MED SURG FINAL - Cardiac, Respiratory, Endocrine, Fluids and Electrolytes, Integumentary, Surgical, and IV

Which statement is the best indication that the patient understands the surgical procedure involving mitral valve replacement? a. "My chest will be opened during surgery, but my heart will not." b. "A piece of my leg will be used to replace the diseased valve." c. "My blood will be circulated through a heart-lung machine." d. "The surgeon will enlarge my valve by inserting a stent."

"My blood will be circulated through a heart-lung machine."

The nurse is teaching a client with hypertension about irbesartan which the health care provider has prescribed. The nurse can explain that losartan exerts which action on the body? a. Blocks aldosterone receptors b. Prevents conversion of angiotensin I c. Blocks angiotensin II receptors d. Prevents renin secretion

Blocks angiotensin II receptors

Which laboratory results would the nurse expect to be elevated if a patient had a myocardial infarction (MI)? a. plasminogen and lactic acid b. sodium & potassium c. red blood cells (RBCs) & platelets d. CK, CK-MB & troponin

CK, CK-MB & troponin

When the patient asks the nurse how cholesterol acts as a cardiac risk factor, what is the BEST explanation? a. Excess fat in the blood expands the circulating blood volume. b. Excess fat in the blood thickens the lining of the arteries c. Excess fat in the blood causes slower blood clotting d. Excess fat in the blood stimulates the heart to beat faster.

Excess fat in the blood thickens the lining of the arteries

When educating a group of nursing students, on antiarrhythmic drugs, the nurse cites which of the following as an example of a class IB antiarrhythmic drug, which has a numbing effect on the heart? a. Lidocaine b. Amiodarone c. Disopyramide d. Propafenone

Lidocaine

Because the patient has been experiencing an increased number of anginal episodes, the physician orders a cardiac catherization and coronary angiogram. Which nursing action can best help reduce the client's anxiety in this situation? a. Explain that the procedure has been very helpful for other patients b. Avoid discussing the heart catheterization until the patient is relaxed. c. Listen to the patient's feelings about this condition d. Teach the patient how coronary artery disease (CAD) is usually treated

Listen to the patient's feelings about this condition

A nurse is assessing a client with angina who has received diltiazem. Which finding should the nurse prioritize and notify the health care provider for further instructions? a. Significant weight loss b. Pulse rate is 48 bpm c. Systolic pressure is 108 mmHg d. Lightheadedness

Pulse rate is 48 bpm

A client presents to the urgent care clinic reporting severe dizziness. On assessment, the nurse learns the client was recently prescribed losartan and quit taking it thinking it was responsible for the dizziness. Which assessment should the nurse prioritize? a. Orthostatic hypotension b. Congested nasal passages c. Anginal attacks d. Rebound hypertension

Rebound hypertension

SELECT ALL THAT APPLY. After recovering from a myocardial infarction (MI) the patient is transferred to the medical-surgical unit for continuous recovery & rehabilitation. The nursing team develops a care plan and expected outcomes for the patient's recovery. Which expected outcomes are most important? a. the patient's activity tolerance will increase b. the patient will comply with dietary restrictions c. the patient will avoid any alcoholic beverages d. the patient will verbalize fears and anxieties freely e. the patient will not gain weight f. the patient will maintain pressure over the intravenous site

a. the patient's activity tolerance will increase b. the patient will comply with dietary restrictions d. the patient will verbalize fears and anxieties freely e. the patient will not gain weight

The nursing instructor is illustrating the proper technique for applying nitroglycerin ointment. Which instructions should the instructor point out as essential to the correct application? Select all that apply. a. Use the chest or upper back for application b. Wear disposable gloves c. Cleanse the area of skin before application d. Apply 2 inches of ointment to the client's skin e. Use the same application site each time the ointment is applied

a. use the chest or upper back for application b. wear disposable gloves c. cleanse the area of the skin before application

Which assessment finding should signal the nurse to withhold applying the client's nitroglycerin patch and notify the physician? a. temperature of 99.8 degrees F (37.6 degrees C) b. apical heart rate of 90 beats/minute c. blood pressure of 94/62 mm Hg c. respiratory rate of 24 breaths/minute at rest

blood pressure of 94/62 mm Hg

The nurse is caring for a client on a cardiac monitor who is alone in a room at the end of the hall. The client has a short burst of ventricular tachycardia (VT), followed by ventricular fibrillation (VF). The client suddenly loses consciousness. Which intervention should the nurse do first? a. run to get a defibrillator from an adjacent nursing unit b. go to the nurses station quickly and call a code c. start oxygen by cannula at 10L/ minute and lower the head of the HOB d. call for help and initiate cardiopulmonary resuscitation (CPR)

call for help and initiate cardiopulmonary resuscitation (CPR)

When providing dietary instructions for the patient with coronary artery disease (CAD), which healthful alternative should the nurse recommend? a. cereal for eggs b. wheat toast for white bread c. ham for sausage d. margarine for butter

cereal for eggs

A client is wearing a continuous cardiac monitor which begins to alarm at the nurse's station. The nurse sees no electrocardiographic complexes on the screen. The nurse should do which first? a. call the health care provider b. press the recorder button on the ECG console c. call a code blue d. check the client status and lead placement

check the client status and lead placement

When gathering nursing assessment data, which finding will adults with chronic cardiac disease most frequently manifest? a. flushed facial skin b. clubbed fingertips c. chest pain d. barrel-shaped chest

clubbed fingertips

Which assessment findings would support the possibility of right-sided heart failure? a. bradycardia b. dry, hacking cough c. flushed, red face d. jugular vein distention

jugular vein distention

Which assessment finding best supports the assumption that the client's cardiac stroke volume is reduced? a. patient manifests bradycardia b. patient has a bounding pulse c. patient faints with activity d. patient develops hypertension (HTN)

patient faints with activity

How can the nurse best measure whether the client has achieved the goal of "an improvement in cardiac output by discharge?" a. the patient will have decreased peripheral edema. b. patient will lose no more than 5 pounds/day. c. patient will have vital signs within normal parameters. d. patient will have a 24-hour urine output of 1000 mL.

patient will have vital signs within normal parameters

After a coronary artery bypass graft (CABG) surgery, which assessment finding provides the best evidence that collateral circulation at the donor graft site is adequate? a. patient's heart rate remains regular b. patient's toes are warm & edematous c. patient moves operative leg easily d. patient is free from chest pain

patient's toes are warm & edematous

What is the most effective method for restoring circulation in a pulseless victim? a. keeping the airway open b. using an automated external defibrillator (AED) c. performing chest compressions d. positioning on a hard, flat surface

performing chest compressions

A 65-year-old patient with severe chest pain is evaluated in the emergency department. A tentative diagnosis of myocardial infarction (MI) is made. Which assessment finding is most closely correlated with an evolving MI? a. facial flushing b. profuse sweating c. coughing up pink-tinged sputum d. severe headache

profuse sweating

If the patient is typical of others who have angina pectoris, the nurse would expect the patient to report that chest pain is best relieved by which nonpharmacologic measure? a. resting in a chair b. applying heat to the chest c. rubbing the chest d. taking a deep breath

resting in a chair

If a heart murmur is related to valve damage caused by a childhood infection, the nurse would expect the patient to report having had which disease? a. varicella (chickenpox) b. rubella (German measles) c. Answer rheumatic fever d. whooping cough

rheumatic fever

Shortly after the a coronary artery bypass graft (CABG) surgery, the patient is returned to the room and assessed by the nurse. The nurse checking the client's leg incision is aware that which is the most common blood vessel used in CABG surgery? a. iliac artery b. femoral artery c. saphenous vein d. popliteal vein

saphenous vein

If the patient's severe chest pain is typical of other people who experience myocardial infarction (MI), the patient is most likely to tell the nurse that the discomfort radiates to which area? a. abdomen b. groin c. shoulder d. flank

shoulder

The nurse assumes that the patient understands how an echocardiogram is performed when the patient tells the nurse that this examination involves imaging the heart using which one of the following? a. electricity b. sound c. heat d. radiation

sound

The best evidence that the patient understands the nurse's instructions regarding dietary restrictions is if the patient states to avoid which food? a. lemon juice b. onion powder c. maple syrup d. soy sauce

soy sauce

The nurse is monitoring a client following cardioversion. Which observations should be of highest priority to the nurse? a. blood pressure b. oxygen flow rate c. level of consciousness c. status of airway

status of airway

To provide adequate care for the patient worsening left-sided heart failure, the nurse should monitor which of the following on a daily basis? a. pupil response b. peripheral edema c. weight d. appetite

weight

The nurse knows that the patient understands the physician's explanation of the percutaneous transluminal coronary angioplasty (PTCA)/ PCI procedure when the patient makes which statement? a. "A battery-operated pacemaker will be implanted to maintain my heart rate." b. "A balloon-tipped catheter will be inserted into my coronary artery." c. "A Teflon graft will be used to replace an area of weakened heart muscle." d. "A section of my leg vein will be grafted around a narrowed coronary artery."

"A balloon-tipped catheter will be inserted into my coronary artery."

The nurse implements the teaching plan for cardiac catheterization and coronary angiogram. Which statement by the patient indicates an understanding of what will happen during the procedure? a. "I will be able to heart my heart beating in my chest." b. "I will feel a warm sensation as the dye instilled." c. "I will be anesthesized and will not feel any discomfort." d. "I will feel a heavy sensation all over my body."

"I will feel a warm sensation as the dye instilled."

The nurse is preparing to administer bumetanide 0.5 mg IV. The available dose is 0.25 mg/mL. How many mL will the nurse administer? Enter the number only.

2 mL

A client is prescribed 10-mg simvastatin orally daily for high cholesterol. The drug is available in 5 mg tablets. The nurse administers:

2 tablets

A client receiving digoxin for heart failure comes to the clinic reporting weakness and drowsiness stating, "I just get so tired sometimes that I can't do what I want to do." Which nursing diagnosis should the nurse prioritize for this client? a. Imbalance Nutrition: Less Than Body Requirements b. Activity Intolerance c. Risk for Injury d. Risk for Bleeding

Activity Intolerance

The nurse is reviewing laboratory results for a patient receiving warfarin and notes the international normalized ratio (INR) is 8.2 . Which medication should the nurse prepare to administer? a. Lidocaine b. Adenosine c. Vitamin K d. Atropine sulfate

Adenosine

A nurse is preparing a teaching plan for a client with edema who has been prescribed a diuretic. Which teaching should the nurse make sure to include as the patient will be taking this medication at home? a. Encourage exercise b. Administer early in the day c. Decrease fluid intake if you think you're urinating too much d. Gradually increase the dosage

Administer early in the day

The nurse knows that the patient understands a cardioversion procedure when stating that is involves which action? a. scanning the heart after injecting a radioisotope b. threading a thin, plastic catheter into the heart c. Administering an electric current to the heart. d. evaluating blood flow to area of heart muscle

Administering an electric current to the heart.

Which of the following medications would be classified as a calcium-channel blocker? a. Enalapril b. Candesartan c. Diltiazem d. Metoprolol

Diltiazem

The patient has been given an ACE inhibitor, Lisinopril. What major common side effect of this medication should the nurse teach the patient about? a. Hypertension b. Fluid overload c. Tachycardia d. Dry cough

Dry cough

During a cardiac catheterization and coronary angiogram, the physician threads the heart catheter through the femoral artery. After the femoral artery has been cannulated and the patient is returned to the room, what should the nurse plan to do first? a. Percuss all four quadrants of the patient's abdomen b. Inspect the skin integrity in the patient's groin. c. Auscultate the patient's heart & breath sounds d. Palpate the patient's distal peripheral pulses

Palpate the patient's distal peripheral pulses

The nurse is assessing a patient who is receiving rosuvastatin to reduce cholesterol. Which finding related to this medication specifically should concern the nurse? a. The patient reports feeling dizzy b. The patient reports black and tarry stools c. The patient reports muscle pain d. The apical pulse is 58 beats/min

The patient reports muscle pain

A client with hypertension is prescribed atenolol. Which assessment findings on the ongoing assessment should the nurse evaluate first? Select all that apply. a. Dizziness b. Bradycardia c. Hypoactive bowel sounds d. Constipation e. Cough

a. dizziness b. bradycardia

A client has been receiving a diuretic as prescribed for edema related to heart failure. Which findings on the ongoing assessment should the nurse prioritize? Select all that apply. a. Muscle Cramps b. Tachycardia c. Dry mouth d. Hypertension e. Diaphoresis

a. muscle cramps b. tachycardia c. dry mouth

SELECT ALL THAT APPLY. The patient with hypertension (HTN) is willing to implement lifestyle changes to reduce blood pressure, which changes encouraged by the nurse, would be most beneficial? a. giving up smoking cigarettes b. assessing blood pressure in the morning and evening c. balancing rest with exercise d. eating a diet high in fiber e. pursuing measures for losing weight f. taking time for more leisure activities

giving up smoking cigarettes pursuing measures for losing weight

The nurse is collecting data on the client with a diagnosis of right-sided heart failure. The nurse should expect to note which specific characteristic of this condition? a. crackles on lung auscultation b. dependent edema c. dyspnea d. hacking cough

hacking cough

Which risk factor would be least likely to predispose a patient to having a myocardial infarction (MI)? a. smoking cigarettes b. drinking an occasional cocktail c. eating fatty foods d. working under emotional stress

drinking an occasional cocktail

Which of the following electrocardiogram (ECG/EKG) change supports the diagnosis that the patient is experiencing a myocardial infarction (MI)? a. widened QRS complex b. elevated ST segment c. prolonged PR interval d. inverted P wave

elevated ST segment

A 78-year-old patient is admitted to the hospital with left-sided heart failure. When obtaining a health history from the patient, the nurse would expect to learn that which of the following was the patient's earliest symptom? a. nausea & vomiting b. anorexia c. headaches d. fatigue & weakness

fatigue & weakness

Which assessment finding documented by the nurse provides the best evidence that the patient has a cardiac bacterial infection? a. fever b. dry cough c. chest pain d. dyspnea

fever

When the patient asks why the physician ordered a stress echocardiogram, how does the nurse correctly explain its purpose? a. it will determine the patient's potential target heart rate b. it will show how the heart performs during exercise c. it will help predict whether the patient will have a heart attack soon d. it will verify how much the patient needs to improve fitness

it will show how the heart performs during exercise