(MS) Cardiovascular 6 {TERM 3}
The client at risk for CAD tells the nurse that his usual breakfast includes sausage, eggs, hash browns, and white bread and butter. When providing dietary instructions for this client, which healthful alternative should the nurse recommend? * A) Cereal for eggs B) Wheat toast for white bread C) Margarine for butter D) Ham for sausage
Cereal for eggs
The client tells the nurse that he is particularly fond of hot apple pies like those sold at a fast-food restaurant and that he eats several per week. He asks the nurse how many calories are in one pie. If the literature supplied by the fast-food chain indicates that one hot apple pie contains 2 g of protein, 14 g of fat, and 31 g of carbohydrates, the nurse would be correct to tell him that one hot apple pie is equal to how many calories? A) 258 B) 47 C) 199 D) 343
258
(Select all that apply.) A nurse is caring for a group of clients. The nurse should recognize which of the following clients as being at risk for the development of a dysrhythmia? (Select all that apply.) A) A client who has metabolic alkalosis B) A client who has COPD C) A client who underwent stent placement in a coronary artery D) A client who has a serum potassium level of 4.3 mEq/L E) A client who has an SaO2 of 96%
A client who has metabolic alkalosis, A client who has COPD, A client who underwent stent placement in a coronary artery
Which assessment finding best supports the assumption that the client's cardiac stroke volume (or ejection fraction) is reduced? * A) The client faints with activity. B) The client develops hypertension. C) The client manifests bradycardia. D) The client has a bounding pulse.
The client faints with activity
A nurse is caring for a client following an angioplasty that was inserted through the femoral artery. While turning the client, the nurse discovers blood underneath the client's lower back. The nurse should suspect: * A) bleeding from the incisional site. B) retroperitoneal bleeding. C) cardiac tamponade. D) heart failure.
bleeding from the incisional site.
Which of the following best describes the nursing responsibilities regarding patient diagnostic procedures? * A) prepare and explain B) prepare and perform C) explain and interpret D) perform and interpret E) all of these choices are correct
prepare and explain
A student nurse is observing a cardioversion procedure and hears the team leader call out, "Stand clear." The student should recognize the purpose of this action is to alert personnel that: * A) they cannot be in contact with equipment connected to the client. B) the cardioverter is being charged to the appropriate setting C) they should initiate CPR due to pulseless electrical activity D) a time-out is being called to verify correct protocols
they cannot be in contact with equipment connected to the client.
A client in a provider's office asks the nurse why her provider prescribed aspirin 81 mg/day. Which of the following is an appropriate response by the nurse? A) "Aspirin reduces the formation of blood clots that could cause a heart attack." B) "Aspirin relieves the pain due to myocardial ischemia." C) "Aspirin dissolves clots that are forming in your coronar y arteries." D) "Aspirin relieves headaches that are caused by other medications."
"Aspirin reduces the formation of blood clots that could cause a heart attack."
The nurse implements the teaching plan for cardiac catheterization and coronary arteriogram. Which statement by the client indicates that he understands what will happen during the testing procedure? A) "I'll feel a warm sensation as the dye is instilled." B) "I'll be able to hear my heart beating in my chest." C) "I'll be anesthetized and will not feel any discomfort." D) "I'll feel a heavy sensation all over my body."
"I'll feel a warm sensation as the dye is instilled."
A nurse is discussing cardioversion with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the procedure? * A) "The client should take an anticoagulant prior to the procedure." B) "The client will receive an unsynchronized countershock during the procedure." C) "The client who has ventricular fibrillation should receive this procedure." D) "The client will be placed on mechanical ventilator during this procedure."
"The client should take an anticoagulant prior to the procedure."
A client in a provider's office tells a nurse, "My cholesterol is 198 mg/dL, but my doctor says my bad cholesterol is too high." Which of the following responses should the nurse give? * A) "This means that your LDL is too high." B) "This means that your HDL is too high." C) "This means that your triglycerides are too high." D) "This means that your cholesterol (total) is too high."
"This means that your LDL is too high."
A nurse is instructing a client who is scheduled for a echocardiogram. Which of the following should the nurse include in the client's teaching? * A) "This test allows for us to see a picture of the inside of your heart." B) "You will need to lie flat during the test." C) "This test will require up to 2 hours to complete." D) "You may experience some discomfort during the test."
"This test allows for us to see a picture of the inside of your heart."
After evaluating the 24-hour Holter monitor tracings, the physician admits the client to the hospital for an abnormal heart rhythm. On admission, the nurse notes that the client has an irregularly fast heart rate and notifies the physician. The physician schedules the client for cardioversion. The nurse knows that the client understands the cardioversion procedure when he tells her that it involves which action? A) Administering an electric current to the heart B) Threading a thin, plastic catheter into his heart C) Evaluating blood flow to areas of heart muscle D) Scanning the heart after injecting a radioisotope
Administering an electric current to the heart
(Select all that apply) A nurse is assisting in the plan of care for a client who had a surgical placement of an synthetic graft to repair an aneurysm. Which of the following interventions should the nurse include in the plan of care? (Select all that apply) A) Assess pedal pulses. B) Monitor for an increase in pain below the graft site. C) Administer prescribed antiplatelet agents. D) Maintain client in high-Fowler's position. E) Report an hourly urine output of 60 mL.
Assess pedal pulses., Monitor for an increase in pain below the graft site., Administer prescribed antiplatelet agents.
(Select all that apply.) A nurse is collecting data on a client who has a new diagnosis of an abdominal aortic aneurysm. Which of the following data collected by the nurse supports this diagnosis? (Select all that apply.) * A) Elevated blood pressure B) Palpable abdominal pulsations C) Bruit heard on auscultation D) Client report of back pain E) Client report of difficulty swallowing
Elevated blood pressure, Palpable abdominal pulsations, Bruit heard on auscultation, Client report of back pain
A nurse is caring for a client following angiography. The nurse informs the client he should lie still for 6 hr because he is at risk for which of the following? * A) Bleeding B) Urinary retention C) Infection D) Respiratory depression
Bleeding
(Select all that apply.) A nurse is caring for a client following peripheral bypass graft surgery of the left lower extremity. Which of the following client findings pose an immediate concern? (Select all that apply.) A) Capillary refill of affected limb of 6 seconds B) Mottled appearance of the limb C) Trace of bloody drainage on dressing D) Throbbing pain of affected limb that is decreased following IV bolus analgesic E) Pulse of 2+ in the affected limb
Capillary refill of affected limb of 6 seconds, Mottled appearance of the limb
A client diagnosed with angina has been advised to reduce his consumption of saturated fat and calories to control the progression of CAD. The best evidence that the client is complying with his diet therapy is that he reports using which type of fat for cooking? A) Corn oil B) Margarine C) Shortening D) Coconut oil
Corn oil
(Select all that apply.) A nurse is reviewing clinical manifestations of a thoracic aortic aneurysm with a newly hired nurse. Which of the following should the nurse include in the discussion? (Select all that apply.) * A) Cough B) Shortness of breath C) Altered swallowing D) Upper chest pain E) Diaphoresis
Cough, Shortness of breath, Altered swallowing
A nurse is completing the admission physical assessment of client who has a histor y of mitral valve insufficiency. Which of the following is an expected finding? * A) Crackles in lung bases B) Hoarseness C) Petechiae D) Splenomegaly
Crackles in lung bases
A 78-year-old woman is admitted to the hospital with left-sided heart failure. When obtaining a health history from the client, the nurse would expect to learn that what was the client's earliest symptom? * A) Dyspnea B) Anorexia C) Nausea D) Headaches
Dyspnea
(Select all that apply.) A nurse is collecting data on a client for hypertension. Which of the following actions by the client increase his risk for hypertension? (Select all that apply.) * A) Eating popcorn at the movie theater B) Consuming 36 oz of beer daily C) Drinking 8 oz of nonfat milk daily D) Walking 1 mile daily at 12 min/mile pace E) Getting a massage once a week
Eating popcorn at the movie theater, Consuming 36 oz of beer daily
(Select all that apply.) A nurse is reinforcing teaching to a client who has a new prescription for clopidogrel (Plavix). Which of the following should be included in the teaching? (Select all that apply.) * A) Effects might not be apparent for several weeks. B) Monitor for the presence of black, tarr C) Use an electric razor D) Schedule a weekly PT test. E) Advise the client about food sources containing vitamin K.
Effects might not be apparent for several weeks., Monitor for the presence of black, tarr
A nurse is assisting a hospitalized client who is newly diagnosed with coronary artery disease (CAD) to make appropriate selections from the dietary menu. The nurse encourages the client to select which of the following meals? * A) Fresh strawberries, steamed vegetables, and baked fish B) Sausage, pancakes, and toast C) Broccoli, buttered rice, and grilled chicken D) Hamburger, baked apples, and avocado salad
Fresh strawberries, steamed vegetables, and baked fish
A client seeks medical attention for intermittent episodes in which the fingers of both hands become cold, pale, and numb. The client states that they then become reddened and swollen with a throbbing, achy pain. The nurse further collects data on the client to see whether these episodes occur with: * A) Ingestion of coffee or chocolate B) Exposure to heat C) Being in a relaxed environment D) Prolonged episodes of inactivity
Ingestion of coffee or chocolate
A nurse in a provider's office is collecting data from a client who has heart failure. Which of the following findings is a clinical manifestation of right-sided heart failure? * A) Jugular vein distension B) Daytime oliguria C) S3 heart sound D) Orthopnea
Jugular vein distension
A nurse is caring for a client with a diagnosis of myocardial infarction (MI) and is assisting the client in completing the diet menu. Which of the following beverages does the nurse instruct the client to select from the menu? * A) Lemonade B) Coffee C) Tea D) Cola
Lemonade
The client with angina pectoris is scheduled to undergo a heart catheterization and coronary arteriogram. Which nursing action can best help to reduce the client's anxiety in this situation? A) Listen to the client express his feelings about his condition. B) Teach the client how CAD is usually treated. C) Explain that the procedure has been very helpful for other clients. D) Avoid discussing the heart catheterization until the client has relaxed.
Listen to the client express his feelings about his condition.
A nurse is assisting in caring for a client in the telemetry unit and is monitoring the client for cardiac changes indicative of hypokalemia. Which occurrence noted on the cardiac monitor indicates the presence of hypokalemia? * A) ST-segment depression and/or a flat T wave. B) Tall, peaked T waves C) Prolonged P-R interval D) Widening of the QRS complex
ST-segment depression and/or a flat T wave.
A nurse is collecting data from a client who is scheduled for a scheduled for a cardiac catheterization. Which of the following client-reported allergies has the highest priority? * A) Shrimp B) Peanuts C) Bananas D) Soy
Shrimp
The nurse provides information to the client about varicose veins. Which activity should the client avoid? * A) Sitting with crossed knees B) Walking in high-heeled shoes C) Wearing nylon pantyhose D) Shaving her lower legs
Sitting with crossed knees
A nurse is conversing with a patient that has recently suffered a heart attack. After hearing the nurse's instructions about activity restrictions and their potentially dangerous consequences, the client correctly states that she knows she should avoid engaging in which activity? * A) Straining during a bowel movement B) Carrying groceries from the car C) Bathing in warm water D) Having intercourse
Straining during a bowel movement
When preparing a client for a pericardiocentesis, how does the nurse position the client? * A) Supine with the head of bed elevated at a 45- to 60-degree angle B) Supine with slight lowering of the head C) Lying on the right side with a pillow under the head D) Lying on the left side with a pillow under the chest wall
Supine with the head of bed elevated at a 45- to 60-degree angle
(Select all that apply.) A nurse is reviewing the health record of a client who is being evaluated for possible valvular heart disease. The nurse should recognize which of the following data as risk factors for this condition? (Select all that apply.) * A) Surgical repair of an atrial septal defect at age 2 years B) Hypertension for 5 years C) Diastolic murmur present D) Measles infection during childhood E) Weight gain of 10 lb in past year
Surgical repair of an atrial septal defect at age 2 years, Hypertension for 5 years, Diastolic murmur present
(Select all that apply.) A nurse is completing the admission assessment of a client who has suspected pulmonary edema. Which of the following are expected findings? (Select all that apply.) A) Tachypnea B) Persistent cough C) Orthopnea D) Increased urinary output E) Thick, yellow sputum
Tachypnea, Persistent cough, Orthopnea
A nurse is assisting in the care of a client diagnosed with rheumatic heart disease. When teaching the client about self-management of this health problem, the nurse reminds the client to alert his dentist about the condition because: * A) The client requires prophylactic antibiotics before treatment. B) The client is at risk for episodes of heart failure triggered by stressful events. C) The dentist should use a lidocaine solution without epinephrine. D) The dentist should use a low-speed drill to avoid dysrhythmias.
The client requires prophylactic antibiotics before treatment.
After a diagnostic workup, the physician informs the client that she has mitral valve stenosis. The nurse accurately describes the mitral valve as being located between which heart structures? * A) The left atrium and left ventricle B) The right ventricle and pulmonary artery C) The right atrium and right ventricle D) The left ventricle and aorta
The left atrium and left ventricle
In order to assess the dorsalis pedis pulse of a client diagnosed with arterial vascular disease, the nurse palpates which anatomical location? Refer to figure. * A) Top of the foot B) Side of the neck C) Inside of the wrist D) Behind the ankle
Top of the foot
A nurse is reviewing the laboratory findings of a client who has a myocardial infarction (MI) and reports that his dyspnea began 2 weeks ago. Which of the following cardiac enzymes would confirm the infarction occurred 14 days ago? * Read: (ATI) The Troponin T level will still be evident 14 to 21 days following an MI. A) Troponin T B) CK-MB C) Troponin I D) Myoglobin
Troponin T
A nurse is reinforcing teaching with a client the importance of remaining still following angiography. Which of the following is an appropriate statement by the nurse? * A) "Too much activity places you at risk for bleeding." B) "Moving in bed increases your risk of a complication due to anesthesia." C) "Too much activity increases your risk for infection." D) "Moving in bed raises your blood pressure."
"Too much activity places you at risk for bleeding."
A 65-year-old client with severe chest pain is evaluated in the emergency department. A tentative diagnosis of myocardial infarction (MI) is made. When obtaining this client's health history, which question about pain is least helpful? A) "When was the last time you had anything to eat or drink?" B) "How long have you been in pain?" C) "Where is your pain located?" D) "What were you doing when your pain started?"
"When was the last time you had anything to eat or drink?"
A nurse is reinforcing teaching with a client who is scheduled for a stress test. Which of the following should be included in the teaching? A) "You will exercise your heart by walking on a treadmill." B) "You should not have anything to eat or drink 8 hours prior to the test." C) "IV contrast will be given during the test." D) "A chest x-ray will be obtained following the test."
"You will exercise your heart by walking on a treadmill."
(Select all that apply.) A nurse is assisting in the care of a client who experienced defibrillation. Which of the following should be included in the documentation of this procedure? (Select all that apply.) A) Follow-up ECG B) Energy settings used C) Skin condition under electrodes D) IV fluid intake E) Urinary output
Follow-up ECG, Energy settings used, Skin condition under electrodes
(Select all that apply.) A nurse is assisting with the plan of care for a client who is postoperative following a percutaneous coronary intervention with the placement of a stent. Which of the following should the nurse include? (Select all that apply.) * A) Maintain the leg in an extended position. B) Place a sandbag over the access site. C) Monitor for dysrhythmias. D) Elevate the head of the bed 45°. E) Restrict oral fluids.
Maintain the leg in an extended position., Place a sandbag over the access site., Monitor for dysrhythmias.
The nurse working on a medical-surgical unit identifies several clients who have been diagnosed with coronary artery disease (CAD). Which of the following client risk factors is most significant for developing CAD? * A) Obesity B) Drinking a nightly cocktail C) History of mitral valve repair D) Rheumatic fever during childhood
Obesity
A nurse is setting up the bedside unit for a client being admitted to the nursing unit from the emergency department with a diagnosis of coronary artery disease (CAD). The nurse should place highest priority on making sure that which of the following is available at the bedside? * A) Oxygen tubing and flowmeter B) Bedside commode C) Rolling shower chair D) Twelve-lead electrocardiogram (ECG) machine
Oxygen tubing and flowmeter
A nurse is assisting with the care of a client who is on telemetry. The client's heart rate is 46/min. The nurse should anticipate that which of the following management strategies will be used for this client? * A) Pacemaker insertion B) Defibrillation C) Synchronized cardioversion D) Administration of IV lidocaine
Pacemaker insertion
A client is admitted to the hospital with a diagnosis of pericarditis. The nurse reviews the client's record for which manifestation that differentiates pericarditis from other cardiopulmonary problems? * A) Pericardial friction rub B) Anterior chest pain C) Weakness and irritability D) Chest pain that worsens on inspiration
Pericardial friction rub
A 65-year-old client with severe chest pain is evaluated in the emergency department. A tentative diagnosis of myocardial infarction (MI) is made. Which assessment finding is most closely correlated with an evolving MI? * A) Profuse sweating B) Facial flushing C) Severe headache D) Coughing up pink-tinged mucus
Profuse sweating
A nurse is collecting data on a client who will undergo peripheral bypass graft surgery on the left leg. Which of the following is an expected finding? * A) Report of intermittent claudication in the affected leg B) Rubor of the affected leg when elevated C) 3+ dorsal pedal pulse in left foot D) Thin, peeling toenails of left foot
Report of intermittent claudication in the affected leg
