Exam 2 EAQ practice questions

The nurse provides postprocedural care to a patient admitted to an inpatient unit after cardiac catheterization. Which assessment is the highest priority? a. Determining the level of pain b. Checking for sensation in the feet c. Verifying the patency of the IV site d. Inspecting the procedure puncture site

d. Inspecting the procedure puncture site

A male patient who has coronary artery disease (CAD) has serum lipid values of low-density lipoprotein (LDL) cholesterol of 98 mg/dL and high-density lipoprotein (HDL) cholesterol of 47 mg/dL. What should the nurse include in patient teaching? A. Consume a diet low in fats. B. Reduce total caloric intake. C. Increase intake of olive oil. D. The lipid levels are normal.

d. Lipid levels are normal

A patient who has received a maximum dose of nitroglycerin continues to report chest pain. Which medication would the nurse anticipate administering to this patient next? a. Esmolol b. Docusate c. Ticagrelor d. Morphine sulfate

d. Morphine sulfate

In which location would a MI occur due to blockage of the right coronary artery? a. Inferior wall b. Anteroseptal c. Anterolateral Anterior wall

a. Inferior wall

The registered nurse observes another health care provider caring for a patient who is undergoing TEE studies. Which action by the provider needs correction?

-Ensures that the patient's dentures fit snugly

A patient with hypertension receives a prescription for lisinopril. Which mechanism of action would the nurse expect from this medication?

Inhibits conversion of angiotensin I to angiotensin II

Cardiac biomarker levels are being evaluated for a patient who is suspected of having an MI. Which biomarker lacks specificity for diagnosing an MI? a. Myoglobin b. CK-MB c. Cardiac specific troponin I Cardiac specific troponin T

a. Myoglobin

Which medication should be used with caution in patients with diabetes because the drug may depress the tachycardia associated with hypoglycemia? a. Diltiazem b. Metoprolol c. Prednisone d. Hydromorphone

b. Metoprolol -beta blockers slow the heart rate

A patient's BP reading is 142/91 mmHg. How should the nurse classify the BP? a. Normal b. Prehypertension c. Hypertension, stage 1 d. Hypertension, stage 2

d. Hypertension, stage 2

The nurse is providing information about potential complications to a patient scheduled for TEE. What info should the nurse include?

-Hemorrhage -Dysrhythmias -Transient hypoxemia

A nurse provides education to a patient with hypertension related to lifestyle modifications to reduce overall cardiovascular risk. Which statement made by the patient indicates effective teaching?

-I should exercise for at least 30 minutes daily -I should achieve and maintain a healthy weight -I should restrict my salt intake to less than or equal to 1500 mg/day

A patient is diagnosed with primary hypertension and asks the nurse what caused this condition a. There is no identified cause b. A decrease in plasma renin levels c. Too much plaque in the blood vessels d. Kidney disease is the most common cause

a. There is no identified cause

A patient who has been taking clonidine for 10 years tells the nurse, "I decided to quit taking the medication a few days ago." For which manifestation would the nurse monitor this patient? a. Tremors b. Lethargy c. Dysphasia d. Bradycardia

a. Tremors

A patient presents to the emergency department reporting chest pain. Which component of the patient's blood work would be most specifically indicating an acute myocardial infarction? a. Troponin b. Myoglobin c. Creatine kinase (CK) C-reactive protein (CRP)

a. Troponin

Teaching plan for patient with hypertension

-Explain the meaning of BP values -Explain potential dangers of uncontrolled hypertension -Do not alter medication dosage without consulting the healthcare provider

Which patients would be high risk for developing hypertension?

-65-year-old black woman -older adult who smokes -35-year-old man who is obese -50-year-old man whose parent had hypertension

Which findings during the cardiovascular assessment of a patient require further evaluation?

-A thready pulse is present -Hands and feet are cold to the touch -Capillary refill takes four seconds

Which factors in a patient's health history are nonmodifiable risk factors for primary hypertension?

-Age of 65 years -Black ethnicity -Family history of hypertension

A nurse is caring for a patient immediately following a TEE. Which interventions would the nurse perform?

-Assess for the return of the gag reflex -Monitor vital signs and oxygen saturation

The nurse provides care to a patient who undergoes intracoronary stent placement along with balloon angioplasty. Which drugs are expected to be used during the procedure to prevent platelet aggregation?

-Bivalirudin -Etifibatide

Which characteristics describe unstable angina?

-New onset angina with minimal exertion -Characterized by increased duration or severity

Which cardiovascular assessment findings are normal?

-Pulse 2+ -PMI not visible -Heart rate 64 -BP 124/80 RA -BP 110/62 LA

Which actions would the nurse take when obtaining a routine BP measurement?

-Support the patient's arm at the heart level -Ensure the patient has not exercised in the past 30 minutes

Which blood studies would the nurse expect to see prescribed in a focused evaluation of a patient with cardiac disease?

-Troponin -Homocysteine -C-reactive protein

A patient tells the nurse, "I had severe chest pain six days ago." Which cardiac biomarker will be most helpful in determining whether the patient had a myocardial infarction at the time the patient experienced chest pain? a. Troponin b. Myoglobin c. Homocysteine Creatine kinase (CK)

a. Troponin

A patient's systolic BP is 120mmHg, and the diastolic pressure is 60mmHg. What is the mean arterial pressure (MAP)?

80mmHg Calculated by (SBP+ 2DBP) / 3 (120+ 2(60)) = 240/3= 80mmHg

A patient is scheduled for cardiac catheterization with coronary angiography. Which primary purpose for the procedure would the nurse explain to the patient? a. Bypassing obstructed vessels b. Assessing the presence of arterial blockages c. Opening and dilating blocked coronary arteries d. Assessing the need for antianginal medications

b. Assessing the presence of arterial blockages

The nurse is caring for a patient having an MI. The healthcare provider prescribes IV infusion of alteplase. Which intervention would the nurse include during the administration of the medication? a. Monitor for changes in neuro status b. Assess BP for OHTN c. Apply a pressure dressing to the IV insertion site Start additional IV lines after alteplase infusion has begun

A. Monitor for neuro status changes

Which location would the nurse assess for edema caused by a cardiac condition?

Ankle

The nurse provides a list of health-promoting regular physical activity examples to a patient with CAD. Which activity would the nurse include on the list?

Brisk walking

What are manifestations of acute coronary syndrome a. Dysrhythmias b. Stable angina c. Unstable angina d. STEMI e. NSTEMI

C, D, E- unstable angina, STEMI, NSTEMI

What should the nurse emphasize when teaching women about the risks and incidence of CAD?

CAD is the leading cause of death in women, with a higher mortality rate after MI than in men

Hypertension has been taking hydrochlorothiazide daily for 10 years. Which parameter would the nurse evaluate to indicate the effectiveness of this drug therapy? a. Weight loss of 2lb b. BP of 118/76 c. Absence of ankle edema d. Urine output of 600mL per eight hours

b. BP of 118/76

Which instruction would the nurse include in the patient's discharge teaching plan regarding prescribed propranolol for hypertension?

Do not stop taking the medication abruptly

A 52-year-old man is admitted to the ER with severe chest pain. On what basis would the nurse suspect an MI?

He has no relief of pain with rest or position change

The nurse provides education to a patient about the DASH diet. Which statement made by the patient indicates an understanding of the teaching?

I should include four to five servings of fruits and vegetables daily

A patient presents to the emergency department with a sudden rise in BP and severe headaches. Which precaution will the nurse take when administering IV labetalol?

Keeping the patient supine

When teaching the patient with angina about taking sublingual NTG tablets, what should the nurse teach the patient?

Lie or sit and place 1 tablet under the tongue when chest pain occurs

Which therapy would the nurse anticipate administering for emergency car of a patient with a suspected myocardial infarction (MI)

Oxygen, nitroglycerin, aspirin, and morphine

Which technique would the nurse use to assess for the presence of a pulse deficit?

Palpate the radial pulse while auscultating the apical pulse

Which assessment data is nonmodifiable risk factor for coronary artery disease? a. 72 year old white male b. 20 pack a year former cigarette smoker c. Adult onset diabetes, hyperlipidemia d. Abdominal aortic aneurysm repair

a. 72 year old white male

The nurse receives information about the assigned patients during shift report. Which patient would the nurse assess first? a. A patient who reports a severe headache and has begun vomiting b. A patient who reports dizziness with a BP of 150/92 mmHg c. A patient with a hip fracture who reports a pain level of 2 on a scale of 10 d. A patient who received ACE inhibitor 30 minutes previously and reports fatigue

a. A patient who reports a severe headache and has begun vomiting

A nurse provides discharge teaching to a patient prescribed nitroglycerin sublingual tablets for the treatment of chronic stable angina. Which statement made by the patient indicates the need for further teaching? a. I will put the bottle in my pant pocket before I leave the house b. The sublingual tablets expire six months after the bottle is opened c. Possible side effects include feeling warm, headache, and lightheadedness d. I can use this medication before exercising to prevent angina from occurring

a. I will put the bottle in my pant pocket before I leave the house

The nurse provides a student nurse with information related to management of a patient following cardiac catheterization. Which intervention would the nurse explain is the specific responsibility of the nurse rather than assistive personnel? a. Vital signs b. Moniotring neurovascular changes c. Asking the patient about comfort measures d. Assisting with oral hygiene, hydration, and meals

b. Monitoring neurovascular changes

A patient's laboratory report reveals increased creatine kinase (CK-MB) enzymes. Which condition is consistent with the result? a. Stroke b. Myocardial Infarction (MI) c. Coronary artery disease (CAD) Peripheral vascular disease (PAV)

b. Myocardial Infarction (MI)

Which instruction is important for the nurse to provide to a patient about the management of stage 1 hypertension? a. Restrict all caffeine b. Restrict sodium intake c. Increase protein intake Use calcium supplements

b. Restrict sodium intake

Which laboratory test result indicates the presence of target organ damage in patient with hypertension? a. Serum uric acid of 3.8 mg/dL b. Serum creatinine of 2.6 mg/dL c. Serum potassium of 3.5 mEq/L d. BUN of 15mg/dL

b. Serum creatinine of 2.6 mg/dL

A patient receives instructions about monitoring BP levels at home. Which information would the nurse teach the patient about measuring the BP in a supine position? a. Take the reading immediately after lying down b. Support the arm with a pillow during measurement c. Take at least two consecutive readings one after another d. Use the arm with the lower BP for all future measurements

b. Support the arm with a pillow during measurement

Which finding in a patient's lab reports supports a conclusion that the patient is at high risk for MI? a. Creatine kinase value of 2% b. Troponin value of 3.5 c. Cholesterol value of 250mg/dL d. BNP value of 140pg/mL

b. Troponin value of 3.5

A patient who has angina is being seen in a healthcare setting. While in the office, the patient experiences chest pain and takes a total of three nitroglycerin tablets, five minutes apart. The patient's chest pain is not relieved. Which is the nurse priority action? a. Assess a complete set of vital signs b. Contact EMS c. Repeat the medication in another five minutes Instruct the patient to lie quietly and take deep breaths

b. contact EMS

The nurse provides medication education to a patient with a new prescription for lisinopril. Which information would the nurse include in the teaching? a. "Never take this medication on an empty stomach" b. "You should not take this medication if you have asthma" c. "You may develop a dry cough while taking this medication" d. "Discontinue this medication if you develop a drop in your BP"

c. "You may develop a dry cough while taking this medication"

Which systolic BP measurement correlates with stage 1 hypertension? a. 118 mmHg b. 129 mmHg c. 132 mmHg d. 142 mmHg

c. 132 mmHg

Which manifestation is an indication that a patient is having a hypertensive emergency? a. Symptoms of a stroke with an elevated BP b. A SBP over 180 mmHg and a DBP over 110mmHg. c. A sudden rise in BP accompanied by neurologic impairment d. A severe elevation of BP that occurs over several days or weeks

c. A sudden rise in BP accompanied by neurologic impairment

A patient is diagnosed with venous thromboembolism. Which assessment finding would the nurse expect? a. Abnormal capillary refill b. Unusually warm extremities c. Asymmetry in limb circumference d. Pitting edema of lower extremities

c. Asymmetry in limb circumference -formation of clots and mostly common in pelvis and lower extremities DVT

Which blood components is a marker of inflammation reflecting an increased risk for cardiovascular disease? a. Myoglobin b. NT-Pro-BNP c. C-reactive protein (CRP) d. BNP

c. C-reactive protein (CRP)

The nurse provides discharge teaching to a female patient who was newly diagnosed with primary hypertension. Which instruction would be included? a. Decrease the intake of omega-3 fatty acids b. Restrict sodium to less than or equal to 2300mg/day c. Limit the intake of alcohol to no more than one drink per day d. Begin taking a calcium supplement to help lower BP

c. Limit the intake of alcohol to no more than one drink per day

The nurse is teaching an older patient with hypertension about developing an exercise program. Which instructions would the nurse include? a. Perform weightlifting on a daily basis b. Perform flexibility and balance exercises daily c. Perform muscle-strengthening activities twice a week d. Perform high-intensity activity for 30 minutes on most days

c. Perform muscle-strengthening activities twice a week

In the patient with chest pain, which results can distinguish unstable angina from an MI? a. ECG changes present at the onset of pain b. A chest x-ray showing left ventricular hypertrophy c. Serum troponin levels increased 4-6 hours after the onset d. CK-MB elevations that peak 6 hours after the infarct

c. Serum troponin levels increased 4-6 hours after the onset

What causes the pain that occurs with myocardial ischemia? a. Death of myocardial tissue b. Dysrhythmias caused by cellular irritability c. Lactic acid accumulation during anaerobic metabolism d. Increased pressure in the ventricles and pulmonary vessels

c. lactic acid accumulation during anaerobic metabolism

While auscultating a patient's heart, the nurse hears turbulent sounds between normal heart sounds. Which complication would the nurse suspect? a. Aneurysm b. Cardiac dysrhythmias c. Left ventricular failure d. Cardiac valve disorder

d. Cardiac valve disorder

Which risk factor for coronary artery disease is considered non-modifiable? a. Obesity b. Diabetes c. Tobacco use d. Family history of heart disease

d. Family history of heart disease

A patient recently diagnosed with coronary artery disease (CAD) asks the nurse: "What caused my problem?" Which cause would the nurse explain? a. Orthostatic hypotension b. Low oxygen saturation of the blood c. The heart's inability to pump effectively d. Fatty deposits on the walls of the coronary arteries

d. Fatty deposits on the walls of the coronary arteries