Lippincott Questions - Cardiovascular Exam I
A client had a below-the-knee amputation secondary to arterial occlusive disease. The nurse is instructing the client about residual limb care. Which statement by the client indicates that the client understands how to implement the plan of care?
"I should rewrap the stump as often as needed."
The nurse is instructing a client who is at risk for peripheral artery disease how to use knee-length elastic stockings (support hose). What instructions should the nurse include in the teaching plan?
1. Apply the elastic stockings before getting out of bed. 2. Remove the stockings q8h, elevate the feet, reapply in 15 minutes
Good dental care is an important measure in reducing the risk of endocarditis. What information about dental care should the nurse include in the teaching plan for a client with mitral stenosis?
1. Brush teeth at least 2x daily 2. Floss 1x/day. 3. Have regular dental checkups
A client with a history of cardiac disease has just returned to the cardiac unit post-cardiac catheterization at the femoral site. What interventions would be included for this client?
1. Check distal pulse 2. Keep client flat in bed 3. Monitor HR/rhythm.
The nurse is caring for a client following a myocardial infarction and is aware that complications can occur due to damage to the myocardium. Which interventions would be appropriate for this client?
1. ECG with any chest pain 2. continuous cardiac monitoring via telemetry 3. auscultating apical pulse q2h 4. bed rest for 24hrs
The client is admitted to the telemetry unit due to chest pain. The client has polysubstance abuse, and the nurse assesses that the client is anxious and irritable and has moist skin. What should the nurse do in order of priority from first to last?
1. EKG 2. VS 3. morphine. 4. Obtain hx of which drugs the client has used
The nurse is conducting a health history on a client with peripheral vascular problems. Which statements would suggest increasing problems with the peripheral vascular circulation?
1. Increased pain in the legs at rest and a chronic ulceration on the right heel 2. Acute lower leg pain/swelling to the left calf over the past 24 hours 3. More swelling in the feet at the end of the day. 4. Numbness and tingling in both feet when sitting for long periods of time
A client has an emergency embolectomy for an embolus in the femoral artery. After the client returns from the recovery room, in what order, from first to last, should the nurse provide care?
1. assess/monitor pulse 2. inspect site dressing
The nurse is assessing a client with chronic heart failure who is demonstrating neurohormonal compensatory mechanisms. Which are expected findings on assessment?
1. decreased CO, 2. increased HR, 3. vasoconstriction in skin, GI tract, and kidneys 4. fluid overload
A client is receiving intravenous (I.V.) heparin for the treatment of thrombophlebitis. Which laboratory value should the nurse monitor throughout heparin therapy?
1. partial thromboplastin time (PTT) 2. platelet count
Where is V1 placed?
4th intercostal space, right sternal border
The nurse instructs the client to avoid using which over-the-counter medication while taking warfarin?
ASA
Stent placements require long-term administration of
ASA or clopidogrel
When teaching the client with hypertension to avoid orthostatic hypotension, the nurse should provide which instructions?
Arise slowly from bed, avoid standing still for long periods
A nurse in a hospital setting suspects that a client is in cardiac arrest. According to the American Heart Association (Heart and Stroke Foundation of Canada), the nurse should perform the actions in what order?
Assess responsiveness, activate EMS, call for AED, assess breathing, admin 2 breaths, assess pulse, start compressions
The client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA) to treat angina. Priority goals for the client immediately after PTCA should include
Preventing fluid volume deficit.
PVCs on ECG
S
A nurse checks the synchronizer switch before using a defibrillator to terminate ventricular fibrillation. Why is this check so important?
The defibrillator will not deliver a shock if the synchronizer switch is turned off
A client is receiving IV heparin for treatment of deep vein thrombosis. Which precautions should the nurse incorporate into the client's plan of care as a result of receiving IV heparin?
Establish a separate IV infusion line for administration of other drugs
To avoid a falsely elevated serum digoxin level after administering oral digoxin, how long should a nurse wait before drawing a blood sample?
at least 8 hours
Before administering digoxin, what are the crucial assessments?
cardiac rate and rhythm
An 86-year-old client with a history of atrial fibrillation takes 5 mg of warfarin daily. Warfarin therapy places the client at risk for which complications? 3 Hs
hemorrhage, hepatitis, hematuria
Catopril is an ACE inhibitor that causes _____ as a SE.
hyperkalemia
ST elevation indicates
injury
T wave inversion indicates
ischemia
After digoxin is metabolized, the body eliminates remaining digoxin as unchanged drug by way of the:
kidneys
Pathological Q wave indicates
necrosis
What instruction should the nurse's discharge teaching plan for the client with heart failure include?
obtaining daily weights at the same time each day
A client with peripheral vascular disease has just undergone femoral-popliteal bypass grafting. Place the items below in the order in which the nurse should conduct the assessment.
peripheral pulses, incision site, urine output, postoperative pain
After the client has a temporary pacemaker inserted, the nurse should verify documentation on the medical record about which information?
pt's cardiovascular status
A nurse should be prepared to manage complications following abdominal aortic aneurysm resection. Which complication is most common?
renal failure
Warfarin (Coumadin) antidote
vit K, kcentra, FFP
A sedentary, obese, middle-aged client is recovering from surgery to remove an embolus in the right iliac artery. The nurse should develop a discharge plan with the client that will focus on participating in which activities?
weight control, aerobic activity