NCLEX Part 2 - Cardiac Health Problems

During rescue breathing in cardiopulmonary resuscitation (CPR), the victim will exhale by: 1. Normal relaxation of the chest. 2. Gentle pressure of the rescuer's hand on the upper chest. 3. The pressure of cardiac compressions. 4. Turning the head to the side.

1

When teaching a client about self-care following placement of a new permanent pacemaker to his left upper chest, the nurse should include which information? Select all that apply. 1. Take and record daily pulse rate. 2. Avoid air travel because of airport security alarms. 3. Immobilize the affected arm for 4 to 6 weeks. 4. Avoid using a microwave oven. 5. Avoid lifting anything heavier than 3 lb.

1, 5

A 74-year-old female is admitted to the telemetry unit for placement of a permanent pace maker because of sinus bradycardia. A priority goal for the client within 24 hours after insertion of a permanent pacemaker is to: 1. Maintain skin integrity. 2. Maintain cardiac conduction stability. 3. Decrease cardiac output. 4. Increase activity level.

2

A client treated for hypertension with furosemide (Lasix), atenolol (Tenormin), and ramipril (Altace) develops a second degree heart block Mobitz type 1. Which of the following actions should the nurse take? 1. Administer a 250 mL fluid bolus. 2. Withhold the atenolol. 3. Prepare for cardioversion. 4. Set up for an arterial line

2

A client who has been given cardiopulmonary resuscitation (CPR) is transported by ambulance to the hospital's emergency department, where the admitting nurse quickly assesses the client's condition. The most effective way to determine the effectiveness of CPR is noting whether the: 1. Pulse rate is normal. 2. Pupils are reacting to light. 3. Mucous membranes are pink. 4. Systolic blood pressure is at least 80 mm Hg.

2

In teaching the hypertensive client to avoid orthostatic hypotension, the nurse should emphasize which of the following instructions? Select all that apply. 1. Plan regular times for taking medications. 2. Arise slowly from bed. 3. Avoid standing still for long periods. 4. Avoid excessive alcohol intake. 5. Avoid hot baths.

2, 3

An exercise program is prescribed for the client with hypertension. Which intervention would be most likely to assist the client in maintaining an exercise program? 1. Giving the client a written exercise program. 2. Explaining the exercise program to the client's spouse. 3. Reassuring the client that he or she can do the exercise program 4. Tailoring a program to the client's needs and abilities

4

The nurse teaches a client, who has recently been diagnosed with hypertension, about dietary restrictions: a low-calorie, low-fat, low-sodium diet. Which of the following menu selections would best meet the client's needs? 1. Mixed green salad with blue cheese dressing, crackers, and cold cuts. 2. Ham sandwich on rye bread and an orange 3. Baked chicken, an apple, and a slice of white bread 4. Hot dogs, baked beans, and celery and carrot sticks

3

Upon assessment of third degree heart block on the monitor, the nurse should first: 1. Call a code. 2. Begin cardiopulmonary resuscitation. 3. Have transcutaneous pacing ready at the bedside. 4. Prepare for defibrillation.

3

Ventricular tachycardia is displayed on the cardiac monitor of a client admitted to the telemetry unit. Which should the nurse do first? 1. Prepare for immediate cardioversion. 2. Begin cardiopulmonary resuscitation (CPR). 3. Check for a pulse. 4. Prepare for immediate defibrillation.

3

When performing external chest compressions on an adult during cardiopulmonary resuscitation (CPR), the rescuer should depress the sternum: 1. 0.5 to 1 inch. 2. 1 to 1.5 inches. 3. 1.5 to 2 inches. 4. 2 to 2.5 inches.

3

If a client is receiving rescue breaths and the chest wall fails to rise during cardiopulmonary resuscitation, the rescuer should first: 1. Try using an ambu bag. 2. Decrease the rate of compressions. 3. Intubate the client. 4. Reposition the airway.

4

A client's job involves working in a warm, dry room, frequently bending and crouching to check the underside of a high-speed press, and wearing eye guards. Given this information, the nurse should assess the client for which of the following? 1. Muscle aches. 2. Thirst. 3. Lethargy. 4. Orthostatic hypotension.

4

Which activity would be appropriate to delegate to unlicensed personnel for a client diagnosed with a myocardial infarction who is stable? 1. Evaluate the lung sounds. 2. Help the client identify risk factors for CAD. 3. Provide teaching on a 2 g sodium diet. 4. Record the intake and output.

4

A client has been admitted to the coronarycare unit. The nurse observes third-degree heart block at a rate of 35 bpm on the client's cardiac monitor. The client has a blood pressure of 90/60. The nurse should take which of the following actions first? 1. Prepare for transcutaneous pacing 2. Prepare to defibrillate the client at 200 joules 3. Administer an IV lidocaine infusion 4. Schedule the operating room for insertion of a permanent pacemaker

1

An industrial health nurse at a large printing plant finds a male employee's blood pressure to be elevated on two occasions 1 month apart and refers him to his private physician. The employee is about 25 lb overweight and has smoked a pack of cigarettes daily for more than 20 years. The client's physician prescribes atenolol (Tenormin) for the hypertension. The nurse should instruct the client to: 1. Avoid sudden discontinuation of the drug. 2. Monitor the blood pressure annually 3. Follow a 2-g sodium diet 4. Discontinue the medication if severe head-aches develop

1

The client has had hypertension for 20 years. The nurse should assess the client for? 1. Renal insufficiency and failure 2. Valvular heart disease 3. Endocarditis 4. Peptic ulcer disease

1

The nurse is developing a care plan with an older adult and is instructing the client that hypertension can be a silent killer. The nurse should instruct the client to be aware of signs and symptoms of other system failures and encourage the client to report signs of which of the following diseases that are often a result of undetected high blood pressure? 1. Cerebrovascular accidents (CVAs). 2. Liver disease. 3. Myocardial infarction. 4. Pulmonary disease.

1

When teaching a client about propranolol hydrochloride, the nurse should base the information on the knowledge that propranolol: 1. Blocks beta-adrenergic stimulation and thus causes decreased heart rate, myocardial contractility, and conduction. 2. Increases norepinephrine secretion and thus decreases blood pressure and heart rate. 3. Is a potent arterial and venous vasodilator that reduces peripheral vascular resistance and lowers blood pressure. 4. Is an angiotensin-converting enzyme inhibitor that reduces blood pressure by blocking the conversion of angiotensin I to angiotensin II.

1

The nurse is preparing the client for cardiaversion. The nurse should do which of the follow ing? Select all that apply. 1. Use a conducting agent between the skin and the paddles. 2. Place the paddles over the client's clothing. 3. Call "clear" before discharging the electrical current. 4. Record the delivered energy and the resulting rhythm. 5. Exert 5 to 10 lb of pressure on each paddle to ensure good skin contact.

1, 3, 4

During cardiopulmonary resuscitation (CPR), the xiphoid process at the lower end of the sternum should not be compressed when performing cardiac compressions. Which of the following organs would be most likely at risk for laceration by forceful compressions over the xiphoid process? 1. Lung. 2. Liver. 3. Stomach. 4. Diaphragm.

2

The monitor technician informs the nurse that the client has started having premature ventricular contractions every other beat. Which is the priority nursing action? 1. Activate the rapid response team. 2. Assess the client's orientation and vital signs. 3. Call the physician. 4. Administer a bolus of lidocaine.

2

The nurse is caring for a client whose condition has been deteriorating. The client becomes unresponsive, the blood pressure is 80/40, and Sp02 is 90% on 50% face mask. The nurse should: 1. Begin chest compressions. 2. Call the rapid response team. 3. Remove the family from the room. 4. Ventilate the client with an ambu bag.

2

The rapid response team has been called to manage an unwitnessed cardiac arrest. The estimated maximum time a person can be without cardiopulmonary function and still not experience permanent brain damage is: 1. 1 to 2 minutes. 2. 4 to 6 minutes. 3. 8 to 10 minutes. 4. 12 to 15 minutes.

2

A client is given amiodarone (Cordarone) in the emergency department for a dysrhythmia. Which of the following indicates the drug is having the desired effect? 1. The ventricular rate is increasing. 2. The absent pulse is now palpable. 3. The number of premature ventricular contractions is decreasing. 4. The fine ventricular fibrillation changes to coarse ventricular fibrillation.

3

Essential hypertension would be diagnosed in a 40-year-old male whose blood pressure readings were consistently at or above which of the following? 1. 120/90 mm Hg. 2. 130/85 mm Hg. 3. 140/90 mm Hg. 4. 160/80 mm Hg.

3

The client realizes the importance of quitting smoking, and the nurse develops a plan to help the client achieve this goal. Which of the following nursing interventions should be the initial step in this plan? 1. Review the negative effects of smoking on the body. 2. Discuss the effects of passive smoking on environmental pollution. 3. Establish the client's daily smoking pattern. 4. Explain how smoking worsens high blood pressure.

3

The client who had a permanent pacemaker implanted 2 days earlier is being discharged from the hospital. The client understands the discharge plan when the client: 1. Selects a low-cholesterol diet to control coronary artery disease. 2. States a need for bed rest for 1 week after discharge. 3. Verbalizes safety precautions needed to prevent pacemaker malfunction. 4. Explains signs and symptoms of myocardial infarction (MI).

3

The most important long-term goal for a client with hypertension would be to: 1. Learn how to avoid stress. 2. Explore a job change or early retirement. 3. Make a commitment to long-term therapy. 4. Lose weight.

3