practice questions

1. A client with severe HF is ordered dobutamine at 2.5 mcg/kg/min. The client's weight is 90.5 kg. How many mg/hr. should the client receive? (Round to the nearest tenth)

13.6

1. A client who is recovering from an acute myocardial infarction (AMI) asks the nurse about resuming sexual intercourse. Which response by the nurse is best? a. "Resumption of sex depends on the healthcare providers assessment of the recovery process." b. "The best time to have intercourse is in the morning" c. "Use erectile dysfunction drugs if your unable to obtain an erection d. "You will not be able to have sexual relations for several months related to increased cardiac output."

a. "Resumption of sex depends on the healthcare providers assessment of the recovery process."

1. The client is admitted to the hospital with heart failure. The client complains of shortness of breath and the nurse notes the Heart rate increases from 86 to 110 beats/min. The nurse also notes the respiratory effort increases with position changes. Which condition is the client experiencing? a. Activity intolerance b. Impaired mobility c. Atrial Fibrillation d. Anxiety

a. Activity intolerance

1. A 20-yr-old patient has a mandatory electrocardiogram (ECG) before participating on a college soccer team and is found to have sinus bradycardia, rate 52. Blood pressure (BP) is 114/54 mm Hg, and the student denies any health problems. What action by the nurse is most appropriate? a. Allow the student to participate on the soccer team. b. Refer the student to a cardiologist for further testing. c. Tell the student to stop playing immediately if any dyspnea occurs. d. Obtain more detailed information about the student's family health history.

a. Allow the student to participate on the soccer team.

1. A nurse on the Cardiac Care Unit is monitoring Telemetry. The following Rhythm appears on the cardiac monitor. Which of the following medications may be used to treat this dysrhythmia? SATA AFIB a. Amiodarone b. Diltiazem c. Lanoxin (digoxin) d. Warfarin e. Morphine

a. Amiodarone b. Diltiazem c. Lanoxin (digoxin) d. Warfarin

1. A client is admitted to the hospital with early-stage heart failure. Which assessment finding does the nurse expect? a. An increase in heart rate and respiratory rate b. A decrease in blood pressure and urine output c. An increase in Creatinine and extremity edema d. A decrease in respiration and oxygen saturation

a. An increase in heart rate and respiratory rate

1. Client with new onset of angina is ordered 1 inch of nitroglycerin ointment. What are some points of instruction for the client? (SELECT ALL THAT APPLY) a. Apply to area free of scars and hair b. Take acetaminophen for headache PRN c. Rise slowly d. Wear patch 24/7 e. Keep appointment to monitor nitrate levels

a. Apply to area free of scars and hair b. Take acetaminophen for headache PRN c. Rise slowly

1. The nurse is performing an admission assessment of an older adult client with multiple chronic diseases. The nurse finds the heart rate to be 48 beats/minute. What will the nurse do first? a. Assess the client's medications b. Administer atropine c. Evaluate the client for a pulse deficit d. Document the finding as normal

a. Assess the client's medications

1. Which is the priority intervention for the client experiencing atrial fibrillation (A-fib)?(blood clot) a. Assessing for shortness of breath b. Assessing pulse oximetry every hour c. Measuring urinary output every hour d. Measuring for orthostatic hypotension

a. Assessing for shortness of breath

1. A client is admitted with a diagnosis of HF exacerbation. Which diagnostic test would support the client has not complied with his therapeutic regime? a. BNP 600 mg/mL b. ECG in sinus Rhythm with occasional PVCs c. Jugular vein distention while supine d. Na+ 144 meq/L

a. BNP 600 mg/mL

1. In an effort to prevent the extension of a MI during the acute phase, which group of drugs would most likely be described? (SELECT ALL THAT APPLY) a. Beta blockers b. Nitroglycerin medications c. Morphine d. Cardio glycosides e. Ibuprofen

a. Beta blockers b. Nitroglycerin medications c. Morphine

1. A client is discharged home with a MI. You are visiting her as a home health care nurse. Which of the following statements should be included in client teaching? SATA a. Call 911 if chest pain is unrelieved after taking 3 nitroglycerin tablets b. Report the need to sleep with extra pillows c. You may resume sexual relations after cardiac clearance d. Report weight gain and dyspnea especially occurring at night e. Take all medications early in the AM

a. Call 911 if chest pain is unrelieved after taking 3 nitroglycerin tablets b. Report the need to sleep with extra pillows c. You may resume sexual relations after cardiac clearance d. Report weight gain and dyspnea especially occurring at night

1. The client is being treated with Atenolol (Tenormin). The nurse notes that the client has been experiencing sinus bradycardia (heart rate 48) what is the highest priority nursing intervention? a. Call the physician, the medication is contraindicated if there is sinus bradycardia b. Teach the patient that he should notify the physician if he experiences a rapid heart rate c. Teach the client the medication schedule must be strictly adhered to d. Call the physician; the dosage should be increased when there is sinus bradycardia

a. Call the physician, the medication is contraindicated if there is sinus bradycardia.

1. A Beta blocker is frequently ordered following a diagnosis of ACS. In which of the following situations would you expect the beta blocker to be discontinued? a. Cardiogenic shock b. Chronic Heart failure c. An elderly client with cardiovascular disease d. Chronic lung diseases without active bronchospasms

a. Cardiogenic shock

1. A patient in the emergency department presents with new onset of rapid rate atrial fibrillation and the RN is preparing a continuous infusion. Which drug is most appropriate for this dysrhythmia? a. Diltiazem (Cardizem) b. Atenolol (Tenormin) c. Lidocaine d. Adenosine (adenocard)

a. Diltiazem (Cardizem)

1. A client is starting captopril therapy. The nurse will monitor for the development of which potential side effects? SATA a. Dry cough b. Hyperkalemia c. Bradycardia d. Pedal edema e. Orthopnea

a. Dry cough b. Hyperkalemia

1. A client presents to the emergency room with chest pain, shortness of breath and fatigue. The following findings are noted on assessment. BNP level 200, elevated troponin level, creatinine level of 3.0, and normal electrolytes. Which of the following nursing interventions are appropriate? (SELECT ALL THAT APPLY) a. Elevated head of bed 30-40 degrees. b. Oxygen per nasal cannula as ordered c. Strict intake and output d. Nitroglycerin SL, PRN for chest pain. e. Unrestricted activity level

a. Elevated head of bed 30-40 degrees. b. Oxygen per nasal cannula as ordered c. Strict intake and output d. Nitroglycerin SL, PRN for chest pain.

1. The patient has decreased cardiac output and is at risk for sudden cardiac death. When reviewing the date, you find the ejection fraction to be <30%. You should expect to prep the client for which - procedure? a. Implantable cardioverter Defibrillator (ICD) b. Permanent Pacemaker c. Implantable Mediport d. Coronary artery bypass graft (CABG)

a. Implantable cardioverter Defibrillator (ICD)

1. A client is ordered Simvastatin (Zocor) for the management of dyslipidemia. The client is instructed by the nurse to have which serum level monitored by the health care provider while on this drug? a. Liver enzymes b. Blood urea nitrogen BUN c. Electrolyte panel d. Cardiac enzymes

a. Liver enzymes

1. A client experiences chest pain and bradycardia during a Cardiac Catheterization. The nurse has which drugs available? a. Nitroglycerin and atropine b. Diazepam and verapamil c. Meperidine and digoxin d. Morphine sulfate and epinephrine

a. Nitroglycerin and atropine

1. Which nursing action can the registered nurse (RN) delegate to experienced unlicensed assistive personnel (UAP) working as telemetry technicians on the cardiac care unit? a. Observe heart rhythms for multiple clients who have telemetry monitoring b. Decide whether a client's heart rate of 116 requires urgent treatment c. Monitor a client's level of consciousness during synchronized cardioversion d. Select the best lead for monitoring a client admitted with acute coronary syndrome

a. Observe heart rhythms for multiple clients who have telemetry monitoring

1. A client is in sinus bradycardia with a heart rate of 45 beats per minute, complains of dizziness, and has a blood pressure of 82/60 mm Hg. Which of the following should the nurse anticipate will be prescribed? a. Prepare for transcutaneous pacing b. Defibrillate the client c. Administer digoxin (Lanoxin) d. Continue to monitor the client

a. Prepare for transcutaneous pacing

1. A patient had a non-ST-segment-elevation myocardial infarction (NSTEMI) 3 days ago. Which nursing intervention included in the plan of care is appropriate for the registered nurse (RN) to delegate to an experienced licensed practical/vocational nurse (LPN/LVN)? a. Reinforcement of teaching about the purpose of prescribed medications b. Completion of the referral form for a home health nurse follow-up c. Education of the patient about the pathophysiology of heart disease d. Evaluation of the patient's response to walking in the hallway

a. Reinforcement of teaching about the purpose of prescribed medications

1. A client of Asian descent is admitted with uncontrolled hypertension, congestive heart failure (CHF) and coronary artery disease (CAD). Which outcome indicates that the client's cultural needs have been addressed? a. The client lists foods lowest in sodium and fat from those normally consumed. b. Written materials are provided for the client and family. c. The client states correct use of medications in native language d. Teaching completed with significant other and client.

a. The client lists foods lowest in sodium and fat from those normally consumed.

1. Two hours after presenting to the emergency department with complaints of substernal chest pain, a client's lab results demonstrate that myoglobin levels have not risen. What would the nurse anticipate as the plan of care? a. The client needs further assessment b. The client would be treated for an evolving MI c. The client would be referred to cardiac rehab d. The client is experiencing exacerbation of heart failure

a. The client needs further assessment

1. A patient admitted 24 hours previously with heart failure and lost 1 kg (2.2lb) of weight, has a heart rate of 88 (which was 105 on admission) and now has crackles only in the bases of the lungs. How will the nurse interpret these assessment findings? a. The treatment regimen is achieving desired effect. b. No further treatment is required at this time because failure has resolved c. Patient's condition is unchanged d. Aggressive treatment is needed

a. The treatment regimen is achieving desired effect.

1. The client has been admitted with acute coronary syndrome (ACS). The nurse evaluates the labs. Which of the following labs requires immediate action? a. Troponin "T" 0.8 mg/mL b. Myoglobin 50.2 mcg/L c. CK MB < 2% d. HDL 70 mg/dL

a. Troponin "T" 0.8 mg/mL

1. Your client is a 55-year-old female admitted with a history of a MI, valvular disorder, and heart failure. The client presents with weight gain, ascites, heart rate of 104/min, crackles, and complaints of fatigue and gastrointestinal symptoms. Which of the following conditions are most likely developing? SATA a. Unstable Angina b. Bi-Ventricular Failure c. Myocardial Infarction d. COPD Exacerbation e. Pulmonary Embolism

a. Unstable Angina b. Bi-Ventricular Failure c. Myocardial Infarction

1. A 68-year-old female who presents with complaints of indigestion and nausea is concerning for which of the following diseases? SATA a. Unstable angina b. St-elevation myocardial infarction c. Gastroesophageal reflux disease d. Crohn's disease e. Non-St. elevated myocardial infarction

a. Unstable angina b. St-elevation myocardial infarction e. Non-St. elevated myocardial infarction

1. The nurse is caring for a client on the medical surgical unit who suddenly become unresponsive and has no pulse. The cardiac monitor shows the rhythm below. After calling for assistance and a defibrillator, which action should the nurse take next. VFIB a. Initiate CPR b. Perform a pericardial thump c. Start an 18-gauge intravenous line. d. Ask the clients family about code status

a. initiate CPR

1. A nurse teaches a client with a new permanent pacemaker. Which instructions should the nurse include in the client's teaching? (Select all that apply) a. "If you feel weak, apply pressure over your generator" b. "Do not lift your left arm above the level of your shoulder for 8 weeks" c. "Report any pulse rates lower than your pacemaker settings" d. "Have your pacemaker turned off before having magnetic resonance imaging (MRI)" e. "Until your incision is healed, do not submerge your pacemaker. Only take showers"

b. "Do not lift your left arm above the level of your shoulder for 8 weeks" c. "Report any pulse rates lower than your pacemaker settings" e. "Until your incision is healed, do not submerge your pacemaker. Only take showers"

1. The client is scheduled for a resting electrocardiography (Electrocardiogram). Which statement by the client indicates a good understanding of the pre-procedure teaching? a. "I cannot eat or drink before the electrocardiography" b. "I must lie as still as possible during the procedure." c. "I am likely to feel warmth as the dye enters the heart" d. "I will increase my fluid intake on the day of the procedure"

b. "I must lie as still as possible during the procedure."

1. A client admitted to the hospital to rule out an MI is diagnosed with unstable angina. The client's physician orders nitroglycerin (NTG) sublingual tablets. Which statement by the client indicates a need for further teaching regarding this therapy? a. "I will allow the NTG tablet dissolve under my tongue" b. "I will swallow my NTG tablet with a full glass of water." c. "If I still have chest pain after I have taken NTG tablets I should call 9/11" d. "I can take Tylenol if I get a headache from taking NGT"

b. "I will swallow my NTG tablet with a full glass of water."

1. The nurse is assessing a client admitted to the cardiac unit. What statement made by the client alerts the nurse to the possibility of right-sided heart failure? a. "I sleep with four pillows at night" b. "My shoes fit really tight lately" c. "I wake up coughing every night" d. "I have trouble catching my breath"

b. "My shoes fit really tight lately"

1. A client with a pulmonary history is being treated for atrial fibrillation with a rapid ventricular response with metoprolol (Toprol XL). The nurse assesses the client and notes the following: Apical HR 62 BPM, BP 118/68. Breathe sounds reveal high pitched wheezing in bilateral anterior and posterior chest. What is the highest priority nursing intervention? a. Educate the client on the importance of taking metoprolol to keep the heart rate in the 60-100 beat per minute range b. Administer the metoprolol as ordered since the heart rate and blood pressure are within the client's trended vital signs c. Teach the client to call the doctor if he experiences chest palpitations d. Hold the metoprolol and contact the healthcare provider and notify him of the wheezing

b. Administer the metoprolol as ordered since the heart rate and blood pressure are within the client's trended vital signs

1. Two days following insertion of a pacemaker, the client calls the cardiac nurse practitioner, stating that he "just doesn't feel right" What question does the nurse ask to assess pacer functioning? a. Are you having diarrhea? b. Are you feeling weak and dizzy? c. Were you able to eat lunch without nausea? d. Do you have a headache?

b. Are you feeling weak and dizzy?

1. When titrating IV nitroglycerin for a patient with a myocardial infarction (MI), which action will the nurse take to evaluate the effectiveness of the drug? a. Monitor heart rate b. Ask about chest pain c. Check blood pressure d. Observe for dysrhythmias

b. Ask about chest pain

1. When admitting a client with a non st-segment elevation myocardial infarction to the Intensive Care Unit, which nursing intervention takes priority? a. Obtain STAT ABGs b. Assess the cardiac rhythm c. Obtain UA/C&S d. Assess the peripheral pulses

b. Assess the cardiac rhythm

1. When admitted a client with atrial fibrillation with rapid ventricular response (RVR) to the intensive care unit, which action should the nurse perform first? a. Assess rhythm b. Auscultate breath sounds c. Assess the peripheral pulses d. Obtain blood pressure

b. Auscultate breath sounds

1. Which finding should alert the nurse to monitor the newly diagnosed client with heart failure more closely? a. Respiratory rate of 22 breaths per min b. Distended neck veins while head of bed is elevated c. Cap Refill of less than 3 seconds d. BP of 145/90 while standing

b. Distended neck veins while head of bed is elevated

1. A client who has recently started pravastatin (Pravachol) and niacin reports several symptoms to the nurse. Which information is most important to communicate to the health care provider? a. Dizziness with rapid position changes b. Generalized muscle aches and pains c. Nausea when taking the drugs before meals d. Flushing and pruritus after taking the drug

b. Generalized muscle aches and pains

1. When caring for a patient who has just arrived on the telemetry unit after having cardiac catheterization, which nursing intervention should the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)? a. Titrate the heparin infusion according to the agency protocol b. Give the scheduled aspirin and lipid-lowering medication c. Teach the client about the usual post procedure plan of care d. Perform the initial assessment of the catheter insertion site

b. Give the scheduled aspirin and lipid-lowering medication

1. Which nursing intervention will be most effective when assessing the client of Middle Eastern descent with coronary artery disease (CAD) to make appropriate dietary changes? a. Give the client a list of low-sodium, low-cholesterol foods that should be included in the diet b. Help the client modify favorite high-fat recipes by using low-cholesterol items when possible c. Inform the client that a diet containing no saturated fat and minimal salt will be necessary d. Emphasize the increased risk for heart problems unless the client makes dietary changes

b. Help the client modify favorite high-fat recipes by using low-cholesterol items when possible

1. You are preparing to administer nitroglycerin sublingual to a 59 y/o male client with unstable angina. He complains of 7/10 chest pain. BP is 95/64, HR 89, and SPO2 of 95%. Which of the following actions should you take next? a. Inform the client that the medication may give him a headache b. Hold the medication and notify the provider c. Reassess his chest pain after administering d. Give the nitroglycerin as ordered

b. Hold the medication and notify the provider

1. The nurse is admitting a client to the med surg unit for a heart exacerbation. Which statement by the client alerts the nurse that the client is not complying with the provider's treatment regime? a. I weigh myself every day at the same time b. I do not take any Lasix because it makes me pee all day c. I haven't had a bologna sandwich in a long time d. I see my Dr. on a regular basis to evaluate treatment

b. I do not take any Lasix because it makes me pee all day

1. A client is involved in an auto accident with blunt abdominal trauma. His history includes atrial fib treated with Coumadin, renal insufficiency, and HTN. A foley catheter is inserted with bright red return. What lab results should be reviewed immediately? SATA a. BNP b. INR c. Serum BUN/ Creatinine d. Myoglobin level e. Hgb and Hct level

b. INR c. Serum BUN/ Creatinine e. Hgb and Hct level

1. Which action by a new registered nurse (RN) who is orienting to the telemetry unit indicates a good understanding of the treatment of heart dysrhythmias? a. Prepares defibrillator settings at 360 joules for a patient whose monitor shows asystole. b. Injects IV adenosine (Adenocard) over 2 seconds to a patient with supraventricular tachycardia c. Turns the synchronizer switch to the "on" position before defibrillating a patient with ventricular fibrillation d. Gives the prescribed dose of diltiazem (Cardizem) to a patient with new-onset type II second degree AV block

b. Injects IV adenosine (Adenocard) over 2 seconds to a patient with supraventricular tachycardia

1. A client presents to the short stay unit with angioedema after being on captopril (Capoten) for one year, which of the following drugs would the nurse expect the health care provider to order to replace the Capoten for this client? a. Lisinopril (Prinivil) b. Losartan (Cozaar) c. Spironolactone (Aldactone) d. Rhythmal (Propafenone)

b. Losartan (Cozaar)

1. An assessment finding by the nurse caring for a client who has had coronary artery bypass - (CABG) using the right radial artery is most important to communicate to the health care provider? a. Complaints of incisional chest pain b. Pallor and weak pulse of the right hand. c. Fine crackles heard at both lungs' bases d. Redness on both sides of the sternal incision

b. Pallor and weak pulse of the right hand.

1. A patient's heart monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern. The patient is unconscious, apneic, and pulseless. Which action should the nurse take first? - (ventricular fibrillation and cardiac arrest) a. Give epinephrine (Adrenalin) IV. b. Perform immediate defibrillation. c. Prepare for endotracheal intubation. d. Ventilate with a bag-valve-mask device.

b. Perform immediate defibrillation.

1. The nurse is assessing a client admitted to the cardiac unit. Which assessment findings are a priority for the nurse to report to the healthcare provider? a. HR 98, BP 110/72, 1+ pedal edema in bilateral extremities b. Pulse oximetry 88% on room air, dry hacking cough, confusion c. Abdominal girth 36 inches, peripheral pulse amplitude regular d. Sodium level 135 mEq/L, scattered crackles in all lung fields

b. Pulse oximetry 88% on room air, dry hacking cough, confusion

1. Which electrocardiographic (ECG) change is most important for the nurse to report to the health care provider when caring for a patient with chest pain? a. Inverted P wave b. ST-segment elevation c. Sinus tachycardia d. First Degree atrioventricular block

b. ST-segment elevation

1. A patient who is being admitted to the emergency department with intermittent chest pain gives the following list of daily medications to the nurse. Which medication has the most immediate implications for the patient's care? a. Captopril b. Sildenafil (Viagra) c. Furosemide (Lasix) d. Warfarin (Coumadin)

b. Sildenafil (Viagra)

after assessing a client who is receiving an amiodarone (Cordarone) intravenous infusion for unstable ventricular tachycardia, the nurse documents the findings and compares these with the previous assessment findings. Based on the assessments, which action should the nurse take? 0800 vitals and assessment: 98 F temp, 68 HR, 135/60 BP, 14 RR, 96% spo2 on 2L nasal cannula. pt alert and oriented with a normal sinus rhythm, skin is warm and dry. respirations are equal and unlabored. client denies SOB and chest pain. 1000 vitals and assessment: 98 F temp, 50 HR, BP 132/57, 16 RR, 95% spo2 on 2 L nasal cannula. PAtient is alert and oriented with sinus bradycardia. skin is warm and dry. respirations are equal and unlabored. client denies SOB and chest pain. client voids 420 ml of clear yellow urine. a. Administer IV normal saline b. Slow the amiodarone infusion rate c. Ask the client to cough and deep breathe d. Stop the infusion and flush the IV

b. Slow the amiodarone infusion rate

1. A patient whose heart monitor shows sinus tachycardia, rate 132, is apneic, and has no palpable pulses. What action should the nurse take next? - (PEA-pulseless electrical activity) a. Perform synchronized cardioversion. b. Start cardiopulmonary resuscitation (CPR). c. Give atropine per agency dysrhythmia protocol. d. Provide supplemental O2 via non-rebreather mask.

b. Start cardiopulmonary resuscitation (CPR).

1. A nurse is evaluating a client's response to cardioversion which of the following observations would be of highest priority to the nurse? a. Blood pressure b. Status of airway c. Oxygen flow rate d. Level of conscience

b. Status of airway

1. A client is admitted to the emergency department with chest pain, shortness of breath, fatigue. The lab results are as follows: Increased BUN and Creatinine, increased level of LDL vs HDL, increased BNP, and normal Troponin level. The client states that the chest pain started yesterday evening and is worse with activity and stress. Which medication would the nurse expect to administer? a. Plavix (clopidogrel) b. Sublingual Nitroglycerin c. Simvastatin (Zocor) d. Tissue-type plasminogen activator (TPA)

b. Sublingual Nitroglycerin

1. When teaching the patient with newly diagnosed heart failure about a 2000-mg sodium diet, the nurse explains that foods to be restricted include a. Fresh or frozen vegetables. b. Yogurt and milk products. c. Eggs and other high-protein foods. d. Canned and frozen fruits.

b. Yogurt and milk products.

1. The nurse is caring for a client on a telemetry unit. The nurse interprets the rhythm strip below from the nursing station monitor. What is the nurse's priority action? VTACH a. Defibrillate b. Assess the client c. Call a code d. Start CPR

b. assess the client

1. A client with a history of Atrial fibrillation (A fib) is prescribed Digoxin (Lanoxin) 0.125mg daily. The nurse needs to determine the amount to be administered per peg tube. On hand: Digoxin 0.5mg/5mL. What is the correct dose to be administered? a. 1.25 ml b. 1 ml c. 1.3 ml d. 1.0 ml

c. 1.3 ml

1. Which of the following people are most likely to experience an episode of angina? a. A 58-year-old female 2-pack-a-day smoker outside in the winter on a smoke break b. A 66-year-old female with COPD who is riding her bicycle c. A 55-year-old male with a sedentary lifestyle shoveling snow from his sidewalk d. A 62-year-old male diabetic out for a walk after eating a large meal

c. A 55-year-old male with a sedentary lifestyle shoveling snow from his sidewalk

1. After receiving change-of-shift report about the following four clients on the cardiac care unit, which client should the nurse assess first? a. A 65-year-old who had a MI 4 days ago and is anxious about today's planned discharge b. A 56- year-old with variant angina who is scheduled to receive nifedipine (Procardia) c. A 59-year-old with unstable angina who has just returned after a percutaneous coronary intervention (PCI) d. A 39-year-old client with pericarditis who is complaining of sharp stabbing chest pain

c. A 59-year-old with unstable angina who has just returned after a percutaneous coronary intervention (PCI)

1. Which nursing action is essential for the client experiencing severe pitting edema secondary to heart failure? a. Turn the client frequently to prevent skin breakdown b. Maintain strict bed rest c. Administer oxygen at 6L/min via nasal cannula d. Place in Sims' position for meals

c. Administer oxygen at 6L/min via nasal cannula

1. The nurse is caring for four clients on a cardiac unit. Which of the following therapeutic nursing interventions is a priority? a. Initiation of teaching concerning reduction of risk factors for heart disease. b. Administration of morning medications. c. Administration of IV push morphine and Digoxin for unstable angina. d. Take a report on a new omission coming on the unit.

c. Administration of IV push morphine and Digoxin for unstable angina.

1. Diltiazem (Cardizem) is ordered for a patient with newly diagnosed Prinzmetal's (variant) angina. When teaching the patient, the nurse will include the information that diltiazem will a. Reduce heart palpitations b. Prevent coronary artery plaque c. Decrease coronary artery spasms d. Increase contractile forces of the heart

c. Decrease coronary artery spasms

1. A client has a history of heart failure and has been taking all the following medications: Furosemide (Lasix), Digoxin (Lanoxin), and potassium. The client complains of nausea, blurred vision, headache, and weakness. The client is confused. The nurse should suspect which of the following diagnosis? a. Fluid volume deficit b. Myocardial infarction c. Digoxin toxicity d. Hyperkalemia

c. Digoxin toxicity

1. Which organs are most adversely affected when heart failure occurs? a. Pancreas and gastrointestinal tract b. Adrenal glands and lungs c. Liver and kidneys d. Brain and spleen

c. Liver and kidneys

1. The client with heart failure has been described intravenous nitroglycerin and furosemide (Lasix) for pulmonary Edema. Which is a priority nursing intervention? a. Insert a Foley catheter. b. Monitor the client's serum glucose level. c. Monitor the client's blood pressure. d. Place a nitroglycerin tablet under the client's tongue.

c. Monitor the client's blood pressure.

1. Client who is receiving dobutamine for the treatment of acute decompensated heart failure (ADHF) has the following interventions included in the plan of care. Which action will be the most appropriate for the RN to delegate to an experienced LPN/LVN? a. Change the peripheral IV site according to agency policy b. Teach the reasons for remaining on bed rest c. Monitor the clients BP and heart rate d. Titrate the rate to keep the systolic BP >90mmHG

c. Monitor the clients BP and heart rate

1. Interpret the following rhythm: a. Sinus arrhythmia b. Sinus bradycardia c. Normal sinus rhythm d. Sinus tachycardia

c. Normal sinus rhythm

1. Which assessment finding in a patient admitted with acute decompensated heart failure (ADHF) requires the most immediate action by the nurse? a. Heart rate of 106 beats/min b. Urine output of 50 mL over 2 hours c. O2 saturation of 88% d. Weight gain of 1 kg (2.2 lbs.)

c. O2 saturation of 88%

1. A 74 y/o male client with recurring stable angina is experiencing chest pain while out for a walk. What action should he take first? a. Take an aspirin b. Call 911 c. Stop and rest for a few minutes before continuing d. Take nitroglycerin sublingual as ordered.

c. Stop and rest for a few minutes before continuing

1. A client is receiving an infusion of tissue plasminogen activator (t-PA). The nurse assesses the client to be disoriented to person, place, and time. What action by the nurse is best? a. Request a neurologic consultation b. Assess the client's pupillary responses c. Stop the infusion and call the provider d. Take and document a full set of vitals

c. Stop the infusion and call the provider

1. A client is returning to the unit following major abdominal surgery. During the surgery the patient experienced an episode of hypotension secondary to bleeding. The client has extensive cardiac history. Which of the following assessment findings should be reported immediately to the health care provider? a. Absence of peristalsis b. Urine output of 40 ml/hr c. Substernal chest pain d. Temp 99 degrees

c. Substernal chest pain

1. The nurse obtains the following data when assessing a client who experienced an ST- segment elevation myocardial infarction (STEMI) 2 days previously. Which information is most important to report to the health care provider? a. The troponin level is elevated b. The client denies ever having a heart attack c. The client is experiencing frequent premature ventricular contractions (PVCs). d. The client has gained three pounds in four days

c. The client is experiencing frequent premature ventricular contractions (PVCs).

1. A client is admitted with a fever and rapid heart rate. The client's temperature is 103 F. The nurse places the client on a cardiac monitor and finds the client's atrial and ventricular rates are above 105 beats per minute. P waves are clearly seen and QRS complexes are normal in appearance. The Rhythm Is regular and blood pressure is normal. The nurse should focus on providing care for which one of the following. -(sinus tachycardia) a. Treatment to reduce heart rate b. Medication to lower heart rate c. Treatment to lower temperature d. Treatment to lower cardiac output

c. Treatment to lower temperature

1. The client is newly prescribed apixaban (Eliquis) for treatment of atrial fibrillation. The nurse evaluates teaching was effective when the client states which one of the following? a. "I will need to get monthly INR levels drawn while on this medication" b. "If I miss my morning dose, I can double up on my evening dose" c. "If I start bleeding, I must get Vitamin K injections" d. "I will not need to have routine laboratory testing while on the medication"

d. "I will not need to have routine laboratory testing while on the medication"

1. A client who is scheduled for an echocardiogram today asks why this test is being performed. How will the nurse respond? a. "The procedure is to assess for abnormal electrical impulses from the sinoatrial node" b. "This procedure will evaluate the oxygen saturation in your blood" c. "This is the best way to evaluate the coronary arteries for any blockages that may be present." d. "This procedure is a way to assess the structure of your heart non-invasively."

d. "This procedure is a way to assess the structure of your heart non-invasively."

1. A client is ordered Nitride to run at 4mcg/Kg/min. The client weighs 75.3 kg. How many mg/hr would the client receive? a. 18.072 mg/hr. b. 18 mg/hr. c. 18.07 mg/hr. d. 18.1 mg/hr.

d. 18.1 mg/hr.

1. After receiving change of shift report about the following four clients, which client should the nurse assess first? a. A 78-year-old admitted with chest pain who just returned from x-ray new line b. 67-year-old admitted for heart failure who is 30 minutes behind in getting morning medications c. 52-year-old being discharged to home after cardiac catheterization d. 48-year-old admitted with history of a-fib complaining of palpitations and shortness of breath

d. 48-year-old admitted with history of a-fib complaining of palpitations and shortness of breath

1. A nurse is assessing clients on a medical-surgical unit. Which client should the nurse identify as being at greatest risk for atrial fibrillation? a. An 80-year-old with chronic obstructive pulmonary disease b. A 78-year-old who had a carotid endarterectomy c. A 45-year-old who takes aspirin daily d. A 50-year-old who is post coronary artery bypass graft surgery

d. A 50-year-old who is post coronary artery bypass graft surgery

1. Which information about a patient who has been receiving thrombolytic therapy for an acute myocardial infarction is most important for the nurse to communicate to the health care provider? a. A large bruise at the patient's IV insertion site. b. A decrease in ST-segment elevation on the electrocardiogram c. An increase in troponin levels from baseline d. A drop in BP and hematuria

d. A drop in BP and hematuria

1. After receiving change-of-shift report on four patients admitted to a heart failure unit, which patient should the nurse assess first? a. A patient who has crackles bilaterally in the lung bases and is receiving oxygen. b. A patient who reported dizziness after receiving the first dose of captopril c. A patient who is receiving IV nesiritide (Natrecor) and has a blood pressure of 100/62 d. A patient who is cool and clammy, with new-onset confusion and restlessness

d. A patient who is cool and clammy, with new-onset confusion and restlessness

1. Three days after experiencing a myocardial infarction (MI), a client who is scheduled for discharge asks for assistance with hygiene activities, saying, "I am too nervous about my heart to be alone while I get washed up." Based on this information, which nursing diagnosis is appropriate? a. Denial related to lack of acceptance of the MI b. Altered body image related to cardiac disease c. Activity intolerance related to weakness d. Anxiety related to change in heath status

d. Anxiety related to change in heath status

1. A patient develops sinus bradycardia at a rate of 32 beats/min, has a blood pressure (BP) of 80/42 mm Hg, and is complaining of feeling faint. Which action should the nurse take next? a. Recheck the heart rhythm and BP in 5 minutes. b. Have the patient perform the Valsalva maneuver. c. Give the scheduled dose of diltiazem (Cardizem). d. Apply the transcutaneous pacemaker (TCP) pads.

d. Apply the transcutaneous pacemaker (TCP) pads.

1. A 19-yr-old student comes to the student health center at the end of the semester complaining that, "My heart is skipping beats." An electrocardiogram (ECG) shows occasional unifocal premature ventricular contractions (PVCs). What action should the nurse take next? a. Have the client taken to the nearest emergency department (ED). b. Start supplemental O2 at 2 to 3 L/min via nasal cannula. c. Insert an IV catheter for emergency use. d. Ask the patient about current stress level and caffeine use.

d. Ask the patient about current stress level and caffeine use.

1. A client has returned from an angiography via the left femoral artery. Two hours after the procedure, the client complains of numbness and tingling. Which are the nurses' first action? a. Document the findings of pedal pulses as normal b. Increase the flow rate of the IV fluids to 125mLhr c. Elevate the left leg and applies a sandbag to the entrance site d. Assess the pulse and temperature of the left leg

d. Assess the pulse and temperature of the left leg

1. A patient with a history of chronic heart failure is admitted to the emergency department with severe dyspnea and a dry, hacking cough. Which action should the nurse do first? a. Check the capillary refill b. Ask about the client's allergies c. Auscultate the abdomen d. Auscultate the breath sounds

d. Auscultate the breath sounds

1. To determine the effects of therapy for a patient who is being treated for heart failure, which laboratory result will the nurse plan to review? a. Troponin b. Homocysteine (Hcy) c. Low-density lipoprotein (LDL) d. B-type natriuretic peptide (BNP)

d. B-type natriuretic peptide (BNP)

1. A nurse is preparing to defibrillate a client in ventricular fibrillation. After placing the paddles on a client's chest and before discharging them which of the following should be done? a. Administer lidocaine hydrochloride b. Ensure that the client has been intubated c. Set the defibrillator to the synchronized mode d. Confirm that the rhythm is actually ventricular fibrillation

d. Confirm that the rhythm is actually ventricular fibrillation

1. A client has an order for nifedipine (Procardia) and furosemide (Lasix). On admission the BP was 150/80, HR 95, RR 22/min. Current vital signs are: BP 100/60, HR 64, RR 20. Which action is most appropriate for the nurse to take? a. Recheck the vital signs in one hour and decide whether to give/hold the medications b. Hold both medications until the next day c. Administer the Procardia, but hold the Lasix, continue to monitor the vital signs d. Consult with the physician to determine parameters for the medications in not in the MAR

d. Consult with the physician to determine parameters for the medications in not in the MAR

1. A patient admitted to the coronary care unit (CCU) with an ST-segment-elevation myocardial infarction (STEMI) is restless and anxious. The blood pressure is 86/40 mm Hg, and heart rate 132 beats/min. Based on this information, which nursing diagnosis is a priority for the patient? a. Acute pain related to myocardial infarction b. Stress overload related to acute change in health c. Anxiety related to perceived threat of death d. Decreased cardiac output related to effects of cardiogenic shock

d. Decreased cardiac output related to effects of cardiogenic shock

1. After reviewing information shown in the accompanying figure from the medical records of a 43-yr-old patient, which risk factor modification for coronary artery disease should the nurse include in patient teaching? History: father died of MI at age 65 y/o. quit smoking 2 years ago. worked full time outside as a landscaper/gardner physical assessment/vitals: waist 34 inches, BMI 22.5, pulse 78, BP 136/80 mmhg diagnostic: total cholesterol 190 mg/dl, HDL 35 mg/dl, LDL 165 mg/dl, triglycerides 142 mg/dl a. Importance of daily physical activity b. Ongoing cardiac risk associated with history of tobacco use c. Effect of weight loss on blood pressure d. Dietary changes to improve lipid levels

d. Dietary changes to improve lipid levels

1. A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which priority intervention should the nurse perform prior to defibrillating this client? a. Make sure the defibrillator is set to the synchronous mode b. Administer 1 mg of intravenous epinephrine c. Test equipment by delivering a smaller shock at 100 joules d. Ensure that everyone is clear of contact with a client in the bed

d. Ensure that everyone is clear of contact with a client in the bed

1. A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure? a. I have experienced blurred vision on several occasions b. My shoes are fitting tighter than usual c. I have been drinking more water than usual d. I must stop halfway up the stairs to catch my breath

d. I must stop halfway up the stairs to catch my breath

1. A client presents with pulmonary edema characterized by tachycardia, hypertension, and cough with frothy sputum. What initial treatment are most common? a. Oxygen, thiazide diuretics, and ACE inhibitors b. Oxygen, morphine, and CCB c. Oxygen and thiazide diuretics d. Oxygen, nitroglycerin, loop diuretics, and morphine

d. Oxygen, nitroglycerin, loop diuretics, and morphine

1. When analyzing the rhythm of a patient's electrocardiogram (ECG), the nurse will need to investigate further upon finding a(n) a. Isoelectric ST segment. b. PR interval of 0.18 second. 0.12- 0.20 c. QT interval of 0.38 second d. QRS interval of 0.14 second 0.6-1.0

d. QRS interval of 0.14 second 0.6-1.0

1. A patient has recently started on digoxin (Lanoxin) in addition to furosemide (Lasix) and captopril for the management of heart failure. Which assessment finding by the home health nurse is a priority to communicate to the health care provider? a. Weight increase from 120 pounds to 122 pounds over 3 days b. Presence of 1+ to 2+ edema in the feet and ankles c. Palpable liver edge 2 cm below the ribs on the right side d. Serum potassium level 3.0 mEq/L after 1 week of therapy

d. Serum potassium level 3.0 mEq/L after 1 week of therapy

1. A client that is status post MI has been started on clopidogrel (Plavix). What is the desired effect of this drug? a. Constriction of coronary arteries raising the blood pressure b. Decreased serum cholesterol levels c. Increased SA node to AV node conduction d. To keep further occlusion from occurring

d. To keep further occlusion from occurring

1. The nurse notes that a patient's heart monitor shows that every other beat is earlier than expected, has no visible P wave, and has a QRS complex that is wide and bizarre in shape. How will the nurse document the rhythm? a. Ventricular couplets b. Ventricular R-on-T phenomenon c. Multifocal premature ventricular contractions d. Ventricular bigeminy

d. Ventricular bigeminy