ATI CARDIAC QUESTIONS

Complications of Cardioversion?

Pulmonary embolism- (AEB dyspnea, chest pain, air hunger, decreased sat) Stoke(CVA)- (AEB decrease LOC, slurred speech, muscle weakness/paralysis) MI- (AEB chest pain and elevated or depressed ST segment)

A nurse is caring for a client in a clinic who asks the nurse why her provider prescribed 1 aspirin per day. which of the following is an appropriate response by the nurse? 1. "Aspirin reduces the formation of blood clots that could cause a heart attack." 2. "Aspirin relieves the pain due to MI." 3. "Aspirin dissolves clots that are forming in your coronary arteries." 4. "Aspirin relieves headaches that are caused by other medications."

1. Aspirin reduces the formation of blood clots that could cause a heart attack-aspirin decreases Plt aggregation that can = MI

PT has complete Heart block HR 34, BP 83/48, he is lethargic, and unable to complete sentences. Which action should you do first? 1. Clean skin with soap and water 2. Prepare PT for insertion of permanent pacemaker 3. Obtain signed informed consent form for a pacemaker 4. Apply transcutaneous pacemaker pads.

1. Clean skin with soap and water- need to do this before applying transcutaneous pads

ER nurse is assessing PT with bradydysrhythmia. Which finding should he expect? 1. Confusion 2. Friction Rub 3. HTN 4. Dry skin

1. Confusion- as a result of decreased tissue perfusion

Right sided Heart failure results in peripheral edema? TRUE OR FALSE

TRUE **Right side Heart failure results in inadequate right ventricle output and systemic congestion (peripheral edema)

PT just had an insertion of a temporary venous pacemaker via the femoral artery and its set to VVI rate of 70/min. Which finding should the RN report? Select all 1. Cool and clammy foot with cap refill of 5 sec 2. Observed pacing spike followed by a QRS complex 3. Twitching of intercostal muscle 4. HR of 84 5. BP 104/62

1. Cool and clammy foot with cap refill of 5 sec-indicates femoral hematoma r/t insertion of the lead wires 3. Twitching of intercostal muscle - indicates lead wire perforation and stimulation of the diaphragm

You are caring for a PT receiving hemodynamic monitoring and has the following readings: PAS 34, PAD 21, PAWP 16, CVP 12. which is the PT at risk for? Select All 1. Heart failure 2. Cor pulmonale 3. Hypovolemic shock 4. Pulmonary hypertension 5. Peripheral edema

1. Heart failure-r/t left ventricular failure=high hemodynamic readings 2. Cor pulmonale r/t right side of heart/pulmonary problems= high readings 4. Pulmonary hypertension- would present with high readings 5. Peripheral edema - would indicate left ventricular failure r/t high readings

You are caring for a PT following insertion of a permanent pacemaker. Which PT statement indicates a potential complication of the insertion procedure? 1. I can't get rid of these hiccups 2. I feel dizzy when i stand 3. My incision stings 4. i have a headache

1. I can't get rid of these hiccups-can indicate the pacemaker is stimulating the chest wall or diaphragm indicating wire lead perforation

You are caring for a PT with dilated cardiomyopathy. PT reports increasing difficulty completing her daily 1 mile walks. You recognize that this is a finding of? 1. left ventricular failure 2.Peripheral vasodilation 3.Pericardial effusion 4. decreased vascular volume

1. Left ventricular failure- activity intolerance is a finding of left ventricular failure r/t dilated cardiomyopthy

You are planning a presentation about HTN which lifestyle modifications would you include? Select All 1. Limit alcohol intake 2. Regular exercise program 3. Decreased mag intake 4. Reduced K intake 5. Smoking cessation

1. Limit alcohol intake- Should limit if HTN 2. Regular exercise program- will reduce HTN 5. Smoking cessation- exacerbates HTN

You are caring for a group of PTs and should recognize which PT is at risk for a dysrhythmia? Select All 1. PT with metabolic acidosis 2. PT with K level of 4.3 3. PT whose O2 sat is 96% 4. COPD PT 5. PT who underwent a stent replacement

1. PT with metabolic acidosis-acid base imbalance = @ risk 4. COPD PT- at risk 5. PT who underwent a stent replacement- at risk

You are to give 0.9NS IV at 50ml/hr to a PT who is receiving hemodynamic monitoring and has an indwelling IV catheter in the left hand. Which sites can it be given in? Select all 1. Peripheral saline lock 2. Port on the arterial line 3. Port on the proximal CVP lumen of the pulmonary artery catheter 4. Port on distal lumen of PA catheter 5. Ballon Inflammation port.

1. Peripheral saline lock 3. Port on the proximal CVP lumen of the pulmonary artery catheter- can be used for fluids also

You are caring for PT with heart failure and Pt asks how should he limit his fluid to 2000ml/day. What is the best response? 1. Pour the amount of fluid you drink into an empty 2 liter bottle to keep track of how much you drink 2. Each glass contains 8 oz there are 30ml per oz so you can have a total of 8 glasses a day 3. the is the same as 2 quarts or about the same as two pots of coffee 4. Take sips of water or ice chips so you will not take too much fluid

1. Pour the amount of fluid you drink into an empty 2 liter bottle to keep track of how much you drink- provides a visual

You are caring for a PT who is experiencing Afib. You should report what finding to the provider? 1. Slurred speech 2. Irregular pulse 3. Dependent edema 4. Persistant fatigue

1. Slurred speech- greatest risk is an embolus and this can indicate embolus

Pt is being evaluated for possible valvular heart disease. What are risk factors for this condition? Select all 1. Surgical repair of an arterial septal defect at age 2 2. Measles infection in childhood 3. HTN for 5 yrs 4. Weight gain of 10lb in past year 5. Diastolic murmur present

1. Surgical repair of an arterial septal defect at age 2-congential malformations= risk 3. HTN for 5 yrs- HTN=risk 5. Diastolic murmur present- indicates turbulent blood flow which is often caused by valvular disease

The RN is discussing the use of cardiopulmonary bypass during surgery for coronary artery bypass graft CABG. Which should be included when discussing? Select all 1. the demand for O2 is lowered 2. Motion of the heart ceases 3. Rewarming the client takes place 4. The PT metabolic rate is increased 5. Blood flow to the heart is stopped.

1. The demand for O2 is lowered-reduces risk of inadequate oxygenation vital organs 2. Motion of the heart ceases- to allow for placement of graft 3. Rewarming the client takes place- its lowered for procedure so this will take place

Rn admitted a PT following placement of a temporary pacemaker. Which of the following actions should the nurse use to promote safety? Select all 1. Wear gloves when handling pacemaker leads 2. Verify the use of three pronged grounding plugs 3. Minimize PT shoulder movements 4. Keep the lead wires taut when turning the client 5. additional batteries should be kept at the RN's station

1. Wear gloves when handling pacemaker leads- gloves should be worn 2. Verify the use of three pronged grounding plugs-reduce the risk of accidental electrical charge 3. Minimize PT shoulder movements- minimze or wear a sling to promote secure anchoring of the lead wires

You are providing teaching to a PT with HF you would instruct him to report what finding? 1. Weight gain of 2lbs in 24hr 2. Increase in 10mmhg in Systolic BP 3. Dyspnea with exertion 4. Dizziness when rising quickly

1. Weight gain of 2lbs in 24hr- fluid retention r/t worsen HF

A nurse is caring for a client who has severe PAD. The nurse should expect that the client will sleep most comfortably in which of the following positions? 1. With the affected limb hanging from the bed 2. With the affected limb elevated on pillows 3. With the head of the bed raised 4. In a side-lying, recumbent position

1. With the affected limb hanging from the bed-dependent position will relieve pain

You are providing teaching to a PT who is 2 days post op following a heart transplant. Which following statements should the nurse include in the teaching? 1. You may no longer be able to feel chest pain 2. Your level of activity intolerance will not change 3. after 6 months you will no longer need to restrict you Na 4. You will be able to stop taking immunosuppressants after 12 months

1. You may no longer be able to feel chest pain- transplant PTs no longer feel chest pain due to denervation of the heart

A nurse is admitting a client who has a suspected MI and a history of angina. which of the following findings will help the nurse distinguish angina from an MI? 1. angina can be relieved with rest and nitroglycerin 2. the pain of an MI resolves in less than 15 min. 3. the type of activity that causes an MI can be identified. 4. angina can occur for longer than 30 min.

1. angina can be relieved with rest and nitroglycerin

A nurse is caring for a client and reviewing a new prescription for an afterload-reducing medication. The nurse should recognize that this medication is administered for which of the following types of shock? 1. cardiogenic 2. obstructive 3. hypovolemic 4. distributive

1. cardiogenic- reducing after load will allow the heart to pump more effectively. **2. obstructive-high after load is due to obstruction so afterload reducers will not work 3. hypovolemic-fluid replacement and reduction of further fluid loss are the focus of hypovolemic shock 4. distributive-afterload reducing meds should not be given due to already decreased after load

A nurse is reviewing clinical manifestations of a theoretic aortic aneurysm with a newly hired nurse. Which of the following should the nurse include in the discussion? (select all that apply) 1. cough 2. shortness of breath 3. upper chest pain 4. diaphoresis 5. altered swallowing

1. cough-manifestation 2. shortness of breath-manifestion 5. altered swallowing - manifestation of thoracic aortic aneurysm

A nurse is assessing a client who has splinter hemorrhages in her nail beds and reports a fever. For which of the following conditions is the client at risk? 1. infective endocarditis 2. pericarditis 3. myocarditis 4. rheumatic endocarditis

1. infective endocarditis- splinter hemorrhages are r/t infective endocarditis

A nurse in a clinic is caring for a client who has been on long-term NSAID therapy to treat myocarditis. Which of the laboratory findings should be reported to the provider? 1. platelets 100,000 2. serum glucose 110 3. serum creatinine 0.7 4. amino alanine transferase (ALT) 30

1. platelets 100,000-long term NSAIDs can lower Plts

Which of these are expected findings of pulmonary edema? Select all 1.Tachypnea 2.Persistent cough 3.Increase urinary output 4.Thick yellow sputum 5.Orthopnea

1.Tachypnea- expected 2.Persistent cough-will be frothy pink and indicates pulm. edema 5.Orthopnea- Expected **3.Increase UOP- would be decreased 4.Thick yellow sputum- would be pink and frothy sputum

Which of the following clients has the greatest risk of acquiring rheumatic endocarditis? 1. An older adult who has chronic obstructive pulmonary disease. 2. A child who has an upper respiratory streptococcal infection. 3. A middle aged adult who has lupus erythematous. 4. A young adult who is at 24 weeks of gestation.

2. A child who has an upper respiratory streptococcal infection.- strep places him at highest risk 50% will develop rheumatic fever

You are caring for PT with heart failure and reports increased SOB you increase O2 per protocol. What action do you do next? 1. Obtain weight 2.Assist client to high fowlers 3. Auscultate lung sounds 4. Check O2 sat with pulse ox.

2. Assist client to high fowlers- ABCs will decrease venous return to the heart(preload) and help relieve lung congestion

You are caring for a client in the first 8 hrs following coronary artery bypass graft (CABG) surgery what findings should you report? 1. Mediastinal drainage 100mL/hr 2. BP 160/80 3.Temp-37.1 4. K 3.8

2. BP 160/80-increased vascular pressure can cause bleeding at incision site

You are screening for HTN which action would increase the risk for HTN? Select all 1. drinkning 8oz of nonfat milk daily 2. Eating popcorn at movie theatre 3. Walking 1 mile daily at 12min/mile 4. consuming 36oz of beer daily 5. getting a massage once a week

2. Eating popcorn at movie theatre contains high Na and Fat- high risk 4. consuming 36oz of beer daily- more than 24oz/day can lead to weight gain-high risk

You are completing discharge teaching to a PT with a mechanical heart valve what demonstrates understanding? 1.I will be glad to get back to my exercise routine right away. 2.I will have my prothrombin time checked on a regular basis 3. I will talk to my dentist about no longer needing antibiotics before dental exams 4. I will continue to limit my intake of foods containing K

2. I will have my prothrombin time checked on a regular basis

You are caring for a PT after CABG hemodynamic monitoring has been initiated what action would facilitate correct monitoring readings? Select all 1. Place the PT in high Fowlers 2. Level transducer to phlebostatic axis 3. Zero Transducer to room air 4. Observe trends in readings 5. compare readings to physical assessment.

2. Level transducer to phlebostatic axis 3. Zero Transducer to room air 4. Observe trends in readings 5. compare readings to physical assessment.

You are caring for a PT who is being treated for HF and has prescriptions for digoxin and furosemide. You plan to monitor for which of the following as an adverse effect of these meds? 1. SOB 2. Lightheadedness 3. Dry cough 4. Metallic taste

2. Lightheadedness- can cause a sudden drop in BP= lightheadedness

You are providing teaching to a group of PTs which of the Pts is at risk for developing PAD? 1. PT with hypothroidism 2. PT with Diabetes Mellitus 3. PT whose daily diet consists of 25% fat 4. Pt who consumes 2 bottles of beer a day

2. PT with Diabetes Mellitus-at risk for microvascular and progressive peripheral arterial disease

PT is prescribed an ace inhibitor. the RN knows the Pt understands the adverse effects when he reports the following? 1. tendon pain 2. Persistent cough 3. Frequent urination 4. constipation

2. Persistent cough- adverse effect of this drug

You are providing discharge teaching to a PT who has a prescription for the transdermal nitroglycerin patch. Which instruction would you include? 1. Apply new patch to the same site as the previous patch. 2. Place the new patch on an area skin away from skin folds and joints 3. Keep the patch on 24 hr per day 4. Replace the patch at the onset of angina

2. Place the new patch on an area skin away from skin folds and joints- should apply to skin that is prone not to move or wrinkle

You are caring for PT when he begins to go into SVT HR is 200-210 a minute what intervention do you anticipate? 1. Delivery of a precordial thump 2. Vagal stimulation 3. Adminster atropine IV 4. Defibrillation

2. Vagal stimulation- this can help return HR to normal sinus rhythm temporarily

You are assessing a PT with Left sided heart failure. What manifestation should you expect to find? 1. Increased abdominal girth 2. Weak peripheral pulses 3. Jugular venous neck distention 4. Dependent edema

2. Weak peripheral pulses- r/t decreased CO from LSHF

A nurse is planning care for a client who has septic shock. Which of the following is the priority action for the nurse to take? 1. maintaining adequate fluid volume with IV infusions 2. administering antibiotic therapy 3. monitoring hemodynamic status 4. administering vasopressor medication

2. administering antibiotic therapy-eliminating endotoxins/bacteria will reduce vasodilation

A nurse is caring for a client who has chronic venous insufficiency. The provider prescribed thigh high compressions stockings. the nurse should instruct the client to 1. Massage both legs firmly with lotion prior to applying the stockings 2. apply the stockings in the morning upon awakening and before getting out of bed 3. roll the stockings down to the knees if they will not stay up on the thighs 4. remove the stockings while out of bed for 1 hr, 4 times a day to allow to rest

2. apply the stockings in the morning upon awakening and before getting out of bed-reduces venous stasis and assists w/ venous return legs are less edema at AM **1. Massage both legs firmly with lotion prior to applying the stockings-massage can dislodge a clot 3. roll the stockings down to the knees if they will not stay up on the thighs- can restrict circulation=edema 4. remove the stockings while out of bed for 1 hr, 4 times a day to allow to rest- removed before bedtime to provide continuous venous support

A nurse in a cardiac unit is assisting with the admission of a client who is to undergo hemodynamic monitoring. which of the following actions should the nurse anticipate preforming? 1. Administer large volumes of IV fluids 2. assist with insertion of pulmonary artery catheter 3. obtain doppler pulses of the extremities 4. gather supplies for insertion of a peripheral IV catheter

2. assist with insertion of pulmonary artery catheter- used for hemodynamic monitoring **1. Administer large volumes of IV fluids- potency is maintained with slow cont. fluids. 3. obtain doppler pulses of the extremities-ECG is done prior 4. gather supplies for insertion of a peripheral IV catheter- would need an arterial line for ABGs and blood samples for hemodynamic monitoring

A nurse in the emergency department is completing an assessment of a client who is in shock. which of the following findings should the nurse expect? (select all that apply) 1. heart rate 60/min 2. seizure activity 3. respiratory rate 42/min 4. increase urine output 5. weak, thready pulse

2. seizure activity- may be present 3. respiratory rate 42/min-Exepected 5. weak, thready pulse- Expected **1. heart rate 60/min- would be tachycardic 4. increase urine output- would be decreased

A nurse is providing teaching for a client who is to have a bone marrow biopsy of the iliac crest. Which of the following statements made by the client indicates a need for further teaching? 1. "Cancer can be detected in the fluid being tested." 2. "I will feel heavy pressure sensation in my hip bone." 3. "The type of antibiotic I need to take can be determined by the test." 4. "I will be awake during the procedure."

3. "The type of antibiotic I need to take can be determined by the test."-culture/sens. will determine what antibiotic will be needed not biopsy

You are monitoring a PT following coronary bypass graft surgery (CABG). Which finding indicates cardiac tamponade? 1. Sternal instability 2. Increased WBC count 3. BP of 140/82 on inspiration and 154/90 on expiration 4. Sinus rhythm with occasional premature atrial contractions and HR 88

3. BP of 140/82 on inspiration and 154/90 on expiration= pulses paradoxus

You are reviewing the lab results of several PTs who have PAD. You plan to provide dietary teaching for the PT with which of the following? 1. Cholesterol 180mg, HDL 70mg, LDL 90mg 2.Cholesterol 185mg, HDL 50mg, LDL 120mg 3.Cholesterol 190mg, HDL 25mg, LDL 160mg 4.Cholesterol 195mg, HDL 55mg, LDL 125mg

3. Cholesterol 190mg, HDL 25mg, LDL 160mg ** cholesterol should be less than 200 HDL above 40 LDL less than 100

You're completing an admisson on PT who has a HX: mitral valve insufficiency. Which is expected? 1. Hoarseness 2. Petechiae 3. Crackles in lungs 4. Splenomegaly

3. Crackles in lungs- expected due to pulmonary congestion

RN is caring for a PT who had an onset of chest pain 24hr ago. The RN should recognize that an increase in which of the following is diagnostic of an MI? 1. Myoglobin 2. C-reactive protein 3. Creatine Kinase MB 4. Homocysteine

3. Creatine Kinase MB- specific to see myocardium and is elevated when the muscle in injured peaks at 24 hr after chest pain

You are caring for a patient who is scheduled for a CABG in 2hr. Which PT statement needs further clarification? 1. My arthritis is really bothering me b/c i haven't taken my aspirin in a week 2. My BP shouldn't be high b/c i took my BPmeds this morning 3. I took my warfarin last night according to my schedule. 4. I will check my blood sugar b/c i took a reduced dose of insulin this morning

3. I took my warfarin last night according to my schedule.- should have stopped 5-7 days prior for bleeding

You are doing discharge teaching with PT who has a permanent pacemaker. Which statement indicates a need for further teaching? 1. I will notify the airport screeners about my pacemaker 2. I will call my doctor about hiccups 3. I will have to disconnect my garage door opener 4. I will take my HR every morning

3. I will have to disconnect my garage door opener-household appliances do not affect it

You are admitting a Pt with a leg ulcer and a HX: of diabetes mellitus. What focused assessment would help differentiate between an arterial ulcer and a venous stasis ulcer? 1. Explore PTs HX: of PAD 2. Note the presence or absence of pain at the site 3. Inquire about the presence or absence of claudication 4. Ask the PT if has had a recent infection.

3. Inquire about the presence or absence of claudication-arterial will have claudication venous will not

You are caring for PT with BP of 254/139, you recognize the PT is in a hypertensive crisis. Which action should you take first? 1. Obtain blood samples for testing 2. Tell the PT to report vision changes 3. Place HOB at 45 degrees 4. Initiate IV access

3. Place HOB at 45 degrees-ABC's this will promote respiratory status and promote venous return reducing workload on heart **Initiate IV access- not first action

A nurse on a cardiac unit is reviewing the laboratory findings of a client who has a diagnosis of MI and reports that his dyspnea began 2 weeks ago. Which of the following cardiac enzymes would conform the infraction occurred 14 days ago? 1. CK-MB 2. Troponin I 3. Troponin T 4. Myoglobin

3. Troponin T- level will still be evident 14-21 days after MI **1. CK-MB- no longer evident after 3 days 2. Troponin I- no longer evident after 7 days 4. Myoglobin- no longer evident after 24hr

You are caring for a PT in the 1st hr following an aortic aneurysm repair. Which of the following findings indicate shock and should be reported. 1. Serosanguineous drainage on dressing 2. Severe pain with coughing 3. Urinary output of 20ml/hr 4. Increase temp from 36.8 to 37.5

3. UOP of 20ml/hr- should be 30ml/hr can indicate shock r/t hemorrhage

A nurse is caring for a client who has hemophilia. The nurse should anticipate a prescription from the provider for which of the following tests? 1. RBC 2. TIBC 3. aPIT 4. MCH

3. aPIT- checks clotting factors **1. RBC-identfies the presence of anemia not clotting 2. TIBC-identfies iron deficiency anemia not clotting 4. MCH- indicates the presence of anemia

A nurse in the emergency department is assisting with the admission of a client who has a possible dissecting abdominal aortic aneurysm. Which of the following is the priority nursing intervention? 1. administer pain medication as prescribed 2. ensure a warm environment 3. administer IV fluids as prescribed 4. initiate a 12-lead ECG

3. administer IV fluids as prescribed-ABCs big risk is inadequate circulatory volume. treat w/ fluids

A nurse in the emergency department is caring for a client who has a allergic reaction to a bee sting. The client is experiencing wheezing and swelling of the tongue. Which of the following medications should the nurse expect to administer first? 1. methylprednisolone (Solu-Medrol) IV bolus 2. diphenhydramine (benadryl) subcutaneously 3. epinephrine (adrenaline) IV 4. albuterol (proventil) inhaler

3. epinephrine (adrenaline) IV-ABCs rapid acting to promote oxygenation

A nurse is admitting a client with a suspected occlusion of a graft of the abdominal aorta. Which of the following is an expected clinical finding? 1. increased urine output 2. bounding pedal pulse 3. increased abdominal grith 4. redness of the lower extremities

3. increased abdominal grith- expected **1. increased urine output-would be decreased 2. bounding pedal pulse-would be decreased or absent 4. redness of the lower extremities- Pallor/ cyanosis would be expected

A nurse is presenting a community education program on recommended lifestyle changes to prevent angina and MI. which of the following changes should the nurse recommend be made first? 1. diet modification 2. relaxation exercises 3. smoking cessation 4. taking omega-3 capsules

3. smoking cessation- ABCs O2 is priority Nicotine causes vasoconstriction

A nurse is instructiong a client who has angina about a new prescription for metoprolol tartrate. which of the following statements by the client indicates understanding of the teaching? 1. "I should place the tablet under my tongue." 2. "I should have my clotting time checked weekly." 3. "I will report any ringing in my ears." 4. "I will call my doctor if my pulse is less than 60."

4. "I will call my doctor if my pulse is less than 60."

A nurse is discussing a new diagnosis of an aneurysm with a client. The client asks the nurse to explain what causes an aneurysm to rupture. Which of the following is an appropriate response by the nurse? 1. "The wall of and artery becomes thin and flexible." 2. "It is due to turbulence in blood flow in the artery." 3. "It is due to abdominal enlargement." 4. "It is due to hypertension."

4. "It is due to hypertension."- increases pressure within walls = rupture **1. "The wall of and artery becomes thin and flexible."- ruptures b/c thickening and lack of elasticity 2. "It is due to turbulence in blood flow in the artery."- indicates the presence of an aneurysm not a rupture 3. "It is due to abdominal enlargement."-not the cause but may occur

The RN is teaching a student on the care of a PT who is receiving hemodynamic monitoring. Which statement indicates teaching was effective? 1. Air should be instilled into the monitoring system 2. The client should be in the prone position 3. The transducer should be level with the 2nd intercostal space 4. A chest X-ray is needed to verify placement.

4. A chest X-ray is needed to verify placement.

You are caring for a PT who had an anterior MI. PTs hx shows she is 1 wk post op open cholecystectomy the RN knows that which intervention is contraindicated? 1. Administering IV morphine 2. giving O2 at 2L NC 3. Helping client to BSC 4. Assisting in thrombolytic therapy

4. Assisting in thrombolytic therapy- having surgery within 3 wks is a contraindication for thrombolytic therapy

A nurse is caring for a client who has pericarditis. Which of the following expected findings should the nurse anticipate? 1. Petechiae 2. Murmur 3. Rash 4. Friction rub

4. Friction rub- can be heard during auscultation of a client who has pericarditis

A nurse in a clinic is caring for a client who has suspected anemia. The nurse should anticipate a prescription from the provider for which of the following tests? 1. INR 2. platelet count 3. WBC count 4. Hgb

4. Hgb- used to confirm anemia **1. INR- for warfarin therapy 2. platelet count-identfies altered immune response 3. WBC count- identifies infection

You are caring for a PT with angina and is scheduled for a stress test at 1100 which Pt statement requires rescheduling? 1. Im still hungry after my cereal this morning 2. I didn't take my heart pills b/c Dr. said not to 3. I have had chest pain a couple times after seeing the Dr. last week 4. I smoked a cigarette this morning to calm my nerves about this test

4. I smoked a cigarette this morning to calm my nerves about this test--this can change the outcome and place you at additional risk

A nurse is instructing a client who has angina about a new prescription for metoprolol tartrate. which of the following statements by the client indicates understanding of the teaching? 1. "I should place the tablet under my tongue." 2. "I should have my clotting time checked weekly." 3. "I will report any ringing in my ears." 4. "I will call my doctor if my pulse is less than 60."

4. I will call my doctor if my pulse is less than 60.

PT is on warfarin r/t to a DVT which finding provides evidence of effectiveness? 1. Hgb 14 2.Minimal bruising 3. Reduced circumference of affected extremity 4. INR 2.5

4. INR 2.5-is within desired therapeutic range this is best evidence

When performing a cardiac assessment what is the point of maximal impulse? 1. 2nd intercostal space right to the sternum 2. 2nd intercostal space left to the sternum 3. 5th intercostal space to the left of thermal border 4. Left 5th intercostal space in the midclavicular line

4. Left 5th intercostal space in the midclavicular line-this is best to hear the apex of the heart which is considered maximal impulse

You are preparing PT for coronary angiography. You should report what finding to the provider prior to procedure? 1. Hgb 14.4 2. HX: PAD peripheral arterial disease 3. UOP of 200ml in 4 hr 4. Previous allergic reaction to shell fish

4. Previous allergic reaction to shell fish- shellfish reaction will often react to iodine

You are reviewing the chart of a PT who is receiving heparin therapy for a DVT. Which intervention should the RN anticipate taking if the PTs aPTT is 96 seconds? 1. Increase heparin infusion rate by 2mL/hr 2. Continue monitor the heparin infusion as prescribed 3. Request a prothrombin time PT 4. Stop the heparin infusion

4. Stop the heparin infusion- pt is above the therapeutic range of 1-5-2 times the control. should discontinue to prevent harm

You are caring for a PT following an abdominal aortic aneurysm resection. Which of the following is priority assessment? 1. Neck vein distention 2. Bowel sounds 3. Peripheral edema 4. Urinary output

4. UOP- greatest risk is graft occlusion or rupture which will reflect blood flow in the kidneys

You are caring for a PT who has endocarditis. Which finding should you recognize as a complication? 1. Ventricular depolarization 2. Guillain Barre Syndrome 3. Myelodysplastic syndrome 4. Valvular disease

4. Valvular disease- damage will occur as a result of inflammation or infection of the endocardium

A nurse is preforming a physical assessment of a client who has chronic peripheral arterial disease (PAD). which of the following is an expected finding? 1. Edema around the clients ankles and feet 2. ulceration around the clients medial malleoli 3. scaling eczema of the clients lower legs with stasis dermatitis 4. pallor on elevation of the clients limbs and rubor when when his limbs are dependent

4. pallor on elevation of the clients limbs and rubor when when his limbs are dependent- seen in chronic PAD

You are teaching a PT the importance of remaining still following angiography. Which statement is the best to say? 1. Moving in bed raises your BP 2. Too much activity increases your risk for infection. 3. moving in bed increases your risk of a complication due to anesthesia 4. too much activity places you at risk for bleeding

4. too much activity places you at risk for bleeding

What is some expected assessment findings of cariogenic shock? Select All 1. tachycardia 2. hypotension 3.crackles 4. angina 5. cool and clammy skin

ALL OF THEM **Cardiogenic shock- complication of pump failure that occurs commonly after MI and injury greater than 40% to the left ventricle. - treat with vasopressors and interpose (digoxin) to increase CO to maintain organ perfusion

What is Pulsus Paradoxus?

When the systolic BP is 10 points higher on expiration than on inspiration **This is indicative of cardiac tamponade

What is cardioversion?

Delivery of direct countercheck to the heart synced with QRS complex. **used for atria dysrhythmias, SVT, Ventricular tachycardia with pulse. TREATMENT OF CHOICE FOR PTs WHO ARE SYMPTOMATIC

What part of the ECG would you look for atrial depolarization?

P wave - atrial depolarization QRS- vetricular depolarization T- Ventricular reploarization

Electrical management for bradycardia would be?

Pacemaker for any rhythm less than 60/min

What are complications of Heart failure?

Pulmonary edema Cardiogenic shock Cardiac tamponade