NUR 202 Mod B Quiz
The clinic nurse is teaching an adolescent about lifestyle modifications to prevent hyperlipidemia. Which statement by the adolescent indicates a need for further teaching?
"I'll start eating more red meat."
A client is in cardiogenic shock. What explanation of cardiogenic shock should the nurse include when responding to a family member's questions about the condition?
A failure of the circulatory pump
The health care provider prescribes isosorbide dinitrate (Isordil) 10 mg as needed three times a day and a nitroglycerin transdermal disk once a day for a client with chronic angina pectoris. The client asks the nurse why the isosorbide dinitrate is prescribed. The nurse's best response is, "The isosorbide dinitrate:
Allows more oxygen to get to heart tissue.
A 5-year-old child undergoes cardiac catheterization. The child is in the post-cardiac catheterization unit for 2 hours when the incoming nurse receives the report from the outgoing nurse. Which part of the child's report should the incoming nurse question?
Bedrest with bathroom privileges
A woman comes to the office of her health care provider, reporting shortness of breath and epigastric distress that is not relieved by antacids. To what question would a woman experiencing a myocardial infarction respond differently than a man?
Do you have chest pain?
A female client whose ECG exhibits multiple premature ventricular complexes is to take oral disopyramide (Norpace). Which side effects should the nurse include when teaching the client about this drug? Select all that apply.
Dry mouth Constipation
A client is returned to the surgical unit immediately after placement of a coronary artery stent that was accomplished via access through the femoral artery. What should the nurse consider the priority when assessing this client?
Hematoma formation
A client arrives at the emergency room complaining of chest pain and dizziness. The client has a history of angina. The health care provider prescribes an electrocardiogram (ECG) and lab tests. A change in which component of the ECG tracing should the nurse recognize as the client actively having a myocardial infarction (MI)?
S-T segment
A nurse is providing discharge instructions for a client with angina who has a prescription for sublingual nitroglycerin tablets. The nurse should teach the client that the nitroglycerin sublingual tablets have lost their potency when:
The tablets are more than three months old
A client is admitted to the cardiac care unit with a myocardial infarction. The cardiac monitor reveals a series of premature ventricular complexes (PVCs). The nurse anticipates that the client will be receiving a prescription for:
Amiodarone (Cordarone)
A nurse identifies premature ventricular complexes (PVCs) on a client's cardiac monitor and concludes that these complexes are a sign of:
Cardiac irritability
A client is on a cardiac monitor. The monitor begins to alarm showing ventricular tachycardia. What should the nurse do first?
Check for a pulse.
A nurse is conducting a health class for adolescents. What modifiable risk factor, most closely associated with the development of coronary heart disease (CHD) in both men and women, should the nurse discuss?
Cigarette smoking
A client presents to the emergency department with symptoms of acute myocardial infarction (MI). The nurse knows that which assessment parameters may indicate acute myocardial infarction?
Elevated serum troponin I
The nurse understands that in a first degree atrioventricular (AV) block
Every P wave is conducted to the ventricles
A 40-year-old client states, "I feel like my heart is jumping out of my chest, and it is skipping beats." The client passes a thallium stress test; however, the health care provider identifies one premature ventricular complex (PVC) and several premature atrial complexes (PACs) on the 24-hour follow-up Holter monitor. Which question is most important for the nurse to ask the client.
How much caffeine do you consume each day?
A client with a coronary occlusion is experiencing chest pain and distress. The nurse administers oxygen to:
Increase oxygen concentration to heart cells
Which instructions should the nurse include in the teaching plan for a client with hyperlipidemia who is being discharged with a prescription for cholestyramine (Questran)?
Increase your intake of fiber and fluid.
A client has coronary artery bypass graft (CABG) surgery for the second time via a sternal incision. What should the nurse teach the client to expect when returning home?
Increased edema in the leg that provided the donor graft
A client experiences crushing chest pain and is brought to the emergency department. When assessing the ECG tracing, the nurse concludes that the client is experiencing premature ventricular complexes (PVCs). Which abnormalities of the electrocardiogram support this conclusion?
Irregular rhythm, absence of a P wave, wide, and distorted QRS
Which signs cause the nurse to suspect cardiac tamponade after a client has cardiac surgery? Select all that apply.
Muffled heart sounds Increased central venous pressure (CVP) Jugular vein distention
A client with angina pectoris is scheduled for a stress echocardiogram. The nurse explains that the echocardiogram is a:
Noninvasive approach to assess cardiovascular status
A client is admitted to the hospital for an emergency cardiac catheterization. What is the most common adaptation that the client is most likely to complain about after this procedure?
Pain at the insertion site
A nurse is caring for a client who is admitted to the hospital with a diagnosis of unstable angina. Sublingual nitroglycerin has been prescribed. What client response indicates that nitroglycerin is effective?
Pain subsides as a result of arteriole and venous dilation
An infant with a congenital heart defect is returned to the unit after cardiac catheterization. The nurse manager is observing a nurse newly assigned to the unit. Which nursing intervention should the nurse manager interrupt?
Performing range-of-motion exercises
A client who is recovering from an acute myocardial infarction reports not being happy about the lack of salt with meals. Recognizing that adherence to a medical regimen improves with understanding, the nurse explains that the salt must be limited to:
Prevent further accumulation of fluid, which increases the workload of the heart
The nurse understands that in a second degree atrioventricular (AV) block: Select all that apply.
Some P waves are conducted to the ventricles Treatment consists of atropine or a pacemaker.
The nurse is caring for a client who has had frequent premature ventricular complexes (PVCs) and monitors the client closely for ventricular fibrillation. The nurse recalls that the risk for ventricular fibrillation is greatest during which phase of the cardiac cycle?
T wave
A client who had a myocardial infarction develops cardiogenic shock despite treatment in the emergency department. Which client responses are related to cardiogenic shock? Select all that apply.
Tachycardia Restlessness Decreased urinary output
What statement is true of ventricular dysrhythmias? Select all that apply.
The QRS complex appears widened and has a bizarre shape. The polarity of the T wave is opposite that of the QRS complex Most ventricular dysrhythmias have no apparent P wave
A client is to receive conscious sedation during a cardiac catheterization. Which route of administration should the nurse explain will be used to deliver the conscious sedation?
Through an intravenous catheter
The nurse is educating a client who is being discharged after insertion of a coronary artery stent. For what signs and symptoms should the nurse instruct the client to seek immediate medical attention? Select all that apply.
Unexplainable profuse diaphoresis Indigestion not relieved by antacids Acute chest pain after rigorous exercise Nonremitting chest pain after three sublingual nitroglycerine tablets
The nurse is analyzing the client's rhythm when she notes multiple premature ventricular contractions (PVCs). Each PVC occurs in no particular pattern and looks like all other PVCs. This indicates that the PVCs are:
Unifocal
A client is receiving continuous ECG monitoring while intravenous medication is being administered for premature ventricular complexes (PVC). What dysrhythmia does the nurse conclude that the client is experiencing when the following rhythm appears on the ECG monitor?
Ventricular tachycardia
A client who had a coronary artery bypass graft six months ago is being discharged after a recent hospitalization for an exacerbation of emphysema. What should the nurse teach the client?
Wear a scarf or mask over the mouth in cold weather. Wearing a scarf or mask over the mouth in cold weather helps to warm the air, thereby preventing bronchospasm
One week after being hospitalized for an acute myocardial infarction, a client reports loss of appetite and feeling nauseated. Which of the client's prescribed medications should be withheld and the health care provider notified?
Digoxin (Lanoxin)
A client presenting to the emergency room with chest pain and dizziness was found to be having a myocardial infarction and subsequently suffered cardiac arrest. The emergency room health care team was able to successfully resuscitate the client. Lab work shows that the client now is acidotic. The nurse understands that the acidic serum pH most likely is caused from :
The decreased tissue perfusion that subsequently caused lactic acid production.
A client with coronary artery disease is scheduled for a cardiac catheterization. The nurse's preoperative teaching is considered effective if the client can describe:
What will be experienced during the procedure
The health care provider prescribes nitroglycerin ointment to be applied topically every eight hours for a client who was admitted for chest pain and a myocardial infarction (MI). Which statement, if made by the client, would indicate understanding of the side effects of nitroglycerin ointment? "I may experience:
A headache."
A client's cardiac monitor indicates multiple premature ventricular complexes (PVCs). The nurse expects that the treatment plan will include a prescription for which medication?
Amiodarone (Cordarone)
A nurse is leading a discussion in a senior citizen center about the risk factors for developing coronary heart disease (CHD) for women versus men. What should the nurse respond when asked to identify the most significant risk factor?
Diabetes
An older adult client who has type 1 diabetes is prescribed atenolol (Tenormin) for the management of angina pectoris. Which clinical manifestation should alert the nurse to the fact that the client may be developing a life-threatening response to the drug?
Difficulty breathing
The client is admitted with sinus tachycardia. To treat the dysrhythmia, the nurse would look for potential causes such as: Select all that apply
Anxiety Caffeine Exercise Anemia
A nurse in the coronary care unit (CCU) identifies ventricular fibrillation on a client's cardiac monitor. What intervention is the priority?
Immediate defibrillation
A client who is suspected of having had a silent myocardial infarction has an electrocardiogram (ECG) prescribed by the health care provider. While the nurse prepares the client for this procedure, the client asks, "Why was this test prescribed?" The best reply by the nurse is, "This test will
Reflect any heart damage."
A client admitted to the hospital for chest pain is diagnosed with angina. The nurse should teach the client that the most common characteristic of anginal pain is that it is:
Relieved by rest
A nurse is preparing to teach a client to apply a nitroglycerin patch (Nitro-Dur) as prophylaxis for angina. Which instruction should the nurse include in the teaching plan?
Remove a previous patch before applying the next one
The nurse caring for a client admitted for chest pain and a myocardial infarction (MI) is preparing to apply nitroglycerin ointment. Before applying, the nurse should:
Remove ointment previously applied
