Critical Care: Cardiac Practice Questions
The nurse is planning to administer hydrocholothiazide to a client. the nurse should monitor for which adverse reaction? A. Hypouricemia, Hyperkalemia B. Increased risk of osteoporosis C. Hypokalemia, hyperglycemia, sulfa allergy D. HyperKalemia, hypoglycemia, penicillin allergy
C
The nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. No P waves, QRS complexes are wide; ventricular rate is 140 beats/minute. The nurse interprets that the client is experiencing which rhythm? A. Sinus tachycardia B. Ventricular fibrillation C. Ventricular tachycardia D. Premature ventricular contractions (PVCs)
C
The nurse notes that a client with sinus rhythm has a premature ventricle contraction that falls on the Twave of the preceding beat. The clients rhythm suddenly changes to one with no p waves, no definable QRS complexes and coarse wavy lines of varying amplitude. How should the nurse correctly interpret this rhythm? A. Asystole B. A fib C. Ventricular fib D. Ventricular tachycardia
C
What is the most common complication of a myocardial infarction? A. Cardiogenic shock B. Heart failure C. Arrhythmias D. Pericarditis
C
What position should the nurse place the head of the bed in to obtain the most accurate reading of jugular vein distention? A. High-Fowler's B. Raised 10 degrees C. Raised 30 degrees D. Supine position
C
What supplemental medication is most frequently ordered in conjunction with furosemide (Lasix)? A. Chloride B. Digoxin C. Potassium D. Sodium
C
Which coronary artery provides blood to the left atrium and left ventricle: A. Right marginal artery B. Posterior descending artery C. Left circumflex artery D. Right coronary artery
C
Which hereditary disease is most closely linked to aneurysm? A. Cystic fibrosis B. Lupus erythematosus C. Marfan's syndrome D. Myocardial infarction
C
Which of the following arteries primarily feeds the anterior wall of the heart? A. Circumflex artery B. Internal mammary artery C. Left anterior descending artery D. Right coronary artery
C
Which of the following conditions is most commonly responsible for myocardial infarction? A. Aneurysm B. Heart failure C. Coronary artery thrombosis D. Renal failure
C
Which of the following risk factors for coronary artery disease cannot be corrected? A. Cigarette smoking B. DM C. Heredity D. HPN
C
a nurse performing a physical assessment for a client with right-sided HF notes a slight indentation lasting 15 seconds. this is categorized as what measurement of edema? A. 1+ B. 3+ C. 2+ D. 4+
C
Which of the following symptoms might a client with right-sided heart failure exhibit? A. Adequate urine output B. Polyuria C. Oliguria D. Polydipsia
C Inadequate deactivation of aldosterone by the liver after right-sided heart failure leads to fluid retention, which causes oliguria
A client is diagnosed with an ST-segment elevation MI (STEMI) and is receiving a tissue plasminogen activator, altepase. Which is action is a priority nursing intervention? A. Monitor for kidney failure B. Monitor for psychosocial status C. monitor for signs of bleeding D. have heparin sodium available
C. =thrombolytic
The nurse is concerned about a deteriorating client. Which signs of cardiogenic shock does the nurse expect? Select all that apply a. cool and moist skin b. hr 126bpm c bounding pedal pulse d. urine output 20ml/hr e. bp 88/46
a, b, d, e
The nurse reviews a clients ECG and notes P waves. With regard to the cardiac cycle, what does the P wave indicate? A. atrial depolarization B. ventricular repolarization C. ventricular depolarization D. Atrial repolarization
A
Toxicity from which of the following medications may cause a client to see a green halo around lights? A. Digoxin B. Furosemide C. Metoprolol D. Enalapril
A
Which of the following conditions most commonly results in CAD? A. Atherosclerosis B. DM C. MI D. Renal failure
A
Which of the following parameters should be checked before administering digoxin? A. Apical pulse B. Blood pressure C. Radial pulse D. Respiratory rate
A
Which of the following symptoms is most commonly associated with left-sided heart failure? A. Crackles B. Arrhythmias C. Hepatic engorgement D. Hypotension
A
You're providing education to a patient who will be undergoing a heart catheterization. Which statement by the patient requires you to re-educate the patient about this procedure? A. "The brachial artery is most commonly used for this procedure." B. "A dye is injected into the coronary arteries to assess for blockages." C. "Not all patients who have a heart catheterization will need a stent placement." D. "I will not be completely asleep and will be able to breathe on my own during the procedure."
A
Keeping the patient in question 4 in mind: What type of diagnostic tests will the physician most likely order (at first) for this patient to evaluate the cause of the patient's symptoms? Select-all-that-apply: A. EKG B. Stress test C. Heart catheterization D. Balloon angioplasty
A, B,
Stimulation of the sympathetic nervous system produces which of the following responses? A. Bradycardia B. Tachycardia C. Hypotension D. Decreased myocardial contractility
B
A hospitalized client with a diagnosis of abdominal aortic aneurysm suddenly complains of severe back pain and shortness of breath. What should the nurse do?
*The nurse should suspect a rupture and should immediately contact the health care provider. The nurse should also stay with the patient, monitor vital signs, and neuro status.
The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles and the nurse suspects pulmonary edema. The nurse immediately asks another nurse to contact the health care provider and prepares to implement which priority interventions: Select all that apply. 1. administer O2 2. insert foley 3. administer furosemide 4. administer morphine IV 5. Transport client to coronary care unit (CCU) Place the client in a low fowlers side lying position
1, 2, 3, 4
The client is taking spironolactone daily is prescribed digoxin for the treatment of HF. Which response by the client indicates an understanding of the medication regimen? Select all that apply 1. Spironolactone may affect my digoxin blood level 2. I should seek medical care if I experience palpitations 3. I should report seeing halos or rings of light 4. Digoxin toxicity is a rare issue 5.My radial pulse rate should decrease
1, 2, 3, 5
A nurse is caring for a client who had a resection of AAA yesterday. The client has an IV infusion rate of 150ml/hr, unchanged for the last 10hrs. The clients' urine output for the last 3 hours has been 90, 50, 28 ml. The clients BUN: 35mg/dL and the serum creatinine level: 1.8 mg/dL. Which nursing action is the priority? 1. Check urine specific gravity 2. call health care provider 3. put iv line on a pump so infusion rate is to stay stable 4. check to see if the client had a blood sample for a serum albumin level drawn
2
A client is admitted to the cardiac unit for MI. How does the nurse prioritize actions? 1. Insert an IV catheter 2. Begin Cardiac monitoring 3. provide a drink of water 4. initiate thrombolytic therapy
2, 1,4, 3
The nurse is monitoring a client who is taking digoxin for adverse effects. Which findings are characteristics of digoxin toxicity? 1. Tremors 2. Diarrhea 3. Irritability 4. Blurred Vision 5. Nausea and Vomiting
2, 4, 5
A client who is receiving digoxin daily has a serum potassium level of 3mEq/L and is complaining of anorexia. The provider prescribes a serum digoxin level to be done. The nurse checks the results and should expect to not which level is outside of therapeutic range? A. 0.3 ng/ml B. 0.5 ng/ml C. 0.8 ng/ml D. 1.0 ng/ml
4
A client has a cardiac catheterization using the femoral insertion site and returns to the nursing unit. What action does the nurse avoid during the immediate recovery period? A. Elevating HOB B.Resuming routine pre-procedure medications C.Assessing the motor function of the client's foot D. Providing fluids by mouth
A
A client has developed atrial fibrillation, which a ventricular rate of 150 beats per minute. A nurse assesses the client for which associated signs/symptoms: a. Hypotension and dizziness b. Nausea and vomiting c. Hypertension and headache d. Flat neck veins
A
A client has frequent bursts of ventricular tachycardia on the cardiac monitor. What should the nurse be most concerned about with this dysrhythmia? A. It can develop into ventricular fibrillation at any time B. It is almost impossible to convert to a normal rhythm C. It is uncomfortable for the client, giving a sense of impending doom D. It produces a high cardiac output that quickly leads to cerebral and myocardial ischemia
A
After an anterior wall myocardial infarction, which of the following problems is indicated by auscultation of crackles in the lungs? A. Left-sided heart failure B. Pulmonic valve malfunction C. Right-sided heart failure D. Tricuspid valve malfunction
A
The nurse cares for a client with atrial fibrillation and a rate of 123bpm. How does the heart rate affect cardiac output for this client? A. Ventricular filling time is decreased B. Stroke Volume Increases C. Oxygen Demand decreases D. Ventricular filling time increases
A
The nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. No P waves; instead, the monitor screen shows there are fibrillatory waves before each QRS complex. The nurse interprets that the client is experiencing which rhythm? A. A Fib B. Sinus Tachycardia C.Ventricular fib D. Ventricular tachycardia
A
A nurse plans care for a client with acute decompensated HF. Which interventions assist the nurse to improve the client's cardiac output? Select all that apply A. Place patient in upright position. B. monitor body temp C. Assess fluid intake and output D. Monitor for dyspnea at rest E. Provide a restful environment
A, B, C, D, E
The nurse cares for a client diagnosed with an acute MI. the nurse attributes what ECG changes to the pathology of MI? A. T wave inversion B. Abnormal Q wave C. Irregular PR interval D. ST elevation E. U wave
A, B, D
A patient is receiving treatment for stable coronary artery disease. The doctor prescribes the patient Plavix. What important information will you include in the patient's teaching? Select-all-that-apply: A. If you are scheduled for any planned surgical procedures, let your doctor know you are taking Plavix because this medication will need to be discontinued 5-7 days prior to the procedure. B. A normal side effect of this medication is a dry cough. C. Avoid green leafy vegetables while taking Plavix. D. Notify the doctor, immediately, if you develop bruising, problems urinating, or fever.
A, D
A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is scheduled for cardiac catheterization. Which med would need to be withheld 24hrs before and 48 hrs after the procedure? A. Glipizide B. Metformin C. Repaglinide D. Regular Insulin
B
A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hr. The nurse would determine that the client is receiving the therapeutic effect based on which of the following results? A. Prothrombin Time of 12.5 seconds B. Activated partial thromboplastin time of 60 seconds C. Activated Partial thromboplastin time of 28 seconds D. Activated Partial thromboplastin time longer than 120 seconds
B
A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing pink frothy sputum. Which finding would the nurse anticipate when auscultating the patients lungs? A. Stridor B. Crackles C. Scattered Rhonchi D. Diminished breath sounds
B
A patient calls the cardiac clinic you are working at and reports that they have taken 3 sublingual doses of nitroglycerin as prescribed for chest pain, but the chest pain is not relieved. What do you educate the patient to do next? A. Take another dose of Nitroglycerin in 5 minutes. B. Call 911 immediately C. Lie down and rest to see if that helps with relieving the pain D. Take two doses of Nitroglycerin in 5 minutes
B
A patient taking Zocor is reporting muscle pain. You are evaluating the patient's lab work and note that which of the following findings could cause muscle pain? A. Elevated potassium level B. Elevated CPK (creatine kinase level) C. Decreased potassium level D. Decreased CPK (creatine kinase level)
B
The nurse provides pre-procedure education to a client scheduled to have a cardiac catheterization. which statement does the nurse include? A. " The procedure is performed at the bedside" B. " You may feel flushing, warmth, or palpitations during the procedure." C. "There may at first be some intense pain that resolves quickly." D. "you may develop a headache but this is normal"
B
The nurse teaches a client scheduled for a percutaneous transluminal coronary angioplasty (PTCA). What response by the client demonstrates an understanding of this procedure? A "The purpose of the procedure is to measure the coronary artery pressure" B " The balloon-tipped catheter compresses the plaque against the walls of the coronary arteries" C "The procedure will cauterize the plaque blocking the coronary artery" D "The procedure inserts a mesh device that keeps the coronary artery patent"
B
What is the definitive test used to diagnose an abdominal aortic aneurysm? A. Abdominal X-ray B. Arteriogram C. CT scan D. Ultrasound
B
What is the first intervention for a client experiencing myocardial infarction? A. Administer morphine B. Administer oxygen C. Administer sublingual nitroglycerin D. Obtain an electrocardiogram
B
Which of the following actions is the first priority care for a client exhibiting signs and symptoms of coronary artery disease? A. Decrease anxiety B. Enhance myocardial oxygenation C. Administer sublingual nitroglycerin D. Educate the client about his symptoms
B
Which of the following complications is of greatest concern when caring for a preoperative abdominal aneurysm client? A. HPN B. Aneurysm rupture C. Cardiac arrhythmias D. Diminished pedal pulses
B
A nurse is caring for a 35-year-old patient who has been diagnosed with hypovolemic shock as a result of severe hemorrhage. In which position should the nurse place this patient to promote optimal circulation? a. In the Sims' position b. Supine with the legs elevated c. Trendelenburg d. Left side-lying with the head flat
B This position promotes venous return from the lower extremities so that blood can flow back to the heart; the cardiovascular system does not have to work as hard and blood can be shunted to central organs until the patient receives appropriate treatment.
A client with MI is developing cardiogenic shock because of the risk of myocardial ischemia, what condition should the nurse carefully assess for? A. Bradycardia B. Ventricular dysrhythmias C. Rising diastolic bp D. falling central venous pressure
B Dysrhythmias occur as a result of decreased oxygenation and severe damage to the myocardium
Which of the following groups of symptoms indicated a ruptured abdominal aneurysm? A. Lower back pain, increased BP, decreased RBC, increased WBC B. Severe lower back pain, decreased BP, decreased RBC, increased WBC C. Severe lower back pain, decreased BP, decreased RBC, decreased WBC D. Intermittent lower back pain, decreased BP, decreased RBC, increased WBC
B Severe lower back pain indicates an aneurysm rupture, secondary to pressure being applied within the abdominal cavity. When rupture occurs, the pain is constant because it can't be alleviated until an aneurysm is repaired. Blood pressure decreases due to the loss of blood. After the aneurysm ruptures, the vasculature is interrupted and blood volume is lost, so blood pressure wouldn't increase. For the same reason, the RBC count is decreased - not increase. The WBC count increases as cells migrate to the site of injury.
Which patient(s) are most at risk for developing coronary artery disease? Select-all-that-apply: A. A 25 year old patient who exercises 3 times per week for 30 minutes a day and has a history of cervical cancer. B. A 35 year old male with a BMI of 30 and reports smoking 2 packs of cigarettes a day. C. A 45 year old female that reports her father died at the age of 42 from a myocardial infraction. D. A 29 year old that has type I diabetes.
B, C, D
A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats/minute. The PR interval is 0.14 second, the QRS complex measures 0.08 second, and the PP and RR intervals are regular. How should the nurse correctly interpret this rhythm? A.Sinus dysrhythmia B.Sinus tachycardia C.Sinus bradycardia D.Normal sinus rhythm
B.
The nurse is monitoring a client who is taking propanolol. Which assessment finding indicates a potential adverse complication associated with this medication A. Development and complaint of insomnia B. The development of audible expiratory wheezes C.A baseline bp of 150/80 followed by a bp of 138/72 after 2 doses D. A baseline resting HR of 88 beats/min followed by a resting HR of 72 beats/min after 2 doses
B. Beta-blockers can cause bronchospasm.
A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A nurse sees no electrocardiographic complexes on the screen. Which is the priority action of the nurse? A. Call a code. B. Call the health care provider. C. Check the client's status and lead placement. D. Press the recorder button on the electrocardiogram console.
C
A hypertensive patient reports to the hospital complaining of chest pain. Cardiac labs come back within normal limits but the physician decides to admit the patient for closer monitoring RR: 22 Temp: 99.6 HR: 145 BP: 80/45 A. Call the physician and ask for an order for vasopressors. B. Provide the client with pain medication. C. Notify the physician and prepare the client for surgery. D. Retake the clients temperature.
C
Medical treatment of coronary artery disease includes which of the following procedures? A. Cardiac catheterization B. Coronary artery bypass surgery C. Oral medication administration D. Percutaneous transluminal coronary angioplasty
C
A client in sinus bradycardia, with a heart rate of 45 beats/minute, complains of dizziness and has a blood pressure of 82/60 mm Hg. Which prescription should the nurse anticipate will be prescribed? A. Defibrillate the client. B. Administer digoxin (Lanoxin). C. Continue to monitor the client. D. Prepare for transcutaneous pacing.
D
A patient reports having crushing chest pain that radiates to the jaw. You administer sublingual nitroglycerin and obtain a 12 lead EKG. Which of the following EKG findings confirms your suspicion of a possible myocardial infraction? A. absent Q wave B. QRS widening C. absent P-wave D. ST segment elevation
D
A patient who has diabetes will be started on Metoprolol for medical management of coronary artery disease. Which of the following will you include in your discharge teaching about this medication? A. Check your heart rate regularly because Metoprolol can cause an irregular heart rate. B. Check your glucose regularly because this medication can cause hyperglycemia. C. Check your blood pressure regularly because this medication can cause hypertension. D. Check your glucose regularly because this medication can mask the typical signs and symptoms of hypoglycemia.
D
A patient with heart failure has been prescribed intravenous diuretic medications to control fluid and congestion. Which nursing intervention would the nurse need to perform in order to best monitor fluid and electrolyte balance in this patient? a. Monitor for signs of pancreatic dysfunction b. Administer pain medications as ordered c. Insert a Foley catheter d. Check the patient's weight daily
D
Lipitor is prescribed for a patient with a high cholesterol level. As the nurse, how do you educate the patient on how this drugs works on the body? A. Lipitor increases LDL levels and decreases HDL levels, total cholesterol, and triglyceride levels. B. Lipitor decreases LDL, HDL levels, total cholesterol, and triglyceride levels. C. Lipitor increases HDL levels, total cholesterol, and triglyceride levels. D. Lipitor increases HDL levels and decreases LDL, total cholesterol, and triglyceride levels.
D
The nurse cares for a client at risk for premature ventricular contractions (PVC). When monitoring the clients ECG rhythm, what characteristics indicate PVC? A. Wide QRS complexes and inverted P waves B. Narrow QRS complexes and no P waves C. Narrow QRS complexes and peaked P waves D. Wide QRS complexes and no P waves
D
The nurse evaluates the cardiac rhythm of a client with CAD. The heart monitor shows isolated premature ventricular contractions (PVC). How does the nurse respond? A. Notify the healthcare provider immediately B. prepare to administer antiarrhythmic C. Prepare for cardioversion D. Continue to monitor the clients' rhythm
D
What is the primary reason for administering morphine to a client with myocardial infarction? A. To sedate the client B. To decrease the client's pain C. To decrease the client's anxiety D. To decrease oxygen demand on the client's heart
D
Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output? A. Angina pectoris B. Cardiomyopathy C. Left-sided heart failure D. Right-sided heart failure
D
Which of the following symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm? A. Abdominal pain B. Absent pedal pulses C. Angina D. Lower back pain
D
Which of the following treatments is the definitive one for a ruptured aneurysm? A. Antihypertensive medication administration B. Aortogram C. Beta-adrenergic blocker administration D. Surgical intervention
D
. Which of the following classes of medications maximizes cardiac performance in clients with heart failure by increasing ventricular contractility? A. Beta-adrenergic blockers B. Calcium channel blockers C. Diuretics D. Inotropic agents
D Inotropic agents are administered to increase the force of the heart's contractions, thereby increasing ventricular contractility and ultimately increasing cardiac output.
The nurse cares for a client with infective endocarditis related to sharing IV needles. What does the nurse expect to find upon physical examination? A.Fever B. Osler Nodes C. Paradoxical pulse D. Pericardial friction rub E.Splinter hemorrhages
a, b, e
True or False: ACE inhibitors work to decrease the workload on the heart by blocking the conversion of Angiotensin II to Angiotensin I which causes vasodilation.
False
True or False: The left anterior descending coronary artery provides blood supply to the right ventricle and to the front of the septum
False
True or False: Patients with left-sided diastolic dysfunction heart failure usually have a normal ejection fraction.
True
The nurse plans care for a client with acute decompensated HF. Which interventions does the nurse include in the client's plan of care? select all that apply A. Administer O2 B. Assess for JVD and hepatomegaly C. Monitor O2 sat and RR D. Administer loop diuretics E. Maintain client in an upright postion
a, b, c, d, e,
Which of the following patients are MOST at risk for developing heart failure? Select-all-that-apply: A. A 69 year old male with a history of alcohol abuse and is recovering from a myocardial infarction. B. A 55 year old female with a health history of asthma and hypoparathyroidism. C. A 30 year old male with a history of endocarditis and has severe mitral stenosis. D. A 45 year old female with lung cancer stage 2. E. A 58 year old female with uncontrolled hypertension and is being treated for influenza.
a, c, e
A 74 year old female presents to the ER with complaints of dyspnea, persistent cough, and unable to sleep at night due to difficulty breathing. On assessment, you note crackles throughout the lung fields, respiratory rate of 25, and an oxygen saturation of 90% on room air. Which of the following lab results confirm your suspicions of heart failure? A. K+ 5.6 B. BNP 820 C. BUN 9 D. Troponin <0.02
b
Patients with heart failure can experience episodes of exacerbation. All of the patients below have a history of heart failure. Which of the following patients are at MOST risk for heart failure exacerbation? A. A 55 year old female who limits sodium and fluid intake regularly. B. A 73 year old male who reports not taking Amiodarone for one month and is experiencing atrial fibrillation. C. A 67 year old female who is being discharged home from heart valve replacement surgery. D. A 78 year old male who has a health history of eczema and cystic fibrosis.
b
Which of the following is a common side effect of Spironolactone? A. Renal failure B. Hyperkalemia C. Hypokalemia D. Dry cough
b
You are assisting a patient up from the bed to the bathroom. The patient has swelling in the feet and legs. The patient is receiving treatment for heart failure and is taking Hydralazine and Isordil. Which of the following is a nursing priority for this patient while assisting them to the bathroom? A. Measure and record the urine voided. B. Assist the patient up slowing and gradually. C. Place the call light in the patient's reach while in the bathroom. D. Provide privacy for the patient.
b
Select all the correct statements about educating the patient with heart failure: A. It is important patients with heart failure notify their physician if they gain more than 6 pounds in a day or 10 pounds in a week. B. Patients with heart failure should receive an annual influenza vaccine and be up-to-date with the pneumonia vaccine." C. Heart failure patients should limit sodium intake to 2-3 grams per day. D. Heart failure is exacerbated by illness, too much fluid or sodium intake, and arrhythmias. E. Patients with heart failure should limit exercise because of the risks.
b, c, d
Select all the correct statements about the pharmacodynamics of Beta-blockers for the treatment of heart failure: A. These drugs produce a negative inotropic effect on the heart by increasing myocardial contraction. B. A side effect of these drugs include bradycardia. C. These drugs are most commonly prescribed for patients with heart failure who have COPD. D. Beta-blockers are prescribed with ACE or ARBs to treat heart failure.
b, d
Which of the following are NOT typical signs and symptoms of right-sided heart failure? Select-all-that-apply: A. Jugular venous distention B. Persistent cough C. Weight gain D. Crackles E. Nocturia F. Orthopnea
b, d, f
A patient is taking Digoxin. Prior to administration you check the patient's apical pulse and find it to be 61 bpm. Morning lab values are the following: K+ 3.3 and Digoxin level of 5 ng/mL. Which of the following is the correct nursing action? A. Hold this dose and administer the second dose at 1800. B. Administer the dose as ordered. C. Hold the dose and notify the physician of the Digoxin level. D. Hold this dose until the patient's potassium level is normal.
c
A patient reports during a routine check-up that he is experiencing chest pain and shortness of breath while performing activities. He states the pain goes away when he rests. This is known as: A. Unstable angina B. Variant angina C. Stable angina D. Prinzmetal angina
c
A patient taking Digoxin is experiencing severe bradycardia, nausea, and vomiting. A lab draw shows that their Digoxin level is 4 ng/mL. What medication do you anticipate the physician to order for this patient? A. Narcan B. Aminophylline C. Digibind D. No medication because this is a normal Digoxin level.
c
A patient with heart failure is taking Losartan and Spironolactone. The patient is having EKG changes that presents with tall peaked T-waves and flat p-waves. Which of the following lab results confirms these findings? A. Na+ 135 B. BNP 560 C. K+ 8.0 D. K+ 1.5
c
A patient with left-sided heart failure is having difficulty breathing. Which of the following is the most appropriate nursing intervention? A. Encourage the patient to cough and deep breathe. B. Place the patient in Semi-Fowler's position. C. Assist the patient into High Fowler's position. D. Perform chest percussion therapy.
c
The nurse educator teaches a nurse about physical assessment for a client with an aortic dissection. What statement by the nurse indicates understanding? A. Reposition the client to semi-fowlers B. Auscultate the carotid arteries for bruits C. Avoid deep palpation of the abdomen D. avoid the side-lying position
c
A patient is being discharged home after hospitalization of left ventricular systolic dysfunction. As the nurse providing discharge teaching to the patient, which statement is NOT a correct statement about this condition? A. "Signs and symptoms of this type of heart failure can include: dyspnea, persistent cough, difficulty breathing while lying down, and weight gain." B. "It is important to monitor your daily weights, fluid and salt intake." C. "Left-sided heart failure can lead to right-sided heart failure, if left untreated." D. "This type of heart failure can build up pressure in the hepatic veins and cause them to become congested with fluid which leads to peripheral edema."
d
A patient is diagnosed with left-sided systolic dysfunction heart failure. Which of the following are expected findings with this condition? A. Echocardiogram shows an ejection fraction of 38%. B. Heart catheterization shows an ejection fraction of 65%. C. Patient has frequent episodes of nocturnal paroxysmal dyspnea. D. Options A and C are both expected findings with left sided systolic dysfunction heart failure.
d
During your morning assessment of a patient with heart failure, the patient complains of sudden vision changes that include seeing yellowish-green halos around the lights. Which of the following medications do you suspect is causing this issue? A. Lisinopril B. Losartan C. Lasix D. Digoxin
d
The physician's order says to administered Lasix 40 mg IV twice a day. The patient has the following morning labs: Na+ 148, BNP 900, K+ 2.0, and BUN 10. Which of the following is a nursing priority? A. Administer the Lasix as ordered B. Notify the physician of the BNP level C. Assess the patient for edema D. Hold the dose and notify the physician about the potassium level
d
These drugs are used as first-line treatment of heart failure. They work by allowing more blood to flow to the heart which decreases the work load of the heart and allows the kidneys to secrete sodium. However, some patients can develop a nagging cough with these types of drugs. This description describes? A. Beta-blockers B. Vasodilators C. Angiotensin II receptor blockers D. Angiotensin-converting-enzyme inhibitors
d
What type of heart failure does this statement describe? The ventricle is unable to properly fill with blood because it is too stiff. Therefore, blood backs up into the lungs causing the patient to experience shortness of breath. A. Left ventricular systolic dysfunction B. Left ventricular ride-sided dysfunction C. Right ventricular diastolic dysfunction D. Left ventricular diastolic dysfunction
d
Which of the following is a late sign of heart failure? A. Shortness of breath B. Orthopnea C. Edema D. Frothy-blood tinged sputum
d
Which of the following tests/procedures are NOT used to diagnose heart failure? A. Echocardiogram B. Brain natriuretic peptide blood test C. Nuclear stress test D. Holter monitoring
d
You're providing diet discharge teaching to a patient with a history of heart failure. Which of the following statements made by the patient represents they understood the diet teaching? A. "I will limit my sodium intake to 5-6 grams a day." B. "I will be sure to incorporate canned vegetables and fish into my diet." C. "I'm glad I can still eat sandwiches because I love bologna and cheese sandwiches." D. "I will limit my consumption of frozen meals."
d
A patient has a history of heart failure. Which of the following statements by the patient indicates the patient may be experiencing heart failure exacerbation? A. "I've noticed that I've gain 6 lbs in one week." B. "While I sleep I have to prop myself up with a pillow so I can breathe." C. "I haven't noticed any swelling in my feet or hands lately." D. Options B and C are correct. E. Options A and B are correct. F. Options A, B, and C are all correct.
e
