Cardio Med Surg Test
A nurse is teaching a parent of an infant who has heart failure about meeting the infant's nutritional needs. Which of the following statements by the parent indicates an understanding of the teaching? A. "I will feed my baby on a schedule every 4 hours. B. "I will add Polycose to each of my baby's bottles." C. "I will allow my baby to take as much time as D. "I will limit my babies crying to 15 minutes prior to each feeding."
"I will add Polycose to each of my baby's bottles."
For each of the following findings in the client's medical record, click to specify if they are consistent with angina or a myocardial infarction (MI). Each finding may support more than one disease process. Answers cannot be displayed for this alternate item format. Rationale: The 12 lead EKG report indicates that ST depression and T-wave inversion can be consistent withboth angina and a non-ST segment myocardial infarction (MI) The result of the client's nitroglycerin therapy is consistent with angina. The discomfort of an MI is relieved only by opioids. The client's initial report of manifestations can be consistent with both angina and an MI. The provider's prescription of a treadmill stress test Thrombolytic therapy, angioplasty, or coronary bypass surgery. A cardiology consult is consistent with both angina and an MI.
- The 12 lead EKG report - The result of the client's nitroglycerin therapy -The client's initial report - The provider's prescription of a treadmill stress test - A cardiology consult thrombolytic therapy, angioplasty, or coronary bypass surgery.
A nurse is preparing to administer a transfusion of RBCs to a client who has heart failure. For which of the following manifestations should the nurse monitor to prevent fluid volume overload? (Select all that apply.) A. Dyspnea B. Gastrointestinal bloating C. Jugular vein distention D. Confusion E. Hypotension
A. Dyspnea C. Jugular vein distention D. Confusion
A nurse is caring for a client who has had a myocardial infarction. Upon his first visit to cardiac rehabilitation, he tells the nurse that he doesn't understand why he needs to be there because there is nothing more to do, as the damage is done. Which of the following is the correct nursing response? A. "Cardiac rehabilitation cannot undo the damage to your heart but it can help you get back to your previous level of activity safely." B. "It's not unusual to feel that way at first, but once you learn the routine, you'll enjoy it." C. "Exercise is good for you and good for your heart." D. "Your doctor is the expert here, and I'm sure he would only recommend what is best for you."
A. "Cardiac rehabilitation cannot undo the damage to your heart but it can help you get back to your previous level of activity safely."
A nurse is teaching the partner of a client who had an acute myocardial infarction (MI) about the reason blood was drawn from the client. Which of the following statements should the nurse make regarding cardiac enzymes studies? A. "These tests help determine the degree of damage to the heart tissues." B. "Cardiac enzymes will identify the location of the MI." C. "These tests will enable the provider to determine the heart structure and mobility of the heart valves." D. "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion."
A. "These tests help determine the degree of damage to the heart tissues."
The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the provider's orders and recognizes that clarification is needed for which of the following medications? A. Carvedilol B. Fluticasone C. Captopril D. Isosorbide dinitrate
A. Carvedilol
A nurse is caring for a client who just had a cardiac catheterization. Which of the following nursing interventions should the nurse include in the client's plan of care? (Select all that apply.) A. Check peripheral pulses in the affected extremity. B. Place the client in high-Fowler's position. C. Measure the client's vital signs every 4 hr. D. Keep the client's hip and leg extended. E. Have the client remain in bed up to 6 hr.
A. Check peripheral pulses in the affected extremity. D. Keep the client's hip and leg extended. E. Have the client remain in bed up to 6 hr.
A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? A. Check the client's vital signs. B. Request a dietitian consult. C. Suggest that the client rests before eating the meal. D. Request an order for an antiemetic.
A. Check the client's vital signs.
A nurse at a rehabilitation center is planning care for a client who had a left hemispheric cerebrovascular accident (CVA) 3 weeks ago. Which of the following goals should the nurse include in the client's rehabilitation program? A. Establish the ability to communicate effectively. B. Compensate for loss of depth perception. C. Learn to control impulsive behavior. D. Improve left-side motor function.
A. Establish the ability to communicate effectively.
A nurse is providing discharge teaching to a client who has a new diagnosis of heart failure. Which of the following instructions should the nurse include in the teaching? A. Exercise at least three times per week. B. Take diuretics early in the morning and before bedtime. C. Notify the provider of a weight gain of 0.5 kg (1 lb) in a week. D. Take naproxen for generalized discomfort
A. Exercise at least three times per week.
49.A nurse is caring for a client who is taking digoxin for heart failure and develops indications of severe digoxin toxicity. Which of the following medications should the nurse prepare to administer? A. Fab antibody fragments B. Flumazenil C. Acetylcysteine D. Naloxone
A. Fab antibody fragments
A nurse is caring for an older adult client who has left-sided heart failure. Which of the following assessment findings should the nurse expect? A. Frothy sputum B. Dependent edema C. Nocturnal polyuria D. Jugular distention
A. Frothy sputum
A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as the cause of the client's low potassium level? A. Furosemide B. Nitroglycerin C. Metoprolol D. Spironolactone
A. Furosemide
A nurse is caring for a client 4 hr following a cardiac catheterization. Which of the following actions should the nurse take? A. Have the client lie flat in bed. B. Keep the affected leg slightly flexed. C. Elevate the head of the bed 45°. D. Keep the client NPO for 4 hr.
A. Have the client lie flat in bed.
nurse is assessing a 3-year-old child who has aortic stenosis. Which of the following findings should the nurse expect? (Select all that apply.) A. Hypotension B. Bradycardia C. Clubbing of the nail beds D. Weak pulses F. Murmur
A. Hypotension D. Weak pulses F. Murmur
A nurse is caring for a client who has peripheral arterial disease (PAD). Which of the following symptoms should the nurse expect to find in the early stage of the disease? A. Intermittent claudication B. Dependent rubor C. Rest pain D. Foot ulcers
A. Intermittent claudication
A nurse is admitting a client who has a serum calcium level of 12.3 mg/dL and initiates cardiac monitoring. Which of the following findings should the nurse expect during the initial assessment? A. Lethargy B. Hyperactive deep tendon reflexes C. Prolonged ST segment D. Hyperactive bowel sounds
A. Lethargy
The nurse asks a client who is about to have a cardiac catheterization about any allergies. The client states, "I always get a rash when I eat shellfish." Which of the following is the priority nursing action? A. Notify the provider of the client's allergy. B. Attach a wrist band indicating the client's allergy. C. Ask the client if any other foods cause such a reaction. D. Notify the dietary department of the client's allergy.
A. Notify the provider of the client's allergy.
A nurse is caring for a client who has peripheral vascular disease and reports difficulty sleeping because of cold feet. Which of the following nursing actions should the nurse take to promote the client's comfort? A. Obtain a pair of slipper-socks for the client. B. Rub the client's feet briskly for several minutes. C. Increase the client's oral fluid intake. D. Place a moist heating pad under the client's feet.
A. Obtain a pair of slipper-socks for the client.
A nurse is assessing a client who has right-sided heart failure. Which of the following findings should the nurse expect? A. Peripheral edema B. Crackles in lungs C. Chest pain D. Heart murmur
A. Peripheral edema
A nurse is caring for a client who receives furosemide to treat heart failure. Which of the following laboratory values should the nurse monitor for this client due to this medication? A. Potassium B. Albumin C. Cortisol D. Bicarbonate
A. Potassium
A nurse is planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication? A. Potassium B. Hemoglobin C. Creatinine D. Blood urea nitrogen
A. Potassium
A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of an acute kidney injury. Which of the following findings should the nurse identify as indicating an increased risk of acute kidney injury (AKI)? A. Serum creatinine 1.8 mg/dL B. Serum Osmolality 290 mOsm/kg H2O C. Blood urea nitrogen (BUN) 20mg/dL. D. Magnesium 2.0 mEq/L
A. Serum creatinine 1.8 mg/dL
A nurse is monitoring the cardiac output of a client who has left-sided heart failure using pulse pressure analysis. Which of the following findings can compromise the readings? A. The client is experiencing premature atrial contractions. B. The client has a decreased oxygen saturation level. C. The client has bilateral wheezes. D. The client has lower leg edema.
A. The client is experiencing premature atrial contractions.
A nurse in the emergency department is caring for a client who is experiencing manifestations of a myocardial infarction (MI). Which of the following laboratory tests should the nurse expect the provider to prescribe? A. Troponin B. Creatinine kinase (CK) injury. C. Brain natriuretic peptide (BNP) D. C-reactive protein
A. Troponin
A nurse in an emergency department is caring for a client who reports substernal chest pain and dyspnea. The client is vomiting and is diaphoretic. Which of the following laboratory tests are used to diagnose a myocardial infarction? (Select all that apply.) A. Troponin I B. Troponin T C. Plasma low-density lipoproteins (LDL) D. CPK E. Myoglobin
A. Troponin I B. Troponin T D. CPK E. Myoglobin
nurse is providing discharge teaching to a client who has peripheral arterial disease (PAD). Which of the following instructions should the nurse include in the teaching? A. Apply a heating pad on a low setting to help relieve leg pain. B. Adjust the thermostat so that the environment is warm. C. Wear antiembolic stockings during the day. D. Rest with the legs above heart level. Rationale: Extreme elevation of the legs can slow the flow of arterial blood to the feet.
B. Adjust the thermostat so that the environment is warm.
A nurse is assessing for paradoxical blood pressure on a client who has constrictive pericarditis. Which of the following findings should the nurse expect? A. Apical pulse rate is different than the radial pulse rate B. Decrease in systolic pressure by more than 10 mm Hg during inspiration C. Increase in heart rate by 20% when moving from sitting to standing D. Drop in systolic BP by 20 mm Hg when changing positions
B. Decrease in systolic pressure by more than 10 mm Hg during inspiration
A nurse is caring for a client who has pericarditis and reports feeling a new onset of palpitations and shortness of breath. Which of the following assessments should indicate to the nurse that the client may have developed atrial fibrillation? A. Different blood pressures in the upper limbs. B. Different apical and radial pulses. C. Differences between oral and axillary temperatures. D. Differences in upper and lower lung sounds.
B. Different apical and radial pulses.
A nurse is teaching a client about following a low-cholesterol diet after coronary artery bypass grafting. Which of the following client food choices reflects the client's understanding of these dietary instructions? A. Liver . B. Milk C. Beans D. Eggs R
C. Beans
A nurse in a cardiac care unit is caring for a client with acute right-sided heart failure. Which of the following findings should the nurse expect? A. Decreased brain natriuretic peptide (BNP). B. Elevated central venous pressure (CVP). C. Increased pulmonary artery wedge pressure (PAWP). D. Decreased specific gravity
B. Elevated central venous pressure (CVP).
A home health nurse is making a home visit to a client who takes a daily diuretic for heart failure. Which of the following manifestations should the nurse identify as indicating the client is hypokalemic? A. Pitting edema B. Fatigue C. Dyspnea D. Oliguria
B. Fatigue
A nurse is providing discharge instructions to the parent of a 10-year-old child following a cardiac catheterization. Which of the following instructions should the nurse include? A. Keep the child home for 1 week. B. Give the child acetaminophen for discomfort. C. Offer the child clear liquids for the first 24 hr. D. Assist the child to take a tub bath for the first 3 days.
B. Give the child acetaminophen for discomfort.
A nurse is caring for a client who has heart failure and is receiving IV furosemide. The nurse should monitor the client for which of the following electrolyte imbalances? A. Hypernatremia B. Hyperuricemia C. Hypercalcemia D. Hyperchloremia
B. Hyperuricemia
A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication? A. Hyperthermia B. Hypotension C. Ototoxicity D. Muscle pain
B. Hypotension
A nurse in the ICU is caring for a client who has heart failure and is receiving a dobutamine drip. The nurse should identify that which of the following findings indicates that the medication is effective? A. Increased heart rate B. Increased urine output C. Decreased blood pressure D. Decreased blood glucose level
B. Increased urine output
A nurse is providing teaching to a client who is postoperative following coronary artery bypass graft (CABG) surgery and is receiving opioid medications to manage discomfort. Aside from managing pain, which of the following desired effects of medications should the nurse identify as most important for the client's recovery? A. It decreases the client's level of anxiety. B. It facilitates the client's deep breathing. C. It enhances the client's ability to sleep. D. It reduces the client's blood pressure.
B. It facilitates the client's deep breathing.
A nurse is assessing a male client who has advanced peripheral artery disease (PAD). Which of the following A. Thin, pliable toe nails B. Leg pain at rest C. Hairy legs D. Flushed, warm legs
B. Leg pain at rest
A nurse is collecting a medication history from a client who is scheduled to have a cardiac catheterization. Which of the following medications taken by the client interacts with contrast material and places the client at risk for acute kidney injury? A. Atorvastatin B. Metformin C. Nitroglycerin D. Carvedilol
B. Metformin
A nurse is caring for a client in a critical care unit who suffered a knife wound to the chest. The nurse suspects the client is developing cardiac tamponade. Which of the following assessment findings should the nurse identify as supporting this suspicion? A. Sudden lethargy. B. Muffled heart sounds. C. Flattened neck veins. D. Bradycardia.
B. Muffled heart sounds.
A nurse is planning care for a client following a cardiac catheterization accessed through his femoral artery. Which of the following actions should the nurse plan to take? A. Instruct the client to perform range-of-motion exercises to his lower extremities. B. Perform neurovascular checks with vital signs. C. Ambulate the client 1 hr following the procedure. D. Restrict the client's fluid intake
B. Perform neurovascular checks with vital signs.
A nurse is caring for a client who has an elevated potassium level and is on a cardiac monitor. The nurse is aware that hyperkalemia may be associated with changes to the T-wave. On the graphic, point and click on the area of the electrocardiogram (ECG) that represents the T-wave. (Selectable areas, or "Hot Spots," can be found by moving your cursor over the artwork until the cursor changes appearance, usually into a hand. Click only on the Hot Spot that corresponds to your answer.)
BOX ON THE FAR RIGHT ( Elevated T wave)
A nurse is caring for a client who has valvular heart disease and is at risk for developing left-sided heart failure. Which of the following manifestations should alert the nurse the client is developing this condition? A. Anorexia B. Weight gain C. Breathlessness D. Distended abdomen
C. Breathlessness
A nurse is teaching a client who has septic shock about the development of disseminated intravascular coagulation (DIC). Which of the following statements should the nurse make? A. "DIC is controllable with lifelong heparin usage." B. "DIC is characterized by an elevated platelet count." C. "DIC is caused by abnormal coagulation involving fibrinogen." D. "DIC is a genetic disorder involving a vitamin K deficiency."
C. "DIC is caused by abnormal coagulation involving fibrinogen."
A nurse is providing discharge instructions for a client who has congestive heart failure. Which of the following client statements indicates to the nurse that the teaching was effective? A. "I will read food labels and limit my sodium to 4 grams per day." B. "I should use naproxen to manage discomfort." C. "I plan to slow down if I am tired the day after exercising." D. "I will take my diuretic before sleep and drink fluids during the day."
C. "I plan to slow down if I am tired the day after exercising."
A nurse is caring for a client who was admitted to the facility in critical condition following a cerebrovascular accident. The client's son says to the nurse, "I wish I could stay, but I need to go home to see how my children are doing. I really hate to leave." Which of the following responses should the nurse make? A. "Perhaps you could call your children to see how they are doing." B. "Don't worry. We'll take good care of your parent while you are gone." C. "You are feeling drawn in two separate directions." D. "There's nothing you can do here. You should go home to your children."
C. "You are feeling drawn in two separate directions."
A nurse is providing discharge instructions to a client following a cardiac catheterization. Which of the following information should the nurse include? A. "You can resume regular exercise as soon as tomorrow." B. "The dressing should be changed within 12 hours of the procedure." C. "You will notice a small hematoma at the incision site." D. "Pain medication will not be necessary." Rationale: Pain medication might be necessary for back pain or discomfort at the insertion s
C. "You will notice a small hematoma at the incision site."
A nurse is interpreting the ECG strip of a client who has bradycardia. Which of the following cardiac components should the nurse identify as the role of the P-wave? A. Ventricular depolarization B. Slow repolarization of ventricular Purkinje fibers C. Atrial depolarization D. Early ventricular repolarization
C. Atrial depolarization
A nurse is planning to calculate a client's cardiac output. Which of the following data should the nurse obtain to calculate the cardiac output? A. Blood pressure B. Respiratory rate C. Heart rate D. Temperature
C. Heart rate
A nurse is caring for a client who has heart failure and a new prescription for furosemide. For which of the following adverse effects should the nurse monitor? A. Hypervolemia B. Hypertension C. Hypokalemia D. Hypoglycemia
C. Hypokalemia
A nurse in the emergency room is caring for a client who presents with manifestations that indicate a myocardial infarction. Which of the following prescriptions should the nurse take first? A. Attach the leads for a 12-lead ECG. B. Obtain a blood sample. C. Initiate oxygen therapy. D. Insert the IV catheter.
C. Initiate oxygen therapy.
137.A nurse is reviewing the laboratory results of a male adult client who is at risk for peripheral arterial disease from atherosclerosis. The nurse should identify that which of the following results places the client at risk? A. Triglycerides 130 mg/dL B. Blood glucose 92 mg/dL C. LDL 172 mg/dL D. HDL 84 mg/dL
C. LDL 172 mg/dL
A nurse in an emergency department is assessing a client who is having a suspected acute myocardial infarction (MI). Which of the following manifestations should the nurse expect to find for a client experiencing an acute MI? (Select all that apply.) A. Orthopnea B. Headache C. Nausea D. Tachycardia E. Diaphoresis
C. Nausea D. Tachycardia E. Diaphoresis
A nurse is caring for a client who reports a new onset of severe chest pain. Which of the following actions should the nurse take to determine if the client is experiencing a myocardial infarction? A. Check the client's blood pressure. B. Auscultate heart tones. C. Perform a 12-lead ECG D. Determine if pain radiates to the left arm.
C. Perform a 12-lead ECG
A nurse is caring for a client who has heart failure and a new prescription for furosemide. Which of the following laboratory values should the nurse review before administering furosemide? A. Bicarbonate B. Carbon dioxide C. Potassium D. Phosphate
C. Potassium
The nurse is evaluating a client who had a cardiac catheterization with a left antecubital insertion site. Which of the following pulses should the nurse palpate? A. Brachial pulse in the left arm B. Brachial pulse in the right arm C. Radial pulse in the left arm D. Radial pulse in the right arm
C. Radial pulse in the left arm
A nurse is reviewing the laboratory values of a client who had a myocardial infarction 3 hr ago. The nurse should expect which of the following laboratory values to be elevated? A. Aspartate aminotransferase (AST). B. Unconjugated bilirubin C. Troponin I D. Serum amylase
C. Troponin I
A nurse is caring for a client who came to the emergency department reporting chest pain. The provider suspects a myocardial infarction. While waiting for the troponin levels report, the client asks what this blood test will show. Which of the following explanations should the nurse provide the client? A. Troponin is an enzyme that indicates damage to brain, heart, and skeletal muscle tissues. B. Troponin is a lipid whose levels reflect the risk for coronary artery disease. C. Troponin is a heart muscle protein that appears in the bloodstream when there is damage to the heart. D. Troponin is a protein that helps transport oxygen throughout the body.
C. Troponin is a heart muscle protein that appears in the bloodstream when there is damage to the heart.
A client who has a history of myocardial infarction (MI) is prescribed aspirin 325 mg. The nurse recognizes that the aspirin is given due to which of the following actions of the medication? A. analgesic B. anti-inflammatory C. antiplatelet aggregate D. antipyretic
C. antiplatelet aggregate
A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? A. "I can walk a mile a day." B. "I've had a backache for several days.". C. "I am urinating more frequently." D. "I feel nauseated and have no appetite."
D. "I feel nauseated and have no appetite."
A nurse is admitting a client who has acute heart failure following myocardial infarction (MI). The nurse recognizes that which of the following prescriptions by the provider requires clarification? A. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain B. Laboratory testing of serum potassium upon admission C. 0.9% normal saline IV at 50 mL/hr continuous D. Bumetanide 1 mg IV bolus every 12 hr
D. Bumetanide 1 mg IV bolus every 12 hr
A nurse is preparing a community health program fo following should the nurse include as a modifiable risk factor? A. Diagnosis of diabetes mellitus B. Family history of cardiac disease C. Increasing age D. Cigarette smoking
D. Cigarette smoking
A nurse is preparing to administer digoxin to a client who has heart failure. Which of the following actions is appropriate? A. Withholding the medication if the heart rate is above 100/min B. Instructing the client to eat foods that are low in potassium C. Measuring apical pulse rate for 30 seconds before administration D. Evaluating the client for nausea, vomiting, and anorexia
D. Evaluating the client for nausea, vomiting, and anorexia
A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect? A. Jugular venous distention B. Abdominal distension C. Dependent edema D. Hacking cough
D. Hacking cough
A nurse is assessing a client who has heart failure and is prescribed furosemide. Which of the following findings is an adverse effect of this medication? A. Weight gain B. Increased blood pressure C. Hypoglycemia D. Leg cramps
D. Leg cramps
A nurse in an emergency department is planning care for a client who is having an acute myocardial infarction (MI). The nurse should plan to administer which of the following medications after the initial acute phase to manage the client's pain and anxiety? A. Nitroglycerin B. Aspirin C. Oxygen D. Morphine
D. Morphine
A nurse is assessing a toddler who has heart failure. Which of the following findings should the nurse expect? A. Weight loss B. Increased urine output C. Bradycardia D. Orthopnea
D. Orthopnea
A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia? A. Furosemide B. Hydrochlorothiazide C. Metolazone D. Spironolactone
D. Spironolactone
A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia? A. Furosemide B. Hydrochlorothiazide C. Metolazone D. Spironolactone
D. Spironolactone
A nurse is caring for a client who has expressive aphasia following a cerebrovascular accident (CVA). Which of the following parameters should the nurse use first in order to assess the client's pain level? A. pulse and blood pressure findings B. behavioral indicators and effect C. scheduled treatments and client illness D. a self-report pain rating scale
D. a self-report pain rating scale
A nurse is assessing a client who had left femoral cardiac angiography. Identify where the nurse will palpate to assess the most distal pulse on the affected side. (Selectable areas, or "Hot Spots," are outlined in the artwork below. Select only the outlined area that corresponds to your answer.) Answers cannot be displayed for this alternate item format. Rationale: The most distal pulse refers to the pulse that is at the farthest point on the affected extremity. The dorsalis pedis pulse on the anterior foot is the most distal pulse below the femoral artery. Because the client had left-sided angiography, the correct answer will be the left pedal pulse
Left Pedal Pulse
A nurse in a coronary care unit is admitting a client who has had CPR following a cardiac arrest. The client is receiving lidocaine IV at 2 mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions? A. Prevents dysrhythmias B. Slows intestinal motility C. Dissolves blood clots D. Relieves pain
Prevents dysrhythmias
A nurse is performing a cardiac assessment on a client and auscultates an S3 sound. The nurse should recognize that this sound represents which of the following heart conditions? A. Atrial gallop . B. Ventricular gallop C. Closure of the mitral valve D. Closure of pulmonic valve
Ventricular gallop
