Nur 336 perfusion study guide

B. Beta Blocker

A client started an oral Lopressor (metoprolol), and the client asks what it is, you tell the client that Lopressor is a: A. Analgesic B. Beta Blocker C. Anticoagulant D. ACE inhibitor

B. Considers further assessment for depression

A client who has been admitted for the third time this year for heart failure says, "This isn't worth it anymore. I just want it all to end." What is the nurse's best response? A. Calls the family to lift the client's spirits B. Considers further assessment for depression C. Sedates the client to decrease myocardial oxygen demand D. Tells the client that things will get better

D. "Avoid grapefruit juice."

A client with hypertension is started on verapamil (Calan). What teaching does the nurse provide for this client? A. "Consume foods high in potassium." B. "Monitor for irregular pulse." C. "Monitor for muscle cramping." D. "Avoid grapefruit juice."

C. Anticoagulation

A patient with atrial fibrillation (AF) with rapid ventricular response has received medication to slow the ventricular rate. The pulse is now 88 beats/min. For which additional therapy does the nurse plan? A. Synchronized cardioversion B. Electrophysiology studies (EPS) C. Anticoagulation D. Radiofrequency ablation therapy

B. increase, increasing preload

A patient with hypovolemic shock is given IV fluids. IV fluids will help _________ cardiac output by: A. decrease; decreasing preload B. increase, increasing preload C. increase, decreasing afterload D. decrease, increasing contractility

B. Pericardial friction rub

After MI, if a patient complained of chest pain characteristic of pericarditis, you would auscultate his chest for? A. S3 heart sound B. Pericardial friction rub C. S4 heart sound D. New murmur

a. digoxin (Lanoxin) therapy daily

An 84 year-old client with heart failure presents to the emergency department with confusion, blurry, vision, and an upset stomach. Which assessment data is most concerning to the nurse? a. digoxin (Lanoxin) therapy daily b. daily metoprolol (lopressor) c. furosemide (Lasix) twice daily d. currently taking an antacid for upset stomach.

B. peripheral edema C. JVD D. Hepatomegaly

An inferior wall MI is associated with risk for right ventricular failure. Patients at risk should be assessed for? SATA A. crackles in lungs B. peripheral edema C. JVD D. Hepatomegaly

C. Progressive

Based on this scenario, what stage of shock is this patient most likely experiencing: A 74-year-old patient is extremely confused and does not respond to commands or stimulation. The patient respiratory rate is 28 and labored, oxygen saturation 86%, heart rate 120, blood pressure 70/40, mean arterial pressure is 50 mmHg, and temperature is 97 'F. The patient's heart rhythm is atrial fibrillation. The patient's urinary output is 5 mL/hr. The patient's labs: blood pH 7.15, serum lactate 15 mmol/L, BUN 55 mg/dL, Creatinine 6 mg/dL. In addition, the patient is now starting to have slight oozing of blood around puncture sites. A. Initial B. Proliferative C. Progressive D. Compensatory

D. norepinephrine and epinephrine, vasoconstriction

During shock, when a patient experiences a drop in cardiac output, the body tries to compensate by stimulating the sympathetic nervous system, which causes the release of _________ and ________. This will lead to? A. acetylcholine and dopamine, vasodilation B. epinephrine and norepinephrine, vasodilation C. dopamine and epinephrine, vasoconstriction D. norepinephrine and epinephrine, vasoconstriction

B. Initial, hypoxia, aerobic, anaerobic

During the __________ stage of shock, the signs and symptoms are very subtle. However, cells are experiencing _________ due to the lack of tissue perfusion, which causes the cells to switch from ___________ metabolism to _________ metabolism. A. Proliferative, hyperoxia, anaerobic, aerobic B. Initial, hypoxia, aerobic, anaerobic C. Compensatory, hypoxia, anaerobic, aerobic D. Fibrotic, hypoxia, aerobic, anaerobic

D. Compensatory

During what stage of shock does the body attempt to utilize the hormonal, neural, and biochemical responses of the body? A. Refractory B. Initial C. Proliferative D. Compensatory

D. Progressive, increased

During what stage of shock is the body unable to compensate for tissue perfusion and the body's cell start to experience hypoxic injury that result in __________capillary permeability? A. Refractory, increased B. Exudative, decreased C. Compensatory, increased D. Progressive, increased

B. Blood pressure (BP) 192/102 mm Hg

For a client with an 8-cm abdominal aortic aneurysm, which problem must be addressed immediately to prevent rupture? A. Heart rate 52 beats/min B. Blood pressure (BP) 192/102 mm Hg C. Report of constipation D. Anxiety

B. Client states that she is able to sleep on one pillow.

How does the nurse in the cardiac clinic recognize that the client with heart failure has demonstrated a positive outcome related to the addition of metoprolol (Lopressor) to the medication regimen? A. Ejection fraction is 25%. B. Client states that she is able to sleep on one pillow. C. Client was hospitalized five times last year with pulmonary edema. D. Client reports that she experiences palpitations.

B. Extreme edema C. Elevated ammonia and lactate levels D. GI bleeding and ulcers E. Dysrhythmias F. Myocardial infraction G. Acute tubular necrosis H. Disseminated intravascular clotting

Select all the complications that can arise from the progressive stage of shock: A. Acute respiratory distress syndrome B. Extreme edema C. Elevated ammonia and lactate levels D. GI bleeding and ulcers E. Dysrhythmias F. Myocardial infraction G. Acute tubular necrosis H. Disseminated intravascular clotting

D. It's the pressure the ventricles must work against to open the semilunar valves so blood can be pumped out of the heart.

Select the statement below that best describes cardiac afterload: A. It's the volume amount that fills the ventricles at the end of diastole. B. It's the volume the ventricles must work against to pump blood out of the body. C. It's the amount of blood the left ventricle pumps per beat. D. It's the pressure the ventricles must work against to open the semilunar valves so blood can be pumped out of the heart.

B. Preload C. Contractility D. Afterload

Stroke volume plays an important part in cardiac output. Select all the factors below that influence stroke volume: A. Heart rate B. Preload C. Contractility D. Afterload E. Blood pressure

false

TRUE or FALSE: All types of shock during the compensatory (early) stage will cause a patient to experience cold and clammy (moist or sweaty) skin. True False

C. "Your concerns are valid; we can review some steps to limit disease progression."

The client undergoing femoral popliteal bypass states that he is fearful he will lose the limb in the near future. Which response by the nurse is most therapeutic? A. "Are you afraid you will not be able to work?" B. "If you control your diabetes, you can avoid amputation." C. "Your concerns are valid; we can review some steps to limit disease progression." D. "What about the situation concerns you most?"

C. "This may be caused by a genetic trait."

The client, a college athlete who collapsed during soccer practice, has been diagnosed with hypertrophic cardiomyopathy. The client says, "This can't be. I am in great shape. I eat right and exercise." What is the nurse's best response? A. "How does this make you feel?" B. "This can be caused by taking performance-enhancing drugs." C. "This may be caused by a genetic trait." D. "Just imagine how bad it would be if you weren't in good shape."

D. "I no longer need my heart pills."

The nurse is teaching a patient with a new permanent pacemaker. Which statement by the patient indicates a need for further discharge education? A. "I will be able to shower again soon." B. "I need to take my pulse every day." C. "I might trigger airport security metal detectors." D. "I no longer need my heart pills."

D. Hold the digoxin, and obtain a prescription for a potassium supplement

The nurse prepares to administer digoxin to a client with heart failure and notes the following information: Temperature: 99.8°F (37.7°C), Pulse: 48 beats/min and irregular, Respirations: 20 breaths/min, Potassium level: 3.2 mEq/L (3.2 mmol/L). What action does the nurse take? A. Give the digoxin; reassess the heart rate in 30 minutes. B. Give the digoxin; document assessment findings in the medical record. C. Hold the digoxin, and obtain a prescription for an additional dose of furosemide. D. Hold the digoxin, and obtain a prescription for a potassium supplement

B. Pacemaker spikes are noted, but no P wave or QRS complex follows.

The nurse receives a report that a patient with a pacemaker has experienced loss of capture. Which situation is consistent with this? A. The pacemaker spike falls on the T wave. B. Pacemaker spikes are noted, but no P wave or QRS complex follows. C. The heart rate is 42 beats/min, and no pacemaker spikes are seen on the rhythm strip. D. The patient demonstrates hiccups.

B. Use canola oil rather than palm oil.

The nurse teaches a client who has had a myocardial infarction (MI) which information regarding diet? A. Less than 30% of the daily caloric intake should be derived from proteins. B. Use canola oil rather than palm oil. C. Consume 10 mg of fiber daily. D. Work toward lowering your high-density lipoprotein (HDL) cholesterol levels

C. The patient is instructed to breathe deeply through the mouth.

The professional nurse is supervising a nursing student performing a 12-lead electrocardiogram (ECG). Under which circumstance does the nurse correct the student? A. The patient is semi-recumbent in bed. B. Chest leads are placed as for the previous ECG. C. The patient is instructed to breathe deeply through the mouth. D. The patient is instructed to lie still.

D. Fowlers and leaning forward

To assessfor a pericardial friction rub, you would help a patient assume which position? A. Left lateral with knees flexed B. Supine with knees flexed C. Semi fowlers with legs elevated D. Fowlers and leaning forward

A. Decreased afterload C. Decreased HR

What are the expected effects of Lopressor? SATA A. Decreased afterload B. Increased BP C. Decreased HR D. Increased HR

A. Vasoconstriction B. Aortic stenosis E. Pulmonary Hypertension

What conditions below can result in an increased cardiac afterload? Select all that apply: A. Vasoconstriction B. Aortic stenosis C. Vasodilation D. Dehydration E. Pulmonary Hypertension

D. Stroke volume

What is the amount of blood pumped by the left ventricle with each beat. A. Cardiac output B. Preload C. Afterload D. Stroke volume

B. decreases anxiety C. Reduces preload

What is the therapeutic action of morphine? SATA A. decreases RR B. decreases anxiety C. Reduces preload D. sweet dreams

B. Client with dilated cardiomyopathy who uses oxygen for exertional dyspnea

Which client is best to assign to an LPN/LVN working on the telemetry unit? A. Client with heart failure who is receiving dobutamine (Dobutrex) B. Client with dilated cardiomyopathy who uses oxygen for exertional dyspnea C. Client with pericarditis who has a paradoxical pulse and distended jugular veins D. Client with rheumatic fever who has a new systolic murmur

C. "Walk to the point of leg pain, then rest, resuming when pain stops."

Which teaching point does the nurse include for a client with peripheral arterial disease (PAD)? A. "Elevate your legs above heart level to prevent swelling." B. "Inspect your legs daily for brownish discoloration around the ankles." C. "Walk to the point of leg pain, then rest, resuming when pain stops." D. "Apply a heating pad to the legs if they feel cold."

C. Nitroglycerin D. Furosemide

Which treatments below would decrease cardiac preload? Select all that apply: A. IV fluid bolus B. Norepinephrine C. Nitroglycerin D. Furosemide

C. A P wave precedes every QRS complex.

Which waveform indicates proper function of the sinoatrial (SA) node? A. The QRS complex is present. B. The PR interval is 0.24 second. C. A P wave precedes every QRS complex. D. The ST segment is elevated.

C. Serum Lactate 9 mmol/L

You're caring for a patient who is experiencing shock. Which lab result below demonstrates that the patient's cells are using anaerobic metabolism? A. Ammonia 18 µ/dL B. Potassium 4.5 mEq/L C. Serum Lactate 9 mmol/L D. Bicarbonate 23 mEq/L

B. Tobacco use. D. High-fat diet. F. Obesity.

A 48-year-old female client having an annual physical asks the nurse about her risk for developing a myocardial infarction. The nurse discusses risk factors with the client. Which modifiable risk factors will the nurse assess to guide the clients teaching plan? Select all that apply. A. Older age. B. Tobacco use. C. Female. D. High fat diet. E. Family history. F Obesity

E. The client's weight decreases by 2.5 kg.

A client admitted for heart failure has a priority problem of hypervolemia related to compromised regulatory mechanisms. Which assessment result obtained the day after admission is A. the best indicator that the treatment has been effective? B. The client has diuresis of 400 mL in 24 hours. C. The client's blood pressure is 122/84 mm Hg. D. The client has an apical pulse of 82 beats/min. E. The client's weight decreases by 2.5 kg.

B. The risk for hypotension

A client begins therapy with lisinopril (Prinivil, Zestril). What does the nurse consider at the start of therapy with this medication? A. The client's ability to understand medication teaching B. The risk for hypotension C. The potential for bradycardia D. Liver function tests

A. Peripheral edema. C. Increased abdominal girth. D. Ascites

A client is diagnosed with right sided heart failure. Which assessment findings will the nurse expect the client to have? Select all that apply. A. Peripheral edema. B. Crackles in both lungs. C. increased abdominal girth. D. Ascites

a. this medication can cause increased potassium levels. b. it is important to change position slowly when you start this medication. c. this medication may cause you to develop a persistent, nonproductive cough. e. be sure to monitor your BP regularly while taking this medication.

A client is prescribed lisinopril (Zestril) for control of hypertension. What health teaching will the nurse provide to this patient? Select all that apply. a. this medication can cause increased potassium levels. b. it is important to change position slowly when you start this medication. c. this medication may cause you to develop a persistent, nonproductive cough. d. To achieve maximum benefit of Zestril, your diet should include foods high in sodium e. be sure to monitor your BP regularly while taking this medication.

A. Increased MAP without a change in vascular volume.

A client thought to be at risk for distributive. Shock is given a drug that constrict blood vessels. What effect does the nurse expect the drug to have on the client mean arterial pressure MAP? A. Increased MAP without a change in vascular volume. B. Increased MAP by increasing vascular volume. C. Decreased MAP from widespread capillary leak. D. Decreased MAP by decreasing vascular volume.

C. I need to take a full course of antibiotics prior to my colonoscopy.

A client who recently had a heart valve replacement is preparing for discharge. What statement by the client indicates that the nurse will need to do additional health teaching? A. I need to brush my teeth, at least twice daily and rinse with water. B.I will eat foods that are low in vitamin K, such as potatoes and iceberg lettuce. C, I need to take a full course of antibiotics prior to my colonoscopy D. I will take my blood pressure every day and call if it's too high or low.

B. Serum potassium level of 2.8 mEq/L (2.8 mmol/L)

A client with heart failure is taking furosemide (Lasix). Which finding concerns the nurse with this new prescription? A. Serum sodium level of 135 mEq/L (135 mmol/L) B. Serum potassium level of 2.8 mEq/L (2.8 mmol/L) C. Serum creatinine of 1.0 mg/dL (88.4 mcmol/L) D. Serum magnesium level of 1.9 mEq/L (0.95 mmol/L)

A. A 36-year-old woman with aortic stenosis

A nurse assesses patients on a cardiac unit. Which patient would the nurse identify as being at greatest risk for the development of left-sided heart failure? A. A 36-year-old woman with aortic stenosis B. A 42-year-old man with pulmonary HTN C. A 59-year-old woman who smokes. cigarettes daily D. A 70-year-old man who had a cerebral vascular accident

A. Smoking cessation

A nurse is presenting education on recommended lifestyle changes to prevent angina and myocardial infarction. Which change should the nurse recommend be made first? A. Smoking cessation B. Relaxation exercises C. Diet modification D. Supplemental Omega-3 capsules

A. Prepare for defibrillation.

A patient admitted after using crack cocaine develops ventricular fibrillation. After determining unresponsiveness, which action does the nurse take next? A. Prepare for defibrillation. B. Establish IV access. C. Place an oral airway and ventilate. D. Start cardiopulmonary resuscitation (CPR).

B. Decrease the patient's blood pressure and decrease cardiac afterload

A patient has a blood pressure of 220/140. The physician prescribes a vasodilator. This medication will? A. Decrease the patient's blood pressure and increase cardiac afterload B. Decrease the patient's blood pressure and decrease cardiac afterload C. Decrease the patient's blood pressure and increase cardiac preload D. Increase the patient's blood pressure but decrease cardiac output.

B. Compensatory D. Initial E. Progressive G. Refractory

A patient is in hypovolemic shock. Select all the stages that a patient can enter when in shock: A. Proliferative B. Compensatory C. Exudative D. Initial E. Progressive F. Fibrotic G. Refractory

C. Sinus tachycardia

A patient's rhythm strip shows a heart rate of 116 beats/min, one P wave occurring before each QRS complex, a PR interval measuring 0.16 second, and a QRS complex measuring 0.08 second. How does the nurse interpret this rhythm strip? A. Normal sinus rhythm B. Sinus bradycardia C. Sinus tachycardia D. Sinus rhythm with premature ventricular contractions

D. The monitor shows an increase in heart rate

How does the nurse recognize that atropine has produced a positive outcome for the patient with bradycardia? A. The patient states he is dizzy and weak. B. The nurse notes dyspnea. C. The patient has a heart rate of 42 beats/min. D. The monitor shows an increase in heart rate

A. A 46-year-old with aortic stenosis who takes digoxin (Lanoxin) and has new-onset frequent premature ventricular contractions (PVCs)

After receiving change-of-shift report about these four clients, which client would the nurse assess first? A. A 46-year-old with aortic stenosis who takes digoxin (Lanoxin) and has new-onset frequent premature ventricular contractions (PVCs) B. A 55-year-old admitted with pulmonary edema who received furosemide (Lasix) and whose current O2 saturation is 94% C. A 68-year-old with pericarditis who is reporting sharp, stabbing chest pain when taking deep breaths D. A 79-year-old admitted for possible rejection of a heart transplant who has sinus tachycardia, heart rate 104 beats/min

D. "Use a stool softener."

In teaching patients at risk for bradydysrhythmias, what information does the nurse include? A. "Avoid potassium-containing foods." B. "Stop smoking and avoid caffeine." C. "Take nitroglycerin for a slow heartbeat." D. "Use a stool softener."

B. Auscultate the client's posterior breath sounds.

The home health nurse visits a client with heart failure who has gained 5 pounds (2.3 kg) in the past 3 days. The client states, "I feel so tired and short of breath." Which action does the nurse take first? A. Assess the client for peripheral edema. B. Auscultate the client's posterior breath sounds. C. Notify the health care provider about the client's weight gain. D. Remind the client about dietary sodium restrictions.

B. QT interval C. Heart rate D. Heart rhythm

The nurse administers amiodarone (Cordarone) to a patient with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? (Select all that apply.) A. Respiratory rate B. QT interval C. Heart rate D. Heart rhythm E. Urine output

A. Urine output of 20 mL over 2 hours

The nurse caring for a client who has had abdominal aortic aneurysm (AAA) repair would be most alarmed by which finding? A. Urine output of 20 mL over 2 hours B. Blood pressure of 106/58 mm Hg C. Absent bowel sounds D. +3 pedal pulses

A. Blurred vision C. Fatigue E. Anorexia

The nurse caring for a client with heart failure is concerned that digoxin toxicity has developed. For which signs and symptoms of digoxin toxicity does the nurse notify the provider? (Select all that apply.) A. Blurred vision B. Tachycardia C. Fatigue D. Serum digoxin level of 1.5 ng/ml (1.92 nmol/L) E. Anorexia

A. "I need to avoid eating hamburgers."

The nurse discusses the importance of restricting sodium in the diet for a client with heart failure. Which statement made by the client indicates that the client needs further teaching? A. "I need to avoid eating hamburgers." B "I must cut out bacon and canned foods." C. "I won't put the salt shaker on the table anymore." D. "I need to avoid lunchmeats but may cook my own turkey."

A. Has maintained a low-sodium, no-added-salt diet B. Has lost 3 pounds (1.4 kg) since last seen in the clinic E. Has cut down on caffeine

The nurse in the cardiology clinic is reviewing teaching about hypertension, provided at the client's last appointment. Which actions by the client indicate that teaching has been effective? (Select all that apply.) A. Has maintained a low-sodium, no-added-salt diet B. Has lost 3 pounds (1.4 kg) since last seen in the clinic C. Cooks food in palm oil to save money D. Exercises once weekly E. Has cut down on caffeine

a. My ankles swell up all the time d.My veins really stick out in my legs e.My ankles have been discovered for years

The nurse is admitting a client with an ulcer on the right foot. Which statement made by the client indicates venous insufficiency? Select all that apply. a. My ankles swell up all the time b.My leg hurts after I walk about a block c.My feet are always really cold d.My veins really stick out in my legs e.My ankles have been discovered for years

C. Splinter hemorrhages

The nurse is assessing a client with a cardiac infection. Which symptoms support the diagnosis of infective endocarditis instead of pericarditis or rheumatic carditis? A. Friction rub auscultated at the left lower sternal border B. Pain aggravated by breathing, coughing, and swallowing C. Splinter hemorrhages D. Thickening of the endocardium

C. Chest pain associated with ECG changes. E. Chest pain relieved only by opioids. F. Chest pain associated with shortness of breath.

The nurse is assessing a client with chest pain. Which symptoms assessed by the nurse would be most indicative of myocardial infarction? Select all that apply. A. Substernal chest discomfort associated with exertion. B. Chest pain that is released with rest. C. Chest pain associated with ECG changes. D. Chest pain relieved with nitroglycerin. E. Chest pain relief only by opioids. F. Chest pain associated with shortness of breath. G. Chest pain that last less than 10 minutes.

A. The client who had percutaneous transluminal angioplasty (PTA) of the right femoral artery 30 minutes ago

The nurse is assigned to all of these clients. Which client would be assessed first? A. The client who had percutaneous transluminal angioplasty (PTA) of the right femoral artery 30 minutes ago B. The client admitted with hypertensive crisis who has a nitroprusside (Nipride) drip and blood pressure of 149/80 mm Hg C. The client with peripheral vascular disease who has a left leg ulcer draining purulent yellow fluid D. The client who had a right femoral-popliteal bypass 3 days ago and has ongoing edema of the foot

D. Positions the client to alleviate dyspnea

The nurse is caring for a client with heart failure in the coronary care unit. The client is now exhibiting signs of air hunger and anxiety. Which nursing intervention does the nurse perform first for this client? A. Determines the client's physical limitations B. Encourages alternate rest and activity periods C. Monitors and documents heart rate, rhythm, and pulses D. Positions the client to alleviate dyspnea

A. Chest discomfort or pain B. Tachycardia E. Fatigue

The nurse is caring for a client with heart failure. For which symptoms does the nurse assess? (Select all that apply.) A. Chest discomfort or pain B. Tachycardia C. Expectorating thick, yellow sputum D. Sleeping on back without a pillow E. Fatigue

d.I will start to exercise gradually, stopping when I have pain

The nurse is caring for a client with intermittent claudication pain related to peripheral arterial disease. Which statement made by the client indicates an understanding of proper self-management? a. I need to reduce the number of cigarettes that I smoke each day. b. I will elevate my legs above the level of my heart. c. I will use a heating pad to promote circulation. d. I will start to exercise gradually, stopping when I have pain.

A. Reproducible leg pain with exercise

The nurse is caring for a client with peripheral arterial disease (PAD). For which symptoms does the nurse assess? A. Reproducible leg pain with exercise B. Unilateral swelling of affected leg C. Decreased pain when legs are elevated D. Pulse oximetry reading of 90%

D. Continue to monitor.

The nurse is caring for a patient on a telemetry unit who has a regular heart rhythm and rate of 60 beats/min; a P wave precedes each QRS complex, and the PR interval is 0.20 second. Additional vital signs are as follows: blood pressure 118/68 mm Hg, respiratory rate 16 breaths/min, and temperature 98.8°F (37°C). All of these medications are available on the medication record. What action does the nurse take? A. Administer atropine. B. Administer digoxin. C. Administer clonidine. D. Continue to monitor.

A. Bearing down for a bowel movement B. Possible inferior wall myocardial infarction (MI) E. Diltiazem (Cardizem) administered 1 hour ago

The nurse is caring for a patient who has developed a bradycardia. Which possible causes does the nurse investigate? (Select all that apply.) A. Bearing down for a bowel movement B. Possible inferior wall myocardial infarction (MI) C. Patient stating that he just had a cup of coffee-50 D. Patient becoming emotional when visitors arrived E. Diltiazem (Cardizem) administered 1 hour ago

B. Heart rate

The nurse is caring for a patient with acute coronary syndrome (ACS) and atrial fibrillation who has a new prescription for metoprolol (Toprol). Which monitoring is essential when administering the medication? A.ST segment B. Heart rate C.Troponin D. Myoglobin

A. Defibrillation

The nurse is caring for a patient with advanced heart failure who develops asystole. The nurse corrects the graduate nurse when the graduate offers to perform which intervention? A. Defibrillation B. Cardiopulmonary resuscitation (CPR) C. Administration of epinephrine D. Administration of oxygen

A. Heparin

The nurse is caring for a patient with atrial fibrillation (AF). In addition to an antidysrhythmic, what medication does the nurse plan to administer? A. Heparin B. Atropine C. Dobutamine D. Magnesium sulfate

A. Palpitations C. Chest discomfort E. Hypotension

The nurse is caring for a patient with heart rate of 143 beats/min. For which manifestations does the nurse observe? (Select all that apply.) A. Palpitations B. Increased energy C. Chest discomfort D. Flushing of the skin E. Hypotension

B. Check the patient for a pulse

The nurse is caring for a patient with unstable angina whose cardiac monitor shows ventricular tachycardia. Which action is appropriate to implement first? A. Defibrillate the patient at 200 joules. B. Check the patient for a pulse. C. Cardiovert the patient at 50 joules. D. Give the patient IV lidocaine

A. Ibuprofen (Motrin)

The nurse is caring for an 82-year-old client admitted for exacerbation of heart failure (HF). The nurse questions the client about the use of which medication because it raises an index of suspicion as to the worsening of the client's HF? A. Ibuprofen (Motrin) B. Hydrochlorothiazide (HydroDIURIL) C. NPH insulin D. Levothyroxine (Synthroid)

A. "I will call the provider if I have a cough lasting 3 or more days."

The nurse is providing discharge teaching to a client with heart failure, focusing on when to seek medical attention. Which statement by the client indicates a correct understanding of the teaching? A. "I will call the provider if I have a cough lasting 3 or more days." B. "I will report to the provider weight loss of 2 to 3 pounds (0.9 to 1.4 kg) in a day." C. "I will try walking for 1 hour each day." D. "I should expect occasional chest pain."

C. "Report nosebleeds to your provider immediately."

What teaching does the nurse include for a patient with atrial fibrillation who has a new prescription for warfarin? A. "It is important to consume a diet high in green leafy vegetables." B. "You would take aspirin or ibuprofen for headache." C. "Report nosebleeds to your provider immediately." D. "Avoid caffeinated beverages."

A. Heart rate C. Stroke volume

What two factors are used to calculate cardiac output? Select all that apply: A. Heart rate B. Blood pressure C. Stroke volume D. Mean arterial pressure

C. Weight loss of 6 pounds (2.7 kg) since the last visit

When following up in the clinic with a client with heart failure, how does the nurse recognize that the client has been compliant with fluid restrictions? A. Auscultation of crackles B. Pedal edema C. Weight loss of 6 pounds (2.7 kg) since the last visit D. Reports sucking on ice chips all day for dry mouth

A. Increase blood volume B. Causes the kidneys to keep sodium and water

When the body is attempting to compensate for shock the adrenal cortex will release aldosterone due to the presence of angiotensin II. Select all the effects aldosterone will have on the body in attempt to increase cardiac output and maintain tissue perfusion: SATA A. Increase blood volume B. Causes the kidneys to keep sodium and water C. Causes the kidneys to excrete sodium and water D. Cause the urine to have a low osmolality

C. B-type natriuretic peptide (BNP) of 760 pg/mL (760 ng/dL)

Which diagnostic test result is consistent with a diagnosis of heart failure (HF)? A. Serum potassium level of 3.2 mEq/L (3.2 mmol/L) B. Ejection fraction of 60% C. B-type natriuretic peptide (BNP) of 760 pg/mL (760 ng/dL) D. Chest x-ray report showing right middle lobe consolidation

D. Marfan syndrome

Which finding in the history of a client with an abdominal aortic aneurysm (AAA) is a risk factor for aneurysm formation? A. Peptic ulcer disease B. Deep vein thrombosis (DVT) C. Osteoarthritis D. Marfan syndrome

C. Place the client in high-Fowler's position with the legs down.

Which intervention best assists the client with acute pulmonary edema in reducing anxiety and dyspnea? A. Monitor pulse oximetry and cardiac rate and rhythm. B. Reassure the client that his distress can be relieved with proper intervention. C. Place the client in high-Fowler's position with the legs down. D. Ask a family member to remain with the client.

C. Setting the defibrillator to the synchronized mode

Which intervention provides safety during cardioversion? A. Setting the defibrillator at 220 joules B. Obtaining informed consent C. Setting the defibrillator to the synchronized mode D. Removing oxygen

B. Carvedilol (Coreg)

Which medication, when given in heart failure, may improve morbidity and mortality? A. Dobutamine (Dobutrex) B. Carvedilol (Coreg) C. Digoxin (Lanoxin) D. Bumetanide (Bumex)

D. Serum lactate, and the serum potassium levels are declining.

Which new assessment finding in a client being treated for hypovolemic shock indicates to the nurse that interventions are currently effective? a. Oxygen saturation remains unchanged. B. Core body temperature has increased to 99°F. C.The client correctly states the month and the year. D. Serum lactate, and the serum potassium levels are declining.

C. Obtain daily weights for several clients with class IV heart failure.

Which nursing action may be delegated to an unlicensed assistive personnel (UAP) working on the medical unit? A. Determine the usual alcohol intake for a client with cardiomyopathy. B. Monitor the pain level for a client with acute pericarditis. C. Obtain daily weights for several clients with class IV heart failure. D. Check for peripheral edema in a client with endocarditis.

C. The nurse obtains a bedside commode before administering furosemide.

Which nursing intervention for a client admitted today with heart failure will assist the client to conserve energy? A. The client ambulates around the nursing unit with a walker. B. The nurse monitors the client's pulse and blood pressure frequently. C. The nurse obtains a bedside commode before administering furosemide. D. The nurse returns the client to bed when the client becomes tachycardic.

A. Taking a 12 lead EKG

Which of the following is the most important in identifying candidates for reperfusion? A. Taking a 12 lead EKG B. Lab draw- serum cardiac biomarkers C. Ensuring no more than 6 hours after chest pain D. Signs and symptoms consistent with MI

A. should reduce chest pain B. improves blood flow to myocardium D. reduces myocardial O2 demands E. must be administered in glass container

Which of the following is true about the administration of Nitroglycerin IV drip? SATA A. should reduce chest pain B. improves blood flow to myocardium C. increases preload D. reduces myocardial O2 demands E. must be administered in glass container F. must be protected from light.

B. decreased PVCs

Which of the following reflects an expected therapeutic effect of lidocaine? A. decreased HR B. decreased PVCs C. Decreased BP D. decreased chest pain

A. active peptic ulcer C. Ischemic stroke two months prior E. Bowel resection surgery 10 days prior

Which of the following would contraindicate fibrinolytic reperfusion therapy? SATA A. active peptic ulcer B. Onset of new chest pain prior to the start of reperfusion C. Ischemic stroke two months prior D. current lab values: PT 12 seconds, aPTT 36 seconds E. Bowel resection surgery 10 days prior F. ST elevation

A. The 64-year-old patient admitted for weakness who has a sinus bradycardia with a heart rate of 58 beats/min

Which patient is appropriate for the cardiac care unit charge nurse to assign to the float RN from the medical-surgical unit? A. The 64-year-old patient admitted for weakness who has a sinus bradycardia with a heart rate of 58 beats/min B. The 71-year-old patient admitted for heart failure who is short of breath and has a heart rate of 120 to 130 beats/min C. The 88-year-old patient admitted with an elevated troponin level who is hypotensive with a heart rate of 96 beats/min D.The 92-year-old patient admitted with chest pain who has premature ventricular complexes and a heart rate of 102 beats/min

D. SA Node, AV Node, Bundle of His, Bundle Branches

Which represents the normal electrical conduction pathway in the heart? A. AV node, Bundle of His, Purkinje System, Internodal Pathways B. SA Node, AV Node, Purkinje Fibers, Bundle Branches C. Intermodal Pathways, SA Node, AV Node, Bundle Branches D. SA Node, AV Node, Bundle of His, Bundle Branches

B. Excessive alcohol use C. Advancing age D. High blood pressure

Which risk factors are known to contribute to atrial fibrillation? (Select all that apply.) A. Use of beta-adrenergic blockers B. Excessive alcohol use C. Advancing age D. High blood pressure E. Palpitations

C. The affected extremity becomes purple and cold.

Which sign/symptom is essential for the nurse to report to the primary health care provider (PCP) when caring for a client with Raynaud's phenomenon? A. Nifedipine (Procardia) administration caused the blood pressure to change from 134/76 to 110/68 mm Hg. B. The client's extremity became white, then red temporarily. C. The affected extremity becomes purple and cold. D. The client states that the digits are painful when they are white

D. Refractory

Which stage of shock is irreversible and unmanageable? A. Progressive B. Initial C. Exudative D. Refractory

B. The amount the ventricles stretch at the end of diastole.

Which statement below best describes the term cardiac preload? A. The pressure the ventricles stretch at the end of systole. B. The amount the ventricles stretch at the end of diastole. C. The pressure the ventricles must work against to pump blood out of the heart. D. The strength of the myocardial cells to shorten with each beat.

C. During this stage blood flow to the kidneys is reduced, which causes the kidneys to activate the renin-angiotensin system, and this will lead to major vasodilation to the arterial and venous system. D. One hallmark sign of this stage is that there is an increase in capillary permeability.

Which statements are INCORRECT about the compensatory stage of shock. Select all that apply: A. This stage is reversible. B. During this stage blood is shunted away from the kidneys, lungs, skin, and gastrointestinal system to the brain and heart. C. During this stage blood flow to the kidneys is reduced, which causes the kidneys to activate the renin-angiotensin system, and this will lead to major vasodilation to the arterial and venous system. D. One hallmark sign of this stage is that there is an increase in capillary permeability. E. A patient is at risk for a paralytic ileus during this stage.

B. Avoid operating electrical appliances over the pacemaker.

Which teaching is essential for a patient who has had a permanent pacemaker inserted? A. Avoid talking on a cell phone. B. Avoid operating electrical appliances over the pacemaker. C. Avoid sexual activity. D. Do not take tub baths.