Med-surg Cardiac First Test

A nurse is caring for a client in the immediate post-cardiac catheterization period. Which interventions should the nurse include in the client's care? Select all that apply. 1. Monitor vital signs every 15 minutes for the first hour. 2. Assess all peripheral pulses frequently. 3. Restrict the client to bed rest for 2 to 6 hours. 4. Assess the insertion site. 5. Perform range of motion exercises.

1, 3, 4

A nurse is caring for a client with Raynaud's phenomenon secondary to systemic lupus erythematosus. Which of the client statements shows an understanding of the nurse's teaching about the disorder? Select all that apply. 1. "My hands get pale, bluish, and feel numb and painful when I'm really stressed." 2. "I can't continue to wash dishes and do my cleaning because of this problem." 3. "I don't need to report any other skin problems with my fingers of hands to my HCP." 4. "I probably got this disorder because I have lupus." 5. "This problem is caused by a temporary lack of circulation in my hands." 6. "Medication might help treat this problem."

1, 4, 5, 6

A nurse is counseling a client about risk factors for hypertension. Which risk factors should the nurse list for primary hypertension? Select all that apply. 1. Obesity 2. Glomerulonephritis 3. Head injury 4. Stress 5. Hormonal contraceptive use 6. High intake of sodium or saturated fat

1, 4, 6

What is the BP for pre hypertension?

120/80

What is the BP for hypertension?

140/90

A client is prescribed lisinopril (Zestril) for the treatment of hypertension. The client asks a nurse about possible adverse effects. Which common adverse effects of angiotensin-converting enzyme (ACE) inhibitors should the nurse include in the teaching? Select all that apply. 1. Constipation 2. Dry cough. 3. Headache 4. Hyperglycemia 5. Hypotension 6. Impotence

2, 3, 5

A nurse is caring for a client with a new prescription of digoxin (Lanoxin). Which client statement would require further teaching about digoxin? Select all that apply. 1. "I will take the digoxin at 9 p.m. daily." 2. "I will take digoxin with my antacids at night." 3. "I will take my pulse before each dose of digoxin." 4. "If I forget a dose, I will catch-up by doubling the next dose." 5. "I will notify my doctor if experiencing increased fatigue or muscle weakness." 6. "I understand that I will need annual blood work to check therapeutic levels."

2, 4, 6

A client is admitted to the ED after complaining of acute chest pain radiating down the left arm. The client appears anxious, dyspneic, and diaphoretic. Which laboratory studies would the nurse anticipate? Select all that apply. 1. Hemoglobin and Hematocrit (HCT) 2. Serum glucose 3. Creatine kinase (CK) 4. Troponin T and troponin 1 5. Myoglobin 6. Blood urea nitrogen (BUN)

3, 4, 5

A nurse is awaiting the arrival of a client from the emergency department with a diagnosis of left ventricular MI. In caring for this client, the nurse should be alert for which signs and symptoms of left-sided heart failure? Select all that apply. 1. Jugular vein distention 2. Hepatomegaly 3. Dyspnea 4. Crackles 5. Tachycardia 6. Right upper quadrant pain

3, 4, 5

A nurse is evaluating the 12-lead ECG of a client experiencing an inferior wall myocardial infarction. While conferring with the health care team, which ECG changes associated with an evolving MI does the nurse correctly identify? Select all that apply. 1. Notched T wave 2. Presence of a U wave 3. T wave inversion 4. Prolonged PR interval 5. ST segment elevation 6. Pathologic Q wave

3, 5, 6

The nurse is preparing to interpret an ECG rhythm strip. Place the following steps for ECG rhythm analysis from first to last, in chronological order. 1. Measure the QRS duration. 2. Interpret the rhythm. 3. Analyze the P waves. 4. Determine the rate and rhythm. 5. Measure the P-R interval.

4, 3, 5, 1, 2

How does the blood flow through the heart? Put in order. 1. Left ventricle 2. Right atrium 3. Lungs 4. Aorta 5. Pulmonary artery 6. Left atrium 7. Right ventricle 8. Right and left pulmonary veins 9. Superior and inferior vena cava

9, 2, 7, 5, 3, 8, 6, 1, 4

Can be used as a diagnostic test, treatment, and medication is fluid in the heart. A. Pericardiocentesis B. Thoracentesis C. Blood draws D. Pericardium

A

What is the desirable mg/dL for LDL's? A. Below 160 B. 100-200 C. 35-70 D. Below 200

A

When assessing a patient, you note a pulse deficit of 23 beats. This finding may be caused by A. Dysthymias B. Heart murmurs C. Gallop rhythms D. Pericardial friction rub

A

When's person's blood pressure rises, the homeostatic mechanism to compensate for an elevation involves stimulation of A. Baroreceptors that's inhibit the sympathetic nervous system, causing vasodilation B. Chemoreceptors that inhibit the sympathetic nervous system, causing vasodilation C. Baroreceptors that inhibit the parasympathetic nervous system, causing vasodilation D. Chemoreceptors that stimulate the sympathetic nervous system, causing an increased heart rate

A

What are causes or secondary hypotension?

Cirrhosis Narrowing or aorta Drugs Endocrine disorders Neurological disorders Pregnancy Renal disease Sleep apnea

What is the desirable mg/dL for cholesterol? A. Below 160 B. 100-200 C. 35-70 D. Below 200

D

What is dyslipidemia?

Elevated triglycerides, low HDL, and small dense LDL

What type of drugs cause secondary hypertension?

Estrogen replacement therapy, oral contraceptives, corticosteroids, no steroidal anti inflammatory drugs, sympathetic stimulants i.e. Cocaine

What are relieving factors for gastric disorders?

Food, antacids, standing upright, belching

What side of the heart carries oxygenated blood? Left or right

Left

What is elevated BP without a cause? Primary or secondary hypertension?

Primary

What are relieving factors for MI?

Rest -only temporary

What are relieving factors for angina?

Rest and nitroglycerin

What side of the heart carries deoxygenated blood? Left or right

Right

What is elevated BP with a specific cause and can be corrected? Primary or secondary hypertension?

Secondary

What are relieving factors for pericarditis?

Shallow breathing, sitting up or leaning forward

What usually happens with the first initial dose of doxazosin

Syncope occurs witching 30-90 min

What are relieving factors for pleural pain?

Warm, moist air; rest; splinting, heat, standing up

Which nursing responsibilities are priorities when caring for a patient returning from a cardiac catheterization. Select all that apply A. Monitoring VS and ECG B. Checking the catheter insertion site and distal pulse C. Assisting the patient to ambulate to the bathroom to void D. Informing e patient that he will be sleepy from the general anesthesia E. Instructing the patient about the risks of the radioactive isotope injection

A, B

A patient has a severe blockage in his right coronary artery. Which cardiac structures are most likely to be affected by this blockage. Selected tall that apply A. AV node B. Left ventricle C. Coronary sinus D. Rig ventricle

A, B, D

What are risk factors that can cause primary hypertension?

Age, alcohol, smoking, diabetes, elevated serum lipids, excess dietary sodium, gender, family history, obesity, ethnicity, sedentary lifestyle, stress, socioeconomic status

What is the emotional response for MI?

Anxiety, fear, impending doom

A P wave on and ECG represents an impulse arising at the A. SA node and repolarizing the atria B. SA node and depolarizing the atria C. AV node and depolarizing the atria D. AV node and spreading to the bundle of His

B

The auscultatory area in the left midclavicular line at the level of the fifth ICS is the best location the hear sounds from which heart valve? A. Aortic B. Mitral C. Tricuspid D. Pulmonic

B

The portion of the vascular system responsible for hemostasis is the A. Thin capillary vessels B. Endothelial layer of the arteries C. Elastic middle layer of the veins D. Smooth muscle of the arterial wall

B

What is the desirable mg/dL for triglycerides? A. Below 160 B. 100-200 C. 35-70 D. Below 200

B

When collecting subjective data related to the cardiovascular system, which information should be obtained from the patient. Select all that apply A. Annual income B. Smoking history C. Religious preference D. Number of pillows used to sleep E. Blood for basic laboratory studie

B, C, D

What are symptoms to hypertension? Select all that apply A. Headache B. Fatigue C. Nosebleeds D. Dizziness E. Angina F. SOB G. Palpitiations

B, D, E, F, G

A patient with a tricuspid valve disorder will have impaired blood flow between the A. Vena cava and right atrium B. Left atrium and left ventricle C. Right atrium and right ventricle D. Right ventricle and pulmonary artery

C

What is the desirable mg/dL for HDL's? A. Below 160 B. 100-200 C. 35-70 D. Below 200

C

What is the pace maker in the heart? A. AV node B. Aortic semilunar C. SA node D. Atrium

C

When assessing the cardiovascular system of a 79 yr old patient, you might expect to find A. A narrowed pulse pressure B. Diminished carotid artery pulses C. Difficulty in isolating the apical pulse D. An increased heart rate in response to stress

C