exam 3 practice test adult

A nurse teaches a patient who is prescribed digoxin (Lanoxin) therapy. Which statement would the nurse include in this patient's teaching?

"Do not take this medication within 1 hour of taking an antacid."

The provider requests the nurse start an infusion of an inotropic agent on a patient. How does the nurse explain the action of this drug to the patient and spouse?

"It increases the force of the heart's contractions."

A nurse assesses a patient admitted to the cardiac unit. Which statement by the patient alerts the nurse to the possibility of right-sided heart failure? "I sleep with four pillows at night." "My shoes fit really tight lately." "I wake up coughing every night." "I have trouble catching my breath."

"My shoes fit really tight lately."

A patient is taking warfarin (Coumadin) and asks the nurse if taking St. John's wort is acceptable. What response by the nurse is best? "No, it may interfere with the warfarin." "There isn't any information about that." "Why would you want to take that?" "Yes, it is a good supplement for you."

"No, it may interfere with the warfarin."

A nurse teaches a patient who has a history of heart failure. Which statement would the nurse include in this patient's discharge teaching? "Avoid drinking more than 3 quarts (3 L) of liquids each day." "Eat six small meals daily instead of three larger meals." "When you feel short of breath, take an additional diuretic." "Weigh yourself daily while wearing the same amount of clothing."

"Weigh yourself daily while wearing the same amount of clothing."

The nurse administers clonidine (Catapres). What finding indicates the medication is therapeutic? Heart rate decrease from 100 beats per minute to 40 beats per minute Blood pressure decrease from 150/100 Hg to 110/70 mm Hg Increased urinary output to 100 mL per hour for six hours Absence of chest pain with mild headache after each dose

Blood pressure decrease from 150/100 Hg to 110/70 mm Hg

A nurse assesses an older adult patient who is experiencing a myocardial infarction. Which clinical manifestation would the nurse expect? Excruciating pain on inspiration Left lateral chest wall pain Disorientation and confusion Numbness and tingling of the arm

Disorientation and confusion

A nurse evaluates laboratory results for a patient with heart failure. Which results would the nurse expect? (Select all that apply.) Hematocrit: 32.8% Serum sodium: 130 mEq/L (130 mmol/L) Serum potassium: 4.0 mEq/L (4.0 mmol/L) Serum creatinine: 1.0 mg/dL (88.4 mcmol/L) Proteinuria Microalbuminuria

Hematocrit: 32.8% Serum sodium: 130 mEq/L (130 mmol/L) Proteinuria Microalbuminuria

A nurse wants to provide community service that helps meet the goals of Healthy People 2020 (HP2020) related to cardiovascular disease and stroke. What activity would best meet this goal?

Participate in blood pressure screenings at the mall.

Which are side effects of hydralazine? Priapism Reflex tachycardia Lupus-like symptoms Edema Bradycardia Constipation

Reflex tachycardia Lupus-like symptoms Edema also palplatation, nasal congestion, GI bleeding, numbness and tingling

A nurse reviews a patient's laboratory results. Which findings would alert the nurse to the possibility of atherosclerosis? (Select all that apply.) Total cholesterol: 280 mg/dL (7.3 mmol/L) High-density lipoprotein cholesterol: 50 mg/dL (1.3 mmol/L) Triglycerides: 200 mg/dL (2.3 mmol/L) Serum albumin: 4 g/dL (5.8 mcmol/L) Low-density lipoprotein cholesterol: 160 mg/dL (4.1 mmol/L)

Total cholesterol: 280 mg/dL (7.3 mmol/L) Low-density lipoprotein cholesterol: 160 mg/dL (4.1 mmol/L). Triglycerides: 200 mg/dL (2.3 mmol/L)

Which drug is a direct renin inhibitor? Verapamil Captopril Aliskiren Atenolol

aliskiren

A patient received tissue plasminogen activator (t-PA) after a myocardial infarction and now is on an intravenous infusion of heparin. The patient's spouse asks why the patient needs this medication. What response by the nurse is best? "The t-PA didn't dissolve the entire coronary clot." "The heparin keeps that artery from getting blocked again." "Heparin keeps the blood as thin as possible for a longer time." "The heparin prevents a stroke from occurring as the t-PA wears off."

"The heparin keeps that artery from getting blocked again."

A nurse cares for a patient who has advanced cardiac disease and states, "I am having trouble sleeping at night." What is the nurse's best response? "I will consult the provider to prescribe a sleep study to determine the problem." "You become hypoxic while sleeping; oxygen therapy via nasal cannula will help." "A continuous positive airway pressure, or CPAP, breathing mask will help you breathe at night." "Use pillows to elevate your head and chest while you are sleeping."

"Use pillows to elevate your head and chest while you are sleeping."

The nurse is teaching a patient who has hypertension about long-term management of the disease and a beta blocker. The patient reports typically consuming 1 to 2 glasses of wine each evening with meals. How will the nurse respond?

"Wine increases the hypotensive effects of the beta blocker."

A nurse assesses a patient who has aortic regurgitation. In which location in the illustration shown below would the nurse auscultate to best hear a cardiac murmur related to aortic regurgitation?

A

A nurse assesses patients on a cardiac unit. Which patient would the nurse identify as being at greatest risk for the development of left-sided heart failure? A 36-year-old woman with aortic stenosis A 42-year-old man with pulmonary hypertension A 59-year-old woman who smokes cigarettes daily A 70-year-old man who had a cerebral vascular accident

A 36-year-old woman with aortic stenosis

What nonpharmacologic comfort measures would the nurse include in the plan of care for a patient with severe varicose veins? (Select all that apply.) Administering mild analgesics for pain Applying elastic compression stockings Elevating the legs when sitting or lying Reminding the patient to do leg exercises Teaching the patient about surgical options

Applying elastic compression stockings Elevating the legs when sitting or lying Reminding the patient to do leg exercises

A nurse is working with a patient who takes atorvastatin (Lipitor). The patient's recent laboratory results include a blood urea nitrogen (BUN) of 33 mg/dL and creatinine of 2.8 mg/dL. What action by the nurse is best? Ask if the patient eats grapefruit. Assess the patient for dehydration. Facilitate admission to the hospital. Obtain a random urinalysis.

Ask if the patient eats grapefruit.

A nurse is caring for a patient on IV infusion of heparin. What actions does this nurse include in the patient's plan of care? (Select all that apply.) Assess the patient for bleeding. Monitor the daily activated partial thromboplastin time (aPTT) results. Stop the IV for aPTT above baseline. Use an IV pump for the infusion. Weigh the patient daily on the same scale.

Assess the patient for bleeding. Monitor the daily activated partial thromboplastin time (aPTT) results. Use an IV pump for the infusion.

A patient has been diagnosed with a deep-vein thrombosis and is to be discharged on warfarin (Coumadin). The patient is adamant about refusing the drug because "it's dangerous." What action by the nurse is best? Assess the reason behind the patient's fear. Remind the patient about laboratory monitoring. Tell the patient that drugs are safer today than before. Warn the patient about consequences of noncompliance.

Assess the reason behind the patient's fear.

A patient is 1 day postoperative after a coronary artery bypass graft. What nonpharmacologic comfort measures does the nurse include when caring for this patient? (Select all that apply.) Administer pain medication before ambulating. Assist the patient into a position of comfort in bed. Encourage high-protein diet selections. Provide complementary therapies such as music. Remind the patient to splint the incision when coughing.

Assist the client into a position of comfort in bed. Provide complementary therapies such as music. Remind the patient to splint the incision when coughing

A nurse assesses a patient who is recovering from a myocardial infarction. The patient's blood pressure reading is 140/88 mm Hg. What action would the nurse take first? Compare the results with previous blood pressure readings. Increase the intravenous fluid rate because these readings are low. Immediately notify the healthcare provider of the elevated blood pressure. Document the finding in the patient's chart as the only action.

Compare the results with previous blood pressure readings.

A nurse assesses a patient with pericarditis. Which assessment finding would the nurse expect to find? Heart rate that speeds up and slows down Friction rub at the left lower sternal border Presence of a regular gallop rhythm Coarse crackles in bilateral lung bases

Friction rub at the left lower sternal border

The nurse is caring for four hypertensive patients. Which drug-laboratory value combination would the nurse report immediately to the healthcare provider? Furosemide (Lasix)/potassium: 2.1 mEq/L Hydrochlorothiazide (Hydrodiuril)/potassium: 4.2 mEq/L Spironolactone (Aldactone)/potassium: 5.1 mEq/L Torsemide (Demadex)/sodium: 142 mEq/L

Furosemide (Lasix)/potassium: 2.1 mEq/L

Which anti-anginal medication is considered long acting?

Isosorbide dinitrate

Which medication is considered an organic nitrate? Hydralazine Lisinopril Isosorbide dinitrate Tadalafil

Isosorbide dinitrate

A nurse is assessing an obese patient in the clinic for follow-up after an episode of deep-vein thrombosis. The patient has lost 20 lbs since the last visit. What action by the nurse is best? Ask if the weight loss was intended. Encourage a high-protein, high-fiber diet. Measure for new compression stockings. Review a 3-day food recall diary.

Measure for new compression stockings.

A student nurse is assessing the peripheral vascular system of an older adult. What action by the student would cause the faculty member to intervene? Assessing blood pressure in both upper extremities Auscultating the carotid arteries for any bruits Classifying capillary refill of 4 seconds as normal Palpating both carotid arteries at the same time

Palpating both carotid arteries at the same time

A nurse is caring for four patients. Which one would the nurse see first? Patient who needs a beta-blocker, and has a blood pressure of 92/58 mm Hg Patient who had a first dose of captopril (Capoten) and needs to use the bathroom Hypertensive patient with a blood pressure of 188/92 mm Hg Patient who needs pain medication prior to a dressing change of a surgical wound

Patient who had a first dose of captopril (Capoten) and needs to use the bathroom

A nurse is in charge of the coronary intensive care unit. Which patient would the nurse see first? Patient on a nitroglycerin infusion at 5 mcg/min, not titrated in the last 4 hours Patient who is 1 day postcoronary artery bypass graft, with blood pressure 180/100 mm Hg Patient who is 1 day postpercutaneous coronary intervention, going home this morning Patient who is 2 days postcoronary artery bypass graft, who became dizzy this a.m. while walking

Patient who is 1 day postcoronary artery bypass graft, with blood pressure 180/100 mm Hg

A nurse is caring for four patients. Which patient would the nurse assess first? Patient with an acute myocardial infarction, pulse 102 beats/min Patient who is 1 hour post-angioplasty, and has tongue swelling and anxiety Patient who is postcoronary artery bypass, with chest tube drained 100 mL/hr Patient who is postcoronary artery bypass, with potassium 4.2 mEq/L (4.2 mmol/L)

Patient who is 1 hour post-angioplasty, and has tongue swelling and anxiety

A nurse prepares a patient for a pharmacologic stress echocardiogram. What actions would the nurse take when preparing this patient for the procedure? (Select all that apply.) Assist the provider to place a central venous access device. Prepare for continuous blood pressure and pulse monitoring. Administer the patient's prescribed beta-blocker. Give the patient nothing by mouth 3 to 6 hours before the procedure. Explain to the patient that dobutamine will simulate exercise for this examination.

Prepare for continuous blood pressure and pulse monitoring. Give the patient nothing by mouth 3 to 6 hours before the procedure. Explain to the patient that dobutamine will simulate exercise for this examination.

A nurse is assessing a patient with left-sided heart failure. For which clinical manifestations would the nurse assess?

Pulmonary crackles Confusion, restlessness cough that worsens at night

A nurse assesses a patient after administering a prescribed beta-blocker. Which assessment would the nurse expect to find? Blood pressure increased from 98/42 to 132/60 mm Hg Respiratory rate decreased from 25 to 14 breaths/min Oxygen saturation increased from 88% to 96% Pulse decreased from 100 to 80 beats/min

Pulse decreased from 100 to 80 beats/min

The nurse is reviewing the lipid panel of a male patient who has atherosclerosis. Which finding is most concerning? Cholesterol: 126 mg/dL High-density lipoprotein cholesterol (HDL-C): 48 mg/dL Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL Triglycerides: 198 mg/dL

Triglycerides: 198 mg/dL

A nurse is caring for a patient with a history of renal insufficiency who is scheduled for a cardiac catheterization. What actions would the nurse take prior to the catheterization?

a. Assess for allergies to iodine. b. Administer intravenous fluids. c. Assess blood urea nitrogen (BUN) and creatinine results.

A nursing student studying acute coronary syndromes learns that the pain of a myocardial infarction (MI) differs from stable angina in what ways? (Select all that apply.) Accompanied by shortness of breath Feelings of fear or anxiety Lasts less than 15 minutes No relief from taking nitroglycerin Pain occurs without known cause

accompanied by shortness of breath feelings of fear or anxiety No relief from taking nitroglycerin Pain occurs without known cause. last LONGER than 15 min

A nurse assesses a patient who is scheduled for a cardiac catheterization. Which assessment would the nurse complete prior to this procedure?

allergies to iodine based agents

A patient is 4 hours postoperative after a femoral-popliteal bypass. The patient reports throbbing leg pain on the affected side, rated as 7/10. What action by the nurse takes priority?

asses distal pulses and skin color

A nurse assesses an older adult patient who has multiple chronic diseases. The patient's heart rate is 48 beats/min. What action would the nurse take first?

assess the patients medications

A nurse is teaching a patient with heart failure who has been prescribed enalapril (Vasotec). Which statement would the nurse include in this patient's teaching?

avoid using salt substitutes

The nurse is evaluating a 3-day diet history with a patient who has an elevated lipid panel. What meal selection indicates that the patient is managing this condition well with diet?

baked chicken breast, broccoli, tomatoes

A nurse assesses a patient who is diagnosed with infective endocarditis. Which assessment findings would the nurse expect? (Select all that apply.) Weight gain Night sweats Cardiac murmur Abdominal bloating Osler's nodes

fever with chills, night sweats, malaise and fatigue, anorexia and weight loss, cardiac murmur, and Osler's nodes on palms of the hands and soles of the feet

The nurse is caring for a patient who is to begin receiving a thiazide diuretic to treat heart failure. When performing a health history on this patient, the nurse will be concerned about a history of which condition?

gout

A nurse assesses a patient who had a myocardial infarction and is hypotensive. Which additional assessment finding would the nurse expect?

heart rate 120 bpm

A nursing student learns about modifiable risk factors for coronary artery disease. Which factors does this include?

hypertension, obesity, smoking, stress

An emergency room nurse assesses a female patient. Which assessment findings would alert the nurse to request a prescription for an electrocardiogram?(Select all that apply.) Hypertension Fatigue despite adequate rest Indigestion Abdominal pain Shortness of breath

indigestion fatigue despite adequate rest shortness of breath

A patient is receiving an infusion of alteplase (Activase) for an intra-arterial clot. The patient begins to mumble and is disoriented. What action by the nurse takes priority?

notify rapid response team

A nurse assesses a patient who is recovering after a left-sided cardiac catheterization. Which assessment finding requires immediate intervention?

slurred speech and confusion

A nurse cares for a patient with infective endocarditis. Which infection control precautions would the nurse use?

standard

The nurse is caring for a patient who is receiving furosemide (Lasix) and an aminoglycoside antibiotic. The nurse will be most concerned if the patient reports which symptom? Dizziness Dysuria Nausea Tinnitus

tinnitus

A patient who has atrial fibrillation is taking digoxin. The nurse expects which medication to be given concurrently to treat this condition? Hydrochlorothiazide Inamrinone Milrinone Warfarin

warfarin