Test 2 Med Surg

A client who has recently started taking Pravastatin and Niacin reports the following symptoms to the nurse, what is most important to communicate to the healthcare provider?

Generalized muscle aches and weakness

What action should the nurse perform when preparing a client with supraventricular tachycardia for cardioversion who is alert and has a blood pressure of 110/66 mm Hg?

Give a sedative before cardioversion is implemented

Client is seen in an outpatient clinic for a work physical, which assessment finding can be used for client education for modifiable risk factors for coronary artery disease (SATA)?

His blood pressure160/90 heart rate 74 fasting blood sugar of 84, he does not currently have a structural physical exercise program, his LDL is 235 HDL is 22 and triglycerides are 142

Patient comes to the emergency room via ambulance, vital signs are heart rate 0, blood pressure 0, cardiopulmonary resuscitation (CPR) in process, the nurse defines this rhythm as pulseless electrical activity, which is caused by what (SATA)?

Hypoglycemia hypovolemia drug overdose pulmonary embolus

Which client statement to the nurse is most consistent with the diagnosis of venous insufficiency

I cannot get my shoes on at the end of the day

Nurse teaches client with chronic stable angina how to use prescribed short acting nitroglycerin, which statement indicates patient understands teaching when they say what?

I will stop what I am doing and sit down before I put the nitroglycerin under my tongue

Nurse provides discharge education to client with implantable cardioversion defibrillator, client understands when they say what

If my ICD fires more than once I will call EMS

What information should be included when teaching client about dietary changes to reduce LDL cholesterol?

Incorporate whole grains, vegetables, and fruits in the diet (following the DASH plan is the wrong answer)

A client has received a permanent demand pacemaker, the nurse knows that following statements are true about this device (SATA)?

It is a pacing device that triggers the pacemaker when no QRS complexes occur within a preset time it has a sensing device that inhibits the pacemaker when the heart rate is equal or above a set rate

Patient on furosemide what should be reported to the HCP?

K= 2.5

A 73-year-old patient with atrial fibrillation develops sudden pain with right leg pulselessness, pallor, and coolness, what should the nurse do?

Keep client in bed in supine position

Picture of ventricular tachycardia

Know what this rhythm looks like

Assessment findings indicate that the client with stable angina is experiencing side effects of Metoprolol (SATA)?

- Blood pressure 90/54 - cardiac monitor shows 58

What information should the nurse include when teaching a client with newly diagnostic hypertension (SATA)?

- Hypertension is usually asymptomatic until target organ damage occurs - walking every day can help control blood pressure - a low sodium diet can help control blood pressure - weight management can help control blood pressure

A 76-year-old client newly diagnosed with peripheral artery disease, which statements made by the client indicate a need for further education (SATA)?

- I will keep your legs elevated whenever I am sitting - I will put elastic compression stockings on early in the morning - exercise only if I do not experience any pain

Patient understand teaching for ace inhibitors when she states (SATA)

- I will tell the HCP if i develop a cough - HCP may order potassium levels to be checked - taking aspirin can affect it

You are planning a discharge education for a client with artery disease, it is important to address which modifiable risk factors (SATA)?

- Loosing weight if applicable -the effects of tobacco use - increase physical activity

Teaching a hypertensive patient about the newly prescribed Ramipril, which statements indicate patient understands medication precautions (SATA)?

- The doctor may order a blood potassium level occasionally - the medication may not work as well if I take any aspirin - I will call the doctor if I notice that I have a frequent cough

A 60-year-old states "I have a heavy feeling in my chest, and it's got me worried, nurse should ask what questions (SATA)?

- When did this feeling start and has it changed - what were you doing when this started - describe this heavy feeling to me - have you experienced this heavy feeling before

The nurse on the intermediate care unit received change of shift report on four clients with hypertension, which client should the nurse assess first?

43-year-old with a blood pressure of 176/92 who is complaining of chest pain

Client is in the office for a recheck 3 months after starting Pravastatin, which lab values is priority to bring to healthcare provider's attention?

ALT 68, AST 60, and Bilirubin 2.0

When caring for a patient recovering from sudden cardiac death and has no evidence of acute myocardial infarction, what will the nurse anticipate teaching the patient?

Additional diagnostic testing will be required

Patient has had an angiography with entrance site in the right femoral artery, one hour later, nurse is unable to palpate the pedal pulse, what is the nurse's best action?

Apply pressure to the right groin, and call for assistance

What action should the nurse take when administering the initial dose of oral Carvedilol with hypertension?

Ask the client to request assistance when getting out of bed

Obtaining health history with client with numerous petechiae on the skin, nurse asks the client about the use of what

Aspirin medications

Client comes to the clinic and says, "I have always taken a walk after dinner, but lately my leg cramps and hurts after just a few minutes of starting but it goes away after I stop walking though", the nurse should do what?

Assess for the presence of the dorsalis pedis and posterior tibial pulses

Nadolol is used for hypertension but the nurse should consult with a healthcare provider if the patient has a history of what?

Asthma

Client with stage 2 hypertension taking IV Furosemide priority lab to give healthcare provider?

Blood potassium level of 2.8 mEq/L

When caring for a client who has returned to the coronary care unit after having angiopathy with stent placement, the nurse obtains the following assessment data, which data indicates a need for immediate action by the nurse?

Chest pain level 7 on a 0 to 10 point scale

Client admitted for hypertension/hypertensive crisis, what is important to tell healthcare provider?

Client's speech becomes slurred and he becomes combative

Telemetry shows a rhythm (pic), patient is lying on floor beside bed with no pulse and no respiration, you begin CPR and call help, what do you do next?

Defibrillation at 200-300 joules

Patient with confusion, nausea, vomiting, seeing halos over people and objects, what medication is priority to report to the healthcare provider?

Digoxin

What does Diltiazem do to a client with prinzmetal's variant angina?

Diltiazem will decrease spasm of the coronary arteries

Information for a client who is receiving an implantable cardioverter defibrillator will include

Encourage the client and caregivers to participate in a local support group

Nurse admitted a newly diagnosed patient with peripheral artery disease, which admission order does the nurse question?

Omeprazole drug therapy

Which client at the cardiovascular clinic requires the most immediate action by the nurse?

Patient with stable angina whose chest pain has recently increased frequency

Which patient at highest risk for development of venous disease?

Person who has been on bed rest for 4 days

What assessment finding is expected in a client with peripheral artery disease and an ulcer on the second toe?

Prolonged capillary refill in all the toes

A 21-year-old college student comes in at the end of the semester complaining of heart skipping beat and the nurse obtains and ECG and notes presence of PVCs, what action should the nurse take first?

Question the client about current stress level and caffeine use

Information to include in the teaching plan to include for a new client with prescriptions for Enalapril?

Report a new clinical finding of a cough to the provider

A client is newly diagnosed with hypertension, which lab value is important to communicate to the healthcare provider?

Serum creatinine of 2.8

A client comes into the emergency department with chest pain and gives the nurse a list of medications he currently takes, which medication has the most immediate implication for the client's care?

Sildenafil

A patient's major risk factors for heart disease, which would the nurse include when taking a history?

Smoking, hypertension, obesity, diabetes, and high LDL

Older patient has been diagnosed with possible white coat hypertension, what should the nurse address that suspected cause of the hypertension?

Teach patient how to self monitor and record blood pressures at home

Which action of the nurse giving Enoxaparin to client with lower leg venous thromboembolism indicates more education about administration if she does what?

The nurse expels the air bubble in the syringe before injecting the drug

Information to tell healthcare provider about client going to magnetic resonance imaging (MRI)?

The patient has a permanent ventricular pacemaker

The nurse received laboratory values for client who developed chest pain 4 hours ago and maybe having a myocardial infarction, which is the most important laboratory result to review?

Troponins

Client diagnosed with chronic peripheral artery disease (PAD), offers further instructions when patient says?

Using a heating pad on feet at night to increase circulation and warmth in feet

Pt has pain while walking and goes away with rest

intermittent caudation

Treatment of V fib

defibrillation

Echocardiogram shows

ejection fraction and valve function

Flow rate is 26 drops per minute, drop factor is 15 drops per mL, how many mL/hr? 35 mL/hr??

figure this one out