NSG 229 EXAM 1 CARDIAC
Which action would a nurse perform when a patient is in Ventricular Fibrillation? (select all) A: Initiating CPR B: Assessing the EKG C: Using a defibrillator D: Obtaining Electrolytes E: Administering epinephrine
A, B, C, D, E
Which assessment finding will the nurse expect when caring for a client with peripheral arterial disease? (select all) A: Abscence of hair on the toes B: Pink and moist ankle ulcers C: Pitting edema of the lower legs D: Reports of pain associated with exercising E: Increased pigmentation of the medial Malleolus area
A, D
Which potential effect will the nurse teach to a client receiving metoprolol? A: Dizziness with strenuous activity B: Acceleration of the heart rate after eating a heavy meal C: Flushing sensations after taking the medication D: Pounding of the heart
A: Dizziness with strenuous Activity
Which agent will be used if an antidote is needed for a client taking warfarin? A: Vitamin K B: Fibrinogen C: Prothrombin D: Protamine Sulfate
A: Vitamin K
which object would the nurse teach the client with a newly implanted pacemaker to avoid? A: strong magnet B: microwave oven C: mobile telephone D: remote control device
A: strong magnet
Which action is essential for the nurse to include in the plan of care for a client with atrial fibrillation? A: take pulse apically for a full minute B: monitor blood pressure at least every 2 hours C: ask client to call for assistance when ambulating D: teach client to avoid taking over the counter aspirin
A: take pulse apically for a full minute
Which intervention would the nurse perform when caring for a client in the emergency department reporting chest pain? (select all) A: providing oxygen B: assessing vital signs C: obtaining a 12 lead EKG D: drawing blood for cardiac enzymes E: auscultating heart sounds F: administering nitroglycerin
ALL THE ABOVE
During auscultation of the heart wher would the nurse expect the first heart sound (S1) to be the loundest?
Apex of the heart
Which information would be included in the discharge planning for a client who has had a new permanent pacemaker implanted above the left clavicle? (select all) A: avoid standing near microwave ovens when they are being used B: take your pulse daily and report changes to the healthcare provider C: notify the health care provider about swelling or drainage at the incision D: inform airport security about the presence of a pacemaker if you are traveling E: Perform full range of motion exercises with the left arm to avoid losing function
B, C, D
Which activity might cause chest pain in a client with stable angina? (select all) A: Deep breathing during meditation B: Walking outside on a cold day C: sexual activity D: taking an afternoon nap E: Smoking a cigarette F: use of an oral decongestant
B, C, E, F
Which adverse effect would a nurse monitor for when caring for a client with hypertension who is prescribed metoprolol? A: Hirsutism B: Bradycardia C: Restlessness D: Angina
B: Bradycardia
which possible complication would a nurse monitor for when a client develops a venous thrombosis in the left calf? A: embolic stroke B: pulmonary embolism C: myocardial infarction D: ischemia of the left foot
B: pulmonary embolism
in which position would the nurse place the client to obtain an accurate reading of jugular vein distention? A: upright at 90 degrees B: supine position C: raised to 30 degrees D: raised to 10 degrees
C: raised to 30 degrees
To assess the status of circulation to the foot, which site would the nurse monitor for a pulse? A: Carotid pulse B: Femoral pulse C: Popliteal pulse D: Dorsalis pedis artery E: Posterior tibial artery
D, E
Which client statement indicates that the teaching about furosemide is understood? (select all) A: it may take 2 or 3 days for this medication to take effect B: i should wear dark glasses when outdoors during the day C: i should avoid lying flat in bed D: i need to change my position slowly E: i should eat more food that is high in potassium
D, E
Which symptom in a client recieving hydrochlorothiazide would cause a nurse to notify the health care provider? A: Insomnia B: Nasal Congestion C: Increased Thirst D: Generalized Weakness
D: Generalized Weakness
Which clinical finding enables the nurse to conclude that the heparin therapy is effective in a client who has atrial fibrillation with rapid ventricular response and is started on a continuous heparin infusion? A: Atrial fibrillation converts to a sinus rhythm B: the heart rate is stabilized at 70 to 90 beats per minute C: The international normalized ratio (INR) is within normal range D: An activated partial thromboplast (aPTT) time is twice the usual value
D: an activated partial thromboplast time is twice the usual value
Which effect would the nurse anticipate after captopril is prescribed for a client? A: increased urine output B: decreased anxiety C: improved sleep D: decreased blood pressure
D: decreased blood pressure
Which concern when caring for a client prescribed furosemide 40 mg every day in conjuction with digoxin would prompt the nurse to ask the health care provider about potassium supplements? A: Digoxin causes significant potassium depletion B: the liver destroys potassium as digoxin is detoxified C: lasix requires adequate serum potassium to promote diuresis D: digoxin toxicity occurs rapidly in the presence of hypokalemia
D: digoxin toxicity occurs rapidly in the presence of hypokalemia
which medication side effect will a nurse for when caring for a client with myocardial infarction receiving intravenous nitroglycerin to relieve pain? A: nausea B: delirium C: bradycardia D: hypotension
D: hypotension
Which instruction would the nurse include when teaching about hydrochlorothiazide given to a client diagnosed with a transient ischemic attack related to hypertension? A: resume regular eating habits B: drink a protein supplement daily C: avoid eating foods high in insoluble fiber D: increase the intake of potassium rich foods
D: increase the intake of potassium rich foods
when the home health nurse is caring for a client with chronic occlusive arterial disease, which finding will be of most concern? A: pedal pulses not palpable B: decreased sensation in both feet C: thick and yellowed toenails bilaterally D: pale and dry appearing ulcer on great toe
D: pale and dry appearing ulcer on great toe
low pulse rate you give?
atropine
THe nurse administers lidocaine hcl at 1.5 mg per minute the medication is available at 500 mg in 100 ml of d5w the nurse will set the intravenous infusion pump to deliver how many mililiters per hour?
18 mL/h
which topic will the nurse include when teaching a goup of clients about risk factors for heart disease? (select all) A: obesity B: hypertension C: diabetes insipidus D: asian-american ancestry E: increased high density lipoprotein
A, B
Whcih assessment finding would the nurse expect when a client is diagnosed with a left sided congestive heart failure? (select alls) A: Dyspnea B: Crackles C: Frequent cough D: Peripheral edema E: jugular distention
A, B, C
Which symptom would the nurse include when teaching a group of female clients about clnical manifestations of coronary artery disease that are more common in women? (select all) A: Dyspnea B: Indigestion C: Unusual Fatigue D: Left chest pain E: substernal pressure
A, B, C
Which clinical indicatior will the nurse monitor to evaluate the effectiveness of treatment for a client with exacerbation of left ventricular failure? (select alls) A: Lung sounds B: Heart sounds C: Heart rate D: Peripheral edema E: Dyspnea on exertion F: jugular vein distention
A, B, C, E
When assessing a client with right ventricular heart failure the nurse would expect which finding? (select all) A: Dependent edema B: swollen hands and fingers C: collapsed neck veins D: right upper quadrant discomfort E: oliguria
A, B, D
Which adverse effect of warfarin will the nurse identify as a reason for a client with a partial occlusion of the left common carotid artery to seek medical consultation? (Select all) A: Hematuria B: Hemoptysis C: Delayed clotting from minor cuts and scrapes D: Bleeding from gums when brushing teeth E: vomiting coffee ground emesis
A, B, D
Which possible dysrhythmia would a nurse anticipate testing for after noting that a client in the clinic has an irregularly irregular pulse rhythm at a rate of 88 beats/minute? A: atrial fibrillation B: ventricular tachycardia C: complete heart block D: supraventricular tachycardia
A: atrial fibrillation
which diagnosis increases the risk for development of a pulmonary embolism? A: atrial fibrillation B: forearm laceration C: migraine headache D: respiratory infection
A: atrial fibrillation
Which action would the nurse take when a client returns after a cardiac catheterization using the right femoral artery and the nurse notes the right pedal pulses are not palpable and the foot is cool? A: notify the healthcare provider immediately B: apply pressure to the femoral insertion site C: increase the intravenous fluid flow rate D: monitor the insertion site and foot frequently
A: notify the healthcare provider immediately
Which subjective manifestation in a client would lead the nurse to suspect that furosemide is infusing too rapidly? (select all) A: hunger B: tinnitus C: weakness D: leg cramps E: excess salivation
B, C, D
Which findings would the nurse expect when caring for a client with cor pulmonale? (select all) A: Weightloss B: Neck Vein Distention C: Lower Extremity Edema D: Right uper quandrant abdominal tenderness E: Lower than normal hemoglobin and hematocrit F: Elevated b-type natriuretic peptide (BNP) Levels
B, C, D, F
which outcome would the nurse anticipate when metoprolol is administered with digoxin to a client with hypertensive heart disease who had an acute episode of heart failure? A: headaches B: bradycardia C: hypertension D: junctional tachycardia
B: bradycardia
For a client arriving in the emergency department with a history of heart failure, which finding requires the most rapid action by the nurse? A: irregular apical pulse B: oxygen saturation 86% C: crackles at both lung bases D: atrial fibrillation on cardiac monitor
B: oxygen saturation 86%
How would the nurse document this rhythm seen in a client on the telemetry unit? A: atrial flutter B: sinus tachycardia C: sinus bradycardia D: atrial fibrillation
B: sinus tachycardia
Which nursing action is a priority before administering prescribed furosemide? A: weigh the client B: assess skin turgor C: review the potassium level results D: check the 24 hour intake and output
C: review the potassium level results
which assessment finding indicates a need for the nurse to consult with the health care provider before administering the prescribed metoprolol to a client with stable angina? A: blood pressure 142/90 mm Hg B: report of chest pain when walking C: sinus bradycardia, rate 54 on monitor D: large Q waves on the electrocardiogram
C: sinus bradycardia, rate 54 on monitor
which collaborative intervention will the nurse anticipate to treat the dysrhythmia when a client has supraventricular tachycardia that has persisted despite treatment with vagal maneuvers and medications? A: defibrillation B: pacemaker placement C: sychronized cardioversion D: Cardiac resynchronization therapy
C: sychronized cardioversion
Which action would the nurse take when calculating a clients heart rate on an electrocardiogram strip? A: count the P waves B: count the T waves C: count the PR interval D: count the QRS complexes
D: count the QRS complexes
Which effect would the nurse anticipate after captopril is prescribed for a client? A: Increased urine output B: decreased anxiety C: improved sleep D: decreased blood pressure
D: decreased blood pressure
The nurse is assessing an electrocardiogram rhythm strip. which component of the tracing will the nurse observe to determine ventricular depolarization? A: p wave B: t wave C: PR interval D: qrs complex
D: qrs complex
In what order does normal cardiac conduction occur through the heart?
Sinatrial node, AV Node, Bundle of HIS, Bundle BRANCHES, Purkinje Fibers
Where would the nurse place the stethoscope to listen for mitral valve insufficiency (regurgitaation)?
The mitral area at the fifth intercostal space at the left midclavicular line (the apex of the heart)
Which waveform on an electrocardiogram illustrates atrial depolarization?
p wave
within which period of time would a nurse advise the client to anticipate pain relief will begin when nitroglycerin sublingual tablets are prescribed for a client with the diagnosis of angina? A: 1 to 3 minutes B: 4 to 5 seconds C: 30 to 45 seconds D: 10 to 15 minutes
A: 1 to 3 minutes
Which clinical manifestation would the nurse include when teaching a client with heart failure about signs and symptoms that indicate a need to contact the primary health care provider? A: weight loss B: extreme fatique C: coughing at night D: excessive urination E: difficulty breathing
B, C, E
How will the nurse document the abnormal heart sound heard in early diastole during the cardiac assessment of an older adult? A: systolic murmur B: third heart sound (S3) C: fourth heart sound (s4) D: pericardial friction rub
B: third heart sound (S3)
When a client on the coronary care unit develops ventricular tachycardia, which action will the nurse take first? A: Initiate immediate defibrillation B: Perform sychronized cardioversion C: Assess clients pulse and blood pressure D: Start cardiopulmonary rescuscitation
C: Assess clients pulse and blood pressure
Which adverse effect would a nurse monitor for when caring for a client receiving furosemide to relieve edema? A: Hypernatremia B: Elevated blood urea nitrogen C: hypokalemia D: increase in the urine specific gravity
C: hypokalemia
A client with paroxysmal supraventricular tachycardia reports a mild "fluttering feeling" in their chest and has a blood pressure of 110/55 mm HG. Whcih potential treatment by the health care provider would the nurse question? A: Intravenous adenosine B: Intravenous metoprolol C: Carotid Sinus Massage D: Synchronized Cardioversion
D: Synchronized Cardioversion
which information about a client who has heart failure would the nurse communicate to the health care provider before administering of the prescribed digoxin? A: apical pulse rate 96 beats/minute B: bilaterial foot and ankle pitting edema C: crackles heard at the base of both lungs D: potassium level of 2.3 mEq/L
D: potassium level of 2.3 mEq/L
Which action would the nurse take after having difficulty in palpating the pedal pulse of a client with venous insufficiency? A: count the pulse at another site B: notify the primary health care C: lower the legs to increase blood flow D: verify the pulse by using a doppler
D: verify the pulse by using a doppler
Whcih action would the nurse take first when the occupational health nurse is working at a construction site and observes a worker who collapses and is pulseless? A: Ask someone to activate the emergency response system immediately B: begin chest compressions that depress the sternum at least 2 inches (5cm) C: Apply the pads for the automatic external defibrillator (AED) that is readily available D: Use a chin lift and head tilt technique and ventilate using a bag valve mask system
A: Ask someone to activate the emergency response system immediately
Which physiological alteration will the nurse monitor to best determine the effectiveness of a clients hydrochlorothiazide therapy? A: Blood pressure B: Decreasing Edema C: Serum Potassium level D: Urine specific gravity
A: Blood pressure
Whcih topic will the nurse include in discharge teaching for a client who has had a mitral valve replacement with a mechanical valve? (select all) A: Need for daily aspirin B: symptoms of infection C: Use of pain medications D: Wound care for leg incision E: purpose of anticoagulant medications
B, C, E
Which nursing action will best evaluate the effectiveness of the furosemide in managing a client with heart failure and acute pulmonary edema? A: Performing daily weights B: Auscultating breath sounds C: Monitoring intake and output D: Assessing for dependent edema
B: Auscultating breath sounds
Whcih nursing intervention will be implemented when the healthcare provider prescribes verapamil to be inadministered intravenously to a 70 year old client with hypertension? A: monitor the electrocardiogram for reflex tachycardia B: keep the client in bed for an hour after giving the medication C: dilute the dose in 50 ml of normal saline and administer it over 15 minutes D: assess the client for wheezes and history of asthma before administered the medication
B: keep the client in bed for an hour after giving the medication
Which finding for a client with pulmonary edema who received furosemide is the best indicator that the treatment has been effective? A: urine output over 1 hour is 200 ml B: oxygen saturation per pulse oximetry is 99% C: cardiac monitor shows sinus rhythm, rate 98 beats/minute D: no jugular vein distention is seen with head elevated to 90 degrees
B: oxygen saturation per pulse oximetry is 99%
Which finding by the nurse would be concerning after a client has had a permanent demand pacemaker implanted? A: blood on the dressing B: pulse rate 40 beats/minute C: blood pressure 104/76 mmHG D: pain at the incisional site
B: pulse rate 40 beats/minute
Which client would the nurse assess first? A: 40 year old with 30 pack year cigarette history who reports tingling in both feet B: 42 year old who takes antihypertensive medication and reports bilateral 4+ ankle swelling C: 65 year old who reports tearing abdominal pain and has a history of uncontrolled hypertension D: 70 year old with peripheral arterial disease who reports severe lower leg burning and numbness
C: 65 year old who reports tearing abdominal pain and has a history of uncontrolled hypertension
When assessing a client the nurse auscultates a murmur at the second left intercostal space along the sternal border. which valve does this sound reflect? A: Aortic B: Mitral C: Pulmonic D: Tricuspid
C: Pulmonic
Which client in the emergency department would the nurse assess first? A: Client with chest pressure and ST segment elevation on the electrocardiogram B: Client who reports a sharp chest pain with deep inspiration for the past week C: Client who has history of heart failure with ascites and bilateral 4+ ankle swelling D: Client with palpitations and paroxysmal atrial fibrillation at a rate of 136 beats/minute
A: Client with chest pressure and ST segment elevation on the elctrocardiogram
Which intervention is the priority when the nurse in the coronary care unit identifies ventricular fibrillation on a clients cardiac monitor? A: Defibrillate the client B: Notify the rapid response team C: Administer intravenous epinephrine D:Initiate cardiopulmonary rescuscitation
A: Defibrillate the client
which information will the nurse include when teaching a client with hypertension about metoprolol? A: do not abruptly discontinue the medication B: consume alcoholic beverages in moderation C: report a heart rate of less than 70 beats per minute D: increase the medication dosage if chest pain occurs
A: do not abruptly discontinue the medication
a client begins therapy with a new medication. one month later the client notices blood in the urine. which medication would the nurse anticipate is the cause? A: warfarin B: nifedipine C: nitrofurantoin D: phenazopyridine
A: warfarin
Which statement by a staff member after an educational session on the use of adenosine for supraventricular tachycardia indicates that the teaching has been effective? A: we will need a crash cart available at the clients bedside B: we will plan to schedule the anesthesiologist to be available C: the medication should be injected over at least 1 to 2 minutes D: infusion of normal saline will be needed before medication injection
A: we will need a crash cart available at the clients bedside
Which sensation reported by a the client would the nurse consider when determining that furosemide is being administered too quickly? A: full bladder B: buzzing ears C: fast heartbeat D: numb arms and legs
B: buzzing ears
which topic would the nurse include when doing discharge teaching about ways to avoid another venous thrombosis when caring for a client hospitalized with deep vein thrombosis? A: daily aspirin use B: frequent ambulation C: warm soaks to legs D: avoidance of cold
B: frequent ambulation
Which action by the nurse is important when preparing for cardioversion of a client with atrial fibrillation? A: Charge defibrillator to the maximum energy level B: Assure that the cardiac monitor alarm is turned on C: Set synchronizer switch on defibrillator to the "on" position D: Take clients apical pulse for a full minute before the procedure
C: Set synchonizer switch on defibrillator to the "on" position
Which rhythm would the nurse document when observing the following dysrhythmia on a clients cardiac monitor? A: Atrial Flutter B: Atrial Fibrillation C: Ventricular Fibrillation D: Ventricular Tachycardia
C: Ventricular Fibrillation
When a previouslt healthy 24 year old client tells the nurse "i sometimes feel my heart racing or skipping beats" which question would the nurse ask? A: do you eat foods that are high in salt or fat B: do you have any family history of heart attacks C: how much caffeine do you consume each day D: how many glasses of water do you drink per day
C: how much caffeine do you consume each day
Which explanation would the nurse give about the purpose of the procedure when a client with angina is scheduled to have a cardiac catheterization? A: to obtain the pressures in the heart chambers B: to determine the existence of congenital heart disease C: to visualize the disease process in the coronary arteries D: to measure the oxygen content of various heart chambers
C: to visualize the disease process in the coronary arteries
Which situation does the nurse consider to be the most appropriate method of obtaining informed consent? A: Consent is given by the client for a medical procedure after the nurse has explained its risks and benefits in detail B: a client provides consent for a surgery after the primary health care provider gives the details of the benefits of the surgery C: A consent is signed for a medical procedure after all the details of the procedure have been provided using strictly medical terminology D: A client signs a consent after the primary health care provider has given a detailed explanation of the risks, benefits and alternatives to the procedure.
D: A client signs a consent after the primary health care provider has given a detailed explanation of the risks, benefits and alternatives to the procedure.
which medication is indicated to treat bradycardia for a client whose heart rate drops to 38 beats/minute during a procedure? A: digoxin B: lidocaine C: amiodarone D: atropine sulfate
D: atropine sulfate
Which dysrhythmia is this client on the telemetry unit exhibiting? A: atrial flutter B: atrial fibrillation C: ventricular fibrillation D: ventricular tachycardia
D: ventricular tachycardia
Which electrical activity of the cardiac conduction system is reflected in the p wave? A: atrial depolarization B: atrial repolarization C: ventricular depolarization D:ventricular repolarization
A: atrial depolarization
Which instruction would the nurse give an unlicensed assistive personel to perform while caring for a client prescribed captopril? (select all) A: obtain blood pressure B: measure intake and output C: weight the client every morning D: notify the nurse if the client has a dry cough E: assit the client to change positions slowly
ALL THE ABOVE
Which assessment finding by the nurse caring for a client with new onset atrial fibrillation would be most important to communicate to the healthcare provider? A: Irregular apical pulse B: Sudden vision change C: exertional dyspnea D: lower extremity edema
B: Sudden vision change
Which action will the nurse take when the international normalized ratio (INR) for a client receiving warfarin for venous thrombosis is 4.6? A: Administer the schedules dose of warfarin B: Offer the client foods that are high in vitamin k C: Notify the health care provider of the lab results D: Warn the client about risk for spontaneous hemorrage
C: Notify the health care provider of the lab results
Which information will the nurse include when providing instructions to a client with the diagnosis of primary hypertension who is started on a regimen of hydrochlorthiazide? A:A common side effect is decreased sexual libido B: one dose should be omitted if dizziness occurs when standing up C: the client should adjust the dosage daily based on the clients blood pressure D: an antihypertensive medication will likely be required for the remainder of life?
D: an antihypertensive medication will likely be required for the remainder of life?
Which intervention is the priority for the unconscious client in ventricular fibrillation? A: Defibrillation B: Start intravenous (IV) access C: Bag Mask ventilation D: High Quality chest compression
A: Defibrillation
which medication is used to treat a client whose cardiac monitor reveals several runs of ventricular tachycardia? A: atropine B: epinephrine C: amiodarone D: sodium bicarbonate
C: amiodarone
which foods will the nurse discuss when teaching a client who has a new prescription for warfarin? A: dairy products B: high fiber fruits C: green leafy vegetables D: whole grain breads and cereals
C: green leafy vegetables
Which is the priority nursing intervention immediately after a client has a ventricular demand pacemaker inserted? A: encourage fluids B: assess the implant site C: monitor the heart rate and rhythm D: encourage turning and deep breathing
C: monitor the heart rate and rhythm
Which statement indicates that further teaching is needed after the nurse completes teaching for a client with foot pain who has peripheral arterial disease? A: I will wear socks B: I will elevate my feet C: I will increase fluid intake D: I will drink a moderate amount of alcohol
B: I will elevate my feet
Which explanation will the nurse give when a client asks about what causes varicose veins? A: abnormal configurations of the veins B: incompetent valves of superficial veins C: decreased pressure within the deep veins D: atherosclerotic formation in the veins
B: Incompetent valves of superficial veins
Which finding for a client who has a diagnosis of paroxysmal atrial fribrillation is most important to report quickly to the health care provider? A: Irregular heartbeat B: right arm weakness C: client report of palpitations D client report of lightheadedness
B: Right Arm Weakness
Whcih clinical manifestation would the nurse expect to identify when performing an admission history and physical for a client with chronic peripheral arterial disease? A: Edema of the feet and ankles B: Reddened and painful areas on the calves C: Pain when exercising and thickening of the toenails D: Ulcers around the ankles and reports of a dull ache in the legs
C: Pain when exercising and thickening of the toenails
Which advice would the nurse include in a teaching plan to reduce the side effects of diltiazem? A: lie down after meals B: avoid dairy products in diet C: take the medication with an antacid D: change slowly from sitting to standing
D: change slowly from sitting to standing
how would the nurse document the high pitched scratchy heart sonds that are associated with pericarditis and occur as the heart contracts and relaxes within the inflamed pericardial sac? A: diastolic murmur B: first heart sound (S1) C: fourth heart sound (S4) D: pericardial friction rubs
D: pericardial friction rubs
Which medication will the nurse be prepared to administer to a client admitted to the hospital with a diagnosis of deep vein thrombosis who is prescribed intravenous heparin sodium if the client experiences excessive bleeding? A: vitamin k B: oprelvekin C:warfarin sodium D: protamine sulfate
D: protamine sulfate
Which adverse hemodynamic effect typically occurs when a client develops tachycardia? (select all) A: Decreased ventricular filling time B: Increased coronary artery filling C: Lower Cardiac output D: enhanced atrial kick E: weaker pulse quality
A, C, E
which finding requires rapid action by the nurse after a client has had a cardiac catheterization? A: heart rate 114 beats/minute B: respiratory rate of 24 breaths/minute C: urine output of 1200ml in the first hour post procedure D: premature atrial contractions notes on the cardiac monitor
A: heart rate 114 beats/minute
information about which vitamin would be included when teaching a client with atrial fibrillation about a new prescription for warfarin? A: vitamin k B: vitamin d C: vitamin b D: vitamin b12
A: vitamin k
which symptom requires the most rapid action by the nurse when caring for a client with known peripheral arterial disease who calls the clinic and tells the nurse about experiencing several symptoms? A: anxiety B: chest pain C: weak pulse quality D: cool and pale lower legs
B: chest pain
Whichi client between the ages of 25 and 55 years would the nurse assess first? A: male client with a hemoglobin of 15.9 B: female client on warfarin with an international normalized ratio C: female client taking daily calcium supplements with a serum calcium level of 9.4 D: male client with a blood urea nitrogen of 20 and a creatinine of 1
B: female client on warfarin with an international normalized ratio
Which finding would the nurse expect when assessing a client with peripheral arterial disease? (select all) A: Pallor of feet B: Warm extremities C: Ulcers on the toes D: Thick hardened skin E: Delayed capillary refill
A, C, E
Which response would a nurse give to a client with hypertension prescribed hydrochlorothiazide who reports hearing that furosemide is more effective and requests a prescription change? A: HCTZ has fewer side effects B: HCTZ does not cause dizziness C: HCTZ is only taken when needed D: HCTZ does not cause dehydration
A: HCTZ has fewer side effects
which information would the nurse include when teaching a client about warfarin? A: periodic blood testing is necessary B: increase intake of green leafy vegetables C: limit the amount of daily physical activity D: it should be continued for minor surgical procedures
A: periodic blood testing is necessary
when a client with a heart murmur reports gaining weight in spite of nausea and anorexia, which additional information would be a priority for the nurse to obtain? A: presence of a cough and exertional dyspnea B: dietary food and salt intake in the past 24 hours C: changes in voiding and bowel patterns within the past month D: history of childhood streptococcal infection or rheumatic fever
A: presence of a cough and exertional dyspnea
Which data collection assessment would be performed to evaluate the effectiveness of furosemide administered to a client with congestive heart failure? A: Daily weight B: intake and output C: monitor for edema D: daily pulse oximetry E: auscultate breath sounds
ALL OF THE ABOVE
Which instruction would the nurse give an unlicensed assistive personnel (UAP) to perform while caring for a client prescribed captopril? (select all) A: Obtain blood pressure B: measure intake and output C: weigh the client every morning D: notify the nurse if the client has a dry cough E: assist the client to change positions slowly
ALL OF THE ABOVE
Which action by a client with peripheral arterial disease indicates that more teaching about how to manage the disease is needed? A: Applying a hot water bottle to the abdomen B: Using a heating pad to warm the extremities C: Drinking a warm cup of tea when feeling chilly D: Turning the room thermostat above 72F
B: Using a heating pad to warm the extremities
which teaching would be given by a nurse when considering the age of a 78 year old client who has hypertension and is beginning treatment with furosemide? A: limit fluids at bedtime B: change positions slowly C: take the medication between meals D: assess the skin for breakdown daily
B: change positions slowly
Which topic would be included when teaching a client with heart failure who will be discharged with a new prescription for digoxin? A: Take Your radial pulse daily and write it down B: Avoid foods that are high in potassium such as bananas and potatoes C: Notify the healthcare provider if you develop any vision changes D: Call the healthcare provider if your pulse is irregular or less than 60 beats/minute. E: Eat at least 1 serving of green leafy vegetables daily.
A, C, D
Which priority nursing action would the nurse implement first when caring for a client receiving nitroglycerin for the treatment of angina A: Instruct the client to sit or stand slowly B: Monitor the clients urine output frequently C: Advise the clients to report when experiencing a headache D: Instruct client to notify the healthcare provider if pain does not subside after 5 minutes
A: Instruct the client to sit or stand slowly
Which action would the nurse take next when a client with a history of heart failure on daily weights has a 4 pound weight gain since the previous day? A: Perform a head to toe assessment B: Place the client on restricted fluid intake C: discuss a restricted sodium diet with the client D: document the findings in the health care record
A: perform a head to toe assessment
which response indicates that sublingual nitroglycerin prescribed for a client with unstable angina is effective? A: pain subsides as a result of arteriole and venous dilation B: pulse rate increases because the cardiac output has been stimulated C: sublingual area tingles because sensory nerves are being triggered D: capacity for activity improves as a response to increased collateral circulation
A: pain subsides as a result of arteriole and venous dilation
Which action will the nurse take first when two hours after a cardiac catheterization that was accessed through the right femoral route, a client reports numbness and pain in the right foot? A: call the primary health care provider B: check the clients pedal pulses bilaterally C: take the clients blood pressure and pulse D: teach about postcatheterization embolus
B: check the clients pedal pulses bilaterally
which response would the nurse provide to a client receiving digoxin who calls the clinic and complains of "yellow vision" A: this is related to your illness rather than to your medication B: this is an expected side effect you will become accustomed to it over time C: this side effect is only temporary you should continue the medication D: the medication may need to be discontinued. come to the clinic this morning
D: the medication may need to be discontinued. come to the clinic this morning
Which physiological change in the cardiovascular system is related to the aging process? (select all) A: Less sensitivity to B-Adrenergic drugs B: Tachycardia when changing positions C: Development of systolic murmurs D: Shortening of the PR, QRS, and QT intervals E: Increase in systolic blood pressure
A, C, E
Which response would a nurse give a client with a prosthetic heart valve asks why it is important to take antibiotics before a dental procedure? A: The antibiotic is taken to prevent infection around your artificial heart valve B: Valvular heart disease increases the risk for dental caries and gum disease C: All clients with murmurs need prophylactic antibiotics before dental procedures D: You only need to take antibiotic if you have a fever before your dental procedure
A: The antibiotic is taken to prevent infection around your artificial heart valve
when a clients cardiac monitor indicated ventricular tachycardia which action would the nurse take after identifying an increased apical pulse rate from 100 to 150 beats/minute? A: administer amiodarone B: administer epinephrine C: assist with insertion of a pacemaker D: administer atropine
A: administer amiodarone
which medication is indicated to prevent progression of a myocardial infarction for a client admitted to the emergency department with crushing chest pain? A: aspirin B: atropine C: gabapentin D: epinephrine
A: aspirin
Which action would the nurse take first after noting a flat line on a clients cardiac monitor? A: assess the clients pulse B: start cardiopulmonary resuscitation C: check another lead to confirm asystole D: call the hospital emergency response team
A: assess the clients pulse
Which parameter would the nurse assess in a client with right sided heart failure? A: fluid volume B: lung sounds C: mental status D: respiratory rate E: peripheral pulses
A: fluid volume
Whcih treatment option will the nurse anticipate the need to teach the client about when caring for a client with symptomatic bradycardia caused by heart block? A: overdrive pacing B: demand pacemakers C: cardiac resynchronization therapy D: implantable cardioverter defibrillators
B: demand pacemakers
which food would the nurse instruct a client taking diltiazem to avoid? A: alcohol B: grapefruit juice C: cheddar cheese D: summer sausage
B: grapefruit juice
Which rationale would the nurse include to address the clients concern about why both warfarin and intravenous (IV) heparin are needed at the same time for a partial occlusion of the left common carotid artery? A: This permits the administration of smaller doses of each medication B: Giving both medications allows clot dissolution while preventing new clot formation C: Heparin provides anticoagulation effects until warfarin reaches therapeutic levels D: Administration of heparin with warfarin provides immediate and maximum protection against clot formation.
C: Heparin provides anticoagulation effects until warfarin reaches therapeutic levels
which of these clients in the emergency department would the nurse see first? A: a client with a head injury B: a client with a fractured femur C: a client with ventricular fibrillation D: a client with a penetrating abdominal wound
C: a client with ventricular fibrillation
which action would the nurse take when a client on a telemetry unit demonstrates a sinus rhythm with an occasional premature atrial contraction? A: continue to monitor the client B: activate the rapid response team C: ensure that a defibrillator is available close by. D: give lidocaine intravenously as per protocol
A: continue to monitor the client
Which topic would be included in discharge teaching for a 22 year old client who has had a mitral valve replacement with a mechanical valve? A: Daily aspirin use B: Care of leg incisions C: anticoagulation therapy D: low fat and cholesterol diet
C: anticoagulation therapy
Which response by the nurse is best when a 50 year old client has aortic stenosis and is chedules for a valve replacement tells the nurse "i gave my spouse all my financial recors in case i dont make it" A: your surgeon is very experienced B: people your age generally do very well C: are you concerned that you may die during surgery D: would you like medication to help you sleep at night
C: are you concerned that you may die during surgery
Which prescribed action has the highest priority when a client comes to the emergencyy department with moderate substernal chest pain that is unrelieved by rest and nitroglycerin? A: administer morphine sulfate B: transfer to the coronary care unit C: obtain a 12 lead electrocardiogram D: have a blood specimen drawn for troponin studies
C: obtain a 12 lead electrocardiogram
Which information will be included when the nurse is providing teaching to a client scheduled for a cardiac catheterization via the femoral approach? A: The client will be ambulated shortly after being transferred to the inpatient room after the procedure B: the client will be given a general anesthetic and will be asleep throughout the procedure C: the client will need to stay in the supine position with the affected leg extended for several hours after the procedure D: the client will be allowed only clear liquids for several hours after being returned to the post procedure unit
C: the client will need to stay in the supine position with the affected leg extended for several hours after the procedure
