrical cells. What are the physiologic characteristics of the electrical cell? a. Automaticity, excitability, potentiality c. Conductivity, potentiality, refractivity b. Automaticity, conductivity, refractivity d. Automaticity, conductivity, excitability

d. Automaticity, conductivity, excitability

1 week post MI, he suddenly becomes agitated, restless and diaphoretic. Pulse pressure drops to 20 mm Hg. Assessment also reveals faint radial and apical pulses that weaken significantly on inspiration. This patient is most likely experiencing: a. Mitral valve rupture b. Pulmonary embolus c. Cardiogenic shock d. Cardiac tamponade

d. Cardiac tamponade

Prior to Mr. Nar Ding treadmill stress test, what instructions should you not give to him? a. Fast for 4 hours before the test c. Wear a comfortable shirt and sneaker b. Avoid stimulants, such as tobacco and caffeine d. Continue to take beta-blockers

d. Continue to take beta-blockers

A client has been hospitalized with heart failure. He is receiving digoxin (Lanoxin) and furosemide (Lasix) intravenously. He tells the nurse that he hears a continuous ringing in his ears and he has never had this problem before. What is the appropriate action for the nurse to take at this time? a. Obtain a digoxin level to check for toxicity. b. Note the observation in the chart and plan to reassess in 2 hours. c. Ask the client if he has been taking aspirin in addition to his other medications. d. Discontinue the furosemide and notify the physician.

d. Discontinue the furosemide and notify the physician.

A client has undergone insertion of a permanent pacemaker. When developing a discharge teaching plan, the nurse writes a goal of, "The client will verbalize symptoms of pacemaker failure." Which symptoms are most important to teach the client? a. Facial flushing. b. Fever. c. Pounding headache. d. Feelings of dizziness.

d. Feelings of dizziness.

A client who is receiving the sixth unit of packed red blood cell transfusion is demonstrating signs and symptoms of a febrile, nonhemolytic reaction. What assessment finding is most important for the nurse to identify? a. Increased anxiety since the transfusion began. c. Complaints of feeling cold. b. Drowsiness after receiving diphenhydramine (Benadryl). d. Flushed skin and headache.

d. Flushed skin and headache.

Dr. Marquez orders a continuous intravenous nitroglycerin infusion for the client suffering from myocardial infarction. Which of the following is the most essential nursing action? a. Monitoring urine output frequently. c. Obtaining serum potassium levels daily. b. Monitoring blood pressure every 4 hours. d. Gather an infusion pump.

d. Gather an infusion pump.

30. The physician prescribes dopamine (Inotropin) to improve the client's hemodynamic status. The nurse knows that this drug is prescribed to: a. Decrease the oxygen demand of the heart c. Decrease circulating blood volume b. Decrease cardiac workload d. Increase cardiac output and stroke volume

d. Increase cardiac output and stroke volume

The physician ordered him for a treadmill stress test. Prior to the procedure, you obtain his baseline BP, PR and rhythm strip. Mr. Nar Ding asks you why he needs to have this test. You answered him back knowingly that the test has the following advantages except: a. Client is not susceptible to infection because it is a non-invasive procedure. b. It helps to determine the cause of the pain. c. It can validate the effectiveness of antianginal or antiarrythmic medications. d. It can identify the size, shape and motion of the cardiac status

d. It can identify the size, shape and motion of the cardiac status

36. Based from the above situation, Mr. Packman is probably suffering from what disorder? a. Angina pectoris b. Left-sided heart failure c. Heart burn d. Myocardial infarction

d. Myocardial infarction

Proper care of CVP insertion is a must because this is directly inserted to the blood stream. What nursing intervention is not needed to prevent infection? a. Dressing must be checked and kept dry at all times. b. Use sterile technique in changing the dressing of the catheter. c. Dressing must be air occlusive. d. Observe the dressing for any discharge.

d. Observe the dressing for any discharge.

A 7-year-old child is admitted to the hospital with a medical diagnosis of acute rheumatic fever. Which of the following diversional activities is least desirable to the child during the acute phase of the illness? a. Reading a book to the father. c. Watching the television with a sibling. b. Playing with a doll with the nurse. d. Playing checkers with a roommate.

d. Playing checkers with a roommate.

. The client's job involves working in a warm, dry room, frequently bending and crouching to check the underside of a high-speed press, and wearing eye guard. Given this information, which side effect of hydrochlorothiazide (hydroDIURIL) should the nurse monitor? a. Muscle aches b. Thirst c. Lethargy d. Postural hypotension

d. Postural hypotension

24. The nurse is caring for a client who is receiving captopril and spirinolactone. Which laboratory value will be most important to monitor? a. Blood urea nitrogen b. Alkaline phosphatase c. Sodium d. Potassium

d. Potassium

The client asks whether he should begin an exercise program. When teaching him about appropriate exercise, the nurse should emphasize which of the following instructions: a. Avoid acute exercise; it will increase the heart's workload to a dangerous level b. Follow exercise session with soaks or steam baths to prevent muscle cramping c. Perform isometric exercise to reduce the heart's workload and improve blood flow d. Practice muscle pumping exercises for the legs when standing for a prolong period

d. Practice muscle pumping exercises for the legs when standing for a prolong period

An intravenous infusion at a "keep vein open" rate would be ordered primarily to: a. Help keep him well hydrated c. Prevent kidney failure b. Help keep him well nourished d. Provide a route for emergency drugs

d. Provide a route for emergency drugs

The nurse is analyzing the waveforms of a client's electrocardiogram. What finding indicates a disturbance in electrical conduction in the ventricles? a. T wave of 0.16 second. c. QT interval of 0.34 second. b. PR interval of 0.18 second. d. QRS interval of 0.14 second.

d. QRS interval of 0.14 second.

46. Alteplase recombinant (TPA), a thrombolytic enzyme, is administered during the first 6 hours following onset of MI to: a. Control chest pain c. Control the dysrhythmia associated with MI b. Reduce coronary artery vasospasm d. Revascularize the blocked coronary artery

d. Revascularize the blocked coronary artery

The nurse administers packed red blood cells (PRBCs) to a client. Which of the following nursing actions is appropriate? a. Discontinue the I.V. catheter if a blood transfusion reaction occurs. b. Administer the PRBCs through a percutaneously inserted central catheter line with a 20-gauge needle. c. Flush PRBCs with 5% dextrose and 0.45% normal saline solution. d. Stay with the client during the first 15 minutes of infusion.

d. Stay with the client during the first 15 minutes of infusion.

You have given defibrillation to your client knowing that the purpose of it in the treatment of cardiac arrest is: a. To treat tachydysrhythmias c. To synchronize with the client's ECG b. To terminate a tachydysrhythmias d. To depolarize myocardial cell

d. To depolarize myocardial cell

14. A murmur is heard at the second left intercostals space along the left sternal border. Which valve area is this? a. Aortic b. Mitral c. Pulmonic d. Tricuspid

d. Tricuspid

Which of the following is considered as a sign of digitalis toxicity that a nurse should teach a client? a. Increased appetite c. Skin rash over the chest and back b. Elevated blood pressure d. Visual disturbances such as seeing yellow spot

d. Visual disturbances such as seeing yellow spot