PassPoint - Cardiovascular

The nurse should give which discharge instructions about thermal injury to a client with peripheral vascular disease? Select all that apply.

"Avoid sunburn during the summer." "Wear extra socks in the winter." "Choose loose, soft, cotton socks."

A client with known coronary artery disease reports intermittent chest pain, usually on exertion. The physician diagnoses angina pectoris and orders sublingual nitroglycerin to treat acute angina episodes. When teaching the client about nitroglycerin administration, which instruction should the nurse provide?

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

A client is admitted to the hospital for evaluation of recurrent episodes of ventricular tachycardia as observed on Holter monitoring. The client is scheduled for electrophysiology studies (EPS) the following morning. Which statement should the nurse include in a teaching plan for this client?

"During the procedure, the health care provider will insert a special wire to increase the heart rate and produce the irregular beats that caused your signs and symptoms."

The nurse instructs a client on the use of transdermal nitroglycerin 0.2 mg/hour patch for angina pectoris. Which client statement indicates that teaching was effective?

"I should report any skin irritation to the healthcare provider."

A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when the client makes which statement?

"I sleep on three pillows each night."

A home care nurse visits a client diagnosed with atrial fibrillation who is ordered warfarin. The nurse teaches the client about warfarin therapy. Which statement by the client indicates the need for further teaching?

"I'll eat four servings of fresh, dark green vegetables every day."

A client weighs 300 lb (136 kg) and has a history of deep vein thrombosis and thrombophlebitis. When coaching a client about behaviors to maintain health, the nurse determines that the client has understood the nurse's instructions when the client makes which statement?

"I'll try to lose weight by following a reduced-calorie, balanced diet."

A newly admitted client reports taking digoxin and warfarin. Which statement would the nurse include in the discharge instructions?

"Notify your healthcare provider if you experiences visual changes."

The nurse is teaching a client who has deep vein thrombosis. What should the nurse tell the client?

"Report such signs as leg swelling, discomfort, redness, or warmth."

The nurse is teaching a client with unstable angina to use sublingual nitroglycerin tablets when chest pain occurs. What should the nurse tell the client?

"Sit down, and then take one tablet. If pain persists after 5 minutes, call 911."

A client is taking verapamil hydrochloride as an antihypertensive. Which statement made by the nurse instructs the client about an adverse effect of verapamil?

"Take your pulse and report any irregular heartbeats."

Which client is at greatest risk for Buerger disease?

29-year-old male client with a 14-year history of cigarette smoking

Following a percutaneous transluminal coronary angioplasty, a client is monitored in the postprocedure unit. The client's heparin infusion was stopped 2 hours earlier. There is no evidence of bleeding or hematoma at the insertion site, and the pressure device is removed. The nurse should plan to safely remove the femoral sheath when the partial thromboplastin time (PTT) is:

50 seconds or less.

A client recovering from an acute myocardial infarction makes a joke about the client's sexual function to the nurse during morning care. What action should the nurse take?

Ask the client if there are questions related to sexuality the client would like to discuss.

While auscultating the apical heart rate, the nurse notes an irregular heart rhythm at a rate of 120 beats/min. What is the nurse's next action?

Assess for a pulse deficit.

The nurse notices on the cardiac monitor that the client has started having premature ventricular contractions every other beat. What should the nurse do first?

Assess the client's orientation and vital signs.

A client in the emergency department has symptoms of anxiety, a "racing heart," and dyspnea. The cardiac monitor shows sinus tachycardia with a heart rate of 122. What is the appropriate action of the nurse?

Assess the client's vital signs and oxygen saturation.

A client with peripheral vascular disease and a history of hypertension is to be discharged on a low-fat, low-cholesterol, low-sodium diet. Which should be the nurse's first step in planning the dietary instructions?

Assess the family's food preferences.

A client with a recent diagnosis of deep vein thrombosis (DVT) has sudden-onset shortness of breath and chest pain that increases with a deep breath. What should the nurse do first?

Assess the oxygen saturation.

The nurse is evaluating arterial wave formation from an arterial line and notes a slow upstroke. What is the best action by the nurse?

Auscultate heart sounds.

A client is scheduled to undergo right axillary-to-axillary artery bypass surgery tomorrow. Before surgery, what action should the nurse take?

Avoid using the right arm for venipuncture.

A client is diagnosed with thrombophlebitis. What nursing action would demonstrate the appropriate level of activity for this client?

Bed rest with the affected extremity elevated

After extensive cardiac bypass surgery, a client returns to the intensive care unit on dobutamine, 5 mcg/kg/minute I.V. Which classification best describes dobutamine?

Direct-acting beta-active agent

The nurse observes that an older female client has small-to-moderate, distended, and tortuous veins running along the inner aspect of their lower legs. What should the nurse do?

Encourage the client to avoid standing in one position for long periods of time.

The nurse reviews the morning laboratory results from a female client admitted with deep vein thrombosis. The client is receiving intravenous heparin. Based on the client's current laboratory values, what should the nurse do?

Maintain the current rate of the heparin infusion.

A client in the intensive care unit has an arterial line that reads 58/30 mm Hg on the monitor. What is the nurse's first action?

Obtain a manual blood pressure.

A nurse hears an irregular heart rate of 110 bpm when auscultating a client's chest. The client also has new-onset shortness of breath. Which action should the nurse take next?

Obtain a prescription for a stat electrocardiogram.

A client has been diagnosed with peripheral arterial occlusive disease. To promote circulation to the extremities, what should the nurse instruct the client to do?

Participate in a regular walking program.

A nurse is caring for a client taking diltiazem hydrochloride for arrhythmias. The nurse knows that diltiazem helps decrease arrhythmias by working during which phase of the cardiac action potential?

Phase 0

A client has been admitted to the coronary care unit. The nurse observes third-degree heart block at a rate of 35 bpm on the client's cardiac monitor. The client has a blood pressure of 90/60 mm Hg. What should the nurse do first?

Prepare for transcutaneous pacing.

The nurse is conducting a health assessment of an older adult. The client tells the nurse about cramping leg pain that occurs when walking for 15 minutes; the pain is relieved with rest. The lower extremities are slightly cool to touch, and pedal pulses are palpable +1. What should the nurse instruct the client to do?

Seek consultation from the health care provider.

A middle-aged client with a history of hypertension reports having "indigestion." The nurse connects the client to a cardiac monitor, which reveals eight premature ventricular contractions per minute. What should the nurse do next?

Start an intravenous (IV) infusion.

One goal in caring for a client with arterial occlusive disease is to promote vasodilation in the affected extremity. What should the nurse instruct the client to do to achieve this goal?

Stop smoking.

A client has a throbbing headache when nitroglycerin is taken for angina. What should the nurse instruct the client to do?

Take acetaminophen or ibuprofen.

The nurse is preparing a teaching plan for a client who is being discharged after being admitted for chest pain. The client had one previous myocardial infarction 2 years ago and has been taking simvastatin 40 mg for the last 2 years. After the nurse reviews the lab results for the client's cholesterol levels (see chart), what should the nurse do?

Tell the client that the cholesterol levels are within normal limits.

A client who had a permanent pacemaker implanted 2 days earlier is being discharged from the hospital. What evidence will indicate to the nurse that the client understands the discharge plan?

The client verbalizes safety precautions needed to prevent pacemaker malfunction.

A nurse is caring for a client returning from cardiac catheterization. The nurse helps transfer the client back to bed. Which transfer technique uses appropriate ergonomic principles?

The nurse raises the bed for transfer, maintains a wide base of support during transfer, and lowers the bed before leaving the room.

A client hospitalized with a myocardial infarction (MI) who has a blood glucose level ranging from 12-28 mmol/L (216-504 mg/dL) asks the nurse why the readings are so high even though there are no added sweets on the diet tray. What is the best response by the nurse?

"The stress level in your body has increased with the MI, and more glucose is released during stressful times."

The nurse is caring for a client prescribed IV heparin for treatment of thromboembolism. The client is prescribed 18 units/kg/hr. The client weighs 145 lb (66 kg). The heparin comes from the pharmacy as 25,000 units in 250 mL of D5W. How many mL/hr should this client receive? Round to the nearest whole number.

12

The most common site of aneurysm formation is in the

abdominal aorta, just below the renal arteries.

A client has a blockage in the proximal portion of a coronary artery. After learning about treatment options, the client decides to undergo percutaneous transluminal coronary angioplasty (PTCA). During this procedure, the nurse expects to administer an

anticoagulant

Three days after surgery to insert a mechanical mitral valve, the client asks what can be done to muffle the clicking sound since it is embarrassing and others will know an artificial valve is in the heart. The nurse's response should reflect the understanding that the client may be experiencing which concern?

anxiety related to altered body image

Three days after mitral valve replacement surgery, the client tells the nurse there is a "clicking" noise coming from the chest incision. The nurse's response should reflect the understanding that the client may be experiencing:

anxiety related to altered body image.

The client has had a myocardial infarction. The nurse has instructed the client to prevent the Valsalva maneuver. Which behavior exhibited by the client indicates they are following the nurse's instructions?

avoids holding their breath during activity

A client is returning from the operating room after inguinal hernia repair. The nurse notes that the client has fluid volume excess from the operation and is at risk for left-sided heart failure. Which sign or symptom indicates left-sided heart failure?

bibasilar crackles

A client has received thrombolytic treatment for an ischemic stroke. The nurse should notify the health care provider (HCP) if there is a rapid increase in which vital sign?

blood pressure

A client comes to the clinic with back pain that has been unrelieved by continuous ibuprofen use over the past several days. Current prescription medications include captopril and hydrochlorothiazide. Which laboratory value should the nurse address?

blood urea nitrogen (BUN) of 26 mg/dL and serum creatinine of 2.35 mg/dL

When monitoring a client who is receiving tissue plasminogen activator (t-PA), the nurse should assess the client for which changes?

cardiac arrhythmias

The nurse is assessing an individual with peripheral artery disease. Which finding indicates complete arterial obstruction in the lower left leg?

coldness of the left foot and ankle

A client is prescribed furosemide to manage heart failure. What laboratory values should the nurse monitor while the client receives this medication? Select all that apply.

complete blood count serum potassium

The nurse is assessing a client with a known history of chronic heart failure. Which finding indicates poor perfusion to the tissues?

cool, pale extremities

A client with hypertrophic cardiomyopathy (HCM) is experiencing dyspnea, chest pain, syncope, fatigue, and palpitations and has an apical systolic thrill and heave, fourth heart sound (S4), and systolic murmur. Which nursing diagnosis should the nurse use to guide this client's care?

decreased cardiac output

The nurse is assessing a client admitted with a myocardial infarction with the following assessment: dyspnea, heart rate of 140 bpm, and crackles in the posterior chest. The nurse would interpret these findings as which condition?

development of congestive heart failure

A client with heart failure is taking furosemide, digoxin, and potassium chloride. The client has nausea, blurred vision, headache, and weakness. The nurse notes that the client is confused. The telemetry strip shows first-degree atrioventricular block. What other information should the nurse obtain next?

digoxin levels

A client returns from a left heart catheterization. The right groin was used for catheter access. To evaluate distal blood flow, the nurse should palpate the pulse on this client at which location?

dorsal surface of the right foot

The nurse is planning the care for a client with risk factors for atherosclerosis. What should the nurse include in the teaching plan for this client as modifiable risk factors? Select all that apply.

e-cigarette use hypertension stress

Which should be the nursing priority of care for a client exhibiting signs and symptoms of coronary artery disease?

enhance myocardial oxygenation

A fourth heart sound (S4) indicates a

failure of the ventricle to eject all blood during systole.

The nurse is assessing a client who has a history of peripheral artery disease. The nurse observes that the left great toe is black. The nurse determines that the black color is caused by which factor?

gangrene

A client has risk factors for coronary artery disease, including smoking cigarettes, eating a diet high in saturated fat, and leading a sedentary lifestyle. Which coaching strategies from the nurse will be most effective in assisting the client to improve their health?

helping the client establish a wellness vision to reduce the health risks

The client has been prescribed lisinopril to treat hypertension. The nurse should assess the client for which electrolyte imbalance?

hyperkalemia

A nurse knows that the major clinical use of dobutamine is to

increase cardiac output.

What mechanical device increases coronary perfusion and cardiac output and decreases myocardial workload and oxygen consumption in a client with cardiogenic shock?

intra-aortic balloon pump

Before surgery to repair an aortic aneurysm, the client's pulse pressure begins to widen, suggesting increased aortic valvular insufficiency. If the branches of the aortic arch are involved, the nurse should assess the client for which symptom?

loss of consciousness

The nurse teaches a client with heart failure to take oral furosemide in the morning. What is the expected outcome for taking this drug in the morning? The client will:

obtain more sleep.

The nurse should adjust a client's heparin dose according to a prescribed anticoagulation order based on maintaining which laboratory value at what therapeutic level for anticoagulant therapy?

partial thromboplastin time, 1.5 to 2.5 times the normal control

A client with peripheral vascular disease has undergone a right femoral-popliteal bypass graft. The blood pressure has decreased from 124/80 mm Hg to 88/62 mm Hg. What should the nurse assess first?

pedal pulses

A nurse in the telemetry unit is caring for a client with diagnosis of postoperative coronary artery bypass graft (CABG) surgery from 2 days ago. On assessment, the nurse notes a paradoxical pulse of 88. Which surgical complication would the nurse suspect?

pericardial tamponade

A client is discharged to a heart rehabilitation program. What lifestyle changes would be appropriate for the nurse to review?

reducing cholesterol levels, increasing activity levels progressively, and coping strategies

The nurse observes a client with an onset of heart failure having rapid, shallow breathing at a rate of 32 breaths/minute. What blood gas analysis does the nurse anticipate finding initially?

respiratory alkalosis

A client whose condition remains stable after a myocardial infarction is to gradually increase activity. Which sign best indicates that the activity is appropriate for the client?

respiratory rate

The nurse is assessing a client who has a long history of uncontrolled hypertension. The nurse should assess the client for damage in which area of the eye?

retina

A nurse is obtaining a history from a new client in the cardiovascular clinic. When investigating for childhood diseases and disorders associated with structural heart disease, which finding should the nurse consider significant?

rheumatic fever

A client who has obesity and diabetes and who has bilateral leg aching is to start cardiac rehabilitation with an exercise program. Using which exercise equipment will be most helpful to the client?

stationary bicycle

A client with a history of myocardial infarction is admitted with shortness of breath, anxiety, and slight confusion. Assessment findings include a regular heart rate of 120 beats/minute, audible third and fourth heart sounds, blood pressure of 84/64 mm Hg, bibasilar crackles on lung auscultation, and a urine output of 5 ml over the past hour. The nurse anticipates preparing the client for transfer to the intensive care unit and pulmonary artery catheter insertion because

the client is going into cardiogenic shock.

The nurse is monitoring a client admitted with a myocardial infarction (MI) who is at risk for cardiogenic shock. The nurse should report which change on the client's chart to the health care provider?

urine output

The client returns to the hospital 3 days after diagnosis of deep vein thrombosis, with reports of cough, hemoptysis, shortness of breath, and sharp pain under the right scapula. The client is subsequently is diagnosed with a pulmonary embolus (PE). The client asks the nurse, "How did I even get a pulmonary embolus?" What is the best response by the nurse? Select all that apply.

venous endothelial changes having any condition that produces venous stasis increased blood coagulability

A client with second-degree atrioventricular heart block is admitted to the coronary care unit. The nurse closely monitors the client's heart rate and rhythm. When interpreting the client's electrocardiogram (ECG) strip, the nurse knows that the QRS complex represents

ventricular depolarization.