cardiac prep u questions
The nurse reviews discharge instructions with a client who underwent a left groin cardiac catheterization 8 hours ago. Which instructions should the nurse include?
"Do not bed at the waist, strain or lift heavy objects for the next 24 hours" page 683
The nurse is volunteering at a community blood pressure screening. A client, never diagnosed with hypertension, presents with a blood pressure of 158/90. Which assessment questions is appropriate for the nurse to ask?
have you recently drank a caffeinated beverage? do you smoke page 869
The physician prescribed a tegapore dressing to treat a venous ulcer. What should the nurse expect that the ankle brachial index (ABI) will be if the circulatory status is adequate?
0.50 page 822
A client needs additional information about a heart condition. The client asks the nurse "what is considered the pacemaker of the heart?"
The SA node page 653
A 18 year old client presents to the emergency department with a severe open fracture of the lower extremity. The health care provider tells the client that the client will need a blood transfusion. The client refuses, despite the advise of the health care provider. What does the nurse understand is the legal implication of the scenario?
The client has a right to refuse the transfusion
The client is admitted for a scheduled cardiac catheterization. On the morning of the procedure while assessing the client's morning laboratory values, the nurse notes a blood urea nitrogen (bun) of 34, and a creatinine of 4.2. what priority reason will the nurse notify the healthcare provider?
The client is at risk for renal failure due to the contract agent that will be given during the procedure page 681
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?
The client says his rings have become tight and are difficult to remove Page 797-798
The nurse is completing a cardiac assessment. Upon ausultation, the nurse hears a grating using the diaphragm of the stethoscope. How will the nurse best document this finding?
friction rub page 670
Which medication is categorized as a loop diuretic?
furosemide page 800
A client with high blood pressure is receiving an antihypertensive drug. When developing a client teaching plan to minimize orthostatic hypotension, which instruction should the nurse include?
"flex you calf muscles, avoid alcohol, and change positions slowly." page 879
A 52 year old female is going through menopause and asks the nurse about estrogen replacement for its cardioprotective benefits. What is the best response by the nurse?
"current evidence indicated that estrogen replacement is not effective at preventing cardiovascular disease and carries some risks." page 656
You are doing an admission assessment on a client who is having outpatient testing done for cardiac problems. What should you ask this client during your assessment?
"Have you had any episodes of dizziness or fainting?" Page 657
A client is placed on a low sodium (500mg/day) diet. Which client statement indicated that the nurse's nutrition teaching plan has been effective?
"I chose broiled chicken with a baked potato for dinner" page 870
A nurse is reviewing self care measures for a client with peripheral vascular disease. Which statement indicates proper self care measures?
"I have my wife look at the soles of my feet each day" page 830
A community health nurse teaches a group of older adults modifiable risk factors that contribute to the development of peripheral arterial disease (PAD). The nurse knows that the teaching was effective based on which statement?
"I will need to stop smoking because the nicotine causes less blood to flow to my hands and feet" page 826-831
The nurse is admitting a client with heart failure. What client statement indicates that fluid overload was occurring at home?
"I'm having trouble going up the steps during the day"
The nurse is assessing vital signs on a client who is 3 months status post myocardial infarction (MI). While the healthcare provider is examining the client, the client's spouse approaches the nurse and states "We are too afrain he will have another heart attack, so we just don't have sex anymore". What is the nurse's best response?
"The physiologic demands are greatest during orgasm and are equivalent to walking 3 to 4 miles per hour on a treadmill." page 662
A 77-year-old client presents to the local community center for a blood pressure (BP) screening; BP is recorded as 180/90 mm Hg. The client has a history of hypertension but currently is not taking the prescribed medications. Which question is most appropriate for the nurse to ask the client first?
"can you tell me the reasons you aren't taking your medication?" page 879
A nurse is caring for a client who has hypertension and diabetes mellitus. The client's blood pressure this morning was 150/92. When the client asks the nurse what his or her blood pressure should be, what is the nurse's most appropriate response?
"clients with diabetes should have a lower blood pressure goal. You should strive for 120/80." page 870
The nurse is administering a stool softener to a client who experienced a myocardial infarction. The client says "I had a heart attack; I don't have a problem with constipation." What explanation will the nurse use to answer the client's question?
"if you strain to have a bowel movement, you can cause a drop in your heart rate that can be dangerous" page 661
The nurse is caring for a client who has had 25 mg of oral hydrochlorothiazide added to the medication regimen for the treatment of hypertension. Which instruction should the nurse give the client?
"increase the amount of fruits and vegetables you eat" page 872
A nurse is preparing a client for a scheduled adenosine stress test. Which statement made by client indicated a need for further education?
"my family is bringing a cup of coffe to drink before the test" page 678
The nurse is assisting a patient with peripheral arterial disease to ambulate in the hallway. What should the nurse include in the education of the patient during ambulation?
"walk to the point of pain, rest until the pain subsides, then resume ambulation" page 829
A client with heart failure is having a decrease in cardiac output. What indication does the nurse have this is occurring?
Blood pressure 80/46 Page 803
A client has been prescribed furosemide 80 mg twice daily. The asymptomatic client begins to have rare premature ventricular contractions followed by runs of big Emily with stable signs. That action will the nurse perform next?
Check the client's potassium level Page 800
Heparin therapy is usually considered therapeutic when the activated partial thromboplastin time (aPTT) is how many times higher than a normal value?
1.5 to 2.5
When administering heparin anticoagulant therapy, the nurse needs to make certain that the activated partial thromboplastin time (aPTT) is within the therapeutic range of :
1.5 to 2.5 times the baseline control page 848
A nurse is teaching a client who is newly diagnosed with hypertension and diabetes mellitus. What will the nurse specify about this client's target blood pressure?
130/80 or lower
Which client is not a candidate to be a blood donor according to the american red cross?
26 year old female with hemoglobin 11
When caring for a patient who has started anticoagulant therapy with warfarin (Coumadin), the nurse knows that therapeutic benefits will not occur for
3 to 5 days page 848
According to the DASH diet, how many servings of vegetables should a person consume each day?
4 or 5
A client with a history of congestive heart failure has an order to receive 1 unit of packed red blood cells. If the nurse hangs the blood at 12 pm, by what time must the infusion be completed?
4 pm
A nurse is preparing a dose of furosemide for an older adult with heart failure. The health care provider orders furosemide 1mg/kg to be given intravenously. The client weights 50kg. The concentration of the drug is 40mg/4ml (10mg/1ml). How many milliliters would the nurse administer?
5
Beginning warfarin concomitantly with heparin can provide a stable INR by which day of heparin treatment?
5 page 848
Approximately what percentage of the arterial lumen must be obstructed before intermittent claudication is experienced?
50 page 822
An older adult client visits the clinic for a blood pressure 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 blood pressure medicine?
A possible adverse effect of blood pressure medicine is dizziness when you stand page 879
While auscultating the heart sounds of a client with heart failure, the nurse hears an extra heart sound immediately after the second heart sound (S2). How should the nurse document this sound?
A third heart sound (S3) Page 796
The nurse admits an adult female client with a medical diagnosis of "rule out MI." The client is very frightened and expresses surprise that a woman would have heart problems. What response by the nurse will be most appropriate?
A woman's heart is smaller and has smaller arteries that become occluded more easily Page 656
A client who was admitted to the hospital with a diagnosis of thrombophlebitis 1 day ago suddenly reports chest pain and shortness of breath and is visibly anxious. The nurse immediately assesses the client for other signs and symptoms of
Pulmonary embolism Page 811
A client with left sided heart failure reports increasing shortness of breath and is agitated and coughing up pink tinged foamy sputum. The nurse should recognize these findings as signs and symptoms of what condition?
Acute pulmonary edema Page 796
A client in the emergency room is in cardiac arrest and exhibiting pulse less electrical activity (PEA) on the cardiac monitor. What will be the nurse's next action?
Administer epinephrine Page 815
The nurse is caring for a client with an elevated blood pressure and no previous history of hypertension. At 0900 the blood pressure was 158/90. At 0930 the blood pressure is 142/82. The nurse is most correct when relating the fall in blood pressure to which structure?
Baroreceptors Page 655
The nurse is caring for a client with heart failure. What sign will lead the nurse to suspect right sided heart failure?
Ascites Page 797
The nurse is teaching a group of clients with heart failure about how to decrease leg edema. What dietary advice will the nurse give to clients with severe heart failure?
Avoid the intake of processed and commercially prepared foods. Page 806
A patient is seen in the emergency department with heart failure secondary to dilated cardimyopathy. What key diagnostic test does the nurse assess to determine the severity of the patient's heart failure?
B type natriuretic peptide (BNP) page 799
A patient in severe pulmonary edema is being intubated by the respiratory therapist. What priority action by the nurse will assist in the confirmation of tube placement in the proper position in the trachea?
Call for a chest x-ray. Page 809
The nurse is taking a health history from a client admitted with medical diagnosis of cardiovascular disease (CVD). Which syndrome correlate with the client's diagnosis?
Chest pain, weight gain, fatigue Page 657
A nurse caring for a client recently admitted to the ICU observes the client coughing up large amounts of pink, frothy sputum. Lung auscultation reveals coarse crackles in the lower lobes bilaterally. Based on this assessment, the nurse recon go see this client is developing
De compensated heart failure with pulmonary edema Page 794-796
A patient is undergoing a pericardiocentesis. Following withdrawal of pericardial fluid, which assessment by the nurse indicates that tamponade has been releived?
Decrease in central venous pressure Page 812
A client asks the nurse if systolic heart failure will affect any other body function. What body system response correlated with systolic heart failure?
Decrease in renal perfusion Page 795
The nurse is admitting a client with frothy pink sputum. What does the nurse suspect is the primary underlying disorder of pulmonary edema?
Decreased left ventricular pumping Page 796
For both outpatients and inpatients scheduled for diagnostic procedures of the cardiovascular system, the nurse performs a thorough initial assessment to establish accurate baseline data. Which data is necessary to collect if the client is experiencing chest pain?
Description of the pain page 658
A client is being scheduled for a stress test. The client is unable to exercise during the test. The nurse would indicate information about which medication used for pharmacological stress testing?
Dipyridamole Page 677
The nurse assessing a client with an exacerbation of heart failure identifies which symptom as a cerebrovascular manifestation of heart failure (HF)?
Dizziness Page 794- 796
The nurse is assessing a client admitted with cardiogenic shock. What medication will the nurse fit rate to improve blood flow to vital organs?
Dopamine Page 814
The nurse is obtaining data on an older adult client. What finding may indicated to the nurse the early symptom of heart failure?
Dyspnea on exertion Page 796
Which diagnostic study is usually performed to confirm the diagnosis of heart failure?
Echocardiogram Page 811-812
The diagnosis of heart failure is usually confirmed by which of the following?
Echocardiogram Page 798
Within the heart, several structures and several layers all play a part in protecting the heart muscle and maintaining cardiac function. The inner layer of the heart is composed of a thin, smooth layer of cells, the folds of which form heart valves. What is the name of this layer of cardiac tissue?
Endocardium Page 651
You are monitoring the results of laboratory tests performed on a client admitted to the cardiac ICU with a diagnosis of myocardial infarction. Which test would you expect to show elevated levels?
Enzymes page 672
Which area of the heart that is located at the third intercostal space to the left of the sternum?
Erb point page 667
Which area of the heart is located at the third intercostal (IC) space to the left of the sternum?
Erb pount Page 667
A client has a significant history of congestive heart failure. What should the nurse specifically assess during the clients semiannual cardiology examination?
Examine the clients neck for distended veins Monitor the client for signs of lethargy or confusion Page 797
A client with acute pericarditis is exhibiting distended jugular veins, tachycardia, tachypnea, and muffled heart sounds. The nurse recognizes these as symptoms of what occurrence?
Excess pericardial fluid compresses the heart and prevents adequate diastolic filling. Page 812
A nurse is assessing a client with heart failure. What breath sounds is commonly auscultation in clients with heart failure?
Fine crackles Page 797
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?
Gradual unexpected weight gain Page 797
The nursing 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?
Gradual unexplained weight gain Page 797
The nurse cares for a client in the emergency department who has a B type natriuretic peptide (BNP) level of 155 pg/ml. The nurse recognizes that this finding is most indicative of which condition ?
Heart failure Page 674
A nurse is administering digoxin. Which client parameter would cause the nurse to hold the digoxin and notify the health care prescriber?
Heart rate of 55 per minute Page 802
The nurse is caring for a client with advanced heart failure. What treatment will be considered after all other therapies have failed?
Heart transplant Page 803
A client is scheduled for surgery to remove an abdominal mass. The nurse knows that which reason hemodilution would be contraindicated as a method to provide blood to the client during surgery?
History of renal disease
The nurse is assessing a patient's blood pressure. What does the nurse document as the difference between the systolic and the diastolic pressure?
Pulse pressure Page 665
The nurse monitors a client for side effects associated with furosemide, which is newly prescribed for the treatment of heart failure. Due to the client's high risk for developing __ as a result of the prescribed medication, the nurse focuses on monitoring for __
Hypokalemia Ventricular arrhythmia Page 801
A patient will need a blood transfusion for the replacement of blood loss from the gastrointestinal tract. The patient states, "that stuff isn't safe." What is the best response from the nurse?
I understand your concern. The blood is carefully screened but is not completely risk free
The nurse is admitting a client with heart failure. What client statement indicates that fluid overload was occurring at home?
I'm having trouble going up to the steps during the day
Which New York Heart Association classification of heart failure has a poor prognosis and includes symptoms of cardiac insufficiency at rest?
IV Page 794-798
The nurse is assessing a client with crackling breath sounds or pulmonary co festoon. What is the cause if the congestion?
Inadequate cardiac output Page 796 - -797
The nurse is assessing a client with cracking breath sounds or pulmonary congestion. What is the cause of the congestion?
Inadequate cardiac output Page 796 - 797
The pathophysiology of pericardial effusion is associated with all of the following except
Increased venous return Page 812
A nurse is assessing a client with congestive heart failure for jugular vein distention (jvd). Which observation is important to report to the physician?
J dis noted 4 cm above the sternal angle Page 805
The nurse is reviewing the morning laboratory test results for a client with cardiac problems. Which finding is a priority to report to the healthcare provider?
K+ 3.1 page 673
The nurse is performing an assessment of the patient's heart. Where would the nurse locate apical if the heart is in a normal position?
Left 5th intercostal space at the midclavicular line page 667
The clinical manifestations of carcinogenic shock reflect the pathophysiology of heart failure. By applying this correlation, the nurse notes that the degree of shock is proportional to which of the following?
Left ventricular function Page 811
The nurse instructs a client with heart failure in restricting sodium in the diet. What client statement indicates that teaching was effective?
Lemon juice and herbs can be used to replace salt when cooking Page 807
The nurse is providing discharge instructions to a client with heart failure preparing to Kearny the following day. What type of diet should the nurse request the dietitian to discuss with the client?
Low sodium diet Page 803
While the nurse is preparing a client for a cardiac catheterization, the client states that they have allergies to seafood. Which of the following medications may the nurse give prior to the procedure?
Methylprednisolone page 679
When a client has increased difficulty breathing when lying flat, the nurse records that the client is demonstrating?
Orthopnea Page 794-796
The client with cardiac failure is taught to report which symptom to the health care provider or clinic immediately?
Persistent couch Page 809
A client is diagnosed with extreme thrombocytosis. The nurse knows this condition is a result of which elevated blood cell count.
Platelets
The nurse is administering digoxin to a client with heart failure. What laboratory value may predispose the client to digoxin toxicity?
Potassium level of 2.8
Which term describes the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole?
Preload Page 794-795
A client is admitted to the hospital with systolic left sided heart failure. The nurse knows to look for which assessment finding for this client?
Pulmonary congestion Page 796
The nurse is discharging a client after a cardiac catheterization. What would the nurse include in. The discharge teaching?
Report any numbness, tingling, or sharp pain in the extremity. Page 677
The nurse recognizes which symptoms as a classic sign of cardiogenic shock?
Restlessness and confusion Page 794-798
The nurse recognizes which symptom as a classic sign of cardiogenic shock?
Restlessness and confusion Page 794-797
The nurse observed a client during an exercise stress test (bicycle). Which finding indicates a positive test and the need for further diagnostic testing?
St segment changes on the ECG Page 677
Which type of lymphocyte is responsible for cellular immunity?
T lymphocyte
The health care provider believes that the client has a deficiency in the leukocyte responsible for cell mediated immunity. What should the nurse check the WBC count for?
T lymphocytes
What disease process contributes to chronic heart failure?
Tachyarrhythmias Valvular disease Renal failure Page 794
A client has a myocardial infarction in the left ventricle and develops crackles bilaterally; 3-pillow orthopnea; an S3 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?
The development of left-sided heart failure Page 796
A nurse is teaching a client about heart failure. What will the nurse explain is causing the heart to fail?
The heart cannot pump sufficient blood to meet the body's metabolic needs Page 794
What is the difference between class 1 and class 2 heart failure as defined by the New York heart association?
The level of physical activity each allows Page 798
What is the main difference between class 1 and class 2 heart failure as defined by the New York heart association?
The level of physical activity each allows Page 798
A nurse is caring for dying client following myocardial infarction. The client is experiencing apnea with a falling blood pressure of 60 per palpitation. Which documentation of pulse quality does the nurse anticipate?
Therapy pulse Page 656
The nurse is assisting in the care of a client who is receiving cardiopulmonary resuscitation (CPR). For which reason will the client be prescribed to receive amino darken during the resuscitation efforts?
Treat pulse less ventricular tachycardia Page 814
A client with newly diagnosed hypertension asks what to do to decrease the risk for related cardiovascular problems. Which risk factor is not modifiable by the client?
age page 866
The following clients are in need of exercise electrocardiography. Which client would the nurse indicate as most appropriate for a drug induced stress test?
a 55 year old recovering from a fall and broken femur page 677
Which of the following client scenarios would be correct for the nurse to identify as a client with secondary hypertension?
a client diagnosed with kidney disease page 866
A nurse is discussing with a nursing student how to accurately measure blood pressure. What statement by the student indicates an understanding of the education?
a cuff too small will give a false high blood pressure page 869
The nurse is assisting the client to manage the cardiovascular risk factors of hyperlipidemia and hypertension. The client asks the nurse what type of diet would be best to follow. What is the best response by the nurse?
a diet low in sodium, fat, and cholesterol page 660
The nurse is assessming a patient who reports feeling "light headed." when obtaining orthostatic vital signs, what does the nurse determine is a significant finding?
a heart rate of more than 20 bpm above resting rate page 666
The nurse is assessing a client with severe hypertension. Which symptom indicates to the nurse that the client is experiencing dissection of the aorta?
a ripping sensation in the chest page 842
The nurse is caring for a client recovering from surgery to treat aortioliliac disease. Which assessment findings indicate to the nurse that manual manipulation of the bowel occurred during the surgery?
abdominal distention absence of bowel sounds page 838
A client with stage IV heart failure has a living will indicating a ventilator may not be used. The client begins experiencing severe dyspnea. What should the nurse who is caring for this client do?
administer oxygen, morphine, and a bronchodilator for client comfort. Page 799
The nurse is administering sublingual nitroglycerin to a client with chest pain. What action will the nurse take after administering two sublingual tablets if the client continues with chest pain and has a blood pressure of 120/82?
administer the third sublingual nitroglycerin tablet page 803
A nurse is assigned to care for a patient with ascites, secondary to cirrhosis. The nurse understands that the fluid accumulation in the peritoneal cavity results from a combination of factors including an alteration in oncotic pressure gradients and increased capillary permeability. Therefore, the nurse monitors the serum level of the plasma protein responsible for maintaining oncotic pressure, which is
albumin
Hypertension is defined as "sustained elevations in systolic or diastolic blood pressures that exceed prehypertension levels." What are some of the consequences of hypertension that make it such a health menace in the US?
all options are correct
A patient is admitted to a special critical care unit for the treatment of an arterial thrombus. The nurse is aware that the preferred drug of choice for clot removal, unless contraindicated, would be:
alteplase page 849
A nurse is changing a dressing on an arterial suture site. The site is red, with foul smelling drainage. Based on these symptoms, the nurse is aware to monitor for which type of aneurysm?
anastomotic page 838-839
To assess the dorsalis pedis artery, the nurse would use the tips of three fingers and apply light pressure to the :
anterior surface of the foot near the ankle joint page 824
You are assessing a client recently admitted to your unit for hypotension. While assessing this client, you dins a pulsatile mass near the umbilicus. What would you suspect?
aortic aneurysm page 839
the physician performs a bone marrow biposy from the posterior iliac crest on a client with pancytopenia. Which intervention should the nurse perform after the procedure?
apply pressure over the site for 5 to 7 minutes
The client states "My doctor says that because I am now taking this water pill, I need to eat more foods that contain potassium. Can you give me some ideas about what foods would be good for this?" What is the appropriate response by the nurse?
apricots, dried peas and beans, dates
The nurse is performing a respiratory assessment for a patient in left sided heart failure. What does the nurse understand is the best determinant of the patient's ventilation and oxygenation status?
arterial blood gases page 809
A home health nurse is seeing an elderly female client for the first time. During the physical assessment of the client's feet, the nurse notes several circular ulcers around the tips of the toes on both feet. The bases of the ulcers are pale, and the client reports the ulcers to be very painful. From these assessment findings, the nurse suspects that the cause of the ulcers is which of the following?
arterial insufficiency page 833
The nurse is caring for a client with heart failure. What sign will lead the nurse to suspect right sided failure?
ascites page 797
A nurse is preparing a client for a cardiac catheterization. The nurse knows that which nursing intervention must be provided when the client returns to the room after the procedure?
assess the puncture site frequently for hematoma formation or bleeding page 682-683
A patient had a cardiac catheterization and is now in the recovery area. What nursing interventions should be included in the plan of care?
assessing the peripheral pulses in the affected extremity checking the insertion site for hematoma formation evaluating temperature and color in the affected extremity page 682
chapter 27
assessment and management of patients with hypertension
chapter 28
assessment of hematologic function and treatment modalities
You are presenting a workshop at the senior citizens center about how the changes of aging predisposes clients to vascular occlusive disorders. What should you name as the most common cause of peripheral arterial problems in the older adult?
atherosclerosis page 826
A client is experiencing an irregular heartbeat. The client asks the nurse how a heartbeat occurs. The nurse explains the conduction system of the heart beginning with the sinoatrial node. Place the conduction sequence of the heart in order beginning with the SA node.
atrial cell stimulation av node bundle of His bundle branches purkinjie fibers page 653
The nurse understands that a client with which cardiac arrhythmia is most at risk for developing heart failure?
atrial fibrillation page 794 - 798
A client in the emergency department states, "I have always taken a morning walk, but lately my leg cramps and hurts after just a few minutes of walking. The pain goes away after I stop walking thought." Based on this statement, which priority assessment should the nurse complete?
attempt to palpate the dorsalis pedis and posterior tibial pulses page 821-823
A client has undergone cardiac catheterization and will be discharged today. What information should the nurse emphasize during discharge teaching?
avoid heavy lifting for the next 24 hours page 675
The nurse is caring for a client with Raynaud's disease. What are important instructions for a client who is diagnosed with this disease to prevent an attack?
avoid situations that contribute to ischemic episodes page 844
When teaching a client with peripheral vascular disease about foot care, a nurse should include which instruction?
avoid wearing canvas shoes page 834
A nurse is checking laboratory values on a client who has crackles in the lower clobes, 2+ pitting edema, and dyspnea with minimal exertion. Which laboratory value does the nurse expect to be abnormal?
b- type natriuretic peptide (BNP) page 674
The nurse recognizes that the most common cause of iron deficiency anemia in an adult is
bleeding
A client recovering from a surgical repair of a dissecting aortic aneurysm. Which assessment findings indicate possible bleeding or recurring dissection?
blood pressure of 82/40 heart rate of 125 bmp page 839
Which of the following is a characteristic of an arterial ulcer?
border regular and well demarcated page 855
The nurse recognizes that which laboratory test is a key to diagnostic indicator of heart failure?
brain natriuretic peptide (BNP) page 794-799
The nursing instructor is teaching their clinical group how to assess a client for a congestive heart failure. How would the instructor teach the students to assess a client with congestive heart failure for nocturnal dyspnea?
by questioning how many pillows the client normally uses for sleep page 796
A nurse is providing education about hypertension to a community group. What are possible consequences of untreated hypertension?
coronary artery disease myocardial infarction stroke page 866
The nurse cares for a client with an intra-arterial blood pressure monitoring device. The nurse recognizes the most preventable complication associated with hemodynamic monitoring includes which condition?
catheter-related bloodstream infections Page 684
A client has been prescribed furosemide 80 mg twice daily. The asymptomatic client begins to have rare premature ventricular contractions followed by runs of bigeminy with stable signs. What action will the nurse perform next?
check the client's potassium level page 800
The nurse is caring for a client who has just returned from the cardiac catheterization laboratory following a coronary angioplasty. What is the nurse's priority assessment?
check the temperature, color and capillary refill of the affected extremity page 681
For a client who has undergone peripheral arteriography, how should the nurse assess the adequacy of peripheral circulation?
checking peripheral pulses page 666
A client with a history of sickle cell anemia has developed iron overload from repeated blood transfusions. What treatment does the nurse anticipate will be prescribed?
chelaton therapy
The nurse is caring for a client with a damaged tricuspid valve. The nurse knows that the tricuspid valve is held in place by which of the following?
chordae tendineae page 653
Health teaching includes advising patients on ways to reduce PAD. The nurse should always emphasize that the strongest risk factor for the development of atherosclerotic lesions is:
cigarette smoking page 827
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, what classification of chronic heart failure does this client have?
class 1 (mild) page 798
Pentoxifylline (Trental) is a medication used for which of the following conditions?
claudication
The nurse prepares to apply ECG electroldes to a male client who requires continuous cardiac monitoring. Which should the nurse complete to optimize skin adherence and conduction of the heart's electrical current?
clip the client's chest hair prior to applying the electrodes page 675
A nursing instructor in a BSN program is preparing for a lecture on disorders of the hematopoietic system. Included in the lecture are conditions caused by reduced levels or absence of blood clotting proteins. Which of the following is the instructor most likely referring to?
coagulopathy
A client is hospitalized for repair of an abdominal aortic aneurysm. The nurse must be alert for signs and symptoms of aneurysm rupture and thus looks for which of the following?
constant, intense back pain and falling blood pressure page 840
A nurse assessing a client who underwent cardiac catheterization finds the client lying flat on the bed. the client's temperature is 99.8, BP is 104/68, pulse is 76. The nurse detects weak pulses in the leg distal to the puncture site. Skin on the leg is cool to the touch. The puncture site is dry, but swollen. What is most appropriate action for the nurse to take?
contact the health care provider and report the findings page 664
The nurse is instructing the client with polycythemia vera how to perform isometric exercises such as contracting and relaxing the quadriceps and gluteal muscle during periods of inactivity. What does the nurse understand is the rationale for this type of exercise?
contraction of skeletal muscle compresses the walls of veins and increases the circulation of venous blood as it returns to the heart
Which of the following is a diagnostic test that involves injection of a contrast media into the venous system through a dorsal vein in the foot?
contrast phlebography page 826
The clinic nurse caring for a client with a cardiovascular disorder is performing an assessment on the client's pulse. which of the following steps is involved in determining the pulse deficit?
count the heart rate at the apex page 666
The nurse is caring for an elderly client with left sided heart failure. When auscultating lung sounds, which adventitous sound is expected?
crackles page 657
A patient is undergoing a pericardiocentesis. Following withdrawal of pericardial fluid, which assessment by the nurse indicated that cardiac tamponade has been relived?
decrease in central venous pressure page 812
The nurse is providing care to a client with cardiogenic shock requiring a intra-aortic balloon pump. What is the therapeutic effect of the IABP therapy?
decreased left ventricular work load
The nurse expects which assessment finding when caring for a client with decreased hemoglobin level?
decreased oxygen level
Nurses should implement measures to relieve emotional stress for clients with hypertension because the reduction of stress
decreases the production of neurotransmitters that constrict peripheral arterioles page 878
The most important reason for a nurse to encourage a client with peripheral vascular disease to initiate a walking program is that this form of exercise:
decreases venous congestion page 830
A patient has been diagnosed with congestive heart failure (CHF). The healthcare provider has ordered a medication to enhance contractility. The nurse would expect which medication to be prescribed for the patient?
digoxin page 656
which medication reverse digitalis toxicity?
digoxin immune FAB page 794 - 802
Which is a characteristic of arterial insufficiency?
diminished or absent pulses page 819-821
The nurse assessing a client who has arterial insufficiency of the legs and an ulcer on the left great toe would expect to find which characteristic?
diminished or absent pulses page 821
A client donated two units of blood to be used for transfusion during spinal fusion surgery. The client received one unit of autologous blood during the procedure but the second unit is not needed during the procedure. The nurse knows which action will come after the procdure is completed?
discard the additional unit
A client receiving a unit of packed red blood cells has been prescribed morphine 1 mg intravenously now for pain. What is the best method for the nurse to administer the morphine?
disconnect the blood tubing, flush with normal saline, administer morphine
The charge nurse should intervene when observing a new nurse perform which action after a client has suffered a possible hemolytic blood transfusion reaction.
disposing of the blood container and tubing in biohazard waste
Which aneurysm results in bleeding into the layers of the arterial wall?
dissecting page 838
A client who is newly diagnosed with hypertension is going to be starting antihypertensive medicine. What is one of the main things the client and the client's spouse watch for?
dizziness page 873
A patient who had a colon resection 3 days ago is complaining of discomfort in the left calf. How should the nurse assess Homan's sign to determine if the patient may have a thrombus formation in the leg?
dorsiflex the foot while the leg is elevated to check for calf pain page 847
The nurse is obtaining data in an older adult client. What finding may indicate to the nurse the early symptom of heart failure?
dyspnea on exertion Page 796
The nurse is teaching a client with heart failure about the ability for the heart to pump out blood. What diagnostic test will measure the ejection fraction of the heart?
echocardiogram page 798
The client with a diagnosis of heart failure reports frequently awakening during the night with need to urinate. What explanation will the nurse offer to explain the urination?
edema is collected in dependent extremities during the day; at night when the client lays down, it is reabsorbed into the circulation and excreted by the kidneys page 661
A client with heart failure is prescribed to receive 2 units of packed red blood cells. Which actions will the nurse take to decrease the client's risk of developing transfusion- associated circulatory overload?
elevate the head of the bed place feet in dependent position reduce the rate of transfusion to 100 ml/hr provide furosemide as prescribed before the transfusion
To check for arterial insufficiency when a client is in a supine position, the nurse should elevate the extremity at a 45 degree angle and then have the client sit up. The nurse suspects arterial insufficiency if the assessment reveals:
elevated pallor page 835
Within the heart, several structures and several layers all play a part in protecting the heart muscle and maintaining cardiac function. The inner layer of the heart is composed of a thin, smooth layer of cells, the folds of which form heart valves. What is the name of this layer of cardiac tissue?
endocardium page 651
A client receiving a blood transfusion reports shortness of breath, appears anxious, and has a pulse of 125 bpm. What is the best action for the nurse to take after stopping the transfusion and awaiting further instruction from the health care provider?
ensure there is an oxygen delivery device at the bedside
A patient is having an angiography to detect the presence of an aneurysm. After the contrast is administered by the interventionist, the patient begins to complain of nausea and difficulty breathing. What medication is priority to administer at this time?
epinephrine page 826
Which statement is accurate regarding Raynaud disease?
episodes may be triggered by unusual sensitivity to cold page 844
A client with severe anemia is admitted to the hospital. Because beliefs, the client is refusing blood transfusions. The nurse anticipates pharmacologic therapy with which drug to stimulate the production of red blood cells?
epoetin alfa
A client with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this client?
erythropoietin
A client is being seen at the clinic for a routine physical when the nurse notes the client's blood pressure is 150/97. The client is considered to be a healthy, well nourished young adult. What type of hypertension does the client have?
essential (primary) page 866
A patient is undergoing platelet pheresis at the outpatient clinic. What does the nurse know is the most likely clinical disorder the patient is being treated for?
essential thrombocythemia
A client wants to donate blood before his or her abdominal surgery next week. What should be the nurse's first action?
explain the time frame needed for autologous donation
A nurse is completing a detailed health history and assessment in the electronic medical record for a client with a disorder of the hematopoietic system. Which symptom is the most commonly reported in association with hematologic diseases?
extreme fatigue
What class of medication lyses and dissolves thrombi?
fibrinolytic page 852
The nurse auscultates the apex beat at which anatomical location?
fifth intercosstal space, midclavicular line page 668
A nurse is instructing a client about using antiembolism stocking. Antiembolism stockings help prevent deep vein thrombosis (DVT) by:
forcing blood into the deep venous system page 847
A 66 year old client presents to the emergency department reporting severe headache and mild nausea for the past 6 hours. Upon assessment, the client's BP is 210/120. The client has a history of hypertension and takes 1 mg clonidine twice daily. Which question is most important for the nurse to ask the client next?
have you taken your prescribed clonidine today
A client with congestive heart failure is admitted to the hospital after reporting shortness of breath. How should the nurse position the client in order to decrease preload?
head of the bed elevated 45 degrees and lower arms supported by pillows page 805
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?
heart and blood vessles
The nurse is reviewing the results of the patient's echocardiogram and observes that the ejection fraction is 35%. The nurse anticipates that the patient will receive treatment for what condition?
heart failure page 655-656
The nurse is performing an assessment on a patient to determine the effects of hypertension on the heart and blood vessels. Which specific assessment data will assist in determining this complication?
heart rate heart rhythm character of apical and peripheral pulses
A nurse is caring for a patient who has had a bone marrow aspiration with biopsy. What complication should the nurse be aware of and monitor the patient for?
hemorrhage
Providing postoperative care to a patient who has percutaneous transluminal angioplasty (PTA), with insertion of a stent, for a femoral artery lesion, includes assessment for the most serious complication of
hemorrhage page 829
A nurse is reviewing laboratory values for a client diagnosed with hyperlipidemia 6 months ago. Which result indicate that the client has been following a therapeutic regimen?
high density lipoprotiens (HDL) increase from 25 to 40 page 660
The nurse is reviewing laboratory values for a client diagnosed with hyperlipidemia 6 months ago. Which results indicated that the client has been following a therapeutic regimen?
high density lipoprotiens (HDL) increase from 25 to 40 page 660
The nurse is preparing to administer hydralazine and iosorbide dinitrate. When obtaining vital signs, the nurse notes that the blood pressure is 90/60. What is the priority action by the nurse?
hold the medication and call the health care provider page 802
A patient with diabetes is being treated for a wound on the lower extremity that has been present for 30 days. What option for treatment is available to increase diffusion of oxygen to the hypoxic wound?
hyperbaric oxygen page 857
A client is taking 50 mg of oral spirolactone twice a day to assist with blood pressure control. While the nurse is performing assessment, the client reports nausea, general muscle cramps, and weakness. The ECG strip shows a peaked, narrow T wave, which is a change. What electrolyte imbalance does the nurse suspect?
hyperkalemia page 873
What risk factors would cause the nurse to become concerned that the client may have atherosclerotic heart disease?
hypertension diabetes obesity family history of early cardiovascular events page 866-867
Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage?
hypertensive emergency page 880
The nurse is administering a beta blocker to a patient in order to decrease automaticity. Which medication will the nurse administer?
metoprolol page 655
The nurse reviews a client's lab results and notes a serum calcium level of 7.9. It is most appropriate for the nurse to monitor the client for what condition?
impaired myocardial contractility page 673
The nurse is caring for a patient who has started anticoagulant therapy with warfarin (coumadin). When does the nurse understand that therapeutic benefits will begin?
in 3 to 5 days page 848
Which sign or symptom suggests that a client's abdominal aortic aneurysm is extending?
increased abdominal and back pain page 845
The pathophysiology of pericardial effusion is associated with all of the following except:
increased venous return page 812
A client is diagnosed with deep vein thrombosis (DVT). Which nursing diagnosis should receive highest priority at this time?
ineffective peripheral tissue perfusion related to venous congestion page 846
A client experiences orthostatic hypotension while receiving furosemide to treat hypertension. How will the nurse intervene?
instruct the client to sit for several minutes before standing page 879
A client is receiving enoxaparin and warfarin therapy for venous thromboembolism (VTE). Which laboratory value indicates that anticoagulation is adequate and enoxaparin can be discontinued?
international normalized ration is 2.5 page 846-848
The nurse cares for a client prescribed warfarin orally. The nurse reviews the client's prothrombin time (PT) level to evaluate the effectiveness of the medication. Which laboratory values should the nurse also evaluate?
international normalized ration(INR) page 673
Which of the following would be inconsistent with a hypertensive urgency?
intracranial hemorrhage page 879
The nurse is caring for a client who has a unit of whole blood removed every 6 weeks as treatment for polycythemia vera. Which laboratory test will the nurse monitor to determine if the procedure is adversely affecting the client?
iron
A patient who has long term packed RBC transfusions has developed symptoms of iron toxicity that affect liver function. What immediate treatment should the nurse anticipate preparing the patient for that can help prevent organ damage?
iron chelation therapy
The nurse is performing a cardiac assessment on an elderly client. Which finding warrants further investigation?
irregularly irregular heart rate page 672
A nurse is educating about lifestyle modifications for a group of clients with newly diagnosed hypertension. While discussing dietary changes, which point would the nurse emphasize?
it takes 2 to 3 months for the taste buds to adapt to decreased salt intake page 878
Which cell of hematopoiesis is responsible for the production of red blood cells and platelets?
meyloid stem cells
When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true?
pressures should not differ more than 5 mm Hg between arms page 870
What is a characteristic of right sided heart failure?
jugular vein distention page 793- 797
The nurse identifies which symptom as a characteristic of right sided heart failure?
jugular vein distention page 794 - 797
A new client has been admitted with right-sided heart failure. When assessing this client, the nurse knows to look for which finding?
jugular venous distention Page 797
A client has been admitted with right sided heart failure. When assessing this client, the nurse knows to look for which finding?
jugular venous distention page 797
A client reports feeling faint after donating blood. What is the nurse's best action?
keep client in recumbent position to rest
The nurse is caring for a client who is scheduled for a transesophageal echocardiogram. What nursing intervention is a priority after the procedure?
keep the head of the bed elevated 45 degrees and keep NPO until return of the gag reflex page 681
A client in acute renal failure has been prescribed 2 units of packed red blood cells. The nurse explains to the client that the blood transfusion is most likely needed for which reason?
lack of erythropoietin
Which observation regarding ulcer formation on the client's lower extremity indicates to the nurse that the ulcer is a result of venous insufficiency?
large and superficial page 853
The nurse is preparing a patient for a bone marrow aspiration and biopsy from the site of the posterior superior iliac crest. What position will the nurse place the patient in?
lateral position with one leg flexed
Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for receiving oxygenated blood from the lungs?
left atrium Page 652
Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to all the cells and tissues of the body?
left ventricle page 651
Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to all the cells and tissues of the body?
left ventricle Page 651
The clinical manifestations of cardiogenic shock reflect the pathophysiology of heart failure. By applying this correlation, the nurse notes that the degree of shock is proportional to which of the following?
left ventricular function page 811
Which blood cell type is match correctly with its function?
leukocyte: fights infection
Which blood cell type is matched correctly with its function?
leukocyte: fights infection
Albumin is important for the maintenance of fluid balance within the vascular system. Albumin is produced by which of the following?
liver
What does the nurse recognize as secondary sites of hematopoiesis that is unique to embrynoic development
liver spleen
The nurse is caring for an older adult client who has come to the clinic for a yearly physical. When assessing the client, the nurse notes the blood pressure is 140/93. The nurse knows that in older clients what happens that may elevate the systolic BP?
loss of arterial elasticity page 866
After a physical examination, the provider diagnosed a patient with a grade 4 heart murmur. During assessment, the nurse expects to hear a murmur that is:
loud and may be associated with a thrill sound similar to (a purring cat) page 671
Which feature is the hallmark of systolic heart failure?
low ejection fraction page 794-799
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?
low sodium diet Page 803
The nurse is caring for a patient with peripheral arterial insufficiency. What can the nurse suggest to help relieve leg pain during rest?
lowering the limb so that it is dependent page 832
Which term refers to a form of white blood cell involved in immune response?
lymphocyte
A nurse is reviewing a client's morning laboratory results and notes a left shift in the band cells. Based on this result, the nurse can interpret that the client
may be developing an infection
Vitamin b and folic acid deficiencies are characterized by production of abnormally large erythrocytes called
megaloblasts
A client is diagnosed with peripheral arterial disease. Review of the client's chart shows an ankle brachial index (ABI) on the right of 0.45. This indicates that the right food has which of the following?
moderate to severe arterial insufficiency page 824
which assessment should a nurse perform when caring for a client following a cardiac catheterization?
monitor BP and pulse frequently inspect pressure dressing for signs of bleeding palpate the pulse in different locations page 682
Which action will the nurse include in the plan of care for a client admitted with acute decompensated heart failure who is receiving milrinone?
monitor blood pressure frequently page 803
which nursing intervention should be incorporated into the plan of care for a client with impaired liver function and a low albumin concentration?
monitor for edema at least once per shift
Which cell of hematopoeisis is responsible for the production of red blood cells and platelets?
myeloid stem cell
Aortic dissection may be mistaken for which of the following disease process?
myocardial infarction (MI) page 841
The body responds to infection by increasing the production of white blood cells (WBCs). The nurse should evaluate the differential count for what type of WBC, which are the first WBC to respond to an inflammatory event?
neutrophils
A client who was recently diagnosed with prehypertension is to meet with a dietitian and return for a follow up with the cardiologist in 6 months. What would the client's treatment likely include?
non-pharmacological interventions
A nurse is assessing a client's right lower leg, which is wrapped with an elastic bandage. Which signs and symptoms suggest circulatory impairment?
numbness, cool skin temperature, and pallor page 822
The nurse cares for a client with clubbing of the fingers and toes. The nurse should complete which action given these findings?
obtain an oxygen saturation level page 664
A client develops a hemolytic reaction to blood transfusion. What actions should the nurse take after this occurs?
obtain appropriate blood specimens collect a urine sample to detect hemoglobin document the reaction according to policy
A nurse reviews the client's medical record and reads in the progress notes that the client has decreased let ventricular function. What assessment will validate the diagnosis?
orthopnea page 796
A client who is diagnosed with Raynaud syndrome reports cold and numbness in the fingers. Which finding should the nurse identify as an early sign of vasoconstriction?
pallor page 844
A client has been diagnosed with peripheral arterial occlusive disease. Which of the following instructions is appropriate for the nurse to give the client for promoting circulation to the extremities?
participate in a regular walking program page 833
A critically ill is admitted to the ICU. The health care provider decides to use intra-arterial pressure monitoring. After this intervention is performed, what assessment should the nurse prioritize?
perfusion distal to the insertion site page 686
A nurse is caring for a client following an arterial vascular bypass graft in the leg. What should the nurse plan to assess over the next 24 hours?
peripheral pulses every 15 minutes after surgery page 840-841
Which is a symptom of severe thrombocytopenia?
petechiae
Under normal conditions, the adult bone marrow produces approximately 70 billion neutrophils. WHat is the major function of neutrophils?
phagocytosis
A client is diagnosed with extreme thrombocytosis. The nurse knows this condition is a result of which elevated blood cell count?
platelets
The nurse would screen a client from which ethnic background hypertension at an early age?
population of african descent
The nurse is educating a patient at risk for atherosclerosis. What nonmodifiable risk factor does the nurse identify for the patient?
positive family history page 658
A patient complains of a "stabbing pain and a burning sensation" in his left foot. The nurse notices that the foot is a lighter color than the rest of the skin. The artery that the nurse suspects is occluded would be the:
posterior tibial page 824
an older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed chlorothiazide and benazepril. What will the nurse monitor this client for?
postural hypotension and resulting injury
a patient is prescribed digitalis preparations. Which of the following conditions should the nurse closely monitor when caring for the patient?
potassium levels 794 - 800
A postoperative client is receiving heparin after developing thrombophlebitis. The nurse monitors the client carefully for bleeding and other adverse effects of heparin. If the client starts to exhibit signs of excessive bleeding, the nurse should expect to administer an antidote that is specific to heparin. Which agent fits this description?
protamine sulfate page 837
The nurse encourages the client diagnosed with hypertension to rise slowly from a sitting or lying position because gradual changes in position
provide time for the heart rate to increase the rate of contraction to resupply oxygen to the brain
A client with a history of an anterior wall myocardial infarction is being transferred from the coronary care unit (CCU) to the cardiac step down unit (CSU). While giving a report to the CSU nurse, the CCU nurse says "His pulmonary artery wedge pressures have been in the high normal range." What additional assessment information would be important for the CSU nurse to obtain?
pulmonary crackles page 796-797
A 35 year old client has been diagnosed with hypertension. The client is a stock broker, smokes daily, and has diabetes. During a follow up appointment, the client states that regular visits to the doctor just to check blood pressure are cumbersome and time consuming. As the nurse, which aspect of client teaching would you recomment?
purchasing a self monitoring BP cuff
When assessing a client with cellulitis of the right leg, which finding should the nurse expect to observe?
red, swollen skin with inflammation spreading to surrounding tissues page 861
A client is brought to the emergency department with reports of a bad headache and an increase in blood pressure. The blood pressure reading obtained by the nurse is 260/180. What is the therapeutic goal for reduction of the mean blood pressure?
reduce the blood pressure by 20% to 25% within the first hour of treatment page 880
a client has been diagnosed with heart failure. What is the major nursing outcome for the client?
reduce the workload on the heart page 803
The physician orders medication to treat a client's cardiac ischemia. What is causeing the client's condition?
reduced blood supply to the heart page 653
What does decreased pulse pressure reflect?
reduced stroke volume page 665
The nurse is working at a blood donation clinic. What teaching should the nurse provide to the donor immediately after blood donation?
remain for observation after eating and drinking
Which of the following is the nurse most correct to recognize as a direct effect of client hypertension?
renal dysfunction resulting from atherosclerosis page 866
The nurse is assessing a client taking an anticoagulant. What nursing intervention is most appropriate for a client at risk for injury related to side effects of medication enoxaprin?
report an incident of bloody urine, stools or both page 661
The nurse is assessing a client taking an anticoagulant. What nursing intervention is most appropriate for a client at risk for injury related to the side effects of medication enoxaparin?
report any incident of blood urine, stools or both page 661
Which finding indicates that hypertension is progressing to target organ damage?
retinal blood vessel damage page 868
A nurse cares for several mothers and babies in the postpartum unit. Which mother does the nurse recognize as being most at risk for a febrile nonhemolytic reaction?
rh negative mother rh positive child
Central venous pressure is measured in which heart chamber?
right atrium page 667
It is important for the nurse to understand cardiac hemodynamic. For blood flow from the right ventrical to the pulmonary artery, the following must occur:
right ventricular pressure must be higher thatn pulmonary arterial pressure page 655
Which of the following is the most effective intervention for preventing progression of vascular disease?
risk factor modification page 833
A client, newly admitted to the nursing unit, has a primary diagnosis of renal failure. When assessing the client, the nurse notes a blood pressure (BP) of 180/100. The nurse knows that this is what kind of hypertension?
secondary page 867
Hypertension that can be attributed to an underlying cause is termed
secondary hypertension page 867
Which term describes high blood pressure from an identified cause, such as renal disease?
secondary hypertension page 867
The nurse is caring for a client prescribed bumentanide for the treatment of stage 2 hypertension. Which finding indicates the client is experiencing an adverse effect of the medication?
serum potassium value of 3.0 page 873
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?
severe pain page 840
following abdominal surgery, which factor predisposes a client to deep vein thrombosis?
the client will be immobile during and shortly after surgery page 849
The electrical conduction system of the heart has several components, all of which are instrumental in maintaining polarization, depolarization, and repolarization of cardiac tissues. Which of the conductive structures is known as the pacemaker of the heart?
sinoatrial node 653
The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety?
sit on the edge of the chair and rise slowly page 870
A nurse providing education about hypertension to a community group is discussing the high risk for cardiovascular complications. What are risk factors for cardiovascular problems in clients with hypertension?
smoking diabetes mellitus physical inactivity page 867
The nurse expects which assessment finding of the oral cavity when the client is diagnosed with pernicious anemia?
smooth tongue
Which diuretic mediation conserves potassium?
spironolactone page 873
A physician admits a client to the health care facility for treatment of an abdominal aortic aneurysm. When planning this client's care, which goal should the nurse keep in mind as she formulates intervention?
stabilizing heart rate and blood pressure and easing anxiety page 840
A diastolic blood pressure of 92 mm Hg is classified as
stage 2 hypertension page 866
Place the following procedural steps in order for transfusing a unit of packed red blood cells (PRBCs)
start an intravenous line obtain the unit of PRBC from the blood bank double check the labels with another nurse to ensure correct ABO group and Rh type initiate the blood transfusion within 30 minutes of receipt monitor closely for signs of a transfusion reaction
Place the following procedural steps in order for transfusing a unit of packed red blood cells
start an intravenous line obtain the unit of PRBCs from the blood bank double check the labels with another nurse to ensure correct ABO group and rh type initiate the blood transuion within 30 minutes of receipt monitor closely for signs of a transfusion reaction
A nurse is providing education about the prevention of arterial construction to a client with peripheral arterial disease. Which of the following includes priority information the nurse would give to the client?
stop smoking page 831
A nurse is transfusing whole blood to a client with impaired renal function. During the transfusion, the client tells the nurse "I feel very short of breath all of the sudden." What is the nurse's primary action?
stop the transfusion
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 is documented. The following revised guidelines for identifying hypertension, which educational pamphlet is helpful?
stress reduction to lower prehypertensive state page 866
The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client?
stroke page 868
The nurse correctly identifies which data as an example of blood pressure and heart rate measurements in a client with postural hypotension?
supine: 120/70, 70 sitting: 100/55 , 90 standing 98/52 , 94 page 666
Which is a manifestation of right-sided heart failure?
systemic venous congestion page 794-797
The nurse is seeing a client for the first time and has just checked the client's blood pressure. The nurse would consider the client prehypertensive if:
systolic BP is between 120 and 139 page 866
A nurse caring for a client with human immunodeficiency virus (HIV) reviews the client's differential WBC count. What type of WBC will the nurse check the level of?
t lymphocytes
the healthcare provider believes that the client has a deficiency in the leukocyte responsible for cell mediated immunity. What should the nurse check the WBC count for?
t lymphocytes
On a routine visit to the physician, a client with chronic arterial occlusive disease reports that he's stopped smoking after 34 years. To relieve symptoms of intermittent claudication, a condition associated with chronic arterial occlusive disease, which additional measure should the nurse recommend?
taking daily walks page 822
What should the nurse do to manage the persistent swelling in a client with severe lymphangitis and lymphadenitis?
teach the client how to apply an elastic sleeve page 853-854
A nurse is caring for a client with a diganosis of lymphocytopenia. Which assessment finding will the nurse consider most concerning when caring for this client?
temperature of 37.7 degrees celsius
A client is returning home after having a bone marrow aspiration and biopsy. Which statement indicated that teaching by the nurse has been effective?
the area might ache for 1 to 2 days
Assessment of a client on a medical surgical unit finds a regular heart rate of 120 bmp, audible third and fourth heart sounds, blood pressure 84/64, bibasilar crackles on lung auscultation and urine output 5mL over the past hour. what is the reason the nurse anticipates transferring the client to int intensive care unit?
the client is going into cardiogenic shock page 811
A nurse cares for a client with megaloblastic anemia who had a total gastrectomy three years ago. What statement will the nurse include in the clients teaching regarding the condition?
the condition is likely caused by a vitamin b 12 deficiency
A nurse cares for a client with megaloblastic anemia who had a total gastrectomy three years ago. What statement will the nurse include in the client's teaching regarding the condition?
the condition is likely caused by a vitamin b12 deficiency
The nurse is caring for a client with hypoxia. What does the nurse understand is true regarding the client's oxygen level and the production of red blood cells?
the kidneys sense low oxygen levels in the blood and produce erythropoietin, stimulating the bone marrow to produce more red blood cells
A patient tells the nurse "i was straining to have a bowel movement and felt like I was going to faint. I took my pulse and it was slow." What does the nurse understand occurred with the patient?
the patient had a vagal response page 661
The nurse is caring for a patient with a diagnosis of pericarditis. Where does the nurse understand the inflammation is located?
the think fibrous sac encasing the heart page 659
A patient recently diagnosed with pericarditis asks the nurse to explain what area of the heart involved. How does the nurse best describe the pericardium to the heart?
this fibrous sac that encases the heart page 651
Which of the following is the most common site for a dissecting aneuysm?
thoracic area page 839
An obese client describes symptoms of palpitations, chronic fatigue, and dyspnea on exertion to the cardiologist. Upon completing the examination, the cardiologist schedules a procedure to confirm the suspected diagnosis. What diagnostic procedure would the nurse expect to be prescribed?
transesophageal echocardiography page 680
The nurse is caring for a patient with venous insufficiency. For what should the nurse assess the patient's lower extremities?
ulceration page 853
What symptoms should the nurse assess for in a client with lymphedema as a result of impaired nutrition to the tissue?
ulcers and infection in the edematous area page 857
While caring for a client, the nurse notes petechiae on the client's truck and lower extremities. What precaution will the nurse take when caring for this client?
use an electric razor when assisting client with shaving
Which statements are true when the nurse is measuring blood pressure?
using a BP cuff that is too small will give a higher BP measurement the client's arm should be positioned at the level of the heart the client should sit quietly while BP is being measured
The nurse teaches the client with peripheral vascular disease (PVD) to refrain from smoking because nicotine causes
vasospasm page 826-830
A home health nurse is seeing an elderly male client for the first time. During the physical assessment of the skin on the lower legs, the nurse notes edema, brown pigmentation in the gaiter area, pedal pulses, and a few irregularly shaped ulcers around the ankles. From these findings, the nurse knows that the client has a problem with peripheral circulation. Which of the following does the nurse suspect?
venous insufficiency page 853
The client is to receive a unit of packed red blood cells. What is the nurse's first action?
verify that the client has signed a written consent form
A client with chronic heart failure is receving digoxin 0.25 mg by mouth daily and furosemide 20 mg by mouth twice daily. The nurse should assess the client for what sign of digoxin toxicity?
visual disturbances page 802
A client comes into the emergency department reporting an enlarged tongue. The tongue appears smooth and beefy red in color. The nurse also observes a 5 cm incision on the upper left quadrant of the abdomen. When questioned, the client states "I had a partial gastrostomy 2 years ago." Based on this information, the nurse attributes these symptoms to which problem?
vitamin b12 deficiency
During auscultation of the lungs, what would a nurse note when assessing a client with left sided heart failure?
wheezes with wet lung sounds page 671
