adult 3- exam 1 quiz/ATI questions
portal vein hypertension causes
decreased preload
ruptured LV aneurysm causes
decreased preload
The nurse needs to obtain a cardiac output measurement from a patient who has just had a pulmonary artery catheter inserted. What are important interventions for ensuring accurate pressure and cardiac output measurements?
ensure rapid injection of fluid through the injectate port, Zero reference the transducer system at the phlebostatic axis
Which of the following clients is at risk for developing peripheral arterial disease?
A client with diabetes mellitus
A nurse is monitoring a patient following a CABG. Which symptom would indicate cardiac tamponade
BP 140/82 on inspiration and 154/90 on expiration
A nurse is assessing a client in the emergency room with a bradydysrhythmia. What symptom would you expect?
confusion
A nurse is caring for a client following an abdominal aortic aneurysm resection. Which of the following a the priority assessment for this client?
urine output
Client's rhythm changes from normal sinus to supraventricular tachycardia. The client is conscious with a pulse of 210 and a faint radial pulse. What treatment can you expect?
vagal stimulation
A nurse is caring for a client with endocarditis. Which of the following findings should the nurse recognize as a potential complication?
valvular disease
A nurse is assessing a patient with left sided HF. Which symptom would you expect?
weakened peripheral pulses
A nurse is reviewing the lab results of several clients with peripheral arterial disease. The nurse should plan to provide dietary teaching to which client?
Cholesterol 190, HDL 25, LDL 160
acute pulmonary embolus causes
increased afterload
A 45-year-old male is visiting the wellness clinic and has been newly diagnosed as a stage I hypertensive patient. His blood pressure assessment over the past 6 months has consistently been 145/92 mm Hg. The patient asks, "What is blood pressure?" What is the best response by the nurse?
"A measurement that takes into consideration the amount of blood your heart is pumping and the size of the vessel diameter the heart must pump against."
The nurse explains to the new RN that angiotensin-converting enzyme inhibitors (ACE inhibitors) should be started within 24 hours of acute myocardial infarction (AMI). Which statement by the new RN indicates that teaching has been effective?
"ACE inhibitors are started within 24 hours to prevent myocardial remodeling."
A nurse is caring for a client following the insertion of a permanent pacemaker. Which of the following client statements indicates a potential complication of the procedure?
"I cant get rid of these hiccups"
A nurse is caring for a client with a hx of angina who is scheduled for a stress test at 1100. Which statement by the client requires possible rescheduling?
"I smoked a cigarette this morning to calm my nerves"
A nurse is caring for a patient who is scheduled for a CABG in 2 hr. Which of the following client statements indicates a need for further clarification from the nurse?
"I took my warfarin last night according to my weekly schedule"
When checking a patient's pulmonary artery occlusion pressure, the nurse inflates the balloon as ordered, not inflating the balloon for more than 8 to 10 seconds. The patient asks the rationale behind the nurse's actions. Which statement should the nurse make?
"Prolonged inflation can obstruct blood flow, resulting in ischemia."
The nurse is orienting a new RN to the ICU. The nurse begins to review orders recently entered by the cardiologist and to explain their rationale to the new RN. Medication orders include dobutamine (Dobutrex) 400 mg in 250 mL 5% dextrose in water titrated to keep cardiac index >2 L/min/m2. Which statement by the new RN indicates that teaching has been effective?
"The cardiac index is the measurement specific to the patient's size or body area."
The nurse is educating a new RN on preparing a patient for assessment of cardiac output using an esophageal monitor. Which statement by the new RN indicates that teaching was effective?
"The procedure involves a thin probe inserted into the esophagus."
What is the best understanding of mixed venous oxygen saturation by the nurse?
An overall picture of oxygen delivery and oxygen consumption
A nurse in the ED is caring for a patient who had an anterior MI. The client's hx reveals she is 1 week postop from an open cholecystectomy. Which intervention is contraindicated?
Assisting with thrombolytic therapy
A nurse is caring for a client 8 hr following a CABG. Which finding should the nurse report to the provider?
Blood pressure 160/80
The nurse is caring for a patient who is being monitored with a central venous catheter. In preparing to record a right atrial pressure reading, what is most important for the nurse to keep in mind when recording an accurate value?
Record the pressure at the end of expiration
The patient presents to the emergency department after having crushing chest pain for the past 5 hours. The ECG and laboratory work confirm suspicions of an acute myocardial infarction (AMI). Which findings would be the most conclusive that the patient is having an AMI?
ECG changes with ST elevation, elevated CKMB enzymes, elevated troponin levels
A nurse is caring for a client with a history of DVT and is receiving warfarin. Which of the following findings shows the effectiveness of warfarin.
INR 2.5
A nurse is caring for a client with a BP of 254/139. The nurse recognizes that the client is in hypertensive crisis. Which action should the nurse take first?
Place HOB 45 degrees
A nurse is providing discharge teaching for a client with a prescription of a transdermal nitroglycerin patch. What teaching should be provided?
Place the patch in an area away from skin folds or joints
What is the best action by the nurse to level and zero a hemodynamic monitoring system transducer?
Position the air-fluid interface of the zeroing transducer at the phlebostatic axis (fourth intercostal space, midaxillary line).
What is the best action by the nurse to accurately record a thermodilution cardiac output (CO)?
Position the patient supine, obtain three values within 10% of each other, and calculate the average cardiac output.
A nurse is preparing a client for a coronary angiography. The nurse should report which finding to the provider?
Previous allergic reaction to shellfish
What is the best position for the nurse to place the patient in to obtain a right atrial pressure measurement?
Supine, either flat or with the head of the bed no more than 60 degrees
A nurse is admitting a client with a leg ulcer and a history of diabetes mellitus. The nurse should use which of the following focused assessments to differentiate between an arterial and a venous ulcer
The presence or absence of intermittent claudication
A nurse is caring for a client in the first hour post-op of an aortic aneurysm repair. Which sign indicates shock and should be reported to the provider?
Urine output 20 ml/hr
A nurse is providing discharge teaching for a client who has HF. Which of the following should the client be told to report to their provider immediately?
Weight gain of 2lbs in 24 hr
A nurse is providing teaching for a client who is 2 days post-op following a heart transplant. Which of the following statements should the nurse include in the teaching?
You may no longer be able to feel chest pain
The nurse is caring for a patient with a diagnosis of acute myocardial infarction (AMI). Which medication should the nurse anticipate administering to the patient to reduce platelet aggregation?
aspirin
Which statements related to the management of unstable angina are true?
calcium channel blockers help to reduce symptoms, early revascularization may be helpful, best treated with rest and nitro
A nurse is caring for a client who had an onset of chest pain 24 hr ago. An increase of which is a sign of a MI?
creatine kinase- MB
home health nursing in africa wearing a woal coat causes
decreased afterload
vasodilator overdose causes
decreased afterload
diabetes insipidus causes
decreased preload
An adult patient suffered an anterior wall myocardial infarction (MI) 4 days ago. Today the patient is experiencing dyspnea and sitting straight up in bed. The nurse's assessment includes bibasilar crackles, an S3 heart sound with a heart rate of 125 beats/min. The nurse anticipates a diagnosis of:
heart failure
home health nursing in arctic circle wearing no coat causes
increased afterload
mitral valve stenosis causes
increased afterload
aortic valve regurgitation causes
increased preload
cardioselective beta blocker overdose causes
increased preload
congestive heart failure causes
increased preload
pulmonic valve regurgitation causes
increased preload
A nurse is caring for a client with dilated cardiomyopathy. She says increasing difficulty in completing her one mile walks. The nurse should recognize this a sign of
left ventricular failure
A nurse is caring for a client being treated for HF and is on digoxin and furosemide. Which is a potential adverse effect of these medications?
lightheadedness
A nurse is planning a presentation on hypertension. Which of the following lifestyle modifications should the nurse include?
limit alcohol intake, regular exercise program, smoking cessation
A 67-year-old female is admitted to the emergency department complaining of midback pain and shortness of breath for the preceding 2 hours. She also complains of nausea and states that she vomited twice before coming to the hospital. She denies any chest discomfort or arm pain. The nurse prepares to the treat the patient for a diagnosis of:
myocardial infarction
The patient, who is being treated for hypercholesterolemia, complains of hot flashes and a metallic taste in the mouth. The nurse educates the patient that this is a side effect of:
nicotinic acid
A patient is complaining of midsternal chest discomfort radiating down the right arm. The discomfort has been present for about 5 minutes. The patient is also asthmatic and allergic to calcium channel blockers. The nurse anticipates an order from the health care provider for which medication?
nitroglycerin sublingual
The patient presents to the emergency department with severe substernal chest discomfort. Cardiac enzymes are elevated, and his ECG shows ST-segment depression in V2 and V3. The nurse anticipates a diagnosis of:
non Q wave MI
A client with HTN has a prescription for an ACE inhibitor. The nurse instructs on adverse effects of the medication. The client exhibits understanding by stating he will notify his provider if he experiences
persistent cough
A nurse is caring for a patient with HF and a-fib. Which should the nurse plan to report to the provider immediately?
slurred speach
A nurse is reviewing the medical record of a client who is receiving heparin therapy for treatment of a DVT. Which intervention should the nurse take for an aPTT of 96 seconds?
stop the infusion
The nurse is caring for a patient who has symptoms of an acute myocardial infarction (AMI). Which lab should the nurse prepare to draw in order to detect myocardial necrosis?
troponin I
