Cardiac PrepU Questions (Exam #3)
A nurse is teaching a client about maintaining a healthy heart. The nurse should include which point in her teaching?
Use alcohol in moderation
A new client has been admitted with right-sided heart failure. The nurse knows to look for which of the following assessment findings when assessing this client?
Jugular vein distention
Which of the following medications is an antidote to heparin?
Protamine sulfate
A client is admitted to the hospital with systolic left-sided heart failure. The nurse knows to look for which of the following assessment findings for this client?
Pulmonary congestion
A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when he makes which statement?
"I sleep on three pillows each night"
A nurse is teaching a client who is having a valuloplasty tomorrow. The client asks what the advantage is for having a tissue valve replacement instead of a mechanical valve. The correct answer by the nurse is which of the following?
"A tissue valve is less likely to generate blood clots, and so long-term anticoagulation therapy is not required."
A nurse and a nursing student are caring for a client with pericarditis and perform the physical assessment together. The client has a pericardial friction rub audible on auscultation. When the nurse and student leave the room, the student asks how to distinguish a pericardial from a pleural friction rub. The nurse's best response is which of the following?
"Ask the client to hold the breath while you auscultate; the pericardial friction rub will continue, while the pleural friction rub will stop."
A nurse is caring for a client who has hypertension and diabetes mellitus. The client's blood pressure this morning was 150/92 mm Hg. He asks the nurse what his blood pressure should be. The nurse's most appropriate response is:
"Clients with diabetes should have a lower blood pressure goal. You should strive for 130/80 mm Hg."
When assessing a client who reports recent chest pain, the nurse obtains a thorough history. Which client statement most strongly suggests angina pectoris?
"The pain occurred while I was mowing the lawn."
A nursing student is assigned to a patient with a mechanical valve replacement. The patient asks the student, "Why do I have to take antibiotics before getting my teeth cleaned?" Which response by the nursing student is most appropriate?
"You are at risk of developing an infection in your heart."
When monitoring a patient who has hypertension and chronic kidney disease, the target pressure for this individual should be less than which blood pressure reading?
130/80 mmHg
A client is receiving intravenous heparin to prevent blood clots. The order is for heparin 1,200 units per hour. The pharmacy sends 25,000 units of heparin in 500 mL of D5W. At how many mL per hour will the nurse infuse this solution? Enter the correct number ONLY.
24
According to the DASH diet, how many servings of vegetables should a person consume per day?
4 to 5
The nurse is explaining the DASH diet to a patient diagnosed with hypertension. The patients inquires about how many servings of fruit per day can be consumed on the diet. The nurse would be correct in stating which of the following?
4 to 5
In order to be effective, percutaneous transluminal coronary angioplasty (PTCA) must be performed within what time frame, beginning with arrival at the emergency department after diagnosis of myocardial infarction?
60 minutes
A client has a blockage in the proximal portion of a coronary artery. After learning about treatment options, the client decides to undergo percutaneous transluminal coronary angioplasty (PTCA). During this procedure, the nurse expects to administer an:
Anticoagulant
Which of the following statements is not accurate regarding an autograft?
Anticoagulation is necessary
A client with left-sided heart failure complains of 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:
Acute pulmonary edema
A client in the emergency department complains of squeezing substernal pain that radiates to the left shoulder and jaw. He also complains of nausea, diaphoresis, and shortness of breath. What should the nurse do?
Administer oxygen, attach a cardiac monitor, take vital signs, and administer sublingual nitroglycerin.
While assessing a patient with pericarditis, the nurse cannot auscultate a friction rub. Which action should the nurse implement?
Ask the patient to lean forward and listen again.
A patient complains about chest pain and heavy breathing when exercising or when stressed. Which of the following is a priority nursing intervention for the patient diagnosed with coronary artery disease?
Assess chest pain and administer prescribed drugs and oxygen
The nurse plays an important role in monitoring and managing potential complications in the patient who has recently undergone a coronary artery bypass graft (CABG). The nurse should be alert to which of the following respiratory complications?
Atelectasis
Which condition most commonly results in coronary artery disease (CAD)?
Atherosclerosis
Which of the following describes a valve used in replacement surgery that is made from the patient's own heart valve?
Autograft
Which of the following is a key diagnostic indicator of heart failure (HF)?
BNP
A client is returning from the operating room after inguinal hernia repair. The nurse notes that he has fluid volume excess from the operation and is at risk for left-sided heart failure. Which sign or symptom indicates left-sided heart failure?
Bibasilar crackles
A client is receiving nitroglycerin ointment (Nitro-Dur) to treat angina pectoris. The nurse evaluates the therapeutic effectiveness of this drug by assessing the client's response and checking for adverse effects. Which vital sign is most likely to reflect an adverse effect of nitroglycerin?
Blood pressure 84/52 mm Hg
Which pulse should the nurse palpate during rapid assessment of an unconscious adult?
Carotid
A client with chest pain arrives in the emergency department and receives nitroglycerin, morphine (Duramorph), oxygen, and aspirin. The physician diagnoses acute coronary syndrome. When the client arrives on the unit, his vital signs are stable and he has no complaints of pain. The nurse reviews the physician's orders. In addition to the medications already given, which medication does the nurse expect the physician to order?
Carvedilol (Coreg)
Which of the following nursing interventions should a nurse perform when a patient with cardiomyopathy receives a diuretic?
Check for dependent edema regularly
A client seeks medical attention for dyspnea, chest pain, syncope, fatigue, and palpitations. A thorough physical examination reveals an apical systolic thrill and heave, along with a fourth heart sound (S4) and a systolic murmur. Diagnostic tests reveal that the client has hypertrophic cardiomyopathy (HCM). Which nursing diagnosis may be appropriate?
Decreased CO
During assessment of a client admitted for cardiomyopathy, the nurse notes the following symptoms: dyspnea on exertion, fatigue, fluid retention, and nausea. The initial appropriate nursing diagnosis is which of the following?
Decreased CO
A client is recovering from coronary artery bypass graft (CABG) surgery. Which nursing diagnosis takes highest priority at this time?
Decreased cardiac output related to depressed myocardial function, fluid volume deficit, or impaired electrical conduction
A patient is exhibiting digitalis toxicity. Which of the following medications would the nurse expect to be ordered for this patient?
Digoxin
Which of the following medications reverses digitalis toxicity?
Digoxin immune FAB (Digibind)
Which drug is most commonly used to treat cardiogenic shock?
Dopamine (Intropin)
During the insertion of a rigid scope for bronchoscopy, a client experiences a vasovagal response. The nurse should expect:
Drop in clients HR
During the insertion of a rigid scope for bronchoscopy, a client experiences a vasovagal response. The nurse should expect:
Drop in the client's heart rate
You are the triage nurse in a walk-in clinic when a diabetic client visits the clinic and asks you to take her blood pressure (BP). The measurements are 150/90 mm Hg. Which of the following would the nurse expect as the treatment to normalize the client's BP?
Drug therapy
Frequently, what is the earliest symptom of left-sided heart failure?
Dyspnea on exertion
A patient has been prescribed a digitalis preparation for heart failure. Which of the following should you, as her nurse, closely monitor when caring for this client?
Electrolyte and water loss
The nursing priority of care for a client exhibiting signs and symptoms of coronary artery disease should be to:
Enhance myocardial oxygenation
A nurse is caring for a client with aortic stenosis whose compensatory mechanisms of the heart have begun to fail. The nurse will monitor the client carefully for which initial symptoms?
Exertional dyspnea, orthopnea, pulmonary edema
Which signs and symptoms accompany a diagnosis of pericarditis?
Fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR)
Which of the following is a nonmodifiable risk factor for coronary artery disease (CAD)?
Gender
A physician treating a client in the cardiac care unit for atrial arrhythmia orders metoprolol (Lopressor), 25 mg P.O. two times per day. Metoprolol inhibits the action of sympathomimetics at beta1-receptor sites. Where are these sites mainly located?
Heart
A nurse is caring for a client experiencing dyspnea, dependent edema, hepatomegaly, crackles, and jugular vein distention. What condition should the nurse suspect?
Heart failure
A nursing student is caring for a client with end-stage cardiomyopathy. The client's spouse asks the student to clarify one of the last treatment options available that the physician mentioned. After checking with the primary nurse, the student would most likely discuss which of the following?
Heart transplant
Which of the following therapies are for patient who have advanced heart failure (HF) after all other therapies have failed?
Heart transplant
A new surgical patient who has undergone a coronary artery bypass graft (CABG) is receiving opioids for pain control. The nurse must be alert to adverse effects of opioids. Which of the following effects would be important for the nurse to document?
Hypotension
Which of the following is inconsistent as a condition related to metabolic syndrome?
Hypotension
Which New York Heart Association classification of heart failure has a poor prognosis and includes symptoms of cardiac insufficiency at rest?
IV
Which of the following would be inconsistent as criterion of extubation in the patient who has undergone a coronary artery bypass graft (CABG)?
Inability to speak
When the nurse notes that the post cardiac surgery patient demonstrates low urine output (< 25 mL/hr) with high specific gravity (> 1.025), the nurse suspects:
Inadequate fluid volume
Which of the following is the most important postoperative assessment parameter for patients undergoing cardiac surgery?
Inadequate tissue perfusion
Which of the following is a characteristic of right-sided heart failure?
JVD (Jugular vein distention)
A 44-year-old client has a history of hypertension. As her nurse, you engage her in client education to make her aware of structures that regulate arterial pressure. Which of the following structures are a component of that process?
Kidneys
An 83-year-old client is undergoing lipid profile studies in an effort to determine a proper nutritional balance for his CAD. In his lipid profile, his LDL is greater than his HDL. Why is this a risk factor for this client?
LDL sticks to the arteries
Which of the following medications is categorized as a loop diuretic?
Lasix
A nurse is teaching a client who receives nitrates for the relief of chest pain. Which instruction should the nurse emphasize?
Lie down or sit in a chair for 5 to 10 minutes after taking the drug.
The nurse is caring for an 82-year-old male client who has come to the clinic for a yearly physical. When assessing the client, the nurse notes the blood pressure (BP) is 140/93. The nurse knows that in older clients what happens that may elevate the systolic BP?
Loss of arterial elasticity
A patient is receiving anticoagulant therapy. The nurse should be alert to potential signs and symptoms of external or internal bleeding, as evidenced by which of the following?
Low BP
Which of the following nursing interventions should a nurse perform to reduce cardiac workload in a patient diagnosed with myocarditis?
Maintain on bedrest
Ralph Wilson, is a 52-year-old client in the hospital unit where you practice nursing. He is being treated for myocarditis. Which of the following nursing interventions should you perform to reduce cardiac workload in a client with myocarditis?
Maintain pt on bed rest
Ralph Wilson, is a 52-year-old client in the hospital unit where you practice nursing. He is being treated for myocarditis. Which of the following nursing interventions should you perform to reduce cardiac workload in a client with myocarditis?
Maintain the client on bed rest
A 73-year-old client has been admitted to the cardiac step-down unit where you practice nursing. After diagnostics, she was brought to your unit with acute pulmonary edema. Which of the following symptoms would you expect to find during your assessment?
Moist, gurgling respirations
Upon discharge from the hospital, patients diagnosed with a myocardial infarction (MI) must be placed on all of the following medications except:
Morphine IV
Which of the following is the analgesic of choice for acute MI?
Morphine sulfate
Postpericardiotomy syndrome may occur in patients who undergo cardiac surgery. The nurse should be alert to which of the following clinical manifestations associated with this syndrome?
Pericardial friction rub
Which of the following medications is given to patients diagnosed with angina and is allergic to aspirin?
Plavix
A physician orders digoxin (Lanoxin) for a client with heart failure. During digoxin therapy, which laboratory value may predispose the client to digoxin toxicity?
Potassium level of 2.8 mEq/L
Which of the following would be inconsistent as a lifestyle change directive for the patient diagnosed with heart failure?
Push fluids
A nurse is obtaining a history from a new client in the cardiovascular clinic. When investigating for childhood diseases and disorders associated with structural heart disease, which finding should the nurse consider significant?
Rheumatic fever
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
A client with severe hypertension states, "I feel fine; I'm not really sick at all." The nurse will teach the client that the system/organs particularly targeted for damage by severe hypertension include which of the following?
Sensory
The nurse is administering nitroglycerin, which he knows decreases preload as well as afterload. Preload refers to which of the following?
The amount of blood presented to the ventricles just before systole
A nurse is administering lanoxin, which she knows increases contractility as well as cardiac output. Contractility refers to which of the following?
The force of the contraction related to the status of the myocardium
A nurse is caring for a 30-year-old client diagnosed with atrial fibrillation who has just had a mitral valve replacement. The client is being discharged with prescribed warfarin (Comaudin). She mentions to you that she relies on the rhythm method for birth control. What education would be a priority for the nurse to provide to this client?
The high risk for complications if she becomes pregnant while taking warfarin
When assessing a client who reports recent chest pain, the nurse obtains a thorough history. Which client statement most strongly suggests angina pectoris?
The pain occurred while I was mowing the lawn
A client with severe angina pectoris and electrocardiogram changes is seen by a physician in the emergency department. In terms of serum testing, it's most important for the physician to order cardiac:
Troponin
The patient has had biomarkers drawn after complaining of chest pain. Which diagnostic of myocardial infarction remains elevated for as long as 3 weeks?
Troponin
Which of the following is also termed preinfarction angina?
Unstable angina
A client in a clinic setting has just been diagnosed with hypertension. She asks what the end goal is for treatment. The correct reply from the nurse is which of the following?
To prevent complications/death by achieving and maintaining a blood pressure of 140/90 or less
A client with chest pain doesn't respond to nitroglycerin. When he's admitted to the emergency department, the health care team obtains an electrocardiogram and administers I.V. morphine. The physician also considers administering alteplase (Activase). This thrombolytic agent must be administered how soon after onset of myocardial infarction (MI) symptoms?
Within 6 hours
Patients who are taking beta-adrenergic blocking agents should be cautioned not to stop taking their medications abruptly because which of the following may occur?
Worsening angina
Which type of graft is utilized when a heart valve replacement is made of tissue from an animal heart valve?
Xenograft
A nurse is caring for a client receiving warfarin (Coumadin) therapy following a mechanical valve replacement. The nurse completed the client's prothrombin time and International Normalized Ratio (INR) at 7 a.m., before the morning meal. The client had an INR reading of 4. The nurse's first priority should be to:
assess the client for bleeding around the gums or in the stool and notify the physician of the laboratory results and most recent administration of warfarin.
Which of the following medications is given to patients diagnosed with angina and is allergic to aspirin?
plavix
A nurse is educating a community group about coronary artery disease. One member asks about how to avoid coronary artery disease. Which of the following items are considered modifiable risk factors for coronary artery disease? Choose all that apply.
• Hyperlipidemia • Tobacco use • Obesity
