Cardiovascular

The nurse is calculating a cardiac client's pulse pressure. If the client's blood pressure is 122/76 mm Hg, what is the client's pulse pressure? 46 mm Hg 99 mm Hg 198 mm Hg 76 mm Hg

46 mm Hg

The nurse is reviewing the medication administration record of a client diagnosed with systolic heart failure. What medication should the nurse anticipate administering to this client? An antiplatelet aggregator A nonsteroidal anti-inflammatory drug (NSAID) A beta-adrenergic blocker A calcium channel blocker

A beta-adrenergic blocker

The husband of a woman about to undergo a conventional CABG procedure wants to know about how long his wife's operation will last. Which response from the nurse is correct? 6 to 9 hours 3 to 6 hours 1 to 3 hours 9 to 12 hours

3 to 6 hours

A client has been experiencing increasing shortness of breath and fatigue. The health care provider has ordered a diagnostic test in order to determine what type of heart failure the client is having. What diagnostic test does the nurse anticipate being ordered? An echocardiogram An electrocardiogram A ventriculogram A chest x-ray

An echocardiogram

A 29-year-old male with a history of cardiac valve disorder calls you to his hospital bed reporting chest pain. Your thorough assessment reveals no emergency but symptomology consistent with his angina secondary to his mitral valve prolapse. You instruct him to lie flat and elevate his legs at a 90 angle for 3 to 5 minutes. What physical response does this nursing intervention facilitate? Distraction Blood volume changes in the heart Alleviation of the pain due to neurotransmitter adjustment caused by repositioning None of the responses are correct

Blood volume changes in the heart

In his presurgical visit to the cardiology practice where you practice nursing client is quite concerned about his upcoming coronary bypass surgery. As the surgeon explains the technology and options available, the client requests the cardiologist explain the techniques in simpler terms. Which technique involves stopping the heart during surgery? CABG MIDCAB OPCAB PACAB

CABG

Which is a cerebrovascular manifestation of heart failure? Dizziness Tachycardia Nocturia Ascites

Dizziness

The nurse is auscultating the heart of a client diagnosed with mitral valve prolapse. Which is often the first and only manifestation of mitral valve prolapse? Extra heart sound Fatigue Dizziness Syncope

Extra heart sound

The nurse reads an athletic client's electrocardiogram. What finding will be consistent with a sinus bradycardia? PR interval of 0.24 seconds. P-to-QR ratio of 1:2. QR interval of 0.25 seconds. Heart rate of 42 beats per minute (bpm).

Heart rate of 42 beats per minute (bpm).

A nurse is caring for a client after cardiac surgery. Upon assessment, the client appears restless and reports nausea and weakness. The client's ECG reveals peaked T waves. The nurse reviews the client's serum electrolytes, anticipating which abnormality? Hyponatremia Hyperkalemia Hypercalcemia Hypomagnesemia

Hyperkalemia

In which type of cardiomyopathy does the heart muscle actually increase in size and mass weight, especially along the septum? Arrhythmogenic right ventricular Restrictive Dilated Hypertrophic

Hypertrophic

An older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed Chlorothiazide and Benazepril. What will the nurse monitor this client for? Postural hypertension and resulting injury Rebound hypertension Postural hypotension and resulting injury Sexual dysfunction

Postural hypotension and resulting injury

A client has had oral anticoagulation ordered. What should the nurse monitor for when the client is taking oral anticoagulation? Hourly IV infusion Urine output Prothrombin time (PT) or international normalized ratio (INR) Vascular sites for bleeding

Prothrombin time (PT) or international normalized ratio (INR)

A patient newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged uncontrolled hypertension is at risk for developing what? Renal failure Anaemia Right ventricular hypertrophy Glaucoma

Renal failure

The nurse is employed in a physician's office and is caring for a client present for an annual exam. A blood pressure of 124/84 mm Hg is documented. Following revised guidelines for identifying hypertension, which educational pamphlet is help? Stress reduction to lower prehypertensive state Use of beta-blockers for treatment of hypertension Increasing fluids for low blood pressure Diagnostic testing for determining cardiac functioning

Stress reduction to lower prehypertensive state

The nurse is caring for a client with Buerger's disease. The nurse knows that most of the care for this disease is carried out at home. What would be important to teach a client with Buerger's disease? The need for adhering to the correct diet The need to cooperate with the home health nurse The importance of smoking cessation The importance of joining a support group

The importance of smoking cessation

A patient who had a myocardial infarction is experiencing severe chest pain and alerts the nurse. The nurse begins the assessment but suddenly the patient becomes unresponsive, no pulse, with the monitor showing a rapid, disorganized ventricular rhythm. What does the nurse interpret this rhythm to be? Ventricular fibrillation Atrial fibrillation Ventricular tachycardia Third-degree heart block

Ventricular fibrillation

When assessing a client who reports recent chest pain, the nurse obtains a thorough history. Which client statement most strongly suggests angina pectoris? "The pain got worse when I took a deep breath." "The pain resolved after I ate a sandwich." "The pain lasted about 45 minutes." "The pain occurred while I was mowing the lawn."

"The pain occurred while I was mowing the lawn."

A patient with pericarditis has been admitted to the CCU. The nurse caring for the patient knows that the most common clinical manifestation of pericarditis is what? Chest pain. Palpitations. Burning sensation in chest. Pounding heart rate.

Chest pain

Digoxin—part of the digitalis class of drugs—is the primary drug used to slow and strengthen the heart. There's a specific name to the method of giving large doses of digoxin at the beginning of therapy to build up therapeutic blood levels of the drug. It is called: Digitalization Digoxination Digoxenotherapy Digoxinerics

Digitalization

You are assessing a patient suspected of having right-sided heart failure. What assessment finding may indicate right-sided heart failure? Pulmonary oedema Distended neck veins Dry cough Orthopnea

Distended neck veins

Frequently, what is the earliest symptom of left-sided heart failure? Anxiety Chest pain Confusion Dyspnea on exertion

Dyspnea on exertion

A client is diagnosed with obstructive atherosclerotic plaque of the left carotid artery. What procedure does the nurse anticipate preparing the client for? Coronary artery bypass graft Thrombectomy Embolectomy Endarterectomy

Endarterectomy

The staff educator is teaching ED nurses about hypertensive crisis. The nurse educator should explain that hypertensive urgency differs from hypertensive emergency in what way? Hypertensive urgency is treated with rest and benzodiazepines to lower BP. Vigilant hemodynamic monitoring is required during treatment of hypertensive emergencies. The BP is always higher in a hypertensive emergency. Hypertensive emergencies are associated with evidence of target organ damage.

Hypertensive emergencies are associated with evidence of target organ damage.

Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage? Primary hypertension Hypertensive emergency Secondary hypertension Hypertensive urgency

Hypertensive emergency

The nurse is creating a plan of care for a client with a cardiomyopathy. What priority goal should underlie most of the assessments and interventions that are selected for this client? Adherence to the self-care program Improved cardiac output Increased activity tolerance Absence of complications

Improved cardiac output

Before invasive procedures, clients with valvular disease are usually prescribed antibiotics. The nurse understands the reason for this preventative action is to avoid which of the following complications? Infective endocarditis Rheumatic heart disease Congestive failure Septic shock

Infective endocarditis

The triage nurse in the emergency department assesses a 66-year-old male patient who presents to the emergency department with complaints of midsternal chest pain that has lasted for the last 5 hours. The nurse is aware that because of the length of time the patient has been experiencing symptoms, if they are due to a MI, what has happened to the myocardium? Has been damaged already, so immediate treatment is no longer necessary. May have developed an increased area of infarction. Will probably not have more damage than if he came in immediately. Can have restoration of the area of dead cells with proper treatment.

May have developed an increased area of infarction.

The heart has valves between the atrium and the ventricles. What valve separates the left atrium and ventricle? Mitral Aortic Pulmonic Tricuspid

Mitral

The physical therapist notifies the nurse that a client with coronary artery disease (CAD) experiences a much greater-than-average increase in heart rate during physical therapy. The nurse recognizes that an increase in heart rate in a client with CAD may result in what? Release of potassium ions from cardiac cells Formation of a pulmonary embolism Myocardial ischemia Development of an atrial-septal defect

Myocardial ischemia

The nurse is working on a telemetry unit, caring for a client who develops dizziness and a second-degree heart block, Mobitz Type 1. What will be the initial nursing intervention? Send the client to the cardiac catheterization laboratory. Prepare to client for cardioversion. Administer an IV bolus of atropine. Review the client's medication record.

Administer an IV bolus of atropine.

A client will be placed on cardiopulmonary bypass for a mitral valve replacement. What type of medication will be required for this client? A calcium channel blocker An antipyretic A beta-adrenergic blocker An anticoagulant

An anticoagulant

Ronald Leonardo, a 65-year-old construction worker, is a client on the cardiac unit where you practice nursing. He is scheduled for bypass surgery to with the intent of preventing an MI. Which of the following is the most important part of your post-operative assessment for Mr. Leonardo after undergoing cardiac surgery? Assess Mr. Leonardo for activity intolerance Assess Mr. Leonardo's blood sugar Assess Mr. Leonardo for inadequate tissue perfusion Assess Mr. Leonardo for mental alertness

Assess Mr. Leonardo for inadequate tissue perfusion

The nurse is caring for a patient with a diagnosis of pericarditis. Where does the nurse understand the inflammation is located? The exterior layer of the heart The thin fibrous sac encasing the heart The heart's muscle fibers The inner lining of the heart and valves

The thin fibrous sac encasing the heart

When a client who has been diagnosed with angina pectoris reports experiencing chest pain more frequently, even at rest, that the period of pain is longer, and that it takes less stress for the pain to occur, the nurse recognizes that the client is describing which type of angina? Refractory Unstable Intractable Variant

Unstable

A client is admitted to the emergency department with chest pain and doesn't respond to nitroglycerin. The health care team obtains an electrocardiogram and administers I.V. morphine. The health care provider also considers administering alteplase. This thrombolytic agent must be administered how soon after onset of myocardial infarction (MI) symptoms? Within 6 hours Within 12 hours Within 24 to 48 hours Within 5 to 7 days

Within 6 hours

A client with CAD thinks diltiazem (Cardizem) has been causing nausea. Diltiazem (Cardizem) is categorized as which type of drug? diuretic calcium-channel blocker nitrate beta-adrenergic blocker

calcium-channel blocker

A client has been having cardiac symptoms for several months and is seeing a cardiologist for diagnostics to determine the cause. How will the client's ejection fraction be measured? cardiac ultrasound cardiac catheterization echocardiogram electrocardiogram

echocardiogram

During the auscultation of heart, what is revealed by an atrial gallop? diseased heart valves hypertensive heart disease turbulent blood flow heart failure

hypertensive heart disease

The nurse is assessing a client with crackling breath sounds or pulmonary congestion. What is the cause of the congestion? nocturia ascites hepatomegaly inadequate cardiac output

inadequate cardiac output

A nurse is conducting procedures to determine the extent of a client's left-sided heart failure. What adventitious lung sounds would the nurse expect to hear during auscultation of the lungs to support the diagnosis? Select all that apply. wheezes stridor labor wet lung sounds

wheezes wet lung sounds

During auscultation of the lungs, what would a nurse note when assessing a client with left-sided heart failure? wheezes with wet lung sounds high-pitched sounds stridor laborious breathing

wheezes with wet lung sounds

The nurse is caring for a client with a history of endocarditis. What topic should the nurse prioritize during health promotion education? Fluid intake Oral hygiene Physical activity Dietary guidelines

Oral hygiene

A nurse is presenting an educational event to the community. The nurse is providing information on rheumatic heart disease. What would the nurse tell the audience is the most effective prevention of rheumatic heart disease? Adhering to anti-hypertenisve medication treatment. Lowering blood cholesterol. Recognising and promptly treating streptococcal infections. Smoking cessation.

Recognising and promptly treating streptococcal infections.

The nurse is documenting assessment findings as a client is being admitted to a medical unit. Which of the following conditions, present with a diagnosis of infectious endocarditis, is correct to be documented as petechiae? Purplish, painful nodules Reddish hemorrhagic spots on the skin White areas in the retina surrounded by areas of hemorrhage Black longitudinal lines in the nails

Reddish hemorrhagic spots on the skin

What is the primary reason that the nurse monitors urine output in the client with a valvular disorder of the heart? The client's kidneys will directly affect the pumping of the heart. Urinary output is a reflection of the effectiveness of valvuloplasty procedures. Urine output will show any lingering signs of infection that may have contributed to the valve problem. Renal output reflects the heart's ability to perfuse the renal arteries.

Renal output reflects the heart's ability to perfuse the renal arteries.

The nurse recognizes which symptom as a classic sign of cardiogenic shock? Hyperactive bowel sounds High blood pressure Increased urinary output Restlessness and confusion

Restlessness and confusion

What disease process is mitral regurgitation associated with? Cellulitis Rheumatic carditis Pulmonary fibrosis Aortic stenosis

Rheumatic carditis

A client with a myocardial infarction develops acute mitral valve regurgitation. The nurse knows to assess for which manifestation that would indicate that the client is developing pulmonary congestion? Tachycardia A loud, blowing murmur Shortness of breath Hypertension

Shortness of breath

A 66-year-old client is having cardiac diagnostic tests to determine the cause of her symptoms. In her follow-up visit to the cardiologist, he indicates dysrhythmias as having the typical conductive pathway but at a rate slower than 60 beats per minute. What type of dysrhythmia would you expect the tests to reveal? Heart block Sinus bradycardia None Atrial bradycardia

Sinus bradycardia

A client with heart failure informs the nurse he has not had a bowel movement in 2 days. Why would it be important for the nurse to obtain an order for a stool softener? The client should not develop hemorrhoids. The client can develop a rectal fissure, which will increase pain levels. The client should have a bowel movement every day to avoid development of an intestinal obstruction. Straining causes the Valsalva maneuver, which can cause dangerous effects.

Straining causes the Valsalva maneuver, which can cause dangerous effects.

The nurse is caring for a client who is believed to have just experienced an MI. The nurse notes changes in the ECG of the patient. What change on an ECG most strongly suggests to the nurse that ischemia is occurring? P wave enlargement P wave inversion Q wave changes with no change in ST or T wave T wave inversion

T wave inversion

A client with a diagnosed abdominal aortic aneurysm (AAA) develops severe lower back pain. Which is the most likely cause? The aneurysm has become obstructed. The aneurysm may be preparing to rupture. The client is experiencing inflammation of the aneurysm. The client is experiencing normal sensations associated with this condition.

The aneurysm may be preparing to rupture

A 52-year-old female patient is going through menopause and asks the nurse about estrogen replacement for its cardioprotective benefits. What is the best response by the nurse? "You need to research it and determine what you want to do." "That's a great idea. You don't want to have a heart attack." "Current evidence indicates that estrogen is ineffective as a cardioprotectant; estrogen is actually potentially harmful and is no longer a recommended therapy." "Current research determines that the replacement of estrogen will protect a woman after she goes into menopause."

"Current evidence indicates that estrogen is ineffective as a cardioprotectant; estrogen is actually potentially harmful and is no longer a recommended therapy."

A client awaiting a heart transplant expresses concern about cyclosporine, the medication he will be taking to prevent organ rejection. The client asks for more information about cyclosporine. The nurse's correct response is which of the following? "If the organ is well matched with your body type, there will not be a problem with organ rejection." "Don't worry about rejection. Plenty of hearts are available for transplantation if your body rejects the first one." "Cyclosporine greatly decreases the body's rejection of transplanted organs, but it also decreases the body's ability to resist infections." "There is no medication that can help with transplant rejection."

"Cyclosporine greatly decreases the body's rejection of transplanted organs, but it also decreases the body's ability to resist infections."

A nurse who works in a busy emergency department provides care for numerous patients who present with complaints of chest pain. Which of the following questions is most likely to help the nurse differentiate between chest pain that is attributable to angina and chest pain due to myocardial infarction (MI)? "When was the first time that you recall having chest pain?" "Have you ever been diagnosed with high blood pressure or diabetes?" "Does resting and remaining still help your chest pain to decrease?" "Does your chest pain make it difficult to move around like you normally would?"

"Does resting and remaining still help your chest pain to decrease?"

The nurse determines that a client recently diagnosed with subacute bacterial endocarditis understands discharge teaching upon which client statement? "I have to call my doctor so I can get antibiotics before seeing the dentist." "If I quit smoking, it will help the endocarditis." "Can I take the antibiotics as a pill now?" "I need a referral to a dietician to understand a low-sodium diet."

"I have to call my doctor so I can get antibiotics before seeing the dentist."

The nurse is teaching a client who is being discharged post vein stripping for varicose veins. Which client statement indicates the client requires additional self-care instructions? "So it's OK for me to return to my job right away as a hairdresser." "I'll need to wear these support stockings every day." "I should try not to cross my knees when I'm sitting." "I should call the doctor if I get a cut on my foot."

"So it's OK for me to return to my job right away as a hairdresser."

The client asks the nurse to explain what is meant by a ventricular bigeminy cardiac rhythm. What is the best response by the nurse? "The rhythm has a normal beat, then a premature beat pattern." "The heart rate is between 150 to 250 bpm." "It is when the heart conduction is primarily from the atrioventricular node." "The rhythm is regular but fast."

"The rhythm has a normal beat, then a premature beat pattern."

A client with a second-degree atrioventricular heart block, Type II is admitted to the coronary care unit. How will the nurse explain the need to monitor the client's electrocardiogram (ECG) strip to the spouse? "When your spouse needs help, an alarm will go off at the desk." "The box is recording the heart's electrical activity, and a physician will review the tracing later." "The heart's electrical activity will be recorded when the heart rate exceeds 60 beats per minute." "The small box will transmit the heart rhythm to the central monitor all the time."

"The small box will transmit the heart rhythm to the central monitor all the time."

The nurse is talking to the spouse of an older adult who is recovering from heart surgery that required cardiopulmonary bypass. The spouse is very upset and believes the client is developing Alzheimer's disease because of severe disorientation. What is the BEST response the nurse can give to this spouse? "This must be very frightening for you. Many older adults develop confusion and disorientation after a surgery like this. In most cases, it gets better over time." "I wouldn't worry about it at all. It doesn't mean anything." "Disorientation after a surgery like this may be a sign of a stroke. The healthcare provider will probably order a cat scan (CT) scan to make sure that no damage has occurred." "You have reason to worry. Sometimes the first signs of dementia occur after a surgery like this."

"This must be very frightening for you. Many older adults develop confusion and disorientation after a surgery like this. In most cases, it gets better over time."

The nurse is caring for a client with symptomatic aortic stenosis. The health care provider has suggested that the client be treated with a balloon valvuloplasty but the client is reluctant to proceed with the procedure. What is the BEST response to the client concerning this issue? "I realize you are worried but having this procedure means you will never have to worry about this problem again." "It's always hard to face a procedure like this but just go ahead and have it done and get it over with." "This must be very frightening to consider but depending on medication alone may result in very serious consequences for you." "I understand your reluctance to have an invasive procedure. Why don't you see if your health care provider can increase your current medication doses?"

"This must be very frightening to consider but depending on medication alone may result in very serious consequences for you."

The nurse is assisting a patient with peripheral arterial disease to ambulate in the hallway. What should the nurse include in the education of the patient during ambulation? "Walk to the point of pain, rest until the pain subsides, then resume ambulation." "If you feel any discomfort, stop and we will use a wheelchair to take you back to your room." "If you feel pain during the walk, keep walking until the end of the hallway is reached." "As soon as you feel pain, we will go back and elevate your legs."

"Walk to the point of pain, rest until the pain subsides, then resume ambulation."

A client with newly diagnosed hypertension has come to the clinic for a follow-up visit. The client asks the nurse why she has to come in so often. What would be the nurse's best response? "We do this to see how often you should change your medication dose." "We do this to make sure your health is stable. We'll then monitor it at routinely scheduled intervals." "We do this so we can identify any of the early symptoms of a stroke." "We do this to determine how your blood pressure changes throughout the day."

"We do this to make sure your health is stable. We'll then monitor it at routinely scheduled intervals."

The nurse is reviewing the results of a total cholesterol level for a client who has been taking simvastatin. What results display the effectiveness of the medication? 160-190 mg/dL 280-300 mg/dL 250-275 mg/dL 210-240 mg/dL

160-190 mg/dL

Upon auscultation of a client's heart, the examiner hears a very loud murmur. The examiner removes the stethoscope completely and can still hear the murmur. How would the nurse expect this murmur to be graded? 3 5 6 4

6

A client has been admitted for a commissurotomy. The nurse knows that a commissurotomy repairs which of the following? A valve An artery A ventricle Part of the myocardium

A valve

The nurse is caring for an older adult client who is in cardiac rehabilitation following heart surgery. The client has been walking on a regular basis for about a week and walks for 15 minutes 3 times a day. The client states that he has cramp-like pain in the legs every time he walks and that the pain gets "better when I rest." The client's care plan should address what problem? Acute pain related to intermittent claudication Decreased mobility related to VTE Decreased mobility related to venous insufficiency Acute pain related to vasculitis

Acute pain related to intermittent claudication

A community health nurse is planning an educational campaign addressing hypertension. The nurse should anticipate that the incidence and prevalence of hypertension are likely to be highest among members of what ethnic group? African-Americans Pacific Islanders Asians Hispanics

African-Americans

The nurse explains to a patient that the primary cause of a varicose vein is: Venous occlusion. An incompetent venous valve. Venospasm. Phlebothrombosis.

An incompetent venous valve

The nurse has conducted preoperative teaching with a client about to undergo cardiovascular surgery. Which of the following methods would best validate that the client understands the procedure before signing the consent form? Make sure that the client is relaxed before leaving the room. Confirm that the client has written instructions about the procedure. Ask the client to explain the surgical procedure. Acknowledge the client's emotions and any expressions of fear.

Ask the client to explain the surgical procedure

The nurse is caring for a client on a monitored telemetry unit. During morning assessment, the nurse notes abnormal ECG waves on the telemetry monitor. Which action would the nurse do first? Assess the client. Assess for mechanical dysfunction. Reposition the client. Call the physician with a report.

Assess the client.

A patient with a diagnosis of deep vein thrombosis (DVT) is being treated with unfractionated heparin, which is being administered intravenously. The nurse who is providing care for this patient should consequently prioritize what assessments? Assessing the patient's pain levels Monitoring the patient's intake and output, and assessing for signs of fluid volume deficit Assessing the patient for internal or external hemorrhage Assessing the patient for adventitious lung sounds and assessing SaO2 levels

Assessing the patient for internal or external hemorrhage

The nurse is providing care for a client with a diagnosis of hypertension. The nurse should consequently assess the client for signs and symptoms of which other health problem? Atrial-septal defect Migraines Thrombocytopenia Atherosclerosis

Atherosclerosis

The home health nurse visits a client who was recently diagnosed with aortic regurgitation. The nurse notes that the client appears unwell and when asked by the nurse if anything has changed since the last visit, the client states, "I was sick to my stomach for a few days and couldn't take the medicine the doctor gave me so I took it all today." With the knowledge that this medication is a beta-blocker, the nurse notifies the health care provider and assesses the client for what signs of an overdose? Select all that apply. Bluish discoloration to the palm Tachycardia Drowsiness Dizziness Irritability

Bluish discoloration to the palm Dizziness Drowsiness

The nurse is caring for a patient who has undergone peripheral arteriography. How should the nurse assess the adequacy of peripheral circulation? By checking for cardiac dysrhythmias By observing the patient for bleeding By hemodynamic monitoring By checking peripheral pulses

By checking peripheral pulses

The nurse determines that a patient has a characteristic symptom of pericarditis. What symptom does the nurse recognize as significant for this diagnosis? Uncontrolled restlessness Dyspnea Constant chest pain Fatigue lasting more than 1 month

Constant chest pain

A client who has recently undergone prosthetic heart valve replacement wants to know why she must take antibiotics following the procedure. What problem would the nurse explain to the client that the antibiotics are used to prevent? Myocarditis Lymphadenitis Phlebitis Endocarditis

Endocarditis

A nurse is teaching about lifestyle modifications to a group of clients with known hypertension. Which statement would the nurse include in the education session? Limit alcohol consumption to no more that 3 drinks per day. Engage in aerobic activity at least 30 minutes/day most days of the week. Maintain a waist circumference of 45 inches (114 cm) (men) and 40 inches (102 cm) (women) or less. Maintain a body mass index between 30 and 35.

Engage in aerobic activity at least 30 minutes/day most days of the week.

The school nurse is providing care to a child with a sore throat. With any sign of throat infection, the nurse stresses which of the following? Obtaining a throat culture Fluid increase to 2500cc Warm, salt water gargling Administering antiseptic lozenges

Obtaining a throat culture

The nurse is caring for a client on the cardiac unit. The licensed practical nurse on the previous shift reported the following vital signs/assessment information: temperature, 100.6° F; pulse, 56 beats/minute; respirations 24 breaths/minute; blood pressure, 116/60 mm Hg; pulse oximetry reading, 92%; and with 2+ edema noted in the lower extremities. Prior to 9 AM antidysrhythmic medication administration, which of the following will the nurse reassess? Temperature Blood pressure Edema Pulse

Pulse

What assessment would be a priority in the postoperative care of a patient with an implantable pacemaker? Pulse Blood pressure Temperature Respiratory rate

Pulse

Where does bradycardia originate? Purkinje fibres. AV node. SA node. Bundle of HIS.

SA node

A patient comes to the emergency department with reports of chest pain after using cocaine. The nurse assesses the patient and obtains vital signs with results as follows: blood pressure 140/92, heart rate 128, respiratory rate 26, and an oxygen saturation of 98%. What rhythm on the monitor does the nurse anticipate viewing? Sinus bradycardia Sinus tachycardia Ventricular tachycardia Normal sinus rhythm

Sinus tachycardia

The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety? Sit on the edge of the chair and rise slowly. Use a pillbox to store daily medication. Do not operate a motor vehicle. Take the medication at the same time daily.

Sit on the edge of the chair and rise slowly.

A 40-year-old man newly diagnosed with hypertension is discussing risk factors with the nurse. The nurse talks about lifestyle changes with the patient and advises that the patient should avoid tobacco use. What is the rationale behind that advice to the patient? Smoking increases cardiac output. Smoking causes obesity, which exacerbates hypertension. Smoking increases the risk of heart disease. Smoking directly causes high blood pressure.

Smoking increases the risk of heart disease.

A physician admits a client to the health care facility for treatment of an abdominal aortic aneurysm. When planning this client's care, which goal should the nurse keep in mind as she formulates interventions? Increasing blood pressure and monitoring fluid intake and output Stabilizing heart rate and blood pressure and easing anxiety Increasing blood pressure and reducing mobility Decreasing blood pressure and increasing mobility

Stabilizing heart rate and blood pressure and easing anxiety

A client comes to the walk-in clinic complaining of frequent headaches. While assessing the client's vital signs, the nurse notes the BP is 161/101 mm Hg. How would this client's BP be defined? Normal Elevated Stage 1 hypertensive Stage 2 hypertensive

Stage 2 hypertensive

A student nurse is taking care of an elderly hypertensive patient during her clinical experience. The instructor asks the student why blood pressure tends to increase with age. What would be the best answer by the student? Decreases in the lumen of the arteries and venous insufficiency are more common in the elderly. Ageing has no bearing on blood pressure. Blood pressure tends to go down with age, not up. Structural and functional changes in the cardiovascular system that occur with age contribute to increases in blood pressure.

Structural and functional changes in the cardiovascular system that occur with age contribute to increases in blood pressure.

A nurse is teaching a client about heart failure. What will the nurse explain is causing the heart to fail? The heart is pumping too slow to disseminate nutrients to the body. The heart is fibrillating. The heart cannot pump sufficient blood to meet the body's metabolic needs. The heart is pumping too fast to adequately meet the body's metabolic needs.

The heart cannot pump sufficient blood to meet the body's metabolic needs.

The nurse is teaching a client with cardiomyopathy. Which statement is a valid teaching point? The treatments include medications, medical devices, surgery, or transplantation. The disease was inherited, so there are no reversal treatments. Clients with cardiomyopathy have a goal to improve lung function. Clients with cardiomyopathy often need to live in a skilled nursing care facility.

The treatments include medications, medical devices, surgery, or transplantation.

Which of the following is the most common site for a dissecting aneurysm? Lumbar area Sacral area Thoracic area Cervical area

Thoracic area

What is an important aspect of defibrillating? Use a conducting sheet between the paddles and the skin. Always use a squeeze on gel between the paddles and the skin. Use a conducting medium between the multifunction paddles and the skin. You can use any gel or paste between the paddles and the skin.

Use a conducting medium between the multifunction paddles and the skin.

The nursing student asks the nurse how to tell the difference between ventricular tachycardia and ventricular fibrillation on an electrocardiogram strip. What is the best response? "The P-R interval will be prolonged in ventricular fibrillation, while in ventricular tachycardia the P-R interval is normal." "The QRS complex in ventricular fibrillation is always narrow, while in ventricular tachycardia the QRS is of normal width." "Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes." "The two look very much alike; it is difficult to tell the difference."

Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes."

A client is diagnosed with pericarditis. What symptom will be the nurse's priority for treatment? anxiety acute pain fatigue denial

acute pain

A client has an irregular heart rate of around 100 beats/minute and a significant pulse deficit. What component of the client's history would produce such symptoms? atrial flutter atrial fibrillation bundle branch block heart block

atrial fibrillation

A client with systemic lupus erythematosus reports palpitations, dyspnea on exertion, and leg swelling. The client's symptoms may indicate: thrombophlebitis. pericarditis. cardiomyopathy. Buerger's disease.

cardiomyopathy

A patient has been prescribed a digitalis preparation for heart failure. What should the nurse closely monitor when caring for this client? electrolyte and water loss flexion contractures enlargement of joints vasculitis

electrolyte and water loss

A client with secondary hypertension has come into the clinic for a routine check-up. When comparing this client's diagnosis to primary hypertension, the nurse recognizes that secondary hypertension: has a more gradual onset than primary hypertension. has a specific cause. does not normally cause target organ damage. does not normally respond to antihypertensive drug therapy.

has a specific cause

A client has a Grade 1 heart murmur. This means the heart murmur is: accompanied by a palpable thrill. moderately loud. loud enough to be heard without the stethoscope. soft and difficult to auscultate.

soft and difficult to auscultate

A client with mitral insufficiency is being treated with quinidine to control tachycardia. When assessing the client, the nurse should observe for signs of: toxicity. anemia. thrombocytosis. infection.

toxicity

A 56-year-old male client at a screening event has a blood pressure reading of 146/96 mm Hg. Upon hearing the reading, the client states, "My pressure has never been this high. Do you think my doctor will prescribe medication to reduce it?" What is the nurse's best response? "A single elevated blood pressure does not confirm hypertension. You will need to have your blood pressure reassessed several times before a diagnosis can be made." "Yes. Hypertension is prevalent among men; it is fortunate we caught this during your routine examination." "We will need to reevaluate your blood pressure because your age places you at high risk for hypertension." "You have no need to worry. Your pressure is probably elevated because you are being tested."

"A single elevated blood pressure does not confirm hypertension. You will need to have your blood pressure reassessed several times before a diagnosis can be made."

The nurse is doing discharge teaching with a client who has coronary artery disease. The client asks why he has to take an aspirin every day if he doesn't have any pain. What would be the nurse's best response? "An aspirin a day eventually helps your blood carry more oxygen that it would otherwise." "Taking an aspirin every day is a simple way to make your blood penetrate your heart more freely." "An aspirin a day can help prevent some of the blockages that can cause chest pain or heart attacks." "Taking an aspirin every day is an easy way to help restore the normal function of your heart."

"An aspirin a day can help prevent some of the blockages that can cause chest pain or heart attacks."

The client with suspected mitral valve prolapse asks the nurse about tests that will be done to confirm the diagnosis. Which is the best response by the nurse? "A halter monitor will be used to confirm diagnosis." "A chest x-ray will reveal a prolapse if present." "An echocardiogram along with clinical symptoms will assist in diagnosis." "An ECG that presents a notched P wave will assist with diagnosis."

"An echocardiogram along with clinical symptoms will assist in diagnosis."

A client with known coronary artery disease reports intermittent chest pain, usually on exertion. When teaching the client about nitroglycerin administration, which instruction should the nurse provide? "Be sure to take safety precautions because nitroglycerin may cause dizziness when you stand up." "A burning sensation after administration indicates that the nitroglycerin tablets are potent." "You may take a sublingual nitroglycerin tablet every 30 minutes, if needed. You may take as many as four doses." "Replace leftover sublingual nitroglycerin tablets every 9 months to make sure your pills are fresh."

"Be sure to take safety precautions because nitroglycerin may cause dizziness when you stand up."

The nurse is caring for a client admitted with angina who is scheduled for cardiac catheterization. The client is anxious and asks the reason for this test. What is the best response? "Cardiac catheterization is most commonly done to evaluate cardiac electrical activity." "Cardiac catheterization is usually done to evaluate cardiovascular response to stress." "Cardiac catheterization is most commonly done to detect how efficiently a client's heart muscle contracts." "Cardiac catheterization is usually done to assess how blocked or open a client's coronary arteries are."

"Cardiac catheterization is usually done to assess how blocked or open a client's coronary arteries are."

A client is a candidate for percutaneous balloon valvuloplasty, but is concerned about how this procedure will affect her busy work schedule. What guidance should the nurse provide to the client? "Clients generally stay in the hospital for 6 to 8 days." "Clients are kept in the hospital until they are independent with all aspects of their care." "Clients need to stay in the hospital until they regain normal heart function for their age." "Clients usually remain at the hospital for 24 to 48 hours."

"Clients usually remain at the hospital for 24 to 48 hours."

The nurse is caring for a client with aortic stenosis who has just been started on medication. The nurse has also given the client information about dietary restrictions related to this condition. Which statement by the client indicates a need for further instruction? "I plan to eat a lot of soup because it is inexpensive, it stores well on the shelf and I can fix it quickly." "I will try to avoid salty snack foods, even though those are some of my favorites." "I will make sure that I don't add any salt to my food when I cook and at the table." "I used to buy a lot of food from the delicatessen but I will try to limit that now."

"I plan to eat a lot of soup because it is inexpensive, it stores well on the shelf and I can fix it quickly."

The nurse is working with a new graduate nurse who is assisting in the care of an older client who is recovering from a surgery that required cardiopulmonary bypass. The client is three days post-surgery and appears drowsy a majority of the time and does not want to engage in conversation with visitors. Which statement by the new graduate represents an understanding of the reason for this client's behavior? "I realize that sometimes older adults experience a change in orientation following cardiac surgery. Sometimes the client may be restless and talk excessively and other times the client may be drowsiness or stuporous." "I'm very concerned that this client is still so drowsy. I wonder if the client sustained brain damage during the surgery." "This client is so tired. I imagine having cardiac surgery is very exhausting. I plan to allow more rest time and I will limit the amount of activity that is required." "This client is acting so odd. I expected confusion and disorientation but not this. I plan to limit the amount of pain medication the client is receiving and see if there is more response."

"I realize that sometimes older adults experience a change in orientation following cardiac surgery. Sometimes the client may be restless and talk excessively and other times the client may be drowsiness or stuporous."

The client with diabetes is taking a beta-adrenergic blocker for the management of valvular disorder. Which statement made by the client indicates a need for further teaching? "I should avoid taking OTC cold medicines." "I should stop taking the medicine if I get dizzy." "I should take the medicine before meals." "I will need to check my blood sugar more often."

"I should stop taking the medicine if I get dizzy."

A client with endocarditis is being discharged home. What statement indicates effectiveness of client teaching about preventing recurrence of the infection? "I am going to take an aspirin a day to prevent lesions around my valve." "I will always be on antibiotic therapy." "I will start an antibiotic when I am exposed to anyone with infections." I will ask for antibiotics whenever I have dental work done."

"I will ask for antibiotics whenever I have dental work done."

The nurse is educating a client about the care related to a new diagnosis of mitral valve prolapse. What statement made by the client demonstrates understanding of the teaching? "I will avoid caffeine, alcohol, and smoking." "I can get my tongue pierced at a store in the shopping mall." "I will take antibiotics before getting my teeth cleaned." "I can get a tattoo at a local parlor."

"I will avoid caffeine, alcohol, and smoking."

The night before heart surgery involving a quadruple bypass, a client has been admitted and preoperatively prepared. The client has signed the consent for surgery. Which of the following statements indicates a greater need for teaching? "I know that I will have to perform deep breathing and coughing and will be ambulating early." "I know that I will be monitored closely in CCU after the surgery and I will be expected to participate in my care." "I will be relieved to have this surgery over with; I have a busy schedule at work right now and can`t afford downtime." "I know I will need to change my eating habits and activity levels to keep my heart healthy."

"I will be relieved to have this surgery over with; I have a busy schedule at work right now and can`t afford downtime."

A nurse is teaching a client who is awaiting a heart transplant. Which statement indicates the client understands what is required to help minimize rejection? "There is no risk of rejection if the donor heart is an exact match." "I will need to take three different types of medications for the rest of my life to help prevent rejection." "I will receive medication before and during surgery, which will eliminate the risk of rejection." "I will need medication following surgery to prevent rejection, but if my body does not reject the new heart, I will not have to take any medication at home."

"I will need to take three different types of medications for the rest of my life to help prevent rejection."

A nurse is speaking to a community group about the importance of organ donation. Which statement by a community member requires further information from the nurse? "The older a person is, the less likely that person is to be an organ donor." "It is hard to families to donate the organs of their loved ones; even when they knew that is what the loved one wanted." "I would donate all of my organs but my family likes big funerals with open caskets and I wouldn't want my family to be upset when they saw me." "Most people who can donate organs are young and haven't left instructions about their wishes for organ donation."

"I would donate all of my organs but my family likes big funerals with open caskets and I wouldn't want my family to be upset when they saw me."

The nurse is caring for a client with mitral valve prolapse and would like to use complementary therapy to treat some of the symptoms if possible. What is the nurse's best response to the client? "If you feel your heart is beating too fast, lie down as quickly as you can so your heart will relax." "Shortness of breath can be relieved by breathing more rapidly to get more oxygen in your lungs." "You will feel better much sooner if you will just take medications." "If you have chest pain, you can lie on the floor and place your legs straight against a wall."

"If you have chest pain, you can lie on the floor and place your legs straight against a wall."

After being discharged from the hospital after undergoing cardiothoracic surgery, the client asks the nurse when he can resume sexual activity. What is the best response by the nurse? "In about 2 to 4 weeks if you are able to climb stairs without difficulty breathing or chest pain." "I can't believe you are worried about that so soon after your surgery." "You may have a difficult time resuming sexual activities after this surgery." "You won't be able to resume sexual activity until your 6-month checkup with the surgeon."

"In about 2 to 4 weeks if you are able to climb stairs without difficulty breathing or chest pain."

The nurse is conducting client teaching about cholesterol levels. When discussing the client's elevated LDL and lowered HDL levels, the client shows an understanding of the significance of these levels by stating what? "The increased LDL will decrease the amount of cholesterol deposited on the artery walls." "Increased LDL has the potential to decrease my risk of heart disease." "Increased LDL and decreased HDL increase my risk of coronary artery disease." "The decreased HDL level will increase the amount of cholesterol moved away from the artery walls."

"Increased LDL and decreased HDL increase my risk of coronary artery disease."

A client is at the clinic for follow-up after cardiothoracic surgery and tells the nurse, "I don't know what is wrong with me. I don't want to eat, and I feel depressed. "What is the best response by the nurse to this statement? "It may take several weeks for your appetite to return, and the depression is normal and temporary." "You need to tell the physician because this could be serious." "There should be no reason for you to be depressed. You came through the surgery fine." "I think we need to get you in to see a psychiatrist."

"It may take several weeks for your appetite to return, and the depression is normal and temporary."

A patient has been newly diagnosed with heart failure (HF) and has come to the meet with the nurse at the clinic for health education. What lifestyle recommendation should the nurse provide to this patient when discussing dietary modifications? "Try to replace as many of the complex carbohydrates in your diet with simple sugars." "Many people with HF find that small, frequent meals allow them to manage their diet effectively." "I'll teach you some good sources of potassium, which you should try to eat regularly." "It's in your best interests to avoid excessive fluids and sodium in your diet."

"It's in your best interests to avoid excessive fluids and sodium in your diet."

A patient is undergoing preoperative teaching before cardiac surgery. The nurse explains that a temporary pacemaker will be placed later that day, and it will be removed after the surgery. The patient asks the nurse what will happen if the pacemaker quits functioning. What is the nurse's best response? "Monitoring for pacemaker malfunctioning and battery failure is something the nurse caring for you does." "Monitoring for pacemaker malfunctioning and battery failure is something the technician down the hall does." "Monitoring for pacemaker malfunctioning and battery failure is something the health care provider caring for you does when he makes rounds every day." "Monitoring for pacemaker malfunctioning and battery failure is something the secretary at the nurse's station does."

"Monitoring for pacemaker malfunctioning and battery failure is something the secretary at the nurse's station does."

The nurse is caring for a client with infective endocarditis. The nurse teaches the client that he will have to take antibiotics periodically for the rest of his life. The client wants to know why. What would be the nurse's best answer to the client? "You will be susceptible to infections from all kinds of germs now." "You will be vulnerable to infective endocarditis for the rest of your life." "Just to be on the safe side." "Your heart has been weakened, and it will need extra help so you can live a long life."

"You will be vulnerable to infective endocarditis for the rest of your life."

The nurse is caring for a client who is being discharged after insertion of a permanent pacemaker. The client, an avid tennis player, is scheduled to play in a tournament in 1 week. What is the best advice the nurse can give related to this activity? "Cancel your tennis tournament and wait until fall, then try hockey; skating is much easier on pacemakers." "You will need to cancel this activity; you must restrict arm movement above your head for 2 weeks." "You should avoid tennis; basketball or football would be a good substitute." "You may resume all normal activity in 1 week; if you are used to playing tennis, you may proceed with this activity."

"You will need to cancel this activity; you must restrict arm movement above your head for 2 weeks."

After performing an ECG on an adult client, the nurse reports that the PR interval reflects normal sinus rhythm. What is the PR interval for a normal sinus rhythm? 0.15 and 0.3 seconds. 0.25 and 0.4 seconds. 0.12 and 0.2 seconds. 0.05 and 0.1 seconds.

0.12 and 0.2 seconds.

Upon auscultation of a client's heart, the examiner hears a very faint murmur when the client is in certain positions. How would the nurse expect this murmur to be graded? 4 1 3 2

1

High blood pressure is highly prevalent in the United States. Approximately how many people have high blood pressure in the United States? 1 in 10 adults 1 in 3 adults 1 in 6 adults 1 in 7 adults

1 in 3 adults

A client who had a prosthetic valve replacement was taking warfarin to reduce the risk of postoperative thrombosis. The client visited the nurse at a clinic once a week. What INR level would alert the nurse to notify the health care provider? 3.0 2.6 3.8 3.4

3.8

Eunice Henderson, a 79-year-old female, is a client in the cardiac unit where you practice nursing. With her diagnosis of pulmonary congestion secondary to left ventricular dysfunction, you would expect her physician to order supplemental oxygen therapy. At what minimum level would you expect to maintain her SpO2? 87 80 90 85

90

A medical nurse has admitted four clients over the course of a 12-hour shift. For which client would assessment of ankle-brachial index (ABI) be most clearly warranted? A client who has peripheral edema secondary to chronic heart failure A client with poorly controlled type 1 diabetes who is a smoker An older adult client who has a diagnosis of unstable angina A client who has community-acquired pneumonia and a history of COPD

A client with poorly controlled type 1 diabetes who is a smoker

Every shift you work in the hospital unit where you practice nursing, blood pressures are measured as a component of your policy-scheduled assessments. Much information can be gleaned from comparing blood pressure measurements. What does a blood pressure reading indicate? Circulating blood volume Pumping efficacy of the heart All of the options are correct. Arterial ability to stretch and fill with blood

All of the options are correct

Fred Edwards, a 48-year-old male, is a biker who has been diagnosed with Buerger's disease. He has a 30-pack-year history and owns a biker bar. In your client education with Mr. Edwards, what actions would you recommend to decrease the complications connected with Buerger's disease? Prevent trauma to extremities Clean his arms and legs daily All options are correct Don't bite his fingernails

All options are correct

Hypertension is defined as "sustained elevations in systolic or diastolic blood pressures that exceed prehypertension levels". What are some of the consequences of hypertension that make it such a health menace in the United States? Cerebrovascular accident Renal disease Cardiac failure All options are correct

All options are correct

A nurse plans to have an education session with a client with cardiomyopathy and the client's spouse about ways to increase activity tolerance. What instructions would the nurse provide? Gradually work up to strenuous activity. Include isometric exercises in the daily routine. Avoid all physical and emotional stress. Alternate active periods with rest periods.

Alternate active periods with rest periods.

Which of the following medication classifications is more likely to be expected when the nurse is caring for a client with atrial fibrillation? Anticoagulant Potassium supplement Antihypertensive Diuretic

Anticoagulant

A nursing student is taking a test on the cardiovascular system. Which of the following would the student correctly identify as cardiac valves? Select all that apply. Thoracic Pulmonic Aortic Mitral Tricuspid

Aortic Mitral Tricuspid Pulmonic

A nurse is caring for a client receiving warfarin therapy following a mechanical valve replacement. The client had a prothrombin time and International Normalized Ratio (INR) drawn before breakfast. The laboratory report shows the client's INR reading was 4. What is the nurse's first priority ? Be prepared to administer an I.M. vitamin K injection and notify the healthcare provider of the results. Assess the client for bleeding and notify the health care provider of the results. Notify the next nurse on afternoon shift to hold the evening dose of warfarin. Notify the health care provider to request an increase in the warfarin dose.

Assess the client for bleeding and notify the health care provider of the results.

The pathophysiology instructor is discussing heart disease with a class of prenursing students. One of the students asks what indications there are for coronary artery bypass surgery with cardiopulmonary bypass. What would be the instructor's answer? Select all that apply. Transluminal coronary angioplasty is necessary. The heart cannot be repaired without compromising oxygenation of the body. The anatomic location of the occlusion(s) interferes with the safe insertion of a coronary artery catheter. Atheromas are calcified and noncompressible. The client has multiple coronary artery occlusions.

Atheromas are calcified and noncompressible. The heart cannot be repaired without compromising oxygenation of the body. The anatomic location of the occlusion(s) interferes with the safe insertion of a coronary

The nurse cares for a client with a dysrhythmia and understands that the P wave on an electrocardiogram (ECG) represents which phase of the cardiac cycle? Ventricular depolarization Ventricular repolarization Early ventricular repolarization Atrial depolarization

Atrial depolarization

A patient with mitral stenosis exhibits symptoms of a dysrhythmia. Based on the pathophysiology of this disease process, the nurse would expect the patient to exhibit what heart rhythm? Electromechanical dissociation Normal sinus rhythm Supraventricular tachycardia Atrial fibrillation

Atrial fibrillation

A client presents to the emergency department via ambulance with a heart rate of 210 beats/minute and a sawtooth waveform pattern per cardiac monitor. The nurse is most correct to alert the medical team of the presence of a client with which disorder? Atrial flutter Ventricular fibrillation Premature ventricular contraction Asystole

Atrial flutter

A client with mitral valve stenosis is receiving health education at an outpatient clinic. To minimize the client's symptoms, the nurse should teach the client to do which of the following? Perform deep breathing and coughing exercises. Avoid activities that cause an increased heart rate. Avoid large crowds and public events. Eat a high-protein, low-carbohydrate diet.

Avoid activities that cause an increased heart rate.

A client with progressive mitral valve prolapse is experiencing sympathetic nervous system symptoms in addition to prolapse symptoms. Which teaching point should be stressed by the nurse in an effort to minimize these effects? Low-dose aspirin daily Antibiotic therapy before invasive procedures Avoid caffeine. Decrease fluid and sodium intake.

Avoid caffeine

The nurse is planning discharge teaching for a patient with a newly inserted permanent pacemaker. What would be important for the nurse to teach this patient? Avoid exposure to high-voltage electrical generators. Start lifting the arm above the shoulder right away to prevent shoulder restriction. Avoid walking through store and library antitheft devices. Avoid cooking with a microwave oven.

Avoid exposure to high-voltage electrical generators.

The nurse is caring for a client with Raynaud's disease. What is an important instruction for a client who is diagnosed with this disease to prevent an attack? Report changes in the usual pattern of chest pain. Avoid situations that contribute to ischemic episodes. Avoid fatty foods and exercise. Take over-the-counter decongestants.

Avoid situations that contribute to ischemic episodes

The nurse is working with a client who has just been diagnosed with an aneurysm. What advice should the nurse provide to this client? Minimize bowel movements and coughing. Avoid situations that contribute to ischemic episodes. Avoid straining during bowel movements and coughing. Wear wool socks and mittens during cold weather.

Avoid straining during bowel movements and coughing.

A nurse is caring for a client who had an aortic balloon valvuloplasty. The nurse should inspect the surgical insertion site closely for which complication(s)? Bleeding and wound dehiscence Bleeding and infection Evisceration Thrombosis and infection

Bleeding and infection

A client with heart failure has met with his primary provider and begun treatment with an angiotensin-converting enzyme (ACE) inhibitor. When the client begins treatment, the nurse should prioritize what assessment? Level of consciousness (LOC) Assessment for nausea Blood pressure Oxygen saturation

Blood pressure

An older adult client has been diagnosed with aortic regurgitation. What change in blood flow should the nurse expect to see on this client's echocardiogram? Blood to flow back from the left atrium to the left ventricle Blood to flow back from the aorta to the left ventricle Obstruction of blood from the left atrium to left ventricle Obstruction of blood flow from the left ventricle

Blood to flow back from the aorta to the left ventricle

A patient has been admitted to the hospital with exacerbation of heart failure (HF) that has resulted in pulmonary and peripheral edema. The nurse has been carefully monitoring the trajectory of the patient's signs and symptoms of HF. How can the nurse best monitor the patient's fluid balance? By measuring and recording the patient's oral fluid intake By monitoring the patient's blood urea nitrogen (BUN) and creatinine levels By assessing the patient's skin turgor at several different sites By performing daily weights at the same time each day

By performing daily weights at the same time each day

A client in the cardiac step-down unit has begun bleeding from the percutaneous coronary intervention (PCI) access site in the femoral region. What is the nurse's most appropriate action? Reposition the client's leg in a nondependent position. Call for assistance and initiate cardiopulmonary resuscitation. Call for help and apply pressure to the access site. Promptly remove the femoral sheath.

Call for help and apply pressure to the access site.

The nurse is caring for a client who has just undergone catheter ablation therapy. The nurse in the step-down unit should prioritize what assessment? Pain assessment Cardiac monitoring Monitoring the client's level of consciousness (LOC) Monitoring the implanted device signal

Cardiac monitoring

The nurse is caring for a patient diagnosed with pericarditis. What serious complication should this patient be monitored for? Hypertension Left ventricular hypertrophy Cardiac tamponade Decreased venous pressure

Cardiac tamponade

The nurse is caring for a client who has had a pulmonary artery catheter inserted. The nurse will use this catheter to obtain which measurements? Select all that apply. Central venous pressure Arterial blood pressure Pulmonary capillary wedge pressure Right ventricular end-diastolic pressure Cardiac output

Central venous pressure Pulmonary capillary wedge pressure

A client has been prescribed furosemide 80 mg twice daily. The asymptomatic client begins to have rare premature ventricular contractions followed by runs of bigeminy with stable signs. What action will the nurse perform next? Notify the health care provider. Calculate the client's intake and output. Administer potassium. Check the client's potassium level.

Check the client's potassium level

The nurse is caring for a client with thrombophlebitis. When assessing this client, what would be most important to assess for? Chest pain and dyspnea Capillary refill of extremity Leg pain and swollen calf Mottled coloring of leg and foot

Chest pain and dyspnea

A client has been prescribed a Class III Antiarrhythmic (potassium channel blocker). The nurse will educate the client that which specific food item may not be eaten (or drank) while on this medication? Tyramine-containing foods Dairy products Red meat Citrus juice, especially grapefruit

Citrus juice, especially grapefruit

A patient with mitral valve stenosis is admitted to your unit. She is scheduled for surgery to repair her valve. What procedure is usually performed to open the mitral valve? Balloon valvuloplasty Commissurotomy Valve replacement Chordoplasty

Commissurotomy

A client who is postoperative day 1 following a CABG has produced 20 mL of urine in the past 3 hours and the nurse has confirmed the patency of the urinary catheter. What is the nurse's most appropriate action? Document the client's low urine output and monitor closely for the next several hours. Increase the infusion rate of the client's IV fluid to prompt an increase in renal function. Contact the dietitian and suggest the need for increased oral fluid intake. Contact the client's health care provider and continue to assess fluid balance and renal function.

Contact the client's health care provider and continue to assess fluid balance and renal function.

A client presents to the clinic complaining of intermittent chest pain on exertion, which is eventually attributed to angina. The nurse should inform the client that angina is most often attributable to what cause? Decreased cardiac output Coronary arteriosclerosis Decreased cardiac contractility Infarction of the myocardium

Coronary arteriosclerosis

The nurse has completed a head-to-toe assessment of a patient who was admitted for the treatment of heart failure (HF). Which of the following assessment findings should signal to the nurse a possible exacerbation of the patient's condition? Blood glucose testing reveals a glucose level of 158 mg/dL. The patient has put out 600 mL of dilute urine over the past 8 hours. The patient's blood pressure (BP) is 144/99. Crackles are audible on chest auscultation.

Crackles are audible on chest auscultation.

A client with diagnosed aortic stenosis is exhibiting fatigue, shortness of breath on exertion, and systolic murmur. Which of the following would the nurse list as the most concerning nursing diagnosis? Ineffective Breathing Pattern Decreased Cardiac Output Fatigue Activity Intolerance

Decreased cardiac output

A patient is admitted to your unit for an electrophysiology (EP) study. Why is an electrophysiology study performed? Freeze hypersensitive cells. Determine the nursing plan of care. Abliterate the area causing the dysrhythmia. Diagnose the dysrhythmia.

Diagnose the dysrhythmia.

The public health nurse is participating in a health fair, and she interviews a woman with a history of hypertension who is currently smoking one pack of cigarettes per day. She has had no manifestations of coronary artery disease (CAD) but a recent low-density lipoprotein (LDL) level of 154 mg/dL was found. Based on her assessment, the nurse would expect that this patient would be treated in what way? Diet therapy and smoking cessation Diet and drug therapy Drug therapy and smoking cessation Diet therapy only

Diet therapy and smoking cessation

A patient has been diagnosed with prehypertension and has been encouraged to exercise regularly and begin a weight loss program. What other healthcare professional may be helpful for the client to see? Occupational therapist Dietician Social worker Pharmacist

Dietician

Which is a characteristic of arterial insufficiency? Superficial ulcer Diminished or absent pulses Aching, cramping pain Pulses are present but may be difficult to palpate

Diminished or absent pulses

Which aneurysm results in bleeding into the layers of the arterial wall? Dissecting False Anastomotic Saccular

Dissecting

Which diagnostic study is usually performed to confirm the diagnosis of heart failure? Electrocardiogram (ECG) Blood urea nitrogen (BUN) Serum electrolytes Echocardiogram

Echocardiogram

You are admitting a patient to the cardiac care unit with complaints of dyspnea on exertion and fatigue. The patient's ECG shows arrhythmias associated with left ventricular hypertrophy. What diagnostic tool would be the most helpful in diagnosing cardiomyopathy? Echocardiogram. Cardiac catheterisation. Swan-Ganz analysis. Arterial blood gases.

Echocardiogram

A patient with long-standing hypertension is admitted to the hospital with hypertensive urgency. The physician orders a chest x-ray, which reveals an enlarged heart. What diagnostic test does the nurse anticipate preparing the patient for to determine left ventricular enlargement? Stress test Echocardiography Tilt-table test Cardiac catheterization

Echocardiography

When caring for a patient with leg ulcers, the positioning of the legs depends on whether the patient's ulcer is arterial or venous in origin. How should the nurse position a patient who has leg ulcers that are venous in origin? Hang the patient's legs over the side of the bed Keep the patient's legs flat without the knees raised. Keep the patient's knees at a 45-degree angle. Elevate the patient's lower extremities.

Elevate the patient's lower extremeties

A client comes to the emergency department reporting chest pain. An electrocardiogram (ECG) reveals myocardial ischemia and an anterior-wall myocardial infarction (MI). Which ECG characteristic does the nurse expect to see? Elevated ST segment Absent Q wave Prolonged PR interval Widened QRS complex

Elevated ST segment

A client reporting heart palpitations is diagnosed with atrial fibrillation caused by mitral valve prolapse. To relieve the symptoms, the nurse should teach the client which dietary intervention? Eliminate dairy products and carbonated beverages Eliminate caffeine and alcohol Decrease the amount of sodium and saturated fat Decrease the amount of acidic beverages and fruits

Eliminate caffeine and alcohol

A client has developed a clot in the femoral artery. The nurse prepares the client for what type of surgery? Commissurotomy Annuloplasty Embolectomy Endarterectomy

Embolectomy

The nurse and the other members of the team are caring for a client who converted to ventricular fibrillation (VF). The client was defibrillated unsuccessfully and the client remains in VF. The nurse should anticipate the administration of what medication? Sodium bicarbonate 1 amp IV push Lidocaine 100 mg IV push Epinephrine 1 mg IV push Amiodarone 300 mg IV push

Epinephrine 1 mg IV push

A client has a significant history of congestive heart failure. What should the nurse specifically assess during the client's semiannual cardiology examination? Select all that apply. Examine the client's joints for crepitus. Monitor the client for signs of lethargy or confusion. Examine the client's eyes for excess tears. Examine the client's neck for distended veins.

Examine the client's neck for distended veins. Monitor the client for signs of lethargy or confusion.

You are caring for an adult patient with heart failure who is prescribed digoxin. What adverse side effects should the nurse explain to the patient that he or she should watch for? Fatigue and nausea. Weight loss. Decreased pulmonary crackles. Increased urine output.

Fatigue and nausea

The nurse is caring for a client who has premature ventricular contractions. What sign or symptom is observed in this client? Fluttering Fever Nausea Hypotension

Fluttering

Which symptom is most important in determining the diagnosis and nursing care for a client experiencing pulmonary hypertension? High systolic pressure Bradycardia Frothy sputum Increased stroke volume

Frothy sputum

The nurse is teaching a client who is experiencing dizziness to rise slowly from a sitting or lying position. What is the rationale for the teaching? Gradual changes in position help reduce the heart's work to resupply oxygen to the brain. Gradual changes in position provide time for the heart to reduce its rate of contraction to resupply oxygen to the brain. Gradual changes in position help reduce the blood pressure to resupply oxygen to the brain. Gradual changes in position provide time for the heart to increase rate of contraction to resupply oxygen to the brain.

Gradual changes in position provide time for the heart to increase rate of contraction to resupply oxygen to the brain.

A brain (B-type) natriuretic peptide (BNP) sample has been drawn from an older adult client who has been experiencing vital fatigue and shortness of breath. This test will allow the care team to investigate the possibility of what diagnosis? Valve dysfunction Cardiomyopathy Pleurisy Heart failure

Heart failure

A nurse is caring for a client experiencing dyspnea, dependent edema, hepatomegaly, crackles, and jugular vein distention. What condition should the nurse suspect? Cardiac tamponade Heart failure Pulmonary embolism Tension pneumothorax

Heart failure

The nurse is performing an assessment on a patient to determine the effects of hypertension on the heart and blood vessels. What specific assessment data will assist in determining this complication? (Select all that apply.) Heart rhythm Heart rate Character of apical and peripheral pulses Lung sounds Respiratory rate

Heart rate Heart rhythm Character of apical and peripheral pulses

The nurse is preparing to administer hydralazine and isosorbide dinitrate. When obtaining vital signs, the nurse notes that the blood pressure is 90/60. What is the priority action by the nurse? Administer the hydralazine and hold the dinitrate. Administer a saline bolus of 250 mL and then administer the medication. Administer the medication and check the blood pressure in 30 minutes. Hold the medication and call the health care provider.

Hold the medication and call the health care provider.

Which New York Heart Association classification of heart failure (HF) has a poor prognosis and includes symptoms of cardiac insufficiency at rest? IV II I III

IV

The nursing instructor is discussing cardiomyopathies with the junior nursing class. The instructor asks the students to work through a plan of care for a patient with a cardiomyopathy. What priority outcomes does the instructor tell the students should be included in the care plan for these patients? Improved cardiac output. Adherence to the self-care programme. Increased activity tolerance. Absence of complications.

Improved cardiac output

The nurse is assessing a client who was admitted to the critical care unit 3 hours ago following cardiac surgery. The nurse's most recent assessment reveals that the client's left pedal pulses are not palpable and that the right pedal pulses are rated at +2. What is the nurse's best action? Inform the client's health care provider of this assessment finding. Reposition the client with his left leg in a dependent position. Document this expected assessment finding during the initial postoperative period. Administer an ordered dose of subcutaneous heparin.

Inform the client's health care provider of this assessment finding.

n preparation for transesophageal echocardiography (TEE), the nurse must: Instruct the patient to drink 1 L of water before the test Inform the patient that blood pressure (BP) and electrocardiogram (ECG) monitoring will occur throughout the test Heavily sedate the patient Inform the patient that an access line will be initiated in the femoral artery

Inform the patient that blood pressure (BP) and electrocardiogram (ECG) monitoring will occur throughout the test

The nurse is taking a health history of a new client who reports pain in his left lower leg and foot when walking. This pain is relieved with rest and the nurse observes that the left lower leg is slightly edematous and is hairless. When planning this client's care, the nurse should most likely address what health problem? Coronary artery disease (CAD) Intermittent claudication Arterial embolus Raynaud disease

Intermittent claudication

Which of the following is the hallmark symptom for peripheral arterial disease (PAD) in the lower extremity? Acute limb ischemia Vertigo Intermittent claudication Dizziness

Intermittent claudication

Which term refers to a muscular, cramp-like pain in the extremities consistently reproduced with the same degree of exercise and relieved by rest? Intermittent claudication Bruit Aneurysm Ischemia

Intermittent claudication

The nurse is preparing to administer warfarin to a client with deep vein thrombophlebitis (DVT). Which laboratory value would most clearly indicate that the client's warfarin is at therapeutic levels? International normalized ratio (INR) between 2 and 3 Hematocrit of 32% Prothrombin time (PT) 8 to 10 times the control Partial thromboplastin time (PTT) within normal reference range

International normalized ratio (INR) between 2 and 3

A client is 15 years status-post cardiac transplant. After the surgery, which change occurs to the transplanted heart as a result of the procedure? It beats faster than the natural heart. There are no significant changes noted in the transplanted heart. It takes less time to increase its rate in response to exercise. It beats slower than the natural heart.

It beats faster than the natural heart.

The nurse is assessing a client new to the clinic. Records brought to the clinic show that the client's hypertension has not improved. What contributing factor should the nurse first explore in an effort to identify the cause of the client's inadequate BP control? Possibility of medication interactions Lack of adherence to prescribed drug therapy Progressive target organ damage Possible heavy alcohol use or use of recreational drugs

Lack of adherence to prescribed drug therapy

Within the physiology of the heart, each chamber has a particular role in maintaining cellular oxygenation. Which chamber of the heart is responsible for pumping blood to all the cells and tissues of the body? Right atrium Right ventricle Left atrium Left ventricle

Left ventricle

The nurse is caring for a client with a valvular disorder. What nutritional intervention would be appropriate for a client with a valvular disorder? Limit sodium intake. Limit caloric intake to maintain optimal weight. Eat six small meals a day. Increase intake of B and C vitamins.

Limit sodium intake

The nurse is caring for a client who is scheduled to undergo mechanical valve replacement. Client education should include which of the following? Steroid therapy Use of IV diuretics Long-term anticoagulant therapy Use of patient-controlled analgesia

Long-term anticoagulant therapy

You are caring for a patient who is scheduled to undergo a valvuloplasty to repair a defective heart valve. You would include in your patient education which priority area? Patient controlled analgesia Exercise program Long-term steroid therapy Long-term anticoagulant therapy

Long-term anticoagulant therapy

The nurse is providing care for a client with high cholesterol and triglyceride values. In teaching the client about therapeutic lifestyle changes such as diet and exercise, the nurse realizes that the desired goal for cholesterol levels is which of the following? High HDL values and high triglyceride values Elevated blood lipids, fasting glucose less than 100 Low LDL values and high HDL values Absence of detectable total cholesterol levels

Low LDL values and high HDL values

The nurse is caring for an acutely ill client who is on anticoagulant therapy. The client has a comorbidity of renal insufficiency. How will this client's renal status affect heparin therapy? Heparin is contraindicated in the treatment of this client. Lower doses of heparin are required for this client. Warfarin will be substituted for heparin. Heparin may be given subcutaneously, but not IV.

Lower doses of heparin are required for this client

Which nursing intervention should a nurse perform to reduce cardiac workload in a client diagnosed with myocarditis? Elevate the client's head Administer supplemental oxygen Administer a prescribed antipyretic Maintain the client on bed rest

Maintain the client on bed rest

The nurse is caring for an older adult client who is deciding whether to have cardiovascular surgery. The client asks the nurse why the risks are greater for them than for a younger person. What would be the nurse's answer? Many older adults have other things wrong with them besides their cardiac problems. Older adults have different thought processes than younger adults do. Older adults have the same risk factors as younger adults. Older adults have hypersensitive renal systems, and younger adults don't.

Many older adults have other things wrong with them besides their cardiac problems.

Diagnostic testing reveals a backflow of blood in the client's left ventricle from the left atrium. The nurse is aware that the patient is suffering from a defect in which valve? Bicuspid Aortic Pulmonic Mitral

Mitral

Mary Seaver is admitted to the pediatrics unit where you practice nursing. She was admitted by her pediatrician due to suspected rheumatic fever. Aggressive antibiotic therapy and comfort measures have been instituted to minimize the long-lasting effects of the systemic inflammation. If Mary were to develop rheumatic carditis, which cardiac valve most likely would be affected? Mitral valve Pulmonic valve Aortic valve Tricuspid valve

Mitral valve

A client is undergoing preoperative teaching before his cardiac surgery and the nurse is aware that a temporary pacemaker will be placed later that day. What is the nurse's responsibility in the care of the client's pacemaker? Making necessary changes to the pacemaker settings Monitoring for pacemaker malfunction or battery failure Determining when it is appropriate to remove the pacemaker Selecting alternatives to future pacemaker use

Monitoring for pacemaker malfunction or battery failure

The nurse is caring for a client who has been admitted to the hospital with chest pains. The client is very worried that the end result will be a coronary artery bypass surgery. The nurse is aware that there are fewer coronary artery bypass grafts surgery currently because of what reason? More individuals are being treated with drug-eluding stents that release a drug to prevent reocclusion of the coronary artery. Medicare will no longer allow the surgery for clients over the age of 70. More effective medications are available that do the same job as the surgery. Private insurance requires the client to be on medication for 6 months before allowing the surgery.

More individuals are being treated with drug-eluding stents that release a drug to prevent reocclusion of the coronary artery.

The nurse is obtaining vital signs for a client in the clinic who has had a cardiac transplant. The nurse obtains an apical heart rate of 110 beats/minute. What is a priority action by the nurse? No action is required because the transplanted heart beats faster than the natural heart. Administer a calcium channel blocker to decrease the heart rate. Obtain an electrocardiogram. Notify the physician.

No action is required because the transplanted heart beats faster than the natural heart.

The nurse is providing an educational event to a local community group. The nurse is talking about coronary artery disease (CAD) and its risk factors. The nurse explains to the community group that CAD has many risk factors, some that can be controlled and some that can't. What risk factors would the nurse list that can be controlled or modified? Stress, family history, and obesity. Obesity, inactivity, diet, and smoking. Gender, obesity, family history, and smoking. Inactivity, stress, gender, and smoking.

Obesity, inactivity, diet, and smoking

Which describes difficulty breathing when a client is lying flat? Orthopnea Bradypnea Paroxysmal nocturnal dyspnea (PND) Tachypnea

Orthopnea

To evaluate a client's atrial depolarization, the nurse observes which part of the electrocardiogram waveform? P wave PR interval QRS complex T wave

P wave

A client is quite concerned about upcoming coronary bypass surgery and requests that the cardiologist explain the techniques in simpler terms. Which technique replaces the long sternal incision with several, small axillary incisions; shortens procedure time to approximately 2 hours; and offers a faster full recovery time? MIDCAB OPCAB CABG PACAB

PACAB

A nurse working in a long-term care facility notes that a new patient, 85 years old, has gangrene of the toes. The nurse knows that gangrene in the elderly is often the first sign of what? AAI ABI PAD CWD

PAD

A critically ill client is admitted to the ICU. The health care provider decides to use intra-arterial pressure monitoring. After this intervention is performed, what assessment should the nurse prioritize? Signs and symptoms of esophageal varices Fluctuations in core body temperature Perfusion distal to the insertion site Signs and symptoms of compartment syndrome

Perfusion distal to the insertion site

A nurse is caring for a client following an arterial vascular bypass graft in the leg. What should the nurse plan to assess over the next 24 hours? Blood pressure every 2 hours Ankle-arm indices every 12 hours Peripheral pulses every 15 minutes after surgery Color of the leg every 4 hours

Peripheral pulses every 15 minutes after surgery

The nurse is educating a patient at risk for atherosclerosis. What nonmodifiable risk factor does the nurse identify for the patient? Positive family history Hyperlipidemia Stress Obesity

Positive family history

A client is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the client is taking these two medications together? Calcium level Potassium level Magnesium level Sodium level

Potassium level

A healthy adult client is seeing a health care provider for an annual physical examination. While the nurse is taking the client's vital signs, the client states, "Occasionally, my heart skips a beat." The nurse believes that the client is experiencing what condition? Premature atrial complex Ventricular fibrillation Sinus tachycardia Atrial flutter

Premature atrial complex

A patient is being seen in the cardiology clinic for hypertension. He states that he is a 2 pack-a-day smoker. It is appropriate for the nurse to recommend smoking cessation for patients with hypertension because nicotine: Decreases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood. Decreases circulating blood volume. Increases the heart rate, constricts arterioles, and increases the heart's ability to eject blood. Raises the heart rate, constricts arterioles, and reduces the heart's ability to eject blood.

Raises the heart rate, constricts arterioles, and reduces the heart's ability to eject blood.

A client is brought to the emergency department with reports of a bad headache and an increase in blood pressure. The blood pressure reading obtained by the nurse is 260/180 mm Hg. What is the therapeutic goal for reduction of the mean blood pressure? Reduce the blood pressure by 20% to 25% within the first hour of treatment. Rapidly reduce the blood pressure so the client will not suffer a stroke. Reduce the blood pressure to about 140/80 mm Hg. Reduce the blood pressure by 50% within the first hour of treatment.

Reduce the blood pressure by 20% to 25% within the first hour of treatment.

Which historical fact is of greatest value to a nurse who is interviewing a client being admitted for possible mitral regurgitation? One-pack-a-day smoker for 20 years Pacemaker inserted 2 years ago Rheumatic fever Congenital neural tube defect

Rheumatic fever

Why does a client with left-sided heart failure require careful monitoring? The client is more likely to develop migraines. Accelerated weight loss is probable. Depression is likely. Right-sided heart failure is a risk.

Right-sided heart failure is a risk.

The nurse's assessment of an older adult client reveals the following data: Lying BP 144/82 mm Hg; sitting BP 121/69 mm Hg; standing BP 98/56 mm Hg. The nurse should consequently identify what nursing diagnosis in the client's plan of care? Risk for imbalanced fluid balance related to hemodynamic variability Risk for ineffective breathing pattern related to hypotension Risk for falls related to orthostatic hypotension Risk for ineffective role performance related to hypotension

Risk for falls related to orthostatic hypotension

The nurse is providing discharge teaching for a client with rheumatic endocarditis but no valvular dysfunction. On which nursing diagnosis should the nurse focus her teaching? Chronic pain Impaired gas exchange Impaired memory Risk for infection

Risk for infection

The nurse is assessing heart sounds in a patient with heart failure. An abnormal heart sound is detected early in diastole. How would the nurse document this? S3 S4 S2 S1

S3

The critical care nurse is caring for a client who has been experiencing bradycardia after cardiovascular surgery. The nurse knows that the heart rate is determined by myocardial cells with the fastest inherent firing rate. Under normal circumstances where are these cells located? Purkinje cells Bundle of His AV node SA node

SA node

Electrical conduction of the heart usually originates in the SA node. Which sequence completes the conduction? SA node to AV node to bundle of HIS to Purkinje fibres. SA node to Bundle of HIS to AV node to Purkinje fibres. SA node to bundle of HIS to Purkinje fibres to AV node. SA node to AV node to Purkinje fibres to Bundle of HIS.

SA node to AV node to bundle of HIS to Purkinje fibres.

You are writing a teaching plan for a patient diagnosed with heart failure. What would be an important aspect to include in the teaching plan? Self-care Nutrition Foot care Dressing changes

Self-care

The nurse is assisting with the monitoring of a client with a dysrhythmia that shows the pattern in the accompanying image. What dysrhythmia does the client have? Sinus bradycardia Atrial fibrillation Sinus tachycardia Ventricular tachycardia

Sinus bradycardia

A client has a myocardial infarction in the left ventricle and develops crackles bilaterally; 3-pillow orthopnea; an S3 heart sound; and a cough with pink, frothy sputum. The nurse obtains a pulse oximetry reading of 88%. What do these signs and symptoms indicate for this client? The development of cor pulmonale The development of left-sided heart failure The development of chronic obstructive pulmonary disease (COPD) The development of right-sided heart failure

The development of left-sided heart failure

Graduated compression stockings have been prescribed to treat a client's venous insufficiency. What education should the nurse prioritize when introducing this intervention to the client? The need to wear the stockings on a "one day on, one day off" schedule The importance of wearing the stockings around the clock to ensure maximum benefit The need to take anticoagulants concurrent with using compression stockings The importance of ensuring the stockings are applied evenly with no pressure points

The importance of ensuring the stockings are applied evenly with no pressure points

A nurse is caring for a client with pericarditis and auscultates a pericardial friction rub. What action does the nurse ask the client to do to distinguish a pericardial friction rub from a pleural friction rub? The nurse asks the client to hold the breath during auscultation. The nurse places the client flat for at least 4 minutes. There is really no question to ask the client to tell the difference. The nurse has the client stand during auscultation.

The nurse asks the client to hold the breath during auscultation.

The nurse is caring for a patient with acute pericarditis. What nursing management would be instituted to minimize complications? The nurse helps the patient with activity restrictions until the pain and fever subside. The nurse encourages coughing and deep breathing. The nurse encourages increased fluid intake until dehydration is resolved. The nurse keeps the patient isolated to prevent nosocomial infections.

The nurse helps the patient with activity restrictions until the pain and fever subside.

The licensed practical nurse is co-assigned with a registered nurse in the care of a client admitted to the cardiac unit with chest pain. The licensed practical nurse is assessing the accuracy of the cardiac monitor, which notes a heart rate of 34 beats/minute. The client appears anxious and states not feeling well. The licensed practical nurse confirms the monitor reading. When consulting with the registered nurse, which of the following is anticipated? The registered nurse stating to administer all medications except those which are cardiotonics The registered nurse stating to hold all medication until the pulse rate returns to 60 beats/minute The registered nurse administering atropine sulfate intravenously The registered nurse stating to administer digoxin

The registered nurse administering atropine sulfate intravenously

The nurse is conducting a morning assessment of an 80-year-old female patient who has a longstanding diagnosis of heart failure (HF). The nurse notes an elevation in jugular venous pressure (JVP) greater than 4 cm above the woman's sternal angle, a finding that did not exist the day before. What conclusion should the nurse draw from this assessment finding? The woman has left-sided heart failure. The woman is demonstrating the early signs of cardiogenic shock. The woman may be experiencing an exacerbation of right-sided HF. The woman is also likely to experience shortness of breath.

The woman may be experiencing an exacerbation of right-sided HF.

A client with angina has been prescribed nitroglycerin. Before administering the drug, the nurse should inform the client about what potential adverse effects? Throbbing headache or dizziness Nervousness or paresthesia Drowsiness or blurred vision Tinnitus or diplopia

Throbbing headache or dizziness

A client in a clinic setting has just been diagnosed with hypertension. When the client asks what the end goal is for treatment, what is the nurse's best response? To stop smoking and increase physical activity to 30 minutes/day most days of the week To lose weight, achieve a body mass index of 24 or less, and to eat a diet rich in fruits and vegetables To prevent complications/death by achieving and maintaining a blood pressure of 145/95 or less To prevent complications/death by achieving and maintaining a blood pressure of 140/90 or less

To prevent complications/death by achieving and maintaining a blood pressure of 140/90 or less

Nursing students are taking a test about cardiovascular surgery. Which of the following would students correctly identify as reasons that clients have cardiovascular surgery? Select all that apply. To remove heart tumors To manage heart trauma To control cholesterol level To replace blood cells To replace the heart with one from a human donor To revascularize the myocardium To repair or replace cardiac valves

To repair or replace cardiac valves To remove heart tumors To manage heart trauma To replace the heart with one from a human donor To revascularize the myocardium

What is the best technique to identify structural changes in the mitral valve? Cardiac catheterization Chest radiography Transthoracic echocardiogram Cardiac stress test

Transthoracic echocardiogram

A patient has come to the clinic for a follow-up assessment. Before taking the blood pressure, the nurse should determine if the patient has what? Tried to rest quietly for 5 minutes before the reading is taken. Avoided drinking coffee for 12 hours before the visit. Been NPO for at least 8 hours. Refrained from smoking for at least 8 hours.

Tried to rest quietly for 5 minutes before the reading is taken.

A client has had cardiothoracic surgery, and the nurse is palpating the peripheral pulses. The nurse cannot palpate the left lower extremity pulse. What is the first action by the nurse? Apply a vasodilator such as nitroglycerin cream on the skin surface and then palpate. Call the charge nurse. Call the physician. Use a Doppler ultrasound device.

Use a Doppler ultrasound device.

An older adult is newly diagnosed with primary hypertension and has just been started on a beta-blocker. What should the nurse include in health education? Maintaining a diet high in dairy to increase protein necessary to prevent organ damage Limiting exercise to avoid injury that can be caused by increased intracranial pressure Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the beta-blocker Use of strategies to prevent falls stemming from postural hypotension

Use of strategies to prevent falls stemming from postural hypotension

Which statements are true when the nurse is measuring blood pressure (BP)? Select all that apply. Using a BP cuff that is too large will give a higher BP measurement. The client's BP should be measured 1 hour before consuming alcohol. The client's arm should be positioned at the level of the heart. The client should sit quietly while BP is being measured. Using a BP cuff that is too small will give a higher BP measurement.

Using a BP cuff that is too small will give a higher BP measurement. The client's arm should be positioned at the level of the heart. The client should sit quietly while BP is being measured.

A client taking an ACE inhibitor has developed a dry, hacking cough. Because of this side effect, the client no longer wants to take that medication. What medication that has similar hemodynamic effects does the nurse anticipate the health care provider ordering? Furosemide Valsartan Metoprolol Isosorbide dinitrate

Valsartan

A patient with hypertension has a newly diagnosed atrial fibrillation. What medication does the nurse anticipate administering to prevent the complication of atrial thrombi? Amiodarone Warfarin Adenosine Atropine

Warfarin

The nurse is caring for a client who is known to have a high risk for venous thromboembolism. What preventive actions should the nurse recommend? Select all that apply. High-protein diet Weight loss Smoking cessation Regular exercise Calcium and vitamin D supplementation

Weight loss Regular exercise Smoking cessation

The nurse is caring for a client who is displaying a third-degree AV block on the EKG monitor. What is the priority nursing intervention for the client? identifying a code-level status assessing blood pressure and heart rate frequently alerting the healthcare provider of the third-degree heart block maintaining intravenous fluids

alerting the healthcare provider of the third-degree heart block

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? aspirin or clopidogrel. aspirin or acetaminophen. penicillin V or erythromycin. pentoxifylline or acetaminophen.

aspirin or clopidogrel.

The nurse is admitting a client with frothy pink sputum. What does the nurse suspect is the primary underlying disorder of pulmonary edema? increased left atrial contractility increased right atrial resistance decreased right ventricular elasticity decreased left ventricular pumping

decreased left ventricular pumping

Nurses should implement measures to relieve emotional stress for clients with hypertension because the reduction of stress decreases the production of neurotransmitters that constrict peripheral arterioles. increases the resistance that the heart must overcome to eject blood. increases the production of neurotransmitters that constrict peripheral arterioles. increases blood volume and improves the potential for greater cardiac output.

decreases the production of neurotransmitters that constrict peripheral arterioles.

For both outpatients and inpatients scheduled for diagnostic procedures of the cardiovascular system, the nurse performs a thorough initial assessment to establish accurate baseline data. Which data is necessary to collect if the client is experiencing chest pain? blood pressure in the left arm sound of the apical pulses description of the pain pulse rate in upper extremities

description of the pain

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? electroencephalogram electrocautery echocardiogram electrocardiogram

electrocardiogram

Which population is at greatest risk of developing CAD? female smokers male nonsmokers premenopausal females males with high meat consumption

female smokers

The nurse auscultates the apex beat at which anatomical location? fifth intercostal space, midclavicular line 5 cm to the left of the lower end of the sternum midsternum 2.5 cm to the left of the xiphoid process

fifth intercostal space, midclavicular line

A nurse is instructing a client about using antiembolism stockings. Antiembolism stockings help prevent deep vein thrombosis (DVT) by: encouraging ambulation to prevent pooling of blood. elevating the extremity to prevent pooling of blood. providing warmth to the extremity. forcing blood into the deep venous system.

forcing blood into the deep venous system.

A client experiences a faster-than-normal heart rate when drinking more than two cups of coffee in the morning. What does the nurse identify on the electrocardiogram as an indicator of sinus tachycardia? PR interval of 0.1 seconds heart rate of 118 bpm QRS duration of 0.16 seconds Q wave of 0.04 seconds

heart rate of 118 bpm

The critical care nurse is caring for a client with a central venous pressure (CVP) monitoring system. The nurse notes that the client's CVP is increasing. This may indicate: psychosocial stress. dislodgment of the catheter. hypomagnesemia. hypervolemia.

hypervolemia

While receiving treatment in hospital for a DVT, a client has several interventions ordered. Complete rest, anticoagulant therapy, and procedures to determine the location and size of the thrombus are all utilized to decrease the danger from the blood clot. Continuous warm, wet packs are ordered to: reduce incidence of clots. increase inflammation. increase warmth. improve circulation.

improve circulation

The nurse cares for a client prescribed warfarin orally. The nurse reviews the client's prothrombin time (PT) level to evaluate the effectiveness of the medication. Which laboratory values should the nurse also evaluate? Sodium international normalized ratio (INR) partial thromboplastic time (PTT) complete blood count (CBC)

international normalized ration (INR)

Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for receiving oxygenated blood from the lungs? left atrium right ventricle left ventricle right atrium

left atrium

In a client's presurgical education, the nurse reinforces the purpose for cardiovascular surgery. What is not a function of cardiovascular surgery? valve repair aneurysm repair myocardium revascularization lung repair

lung repair

If a client were to develop rheumatic carditis, which cardiac structure would most likely be affected? mitral valve septum coronary arteries inferior vena cava

mitral valve

The nurse is admitting a client with an elevated creatine kinase-MB isoenzyme (CK-MB). What is the cause for the elevated isoenzyme? myocardial necrosis I.M. injection cerebral bleeding skeletal muscle damage due to a recent fall

myocardial necrosis

The nurse completes an assessment of a client admitted with a diagnosis of right-sided heart failure. What will be a significant clinical finding related to right-sided heart failure? decreased O2 saturation levels oliguria pitting edema S4 ventricular gallop sign

pitting edema

A nurse hears bilateral crackles in a client's lungs. What could be a cause of crackles in the bases of the client's lungs? heart palpitations pulmonary hypertension mitral valve stenosis pulmonary congestion

pulmonary congestion

What does decreased pulse pressure reflect? elevated stroke volume reduced stroke volume tachycardia reduced distensibility of the arteries

reduced stroke volume

A group of nurses is participating in orientation to a telemetry unit. The nurse who is providing the education should tell the class that ST segments: are the part of an ECG that reflects the time from ventricular depolarization through repolarization. are the part of an ECG used to calculate ventricular rate and rhythm. are the part of an ECG that reflects systole. represent early ventricular repolarization.

represent early ventricular repolarization.

Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for receiving deoxygenated blood from the venous system? left ventricle right ventricle right atrium left atrium

right atrium

A client is readying for coronary artery bypass surgery. Which blood vessel is most likely to be used for this client's graft? internal mammary artery cephalic vein saphenous vein radial artery

saphenous vein

A client with a family history of coronary artery disease reports experiencing chest pain and palpitations during and after morning jogs. What would reduce the client's cardiac risk? smoking cessation exercise avoidance a protein-rich diet antioxidant supplements

smoking cessation

The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client? right-sided heart failure stroke pulmonary insufficiency peripheral edema

stroke