Perfusion 1 EAQs
The spouse of a client who had coronary artery bypass graft (CABG) surgery asks why there is a dressing on the client's left leg. Which explanation would the nurse give?
"A vein in the left leg was used to bypass the coronary artery"
A registered nurse is teaching a nursing student about when a client with high blood pressure would follow up with the primary health care provider. Which statement made by the nursing student indicates effective learning?
"I will advise a client with a blood pressure of 130/80 mm Hg to follow up in a year"
Nitroglycerin sublingual tablets are prescribed for a client with the diagnosis of angina. The nurse advises the client to anticipate pain relief will begin within which period of time?
1 to 3 minutes
Which of these clients seen at a health fair will be most at risk for hypertension?
62-year-old African American man
When planning care for a client who has just returned to the nursing unit after placement of a coronary artery stent that was accomplished via access through the femoral artery, which complication is a priority for the nurse to prevent?
Hematoma formation
The nurse has administered sublingual nitroglycerin. Which outcome would the nurse use to determine the effectiveness of sublingual nitroglycerin?
Relief of anginal pain
When a client is admitted to the coronary care unit with a diagnosis of ST segment elevation myocardial infarction, how will the nurse expect to describe the pain?
Severe, intense chest pain
When a client is diagnosed with microvascular angina, which topics would the nurse include in client teaching? SATA
Taking daily dose of aspirin Smoking cessation Taking nitroglycerin
Which finding in a client who has been admitted with myocardial infarction is most important to communicate to the health care provider?
Urine output 15 mL/h
When teaching about prevention of coronary artery disease (CAD) for a 50-year-old man who is 6 feet (183cm) tall and weighs 293 pounds (133kg), smokes 1 pack a day of cigarettes, and has siblings with CAD, which topics are most important for the nurse to include? SATA
Weight Tobacco use
Which instructions about the use of nitroglycerin to prevent angina will the nurse provide to a client?
"Before physical activity, place one tablet under the tongue, and repeat the does in 5 minutes if pain occurs"
Which instruction is beneficial for an aging African-American client with hypertension?
"Have an annual urinalysis"
Which diagnostic test is most important to obtain rapidly when caring for a client who has just arrived in the emergency department with possible acute coronary syndrome?
12-lead electrocardiogram (ECG)
A 30-year-old client who is diagnosed with hyperlipidemia and hypertension asks the nurse to explain why treatment is important, stating "I feel fine, so I don't really see the need to make any changes." Which response would the nurse make?
"Both high blood pressure and high cholesterol contribute to development of heart disease"
Sublingual nitroglycerin is prescribed for a client with a history of a myocardial infarction and atrial tachycardia. The nurse instructs the client about the prophylactic use of these tablets. Which statement by the client indicates the teaching was effective?
"I should take one tablet before attempting activity that has caused angina"
Which finding in a client with a diagnosis of stable angina is most important for the nurse to communicate to the health care provider?
Angina episodes are occurring more frequently
Which nursing action is a priority of care provided to clients with chest pain?
Assessing airway-breathing-circulation (ABC)
A health care provider prescribes morphine for a client being treated for myocardial infarction. Which physiological response will occur if the client experiences the intended therapeutic effect of morphine?
Decreased workload of the heart
When a client comes to the emergency department with moderate substernal chest pain that is unrelieved by rest and nitroglycerin, which prescribed action has the highest priority?
Obtain a 12-lead electrocardiogram (ECG)
Which clinical finding would the nurse expect for a client with hypertensive emergency?
Severe pounding headache
After consistently obtaining a blood pressure of 140/76 mm Hg for a client, which stage of hypertension will the nurse document?
Stage 2
Which laboratory test is most important for the nurse to monitor when a client is admitted with acute coronary syndrome?
Troponin
After the nurse has completed discharge teaching for a client who has had a myocardial infarction, which client statement indicates that more teaching is needed?
"I will avoid physical activity"
After the nurse has finished teaching a 50-year-old female client about symptoms of coronary artery disease in women, which statement indicates that the teaching has been effective?
"I will call my health care provider about any unusual fatigue"
Which response by the nurse is best when a client who has had an ST segment elevation myocardial infarction (STEMI) asks about the resumption of sexual activity?
"Sexual activities can be safely resumed after an exercise stress test with no heart symptoms"
When a client who is scheduled to have coronary artery bypass graft surgery asks the nurse what benefit can be expected from the surgery, which response would the nurse make?
"This surgery significantly decreases symptoms in most clients"
When caring for a client who has just arrived in the emergency department with possible acute coronary syndrome, which prescribed action would the nurse take first?
Ask the client about the level of intensity of the chest pain
Which nursing action has the highest priority when caring for a client receiving nitroglycerin for the treatment of angina?
Asking the client to sit or stand slowly
A client is admitted to the emergency department with crushing chest pain. A diagnosis of acute coronary syndrome is suspected. Which medication is indicated to prevent progression to a myocardial infarction?
Aspirin
A client who is being treated for uncontrolled hypertension develops a nosebleed. After applying pressure to the nose, which action would the nurse take next?
Assess the client's blood pressure
Which clinical condition will result in changes in the integrity of the arterial walls and small blood vessels?
Atherosclerosis
A client is admitted to the hospital with a long history of uncontrolled hypertension. Which laboratory result will be most important for the nurse to review?
Blood urea nitrogen
Metoprolol is prescribed for a client with hypertension. The nurse monitors the client for which adverse effect?
Bradycardia
A client with known peripheral arterial disease calls the clinic and tells the nurse about experiencing several symptoms. Which symptom requires the most rapid action by the nurse?
Chest pain
A client with long-term cocaine use presents with extreme suspiciousness. Which additional clinical manifestations would the nurse monitor for? SATA
Chest pains Panic attacks Nasal damage
Which information about a client who is being discharged 3 days after having an ST segment elevation myocardial infarction (STEMI) and coronary artery stent placement indicates that a home health referral may be needed at discharge?
Client reports frequently forgetting to take medications
Which client in the emergency department would the nurse assess first?
Client with chest pressure and ST segment elevation on the electrocardiogram
Which client would be at an increased risk for coronary artery disease (CAD)? (cholesterol) SATA
Client with total cholesterol 250 mg/dL and LDL cholesterol 120 mg/dL
Which finding about a client's angina is most important for the nurse to communicate to the health care provider?
Continues after rest and nitroglycerin
A client is receiving metoprolol. Which potential side effect will the nurse teach the client to expect?
Dizziness with strenuous activity
A client with hypertension has received a prescription for metoprolol. Which information will the nurse include when teaching this client about metoprolol?
Do no abruptly discontinue the medication
When teaching a group of female clients about the clinical manifestations of coronary artery disease that are more common in women, which symptoms would the nurse include?
Dyspnea Indigestion Unusual fatigue
When an obese client receives a diagnosis of high blood pressure, which topic would be the most important to include in client teaching?
Effect of weight loss in hypertension
When planning discharge teaching for a client who had coronary artery bypass graft (CABG) surgery using a vein graft, which information will the nurse include?
Elevate the leg that provided the vein graft whenever you are sitting
When caring for a client who presents to the emergency department with an ST-segment-elevation myocardial infarction (STEMI), which laboratory result will the nurse expect?
Elevated serum troponin I and T
After a client has had a cardiac catheterization, which finding requires the most rapid action by the nurse?
Heart rate 114 beats/minute
The health care provider prescribes atenolol for a client with angina. Which potential side effect will the nurse mention when instructing the client about this medication?
Hypotension
While in the postanesthesia care unit, a client reports shortness of breath and chest pain. Which is the most appropriate initial response by the nurse? 1 Initiate oxygen via a nasal cannula 2 Administer the prescribed morphine 3 Prepare the client for endotracheal intubation 4 Place a nitroglycerin tablet under the client's tongue
Initiate oxygen therapy via a nasal cannula
Which information would the nurse include when explaining the purpose of a thallium scan to the client who has a history of chest pain?
It assesses myocardial ischemia and perfusion
When assessing a client's blood pressure, the nurse notes that the diastolic blood pressure reading in the right arm is 10 mm Hg higher than the blood pressure in the left arm. Which statement reflects the nurse's understanding of this occurrence?
It is a normal occurrence
Which dietary choices would the nurse teach for the client with peripheral artery disease? SATA
Limit salt intake Eat whole-grain breads Use liquid vegetable oils Avoid processed meats
When the nurse is caring for a client who is 90 minutes postcoronary stenting through the femoral artery, which assessment finding would prompt the nurse to activate the rapid response team?
Loss of pedal pulse on the affected limb
When teaching a group of clients about risk factors for heart disease, which topics will the nurse include? SATA
Obesity Hypertension
Which information obtained by the nurse about a client would represent risk factors for the client's admission diagnosis of hypertension? SATA
Occasional cocaine use African American heritage
A client with myocardial infarction is brought to the emergency department, and the primary health care provider recommends the placement of a stent. The client is incompetent to understand the situation. Which model would the nurse manager think would be beneficial in this situation?
Patient-benefit model
The nurse is caring for a client who is receiving aspirin therapy. Which clinical indicator would be related to this therapy?
Prolonged bleeding time
A client enters the emergency department reporting shortness of breath and epigastric distress. Which would be the triage nurse's first intervention?
Provide the client with oxygen
Which intervention would the nurse perform when caring for a client in the emergency department reporting chest pain? SATA
Providing oxygen Assessing vital signs Obtaining a 12-lead EKG Drawing blood for cardiac enzymes Auscultating heart sounds Administering nitroglycerin
When caring for a client who is hospitalized for an acute myocardial infarction, which prescription by the health care provider would the nurse question?
Rectal suppository as needed for constipation
After obtaining client blood pressures of 172/104 mm Hg and 164/98 mm Hg during a blood pressure screening, which action would the nurse take next?
Refer the client to a primary health care provider
A client in the coronary care unit develops "viselike" chest pain radiating to the neck. Assessment reveals a blood pressure of 124/64 mm Hg, an irregular apical pulse of 64 beats per minute, and diaphoresis. Cardiac monitoring is instituted, and morphine sulfate 4 mg intravenous (IV) push stat is prescribed. Which intervention is the priority nursing care for this client?
Relief of pain
Which pain characteristic would the nurse expect to observe when a client is experiencing anginal pain?
Relieved by sublingual nitroglycerin
When the nurse is obtaining a health history for a client scheduled for cardiac catheterization, which client information is most important to communicate to the health care provider?
Reports allergy to most shellfish
Which finding in a client seen in the emergency department with chest pain is most important to communicate to the health care provider?
ST segment elevation on electrocardiogram
Which finding for a client who has just returned to the nursing unit after an emergency cardiac catheterization would be most important to report to the primary health care provider?
ST-segment elevation on the electrocardiogram
Which information is most important to include when the nurse is teaching a client who has had an ST segment elevation myocardial infarction (STEMI) about the purpose of salt restriction?
Salt intake increases the work of the heart
Which clinical manifestations are more likely to occur in women with coronary artery disease compared with men? SATA
Severe fatigue Sense of unease Shortness of breath
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?
Sinus bradycardia, rate of 54 on monitor
Which information would the nurse include when teaching a client with coronary artery disease about aspirin therapy? SATA
Take aspirin with food Report ringing in the ears Monitor and report excessive bleeding and bruising Avoid over-the-counter pain medications that contain aspirin
When a client with angina is scheduled to have a cardiac catheterization, which explanation would the nurse give about the purpose of the procedure?
To visualize the disease process in the coronary arteries
Which laboratory value will be most important for the nurse to monitor to determine whether a client with chest pain has acute coronary syndrome (ACS)?
Troponin T (cTnT)
When discharging a client who has had insertion of a coronary artery stent, the nurse will instruct the client to seek immediate medical attention for which signs and symptoms? SATA
Unexplainable profuse diaphoresis Indigestion not relieved by antacids Acute chest pain after rigorous exercise Continued chest pain after nitroglycerin use
After the nurse teaches a group of women about coronary artery disease (CAD) and myocardial infarction (MI), which statement by the women indicates that the teaching has been effective?
Unusual fatigue is a common symptom of CAD in women
Which topics would the nurse include in teaching a client with a new diagnosis of hypertension? SATA
Use of a home blood pressure monitor Adverse effects of tobacco on blood pressure Benefits of moderate daily exercise
Which activities might cause chest pain in a client with stable angina? SATA
Walking outside on a cold day Sexual activity Smoking a cigarette Use of an oral decongestant