NCLEX CARDIOLOGY
A nurse determines that a client with coronary artery disease (CAD) has the necessary understanding of disease management if the client makes which statement?
"I will walk for one-half hour daily."*** "My weight has nothing to do with this disease." "As long as I exercise, I can eat anything I wish." "It doesn't matter if my father had high cholesterol."
A client with a diagnosis of congestive heart failure is preparing for discharge to home from the hospital. The nurse determines that the client is ready for discharge to home if the client can:
***Verbally describe the daily medications, doses, and times to be administered. Get the prescriptions filled. Be self-sufficient at home without any help. Independently dress and put on support hose.
A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin sodium (Coumadin). The nurse is told that the client's prothrombin time is 18 seconds with a control of 11 seconds. The nurse plans to:
Double the next dose of warfarin sodium. Withhold the next dose of warfarin sodium. Administer the next dose of warfarin sodium.** Cut the next dose of warfarin sodium in half.
A client who has undergone a left heart catheterization using the right femoral approach is returned to the nursing unit. Thirty minutes later the client complains of numbness and tingling of the right foot. The pedal pulse is weak, and the foot is pale. The nurse notifies the registered nurse immediately because these symptoms are consistent with:
Femoral artery thrombus or hematoma** Local allergic reaction to the contrast dye Right sciatic nerve damage Early massive infection at the catheter insertion site
A client has just returned from the cardiac catheterization laboratory. The left femoral vessel was used as the access site. After returning the client to bed and conducting an initial assessment, the nurse assisting in caring for the client expects that the health care provider wrote a prescription for the client to remain on bedrest:
In the high-Fowler's position With the head of bed elevated at least 60 degrees With the head of bed elevated no more than 30 degrees*** With the foot of bed elevated as much as tolerated by the client
A male client who experienced a myocardial infarction (MI) tells the nurse that he is fearful about not being able to return to a normal life. Which action by the nurse is therapeutic at this time?
Tell the client that his fears are not rational. Tell the client that his life has not changed. ** Explore the specific concerns with the client. Tell the client to talk it out with the significant other.
A nurse working in a long-term care facility is collecting data from a client experiencing chest pain. The nurse would interpret that the pain is likely a result of myocardial infarction (MI) if which of the following observations is made by the nurse?
The client is not experiencing nausea or vomiting. The pain is described as substernal and radiating to the left arm. The pain has not been unrelieved by rest and nitroglycerin tablets.** The client says the pain began while trying to open a stuck dresser drawer.
A hospitalized client with a history of angina pectoris is ambulating in the corridor. The client suddenly complains of severe substernal chest pain. The nurse should take which action first?
Administer sublingual nitroglycerin. Assist the client to sit or lie down.** Apply nasal oxygen at a rate of 2 L/min. Check the client's vital signs.
A client has a history of left-sided heart failure. The nurse would look for the presence of which of the following to determine whether the problem is currently active?
Bilateral lung crackles** Pedal edema bilaterally Jugular vein distention Presence of ascites
A client is receiving a continuous intravenous (IV) infusion of heparin in the treatment of deep vein thrombosis. The nurse is told that the client's activated partial thromboplastin time (aPTT) level is 65 seconds and that the client's baseline before the initiation of therapy was 30 seconds. The nurse identifies these results as:
Low Elevated Within the therapeutic range** Abnormal
A client with infective endocarditis is at risk for heart failure. The nurse monitors the client for which of the following?
Lung crackles, peripheral edema, and weight gain** Confusion, decreasing level of consciousness, and aphasia Respiratory distress, chest pain, and the use of accessory muscles Flank pain with radiation to the groin, accompanied by hematuria
A client admitted to the hospital with a diagnosis of myocardial infarction (MI) tells the nurse that the pain likely resulted from the fried chicken sandwich that the client had for lunch. The nurse responds to the client, using the knowledge that:
Most people love high-fat diets. Denial is a common occurrence early after MI.** The client probably wants to belittle the opinion of the staff. The client is not motivated to learn about heart disease at this time.
A nurse is preparing to care for a client who will be arriving from the recovery room after an above-the-knee amputation. The nurse ensures that which priority item is in the client's hospital room?
Surgical tourniquet** Dry sterile dressings Incentive spirometer Over-the-bed trapeze
A nurse is assisting in caring for a client in the telemetry unit who is receiving an intravenous infusion of 1000 mL 5% dextrose with 40 mEq of potassium chloride. Which occurrence observed on the cardiac monitor indicates the presence of hyperkalemia?
Tall, peaked T waves** ST segment depressions Shortened P-R intervals Shortening of the QRS complex
A client has received instructions about an upcoming cardiac catheterization. The nurse determines that the client has the best understanding of the procedure if the client knows to report which of the following items?
Warm, flushed feeling Pressure at the insertion site Chest pain** Urge to cough
