Cardiovascular System
The nurse is reviewing the laboratory results for newly admitted patients on the cardiovascular unit. Which laboratory result is most important to communicate rapidly to the health care provider? a. High troponin I level b. Increased triglyceride level c. Very low homocysteine level d. Elevated C-reactive protein level
a. High troponin I level
The standard policy on the cardiac unit states, "Notify the health care provider for mean arterial pressure (MAP) less than 70 mm Hg." Which patient should the nurse call the health care provider about? a. Postoperative patient with a BP of 116/42 mm Hg. b. Newly admitted patient with a BP of 150/87 mm Hg. c. Patient with left ventricular failure who has a BP of 110/70 mm Hg. d. Patient with a myocardial infarction who has a BP of 140/86 mm Hg.
a. Postoperative patient with a BP of 116/42 mm Hg.
The nurse hears a murmur between the S1 and S2 heart sounds at the patient's left fifth intercostal space and midclavicular line. How will the nurse record this information? a. Systolic murmur heard at mitral area. b. Systolic murmur heard at Erb's point. c. Diastolic murmur heard at aortic area. d. Diastolic murmur heard at the point of maximal impulse.
a. Systolic murmur heard at mitral area.
The nurse has received the laboratory results for a patient who developed chest pain 4 hours ago and may be having a myocardial infarction. Which laboratory test result should be most helpful in indicating myocardial damage? a. Troponins b. Myoglobin c. Homocysteine (Hcy) d. Creatine kinase-MB (CK-MB)
a. Troponins
A patient is scheduled for a cardiac catheterization with coronary angiography. What information should the nurse provide before the procedure? a. It will be important not to move at all during the procedure. b. A flushed feeling is common when the contrast dye is injected. c. Monitored anesthesia care will be provided during the procedure. d. Arterial pressure monitoring will be needed for 24 hours after the test.
b. A flushed feeling is common when the contrast dye is injected.
The nurse and unlicensed assistive personnel (UAP) on the telemetry unit are caring for four patients. Which nursing action can be delegated to the UAP? a. Teaching a patient about exercise electrocardiography b. Attaching ECG monitoring electrodes after a patient bathes c. Monitoring a patient after a transesophageal echocardiogram d. Checking the patient's catheter site after a coronary angiogram
b. Attaching ECG monitoring electrodes after a patient bathes
How should the nurse document a loud humming sound auscultated over the patient's abdominal aorta? a. Thrill b. Bruit c. Murmur d. Normal finding
b. Bruit
When assessing a newly admitted patient, the nurse notes a murmur along the left sternal border. To obtain more information about the murmur, which action should the nurse take? a. Palpate the peripheral pulses. b. Determine the timing of the sound. c. Find the point of maximal impulse. d. Compare apical and radial pulse rates.
b. Determine the timing of the sound.
When admitting a patient for a cardiac catheterization and coronary angiogram, which information about the patient is important for the nurse to communicate to the health care provider before the test? a. The patient's pedal pulses are +1. b. The patient is allergic to shellfish. c. The patient had a heart attack 1 year ago. d. The patient has not eaten anything today.
b. The patient is allergic to shellfish.
A registered nurse (RN) is observing a student nurse who is assessing a patient. Which action observed by the RN requires immediate intervention? a. The student nurse presses on the skin over the tibia for 10 seconds to check for edema. b. The student nurse palpates both carotid arteries simultaneously to compare pulse quality. c. The student nurse documents a murmur heard along the right sternal border as a pulmonic murmur. d. The student nurse places the patient in the left lateral position to check for the point of maximal impulse.
b. The student nurse palpates both carotid arteries simultaneously to compare pulse quality.
How should the nurse listen to auscultate for S3 or S4 gallops in the mitral area? a. Use the diaphragm of the stethoscope with the patient lying flat. b. Use the bell of the stethoscope with the patient in the left lateral position. c. Use the diaphragm of the stethoscope with the patient in a supine position. d. Use the bell of the stethoscope with the patient sitting and leaning forward.
b. Use the bell of the stethoscope with the patient in the left lateral position.
During a physical examination of an older patient, the nurse palpates the point of maximal impulse (PMI) in the sixth intercostal space lateral to the left midclavicular line. What would be the most focused follow-up action for the nurse to take? a. Ask about risk factors for atherosclerosis. b. Determine family history of heart disease. c. Assess for symptoms of left ventricular hypertrophy. d. Auscultate carotid arteries for the presence of a bruit.
c. Assess for symptoms of left ventricular hypertrophy.
When the nurse is monitoring a patient who is undergoing exercise (stress) testing on a treadmill, which assessment finding requires the most rapid action by the nurse? a. Patient reports feeling tired b. Sinus tachycardia at a rate of 110 beats/min c. Inversion of T waves on the electrocardiogram d. Blood pressure (BP) increase from 134/68 to 150/80 mm Hg
c. Inversion of T waves on the electrocardiogram
The nurse notes that a patient who was admitted with heart failure has jugular venous distention (JVD) when lying flat. Which follow-up action should the nurse take? a. Encourage the patient to drink more liquids. b. Check the apical and radial pulse for a pulse deficit. c. Observe the neck veins with the patient elevated 45 degrees. d. Have the patient bear down to perform the Valsalva maneuver.
c. Observe the neck veins with the patient elevated 45 degrees.
A transesophageal echocardiogram (TEE) is planned for a patient hospitalized with possible endocarditis. Which action included in the standard TEE orders will the nurse need to accomplish first? a. Start an IV line. b. Start O2 per nasal cannula. c. Place the patient on NPO status. d. Give lorazepam (Ativan) 1 mg IV.
c. Place the patient on NPO status.
Which action will the nurse implement for a patient who arrives for a calcium-scoring CT scan? a. Insert an IV catheter. b. Administer oral sedative medications. c. Teach the patient about the procedure. d. Confirm that the patient has been fasting.
c. Teach the patient about the procedure.
Which information obtained by the nurse who is admitting the patient for magnetic resonance imaging (MRI) will be important to report to the health care provider before the MRI? a. The patient has an allergy to shellfish. b. The patient has a history of atherosclerosis. c. The patient has a permanent cardiac pacemaker. d. The patient took the prescribed heart medications today.
c. The patient has a permanent cardiac pacemaker.
Which laboratory test result will the nurse review to determine the effects of therapy for a patient being treated for heart failure? a. Troponin b. Homocysteine (Hcy) c. Low-density lipoprotein (LDL) d. B-type natriuretic peptide (BNP)
d. B-type natriuretic peptide (BNP)
While doing the hospital admission assessment for a thin older adult, the nurse observes pulsation of the abdominal aorta in the epigastric area. Which action should the nurse take next? a. Teach the patient about aneurysms. b. Notify the hospital rapid response team. c. Instruct the patient to remain on bed rest. d. Document the finding in the patient chart.
d. Document the finding in the patient chart.
A patient will be evaluated for rhythm disturbances with a Holter monitor. What should the nurse teach the patient to do? a. Connect the recorder to a computer once daily. b. Exercise more than usual while the monitor is in place. c. Remove the electrodes when taking a shower or tub bath. d. Keep a diary of daily activities while the monitor is worn.
d. Keep a diary of daily activities while the monitor is worn.
The nurse is reviewing the 12-lead electrocardiograph (ECG) for a healthy older adult patient who is having an annual physical examination. What finding should be of most concern to the nurse? a. A right bundle branch block. b. The PR interval is 0.21 seconds. c. The QRS duration is 0.13 seconds. d. The heart rate (HR) is 41 beats/min.
d. The heart rate (HR) is 41 beats/min.
An older adult patient who has just arrived in the emergency department has a pulse deficit of 46 beats. The nurse should expect that the patient may require: a. cardiac catheterization. b. emergent cardioversion. c. hourly blood pressure checks. d. electrocardiographic monitoring.
d. electrocardiographic monitoring.
