Cardiovascular Review Questions

The nurse is evaluating the condition of a client after pericardiocentesis performed to treat cardiac tamponade. Which observation would indicate that the procedure was effective? 1. Muffled heart sounds 2. A rise in blood pressure 3. Jugular venous distention 4. Client expressions of dyspnea

2. A rise in blood pressure

The nurse provides discharge teaching for a client with a history of hypertension who had a femoropopliteal bypass graft. Which client statement indicates teaching is effective? A. "I should massage my calves and feet every day." B. "I should keep my foot elevated when I am in bed." C. "I should sit in a hot bath for half an hour twice a day." D. "I should observe the color and pulses of my legs every day."

D. "I should observe the color and pulses of my legs every day."

A client with impaired peripheral pulses and signs of chronic hypoxia in a lower extremity has a femoral angiogram. What is the priority nursing action after the angiogram? A. Elevate the foot of the bed. B. Encourage the client to void. C. Maintain the high-Fowler position. D. Assess the client's affected extremity.

D. Assess the client's affected extremity.

The nurse is assessing a client newly diagnosed with mild hypertension. Which assessment finding should the nurse expect? 1.Asymptomatic 2.Shortness of breath 3.Visual disturbances 4.Frequent nosebleeds

1.Asymptomatic

The nurse is performing a cardiovascular assessment on a client. Which parameter would the nurse assess to gain the best information about the client's left-sided heart function? 1.Breath sounds 2.Peripheral edema 3.Hepatojugular reflux 4.Jugular vein distention

1.Breath sounds

The nurse notes bilateral 2+ edema in the lower extremities of a client with myocardial infarction who was admitted 2 days ago. Based on this observation, what should the nurse plan to do first? 1.Review intake and output records for the last 2 days. 2.Prescribe daily weights starting on the following morning. 3.Change the time of diuretic administration from morning to evening. 4.Request a sodium restriction of 1 g/day from the health care provider (HCP).

1.Review intake and output records for the last 2 days.

A client recovering from pulmonary edema is preparing for discharge. What should the nurse plan to teach the client to do to manage or prevent recurrent symptoms after discharge? 1.Weigh self on a daily basis. 2.Sleep with the head of the bed flat. 3.Take a double dose of the diuretic if peripheral edema is noted. 4.Withhold prescribed digoxin if slight respiratory distress occurs.

1.Weigh self on a daily basis. tip- Eliminate options 3 and 4 first because they are comparable or alike

The nurse is teaching the client with angina pectoris about disease management and lifestyle changes that are necessary to control disease progression. Which statement by the client indicates a need for further teaching? 1."I will avoid using table salt with meals." 2."It is best to exercise once a week for 1 hour." 3."I will take nitroglycerin whenever chest discomfort begins." 4."I will use muscle relaxation to cope with stressful situations."

2."It is best to exercise once a week for 1 hour."

The nurse who is auscultating a 56-year-old client's apical heart rate before administering digoxin notes that the heart rate is 52 beats/min. The nurse should make which interpretation of this information? 1.Normal, because of the client's age 2.Abnormal, requiring further assessment 3.Normal, as a result of the effects of digoxin 4.Normal, because this is the reason the client is receiving digoxin

2.Abnormal, requiring further assessment tip-Focus on the subject, a heart rate of 52 beats/min. Recall that the normal heart rate is 60 to 100 beats/min. This will direct you to the correct option. Also, note that options 1, 3, and 4 are comparable or alike in that they all indicate a normal finding.

The nurse is planning to teach a client with peripheral arterial disease about measures to limit disease progression. Which items should the nurse include on a list of suggestions for the client? Select all that apply. 1.Soak the feet in hot water daily. 2.Be careful not to injure the legs or feet. 3.Use a heating pad on the legs to aid vasodilation. 4.Walk each day to increase circulation to the legs. 5.Cut down on the amount of fats consumed in the diet.

2.Be careful not to injure the legs or feet. 4.Walk each day to increase circulation to the legs. 5.Cut down on the amount of fats consumed in the diet.

A client is admitted to the hospital with a diagnosis of pericarditis. The nurse should assess the client for which manifestation that differentiates pericarditis from other cardiopulmonary problems? 1.Anterior chest pain 2.Pericardial friction rub 3.Weakness and irritability 4.Chest pain that worsens on inspiration

2.Pericardial friction rub

Spironolactone is prescribed for a client with heart failure. In providing dietary instructions to the client, the nurse identifies the need to avoid foods that are high in which electrolyte? 1.Calcium 2.Potassium 3.Magnesium 4.Phosphorus

2.Potassium

The nurse is monitoring a client with acute pericarditis for signs of cardiac tamponade. Which assessment finding indicates the presence of this complication? 1. Flat neck veins 2. A pulse rate of 60 beats/minute 3. Muffled or distant heart sounds 4. Wheezing on auscultation of the lungs

3. Muffled or distant heart sounds

A client has been admitted with left-sided heart failure. When planning care for the client, interventions should be focused on reduction of which specific problem associated with this type of heart failure? 1.Ascites 2.Pedal edema 3.Bilateral lung crackles 4.Jugular vein distention

3.Bilateral lung crackles

The nurse working in a long-term care facility is assessing a client who is experiencing chest pain. The nurse should interpret that the pain is most likely caused by myocardial infarction (MI) on the basis of what assessment finding? 1.The client is not experiencing dyspnea. 2.The client is not experiencing nausea or vomiting. 3.The pain has not been relieved by rest and nitroglycerin tablets. 4.The client says the pain began while she was trying to open a stuck dresser drawer.

3.The pain has not been relieved by rest and nitroglycerin tablets.

A client is admitted to the visiting nurse service for assessment and follow-up after being discharged from the hospital with new-onset heart failure (HF). The nurse teaches the client about the dietary restrictions required with HF. Which statement by the client indicates that further teaching is needed? 1. "I'm not supposed to eat cold cuts." 2."I can have most fresh fruits and vegetables." 3."I'm going to weigh myself daily to be sure I don't gain too much fluid." 4."I'm going to have a ham and cheese sandwich and potato chips for lunch."

4."I'm going to have a ham and cheese sandwich and potato chips for lunch."

The nurse is teaching a client with cardiomyopathy about home care safety measures. The nurse should address with the client which most important measure to ensure client safety? 1.Assessing pain 2.Administering vasodilators 3.Avoiding over-the-counter (OTC) medications 4.Moving slowly from a sitting to a standing position

4.Moving slowly from a sitting to a standing position

The nurse is performing an admission assessment on a client with a diagnosis of Raynaud's disease. How should the nurse assess for this disease? 1.Checking for a rash on the digits 2.Observing for softening of the nails or nail beds 3.Palpating for a rapid or irregular peripheral pulse 4.Palpating for diminished or absent peripheral pulses

4.Palpating for diminished or absent peripheral pulses

A client recovering from an exacerbation of left-sided heart failure is experiencing activity intolerance. Which change in vital signs during activity would be the best indicator that the client is tolerating mild exercise? 1.Oxygen saturation decreased from 96% to 91%. 2.Pulse rate increased from 80 to 104 beats per minute. 3.Blood pressure decreased from 140/86 to 112/72 mm Hg. 4.Respiratory rate increased from 16 to 19 breaths per minute.

4.Respiratory rate increased from 16 to 19 breaths per minute. Vital signs that remain near baseline indicate good cardiac reserve with exercise.

A woman comes to the office of her healthcare provider reporting shortness of breath and epigastric distress that is not relieved by antacids. To which question would a woman experiencing a myocardial infarction respond differently than a man? A. "Do you have chest pain?" B. "Are you feeling anxious?" C. "Do you have any palpitations?" D. "Are you feeling short of breath?"

A. "Do you have chest pain?" Females may present with atypical symptoms of myocardial infarction, such as absence of chest pain, overwhelming fatigue, and indigestion. Anxiety, palpitations, and shortness of breath are common clinical manifestations in both males and females who are experiencing a myocardial infarction.

Which patient is most at risk for developing coronary artery disease? A. A hypertensive patient who smokes cigarettes B. An overweight patient who uses smokeless tobacco C. A patient who has diabetes and uses methamphetamines D. A sedentary patient who has elevated homocysteine levels

A. A hypertensive patient who smokes cigarettes

A nurse identifies that a client may be dehydrated. Which clinical manifestations would the client exhibit? Select all that apply. A. Oliguria B. Dyspnea C. Hypotension D. Pulmonary crackles E. Tenting tissue turgor

A. Oliguria C. Hypotension E. Tenting tissue turgor

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? A. Causes mild perspiration B. Occurs after moderate exercise C. Continues after rest and nitroglycerin D. Precipitates discomfort in the arms and jaw

C. Continues after rest and nitroglycerin

The nurse is performing an admission assessment on a client with a diagnosis of angina pectoris who takes nitroglycerin for chest pain at home. During the assessment the client complains of chest pain. The nurse should immediately ask the client which question? 1. "Where is the pain located?" 2. "Are you having any nausea?" 3. "Are you allergic to any medications?" 4. "Do you have your nitroglycerin with you?"

1. "Where is the pain located?"

The nurse is performing an assessment on a client with a diagnosis of left-sided heart failure. Which assessment component would elicit specific information regarding the client's left-sided heart function? 1. Listening to lung sounds 2. Palpating for organomegaly 3. Assessing for jugular vein distention 4. Assessing for peripheral and sacral edema

1. Listening to lung sounds

The nurse is developing a plan of care for a client who will be admitted to the hospital with a diagnosis of deep vein thrombosis (DVT) of the right leg. The nurse develops the plan, expecting that the health care provider (HCP) will most likely prescribe which option? 1. Maintain activity level as prescribed. 2. Maintain the affected leg in a dependent position. 3. Administer an opioid analgesic every 4 hours around the clock. 4. Apply cool packs to the affected leg for 20 minutes every 4 hours.

1. Maintain activity level as prescribed.

The nurse has provided dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions? 1. "I'll need to become a strict vegetarian." 2. "I should use polyunsaturated oils in my diet." 3. "I need to substitute eggs and whole milk for meat." 4. "I should eliminate all cholesterol and fat from my diet."

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

A client is suspected of having thrombophlebitis of the left lower extremity. For what clinical finding should the nurse assess the client? A. Edema of the left leg B. Mobility of the left leg C. Positive left-sided Babinski reflex D. Presence of left arterial peripheral pulse

A. Edema of the left leg

Before a client has a cardiac catheterization, an electrocardiogram (ECG) is performed, and hypokalemia is suspected. The nurse expects that the diagnosis will be confirmed by which diagnostic test? a. Complete blood count b. Serum potassium level c. X-ray film of long bones d. Blood cultures times three

b. Serum potassium level

The nurse is conducting a health history of a client with a primary diagnosis of heart failure. Which conditions reported by the client could play a role in exacerbating the heart failure? Select all that apply. 1.Emotional stress 2.Atrial fibrillation 3.Nutritional anemia 4.Peptic ulcer disease 5.Recent upper respiratory infection

1.Emotional stress 2.Atrial fibrillation 3.Nutritional anemia 5.Recent upper respiratory infection

The nurse is caring for a client immediately after insertion of a permanent demand pacemaker via the right subclavian vein. Which activity will assist with preventing dislodgement of the pacing catheter? 1.Limiting both movement and abduction of the left arm 2.Limiting both movement and abduction of the right arm 3.Assisting the client to get out of bed and ambulate with a walker 4.Having the physical therapist do active range-of-motion exercises to the right arm

2.Limiting both movement and abduction of the right arm

A client is seen in the emergency department for complaints of chest pain that began 3 hours ago. The nurse should suspect myocardial injury or infarction if which laboratory value comes back elevated? 1.Myoglobin 2.Troponin 3.C-reactive protein 4.Creatine kinase (CK)

2.Troponin

The nurse is providing instructions to a client with a diagnosis of hypertension regarding high-sodium items to be avoided. The nurse instructs the client to avoid consuming which item? 1. Bananas 2. Broccoli 3. Antacids 4. Cantaloupe

3. Antacids tip- Note that options 1, 2, and 4 are comparable or alike in that they all identify fresh fruits and vegetables.

The nurse in the medical unit is reviewing the laboratory test results for a client who has been transferred from the intensive care unit (ICU). The nurse notes that a cardiac troponin T assay was performed while the client was in the ICU. The nurse determines that this test was performed to assist in diagnosing which condition? 1. Heart failure 2. Atrial fibrillation 3. Myocardial infarction 4. Ventricular tachycardia

3. Myocardial infarction

The nurse is preparing discharge instructions for a client with Raynaud's disease. The nurse should plan to provide which instruction to the client? 1. Use nail polish to protect the nail beds from injury. 2. Wear gloves for all activities involving the use of both hands. 3. Stop smoking because it causes cutaneous blood vessel spasm. 4. Always wear warm clothing, even in warm climates, to prevent vasoconstriction.

3. Stop smoking because it causes cutaneous blood vessel spasm. tip- Eliminate options 2 and 4 first because of the closed-ended words all and always.

A client with no history of cardiovascular disease comes to the ambulatory clinic with flulike symptoms. The client suddenly complains of chest pain. Which question should best help the nurse discriminate pain caused by a noncardiac problem? 1."Can you describe the pain to me?" 2."Have you ever had this pain before?" 3."Does the pain get worse when you breathe in?" 4."Can you rate the pain on a scale of 1 to 10, with 10 being the worst?"

3."Does the pain get worse when you breathe in?" tip-Note the strategic word, best. The incorrect options, although appropriate to use in practice, are general assessment questions only. The correct option will discriminate between a cardiac and noncardiac cause of pain.

The nurse is caring for a client with a diagnosis of myocardial infarction (MI) and is assisting the client in completing the diet menu. Which beverage should the nurse instruct the client to select from the menu? 1. Tea 2. Cola 3. Coffee 4. Raspberry juice

4. Raspberry juice A client with a diagnosis of MI should not consume caffeinated beverages. Caffeinated products can produce a vasoconstrictive effect, leading to further cardiac ischemia. Tip- Note that options 1, 2, and 3 are comparable or alike and contain caffeine. Raspberry juice is the only beverage listed that does not contain caffeine.

The nurse is discussing smoking cessation with a client diagnosed with coronary artery disease (CAD). Which statement should the nurse make to try to motivate the client to quit smoking? 1."None of the cardiovascular effects are reversible, but quitting might prevent lung cancer." 2."Because most of the damage has already been done, it will be all right to cut down a little at a time." 3."If you totally quit smoking right now, you can cut your cardiovascular risk to zero within a year." 4."If you quit now, your risk of cardiovascular disease will decrease to that of a nonsmoker in 3 to 4 years."

4."If you quit now, your risk of cardiovascular disease will decrease to that of a nonsmoker in 3 to 4 years." tip- Eliminate options 1 and 3 because of the closed-ended words none and totally.

A client presents to the emergency department with weakness and dizziness. The blood pressure is 90/60 mm Hg, pulse is 92 and weak, and body weight reflects a 3-pound (1.4 kilogram) loss in two days. The weather has been hot. Which condition should the nurse conclude is the priority for this client? A. Deficient fluid volume B. Impaired skin integrity C. Inadequate nutritional intake D. Decreased participation in activities

A. Deficient fluid volume

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? A. Monitor the vital signs every 15 minutes B. Maintain the client in the supine position C. Keep the client's lower extremities in extension D. Administer the prescribed oxygen at 4 L/min via nasal cannula

A. Monitor the vital signs every 15 minutes A cardiac catheterization may cause cardiac irritability; therefore the client's vital signs should be monitored every 15 minutes for 1 hour and then every 30 minutes for the next 2 hours until stable. The vital signs may then be monitored every 4 hours. When a brachial artery is used for catheter insertion, a low-Fowler, not supine, position usually is recommended because it promotes respirations.

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? A. "I must check my pulse every day." B. "I can gradually increase my exercise as long as I take rest periods." C. "I should call my healthcare provider if I have difficulty breathing when I am lying flat." D. "I can use a little table salt on my food as long as I do not use it when cooking food."

D. "I can use a little table salt on my food as long as I do not use it when cooking food."

The nurse teaches a patient with peripheral arterial disease. The nurse determines that further teaching is needed if the patient makes which statement? A. "I should not use heating pads to warm my feet." B. "I should cut back on my walks if it causes pain in my legs." C. "I will examine my feet every day for any sores or red areas." D. "I can quit smoking if I use nicotine gum and a support group."

B. "I should cut back on my walks if it causes pain in my legs."

A patient with a history of chronic heart failure is hospitalized with severe dyspnea and a dry, hacking cough. Assessment findings include pitting edema in both ankles, BP 170/100 mm Hg, pulse 92 beats/minute, and respirations 28 breaths/minute. Which explanation, if made by the nurse, is most accurate? A. "The assessment indicates that venous return to the heart is impaired, causing a decrease in cardiac output." B. "The manifestations indicate impaired emptying of both the right and left ventricles, with decreased forward blood flow." C. "The myocardium is not receiving enough blood supply through the coronary arteries to meet its oxygen demand." D. "The patient's right side of the heart is failing to pump enough blood to the lungs to provide systemic oxygenation."

B. "The manifestations indicate impaired emptying of both the right and left ventricles, with decreased forward blood flow."

A patient with left-sided heart failure is prescribed oxygen at 4 L/min per nasal cannula, furosemide (Lasix), spironolactone (Aldactone), and enalapril (Vasotec). Which assessment should the nurse complete to best evaluate the patient's response to these drugs? A. Observe skin turgor B. Auscultate lung sounds C. Measure blood pressure D. Review intake and output

B. Auscultate lung sounds you want to make sure that the crackles from the fluid being in the lungs is gone

A client is admitted to the hospital with multiple signs and symptoms associated with a cardiac problem. What clinical finding alerts the nurse that the primary healthcare provider probably will insert a pacemaker? A. Angina B. Chest pain C. Heart block D. Tachycardia

C. Heart block Heart block is the primary indication for a pacemaker because there is an interference with the electrical conduction of impulses from the atria to the ventricles of the heart.

A patient with peripheral artery disease has marked peripheral neuropathy. An appropriate nursing diagnosis for the patient is A. Risk for injury related to decreased sensation. B. Impaired skin integrity related to decreased peripheral circulation. C. Ineffective peripheral tissue perfusion related to decreased arterial blood flow. D. Activity intolerance related to imbalance between oxygen supply and demand.

C. Ineffective peripheral tissue perfusion related to decreased arterial blood flow.

The nurse is providing teaching to a client who is scheduled for a cardiac catheterization via the femoral approach. What teaching will be included? A. The client will be ambulated shortly after being transferred to the inpatient room after the procedure. B. The client will be given a general anesthetic and therefore will be asleep during the procedure. C. The client will need to stay In the supine position with the affected leg extended for several hours after the procedure. D. The client will be allowed only clear liquids for the remainder of the procedure day.

C. The client will need to stay In the supine position with the affected leg extended for several hours after the procedure.

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. A. Age B. Height C. Weight D. Smoking E. Family history

C. Weight D. Smoking