Cardio exam

A 24-year-old man seeks medical attention for complaints of claudication in the arch of the foot. The nurse also notes superficial thrombophlebitis of the lower leg. Next, the nurse should check the client's medical history for which item? 1.Smoking history 2.Recent exposure to allergens 3.History of recent insect bites 4.Familial tendency toward peripheral vascular disease

1. Smoking history

The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles, and the nurse suspects pulmonary edema. The nurse immediately notifies the registered nurse (RN) and expects which interventions to be prescribed? Select all that apply. 1.Administering oxygen 2.Inserting a Foley catheter 3.Administering furosemide 4.Administering morphine sulfate intravenously 5.Transporting the client to the coronary care unit 6.Placing the client in a low-Fowler's side-lying position

1.Administering oxygen 2.Inserting a Foley catheter 3.Administering furosemide 4.Administering morphine sulfate intravenously

The nurse is giving discharge instructions to the client with varicose veins. The nurse realizes there is a need for further teaching when the client makes which statement? 1."I need to watch my diet to lose weight." 2."I should put my elastic support hose on when I get up." 3."I want to start taking the herbal supplement, bilberry." 4."I need to sit as much as possible with my legs elevated."

4."I need to sit as much as possible with my legs elevated."

About which laboratory values should the nurse be immediately concerned because they could cause cardiac arrest? Select all that apply. 1.Calcium 7.9 mg/L 2.Potassium 5.9 mEq/L 3.Sodium 138 mEq/L 4.Chloride 104 mEq/L 5.Magnesium 1.7 mg/dL

1.Calcium 7.9 mg/L 2.Potassium 5.9 mEq/L

A client is scheduled for a dipyridamole thallium scan. The nurse should check to make sure that the client has not consumed which substance before the procedure? 1.Caffeine 2.Fatty meal 3.Excess sugar 4.Milk products

1.Caffeine

A client is receiving digoxin daily. The nurse suspects digoxin toxicity after noting which signs and symptoms? Select all that apply. 1.Visual disturbances 2.Nausea and vomiting 3.Apical pulse rate of 63 beats per minute 4.Serum digoxin level of 2.3 ng/mL (2.93 nmol/L) 5.Serum potassium level of 3.9 mEq/L (3.9 mmol/L)

1.Visual disturbances 2.Nausea and vomiting 4.Serum digoxin level of 2.3 ng/mL (2.93 nmol/L)

The nurse is assisting in developing a plan of care for a client who will be returning to the nursing unit following a cardiac catheterization via the femoral approach. Which nursing intervention should be included in the postprocedure plan of care? 1.Place the client's bed in the Fowler's position. 2.Encourage the client to increase fluid intake. 3.Instruct the client to perform range-of-motion exercises of the extremities. 4.Hold regularly scheduled medications for 24 hours following the procedure.

2.Encourage the client to increase fluid intake.

The nurse has reinforced instructions to the client with Raynaud's disease about self-management of the disease process. The nurse determines that the client needs further teaching if the client makes which statement? 1."Smoking cessation is very important." 2."Moving to a warmer climate should help." 3."Sources of caffeine should be eliminated from the diet." 4."Taking nifedipine as prescribed will decrease vessel spasm."

2."Moving to a warmer climate should help."

The nurse is monitoring a client with an abdominal aortic aneurysm (AAA). Which finding is probably unrelated to the AAA? 1.Pulsatile abdominal mass 2.Hyperactive bowel sounds in the area 3.Systolic bruit over the area of the mass 4.Subjective sensation of "heart beating" in the abdomen

2.Hyperactive bowel sounds in the area

The nurse is planning to administer hydrochlorothiazide to a client. Which are concerns related to the administration of this medication? 1.Hypouricemia, hyperkalemia 2.Hypokalemia, hyperglycemia, sulfa allergy 3.Hypokalemia, increased risk of osteoporosis 4.Hyperkalemia, hypoglycemia, penicillin allergy

2.Hypokalemia, hyperglycemia, sulfa allergy

The nurse is monitoring a client following cardioversion. Which observations should be of highest priority to the nurse? 1.Blood pressure 2.Status of airway 3.Oxygen flow rate 4.Level of consciousness

2.Status of airway

An ambulatory clinic nurse is interviewing a client who is complaining of flulike symptoms. The client suddenly develops chest pain. Which question best assists the nurse to discriminate pain caused by a noncardiac problem? 1."Can you describe the pain to me?" 2."Have you ever had this pain before?" 3."Does the pain get worse when you breathe in?" 4."Can you rate the pain on a scale of 1 to 10, with 10 being the worst?"

3."Does the pain get worse when you breathe in?"

The nurse has reinforced dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions? 1."I need to substitute eggs and milk for meat." 2."I will eliminate all cholesterol and fat from my diet." 3."I should routinely use polyunsaturated oils in my diet." 4."I need to seriously consider becoming a strict vegetarian."

3."I should routinely use polyunsaturated oils in my diet."

A hypertensive client who has been taking metoprolol has been prescribed to decrease the dose of the medication. The client asks the nurse why this must be done over a period of 1 to 2 weeks. In formulating a response, the nurse incorporates the understanding that abrupt withdrawal could affect the client in which way? 1.Result in hypoglycemia 2.Give the client insomnia 3.Precipitate rebound hypertension 4.Cause enhanced side effects of other prescribed medications

3.Precipitate rebound hypertension

A client has been diagnosed with Prinzmetal's angina. The nurse reviews the medical record and notes which accompanying characteristics? Select all that apply. 1.Relieved by rest 2.Occurs after exercise 3.Prolonged severe pain 4.Nitroglycerine relieves the pain 5.Happens at the same time each day

3.Prolonged severe pain 5.Happens at the same time each day

A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and shortness of breath, and the client is visibly anxious. Which is a life-threatening complication that could be occurring? 1.Pneumonia 2.Pulmonary edema 3.Pulmonary embolism 4.Myocardial infarction

3.Pulmonary embolism

The nurse has reinforced instructions to the family of an older client who seems anxious about being discharged after cardiac surgery. The nurse understands further teaching is needed if a family member makes which statement? 1."Recuperation after cardiac surgery is generally slower for older people." 2."It's important to get out of bed every day even if tired or weak at first." 3."Fatigue, discomfort, and lack of appetite occur more commonly with older people and may last for 2 to 5 weeks." 4."A daily, half-mile-long, brisk walk generally helps people bounce back more quickly and provides more of a sense of control."

4."A daily, half-mile-long, brisk walk generally helps people bounce back more quickly and provides more of a sense of control."

A client is taking nicotinic acid for hyperlipidemia, and the nurse reinforces instructions to the client about the medication. Which statement by the client indicates an understanding of the instructions? 1."It is not necessary to avoid the use of alcohol." 2."The medication should be taken with meals to decrease flushing." 3."Clay-colored stools are a common side effect and should not be of concern." 4."Ibuprofen taken 30 minutes before the nicotinic acid should decrease the flushing."

4."Ibuprofen taken 30 minutes before the nicotinic acid should decrease the flushing."

A client is scheduled for a cardiac catheterization using a radiopaque dye. The nurse checks which most critical item before the procedure? 1.Intake and output 2.Height and weight 3.Peripheral pulse rates 4.Prior reaction to contrast media

4.Prior reaction to contrast media

The nurse is caring for a client with a new onset of atrial fibrillation. Which prescribed treatments should the nurse expect? Select all that apply. 1.Digoxin 2.Warfarin 3.Amiodarone 4.Defibrillation 5.Electrical cardioversion

1.Digoxin 2.Warfarin 5.Electrical cardioversion

A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. The nurse listens to breath sounds expecting to hear which breath sounds bilaterally? 1.Rhonchi 2.Crackles 3.Wheezes 4.Diminished breath sounds

2.Crackles

A client with a diagnosis of myocardial infarction has a new activity prescription allowing the client to have bathroom privileges. As the client stands and begins to walk, the client begins to complain of chest pain. The nurse should take which action? 1.Assist the client to get back into bed. 2.Report the chest pain episode to the health care provider. 3.Tell the client to stand still, and take the client's blood pressure. 4.Give a nitroglycerin tablet, and assist the client to the bathroom.

1.Assist the client to get back into bed.

A client is diagnosed with disseminated intravascular coagulopathy (DIC). The nurse should become concerned with which laboratory values? Select all that apply. 1.Increased D-dimer 2.Decreased hemoglobin 3.Increased platelet count 4.Decreased fibrinogen level 5.Decreased prothrombin level

1.Increased D-dimer 2.Decreased hemoglobin 4.Decreased fibrinogen level

A client with infective endocarditis is at risk for heart failure. The nurse monitors the client for which signs and symptoms of heart failure? 1.Lung crackles, peripheral edema, and weight gain 2.Confusion, decreasing level of consciousness, and aphasia 3.Respiratory distress, chest pain, and the use of accessory muscles 4.Flank pain with radiation to the groin, accompanied by hematuria

1.Lung crackles, peripheral edema, and weight gain

The nurse is caring for a client with left-sided heart failure. Which clinical signs are most important for the nurse to communicate to the health care provider? Select all that apply. 1.Pink-tinged frothy sputum 2.Increase in respiratory rate 3.Ankle and lower leg swelling 4.Paroxysmal nocturnal dyspnea 5.Auscultation of crackles throughout the lungs

1.Pink-tinged frothy sputum 2.Increase in respiratory rate 5.Auscultation of crackles throughout the lungs

The nurse is planning to reinforce instructions to a client with peripheral arterial disease about measures to limit disease progression. The nurse should include which items on a list of suggestions to be given to the client? Select all that apply. 1.Wear elastic stockings. 2.Be careful not to injure the legs or feet. 3.Use a heating pad on the legs to aid vasodilation. 4.Walk each day to increase circulation to the legs. 5.Cut down on the amount of fats consumed in the diet.

2.Be careful not to injure the legs or feet. 4.Walk each day to increase circulation to the legs. 5.Cut down on the amount of fats consumed in the diet.

A client is wearing a continuous cardiac monitor which begins to alarm at the nurse's station. The nurse sees no electrocardiographic complexes on the screen. The nurse should do which action first? 1.Call a code blue. 2.Check the client status and lead placement. 3.Call the primary health care provider (PHCP). 4.Press the recorder button on the ECG console.

2.Check the client status and lead placement.

A client is admitted with an arterial ischemic leg ulcer. The nurse expects to note that this ulcer has which typical characteristic? 1.Dark, pink base 2.Deep and painful 3.Accompanied by very slight pain 4.Brown pigmentation of surrounding skin

2.Deep and painful

A client is admitted to the hospital with a diagnosis of pericarditis. The nurse reviews the client's record for which sign or symptom that differentiates pericarditis from other cardiopulmonary problems? 1.Anterior chest pain 2.Pericardial friction rub 3.Weakness and irritability 4.Chest pain that worsens on inspiration

2.Pericardial friction rub

An older client with ischemic heart disease has experienced an episode of dizziness and shortness of breath. The nurse reviews the plan of care and notices documentation of decreased cardiac output, dyspnea, and syncopal episodes. The nurse plans to take which important action? 1.Monitor oxygen saturation levels. 2.Place the client on a cardiac monitor. 3.Measure blood pressure every 4 hours. 4.Check capillary refill at least once per shift.

2.Place the client on a cardiac monitor.

The nurse is assisting in caring for a client in the telemetry unit and is monitoring the client for cardiac changes indicative of hypokalemia. Which occurrence noted on the cardiac monitor indicates the presence of hypokalemia? 1.Tall, peaked T waves 2.ST-segment depression 3.Prolonged P-R interval 4.Widening of the QRS complex

2.ST-segment depression

A client returns to the nursing unit after an above-knee amputation of the right leg. In which position should the nurse place the client? 1.Prone with the head on a pillow 2.With the foot of the bed elevated 3.Reverse Trendelenburg's position 4.With the residual limb flat on the bed

2.With the foot of the bed elevated

A client has an inoperable abdominal aortic aneurysm (AAA). Which measure should the nurse anticipate reinforcing when teaching the client? 1.Bed rest 2.Restricting fluids 3.Antihypertensives 4.Maintaining a low-fiber diet

3.Antihypertensives

A client is diagnosed with thrombophlebitis. The nurse should tell the client that which prescription is indicated? 1.Bed rest with bathroom privileges only 2.Bed rest keeping the affected extremity flat 3.Bed rest with elevation of the affected extremity 4.Bed rest with the affected extremity in a dependent position

3.Bed rest with elevation of the affected extremity

The nurse is collecting data on a client with a diagnosis of right-sided heart failure. The nurse should expect to note which specific characteristic of this condition? 1.Dyspnea 2.Hacking cough .Dependent edema 4.Crackles on lung auscultation

3.Dependent edema

A client with coronary artery disease has selected guided imagery to help cope with psychological stress. Which statement by the client indicates understanding of this stress reduction measure? 1."This will help only if I play music at the same time." 2."This will work for me only if I am alone in a quiet area." 3."I need to do this only when I lie down in case I fall asleep." 4."The best thing about this is that I can use it anywhere, anytime."

4."The best thing about this is that I can use it anywhere, anytime."

The nurse is preparing to ambulate a postoperative client after cardiac surgery. The nurse plans to do which to enable the client to best tolerate the ambulation? 1.Provide the client with a walker. 2.Remove the telemetry equipment. 3.Encourage the client to cough and deep breathe. 4.Premedicate the client with an analgesic before ambulating.

4.Premedicate the client with an analgesic before ambulating.

The nurse is working with a client who has been diagnosed with Prinzmetal's (variant) angina. The nurse plans to reinforce which information about this type of angina when teaching the client? 1.Prinzmetal's angina is effectively managed by beta-blocking agents. 2.Prinzmetal's angina improves with a low-sodium, high-potassium diet. 3.Prinzmetal's angina has the same risk factors as stable and unstable angina. 4.Prinzmetal's angina is generally treated with calcium channel blocking agents.

4.Prinzmetal's angina is generally treated with calcium channel blocking agents.

The nurse is assigned to assist with caring for a client after cardiac catheterization performed through the left femoral artery. The nurse should plan to maintain bed rest for this client in which position? 1.High-Fowler's position 2.Supine with no head elevation 3.Left lateral (side-lying) position 4.Supine with head elevation no greater than 30 degrees

4.Supine with head elevation no greater than 30 degrees

The health care provider is discharging a client with a diagnosis of primary hypertension. Which health maintenance instructions should the nurse reinforce in the discharge teaching plan? Select all that apply. 1.Monitor the blood pressure at home. 2.Restrict sodium intake as prescribed. 3.Take a calcium supplement to lower blood pressure. 4.Eye examinations with an ophthalmoscope should be routine. 5.Follow-up appointments for blood pressure checks are important.

1.Monitor the blood pressure at home. 2.Restrict sodium intake as prescribed. 4.Eye examinations with an ophthalmoscope should be routine. 5.Follow-up appointments for blood pressure checks are important.

A student nurse is assigned to assist in caring for a client with acute pulmonary edema who is receiving digoxin and heparin therapy. The nursing instructor reviews the plan of care formulated by the student and tells the student that which intervention is unsafe? 1.Restricting the client's potassium intake 2.Encouraging the client to rest after meals 3.Administering the heparin with a 25-gauge needle 4.Holding the digoxin for a heart rate less than 60 beats per minute

1.Restricting the client's potassium intake

The nurse notes bilateral 2+ edema in the lower extremities of a client with known coronary artery disease who was admitted to the hospital 2 days ago. Based on this finding, the nurse should implement which action? 1.Review the intake and output records for the last 2 days. 2.Prescribe daily weights starting on the following morning. 3.Change the time of diuretic administration from morning to evening. 4.Request a sodium restriction of 1 g/day from the health care provider.

1.Review the intake and output records for the last 2 days.

The nurse is preparing to care for a client who will be arriving from the recovery room after an above-the-knee amputation. The nurse ensures that which priority item is available for emergency use? 1.Surgical tourniquet 2.Dry sterile dressings 3.Incentive spirometer 4.Over-the-bed trapeze

1.Surgical tourniquet

The nurse is assisting in the care of a client diagnosed with rheumatic heart disease. The nurse should reinforce instructions to the client to notify the dentist before dental procedures for which reason? 1.The client requires prophylactic antibiotics before treatment. 2.The dentist should use a low-speed drill to avoid dysrhythmias. 3.The dentist should use a lidocaine solution without epinephrine. 4.The client is at risk for episodes of heart failure triggered by stressful events.

1.The client requires prophylactic antibiotics before treatment.

The primary health care provider (PHCP) is going to perform carotid massage on a client with rapid rate atrial fibrillation. Which interventions should the nurse anticipate? Select all that apply. 1.The client should be placed on a cardiac monitor. 2.The PHCP massages the carotid artery for a full minute. 3.The head should be turned toward the side to be massaged. 4.Rhythm strips should be obtained before, during, and after the procedure. 5.Monitor the vital signs, cardiac rhythm, and level of consciousness after the procedure.

1.The client should be placed on a cardiac monitor. 4.Rhythm strips should be obtained before, during, and after the procedure. 5.Monitor the vital signs, cardiac rhythm, and level of

An emergency department client who complains of slightly improved but unrelieved chest pain for 2 days is reluctant to take a nitroglycerin sublingual tablet offered by the nurse. The client states, "I don't need that—my dad takes that for his heart. There's nothing wrong with my heart." Which description best describes the client's response? 1.Angry 2.Denial 3.Phobic 4.Obsessive-compulsive

2.Denial

A client has just completed an information session about measures to minimize the progression of coronary artery disease (CAD). Which statement indicates an initialunderstanding of lifestyle alterations? 1.I should take daily medication for life. 2.I should eat a diet that is low in fat and cholesterol. 3.I should continue to smoke to keep the metabolic rate high. 4.I should begin to exercise if diet is not sufficient to achieve weight loss.

2.I should eat a diet that is low in fat and cholesterol.

The nurse is assisting with caring for the client immediately after insertion of a permanent demand pacemaker via the right subclavian vein. The nurse prevents dislodgement of the pacing catheter by implementing which intervention? 1.Limiting movement and abduction of the left arm 2.Limiting movement and abduction of the right arm 3.Assisting the client to get out of bed and ambulate with a walker 4.Having the physical therapist do active range of motion to the right arm

2.Limiting movement and abduction of the right arm

A client is admitted to the hospital with a venous stasis leg ulcer. The nurse is reviewing the physical examination in the medical record. Which symptom is least likely to be noted by the primary health care provider? 1.Itchy scaly skin 2.Lower leg edema 3.Sharp pain in the leg 4.Brownish skin discoloration

3.Sharp pain in the leg

A client is admitted to the hospital with possible rheumatic endocarditis. The nurse should check for a history of which type of infection? 1.Viral infection 2.Yeast infection 3.Streptococcal infection 4.Staphylococcal infection

3.Streptococcal infection

When preparing a client for a pericardiocentesis, in which position does the nurse place the client? 1.Supine with slight lowering of the head 2.Lying on the right side with a pillow under the head 3.Lying on the left side with a pillow under the chest wall 4.Supine with the head of bed elevated at a 45- to 60-degree angle

4.Supine with the head of bed elevated at a 45- to 60-degree angle

A client has an Unna boot applied for treatment of a venous stasis leg ulcer. The nurse notes that the client's toes are mottled and cool, and the client verbalizes some numbness and tingling of the foot. Which interpretation should the nurse make of these findings? 1.The boot has not yet dried. 2.The boot is controlling leg edema. 3.The boot is impairing venous return. 4.The boot has been applied too tightly.

4.The boot has been applied too tightly.

A postcardiac surgery client with a blood urea nitrogen (BUN) level of 45 mg/dL (16.2 mmol/L) and a serum creatinine level of 2.2 mg/dL (193.6 mcmol/L) has a total 2-hour urine output of 25 mL. The nurse understands that the client is at risk for which condition? 1.Hypovolemia 2.Acute kidney injury 3.Glomerulonephritis 4.Urinary tract infection

2.Acute kidney injury

A client with myocardial infarction (MI) has been transferred from the coronary care unit (CCU) to the general medical unit with cardiac monitoring via telemetry. The nurse assisting in caring for the client expects to note which type of activity prescribed? 1.Strict bed rest for 24 hours 2.Bathroom privileges and self-care activities 3.Unrestricted activities because the client is monitored 4.Unsupervised hallway ambulation with distances less than 200 feet

2.Bathroom privileges and self-care activities

A client asks the nurse about metabolic syndrome and what it means. The teaching plan should include which characteristics that define metabolic syndrome? Select all that apply. 1.The triglyceride level is not considered in the diagnosis of metabolic syndrome. 2.Blood pressure is elevated with systolic values greater than 130 mm Hg and diastolic values greater than 85 mm Hg. 3.Fasting blood glucose levels are greater than 200 mg/dL or the client is taking medication for glucose control. 4.The client has abdominal obesity with a waist greater than 40 inches in males and greater 35 inches in females. 5.High density lipoprotein (HDL) cholesterol is greater than 40 mg/dL for males or 50 mg/dl in females or on drug treatment.

2.Blood pressure is elevated with systolic values greater than 130 mm Hg and diastolic values greater than 85 mm Hg. 4.The client has abdominal obesity with a waist greater than 40 inches in males and greater 35 inches in females.

The nurse is checking the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago, after undergoing an aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission. Based on this data, the nurse should make which determination about the client's neurovascular status? 1.Moderately impaired, and the surgeon should be called 2.Normal, caused by increased blood flow through the leg 3.Slightly deteriorating, and should be monitored for another hour 4.Adequate from an arterial approach, but venous complications are arising

2.Normal, caused by increased blood flow through the leg

The nurse has given simple instructions on preventing some of the complications of bed rest to a client who experienced a myocardial infarction. The nurse should intervene if the client were performing which of these contraindicated activities? 1.Deep breathing and coughing 2.Repositioning self from side to side 3.Isometric exercises of the arms and legs 4.Ankle circles, plantar, and dorsiflexion exercises

3.Isometric exercises of the arms and legs (working out)

The client scheduled for a right femoropopliteal bypass graft is at risk for compromised tissue perfusion to the extremity. The nurse takes which action before surgery to address this risk? 1.Having the client void before surgery 2.Completing a preoperative checklist 3.Marking the location of the pedal pulses on the right leg 4.Checking the results of any baseline coagulation studies

3.Marking the location of the pedal pulses on the right leg

The nurse is collecting data from a client with varicose veins. Which finding would the nurse identify as an indication of a potential complication associated with this disorder? 1.Legs are unsightly in appearance and distress the client. 2.The client complains of aching and feelings of heaviness in the legs. 3.The client complains of leg edema, and skin breakdown has started. 4.The legs become distended when the tourniquet is released during the Trendelenburg's test.

3.The client complains of leg edema, and skin breakdown has started.