Exam 2 NCLEX style Questions From Lecture

A nurse is providing discharge teaching to a client who has a new diagnosis of heart failure . Which of the following instructions should the nurse include in the teaching ? 1 ) Exercise at least three times per week . 2 Take diuretics early in the morning and before bedtime . 3 Notify the provider of a weight gain of 0.5 kg ( 1 lb ) in a week . 4 ) Take naproxen for generalized discomfort .

1 ) Exercise at least three times per week . The nurse encourage the client to stay as active as possible and to develop a regular exercise regimen . Clients who have heart failure who remain active appear to have improved outcome. The client should try to walk at least three times per week and should slowly increase the amount of time walked over several months. Regular exercise strengthens the heart and cardiovascular system , thereby improving circulation and lowering blood pressure .

A nurse is assessing a client who has fluid overload . Which of the following findings should the nurse expect ? ( Select all that apply . 1 ) Increased heart rate 2 ) Increased blood pressure 3 ) Increased respiratory rate 4 ) Increase hematocrit 5 ) Increased temperature

1 ) Increased heart rate 2 ) Increased blood pressure 3 ) Increased respiratory rate

A nurse is admitting a client who has acute heart failure following myocardial infarction The nurse recognizes that which of the following prescriptions by the provider requires clarification ? 1 ) Morphine sulfate 2 mg IV bolus every 2 hr PRN pain . 2 ) Laboratory testing of serum potassium upon admission 3 ) 0.9 % normal saline IV at 50 mL / hr continuous 4 ) Bumetanide 1 mg IV bolus every 12 hr

3 ) 0.9 % normal saline IV at 50 mL / hr continuous 0.9 % sodium chloride is isotonic and will not cause the fluid shift needed in this client to reduce circulatory overload . This prescription requires clarification .

A nurse is caring for a client who has heart failure and a new prescription for furosemide. Which of the following laboratory values should the nurse review before administering furosemide ? 1 ) Bicarbonate 2 ) Carbon dioxide 3 ) Potassium 4 ) Phosphate

3) Potassium Furosemide is a loop diuretic and therefore promotes excretion of potassium . The nurse should monito the client's serum potassium level before administering it to prevent hypokalemia

A client who has a history of myocardial infarction ( MI ) is prescribed aspirin 325mg. The nurse recognizes that the aspirin is given due to which of the following actions of the medication? 1) analgesic 2) Anti-inflammatory 3) antiplatelet aggregate 4) antipyretic

3) antiplatelet aggregate Aspirin is used to decrease the likelihood of blood clotting. It also is used to reduce the risk of a second heart attack or stroke by inhibiting platelet aggregation and reducing thrombus formation in an artery, a vein, or the heart.

A nurse is assessing a client who has heart failure and is prescribed furosemide. Which of the following findings is an adverse effect of this medication? 1) weight gain 2) increased blood pressure 3) Hypoglycemia 4) Leg cramps

4) Leg Cramps

A nurse is planning to administer digoxin to a client who has heart failure. Which of the following labratory results is the priority for the nurse to review prior to the administering the medication? • potassium • hemoglobin • creatinine • BUN

•potassium Digoxin is a cardiac glycoside medication used to improve myocardial contractility , increasing stroke volume and cardiac output in a client who has heart failure . During therapy , the nurse should closely monitor the client's potassium level as hypokalemia increases the risk of digitalis toxicity and cardiac arrhythmias .

A nurse is caring for an older adult client who has left-sided heart failure. Which of the following assessment findings should the nurse expect? 1) Frothy sputum 2) Dependent edema 3) Nocturnal polyuria 4) Jugular distention

1) Frothy sputum Left-sided heart failure reduces cardiac output and raises pulmonary venous pressure. Manifestations include hacking cough, frothy sputum, wheezing, fatigue, and weakness.

A nurse in the emergancy department is caring for a client who has cardiogenic pulmonary edema. The client's assessment findings include anxiousness, dyspnea at rest, crackles, BP 110/79, and apical HR of 112/min. Which of the following interventions is the nurse's priority? 1) Provide the client with supplimental oxygen at 5L/min via facemask 2) Place the client in high-fowler's position with their legs in a dependent position. 3) Give the client sublingual nitroglycerin. 4) Administer morphine sulfate IV.

1) Provide the client with supplimental oxygen at 5L/min via facemask

A nurse is monitoring the cardiac output of a client who has left-sided heart failure using pulse pressure analysis. Which of the following findings can compromise the reading? 1) The client is experiencing premature atrial contractions. 2)The client has a dcreased oxygen saturation level. 3)The client has bilateral wheezes. 4) The client has lower leg edema.

1) The client is experiencing premature atrial contractions. Pulse pressure devices require the presence of optimal arterial waveforms in order to capture accurate data. Therefore, a dysrhythmia, such as a premature atrial contraction will compromise the readings.

A nurse is preparing to administer a transfusion of RBCs to a client who has heart failure. For which of the following manifestations should the nurse monitor to prevent fluid volume overload? (Selcect all that apply) 1) Dyspnea 2) Gastrointestinal bloating 3) Jugular venous distention 4) Confusion 5) Hypotension

1) Dyspnea 3) Jugular venous distention 4) Confusion All of these are clinical manifestations of fluid volume overload

A nurse is providing discharge teaching for a client who has pulmonary edema and is about to start taking furosemide . Which of the following instructions should the nurse include ? 1 ) Take aspirin if headaches develop . 2 ) Eat foods that contain plenty of potassium . 3 ) Expect some swelling in the hands and feet 4 ) Take the medication at bedtime

2 ) Eat foods that contain plenty of potassium Furosemide, a high-ceiling (loop) diuretic, can cause potassium loss. The client should add potassium-rich foods to thier diet, such as nuts, dried fruits, bananas, and citrus fruits.

A nurse in a cardiac care unit is caring for a client with acute right-sided heart failure. Which of the following findings should the nurse expect? 1) Decreased BNP. 2) Elevated central venous pressure (CVP). 3) Increased pulmonary artery wedge pressure (PAWP). 4) Decreased specific gravity

2) Elevated central venous pressure. CVP is a measurement of the pressure in the right atria or ventricle at the end of diastole. An elevated CVP is indicative of heart failure.

A nurse is providing discharge instructions for a client who has congestive heart failure . Which of the following client statements indicates to the nurse that the teaching was effective ? 1 ) " I will read food labels and limit my sodium to 4 grams per day . " 2 ) " I should use naproxen to manage discomfort . " 3 ) " I plan to slow down if I am tired the day after exercising . " 4 ) " I will take my diuretic before sleep and drink fluids during the day . "

3 ) " I plan to slow down if I am tired the day after exercising . " Clients who experience chest pain or dyspnea while exercising or experience fatigue the next day are probably advancing the activity too quickly and should slow down .

A nurse is caring for a client who has valvular heart disease and is at risk for developing left-sided heart failure. Which of the following manifestations should alert the nurse the client is developing this condition? • Anorexia • Weight gain • Shortness of breath • Abdominal distesion

• Shortness of breath Manifestations of left - sided heart failure include crackles or wheezes and breathlessness due to pulmonary congestion

Anuse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect? • JVD • Abdominal distension • Depentent edema • Hacking cough

•Hacking cough A hacking cough is a manifestation of left - sided heart failure that occurs due to pulmonary congestion.