NURS 223 Exam 2 Practice Questions

What is your first action when you see this rhythm? a. Call a code b. Prepared to defibrillate c. Check for pulse d. Start CPR

C. Check for a pulse

A nurse is teaching a client with hypertension about the newly prescribed captopril. Which of the following statements indicates that teaching has been successful? a. "I will contact the doctor is I notice any swelling around my lips." b. "I will take aspirin for headaches." c. "I will take my medicine every day with food. d. "I need to remember to take this medication with food."

a. "I will contact the doctor is I notice any swelling around my lips."

A client comes to the emergency department reporting of severe substernal chest pain radiating down the left arm. The client is admitted to the coronary care unit with a diagnosis of myocardial infarction (MI). Which of the following should the nurse do first when the client is admitted to the coronary care unit? a. Begin telemetry monitoring b. Obtain a health history c. Auscultate heart sounds d. Evaluate the client's pain

a. Begin telemetry monitoring

Which of the following outcome is desired when a client with arterial insufficiency has poor tissue perfusion in the extremities? a. Extremities warm to touch. b. Improved respiratory status. c. Increased muscle pain with activity. d. Lungs clear to auscultation.

a. Extremities warm to touch

Fluid retention as a hemodynamic response to myocardial infarction a. Increases preload b. Decreases preload c. Increases contractility d. Decreases contractility

a. Increases preload

After reviewing the chart of a patient with hypertension who is receiving captopril, which finding would cause the nurse to notify the HCP? a. Positive TB test b. Positive Pregnancy test c. Positive herpes test d. Positive HIV test

b. Positive pregnancy test

The nurse is developing an education plan for clients with hypertension. The nurse should emphasize which long-term goal? a. Develop a plan to limit b. Participate in a weight reduction program c. Commit to lifelong therapy d. Monitor blood pressure regularly

c. Commit to a lifelong therapy

One of the reasons to use a cardio-selective beta blocker like atenolol (Tenormin) for patients with MI is to: a. Reduce oxygen supply. b. Increase heart rate. c. Reduce oxygen demand. d. Increase cardiac contractility.

c. Reduce oxygen demand.

The pathophysiology associated with cardiac ischemia includes: a. Atherosclerosis b. Thrombus formation c. Vasospasms d. All of the above e. None of the above

d. All of the above

The nurse is caring for several patients. For which patient diagnosis would a prescription for nifedipine be least appropriate? a. hypertension b. angina c. atrial fibrillation d. pvc's

d. pvc's

A patient has a new prescription for an angiotensin-converting enzyme inhibitor. During a review of the patient's list of current medications, which medication does the nurse identify as potentially interacting with this new prescription? Select all that apply. a. NSAIDs b. Spirolactone c. Acetaminophen d. Potassium e. Hydralazine

A, B, D

Which of the following orders would the nurse anticipate initially in a client admitted with unrelieved chest pain? Select all that apply. a. Troponin level now b. Morphine sulfate 4 mg intramuscularly as needed for chest pain c. Electrocardiogram in 72 hours d. Computerized tomography scan of chest e. Cardiac diet f. Bed rest

A, E, F

When assessing a client with heart failure, the nurse should report which findings to the health care provider (HCP)? Select all that apply a. bibasilar crackles. b. blood pressure 108/62 mm Hg, heart rate 88 bpm c. O2 saturation 94% on room air d. 2-pound (0.9 Kg) weight gain in 5 days e. urine output 20 mL/hr

D, E

What is the nurse's priority action for a client experiencing dyspnea, dependent edema, hepatomegaly, crackles, and jugular vein distention? a. Reposition the client so his lower legs dangle off the bed b. Apply supplemental oxygen at 4 L/min c. Administer furosemide 40 mg IV as ordered d. Notify the attending physician

a. Reposition the client so his lower legs dangle off the bed

After being sick for 3 days, a client with a history of congestive heart failure is admitted to the hospital with complaints of general muscle weakness and extreme fatigue. The nurse should evaluate which diagnostic test results to prevent arrhythmias? a. Serum potassium level b. Serum calcium level c. Serum sodium level d. Serum chloride leveld

a. Serum potassium level

A 62 year old patient is admitted to the ED with severe lower back pain and indigestion. Auscultation of the lungs reveals multiple rales with productive cough. VS: 110/76, HR irregular at 114, RR 42 and shallow, pulse ox not detectable. What is the nursing priority action? a. Sit patient straight up in bed b. Apply oxygen c. Administer digoxin d. Prepare to cardiovert

a. Sit patient straight up in bed

What effect do calcium channels have on vascular smooth muscle? a. Positive Inotrope b.. Postiive chromotope c. Negative Chromotrope d. Negative Inotrope

a. positive inotrope

A nurse on the telemetry unit is faced with various monitor rhythms. Which rhythm takes priority? a. A client's cardiac monitor suddenly reveals sinus tachycardia with isolated premature ventricular contractions. b. A client's cardiac rhythm suddenly changes from normal sinus rhythm to uncontrolled atrial fibrillation. c. A client's monitor shows frequent-paced beats with capture. d. A client's monitor shows sinus tachycardia with frequent premature atrial contractions (PACs).

b. A client's cardiac rhythm suddenly changes from normal sinus rhythm to uncontrolled atrial fibrillation.

A nurse is assigned to care for a group of cardiac clients. Which client should the nurse address first? a. The client admitted with unstable angina pectoris who wants to be discharged. b. The client who suffered an acute myocardial infarction (MI) who is complaining of constipation. c. The client who had a pacemaker inserted yesterday and who is complaining of incisional pain. d. The client who has his call light on.

b. The client who suffered an acute myocardial infarction (MI) who is complaining of constipation.

Which adverse effect will the nurse monitor for in a patient who is receiving amlodipine? a. Diarrhea b. Ankle edema c. Diaphoresis d. backache

b. ankle edema

A client takes hydrochlorothiazide (HCTZ) for treatment of hypertension. The nurse should instruct the client to report which effects? a. muscle twitching b. muscle weakness c. confusion e. insomnia

b. muscle weakness

The nurse reviews a patient's laboratory values and observes a digoxin level of 2.5 ng/mL and a potassium level of 5.9 mEq/L. Upon physical assessment, the patient begins to experience changes in heart rate and rhythm (dysrhythmias). Which drug would the nurse be prepared to administer? a. Potassium supplements b. Quinidiine c. Digi-band d. Digoxin

c. Digi-band

A client with long-standing type 1 diabetes is admitted to the hospital with unstable angina pectoris and a blood glucose of 220. After evaluating the client's diabetic management regimen the nurse should do what? a. Prepare to schedule a pancreatic ultrasound b. Prepare to defibrillate c. Obtain a blood sample for troponin level d. Expect to give large doses of Dextrose 25%

c. Obtain a blood sample for a troponin level

Which drug does the nurse recognize as interacting with an angiotensin-converting enzyme (ACE) inhibitor? a. Steroids b. Furosemide c. Spironolactone d. Digoxin

c. Spironolactone

Which drug does the nurse know works to lower blood pressure by blocking angiotensin II receptor sites? a. Enalapril b. Furosemide c. Valsartan d. Renin

c. Valsartan

The heart undergoes cardiac remodeling during the initial phase of heart failure. Which structural change occurs with heart failure? a. Ventricular constriction b. Ventricular spasm c. Ventricular wall thickening d. Ventricular dysrhythmia

c. Ventricular wall thickening

An adult male patient who takes a beta blocker for blood pressure management tells the nurse, "I'm not going to take the drug anymore because it is interfering with my sex life." Which response by the nurse is most appropriate a. "I am glad you told me about this expected side effect. It is difficult to talk about such personal subjects." b. "I am sure this is difficult for you at this time; but the life saving medication is more important than sexual performance." c. "Talk about this with your HCP. There are other medications available that might be more appropriate for you." d. "I am sure this is frustrating. Give it a little more time and things may improve."

c."Talk about this with your HCP. There are other medications available that might be more appropriate for you."

The nurse is evaluating the cardiac function of a client with history of left ventricular hypertrophy and new diltiazem administration. Which client statement does NOT indicate adequate cardiac functioning? a. "I am sleeping well in the second floor bedroom." b. "My blood pressure has been consistently in the 130/70 range." c. "I am completing all of my activities of daily living independently." d. "In the morning, I notice 2 plus edema in my ankles."

d. "In the morning, I notice 2+ edema in my ankles."

Which of the following represents the functional impairment of the myocardium caused by myocardial infarction? a. Altered left ventricular compliance b. Decreased cardiac contractility with abnormal wall movement c. Decreased stroke volume d. All of the above

d. All of the above

The doctor has started your patient on metoprolol for his hypertension. Your teaching plan is based on the knowledge that metoprolol a. Is a potent arteriolar and venous vasodilator that reduces peripheral vascular resistance and lowers blood pressure b. Increases norepinephrine secretion and thus decreases blood pressure and heart rate c. Is an angiotensin converting enzyme (ACE) inhibitor that reduces blood pressure by blocking the conversion of angiotensin I to angiotensin II d. Blocks beta adrenergic receptor stimulation and thus causes decreased heart rate, myocardial contractility and conduction.

d. Blocks beta adrenergic receptor stimulation and thus causes decreased heart rate, myocardial contractility and conduction.