Exam 2 PrepU

Typical candidates for a heart transplant have severe symptoms uncontrolled by medical therapy, no other surgical options, and a prognosis of less than_______ year(s) to live.

1 to 2

The nurse monitors a client for side effects associated with furosemide, which is newly prescribed for the treatment of heart failure. Due to the client's high risk for developing [1] as a result of the prescribed medication, the nurse focuses on monitoring the client for [2]

1. hypokalemia 2. ventricular arrhythmia

Hypertension is defined by the American College of Cardiology (ACC)/American Heart Association (AHA) Task Force as a systolic BP of ________ mm Hg or higher and a diastolic BP of 80 mm Hg or higher.

130

A hypertensive emergency is a situation in which the systolic BP is above________ mm Hg and must be lowered immediately.

180

A client is receiving intravenous heparin to prevent blood clots. The order is for heparin 1,200 units per hour. The pharmacy sends 25,000 units of heparin in 500 mL of D5W. At how many milliliters per hour will the nurse infuse this solution? Record your answer using a whole number.

24

______________, the most common disease of the arteries, is a process whereby the muscle fibers and the endothelial lining of the walls of small arteries and arterioles become thickened.

Arterioscholerosis

Which medication reverses digitalis toxicity? a. Amlodipine b. Ibuprofen c. Digoxin immune FAB d. Warfarin

Digoxin immune FAB

Orthostatic (postural) hypotension is a sustained decrease of at least 10 mm Hg in systolic BP or 20 mm Hg in diastolic BP within 3 minutes of moving from a lying or sitting to a standing position. a. TRUE b. FALSE

FALSE

_________ changes are recommended to lower cholesterol levels.

Lifestyle

During _______________ systole, contraction of the papillary muscles causes the chordae tendineae to become taut, keeping the valve leaflets approximated and closed.

Ventricular

You are doing an admission assessment on a client who is having outpatient testing done for cardiac problems. What should you ask this client during your assessment? a) "Have you had any episodes of dizziness or fainting?" b) "Have you had any episodes when you are to nauseous?" c) "Have you had any episodes of mottling in your hands?" d) "Have you had any episodes of pain radiating into your lower extremities?"

a) "Have you had any episodes of dizziness or fainting?"

The clinic nurse is assessing a client's pulse before outpatient diagnostic testing. What should the nurse document when assessing the client's pulse? a) rate, quality, and rhythm b) pressure, rate, and rhythm c) rate, rhythm, and volume d) quality, volume, and rate

a) rate, quality, and rhythm

The school nurse is providing care to a child with a sore throat. With any sign of throat infection, the nurse stresses which of the following? a. Obtaining a throat culture b. Warm, saltwater gargling c. Fluid increase to 2500cc d. Administering antiseptic lozenges

a. Obtaining a throat culture

A patient with pulmonary edema should be positioned upright, preferably with the legs dangling over the side of the bed, if possible. a. TRUE b. FALSE

a. TRUE

A priority nursing assessment when caring for a patient in hypertensive crisis receiving vasodilators is assessing I&O. a. TRUE b. FALSE

a. TRUE

The best sandwich choice for a client on a diet with sodium restriction would most likely be __________. a. grilled chicken b. hard salami c. packaged ham slices d. pastrami

a. grilled chicken

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

a. hypovolemia

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

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

Human valves, obtained from cadaver tissue donations and used for aortic and pulmonic valve replacement, are called homografts or ___________.

allografts

Clinical manifestations of right-sided heart failure include dependent edema, hepatomegaly,____________, and weight gain due to fluid retention.

ascites

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 a. lie down and elevate the feet. b. avoid caffeinated beverages. c. apply supplemental oxygen. d. request sublingual nitroglycerin.

avoid caffeinated beverages.

The nurse is caring for a client on a monitored telemetry unit. During morning assessment, the nurse notes abnormal ECG waves on the telemetry monitor. Which action would the nurse do first? a) Call the physician with a report. b) Assess the client c) Assess for mechanical dysfunction d) Reposition the client

b) Assess the client

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

b. Sit on the edge of the chair and rise slowly.

A client reports chest pain that occurs when playing tennis but resolves when sitting down. The nurse knows these symptoms are common for which type of angina? a. Intractable b. Stable c. Unstable d. Variant

b. Stable

Two days after undergoing a total abdominal hysterectomy, a client complains of left calf pain. Venography reveals deep vein thrombosis (DVT). When assessing this client, the nurse is likely to detect: a. pallor and coolness of the left foot. b. left calf circumference 1" (2.5 cm) larger than the right. c. loss of hair on the lower portion of the left leg. d. a decrease in the left pedal pulse.

b. left calf circumference 1" (2.5 cm) larger than the right.

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

b. secondary hypertension.

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: a. systolic BP is above 180 mm Hg. b. systolic BP is between 120 and 139 mm Hg. c. diastolic BP is 100 mm Hg. d. diastolic BP is between 70 and 79 mm Hg.

b. systolic BP is between 120 and 139 mm Hg.

Prevention of aortic regurgitation is primarily based on prevention of and treatment for ________ infections.

bacterial

Sinus ___________ occurs when the SA node creates an impulse at a rate less than 60 bpm in an adult.

bradycardia

The nurse is reviewing the results of the patient's echocardiogram and observes that the ejection fraction is 35%. The nurse anticipates that the patient will receive treatment for what condition? a) Pulmonary embolism b) Myocardial infarction c) Heart Failure d) Pericarditis

c) Heart Failure

A nurse is reviewing laboratory values for a client diagnosed with hyperlipidemia 6 months ago. Which results indicate that the client has been following a therapeutic regimen? a) Low density lipoproteins (LDL) increase from 180 mg/dl to 190 mg/dl. b) Total cholesterol level increases from 250 mg/dl to 275 mg/dl. c) High density lipoproteins (HDL) increase from 25 mg/dl to 40 mg/dl. d) Triglycerides increase from 225 mg/dl to 250 mg/dl.

c) High density lipoproteins (HDL) increase from 25 mg/dl to 40 mg/dl.

After a physical examination, the provider diagnosed a patient with a grade 4 heart murmur. When auscultating a murmur, what does the nurse expect to hear? a) Easily heard with no palpable thrill. b) Quiet but readily heard. c) Loud and may be associated with a thrill sound similar to (a purring cat). d) Very loud; can be heard with the stethoscope half-way off the chest.

c) Loud and may be associated with a thrill sound similar to (a purring cat).

The client with cardiac failure is taught to report which symptom to the health care provider or clinic immediately? a) Ability to sleep through the night b) Increased appetite c) Persistent cough d) Weight loss

c) Persistent cough

The nurse is assessing a patient's electrocardiogram (ECG). What phase does the nurse determine is the resting phase before the next depolarization? a) Phase 2 b) Phase 1 c) Phase 4 d) Phase 3

c) Phase 4

1) The patient has a heart rate of 72 bpm with a regular rhythm. Where does the nurse determine the impulse arises from? a) The Purkinje fibers b) The ventricles c) The sinoatrial node d) The AV node

c) The sinoatrial node

A patient recently diagnosed with pericarditis asks the nurse to explain what area of the heart is involved. How does the nurse best describe the pericardium to the client? a) Exterior layer of the heart. b) Heart's muscle fibers. c) Thin fibrous sac that encases the heart. d) Inner lining of the heart and valves.

c) Thin fibrous sac that encases the heart.

During auscultation of the lungs, what would a nurse note when assessing a client with left-sided heart failure? a) Stridor b) Laborious breathing c) Wheezes with wet lung sounds d) high-pitched sounds

c) Wheezes with wet lung sounds

Which area of the heart is located at the third intercostal (IC) space to the left of the sternum? a) pulmonic area b) aortic area c) erb point d) epigastric area

c) erb point

A client's chart indicates an S4 heart sound, and is scheduled for a cardiac workup. The nurse is aware that this client may have which cardiac condition? a) pericarditis b) diseased heart valves c) hypertensive heart disease d) heart failure

c) hypertensive heart disease

The nurse is caring for a patient who has started anticoagulant therapy with warfarin (Coumadin). When does the nurse understand that therapeutic benefits will begin? a. Within 12 hours b. Within the first 24 hours c. In 3 to 5 days d. In 2 days

c. In 3 to 5 days

A nurse is assessing a client's right lower leg, which is wrapped with an elastic bandage. Which signs and symptoms suggest circulatory impairment? a. Redness, cool skin temperature, and swelling b. Swelling, warm skin temperature, and drainage c. Numbness, cool skin temperature, and pallor d. Numbness, warm skin temperature, and redness

c. Numbness, cool skin temperature, and pallor

Which terms describes the backward flow of blood through a heart valve? a. Stenosis b. Hypertrophy c. Regurgitation d. Prolapse

c. Regurgitation

The nurse is caring for a client diagnosed with coronary artery disease (CAD). What condition most commonly results in CAD? a. myocardial infarction b. renal failure c. atherosclerosis d. diabetes mellitus

c. atherosclerosis

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: a. inherent rhythmicity of all muscle tissue. b. sufficient blood pressure. c. inherent rhythmicity of cardiac muscle tissue. d. inherent electrons in muscle tissue.

c. inherent rhythmicity of cardiac muscle tissue.

The client returns to the clinic for a follow-up appointment following a permanent pacemaker insertion and reports tenderness and throbbing around the incision. The nurse observes mild swelling, erythema, and warmth at the pacemaker insertion site. What does the nurse suspect? a. postoperative site hematoma b. internal bleeding at pacemaker site c. pacemaker site infection d. normal postoperative healing

c. pacemaker site infection

The nurse is caring for a client after cardiac surgery. What is the most immediate concern for the nurse? a. weight gain of 6 ounces b. serum glucose of 124 mg/dL c. potassium level of 6 mEq/L d. bilateral rales and rhonchi

c. potassium level of 6 mEq/L

The nurse is caring for a patient with systolic blood pressure of 135 mm Hg. This finding would be classified as a. normal. b. elevated. c. stage 1 hypertension. d. stage 2 hypertension.

c. stage 1 hypertension.

If the tachycardia is persistent and causing hemodynamic instability, synchronized ____________ is the treatment of choice.

cardioversion

The most common valvuloplasty procedure is a _________________.

commissurotomy

A nurse is preparing a client for a scheduled adenosine stress test. Which statement made by the client indicates a need for further education? a) "The medication will have an effect on my heart similar to exercise." b) "The effects of this medication will wear off quickly." c) "I may feel some flushing or nausea with this medication." d) "My family is bringing me a cup of coffee to drink before the test."

d) "My family is bringing me a cup of coffee to drink before the test."

The nurse cares for a client with clubbing of the fingers and toes. The nurse should complete which action given these findings? a) Assess the client for pitting edema. b) Assess the client's capillary refill. c) Obtain a 12-lead ECG tracing d) Obtain an oxygen saturation level

d) Obtain an oxygen saturation level

The nurse observes a client during an exercise stress test (bicycle). Which finding indicates a positive test and the need for further diagnostic testing? a) Heart rate changes; 78 bpm to 112 bpm b) BP changes; 148/80 mm Hg to 166/90 mm Hg c) Dizziness and leg cramping d) ST-segment changes on the ECG

d) ST-segment changes on the ECG

During an initial assessment, the nurse measures the client's apical pulse and compares it to the peripheral pulse. The difference between the two is known as pulse: a) volume. b) quality c) rhythm d) deficit

d) deficit

During the auscultation of a client's heart sounds, the nurse notes an S4. The nurse recognizes that an S4 is associated with which condition? a) diseased heart valves b) turbulent blood flow c) heart failure d) hypertensive heart disease

d) hypertensive heart disease

Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to all the cells and tissues of the body? a) left atrium b) right atrium c) right ventricle d) left ventricle

d) left ventricle

The nurse recognizes which as being true of cardioversion? a. Amount of voltage used should exceed 400 watts/second. b. Defibrillator should be set in the non-synchronous mode so the nurse can hit the button at the right time. c. Electrical impulse can be discharged during the T wave. d. Defibrillator should be set to deliver a shock during the QRS complex.

d. Defibrillator should be set to deliver a shock during the QRS complex.

The nurse assessing a client who has arterial insufficiency of the legs and an ulcer on the left great toe would expect to find which characteristic? a. Superficial ulcer b. Aching, cramping pain c. Pulses that are present but difficult to palpate d. Diminished or absent pulses

d. Diminished or absent pulses

A nurse evaluates a client with a temporary pacemaker. The client's ECG tracing shows each P wave followed by the pacing spike. What is the nurse's best response? a. Reposition the extremity and turn the client to left side b. Check the security of all connections and increase the milliamperage c. Obtain a 12-lead ECG and a portable chest x-ray d. Document the findings and continue to monitor the client

d. Document the findings and continue to monitor the client

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? a. A pulmonary arteriography b. Electrocardiogram c. A chest radiograph d. Echocardiogram

d. Echocardiogram

The diagnosis of aortic regurgitation (AR) is confirmed by which of the following? a. Myocardial biopsy b. Exercise stress testing c. Cardiac catheterization d. Echocardiography

d. Echocardiography

A client is taking 50 mg of oral spironolactone twice a day to assist with blood pressure control. While the nurse is performing the morning assessment, the client reports nausea, general muscle cramps, and weakness. The ECG strip shows a peaked, narrow T-wave, which is a change. What electrolyte imbalance does the nurse suspect? a. Hypokalemia b. Hypernatremia c. Hyponatremia d. Hyperkalemia

d. Hyperkalemia

When the postcardiac surgical patient demonstrates vasodilation, hypotension, hyporeflexia, slow gastrointestinal motility (hypoactive bowel sounds), lethargy, and respiratory depression, the nurse suspects which electrolyte imbalance? a. Hypokalemia b. Hypomagnesemia c. Hyperkalemia d. Hypermagnesemia

d. Hypermagnesemia

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

d. IV

A home health nurse is teaching a client with peripheral arterial disease ways to improve circulation to the lower extremities. The nurse encourages which of the following in teaching? a. Use of antiembolic stockings b. Application of ace wraps from the toe to below the knees c. Elevation of the legs above the heart d. Keeping the legs in a neutral or dependent position

d. Keeping the legs in a neutral or dependent position

A nurse is teaching a client who receives nitrates for the relief of chest pain. Which instruction should the nurse emphasize? a. Repeat the dose of sublingual nitroglycerin every 15 minutes for three doses. b. Restrict alcohol intake to two drinks per day. c. Store the drug in a cool, well-lit place. d. Lie down or sit in a chair for 5 to 10 minutes after taking the drug.

d. Lie down or sit in a chair for 5 to 10 minutes after taking the drug.

Which discharge instruction for self-care should the nurse provide to a client who has undergone a percutaneous transluminal coronary angioplasty (PTCA) procedure? a. Refrain from sexual activity for 1 month b. Normal activities of daily living can be resumed the first day after surgery c. Cleanse the site with disinfectants and dress the wound appropriately d. Monitor the site for bleeding or hematoma.

d. Monitor the site for bleeding or hematoma.

A home health nurse is seeing an elderly male client for the first time. During the physical assessment of the skin on the lower legs, the nurse notes edema, brown pigmentation in the gaiter area, pedal pulses, and a few irregularly shaped ulcers around the ankles. From these findings, the nurse knows that the client has a problem with peripheral circulation. Which of the following does the nurse suspect? a. Trauma b. Neither venous nor arterial insufficiency c. Arterial insufficiency d. Venous insufficiency

d. Venous insufficiency

The term for a diagnostic test that involves injection of a contrast media into the venous system through a dorsal vein in the foot is a. air plethysmography. b. lymphangiography. c. lymphoscintigraphy. d. contrast phlebography.

d. contrast phlebography.

The nurse witnesses a client experiencing ventricular fibrillation. What is the nurse's priority action? a. cardioversion b. IV bolus of dobutamine c. IV bolus of atropine d. defibrillation

d. defibrillation

A nurse is instructing a client about using antiembolism stockings. Antiembolism stockings help prevent deep vein thrombosis (DVT) by: a. providing warmth to the extremity. b. elevating the extremity to prevent pooling of blood. c. encouraging ambulation to prevent pooling of blood. d. forcing blood into the deep venous system.

d. forcing blood into the deep venous system.

A nurse is monitoring the vital signs and blood results of a client who is receiving anticoagulation therapy. What does nurse identify as a major indication of concern? a. blood pressure of 129/72 mm Hg b. heart rate of 87 bpm c. hemoglobin of 16 g/dL d. hematocrit of 30%

d. hematocrit of 30%

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

d. inadequate cardiac output

The first symptom of mitral stenosis often is __________ on exertion as a result of pulmonary venous hypertension.

dyspnea

The nurse working in the emergency department places a client in anaphylactic shock on a cardiac monitor and sees the cardiac rhythm shown. Which dysrhythmia should the nurse document? a. junctional rhythm b. sinus rhythm c. atrial fibrillation d. ventricular asystole e. ventricular tachycardia

e. ventricular tachycardia

Target organ damage can be shown in blood vessels throughout the body, particularly in organs such as the heart, kidneys, brain, and _________.

eyes

The apical impulse, formerly called the point of maximum impulse (PMI), is normally palpable at the intersection of the midclavicular line of the left chest and at the ____________ intercostal space.

fifth

The outcomes of arterial _____________ can include reduced mobility and activity as well as a loss of independence.

insufficiency

Angina pectoris is the chest pain resulting from myocardial __________of the heart muscle.

ischemia

____________causes myocardial dysfunction in heart failure because it deprives heart cells of oxygen and causes cellular damage.

ischemia

Because HF is a complex and progressive condition, patients are at risk for many complications, including acute decompensated HF, pulmonary edema, ____________ disease, and life-threatening dysrhythmias.

kidney

Hypertension also increases the work of the _______ ventricle, which must pump harder to eject blood into the arteries.

left

The most important diagnostic indication of an abdominal aortic aneurysm is a pulsatile ___________ in the middle and upper abdomen.

mass

The S1 heart sound results from closure of the ___________ and tricuspid valves.

mitral

Turbulent blood flow caused by a narrowed or malfunctioning valve is called a __________ , which can be heard during auscultation of the heart.

murmur

Patients with atrial fibrillation are at increased risk of heart failure, ____________ ischemia, and embolic events such as stroke.

myocardial

Pulmonary edema can also develop slowly, especially when it is caused by ________ disorders such as kidney disease and other conditions that cause fluid overload.

noncardiac

Left-sided heart failure refers to failure of the left ventricle, which results in __________ congestion.

pulmonary

The right side of the heart pumps blood through the lungs to the _______________ circulation.

pulmonary

Patients need to be informed that __________ hypertension can occur if antihypertensive medications are suddenly stopped.

rebound

A ___________ aneurysm is a localized sac or dilation formed at a weak point in the wall of the artery that projects from only one side of the vessel.

saccular

Blood vessels commonly used to bypass occluded coronary arteries include the __________ veins of the leg.

saphenous

A _______ provides structural support to a coronary artery following angioplasty to minimize the risk of vessel stenosis.

stent

The electrical stimulation of the cardiac muscle cells is called depolarization; the mechanical contraction is called _________ .

systole

The recommended initial medication regimen for patients with uncomplicated hypertension, and no indications for another medication, is __________ diuretics.

thiazide

1) Management of an elevated ____________ level focuses on weight reduction and increased physical activity.

triglyceride

A 45-year-old female (Ht.: 6'0" Wt.: 230 lbs.) was diagnosed with congestive heart failure. She has a history of coronary heart disease, hypertension, and used to smoke 2 packs of cigarettes daily. She experiences shortness of breath, making it difficult for her to eat. She consumes approximately 50% of her estimated needs and has significant edema in her lower extremities. The client's reduced renal blood flow can causes her adrenal glands to secrete ___1___. This can cause retention of ___2___ and ___3___, which is most likely contributing to her edema.

1. aldosterone 2. water 3. sodium Rationale: Congestive heart failure results in reduced blood flow that reaches the kidneys. Normally, low renal blood flow indicates hypovolemia. The body's natural response to low blood flow is to increase the volume of blood in the body through the vasopressin and renin-angiotensin-aldosterone systems. However, in the case of congestive heart failure, the low renal blood flow does not indicate hypovolemia. Because the kidneys continue to increase blood volume, the blood becomes more dilute, and edema ensues.

For each assessment finding, use an X to indicate whether nursing and collaborative interventions were effective (helped to meet expected outcomes), or ineffective (did not help to meet expected outcomes). Assessment Finding -Reduced edema in the lower extremities. -Consumes 2300 mg of sodium per day. -Limits fluid to 2 L per day. -Eats foods such as mashed potatoes, applesauce, and pureed peas when eating is difficult. -Has low potassium levels. -Seasons chicken with sodium-free spices such as pepper and garlic powder.

Effective Reduced edema in the lower extremities. X Limits fluid to 2 L per day. X Eats foods such as mashed potatoes, applesauce, and pureed peas when eating is difficult. X Seasons chicken with sodium-free spices such as pepper and garlic powder. X Ineffective Consumes 2300 mg of sodium per day. X Has low potassium levels. X Rationale: Resolving edema is a sign that fluid balance is returning and that the intervention is working. The client is following the guidelines to limit fluid to 2 L per day, but he is consuming 2300 mg of sodium, which is over the recommended intake of 2000 mg per day. He is consuming soft foods and using sodium-free herbs and spices, such as pepper and garlic powder, to season foods. However, his low potassium levels indicate that he needs to supplement potassium to return those levels to normal.

For each health teaching below, use an X to identify which are indicated (appropriate or necessary) or contraindicated (could be harmful) for the client. Health Teaching -Use herbs to season foods. -Avoid salty processed foods such as chips, pickles, olives, and ham. -Supplement thiamin and potassium if taking a diuretic. -You do not have to limit alcohol consumption. -Limit meals to 2 or 3 per day if having difficulty eating enough calories.

Indicated Use herbs to season foods. X Avoid salty processed foods such as chips, pickles, olives, and ham. X Supplement thiamin and potassium if taking a diuretic. X Contraindicated You do not have to limit alcohol consumption. X Limit meals to 2 or 3 per day if having difficulty eating enough calories. X Rationale: To restrict sodium, clients can use sodium-free herbs and spices during cooking. Clients should avoid salty processed foods and supplement thiamine and potassium, which might be lost with frequent diuretic use. Clients should avoid or limit alcohol to 1 drink per day. Small frequent meals, such as 5 to 6 meals per day, might be helpful for these clients to consume all their calorie needs.

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

b. dyspnea on exertion

According to the classification of hypertension diagnosed in older adults, hypertension that can be attributed to an underlying cause is termed a. secondary. b. primary. c. essential. d. isolated systolic.

a. secondary.

The nurse cares for a client prescribed warfarin orally. The nurse reviews the client's prothrombin time (PT) level to evaluate the effectiveness of the medication. Which laboratory values should the nurse also evaluate? a) International normalized ratio (INR) b) Sodium c) completed blood count (CBC) d) partial thermoplastic time (PTT)

a) International normalized ratio (INR)

1) A nurse assessing a client who underwent cardiac catheterization finds the client lying flat on the bed. The client's temperature is 99.8° F (37.7° C). The client's blood pressure is 104/68 mm Hg. The client's pulse rate is 76 beats/minute. The nurse detects weak pulses in the leg distal to the puncture site. Skin on the leg is cool to the touch. The puncture site is dry, but swollen. What is the most appropriate action for the nurse to take? a) Contact the health care provider and report the findings. b) Encourage the client to perform isometric leg exercise to improve circulation in the legs. c) Document findings and check the client again in 1 hour. d) Slow the I.V. fluid to prevent any more swelling at the puncture site.

a) Contact the health care provider and report the findings.

The clinic nurse caring for a client with a cardiovascular disorder is performing an assessment of the client's pulse. Which of the following steps is involved in determining the pulse deficit? a) Count the heart rate at the apex. b) Calculate the palpated volume. c) Calculate the pauses between pulsations. d) Count the radial pulse for 20 to 25 seconds.

a) Count the heart rate at the apex.

The nurse is performing an assessment of the patient's heart. Where would the nurse locate the apical pulse if the heart is in a normal position? a) Left 5th intercostal space at the midclavicular line b) Right 2nd intercostal space at the midclavicular line c) Right 3rd intercostal space at the midclavicular line d) Left 2nd intercostal space at the midclavicular line

a) Left 5th intercostal space at the midclavicular line

It is important for a nurse to understand cardiac hemodynamics. For blood to flow from the right ventricle to the pulmonary artery, the following must occur: a) Right ventricular pressure must be higher than pulmonary arterial pressure. b) The pulmonic valve must be closed. c) The atrioventricular valves must open. d) Right ventricular pressure must decrease with systole.

a) Right ventricular pressure must be higher than pulmonary arterial pressure.

A patient tells the nurse, "I was straining to have a bowel movement and felt like I was going to faint. I took my pulse and it was so slow." What does the nurse understand occurred with this patient? a) The patient has a vagal response b) The patient may have had a myocardial infarction. c) The patient was anxious about being constipated. d) The patient may have an abdominal aortic aneurysm.

a) The patient has a vagal response

A critically ill client is admitted to the ICU. The health care provider decides to use intra-arterial pressure monitoring. After this intervention is performed, what assessment should the nurse prioritize? a) perfusion distal to the insertion site b) signs and symptoms of compartment syndrome c) fluctuations in core body temperature d) Signs and symptoms of esophageal varices

a) perfusion distal to the insertion site

A client, who has undergone a percutaneous transluminal coronary angioplasty (PTCA), has received discharge instructions. Which statement by the client would indicate the need for further teaching by the nurse? a. "I should expect a low-grade fever and swelling at the site for the next week." b. "I should avoid taking a tub bath until my catheter site heals." c. "I should expect bruising at the catheter site for up to 3 weeks." d. "I should avoid prolonged sitting."

a. "I should expect a low-grade fever and swelling at the site for the next week."

The nurse is educating a client about the care related to a new diagnosis of mitral valve prolapse. What statement made by the client demonstrates understanding of the teaching? a. "I will avoid caffeine, alcohol, and smoking. b. "I can get my tongue pierced at a store in the shopping mall." c. "I will take antibiotics before getting my teeth cleaned." d. "I can get a tattoo at a local parlor."

a. "I will avoid caffeine, alcohol, and smoking.

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? a. "Spike" on the rhythm strip b. Vibration under the skin c. Quality of the pulse d. Scar on the chest

a. "Spike" on the rhythm strip

A nurse is caring for a client newly diagnosed with mitral valve prolapse. The health care provider indicates the client has probably had this condition for years. What factor is important for the nurse to consider when teaching the client about valvular disease? a. "The client may have to wear antiembolism stocking to help with venous return." b. "The client needs premium insurance to cover the cost of medications." c. "The client's religion may prohibit the client from seeking medical attention." d. "The client with mitral valve prolapse probably had no health symptoms."

a. "The client may have to wear antiembolism stocking to help with venous return."

1) When assessing a client who reports recent chest pain, the nurse obtains a thorough history. Which client statement most strongly suggests angina pectoris? a. "The pain occurred while I was mowing the lawn." b. "The pain lasted about 45 minutes." c. "The pain resolved after I ate a sandwich." d. "The pain got worse when I took a deep breath."

a. "The pain occurred while I was mowing the lawn."

A nurse and a nursing student are performing a physical assessment of a client with pericarditis. The client has an audible pericardial friction rub on auscultation. When leaving the room, the student asks the nurse what causes the sound. The nurse's best response is which of the following? a. "The pericardial surfaces lose their lubricating fluid because of inflammation and rub against each other." b. "The layers of the heart become loose from each other and rub together with each heart beat." c. "The lung surfaces lose their lubrication and rub against the myocardium with each heart beat." d. "The great vessels rub against the pericardium with each heart beat."

a. "The pericardial surfaces lose their lubricating fluid because of inflammation and rub against each other."

The nurse is teaching a client with suspected acute myocardial infarction about serial isoenzyme testing. When is it best to have isoenzyme creatinine kinase of myocardial muscle (CK-MB) tested? a. 4 to 6 hours after pain b. 30 minutes to 1 hour after pain c. 2 to 3 hours after admission d. 12 to 18 hours after admission

a. 4 to 6 hours after pain

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

a. A client diagnosed with kidney disease

A nurse is caring for a client with aortic stenosis whose compensatory mechanisms of the heart have begun to fail. The nurse will monitor the client carefully for which initial symptoms? a. Exertional dyspnea, orthopnea, pulmonary edema b. Nausea, vomiting, exertional fatigue c. Syncope, fever, vomiting d. Dizziness, nausea, diarrhea

a. Exertional dyspnea, orthopnea, pulmonary edema

A client experiencing palpitations is diagnosed with mitral valve prolapse after having an echocardiogram. Which teachings will the nurse provide to the client about this condition? Select all that apply. a. Abstain from all tobacco products b. Ask for antibiotics before dental procedures. c. Expect to take anticoagulants throughout the lifespan. d. Eliminate alcohol from the diet.

a. Abstain from all tobacco products d. Eliminate alcohol from the diet.

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

a. Atrial flutter

The nurse is caring for a client with Raynaud's disease. What are important instructions for a client who is diagnosed with this disease to prevent an attack? a. Take over-the-counter decongestants. b. Report changes in the usual pattern of chest pain. c. Avoid fatty foods and exercise. d. Avoid situations that contribute to ischemic episodes.

a. Avoid situations that contribute to ischemic episodes.

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

a. Hypertensive emergency

The nurse is performing an assessment on a patient to determine the effects of hypertension on the heart and blood vessels. What specific assessment data will assist in determining this complication? (Select all that apply.) a. Character of apical and peripheral pulses b. Respiratory rate c. Heart rhythm d. Heart rate e. Lung sounds

a. Character of apical and peripheral pulses c. Heart rhythm d. Heart rate

Which nursing intervention should a nurse perform when a client with cardiomyopathy receives a diuretic? a. Check regularly for dependent edema b. Administer oxygen c. Maintain bed rest d. Allow unrestricted physical activity

a. Check regularly for dependent edema

Health teaching includes advising patients on ways to reduce PAD. The nurse should always emphasize that the strongest risk factor for the development of atherosclerotic lesions is: a. Cigarette smoking. b. Stress. c. Lack of exercise. d. Obesity.

a. Cigarette smoking.

A client is hospitalized for repair of an abdominal aortic aneurysm. The nurse must be alert for signs and symptoms of aneurysm rupture and thus looks for which of the following? a. Constant, intense back pain and falling blood pressure b. Constant, intense headache and falling blood pressure c. Slow heart rate and high blood pressure d. Higher than normal blood pressure and falling hematocrit

a. Constant, intense back pain and falling blood pressure

Combining the _________ with a low-sodium diet significantly reduces blood pressure. a. DASH diet b. Atkins diet c. Paleo diet d. Whole 30 diet

a. DASH diet

In which type of cardiomyopathy does the heart muscle actually increase in size and mass weight, especially along the septum? a. Hypertrophic b. Arrhythmogenic right ventricular c. Dilated d. Restrictive

a. Hypertrophic

A client is admitted to the intensive care unit (ICU) with a diagnosis of hypertension emergency/crisis. The client's blood pressure (BP) is 200/130 mm Hg. The nurse is preparing to administer IV nitroprusside. Upon assessment, which finding requires immediate intervention by the nurse? a. Numbness and weakness in the left arm b. Chest pain score of 3 (on a scale of 1 to 10) c. Nausea and severe headache d. Urine output of 40 mL over the past hour

a. Numbness and weakness in the left arm

1) A nurse is teaching about risk factors that increase the probability of heart disease to a community group. Which risk factors will the nurse include in the discussion? Select all that apply. a. Elevated C-reactive protein b. Body mass index (BMI) of 23 c. Family history of coronary heart disease d. African-American descent e. Age greater than 45 years for men

a. Elevated C-reactive protein c. Family history of coronary heart disease d. African-American descent e. Age greater than 45 years for men

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? a. Elevated ST segment b. Prolonged PR interval c. Absent Q wave d. Widened QRS complex

a. Elevated ST segment

Which medication is categorized as a loop diuretic? a. Furosemide b. Chlorthalidone c. Spironolactone d. Chlorothiazide

a. Furosemide

A client is diagnosed with rheumatic endocarditis. What bacterium is the nurse aware causes this inflammatory response? a. Group A. beta-hemolytic streptococcus b. Serratia marcescens c. Staphylococcus aureus d. Pseudomonas aeruginosa

a. Group A. beta-hemolytic streptococcus

High serum level of which of the following lipoproteins is protective against CVD? a. HDL cholesterol b. LDL cholesterol c. Triglycerides d. VLDL cholesterol

a. HDL cholesterol

A nurse is educating about lifestyle modifications for a group of clients with newly diagnosed hypertension. While discussing dietary changes, which point would the nurse emphasize? a. It takes 2 to 3 months for the taste buds to adapt to decreased salt intake. b. A person with hypertension should never consume alcohol. c. There is usually no need to change alcohol consumption for clients with hypertension. d. The taste buds never adapt to decreased salt intake.

a. It takes 2 to 3 months for the taste buds to adapt to decreased salt intake.

A nurse is caring for a client with end-stage cardiomyopathy and the client's spouse asks the nurse to clarify one of the last treatment options available that the health care provider mentioned earlier. What option will the nurse most likely discuss? a. Left ventricular assist device b. Annuloplasty c. Chordoplasty d. Open commissurotomy

a. Left ventricular assist device

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

a. Pacer rate

A 45-year-old female (Ht.: 6'0" Wt.: 230 lbs.) was diagnosed with congestive heart failure. She has a history of coronary heart disease, hypertension, and used to smoke 2 packs of cigarettes daily. She experiences shortness of breath, making it difficult for her to eat. She consumes approximately 50% of her estimated needs and has significant edema in her lower extremities. From the list below, select all of the recommended dietary intervention strategies for this client. a. Limit fluid b. Limit sodium c. Utilize diuretics d. Supplement folate, vitamin B12, and magnesium e. Increase sodium intake f. Limit potassium intake g. Consume large frequent meals h. Incorporate soft foods if eating is exhaustive

a. Limit fluid b. Limit sodium c. Utilize diuretics d. Supplement folate, vitamin B12, and magnesium g. Consume large frequent meals h. Incorporate soft foods if eating is exhaustive Rationale: Diet recommendations for congestive heart failure include restricting fluid and sodium to normalize fluid balance. Diuretics can help to manage fluid retention, but the health care team should monitor potassium levels and supplement, if indicated. Supplements, such as folate, vitamin B12, and magnesium, might be indicated in clients with congestive heart failure. Lastly, congestive heart failure can cause shortness of breath and make eating a challenge. The medical nutrition therapy guidelines for clients that feel exhausted during mealtime is to consume soft foods that do not require as much energy for physical digestion. Small frequent meals can also help these clients consume more total calories throughout the day.

A client is diagnosed with peripheral arterial disease. Review of the client's chart shows an ankle-brachial index (ABI) on the right of 0.45. This indicates that the right foot has which of the following? a. Moderate to severe arterial insufficiency b. Tissue loss to that foot c. Very mild arterial insufficiency d. No arterial insufficiency

a. Moderate to severe arterial insufficiency

The pathophysiology of all cardiomyopathies is a series of events that culminates in impaired cardiac output. a. TRUE b. FALSE

a. TRUE

A client has been diagnosed with peripheral arterial occlusive disease. Which of the following instructions is appropriate for the nurse to give the client for promoting circulation to the extremities? a. Participate in a regular walking program. b. Use a heating pad to promote warmth. c. Massage the calf muscles if pain occurs. d. Keep the extremities elevated slightly.

a. Participate in a regular walking program.

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. a. Physical inactivity b. Diabetes mellitus c. Gallbladder disease d. Frequent upper respiratory infections e. Smoking

a. Physical inactivity b. Diabetes mellitus e. Smoking

Which medication is an antidote to heparin? a. Protamine sulfate b. Clopidogrel c. Aspirin d. Alteplase

a. Protamine sulfate

The nurse recognizes which symptom as a classic sign of cardiogenic shock? a. Restlessness and confusion b. Hyperactive bowel sounds c. High blood pressure d. Increased urinary output

a. Restlessness and confusion

A client comes to the clinic reporting fever, chills, and sore throat and is diagnosed with streptococcal pharyngitis. A nurse knows that early diagnosis and effective treatment is essential to avoid which preventable disease? a. Rheumatic fever b. Pericarditis c. Mitral stenosis d. Cardiomyopathy

a. Rheumatic fever

A nurse is caring for a client with acute mitral regurgitation related to an acute myocardial infarction. The nurse knows to monitor the client carefully for symptoms of which initial complication or result? a. Severe heart failure b. infarcted bowel c. Kidney failure d. Cerebral vascular accident (CVA)

a. Severe heart failure

The sinoatrial (SA) node, with an inherent firing rate of 60 to 100 impulses/min, is considered the primary pacemaker of the heart. a. TRUE b. FALSE

a. TRUE

Ventricular tachycardia is considered an emergency situation because the patient is usually (but not always) unresponsive and pulseless. a. TRUE b. FALSE

a. TRUE

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 helpful? a. Stress reduction to lower prehypertensive state b. Diagnostic testing for determining cardiac functioning c. Use of beta-blockers for treatment of hypertension d. Increasing fluids for low blood pressure

a. Stress reduction to lower prehypertensive state

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

a. Stroke c. Myocardial infarction e. Coronary artery disease

A patient with atrial fibrillation is at high risk for thrombus formation. a. TRUE b. FALSE

a. TRUE

ACE inhibitors are recommended for prevention of HF in patients at risk due to vascular disease and diabetes. a. TRUE b. FALSE

a. TRUE

An elevated blood level of the amino acid homocysteine is believed to indicate a high risk for coronary artery disease. a. TRUE b. FALSE

a. TRUE

Atrial fibrillation is the most common sustained arrhythmia, affecting as many as 6.1 million Americans. a. TRUE b. FALSE

a. TRUE

Clopidogrel is commonly prescribed in addition to aspirin in patients at high risk for MI. a. TRUE b. FALSE

a. TRUE

During diastole, the tricuspid and mitral valves are open, allowing the blood in the atria to flow freely into the relaxed ventricles. a. TRUE b. FALSE

a. TRUE

Fluid overload and decreased tissue perfusion result when the heart cannot generate cardiac output (CO) sufficient to meet the body's demands for oxygen and nutrients. a. TRUE b. FALSE

a. TRUE

For a patient to be considered a candidate for a coronary artery bypass graft (CABG), the coronary arteries to be bypassed must have at least a 70% occlusion (50% if the affected artery is the left main coronary artery). a. TRUE b. FALSE

a. TRUE

Graduated compression stockings usually are prescribed for patients with venous disease as soon as possible after diagnosis. a. TRUE b. FALSE

a. TRUE

Mitral valve prolapse is a deformity that usually produces no symptoms. a. TRUE b. FALSE

a. TRUE

Nicotine from tobacco products causes vasospasm and can thereby dramatically reduce circulation to the extremities. a. TRUE b. FALSE

a. TRUE

Spironolactone, an aldosterone receptor blocker that is prescribed for hypertension, is contraindicated for patients with hyperkalemia and impaired renal function. a. TRUE b. FALSE

a. TRUE

Studies report that the average venous ulcer requires as long as 6 to 12 months to heal completely. a. TRUE b. FALSE

a. TRUE

The Dietary Approaches to Stop Hypertension (DASH) diet recommends 4 to 5 servings of fruit and vegetables a day (based on a 2000 calorie diet). a. TRUE b. FALSE

a. TRUE

The most characteristic clinical manifestation of pericarditis is a creaky or scratchy friction rub that can be clearly heard during auscultation at the left lower sternal border. a. TRUE b. FALSE

a. TRUE

The most common cause of cardiovascular disease in the United States is atherosclerosis, an abnormal accumulation of lipid, or fatty substances, and fibrous tissue in the lining of arterial blood vessel walls. a. TRUE b. FALSE

a. TRUE

What should the nurse do to manage the persistent swelling in a client with severe lymphangitis and lymphadenitis? a. Teach the client how to apply an elastic sleeve b. Inform the physician if the client's temperature remains low c. Offer cold applications to promote comfort and to enhance circulation d. Avoid elevating the area

a. Teach the client how to apply an elastic sleeve

A pregnant client who developed deep vein thrombosis (DVT) in her right leg is receiving heparin I.V. on the medical floor. Physical therapy is ordered to maintain her mobility and prevent additional DVT. A nursing assistant working on the medical unit helps the client with bathing, range-of-motion exercises, and personal care. Which collaborative multidisciplinary considerations should the care plan address? a. The client is at risk for heparin-induced thrombocytopenia; therefore, the care plan should include reporting evidence of bleeding or easy bruising. b. The client is at risk for heparin-induced thrombocytopenia; therefore, the care plan should include sequential compression device application and strict bed rest. c. The client is at risk for developing another DVT; therefore, the care plan should include reporting redness, tenderness, or edema in the other lower extremity. d. The client is pregnant and receiving I.V. heparin, placing her at risk for premature labor; therefore, the care plan should include reporting signs of premature labor.

a. The client is at risk for heparin-induced thrombocytopenia; therefore, the care plan should include reporting evidence of bleeding or easy bruising.

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? a. To decrease workload of the heart b. To dilate coronary arteries c. To prevent angiotensin II conversion d. To decrease homocysteine levels

a. To decrease workload of the heart

A nurse is educating a community group about coronary artery disease. One member asks about how to avoid coronary artery disease. Which of the following items are considered modifiable risk factors for coronary artery disease? Choose all that apply. a. Tobacco use b. Gender c. Race d. Hyperlipidemia e. Obesity

a. Tobacco use d. Hyperlipidemia e. Obesity

Which term refers to preinfarction angina? a. Unstable angina b. Variant angina c. Stable angina d. Silent ischemia

a. Unstable angina

A client is admitted to the emergency department with chest pain and doesn't respond to nitroglycerin. The health care team obtains an electrocardiogram and administers I.V. morphine. The health care provider also considers administering alteplase. This thrombolytic agent must be administered how soon after onset of myocardial infarction (MI) symptoms? a. Within 6 hours b. Within 5 to 7 days c. Within 24to 48 hours d. Within 12 hours

a. Within 6 hours

An example of a profile consistent with metabolic syndrome is __________. a. a 19-year-old male with a waist circumference of 42 inches, triglyceride level of 225 mg/dL, and a blood pressure of 166/84 mm Hg b. a 20-year-old male with a waist circumference of 34 inches, triglyceride level of 134 mg/dL, and a blood pressure of 123/68 mm Hg c. a 28-year-old woman with a fasting glucose level of 83 mg/dL, HDL cholesterol level of 58 mg/dL, and a blood pressure of 124/76 mm Hg d. a 32-year-old woman with a waist circumference of 24 inches, fasting glucose level of 110 mg/dL, and HDL cholesterol level of 63 mg/dL

a. a 19-year-old male with a waist circumference of 42 inches, triglyceride level of 225 mg/dL, and a blood pressure of 166/84 mm Hg b. a 20-year-old male with a waist circumference of 34 inches, triglyceride level of 134 mg/dL, and a blood pressure of 123/68 mm Hg

A client is diagnosed with pericarditis. What symptom will be the nurse's priority for treatment? a. acute pain b. denial c. fatigue d. anxiety

a. acute pain

A client has a medical diagnosis of an advanced first-degree atrioventricular block and is symptomatic. What initial treatment will the nurse be prepared to complete? a. prepare the client for a cardioversion b. prepare client for a cardiac catheterization c. administer an IV bolus of atropine d. administer an IV bolus of furosemide

a. administer an IV bolus of atropine

The nurse is beginning discharge teaching with a client diagnosed with a myocardial infarction (MI). The nurse will include teaching on what medications? Select all that apply. a. enalapril b. aspirin c. sildenafil d. morphine e. atorvastatin

a. enalapril b. aspirin e. atorvastatin

The nurse is admitting a client with an elevated creatine kinase-MB isoenzyme (CK-MB). What is the cause for the elevated isoenzyme? a. myocardial necrosis b. skeletal muscle damage due to a recent fall c. cerebral bleeding d. I.M. injection

a. myocardial necrosis

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

a. nausea and vomiting

Which dysrhythmia is common in older clients? a. sinus bradycardia b. ventricular tachycardia c. sinus tachycardia d. sinus arrhythmia

a. sinus bradycardia

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

a. stroke

Catheter __________ therapy is a treatment that destroys specific cells that are the cause or central conduction route of a tachyarrhythmia that did not respond to medications and is not suitable for antitachycardia pacing.

ablation

A 52-year-old female patient is going through menopause and asks the nurse about estrogen replacement for its cardioprotective benefits. What is the best response by the nurse? a) "That's a great idea. You don't want to have a heart attack." b) "Current evidence indicates that estrogen replacement is not effective at preventing cardiovascular disease and carries some risks." c) "You need to research hormone replacement therapy and determine what you want to do." d) "Current research determines that estrogen replacement protects heart health for most women after menopause."

b) "Current evidence indicates that estrogen replacement is not effective at preventing cardiovascular disease and carries some risks."

You are monitoring the results of laboratory tests performed on a client admitted to the cardiac ICU with a diagnosis of myocardial infarction. Which test would you expect to show elevated levels? a) RBC b) Enzymes c) Platelets d) WBC

b) Enzymes

A nurse is completing a head to toe assessment on a client diagnosed with right-sided heart failure. To assess peripheral edema, which of the following areas should be examined? a) Under the sacrum b) Feet and ankles c) Lips and earlobes d) Shoulders and elbows

b) Feet and ankles

After a physical examination, the provider diagnosed a patient with a grade 4 heart murmur. During assessment, the nurse expects to hear a murmur that is: a) Very loud; can be heard with the stethoscope half-way off the chest. b) Loud and may be associated with a thrill sound similar to (a purring cat). c) Quiet but readily heard. d) Easily heard with no palpable thrill.

b) Loud and may be associated with a thrill sound similar to (a purring cat).

The nurse is administering a beta blocker to a patient in order to decrease automaticity. Which medication will the nurse administer? a) Amiodarone b) Metoprolol c) Propafenone d) Diltiazem

b) Metoprolol

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

b. heart rate of 55 beats per minute

The nurse is caring for a patient with a diagnosis of pericarditis. Where does the nurse understand the inflammation is located? a) The exterior layer of the heart b) The thin fibrous sac encasing the heart c) The heart's muscle fibers d) The inner lining of the heart and valves

b) The thin fibrous sac encasing the heart

For both outpatients and inpatients scheduled for diagnostic procedures of the cardiovascular system, the nurse performs a thorough initial assessment to establish accurate baseline data. Which data is necessary to collect if the client is experiencing chest pain? a) sound of the apical pulses b) description of the pain c) blood pressure in the left arm d) pulse rate in upper extremities

b) description of the pain

Within the heart, several structures and several layers all play a part in protecting the heart muscle and maintaining cardiac function. The inner layer of the heart is composed of a thin, smooth layer of cells, the folds of which form heart valves. What is the name of this layer of cardiac tissue? a) pericardium b) endocardium c) epicardium d) myocardium

b) endocardium

The nurse is caring for a client who is being discharged after insertion of a permanent pacemaker. The client, an avid tennis player, is scheduled to play in a tournament in 1 week. What is the best advice the nurse can give related to this activity? a. "Cancel your tennis tournament and wait until fall, then try hockey; skating is much easier on pacemakers." b. "You will need to cancel this activity; you must restrict arm movement above your head for 2 weeks." c. "You may resume all normal activity in 1 week; if you are used to playing tennis, you may proceed with this activity." d. "You should avoid tennis; basketball or football would be a good substitute."

b. "You will need to cancel this activity; you must restrict arm movement above your head for 2 weeks."

When caring for a patient who has started anticoagulant therapy with warfarin (Coumadin), the nurse knows that therapeutic benefits will not occur for: a. At least 12 hours. b. 3 to 5 days. c. The first 24 hours. d. 2 to 3 days.

b. 3 to 5 days.

A client asks the nurse how long to wait after taking nitroglycerin before experiencing pain relief. What is the best answer by the nurse? a. 15 minutes b. 5 minutes c. 30 minutes d. 60 minutes

b. 5 minutes

To be effective, percutaneous transluminal coronary angioplasty (PTCA) must be performed within what time frame, beginning with arrival at the emergency department after diagnosis of myocardial infarction (MI)? a. 30 minutes b. 60 minutes c. 9 days d. 6 to 12 months

b. 60 minutes

1) A client is admitted to the emergency department reporting chest pain and shortness of breath. The nurse notes an irregular rhythm on the bedside electrocardiograph monitor. The nurse counts 9 RR intervals on the client's 6-second rhythm tracing. The nurse correctly identifies the client's heart rate as a. 100 bpm. b. 90 bpm. c. 70 bpm. d. 80 bpm.

b. 90 bpm.

A nurse is reevaluating a client receiving IV fibrinolytic therapy. Which finding requires immediate intervention by the nurse? a. Chest pain 2 of 10 (on a 1-to-10 pain scale) b. Altered level of consciousness c. Minimal oozing of blood from the IV site d. Presence of reperfusion dysrhythmias

b. Altered level of consciousness

To assess the dorsalis pedis artery, the nurse would use the tips of three fingers and apply light pressure to the: a. Outside of the foot just below the heel. b. Anterior surface of the foot near the ankle joint. c. Exterior surface of the foot near the heel. d. Inside of the ankle just above the heel.

b. Anterior surface of the foot near the ankle joint.

Which would the nurse stress as a periodic lifelong necessity for a client managing infective endocarditis? a. Exercise regimen b. Antibiotic therapy c. Antihypertensive medication d. Potassium replacement

b. Antibiotic therapy

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? a. Reorient the client to place and time. b. Assess for factors that may be causing the client's delirium. c. Document the early signs of dementia and ensure the client's safety. d. Educate the family about how confusion is expected in older adults postoperatively.

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

Nursing interventions may involve applications of warmth to promote arterial flow and instructions to the patient to avoid exposure to cold temperatures, which causes vasodilation. a. TRUE b. FALSE

b. FALSE

Often the first and only sign of mitral valve prolapse is an extra heart sound, referred to as a diastolic click. a. TRUE b. FALSE

b. FALSE

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

b. Avoid undergoing magnetic resonance imaging (MRI).

Which diagnostic study is usually performed to confirm the diagnosis of heart failure? a. Echocardiogram b. Blood urea nitrogen (BUN) c. Electrocardiogram (ECG) d. Serum electrolytes

b. Blood urea nitrogen (BUN)

Which is a diagnostic marker for inflammation of vascular endothelium? a. Low-density lipoprotein (LDL) b. C-reactive protein (CRP) c. High-density lipoprotein (HDL) d. Triglyceride

b. C-reactive protein (CRP)

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? a. Eating extra potassium due to loss of potassium related to medications b. Changing positions slowly related to possible hypotension c. Being sure to keep follow-up appointments d. Walking as far as the client is able every day

b. Changing positions slowly related to possible hypotension

A middle-aged client presents to the ED reporting severe chest discomfort. Which finding is most indicative of a possible myocardial infarction (MI)? a. Anxiousness, restlessness, and lightheadedness b. Chest discomfort not relieved by rest or nitroglycerin c. Intermittent nausea and emesis for 3 days d. Cool, clammy skin and a diaphoretic, pale appearance

b. Chest discomfort not relieved by rest or nitroglycerin

Health teaching includes advising patients on ways to reduce PAD. The nurse should always emphasize that the strongest risk factor for the development of atherosclerotic lesions is: a. Obesity. b. Cigarette smoking. c. Stress. d. Lack of exercise.

b. Cigarette smoking.

A client has severe coronary artery disease (CAD) and hypertension. Which medication order should the nurse consult with the health care provider about that is contraindicated for a client with severe CAD? a. Amiloride b. Clonidine c. Bumetanide d. Methyldopa

b. Clonidine

A client had a percutaneous transluminal coronary angioplasty (PTCA). What medication will the nurse administer to prevent thrombus formation in the stent? a. Isosorbide mononitrate b. Clopidogrel c. Diltiazem d. Metoprolol

b. Clopidogrel

The nurse is caring for a client recovering from acute axillary lymphangitis. Which treatment will the nurse anticipate being prescribed for this client after antibiotic therapy has concluded? a. Arm sling b. Compression sleeve c. Physical therapy d. Aspirin therapy

b. Compression sleeve

A nurse is caring for a client who experienced an MI. The client is ordered to received metoprolol. The nurse understands that this medication has which therapeutic effect? a. Decreases platelet aggregation b. Decreases resting heart rate c. Increases cardiac output d. Decreases cholesterol level

b. Decreases resting heart rate

Recent research has shown that the highest prevalence of hypertension is in middle-age men. a. TRUE b. FALSE

b. FALSE

The P wave represents atrial depolarization and atrial repolarization. a. TRUE b. FALSE

b. FALSE

The most common type of heart failure is heart failure with preserved ejection fraction (HFpEF), or diastolic heart failure, which is characterized by myocardial stiffness. a. TRUE b. FALSE

b. FALSE

The patient undergoing nuclear imaging techniques with stress testing should be instructed not to eat or drink anything for at least 12 hours before the test. a. TRUE b. FALSE

b. FALSE

A client is admitted to the hospital with possible acute pericarditis and pericardial effusion. The nurse knows to prepare the client for which diagnostic test to confirm the client's diagnosis? a. Chest x-ray b. Echocardiography c. Cardiac catheterization d. Computed tomography

b. Echocardiography

A client with acute pericarditis is exhibiting distended jugular veins, tachycardia, tachypnea, and muffled heart sounds. The nurse recognizes these as symptoms of what occurrence? a. The parietal and visceral pericardial membranes adhere to each other, preventing normal myocardial contraction. b. Excess pericardial fluid compresses the heart and prevents adequate diastolic filling. c. The pericardial space is eliminated with scar tissue and thickened pericardium. d. Fibrin accumulation on the visceral pericardium infiltrates into the myocardium, creating generalized myocardial dysfunction.

b. Excess pericardial fluid compresses the heart and prevents adequate diastolic filling.

1) Beta-blockers, such as Lopressor and Toprol, are the standard treatment for angina pectoris. a. TRUE b. FALSE

b. FALSE

A nurse should teach the patient newly diagnosed with hypertension to reduce sodium intake to no more than 200 mmol/day. a. TRUE b. FALSE

b. FALSE

A patient with a permanent pacemaker should be instructed not to use a cellular phone. a. TRUE b. FALSE

b. FALSE

An autograft is a heart valve replacement made from a donor heart valve. a. TRUE b. FALSE

b. FALSE

Digitalis (digoxin) is considered the most essential and most frequently prescribed pharmacologic agent for the treatment of heart failure. a. TRUE b. FALSE

b. FALSE

Myocardial dysfunction occurs when irreversibly damaged heart muscle is replaced by adipose tissue. a. TRUE b. FALSE

b. FALSE

A client with lower extremity edema is diagnosed with lymphedema. For which medication will the nurse prepare teaching for this client? a. Oxycodone b. Furosemide c. Heparin d. Amoxicillin

b. Furosemide

A nurse teaches a client with angina pectoris that he or she needs to take up to three sublingual nitroglycerin tablets at 5-minute intervals and immediately notify the health care provider if chest pain doesn't subside within 15 minutes. What symptoms may the client experience after taking the nitroglycerin? a. Flushing, dizziness, headache, and pedal edema. b. Headache, hypotension, dizziness, and flushing. c. Sedation, nausea, vomiting, constipation, and respiratory depression. d. Nausea, vomiting, depression, fatigue, and impotence.

b. Headache, hypotension, dizziness, and flushing.

Which term describes a situation in which blood pressure is very elevated but there is no evidence of impending or progressive target organ damage? a. Hypertensive emergency b. Hypertensive urgency c. Secondary hypertension d. Primary hypertension

b. Hypertensive urgency

A client is diagnosed with infective endocarditis. What laboratory values will the nurse assess? Select all that apply. a. decreased erythrocyte sedimentation rate b. elevated C-reactive protein c. elevated erythrocyte sedimentation rate (ESR) d. elevated white blood cell (WBC) count e. decreased C-reactive protein

b. elevated C-reactive protein c. elevated erythrocyte sedimentation rate (ESR) d. elevated white blood cell (WBC) count

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

b. It is used to eliminate ventricular arrhythmias.

The nurse is caring for an older adult client who has come to the clinic for a yearly physical. When assessing the client, the nurse notes the blood pressure (BP) is 140/93. The nurse knows that in older clients what happens that may elevate the systolic BP? a. Decrease in blood volume b. Loss of arterial elasticity c. Increase in calcium intake d. Decrease in cardiac output

b. Loss of arterial elasticity

On auscultation, the nurse suspects a diagnosis of mitral valve stenosis when which of the following is heard? a. Mitral valve click b. Low-pitched, rumbling diastolic murmur at the apex of the heart c. Diastolic murmur at the left sternal border of the heart d. High-pitched blowing sound at the apex

b. Low-pitched, rumbling diastolic murmur at the apex of the heart

The nurse is planning the care of a patient admitted to the hospital with hypertension. What objective will help to meet the needs of this patient? a. Making sure that the patient adheres to the therapeutic medication regimen b. Lowering and controlling the blood pressure without adverse effects and without undue cost c. Scheduling the patient for all follow-up visits and making phone calls to the home to ensure adherence d. Instructing the patient to enter a weight loss program and begin an exercise regimen

b. Lowering and controlling the blood pressure without adverse effects and without undue cost

Aortic dissection may be mistaken for which of the following disease processes? a. Stroke b. Myocardial infarction (MI) c. Pneumothorax d. Angina

b. Myocardial infarction (MI)

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? a. Rapidly reduce the blood pressure so the client will not suffer a stroke. b. Reduce the blood pressure by 20% to 25% within the first hour of treatment. c. Reduce the blood pressure by 50% within the first hour of treatment. d. Reduce the blood pressure to about 140/80 mm Hg.

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

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

b. high LDL level

A patient in the recovery room after cardiac surgery begins to have extremity paresthesia, peaked T waves, and mental confusion. What type of electrolyte imbalance does the nurse suspect this patient is having? a. Calcium b. Potassium c. Sodium d. Magnesium

b. Potassium

A client is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the client is taking these two medications together? a. Sodium level b. Potassium level c. Calcium level d. Magnesium level

b. Potassium level

When caring for a client with essential hypertension what instruction should the nurse provide to the client to normalize blood pressure? a. Increase iodine intake. b. Reduce sodium intake. c. Increase intake of fluids. d. Avoid intake of low-fat diet.

b. Reduce sodium intake.

The nurse cares for a client who has developed junctional tachycardia with a heart rate (HR) of 80 bpm. Which action should the nurse complete? a. Prepare to administer IV lidocaine b. Request a digoxin level be ordered c. Prepare for emergent electrical cardioversion d. Withhold the client's oral potassium supplement

b. Request a digoxin level be ordered

The nurse is educating the patient about administering nitroglycerin prior to discharge from the hospital. What information should the nurse include in the instructions? a. Take 2 nitroglycerines every 10 minutes until a total of 6 pills are taken. If pain is not relieved, activate the emergency medical system. b. Take a nitroglycerin and repeat every 5 minutes if the pain is not relieved until a total of 3 are taken. If pain is not relieved, activate the emergency medical system. c. Take 2 nitroglycerines and if the pain is not relieved, go to the emergency department. d. Take a nitroglycerin and if the pain is not relieved, drive to the nearest emergency department.

b. Take a nitroglycerin and repeat every 5 minutes if the pain is not relieved until a total of 3 are taken. If pain is not relieved, activate the emergency medical system.

A patient with coronary artery disease (CAD) is having a cardiac catheterization. What indicator is present for the patient to have a coronary artery bypass graft (CABG)? a. The patient has had angina longer than 3 years. b. The patient has at least a 70% occlusion of a major coronary artery. c. The patient has compromised left ventricular function. d. The patient has an ejection fraction of 65%.

b. The patient has at least a 70% occlusion of a major coronary artery.

The nurse documents that a client is having a normal sinus rhythm. What characteristics of this rhythm has the nurse assessed? a. The ventricles depolarize in 0.5 seconds or less. b. The sinoatrial (SA) node initiates the impulse. c. Impulse travels to the atrioventricular (AV) node in 0.15 to 0.5 seconds. d. Heart rate between 60 and 150 beats per minute.

b. The sinoatrial (SA) node initiates the impulse.

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

b. 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? a. Intractable b. Unstable c. Variant d. Refractory

b. Unstable

The laboratory values for a client diagnosed with coronary artery disease (CAD) have just come back from the lab. The client's low-density lipoprotein (LDL) level is 112 mg/dL. The nurse recognizes that this value is a. within the optimal range b. above the optimal range c. below the optimal range d. extremely high

b. above the optimal range

Nurses should implement measures to relieve emotional stress for clients with hypertension because the reduction of stress a. increases blood volume and improves the potential for greater cardiac output. b. decreases the production of neurotransmitters that constrict peripheral arterioles. c. increases the resistance that the heart must overcome to eject blood. d. increases the production of neurotransmitters that constrict peripheral arterioles.

b. decreases the production of neurotransmitters that constrict peripheral arterioles.

What risk factors would cause the nurse to become concerned that the client may have atherosclerotic heart disease? Select all that apply. a. lowered triglyceride levels b. diabetes c. hypertension d. active lifestyle e. family history of early cardiovascular events f. obesity

b. diabetes c. hypertension e. family history of early cardiovascular events f. obesity

5. Specific recommendations to decrease high blood pressure include __________. a. decreasing intake of potassium b. increasing intake of potassium c. decreasing intake of magnesium d. increasing intake of magnesium

b. increasing intake of potassium

A student nurse is to perform a cardiac assessment for a client and asks the instructor why the aortic valve closure is best heard on the right side of the sternum. What is the best response by the nurse? a) "The aortic valve is located near the apex of the heart, which is on the right side." b) "The aortic valve is located on the right side of the heart." c) "The aortic arch causes the closure of the aortic valve to be heard best on the right side of the sternum." d) "The aortic valve is located near the base of the heart on the right side."

c) "The aortic arch causes the closure of the aortic valve to be heard best on the right side of the sternum."

The nurse is caring for a client with a damaged tricuspid valve. The nurse knows that the tricuspid valve is held in place by which of the following? a) Semilunar tendineae b) Papillary tendons c) Chordae tendineae d) Atrioventricular tendons

c) Chordae tendineae

The client with a diagnosis of heart failure reports frequently awakening during the night with the need to urinate. What explanation will the nurse offer to explain the urination? a) The blood pressure is lower when the client is recumbent, which causes the kidneys to work harder; therefore, more urine is produced. b) When the client is in the recumbent position, more pressure is put on the bladder, with the result of increased need to urinate. c) Edema is collected in dependent extremities during the day; at night when the client lays down, it is reabsorbed into the circulation and excreted by the kidneys. d) Fluid that is held in the lungs during the day becomes part of the circulation at night, causing the kidneys to produce an increased amount of urine.

c) Edema is collected in dependent extremities during the day; at night when the client lays down, it is reabsorbed into the circulation and excreted by the kidneys.

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

c. 4 or 5

A client with known coronary artery disease reports intermittent chest pain, usually on exertion. When teaching the client about nitroglycerin administration, which instruction should the nurse provide? a. "A burning sensation after administration indicates that the nitroglycerin tablets are potent." b. "You may take a sublingual nitroglycerin tablet every 30 minutes, if needed. You may take as many as four doses." c. "Be sure to take safety precautions because nitroglycerin may cause dizziness when you stand up." d. "Replace leftover sublingual nitroglycerin tablets every 9 months to make sure your pills are fresh."

c. "Be sure to take safety precautions because nitroglycerin may cause dizziness when you stand up."

A nurse is caring for a client who has hypertension and diabetes mellitus. The client's blood pressure this morning was 150/92 mm Hg. When the client asks the nurse what his or her blood pressure should be, what is the nurse's most appropriate response? a. "Your blood pressure is fine. Just keep doing what you're doing." b. "The lower the better. Blood pressure of 130/80 mm Hg is best for everyone." c. "Clients with diabetes should have a lower blood pressure goal. You should strive for 120/80 mm Hg." d. "The current recommendation is for everyone to have blood pressure of 140/90 mm Hg or lower."

c. "Clients with diabetes should have a lower blood pressure goal. You should strive for 120/80 mm Hg."

The nurse is providing discharge teaching with a client about pacemaker surveillance. Which client statement indicates a need for further teaching? a. "The surveillance frequency of the follow-up varies with each person." b. "The surveillance checks will determine how much battery life is available." c. "I will take acetaminophen prior to the appointment to lessen the interrogation pain." d. "If possible, I would like to use the transtelephonic method for a follow-up."

c. "I will take acetaminophen prior to the appointment to lessen the interrogation pain."

1. The nurse is caring for a client who has had 25 mg of oral hydrochlorothiazide added to the medication regimen for the treatment of hypertension. Which instruction should the nurse give the client? a. "Take this medication before going to bed." b. "You may develop nasal congestion or depression while taking this medication." c. "Increase the amount of fruits and vegetables you eat." d. "You may drink alcohol while taking this medication."

c. "Increase the amount of fruits and vegetables you eat."

A nurse is teaching a client with newly diagnosed hypertension who asks if there is any harm in stopping antihypertensive medication. What is the nurse's best response? a. "Postural hypertension can occur." b. "Rebound hypotension can occur." c. "Rebound hypertension can occur." d. "Postural hypotension can occur."

c. "Rebound hypertension can occur."

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

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

The nurse completes an assessment of a client with mitral regurgitation. What statement represents the appropriate physical finding for a client with this condition? a. "I heard a low-pitched diastolic murmur at the apex." b. "I knew I would hear a diastolic murmur at the left sternal border." c. "The high-pitched blowing sound at the apex is indicative of a systolic murmur." d. "I auscultated a mitral click."

c. "The high-pitched blowing sound at the apex is indicative of a systolic murmur."

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? a. "If you feel pain during the walk, keep walking until the end of the hallway is reached." b. "As soon as you feel pain, we will go back and elevate your legs." c. "Walk to the point of pain, rest until the pain subsides, then resume ambulation." d. "If you feel any discomfort, stop and we will use a wheelchair to take you back to your room."

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

An older adult client visits the clinic for a blood pressure (BP) check. The client's hypertension is not well controlled, and a new blood pressure medicine is prescribed. What is important for the nurse to teach this client about the blood pressure medicine? a. A severe drop in blood pressure is possible. b. Take the medicine on an empty stomach. c. A possible adverse effect of blood pressure medicine is dizziness when you stand. d. There are no adverse effects from blood pressure medicine.

c. A possible adverse effect of blood pressure medicine is dizziness when you stand.

The nurse is assessing a client with severe hypertension. Which symptom indicates to the nurse that the client is experiencing dissection of the aorta? a. Pain when flexing the neck forward b. Numbness and pain of the left arm c. A ripping sensation in the chest d. Gradual onset of a frontal headache

c. A ripping sensation in the chest

Following a percutaneous coronary intervention (PCI), a client is returned to the nursing unit with large peripheral vascular access sheaths in place. The nurse understands that which method to induce hemostasis after sheath is contraindicated? a. Application of a mechanical compression device b. Direct manual pressure c. Application of a sandbag to the area d. Application of a vascular closure device

c. Application of a sandbag to the area

Which of the following is a characteristic of an arterial ulcer? a. Edema may be severe b. Ankle-brachial index (ABI) > 0.90 c. Border regular and well demarcated d. Brawny edema

c. Border regular and well demarcated

The nurse is caring for a patient diagnosed with pericarditis. What serious complication should this patient be monitored for? a. Left ventricular hypertrophy b. Decreased venous pressure c. Cardiac tamponade d. Hypertension

c. 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? a. Blood pressure 110/68 mm Hg b. Heart rate 66 bpm c. Central venous pressure reading of 1 d. Pain score 5/10

c. Central venous pressure reading of 1

A nurse evaluates a client and suspects pericarditis. What indicator is considered the most characteristic symptom of pericarditis? a. Fatigue b. Orthopnea c. Chest pain d. Dyspnea

c. Chest pain

Which medication is given to clients who are diagnosed with angina but are allergic to aspirin? a. Amlodipine b. Felodipine c. Clopidogrel d. Diltiazem

c. Clopidogrel

The nurse determines that a patient has a characteristic symptom of pericarditis. What symptom does the nurse recognize as significant for this diagnosis? a. Dyspnea b. Fatigue lasting more than 1 month c. Constant chest pain d. Uncontrolled restlessness

c. Constant chest pain

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. An irregular rhythm b. P waves hidden with the QRS complex c. Delayed conduction, producing a prolonged PR interval d. A variable heart rate, usually fewer than 60 bpm

c. Delayed conduction, producing a prolonged PR interval

The nurse assessing a client who has arterial insufficiency of the legs and an ulcer on the left great toe would expect to find which characteristic? a. Superficial ulcer b. Pulses that are present but difficult to palpate c. Diminished or absent pulses d. Aching, cramping pain

c. Diminished or absent pulses

Which aneurysm results in bleeding into the layers of the arterial wall? a. Saccular b. Anastomotic c. Dissecting d. False

c. Dissecting

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? a. Extend the leg, plantar flex the foot, and check for the patency of the dorsalis pedis pulse. b. Elevate the patient's legs for 20 minutes and then lower them slowly while checking for areas of inadequate blood return. c. Dorsiflex the foot while the leg is elevated to check for calf pain. d. Lower the patient's legs and massage the calf muscles to note any areas of tenderness.

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

A client with an atrial dysrhythmia has come to the clinic for a follow-up appointment and to talk with the health care provider about options to stop this dysrhythmia. What procedure could be used to treat this client? a. Mace procedure b. Elective electrical defibrillation c. Elective electrical cardioversion d. Chemical cardioversion

c. Elective electrical cardioversion

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

c. Episodes may be triggered by unusual sensitivity to cold.

A patient is 2 days postoperative after having a permanent pacemaker inserted. The nurse observes that the patient is having continuous hiccups as the patient states, "I thought this was normal." What does the nurse understand is occurring with this patient? a. Faulty generator b. Fracture of the lead wire c. Lead wire dislodgement d. Sensitivity is too low

c. Lead wire dislodgement

A nurse is caring for a client with end-stage cardiomyopathy and the client's spouse asks the nurse to clarify one of the last treatment options available that the health care provider mentioned earlier. What option will the nurse most likely discuss? a. Annuloplasty b. Open commissurotomy c. Left ventricular assist device d. Chordoplasty

c. Left ventricular assist device

Which nursing intervention would reduce cardiac workload in a client with myocarditis? a. Administer a prescribed antipyretic. b. Eliminate all phone calls and visitors. c. Maintain the client on bed rest. d. Lower the client's head.

c. Maintain the client on bed rest.

Which action will the nurse include in the plan of care for a client admitted with acute decompensated heart failure (ADHF) who is receiving milrinone? a. Teach the client about safe home use of the medication b. Titrate milrinone rate slowly before discontinuing c. Monitor blood pressure frequently d. Encourage the client to ambulate in room

c. Monitor blood pressure frequently

A client presents to the ED reporting anxiety and chest pain after shoveling heavy snow that morning. The client says that nitroglycerin has not been taken for months but upon experiencing this chest pain did take three nitroglycerin tablets. Although the pain has lessened, the client states, "They did not work all that well." The client shows the nurse the nitroglycerin bottle; the prescription was filled 12 months ago. The nurse anticipates which order by the physician? a. Chest x-ray b. Ativan 1 mg orally c. Nitroglycerin SL d. Serum electrolytes

c. Nitroglycerin SL

A client who is diagnosed with Raynaud syndrome reports cold and numbness in the fingers. Which finding should the nurse identify as an early sign of vasoconstriction? a. Gangrene b. Ulceration c. Pallor d. Cyanosis

c. Pallor

When measuring the blood pressure in each arm of a healthy adult client, the nurse recognizes that which statement is true? a. Pressures must be equal in both arms. b. Pressures may vary 10 mm Hg or more between arms. c. Pressures should not differ more than 5 mm Hg between arms. d. Pressures may vary, with the higher pressure found in the left arm.

c. Pressures should not differ more than 5 mm Hg between arms.

A 28-year-old client presents to the emergency department, stating severe restlessness and anxiety. Upon assessment, the client's heart rate is 118 bpm and regular, the client's pupils are dilated, and the client appears excitable. Which action should the nurse take next? a. instruct the client to hold the breath and bear down. b. Prepare to administer a calcium channel blocker. c. Question the client about alcohol and illicit drug use. d. Place the client on supplemental oxygen.

c. Question the client about alcohol and illicit drug use.

A nurse is providing education about the prevention of arterial constriction to a client with peripheral arterial disease. Which of the following includes priority information the nurse would give to the client? a. Wear antiembolic stockings daily to assist with blood return to the heart. b. Do not cross your legs for more than 30 minutes at a time. c. Stop smoking. d. Keep your feet elevated above your heart.

c. Stop smoking.

On a routine visit to the physician, a client with chronic arterial occlusive disease reports that he's stopped smoking after 34 years. To relieve symptoms of intermittent claudication, a condition associated with chronic arterial occlusive disease, which additional measure should the nurse recommend? a. Abstaining from foods that increase levels of high-density lipoproteins (HDLs) b. Engaging in anaerobic exercise c. Taking daily walks d. Reducing daily fat intake to less than 45% of total calories

c. Taking daily walks

What should the nurse do to manage persistent swelling in a client with severe lymphangitis and lymphadenitis? a. Avoid elevating the area. b. Inform the physician if the client's temperature remains low. c. Teach the client how to apply a graduated compression stocking. d. Offer cold applications to promote comfort and to enhance circulation.

c. Teach the client how to apply a graduated compression stocking.

The client is prescribed nadolol for hypertension. What is the reason the nurse will teach the client not to stop taking the medication abruptly? a. The abrupt stop can lead to formation of blood clots. b. The abrupt stop will precipitate internal bleeding. c. The abrupt stop can cause a myocardial infarction. d. The abrupt stop can trigger a migraine headache.

c. The abrupt stop can cause a myocardial infarction.

The client has had biomarkers tested after reporting chest pain. Which diagnostic marker of myocardial infarction remains elevated for as long as 2 weeks? a. Myoglobin b. Total creatine kinase c. Troponin d. CK-MB

c. Troponin

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

c. calcium-channel blocker

When measuring blood pressure in each arm of a healthy adult, the nurse recognizes that the pressures a. must be equal in both arms. b. may vary 10 mm Hg or more between arms. c. differ no more than 5 mm Hg between arms. d. a may vary, with the higher pressure found in the left arm.

c. differ no more than 5 mm Hg between arms.

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

c. enhance myocardial oxygenation

A nurse is teaching a client about mitral stenosis. What is the key teaching point regarding the disruption to the normal flow of blood through the heart due to mitral stenosis? a. atrial hypertrophy b. pulmonary circulation congestion c. increased resistance of a narrowed orifice between the left atrium and the left ventricle d. inadequate left and right ventricle filling

c. increased resistance of a narrowed orifice between the left atrium and the left ventricle

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? a. asking the client about comfort level b. using mechanical ventilation c. measuring intake and output d. obtaining cardiac output with a pulmonary catheter

c. measuring intake and output

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

c. orthopnea.

The nurse admits an adult female client with a medical diagnosis of "rule out MI." The client is very frightened and expresses surprise that a woman would have heart problems. What response by the nurse will be most appropriate? a) "A woman's resting heart rate is lower than a man's." b) "The stroke volume from a woman's heart is lower than from a man's heart." c) "It takes longer for an electrical impulse to travel from the sinoatrial node to the atrioventricular node in a woman." d) "A woman's heart is smaller and has smaller arteries that become occluded more easily."

d) "A woman's heart is smaller and has smaller arteries that become occluded more easily."

The nurse is assessing vital signs on a client who is 3 months status post myocardial infarction (MI). While the healthcare provider is examining the client, the client's spouse approaches the nurse and states "We are too afraid he will have another heart attack, so we just don't have sex anymore." What is the nurse's best response? a) "Having an orgasm is very strenuous and your husband must be in excellent physical shape before attempting it." b) "It is usually better to just give up sex after a heart attack." c) "The medications will prevent your husband from having an erection." d) "The physiologic demands are greatest during orgasm and are equivalent to walking 3 to 4 miles per hour on a treadmill."

d) "The physiologic demands are greatest during orgasm and are equivalent to walking 3 to 4 miles per hour on a treadmill."

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? a. Blood urea nitrogen (BUN) b. Complete blood count (CBC) c. Serum electrolytes d. B-type natriuretic peptide (BNP)

d. B-type natriuretic peptide (BNP)

A patient has been diagnosed with congestive heart failure (CHF). The health care provider has ordered a medication to enhance contractility. The nurse would expect which medication to be prescribed for the patient? a) Enoxaparin b) Heparin c) Clopidogrel d) Digoxin

d) Digoxin

The nurse reviews a client's lab results and notes a serum calcium level of 7.9 mg/dL. It is most appropriate for the nurse to monitor the client for what condition? a) Increased risk of heart block b) Enhanced sensitivity to digitalis c) Inclination to ventricular fibrillation d) Impaired myocardial contractility

d) Impaired myocardial contractility

Which of the following is the hallmark symptom for peripheral arterial disease (PAD) in the lower extremity? a. Dizziness b. Vertigo c. Acute limb ischemia d. Intermittent claudication

d. Intermittent claudication

An asymptomatic client questions the nurse about the diagnosis of mitral regurgitation and inquires about continuing an exercise routine. Which is the most appropriate response by the nurse? a. "Continue the exercise routine but take ample rest after exercising." b. "Avoid strenuous cardiovascular exercise." c. "Avoid any type of exercise." d. "Continue the exercise routine unless symptoms such as shortness of breath or fatigue develop."

d. "Continue the exercise routine unless symptoms such as shortness of breath or fatigue develop."

A client with high blood pressure is receiving an antihypertensive drug. When developing a client teaching plan to minimize orthostatic hypotension, which instruction should the nurse include? a. "Avoid drinking alcohol and straining at stool, and eat a low-protein snack at night." b. "Wear elastic stockings, change positions quickly, and hold onto a stationary object when rising." c. "Rest between demanding activities, eat plenty of fruits and vegetables, and drink 6 to 8 cups of fluid daily." d. "Flex your calf muscles, avoid alcohol, and change positions slowly."

d. "Flex your calf muscles, avoid alcohol, and change positions slowly."

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? a. "I'm glad I can still have chicken bouillon." b. "I can still eat a ham-and-cheese sandwich with potato chips for lunch." c. "I chose a tossed salad with sardines and oil and vinegar dressing for lunch." d. "I chose broiled chicken with a baked potato for dinner."

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

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? a. "Because my family is from Italy, I have a higher risk of developing peripheral arterial disease." b. "I will need to increase the amount of green leafy vegetables I eat to lower my cholesterol levels." c. "The older I get the higher my risk for peripheral arterial disease gets." d. "I will need to stop smoking because the nicotine causes less blood to flow to my hands and feet."

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

The nurse is providing teaching to a client with an implanted cardiac device. Which client statement indicates that teaching has been effective? a. "I can safely have an MRI in the future if I need one." b. "I will not be able to fly with a pacemaker." c. "I will stop using the microwave oven." d. "I will not place my cell phone in my chest pocket."

d. "I will not place my cell phone in my chest pocket."

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? a. "The heart's electrical activity will be recorded when the heart rate exceeds 60 beats per minute." b. "The box is recording the heart's electrical activity, and a physician will review the tracing later." c. "When your spouse needs help, an alarm will go off at the desk." d. "The small box will transmit the heart rhythm to the central monitor all the time."

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

A nurse is teaching a client about valve replacement surgery. Which statement by the client indicates an understanding of the benefit of an autograft replacement valve? a. "The valve is from a tissue donor, and I will not need to take any blood-thinning drugs when I am discharged." b. "The valve is mechanical, and it will not deteriorate or need replacing." c. "The valve is made from a pig tissue, and I will not need to take any blood-thinning drugs when I am discharged." d. "The valve is made from my own heart valve, and I will not need to take any blood-thinning drugs when I am discharged."

d. "The valve is made from my own heart valve, and I will not need to take any blood-thinning drugs when I am discharged."

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? a. "The two look very much alike; it is difficult to tell the difference." b. "The P-R interval will be prolonged in ventricular fibrillation, while in ventricular tachycardia the P-R interval is normal." c. "The QRS complex in ventricular fibrillation is always narrow, while in ventricular tachycardia the QRS is of normal width." d. "Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes."

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

A client with newly diagnosed hypertension asks what to do to decrease the risk for related cardiovascular problems. Which risk factor is not modifiable by the client? a. Dyslipidemia b. Obesity c. Inactivity d. Age

d. Age

A nurse plans to have an education session with a client with cardiomyopathy and the client's spouse about ways to increase activity tolerance. What instructions would the nurse provide? a. Gradually work up to strenuous activity. b. Include isometric exercises in the daily routine. c. Avoid all physical and emotional stress. d. Alternate active periods with rest periods.

d. Alternate active periods with rest periods.

A nurse provides evening care for a client wearing a continuous telemetry monitor. While the nurse is giving the client a back rub, the client 's monitor alarm sounds and the nurse notes a flat line on the bedside monitor system. What is the nurse's first response? a. Administer a pericardial thump. b. Call for assistance and begin CPR. c. Call a code and obtain the crash cart. d. Assess the client and monitor leads.

d. Assess the client and monitor leads.

When a patient is taking an immunosuppressant following heart transplantation, the nurse would determine which of the following as the MOST important intervention? a. Place the patient in an isolation room. b. Educate the patient regarding signs and symptoms of infection. c. Prevent exposure to potentially harmful agents such as fresh fruit. d. Assess vital signs every 4 hours.

d. Assess vital signs every 4 hours.

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? a. Early ventricular repolarization b. Ventricular repolarization c. Ventricular depolarization d. Atrial depolarization

d. 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? a. Asystole b. Ventricular fibrillation c. Premature ventricular contraction d. Atrial flutter

d. 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? a. Atrial fibrillation b. Ventricular tachycardia c. Ventricular fibrillation d. Atrial flutter

d. Atrial flutter

A client is recovering from surgical repair of a dissecting aortic aneurysm. Which assessment findings indicate possible bleeding or recurring dissection? a. Urine output of 15 ml/hour and 2+ hematuria b. Blood pressure of 82/40 mm Hg and heart rate of 45 beats/minute c. Urine output of 150 ml/hour and heart rate of 45 beats/minute d. Blood pressure of 82/40 mm Hg and heart rate of 125 beats/minute

d. Blood pressure of 82/40 mm Hg and heart rate of 125 beats/minute

A client comes to the emergency department (ED) reporting precordial chest pain. In describing the pain, the client describes it as pressure with a sudden onset. What disease process would the nurse suspect in this client? a. Cardiogenic shock b. Raynaud syndrome c. Venous occlusive disease d. Coronary artery disease

d. Coronary artery disease

The nurse is to administer morphine sulfate to a client with chest pain. What initial nursing action is required prior to administration? a. Check the radial pulse for dysrhythmias. b. Measure the blood pressure for hypertension. c. Measure urinary output for dehydration. d. Count the respiratory rate for bradypnea.

d. Count the respiratory rate for bradypnea.

Which diagnostic method is recommended to determine whether left ventricular hypertrophy has occurred? a. Blood chemistry b. Electrocardiography c. Blood urea nitrogen d. Echocardiography

d. Echocardiography

The nurse is caring for a client who has premature ventricular contractions. What sign or symptom is observed in this client? a. Nausea b. Hypotension c. Fever d. Fluttering

d. Fluttering

An adult client with a tentative diagnosis of infective endocarditis is admitted to an acute care facility. The medical history reveals diabetes mellitus, hypertension, and pernicious anemia. The client underwent an appendectomy 20 years earlier and an aortic valve replacement 2 years before this admission. What history finding is a major risk factor for infective endocarditis? a. Age b. History of diabetes mellitus c. Race d. History of aortic valve replacement

d. History of aortic valve replacement

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? a. Older adults are at increased risk for asthma. b. Older adults are at increased risk for hyperthyroidism. c. Older adults are at increased risk for cardiac arrests. d. Older adults are at increased risk for toxicity.

d. Older adults are at increased risk for toxicity.

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? a. Postural hypertension and resulting injury b. Sexual dysfunction c. Rebound hypertension d. Postural hypotension and resulting injury

d. Postural hypotension and resulting injury

A client is taking amiloride and lisinopril for the treatment of hypertension. What laboratory studies should the nurse monitor while the client is taking these two medications together? a. Calcium level b. Sodium level c. Magnesium level d. Potassium level

d. Potassium level

The instructor is talking with a nursing student who is caring for a client with pericarditis. The instructor asks the student to name the main characteristic of pericarditis. What should be the student's answer? a. Fever b. Respiratory symptoms c. Dyspnea d. Precordial pain

d. Precordial pain

A postoperative client is receiving heparin after developing thrombophlebitis. The nurse monitors the client carefully for bleeding and other adverse effects of heparin. If the client starts to exhibit signs of excessive bleeding, the nurse should expect to administer an antidote that is specific to heparin. Which agent fits this description? a. Plasma protein fraction b. Phytonadione (vitamin K) c. Thrombin d. Protamine sulfate

d. Protamine sulfate

The nurse is caring for a client following a coronary artery bypass graft (CABG). The nurse notes persistent oozing of bloody drainage from various puncture sites. The nurse anticipates that the physician will order which medication to neutralize the unfractionated heparin the client received? a. Aspirin b. Alteplase c. Clopidogrel d. Protamine sulfate

d. Protamine sulfate

A 35-year-old client has been diagnosed with hypertension. The client is a stock broker, smokes daily, and has diabetes. During a follow-up appointment, the client states that regular visits to the doctor just to check blood pressure (BP) are cumbersome and time consuming. As the nurse, which aspect of client teaching would you recommend? a. Discussing methods for stress reduction b. Administering glycemic control c. Advising smoking cessation d. Purchasing a self-monitoring BP cuff

d. Purchasing a self-monitoring BP cuff

Which ECG waveform characterizes conduction of an electrical impulse through the left ventricle? a. QT interval b. P wave c. PR interval d. QRS complex

d. QRS complex

A client has been diagnosed with heart failure. What is the major nursing outcome for the client? a. Walk 30 minutes three times a week. b. Maintain a healthy diet. c. Sleep 8 hours per night. d. Reduce the workload on the heart.

d. Reduce the workload on the heart.

The nurse is providing discharge teaching for a client with rheumatic endocarditis but no valvular dysfunction. On which nursing diagnosis should the nurse focus her teaching? a. Impaired gas exchange b. Chronic pain c. Impaired memory d. Risk for infection

d. Risk for infection

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? a. Sinus bradycardia b. Normal sinus rhythm c. Ventricular tachycardia d. Sinus tachycardia

d. Sinus tachycardia

A nurse and physician are preparing to visit a hospitalized client with peripheral arterial disease. As you approach the client's room, the physician asks if the client has reported any intermittent claudication. The client has reported this symptom. The nurse explains to the physician which of the following details? a. The client's fingers tingle when left in one position for too long. b. The client experiences shortness of breath after walking about 50 feet. c. The client's legs awaken him during the night with itching. d. The client can walk about 50 feet before getting pain in the right lower leg.

d. The client can walk about 50 feet before getting pain in the right lower leg.

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? a. The registered nurse stating to hold all medication until the pulse rate returns to 60 beats/minute b. The registered nurse stating to administer digoxin c. The registered nurse stating to administer all medications except those which are cardiotonics d. The registered nurse administering atropine sulfate intravenously

d. The registered nurse administering atropine sulfate intravenously

The nurse is assisting in the care of a client who is receiving cardiopulmonary resuscitation (CPR). For which reason will the client be prescribed to receive amiodarone during the resuscitation efforts? a. Correct metabolic acidosis. b. Reduce the development of torsade de pointes. c. Prevent the development of hypotension. d. Treat pulseless ventricular tachycardia.

d. Treat pulseless ventricular tachycardia.

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? a. persistent cough b. blurred vision c. tremor d. dizziness

d. dizziness

A nurse is teaching a client about mitral stenosis. What is the key teaching point regarding the disruption to the normal flow of blood through the heart due to mitral stenosis? a. inadequate left and right ventricle filling b. atrial hypertrophy c. pulmonary circulation congestion d. increased resistance of a narrowed orifice between the left atrium and the left ventricle

d. increased resistance of a narrowed orifice between the left atrium and the left ventricle

If a client were to develop rheumatic carditis, which cardiac structure would most likely be affected? a. coronary arteries b. septum c. inferior vena cava d. mitral valve

d. mitral valve