CV pass point
A nurse is monitoring a client receiving a continuous infusion of lidocaine for ventricular dysrhythmias. During breakfast, the client states, "I am so tired. My vision is so blurry I can't see my food." What is the nurse's best action?
Notify the primary registered nurse of the client's symptoms.
An increase in the creatine kinase-MB isoenzyme (CK-MB) can be caused by:
myocardial necrosis.
The nurse is administering enteric coated erythromycin to a client. What adverse reaction should the nurse monitor for?
nausea and vomiting
The nurse is reinforcing education for a client regarding risk factors for hypertension. Which risk factors should the nurse list for primary hypertension? Select all that apply
obesity stress high intake of sodium or saturated fat
A client is experiencing chest pain at rest that is unresponsive to nitroglycerin. The health care provider diagnoses unstable angina and alerts the nurse that the client will require treatment with immediate surgical intervention. For which treatment does the nurse prepare the client?
percutaneous transluminal coronary angioplasty (PTCA)
The nurse is caring for a client with cardiac tamponade. Which treatment will the nurse prepare the client for?
pericardiocentesis
The nurse is reviewing the telemetry for a group of assigned clients. Sinus bradycardia would be considered a normal finding in a
physically conditioned adolescent.
A client has recently been diagnosed with hypertension. The client has an elevated blood pressure with no symptoms, and the cause is uncertain. Which term bestdescribes this condition?
primary hypertension
The physician has ordered digoxin for a client with pulmonary edema. The nurse knows that digoxin has a direct and beneficial effect on myocardial contraction in the failing heart. This effect:
slows the conduction of impulses through the atrioventricular (AV) node.
A child is preparing for discharge to home after undergoing a cardiac catheterization. Which statements by the child indicates the need for further instruction? Select all that apply
"I will be able to go to school tomorrow." "It will be at least 2 to 4 weeks before I can participate in gym class."
The nurse is obtaining a history from a new client in the cardiovascular clinic. When investigating for childhood diseases and disorders associated with structural heart disease, the nurse should consider which finding significant?
Rheumatic fever
A child returns to the unit after a cardiac catheterization. The nurse should reinforce education for the child and parents on which point regarding mobility?
The child will be maintained on bed rest with the affected extremity immobilized
Propranalol 80 mg PO BID has been ordered by the health care provider. The nurse reinforces teaching of this medication. Which indicates teaching has been successful?
The client checks pulse for bradycardia.
A client with severe angina and electrocardiogram changes is seen in the emergency department. In terms of serum testing, the nurse can expect which laboratory test to be ordered?
Troponin
During a local wellness fair, a nurse takes some clients' blood pressures. Which client is at the highest risk for the diagnosis of essential (primary) hypertension?
a 72-year-old female with a blood pressure of 142/88 mm Hg
A nurse is caring for several clients on a medical floor. Which client does the nurse identify to have the greatest chance of developing cardiogenic shock?
a client with acute myocardial infarction (MI)
A nurse is reinforcing education provided to a client about reducing risk factors for coronary artery disease. Which risk factor does the nurse inform the client is nonmodifiable?
age
A client has a blockage in the proximal portion of a coronary artery. After learning about treatment options, the client decides to undergo percutaneous transluminal coronary angioplasty (PTCA). During this procedure, the nurse expects which medication to be administered to the client?
anticoagulant
A client is admitted with acute pulmonary edema. Which signs and symptoms should the nurse expect to find when collecting data on this client?
apprehension and restlessness, cough with frothy pink sputum, moist gurgling respirations with tachypnea, and orthopnea
A nurse receives a report on a client who has been diagnosed with an abdominal aortic aneurysm (AAA). The nurse would expect the client to have which underlying disease?
atherosclerosis
Which condition most commonly results in coronary artery disease (CAD)?
atherosclerosis
A client is admitted to the hospital displaying sinus bradycardia, nausea, anorexia, and blurred vision. What should the nurse suspect this client to be experiencing?
digoxin toxicity
A client is admitted with a diagnosis of postthrombotic deep vein changes in both legs. Which signs and symptoms does the nurse expect to see in this client?
edema and pigmentation
A client is admitted to the emergency department with chest discomfort, diaphoresis, and nausea. Suspecting possible in front of myocardial infarction (MI), the nurse would anticipate that the health care provider will prescribe which diagnostic test to quickly determine myocardial damage?
electrocardiogram
A nurse who is caring for a client in labor with a history of rheumatic heart disease should gather what data to determine fetal well-being?
fetal heart tones
The nurse is assessing a client with heart failure. The breath sounds commonly auscultated in clients with heart failure are:
fine crackles
Which finding is common when gathering data from a child with a total anomalous pulmonary venous return defect?
frequent respiratory infections
The nurse is assigned a child who has been diagnosed with heart failure. Which data finding is consistent with this condition?
gallop murmur
When gathering data from a client admitted with hypertension, the nurse should expect the client to report which symptom?
headache
The nurse is caring for a client experiencing dyspnea, dependent edema, hepatomegaly, crackles, and jugular vein distention. Which condition should the nurse suspect?
heart failure
Before administering digoxin to a client, a nurse reviews information about the drug. She learns that after digoxin is metabolized, the body eliminates remaining digoxin as unchanged drug by way of the:
kidneys
A client who had an anterior wall myocardial infarction (MI) would have a greater risk for exhibiting crackles in the lungs related to which disorder?
left-sided heart failure
The nurse is caring for a child with acute rheumatic fever. Which data does the nurse anticipate in this child?
leukocytosis
A client comes to the emergency department reporting chest pain. Upon further evaluation, the nurse suspects unstable angina. Which disease process should the nurse reinforce teaching this client about because it is directly related to unstable angina?
myocardial infarction (MI)
A client is admitted to the acute care facility for treatment of heart failure. The nurse expects the physician to prescribe which drug?
Furosemide
Which of the following complications is most common after an abdominal aortic aneurysm resection?
Hemorrhage and shock
Which statement best explains why furosemide is administered to treat hypertension?
It inhibits reabsorption of sodium and water in the loop of Henle.
A client who suffered blunt chest trauma in a car accident reports chest pain, which is exacerbated by deep inspiration. On auscultation, the nurse detects a pericardial friction rub — a classic sign of acute pericarditis. The physician confirms acute pericarditis and begins appropriate medical intervention. To relieve chest pain associated with pericarditis, the nurse should encourage the client to assume which position?
Leaning forward while sitting
A 9-year-old child had cardiac surgery 2 days ago. The child tells the nurse: "I'm sore and I don't want to move today." Which action by the nurse is most appropriate?
Medicate the child for discomfort and then begin activities related to ambulation.
The nurse is caring for a client with hypertension. What is the best action for the nurse to take when administering a new blood pressure medication to a client?
Inform the client of the new medication, its name, its use, and the reason for the change
A client with hypertension visits the health clinic for a routine checkup. The nurse measures the client's blood pressure at 164/92 mm Hg and notes a 5-lb (2.3-kg) weight gain over the past 6 months. Which nursing diagnosis reflects the most serious problem in managing a client with hypertension?
Noncompliance (nonadherence to therapeutic regimen)
A client is being discharged after an acute myocardial infarction (MI). The client asks why metoprolol was prescribed. What education does the nurse reinforce?
"Metoprolol slow the heart rate and decreases the amount of work it has, so it can heal."
A 15-year-old child has been scheduled to have a cardiac catheterization. Which statements by the teen or parent indicate the need for further instruction? Select all that apply.
"My health care provider will put me to sleep for the catheterization." "The sound waves will let the health care providers see how my heart moves."
The nurse is talking with the parent of a 5-year-old child. The parent reports having recently read an article about rheumatic fever and heart disease and questions how to prevent this from happening to the child. What is the best response by the nurse?
"Prompt treatment of strep infections is a key to preventing this condition."
Which interventions are appropriate when caring for a client with acute thrombophlebitis?
Apply warm soaks and elevate the client's legs higher than the level of the heart.
A client is admitted for right leg vein ligation and stripping for varicose veins. Which nursing intervention postoperatively should the nurse include?
Ask the client to elevate the legs when sitting
A client with a forceful, pounding heartbeat is diagnosed with mitral valve prolapse. This client should be instructed to avoid which of the following?
Caffeine-containing products
The telemetry monitor technician notifies the nurse that a client has sinus bradycardia with a heart rate of 42 beats/minute. What should the nurse do first?
Check the client's level of consciousness, obtain vital signs, and assess the client for symptoms.
Which statement by the client best indicates an understanding on how to prevent complications while taking warfarin?
"I should use a soft toothbrush."
Before discharge, which instruction should the nurse give to a client receiving digoxin?
"Call the physician if your heart rate goes above 120 beats/minute."
A client comes to the health care provider's office for a follow-up visit 4 weeks after suffering a myocardial infarction (MI). The nurse gathers data regarding the knowledge of the client regarding the prescribed cardiac rehabilitation program. What statement suggests that the client needs more instruction?
"Client walks 4 miles (6.4 km) in 1 hour every day."
A client with high blood pressure is receiving an antihypertensive drug. The nurse knows that antihypertensive drugs commonly cause fatigue and dizziness, especially on rising. When developing a client teaching plan to minimize orthostatic hypotension, the nurse should include which instruction?
"Flex your calf muscles, avoid alcohol, and change positions slowly."
The nurse is reinforcing teaching with a client who has a new order for the medication enoxaparin. The nurse determines the client needs further instruction when the client makes which statement?
"I need to have my partial prothrombin time (aPTT) monitored everyday while on enoxaparin."
Propranolol has been prescribed for a teen who has been diagnosed with hypertension. When discussing the medication with the teen, which statement indicates the need for further instruction?
"I should take this medication daily on an empty stomach."
A client is being discharged after an acute myocardial infarction (MI). The client asks why metoprolol was prescribed. What education does the nurse reinforce
"Metoprolol slow the heart rate and decreases the amount of work it has, so it can heal."
The nurse is reinforcing discharge instructions for a client with varicose veins. Which statement by the client indicates a need for further instruction?
"Wearing tight clothes won't affect me."
When obtaining data from a child with suspected Kawasaki disease, which symptom is common?
"strawberry" tongue
A 2-year-old child is showing signs of shock. A 10-mL/kg bolus of normal saline solution is ordered. The child weighs 20 kg. How many milliliters should be administered? Record your answer using a whole number
200
Erythromycin is given to a 6-year-old child before dental work to prevent endocarditis. The child weighs 44 lb (20 kg). The order is for 20 mg/kg by mouth 2 hours before the procedure. How many milligrams should be given to this child? Record your answer using a whole number
400
A client who has been experiencing severe chest pain tells the nurse that the pain has diminished and asks to go to the bathroom to have a bowel movement. What action should the nurse take?
Allow the use of a bedside commode.
Which precaution should a nurse take when caring for a client with a myocardial infarction (MI) who has received a thrombolytic agent?
Avoid puncture wounds.
A client sustained a stroke and has impaired verbal communication. What interventions can the nurse provide that will maintain the client's dignity? Select all that apply.
Be honest when unable to decipher the client's speech. Use a normal tone of voice when communicating. Allow adequate time for the client to
A client sustained a stroke and has impaired verbal communication. What interventions can the nurse provide that will maintain the client's dignity? Select all that apply.
Be honest when unable to decipher the client's speech. Use a normal tone of voice when communicating. Allow adequate time for the client to respond.
A client is evaluated for hypertension. The physician prescribes atenolol, 50 mg by mouth daily. Atenolol should have which therapeutic effect on the client?
Decreased cardiac output and systolic and diastolic blood pressure
The physician prescribes digoxin for a client with heart failure. During digoxin therapy, which electrolyte imbalance may predispose the client to digoxin toxicity?
Hypokalemia
A nurse is reinforcing education for a client with a family history of atherosclerosis. To decrease the risk of atherosclerosis, what should the nurse encourage the client to do?
Increase activity level
The nurse is caring for a child undergoing repair of a cardiac defect. Which intervention should be included when assisting with the development of plan of care?
Maintain a low blood pressure.
A nurse is monitoring a client who has symptoms of anxiety and dyspnea. The cardiac monitor shows sinus tachycardia with a heart rate of 122. What is the appropriate action of the nurse?
Obtain the client's vital signs and oxygen saturation
A client with a history of I.V. drug abuse is admitted to the medical-surgical unit for evaluation for infective endocarditis. Nursing assessment is most likely to reveal that this client has:
Osler's nodes and splinter hemorrhages
A client is receiving captopril for heart failure. Which finding indicates that the medication isn't producing the desired treatment outcome and requires the nurse to notify the physician?
Peripheral edema
An average-weight client reports of generalized steady abdominal pain. The nurse should suspect an abdominal aortic aneurysm, if the abdominal pain is accompanied by which finding?
Pulsating mass in the periumbilical area
When assisting with an electrocardiogram (ECG), the nurse would expect to place the client in which position?
Supine
A client comes to the emergency department reporting visual changes and a severe headache. The nurse measures the client's blood pressure at 210/120 mm Hg. However, the client denies having hypertension or any other disorder. After diagnosing malignant hypertension, a life-threatening disorder, the physician initiates emergency intervention. What is the most common cause of malignant hypertension?
Untreated hypertension
The health care provider has prescribed digoxin and a diuretic for a child. How should the nurse administer the drug to the child?
Use a graduated dropper.
A client is experiencing cardiac tamponade after a chest trauma. Which type of shock will the nurse monitor for?
cardiogenic
A male with heart failure is experiencing tachycardia, decreased blood pressure, and decreased peripheral pulses. The nurse interprets these symptoms as indicating which condition?
cardiogenic shock
A child with tetralogy of Fallot has clubbing of the fingers and toes. The nurse understands that this finding is related to which condition?
chronic hypoxia
An older adult client is newly diagnosed with left-sided heart failure. Which sign most commonly associated with this type of heart failure would the nurse expect to find when obtaining data for this client?
crackles
Which characteristic indicates that a child with Kawasaki disease has entered the subacute phase?
desquamation of the hands and feet
A nurse is caring for a client diagnosed with myocardial infarction (MI) who is prescribed a nitrate. What does the nurse identify as the purpose of giving a nitrate to this client?
to dilate coronary arteries
A client with a history of severe angina is being seen in the emergency department for chest pain. In terms of diagnostic laboratory testing, it's most important for the nurse to advocate ordering a:
troponin level.
