Practice quizzes for cardiac
A client presents to the ED reporting increasing shortness of breath. The nurse assessing the client notes a history of left-sided heart failure. The client is agitated and occasionally coughing up pink-tinged, foamy sputum. The nurse should recognize the signs and symptoms of what health problem? A: acute pulmonary edema B: cardiogenic shock C: pneumonia D: rt sided HF
A
The critical care nurse is caring for a client just admitted in a hypertensive emergency. The nurse should anticipate the administration of what medication? A: sodium nitroprusside B: warfarin C: ramipril D: furosemide
A
The nurse is performing an initial assessment of a client diagnosed with heart failure. The nurse also assesses the client's sensorium and LOC. Why is the assessment of the client's sensorium and LOC important in clients with heart failure? A: HF ultimately affect Oxygen transportation to the brain B: Clients with heart failure are susceptible to overstimulation of the sympathetic nervous system.
A
The nurse is planning the care of a client who has been diagnosed with hypertension, but who otherwise enjoys good health. When assessing the response to an antihypertensive drug regimen, what blood pressure would be the goal of treatment? A: 140/90 mmHG or lower B: average of two BP readings of 150/80 mmHg C: 156/96 mmHg or lower D: 120/80 mmHg or lower
A
The nurse is providing care for a client with a new diagnosis of hypertension. How can the nurse best promote the client's adherence to the prescribed therapeutic regimen? A: Have the pt participate in monitoring their own BP B: screen the pt for visual disturbances regularly C: emphasize the dire health outcomes associated with inadequate BP control
A
The nurse is teaching a client diagnosed with aortic stenosis appropriate strategies for attempting to relieve the symptom of angina without resorting to taking medications. What should the nurse teach the client? A: rest and relax before taking nitroglycerin B: engage in 15 min of light exercise before taking nitro C: eat small meal before taking nitro
A
The nurse is writing a care plan for a client who has been diagnosed with angina pectoris. The client describes herself as being "distressed" and "shocked" by her new diagnosis. What nursing diagnosis is most clearly suggested by the woman's statement? A: Anxiety related to cardiac symptoms B: Acute confusion related to prognosis for recovery C: Deficient knowledge related to treatment of angina pectoris
A
The staff educator is teaching ED nurses about hypertensive crisis. The nurse educator should explain that hypertensive urgency differs from hypertensive emergency in what way? A: Hypertensive emergencies are associated with evidence of target organ damage. B: Hypertensive urgency is treated with rest and benzodiazepines to lower BP. C: The BP is always higher in a hypertensive emergency.
A
A nurse in the CCU is caring for a client with heart failure who has developed an intracardiac thrombus. The nurse should assess for signs and symptoms of what sequela? A: hemorrhage B: stroke C: MI D: peripheral edema
B
The OR nurse is explaining to a client that cardiac surgery requires the absence of blood from the surgical field. At the same time, it is imperative to maintain perfusion of body organs and tissues. What technique for achieving these simultaneous goals should the nurse describe? A: Coronary artery bypass graft (CABG) B: Percutaneous transluminal coronary angioplasty (PTCA) C: Cardiopulmonary bypass D: Atherectomy
C
A nurse is working with a client who has been scheduled for a percutaneous coronary intervention (PCI) later in the week. What anticipatory guidance should the nurse provide to the client? A: A sheath will be placed over the insertion site after the procedure is finished. B: The procedure will likely be repeated in 6 to 8 weeks to ensure success.
a
The public health nurse is participating in a health fair and interviews a client with a history of hypertension, who is currently smoking one pack of cigarettes per day. The client denies any of the most common manifestations of CAD. The nurse should expect the focuses of CAD treatment to be: A: diet therapy and smoking cessation. B: diet and drug therapy. C: drug therapy and smoking cessation. D: diet therapy only
a
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. A: numbness B: chest pain C: weakness D: SOB E: anxiety
a, c
The nurse is teaching a client about some of the health consequences of uncontrolled hypertension. What health problems should the nurse describe? Select all that apply. A: right ventricular hypertrophy B: transient ischemic attacks (TIAs) C: venous insufficiency D: cerebrovascular disease E: retinal hemorrhage
b, d,e
A 17-year-old boy is being treated in the ICU after going into cardiac arrest during a football practice. Diagnostic testing reveals cardiomyopathy as the cause of the arrest. What type of cardiomyopathy is particularly common among young people who appear otherwise healthy? A: Hypertrophic cardiomyopathy (HCM) B: Dilated cardiomyopathy (DCM) C: Arrhythmogenic right ventricular cardiomyopathy (ARVC
A
A cardiac surgery client's new onset of signs and symptoms is suggestive of cardiac tamponade. As a member of the interdisciplinary team, what is the nurse's most appropriate action? A: prepare to assist with pericardiocentesis B: reposition the pt into a prone posiiton C: admin a bolus of normal saline as prescribed
A
A cardiovascular client with a previous history of pulmonary embolism (PE) is experiencing a sudden onset of dyspnea, rapid breathing, and chest pain. The nurse recognizes the characteristic signs and symptoms of a PE. What is the nurse's best action? A: rapidly assess the clients cardiopulmonary status B: increase the height of the clients bed C: manage the clients anxiety
A
A client has been diagnosed with a valvular disorder. The client tells the nurse that he has read about numerous treatment options, including valvuloplasty. What should the nurse teach the client about valvuloplasty? A: "For some clients, valvuloplasty can be done in a cardiac catheterization laboratory." B: "Valvuloplasty is a dangerous procedure, but it has excellent potential if it goes well." C: "Valvuloplasty is open heart surgery, but this is very safe these days and normally requires only an overnight hospital stay."
A
A client has been living with dilated cardiomyopathy for several years but has experienced worsening symptoms despite aggressive medical management. The nurse should anticipate what potential treatment? A: heart transplantation B: stent placement C: ballon valvuloplasty d: cardiac catheterization
A
A client has been prescribed antihypertensives. After assessment and analysis, the nurse has identified a nursing diagnosis of risk for ineffective health maintenance related to nonadherence to therapeutic regimen. When planning this client's care, what desired outcome should the nurse identify? A: Client takes medication as prescribed and reports any adverse effects. B: Client's BP remains consistently below 140/90 mm Hg
A
A client has come to the clinic for a follow-up assessment that will include a BP reading. To ensure an accurate reading, the nurse should confirm that the client has done which of the following? A: tried to rest quietly for 5 min before the reading is taken B: avoided drinking coffee for 12 hrs prior to visit C: drunk adequate fluids during the day prior D: refrained from smoking for at least 8 hrs
A
A client in hypertensive urgency is admitted to the hospital. The nurse should be aware of what goal of treatment for a client in hypertensive urgency? A: normalizing BP within 24-48 hrs B: obtaining a BP of less than 120/80 within 36 hrs C: normalizing BP within 2 hrs D: obtaining BP of less than 110/70 within 36 hrs
A
A client is admitted to the critical care unit (CCU) with a diagnosis of cardiomyopathy. When reviewing the client's most recent laboratory results, the nurse should prioritize assessment of which of the following? A: sodium B: white blood cell differential C: BUN D: ASt, ALT, bilirubin
A
A client with heart failure has met with his primary provider and begun treatment with an angiotensin-converting enzyme (ACE) inhibitor. When the client begins treatment, the nurse should prioritize what assessment? A: BP B: assessment of nausea C: LOC D: oxygen saturation
A
A client with hypertrophic cardiomyopathy (HCM) has been admitted to the medical unit. During the nurse's admission interview, the client states that she takes over-the-counter (OTC) "water pills" on a regular basis. How should the nurse best respond to the fact that the client has been taking diuretics? A: inform the care provider because diuretics are contraindicated B: increase the clients oral sodium intake C: encourage the client to drink at least 2 L of fluid daily
A
A client with mitral valve stenosis is receiving health education at an outpatient clinic. To minimize the client's symptoms, the nurse should teach the client to do which of the following? A: avoid activities that cause an increased HR B: avoid large crowds and public events
A
A client with newly diagnosed hypertension has come to the clinic for a follow-up visit. The client asks the nurse why she has to come in so often. What would be the nurse's best response? A: "We do this to make sure your health is stable. We'll then monitor it at routinely scheduled intervals." B: "We do this so we can identify any of the early symptoms of a stroke."
A
A client with primary hypertension comes to the clinic reporting a gradual onset of blurry vision and decreased visual acuity over the past several weeks. The nurse is aware that these symptoms could be indicative of what? A: retinal blood vessel damage B: hypertensive emergency C: glaucoma
A
A client with primary hypertension reports dizziness with ambulation when taking the prescribed alpha-adrenergic blocker. When teaching this client, what should the nurse emphasize? A: rising slowly from a lying or sitting position B: taking medications first thing in the morning C: increasing fluids to maintain BP
A
A community health nurse is presenting an educational event and is addressing several health problems, including rheumatic heart disease. What should the nurse describe as the most effective way to prevent rheumatic heart disease? A: Recognizing and promptly treating streptococcal infections B: Adhering closely to the recommended child immunization schedule C: Prophylactic use of calcium channel blockers in high-risk populations D: smoking cessation
A
A newly diagnosed client with hypertension is prescribed a thiazide diuretic. What client education should the nurse provide to this client? A: "This medication can cause low blood pressure and dizziness, especially when you get up suddenly." B: "Take over-the-counter potassium pills because this medication causes your kidneys to lose potassium." C: "Eat a banana every day because this medication causes moderate hyperkalemia."
A
A nurse is teaching an adult female client about the risk factors for hypertension. What should the nurse explain as risk factors for primary hypertension? A: obesity and high intake of sodium and saturated fat B: metabolic syndrome and smoking
A
Diagnostic imaging reveals that the quantity of fluid in a client's pericardial sac is dangerously increased. The nurse should collaborate with the other members of the care team to prevent the development of what complication? A: cardiac tamponade B: pulmonary edema C: pericarditis D: percardiocentesis
A
In preparation for cardiac surgery, a client was taught about measures to prevent venous thromboembolism. What statement indicates that the client clearly understood this education? A: "I'll make sure that I don't cross my legs when I'm resting in bed." B: "I'll try to stay in bed for the first few days to allow myself to heal." C: "I'll put on those compression stockings if I get pain in my calves." D: "I'll keep pillows under my knees to help my blood circulate better."
A
The community health nurse cares for many clients who have hypertension. What nursing diagnosis is most common among clients who are being treated for this health problem? A: Noncompliance with therapeutic regimen related to adverse effects of prescribed therapy B: Deficient knowledge regarding the lifestyle modifications for management of hypertension C: Deficient knowledge regarding BP monitoring D: Noncompliance with treatment regimen related to medication costs
A
The critical care nurse is caring for a client who is receiving cyclosporine postoperative heart transplant. What outcome represents a therapeutic outcome of this pharmacologic treatment? A: The client does not experience organ rejection. B: The client maintains adequate cardiac output. C: The client's white cell count increases.
A
The hospital nurse is caring for a client who tells the nurse that he has an angina attack beginning. What is the nurse's most appropriate initial action? A: Place the client on bed rest in a semi-Fowler position. B: Have the client stand still and bend over at the waist. C: Have the client sit down and put his head between his knees.
A
The nurse is admitting a client with reports of dyspnea on exertion and fatigue. The client's ECG shows dysrhythmias that are sometimes associated with left ventricular hypertrophy. What diagnostic tool would be most helpful in diagnosing cardiomyopathy? A: echocardiogram B: exercise stress test C: arterial blood gases D: cardiac catheterization
A
The nurse is assessing a client who was admitted to the critical care unit 3 hours ago following cardiac surgery. The nurse's most recent assessment reveals that the client's left pedal pulses are not palpable and that the right pedal pulses are rated at +2. What is the nurse's best action? A: Inform the client's health care provider of this assessment finding. B: Document this expected assessment finding during the initial postoperative period. C: Administer an ordered dose of subcutaneous heparin.
A
The nurse is auscultating the breath sounds of a client with pericarditis. What finding is most consistent with this diagnosis? A: friction rub B: fine crackles C: coarse crackles D: wheezes
A
The nurse is caring for a client who has undergone percutaneous transluminal coronary angioplasty (PTCA). What is the major indicator of success for this procedure? A: increase in the size of the artery's lumen B: increase in the clients resting HR C: increase in the clients level of consciousness D: decrease in the arterial blood flow in relation to venous flow
A
The nurse is caring for a client with acute pericarditis. What nursing management should be instituted to minimize complications? A: the nurse helps the client with activities until the pain and fever subside B: nurse encourages coughing and deep breathing C: nurse keeps the client isolated to prevent nosocomial infections
A
The nurse is caring for a client with mitral stenosis who is scheduled for a balloon valvuloplasty. The client tells the nurse that he is unsure why the surgeon did not opt to replace his damaged valve rather than repair it. What is an advantage of valvuloplasty that the nurse should cite? A: repaired valves tend to function longer than replaced valves B: Lower doses of antirejection drugs are required than with valve replacement. C: The procedure can be performed on an outpatient basis in a physician's office.
A
The nurse is caring for a client with systolic heart failure whose previous adverse reactions rule out the safe use of ACE inhibitors. The nurse should anticipate that the prescriber may choose what combination of drugs? A: combination of hydralazine and isosorbide dinitrate B: Combination of digoxin and normal saline C: Loop diuretic and antiplatelet aggregator
A
The nurse is caring for an adult client who had symptoms of unstable angina upon admission to the hospital. What nursing diagnosis underlies the discomfort associated with angina? A: Ineffective cardiopulmonary tissue perfusion related to coronary artery disease (CAD) B:Anxiety related to fear of death C: Impaired skin integrity related to CAD
A
The nurse is caring for an older adult client who has just returned from the OR after inguinal hernia repair. The OR report indicates that the client received large volumes of IV fluids during surgery and the nurse recognizes that the client is at risk for left-sided heart failure. What signs and symptoms would indicate left-sided heart failure? A: Bibasilar fine crackles B: dependent edema C: rt upper quadrant pain D: JVD
A
The nurse is developing a nursing care plan for a client who is being treated for hypertension. What is a measurable client outcome that the nurse should include? A: client will reduce Na+ intake to no more than 2.4 g daily B: client will have a stable BUN and serum creatinine levels C: client will abstain from fat intake and reduce calorie intake
A
When assessing the client with pericardial effusion, the nurse will assess for pulsus paradoxus. Pulsus paradoxus is characterized by what assessment finding? A: A systolic blood pressure that is lower during inhalation B: A diastolic blood pressure that is lower during exhalation
A
When discussing angina pectoris secondary to atherosclerotic disease with a client, the client asks why he tends to experience chest pain when he exerts himself. The nurse should describe which of the following phenomena? a: Exercise increases the heart's oxygen demands. B: Exercise shunts blood flow from the heart to the mesenteric area. C: Exercise causes vasoconstriction of the coronary arteries. D: Exercise increases the metabolism of cardiac medications.
A
The nurse is planning the care of a client with heart failure. The nurse should identify what overall goals of this client's care? Select all that apply. A: extend survival B: relieve clients symptoms C: improve functional status D: limit physical activity E: prevent endocaditis
A, B, C
The nurse is creating a care plan for a client diagnosed with heart failure. When addressing the problem of anxiety, what interventions should the nurse include in the care plan? Select all that apply. a: provide validation of the client's expressions of anxiety B: Administer benzodiazepines two to three times daily C: Provide supplemental oxygen, as needed D: Facilitate the presence of friends and family whenever possible
A, C, D
The critical care nurse is caring for a client who is in cardiogenic shock. What assessments should the nurse perform on this client? Select all that apply. A: cardiac rhythm B: sputum volume C: platelet level D: action of medications E: fluid status
A, D, E
The nurse is reviewing the medication administration record of a client who takes a variety of medications for the treatment of hypertension. What potential therapeutic benefits of antihypertensives should the nurse identify? Select all that apply. A: decrease blood volume B: increase venous return C: decreased peripheral resistance D: decreased blood viscosity E: decreased strength and rate of myocardial contractions
A, c, E
A client has been admitted to the medical unit with signs and symptoms suggestive of endocarditis. The health care provider's choice of antibiotics would be primarily based on what diagnostic test? A: cardiac aspiration B: blood cultures C: CBC D: echocardiography
B
A client has been admitted with an aortic valve stenosis and has been scheduled for a balloon valvuloplasty in the cardiac catheterization lab later today. During the admission assessment, the client tells the nurse he has thoracolumbar scoliosis and is concerned about lying down for any extended period of time. What is a priority action for the nurse? A: arrange for an alternative bed B: notify the surgeon immediately C: measure the degree of curvature
B
A client has been diagnosed as being prehypertensive. What should the nurse encourage this client to do to aid in preventing a progression to a hypertensive state? A: Eat less protein and more vegetables B: Exercise on a regular basis C: limit morning activity
B
A client has undergone a successful heart transplant and has been discharged home with a medication regimen that includes cyclosporine and tacrolimus. In light of this client's medication regimen, what nursing diagnosis should be prioritized? A: risk for injury B: risk for infection C: risk for unstable blood glucose D: risk for peripheral neurovascular dysfunction
B
A client newly diagnosed with hypertension is discussing risk factors with the nurse. The nurse talks about lifestyle changes with the client and advises that the client should avoid tobacco use. What is the primary rationale behind that advice to the client? A: Tobacco use is associated with a sedentary lifestyle. B: Tobacco use increases the client's concurrent risk of heart disease. C: Tobacco use causes ventricular hypertrophy.
B
A client presents to the ED reporting severe substernal chest pain radiating down his left arm. He is admitted to the coronary care unit (CCU) with a diagnosis of myocardial infarction (MI). What nursing assessment activity is a priority on admission to the CCU? A: determine if the client smokes B: begin ECG monitoring C: obtain info about family history or heart disease D: auscultate lung fields
B
A client who has undergone valve replacement surgery is being prepared for discharge home. Because the client will be discharged with a prescription for warfarin (Coumadin), the nurse should educate the client about which of the following? A: the need to avoid foods that contain vitamin K B: the need for regularly scheduled testing of the client's INR
B
A client who is postoperative day 1 following a CABG has produced 20 mL of urine in the past 3 hours and the nurse has confirmed the patency of the urinary catheter. What is the nurse's most appropriate action?] A: Increase the infusion rate of the client's IV fluid to prompt an increase in renal function. B: Contact the client's health care provider and suggest assessment of fluid balance and renal function. C: Document the client's low urine output and monitor closely for the next several hours. D: Contact the dietitian and suggest the need for increased oral fluid intake.
B
A client with a history of rheumatic heart disease knows that she is at risk for bacterial endocarditis when undergoing invasive procedures. Prior to a scheduled cystoscopy, the nurse should ensure that the client knows the importance of taking which of the following drugs? A: azathioprine B: amoxicillin C: metoprolol D: enoxaparin
B
A client with an occluded coronary artery is admitted and has an emergency percutaneous transluminal coronary angioplasty (PTCA). The client is admitted to the cardiac critical care unit after the PTCA. The complications for which the nurse should monitor the client include which of the following? A: peripheral edema B: bleeding at insertion site C: left ventricular hypertrophy D: pulmonary edema
B
A client with cardiovascular disease is being treated with amlodipine, which is intended to cause what therapeutic effect? A: Increasing the efficiency of myocardial oxygen consumption, thus decreasing ischemia and relieving pain B: Reducing the heart's workload by decreasing heart rate and myocardial contraction C: Reducing myocardial oxygen consumption by blocking adrenergic stimulation to the heart D: Preventing platelet aggregation and subsequent thrombosis
B
A client with pericarditis has just been admitted to the CCU. The nurse planning the client's care should prioritize what nursing diagnosis? A: anxiety related to pericarditis B: acute pain related to pericarditis C: ineffective tissue perfusion related to pericarditis
B
A community health nurse is planning an educational campaign addressing hypertension. The nurse should anticipate that the incidence and prevalence of hypertension are likely to be highest among members of what ethnic group? A: pacific islanders B: blacks C: hispanics D asians
B
A community health nurse teaching a group of adults about preventing hypertension. The nurse should encourage these participants to collaborate with their primary providers and regularly monitor which of the following? A: potassium levels B: blood lipid levels C: sodium levels D: heart rate
B
A nurse is planning discharge health education for a client who will soon undergo placement of a mechanical valve prosthesis. What aspect of health education should the nurse prioritize in anticipation of discharge? A: need for long term antibiotics B: strategies for infection prevention C: need for 7-10 days of bed rest D: strategies for preventing atherosclerosis
B
An adult client is admitted to the ED with chest pain. The client states that he had unrelieved chest pain for approximately 20 minutes before coming to the hospital. To minimize cardiac damage, the nurse should expect to administer which of the following interventions? A: bed rest, albuterol neb treatments, O2 B: morphine, O2, bed rest C: O2 and beta blockers
B
An older adult client has been diagnosed with aortic regurgitation. What change in blood flow should the nurse expect to see on this client's echocardiogram? A: obstruction of blood flow from the left ventricle B: blood to flow back from the aorta to the left ventricle c: obstruction of blood from the left atrium to the left ventricle
B
An older adult is newly diagnosed with primary hypertension and has just been started on a beta-blocker. What should the nurse include in health education?? A: Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the beta-blocker B: Use of strategies to prevent falls stemming from postural hypotension C: Maintaining a diet high in dairy to increase protein necessary to prevent organ damage
B
Family members bring a client to the ED with pale cool skin, sudden midsternal chest pain unrelieved with rest, and a history of CAD. How should the nurse best interpret these initial data? A: the symptoms indicate angina should be treated as such B: The symptoms indicate an acute coronary episode and should be treated as such.
B
The home health nurse is caring for a client who has a diagnosis of hypertension. What assessment question most directly addresses the possibility of worsening hypertension? A: "Do you ever get chest pain when you exercise?" B: "Do you ever see spots in front of your eyes?" C: "Are you eating less salt in your diet?"
B
The nurse is addressing exercise and physical activity during discharge education with a client diagnosed with heart failure. What should the nurse teach this client about exercise? A: "Do not exercise unsupervised." B: "Eventually aim to work up to 30 minutes of exercise each day." C: "Slow down if you get dizzy or short of breath."
B
The nurse is assessing a client new to the clinic. Records brought to the clinic show that the client's hypertension has not improved. What contributing factor should the nurse first explore in an effort to identify the cause of the client's inadequate BP control? A: Progressive target organ damage B: Lack of adherence to prescribed drug therapy c: possibility of medication interactions
B
The nurse is assessing a client who is known to have right-sided heart failure. What assessment finding is most consistent with this client's diagnosis? A: orthopnea B: distended nick veins C: pulmonary edema D: dry cough
B
The nurse is caring for a client who is believed to have just experienced an MI. What change on an ECG most strongly suggests to the nurse that ischemia is occurring? A: P wave inversion B: T wave inversion C: Q wave changes with no change in ST or T wave D: P wave enlargement
B
The nurse is caring for a client with a history of endocarditis. What topic should the nurse prioritize during health promotion education? a: fluid intake B: orla hygiene C: dietary guidelines D: physical activity
B
The nurse is caring for an adult client whom the nurse suspects has digoxin toxicity. In addition to physical assessment, the nurse should collect what assessment information? A: peripheral pulses B: potassium level C: white blood cell count D: skin turgor
B
The nurse is caring for an older adult with a diagnosis of hypertension who is being treated with a diuretic and beta-blocker. What should the nurse integrate into the management of this client's hypertension? A: Ensure that the client receives a larger initial dose of antihypertensive medication due to impaired absorption B: Pay close attention to hydration status because of increased sensitivity to extracellular volume depletion C: Carefully assess for weight loss because of impaired kidney function resulting from normal aging
B
The nurse is collaborating with the dietitian and a client with hypertension to plan dietary modifications. What modifications should be made? A: Increased intake of potassium, vitamin B12, and vitamin D B: Reduced intake of fat and sodium C: Increased intake of calcium and vitamin D
B
The nurse is participating in the care conference for a client with ACS. What goal should guide the care team's selection of assessments, interventions, and treatments? A: Increasing the size of the myocardial muscle B: Balancing myocardial oxygen supply with demand C: Maximizing cardiac output while minimizing heart rate D:Decreasing energy expenditure of the myocardium
B
The nurse is providing discharge education to a client diagnosed with heart failure. What should the nurse teach this client to do to assess fluid balance in the home setting? A: assess radial pulses daily B: monitor wt daily C: monitor BP daily D: monitor Bowel movements
B
The nurse is screening a number of adults for hypertension. What range of blood pressure is considered normal? A: less than 130/90 B: less than 120/80 C: less than 129/89 D: less than 140/90
B
The nurse notes that a client has developed a cough productive for mucoid sputum, is short of breath, has cyanotic hands, and has noisy, moist-sounding, rapid breathing. These symptoms and signs are suggestive of what health problem? A: cardiomyopathy B: pulmonary edema C: rt ventricular hypertrophy D: pericardiitis
B
The nurse on the hospital's infection control committee is looking into two cases of hospital-acquired infective endocarditis. What classification of clients would be at greatest risk for hospital-acquired endocarditis? A: children under age of 12 B: hemodialysis clients C: clients who undergo intermittent urinary catheterization D: clients of immunoglobulins
B
The nurse overseeing care in the ICU reviews the shift report on four clients. The nurse recognizes which client to be at greatest risk for the development of cardiogenic shock? A: the client admitted with malignant hypertension B: the pt admitted following an MI C: the pt admitted with an acute kidney injury
B
The nurse's comprehensive assessment of a client who has heart failure includes evaluation of the client's hepatojugular reflux. What action should the nurse perform during this assessment? A: press above the pts symphysis pubis B: press the rt upper abdomen C: elevate the pts head to 90 degrees D: lay the pts flat in bed
B
The nursing lab instructor is teaching student nurses how to take blood pressure. To ensure accurate measurement, the lab instructor would teach the students to avoid which of the following actions? A: using bare forearm supported at heart level on a firm surface B: taking the BP at least 10 min after nicotine or coffee ingestion C: using a cuff with a bladder that encircles at least 80% of the limb
B
The triage nurse in the ED is assessing a client with chronic heart failure who has presented with worsening symptoms. In reviewing the client's medical history, what is a potential primary cause of the client's heart failure? A: atrial septal defect B: atherosclerosis C: pleural effusion D: endocarditiis
B
The client has just returned to the floor after balloon valvuloplasty of the aortic valve and the nurse is planning appropriate assessments. The nurse should assess for indications of what potential complications? Select all that apply. A: plaque formation B: ventricular dysrhythmia C: emboli D: mitral valve damage E: atrial septal defect
B, C, D
A 55-year-old client comes to the clinic for a routine check-up. The client's BP is 159/100 mm Hg and the physician diagnoses hypertension after referring to previous readings. The client asks why it is important to treat hypertension, since the client denies any discomfort. What would be the nurse's best response? A: "Hypertension puts you at increased risk of type 1 diabetes and cancer in your age group." B: "Hypertension can cause you to develop dangerous blood clots in your legs that can migrate to your lungs." C: "Hypertension greatly increases your risk of stroke and heart disease."
C
A cardiac client's resistance to left ventricular filling has caused blood to back up into the client's circulatory system. What health problem is likely to result? A: rt sided HF B: Lft sided HF C: acute pulmonary edema D: rt ventricular hypertrophy
C
A client comes to the walk-in clinic complaining of frequent headaches. While assessing the client's vital signs, the nurse notes the BP is 161/101 mm Hg. According to JNC 7, how would this client's BP be defined if a similar reading were obtained at a subsequent office visit? a: normal B: high normal C: stage 2 hypertensive D: stage 1 hypertensive
C
A client in a hypertensive emergency is admitted to the ICU. The nurse anticipates that the client will be treated with IV vasodilators, and that the primary goal of treatment is what? A: Lower the BP to reduce onset of neurologic symptoms, such as headache and vision changes B: Reduce the BP to ≤120/75 mm Hg as quickly as possible C: Decrease the mean arterial pressure between 20% and 25% in the first hour of treatment
C
A client in the cardiac step-down unit has begun bleeding from the percutaneous coronary intervention (PCI) access site in the femoral region. What is the nurse's most appropriate action? a: Reposition the client's leg in a nondependent position. B: Call for assistance and initiate cardiopulmonary resuscitation. C: Call for help and apply pressure to the access site
C
A client is a candidate for percutaneous balloon valvuloplasty, but is concerned about how this procedure will affect her busy work schedule. What guidance should the nurse provide to the client? A: "Clients need to stay in the hospital until they regain normal heart function for their age. B: "Clients are kept in the hospital until they are independent with all aspects of their care." C: "Clients usually remain at the hospital for 24 to 48 hours."
C
A client is recovering in the hospital from cardiac surgery. The nurse has identified the diagnosis of risk for ineffective airway clearance related to pulmonary secretions. What intervention best addresses this risk? A: Client's active participation in the cardiac rehabilitation program B: Administration of bronchodilators by nebulizer C: Client's consistent performance of deep-breathing and coughing exercises D: Administration of inhaled corticosteroids by metered dose inhaler (MDI)
C
A client presents to the ED in distress and complains of "crushing" chest pain. What is the nurse's priority for assessment? A: Palpation of the clients apex B: rapid assessment of the clients peripheral pulses C: prompt initiation of ECG
C
A client presents to the clinic complaining of intermittent chest pain on exertion, which is eventually attributed to angina. The nurse should inform the client that angina is most often attributable to what cause? A: decreased cardiac contractility B: decreased cardiac output C: coronary arteriosclerosis D: infarction of the myocardium
C
A client who has recently recovered from a systemic viral infection is undergoing diagnostic testing for myocarditis. Which of the nurse's assessment findings is most consistent with myocarditis? A: sudden changes in LOC B: pleuritic chest pain C: flulike symptoms D: Peripheral edema and pulmonary edema
C
A client who is at high risk for developing intracardiac thrombi has been placed on long-term anticoagulation. What aspect of the client's health history creates a heightened risk of intracardiac thrombi? A: recent surgery B: recurrent pneumonia C: atrial fibrillation D: ineffective endocarditis
C
A client with a diagnosis of heart failure is started on a beta-blocker. What is the nurse's priority role during gradual increases in the client's dose? A: Making adjustments to each day's dose based on the blood pressure trends B: Stressing that symptom relief may take up to 4 months to occur C: Educating the client that symptom relief may not occur for several weeks
C
A client with heart failure is placed on a low-sodium diet. Which statement by the client indicates that the nurse's nutritional teaching plan has been effective? A: "I will have a tossed salad with cheese and croutons for lunch." B: "I will have a ham and cheese sandwich for lunch." C: "I will have a baked potato with broiled chicken for dinner."
C
A client with mitral stenosis exhibits new symptoms of a dysrhythmia. Based on the pathophysiology of this disease process, the nurse would expect the client to exhibit what heart rhythm? A: VF B: sinus bradycardia C: atrial fibrillation D: VT
C
A client with secondary hypertension has come into the clinic for a routine check-up. When comparing this client's diagnosis to primary hypertension, the nurse recognizes that secondary hypertension: A: does not normally cause target organ damage B: does not normally respond to antihypertensive drug therapy C: has a specific cause
C
A nurse is performing blood pressure screenings at a local health fair. While obtaining subjective assessment data from a client with hypertension, the nurse learns that the client has a family history of hypertension and she herself has high cholesterol and lipid levels. The client says she smokes one pack of cigarettes daily and drinks "about a pack of beer" every day. The nurse notes what nonmodifiable risk factor for hypertension? A: excessive alcohol intake B: hyperlipidemia C: a family of hypertension D: closer adherence to medical regimen
C
An OR nurse is preparing to assist with a coronary artery bypass graft (CABG). The OR nurse knows that the vessel most commonly used as source for a CABG is what? A: femoral artery B: brachial vein C: greater saphenous vein D: brachial artery
C
An older adult client with heart failure is being discharged home on an ACE inhibitor and a loop diuretic. The client's most recent vital signs prior to discharge include oxygen saturation of 93% on room air, heart rate of 81 beats per minute, and blood pressure of 94/59 mm Hg. When planning this client's subsequent care, what nursing diagnosis should be identified? A: Risk for ineffective tissue perfusion related to dysrhythmia B: Risk for ineffective breathing pattern related to hypoxia C: risk for falls related to hypotension
C
Cardiopulmonary resuscitation has been initiated on a client who was found unresponsive. When performing chest compressions, the nurse should do which of the following? A: Pause chest compressions to allow for vital signs monitoring every 4 to 5 minutes B: Pause to allow a colleague to provide a breath every 10 compressions c: Perform at least 100 chest compressions per minute
C
The cardiac nurse is caring for a client who has been diagnosed with dilated cardiomyopathy (DCM). Echocardiography is likely to reveal what pathophysiological finding? A: mitral valve regurgitation B: ventricular hypertrophy C: decreased ejection fraction D: decreased HR
C
The nurse has entered a client's room and found the client unresponsive and not breathing. What is the nurse's next appropriate action? A: begin performing chest compressions B: illuminate the pts call light C: activate the emergency response system (ERS) D: palpate the pts carotid pulse
C
The nurse is caring for a client with right ventricular hypertrophy and consequently, decreased right ventricular function. What valvular disorder may have contributed to this client's diagnosis? A: mitral valve regurgitation B: aortic stenosis C: mitral valve stenosis D: aortic regurgiation
C
The nurse is caring for a client with severe left ventricular dysfunction who has been identified as being at risk for sudden cardiac death. What medical intervention can be performed that may extend the survival of the client? A: admin beta blocker B: insertion of implantable pacemaker C: Insertion of an implantable cardioverter defibrillator (ICD)
C
The nurse is caring for a recent immigrant who has been diagnosed with mitral valve regurgitation. The nurse should know that in developing countries the most common cause of mitral valve regurgitation is what? A: insect bite B: sepsis and its sequelae C: rheumatic heart disease and its sequelae D: decrease in gamma globulins
C
The nurse is creating a plan of care for a client with a cardiomyopathy. What priority goal should underlie most of the assessments and interventions that are selected for this client? A: increase activity tolerance B: adherence to self care program C: improved cardiac output D: absence of complications
C
The nurse is educating an 80-year-old client diagnosed with heart failure about his medication regimen. What should the nurse teach this client about the use of oral diuretics? A: Avoid drinking fluids for 2 hours after taking the diuretic B: Take the diuretic only on days when experiencing shortness of breath C: Take the diuretic in the morning to avoid interfering with sleep
C
The nurse is performing a physical assessment on a client suspected of having heart failure. The presence of what sound would signal the possibility of impending heart failure? A: heart murmur B: pleural friction rub C: S3 heart sound D: faint breath sounds
C
The nurse is preparing a client for cardiac surgery. During the procedure, the client's heart will be removed and a donor heart implanted at the vena cava and pulmonary veins. What procedure will this client undergo? A: heterotropic transplant B: homograft C: orthotopic transplant D: xenograft
C
The nurse is providing client education prior to a client's discharge home after treatment for heart failure. The nurse gives the client a home care checklist as part of the discharge teaching. What should be included on this checklist? A: limit physical activity to only those tasks that are absolutely necessary B: measure everything you eat and drink until otherwise instructed c: know how to recognize and prevent orthostatic hypotension
C
The nurse is providing health education to an older adult client. What should the nurse teach the client about the relationship between hypertension and age? A: "Decreases in the strength of arteries and the presence of venous insufficiency cause hypertension in the elderly." B: "Because of reduced smooth muscle tone in blood vessels, blood pressure tends to go down with age, not up." C: "Structural and functional changes in the cardiovascular system that occur with age contribute to increase in blood pressure. D: "The neurologic system of older adults is less efficient at monitoring and regulating blood pressure."
C
The nurse is reviewing a newly admitted client's electronic health record, which notes a history of orthopnea. What nursing action is most clearly indicated? A: limit the pts activity level B: teach the pt deep breathing and coughing exercises C: avoid positioning the client supine
C
The nurse working on the coronary care unit is caring for a client with ACS. How can the nurse best meet the client's psychosocial needs? A: Reinforce the fact that treatment will be successful B: Increase the client's participation in rehabilitation activities C: Directly address the client's anxieties and fears D: Facilitate a referral to a chaplain or spiritual leader
C
The triage nurse in the ED assesses an adult client who presents to the ED with reports of midsternal chest pain that has lasted for the last 5 hours. If the client's symptoms are due to an MI, what will have happened to the myocardium? A: It has been irreparably damaged, so immediate treatment is no longer necessary. B: It may be responsive to restoration of the area of dead cells with proper treatment C: It may have developed an increased area of infarction during the time without treatment. D: It will probably not have more damage than if the client came in immediately.
C
When assessing a client diagnosed with angina pectoris, it is most important for the nurse to gather what information? A: The client's coping strategies surrounding the attacks B: The client's understanding of the pathology of angina C: The client's symptoms and the activities that precipitate attacks D: The client's activities, limitations, and level of consciousness after the attacks
C
The nurse is caring for an adult client with heart failure who is prescribed digoxin. When assessing the client for adverse effects, the nurse should assess for which of the following signs and symptoms? Select all that apply. A: chest pain B: SOB C: bradycardia D: diuresis E: confusion F: numbness and tingling in the extremities
C, E
A 56-year-old male client at a screening event has a blood pressure reading of 146/96 mm Hg. Upon hearing the reading, the client states, "My pressure has never been this high. Do you think my doctor will prescribe medication to reduce it?" What is the nurse's best response? A: "Yes. Hypertension is prevalent among men; it is fortunate we caught this during your routine examination." B: "We will need to reevaluate your blood pressure because your age places you at high risk for hypertension." C: "You have no need to worry. Your pressure is probably elevated because you are being tested." D: "A single elevated blood pressure does not confirm hypertension. You will need to have your blood pressure reassessed several times before a diagnosis can be made."
D
A client admitted to the medical unit with heart failure is exhibiting signs and symptoms of pulmonary edema. How should the nurse best position the client? A: in a flat, supine position B: in the trendelenburg position C: on the left side lying position D: in high fowler
D
A client in hypertensive emergency is being cared for in the ICU. The client has become hypovolemic secondary to natriuresis. What is the nurse's most appropriate action? A: add sodium to the clients IV fluids as prescribed B: promptly cease antihypertensive therapy C: administer a vasoconstrictor as prescribed D: administer normal saline IV as prescribed
D
A client is undergoing diagnostic testing for mitral stenosis. What statement by the client during the nurse's interview is most suggestive of this valvular disorder? A: "I get chest pain from time to time, but it usually resolves when I rest." B: "Sometimes when I'm resting, I can feel my heart skip a beat C: "My feet and ankles have gotten terribly puffy the last few weeks." D: "Whenever I do any form of exercise I get terribly short of breath."
D
A client newly admitted to the telemetry unit is experiencing progressive fatigue, hemoptysis, and dyspnea. Diagnostic testing has revealed that these signs and symptoms are attributable to pulmonary venous hypertension. What valvular disorder should the nurse anticipate being diagnosed in this client? a: aortic regurgitation B: aortic stenosis C: mitral valve prolapse D: mitral stenosis
D
A client newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a client with prolonged, uncontrolled hypertension is at risk for developing what health problem? A: right ventricular hypertrophy B: anemia C: glaucoma D: kidney injury
D
A client who has undergone a valve replacement with a mechanical valve prosthesis is due to be discharged home. During discharge teaching, the nurse should discuss the importance of antibiotic prophylaxis prior to which of the following? A: future hospital adminissions B: live vaccinations C: exposure to immunocompromised individuals D: dental procedures
D
A client with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should inform the client about what potential adverse effects? A: Tinnitus or diplopia B: Nervousness or paresthesia C: Drowsiness or blurred vision D: Throbbing headache or dizziness
D
A client's medication regimen for the treatment of hypertension includes hydrochlorothiazide. Following administration of this medication, the nurse should anticipate what effect? A: mild agitation B: drowsiness or lethargy C: decreased heart rate D: increased urine output
D
A client's recently elevated BP has prompted the primary provider to prescribe furosemide. The nurse should closely monitor which of the following? A: the pts RBCs, hematocrit and hemoglobin B: the pts level of consciousness C: the O2 saturation level D: the pts potassium level
D
A nurse has taken on the care of a client who had a coronary artery stent placed yesterday. When reviewing the client's daily medication administration record, the nurse should anticipate administering what drug? A: ibuprofen B: acetaminophen C: dipyridamole D: clopidogrel
D
During an adult client's last two office visits, the nurse obtained BP readings of 122/84 mm Hg and 130/88 mm Hg, respectively. How would this client's BP be categorized? a: stage 1 hypertensive B: normal C: stage 2 hypertensive D: prehypertensive
D
The ED nurse is caring for a client with a suspected MI. What drug should the nurse anticipate administering to this client? A: acetaminophen B: oxycodone C: warfarin D: morphine
D
The cardiac monitor alarm alerts the critical care nurse that the client is showing no cardiac rhythm on the monitor. The nurse's rapid assessment suggests cardiac arrest. In providing cardiac resuscitation documentation, how should the nurse describe this initial absence of cardiac rhythm? A: v fib B: v tach C: PEA D: asystole
D
The nurse has just admitted a client for cardiac surgery. The client tearfully describes feeling afraid of dying while undergoing the surgery. What is the nurse's best response? a: Teach the client guided imagery techniques B: Obtain an order for a PRN benzodiazepine C: Describe the procedure in greater detail D: Explore the factors underlying the client's anxiety
D
The nurse is assessing an older adult client with numerous health problems. What assessment datum indicates an increase in the client's risk for heart failure? A: The client takes furosemide 20 mg/day. B: client is an African-American man C: The client's potassium level is 4.7 mEq/L. :D The client's age is greater than 65.
D
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? A: High density cholesterol B: white blood cells C: lipoproteins D: lipids and fibrous tissue
D
The nurse is caring for a client who has developed obvious signs of pulmonary edema. What is the priority nursing action? A: Notify the family of the client's critical state B: Update the health care provider C: Lay the client flat D: Stay with the client
D
The nurse is caring for a client who is receiving a loop diuretic for the treatment of heart failure. What assessment should the nurse prioritize? a: monitor potassium level B: vitamin D intake C: monitor liver function studies D: blood pressure
D
The nurse is caring for a client who is scheduled for cardiac surgery. What should the nurse include in preoperative care? A: Withhold the client's scheduled medications for at least 12 hours preoperatively. B: Inform the client that health teaching will begin as soon as possible after surgery. C: Avoid discussing the client's fears as not to exacerbate them. D: With the client, clarify the surgical procedure that will be performed.
D
The nurse is caring for a client who is scheduled to undergo mechanical valve replacement. Client education should include which of the following? A: use of IV diuretics B: use of client controlled analgesia C: steroid therapy D: long term anticoagulant therapy
D
The nurse is caring for a client who will have coronary artery revascularization. When explaining the pre- and postoperative regimens, the nurse should address which subject? A: complications requiring graft removal B: symptoms of hypovolemia C: symptoms of low blood pressure D: intubation and mechanical ventilation
D
The nurse is creating a plan of care for a client with acute coronary syndrome. What nursing action should be included in the client's care plan? A: Have client maintain supine positioning when in bed. B:Perform chest physiotherapy, as indicated. C: Facilitate daily arterial blood gas (ABG) sampling. D: Administer supplementary oxygen, as needed.
D
The nurse is providing care for a client with a diagnosis of hypertension. The nurse should consequently assess the client for signs and symptoms of which other health problem? A: thrombocytopenia B: atrial septal defect C: migraines D: atherosclerosis
D
The nurse is providing care for a client with high cholesterol and triglyceride values. In teaching the client about therapeutic lifestyle changes such as diet and exercise, the nurse realizes that the desired goal for cholesterol levels is which of the following? A: High HDL values and high triglyceride values B: Absence of detectable total cholesterol levels C: Elevated blood lipids, fasting glucose less than 100 D: Low LDL values and high HDL values
D
The nurse is reviewing the echocardiography results of a client who has just been diagnosed with dilated cardiomyopathy (DCM). What changes in heart structure is this client experiencing? A: dilation of atria and hypertrophy of ventricles B: dilation and hypertrophy of all four heart chambers C: dilated ventricles and atrophy of ventricles D: dilated ventricles without hypertrophy of the ventricles
D
The nurse is reviewing the medication administration record of a client diagnosed with systolic heart failure. What medication should the nurse anticipate administering to this client? A: A nonsteroidal anti-inflammatory drug (NSAID) B: A calcium channel blocker C: antiplatelet aggregator D: a beta-adrenergic blocker
D
The nurse is working with a client who had an MI and is now active in rehabilitation. The nurse should teach this client to cease activity if which of the following occurs? A: The client's oxygen saturation level drops below 96%. B: The client experiences a noticeable increase in heart rate during activity. C: The client's respiratory rate exceeds 30 breaths/min. D: The client experiences chest pain, palpitations, or dyspnea.
D
The staff educator is presenting a workshop on valvular disorders. When discussing the pathophysiology of aortic regurgitation, the educator describes what consequence of this disorder ? A: ventricular insufficiency B: cardiac tmaponade C: rt sided HF D: left ventricular hypertrophy
D
The triage nurse in the ED is performing a rapid assessment of a man with reports of severe chest pain and shortness of breath. The client is diaphoretic, pale, and weak. When the client collapses, what should the nurse do first? A: check for a carotid pulse B: give two full breaths C: apply supplemental oxygen D: gently shake and shout "are you OK?"
D
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. A: syncope B: unusual fatigue C: hypotension D: peripheral cyanosis E: dyspnea
a, b, e
The nurse is caring for a client with mitral valve prolapse. Most people with mitral valve prolapse never have symptoms, though this is not the case for every client. What symptoms would be consistent with this diagnosis? Select all that apply. A: fatigue B: palpations C: shoulder pain D: tachypnea E: anxiety
a, b, e
The nurse providing care for a client post PTCA knows to monitor the client closely. For what complications should the nurse monitor the client? Select all that apply. A: retroperitoneal bleeding B: bleeding at the insertion site C: arterial occlusion D: abrupt closure of the coronary artery E: venous insufficiency
a,b,c,d
The nurse is providing an educational workshop about coronary artery disease (CAD) and its risk factors. The nurse explains to participants that CAD has many risk factors, some that can be controlled and some that cannot. What risk factors should the nurse list that can be controlled or modified? a: Gender, obesity, family history, and smoking B: Cholesterol levels, hypertension, and smoking c: Inactivity, stress, gender, and smoking D: Stress, family history, and obesity
b
