cardiology Hesi practice test
A client is experiencing tachycardia. Which adverse hemodynamic effects will the nurse consider when planning care for this client? Select all that apply. Select all that apply Some correct answers were not selected Decreased ventricular filling time Increased coronary artery filling Decreased cardiac output Increased atrial kick Increased cardiac output
A, C
A nurse is teaching a group of clients about risk factors for heart disease. Which factors will the nurse include that increase a client's risk for a myocardial infarction (MI)? Select all that apply. Select all that apply Obesity Hypertension Diabetes insipidus Asian-American ancestry Increased high-density lipoprotein (HDL)
a, b
A nurse identifies premature ventricular complexes (PVCs) on a client's cardiac monitor. What does the nurse conclude that these complexes are a sign of? Atrial fibrillation Cardiac irritability Impending heart block Ventricular tachycardia
b
A thallium scan is prescribed for a client with a history of chest pain. Which information should the nurse include when explaining the purpose of the test to the client? It monitors action of the heart valves. It assesses myocardial ischemia and perfusion. It visualizes ventricular systole and diastole. It identifies the adequacy of electrical conductivity.
b
During auscultation of the heart, where does the nurse expect the first heart sound (S 1) to be the loudest? Base of the heart Apex of the heart Left lateral border Right lateral border
b
When an older client with heart failure is transferred from the emergency department to the medical service, what should the nurse on the unit do first? Interview the client for a health history. Assess the client's heart and lung sounds. Monitor the client's pulse and temperature. Obtain the client's blood specimen for electrolytes.
b
A client is admitted to the hospital with the diagnosis of myocardial infarction. The nurse should monitor this client for which signs and symptoms associated with heart failure? Select all that apply. Select all that apply Weight loss Unusual fatigue Dependent edema Nocturnal dyspnea Increased urinary output
b, c, d
A nurse is caring for a client after cardiac surgery. Which signs will cause the nurse to suspect cardiac tamponade? Select all that apply. Select all that apply Hypertension Pulsus paradoxus Muffled heart sounds Jugular vein distention Increased urine output
b, c, d
A client has serially decreasing blood pressures after surgery. Which mechanisms involved in the regulation of blood pressure should the nurse consider? Select all that apply. Select all that apply Some correct answers were not selected Dilation of arterioles to increase peripheral resistance Activation of regulators that control renal angiotensin II Release of vasodilators, for example antidiuretic hormone Increase of left ventricular stroke volume to maintain blood volume Enervation of the sympathetic nervous system to constrict arterioles
b, d, e
A client is admitted to the hospital for an emergency cardiac catheterization. What adaptation is the client most likely to complain of after this procedure? Fear of dying Skipped heartbeats Pain at the insertion site Anxiety in response to intensive monitoring
c
A client is admitted to the hospital with atrial fibrillation. A diagnosis of mitral valve stenosis is suspected. The nurse concludes that it is most significant if the client presents with what history? Cystitis as an adult Pleurisy as an adult Childhood strep throat Childhood German measles
c
A client with a coronary occlusion is experiencing chest pain and distress. Why does the nurse administer oxygen? To prevent dyspnea To prevent cyanosis To increase oxygen concentration to heart cells To increase oxygen tension in the circulating blood
c
A client with a long history of cardiovascular problems, including angina and hypertension, is scheduled to have a cardiac catheterization. During preprocedure teaching, what does the nurse explains to the client is the major purpose for catheterization? To obtain the pressures in the heart chambers To determine the existence of congenital heart disease To visualize the disease process in the coronary arteries To measure the oxygen content of various heart chambers
c
A nurse discovers lower extremity pitting edema in a client with right ventricular heart failure. Which information should the nurse consider when planning care? Client has decreased plasma colloid osmotic pressure. Client has increased tissue colloid osmotic pressure. Client has increased plasma hydrostatic pressure. Client has decreased tissue hydrostatic pressure.
c
An electrocardiogram (ECG) is prescribed for a client who reports chest pain. Which early finding does the nurse expect on the lead over the infarcted area? Flattened T waves Absence of P waves Elevated ST segments Disappearance of Q waves
c
An electrocardiogram is prescribed for a client complaining of chest pain. The nurse recognizes which as an early finding of an infarcted area of the heart? Flattened T waves Absence of P waves Elevated ST segments Disappearance of Q waves
c
How can the nurse best describe heart failure to a client? A cardiac condition caused by inadequate circulating blood volume An acute state in which the pulmonary circulation pressure decreases An inability of the heart to pump blood in proportion to metabolic needs A chronic state in which the systolic blood pressure drops below 90 mm Hg
c
Metoprolol is prescribed for a client. Which condition in the client's electronic medical record will cause the nurse to question the prescription? Hypertension Angina pectoris Sinus bradycardia Myocardial infarction
c
A nurse is conducting cholesterol screening for a manufacturing corporation during a health fair. A 50-year-old man who is 6 feet (183 cm) tall and weighs 293 pounds (133 kg) puts out his cigarette and asks the nurse how to modify his risk factors for coronary artery disease. On which risk factors should the nurse help the client focus? Select all that apply. Age Height Weight Smoking Family history
c, d
A client is admitted for a coronary artery bypass graft. The client states that the preoperative teaching materials contain information about pacemaker wires being inserted during surgery as a precautionary measure. The client asks, "What is the purpose of the pacemaker?" What is the best response by the nurse? "These pacing wires can be attached to a temporary pacemaker to shock the heart if it starts beating too fast." "This type of pacemaker will automatically defibrillate the heart if the heart forgets to beat." "The pacemaker will maintain a constant cardiac rhythm." "In case of too slow of a heart rate, the epicardial leads are attached to a pacemaker to maintain a normal rate."
d
A nurse is caring for a client with a myocardial infarction. What is most important for the nurse to assess that has a direct relationship to the action potential of the heart? Heart rate Refractory period Pulmonary pressure Strength of contractions
d
A nurse is caring for a client with the diagnosis of right ventricular failure. Which condition unrelated to cardiac disease is the major cause of right ventricular failure? Renal disease Hypovolemic shock Severe systemic infection Chronic obstructive pulmonary disease (COPD)
d
When a client has a myocardial infarction, one of the major manifestations is a decrease in the conductive energy provided to the heart. When assessing this client, the nurse is aware that the existing action potential is in direct relationship to what? Heart rate Refractory period Pulmonary pressure Strength of contraction
d
The nurse is planning to teach a client with heart failure about the signs and symptoms of cardiac decompensation. What clinical manifestations should the nurse include? Select all that apply. Select all that apply Weight loss Extreme fatigue Coughing at night Excessive urination Difficulty breathing
B, C, E
The nurse is evaluating the client's cardiac rhythm and measures a PR interval of 0.08 seconds (two small boxes). How should the nurse interpret this finding? Normal conduction in the atrioventricular (AV) node End of the P wave to the next deflection Delayed conduction in the AV node Abnormally fast conduction
D
A client admitted to the hospital for chest pain is diagnosed with stable angina. Which information should the nurse include in the teaching session? It is relieved by rest. It is precipitated by light activity. It is described as sharp or knifelike. It is unaffected by the administration of vasodilators.
a
A client is brought to the emergency department with chest pain. The client asks why an electrocardiogram (ECG) has been prescribed. What does the nurse explain that the ECG will do? Indicates acutely impaired blood flow to the heart muscle Detect altered heart sounds Determine the flow of blood to the heart muscle Evaluate the spatial relationship of structures within the heart
a
A client is in the intensive care unit. The nurse observing the telemetry monitor identifies flattening T waves and peaked P waves. What problem should the nurse consider based on these ECG changes? Hypokalemia Hypocalcemia Hyponatremia Hypomagnesemia
a
A client is scheduled to have a coronary artery bypass graft (CABG). The client's spouse asks what the benefit of the surgery is. How should the nurse respond? "This surgery significantly decreases symptoms in most clients." "This procedure will enable your spouse to return to work after healing occurs." "Studies have consistently shown that this surgery increases an individual's life span." "Evidence substantiates that surgery can prevent progression of coronary artery disease."
a
A client who just returned from surgery reports shortness of breath and chest pain. Which should the nurse initially administer? Supplemental oxygen Intravenous morphine Endotracheal intubation Sublingual nitroglycerin
a
A nurse is assessing a client's ECG reading. The client's atrial and ventricular heart rates are equal at 88 beats per min. The PR interval is 0.14 seconds, and the QRS width is 0.10 seconds. Rhythm is regular with normal P waves and QRS complexes. How will the nurse interpret this rhythm? Normal sinus rhythm Sinus tachycardia Sinus bradycardia Sinus arrhythmia
a
A nurse is caring for a client with heart failure. The healthcare provider prescribes a 2-gram sodium diet. What should the nurse include when explaining how a low-salt diet helps achieve a therapeutic outcome? Allows excess tissue fluid to be excreted Helps to control the volume of food intake and thus weight Aids the weakened heart muscle to contract and improves cardiac output Assists in reducing potassium accumulation that occurs when sodium intake is high
a
A nurse is providing postprocedure care to a client who had a cardiac catheterization via a brachial artery. For the first hour after the procedure, what is the priority nursing intervention? Monitor the vital signs every 15 minutes Maintain the client in the supine position Keep the client's lower extremities in extension Administer the prescribed oxygen at 4 L/min via nasal cannula
a
A primary healthcare provider prescribes a heart-healthy diet for a client with angina. The client's spouse says to the nurse, "I guess I'm going to have to cook two meals, one for my spouse and one for myself." Which is the most appropriate response by the nurse? "The diet prescribed for your spouse is a healthy diet. It contains guidelines that many of us should follow." "I wouldn't bother. For this diet all that you need to do is to reduce the amount of salt you use and fry foods in peanut oil." "You're right. Be careful to cook a small portion for each of you to eat to not waste food." "This is a difficult diet to follow. I recommend that you shop daily for food so there are no temptations in the kitchen."
a
For which expected response should the nurse monitor a client after a cardiac catheterization? Marked increase in the volume of urine output Decrease in blood pressure of 25% from the precatheterization blood pressure Complaints of heart pounding with mild chest discomfort Respiratory distress with an increase in respiratory rate of more than 24 respirations per minute
a
Serum cardiac marker studies are prescribed for a client after a myocardial infarction. Which laboratory test is most important for the nurse to monitor? Troponin Myoglobin Homocysteine Creatine kinase (CK)
a
The client is in atrial fibrillation. Which information should the nurse consider about atrial fibrillation when planning care for this client? A loss of atrial kick No physiologic changes Increased cardiac output Decreased risk of pulmonary embolism
a
The nurse is assessing a client with the diagnosis of chronic heart failure. Which clinical finding should the nurse expect the client to experience? Dependent edema in the evening Chest pain that decreases with rest Palpitations in the chest when resting Frequent coughing with yellow sputum
a
Which catecholamine receptor is responsible for increased heart rate? Beta 1 receptor Beta 2 receptor Alpha 1 receptor Alpha 2 receptor
a
A woman comes to the emergency department reporting signs and symptoms that are determined by the primary healthcare provider to be caused by a myocardial infarction. The nurse obtains a health history. Which reported symptoms does the nurse determine are specifically related to a myocardial infarction in women? Select all that apply. Select all that apply Severe fatigue Sense of unease Choking sensation Chest pain relieved by rest Pain radiating down the left arm
a, b
An older adult client is diagnosed with left-sided congestive heart failure. Which assessments should the nurse expect to find? Select all that apply. Select all that apply Dyspnea Crackles Hacking cough Peripheral edema Jugular distention
a, b, c
The client is admitted with paroxysmal supraventricular tachycardia at a rate of 140 beats per minute. The client's blood pressure is 110/55 mm Hg, and the client is asymptomatic except for a "fluttering feeling" in the chest. Which treatments should the nurse be prepared to administer? Select all that apply. Select all that apply Some correct answers were not selected Intravenous adenosine Intravenous beta blockers Intravenous amiodarone Synchronized cardioversion Intravenous calcium channel blockers
a, b, c, e
A nurse is caring for a client with a diagnosis of right ventricular heart failure. The nurse expects what assessment findings associated with right-sided heart failure? Select all that apply. Select all that apply Dependent edema Swollen hands and fingers Collapsed neck veins Right upper quadrant discomfort Oliguria
a, b, d
Which clinical indicators is the nurse most likely to identify when taking the admission history of a client with right ventricular failure? Select all that apply. Edema Vertigo Polyuria Ascites Palpitations
a, d
A client arrives at the emergency room complaining of chest pain and dizziness. The client has a history of angina. The primary healthcare provider prescribes an electrocardiogram (ECG) and lab tests. A change in which component of the ECG tracing should the nurse recognize as the client actively having a myocardial infarction (MI)? QRS complex S-T segment P wave R wave
b
A client is experiencing a myocardial infarction. What should the nurse identify as the primary cause of the pain experienced by a client with a coronary occlusion? Arterial spasm Heart muscle ischemia Blocking of the coronary veins Irritation of nerve endings in the cardiac plexus
b
A client who is suspected of having had a silent myocardial infarction has an electrocardiogram (ECG) prescribed by the primary healthcare provider. While the nurse prepares the client for this procedure, the client asks, "Why was this test prescribed?" Which is the best reply by the nurse? "This test will detect your heart sounds." "This test will reflect any heart damage." "This procedure helps us change your heart's rhythm." "The ECG will tell us how much stress your heart can tolerate."
b
A client who recently had a myocardial infarction is admitted to the cardiac care unit. How can the nurse best determine the effectiveness of the client's ventricular contractions? Observing anxiety levels Monitoring urinary output hourly Evaluating cardiac enzyme results Assessing breath sounds frequently
b
A client with angina pectoris is scheduled for a stress echocardiogram. What should the nurse tell the client that an echocardiogram is? A tool used solely to determine the cause of chest pain A noninvasive approach to assess cardiovascular status A modality of minimal value in planning treatment for angina An invasive test that measures the body's reaction to progressive increases in exertion
b
An 80-year-old client with a history of coronary artery disease is admitted to the hospital for observation after a fall. During the night the client has an episode of paroxysmal nocturnal dyspnea. In what position should the nurse place the client to best decrease preload? Contour Orthopneic Recumbent Trendelenburg
b
The nurse is caring for a client who is admitted with the diagnosis of mild heart failure. Which type of lung sounds should the nurse expect to hear? Stridor Crackles Wheezes Friction rubs
b
What must the nurse do to determine a client's pulse pressure? Multiply the heart rate by the stroke volume. Subtract the diastolic from the systolic reading. Determine the mean blood pressure by averaging the two. Calculate the difference between the apical and radial rate.
b
A nurse is caring for a client with right-sided heart failure. Which assessment findings are key features of right-sided heart failure? Select all that apply. Select all that apply Some correct answers were not selected Collapsed neck veins Distended abdomen Dependent edema Urinating at night Cool extremities
b, c, d
What are the clinical manifestations of myocardial infarction in women? Select all that apply. Select all that apply Some correct answers were not selected Anoxia Indigestion Unusual fatigue Sleep disturbances Tightness of the chest
b, c, d
A client who has been experiencing chest pain and vomiting for several hours is admitted to the hospital with a diagnosis of myocardial infarction. The client is transferred immediately to the cardiac intensive care unit. The client's potassium level is below the expected range. Considering this laboratory result, what should the nurse monitor the client's electrocardiogram (ECG) for? Tall, peaked P waves Increased P-R intervals Elevated U and flattened T waves Multiple trigeminy and bigeminy runs
c
A client with a coronary occlusion is experiencing chest pain and distress. What is the primary reason that the nurse should administer oxygen to this client? Prevent dyspnea Prevent cyanosis Increase oxygen concentration to heart cells Increase oxygen tension in the circulating blood
c
The client's underlying heart rhythm is sinus rhythm, but the rhythm is irregular because of occasional early beats. The configuration of the P waves is normal, except the P wave of the early beat does not look the same as the others. The morphology of the QRS complex is the same for all beats. The heart rate is 66 beats per min, and the blood pressure is normal. How should the nurse interpret this finding? Sinus tachycardia Normal sinus rhythm Sinus rhythm with premature atrial contractions (PACs) Sinus bradycardia with premature ventricular contractions (PVCs)
c
The nurse provides discharge teaching to a client with a history of angina. The nurse instructs the client to call for emergency services immediately if the client's pain exhibits which characteristic? Causes mild perspiration Occurs after moderate exercise Continues after rest and nitroglycerin Precipitates discomfort in the arms and jaw
c
The spouse of a client who had emergency coronary artery bypass surgery asks why there is a dressing on the client's left leg. How should the nurse explain the dressing? "This is the access site for the heart-lung machine." "A filter is inserted in the leg to prevent embolization." "A vein in the leg was used to bypass the coronary artery." "The arteries in the extremities are examined during surgery."
c
client with an inferior myocardial infarction has a heart rate of 120 beats per minute. Which goal achievements are priority? Increase left ventricular filling and improve cardiac output Decrease oxygen needs of the vital organs and prevent cardiac dysrhythmias Decrease the workload on the heart and promote maximum coronary artery filling Increase venous return to the right atrium and increase pulmonary arterial blood flow
c
A client with heart disease has been reading on the Internet about the anatomy and physiology of the heart and tells the nurse, "I'm so confused." The nurse reinforces the pattern of circulation in the body. Which client statement indicates a correct understanding? "Blood enters the heart through the ductus arteriosus, flows into the left side of the heart, and exits via the aorta into the systemic circulation." "Blood enters the heart from the inferior vena cava; it then flows through the left atrium into the left ventricle, then into the lungs, and back into the aorta." "Blood enters the heart from the aorta, flows into the right atrium and right ventricle, through the lungs, then into the left atrium and left ventricle, and finally exits through the superior vena cava." "Blood enters the right atrium via the superior and inferior vena cava, flows to the right ventricle and then into the lungs, returns from the lungs to the left atrium and left ventricle, and exits out the aorta."
d
A nurse is assessing a client with a diagnosis of early left ventricular heart failure. Specific to this type of heart failure, what statement by the client would the nurse expect? "My ankles are swollen." "I am tired at the end of the day." "When I eat a large meal, I feel bloated." "I have trouble breathing when I walk rapidly."
d
A nurse witnesses a person fall. The person becomes unresponsive and pulseless. The nurse plans to use an automated external defibrillator (AED) that is available on site. What should the nurse do first? Remove all jewelry. Wash the chest area. Use a grounded electrical source. Remove medication patches on the chest.
d
The nurse is conducting a nutrition class for a group of clients with heart failure (HF). Which information is most important for the nurse to share with the class? Restricting fluid intake Eating a low caloric diet to reduce weight Recognizing which products are high in cholesterol Choosing fresh or frozen vegetables instead of canned ones
d
The nurse provides discharge teaching to a client who has received prescriptions for digoxin, furosemide, and a 2-gram sodium diet. Which statement from the client indicates that further teaching is needed? "I must check my pulse every day." "I can gradually increase my exercise as long as I take rest periods." "I should call my healthcare provider if I have difficulty breathing when I am lying flat." "I can use a little table salt on my food as long as I do not use it when cooking food."
d
