Week 5 NCLEX style practice questions (CAD/PAD)

A key aspect of teaching for the patient on anticoagulant therapy includes which instructions? a. Monitor for and report any signs of bleeding. b. Do not take acetaminophen (Tylenol) for a headache. containing vitamin K. c.Decrease your dietary intake of foods containing vitamin K D.arrange to have blood drawn twice a week to check drug effects.

A

Which clinical manifestations are seen in patients with either Buerger's disease or Raynaud's phenomenon (select all that apply? a. Intermittent fevers b. Sensitivity to cold temperatures C. Gangrenous ulcers on fingertips d. Color changes of fingers and toes e. Episodes of superficial vein thrombosis

B C D

Which are clinical findings in a person with an acute lower extremity VTE (select all that apply)? a. Pallor and coolness of foot and calf b. Mild to moderate calf pain and tenderness c. Grossly diminished or absent pedal pulses d. Unilateral edema and induration of the thigh e. Palpable cord along a superficial varicose vein

B D

When providing nutritional counseling for patients at risk for CAD, which foods would the nurse encourage patients to include in their diet (select all that apply)? A. Tofu B. Walnuts C. Tuna fish D. Whole milk E. Orange juice

A, B, C. Tuna fish, tofu, and walnuts are all rich in omega-3 fatty acids, which have been shown to reduce the risks associated with CAD when consumed regularly

After teaching about ways to decrease risk factors for CAD, the nurse recognizes that additional teaching is needed when the patient says ? A- "I would like to ass weight lifting to my exercise program" B- " I can only keep my blood pressure normal with my medication" C- "I can change my diet to decrease my intake of saturated fats" D- "I will change my lifestyle to reduce activites that increase my stress"

A- "I would like to ass weight lifting to my exercise program"

A patient is admitted to the ICU with the diagnosis of unstable angina. Which drug(s) would the nurse expect the patient to receive? ( select all that apply) A- ACE inhibitor B- Antiplatelet Therapy C- Thrombolytic Therapy D- Prophylactic Antibiotics E- Intravenous Nitroglycerin

A- ACE inhibitor B- Antiplatelet Therapy E- Intravenous Nitroglycerin

The nurse teaches the client with angina about the common expected side effects of nitroglycerin, including: A-Headache B-High blood pressure C-Shortness of breath D-Stomach cramps

A-Headache

Which individuals would the nurse identify as having the highest risk for CAD? A. A 45-year-old depressed male with a high-stress job B. A 60-year-old male with below normal homocysteine levels C. A 54-year-old female vegetarian with elevated high-density lipoprotein (HDL) levels D. A 62-year-old female who has a sedentary lifestyle and body mass index (BMI) of 23 kg/m2

A. A 45-year-old depressed male with a high-stress job The 45-year-old depressed male with a high-stress job is at the highest risk for CAD. Studies demonstrate that depression and stressful states can contribute to the development of CAD. Elevated HDL levels and low homocysteine levels actually help to prevent CAD. Although a sedentary lifestyle is a risk factor, a BMI of 23 kg/m2 depicts normal weight, and thus the patient with two risk factors is at greatest risk for developing CAD.

When planning emergent care for a patient with a suspected MI, what should the nurse anticipate administrating? A. Oxygen, nitroglycerin, aspirin, and morphine B. Oxygen, furosemide (Lasix), nitroglycerin, and meperidine C. Aspirin, nitroprusside (Nipride), dopamine (Intropin), and oxygen D. Nitroglycerin, lorazepam (Ativan), oxygen, and warfarin (Coumadin)

A. Oxygen, nitroglycerin, aspirin, and morphine The American Heart Association's guidelines for emergency care of the patient with chest pain include the administration of oxygen, nitroglycerin, aspirin, and morphine. These interventions serve to relieve chest pain, improve oxygenation, decrease myocardial workload, and prevent further platelet aggregation. The other medications may be used later in the patient's treatment

The patient at highestrisk for a venous thromboembolism (VTE) is a. a 62-year-old man with spider veins who is having arthroscopic knee surgery. b. a 32-year-old woman who smokes, takes oral contraceptives and is planning a trip to Europe. c.a 26-year-old woman who is 3 days postpartum and received maintenance IV fluids for 12 hours during her labor. d. an active 72-year-old man at home recovering from transure thral resection of the prostate for benign prostatic hyperplasia.

B

The recommended treatment for an initial VTE in an otherwise healthy person with no significant co-morbidities would include a. IV argatroban (Acova) as an inpatient. b. IV unfractionated heparin as an inpatient. c. subcutaneous unfractionated heparin as an outpatient d. subcutaneous low-molecular-weight heparin as an outpatient.

B

The nurse would assess a patient with complaints of chest pain for which clinical manifestations associated with a myocardial infarction (MI) (select all that apply)? A. Flushing B. Ashen skin C. Diaphoresis D. Nausea and vomiting E. S3 or S4 heart sounds

B, C, D, E. During the initial phase of an MI, catecholamines are released from the ischemic myocardial cells, causing increased sympathetic nervous system (SNS) stimulation. This results in the release of glycogen, diaphoresis, and vasoconstriction of peripheral blood vessels. The patient's skin may be ashen, cool, and clammy (not flushed) as a result of this response. Nausea and vomiting may result from reflex stimulation of the vomiting center by severe pain. Ventricular dysfunction resulting from the MI may lead to the presence of the abnormal S3 and S4 heart sounds.

When administered a thrombolytic drug to the client experiencing an MI, the nurse explains to him that the purpose of this drug is to: A-Help keep him well hydrated B- Dissolve clots he may have C-Prevent kidney failure D-Treat potential cardiac arrhythmias

B- Dissolve clots he may have

In teaching a patient about CAD, the nurse explains that the changes that occur in this disorder include? (select all that apply) A- diffuse involvement of plaque formation in coronary veins B- abnormal levels of cholesterol , Especially LDLs C- accumulation of lipid and fibrous tissue within the coronary arteries D- development of Angina due to a decreased blood supply to the heart muscle E- Chronic Vasoconstriction of coronary arteries leasing to permanent vasospasms

B- abnormal levels of cholesterol , Especially LDLs C- accumulation of lipid and fibrous tissue within the coronary arteries D- development of Angina due to a decreased blood supply to the heart muscle

A hospitalized patient with a history of chronic stable angina tells the nurse that she is having chest pain. The nurse bases his actions on the knowledge that ischemia...? A- will always progress to myocardial Infarction B- will be relived by rest, nitroglycerin, or both. C- indicated that irreversible myocardial damage is occurring. D- is frequently associated with vomiting and extreme fatigue.

B- will be relived by rest, nitroglycerin, or both.

When teaching a patient why spironolactone (Aldactone) and furosemide (Lasix) are prescribed together, the nurse bases teaching on the knowledge that: A-Moderate doses of two different types of diuretics are more effective than a large dose of one type B-This combination promotes diuresis but decreases the risk of hypokalemia C-This combination prevents dehydration and hypovolemia D-Using two drugs increases osmolality of plasma and the glomerular filtration rate

B-This combination promotes diuresis but decreases the risk of hypokalemia

The nurse is examining the ECG of a patient who has just been admitted with a suspected MI. Which ECG change is most indicative of prolonged or complete coronary occlusion? A. Sinus tachycardia B. Pathologic Q wave C. Fibrillatory P waves D. Prolonged PR interval

B. Pathologic Q wave

A 50-year-old woman weighs 95 kg and has a history of tobacco use, high blood pressure, high sodium intake, and sedentary life- style. When developing an individualized care plan for her, the nurse determines that the most important risk factors for periph- eral artery disease (PAD) that must be modified a. weight and diet. b. activity level and salt intake. c. tobacco use and high blood pressure. d. sedentary lifestyle and exercise training.

C

A patient with infective endocarditis develops sudden left leg pain with pallor, paresthesia, and a loss of peripheral pulses. The nurse's initial action should be to a. elevate the leg to promote venous return. b. start anticoagulant therapy with IV heparin. c. notify the HCP of the change in peripheral perfusion. D. place the bed in reverse Trendelenburg to promote perfusion.

C

Rest pain is a manifestation of PAD that occurs due to a chronic a. vasospasm of small cutaneous arteries in the feet. b. increase in retrograde venous blood flow in the legs. c. decrease in arterial blood flow to the nerves of the feet. d. constriction in arterial blood flow to the leg muscles during exercise.

C

The most common finding in individuals at risk for sudden cardiac death is A- aortic valve disease B- mitral Valve disease C- left ventricular dysfunction D- Atherosclerotic heart disease

C- left ventricular Dysfunction

One hour after administering IV furosemide (Lasix) to a client with heart failure, a short burst of ventricular tachycardia appears on the cardiac monitor. Which of the following electrolyte imbalances should the nurse suspect? A-Hypocalcemia B-Hypermagnesemia C-Hypokalemia D-Hypernatremia

C-Hypokalemia

A murmur is heard at the second left intercostal space along the left sternal border. Which valve is this? A-Aortic B-Mitral C-Pulmonic D-Tricuspid

C-Pulmonic

Sublingual nitroglycerin tablets begin to work within 1 to 2 minutes. How should the nurse instruct the client to use the drug when chest pain occurs? A-Take one tablet every 2 to 5 minutes until the pain stops. B-Take one tablet and rest for 10 minutes. Call the physician if pain persists after 10 minutes. C-Take one tablet, then an additional tablet every 5 minutes for a total of 3 tablets. Call the physician if pain persists after three tablets. D-Take one tablet. If pain persists after 5 minutes, take two tablets. If pain still persists 5 minutes later, call the physician.

C-Take one tablet, then an additional tablet every 5 minutes for a total of 3 tablets. Call the physician if pain persists after three tablets.

Which of the following blood tests is most indicative of cardiac damage? A-Lactate dehydrogenase B-Complete blood count (CBC) C-Troponin I D-Creatine kinase (CK

C-Troponin I

As an initial step in treating a client with angina, the physician prescribes nitroglycerin tablets, 0.3mg given sublingually. This drug's principal effects are produced by: A-Antispasmodic effect on the pericardium B-Causing an increased myocardial oxygen demand C-Vasodilation of peripheral vasculature D-Improved conductivity in the myocardium

C-Vasodilation of peripheral vasculature

A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin (Coumadin). The client's prothrombin time is 20 seconds, with a control of 11 seconds. The nurse assesses that this result is: A-The same as the client's own baseline level B-Lower than the needed therapeutic level C-Within the therapeutic range D- Higher than the therapeutic range

C-Within the therapeutic range

In planning care and patient teaching for the patient with venous leg ulcers, the nurse recognizes that the most important intervention in healing and control of this condition is- a. discussing activity guidelines b. using moist environment dressings.. c. taking horse chestnut seed extract daily. d. applying graduated compression stockings.

D

A client is scheduled for a cardiac catheterization using a radiopaque dye. Which of the following assessments is most critical before the procedure? A- Intake and Output B- Baseline Peripheral Pulse Rates C- Height and Weight D- Allergies to Shellfish or Iodine

D- Allergies to Shellfish or Iodine

The nurse receives emergency laboratory results for a client with chest pain and immediately informs the physician. An increased myoglobin level suggests which of the following? A-Cancer B-Hypertension C-Liver disease D-Myocardial infarction

D-Myocardial infarction

IV heparin therapy is ordered for a client. While implementing this order, a nurse ensures that which of the following medications is available on the nursing unit? A-Vitamin K B- Aminocaproic acid C-Potassium chloride D-Protamine sulfate

D-Protamine sulfate