Acute Wk 5 In-Class Jeopardy: Basic

The client asks the nurse what urine output has to do with cardiac function. What is the best response by the nurse? A."Poor urine output may indicate inadequate blood flow to the kidneys." B."The heart may be working too hard if there is not enough urine." C."The heart and kidneys work independently to keep the body's fluids in balance." D."High urine output may indicate poor cardiac function."

A."Poor urine output may indicate inadequate blood flow to the kidneys."

A nurse completes a shift assessment on a client admitted to the telemetry unit with a diagnosis of syncope. The client's heart rate is 55 bpm with a blood pressure of 90/66 mm Hg. The client is also experiencing dizziness and shortness of breath. Which medication will the nurse anticipate administering to the client based on these clinical findings? A.Atropine B.Lidocaine C.Pronestyl D.Cardizem

A.Atropine

The nurse in the intensive care unit (ICU) hears an alarm sound in the patient's room. Arriving in the room, the patient is unresponsive, without a pulse, and a flat line on the monitor. What is the first action by the nurse? A.Begin cardiopulmonary resuscitation (CPR) B.Administer epinephrine C.Administer atropine 0.5 mg D.Defibrillate with 360 joules (monophasic defibrillator)

A.Begin cardiopulmonary resuscitation (CPR)

A client in the cardiac step-down unit has begun bleeding from the percutaneous coronary intervention (PCI) access site located in the femoral region. Which would be the nurse's priority action(s)? Select all that apply. A.Call for assistance. B.Reposition the client's leg in a nondependent position. C.Promptly remove the femoral sheath. D.Apply pressure to the access site. E.Be prepared to initiate cardiopulmonary resuscitation.

A.Call for assistance. D.Apply pressure to the access site.

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. A.Family history of coronary heart disease B.Age greater than 45 years for men C.Age greater than 55 years for women D.Body mass index (BMI) of 23 E.Elevated C-reactive protein

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

A nurse is caring for a client who has premature ventricular contractions. What sign would the nurse assess in this client? A.Fluttering/heart skipping B.Nausea C.Hypotension D.Fever

A.Fluttering/heart skipping

A client is treated in the intensive care unit (ICU) following an acute myocardial infarction (MI). During the nursing assessment, the client reports shortness of breath and chest pain. In addition, the client's blood pressure (BP) is 100/60 mm Hg with a heart rate (HR) of 53 bpm, and the electrocardiogram (ECG) tracing shows more P waves than QRS complexes. Which action should the nurse complete first? A.Initiate transcutaneous pacing B.Prepare for defibrillation C.Administer 1 mg of IV atropine D.Obtain a 12-lead ECG

A.Initiate transcutaneous pacing

Which assessments should a nurse perform when caring for a client following a cardiac catheterization? Select all that apply. A.Monitor BP and pulse frequently. B.Inspect pressure dressing for signs of bleeding. C.Palpate the pulse in different locations. D.Inspect the color in every extremity. E.Palpate the insertion site for tenderness.

A.Monitor BP and pulse frequently. B.Inspect pressure dressing for signs of bleeding. C.Palpate the pulse in different locations.

The nurse has been asked to teach a patient how to self-administer nitroglycerin. The nurse should instruct the patient to do which of the following? Select all of the teaching points that apply. A.Put some of the tablets in a small metal or plastic pillbox that can be easily carried at all times and be accessible quickly, when needed. B.Let the tablet dissolve in the mouth and keep the tongue still. The tablet can be crushed between the teeth but not swallowed. C.Keep the tablets at home on the kitchen counter or bedside table so they can be reached quickly. D.Renew the supply every 6 months. E.Take the tablet in anticipation of any activity that can produce pain. F. Call emergency services if, after taking two tablets (one every 5 minutes), pain persists

A.Put some of the tablets in a small metal or plastic pillbox that can be easily carried at all times and be accessible quickly, when needed. D.Renew the supply every 6 months. E.Take the tablet in anticipation of any activity that can produce pain. F. Call emergency services if, after taking two tablets (one every 5 minutes), pain persists

The nurse is caring for a client recovering from an acute myocardial infarction (MI). Which outcome indicates that care provided to maintain adequate tissue perfusion has been effective? Select all that apply. A.Urine output 60 mL/hr B.Blood pressure 118/60 mm Hg C.Rates pain as 0 on a scale of 0 to 10 D.Normal sinus rhythm at 72 beats per minute

A.Urine output 60 mL/hr B.Blood pressure 118/60 mm Hg D.Normal sinus rhythm at 72 beats per minute

A client reports light-headedness, chest pain, and shortness of breath. They physician orders tests to ascertain what is causing the client's problems. Which test is used to identify cardiac rhythms? A.electrocardiogram B.electroencephalogram C.echocardiogram D.electrocautery

A.electrocardiogram

A client returns for a follow-up visit to the cardiologist 4 days after a trip to the ED for sudden shortness of breath and abdominal pain. The nurse realizes the client had a myocardial infarction because the results from the blood work drawn in the hospital shows: A.elevated troponin levels. B.decreased LDH levels. C.decreased myoglobin levels. D.increased C-reactive protein levels.

A.elevated troponin levels.

The electrical conduction system of the heart has several components, all of which are instrumental in maintaining polarization, depolarization, and repolarization of cardiac tissue. Which of the conductive structures is known as the pacemaker of the heart? A.sinoatrial node B.atrioventricular node C.bundle of His D.bundle branches

A.sinoatrial node

A nurse is educating a client with coronary artery disease about nitroglycerin administration. The nurse tells the client that nitroglycerin has what actions? Select all that apply. A.Reduces myocardial oxygen consumption B.Decreases the urge to use tobacco C.Dilates blood vessels D.Decreases ischemia E.Relieves pain

All answers right

A nurse is assigned four clients with diagnoses that rule out myocardial infarction (MI) due to chest pain. Which client's test results best demonstrate the specific diagnosis of unstable angina (USA)? A.A 63-year-old client with elevated troponins and no elevation in the ST segment. B.A 72-year-old client with an increase in myoglobin, no elevation in the ST segment, and no elevation in troponins. C.A 54-year-old client with elevated creatine kinase myocardial band (CK-MB) and ST segment elevations in two contiguous leads on the electrocardiogram (ECG). D.A 48-year-old client with T wave inversions, ST elevation, and abnormal Q waves.

B.A 72-year-old client with an increase in myoglobin, no elevation in the ST segment, and no elevation in troponins.

When the postcardiac surgery client demonstrates restlessness, nausea, weakness, and peaked T waves, the nurse reviews the client's serum electrolytes, anticipating which abnormality? A.Hypercalcemia B.Hyperkalemia C.Hyponatremia D.Hypomagnesemia

B.Hyperkalemia

The physician orders medication to treat a client's cardiac ischemia. What is causing the client's condition? A.pain on exertion B.reduced blood supply to the heart C.high blood pressure D.indigestion

B.reduced blood supply to the heart

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? A.Pulse rate of 84 beats/minute B.Respiration 26 breaths/minute C.Blood pressure 84/52 mm Hg D.Temperature of 100.2° F (37.9° C)

C.Blood pressure 84/52 mm Hg

The nurse is caring for a client with a suspected myocardial infarction (MI). Which medication(s) will the nurse prepare to administer the client immediately? Select all that apply. A.Oxycodone B.Warfarin C.Morphine D.Acetaminophen E.Aspirin

C.Morphine E.Aspirin

The nurse is educating the patient about administering nitroglycerin prior to discharge from the hospital. What information should the nurse include in the instructions? A.Take a nitroglycerin and if the pain is not relieved, drive to the nearest emergency department. B.Take 2 nitroglycerines and if the pain is not relieved, go to the emergency department. C.Take a nitroglycerin and repeat every 5 minutes if the pain is not relieved until a total of 2 are taken. If pain is not relieved, activate the emergency medical system. D.Take 2 nitroglycerines every 10 minutes until a total of 6 pills are taken. If pain is not relieved, activate the emergency medical system.

C.Take a nitroglycerin and repeat every 5 minutes if the pain is not relieved until a total of 2 are taken. If pain is not relieved, activate the emergency medical system.

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? A.aspirin or acetaminophen. B.pentoxifylline or acetaminophen. C.aspirin or clopidogrel. D.penicillin V or erythromycin.

C.aspirin or clopidogrel.

A client with hypertension is ambulating in the hospital hallway and reports chest pain. In which order would the nurse assess and treat this client? a. The nurse assesses the client's angina b. The client receives the first dose of nitroglycerin c. The first set of vital signs are done. d. The client is instructed to stop all activity e. A 12-lead electrocardiogram (ECG) is performed f. The client is transferred to a higher acuity unit.

D A C E B F

A client is experiencing an irregular heartbeat. The client asks the nurse how a heartbeat occurs. The nurse explains the conduction system of the heart beginning with the sinoatrial node (SA node). Place the conduction sequence of the heart in order beginning with the SA node. Use all options. a. Bundle branches b. AV node c. Purkinje fibers d. Atrial cell stimulation e. Bundle of His

D B E A C

A nurse is preparing to assist with a coronary artery bypass graft (CABG). Which vessel(s) will the nurse identify that will be prepared for the graft? Select all that apply. A.Brachial artery B.Brachial vein C.Femoral artery D.Greater saphenous vein E.Left internal mammary artery

D.Greater saphenous vein E.Left internal mammary artery

The nurse auscultates the PMI (point of maximal impulse) at which anatomic location? A.3 cm to the right of the sternum B.5 cm to the left of the lower end of the sternum C.2.5 cm to the left of the xiphoid process D.left midclavicular line, fifth intercostal space

D.left midclavicular line, fifth intercostal space

The nurse is caring for a client with a cardiac arrhythmia whose cardiac function is being continuously monitored. In which order will the nurse analyze the rhythm strip? a. Identify P wave and presence before QRS complexes. b. Determine the PR interval for consistency and number for each QRS complex. c. Determine the ventricular rhythm. d. Identify P wave consistency and shape. e. Determine the QRS duration. f. Determine the ventricular rate. g. Determine the atrial rate. h. Determine the atrial rhythm. i. Identify the shape of the QRS j. Determine consistency of the QRS duration.

F C E J I A D G H B

The nurse reviews laboratory tests for cardiac biomarkers for a client suspected of suffering an MI. What is the earliest marker of an MI? •Creatinine kinase-myocardial band (CK-MB) •Total creatinine kinase (CK) •Myoglobin •Troponin I and T

•Myoglobin