Exam 2 cardiovascular system questions
Which of the following conditions is most commonly responsible for MI? a. aneurysm b. HF c. coronary artery thrombosis d. renal failure
c. coronary artery thrombosis
Which of the following risk factors for CAD cannot be corrected? a. smoking b. DM c. heredity d. hypertension
c. heredity
Which of the following arteries primarily feeds the anterior wall of the heart? a. circumflex artery b. internal mammary artery c. left anterior descending artery d. right coronary artery
c. left anterior descending artery
Which of the following symptoms might a client with right sided heart failure exhibit? a. adequate urine output b. polyuria c. oliguria d. polydipsia
c. oliguria
Medical treatment of coronary artery disease includes which of the following procedures? a. cardiac catheterization b. coronary artery bypass surgery c. oral medication administration d. percutaneous transluminal coronary angioplasty
c. oral medication administration
A client is admitted to a hospital with acute MI and is started on tissue plasminogen activator (t0PA, Activase) by infusion. Of the following parameters, which one would a nurse determine requires the least frequent assessment to detect complications with this therapy? a. O2 saturation b. neurological signs c. BP and pulse d. complaints of abdominal and back pain
a. O2 saturation
A pulsating abdominal mass usually indicates which of the following conditions? a. abdominal aortic aneurysm b. enlarged spleen c. gastric distention d. gastritis
a. abdominal aortic aneurysm
A client has frequent bursts of ventricular tachycardia on the cardiac monitor. What should the nurse be most concerned about with this dysrhythmia? 1.It can develop into ventricular fibrillation at any time. 2.It is almost impossible to convert to a normal rhythm. 3.It is uncomfortable for the client, giving a sense of impending doom. 4.It produces a high cardiac output that quickly leads to cerebral and myocardial ischemia.
1.It can develop into ventricular fibrillation at any time.
A nurse employed in a cardiac unit determines that which client is the least likely to have implantation of an automatic internal cardioverter-defibrillator (AICD)? 1.A client with syncopal episodes related to ventricular tachycardia 2.A client with ventricular dysrhythmias despite medication therapy 3.A client with an episode of cardiac arrest related to myocardial infarction 4.A client with three episodes of cardiac arrest unrelated to myocardial infarction
3.A client with an episode of cardiac arrest related to myocardial infarction
A client with pulmonary edema has been on diuretic therapy. The client has an order for additional furosemide(lasix) in the amount of 40 mg IV push. Knowing that the client will also be started on digoxin (lanoxin), a nurse checks the clients most recent: 1. digoxin level 2. sodium level 3.potasium level 4. creatinine level
3.potasium level
Prolonged occlusion of the right coronary artery produces an infarction in which of the following areas of the heart? A) Anterior B) Apical C) Inferior D) Lateral
C) Inferior
What position should the nurse place the head of the bed in to obtain the most accurate reading of jugular vein distension? a. high fowlers b. raised 10 degrees c. raised 30 degrees d. supine position
c. raised 30 degrees
Which of the following parameters should be checked before administering digoxin? a. apical pulse b. BP c. radial pulse d. respiratory rate
a. apical pulse
What is the most common cause of an abdominal aortic aneurysm? a. atherosclerosis b. DM c. hypertension d. syphilis
a. atherosclerosis
Which of the following conditions most commonly results in CAD? a. atherosclerosis b. diabetes mellitus c. MI d. renal failure
a. atherosclerosis
Which of the following classes of medications protects the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation? a. beta-adrenergic blockers b. calcium channel blockers c. narcotics d. nitrates
a. beta-adrenergic blockers
Which of the following is the most common symptom of MI? a. chest pain b. dyspnea c. edema d. palpitations
a. chest pain
Which of the following symptoms is most commonly associated with left sided heart failure? crackles b. arrhythmias c. hepatic engorgement d. hypotension
a. crackles
Toxicity from which of the following medications may cause a client to see a green halo around lights? a. digoxin b. furosemide (lasix) c. metoprolol (lopressor) d. Enalapril (vasotec)
a. digoxin
A client has developed A-fib with a ventricular rate of 150 beats per minute. a nurse assesses the client for: a. hypotension and dizziness b. nausea and vomiting c. hypertension and headache d. flat neck veins
a. hypotension and dizziness
A client seeks treatment in a physicians office for unsightly varicose veins, and sclerotherapy is recommended. Before leaving the examination room the client says to the nurse " Can you tell me again how this sclerotherapy is done"? In formulating a response, the nurse incorporates the knowledge that sclerotherapy consists of: a. injecting an agent into the vein to damage the vein wall and close off the vein b. tying off the vein at the upper end to prevent stasis from occurring c. tying off the vein at the lower end to prevent statis from occurring d. surgical removal of the varicosity
a. injecting an agent into the vein to damage the vein wall and close off the vein
A nurse assesses the sternotomy incision of a client on the third day after cardiac surgery. The incision shows some slight puffiness along the edges and is non reddened with no apparent drainage. Temp is 99F orally. The WBC is 7500/mm3. The nurse interprets that the incision line: a. is slightly edematous but shows no active signs of infection b. shows no signs of infection although the WBC count is elevated c. shows early signs of infection, although the temperature is near normal d. shows early signs on infection, supported by an elevated WBC
a. is slightly edematous but shows no active signs of infection
A nurse is watching the cardiac monitor and a clients rhythm suddenly changes. There are no P waves, instead there are wavy lines. The QRS complexes measure 0.08 seconds, but they are very irregular with a rate of 120 beats per minute. The nurse interprets that this rhythm is: a. sinus tachycardia b. A-fib c. ventricular tachycardia d. ventricular fibrillation
b. A-fib
Which of the following illnesses is the leading cause of death in the USA? a. cancer b. CAD c. liver failure d. renal failure
b. CAD
With which of the following disorders is jugular vein distension most prominent? a. abdominal aortic aneurysm b. HF c. MI d. pneumothorax
b. HF
What supplemental medication is most frequently ordered in conjunction to furosemide (Lasix)? a. Chlorine b. Digoxin c. K d. Na
c. K
A client is receiving thrombolytic therapy with a continuous infusion of streptokinase. the client studently becomes extremely anxious and complains of itching. A nurse hears stridor and upon examination of the client notes generalized urticaria and hypotension. The nurse should : a. administer O2 and protamine sulfate b. cut the infusion rate in half and sit the client up in bed c. stop the infusion and call the physician d. administer diphenhydramine (benadryl) and continue the infusion
c. stop the infusion and call the physician
Which of the following blood tests is most indicative of cardiac damage? a. lactate dehydrogenase b. CBC c. troponin I d. creatinine kinase (CK)
c. troponin I
A client with angina complains that the anginal pain is prolonged and sever and occurs at the same time each day, most often in the morning. On further assessment, a nurse notes that the pain occurs in the absence of precipitating factors. This type of angina is best described as: a. stable angina b. unstable angina c. variant angina d. nonanginal pain
c. variant angina
A client is admitted with pulmonary thromboembolism and is to be treated with streptokinase. a nurse would report which of the following assessments to the physician before therapy is initiated? a. adventitious breath sounds b. RR of 28 per min c. Temp of 99.4 F d. BP 198/110 mmHg
d. BP 198/110 mmHg
Which of the following diagnostic tools is most commonly used to determine the location of myocardial damage? a. cardiac catheterization b. cardiac enzymes c. Echocardiogram d. ECG
d. ECG
IV heparin therapy is ordered for a client. While implementing this order, a nurse ensures that which of the following medications is available on the nursing unit? a. Vitamin K b. Aminocaporic acid c. Potassium chloride d. Protamine sulfate
d. Protamine sulfate
A client who had cardiac surgery 24 hours ago has a urine output averaging 20 mL/hr for 2 hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for the subsequent hour was 25 mL. Daily laboratory results indicate that the blood urea nitrogen (BUN) is 45 mg/dl and the serum creatinine is 2.2 mg/dL. A nurse interprets that the client is at risk for: a. hypovolemia b. UTI c. Glomerulonephritis d. acute renal failure
d. acute renal failure
A client is scheduled for a cardiac cauterization using a radiopaque dye. Which of the following assessments is most critical before the procedure? a. intake and output b. baseline peripheral pulse rates c. height and weight d. allergy to iodine or shellfish
d. allergy to iodine or shellfish
A nurse is caring for a client who had a resection of an abdominal aortic aneurysm yesterday. The client has an IV with a rate of 150 ml /hr, unchanged for the last 10 hrs . The client's urine output for the last 3 hrs was 90 ml, 50 ml and 28 ml. The clients BUN is 1.8 mg/dL drawn this morning. Which of the following actions should the nurse take next? a. put the IV on a pump so that the infusion rate is sure to stay stable b. check to see if the client had a serum albumin level drawn c. check the urine specific gravity d. call the physician
d. call the physician
A client in cardiogenic shock had insertion of an intraaortic balloon pump (IABP) 24 hours ago via the left femoral approach. A nurse notes that the left foot is cool and mottled and the left pedal pulse is weak. The nurse would: a. document the data, as this is expected because of catheter size b. reevaluate the neurovascular status in another hour c. increase the rate of intravenous nitroglycerin that is infusing d. call the physician immediately
d. call the physician immediately
A nurse caring for a client in one room is told by another nurse that a second client has developed severe pulmonary edema. Upon entering the second clients room, the nurse would expect the client to be: a. slightly anxious b. mildly anxious c. moderately anxious d. extremely anxious
d. extremely anxious
A client is admitted with a venous stasis leg ulcer. A nurse assesses the ulcer, expecting to note that the ulcer: a. has a pale colored base b. is deep with even edges c. has little granulation tissue d. has brown pigmentation surrounding it
d. has brown pigmentation surrounding it
A client with MI is going into cardiogenic shock. Because of myocardial ischemia a nurse would carefully assess the client for: a. ventricular dysrhythmias b. bradycardia c. rising diastolic blood pressure d. falling central venous pressure (CVP)
a. ventricular dysrhythmias
A nurse is evaluating the condition of a client after pericardiocentesis for cardiac tamponade. Which of the following observations would indicate that the procedure was unsuccessful? a. rising central venous pressure CVP b. rising BP c. client expressions of relief d. clearly audible heart sounds
a. rising central venous pressure CVP
When do coronary arteries primarily receive blood flow? a. during inspiration b. during diastole c. during expiration d. during systole
b. during diastole
A client with angina pectoris has a 12 lead ECG taken during an episode of chest pain. A nurse examines the tracing for which ECG change caused by myocardial ischemia? a. prolonged PR interval b. widened QRS complex c. ST segment elevation or depression d. Tall, peaked T waves
c. ST segment elevation or depression
A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin (Coumadin). The client's prothrombin time is 20 seconds, with a control of 11 seconds. The nurse assesses that this result is: a. The same as the client's own baseline level b. Lower than the needed therapeutic level c. Within the therapeutic range d. Higher than the therapeutic range
c. Within the therapeutic range
A nurse is viewing the cardiac monitor in a client's room and notes that the client has just gone into VT. The client is awake and alert and has good skin color. The nurse would prepare to do which of the following? a. immediately defibrillate b. prepare for pacemaker insertion c. administer lidocaine hydrochloride (xylocaine) IV d. administer epinephrine (adrenalin) IV
c. administer lidocaine hydrochloride (xylocaine) IV it is an antidysrhythmic other are procainamide and bretylium Cardioversion may also be needed to correct the rhythm
A nurse is performing CPR on a client who had a cardiac arrest. An automatic external defibrillator is available to treat the client. The nurse uses the AED and assesses the cardiac rhythm by: a. applying standard ECG monitoring leads to the client and observing rhythm b. holding the defibrillator paddles firmly against the chest c. applying the adhesive patch electrodes to the chest and moving away from the client d. connecting standard ECG electrodes to a transtelephonic monitoring device
c. applying the adhesive patch electrodes to the chest and moving away from the client
What is the most common complication of a MI? a. cardiogenic shock b. HF c. arrhythmias d. pericarditis
c. arrhythmias
A nurse is conducting a health history with a client with a primary diagnosis of HF. Which of the following disorders reported by the client does not play a role in exacerbating the heart failure? a. recent upper respiratory infection b. nutritional anemia c. peptic ulcer disease d. atrial fibrillation
c. peptic ulcer disease
A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and SOB and is visibly anxious. A nurse immediately assesses the client for other signs and symptoms of: a. MI b. Pneumonia c. pulmonary emboli d. pulmonary edema
c. pulmonary emboli
A murmur is heard at the second left intercostal space along the left sternal boarder. Which valve area is this? a. aortic b. mitral c. pulmonic d. tricuspid
c. pulmonic
A client having a follow-up physician office visit after vein ligation and stripping. The client describes a sensation of pins and needles in the affected leg. On the basis of evaluation of his comment the nurse: a. reassures the client that this is only temporary b. advises the client to take acetaminophen until it is gone c. states that warm packs should help d. reports the complaint to the physician
d. reports the complaint to the physician
Which of the following conditions is most closely associated with weight gain, nausea and decreased in urine output? a. angina pectoris b. cardiomyopathy c. left sided HF d. right sided HF
d. right sided HF
Which of the following disorders would the nurse expect to assess sacral edema in a bedridden client? a. DM b. pulmonary emboli c. renal failure d. right sided heart failure
d. right sided heart failure
A client 's ECG strip shows atrial and ventricular rates of 80 complexes per minute. The PR interval is 0.14 seconds, the QRS complex measures 0.08 seconds and the PP interval is slightly irregular. The nurse interprets this rhythm as: a. normal sinus rhythm b. sinus bradycardia c. sinus tachycardia d. sinus dysrhythmia
d. sinus dysrhythmia
A nurse is assessing the BP of a client diagnosed with primary hypertension. The nurse ensures accurate measurement by avoiding which of the following>? a. seating the client with arm bared, supported and at heart level b. measuring the blood pressure after the client has been seated quietly for 5 min c. using a cuff with a rubber bladder that encircles at least 80% of the limb d. taking the BP within 30 min after nicotine or caffeine ingestion
d. taking the BP within 30 min after nicotine or caffeine ingestion
What is the primary reason for administering morphine to a client with an MI? a. to sedate the client b. to decrease his pain c. to decrease his anxiety d. to decrease O2 demand on the clients heart
d. to decrease O2 demand on the clients heart
After an anterior wall MI, which of the following problems is indicated by auscultation of crackles in the lungs? a. left sided heart failure b. pulmonic valve malfunction c. right sided heart failure d. tricuspid valve malfunction
a. left sided heart failure
A nurse is caring for a client immediately after insertion of a permanent demand pacemaker via right subclavian vein. The nurse takes care not to dislodge the pacing catheter by: a. limiting movement and abduction of the right arm b. limiting movement and abduction of the left arm c. assisting the client to get out of bed and ambulate with a walker d. having the physical therapist do active range of motion to the right arm
a. limiting movement and abduction of the right arm
A nurse is assessing an ECG rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 seconds and QRS complexes measure 0.06 seconds. The overall heart rate is 64 beats per minute. The nurse assesses the cardiac rhythm as: a. normal sinus rhythm b. sinus bradycardia c. sick sinus syndrome d. first degree heart block
a. normal sinus rhythm 60-100 beats
A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but over 100. The nurse determines that the client is experiencing: a. Premature ventricular contractions b. Ventricular tachycardia c. Ventricular fibrillation d. Sinus tachycardia
b. Ventricular tachycardia
What is the first intervention for a client experiencing MI? a. administer morphine b. administer O2 c. administer sublingual nitroglycerin d. obtain an ECG
b. administer O2
Exceeding which of the following serum cholesterol levels significantly increases the risk of coronary artery disease? A) 100 mg/dl B) 150 mg/dl C) 175 mg/dl D) 200 mg/dl
D) 200 mg/dl
A nurse is assessing the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission. The nurse interprets that the neurovascular status is: a. normal, because of increased blood glow throughout the leg b. slightly deteriorating and should be monitored c. moderately impaired and the surgeon should be called d. adequate from an arterial approach but venous complications are arising.
a. normal, because of increased blood glow throughout the leg
A nurse notes bilateral 2+ edema in the lower extremities of a client with MI who was admitted 2 days ago. The nurse would plan to do which of the following next? a. review the intake and output records for the last 2 days b. change the time of diuretic administration from morning to evening c. request a sodium restriction of 1g/ day from the physician d. order daily weights starting on the following morning
a. review the intake and output records for the last 2 days
What is the most appropriate nursing response to a MI client who is fearful of dying? a. tell me about your feelings right now b. when the doctor arrives , everything will be fine c. this is a bad situation, but you'll feel better soon d. please be assured we're doing everything we can to make you feel better
a. tell me about your feelings right now
A client with rapid-rate A-fib asks a nurse why the physician is going to perform carotid massage. The nurse responds that this procedure may stimulate the: a. vagus nerve to slow the heart rate b. vagus nerve to increase the heart rate, overdriving the rhythm c. diaphragmatic nerve to slow the heart rate. d. diaphragmatic nerve to overdrive the rhythm
a. vagus nerve to slow the heart rate
Which of the following complications is indicated by a third heart sound S3? a. ventricular dilation b. systemic hypertension c. aortic valve malfunction d. increased arterial contractions
a. ventricular dilation
A nurse is preparing for the admission of a client with HF who is being sent directly to the hospital from the physician's office. The nurse would plan on having which of the following medications readily available for use? a. Diltiazem (cardizem) b. Digoxin (lanoxin) c. Propranolol (inderal) d. Metoprolol (lopresor)
b. Digoxin (lanoxin)
A nurse notices frequent artifact on the ECG monitor for a client whose leads are connected by cable to a console at the bedside. The nurse examines the client to determine the cause. Which of the following items is unlikely to be responsible for the artifact? a. Frequent movement of the client b. Tightly secured cable connections c. Leads applied over hairy areas d. Leads applied to the limbs
b. Tightly secured cable connections
A nurse is caring for a client who has just had implantation of an automatic internal cardioverter defibrillator (AICD). The nurse would immediately determine which of the following items, based on priority? a. activate status of the device, heart rate cutoff and number of shocks it is programmed to deliver b. presence of Medic- Alert card for the client to carry c. anxiety level of the client and family d. knowledge of restrictions of postdischarge physical activity
a. activate status of the device, heart rate cutoff and number of shocks it is programmed to deliver
A client is having frequent premature ventricular contractions PVCs. A nurse would place priority on assessment of which of the following items? a. blood pressure and peripheral perfusion b. sensation of palpitations c. causative factors such as caffeine d. precipitating factors such as infection
a. blood pressure and peripheral perfusion PVCs cause hemodynamic compromise.
A client is admitted to an emergency room with chest pain and is being rulled out for myocardial infraction (MI). VS at 11:00 are : P 92, RR24, BP 140/88. VS at 11:15 are: P96, RR26, BP128/82. VS at 11:30 are P 104, RR28,BP 104/68. VS at 11:45 are: P118, RR32, BP88/58 A nurse alerts the physician because these changes are most consistent with: a. cardiogenic shock b. cardiac tamponade c. pulmonary embolism d. dissecting thoracic aortic aneurysm
a. cardiogenic shock
A client is wearing a continuous cardiac monitor which begins to sound its alarm. A nurse sees no ECG complexes on the screen. The first action of the nurse is to: a. check the client status and lead placement b. press the recorder button on the ECF console c. call the physician d. call a code blue
a. check the client status and lead placement
What is the most common symptom in a client with abdominal aortic aneurysm ? a. abdominal pain b. diaphoresis c. headache d. upper back pain
a. abdominal pain
A home care nurse is making a routine visit to a client receiving digoxin (Lanoxin) in the treatment of heart failure. The nurse would particularly assess the client for: a. thrombocytopenia and weight gain b. anorexia, nausea and visual disturbances c. diarrhea and hypotension d. fatigue and muscle twitching
b. anorexia, nausea and visual disturbances
A nurse would evaluate the defibrillation of a client was most successful if which of the following observations was made? a. nonarousable, sinus rhythm, BP 88/60 mmHg b. arousable, sinus rhythm BP 116/72 c. nonarousable, supraventricular tachycardia, BP 122/60 mmHg d. arousable, marked bradycardia, BP 86/54
b. arousable, sinus rhythm BP 116/72
A client with MI has been transferred from a coronary care unit (CCU) to a general medical unit with cardiac monitoring via telemetry. A nurse plans to allow for which of the following client activities? a. strict bed rest for 24 hrs after transfer b. bathroom privileges and self care activities c. unsupervised hallway ambulation with distances under 200 feet d. ad lib activities since the client is monitored
b. bathroom privileges and self care activities
A nurse is caring for a client who had percutaneous insertion of an inferior vena cava IVC filter, and was on heparin therapy prior to surgery. The nurse would inspect the surgical site most closely for signs of: a. thrombosis and infection b. bleeding and infection c. bleeding and wound dehiscence d. wound dehiscence and evisceration
b. bleeding and infection
A client is scheduled for a dipyridamole (Presantine) thallium 201 scan. A nurse would assess to make sure that the client avoided which of the following prior to the procedure? a. milk products b. caffeine c. excess sugar d. fatty meal
b. caffeine
In which of the following area is an abdominal aortic aneurysm most commonly located? a. distal to the iliac arteries b. distal to the renal arteries c. adjacent to the aortic arch d. proximal to the renal arteries
b. distal to the renal arteries
Which of the following actions is the first priority of care for a client exhibiting signs and symptoms of CAD? a. decreased anxiety b. enhance myocardial oxygenation c. administer sublingual nitroglycerin d. educate the client about his symptoms
b. enhance myocardial oxygenation
A nurse is assessing a client with an abdominal aortic aneurysm (AAA). which of the following assessment findings by the nurse is probably unrelated to the AAA? a. pulsatile abdominal mass b. hyperactive bowel sounds in the area c. systolic bruit over the area of the mass d. subjective sensation of heart beating in the abdomen
b. hyperactive bowel sounds in the area
A nurse is caring for a client with unstable VT. The nurse instructs the client to do which of the following if prescribed during an episode of VT? a. breathe deeply, regularly and easily b. inhale deeply and cough forcefully every 1 to 3 seconds c. lie down flat in bed d. remove any metal jewelry
b. inhale deeply and cough forcefully every 1 to 3 seconds cough CPR
A client who has been receiving heparin therapy is also started on warfarin sodium (coumadin). The client asks the nurse why both medications are being administered. in formulating a response, the nurse incorporates he understanding that warfarin sodium : a. stimulates breakdown of specific clotting factors by the liver and it takes 2 to 3 days for this to exert an anticoagulant effect b. inhibits synthesis of specific clotting factors in the liver and it takes 3 to 4 days for this medication to exert an anticoagulant effect c. stimulates production of the body's own thrombolytic substances but it takes 2 to 4 days for this to begin d. has the same mechanism of action as heparin and the cross over time is needed for the srum level of warfarin sodium to be therapeutic
b. inhibits synthesis of specific clotting factors in the liver and it takes 3 to 4 days for this medication to exert an anticoagulant effect
Which of the following landmarks is the correct one for obtaining an apical pulse? a. left 5th intercostal space, midaxillary line b. left 5th intercostal space, midclavicular line c. left second intercostal space, midclavicular line d. left seventh intercostal space. midclavicular line
b. left 5th intercostal space, midclavicular line
Atherosclerosis impedes coronary blood flow by which of the following mechanisms? a. plaques obstruct the vein b. plaques obstruct the artery c. blood clots from outside the vessel wall d. hardened vessels dilate to allow blood to flow through
b. plaques obstruct the artery
A nurse is preparing to ambulate a client on the 3rd day after cardiac surgery. The nurse would plan to do which of the following to enable the client to best tolerate the ambulation? a. encourage the client to cough and deep breathe b. premedicate the client with an analgesic c. provide the client with a walker d. remove telemetry equipment
b. premedicate the client with an analgesic
A 24 year old male seeks medical attention for complaints of claudication in the arch of the foot. A nurse also notes superficial thrombophlebitis of the lower leg. The nurse would next assess the client for: a. familial tendency towards PVD b. smoking history c. recent exposure to allergens d. history of recent insect bites.
b. smoking history
A nurse is evaluating a client's response to cardioversion. Which of the following observations would be of highest priority to the nurse? a. O2 flow rate b. status of airway c. BP d. LOC
b. status of airway
Stimulation of the sympathetic nervous system produces which of the following responses? a. bradycardia b. tachycardia c. hypotension d. decreased myocardial contractability
b. tachycardia
A nurse is preparing to defibrillate a client in VF. The nurse places the paddles on the clients chest and before defibrillating the client, assesses that: a. the client has received lidocaine hydrochloride (xylocaine) b. the rhythm is actually VF c. the machine has been set to the synchronize mode d. the client has been intubated
b. the rhythm is actually VF
A nurse notes that a client with sinus rhythm has a premature ventricular contraction PVC that falls on the T wave of the preceding beat. The client's rhythm suddenly changes to one with no P waves or definable QRS complexes. Instead there are coarse wavy lines of varying amplitude. The nurse assesses this rhythm to be: a. ventricular tachycardia b. ventricular fibrillation c. atrial fibrillation d. asystole
b. ventricular fibrillation
A client with no history of cardiovascular disease presents to the ambulatory clinic with flulike symptoms. The client studently complains of chest pain. Which of the following questions would best help a nurse to discriminate pain caused by a noncardiac problem? a. "have you ever had this pain before?" b. " can you describe the pain to me?" c. "does the pain get worse when you breathe in?" d. " Can you rate the pain on a scale of 1 to 10, with 10 being the worse?"
c. "does the pain get worse when you breathe in?"
A client in VF is about to be defibrillated. A nurse knows that in order to effectively convert this rhythm., the machine should be set at which of the following energy levels for the first delivery? a. 50 joules b. 100 joules c. 200 joules d. 360 joules
c. 200 joules
A client in cardiogenic shock has a millilumen pulmonary artery catheter placed. The nurse would interpret that the client is most unstable if which of the following cardiac output (CO) and pulmonary capillary wedge pressure (PCWP) readings were obtained? a. CO 5L/min, CWP low b. CO 4L/min, CWP high c. CO 3L/min, CWP high d. CO 2L/min, CWP low
c. CO 3L/min, CWP high
A client with myocardial infraction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy pink- tinged sputum. A nurse listens to breath sounds, expecting to hear bilateral: a. rhonchi b. crackles in bases c. Crackles to apices d. wheezes
c. Cracklest or rales to apices due to pulmonary edema
Which of the following classes of medications maximizes cardiac performance in clients with HF by increasing ventricular contractability? a. beta adrenergic blockers b. calcium channel blockers c. diuretics d. inotropic agents
d. inotropic agents
After a MI, serum glucose levels and free fatty acid production both increase. What type of physiologic changes are these? a. electrophysiologic b. hematologic c. mechanical d. metabolic
d. metabolic
A nurse has given instructions to the client with Raynaud's disease about self management of the disease process. The nurse would evaluate that the client needs further reinforcement if the client states that: a. smoking cessation is very important b. sources of caffeine should be eliminated from the diet c. taking nifedipine (procardia) as prescribed will decrease vessel spasm d. moving to a warmer climate is needed
d. moving to a warmer climate is needed
Which of the following systems is the most likely origin of pain the client describes as knifelike chest pain that increases in intensity with inspiration? a. cardiac b. gastrointestinal c. musculoskeletal d. pulmonary
d. pulmonary
