Chapter 25-29 Prep U Questions

A client needs an endarterectomy. This procedure is most commonly indicated when the: client's femoral artery is obstructed with atherosclerotic plaque. client's doctor needs to measure the client's coronary artery pressure. client is at risk for blood clots called thrombi. doctor is checking for pulmonary capillary wedge pressure.

client's femoral artery is obstructed with atherosclerotic plaque.

A client who is newly diagnosed with hypertension is going to be starting antihypertensive medicine. What is one of the main things the client and the client's spouse should watch for? dizziness persistent cough blurred vision tremor

dizziness

Frequently, what is the earliest symptom of left-sided heart failure? dyspnea on exertion anxiety confusion chest pain

dyspnea on exertion

A client with secondary hypertension has come into the clinic for a routine check-up. When comparing this client's diagnosis to primary hypertension, the nurse recognizes that secondary hypertension: has a specific cause. has a more gradual onset than primary hypertension. does not normally cause target organ damage. does not normally respond to antihypertensive drug therapy.

has a specific cause.

A client experiences a faster-than-normal heart rate when drinking more than two cups of coffee in the morning. What does the nurse identify on the electrocardiogram as an indicator of sinus tachycardia? heart rate of 118 bpm PR interval of 0.1 seconds QRS duration of 0.16 seconds Q wave of 0.04 seconds

heart rate of 118 bpm

A nurse is administering digoxin. What client parameter would cause the nurse to hold the digoxin and notify the health care prescriber? urine output of 300 mL in eight hours atrial fibrillation rhythm blood pressure of 125/80 heart rate of 55 beats per minute

heart rate of 55 beats per minute

A client's lipid profile reveals an LDL level of 122 mg/dL. This is considered a: high LDL level. low LDL level. normal LDL level. fasting LDL level.

high LDL level

A client is awaiting peripheral vascular surgery, specifically a vascular graft. The nurse reviews the different options for grafting material the surgeon might use. What will be included in this discussion? Select all that apply. human tissue cotton thread synthetic fiber, such as Teflon silk

human tissue synthetic fiber, such as Teflon

The nurse is reviewing the diet of a client who has been diagnosed with hypertension. The nurse recommends reducing or avoiding caffeine because caffeine: increases the heart rate and causes vasoconstriction. reduces the heart rate and leads to a coronary artery disease. reduces the heart rate and causes low blood pressure. increases the heart rate and causes angina.

increases the heart rate and causes vasoconstriction.

A client asks the nurse what causes the heart to be an effective pump. The nurse informs the client that this is due to the: inherent rhythmicity of cardiac muscle tissue. inherent rhythmicity of all muscle tissue. sufficient blood pressure. inherent electrons in muscle tissue.

inherent rhythmicity of cardiac muscle tissue.

In a client's presurgical education, the nurse reinforces the purpose for cardiovascular surgery. What is not a function of cardiovascular surgery? valve repair lung repair aneurysm repair myocardium revascularization

lung repair

A client who was recently diagnosed with prehypertension is to meet with a dietitian and return for a follow-up with the cardiologist in 6 months. What would this client's treatment likely include? nonpharmacological interventions pharmacological interventions procedural interventions observation only

nonpharmacological interventions

The nurse analyzes a 6-second electrocardiogram (ECG) tracing. The P waves and QRS complexes are regular. The PR interval is 0.18 seconds long, and the QRS complexes are 0.08 seconds long. The heart rate is calculated at 70 bpm. The nurse correctly identifies this rhythm as normal sinus rhythm. sinus tachycardia. junctional tachycardia. first-degree atrioventricular block.

normal sinus rhythm.

Hypertension that can be attributed to an underlying cause is termed primary hypertension. essential hypertension. secondary hypertension. isolated systolic hypertension.

secondary hypertension.

A client is diagnosed with a dysrhythmia at a rate slower than 60 beats/minute with a regular interval between 0.12 and 0.20 seconds. What type of dysrhythmia does the client have? sinus bradycardia atrial bradycardia heart block none

sinus bradycardia

A client's Holter monitor strip reveals a heart rate with normal conduction but with a rate consistently above 105 beats/minute. What type of dysrhythmia would the cardiologist likely diagnose? sinus tachycardia sinus bradycardia supraventricular tachycardia supraventricular bradycardia

sinus tachycardia

A client with a family history of coronary artery disease reports experiencing chest pain and palpitations during and after morning jogs. What would reduce the client's cardiac risk? smoking cessation a protein-rich diet exercise avoidance antioxidant supplements

smoking cessation

The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client? peripheral edema right-sided heart failure stroke pulmonary insufficiency

stroke

The nurse is seeing a client for the first time and has just checked the client's blood pressure. The nurse would consider the client prehypertensive if: diastolic BP is between 70 and 79 mm Hg. diastolic BP is 100 mm Hg. systolic BP is between 120 and 139 mm Hg. systolic BP is above 180 mm Hg.

systolic BP is between 120 and 139 mm Hg.

A nurse suspects that a client has digoxin toxicity. The nurse should assess for: hearing loss. vision changes. decreased urine output. gait instability.

vision changes.

A client with chronic heart failure is receiving digoxin 0.25 mg by mouth daily and furosemide 20 mg by mouth twice daily. The nurse should assess the client for what sign of digoxin toxicity? nocturia and sleep disturbances. visual disturbances. taste and smell alterations. dry mouth and urine retention.

visual disturbances

The home health nurse is caring for a client who has a diagnosis of hypertension. What assessment question most directly addresses the possibility of worsening hypertension? "Are you eating less salt in your diet?" "How is your energy level these days?" "Do you ever get chest pain when you exercise?" "Do you ever see spots in front of your eyes?"

"Do you ever see spots in front of your eyes?"

A nurse working in the clinic is seeing a client who has just been prescribed a new medication for hypertension. The client asks why hypertension is sometimes called the "silent killer." What is the best response by the nurse? "Hypertension often causes no symptoms." "Hypertension often kills early in the disease process." "Hypertension often causes no pain." "Hypertension is difficult to diagnose."

"Hypertension often causes no symptoms."

A community health nurse teaches a group of older adults about modifiable risk factors that contribute to the development of peripheral arterial disease (PAD). The nurse knows that the teaching was effective based on which statement? "I will need to stop smoking because the nicotine causes less blood to flow to my hands and feet." "I will need to increase the amount of green leafy vegetables I eat to lower my cholesterol levels." "The older I get the higher my risk for peripheral arterial disease gets." "Because my family is from Italy, I have a higher risk of developing peripheral arterial disease."

"I will need to stop smoking because the nicotine causes less blood to flow to my hands and feet."

A client needs to have a cardiac valve replacement. The nurse offers client education about the procedures involved—including the benefits and risks. Which client statement indicates the need for more education? "I'm anxious because I'll need to have cardiopulmonary bypass." "Since the procedure is minimally invasive, there is less postoperative pain than with other techniques." "I might lose some blood, but not likely a large quantity of it." "Since the procedure is minimally invasive, there is less surgical trauma."

"I'm anxious because I'll need to have cardiopulmonary bypass."

A client needs to have a cardiac valve replacement. Following client education, which client statement indicates the need for more education? "Since the procedure is minimally invasive, there's no cardiopulmonary bypass involved." "Since the procedure is minimally invasive, there's less postoperative pain." "Since the procedure is minimally invasive, there's decreased blood loss." "Since the procedure is minimally invasive, there's less surgical trauma."

"Since the procedure is minimally invasive, there's no cardiopulmonary bypass involved."

A client is unconscious on arrival to the emergency department. The nurse in the emergency department identifies that the client has a permanent pacemaker due to which characteristic? Scar on the chest "Spike" on the rhythm strip Quality of the pulse Vibration under the skin

"Spike" on the rhythm strip

After performing an ECG on an adult client, the nurse reports that the PR interval reflects normal sinus rhythm. What is the PR interval for a normal sinus rhythm? 0.05 and 0.1 seconds. 0.12 and 0.2 seconds. 0.15 and 0.3 seconds. 0.25 and 0.4 seconds.

0.12 and 0.2 seconds.

The nurse is reviewing the results of a total cholesterol level for a client who has been taking simvastatin. What results display the effectiveness of the medication? 160-190 mg/dL 210-240 mg/dL 250-275 mg/dL 280-300 mg/dL

160-190 mg/dL

According to the DASH diet, how many servings of vegetables should a person consume each day? 2 or fewer 2 or 3 4 or 5 7 or 8

4 or 5

A client is scheduled for a conventional CABG procedure and wants to know approximately how long he will be hospitalized. What response from the nurse is correct? 7 to 10 days 1 to 2 days 3 to 5 days 12 to 14 days

7 to 10 days

A client in the cardiac unit has been diagnosed with pulmonary congestion secondary to left ventricular dysfunction. The physician orders supplemental oxygen therapy. At what minimum level should the client's SpO2 be maintained? 90 87 85 80

90

Eunice Henderson, a 79-year-old female, is a client in the cardiac unit where you practice nursing. With her diagnosis of pulmonary congestion secondary to left ventricular dysfunction, you would expect her physician to order supplemental oxygen therapy. At what minimum level would you expect to maintain her SpO2? 90 87 85 80

90

The nurse is assigned the following client assignment on the clinical unit. For which client does the nurse anticipate cardioversion as a possible medical treatment? A new myocardial infarction client A client with poor kidney perfusion A client with third-degree heart block A client with atrial dysrhythmias

A client with atrial dysrhythmias

The licensed practical nurse is setting up the room for a client arriving at the emergency department with ventricular arrhythmias. The nurse is most correct to place which of the following in the room for treatment? A suction machine A defibrillator Cardioversion equipment An ECG machine

A defibrillator

A client has been admitted for a commissurotomy. The nurse knows that a commissurotomy repairs which of the following? Part of the myocardium A valve A ventricle An artery

A valve

A patient is being discharged to home. The nurse must emphasize the importance of being weighed daily. Which significant weight change would need to be reported to the patient's health care provider? As weight gain of 4 pounds in a week A weight gain of 1 pound in a day A weight gain of 2½ pounds in a day A weight gain of 3 pounds in a week

A weight gain of 2½ pounds in a day

A client newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a client with prolonged, uncontrolled hypertension is at risk for developing what health problem? Acute kidney injury Right ventricular hypertrophy Glaucoma Anemia

Acute kidney injury

A patient presents to the emergency department complaining of increasing shortness of breath. The nurse assessing the patient notes a history of left-sided heart failure. The patient is agitated and coughing up pink-tinged, foamy sputum. What should the nurse recognise these as signs and symptoms of? Cardiogenic shock. Pneumonia. Right-sided heart failure. Acute pulmonary oedema.

Acute pulmonary oedema.

A client had a cardiac transplant 6 weeks ago. The client calls the clinic and informs the nurse he has a fever of 101°F, chest tenderness, and flulike symptoms. What does the nurse suspect the client is experiencing? Subacute rejection Chronic rejection Hyperacute rejection Acute rejection

Acute rejection

The nurse is working on a telemetry unit, caring for a client who develops dizziness and a second-degree heart block, Mobitz Type 1. What will be the initial nursing intervention? Administer an IV bolus of atropine. Send the client to the cardiac catheterization laboratory. Prepare to client for cardioversion. Review the client's medication record.

Administer an IV bolus of atropine.

The nurse is creating a plan of care for a client with acute coronary syndrome. What nursing action should be included in the client's care plan? Facilitate daily arterial blood gas (ABG) sampling. Administer supplementary oxygen, as needed. Have client maintain supine positioning when in bed. Perform chest physiotherapy, as indicated.

Administer supplementary oxygen, as needed.

A client has completed diagnostics and the cardiologist has reported that coronary bypass is indicated. What findings indicate that coronary bypass is indicated instead of PTCA? anatomic location of occlusions calcified, noncompressible atheromas multiple coronary artery occlusions All options are correct.

All options are correct.

A client's Holter monitor strip reveals a heart rate with normal conduction but with a rate consistently above 105 beats/minute. What other conditions can cause this response in a healthy heart? All options are correct. elevated temperature shock strenuous exercise

All options are correct.

A patient is admitted to a special critical care unit for the treatment of an arterial thrombus. The nurse is aware that the preferred drug of choice for clot removal, unless contraindicated, would be: Alteplase. Reteplase. Urokinase. Streptokinase

Alteplase

The nurse is administering captopril to a client with a diagnosis of heart failure. What type of medication does the nurse inform the client is taking? An angiotensin converting enzyme inhibitor (ACE) inhibitor A thiazide diuretic A calcium channel blocker An angiotensin receptor blocker (ARB)

An angiotensin converting enzyme inhibitor (ACE) inhibitor

The nurse has conducted preoperative teaching with a client about to undergo cardiovascular surgery. Which of the following methods would best validate that the client understands the procedure before signing the consent form? Ask the client to explain the surgical procedure. Make sure that the client is relaxed before leaving the room. Acknowledge the client's emotions and any expressions of fear. Confirm that the client has written instructions about the procedure.

Ask the client to explain the surgical procedure.

An older adult is postoperative day one, following a coronary artery bypass graft (CABG). The client's family members express concern to the nurse that the client is uncharacteristically confused. After reporting this change in status to the health care provider, what additional action should the nurse take? Educate the family about how confusion is expected in older adults postoperatively. Assess for factors that may be causing the client's delirium. Document the early signs of dementia and ensure the client's safety. Reorient the client to place and time.

Assess for factors that may be causing the client's delirium.

A client who has undergone a femoral to popliteal bypass graft surgery returns to the surgical unit. Which assessments should the nurse perform during the first postoperative day? Assess pulse of affected extremity every 15 minutes at first. Palpate the affected leg for pain during every assessment. Assess the client for signs and symptoms of compartment syndrome every 2 hours. Perform Doppler evaluation once daily.

Assess pulse of affected extremity every 15 minutes at first.

The nurse is caring for a client with coronary artery disease (CAD). What is an appropriate nursing action when evaluating a client with CAD? Assess the client's mental and emotional status. Assess the skin of the client. Assess the characteristics of chest pain. Assess for any kind of drug abuse.

Assess the characteristics of chest pain.

The nurse is presenting a workshop at the senior citizens center about how the changes of aging predispose clients to vascular occlusive disorders. What would the nurse name as the most common cause of peripheral arterial problems in the older adult? Arteriosclerosis Coronary thrombosis Atherosclerosis Raynaud's disease

Atherosclerosis

The nurse is providing care for a client with a diagnosis of hypertension. The nurse should consequently assess the client for signs and symptoms of which other health problem? Migraines Atrial-septal defect Atherosclerosis Thrombocytopenia

Atherosclerosis

The nurse cares for a client with a dysrhythmia and understands that the P wave on an electrocardiogram (ECG) represents which phase of the cardiac cycle? Atrial depolarization Early ventricular repolarization Ventricular depolarization Ventricular repolarization

Atrial depolarization

A client presents to the emergency department via ambulance with a heart rate of 210 beats/minute and a sawtooth waveform pattern per cardiac monitor. The nurse is most correct to alert the medical team of the presence of a client with which disorder? Asystole Premature ventricular contraction Atrial flutter Ventricular fibrillation

Atrial flutter

The nurse is monitoring a patient in the postanesthesia care unit (PACU) following a coronary artery bypass graft, observing a regular ventricular rate of 82 beats/min and "sawtooth" P waves with an atrial rate of approximately 300 beat/min. How does the nurse interpret this rhythm? Atrial fibrillation Atrial flutter Ventricular tachycardia Ventricular fibrillation

Atrial flutter

Which dysrhythmia has an atrial rate between 250 and 400, with saw-toothed P waves? Atrial flutter Atrial fibrillation Ventricular fibrillation Ventricular tachycardia

Atrial flutter

A nurse completes a shift assessment on a client admitted to the telemetry unit with a diagnosis of syncope. The client's heart rate is 55 bpm with a blood pressure of 90/66 mm Hg. The client is also experiencing dizziness and shortness of breath. Which medication will the nurse anticipate administering to the client based on these clinical findings? Atropine Lidocaine Pronestyl Cardizem

Atropine

The nurse is planning discharge teaching for a client with a newly inserted permanent pacemaker. What is the priority teaching point for this client? Start lifting the arm above the shoulder right away to prevent chest wall adhesion. Avoid cooking with a microwave oven. Avoid exposure to strong electromagnetic fields Avoid walking through store and library antitheft devices.

Avoid exposure to strong electromagnetic fields

The nurse is reviewing a newly admitted client's electronic health record, which notes a history of orthopnea. What nursing action is most clearly indicated? Administer supplemental oxygen at all times. Avoid positioning the client supine. Limit the client's activity level. Teach the client deep breathing and coughing exercises.

Avoid positioning the client supine.

A patient is seen in the emergency department (ED) with heart failure secondary to dilated cardiomyopathy. What key diagnostic test does the nurse assess to determine the severity of the patient's heart failure? Blood urea nitrogen (BUN) Complete blood count (CBC) B-type natriuretic peptide (BNP) Serum electrolytes

B-type natriuretic peptide (BNP)

A client has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this client? Chest pain Bleeding at the implantation site Malignant hyperthermia Bradycardia

Bleeding at the implantation site

A client with heart failure has met with his primary provider and begun treatment with an angiotensin-converting enzyme (ACE) inhibitor. When the client begins treatment, the nurse should prioritize what assessment? Oxygen saturation Level of consciousness (LOC) Assessment for nausea Blood pressure

Blood pressure

In his presurgical visit to the cardiology practice where you practice nursing client is quite concerned about his upcoming coronary bypass surgery. As the surgeon explains the technology and options available, the client requests the cardiologist explain the techniques in simpler terms. Which technique involves stopping the heart during surgery? OPCAB MIDCAB PACAB CABG

CABG

A client in the cardiac step-down unit has begun bleeding from the percutaneous coronary intervention (PCI) access site in the femoral region. What is the nurse's most appropriate action? Call for assistance and initiate cardiopulmonary resuscitation. Reposition the client's leg in a nondependent position. Promptly remove the femoral sheath. Call for help and apply pressure to the access site.

Call for help and apply pressure to the access site.

The nurse is caring for a client who has just undergone catheter ablation therapy. The nurse in the step-down unit should prioritize what assessment? Cardiac monitoring Monitoring the implanted device signal Pain assessment Monitoring the client's level of consciousness (LOC)

Cardiac monitoring

A client was driving a car without wearing a seat belt and slid off of the road and hit a tree. The client's chest was crushed against a steering wheel. What type of lethal injury does the nurse anticipate the client may have suffered? Bladder trauma Fractured pelvis A pleural effusion Cardiac tamponade

Cardiac tamponade

A nurse is caring for a client in the cardiovascular intensive care unit following a coronary artery bypass graft. Which clinical finding requires immediate intervention by the nurse? Central venous pressure reading of 1 Pain score 5/10 Blood pressure 110/68 mm Hg Heart rate 66 bpm

Central venous pressure reading of 1

The nurse is participating in a health fair and interviews a patient with a history of hypertension, who is currently smoking one pack of cigarettes per day. She has had no manifestations of coronary artery disease but a recent LDL level of 154 mg/dL. Based on her assessment, the nurse would expect that the physician would treat this cholesterol level in what way? Drug therapy. Diet and drug therapy. Diet therapy only. Cessation of cigarettes and diet therapy.

Cessation of cigarettes and diet therapy.

The nurse is caring for a client who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output (CO). What change in status may signal to the nurse a decrease in cardiac output? Increased blood pressure Bounding peripheral pulses Changes in level of consciousness Skin flushing

Changes in level of consciousness

The nurse is evaluating a client who underwent heart transplantation surgery. Based on findings, the nurse alerts the physician that the client may be rejecting the donor organ. Which of the following findings is consistent with the nurse's report? Heart rate of 105 beats/minute Hypotension Client report of nausea and shortness of breath Temperature of 99.7 degrees F

Client report of nausea and shortness of breath

A client is recovering in the hospital from cardiac surgery. The nurse has identified the diagnosis of risk for ineffective airway clearance related to pulmonary secretions. What intervention best addresses this risk? Administration of bronchodilators by nebulizer Administration of inhaled corticosteroids by metered dose inhaler (MDI) Client's consistent performance of deep-breathing and coughing exercises Client's active participation in the cardiac rehabilitation program

Client's consistent performance of deep-breathing and coughing exercises

A nurse is providing education about hypertension to a community group. What are possible consequences of untreated hypertension? Select all that apply. Coronary artery disease Myocardial infarction Pancreatitis Tension pneumothorax Stroke

Coronary artery disease Myocardial infarction Stroke

A patient has been diagnosed with prehypertension and has been encouraged to exercise regularly and begin a weight loss program. What other healthcare professional may be helpful for the client to see? Occupational therapist Dietician Pharmacist Social worker

Dietician

A client is in the intensive care unit with a diagnosis of severe uncontrolled hypertension. What method of monitoring would best meet the needs of this client? Pulmonary artery pressure monitoring Direct blood pressure monitoring Central venous pressure monitoring Manual blood pressure readings with a sphygmomanometer

Direct blood pressure monitoring

A patient who had a colon resection 3 days ago is complaining of discomfort in the left calf. How should the nurse assess Homan's sign to determine if the patient may have a thrombus formation in the leg? Dorsiflex the foot while the leg is elevated to check for calf pain. Elevate the patient's legs for 20 minutes and then lower them slowly while checking for areas of inadequate blood return. Extend the leg, plantar flex the foot, and check for the patency of the dorsalis pedis pulse. Lower the patient's legs and massage the calf muscles to note any areas of tenderness.

Dorsiflex the foot while the leg is elevated to check for calf pain.

The nurse is caring for a client with heart failure. What procedure should the nurse prepare the client for in order to determine the ejection fraction to measure the efficiency of the heart as a pump? Echocardiogram A pulmonary arteriography A chest radiograph Electrocardiogram

Echocardiogram

A 65-year-old client has come to the emergency department reporting lightheadedness, chest pain, and shortness of breath. As you finish your assessment, the physician enters and orders tests to ascertain what is causing the client's problems. In your client education, you explain the tests. Which test is used to identify cardiac rhythms? Electrocardiogram Electroencephalogram Echocardiogram Electrocautery

Electrocardiogram

What would you encourage a patient to do to aid in preventing progression to a hypertensive state? Teach the patient not to take potassium tablets. Exercise routinely. Eat less protein and more vegetables. Exercise every other week.

Exercise routinely.

The nurse has just admitted a client for cardiac surgery. The client tearfully describes feeling afraid of dying while undergoing the surgery. What is the nurse's best response? Explore the factors underlying the client's anxiety. Teach the client guided imagery techniques. Obtain an order for a PRN benzodiazepine. Describe the procedure in greater detail.

Explore the factors underlying the client's anxiety.

You are caring for an adult patient with heart failure who is prescribed digoxin. What adverse side effects should the nurse explain to the patient that he or she should watch for? Weight loss. Fatigue and nausea. Decreased pulmonary crackles. Increased urine output.

Fatigue and nausea.

A client presents to the emergency room with characteristics of atherosclerosis. What characteristics would the client display? Fatty deposits in the lumen of arteries Cholesterol plugs in the lumen of veins Blood clots in the arteries Emboli in the veins

Fatty deposits in the lumen of arteries

Which medication is categorized as a loop diuretic? Chlorothiazide Chlorthalidone Spironolactone Furosemide

Furosemide

Which New York Heart Association classification of heart failure has a poor prognosis and includes symptoms of cardiac insufficiency at rest? I II III IV

IV

The nurse enters the client's room and finds the client pulseless and unresponsive. What would be the treatment of choice for this client? IV lidocaine Chemical cardioversion Immediate defibrillation Electric cardioversion

Immediate defibrillation

A client admitted to the medical unit with heart failure is exhibiting signs and symptoms of pulmonary edema. How should the nurse best position the client? In a high Fowler position On the left side-lying position In a flat, supine position In the Trendelenburg position

In a high Fowler position

Which sign or symptom suggests that a client's abdominal aortic aneurysm is extending? Increased abdominal and back pain Decreased pulse rate and blood pressure Retrosternal back pain radiating to the left arm Elevated blood pressure and rapid respirations

Increased abdominal and back pain

A 40-year-old male newly diagnosed with hypertension is discussing risk factors with the nurse. The nurse talks about lifestyle changes with the patient and advises that the patient should avoid tobacco use. What is the rationale behind that advice to the patient? Causes high blood pressure. Increases the risk of heart disease. Causes obesity. Increases cardiac output.

Increases the risk of heart disease.

The nurse is caring for a client who is diagnosed with Raynaud phenomenon. The nurse should plan interventions to address what nursing diagnosis? Chronic pain Ineffective tissue perfusion Impaired skin integrity Risk for injury

Ineffective tissue perfusion

A client experiences orthostatic hypotension while receiving furosemide to treat hypertension. How will the nurse intervene? Administer I.V. fluids as ordered. Administer an isosorbide as ordered. Insert an indwelling urinary catheter as ordered. Instruct the client to sit for several minutes before standing.

Instruct the client to sit for several minutes before standing.

You are caring for a 72-year-old patient who is in cardiac rehabilitation following open-heart surgery. The patient has been walking on a regular basis for about a week and walks for 15 minutes three times a day. The patient informs you that he is having a cramp-like pain in the legs every time he walks and that the pain gets "better when I rest." What would you suspect is the problem with this patient? Glomerular nephritis Intermittent claudication Venous insufficiency Vasculitis

Intermittent claudication

Which is a characteristic of right-sided heart failure? Jugular vein distention Dyspnea Pulmonary crackles Cough

Jugular vein distention

The nurse is providing client education prior to a client's discharge home after treatment for heart failure. The nurse gives the client a home care checklist as part of the discharge teaching. What should be included on this checklist? Know how to recognize and prevent orthostatic hypotension. Weigh yourself weekly at a consistent time of day. Measure everything you eat and drink until otherwise instructed. Limit physical activity to only those tasks that are absolutely necessary.

Know how to recognize and prevent orthostatic hypotension.

A client is undergoing lipid profile studies in an effort to determine a proper nutritional balance for CAD. The client's lipid profile reveals LDL greater than HDL. This is a risk factor for this client because the: LDL sticks to arteries. HDL sticks to arteries. LDL carries cholesterol to the liver. HDL carries cholesterol to the liver.

LDL sticks to arteries.

The nurse is assessing a client new to the clinic. Records brought to the clinic show that the client's hypertension has not improved. What contributing factor should the nurse first explore in an effort to identify the cause of the client's inadequate BP control? Progressive target organ damage Possibility of medication interactions Lack of adherence to prescribed drug therapy Possible heavy alcohol use or use of recreational drugs

Lack of adherence to prescribed drug therapy

What range of blood pressure is considered normal? Less than 135/90 Less than 130/90 Less than 129/89 Less than 120/80

Less than 120/80

The nurse is screening a number of adults for hypertension. What range of blood pressure is considered normal? Less than 140/90 mm Hg Less than 130/90 mm Hg Less than 129/89 mm Hg Less than 120/80 mm Hg

Less than 120/80 mm Hg

The nurse is providing care for a client with high cholesterol and triglyceride values. In teaching the client about therapeutic lifestyle changes such as diet and exercise, the nurse realizes that the desired goal for cholesterol levels is which of the following? High HDL values and high triglyceride values Absence of detectable total cholesterol levels Elevated blood lipids, fasting glucose less than 100 Low LDL values and high HDL values

Low LDL values and high HDL values

The nurse is providing discharge instructions to a client with heart failure preparing to leave the following day. What type of diet should the nurse request the dietitian to discuss with the client? Low-sodium diet Low-cholesterol diet Low-fat diet Low-potassium diet

Low-sodium diet

The nurse is caring for an acutely ill client who is on anticoagulant therapy. The client has a comorbidity of renal insufficiency. How will this client's renal status affect heparin therapy? Heparin is contraindicated in the treatment of this client. Heparin may be given subcutaneously, but not IV. Lower doses of heparin are required for this client. Warfarin will be substituted for heparin.

Lower doses of heparin are required for this client.

You are writing a plan of care for a patient with a cardiac dysrhythmia. What would be the most appropriate goal for the patient? Maintain nutritional intake. Maintain fluid intake. Maintain cardiac output. Maintain social contacts.

Maintain cardiac output.

The nurse is caring for an older adult client who is deciding whether to have cardiovascular surgery. The client asks the nurse why the risks are greater for them than for a younger person. What would be the nurse's answer? Many older adults have other things wrong with them besides their cardiac problems. Older adults have different thought processes than younger adults do. Older adults have the same risk factors as younger adults. Older adults have hypersensitive renal systems, and younger adults don't.

Many older adults have other things wrong with them besides their cardiac problems.

Which nursing intervention must a nurse perform when administering prescribed vasopressors to a client with a cardiac dysrhythmia? Keep the client flat for one hour after administration Administer every five minutes during cardiac resuscitation Document heart rate before and after administration Monitor vital signs and cardiac rhythm

Monitor vital signs and cardiac rhythm

Gary Larkins, a 51-year-old salesman, has a 20-pack-year history which directly impacts his newly diagnosed high blood pressure. Why do you, as his nurse, recommend smoking cessation for Gary? Nicotine raises his heart rate, constricts arterioles, and reduces his heart's ability to eject blood. Nicotine decreases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood. Nicotine increases the heart rate, constricts arterioles, and increases the heart's ability to eject blood. Nicotine decreases circulating blood volume

Nicotine raises his heart rate, constricts arterioles, and reduces his heart's ability to eject blood.

The nurse is obtaining vital signs for a client in the clinic who has had a cardiac transplant. The nurse obtains an apical heart rate of 110 beats/minute. What is a priority action by the nurse? Notify the physician. Administer a calcium channel blocker to decrease the heart rate. Obtain an electrocardiogram. No action is required because the transplanted heart beats faster than the natural heart.

No action is required because the transplanted heart beats faster than the natural heart.

An 87-year-old client was just recently diagnosed with prehypertension. She is to meet with a dietician and return for follow-up with her cardiologist in six months. As her nurse, what would you expect her treatment to include? Nonpharmacological interventions Pharmacological interventions Procedural interventions No intervention, just observation

Nonpharmacological interventions

During postoperative assessment of a client who has undergone cardiovascular surgery, oxygen saturation is at 85%. What action should the nurse perform next? Notify the physician immediately. Wait 30 minutes and re-assess the client. Ask another nurse to check the reading. Nothing, this is a normal postoperative finding.

Notify the physician immediately.

Which risk factor is related to venous stasis for deep vein thrombosis (DVT) and pulmonary embolism (PE)? Trauma Pacing wires Obesity Surgery

Obesity

A client with an ICD calls his cardiologist's office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the client to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what? Infection Failure to capture Premature battery depletion Oversensing of dysrhythmias

Oversensing of dysrhythmias

To evaluate a client's atrial depolarization, the nurse observes which part of the electrocardiogram waveform? P wave PR interval QRS complex T wave

P wave

The nurse is assessing vital signs in a patient with a permanent pacemaker. What should the nurse document about the pacemaker? Date and time of insertion Location of the generator Model number Pacer rate

Pacer rate

An older adult client has newly diagnosed stage 2 hypertension. The health care provider has prescribed Chlorothiazide and Benazepril. What will the nurse monitor this client for? Postural hypertension and resulting injury Rebound hypertension Sexual dysfunction Postural hypotension and resulting injury

Postural hypotension and resulting injury

A patient comes to the walk-in clinic. While assessing the patient's vital signs, the nurse assesses the patient's blood pressure at 128/89 mm Hg. According to JNC7, how would this patient's blood pressure be classified? Hypertensive Normal Slightly hypertensive Prehypertensive

Prehypertensive

The nurse observes an electrocardiogram (ECG) tracing on a cardiac monitor with a pattern in lead II as well as a bizarre, abnormal shape to the QRS complex. The nurse has likely observed which ventricular dysrhythmia? Ventricular bigeminy Ventricular tachycardia Premature ventricular contraction Ventricular fibrillation

Premature ventricular contraction

A patient is admitted to the intensive care unit (ICU) with left-sided heart failure. What clinical manifestations does the nurse anticipate finding when performing an assessment? (Select all that apply.) Jugular vein distention Cough Pulmonary crackles Dyspnea Ascites

Pulmonary crackles Dyspnea Cough

The nurse notes that a client has developed a cough productive for mucoid sputum, is short of breath, has cyanotic hands, and has noisy, moist-sounding, rapid breathing. These symptoms and signs are suggestive of what health problem? Right ventricular hypertrophy Cardiomyopathy Pulmonary edema Pericarditis

Pulmonary edema

The nurse is caring for a client on the cardiac unit. The licensed practical nurse on the previous shift reported the following vital signs/assessment information: temperature, 100.6° F; pulse, 56 beats/minute; respirations 24 breaths/minute; blood pressure, 116/60 mm Hg; pulse oximetry reading, 92%; and with 2+ edema noted in the lower extremities. Prior to 9 AM antidysrhythmic medication administration, which of the following will the nurse reassess? Temperature Pulse Blood pressure Edema

Pulse

What assessment would be a priority in the postoperative care of a patient with an implantable pacemaker? Temperature Pulse Blood pressure Respiratory rate

Pulse

A patient is flying overseas for 1 week for business and packed antihypertensive medications in a suitcase. After arriving at the intended destination, the patient found that the luggage had been stolen. If the patient cannot take the medication, what condition becomes a concern? Isolated systolic hypertension Rebound hypertension Angina Left ventricular hypertrophy

Rebound hypertension

The nurse is caring for a client who has had an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. How should the nurse best respond? Recognize that the view of the electrical current changes in relation to the lead placement. Recognize that the electrophysiological conduction of the heart differs with lead placement. Inform the technician that the ECG equipment has malfunctioned. Inform the physician that the client is experiencing a new onset of dysrhythmia.

Recognize that the view of the electrical current changes in relation to the lead placement.

A client is brought to the emergency department with reports of a bad headache and an increase in blood pressure. The blood pressure reading obtained by the nurse is 260/180 mm Hg. What is the therapeutic goal for reduction of the mean blood pressure? Reduce the blood pressure by 20% to 25% within the first hour of treatment. Reduce the blood pressure to about 140/80 mm Hg. Rapidly reduce the blood pressure so the client will not suffer a stroke. Reduce the blood pressure by 50% within the first hour of treatment.

Reduce the blood pressure by 20% to 25% within the first hour of treatment.

The nurse is collaborating with the dietitian and a client with hypertension to plan dietary modifications. What modifications should be made? Reduced intake of protein and carbohydrates Increased intake of calcium and vitamin D Reduced intake of fat and sodium Increased intake of potassium, vitamin B12 and vitamin D

Reduced intake of fat and sodium

Sandy Garrison, a 37-year-old bus driver, has been recently diagnosed with hypertension and is having a difficult time emotionally adjusting to her condition. Why is it important for you, as her nurse, implement measures to relieve emotional stress for clients with hypertension? Choose the correct option. Reduced stress decreases the production of neurotransmitters that constrict peripheral arterioles. Reduced stress increases the production of neurotransmitters that constrict peripheral arterioles. Reduced stress increases the resistance that the heart must overcome to eject blood. Reduced stress increases the blood volume and improves the potential for greater cardiac output

Reduced stress increases the production of neurotransmitters that constrict peripheral arterioles.

The nurse is preparing a client for an endarterectomy and knows that this procedure is intended to do what for the client? Removal of the lining of an artery Removal of an embolus from an artery Removal of a thrombus from an artery Removal of an aneurysm from an artery

Removal of the lining of an artery

Where does bradycardia originate? AV node. Bundle of HIS. SA node. Purkinje fibres.

SA node.

Which term describes high blood pressure from an identified cause, such as renal disease? Primary hypertension Secondary hypertension Rebound hypertension Hypertensive emergency

Secondary hypertension

The nurse is assisting with the monitoring of a client with a dysrhythmia that shows the pattern in the accompanying image. What dysrhythmia does the client have? Sinus bradycardia Sinus tachycardia Atrial fibrillation Ventricular tachycardia

Sinus bradycardia

A nurse providing education about hypertension to a community group is discussing the high risk for cardiovascular complications. What are risk factors for cardiovascular problems in clients with hypertension? Select all that apply. Gallbladder disease Smoking Diabetes mellitus Physical inactivity Frequent upper respiratory infections

Smoking Physical inactivity Diabetes mellitus

A 40-year-old man newly diagnosed with hypertension is discussing risk factors with the nurse. The nurse talks about lifestyle changes with the patient and advises that the patient should avoid tobacco use. What is the rationale behind that advice to the patient? Smoking directly causes high blood pressure. Smoking increases the risk of heart disease. Smoking causes obesity, which exacerbates hypertension. Smoking increases cardiac output.

Smoking increases the risk of heart disease.

A student nurse is taking care of an elderly hypertensive patient during her clinical experience. The instructor asks the student why blood pressure tends to increase with age. What would be the best answer by the student? Blood pressure tends to go down with age, not up. Decreases in the lumen of the arteries and venous insufficiency are more common in the elderly. Structural and functional changes in the cardiovascular system that occur with age contribute to increases in blood pressure. Ageing has no bearing on blood pressure.

Structural and functional changes in the cardiovascular system that occur with age contribute to increases in blood pressure.

The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting state of the client's heart? P wave T wave U wave QRS complex

T wave

A nurse is admitting a 45-year-old man to the Medical Surgical unit. The patient has a diagnosis of Buerger's disease. While taking the patient's health history he reveals that he smokes about 2 packs of cigarettes a day, has a history of alcohol abuse, and does not exercise. What would be the priority teaching for this patient? The lack of exercise, which is the identified cause of Buerger's disease. The likelihood that drinking alcohol and not exercising may cause his death in the near future without a significant change in behaviour. The cigarettes contain nicotine, which is a powerful vasoconstrictor and may cause or aggravate Buerger's disease. The fact that alcohol suppresses the immune system, creates high glucose levels, and may cause Buerger's disease.

The cigarettes contain nicotine, which is a powerful vasoconstrictor and may cause or aggravate Buerger's disease.

What is blood pressure? The force produced by the volume of blood in arterial walls The force produced by the volume of blood in the venous system The measurement of cardiac output The peripheral resistance of the cardiac output

The force produced by the volume of blood in the venous system

When assessing a patient diagnosed with angina pectoris it is important for the nurse to gather what information? The patient's activities after the attacks. The patient's symptoms and activities that precipitate attacks. The patient's symptoms following the attacks. The patient's mental symptoms.

The patient's symptoms and activities that precipitate attacks.

The client has just been diagnosed with a dysrhythmia. The client asks the nurse to explain normal sinus rhythm. What would the nurse explain is the characteristic of normal sinus rhythm? Heart rate between 60 and 150 beats/minute. Impulse travels to the atrioventricular (AV) node in 0.15 to 0.5 second. The ventricles depolarize in 0.5 second or less. The sinoatrial (SA) node initiates the impulse.

The sinoatrial (SA) node initiates the impulse.

When discussing the nursing process, the instructor stresses that for clients undergoing cardiac surgery, it is important for the nurse to demonstrate competence. What is the rationale for this statement? To acknowledge the client's emotion To encourage verbal conversation To relieve the client's insecurity and anxiety To encourage the client to communicate

To relieve the client's insecurity and anxiety

A client newly diagnosed with hypertension is discussing risk factors with the nurse. The nurse talks about lifestyle changes with the client and advises that the client should avoid tobacco use. What is the primary rationale behind that advice to the client? Quitting smoking will cause the client's hypertension to resolve. Tobacco use increases the client's concurrent risk of heart disease. Tobacco use is associated with a sedentary lifestyle. Tobacco use causes ventricular hypertrophy.

Tobacco use increases the client's concurrent risk of heart disease.

An older adult is newly diagnosed with primary hypertension and has just been started on a beta-blocker. What should the nurse include in health education? Increasing fluids to avoid extracellular volume depletion from the diuretic effect of the beta-blocker Maintaining a diet high in dairy to increase protein necessary to prevent organ damage Use of strategies to prevent falls stemming from postural hypotension Limiting exercise to avoid injury that can be caused by increased intracranial pressure

Use of strategies to prevent falls stemming from postural hypotension

Which statements are true when the nurse is measuring blood pressure (BP)? Select all that apply. Using a BP cuff that is too small will give a higher BP measurement. The client's arm should be positioned at the level of the heart. Using a BP cuff that is too large will give a higher BP measurement. The client's BP should be measured 1 hour before consuming alcohol. The client should sit quietly while BP is being measured.

Using a BP cuff that is too small will give a higher BP measurement. The client should sit quietly while BP is being measured. The client's arm should be positioned at the level of the heart.

A patient with hypertension has a newly diagnosed atrial fibrillation. What medication does the nurse anticipate administering to prevent the complication of atrial thrombi? Adenosine Amiodarone Warfarin Atropine

Warfarin

A client has just undergone open chest cardiac surgery. Upon regaining consciousness, the client might be temporarily disturbed by: a painless lump at the proximal incision. lack of appetite. coughing. Insomnia.

a painless lump at the proximal incision.

The nurse is caring for a client who is displaying a third-degree AV block on the EKG monitor. What is the priority nursing intervention for the client? assessing blood pressure and heart rate frequently identifying a code-level status maintaining intravenous fluids alerting the healthcare provider of the third-degree heart block

alerting the healthcare provider of the third-degree heart block

A client has been diagnosed as experiencing "white-coat hypertension." This refers to: anxiety insomnia depression loss of consciousness

anxiety

The nurse is writing a plan of care for a client with a cardiac dysrhythmia. What would be the priority goal for the client? Maintain a resting heart rate below 70 bpm. Maintain adequate control of chest pain. Maintain adequate cardiac output. Maintain normal cardiac structure.

Maintain adequate cardiac output.

The nurse is caring for a client with malignant hypertension. What would be an appropriate nursing intervention for this client? Monitor the client's mental and emotional status every hour. Monitor the blood pressure (BP) every few minutes by applying an automatic BP recording machine. Monitor the client's blood sugar every hour. Monitor the client's temperature every few minutes.

Monitor the blood pressure (BP) every few minutes by applying an automatic BP recording machine.

A client has a significant history of congestive heart failure. What should the nurse specifically assess during the client's semiannual cardiology examination? Select all that apply. Monitor the client for signs of lethargy or confusion. Examine the client's neck for distended veins. Examine the client's eyes for excess tears. Examine the client's joints for crepitus.

Monitor the client for signs of lethargy or confusion. Examine the client's neck for distended veins.

A nurse is teaching an adult female client about the risk factors for hypertension. What should the nurse explain as risk factors for primary hypertension? Obesity and high intake of sodium and saturated fat Diabetes and use of oral contraceptives Metabolic syndrome and smoking Renal disease and coarctation of the aorta

Obesity and high intake of sodium and saturated fat

A 47-year-old male patient calls the nurse and asks about the risk factors of hypertension. What should the nurse list as risk factors for primary hypertension? Obesity, high intake of sodium and saturated fat. Diabetes mellitus, oral contraceptives. Metabolic syndrome, smoking. Renal disease, coarctation of the aorta.

Obesity, high intake of sodium and saturated fat.

The nurse is providing an educational event to a local community group. The nurse is talking about coronary artery disease (CAD) and its risk factors. The nurse explains to the community group that CAD has many risk factors, some that can be controlled and some that can't. What risk factors would the nurse list that can be controlled or modified? Gender, obesity, family history, and smoking. Inactivity, stress, gender, and smoking. Obesity, inactivity, diet, and smoking. Stress, family history, and obesity.

Obesity, inactivity, diet, and smoking.

A client is brought to the ED and determined to be experiencing symptomatic sinus bradycardia. The nurse caring for this client is aware the medication of choice for treatment of this dysrhythmia is the administration of atropine. What guidelines will the nurse follow when administering atropine? Administer atropine 0.5 mg as an IV bolus every 3 to 5 minutes to a maximum of 3.0 mg. Administer atropine as a continuous infusion until symptoms resolve. Administer atropine as a continuous infusion to a maximum of 30 mg in 24 hours. Administer atropine 1.0 mg sublingually.

Administer atropine 0.5 mg as an IV bolus every 3 to 5 minutes to a maximum of 3.0 mg.

Every shift you work in the hospital unit where you practice nursing, blood pressures are measured as a component of your policy-scheduled assessments. Much information can be gleaned from comparing blood pressure measurements. What does a blood pressure reading indicate? All of the options are correct. Arterial ability to stretch and fill with blood Pumping efficacy of the heart Circulating blood volume

All of the options are correct.

Much information can be gained from comparing blood pressure measurements. What does a blood pressure reading indicate? All of the options are correct. arterial ability to stretch and fill with blood pumping efficacy of the heart circulating blood volume

All of the options are correct.

A client will be placed on cardiopulmonary bypass for a mitral valve replacement. What type of medication will be required for this client? An antipyretic A beta-adrenergic blocker A calcium channel blocker An anticoagulant

An anticoagulant

The client is being prepared for cardiothoracic surgery and is very apprehensive. What medication can be administered with a physician's order to decrease the amount of anesthetic that the client will receive in surgery? An analgesic An anxiolytic drug An antipsychotic drug An anticholinergic drug

An anxiolytic drug

Which of the following medication classifications is more likely to be expected when the nurse is caring for a client with atrial fibrillation? Diuretic Anticoagulant Antihypertensive Potassium supplement

Anticoagulant

A client reports chest pain and heavy breathing when exercising or when stressed. Which is a priority nursing intervention for the client diagnosed with coronary artery disease? Assess chest pain and administer prescribed drugs and oxygen Assess blood pressure and administer aspirin It is not important to assess the client or to notify the physician Assess the client's physical history

Assess chest pain and administer prescribed drugs and oxygen

A nurse is caring for a client who's experiencing sinus bradycardia with a pulse rate of 40 beats/minute. The client's blood pressure is 80/50 mm Hg and the client reports dizziness. Which medication does the nurse anticipate administering to treat bradycardia? Atropine Dobutamine Amiodarone Lidocaine

Atropine

Which medication is the drug of choice for sinus bradycardia? Atropine Lidocaine Pronestyl Cardizem

Atropine

The nurse is planning discharge teaching for a patient with a newly inserted permanent pacemaker. What would be important for the nurse to teach this patient? Start lifting the arm above the shoulder right away to prevent shoulder restriction. Avoid cooking with a microwave oven. Avoid exposure to high-voltage electrical generators. Avoid walking through store and library antitheft devices.

Avoid exposure to high-voltage electrical generators.

The nurse is working with a client who has just been diagnosed with an aneurysm. What advice should the nurse provide to this client? Minimize bowel movements and coughing. Avoid situations that contribute to ischemic episodes. Avoid straining during bowel movements and coughing. Wear wool socks and mittens during cold weather.

Avoid straining during bowel movements and coughing.

A nurse is creating an education plan for a client with venous insufficiency. What measure should the nurse include in the plan? Avoid tight-fitting socks. Limit activity whenever possible. Sleep with legs in a dependent position. Avoid the use of pressure stockings.

Avoid tight-fitting socks.

The nurse is providing discharge instructions to a client after a permanent pacemaker insertion. Which safety precaution will the nurse communicate to the client? Stay at least 5 feet away from microwave ovens. Never engage in activities that require vigorous arm and shoulder movement. Avoid going through airport metal detectors. Avoid undergoing magnetic resonance imaging (MRI).

Avoid undergoing magnetic resonance imaging (MRI).

A client presents to the ED reporting severe substernal chest pain radiating down his left arm. He is admitted to the coronary care unit (CCU) with a diagnosis of myocardial infarction (MI). What nursing assessment activity is a priority on admission to the CCU? Begin ECG monitoring. Obtain information about family history of heart disease. Auscultate lung fields. Determine if the client smokes.

Begin ECG monitoring.

A nurse provides morning care for a client in the intensive care unit (ICU). Suddenly, the bedside monitor shows ventricular fibrillation and the client becomes unresponsive. After calling for assistance, what action should the nurse take next? Begin cardiopulmonary resuscitation Prepare for endotracheal intubation Provide electrical cardioversion Administer intravenous epinephrine

Begin cardiopulmonary resuscitation

The nurse should know that both off-Pump coronary artery bypass (CAB) and minimally invasive direct coronary artery bypass have what significant feature in common? Both surgeries are conducted on a heart that continues to beat. Both surgeries require a sternal incision. Both surgeries limit the number of vessels bypassed to two. Both surgeries involve cardioplegia.

Both surgeries are conducted on a heart that continues to beat.

The nurse recognizes that which laboratory test is a key diagnostic indicator of heart failure? Complete blood count (CBC) Blood urea nitrogen (BUN) Creatinine Brain natriuretic peptide (BNP)

Brain natriuretic peptide (BNP)

The nurse is caring for an elderly client with a diagnosis of hypertension, who is taking several antihypertensive medications. Which safety precaution is the nurse most likely to reinforce? Changing positions slowly related to possible hypotension Eating extra potassium due to loss of potassium related to medications Being sure to keep follow-up appointments Walking as far as the client is able every day

Changing positions slowly related to possible hypotension

The nurse is answering questions that the client and family have about the upcoming cardiovascular surgery the client is having. What expected outcome would be best for a nursing diagnosis of Deficient Knowledge related to unfamiliarity with diagnostic tests, preoperative preparations, and postoperative care? Clarify misconceptions concerning surgery. Client and family will understand the purpose, preparation, and aftercare of tests and surgery. Provide verbal and written information concerning the surgical procedure and aftercare. Ask the client or family member to explain the surgical procedure before signing the consent form.

Client and family will understand the purpose, preparation, and aftercare of tests and surgery.

A patient has been prescribed antihypertensives. After assessment and analysis, the nurse has identified a nursing diagnosis of risk for ineffective health maintenance related to nonadherence to therapeutic regimen. When planning this client's care, what desired outcome should the nurse identify? Client takes medication as prescribed and reports any adverse effects. Client's BP remains consistently below 140/90 mm Hg. Client denies signs and symptoms of hypertensive urgency. Client is able to describe modifiable risk factors for hypertension.

Client takes medication as prescribed and reports any adverse effects.

A client who is postoperative day 1 following a CABG has produced 20 mL of urine in the past 3 hours and the nurse has confirmed the patency of the urinary catheter. What is the nurse's most appropriate action? Document the client's low urine output and monitor closely for the next several hours. Contact the dietitian and suggest the need for increased oral fluid intake. Contact the client's health care provider and continue to assess fluid balance and renal function. Increase the infusion rate of the client's IV fluid to prompt an increase in renal function.

Contact the client's health care provider and continue to assess fluid balance and renal function.

A client presents to the ED in distress and reporting "crushing" chest pain. What is the nurse's priority for assessment? Prompt initiation of an ECG Auscultation of the client's point of maximal impulse (PMI) Rapid assessment of the client's peripheral pulses Palpation of the client's cardiac apex

Prompt initiation of an ECG

A client has had oral anticoagulation ordered. What should the nurse monitor for when the client is taking oral anticoagulation? Prothrombin time (PT) or international normalized ratio (INR) Hourly IV infusion Vascular sites for bleeding Urine output

Prothrombin time (PT) or international normalized ratio (INR)

The nurse is caring for a client with refractory atrial fibrillation who underwent the maze procedure several months ago. The nurse reviews the result of the client's most recent cardiac imaging, which notes the presence of scarring on the atria. How should the nurse best interpret this finding? Recognize that the procedure was unsuccessful. Recognize this as a therapeutic goal of the procedure. Liaise with the care team in preparation for repeating the maze procedure. Prepare the client for pacemaker implantation.

Recognize this as a therapeutic goal of the procedure.

A patient newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged uncontrolled hypertension is at risk for developing what health problem? Renal failure Right ventricular hypertrophy Glaucoma Anemia

Renal failure

A patient newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged uncontrolled hypertension is at risk for developing what? Renal failure Right ventricular hypertrophy Glaucoma Anaemia

Renal failure

The nurse is caring for a client presenting to the emergency department (ED) reporting chest pain. Which electrocardiographic (ECG) finding would be most concerning to the nurse? ST elevation Isolated premature ventricular contractions (PVCs) Sinus tachycardia Frequent premature atrial contractions (PACs)

ST elevation

Ed Jones, a 65-year-old retired athlete, is readying for coronary artery bypass surgery. As his nurse, you continually reinforce his education about the upcoming procedure, assessing his understanding and re-teaching, when necessary. Which blood vessel is most likely to be used for his graft? Cephalic vein Internal mammary artery Saphenous vein Radial artery

Saphenous vein

A patient with secondary hypertension has come into the clinic for a routine check-up. The nurse is aware that the difference between primary and secondary hypertension is what? Secondary hypertension has a specific cause. Secondary hypertension has a more gradual onset than primary hypertension. Secondary hypertension does not cause target organ damage. Secondary hypertension does not respond to antihypertensive drug therapy.

Secondary hypertension has a specific cause.

A patient with secondary hypertension has come into the clinic for a routine check-up. The nurse is aware that the difference between primary hypertension and secondary hypertension is what? Secondary hypertension has a specific cause. Secondary hypertension has a more gradual onset than primary hypertension. Secondary hypertension does not cause target organ damage. Secondary hypertension does not respond to antihypertensive drug therapy.

Secondary hypertension has a specific cause.

A 66-year-old client is having cardiac diagnostic tests to determine the cause of her symptoms. In her follow-up visit to the cardiologist, he indicates dysrhythmias as having the typical conductive pathway but at a rate slower than 60 beats per minute. What type of dysrhythmia would you expect the tests to reveal? Sinus bradycardia Atrial bradycardia Heart block None

Sinus bradycardia

A patient comes to the emergency department with reports of chest pain after using cocaine. The nurse assesses the patient and obtains vital signs with results as follows: blood pressure 140/92, heart rate 128, respiratory rate 26, and an oxygen saturation of 98%. What rhythm on the monitor does the nurse anticipate viewing? Sinus bradycardia Ventricular tachycardia Normal sinus rhythm Sinus tachycardia

Sinus tachycardia

The nurse is instructing a client who is newly prescribed an antihypertensive medication. Which nursing instruction is emphasized to maintain client safety? Use a pillbox to store daily medication. Sit on the edge of the chair and rise slowly. Do not operate a motor vehicle. Take the medication at the same time daily.

Sit on the edge of the chair and rise slowly.

A client comes to the walk-in clinic complaining of frequent headaches. While assessing the client's vital signs, the nurse notes the BP is 161/101 mm Hg. How would this client's BP be defined? Elevated Normal Stage 1 hypertensive Stage 2 hypertensive

Stage 2 hypertensive

The physician has prescribed a thrombolytic for a patient who has chest pain unrelieved by nitroglycerin. Which of the following should the nurse assess before administering thrombolytic agents to older patients? Streptococcal infections Joint pains Hair loss Skin integration

Streptococcal infections

The nurse is employed in a physician's office and is caring for a client present for an annual exam. A blood pressure of 124/84 mm Hg is documented. Following revised guidelines for identifying hypertension, which educational pamphlet is help? Increasing fluids for low blood pressure Stress reduction to lower prehypertensive state Use of beta-blockers for treatment of hypertension Diagnostic testing for determining cardiac functioning

Stress reduction to lower prehypertensive state

Mr. Faulkner is a 69-year-old man who has enjoyed generally good health for his entire adult life. As a result, he has been surprised to receive a new diagnosis of hypertension after a series of visits to his primary care provider. The nurse who is working with Mr. Faulkner should recognize which of the following aspects of aging and hypertension? The diagnostic criteria for hypertension in adults over 65 differ from those for younger adults. The incidence and prevalence of hypertension increase with age. Blood pressure remains stable throughout adulthood but tends to be assessed more often by health care providers of older adults. Older adults are less vulnerable to the pathophysiological effects of hypertension than are younger adults.

The incidence and prevalence of hypertension increase with age.

The licensed practical nurse is co-assigned with a registered nurse in the care of a client admitted to the cardiac unit with chest pain. The licensed practical nurse is assessing the accuracy of the cardiac monitor, which notes a heart rate of 34 beats/minute. The client appears anxious and states not feeling well. The licensed practical nurse confirms the monitor reading. When consulting with the registered nurse, which of the following is anticipated? The registered nurse stating to administer digoxin The registered nurse administering atropine sulfate intravenously The registered nurse stating to hold all medication until the pulse rate returns to 60 beats/minute The registered nurse stating to administer all medications except those which are cardiotonics

The registered nurse administering atropine sulfate intravenously

Family members bring a client to the ED with pale cool skin, sudden midsternal chest pain unrelieved with rest, and a history of CAD. How should the nurse best interpret these initial data? The symptoms indicate angina and should be treated as such. The symptoms indicate a pulmonary etiology rather than a cardiac etiology. The symptoms indicate an acute coronary episode and should be treated as such. Treatment should be determined pending the results of an exercise stress test.

The symptoms indicate an acute coronary episode and should be treated as such.

A patient with angina is beginning nitroglycerin. Before administering the drug, the nurse informs the patient that, immediately after administration, the patient may experience what? Nervousness or paresthesia Throbbing headache or dizziness Drowsiness or blurred vision Tinnitus or diplopia

Throbbing headache or dizziness

In the treatment of coronary artery disease (CAD), medications are often ordered to control blood pressure in the client. Which of the following is a primary purpose of using beta-adrenergic blockers in the nursing management of CAD? To dilate coronary arteries To decrease workload of the heart To decrease homocysteine levels To prevent angiotensin II conversion

To decrease workload of the heart

A patient has been admitted to the unit for an electrophysiology (EP) study. For what is an electrophysiology study primarily performed? To facilitate cardioversion To freeze hypersensitive cells To diagnose the dysrhythmia To determine the nursing plan of care

To diagnose the dysrhythmia

The nurse is teaching a client about some of the health consequences of uncontrolled hypertension. What health problems should the nurse describe? Select all that apply. Transient ischemic attacks (TIAs) Cerebrovascular disease Retinal hemorrhage Venous insufficiency Right ventricular hypertrophy

Transient ischemic attacks (TIAs) Cerebrovascular disease Retinal hemorrhage

A client has come to the clinic for a follow-up assessment that will include a BP reading. To ensure an accurate reading, the nurse should confirm that the client has done which of the following? Tried to rest quietly for 5 minutes before the reading is taken Refrained from smoking for at least 8 hours Drank adequate fluids during the day prior Avoided drinking coffee for 12 hours before the visit

Tried to rest quietly for 5 minutes before the reading is taken

A patient has come to the clinic for a follow-up assessment. Before taking the blood pressure, the nurse should determine if the patient has: Tried to rest quietly for 5 minutes before the reading is taken Refrained from smoking for at least 8 hours Been NPO for at least 2 hours Avoided drinking coffee for 12 hours before the visit

Tried to rest quietly for 5 minutes before the reading is taken

What symptoms should the nurse assess for in a client with lymphedema as a result of impaired nutrition to the tissue? Loose and wrinkled skin Ulcers and infection in the edematous area Evident scaring Cyanosis

Ulcers and infection in the edematous area

When a client who has been diagnosed with angina pectoris reports experiencing chest pain more frequently, even at rest, that the period of pain is longer, and that it takes less stress for the pain to occur, the nurse recognizes that the client is describing which type of angina? Intractable Variant Unstable Refractory

Unstable

The nurse reports to the cardiac nurse practitioner that the client is consistently exhibiting a normal sinus rhythm. What characteristics are understood? Select all that apply. Heart rate 106 beats/minute Upright P wave before each QRS complex Each impulse occurs regularly. Impulse travels to the SA node from the AV node. Wave ends with a T wave Ventricles depolarize in the QRS complex.

Upright P wave before each QRS complex Each impulse occurs regularly. Wave ends with a T wave Ventricles depolarize in the QRS complex.

A client has had cardiothoracic surgery, and the nurse is palpating the peripheral pulses. The nurse cannot palpate the left lower extremity pulse. What is the first action by the nurse? Call the physician. Apply a vasodilator such as nitroglycerin cream on the skin surface and then palpate. Call the charge nurse. Use a Doppler ultrasound device.

Use a Doppler ultrasound device.

A client has had cardiothoracic surgery, and the nurse is palpating the peripheral pulses. The nurse cannot palpate the left lower extremity pulse. What is the first action by the nurse? Use a Doppler ultrasound device. Call the charge nurse. Apply a vasodilator such as nitroglycerin cream on the skin surface and then palpate. Call the physician.

Use a Doppler ultrasound device.

Which nursing intervention should the nurse perform when a client with valvular disorder of the heart has a heart rate less than 60 beats/min before administering beta-blockers? Observe for symptoms of pulmonary edema. Continue the drug and document in the client's chart. Withhold the drug and inform the primary health care provider. Check for signs of toxicity.

Withhold the drug and inform the primary health care provider.

The nurse is caring for a client with hypertension. The nurse is correct to realize that a 24-hour urine is ordered to determine if the cause of hypertension is related to the dysfunction of which of the thyroid gland adrenal gland pituitary gland thymus

adrenal gland

The nurse is assessing a client with symptomatic bradycardia. What medication does the nurse anticipate will be ordered by the healthcare provider to treat the bradycardia? atropine lidocaine diltiazem adenosine

atropine

A client tells the nurse "my heart is skipping beats again; I'm having palpitations." After completing a physical assessment, the nurse concludes the client is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the client to avoid caffeinated beverages. request sublingual nitroglycerin. apply supplemental oxygen. lie down and elevate the feet.

avoid caffeinated beverages.

A client with CAD thinks diltiazem (Cardizem) has been causing nausea. Diltiazem (Cardizem) is categorized as which type of drug? calcium-channel blocker beta-adrenergic blocker nitrate diuretic

calcium-channel blocker

Post-hospitalization, a client is on prescribed medication intended to produce arterial vasodilation. At the follow up examination, the cardiologist asks the client about the efficacy of the medication since hospitalization. What type of medication is not as effective as a vasodilator as others? calcium-channel blockers beta-adrenergic blockers nitrates All are similarly effective.

calcium-channel blockers

A client who has developed congestive heart failure must learn to make dietary adaptations. The client should avoid: canned peas. dried peas. angel food cake. ready-to-eat cereals.

canned peas.

The public health nurse is participating in a health fair and interviews a client with a history of hypertension, who is currently smoking one pack of cigarettes per day. The client denies any of the most common manifestations of CAD. The nurse should expect the focuses of CAD treatment to be: drug therapy and smoking cessation. diet and drug therapy. diet therapy only. diet therapy and smoking cessation.

drug therapy and smoking cessation.

The nurse is teaching a client about hypertension and the effects on the left ventricle. What diagnostic test will the nurse describe? echocardiography computed tomographic (CT) scan fluorescein angiography positron emission tomography (PET) scan

echocardiography

A client reports light-headedness, chest pain, and shortness of breath. They physician orders tests to ascertain what is causing the client's problems. Which test is used to identify cardiac rhythms? electrocardiogram electroencephalogram echocardiogram electrocautery

electrocardiogram

The nurse is caring for a client with coronary artery disease. What is the nurse's priority goal for the client? decrease anxiety enhance myocardial oxygenation administer sublingual nitroglycerin educate the client about his symptoms

enhance myocardial oxygenation

The nurse is reviewing the laboratory results for a client diagnosed with coronary artery disease (CAD). The client's low-density lipoprotein (LDL) level is 115 mg/dL. The nurse interprets this value as high. low. within normal limits. critically high.

high

The nurse assesses a client with a heart rate of 120 beats per minute. What are the known causes of sinus tachycardia? hypovolemia vagal stimulation hypothyroidism digoxin

hypovolemia

The nurse is assessing a client with crackling breath sounds or pulmonary congestion. What is the cause of the congestion? hepatomegaly ascites nocturia inadequate cardiac output

inadequate cardiac output

It is appropriate for the nurse to recommend smoking cessation for clients with hypertension because nicotine increases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood. decreases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood. increases the heart rate, constricts arterioles, and increases the heart's ability to eject blood. decreases circulating blood volume.

increases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood.

Papilledema is a fairly common symptom of elevated blood pressure. The best way to detect this condition is through: ophthalmic examination. using a sphygmomanometer. laboratory tests. an MRI.

ophthalmic examination.

The nurse is administering a calcium channel blocker to a patient who has symptomatic sinus tachycardia at a rate of 132 bpm. What is the anticipated action of the drug for this patient? Decreases the sinoatrial node automaticity Increases the atrioventricular node conduction Increases the heart rate Creates a positive inotropic effect

Decreases the sinoatrial node automaticity

A nurse in a long-term care facility is caring for an 83-year-old woman who has a history of heart failure and peripheral arterial disease. At present the patient is unable to stand or ambulate. What does the nurse know the patient is at significant risk for? Aoritis Deep vein thrombosis Thoracic aortic aneurysm Raynaud's disease

Deep vein thrombosis

A nurse is caring for a client who is exhibiting ventricular tachycardia (VT). Because the client is pulseless, the nurse should prepare for what intervention? Defibrillation ECG monitoring Implantation of a cardioverter defibrillator Angioplasty

Defibrillation

The nurse is observing the monitor of a patient with a first-degree atrioventricular (AV) block. What is the nurse aware characterizes this block? A variable heart rate, usually fewer than 60 bpm An irregular rhythm Delayed conduction, producing a prolonged PR interval P waves hidden with the QRS complex

Delayed conduction, producing a prolonged PR interval

A client is admitted to the cardiac care unit for an electrophysiology (EP) study. What goal should guide the planning and execution of the client's care? Ablate the area causing the dysrhythmia. Freeze hypersensitive cells. Diagnose the dysrhythmia. Determine the nursing plan of care.

Diagnose the dysrhythmia.

A patient is admitted to your unit for an electrophysiology (EP) study. Why is an electrophysiology study performed? Abliterate the area causing the dysrhythmia. Freeze hypersensitive cells. Diagnose the dysrhythmia. Determine the nursing plan of care.

Diagnose the dysrhythmia.

A client has been living with an internal, fixed-rate pacemaker. When checking the client's readings on a cardiac monitor the nurse notices an absence of spikes. What should the nurse do? Double-check the monitoring equipment. Do nothing; there is no cause for alarm. Suggest the need for a new beta-blocker to the doctor. Measure the client's blood pressure.

Double-check the monitoring equipment.

The nurse is preparing a client for upcoming electrophysiology (EP) studies and possible ablation for treatment of atrial tachycardia. What information will the nurse include in the teaching? During the procedure, the dysrhythmia will be reproduced under controlled conditions. The procedure will occur in the operating room under general anesthesia. The procedure takes less time than a cardiac catheterization. After the procedure, the dysrhythmia will not recur.

During the procedure, the dysrhythmia will be reproduced under controlled conditions.

The diagnosis of heart failure is usually confirmed by which of the following? Chest x-ray Echocardiogram Electrocardiogram (12-lead) Ventriculogram

Echocardiogram

When caring for a patient with leg ulcers, the positioning of the legs depends on whether the ulcer is arterial or venous in origin. How would you position a patient who has leg ulcers that are venous in origin? Keep the legs flat without the knee gauche raised. Gauche the knees to about a 45° angle. Elevate lower extremities. Hang the legs over the side of the bed.

Elevate lower extremities.

How should the nurse best position a client who has leg ulcers that are venous in origin? Keep the client's legs flat and straight. Keep the client's knees bent to 45-degree angle and supported with pillows. Elevate the client's lower extremities. Dangle the client's legs over the side of the bed.

Elevate the client's lower extremities.

A client comes to the emergency department reporting chest pain. An electrocardiogram (ECG) reveals myocardial ischemia and an anterior-wall myocardial infarction (MI). Which ECG characteristic does the nurse expect to see? Prolonged PR interval Absent Q wave Elevated ST segment Widened QRS complex

Elevated ST segment

A client has developed a clot in the femoral artery. The nurse prepares the client for what type of surgery? Commissurotomy Annuloplasty Embolectomy Endarterectomy

Embolectomy

A nurse has written a plan of care for a man diagnosed with peripheral arterial insufficiency. One of the nursing diagnoses in the care plan is altered peripheral tissue perfusion related to compromised circulation. What is the most appropriate intervention for this diagnosis? Elevate his legs and arms above his heart when resting. Encourage the client to engage in a moderate amount of exercise. Encourage extended periods of sitting or standing. Discourage walking in order to limit pain.

Encourage the client to engage in a moderate amount of exercise.

A client is diagnosed with obstructive atherosclerotic plaque of the left carotid artery. What procedure does the nurse anticipate preparing the client for? Endarterectomy Thrombectomy Coronary artery bypass graft Embolectomy

Endarterectomy

A client who has recently undergone prosthetic heart valve replacement wants to know why she must take antibiotics following the procedure. What problem would the nurse explain to the client that the antibiotics are used to prevent? Lymphadenitis Endocarditis Myocarditis Phlebitis

Endocarditis

A client who has recently undergone prosthetic heart valve replacement wants to know why she must take antibiotics following the procedure. What problem would the nurse explain to the client that the antibiotics are used to prevent? Phlebitis Lymphadenitis Endocarditis Myocarditis

Endocarditis

The ED nurse is caring for a client who has gone into cardiac arrest. During external defibrillation, what action should the nurse perform? Place gel pads over the apex and posterior chest for better conduction. Ensure no one is touching the client at the time shock is delivered. Continue to ventilate the client via endotracheal tube during the procedure. Allow at least 3 minutes between shocks.

Ensure no one is touching the client at the time shock is delivered.

A nurse on a busy medical unit is aware of the importance of accurate blood pressure (BP) measurement. To ensure accuracy when assessing patients' blood pressures, the nurse should always: Use a manual, rather than automated, sphygmomanometer Alternate blood pressure readings between patients' right and left arms Take serial blood pressure readings on each patient Ensure that the correct cuff size is used for each patient

Ensure that the correct cuff size is used for each patient

The nurse and the other members of the team are caring for a client who converted to ventricular fibrillation (VF). The client was defibrillated unsuccessfully and the client remains in VF. The nurse should anticipate the administration of what medication? Epinephrine 1 mg IV push Lidocaine 100 mg IV push Amiodarone 300 mg IV push Sodium bicarbonate 1 amp IV push

Epinephrine 1 mg IV push

Which statement is accurate regarding Raynaud disease? The disease generally affects the client trilaterally. It affects more than two digits on each hand or foot. It is most common in men 16 to 40 years of age. Episodes may be triggered by unusual sensitivity to cold.

Episodes may be triggered by unusual sensitivity to cold.

A nurse is performing blood pressure screenings at a local health fair. While obtaining subjective assessment data from a patient with hypertension, the patient tells the nurse that she has a family history of hypertension and she herself has high cholesterol and lipids. The patient says she smokes 1 pack of cigarettes daily and drinks "about a pack of beer" every day. The nurse notes that a modifiable risk factor of this patient is what? Hyperlipidaemia. Excessive alcohol intake. A family history of hypertension. Stricter compliance with medical regime.

Excessive alcohol intake.

When discussing angina pectoris secondary to atherosclerotic disease with a client, the client asks why he tends to experience chest pain when he exerts himself. The nurse should describe which of the following phenomena? Exercise increases the heart's oxygen demands. Exercise causes vasoconstriction of the coronary arteries. Exercise shunts blood flow from the heart to the mesenteric area. Exercise increases the metabolism of cardiac medications.

Exercise increases the heart's oxygen demands.

The nurse is creating a community teaching demonstration focusing on the cause of blood pressure. When completing the visual aid, which body structures represent the mechanism of blood pressure? Lung and arteries Heart and blood vessels Brain and sympathetic nervous system Kidneys and autonomic nervous system

Heart and blood vessels

The nurse reads an athletic client's electrocardiogram. What finding will be consistent with a sinus bradycardia? PR interval of 0.24 seconds. Heart rate of 42 beats per minute (bpm). QR interval of 0.25 seconds. P-to-QR ratio of 1:2.

Heart rate of 42 beats per minute (bpm).

When being assessed by her new nurse practitioner, a woman states that she has had Raynaud's disease for many years, a problem that occasionally affects her quality of life. When performing health education surrounding this problem, what should the nurse emphasize? Teaching the woman about atherosclerosis and its role in Raynaud's disease Teaching the woman about the correct use of anticoagulants Helping the woman identify and avoid the specific triggers of her problem Teaching the woman the signs and symptoms of deep vein thrombosis

Helping the woman identify and avoid the specific triggers of her problem

Providing postoperative care to a patient who has percutaneous transluminal angioplasty (PTA), with insertion of a stent, for a femoral artery lesion, includes assessment for the most serious complication of: Hemorrhage. Thrombosis of the graft. Decreased motor function. Stent dislodgement.

Hemorrhage

The staff educator is teaching ED nurses about hypertensive crisis. The nurse educator should explain that hypertensive urgency differs from hypertensive emergency in what way? The BP is always higher in a hypertensive emergency. Vigilant hemodynamic monitoring is required during treatment of hypertensive emergencies. Hypertensive urgency is treated with rest and benzodiazepines to lower BP. Hypertensive emergencies are associated with evidence of target organ damage.

Hypertensive emergencies are associated with evidence of target organ damage.

Which describes a situation in which blood pressure is severely elevated and there is evidence of actual or probable target organ damage? Hypertensive emergency Hypertensive urgency Primary hypertension Secondary hypertension

Hypertensive emergency

A client diagnosed with a myocardial infarction (MI) is being moved to the rehabilitation unit for further therapy. Which statement reflects a long-term goal of rehabilitation for the client with an MI? Improvement in quality of life Limitation of the effects and progression of atherosclerosis Ability to return to work and a pre-illness functional capacity Prevention of another cardiac event

Improvement in quality of life

A client is placed on a low-sodium (500 mg/day) diet. Which client statement indicates that the nurse's nutrition teaching plan has been effective? "I can still eat a ham-and-cheese sandwich with potato chips for lunch." "I chose broiled chicken with a baked potato for dinner." "I chose a tossed salad with sardines and oil and vinegar dressing for lunch." "I'm glad I can still have chicken bouillon."

"I chose broiled chicken with a baked potato for dinner."

A nurse is reviewing self-care measures for a client with peripheral vascular disease. Which statement indicates proper self-care measures? "I like to soak my feet in the hot tub every day." "I walk only to the mailbox in my bare feet." "I stopped smoking and use only chewing tobacco." "I have my wife look at the soles of my feet each day."

"I have my wife look at the soles of my feet each day."

A client is diagnosed with deep vein thrombosis (DVT). Which nursing diagnosis should receive highest priority at this time? Impaired gas exchange related to increased blood flow Excess fluid volume related to peripheral vascular disease Risk for injury related to edema Ineffective peripheral tissue perfusion related to venous congestion

Ineffective peripheral tissue perfusion related to venous congestion

A client is going home with a prescription for nitroglycerin (Nitrostat) for his anginal symptoms. Which of the following statements indicates the client understands the information needed to safely self-medicate? "I will store the nitroglycerin in the refrigerator." "I will take one tablet every 15 minutes when I have angina." "I should sit down or lie down before taking the nitroglycerin." "I am to swallow the nitroglycerin tablet after I put it in my mouth"

"I should sit down or lie down before taking the nitroglycerin."

In preparation for cardiac surgery, a client was taught about measures to prevent venous thromboembolism. What statement indicates that the client clearly understood this education? "I'll try to stay in bed for the first few days to allow myself to heal." "I'll make sure that I don't cross my legs when I'm resting in bed." "I'll keep pillows under my knees to help my blood circulate better." "I'll put on those compression stockings if I get pain in my calves."

"I'll make sure that I don't cross my legs when I'm resting in bed."

A client has been discharged from the hospital following coronary artery bypass grafting (CABG). The client asks the nurse about the chest pain he experienced prior to coming to the hospital during the heart attack. What instructions should the nurse include in the discharge instructions? "You should not have chest pain because you had the CABG, and it fixed the problem with your heart." "If chest pain occurs, take a nitroglycerin. If unrelieved, take another one 5 minutes later. If relieved, no further action is required". "If chest pain occurs, rest. If it doesn't go away, take nitroglycerin and report the event to the physician even if the pain is relieved." "If chest pain occurs, it may be related to gastritis. Take an antacid and lie down for 30 minutes."

"If chest pain occurs, rest. If it doesn't go away, take nitroglycerin and report the event to the physician even if the pain is relieved."

Which client statement indicates a good understanding of the nutritional modifications needed to manage hypertension? "A glass of red wine each day will lower my blood pressure." "I should eliminate caffeine from my diet to lower my blood pressure." "If I include less fat in my diet, I'll lower my blood pressure." "Limiting my salt intake to 2 grams per day will improve my blood pressure."

"Limiting my salt intake to 2 grams per day will improve my blood pressure."

A patient is undergoing preoperative teaching before cardiac surgery. The nurse explains that a temporary pacemaker will be placed later that day, and it will be removed after the surgery. The patient asks the nurse what will happen if the pacemaker quits functioning. What is the nurse's best response? "Monitoring for pacemaker malfunctioning and battery failure is something the nurse caring for you does." "Monitoring for pacemaker malfunctioning and battery failure is something the technician down the hall does." "Monitoring for pacemaker malfunctioning and battery failure is something the secretary at the nurse's station does." "Monitoring for pacemaker malfunctioning and battery failure is something the health care provider caring for you does when he makes rounds every day."

"Monitoring for pacemaker malfunctioning and battery failure is something the nurse caring for you does."

A nurse is educating a client about monitoring blood pressure readings at home. What will the nurse be sure to emphasize? "Avoid smoking cigarettes for 8 hours prior to taking blood pressure." "Sit quietly for 5 minutes prior to taking blood pressure." "Sit with legs crossed when taking your blood pressure." "Be sure the forearm is well supported above heart level while taking blood pressure."

"Sit quietly for 5 minutes prior to taking blood pressure."

During a CPR class, a participant asks about the difference between cardioversion and defibrillation. What would be the instructor's best response? "Cardioversion is done on a beating heart; defibrillation is not." "The difference is the timing of the delivery of the electric current." "Defibrillation is synchronized with the electrical activity of the heart, but cardioversion is not." "Cardioversion is always attempted before defibrillation because it has fewer risks."

"The difference is the timing of the delivery of the electric current."

The client asks the nurse to explain what is meant by a ventricular bigeminy cardiac rhythm. What is the best response by the nurse? "It is when the heart conduction is primarily from the atrioventricular node." "The rhythm has a normal beat, then a premature beat pattern." "The rhythm is regular but fast." "The heart rate is between 150 to 250 bpm."

"The rhythm has a normal beat, then a premature beat pattern."

A client with a second-degree atrioventricular heart block, Type II is admitted to the coronary care unit. How will the nurse explain the need to monitor the client's electrocardiogram (ECG) strip to the spouse? "The small box will transmit the heart rhythm to the central monitor all the time." "When your spouse needs help, an alarm will go off at the desk." "The box is recording the heart's electrical activity, and a physician will review the tracing later." "The heart's electrical activity will be recorded when the heart rate exceeds 60 beats per minute."

"The small box will transmit the heart rhythm to the central monitor all the time."

The nurse is providing care to a client who has just undergone an electrophysiologic (EP) study. The client states that she is nervous about "things going wrong" during the procedure. What is the nurse's best response? "This is basically a risk-free procedure." "Thousands of clients undergo EP every year." "Remember that this is a step that will bring you closer to enjoying good health." "The whole team will be monitoring you very closely for the entire procedure."

"The whole team will be monitoring you very closely for the entire procedure."

A patient who has undergone an implantable cardioverter defibrillator (ICD) procedure asks the nurse about the purpose of this device. What would be the nurse's best response? "To detect and treat ventricular fibrillation and ventricular tachycardia." "To detect and treat bradycardia." "To detect and treat atrial fibrillation." "To shock your heart if you have a heart attack at home."

"To detect and treat ventricular fibrillation and ventricular tachycardia."

The nursing student asks the nurse how to tell the difference between ventricular tachycardia and ventricular fibrillation on an electrocardiogram strip. What is the best response? "Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes." "The two look very much alike; it is difficult to tell the difference." "The QRS complex in ventricular fibrillation is always narrow, while in ventricular tachycardia the QRS is of normal width." "The P-R interval will be prolonged in ventricular fibrillation, while in ventricular tachycardia the P-R interval is normal."

"Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes."

The nurse is assisting a patient with peripheral arterial disease to ambulate in the hallway. What should the nurse include in the education of the patient during ambulation? "As soon as you feel pain, we will go back and elevate your legs." "If you feel pain during the walk, keep walking until the end of the hallway is reached." "Walk to the point of pain, rest until the pain subsides, then resume ambulation." "If you feel any discomfort, stop and we will use a wheelchair to take you back to your room."

"Walk to the point of pain, rest until the pain subsides, then resume ambulation."

A client is 15 years status-post cardiac transplant. After the surgery, which change occurs to the transplanted heart as a result of the procedure? It beats slower than the natural heart. It beats faster than the natural heart. There are no significant changes noted in the transplanted heart. It takes less time to increase its rate in response to exercise.

It beats faster than the natural heart.

The staff educator is teaching a class in dysrhythmias. What statement is correct for defibrillation? It is a scheduled procedure 1 to 10 days in advance. The client is sedated before the procedure. It is used to eliminate ventricular dysrhythmias. It uses less electrical energy than cardioversion.

It is used to eliminate ventricular dysrhythmias.

The triage nurse in the ED assesses an adult client who presents with reports of midsternal chest pain that has lasted for the last 5 hours. If the client's symptoms are due to an MI, what will have happened to the myocardium? It may have developed an increased area of infarction during the time without treatment. It will probably not have more damage than if the client came in immediately. It may be responsive to restoration of the area of dead cells with proper treatment. It has been irreparably damaged, so immediate treatment is no longer necessary.

It may have developed an increased area of infarction during the time without treatment.

Which of the following client scenarios would be correct for the nurse to identify as a client with secondary hypertension? A client experiencing depression A client diagnosed with kidney disease A client of advanced age A client with excessive alcohol intake

A client diagnosed with kidney disease

The nurse is working on a busy cardiac unit caring for four hypertensive clients. Which client description would the nurse assess first because the client is at an increased risk for malignant hypertension? A client with anorexia and history of no health care insurance A client with liver dysfunction who drinks alcohol daily A schizophrenic residing at an assisted living facility A client with chronic asthma who uses a corticosteroid inhaler

A client with anorexia and history of no health care insurance

A nurse is performing blood pressure screenings at a local health fair. While obtaining subjective assessment data from a client with hypertension, the nurse learns that the client has a family history of hypertension and she herself has high cholesterol and lipid levels. The client says she smokes one pack of cigarettes daily and drinks "about a pack of beer" every day. The nurse notes what nonmodifiable risk factor for hypertension? Hyperlipidemia Excessive alcohol intake A family history of hypertension Closer adherence to medical regimen

A family history of hypertension

The nurse is assessing the blood pressure for a patient who has hypertension and the nurse does not hear an auscultatory gap. What outcome may be documented in this circumstance? A low diastolic reading A high systolic pressure reading A normal reading A high diastolic or low systolic reading

A high diastolic or low systolic reading

The nurse is working with a new graduate nurse who is assisting in the care of an older client who is recovering from a surgery that required cardiopulmonary bypass. The client is three days post-surgery and appears drowsy a majority of the time and does not want to engage in conversation with visitors. Which statement by the new graduate represents an understanding of the reason for this client's behavior? "I realize that sometimes older adults experience a change in orientation following cardiac surgery. Sometimes the client may be restless and talk excessively and other times the client may be drowsiness or stuporous." "I'm very concerned that this client is still so drowsy. I wonder if the client sustained brain damage during the surgery." "This client is so tired. I imagine having cardiac surgery is very exhausting. I plan to allow more rest time and I will limit the amount of activity that is required." "This client is acting so odd. I expected confusion and disorientation but not this. I plan to limit the amount of pain medication the client is receiving and see if there is more response."

"I realize that sometimes older adults experience a change in orientation following cardiac surgery. Sometimes the client may be restless and talk excessively and other times the client may be drowsiness or stuporous."

The night before heart surgery involving a quadruple bypass, a client has been admitted and preoperatively prepared. The client has signed the consent for surgery. Which of the following statements indicates a greater need for teaching? "I know that I will have to perform deep breathing and coughing and will be ambulating early." "I know that I will be monitored closely in CCU after the surgery and I will be expected to participate in my care." "I will be relieved to have this surgery over with; I have a busy schedule at work right now and can`t afford downtime." "I know I will need to change my eating habits and activity levels to keep my heart healthy."

"I will be relieved to have this surgery over with; I have a busy schedule at work right now and can`t afford downtime."

A client with heart failure is placed on a low-sodium diet. Which statement by the client indicates that the nurse's nutritional teaching plan has been effective? "I will have a ham and cheese sandwich for lunch." "I will have a tossed salad with cheese and croutons for lunch." "I will have a baked potato with broiled chicken for dinner." "I will have chicken noodle soup with crackers and an apple for lunch."

"I will have a baked potato with broiled chicken for dinner."

A nurse is speaking to a community group about the importance of organ donation. Which statement by a community member requires further information from the nurse? "The older a person is, the less likely that person is to be an organ donor." "It is hard to families to donate the organs of their loved ones; even when they knew that is what the loved one wanted." "Most people who can donate organs are young and haven't left instructions about their wishes for organ donation." "I would donate all of my organs but my family likes big funerals with open caskets and I wouldn't want my family to be upset when they saw me."

"I would donate all of my organs but my family likes big funerals with open caskets and I wouldn't want my family to be upset when they saw me."

After being discharged from the hospital after undergoing cardiothoracic surgery, the client asks the nurse when he can resume sexual activity. What is the best response by the nurse? "You won't be able to resume sexual activity until your 6-month checkup with the surgeon." "You may have a difficult time resuming sexual activities after this surgery." "I can't believe you are worried about that so soon after your surgery." "In about 2 to 4 weeks if you are able to climb stairs without difficulty breathing or chest pain."

"In about 2 to 4 weeks if you are able to climb stairs without difficulty breathing or chest pain."

The nurse is caring for a client who is recovering from coronary artery bypass surgery. The client is concerned that the surgeon removed enough vein from the leg because there are only a few small wounds along the leg. The client says, "I have a friend who had this same surgery, and he has a big long incision on his leg. Why does mine look different?" What is the BEST response by the nurse to this client? "In your case, your surgeon used a scope to harvest the vein because there are fewer complications with this method." "Your incision looks different because you have shorter veins and it took multiple small incisions to get what was needed instead of one big long one." "The surgeon was able to quickly find your vein and didn't have to make a long incision." "I wouldn't worry about it. The surgeon wouldn't have stopped with the little incisions if it wasn't enough."

"In your case, your surgeon used a scope to harvest the vein because there are fewer complications with this method."

A nurse is attempting to alleviate the anxiety of a client about to undergo cardiovascular surgery. Which of the following remarks from the client would the nurse address first? "I just hope my family will be OK no matter what happens to me." "I'm not going to beat myself up for being scared about this—it's a normal reaction." "I am looking forward to when this is over and hopefully an uneventful recovery." "It doesn't really matter if I'm anxious. The anesthesia will knock me out soon."

"It doesn't really matter if I'm anxious. The anesthesia will knock me out soon."

A client is at the clinic for follow-up after cardiothoracic surgery and tells the nurse, "I don't know what is wrong with me. I don't want to eat, and I feel depressed. "What is the best response by the nurse to this statement? "You need to tell the physician because this could be serious." "It may take several weeks for your appetite to return, and the depression is normal and temporary." "There should be no reason for you to be depressed. You came through the surgery fine." "I think we need to get you in to see a psychiatrist."

"It may take several weeks for your appetite to return, and the depression is normal and temporary."

The nurse is talking to the spouse of an older adult who is recovering from heart surgery that required cardiopulmonary bypass. The spouse is very upset and believes the client is developing Alzheimer's disease because of severe disorientation. What is the BEST response the nurse can give to this spouse? "This must be very frightening for you. Many older adults develop confusion and disorientation after a surgery like this. In most cases, it gets better over time." "I wouldn't worry about it at all. It doesn't mean anything." "You have reason to worry. Sometimes the first signs of dementia occur after a surgery like this." "Disorientation after a surgery like this may be a sign of a stroke. The healthcare provider will probably order a cat scan (CT) scan to make sure that no damage has occurred."

"This must be very frightening for you. Many older adults develop confusion and disorientation after a surgery like this. In most cases, it gets better over time."

The husband of a woman about to undergo a conventional CABG procedure wants to know about how long his wife's operation will last. Which response from the nurse is correct? 9 to 12 hours 3 to 6 hours 6 to 9 hours 1 to 3 hours

3 to 6 hours

On his return to the cardiac step-down unit after his diagnostic procedure, a client awaits the report from his cardiologist. As the client's nurse, you review the process of measuring ejection fraction and explain to the client that it measures the percentage of blood the left ventricle ejects upon contraction. What is the typical percentage of blood a healthy heart ejects? 50% 55% 40% 45%

55%

A total artificial heart (TAH) is an electrically powered pump that circulates blood into the pulmonary artery and the aorta, thus replacing the functions of both the right and left ventricles. What makes it different from an LVAD? It never needs batteries. It is designed for extremely active patients. An LVAD only supports a failing left ventricle. It is specifically designed for long-term use.

An LVAD only supports a failing left ventricle.

A client has been experiencing increasing shortness of breath and fatigue. The health care provider has ordered a diagnostic test in order to determine what type of heart failure the client is having. What diagnostic test does the nurse anticipate being ordered? An electrocardiogram A chest x-ray A ventriculogram An echocardiogram

An echocardiogram

Ronald Leonardo, a 65-year-old construction worker, is a client on the cardiac unit where you practice nursing. He is scheduled for bypass surgery to with the intent of preventing an MI. Which of the following is the most important part of your post-operative assessment for Mr. Leonardo after undergoing cardiac surgery? Assess Mr. Leonardo for inadequate tissue perfusion Assess Mr. Leonardo's blood sugar Assess Mr. Leonardo for mental alertness Assess Mr. Leonardo for activity intolerance

Assess Mr. Leonardo for inadequate tissue perfusion

The nurse is caring for an older adult client who has just returned from the OR after inguinal hernia repair. The OR report indicates that the client received large volumes of IV fluids during surgery and the nurse recognizes that the client is at risk for left-sided heart failure. What signs and symptoms would indicate left-sided heart failure? Jugular vein distention Bibasilar fine crackles Right upper quadrant pain Dependent edema

Bibasilar fine crackles

A patient has been admitted to the hospital with exacerbation of heart failure (HF) that has resulted in pulmonary and peripheral edema. The nurse has been carefully monitoring the trajectory of the patient's signs and symptoms of HF. How can the nurse best monitor the patient's fluid balance? By monitoring the patient's blood urea nitrogen (BUN) and creatinine levels By measuring and recording the patient's oral fluid intake By performing daily weights at the same time each day By assessing the patient's skin turgor at several different sites

By performing daily weights at the same time each day

A client has been prescribed furosemide 80 mg twice daily. The asymptomatic client begins to have rare premature ventricular contractions followed by runs of bigeminy with stable signs. What action will the nurse perform next? Notify the health care provider. Check the client's potassium level. Calculate the client's intake and output. Administer potassium.

Check the client's potassium level.

The nurse is caring for a client who has had coronary artery surgery which necessitated the insertion of a pulmonary artery pressure monitor. While completing a measurement, the nurse must remember to complete what action? Place the client in a supine position before beginning the measurement. Inject 10 mL of warm normal saline to measure cardiac output. Deflate the balloon immediately after obtaining the pulmonary capillary wedge pressure. Keep the client's left arm elevated for five minutes before taking the measurement.

Deflate the balloon immediately after obtaining the pulmonary capillary wedge pressure.

The nurse is performing an initial assessment of a client diagnosed with heart failure. The nurse also assesses the client's sensorium and LOC. Why is the assessment of the client's sensorium and LOC important in clients with heart failure? The most significant adverse effect of medications used for heart failure treatment is altered LOC. Decreased LOC causes an exacerbation of the signs and symptoms of heart failure. Heart failure ultimately affects oxygen transportation to the brain. Clients with heart failure are susceptible to overstimulation of the sympathetic nervous system.

Heart failure ultimately affects oxygen transportation to the brain.

The nurse listens to the lung sounds of a postoperative client and determines that the client is not able to clear the secretions from the lungs. What intervention should the nurse provide prior to suctioning? Place the client in the supine position. Plan to suction for at least 20 seconds to remove secretions. Hyperoxygenate the client with 100% oxygen. Administer a sedative prior to suctioning.

Hyperoxygenate the client with 100% oxygen.

A client is already being treated for hypertension. The doctor is concerned about the potential for heart failure, and has the client return for regular check-ups. What does hypertension have to do with heart failure? Heart failure occurs when blood pressures drops. Hypertension causes the heart's chambers to shrink. Hypertension causes the heart's chambers to enlarge and weaken. Hypertension in older males regularly leads to heart failure.

Hypertension causes the heart's chambers to enlarge and weaken.

The nurse is caring for a client who has had a heart transplant and is beginning to learn about the antirejection medications that must be taken daily and will be needed for the client's entire lifetime. The nurse teaches the client that which side effects are associated with antirejection medications? Increased risk for infection Diabetes insipidus Hypotension Dehydration

Increased risk for infection

Ronald Leonardo, a 65-year-old construction worker, is a client on the cardiac unit where you practice nursing. He is scheduled for bypass surgery to with the intent of preventing an MI. Which of the following techniques is used for surgically revascularizing myocardium? Balloon bypass Gastric bypass Minimally invasive direct coronary bypass Peripheral bypass

Minimally invasive direct coronary bypass

The nurse is providing discharge teaching to a patient diagnosed with heart failure. What should the nurse teach this patient to do to monitor fluid balance? Monitor blood pressure. Assess radial pulses. Monitor weight daily. Monitor bowel movements

Monitor weight daily.

The nurse is caring for a client who has been admitted to the hospital with chest pains. The client is very worried that the end result will be a coronary artery bypass surgery. The nurse is aware that there are fewer coronary artery bypass grafts surgery currently because of what reason? Private insurance requires the client to be on medication for 6 months before allowing the surgery. More individuals are being treated with drug-eluding stents that release a drug to prevent reocclusion of the coronary artery. More effective medications are available that do the same job as the surgery. Medicare will no longer allow the surgery for clients over the age of 70.

More individuals are being treated with drug-eluding stents that release a drug to prevent reocclusion of the coronary artery.

A client develops cardiogenic pulmonary edema and is extremely apprehensive. What medication can the nurse administer with physician orders that will relieve anxiety and slow respiratory rate? Dopamine Morphine sulfate Nitroglycerin Furosemide

Morphine sulfate

The nurse is working in a long-term care facility with a group of older adults with cardiac disorders. Why would it be important for the nurse to closely monitor an older adult receiving digitalis preparations for cardiac disorders? Older adults are at increased risk for toxicity. Older adults are at increased risk for cardiac arrests. Older adults are at increased risk for hyperthyroidism. Older adults are at increased risk for asthma.

Older adults are at increased risk for toxicity.

Left-sided heart failure results in several symptoms as a result of reduced cardiac output. A client is diagnosed with heart failure. Which of the following symptoms would NOT have contributed to this diagnosis? Diminished urine output Moist crackles Polydipsia Rapid pulse

Polydipsia

The nurse is caring for an adult client whom the nurse suspects has digoxin toxicity. In addition to physical assessment, the nurse should collect what assessment information? Skin turgor Potassium level White blood cell count Peripheral pulses

Potassium level

A patient is prescribed digitalis preparations. Which of the following conditions should the nurse closely monitor when caring for the patient? Potassium levels Vasculitis Flexion contractures Enlargement of joints

Potassium levels

An older adult client with heart failure is being discharged home on an ACE inhibitor and a loop diuretic. The client's most recent vital signs prior to discharge include oxygen saturation of 93% on room air, heart rate of 81 beats per minute, and blood pressure of 94/59 mm Hg. When planning this client's subsequent care, what nursing diagnosis should be identified? Risk for ineffective breathing pattern related to hypoxia Risk for fluid volume excess related to medication regimen Risk for falls related to hypotension Risk for ineffective tissue perfusion related to dysrhythmia

Risk for falls related to hypotension

A client with heart failure informs the nurse he has not had a bowel movement in 2 days. Why would it be important for the nurse to obtain an order for a stool softener? The client should not develop hemorrhoids. The client should have a bowel movement every day to avoid development of an intestinal obstruction. The client can develop a rectal fissure, which will increase pain levels. Straining causes the Valsalva maneuver, which can cause dangerous effects.

Straining causes the Valsalva maneuver, which can cause dangerous effects.

A client has a myocardial infarction in the left ventricle and develops crackles bilaterally; 3-pillow orthopnea; an S3 heart sound; and a cough with pink, frothy sputum. The nurse obtains a pulse oximetry reading of 88%. What do these signs and symptoms indicate for this client? The development of right-sided heart failure The development of left-sided heart failure The development of cor pulmonale The development of chronic obstructive pulmonary disease (COPD)

The development of left-sided heart failure

The nurse is conducting a morning assessment of an 80-year-old female patient who has a longstanding diagnosis of heart failure (HF). The nurse notes an elevation in jugular venous pressure (JVP) greater than 4 cm above the woman's sternal angle, a finding that did not exist the day before. What conclusion should the nurse draw from this assessment finding? The woman is demonstrating the early signs of cardiogenic shock. The woman has left-sided heart failure. The woman is also likely to experience shortness of breath. The woman may be experiencing an exacerbation of right-sided HF.

The woman may be experiencing an exacerbation of right-sided HF.

Alicia Nelson is 15 years status-post cardiac transplant. After her surgery, which of the following changes occurred to the transplanted heart as a result of the procedure? Transplanted heart takes less time to increase its rate in response to exercise Transplanted heart beats slower than the natural heart Transplanted heart beats faster than the natural heart There are no significant changes noted in the transplanted heart

Transplanted heart beats faster than the natural heart

The nurse is preparing to administer digoxin to a client with heart failure. The nurse obtains an apical pulse rate for 1 minute and determines a rate of 52 beats/minute. What is the first action by the nurse? Administer atropine to speed the heart rate and then administer the digoxin. Administer the medication and inform the charge nurse about the rate. Administer the medications and then notify the physician. Withhold the medication and notify the physician of the heart rate.

Withhold the medication and notify the physician of the heart rate.

A client needs an endarterectomy. This procedure is most commonly indicated when the: doctor is checking for pulmonary capillary wedge pressure. client's doctor needs to measure the client's coronary artery pressure. client is at risk for blood clots called thrombi. client's femoral artery is obstructed with atherosclerotic plaque.

client's femoral artery is obstructed with atherosclerotic plaque.

A nurse caring for a client recently admitted to the ICU observes the client coughing up large amounts of pink, frothy sputum. Lung auscultation reveals coarse crackles in the lower lobes bilaterally. Based on this assessment, the nurse recognizes this client is developing acute exacerbation of chronic obstructive pulmonary disease. tuberculosis. decompensated heart failure with pulmonary edema. bilateral pneumonia.

decompensated heart failure with pulmonary edema.

A client asks the nurse if systolic heart failure will affect any other body function. What body system response correlates with systolic heart failure (HF)? decrease in renal perfusion increased blood volume ejected from ventricle vasodilation of skin dehydration

decrease in renal perfusion

The nurse is admitting a client with frothy pink sputum. What does the nurse suspect is the primary underlying disorder of pulmonary edema? increased right atrial resistance decreased left ventricular pumping increased left atrial contractility decreased right ventricular elasticity

decreased left ventricular pumping

The nurse is teaching a client about medications prescribed for severe volume overload from heart failure. What diuretic is the first-line treatment for clients diagnosed with heart failure? metolazone furosemide mannitol spironolactone

furosemide

The nurse is caring for a client with advanced heart failure. What treatment will be considered after all other therapies have failed? heart transplant ventricular access device implantable cardiac defibrillator (ICD) cardiac resynchronization therapy

heart transplant

The nurse is caring for a client with heart failure who is receiving a diuretic medication. What implementation will help the nurse evaluate the client's response of the medication? asking the client about comfort level measuring intake and output using mechanical ventilation obtaining cardiac output with a pulmonary catheter

measuring intake and output

A client is prescribed digitalis medication. Which condition should the nurse closely monitor when caring for the client? Flexion contractures Enlargement of joints Vasculitis nausea and vomiting

nausea and vomiting

When a client has increased difficulty breathing when lying flat, the nurse records that the client is demonstrating orthopnea. dyspnea upon exertion. hyperpnea. paroxysmal nocturnal dyspnea.

orthopnea

A client is readying for coronary artery bypass surgery. Which blood vessel is most likely to be used for this client's graft? internal mammary artery saphenous vein radial artery cephalic vein

saphenous vein

A client is scheduled for bypass surgery with the intent of preventing a MI. For this client, the most important characteristic to assess postoperatively is the client's: mental alertness. activity tolerance. tissue perfusion. blood sugar.

tissue perfusion.