Test 5
18. Which of the following is the nurse most correct to recognize as a direct effect of client hypertension? A. Renal dysfunction resulting from atherosclerosis B. Emphysema related to poor gas exchange C. Anemia resulting from bone marrow suppression D. Hyperglycemia resulting from insulin receptor resistance
A
41. A client with Raynaud's disease complains of cold and numbness in the fingers. Which of the following would the nurse identify as an early sign of vasoconstriction? A. pallor B. clubbing of the fingers C. gangrene D. cyanosis
A
A client with left-sided heart failure is in danger of impaired renal perfusion. How would the nurse assess this client for impaired renal perfusion? A. Assess for elevated blood urea nitrogen levels. B. Assess for reduced blood sodium levels. C. Assess for reduced urine output. D. Assess for elevated blood potassium levels.
A
A client with venous insufficiency is instructed to exercise, apply elastic stockings, and elevate the extremities. Which is the primary benefit for this nursing management regime? A. Improve venous return B. Increase venous congestion C. Improve arterial flow D. Strengthen venous valves
A
A pacemaker is the treatment of choice for what cardiac arrhythmia? complete heart block supraventricular tachycardia atrial flutter ventricular fibrillation
A
After 2-hour onset of acute chest pain, the client is brought to the emergency department for evaluation. Elevation of which diagnostic findings would the nurse identify as suggestive of an acute myocardial infarction (MI) at this time? A. Myoglobin B. C-reactive protein C. White blood cell (WBC) count D. Troponin I
A
The nurse is providing instruction to a group of new nurses orienting on the unit, highlighting the benefits of the automatic implanted cardioverter defibrillator (AICD). While pointing at a diagram of the heart, at which location would the nurse identify the placement of the electrical lead? A. In the right ventricle near the septum B. On the right atrium near the SA node C. On the left ventricle on the posterior wall D. At the left atrium on the anterior wall
A
The nurse is working on a busy cardiac unit caring for four hypertensive clients. Which client description would the nurse assess first because the client is at an increased risk for malignant hypertension? A. A client with anorexia and history of no healthcare insurance B. A client with chronic asthma who uses a corticosteroid inhaler C. A schizophrenic residing at an assisted living facility D. A client with liver dysfunction who drinks alcohol daily
A
The nurse knows that women and the elderly are at greater risk for a fatal myocardial event. Which factor is the primary contributor of this cause? A. Vague symptoms B. Chest pain is typical C. Decreased sensation to pain D. Gender bias
A
The nursing student is part of a group of nursing students who are making a presentation on chronic hypertension. What is one subject the nursing student would need to include in the presentation as a possible consequence of untreated chronic hypertension? A. Stroke B. Peripheral edema C. Pulmonary insufficiency D. Right-sided heart failure
A
Which of the following factors would the nurse identify as a modifiable risk factor for the development of varicose veins? A. Employed as over-the-road truck driver B. Mother and maternal grandmother had varicose veins C. History of thrombophlebitis in both extremities D. Weight gained during past pregnancies
A
The nurse is preparing to administer nadolol. Which assessments should the nurse investigate before administering the medication? Select all that apply. A. Pulse rate on both arms B. Blood pressure on both arms C. Blood pressure in the sitting position D. Pulse rate on one arm E. Blood pressure on one arm
A, B, C,
26. The nurse is teaching a client about the prescribed metolazone and providing suggestions for foods to eat which will help increase potassium consumption. The nurse determines the teaching is successful after the client correctly chooses which foods? Select all that apply. A. asparagus B. salmon C. peanuts D. bananas E. pinto beans
A, B, C, D,
The nurse is assessing a client who is prescribed digoxin who is reporting nausea and anorexia. Which suggestions should the nurse prioritize to assist the client with these adverse reactions? Select all that apply. E. Avoiding fluid intake 1 hour before and after meals D. Restricting fluids at mealtime C. Eating frequent smaller meals B. Maintaining good oral hygiene A. Eating more protein
A, B, C, D,
The nurse is teaching a client and caregiver about the antihypertensive medication which has been prescribed. Which instructions should the nurse point out as most important to the client and caregiver? Select all that apply. A. "Avoid the use of nonprescription drugs unless approved by the health care provider." B. "Never discontinue use of the antihypertensive drug except on the advice of the health care provider." C. "Avoid alcohol unless its use has been approved by the health care provider" D. "Notify the health care provider if the diastolic pressure suddenly increases to 130 mm Hg or higher." E. "Know that unexplained weakness or fatigue is a normal adverse reaction."
A, B, C, D,
A nurse is administering digoxin emergently to a client. The nurse is prepared to complete which actions when administering this medication? Select all that apply. A. Limit the IM dose to 2 mL B. Give IM if IV access not available C. Massage the site after injection D. Start an IV immediately to administer dose E. Ensure injection is deep into the muscle
A, B, C, E
A nurse is preparing to administer a diuretic to a client. The nurse should question administering which drug after noting an allergy to sulfamethoxazole/trimethoprim? Select all that apply. A. chlorothiazide B. metolazone C. chlorthalidone D. spironolactone E. furosemide
A, B, C, E
10. A client has been receiving acetazolamide as prescribed. Which substance will the nurse prioritize for monitoring on routine laboratory work? Select all that apply. A. Potassium B. Chloride C. Bicarbonate D. Sodium E. Magnesium
A, C, D
17. The nurse is preparing to administer a diuretic to a client. The nurse should question this order if which disorder is noted in the client's history? Select all that apply. A. anuria B. hypertension C. hypokalemia D. hyponatremia E. asthma
A, C, D
27. The nurse is preparing to administer digoxin to an elderly client with heart failure. The nurse will also prepare to administer which additional drugs as part of this client's overall therapy? Select all that apply. A. Angiotensin-converting enzyme inhibitors (ACEIs) B. Calcium channel blockers C. Beta blockers D. Loop diuretics E. Thiazide diuretics
A, C, D
The nurse is preparing to administer amiloride to a client. The nurse will exercise caution if the client is diagnosed with which disorder? Select all that apply. A. diabetes B. glaucoma C. hepatic disease D. asthma E. gout
A, C, E
3. A nurse is assessing the blood pressure of a large adult client diagnosed with primary hypertension. To ensure an accurate blood pressure reading, the nurse follows which standard of care? Select all that apply. A. Document the results immediately after the reading is completed. B. Obtain supine, sitting, and standing readings daily. C. Place the cuff midway between the acromion and olecranon process. D. Vary the blood pressure reading sites every other day. E. Use the appropriate-sized adult blood pressure cuff.
A, C, E,
The client has just been admitted with bradycardia and scheduled for the insertion of a pacemaker. The nurse notifies the physician that the client's heart rate has dropped into the 40-beats/minute range. The physician orders a temporary pacemaker. The nurse knows that there are different types of temporary pacemakers. What types of temporary pacemakers are there? Select all that apply. A. transcutaneous B. transabdominal C. transvenous D. transatrial E. transthoracic
A, C, E,
A client has a nursing diagnosis of Activity Intolerance related to fatigue and weakness. Which actions would be appropriate for the nurse to include in the client's plan of care? Select all that apply. A. Promoting rest periods throughout the day as necessary B. Mandating the use of assistive devices C. Maintaining bed rest as much as possible D. Encouraging ambulation as tolerated E. Encouraging activities early in the morning when fatigue is less
A, D,
The nurse is preparing a teaching session for a client who is prescribed digoxin. The nurse should point out the danger of using which nonprescription medications without permission from the health care provider when taking digoxin? Select all that apply. A. Antidiarrheals B. Topical arthritis treatments C. Artificial tear products D. Antacids E. Allergy products
A, D,
What disease processes contribute to chronic heart failure? Select all that apply. A. Valvular disease B. Pancreatic disease C. Pulmonary insufficiency D. Tachydysrhythmias E. Renal failure
A, D, E,
28. A client with congestive heart failure and currently administered digoxin is now prescribed indapamide for edema. Which intervention should the nurse prioritize? A. Encourage oral fluids at frequent intervals during waking hours. B. Frequently monitor the client's pulse rate and rhythm. C. Closely monitor the client for signs of hyperkalemia. D. Encourage the client to eat or drink between meals and in the evening.
B
The licensed practical nurse is co-assigned with a registered nurse in the care of a client admitted to the cardiac unit with chest pain. The licensed practical nurse is assessing the accuracy of the cardiac monitor, which notes a heart rate of 34 beats/minute. The client appears anxious and states not feeling well. The licensed practical nurse confirms the monitor reading. When consulting with the registered nurse, which of the following is anticipated? A. The registered nurse stating to administer all medications except those that are cardiotonics B. The registered nurse administering atropine sulfate intravenously C. The registered nurse stating to hold all medication until the pulse rate returns to 60 beats/minute D. The registered nurse stating to administer digoxin
B
The licensed practical nurse is setting up the room for a client arriving at the emergency department with ventricular arrhythmias. The nurse is most correct to place which of the following in the room for treatment? A. Cardioversion equipment B. A defibrillator C. An ECG machine D. A suction machine
B
The nurse and a dietitian are instructing the client on a low-sodium diet needed to lower the blood pressure. Which question, asked by the nurse, is most important? A. "Who eats meals with you?" B. "How do you prepare your food?" C. "Do you eat three meals per day?" D. "Do you snack in the evening?"
B
The nurse is caring for a client who is newly diagnosed with hypertension. The client states, "I do not understand what is causing my blood pressure to continue to rise." Which information does the nurse recognize as the key structure in regulating arterial blood pressure? A. lung B. kidney C. heart D. brain
B
The nurse is assessing a client diagnosed with left ventricular dysfunction. Which symptoms would the nurse most likely assess? Select all that apply. A. peripheral edema B. dyspnea C. insomnia D. moist cough E. neck vein distension
B, D,
A client is admitted to the emergency department in hypertensive crisis. The nurse will prioritize which assessment to monitor for potential damage as this client receives emergent treatment? Select all that apply. A. gallbladder B. kidneys C. pancreas D. heart E. eyes
B, D, E,
A client with hypertension comes to the clinic for a follow-up visit. Which activities would be appropriate for the nurse to do when assisting the client in managing his hypertension? Select all that apply. A. Schedule an appointment to see a cardiologist. B. Schedule regular monitoring of weight and blood pressure. C. Schedule an appointment to see a nephrologist. D. Find local resources in the community for taking blood pressure. E. Teach client how to properly record weight and blood pressure.
B, D, E,
A nurse is preparing a teaching plan for a client with edema who is prescribed a diuretic. Which teaching should the nurse prioritize? A. Encourage exercise. B. Decrease fluid intake. C. Administer early in the day. D. Gradually increase the dosage.
C
Understanding atherosclerosis, the nurse identifies which of the following to be both a risk factor for the development of the disorder and an outcome? A. glucose intolerance B. hyperlipidemia C. hypertension D. obesity
C
The nurse is screening a client at a health fair for hypertension. Which assessment data, provided by the client, would prompt the nurse to stress physician involvement? Select all that apply. A. constipation B. blurred vision C. fatigue D. dysuria E. insomnia F. headache
C, D, E, F,
The nurse has administered acetazolamide to a client. The nurse should question the client's serum sodium level after noting which findings on the ongoing assessment? Select all that apply. A. bradycardia B. hypoglycemia C. hypotension D. anorexia E. decreased skin turgor
C, E,
3. An older client with hypertension is prescribed furosemide and atenolol. The client reports perspiring a lot lately and having diarrhea. Which nursing diagnosis would the nurse most likely prioritize? A. Ineffective Sexuality Patterns B. Acute Pain C. Activity Intolerance D. Risk for Deficient Fluid Volume
D
A nurse is performing the ongoing assessment on a client who has received milrinone for a diagnosis of heart failure. The nurse should prioritize which finding on the assessment? A. bradycardia B. edema C. cyanosis D. hypotension
D
A nurse is preparing to administer ivabradine to a client with heart failure. Which preadministration assessment should the nurse prioritize on this client? A. Inspect skin for rash. B. Obtain blood glucose levels. C. Inspect joints for swelling. D. Check for jugular vein distention.
D
The nurse instructs the client with heart failure to weigh themselves at the same time each day using the same scale. When should the client contact the physician? A. If the weight gain is more than 1 lb in 48 hours. B. If the weight gain is more than 4 lb in 1 month. C. If the weight gain is more than 3 lb in 1 week. D. If the weight gain is more than 2 lb in 24 hours.
D
The nurse is caring for a client who has premature ventricular contractions. What sign or symptom is observed in this client? A. nausea B. hypotension C. fever D. fluttering
D
The nurse is caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the arrhythmia? A. defibrillation B. pacemaker implantation C. maze procedure D. elective cardioversion
D
The nurse is caring for a client with long-standing hypertension. As a client advocate, which instruction is most helpful in preventing further complications? A. Maintain a healthy diet of fruits and vegetables. B. Avoid use of caffeinated beverages. C. Focus on exercise at least twice a week. D. Obtain a regular appointment with eye doctor.
D
The nurse is obtaining data on an older adult client. What finding may indicate to the nurse the early symptom of heart failure? A. Decreased urinary output B. Tachycardia C. Hypotension D. Dyspnea on exertion
D
39. The nurse is assigned the following client assignment on the clinical unit. For which client does the nurse anticipate cardioversion as a possible medical treatment? A. A client with atrial arrhythmias B. A new myocardial infarction client C. A client with third-degree heart block D. A client with poor kidney perfusion
A
60. The staff educator is teaching a class in arrhythmias. What statement is correct for defibrillation? A. It is used to eliminate ventricular arrhythmias. B. It uses less electrical energy than does cardioversion. C. The client is sedated before the procedure. D. It is a scheduled procedure 1 to 10 days in advance.
A
92. A client with a strong family history of coronary artery disease asks the nurse how to reduce the risk of developing the disorder. Which is the best response by the nurse? A. "Exercise, keep your blood sugar in check, and manage your stress." B. "Ask your physician to prescribe the new reverse lipid drug." C. "Moderation is the key to everything." D. "Increase the soy In your diet."
A
98. The nurse is caring for clients on a telemetry unit. Which nursing consideration best represents concerns of altered rhythmic patterns of the heart? A. Altered patterns frequently affect the heart's ability to pump blood effectively. B. Altered patterns frequently cause a variety of home safety issues. C. Altered patterns frequently produce neurologic deficits. D. Altered patterns frequently turn into life-threatening arrhythmias.
A
A client diagnosed with pulmonary edema has a PaCO of 72 mm Hg and an oxygen saturation of 84%. What method of oxygen delivery would best meet the needs of this client? A. Intubation and mechanical ventilation B. Venturi mask at 35% C. Oxygen cannula at 6 L/minute D. Face mask with non-rebreather
A
A client has just been diagnosed with prehypertension. What would the nurse instruct this client to do to restore his blood pressure below hypertensive levels? A. Decrease sodium intake. B. Increase iodine intake. C. Avoid over-the-counter decongestants. D. Increase fluid intake.
A
A client is admitted to the hospital with a diagnosis of heart failure, and the physician orders a BNP level. What results would indicate to the nurse that the client is in moderate heart failure? A. 980 pg/mL B. 400 pg/mL C. 120 pg/mL D. 780 pg/mL
A
A client is awaiting the availability of a heart for transplant. What option may be available to the client as a bridge to transplant? A. Ventricular assist device (VAD) B. Pacemaker C. Implanted cardioverter-defibrillator (ICD) D. Intra-aortic balloon pump (IABP)
A
A client is receiving a diuretic for the treatment of hypertension. Which assessment finding on the laboratory reports should the nurse prioritize? A. hyponatremia B. hypomagnesemia C. hypoalcemia D. hyperkalemia
A
A client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA) immediately following confirmed diagnosis of acute myocardial infarction. The client is overtly anxious and crying. Which response by the nurse is most appropriate? A. "Tell me what concerns you most." B. "Don't cry; you have the best team of doctors." C. "Everything will be fine. Your family is here for you." D. "Would you like something to calm your nerves?"
A
A client presents to the emergency room with characteristics of atherosclerosis. What characteristics would the client display? A. Fatty deposits in the lumen of arteries B. Blood clots in the arteries C. Cholesterol plugs in the lumen of veins D. Emboli in the veins
A
The client has just been diagnosed with an arrhythmia. The client asks the nurse to explain normal sinus rhythm. What would the nurse explain is the characteristic of normal sinus rhythm? A. The sinoatrial (SA) node initiates the impulse. B. The ventricles depolarize in 0.5 second or less. C. Heart rate between 60 and 150 beats/minute. D. Impulse travels to the atrioventricular (AV) node in 0.15 to 0.5 second.
A
The nurse is caring for a client at risk for thrombosis. What is an appropriate nursing action when evaluating this client? A. Examine the legs for color, capillary refill time, and tissue integrity. B. Examine the client's mental and emotional status. C. Examine for pain around the shoulder and neck region. D. Examine the extremities for skin lesions.
A
The nurse is caring for a client in the hospital with chronic heart failure that has marked limitations in his physical activity. The client is comfortable when resting in the bed or chair, but when ambulating in the room or hall, he becomes short of breath and fatigued easily. What type of heart failure is this considered according to the New York Heart Association (NYHA)? A. Class III (Moderate) B. Class I (Mild) C. Class II (Mild) D. Class IV (Severe)
A
The nurse is caring for a client who has been resistant to past antiarrhythmic therapy. Which cardiac arrhythmic medication is administered for ventricular arrhythmias when other mediations have failed? A. amiodarone B. flecainide C. propranolol D. lidocaine hydrochloride
A
The nurse is caring for a client who is ordered diazoxide IV to decrease blood pressure. Which nursing consideration is a priority? A. Use an automatic blood pressure recording machine. B. Assess the client's deep tendon reflex. C. Elevate the head of the bed. D. Place a Foley catheter to monitor urine output.
A
The nurse is caring for a client with a resting heart rate of 150 beats/minute. Which nursing intervention would be the highest priority in plan of care? A. Instruct to sit on the edge of the bed before rising. B. Arrange periods of activity with periods of rest. C. Maintain strict intake and output. D. Place a pillow under the feet and ankles.
A
The nurse is caring for a client with right-sided heart failure who has ascites and hepatomegaly. What interventions can the nurse first provide to ensure the client has adequate nutritional intake? A. Offer small, frequent feedings. B. Give the client anything he wants to eat. C. Give a medication to stimulate the appetite. D. Offer three larger meals throughout the day.
A
The nurse is evaluating the types of medications prescribed for a client's hypertension. Which of the following medication classifications establishes an action on vasoconstrictive hormones in the blood stream? A. ACE inhibitor B. beta-blocker C. calcium channel blocker D. loop diuretic
A
The nurse is in the mall and observes a client slump to the floor. The nurse assesses the client and notes no pulse. The nurse calls for assistance to others in the mall and requests which piece of equipment? A. An automatic external defibrillator B. A stethoscope C. A blood pressure cuff D. A cell phone to call 911
A
The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety? A. Sit on the edge of the chair and rise slowly. B. Do not operate a motor vehicle. C. Use a pillbox to store daily medication. D. Take the medication at the same time daily.
A
The nurse is preparing to defibrillate a client with no breathing or pulse. Which nursing action precedes the nurse pressing the discharge button? A. Shouts, "All clear" B. States, "Charging" C. Checking the ECG rhythm D. Placing gel on the chest
A
The nurse is presenting a workshop at the senior citizens center about how the changes of aging predispose clients to vascular occlusive disorders. What would the nurse name as the most common cause of peripheral arterial problems in the older adult? A. atherosclerosis B. Raynaud's disease C. coronary thrombosis D. arterioscleriosis
A
The nurse is providing discharge instructions to a client with heart failure preparing to leave the following day. What type of diet should the nurse request the dietitian to discuss with the client? A. Low-sodium diet B. Low-potassium diet C. Low-cholesterol diet D. Low-fat diet
A
A client with heart failure is receiving digoxin. Which assessment will the nurse prioritize if the client is noted to be edematous? A. Measurement of intake and output B. Observation of respiratory rate C. Observation of pulse rate ✘\ D. Auscultation of bowel sounds
A,
A nurse is reviewing the laboratory test results of a client who is receiving diuretic therapy. The nurse determines that the client is at risk for electrolyte imbalance based on which results? Select all that apply. A. Potassium 2.9 mEq/L B. Sodium 124 mEq/L C. Potassium 4.5 mEq/L D. Magnesium 2 mEq/L E. Sodium 139 mEq/L
A, B,
A nursing instructor is teaching a class on the actions of the different classes of diuretics. Which drugs will the instructor point out as exerting action on the loop of Henle and distal and proximal tubules? Select all that apply. A. Furosemide B. Bumetanide C. Chlorothiazide D. Mannitol E. Spironolactone
A, B,
The client with hypertension, who has been prescribed aliskiren, reports to the clinic not feeling well. Which assessment finding should the nurse prioritize? Select all that apply. A. Swelling of the throat B. Swelling of the face C. Fever greater than 100°F D. Blood pressure above 170/100 mm Hg E. Heart rate above 100 beats per minute
A, B,
4. A client has been receiving a diuretic as prescribed. Which findings on the ongoing assessment should the nurse prioritize? Select all that apply. A. dry mouth B. muscle cramps C. tachycardia D. hypertension E. diaphoresis
A, B, C,
A nursing student is preparing a presentation discussing hypertension. Which factors should the student explain can increase the risk of someone developing hypertension? Select all that apply. A. chronic alcohol consumption B. family history C. advancing age D. caucasian rce E. cigarette smoking
A, B, C, E
The nurse is preparing to administer digoxin to a client. Which physical assessments should the nurse prioritize before administering this drug? Select all that apply. A. Respiratory rate B. Weight measurement C. Blood pressure D. Urinalysis E. Apical-radial pulse rate
A, B, C, E
A client is brought to the emergency department by rescue squad with suspicion of cardiogenic pulmonary edema. What complication should the nurse monitor for? Select all that apply. A. Cardiac arrest B. Cardiac dysrhythmias C. Pulmonary embolism D. Respiratory arrest E. Nausea and vomiting
A, B, D,
After teaching a group of nursing students about digoxin, the instructor determines that the teaching was successful when the students correctly choose which factor as necessary to monitor serum digoxin levels? Select all that apply. A. Draw 6 to 8 hours after the last dose. B. Draw immediately before the next dose. C. A level between 0.5 and 1.5 ng/mL is therapeutic. D. A toxic Level is greater than 2 ng/mL E. Draw blood immediately after the dose.
A, B, D,
The nurse is preparing a presentation for a local health fair to explain various aspects of hypertension. Which factors should the nurse include when pointing out various risk factors which can increase the potential of developing hypertension? Select all that apply. A. lack of potassium in the diet B. chronic alcohol use C. men older than 50 years old D. obesity E. hispanic ethnicity
A, B, D,
The nursing instructor is teaching a group of students about the various medications used to treat hypertension. After the session the instructor determines the session is successful when the students correctly connect which actions with calcium channel blockers? Select all that apply. A. Relaxation of blood vessels B. Increased oxygen supply to the heart C. Increased workload on the kidneys D. Reduced workload on the heart E. Decreased blood pressure
A, B, D, E,
The health care provider has prescribed digoxin for a client diagnosed with heart failure. The nurse will prepare to assess which laboratory results before administering this medication? Select all that apply. A. Liver function tests ✓ B. Electrolyte levels ✓ C. Blood glucose ✘ D. Complete blood count ✓ D. Renal function tests
A, B, D.
29. A nurse checks the serum digoxin level of a client and finds it to be increased. The nurse should question administering which additional medication in this situation? Select all that apply. A. Clarithromycin B. Colestipol C. Spironolactone D. Verapamil E. Calcium carbonate
A, C, D
A nurse is preparing to administer the prescribed digoxin. After appraising the morning laboratory results, the nurse determines caution is warranted with which result? Select all that apply. A. Potassium 3 mEq/L B. Magnesium 3 mEq/L C. Calcium 4.3 mEq/L D. Magnesium 1.0 mEq/L E. Calcium 5.5 mEq/L
A, C, D
30. A nurse notes on assessment of a client receiving furosemide a decrease in urinary output. Which drugs should the nurse suspect is affecting the diuretic? Select all that apply. A. phenytoin B. lithium C. ibuprofen D. naproxen E. digoxin
A, C, D,
A nursing instructor is conducting a class on heart failure and the events that occur. The instructor should point out that the increase in neurohormonal activity will result in which changes? Select all that apply. A. Increased need for oxygen B. Decreased secretion of catecholamines C. Cardiac necrosis D. Remodeling of the cardiac muscle cells E. Hypertrophy of the heart
A, C, D, E,
The nurse is preparing to administer furosemide to a client. Which factors should the nurse prioritize on the preadministration assessment? Select all that apply. A. temperature B. blood glucose C. pulse D. respiratory rate E. weight
A, C, D, E,
A nursing instructor is teaching a group of students about cardiotonics. The instructor determines the session is successful when the students correctly relate which as actions of the cardiotonics? Select all that apply. A. Improves profusion to all body tissues B. Increases peripheral edema C. Increases myocardial efficiency D. Increases blood pressure E. Improves myocardial contractility
A, C, E
The nurse has administered torsemide to a client. Which findings on the ongoing assessment should the nurse prioritize? Select all that apply. A. anorexia B. hypoglycemia C. depression D. diarrhea E. drowsiness
A, C, E,
The nurse is preparing to administer ivabradine to a client in heart failure. The nurse should question this order if which disorder is documented in the client's medical history? Select all that apply. A. Digitalis toxicity B. Hypotension C. Ventricular tachycardia D. Hypertension E. Cardiac tamponade
A, C, E,
The nurse is preparing to teach a group of middle-aged client's ways to reduce hypertension. Which instructions should the nurse point out during this session? Select all that apply A. reduce stress B. decrease exercise C. lose weight D. increase sodium intake E. stop smoking
A, C, E,
The nursing instructor is teaching a group of nursing students comparing the different classes of diuretics. The instructor determines the session is successful when the students correctly choose which drugs as affecting carbonic anhydrase? Select all that apply. A. Methazolamide B. Hydrochlorothiazide C. Torsemide D. Furosemide E. Acetazolamide
A, D
1. A group of nursing students are comparing the actions of the various diuretic classes. Which drugs should the students choose when examining the ones that work on the glomerulus? Select all that apply. A. mannitol B. torsemide C. ethacrynic acid D. urea E. amiloride
A, D,
12. In providing nursing management to a client post-varicose vein surgery, the nurse would include which of the following teaching measures? Select all that apply. A. Exercise B. Stand rather than sit. C. Take warm showers in the morning. D. Lower the extremities. E. Cool compresses F. Elastic stockings
A, D,
61. The nurse is caring for a client who is suspected of having coronary artery disease. The client is scheduled to have a nuclear stress test using thallium. When would the thallium be injected to determine narrowing of the coronary arteries? A. Before and during exercise electrocardiography B. During and a few hours after exercise electrocardiography C. Before and a few hours after exercise electrocardiography D. Before, during, and a few hours after exercise electrocardiography
B
75. Which ethnic background would the nurse screen for hypertension at an early age? A. Japanese population B. African American population C. Mexican population D. Asian population
B
80. Clients taking vasodilator drugs can be a greater risk for postprandial hypotension. Which of the following is the best nursing explanation for this phenomenon? A. Bronchospasms are increased when food enters the stomach. B. Blood is being diverted to the gastrointestinal tract. C. Decreased peripheral blood flow results. D. Gravity pulls blood to the lower extremities while sitting.
B
83. In the treatment of coronary artery disease (CAD), medications are often ordered to control blood pressure in the client. Which of the following is a primary purpose of using beta-adrenergic blockers in the nursing management of CAD? A. To prevent angiotensin II conversion B. To decrease workload of the heart C. To dilate coronary arteries D. To decrease homocysteine levels
B
A client comes to the emergency department (ED) complaining of precordial chest pain. In describing the pain, the client describes it as pressure with a sudden onset. What disease process would the nurse suspect in this client? A. Raynaud's disease B. Coronary artery disease C. Venous occlusive disease D. Cardiogenic shock
B
A client develops cardiogenic pulmonary edema and is extremely apprehensive. What medication can the nurse administer with physician orders that will relieve anxiety and slow respiratory rate? A. Furosemide B. Morphine sulfate C. Nitroglycerin D. Dopamine
B
A client is admitted in acute renal failure and prescribed mannitol. The nurse prepares to administer this drug via which route? A. intramuscularly B. intravenously C. orally D. subcutaneously
B
A client with pulmonary edema has been admitted to the ICU. What would be the standard care for this client? A. Intubation of the airway B. BP and pulse measurements every 15 to 30 minutes C. Insertion of a central venous catheter D. Hourly administration of a fluid bolus
B
A nurse is assessing the serum digoxin level of a client who is receiving treatment for atrial fibrillation. Which result should the nurse prioritize and report to the primary health care provider? A. 1.8 ng/mL B. 2.2 ng/mL C. 2.0 ng/mL D. 1.6 ng/mL
B
A nurse is preparing to administer IV digoxin to a client. The nurse prepares to administer the drug over which time frame? A. 30 minutes B. 5 minutes C. 30 seconds D. 2 minutes
B
Following a percutaneous transluminal coronary angioplasty (PTCA), which of the following nursing assessments would be considered as primary for this client? A. Monitor gag reflex. B. Assess peripheral pulses in affected extremity. C. Monitor for signs of fluid volume deficit. D. Evaluate for signs of infection.
B
The charge nurse was discussing with the nursing student that studies have been published that suggest inflammation increases the risk of heart disease. Which factor would the nursing student target in teaching clients about prevention of inflammation that can lead to atherosclerosis? A. Avoiding use of caffeine B. Addressing obesity C. Drinking at least 2 liters of water a day D. Encouraging use of a multivitamin
B
The client asks the nurse to explain the difference between arteriosclerosis and atherosclerosis. Which is the best explanation provided by the nurse? A. "Arteriosclerosis is when the vessels become dilated and weakened, whereas atherosclerosis is the deposit of fatty substances in the vessel lining." B. "Arteriosclerosis is a condition that produces structural changes in the arteries, and atherosclerosis is a specific type of arteriosclerosis." C. "Arteriosclerosis and atherosclerosis are the same disorder. The terms are interchangeable." D. "Atherosclerosis and arteriosclerosis are disorders in which the lining of the vessels become narrowed because of plaque formation."
B
The health care provider has prescribed spironolactone for a client. The nurse is prepared to carefully monitor the client's potassium level if the client is also administered which drug? A. metoprolol B. lisinopril C. terazosin D. diltiazem
B
The licensed practical nurse is monitoring the waveform pattern on the cardiac monitor of the client admitted following a myocardial infarction. The nurse notes that every other beat includes a premature ventricular contraction (PVC). The nurse notes which of the following in the permanent record? A. multifocal PVCs B. bigeminy C. couplets D. R-on-T phenomenon
B
The nurse documents pitting edema in the bilateral lower extremities of the client. What does this documentation mean? A. There is excess fluid volume in the arterial system of the lower extremities. B. There is excess fluid volume in the interstitial space in areas affected by gravity. C. There is excess fluid volume in the venous system of the lower extremities. D. There is excess fluid volume in the hepatic system.
B
The nurse enters the client's room and finds the client pulseless and unresponsive. What would be the treatment of choice for this client? A. Electric cardioversion B. Immediate defibrillation C. Chemical cardioversion D. IV lidocaine
B
The nurse has finished a teaching session with a client who is prescribed a diuretic to be taken twice a day. The nurse determines the session is successful when the client correctly chooses which times to take the drug? A. In the early morning and at bedtime B. At breakfast and midafternoon C. After lunch and dinner D. Midmorning and before dinner
B
The nurse is assessing a client with renal disease and discovers the client's blood pressure has increased since the last visit. The nurse suspects the client has developed which concern? A. Essential hypertension B. Secondary hypertension C. Hypertensive emergency D. Rebound hypertension
B
The nurse is caring for a client who is status postoperative from a vein stripping. What would the nurse monitor for in the client? A. Blood on the dressing on the inoperative leg B. Swelling in the operative leg C. Swelling in the inoperative leg D. Warm, pink toes in the inoperative leg
B
The nurse is caring for a client with accelerated hypertension. Which body system would the nurse assess to identify early signs of blood pressure progression? A. kidneys B. eyes C. heart D. musculoskeletal system
B
The nurse is caring for a client with an arrhythmia. While assessing the data in the history of the chart, the nurse anticipates the cause of the arrhythmia to be which of the following? A. Peripheral vascular disease B. Ischemic heart disease C. Atherosclerotic heart disease D. Aortic stenosis
B
The nurse is caring for a client with essential hypertension. The nurse reviews lab work and assesses kidney function. Which action of the kidney would the nurse evaluate as the body's attempt to regulate high blood pressure? A. The kidney retains sodium and water. B. The kidney excretes sodium and water. C. The kidney retains water and excretes sodium. D. The kidney retains sodium and excretes water.
B
The nurse is caring for a client with hypertension. The nurse is correct to realize that a 24-hour urine is ordered to determine if the cause of hypertension is related to the dysfunction of which of the following? A. The thyroid gland B. The adrenal gland C. The pituitary gland D. The thymus
B
The nurse is caring for a client with malignant hypertension. What would be an appropriate nursing intervention for this client? A. Monitor the client's mental and emotional status every hour. B. Monitor the blood pressure (BP) every few minutes by applying an automatic BP recording machine. C. Monitor the client's blood sugar every hour. D. Monitor the client's temperature every few minutes.
B
The nurse is caring for a client with suspected right-sided heart failure. What would the nurse know that clients with suspected right-sided heart failure may experience? A. Sleeping in a chair or recliner B. Gradual unexplained weight gain C. Increased urine output D. Increased perspiration
B
The nurse is creating a community teaching demonstration focusing on the cause of blood pressure. When completing the visual aid, which body structures represent the mechanism of blood pressure? A. Kidneys and autonomic nervous system B. Heart and blood vessels C. Lung and arteries D. Brain and sympathetic nervous system
B
The nurse is employed in a physician's office and is caring for a client present for an annual exam. A blood pressure of 124/84 mm Hg is documented. Following revised guidelines for identifying hypertension, which educational pamphlet is of help? A. Increasing fluids for low blood pressure B. Stress reduction to lower prehypertensive state C. Use of beta-blockers for treatment of hypertension D. Diagnostic testing for determining cardiac functioning
B
The nurse is obtaining a healthy history from a client with blood pressure of 146/88 mm Hg. The client states that lifestyle changes have not been effective in lowering the blood pressure. Which medication classification does the nurse anticipate first? A. calcium channel blocker B. thiazide diuretic C. beta-blockerss D. ACE inhibitors
B
The nurse is preparing to teach a client with renal insufficiency about the recently prescribed bumetanide for hypertension. Which instruction should the nurse prioritize for this client? A. Avoid salt substitutes containing potassium. B. Avoid over-the-counter drugs for cold symptoms. C. Omit the drug dose when feeling dizzy D. Always take the drug before meals.
B
The nurse is working on a monitored unit assessing the cardiac monitor rhythms. Which waveform pattern needs attention first? A. Supraventricular tachycardia B. Ventricular fibrillation C. Atrial fibrillation D. Sustained asystole
B
The nurse observes a client with an onset of heart failure having rapid, shallow breathing at a rate of 32 breaths/minute. What blood gas analysis does the nurse anticipate finding initially? A. Metabolic acidosis B. Respiratory alkalosis C. Respiratory acidosis D. Metabolic alkalosis
B
The nursing student is taking a prenursing pharmacology class. Today, the nursing student is learning about antiarrhythmic drugs. What drug is a potassium channel blocker? A. isoproterenol B. amiodarone C. lidocaine D. flecainide
B
The student nurse is caring for a client with heart failure. Diuretics have been ordered. What method might be used with a debilitated client to help the nurse evaluate the client's response to diuretics? A. Using a biventricular pacemaker B. Using a urinary catheter C. Using mechanical ventilation D. Using a pulmonary artery catheter
B
What is blood pressure? A. The measurement of cardiac output B. The force produced by the volume of blood in arterial walls C. The peripheral resistance of the cardiac output D. The force produced by the volume of blood in the venous system
B
Which assessment finding by the nurse is the most significant finding suggestive of aortic aneurysm? A. nausea and vomiting B. abdomen bruit C. high blood pressure D. severe back pain
B
Which of the following client scenarios would be correct for the nurse to identify as a client with secondary hypertension? A. A client with excessive alcohol intake B. A client diagnosed with kidney disease C. A client of advanced age D. A client experiencing depression
B
Which of the following diagnostic tests may reveal an enlarged left ventricle? A. Positron emission tomography (PET) scan B. Echocardiography C. Computed tomographic (CT) scan D. Fluorescein angiography
B
Which of the following does the nurse recognize as the therapeutic goal of radiofrequency catheter ablation for a client with cardiac arrhythmias? A. Dilation of arterial blood vessels B. Destruction of errant tissue C. Stimulation of the impulse center D. Reperfusion of ischemic heart tissue
B
A client receiving digoxin for heart failure comes to the clinic reporting weakness and drowsiness stating, "I just get so tired sometimes that I can't do what I want to do." Which nursing diagnosis should the nurse prioritize for this client? A. Imbalanced Nutrition: Less Than Body Requirements B. Activity Intolerance C. Decreased Cardiac Output D. Risk for Injury
B,
A nurse is monitoring the response of a 4-year-old child to digoxin. Which apical pulse rate should the nurse prioritize and notify the primary health care provider? A. 96 beats per minute B. 66 beats per minute C. 76 beats per minute D. 86 beats per minute
B,
A client comes to the clinic for a follow-up visit with a caregiver. The caregiver is questioning if the client is starting to have some reactions to the digoxin. Which reported symptoms should the nurse prioritize? Select all that apply. A. Inability to relax B. Anorexia ✓ C. Disorientation ✓ D. Weakness ✓ E. Photosensitivity
B, C, D
The nurse is preparing to administer bumetanide to the client. The nurse should question this order after noting which drugs are currently being administered? Select all that apply. A. phenytoin B. digoxin C. warfarin D. gentamicin E. lithium
B, C, D, E.
The nurse is preparing to teach a client about the prescribed digoxin. Which points should the nurse point out to the client in this teaching session? Select all that apply. A. Capsule doses are less absorbed. B. Tablets can be crushed and mixed with food or fluids. C . Oral dosage forms can be administered without regard to meals. D. The recommended dosage of the capsules is 80% more than that of tablets. E. Alternating between capsules and tablets should be avoided.
B, C, E
The nurse reports to the cardiac nurse practitioner that the client is consistently exhibiting a normal sinus rhythm. What characteristics are understood? Select all that apply. A. Heart rate 106 beats/minute B. Wave ending with a T wave C. Ventricles depolarizing in the QRS complex D. Impulse traveling to the SA node from the AV node E. Upright P wave before each QRS complex F. Each impulse occurring regularly
B, C, E
The nurse is preparing to administer losartan to a client with hypertension. The nurse should question this order if which disorder is noted in the client's medical record? Select all that apply. A. hyperlipidemia B. bilateral stenosis C. pregnancy D. diabetes E. angioedema
B, C, E,
A nurse is administering amiloride to several clients. The nurse should prioritize monitoring the serum potassium levels for clients with which noted disorder? Select all that apply. A. epilepsy B. renal disease C. hypertension D. asthma E. diabetes
B, D,
A client with hypertension is prescribed atenolol. Which assessment findings on the ongoing assessment should the nurse evaluate first? Select all that apply. A. cough B. bradycardia C. constipation D. hyperkalemia E. dizziness
B, E,
A nurse is preparing to teach a client about captopril which has been prescribed to treat hypertension. Which instructions should the nurse point out during this teaching session? Select all that apply. A. Reporting any swelling of the face, throat, or extremities B. Taking measures to reduce injury from hypotension C Crushing the capsule before taking it D. Taking the drug with meals to decrease GI upset E. Informing the client about the possibility of a cough
B, E,
The nurse is conducting an ongoing assessment after the administration of an antihypertensive. Which findings should the nurse prioritize? Select all that apply. A. Insomnia B. Weight gain of 2 lb. or more per day C. Headache D. Sedation E. Edema
B, E,
121. Which of the following nursing diagnosis is the nurse most correct to choose when caring for a client with long-standing hypertension? A. Impaired Gas Exchange B. Risk for Decreased Cardiac Output C. Ineffective Tissue Perfusion D. Activity Intolerance
C
16. A health care provider prescribes diuretic therapy to a client with nephrotic syndrome. The nurse suspects that the client is hyponatremic based on which assessment finding? A. visual hallucination B. parethesias C. tachycardia D.tremors
C
20. A client has been admitted to a health care center with reports of dyspnea. The nurse suspects left-sided heart failure based on which assessment finding? A. Weight gain B. Nocturia C. Orthopnea E. Pitting edema
C
23. A client with heart failure requires long-term digoxin therapy. Which instruction should the nurse point out in the discharge teaching? A. Report to the center if the pulse is less than 70 bpm. B. Take the drug with high-fiber meals. C. Take the drug regularly without skipping a dose. D. Take antacids promptly to avoid gastric problems.
C
27. The nurse is working in a long-term care facility with a group of older adults with cardiac disorders. Why would it be important for the nurse to closely monitor an older adult receiving digitalis preparations for cardiac disorders? A. Older adults are at increased risk for hyperthyroidism. B. Older adults are at increased risk for asthma. C. Older adults are at increased risk for toxicity. D. Older adults are at increased risk for cardiac arrests.
C
40. A client with right-sided heart failure is admitted to the medical-surgical unit. What information obtained from the client may indicate the presence of edema? A. The client says he has been hungry in the evening. B. The client says that he has been urinating less frequently at night. C. The client says his rings have become tight and are difficult to remove. D. The client says he is short of breath when ambulating.
C
58. The nurse is caring for a client on the cardiac unit. The licensed practical nurse on the previous shift reported the following vital signs/assessment information: temperature, 100.6° F; pulse, 56 beats/minute; respirations, 24 breaths/minute; blood pressure, 116/60 mm Hg; pulse oximetry reading, 92%; and with 2+ edema noted in the lower extremities. Before 9 am antiarrhythmic medication administration, which of the following will the nurse reassess? A. temperature B. blood pressure C. pulse D. edema
C
7. The nurse is caring for a client with abdominal aortic aneurysm (AAA). Which assessment finding is most likely to indicate a dissection of the aneurysm? A. hematemesis B. hypertensive crisis C. severe back pain D. rectal bleeding
C
78. Which of the following medications does the nurse anticipate administering to a client preparing for cardioversion? A. atropine B. enalapril C. diazepam D. dogoxin
C
A client diagnosed with heart failure has been admitted to the ICU before invasive treatment. What treatment could be considered curative for this client? A. Ventricular assist device B. External pacemaker placement C. Surgical ventricular restoration D. Cardiomyoplasty
C
A client in the hospital informs the nurse he "feels like his heart is racing and can't catch his breath." What does the nurse understand occurs as a result of a tachydysrhythmia? A. It causes a loss of elasticity in the myocardium. B. It increases afterload. C. It reduces ventricular ejection volume. A. It increases preload.
C
A client is being evaluated for coronary artery disease (CAD) and is scheduled for an electron beam computed tomography (EBCT). The nurse understands that the primary advantage of this radiologic test is which of the following? A. Less invasive procedure B. Clear images C. Quantifies calcified plaque D. Less exposure to radiation
C
A client is prescribed clonidine as a transdermal patch. After instructing the client about this drug, the nurse determines that the teaching was successful when the client states that the patch should remain in place for how long? A. 24 hours B. 2 weeks C. 7 days D. 3 days
C
A client is scheduled for a multiple gated acquisition (MUGA) scan the following day. What medication should the nurse be sure not to administer the morning of the procedure? A. Acetaminophen B. Guaifenesin C. Furosemide D. Morphine sulfate
C
A client is taking furosemide for the treatment of heart failure. What food should the nurse suggest that is rich in potassium? A. coffee B. pasta C. peanut butter D. angel food cake
C
A client presents to the emergency department via ambulance with a heart rate of 210 beats/minute and a sawtooth waveform pattern per cardiac monitor. The nurse is most correct to alert the medical team of the presence of a client with which disorder? A. premature ventricular contraction B. ventricular fibrillation C. atrial flutter D. asystole
C
A client presents to the urgent care clinic reporting severe dizziness. On assessment, the nurse learns the client was recently prescribed losartan and quit taking it thinking it was responsible for the dizziness. Which assessment should the nurse prioritize? A. Anginal attacks B. Breathing difficulty C. Rebound hypertension D. Orthostatic hypotension
C
A client who is receiving diuretic therapy comes to the clinic for a follow-up visit. The client states that their mouth is often dry and that they are "urinating like there is no tomorrow." Assessment reveals dry mucous membranes and decreased skin turgor. Which nursing diagnosis would the nurse most likely prioritize? A. Risk for Injury B. Deficient Knowledge C. Risk for Deficient Fluid Volume D. Impaired Urinary Elimination
C
A client with a history of seizures is admitted to the unit with pulmonary edema. After administering furosemide, which assessment should the nurse prioritize after discovering the client is also prescribed phenytoin? A. Increased risk of bleeding B. Increased seizure episodes C. Decreased diuretic effectiveness D. Increased blood glucose levels
C
A client, newly prescribed a low-sodium diet because of hypertension, is asking for help with meal choices. The client provides four meal choices, which are favorites. Which selection would be best? A. Hot dog with ketchup and relish on whole wheat bun B. Creamed chipped beef over toast with mashed potatoes C. Green pepper stuffed with diced tomatoes and chicken D. Toasted cheese sandwich on whole wheat toast with tomato soup
C
A client, who has undergone a percutaneous transluminal coronary angioplasty (PTCA), has received discharge instructions. Which statement by the client would indicate the need for further teaching by the nurse? A. "I should avoid prolonged sitting." B. "I should expect bruising at the catheter site for up to 3 weeks." C. "I should expect a low-grade fever and swelling at the site for the next week." D. "I should avoid taking a tub bath until my catheter site heals."
C
A nurse notes a client has a new prescription for fluconazole who has also been administered losartan for several months. The nurse determines the client should be monitored for which result of this combination? A. Increased risk of hypersensitivity reaction B. Decreased hypotensive effect of losartan C. Increased risk of adverse effects of losartan D. Increased risk of hypoglycemia
C
Severe chest pain is reported by a client during an acute myocardial infarction. Which of the following is the most appropriate drug for the nurse to administer? A. Nitroglycerin transdermal patch B. Meperidine hydrochloride C. Morphine sulfate D. Isosorbide dinitrate
C
The nurse assists the client to the bathroom, which is approximately 10 feet from the bed. The client ambulates 3 feet and states, "I cannot catch my breath." How would the nurse document this finding? A. "Has paroxysmal nocturnal dyspnea when walking." B. "Can't walk without becoming short of breath." C. Experiences exertional dyspnea when walking 3 feet; states, "I cannot catch my breath." D. "Has orthopnea when walking."
C
The nurse in an oncology clinic notes that the client being treated has hypertension. What tumor is a predisposing condition for secondary hypertension? A. Astrocytoma B. Wilms's tumor C. Pheochromocytoma D. Lymphoma
C
The nurse is administering captopril to a client with a diagnosis of heart failure. What type of medication does the nurse inform the client is taking? A. A calcium channel blocker B. An angiotensin receptor blocker (ARB) C. An angiotensin-converting enzyme (ACE) inhibitor D. A thiazide diuretic
C
The nurse is caring for a client diagnosed with secondary hypertension. What would be a predisposing condition for this diagnosis? A. Pancreatic disease B. Hypoaldosteronism C. Use of oral contraceptives D. Use of diazepam
C
The nurse is caring for a client with coronary artery disease (CAD). What is an appropriate nursing action when evaluating a client with CAD? A. Assess for any kind of drug abuse. B. Assess the skin of the client. C. Assess the characteristics of chest pain. D. Assess the client's mental and emotional status.
C
The nurse is caring for a client with heart failure. What procedure should the nurse prepare the client for in order to determine the ejection fraction to measure the efficiency of the heart as a pump? A. Electrocardiogram B. A chest radiograph C. Echocardiogram D. A pulmonary arteriography
C
The nurse is caring for a client with hypertension who is experiencing complications. What diagnostic test evaluates the efficiency or inefficiency of the heart to pump blood? A. Echocardiography B. Computed tomography scan C. Multiple gated acquisition (MUGA) scan D. Chest radiography
C
The nurse is conducting the ongoing assessment of a client with heart failure who was administered digoxin. Which additional medication does the nurse anticipate the health care provider to prescribed after reporting a heart rate of 48 bpm, muscle weakness, anorexia, and reports of generalized headache? A. cholestyramine B. milrinone C. atropine D. furosemide
C
The nurse is instructing on home care after placement of an automatic implanted cardioverter defibrillator (AICD). Which statement, made by the client, needs clarification by the nurse? A. "I should opt for a hand search at the airport instead of metal detector scan." B. "I need to notify my cardiologist if I feel frequent kicks to the chest." C. "I need to stay away from microwaves." D. "I can continue to work with my power tools."
C
The nurse is preparing a client for a multiple gated acquisition (MUGA) scan. What would be an important instruction for the nurse to give a client who is to undergo a MUGA scan? A. Drink plenty of fluids during the test. B. Avoid any activity at least 2 hours before the test. C. Lie very still at intermittent times during the test. D. Avoid dairy products a day before and a day after the test.
C
The nurse obtains a blood pressure of 136/86 mm Hg on morning assessment of a client with history of hypertension. Which pressure is of most concern when considering ventricular relaxation? A. Systolic pressure B. Central aortic pressure C. Diastolic pressure D. Central venous pressure
C
The physician is ordering a test for the hypertensive client that will be able to evaluate whether the client has experienced heart damage. Which diagnostic test would the nurse anticipate to determine heart damage? A. Chest radiograph B. Blood chemistry C. Multiple gated acquisition scan (MUGA) D. Fluorescein angiography
C
Two clients in cardiac rehabilitation are discussing scheduled cardioversion and unexpected defibrillation. Which statement does the nurse note is not correct? A. Both used to eliminate ventricular arrhythmias. B. Both procedures sedate the clients. C. Cardioversion uses more electrical energy than does defibrillation. D. Machine determines when electrical energy is delivered.
C
Which nursing actions would be of greatest importance in the management of a client preparing for angioplasty? A. Inform client of diagnostic tests. B. Remove hair from skin insertion sites. C. Withhold anticoagulant therapy. D. Assess distal pulses.
C
An elderly client with hypertension is prescribed labetalol. Which instruction should the nurse prioritize for the client? Select all that apply. A. Increase salt intake to counteract the hypotension. B. Rise quickly from a chair when moving to a standing position. C. Sit on the bed for 1 or 2 minutes when rising from a lying position. D. Have someone assist the client if dizziness or weakness occurs. E. Take the antihypertensive less frequently if hypotension occurs.
C, D,
The nurse has administered a loading dose of milrinone to a client with acute heart failure. Which finding noted on the ongoing assessment should the nurse prioritize? Select all that apply. A. hypertension B. hyperkalemia C. headache D. angina E. insomnia
C, D,
A client with diabetes, controlled by metformin, was recently prescribed a diuretic. The nurse should question the administration of which drug after noting the elevation of blood glucose levels? Select all that apply. A. furosemide B. chlorthalidone C. metolazone D. acetazolamide E. hydrochlorothazide
C, D, E,
1. The nurse is teaching a client with hypertension about the prescribed transdermal clonidine. The nurse determines the session is successful when the client correctly articulates which instructions? Select all that apply. A. The use of the adhesive overlay is not necessary. B. A new patch is applied daily. C. The patch should be applied to a hairless area. D. A different body area should be selected for each application. E. If the patch loosens, a new patch should be applied.
C,D
5. A client with cerebral edema is prescribed mannitol. Which assessment should the nurse prioritize during the ongoing assessment? A. Joint pain. B. Serum uric acid concentrations. C. Blood pressure every 4 hours. D. Response of pupils to light.
D
52. Which diagnostic study best evaluates different medications ability to restore normal heart rhythm? A. Electrocardiogram (ECG) B. Echocardiogram C. Elective electrical cardioversion D. Electrophysiology study
D
53. Which of the following medication classifications is more likely to be expected when the nurse is caring for a client with atrial fibrillation? A. diuretic B. antihypertensive C. potassium supplements D. anticoagulant
D
57. The nurse is caring for a client with Raynaud's disease. What is an important instruction for a client who is diagnosed with this disease to prevent an attack? A. Take over-the-counter decongestants. B. Report changes in the usual pattern of chest pain. C. Avoid fatty foods and exercise. D. Avoid situations that contribute to ischemic episodes.
D
6. A primary health care provider has prescribed a loop diuretic for hypertension in a client with diabetes mellitus. Which assessment should the nurse prioritize? A. Occurrence of gout attacks B. Sudden pain in the joints C. Sudden increase in weight D. Increased blood glucose levels
D
87. A client with heart failure informs the nurse he has not had a bowel movement in 2 days. Why would it be important for the nurse to obtain an order for a stool softener? A. The client can develop a rectal fissure, which will increase pain levels. B. The client should not develop hemorrhoids. C. The client should have a bowel movement every day to avoid development of an intestinal obstruction. D. Straining causes the Valsalva maneuver, which can cause dangerous effects.
D
A client has a myocardial infarction in the left ventricle and develops crackles bilaterally, 3-pillow orthopnea, an S heart sound, and a cough with pink, frothy sputum. The nurse obtains a pulse oximetry reading of 88%. What do these signs and symptoms indicate for this client? A. The development of cor pulmonale B. The development of chronic obstructive pulmonary disease (COPD) C. The development of right-sided heart failure D. The development of left-sided heart failure
D
A client has had oral anticoagulation ordered. What should the nurse monitor for when the client is taking oral anticoagulation? A. Urine output B. Hourly IV infusion C. Vascular sites for bleeding D. Prothrombin time (PT) or international normalized ratio (INR)
D
A client is admitted to the emergency department with a severe headache, nausea, shortness of breath, and blood pressure of 200/120 mm Hg. Which response should the nurse prioritize? A. Measure the pulse rate every hour. B. Alternate the arms for assessing the blood pressure and pulse. C. Take a blood pressure every 30 minutes. D. Continuously monitor the client's status.
D
A client with chronic heart failure is able to continue with his regular physical activity and does not have any limitations as to what he can do. According to the New York Heart Association (NYHA), what classification of chronic heart failure does this client have? A. Class III (Moderate) B. Class IV (Severe) C. Class II (Mild) D. Class I (Mild)
D
A client with heart failure is having a decrease in cardiac output. What indication does the nurse have that this is occurring? A. Oxygen saturation 94% B. Heart rate of 72 beats/minute C. Respiratory rate of 20 breaths/minute D. Blood pressure 80/46 mm Hg
D
A client with severe mitral valve insufficiency has been admitted to the unit. The client has heart failure and has developed pulmonary edema. What would be the best course of treatment for this client? A. Cardiac glycosides B. Palliative care C. Beta-blockers D. Surgery
D
A nurse administers chlorothiazide to a client with renal compromise. Which action should the nurse prioritize after noting the BUN level is rising? A. Give prescribed magnesium supplements. B. Administer the drug in a diluted form. C. Increase the fluid intake for the client. D. Withhold the next dose of the drug.
D
A nurse is analyzing the medical records of several clients who have come to the clinic for a visit. The nurse determines that a client with which blood pressure readings would be identified as prehypertensive? A. 144/92 mm Hg B. 112/72 mm Hg C. 164/102 mm Hg D. 128/86 mm Hg
D
After teaching a group of nursing students on the mechanism of action of angiotensin- converting enzyme inhibitor (ACEI) drugs, the instructor determines the session is successful after the students correctly choose which action as the result of aldosterone? A. Causes excess potassium retention B. Promotes angiotensin I conversion C. Inhibits renin secretion D. Causes sodium and water retention
D
An older adult client visits the clinic for a blood pressure (BP) check. The client's hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about the blood pressure medicine? A. A severe drop in blood pressure is possible. B. Take the medicine on an empty stomach. C. There are no adverse effects from blood pressure medicine. D. A possible adverse effect of blood pressure medicine is dizziness when you stand.
D
Elective cardioversion is similar to defibrillation except that the electrical stimulation waits to discharge until an R wave appears. What does this prevent? A. Disrupting the heart during the critical period of atrial repolarization B. Disrupting the heart during the critical period of ventricular depolarization C. Disrupting the heart during the critical period of atrial depolarization D. Disrupting the heart during the critical period of ventricular repolarization
D
NO QUESTION A. Blindness B. Rebound hypertension C. Stroke D. Significant hypotension
D
The client has returned to the floor with a transthoracic pacemaker ready to be connected. The nurse knows that a transthoracic pacemaker is a temporary pacemaker used in what situation? A. Transthoracic pacemakers are used when a client has an MI. B. Transthoracic pacemakers are used after a coronary bypass graft surgery. C. Transthoracic pacemakers are used for tachyarrhythmias. D. Transthoracic pacemakers are used in a client who has had open heart surgery.
D
The nurse and student nurse are observing a cardioversion procedure completed by a physician. At which time is the nurse most correct to identify to the student when the electrical current will be initiated? A. During the QRS complex B. During repolarization of the heart C. During stimulation of the SA node D. During ventricular depolarization
D
The nurse is preparing to administer digoxin to a client with heart failure. The nurse obtains an apical pulse rate for 1 minute and determines a rate of 52 beats/minute. What is the first action by the nurse? A. Administer the medication and inform the charge nurse about the rate. B. Administer atropine to speed the heart rate and then administer the digoxin. C. Administer the medications and then notify the physician. D. Withhold the medication and notify the physician of the heart rate.
D
The nurse is preparing to administer furosemide to a client with severe heart failure. What lab study should be of most concern for this client while taking furosemide? A. Sodium level of 135 B. BNP of 100 C. Hemoglobin of 12 D. Potassium level of 3.1
D
The nurse is teaching a client with hypertension about losartan which the health care provider has prescribed. The nurse can explain that losartan exerts which action on the body? A. Blocks aldosterone receptors B. Prevents conversion of angiotensin I C. Prevents renin secretion D. Blocks angiotensin II receptors
D
The nurse is teaching a health class at the local community center. What body system would the nurse explain regulates arterial blood pressure? A. Lymphatic system B. Immune system C. Cardiovascular system D. Autonomic nervous system
D
Which nursing diagnosis is most significant in planning the care for a client with Raynaud's disease? A. Disturbed Sensory Perception B. Self-Care Deficit C. Activity Intolerance D. Acute Pain
D
The nurse is reviewing the client's laboratory results and notes the potassium level is 6 mEq/L. The nurse should question the continued administration of which drug if noted in the client's record? Select all that apply. A. clonidine B. metoprolol C. atenolo D. eplerenone E. aliskiren
D, E,
29. A nurse is preparing to administer spironolactone to a client. The nurse would question this order if which disorder is noted in the client's history? A. hyperkalemia B. gout C. liver disease D. diabetes
A
The nurse is gathering data from a client recently admitted to the hospital. The nurse asks the client about experiencing orthopnea. What question would the nurse ask to obtain this information? A. "Are you only able to breathe when you are sitting upright?" B. "Are you urinating excessively at night?" C. "Are you coughing up blood at night?" D. "How far can you walk without becoming short of breath?"
A
The nurse is volunteering at a community blood pressure screening. A client, never diagnosed with hypertension, presents with a blood pressure of 158/90 mm Hg. Which assessment questions, asked by the nurse, are appropriate? Select all that apply. A. "Do you smoke?" B. "Do you have a friend accompanying you?" C. "Did you have a beer after work?" D. "Are you married and with children?" E. "Have you recently drunk a caffeinated beverage?"
A, E,
24. A nurse is administering urea to a client with increased intraocular pressure. Which ongoing assessment should the nurse prioritize? A. cramping B. syncope C. photosensitivity D. blurred vision
B
2. A client is unconscious on arrival to the emergency department. The nurse in the emergency department identifies that the client has a permanent pacemaker because of which characteristic? A. Quality of the pulse B. "Spike" on the rhythm strip C. Scar on the chest D. Vibration under the skin
B
The nurse is preparing the discharge teaching for client who is prescribed digoxin. The nurse will point out the client may be receiving the digoxin in which form depending on the pharmaceutical company? Select all that apply. A. ointment B. patch C.capsule D.tablet E. njection
C, D,
10. The nursing instructor is teaching a class on the signs of heart failure. The instructor determines the session is successful when the students correctly choose which ejection fraction as suggesting left ventricular systolic dysfunction? A. 58% B. 68% C. 48% D. 38%
D
11. A client receives the prescribed daily digoxin at 9 a.m. The nurse would expect to obtain a serum drug level at which time? A. 9 p.m. tonight B. 12 midnight C. 12 noon today D. 4 p.m. today
D
18. The nurse is completing a teaching session with a client with heart failure. The nurse determines that additional teaching is needed about the cardiotonic drug therapy when the client states which comment? A. "I can crush the tablet and mix it with food." B. "I need to notify my health care provider if I have blurred vision." C. "I will take the drug at the same time each day." D. "I should call if my pulse rate is below 80 beats per minute."
D
The nurse is working on a clinical research study, obtaining data evaluating central aortic systolic pressure and brachial arm systolic pressure. The client notes difference in the readings. Which response by the nurse is most accurate? A. "The difference is due to the constrictive force on the arteries when the measurement is taken." B. "The difference is due to machine calibration." C. "The difference is due to the discomfort caused by the measurement procedure." D. "The difference is due to the location of pressure measurement."
D
The nurse is working with a client who has just been diagnosed with an aneurysm. What advice should the nurse provide to this client? A. Minimize bowel movements and coughing. B. Avoid situations that contribute to ischemic episodes. C. Wear wool socks and mittens during cold weather. D. Avoid straining during bowel movements and coughing.
D
The nursing instructor has completed a teaching session explaining the various antihypertensive drugs. The instructor determines additional training is needed when the students choose which drugs as an angiotensin-converting enzyme inhibitor? A. enalapril B. benazepril C. quinapril D. pindolol
D
The nursing mentor is supervising a group of nursing students in the clinic. The mentor determines the students are well prepared when they prioritize which assessment with clients receiving medications such as doxazosin? A. Weight measurement B. Pain rating C. Reports adverse reactions D. Blood pressure monitoring
D
Which of the following nursing assessment findings are suggestive of increased risk for coronary artery disease (CAD)? Select all that apply. A. Motor changes B. Plump ear lobes C. Pear-shaped body D. Sensory loss E. Xanthelasma F. Arcus senilis
E, F,
