MS2 Final Exam Coursepoint Review Questions

A client comes to the health care provider's office for a follow-up visit 4 weeks after suffering a myocardial infarction (MI). Which evaluation statement suggests that the client needs more instruction?

"Client walks 4 miles in 1 hour every day."

After performing an ECG on an adult client, the nurse reports that the PR interval reflects normal sinus rhythm. What is the PR interval for a normal sinus rhythm?

0.12 and 0.2 seconds.

A client has recently undergone a coronary artery bypass graft (CABG). The nurse should be alert to which respiratory complication?

Atelectasis

A client presents to the emergency department via ambulance with a heart rate of 210 beats/minute and a sawtooth waveform pattern per cardiac monitor. The nurse is most correct to alert the medical team of the presence of a client with which disorder?

Atrial flutter

The nurse recognizes that which laboratory test is a key diagnostic indicator of heart failure?

Brain natriuretic peptide (BNP)

Which medication is given to clients who are diagnosed with angina but are allergic to aspirin?

Clopidogrel

A client has been having cardiac symptoms for several months and is seeing a cardiologist for diagnostics to determine the cause. How will the client's ejection fraction be measured?

Echocardiogram

A nurse is teaching about risk factors that increase the probability of heart disease to a community group. Which risk factors will the nurse include in the discussion? Select all that apply.

Family history of coronary heart disease Age greater than 45 years for men Elevated C-reactive protein

Which is a characteristic of right-sided heart failure?

Jugular vein distention

The nurse is caring for an older adult client who has come to the clinic for a yearly physical. When assessing the client, the nurse notes the blood pressure (BP) is 140/93. The nurse knows that in older clients what happens that may elevate the systolic BP?

loss of arterial elasticity

A client has been rushed to the ED with pulmonary edema and is going to need oxygen immediately. Which oxygen delivery system should be used first?

mask

The nurse is administering digoxin to a client with heart failure. What laboratory value may predispose the client to digoxin toxicity?

potassium level of 2.8 mEq/L

A client has been prescribed three medications for hypertension and the nurse measured a blood pressure of 180/80. Which question will the nurse ask the client first?

"Are you still taking the medication?"

A nurse is caring for a client who has hypertension and diabetes mellitus. The client's blood pressure this morning was 150/92 mm Hg. When the client asks the nurse what his or her blood pressure should be, what is the nurse's most appropriate response?

"Clients with diabetes should have a lower blood pressure goal. You should strive for 120/80 mm Hg."

The nurse assists the client to the bathroom, which is approximately 10 feet from the bed. The client ambulates 3 feet and states, "I cannot catch my breath." How would the nurse document this finding?

"Experiences exertional dyspnea when walking 3 feet; states, I cannot catch my breath."

A nurse working in the clinic is seeing a client who has just been prescribed a new medication for hypertension. The client asks why hypertension is sometimes called the "silent killer." What is the best response by the nurse?

"Hypertension often causes no symptoms."

The nurse instructs a client with Raynaud phenomenon on actions to improve the symptoms. Which client statement indicates the need for additional instruction?

"I will limit the amount of cigarettes I smoke."

The nurse is caring for a client who has had 25 mg of oral hydrochlorothiazide added to the medication regimen for the treatment of hypertension. Which instruction should the nurse give the client?

"Increase the amount of fruits and vegetables you eat."

The nurse instructs a client with heart failure on restricting sodium in the diet. Which client statement indicates that teaching was effective?

"Lemon juice and herbs can be used to replace salt when cooking."

Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension?

"Limiting my salt intake to 2 grams per day will improve my blood pressure."

A client is unconscious on arrival to the emergency department. The nurse in the emergency department identifies that the client has a permanent pacemaker due to which characteristic?

"Spike" on the rhythm strip

The nurse knows that what PR interval presents a first-degree heart block?

0.24 seconds

The nurse is reviewing the results of a total cholesterol level for a client who has been taking simvastatin. What results display the effectiveness of the medication?

160-190 mg/dL

When caring for a patient who has started anticoagulant therapy with warfarin (Coumadin), the nurse knows that therapeutic benefits will not occur for:

3 to 5 days.

The nurse is assigned the following client assignment on the clinical unit. For which client does the nurse anticipate cardioversion as a possible medical treatment?

A client with atrial arrhythmias

The nurse is assessing a client with severe hypertension. Which symptom indicates to the nurse that the client is experiencing dissection of the aorta?

A ripping sensation in the chest

The nurse provides care to a menopausal client, who states, "I read a news article that says I am at risk for coronary vascular disease due to inflammation." Which method should the nurse suggest to the client to aid in the prevention of inflammation that can lead to atherosclerosis?

Addressing obesity

To assess the dorsalis pedis artery, the nurse would use the tips of three fingers and apply light pressure to the:

Anterior surface of the foot near the ankle joint.

A client with left-sided heart failure is in danger of impaired renal perfusion. How would the nurse assess this client for impaired renal perfusion?

Assess for elevated blood urea nitrogen levels.

An older adult is postoperative day one, following a coronary artery bypass graft (CABG). The client's family members express concern to the nurse that the client is uncharacteristically confused. After reporting this change in status to the health care provider, what additional action should the nurse take?

Assess for factors that may be causing the client's delirium.

A nurse provides evening care for a client wearing a continuous telemetry monitor. While the nurse is giving the client a back rub, the client 's monitor alarm sounds and the nurse notes a flat line on the bedside monitor system. What is the nurse's first response?

Assess the client and monitor leads.

You are presenting a workshop at the senior citizens center about how the changes of aging predisposes clients to vascular occlusive disorders. What would you name as the most common cause of peripheral arterial problems in the older adult?

Atherosclerosis

The nurse cares for a client with a dysrhythmia and understands that the P wave on an electrocardiogram (ECG) represents which phase of the cardiac cycle?

Atrial depolarization

The nurse is monitoring a patient in the postanesthesia care unit (PACU) following a coronary artery bypass graft, observing a regular ventricular rate of 82 beats/min and "sawtooth" P waves with an atrial rate of approximately 300 beat/min. How does the nurse interpret this rhythm?

Atrial flutter

The nurse is caring for a client with Raynaud's disease. What are important instructions for a client who is diagnosed with this disease to prevent an attack?

Avoid situations that contribute to ischemic episodes.

A patient is seen in the emergency department (ED) with heart failure secondary to dilated cardiomyopathy. What key diagnostic test does the nurse assess to determine the severity of the patient's heart failure?

B-type natriuretic peptide (BNP)

A community health nurse teaching a group of adults about preventing and treating hypertension. The nurse should encourage these participants to collaborate with their primary care providers and regularly monitor which of the following?

Blood lipid levels

A client is receiving nitroglycerin ointment to treat angina pectoris. The nurse evaluates the therapeutic effectiveness of this drug by assessing the client's response and checking for adverse effects. Which vital sign is most likely to reflect an adverse effect of nitroglycerin?

Blood pressure 84/52 mm Hg

A client is recovering from surgical repair of a dissecting aortic aneurysm. Which assessment findings indicate possible bleeding or recurring dissection?

Blood pressure of 82/40 mm Hg and heart rate of 125 beats/minute

An older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed the client hydrochlorothiazide and enalapril. What will the nurse be sure to include in educating this client?

Change positions (lying or sitting to standing) slowly.

A client is hospitalized for repair of an abdominal aortic aneurysm. The nurse must be alert for signs and symptoms of aneurysm rupture and thus looks for which of the following?

Constant, intense back pain and falling blood pressure

A client is admitted for treatment of Prinzmetal angina. When developing this client's care plan, the nurse should keep in mind that this type of angina is a result of what trigger?

Coronary artery spasm.

A nurse is caring for a client who experienced an MI. The client is ordered to receive metoprolol. The nurse understands that this medication has which therapeutic effect?

Decreases resting heart rate

The nurse is assessing a patient with a probable diagnosis of first-degree AV block. The nurse is aware that this dysrhythmia is evident on an ECG strip by what indication?

Delayed conduction, producing a prolonged PR interval

A client is admitted to the cardiac care unit for an electrophysiology (EP) study. What goal should guide the planning and execution of the client's care?

Diagnose the dysrhythmia.

Which is a characteristic of arterial insufficiency?

Diminished or absent pulses

A client has been experiencing increasing shortness of breath and fatigue. The health care provider has ordered a diagnostic test in order to determine what type of heart failure the client is having. What diagnostic test does the nurse anticipate being ordered?

Echocardiogram

A client with congestive heart failure is admitted to the hospital after reporting shortness of breath. How should the nurse position the client in order to decrease preload?

Head of the bed elevated 45 degrees and lower arms supported by pillows

The nurse is creating a community teaching demonstration focusing on the cause of blood pressure. When completing the visual aid, which body structures represent the mechanism of blood pressure?

Heart and blood vessels

A client is already being treated for hypertension. The doctor is concerned about the potential for heart failure, and has the client return for regular check-ups. What does hypertension have to do with heart failure?

Hypertension causes the heart's chambers to enlarge and weaken.

A new surgical patient who has undergone a coronary artery bypass graft (CABG) is receiving opioids for pain control. The nurse must be alert to adverse effects of opioids. Which of the following effects would be important for the nurse to document?

Hypotension

Which of the following is inconsistent as a condition related to metabolic syndrome?

Hypotension

A client is diagnosed with deep vein thrombosis (DVT). Which nursing diagnosis should receive highest priority at this time?

Ineffective peripheral tissue perfusion related to venous congestion

A client experiences orthostatic hypotension while receiving furosemide to treat hypertension. How will the nurse intervene?

Instruct the client to sit for several minutes before standing.

A nurse is educating about lifestyle modifications for a group of clients with newly diagnosed hypertension. While discussing dietary changes, which point would the nurse emphasize?

It takes 2 to 3 months for the taste buds to adapt to decreased salt intake.

The nurse is planning the care of a patient admitted to the hospital with hypertension. What objective will help to meet the needs of this patient?

Lowering and controlling the blood pressure without adverse effects and without undue cost

A client is admitted to the intensive care unit (ICU) with a diagnosis of hypertension emergency/crisis. The client's blood pressure (BP) is 200/130 mm Hg. The nurse is preparing to administer IV nitroprusside. Upon assessment, which finding requires immediate intervention by the nurse?

Numbness and weakness in the left arm

A nurse is assessing a client's right lower leg, which is wrapped with an elastic bandage. Which signs and symptoms suggest circulatory impairment?

Numbness, cool skin temperature, and pallor

When a client has increased difficulty breathing when lying flat, the nurse records that the client is demonstrating

Orthopnea

Which describes difficulty breathing when a client is lying flat?

Orthopnea

An older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed Chlorothiazide and Benazepril. What will the nurse monitor this client for?

Postural hypotension and resulting injury

A patient in the recovery room after cardiac surgery begins to have extremity paresthesia, peaked T waves, and mental confusion. What type of electrolyte imbalance does the nurse suspect this patient is having?

Potassium

A client is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the client is taking these two medications together?

Potassium level

The nurse is preparing to administer furosemide to a client with severe heart failure. What lab study should be of most concern for this client while taking furosemide?

Potassium level of 3.1

A patient is prescribed digitalis preparations. Which of the following conditions should the nurse closely monitor when caring for the patient?

Potassium levels

A client with systemic lupus erythematosus (SLE) complains that his hands become pale, blue, and painful when exposed to the cold. What disease should the nurse cite as an explanation for these signs and symptoms?

Raynaud's disease

Which of the following is the nurse most correct to recognize as a direct effect of client hypertension?

Renal dysfunction resulting from atherosclerosis

Which of the following is the most effective intervention for preventing progression of vascular disease?

Risk factor modification

The nurse is caring for a client presenting to the emergency department (ED) reporting chest pain. Which electrocardiographic (ECG) finding would be most concerning to the nurse?

ST elevation

Which term describes high blood pressure from an identified cause, such as renal disease?

Secondary hypertension

Which diuretic medication conserves potassium?

Spironolactone

Which is a potassium-sparing diuretic used in the treatment of heart failure (HF)?

Spironolactone

A nurse is providing education about the prevention of arterial constriction to a client with peripheral arterial disease. Which of the following includes priority information the nurse would give to the client?

Stop smoking.

The nurse is administering furosemide to a client with heart failure. What best describes the therapeutic action of the medication?

The medication blocks sodium reabsorption in the ascending loop and dilate renal vessels.

The licensed practical nurse is co-assigned with a registered nurse in the care of a client admitted to the cardiac unit with chest pain. The licensed practical nurse is assessing the accuracy of the cardiac monitor, which notes a heart rate of 34 beats/minute. The client appears anxious and states not feeling well. The licensed practical nurse confirms the monitor reading. When consulting with the registered nurse, which of the following is anticipated?

The registered nurse administering atropine sulfate intravenously

The client has just been diagnosed with a arrhythmia. The client asks the nurse to explain normal sinus rhythm. What would the nurse explain is the characteristic of normal sinus rhythm?

The sinoatrial (SA) node initiates the impulse.

In the treatment of coronary artery disease (CAD), medications are often ordered to control blood pressure in the client. Which of the following is a primary purpose of using beta-adrenergic blockers in the nursing management of CAD?

To decrease workload of the heart

The client has had biomarkers tested after reporting chest pain. Which diagnostic marker of myocardial infarction remains elevated for as long as 2 weeks?

Troponin

What symptoms should the nurse assess for in a client with lymphedema as a result of impaired nutrition to the tissue?

Ulcers and infection in the edematous area

A patient with hypertension has a newly diagnosed atrial fibrillation. What medication does the nurse anticipate administering to prevent the complication of atrial thrombi?

Warfarin

While auscultating the heart sounds of a client with heart failure, the nurse hears an extra heart sound immediately after the second heart sound (S2). How should the nurse document this sound?

a third heart sound (S3).

A client with chronic arterial occlusive disease undergoes percutaneous transluminal coronary angioplasty (PTCA) for mechanical dilation of the right femoral artery. After the procedure, the client will be prescribed long-term administration of which drug?

aspirin or clopidogrel.

The nurse is caring for a client diagnosed with coronary artery disease (CAD). What condition most commonly results in CAD?

atherosclerosis

The nurse is assessing a client with symptomatic bradycardia. What medication does the nurse anticipate will be ordered by the healthcare provider to treat the bradycardia?

atropine

The nurse is admitting a client to a telemetry unit with an atrial dysrhythmia. What symptoms will the nurse further evaluate?

chest pain

The term for a diagnostic test that involves injection of a contrast media into the venous system through a dorsal vein in the foot is

contrast phlebography.

A nurse caring for a client recently admitted to the ICU observes the client coughing up large amounts of pink, frothy sputum. Lung auscultation reveals coarse crackles in the lower lobes bilaterally. Based on this assessment, the nurse recognizes this client is developing

decompensated heart failure with pulmonary edema.

A client asks the nurse if systolic heart failure will affect any other body function. What body system response correlates with systolic heart failure (HF)?

decrease in renal perfusion

The nurse is admitting a client with frothy pink sputum. What does the nurse suspect is the primary underlying disorder of pulmonary edema?

decreased left ventricular pumping

The most important reason for a nurse to encourage a client with peripheral vascular disease to initiate a walking program is that this form of exercise:

decreases venous congestion.

The nurse witnesses a client experiencing ventricular fibrillation. What is the nurse's priority action?

defibrillation

When measuring blood pressure in each arm of a healthy adult, the nurse recognizes that the pressures

differ no more than 5 mm Hg between arms.

A nurse is instructing a client about using antiembolism stockings. Antiembolism stockings help prevent deep vein thrombosis (DVT) by:

forcing blood into the deep venous system.

A client experiences a faster-than-normal heart rate when drinking more than two cups of coffee in the morning. What does the nurse identify on the electrocardiogram as an indicator of sinus tachycardia?

heart rate of 118 bpm

The nurse monitors a client for side effects associated with furosemide, which is newly prescribed for the treatment of heart failure. Complete the following sentence by choosing from the lists of options. Due to the client's high risk for developing ________ as a result of the prescribed medication, the nurse focuses on monitoring the client for ______ ventricular.

hypokalemia; ventricular arrythmia

A client who was recently diagnosed with prehypertension is to meet with a dietitian and return for a follow-up with the cardiologist in 6 months. What would this client's treatment likely include?

nonpharmacological interventions

The nurse teaches the client with peripheral vascular disease (PVD) to refrain from smoking because nicotine causes

vasospasm

The nurse working in the emergency department places a client in anaphylactic shock on a cardiac monitor and sees the cardiac rhythm shown. Which dysrythmia should the nurse document?

ventricular tachycardia

A nurse suspects that a client has digoxin toxicity. The nurse should assess for:

vision changes.

A client with chronic heart failure is receiving digoxin 0.25 mg by mouth daily and furosemide 20 mg by mouth twice daily. The nurse should assess the client for what sign of digoxin toxicity?

visual disturbances.