Perfusion Lecture

Which client seen at a health fair will be most at risk for hypertension? A. 23-year-old white man B. 44-year-old white woman C. 50-year-old Mexican-American woman D. 62-year-old African American man

D. 62-year-old African American man

When assessing a client with right ventricular heart failure, the nurse would expect which finding? A. Dependent edema B. Swollen hands and fingers C. Collapsed neck veins D. Right upper quadrant discomfort E. Oliguria

A. Dependent edema B. Swollen hands and fingers D. Right upper quadrant discomfort

Which response would the nurse give when a client is admitted with chest pain and a family memeber asks about the purpose of the prescribed 12-lead electrocardiogram? A. Indicates whether a heart attack is occuring B. Detects changes in the structures in the heart C. Shows wheter the heart muscle is pumping D. Evaluates for prognosis after heart attack.

A. Indicates whether a heart attack is occuring

Which nursing action is the priority for a client who has a serum potassium level of 6.7? A. Monitor for cardiac dysrhythmias B. Inquire about changes in bowel patterns C. Assess for leg muscle twithcing or weakness D. Assess for signs and symptoms of dehydration

A. Monitor for cardiac dysrhythmias

Which pain relief medication would the nurse expect to find in the plan of care of a client with a myocardial infarction admitted to the cardiac intensive care unit? A. Morphine B. Diazepam C. Midazolam D. Oxycodone

A. Morphine

Which action would the nurse take next when a client with a hisotry of heart failure on daily weights has a 4-pound weight gain since the previous day? A. Preform a head-to-toe assessment B. Place the client on restricted fluid intake C. Discuss a restricted sodium diet with the client D. Document the findings in the heart care record

A. Preform a head-to-toe assessment

Which clincal finding would the nurse expect for a client with hypertensive emergency? A. Increased urine output B. Severe pounding headache C. Heart rate 110 beats/minute D. Weak and thready radial pulses

B. Severe pounding headache

Which topic would the nurse include in teaching for a client with a new diagnosis of hypertension? A. Reason for daily low-dose aspiring use B. Use of home blood pressure monitor C. Adverse effects of tobacco on blood pressure D. Avoidance of an alcohol consumption E. Benefits of moderate daily exercise

B. Use of home blood pressure monitor C. Adverse effects of tobacco on blood pressure E. Benefits of moderate daily exercise

Which clincal condition is the result of changes in the integrity of arterial walls and small blood vessels? A. Contusion B. Thrombosis C. Atherosclerosis D. Tourniquet effect

C. Atherosclerosis

Which finding on an electrocardiogram for a client reporting chest pain indicates possible acute myocardial infarction. A. Flattened T waves B. Absense of P waves C. Elevated ST segments D. Disappearance of Q waves

C. Elevated ST segments

Which nursing action is important when a health care provider prescribes enalapril for a client? A. Assess the client for hypokalemia B. Monitor for adverse effects on renal function C. Monitor the client's blood pressure during therapy D. Assess the client for hypoglycemia

C. Monitor the client's blood pressure during therapy

Which dietary choice reflects the recommendations of the Dietary Approaches to Stop Hypertension (DASH) diet? A. Salami B. Pickles C. Salmon D. French fries

C. Salmon

When taking the health history for a client admitted with heart failure, which assessment finding will the nurse expect the client to report? A. Losing weight over the past week B. Tingling in the upper extremities C. Using several pillows at night to sleep D. Wheezing when exposed to dust or pollen

C. Using several pillows at night to sleep

Which diagnostic test is most important for the nurse to obtain rapidly when caring for a client who has just arrived in the emergency department with possible acute coronary syndrome (ACS)? A. Chest radiograph B. Troponin T (cTnT) C. Creatine kinase MB (CK-MB) D. 12-lead electrocardiogram (ECG)

D. 12-lead electrocardiogram (ECG)

Which over-the-counter medication would the nurse teach a client taking antihypertensive medication to avoid? A. Omeprazole B. Acetaminophen C. Docusate sodium D. Pseudoephedrine

D. Pseudoephedrine

Which medication is indicated to prevent progression of a myocardial infarction for a client admitted to the emergency department with crushing chest pain? A. Aspirin B. Atropine C. Gabapentin D. Epinephrine

A. Aspirin

Which information will the nurse include when teaching a client with hypertension about metoprolol? A. Do not abruptly discontinue the medication B. Consume alcholic beverages in moderate C. Report a heart rate of less than 70 beats per minute D. Increase the medication dosage if chest pain occurs.

A. Do not abruptly discontinue the medication

Which symptom would the nurse include when teaching a group of female clients about clinical manifestations of coronary artery disease that are more common in women? A. Dyspnea B. Indigestion C. Unusual fatigue D. Left chest pain E. Substernal pressure

A. Dyspnea B. Indigestion C. Unusual fatigue

Which rationale explains why the nurse also monitors a client with a history of gastroesophageal reflux disease (GERD) for clinical manifestations of heart disease? A. Esophageal pain may imitate the symptoms of a heart attack. B. GERD may predispose the client to the development of heart disease. C. Strenuous exercise may exacerbate reflux problems. D. Similar laboratory study changes may occur in both problems

A. Esophageal pain may imitate the symptoms of a heart attack.

Sildenafil is prescribed for a man with erectile dysfunction. Which side effects of this medication would the nurse mention in teaching? A. Flushing B. Headache C. Dyspepsia D. Constipation E. Hypertension

A. Flushing B. Headache C. Dyspepsia

The nurse is instructing a community group regarding risk factors for coronary artery disease. Which risk factor cannot be modified? A. Heredity B. Hypertension C. Cigarette smoking D. Diabetes mellitus

A. Heredity

Which action would the nurse preform when a client is in ventricular fibrillation? A. Initiating CPR B. Assessing the EKG C. Using a defibrillator D. Obtaining electrolytes E. Administering epinerphine

A. Initiating CPR B. Assessing the EKG C. Using a defibrillator D. Obtaining electrolytes E. Administering epinerphine

Which priorty nursing action would the nurse implement first when caring for a client recieving nitroglycerin for the treatment of angina? A. Instruct the client to sit or stand slowly B. Monitor the client's urine output frequently C. Advise the client to report when experiencing a headache. D. Instruct client to notify the health care provider if pain does not subside after 5 minutes.

A. Instruct the client to sit or stand slowly

Which lifestyle factor, that may have contributed to the ankle swelling, would a nurse ask about when questioning a client with heart failure and new onset ankle edema? A. Intake of salty foods B. Dietary fat intake C. Medication compliance D. Family stesses E. Recent travel

A. Intake of salty foods C. Medication compliance E. Recent travel

Which action would the nurse taken when a client returns after a cardiac catheterization using the right femoral artery and the nurse notes the right pedal pulses are not palpablr and the foot is cool? A. Notify the health care provider immediately. B. Apply pressure to the femoral insertion site. C. Increase teh intravenous fluid flow rate D. Monitor the insertion site and foot frequently.

A. Notify the health care provider immediately.

Which instruction would the nurse give an unlicensed assistive personnel (UAP) to pregorm while caring for a client prescribed captopril? A. Obtain blood pressure B. Measure intake and output C. Weigh the client every morning D. Notify the nurse if the client has a dry cough. E. Assist the client to change positions slowly.

A. Obtain blood pressure B. Measure intake and output C. Weigh the client every morning D. Notify the nurse if the client has a dry cough. E. Assist the client to change positions slowly.

Which laboratory valve will be important for the nurse to monitor to determine whether a client with chest pain has acute coronary syndrome (ACS)? A. Troponin T (cTnT) B. C-reactive protein (CRP) C. Low-density lipoprotein (LDL) D. B-type natriuretic protein (BNP)

A. Troponin T (cTnT)

Which statement for a client who is seen for follow-up in the heart failure clinic is most important for the nurse to communicate to the health care provider? A." I am unable to run 1 mile now" B. "I wake up at night short of breath" C. "My spouse says I snore loudly" D. "My shoes seem larger lately"

B. "I wake up at night short of breath"

Which hypersensitiity condition would the nurse suspect when a client presents with cutaneous lesions, swelling of the face, eyelids, and lips from dilation and engorgement of the capillaries but no observable welts or vesicles? A. Urticarial dermatitis B. Angioedema C. Atopic dermatitis D. Systemic lupus erythematosus (SLE)

B. Angioedema

Which action will the nurse take first when two hours after a cardiac catheterization that was accessed through the right femoral route, a client reports numbness and pain in the right foot? A. Call the primary health care provider B. Check the client's pedal pulses bilaterally. C. Take the client's blood pressure and pulse D. Teach about postcatheterization embolus

B. Check the client's pedal pulses bilaterally.

Whic type of lung sounds would the nurse expect to hear when caring for a client with heart failure? A. Stridor B. Crackles C. Wheezes D. Rhonchi

B. Crackles

Which explanation would the nurse include when teachign a client with heart failure about the reason for low-sodium diet? A. Body weight control B. Decreased fluid retention C. Lowering of blood pressure D. Prevention of hypernatremia

B. Decreased fluid retention

Which assessment finding is consistent with a client diagnosis of right-sided heart failure? A. Collapsed neck veins B. Distended abdomen C. Dependent edema D. Decreased appetite E. Cool extremities

B. Distended abdomen C. Dependent edema D. Decreased appetite

Which laboratory result will the nurse expect when caring for a client who presents to the emergency department with an ST-segment-elevation myocardial infarction (STEMI)? A. Decreased white blood cell count B. Elevated serum troponins I and T C. Decreased creatine kinase-MB (CK-MB) D. Decreased B-type natriuretic preptide (BNP)

B. Elevated serum troponins I and T

After the nurse has completed teaching a client with hypertension about a heart-healthy diet, which meal choice by the client indicated that the teaching has been effective? A. Bean soup with ham B. Grilled steak and green salad. C. Chicken and cheese enchiladas D. Fried fish and green beans

B. Grilled steak and green salad.

Which sign of hypokalemia will the nurse monitor for in a client receiving furosemide? A. Chvostek sign B. Muscle weakness C. Anxious behavior D. Abdominal cramping

B. Muscle weakness

Which client information is important to communicate to the health care provider when the nurse is obtaining a health history for a client scheduled for cardiac catheterization? A. Drinks 2 cups of coffee daily B. Reports allergy to most shellfish C. Recently had dobutamine stress test D. Takes daily low-dose aspirin tablet

B. Reports allergy to most shellfish

Which finding for a client who has just returned to the nursing unit after an emergency cardiac catheterization would be most important to report to the primary health care provider? A. Anxiety about the results of the procedure B. ST-segment elevation on the electrocardiogram C. Pain at the femoral artery catheter insertion site D. Premature atrial contractions on the cardiac monitor.

B. ST-segment elevation on the electrocardiogram

Which condition would the nurse conclude that the client is experiencing when the monitor shows a PQRST wave for each beat, indicates a rate of 120 beats per minute, and the rhythm is regular? A. Atrial fibrillation B. Sinus tachycardia C. Ventricular fibrillation D. First- degree atrioventricular block

B. Sinus tachycardia

Which statement by a client indiacted that the nurse's preprocedure teaching about cardiac catheterization has been effective? A. "I will be asleep during most of the procedure" B. "I will be in the catheterization laboratory for about 15 minutes" C. "I will need to be in bed for several hours after the procedure" D. "I will need to deep breathe and cough frequently after the procedure"

C. "I will need to be in bed for several hours after the procedure"

Which instruction will the nurse provide about an angiotension II receptor blocker (ARB) prescribed to a client with hypertension? A. "Monitor the blood pressure daily" B. "Stop treatment if a cough develops" C. "Stop the medication if swelling of the mouth, lips, or face develops" D. "Have blood drawn for potassium levels 2 weeks after starting the medication" E. "Do not take NSAIDS concurrently with this medication

C. "Stop the medication if swelling of the mouth, lips, or face develops" D. "Have blood drawn for potassium levels 2 weeks after starting the medication"

Which action would the nurse preform first when prioritizing care for a hypertensive client? A. Administer oxygen B. Monitor for blood pressure C. Assess for a severe headache D. Place the client in semi-Fowler position

C. Assess for a severe headache

Which laboratory result will be imprortant for the nurse to review when a client is admitted to the hospital with a long history of uncontrolled hypertension? A. Blood glucose level B. White blood cell count C. Blood urea nitrogen D. Lactic dehydrogenase

C. Blood urea nitrogen

Which complication is a priority for the nurse to prevent for a client who has just returned to the nursing unit after coronary artery stenting via access through the femoral artery? A. Infection B. Urinary Retention C. Hematoma formation D. Orthostatic hypotension

C. Hematoma formation

Which rationale supports the nurse's instruction that a client with chronic kidney disease is to avoid all salt substances? A. A person's body tends to retain fluid when a salt subsitute is included in the diet B. Limiting salt substitutes in the diet prevents a buildup of waste produces in the blood? C. Salt substitues contain potassium, which must be limited to prevent abnormal heartbeats. D. The salt substitue substances interfere with capillary membrane transfer, resulting in anasarca.

C. Salt substitues contain potassium, which must be limited to prevent abnormal heartbeats.

A client with a coronary occlusion is experiencing chest pain and distress. Which is the primary reason that the nurse administers oxygen? A. To prevent dyspnea B. To prevent cyanosis C. To increase oxygen concentration to heart cells D. To increase oxygen tension in the circulating blood.

C. To increase oxygen concentration to heart cells

Which statement by a client is consistent with a diagnosis of heart failure? A. "I see spots before my eyes" B. "I am tired at the end of the day" C. "I feel bloated when I eat a large meal" D. "I have trouble breathing when I climb a flight of stairs"

D. "I have trouble breathing when I climb a flight of stairs"

Which statement by the client would the nurse expect when assessing a client with a diagnosis of left ventricular failure? A. "My ankles are swollen" B. "My appetitie is not very good" C. "When I eat a large meal, I feel bloated" D. "I have trouble breathing when I walk rapidly"

D. "I have trouble breathing when I walk rapidly"

Which response would the nurse give to a client with a possible past history of myocardial infarction who asks about the purpose of the ECG that has been prescribed? A. "This test will look for heart valve problems" B. "This test will show how well your heart is pumping" C. "The ECG will tell us how much exercise your heart can tolerate" D. "The ECG will show if there has been damage to the heart muscle"

D. "The ECG will show if there has been damage to the heart muscle"

Which client statement indicates an understanding of the nurse's instructions concerning a Holter monitor? A. "The only times the monitor should be taken off are for showering and sleep" B. "The monitor will record my activites and symptoms if an abnormal rhythm occurs" C. "The results from the monitor will be used to determine the size and shape of my heart" D. "The monitor will record any abnormal heart rhythms while I go abouse my usual activities"

D. "The monitor will record any abnormal heart rhythms while I go abouse my usual activities"

Which information will the nurse include when providing instructions to a client with the diagnosis of primary hypertension who is started on a regimen of hydrochlorothiazide? A. A common side effect is decreased sexual libido B. One dose should be omitted if dizziness occurs when standing up. C. The client should adjust the dosage daily based on the client's blood pressure D. An antihypertensive medication will likely be required for the remainder of life.

D. An antihypertensive medication will likely be required for the remainder of life.

Which antihypertensive medication class would the nurse identify as the likely cause of the cough in a client taking multipe medications for hypertension who develops a persistent, hacking cough? A. Thiazide diuretics B. Calcium channel blockers C. Direct renin inhibitors D. Angiotensin-coverting enzyme (ACE) Inhibitors

D. Angiotensin-coverting enzyme (ACE) Inhibitors

Which prescription by the health care provider would the nurse question when caring for a client who is hospitalized for an acute myocardial infarction? A. Long-acting beta blocker B. Daily low-dose aspiring tablet C. H1 blocker to reduce gastric acid secretions D. Rectal suppository as needed for constipation

D. Rectal suppository as needed for constipation