NUR361 CARDIO
What is an important teaching point for those with valvular dysfunction, cardiac infection, or cardiomyopathy?
Taking preventative antibiotic therapy before any invasive dental procedure
Which is an example of a loop diuretic? a) Furosemide b) Metoprolol c) Amlodipine d) Lisinopril e) Losartan
a) Furosemide
A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect? (Select all that apply) a) Increased heart rate b) Increased BP c) Increased respiratory rate d) Increase hematocrit e) Increased temperature
a) Increased HR b) Increased BP c) Increased respiratory rate
A client who is in the progressive stage of hypovolemic shock has all of the following signs, symptoms, or changes. Which ones does the nurse attribute to ongoing compensatory mechanisms? (Select all that apply). a) Increasing pallor b) Increasing thirst c) Increasing confusion d) Increasing HR e) Increasing RR f) Decreasing systolic BP g) Decreasing blood pH h) Decreasing urine output
a) Increasing pallor b) Increasing thirst d) Increasing HR e) Increasing RR h) Decreasing urine output
Complications for left-sided heart catheterization. (Select all that apply) a) MI b) Stroke c) Vagal response d) Dysrhythmias e) Pulmonary edema f) Thrombophlebitis g) Arterial bleeding or thromboembolism h) PE i) Cardiac tamponade j) Hypovolemia k) Hypervolemia
a) MI b) Stroke d) Dysrhythmias e) Pulmonary edema g) Arterial bleeding or thromboembolism i) Cardiac tamponade j) Hypovolemia
Which of the following are symptoms of hypertrophic cardiomyopathy? (Select all that apply) a) Mild cardiomegaly b) Moderate-severe cardiomegaly c) Dysrhythmias or heart block d) Left-sided HF e) Right-sided HF f) Sudden death g) Only S4 gallop h) S3 and S4 gallops i) Angina j) Dyspnea k) Ventricular dysrhythmias l) Syncope m) Systemic or pulmonary emboli n) Palpitations
a) Mild cardiomegaly f) Sudden death g) Only S4 gallop i) Angina j) Dyspnea k) Ventricular dysrhythmias l) Syncope n) Palpitations
A nurse on a med-surge unit is caring for a client who reports pain in the jaw, back, and shoulder, and shortness of breath and nausea. Which of the following actions should the nurse take? a) Obtain an EKG b) Administer enteric-coated acetaminophen' c) Administer ibuprofen d) Maintain O2 saturations greater than or equal to 92%
a) Obtain an EKG
A nurse is monitoring a client who is on telemetry. Which of the following findings on the ECG strip should the nurse recognize as normal sinus rhythm? a) The P wave falls before the QRS complex. b) The T wave is in the inverted position. c) The P-R interval measures 0.22 seconds. d) The QRS duration is 0.20 seconds.
a) The P wave falls before the QRS complex.
A nurse is auscultating a client's heart sounds and hears an extra heart sound before what should be considered the first heart sound S1. The nurse should document this finding as which of the following heart sounds? a) The fourth heart sound (S4) b) A friction rub c) The third heart sound (S3) d) A split second heart sound S2
a) The fourth heart sound (S4)
On an ECG strip, how many seconds does each box represent?
0.20
Normal range for cardiac troponin T. Normal range for cardiac troponin I. ________ indicate myocardial injury or infarction.
<0.10 ng/mL <0.03 ng/mL Elevations
What is the purpose of calcium channel blockers like verapamil and amiodarone?
Lowers BP
Normal triglyceride value is... a) <150 b) <200 c) <250 d) <300
a) <150
What is S4 referred as? a) Atrial gallop b) Ventricular gallop c) Axiomatic splitting d) Paradoxical splitting
a) Atrial gallop
During routine suctioning of a client with a tracheostomy, the client becomes diaphoretic and nauseous, and the HR decreases to 39bpm. What is the nurse's best action at this time? a) Continue to clear the airway b) Stop suctioning the patient c) Administer atropine d) Call the health care provider immediately
b) Stop suctioning the patient
Normal LDL-C with CVD or DM value is... a) <50 b) <60 c) <70 d) <80
c) <70
What is the first line medication for HTN? a) ACE inhibitors b) Beta blockers c) Metoprolol d) Hydrochlorothiazide
d) Hydrochlorothiazide
What type of chest discomfort is variable...moderate ache, worse on inspiration...felt in the lung fields...continuous until the underlying condition is treated or the patient has rested? a) Angina b) MI c) Pericarditis d) Pleuropulmonary e) Esophageal-Gastric f) Anxiety
d) Pleuropulmonary
What condition has symptoms of low blood pressure, shortness of breath, and lightheadedness? a) HTN b) Cardiomyopathy c) Mitral regurgitation d) Cardiac tamponade
d) cardiac tamponade
Angina is the pain associated with...? An MI indicates ____ of the heat muscle.
decreased blood flow; necrosis
What type of chest discomfort is variable, may be in response to stress or fatigue...dull ache to sharp stabbing; may be associated with numbness in fingers...not well located and usually does not radiate to other parts of the body as pain...usually lasts a few minutes? a) Angina b) MI c) Pericarditis d) Pleuropulmonary e) Esophageal-Gastric f) Anxiety
f) Anxiety
Assess patients for allergy to _______-based contrast media before having invasive diagnostic tests requiring an ______-based contrast agent.
iodine
After invasive cardiovascular diagnostic testing, such as cardiac catheterization, monitor the insertion site for what? a) redness and swelling b) redness and bleeding c) bleeding and hematoma d) infection and bleeding
c) bleeding and hematoma
What should the nurse give a patient who is having heparin toxicity, and needs reversed quickly? a) protamine sulfate b) vitamin k c) fresh frozen plasma d) digoxin
c) fresh frozen plasma
What do you administer to the patient showing Torsade's? a) calcium b) vitamin k c) magnesium d) sodium
c) magnesium
A nurse is caring for a client who is receiving a unit of packed red blood cells. Fifteen minutes following the start of the transfusion, the nurse notes that the client is febrile, with chills and red-tinged urine. Which of the following transfusion reactions should the nurse suspect? a) Febrile b) Allergic c) Acute pain d) Hemolytic
d) Hemolytic
A client with CHF presents to the ED with a new onset of a-fib. Which of the following medications would the nurse question? a) Furosemide b) Metoprolol succinate c) Diltiazem d) Ivabradine
d) Ivabradine
Which is an example of an ACE inhibitor? a) Furosemide b) Metoprolol c) Amlodipine d) Lisinopril e) Losartan
d) Lisinopril
What is abnormal splitting of S2 referred as? a) Atrial gallop b) Ventricular gallop c) Axiomatic splitting d) Paradoxical splitting
d) Paradoxical splitting
Which new assessment finding in a client being treated for hypovolemic shock indicates to the nurse that interventions are currently effective? a) O2 remains unchanged b) Core body temperature has increased to 99 degrees c) The client correctly states the month and year d) Serum lactate and serum potassium levels are declining
d) Serum lactate and serum potassium levels are declining
A nurse is preparing to administer dabigatran to a client who had a-fib. The nurse should explain that the purpose of this medication is which of the following? a) To convert a-fib to sinus rhythm b) To dissolve clots in the bloodstream c) To slow the response of the ventricles to the fast atrial impulses d) To reduce the risk of stroke in clients who have a-fib
d) To reduce the risk of stroke in clients who have a-fib
Each beat of the heart pumps about ____mL of blood. a) 140 b) 120 c) 100 d) 80 e) 60
e) 60
How do you assess baroreceptor sensitivity? a) Assess HR and rhythm and heart sounds for murmurs b) Assess ECG and heart rhythm for dysthymias or a HR less than 60bpm c) Assess for activity intolerance and QRS complex and QT interval changes d) Assess BP and peripheral pulses e) Assess the patient's BP with the patient lying and then sitting or standing
e) Assess the patient's BP with the patient lying and then sitting or standing
What type of chest discomfort is variable...squeezing, heartburn, variable severity...substernal; may spread to the shoulders or the abdomen...variable; may be relieved with antacid administration, food intake, or taking a sitting position? a) Angina b) MI c) Pericarditis d) Pleuropulmonary e) Esophageal-Gastric f) Anxiety
e) Esophageal-Gastric
Which is an example of an ARB? a) Furosemide b) Metoprolol c) Amlodipine d) Lisinopril e) Losartan
e) Losartan
Which heart sound is created by the closure of the mitral valve and tricuspid valves...softer and longer...low pitched and best heard at the lower left sternal border or the apex of the heart?
S1
Which heart sound is created by the closure of the aortic and pulmonic valves...shorter...higher pitched...heard best at the base of the heart?
S2
What is the purpose of beta blockers like propranolol and acebutolol?
Slowing down the heart with less force to decrease BP
What is the purpose of sodium channel blockers like disopyramide phosphate?
Slows the electrical impulse conduction in the heart muscle itself.
Left-sided HF symptoms. (select all that apply) a) Fatigue b) Tachypnea c) Weight gain d) Anorexia and nausea e) Pallor f) Angina g) Dizziness h) BP changes i) Weakness j) Cool extremities
a) Fatigue b) Tachypnea e) Pallor f) Angina g) Dizziness i) Weakness j) Cool extremities
A nurse is reinforcing teaching with a client regarding reduction of risk factors for coronary artery disease. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply) a) "I must stop smoking." b) "I should limit my exercise." c) "I will stop consuming alcohol." d) "I need to monitor my weight." e) "I am limiting my intake of fast foods."
a) "I must stop smoking." d) "I need to monitor my weight." e) "I am limiting my intake of fast foods."
A nurse is teaching the partner of a client who had an acute MI about the reason blood was drawn from the client. Which of the following statements should the nurse make regarding cardiac enzymes studies? a) "These tests help determine the degree of damage to the heart tissues." b) "Cardiac enzymes will identify the location of the MI." c) "These tests will enable the provider to determine the heart structure and mobility of the heart valves." d) "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion."
a) "These tests help determine the degree of damage to the hart tissues."
A client is prescribed lisinopril for control of HTN. 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 positions slowly when you start the medication." c) "This medication may cause you to develop a persistent non-productive cough." d) "To achieve max benefit of lisinopril, your diet should include foods high in sodium." e) "Be sure to monitor your BP regularly while taking this medication."
a) "This medication can cause increased potassium levels." b) "It is important to change positions slowly when you start the medication." c) "This medication may cause you to develop a persistent non-productive cough." e) "Be sure to monitor your BP regularly while taking this medication."
The nurse is reviewing the EKG strip of a client who has prolonged vomiting. Which of the following abnormalities on the client's EKG should the nurse interpret as a sign of hypokalemia? a) Abnormally prominent U wave b) Elevated ST segment c) Wide QRS d) Inverted P wave
a) Abnormally prominent U wave
What anti-dysrhythmic medications need to be given to slow ventricular conduction and convert back to NSR? (Select all that apply) a) Amiodarone b) Beta blockers c) Calcium channel blockers d) Digoxin e) Dofetilide f) Furosemide g) Propafenone
a) Amiodarone b) Beta blockers d) Digoxin e) Dofetilide g) Propafenone
What type of chest discomfort is sudden, in response to exertion, emotion, or extremes in temperature...squeezing, viselike pain...usually on the left side of chest w/o radiation, substernal; may spread across chest and back and/or down the arms...usually lasts less than 15 minutes; relieved with rest, nitrate administration or oxygen therapy? a) Angina b) MI c) Pericarditis d) Pleuropulmonary e) Esophageal-Gastric f) Anxiety
a) Angina
What are symptoms severe uncontrolled HTN greater than 180/120? (Select all that apply) a) Chest pain b) bruising c) SOB d) Dizziness e) nose bleeding f) shock g) headache
a) Chest pain c) SOB d) Dizziness e) nose bleeding g) headache
A nurse is caring for a client who develops a ventricular fibrillation rhythm. The client is unresponsive, pulseless, and apneic. Which of the following actions is the nurse's priority? a) Defibrillation b) Airway management c) Epinephrine administration d) Amiodarone administration
a) Defibrillation
An 84y/o client with HF presents to the emergency room with confusion, blurry vision, and an upset stomach. Which assessment data are most concerning to the nurse? a) Digoxin therapy qd b) qd metoprolol c) Furosemide q2d d) Currently taking an antacid for upset stomach
a) Digoxin therapy qd
Which nonspecific cardiovascular symptoms are seen in women? (Select all that apply) a) Fatigue b) SOB c) Headache d) Malaise e) Neuropathy f) Anxiety
a) Fatigue b) SOB d) Malaise f) Anxiety
A client is diagnosed with right-sided HF. 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 e) tachypnea
a) peripheral edema c) increased abdominal girth d) ascites e) tachypnea
What is the antidote for heparin? a) protamine sulfate b) vitamin k c) Fresh frozen plasma d) Digoxin
a) protamine sulfate
Monitor the _____ of patients taking digoxin before administration. a) Pulse b) BP c) HR d) RR
a) pulse
What are the risk factors for CVD? (Select all that apply) a) smoking b) hyperlipidemia c) hyperthyroidism d) hypotension e) hypertension f) obesity g) HDL 45 mg/dL or higher h) psychological stress
a) smoking b) hyperlipidemia e) hypertension f) obesity h) psychological stress
Which statement made by the client on the way to the Cath lab requires an immediate action by the nurse? a) "My allergies are bothering me, so I took some Benadryl last night before bed." b) "I was nervous last night, but I still remembered to take my warfarin." c) "I sure am hungry. I haven't had anything to eat since I went to bed last night." d) "I don't know what I am going to do if they find a blockage in my heart."
b) "I was nervous last night, but I still remembered to take my warfarin."
Normal cholesterol value is... a) <100 b) <200 c) <300 d) <400
b) <200
Monitor the HF patient on beta blockers carefully for...? a) Hypotension and tachycardia b) Hypotension and bradycardia c) Hypertension and tachycardia d) Hypertension and bradycardia
b) Hypotension and bradycardia
What type of chest discomfort is sudden, w/o precipitating factors, often in early morning...Intense stabbing, viselike pain or pressure, severe...substernal; may spread throughout the anterior chest and to the arms, jaw, back, or neck...continuous or no chest discomfort; relieved with morphine, cardiac drugs, and oxygen therapy? a) Angina b) MI c) Pericarditis d) Pleuropulmonary e) Esophageal-Gastric f) Anxiety
b) MI
A nurse is caring for a client who recently had surgery for insertion of a permanent pacemaker. Which of the following prescriptions should the nurse clarify? a) Serum cardiac enzyme levels b) MRI of the chest c) Physical therapy d) Low-sodium diet
b) MRI of the chest
Which is an example of a beta blocker? a) Furosemide b) Metoprolol c) Amlodipine d) Lisinopril e) Losartan
b) Metoprolol
Which of the following are symptoms of dilated cardiomyopathy? (Select all that apply) a) Mild cardiomegaly b) Moderate-severe cardiomegaly c) Dysrhythmias or heart block d) Left-sided HF e) Right-sided HF f) Sudden death g) Only S4 gallop h) S3 and S4 gallops i) Angina j) Dyspnea k) Ventricular dysrhythmias l) Syncope m) Systemic or pulmonary emboli n) Palpitations
b) Moderate-severe cardiomegaly c) Dysrhythmias or heart block d) Left-sided HF h) S3 and S4 gallops m) Systemic or pulmonary emboli
The nurse assesses a client who had a CABG yesterday. Which assessment finding will cause the nurse to suspect cardiac tamponade? a) Incisional pain with decreased urine output b) Muffled heart sounds with the presence of jugular vein distention c) Sternal would drainage with nausea d) Increased blood pressure and decreased HR
b) Muffled heart sounds with the presence of jugular vein distention
A nurse is interpreting a client's ECG strip. Which of the following components of the ECG should the nurse examine to determine the time it takes for ventricular depolarization and repolarization? a) PR interval b) QT interval c) ST segment d) QRS complex
b) QT interval
What is S3 referred as? a) Atrial gallop b) Ventricular gallop c) Axiomatic splitting d) Paradoxical splitting
b) Ventricular gallop
While performing an admission on a client, the nurse assesses which of the following as risk factors for CVD? (Select all that apply) a) BMI of 22 b) Well-controlled DM c) Exposure to secondhand cigarette smoke d) BP of 128/54 e) H/o repeated streptococcal tonsillitis f) Family h/o CVD g) Total cholesterol level of 140 mg/dL
b) Well-controlled DM c) Exposure to secondhand cigarette smoke e) H/o repeated streptococcal tonsillitis f) Family h/o CVD
What should you look for in the ECG strip when suspecting left ventricle changes like increased size and stiffness? a) Widened QRS complex and a shorter QT interval b) Widened QRS complex and a longer QT interval c) Narrowed QRS complex and a shorter QT interval d) Narrowed QRS complex and a longer QT interval
b) Widened QRS complex and a longer QT interval
What is the antidote for Coumadin? a) protamine sulfate b) vitamin k c) fresh frozen plasma d) digoxin
b) vitamin k
What are the long term effects of HTN on the eyes? (name 3)
bleeding in the eye, blurred vision, vision loss
The PCP prescribes warfarin for a client with A-fib. Which statement made by the client indicates that additional education is needed? a) "I need to go to the clinic once a week to have my blood level checked." b) "If my stools turn black, I will be sure to call my PCP." c) "I am glad I do not need to change my diet. Salads are my favorite food" d) "I need to stop taking my herbal supplement."
c) "I am glad I do not need to change my diet. Salads are my favorite food"
The nurse is teaching a client with a newly diagnosed cardiovascular disorder. Which statement made by the client demonstrates health promotion? a) "My heart disease will go away when I cut down to one cigarette a day." b) "I am glad I don't have to change my diet and can continue to eat whatever I want." c) "I need to get at least 150 minutes of moderate exercise a week." d) "I finally have my BP to a normal level of 150/85."
c) "I need to get at least 150 minutes of moderate exercise a week."
A nurse in a clinic is caring for a client who has a prescription for digoxin. Which of the following statements indicates the client is experiencing digoxin toxicity? a) "I am gaining weight." b) "I am constipated." c) "My vision seems yellow." d) "My tongue is red and beefy."
c) "My vision seems yellow."
A nurse is admitting a client who has acute HF following MI. The nurse recognizes that which of the following prescriptions by the provider requires clarification? a) Morphine sulfate 2mg IV bolus every 2 hr PRN pain b) Lab testing of serum potassium upon admission c) 0.9% normal saline IV at 50 mL/hr continuous d) Bumetanide 1mg IV bolus every 12 hr
c) 0.9% normal saline IV at 50 mL/hr continuous
With which client should the nurse remain alert for the possibility of sepsis and septic shock? a) 41 yo man who sustained a closed depression fracture of the face when hit with a baseball b) 53 yo woman who had an open abdominal hysterectomy 3 days ago to remove several large fibroid tumors c) 67 yo woman on chronic corticosteroid therapy who had several teeth pulled 2 days ago d) 72 yo man with severe allergies who is undergoing radiation therapy for early stage prostate cancer
c) 67 yo woman on chronic corticosteroid therapy who had several teeth pulled 2 days ago
Normal HDL-C value is... a) >20 b) >30 c) >40 d) >50
c) >40
Which is an example of a calcium channel blocker? a) Furosemide b) Metoprolol c) Amlodipine d) Lisinopril e) Losartan
c) Amlodipine
A client who has a history of MI is prescribed aspirin 325mg. The nurse recognizes that the aspirin is given due to which of the following actions of the medication? a) Analgesic b) Anti-inflammatory c) Anti-platelet aggregation d) Antipyretic
c) Anti-platelet aggregation
A nurse is interpreting the ECG strip of a client who has bradycardia. Which of the following cardiac components should the nurse identify as the role of the P wave? a) Ventricular depolarization b) Slow depolarization of ventricular Purkinje fibers c) Atrial depolarization d) Early ventricular depolarization
c) Atrial depolarization
The nurse is assessing a client with chest pain. Which symptoms assessed by the nurse would be the most indicative of MI? (Select all that apply) a) Substernal chest discomfort associated with exertion b) Chest pain that is relieved with rest c) Chest associated with ECG changes d) Chest pain relieved with nitroglycerin e) Chest pain relieved only by opioids f) Chest pain associated with SOB g) Chest pain that lasts less than 10 mins
c) Chest associated with ECG changes e) Chest pain relieved only by opioids f) Chest pain associated with SOB
A nurse is reviewing BP classifications with a group of nurses at an in-service meeting. Which of the following should the nurse include as a risk factor for the development of HTN? a) HDL level of 70mg/dL b) A diet high in potassium c) Obstructive sleep apnea (OSA) d) Taking benazepril
c) Obstructive sleep apnea (OSA)
What type of chest discomfort is sudden...sharp, stabbing, moderate to severe... substernal; usually spreads to the left side or the back...Intermittent; relieved with sitting upright, analgesia, or administration of anti-inflammatory agents? a) Angina b) MI c) Pericarditis d) Pleuropulmonary e) Esophageal-Gastric f) Anxiety
c) Pericarditis
The nurse is evaluating a client who had a cardiac catheterization with a left antecubital insertion site. Which of the following pulses should the nurse palpate? a) Brachial pulse on the left arm b) Brachial pulse on the right arm c) Radial pulse on the left arm d) Radial pulse on the right arm
c) Radial pulse on the left arm
A nurse is assessing a client before administering a unit of packed RBCs. The nurse should identify which of the following data as most important to obtain prior to the infusion? a) Skin color b) Fluid intake c) Temperature d) Hemoglobin level
c) Temperature
Complications for right-sided heart catheterization. (Select all that apply) a) MI b) Stroke c) Vagal response d) Dysrhythmias e) Pulmonary edema f) Thrombophlebitis g) Arterial bleeding or thromboembolism h) PE i) Cardiac tamponade j) Hypovolemia k) Hypervolemia
c) Vagal response e) Pulmonary edema f) Thrombophlebitis h) PE i) Cardiac tamponade j) Hypovolemia
Right-sided HF symptoms. (Select all that apply) a) Fatigue b) Tachypnea c) Weight gain d) Anorexia and nausea e) Pallor f) Angina g) Dizziness h) BP changes i) Weakness j) Cool extremities
c) Weight gain d) Anorexia and nausea h) BP changes
What is the transient loss of consciousness that is common among older adults?
syncope
ACE inhibitors, ARBs, and diuretics are commonly used to treat _____ HF?
systolic
