test 3 chapter 25

A client needs additional information about her heart condition. The client states to the nurse, "What is considered the pacemaker of the heart?" The AV node The bundle of HIS The Purkinje fibers The SA node

The SA node

The nurse is doing discharge teaching with a client who has coronary artery disease. The client asks why he has to take an aspirin every day if he doesn't have any pain. What would be the nurse's best response? "Taking an aspirin every day is an easy way to help restore the normal function of your heart." "An aspirin a day can help prevent some of the blockages that can cause chest pain or heart attacks." "Taking an aspirin every day is a simple way to make your blood penetrate your heart more freely." "An aspirin a day eventually helps your blood carry more oxygen that it would otherwise."

"An aspirin a day can help prevent some of the blockages that can cause chest pain or heart attacks."

The physician has ordered a high-sensitivity C-reactive protein (hs-CRP) drawn on a client. The results of this test will allow the nurse to evaluate the role of what process that is implicated in the development of atherosclerosis? Immunosuppression Inflammation Infection Hemostasis

Inflammation

Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to all the cells and tissues of the body? left ventricle left atrium right ventricle right atrium

left ventricle

The physician orders medication to treat a client's cardiac ischemia. What is causing the client's condition? reduced blood supply to the heart pain on exertion high blood pressure indigestion

reduced blood supply to the heart

Which assessments should a nurse perform when caring for a client following a cardiac catheterization? Select all that apply. Monitor BP and pulse frequently. Inspect pressure dressing for signs of bleeding. Palpate the pulse in different locations. Inspect the color in every extremity. Palpate the insertion site for tenderness.

Monitor BP and pulse frequently. Inspect pressure dressing for signs of bleeding. Palpate the pulse in different locations.

The nurse is administering a stool softener to a client who experienced a myocardial infarction. The client says, "I had a heart attack; I don't have a problem with constipation." What explanation will the nurse use to answer the client's question? "If you strain to have a bowel movement, you can cause a drop in your heart rate that can be dangerous." "The heart attack sets you up for limited activity, so constipation is often a problem for clients after a heart attack." "Please talk this over with your healthcare provider for further information." "The prescribed stool softener will decrease stress with a bowel movement and protect your heart from further injury."

"If you strain to have a bowel movement, you can cause a drop in your heart rate that can be dangerous."

The nurse is caring for a client on a monitored telemetry unit. During morning assessment, the nurse notes abnormal ECG waves on the telemetry monitor. Which action would the nurse do first? Call the physician with a report. Assess the client. Assess for mechanical dysfunction. Reposition the client.

Assess the client.

A nurse is preparing a client for cardiac catheterization. The nurse knows that which nursing intervention must be provided when the client returns to the room after the procedure? Withhold analgesics for at least 6 hours after the procedure. Assess the puncture site frequently for hematoma formation or bleeding. Inform the client that he or she may experience numbness or pain in the leg. Restrict fluids for 6 hours after the procedure.

Assess the puncture site frequently for hematoma formation or bleeding.

A client has undergone cardiac catheterization and will be discharged today. What information should the nurse emphasize during discharge teaching? Avoid heavy lifting for the next 24 hours. Take a tub bath, rather than a shower. New bruising at the puncture site is normal. Bend only at the waist.

Avoid heavy lifting for the next 24 hours.

The nurse is caring for a client who has just returned from the cardiac catheterization laboratory following a coronary angioplasty. What is the nurse's priority assessment? Check the temperature, color, and capillary refill of the affected extremity. Check the client's tolerance to ambulation to the bathroom. Assess when the client last had a bowel movement. Assess pupils for size and reactivity.

Check the temperature, color, and capillary refill of the affected extremity

The nurse is caring for a geriatric client. The client is ordered Lanoxin (digoxin) tablets 0.125mg daily for a cardiac dysrhythmia. Which of the following assessment considerations is essential when caring for this client? Digoxin level Cardiac output Activity level Dyspnea

Digoxin level

A client reports chest pain. Which questions related to the client's history are most important to ask? Select all that apply. How would you describe your symptoms? Are you allergic to any medications or foods? Do you have any children? How did your mother die?

How did your mother die? How would you describe your symptoms? Are you allergic to any medications or foods?

The nurse is reviewing the morning laboratory test results for a client with cardiac problems. Which finding is a priority to report to the healthcare provider? Na+ 140 mEq/L Ca++ 9 mg/dL K+ 3.1 mEq/L Mg++ 2 mEq/L

K+ 3.1 mEq/L

While the nurse is preparing a client for a cardiac catheterization, the client states that they have allergies to seafood. Which of the following medications may the nurse give prior to the procedure? Methylprednisolone Furosemide Lorazepam Phenytoin

Methylprednisolone

The student nurse is preparing a teaching plan for a client being discharged status post MI. What should the nurse include in the teaching plan? Select all that apply. Need for careful monitoring for cardiac symptoms Need for carefully regulated exercise Need for dietary modifications Need for early resumption of prediagnosis activity Need for increased fluid intake

Need for carefully regulated exercise Need for careful monitoring for cardiac symptoms Need for dietary modifications

The nurse is assessing a client taking an anticoagulant. What nursing intervention is most appropriate for a client at risk for injury related to side effects of medication enoxaparin? Report any incident of bloody urine, stools, or both. Administer calcium supplements. Assess for hypokalemia. Assess for clubbing of the fingers.

Report any incident of bloody urine, stools, or both.

A nurse is aware that the patient's heart rate is influenced by many factors. The nurse understands that the heart rate can be decreased by: An excess level of thyroid hormone. Stimulation of the vagus nerve. An increased level of catecholamines. Sympathetic nervous system stimulation.

Stimulation of the vagus nerve.

A nurse is caring for a dying client following myocardial infarction. The client is experiencing apnea with a falling blood pressure of 60 per palpation. Which documentation of pulse quality does the nurse anticipate? Bounding pulse Weak pulse Thready pulse A pulse deficit

Thready pulse

The nurse accompanies a client to an exercise stress test. The client can achieve the target heart rate, but the electrocardiogram indicates ST-segment elevation. Which procedure will the nurse prepare the client for next? cardiac catheterization telemetry monitoring transesophageal echocardiogram pharmacologic stress test

cardiac catheterization

You are evaluating the expected outcomes on a client who is recovering from a cardiac catheterization. What is an expected outcome that you would evaluate? The client and family understands the client's CV diagnosis. The client and family understands the need for medication. The client and family understands the need to restrict activity for 72 hours. The client and family understands the discharge instructions.

The client and family understands the discharge instructions.

The nurse reviews discharge instructions with a client who underwent a left groin cardiac catheterization 8 hours ago. Which instructions should the nurse include? "You can take a tub bath or a shower when you get home." "Contact your primary care provider if you develop a temperature above 102°F." "Do not bend at the waist, strain, or lift heavy objects for the next 24 hours." "If any discharge occurs at the puncture site, call 911 immediately."

"Do not bend at the waist, strain, or lift heavy objects for the next 24 hours."

The nurse prepares to apply ECG electrodes to a male client who requires continuous cardiac monitoring. Which action should the nurse complete to optimize skin adherence and conduction of the heart's electrical current? Clip the client's chest hair prior to applying the electrodes. Apply baby powder to the client's chest prior to placing the electrodes. Clean the client's chest with alcohol prior to application of the electrodes. Once the electrodes are applied, change them every 72 hours.

Clip the client's chest hair prior to applying the electrodes.

A cardiac patient with a magnesium lab result of 2.5 mEq/L would most likely evidence which of the following? Atrial tachycardia Ventricular arrhythmias Depressed myocardial contractility Increased cardiac excitability.

Depressed myocardial contractility

The nurse is administering a beta blocker to a patient in order to decrease automaticity. Which medication will the nurse administer? Diltiazem Metoprolol Amiodarone Propafenone

Metoprolol

The nurse is discharging a client after a cardiac catheterization. What would the nurse include in the discharge teaching? Eat only soft foods for the next 12 hours. Report any numbness, tingling, or sharp pain in the extremity. Restrict your intake of water until the dye is out of the body. Move around whenever the client feels like getting up.

Report any numbness, tingling, or sharp pain in the extremity.

A client is seen in the emergency department and reports left arm pain, fatigue, palpitations, and shortness of breath. Which condition would the nurse suspect? acute coronary syndrome renal failure diabetes mellitus diabetes insipidus

acute coronary syndrome

The nurse is assessing an older adult client's electrocardiogram (ECG). What age related change to the conduction system may the nurse observe? Heart block Murmur Thrills Tachycardia

Heart block

The nurse is caring for a client who has a history of heart disease. What factor should the nurse identify as possibly contributing to a decrease in cardiac output? A change in position from standing to sitting A heart rate of 54 bpm A pulse oximetry reading of 94% An increase in preload related to ambulation

A heart rate of 54 bpm

The nurse admits an adult female client with a medical diagnosis of "rule out MI." The client is very frightened and expresses surprise that a woman would have heart problems. What response by the nurse will be most appropriate? "A woman's heart is smaller and has smaller arteries that become occluded more easily." "A woman's resting heart rate is lower than a man's." "It takes longer for an electrical impulse to travel from the sinoatrial node to the atrioventricular node in a woman." "The stroke volume from a woman's heart is lower than from a man's heart."

"A woman's heart is smaller and has smaller arteries that become occluded more easily."

The client states, "My doctor says that because I am now taking this water pill, I need to eat more foods that contain potassium. Can you give me some ideas about what foods would be good for this?" What is the appropriate response by the nurse? Apricots, dried peas and beans, dates Asparagus, blueberries, green beans Cranberries, apples, popcorn Bok choy, cooked leeks, alfalfa sprouts

Apricots, dried peas and beans, dates

A patient had a cardiac catheterization and is now in the recovery area. What nursing interventions should be included in the plan of care? (Select all that apply.) Assessing the peripheral pulses in the affected extremity Checking the insertion site for hematoma formation Evaluating temperature and color in the affected extremity Assisting the patient to the bathroom after the procedure Assessing vital signs every 8 hours

Assessing the peripheral pulses in the affected extremity Checking the insertion site for hematoma formation Evaluating temperature and color in the affected extremity

The nurse is providing discharge education for a client going home after cardiac catheterization. What information is a priority to include when providing discharge education? Avoid tub baths, but shower as desired. Do not ambulate until the healthcare provider indicates it is appropriate. Expect increased bruising to appear at the site over the next several days. Returning to work immediately is okay.

Avoid tub baths, but shower as desired.

You are monitoring the results of laboratory tests performed on a client admitted to the cardiac ICU with a diagnosis of myocardial infarction. Which test would you expect to show elevated levels? RBC Platelets Enzymes WBC

Enzymes

A client is brought into the ED by family members who tell the nurse the client grabbed his chest and complained of substernal chest pain. The care team recognizes the need to monitor the client's cardiac function closely while interventions are performed. What form of monitoring should the nurse anticipate? Left-sided heart catheterization Cardiac telemetry Transesophageal echocardiography Hardwire continuous ECG monitoring

Hardwire continuous ECG monitoring

The nurse receives a laboratory report indicating the client's magnesium level is 5.2 mEq/L. What symptoms is the client at risk to experience? Select all that apply. Ventricular tachycardia Atrial tachycardia Headache Hypotension Irregular heartbeat

Headache Hypotension Irregular heartbeat

The client is admitted for a scheduled cardiac catheterization. On the morning of the procedure, while assessing the client's morning laboratory values, the nurse notes a blood urea nitrogen (BUN) of 34 mg/dL and a creatinine of 4.2 mg/dL. What priority reason will the nurse notify the healthcare provider? The client is at risk for renal failure due to the contrast agent that will be given during the procedure. These values show a risk for dysrhythmias. The client is overhydrated, which puts him at risk for heart failure during the procedure. The client is at risk for bleeding.

The client is at risk for renal failure due to the contrast agent that will be given during the procedure.

A patient tells the nurse, "I was straining to have a bowel movement and felt like I was going to faint. I took my pulse and it was so slow." What does the nurse understand occurred with this patient? The patient may have had a myocardial infarction. The patient had a vagal response. The patient was anxious about being constipated. The patient may have an abdominal aortic aneurysm.

The patient had a vagal response.

The nurse is caring for a client admitted with unstable angina. The laboratory result for the initial troponin I is elevated in this client. The nurse should recognize what implication of this assessment finding? This is only an accurate indicator of myocardial damage when it reaches its peak in 24 hours. Because the client has a history of unstable angina, this is a poor indicator of myocardial injury. This is an accurate indicator of myocardial injury. This result indicates muscle injury, but does not specify the source.

This is an accurate indicator of myocardial injury.

The nurse is performing an intake assessment on a client with a new diagnosis of coronary artery disease. What would be the most important determination to make during this intake assessment? Whether the client and involved family members understand the role of genetics in the etiology of the disease Whether the client and involved family members understand dietary changes and the role of nutrition Whether the client and involved family members are able to recognize symptoms of an acute cardiac problem and respond appropriately Whether the client and involved family members understand the importance of social support and community agencies

Whether the client and involved family members are able to recognize symptoms of an acute cardiac problem and respond appropriately

A nurse assessing a client who underwent cardiac catheterization finds the client lying flat on the bed. The client's temperature is 99.8° F (37.7° C). The client's blood pressure is 104/68 mm Hg. The client's pulse rate is 76 beats/minute. The nurse detects weak pulses in the leg distal to the puncture site. Skin on the leg is cool to the touch. The puncture site is dry, but swollen. What is the most appropriate action for the nurse to take? Document findings and check the client again in 1 hour. Slow the I.V. fluid to prevent any more swelling at the puncture site. Contact the health care provider and report the findings. Encourage the client to perform isometric leg exercise to improve circulation in the legs.

Contact the health care provider and report the findings.

The nurse is caring for a client admitted with angina who is scheduled for cardiac catheterization. The client is anxious and asks the reason for this test. What is the best response? "Cardiac catheterization is usually done to assess how blocked or open a client's coronary arteries are." "Cardiac catheterization is most commonly done to detect how efficiently a client's heart muscle contracts." "Cardiac catheterization is usually done to evaluate cardiovascular response to stress." "Cardiac catheterization is most commonly done to evaluate cardiac electrical activity."

"Cardiac catheterization is usually done to assess how blocked or open a client's coronary arteries are."

The nurse cares for a client with diabetes who is scheduled for a cardiac catheterization. Prior to the procedure, it is most important for the nurse to ask which question? "Are you allergic to shellfish?" "Are you having chest pain?" "When was the last time you ate or drank?" "What was your morning blood sugar reading?"

"Are you allergic to shellfish?

The nurse is explaining vasovagal syncope to a client. What does the nurse associate the temporary loss of consciousness with for the client? vertigo increase fluid intake blood pressure 190/50 standing heart rate 48

heart rate 48

The nurse cares for a client prescribed warfarin orally. The nurse reviews the client's prothrombin time (PT) level to evaluate the effectiveness of the medication. Which laboratory values should the nurse also evaluate? international normalized ratio (INR) partial thromboplastic time (PTT) complete blood count (CBC) Sodium

international normalized ratio (INR)