Cardiovascular NCLEX-PN Questions

A nurse is preparing to provide a therapeutic environment for a client who recently had a myocardial infarction (MI). The nurse should alter the environment to ensure that it is:

Low stimulus, low stress

A nurse is caring for a client who has a malignant lung neoplasm and has developed cardiopulmonary complications. (Click on the sound icon.) On auscultation, the nurse hears these breath sounds over the left lower sternal border (over the apical area) and interprets the sounds as which of the following

Pericardial friction rub

A nurse is asked to assist another health care member in providing care to a client who is placed in a modified Trendelenburg's position. The nurse interprets that the client is likely being treated for which condition?

Shock

A 24-year-old man seeks medical attention for complaints of claudication in the arch of the foot. The nurse also notes superficial thrombophlebitis of the lower leg. The nurse would next check the client for:

Smoking History

A nurse provides instructions to a client at risk for thrombophlebitis regarding measures to minimize its occurrence. Which statement by the client indicates an understanding of this information?

"I should avoid sitting in one position for long periods of time."

A client receiving parenteral nutrition (PN) has a history of congestive heart failure. The health care provider has prescribed furosemide (Lasix) 40 mg orally daily to prevent fluid overload. The nurse monitors which laboratory value to identify an adverse effect from this medication?

Potassium

A client seeks medical attention for intermittent episodes in which the fingers of both hands become cold, pale, and numb. The client states that they then become reddened and swollen with a throbbing, achy pain. The nurse further collects data on the client to see whether these episodes occur with:

Ingestion of coffee or chocolate

A client had an aortic valve replacement 2 days ago. This morning, the client says to the nurse, "I don't feel any better than I did before surgery." The appropriate response by the nurse is:

"You are concerned that you don't feel any better after surgery?"

A client with a diagnosis of congestive heart failure is preparing for discharge to home from the hospital. The nurse determines that the client is ready for discharge to home if the client can:

Verbally describe the daily medications, doses, and times to be administered.

A nurse is caring for a client on a cardiac monitor who is alone in a room at the end of the hall. The client has a short burst of ventricular tachycardia (VT) followed by ventricular fibrillation (VF). The client suddenly loses consciousness. Which intervention should the nurse do first?

Call for help and initiate cardiopulmonary resuscitation (CPR).

A nurse is planning a dietary menu for a client with heart failure being treated with digoxin (Lanoxin) and furosemide (Lasix). Which of the following would be the best dinner choice from the daily menu?

aked pollack, mashed potatoes, and carrot-raisin salad

A client's blood pressure is 100/78 mm Hg; the client has tachycardia and is cool and pale. The nurse assists the client to which position to promote tissue oxygenation?

Semi-Fowler's

A nurse carries out a standard prescription for a stat electrocardiogram (ECG) on a client who has an episode of chest pain. The nurse should take which action next?

Give sublingual nitroglycerin (Nitrostat) per the health care provider's prescriptions.

A client is at risk for developing disseminated intravascular coagulopathy (DIC). The nurse should become concerned with which of the following fibrinogen levels?

90 mg/dL

A sublingual nitroglycerin (Nitrostat) tablet administered to a client for chest pain has relieved the pain. The nurse ensures that the client has which important item within easy reach before leaving the room?

Call Bell

A nurse is providing dietary instructions to a client with congestive heart failure (CHF). The nurse determines that the client understands the instructions if the client states that which of the following food items will be avoided

Catsup

A client is admitted with an arterial ischemic leg ulcer. The nurse expects to note that this ulcer has which of the following typical characteristics?

Deep and painful

A client admitted to the hospital with a diagnosis of myocardial infarction (MI) tells the nurse that the pain likely resulted from the fried chicken sandwich that the client had for lunch. The nurse responds to the client, using the knowledge that:

Denial is a common occurrence early after MI.

A nurse is collecting data on a client with a diagnosis of right-sided heart failure. The nurse would expect to note which specific characteristic of this condition?

Dependent edema

A client with a history of angina pectoris tells the nurse that chest pain usually occurs after going up two flights of stairs or after walking four blocks. The nurse interprets that the client is experiencing which of the following types of angina?

Stable

A nurse working in a long-term care facility is collecting data from a client experiencing chest pain. The nurse would interpret that the pain is likely a result of myocardial infarction (MI) if which of the following observations is made by the nurse?

The pain has not been unrelieved by rest and nitroglycerin tablets.

A nurse has completed nutritional counseling with an overweight client about weight reduction to modify the risk for coronary artery disease. The nurse would determine the teaching as successful if the client stated that a safe weight loss goal is:

Two pounds per week

A client with angina complains that the anginal pain is prolonged and severe and occurs at the same time each day, most often in the morning. On further data collection, the nurse notes that the pain occurs in the absence of precipitating factors. This type of anginal pain is best described as:

Variant angina

A client has experienced several episodes of sickle cell crisis. Which instruction should be included in the client's teaching plan to prevent recurrence?

Wear shoes and socks when walking outside to prevent damage to the feet.

A nurse notes that a client who is attached to a cardiac monitor suddenly develops atrial fibrillation at a rate of 130. The nurse notifies the registered nurse immediately and prepares the client for which initial intervention?

Administration of a calcium channel blocker

A client has an inoperable abdominal aortic aneurysm (AAA). The nurse teaches the client about the need for:

Antihypertensives

The nurse notes this dysrhythmia on the client's cardiac monitor (refer to figure). The nurse next reports that the client is experiencing which of the following?

Atrial fibrillation

A nurse is assisting in the care of a client with myocardial infarction who should reduce intake of saturated fat and cholesterol. The nurse should help the client comply with diet therapy by selecting which of the following food items from the dietary menu?

Baked haddock, steamed broccoli, herbed rice, sliced strawberries

A client has a history of left-sided heart failure. The nurse would look for the presence of which of the following to determine whether the problem is currently active?

Bilateral lung crackles

A nurse is beginning to ambulate a client with activity intolerance caused by bacterial endocarditis. The nurse determines that the client is best tolerating ambulation if which parameter is noted?

Blood pressure that increases from 114/82 to 118/86 mm Hg

A nurse enters a client's room and finds the client slumped down in the chair. Breathing is shallow and a pulse is present. Based on these data, the nurse determines that the priority would be to:

Check the vital signs and level of consciousness.

A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. A nurse listens to breath sounds, expecting to hear bilateral:

Crackles

A nurse understands that which of the following is a correct guideline for adult cardiopulmonary resuscitation (CPR) for a health care provider?

Each rescue breath should be given over 1 second and should produce a visible chest rise.

A client has just completed an information session about measures to minimize the progression of coronary artery disease (CAD). The nurse determines that the client indicates an initial understanding of lifestyle alterations if the client states an intention to:

Eat a diet that is low in fat and cholesterol.

A client admitted to the hospital with coronary artery disease complains of dyspnea at rest. The nurse determines that which of the following items would be of most help to the client?

Elevating the head of the bed to at least 45 degrees

A nurse is working with a client who has been diagnosed with Prinzmetal's (variant) angina. The nurse plans to teach the client that this type of angina:

Is generally treated with calcium-channel blocking agents

A nurse has given simple instructions on preventing some of the complications of bedrest to a client who experienced a myocardial infarction. The nurse would intervene if the client were performing which of these activities, which would be contraindicated?

Isometric exercises of the arms and legs

A nurse is caring for a client with a diagnosis of myocardial infarction (MI) and is assisting the client in completing the diet menu. Which of the following beverages does the nurse instruct the client to select from the menu?

Lemonade

A nurse is checking the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission. The nurse interprets that the neurovascular status is:

Normal, caused by increased blood flow through the leg

A nurse is caring for a client who has been admitted to the hospital with a diagnosis of angina pectoris. The client is receiving oxygen via nasal cannula at 2 L. The client asks the nurse why the oxygen is necessary. The nurse bases the response on which of the following?

Oxygen supply to the heart cells that is deficient results in angina pectoris pain.

A nurse is using a stethoscope to listen to the client's heart and hears this sound. (Click on the sound icon.) To assist in identifying the sound, the nurse should take which initial best action?

Palpate the carotid pulse for a pulsation

An older client with ischemic heart disease has experienced an episode of dizziness and shortness of breath. The nurse reviews the plan of care and notes documentation of decreased cardiac output, dyspnea, and syncopal episodes. The nurse plans to take which important action in the care of the client?

Place the client on a cardiac monitor.

A hypertensive client who has been taking metoprolol (Lopressor) has been prescribed to decrease the dose of the medication. The client asks the nurse why this must be done over a period of 1 to 2 weeks. In formulating a response, the nurse incorporates the understanding that abrupt withdrawal could:

Precipitate rebound hypertension

A nurse is planning measures to decrease the incidence of chest pain for a client with angina pectoris. The nurse should do which of the following to effectively accomplish this goal?

Provide a quiet and low-stimulus environment.

A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and shortness of breath, and the client is visibly anxious. The nurse understands that a life-threatening complication of this condition is:

Pulmonary Embolism

A client with angina pectoris who was given a first dose of newly prescribed nitroglycerin (Nitrostat) sublingual tablet complains of slight dizziness and headache. The nurse takes which action first?

Takes the client's blood pressure

In order to assess the dorsalis pedis pulse of a client diagnosed with arterial vascular disease, the nurse palpates which anatomical location? Refer to figure

Top of the foot

A client with angina pectoris has just been started on medication therapy with nitroglycerin (Nitrostat). In planning care for this client, the nurse would place priority on measuring:

Vital S

A nurse is teaching the client with angina pectoris about disease management and lifestyle changes that are necessary in order to control disease progression. Which statement by the client indicates a need for further teaching?

"It is best to exercise once a week for an hour."

A male client who experienced a myocardial infarction (MI) tells the nurse that he is fearful about not being able to return to a normal life. Which action by the nurse is therapeutic at this time?

Explore the specific concerns with the client.

A licensed practical nurse (LPN) is assisting in caring for a client with a diagnosis of myocardial infarction (MI). The client is experiencing chest pain that is unrelieved by the administration of nitroglycerin. The registered nurse administers morphine sulfate to the client as prescribed by the health care provider. Following administration of the morphine sulfate, the LPN plans to monitor:

Respirations and blood pressure

A client with chronic atrial fibrillation is being started on amiodarone (Cordarone) as maintenance therapy for dysrhythmia suppression. A nurse provides instructions to the client about the medication. Which statement by the client indicates a need for further instruction?

"I will stop taking the prescribed anticoagulant after starting this new medication."

A nurse determines that a client with coronary artery disease (CAD) understands disease management if the client makes which of the following statements?

"I will walk for one-half hour daily."

A client who has undergone femoropopliteal bypass grafting says to the nurse, "I hope I don't have any more problems that could make me lose my leg. I'm so afraid that I'll have gone through this for nothing." The appropriate nursing response is which of the following?

"You are concerned about losing your leg?"

A nurse is assisting in developing a plan of care for a client who will be returning to the nursing unit following a cardiac catheterization via the femoral approach. Which nursing intervention will be included in the post-procedure plan of care?

Encourage the client to increase fluid intake.

The nurse observes the following rhythm on the cardiac monitor. (Refer to the figure.) Which action should the nurse take first?

Evaluate the client for hypotension and assess mental status.

A client is at risk for complications of heart failure. What is the nurse's priority for early detection of the most likely cause of complications with this client?

Evaluating total body fluid

A nurse working the 3:00 to 11:00 PM shift notes that a client with coronary artery disease (CAD) has a prescription for serum lipid levels to be drawn in the morning. The nurse places the client on which dietary preparation to ensure accurate test results?

Fasting for 12 hours

A client diagnosed with angina pectoris returns to the nursing unit after experiencing an angioplasty. The nurse reinforces instructions to the client regarding the procedure and home care measures. Which statement by the client indicates an understanding of the instructions?

"I need to adhere to my dietary restrictions."

A nurse is collecting data on a client with a diagnosis of angina pectoris who takes nitroglycerin for chest pain. During the admission, the client reports chest pain. The nurse immediately asks the client which of the following questions?

"Where is the pain located?"

A client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin grains 1/150 sublingually. Five minutes later, the client is still experiencing chest pain. If the blood pressure is still stable, the nurse should take which action next?

Administer another nitroglycerin tablet.

A client undergoing computed tomography (CT) scan develops chest pain, wheezing, and stridor after injection of contrast media. Which type of shock is this client most likely exhibiting?

Anaphylactic

A nurse is assisting a hospitalized client who is newly diagnosed with coronary artery disease (CAD) to make appropriate selections from the dietary menu. The nurse encourages the client to select which of the following meals?

Fresh strawberries, steamed vegetables, and baked fish

A nurse is assigned to assist with caring for a client after cardiac catheterization. The nurse plans to maintain bedrest with:

Head elevation of no more than 30 degrees

A nurse is providing discharge teaching for a post myocardial infarction (MI) client who will be taking one baby aspirin a day. The nurse determines that the client understands the use of this medication if the client makes which statement?

"I will take this medication every day."

A nurse is caring for a client with a diagnosis of myocardial infarction (MI). The client reports chest pain. When the administration of a sublingual nitroglycerin tablet as prescribed does not relieve the chest pain, the next nursing action is to:

Check the blood pressure and administer another nitroglycerin tablet.

A nurse has completed counseling about smoking cessation with a client with coronary artery disease. The nurse determines that the client has understood the material best if the client states that:

"A smoker has twice the risk of having a heart attack than a nonsmoker."

An ambulatory clinic nurse is interviewing a client who is complaining of flu-like symptoms. The client suddenly develops chest pain. Which question would best help the nurse to discriminate pain caused by a noncardiac problem?

"Does the pain get worse when you breathe in?"

A nurse is providing cardiopulmonary resuscitation (CPR) to an adult cardiac arrest victim. What is the proper compression-to-ventilation ratio for one-person CPR?

30:2

A nurse determines that which of the following clients is most likely to be a candidate for cardioversion?

Client with unstable rapid atrial fibrillation

A client has experienced an episode of pulmonary edema. The nurse determines that the client's respiratory status is improving if which of the following breath sounds are noted?

Crackles in the lung bases

A client with known coronary artery disease (CAD) begins to experience chest pain while getting out of bed. The nurse should take which action first?

Have the client stop and lie back down in bed

A client returns to the nursing unit after an above-the-knee amputation of the right leg. The nurse positions the client

With the foot of the bed elevated

A nurse is told during shift report that a client is having occasional ventricular dysrhythmias. The nurse reviews the client's laboratory results, recalling that which electrolyte imbalance could be responsible for this development?

Hypokalemia

A client complaining of chest pain has an as-needed (PRN) prescription for sublingual nitroglycerin (Nitrostat). Before administering the medication to the client, the nurse should first check the client's:

Blood pressure

A nurse is monitoring a client following cardioversion. Which of the following observations would be of highest priority to the nurse?

Status of airway

A nurse has reinforced dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions?

"I should routinely use polyunsaturated oils in my diet."

A client with a diagnosis of myocardial infarction has a new activity prescription allowing the client to have bathroom privileges. As the nurse stands and begins to walk, the client begins to complain of chest pain. The nurse should initially take which action?

Assist the client to get back into bed.

A nurse is planning adaptations needed for activities of daily living for a client with cardiac disease. The nurse would incorporate which of the following in discussions with the client?

Take in adequate daily fiber to prevent straining during a bowel movement.

A licensed practical nurse (LPN) is assisting in the care of a client who is having central venous pressure (CVP) measurements taken by the registered nurse (RN). The LPN would assist the RN by placing the bed in which of the following positions for the reading?

Flat

A client is admitted to the hospital with a venous stasis leg ulcer. The nurse inspects the ulcer, expecting to note that the ulcer:

Has a brownish or "brawny" appearance

A nurse determines that a client with coronary artery disease (CAD) has the necessary understanding of disease management if the client makes which statement?

"I will walk for one-half hour daily."

A nurse is assisting in the care of a client diagnosed with rheumatic heart disease. When teaching the client about self-management of this health problem, the nurse reminds the client to alert his dentist about the condition because:

The client requires prophylactic antibiotics before treatment.

A nurse is caring for a client with Buerger's disease. Which finding would the nurse determine is a potential complication associated with this disease?

Numbness and tingling in the legs

A client has just returned from the cardiac catheterization laboratory. The left femoral vessel was used as the access site. After returning the client to bed and collecting initial data, the nurse places a sign above the bed stating that the client should remain on bedrest:

With the head of the bed elevated no more than 15 degrees

A nurse is preparing to care for a client who will be arriving from the recovery room after an above-the-knee amputation. The nurse ensures that which priority item is in the client's hospital room?

Surgical tourniquet

A nurse has reinforced home care instructions to a client who had a permanent pacemaker inserted. Which educational outcome has the greatest impact on the client's long-term cardiac health?

Ability to take an accurate pulse in either the wrist or neck

A postcardiac surgery client with a blood urea nitrogen (BUN) level of 45 mg/dL and a serum creatinine level of 2.2 mg/dL has a total 2-hour urine output of 25 mL. The nurse understands that the client is at risk for:

Acute renal failure

A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin sodium (Coumadin). The nurse is told that the client's prothrombin time is 18 seconds with a control of 11 seconds. The nurse plans to:

Administer the next dose of warfarin sodium.

A client's serum calcium level is 7.9 mg/dL. The nurse is immediately concerned, knowing that this level could lead to:

Cardiac arrest

A client with coronary artery disease has selected guided imagery to help cope with psychological stress. Which statement by the client indicates the best understanding of this stress reduction measure?

"The best thing about this is that I can use it anywhere, anytime."

A nurse finds a client tensing while lying in bed staring at the cardiac monitor. What is the nurse's best response when the client states, "There sure are a lot of wires around there. I sure hope we don't get hit by lightning!"?

"Yes, this equipment is a little scary. Can we talk about how the cardiac monitor works?"

A client has an Unna boot applied for treatment of a venous stasis leg ulcer. The nurse notes that the client's toes are mottled and cool, and the client verbalizes some numbness and tingling of the foot. The nurse interprets that the boot:

Has been applied too tightly

A nurse is caring for a client with coronary artery disease, and a topical nitrate is prescribed for the client. The nurse provides medication instructions and tells the client that acetaminophen (Tylenol) is usually prescribed to be taken before the administration of the topical nitrate because:

Headache is a common side effect of nitrates.

A client in a long-term care facility who has a history of angina pectoris wants to go for a short walk outside with a family member. It is a sunny but chilly December day. The nurse should do which of the following to care for this client in a holistic manner?

Instruct the family member to dress the client warmly before going outside.

A nurse is planning to teach a client with peripheral arterial disease about measures to limit disease progression. The nurse should include which items on a list of suggestions to be given to the client? Select all that apply.

Cut down on the amount of fats consumed in the diet, Walk each day to increase circulation to the legs, Be careful not to injure the legs or feet, Eat a well-balanced diet every day.

A client is wearing a continuous cardiac monitor, which begins to alarm at the nurse's station. The nurse sees no electrocardiographic complexes on the screen. The nurse would first:

Check the client status and lead placement.

For a client diagnosed with pulmonary edema, the nurse establishes a goal to have the client participate in activities that reduce cardiac workload. Which of the following client activities will contribute to achieving this goal?

Using a bedside commode for stools

The nurse is caring for the client immediately after insertion of a permanent demand pacemaker via the right subclavian vein. The nurse prevents dislodgement of the pacing catheter by implementing which intervention?

Limiting movement and abduction of the right arm

A client is admitted to the hospital with a diagnosis of pericarditis. The nurse reviews the client's record for which manifestation that differentiates pericarditis from other cardiopulmonary problems?

Pericardial friction rub