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Cardiotest
| Question | Answer |
|---|---|
| Normal heart sounds | S1 then S2 |
| The S1 heart sound corresponds to | Closure of the AV valves |
| Adult heart rate | 60-90 beats per min |
| tachycardia | more than 100 beats per min |
| bradycardia | less than 60 beats per min |
| S1 is heard the loudest | Left midclavicular line at the fifth intercostal space |
| At what location will S2 be heard the loudest? | Right sternal border at the second intercostal space |
| In the client with hypovolemic shock, the nurse realizes that the heart sounds will change | Diminished S2 and accentuated S1 |
| The presence of an additional sound immediately following S2 is called ________, which can result from ________. | S3, ventricular volume overload |
| left atrium thrombus due to a dysrhythmia (altered heart rhythm). Which of the following common cardiac tests will be ordered to assess for thrombus? | Transesophageal echocardiography (TEE) |
| Pericardiocentesis would be utilized in which of the following client situations? | Cardiac tamponade |
| An older adult is being evaluated for age-related cardiac changes which include? | Increased blood pressure and Decreased cardiac output |
| asking the client if they have had tests to check the function of their heart? | Health perception-health management |
| An important nutritional-metabolic interview question to ask clients who are being evaluated for heart conditions is: | "Have you had a recent weight gain or loss?" |
| A common lab test related to heart assessment is a lipid profile | A normal triglyceride level is 40-190 mg/dl |
| which of the following may require closer evaluation for CHD? | Positive family history, Hyperlipidemia, Diabetes |
| A nurse is conducting teaching about risk factor management for cardiovascular heart disease at a senior center. | Stop smoking |
| The client asks the nurse about metabolic syndrome. | "This syndrome is caused by obesity, physical inactivity, and genetic factors." |
| Drugs used to treat hyperlipidemia | Include lovastatin (Mevacor), which acts by lowering LDL levels. |
| A client on the Pritikin Diet should | Eat foods high in complex carbohydrates and fiber, low in cholesterol, and low in fat and walk 45 minutes daily and vitamin supplements including vitamins C, E, and folate. |
| A client who is taking atorvastatin (Lipitor) should be monitored for: | Serum cholesterol and liver enzymes. |
| Appropriate nursing care for chest pain includes: | Aspirin 325 mg a day per physician order. |
| A 52-year-old obese male client who is admitted with elevated triglycerides and a history of smoking two packs of cigarettes a day for 20 years | Is at risk for coronary artery disease. |
| Chest pain that began four hours ago. Which of the following tests will be most specific in identifying acute heart damage? | Troponin |
| When a client's ECG shows frequent premature ventricular contractions (PVCs), the nurse expects that the physician will create an order for | Oxygen, Antidysrhythmic agents and Beta-blockers |
| The nurse realizes that the client in the critical care unit with ventricular tachycardia will require which of the following | Immediate assessment and probable emergency intervention by the nurse, Cardioversion, if sustained and symptomatic. |
| The priority of care for a client with a junctional escape rhythm is: | Assess the client for symptoms associated with the rhythm. |
| Sinus bradycardia (rate 56) is identified in a sleeping client on telemetry. The nurse realizes that the priority is to | Awaken the client and see how the heart rate responds. |
| A client is in sinus tachycardia. The nurse realizes that the needed interventions are to: | Administer two tablets of acetaminophen (Tylenol) if an elevated temperature is present.Observe the client for effects on cardiac function. Administer normal saline 0.9% IV at the ordered rate of 200 ml per hour if hypovolemia is suspected as the cause. |
| The nurse notes an ECG rhythm with a rate of 80, a regular rhythm, a 1:1 relationship of P:QRS, a PR interval of 0.16, and a QRS complex measurement of 0.8. The nurse realizes that this rhythm is evidence of: | Normal sinus rhythm. |
| The client has a pacemaker that creates a pacer spike before each QRS on the ECG when the intrinsic heart rate falls below 70. The nurse realizes that this is: | Normal, because the demand pacemaker is responding to the heart rate drop at the preset level |
| the client has a pacemaker with one pacing spike seen on the ECG before every QRS complex. There is no change in the pacemaker rhythm over time, with rest or with activity. The nurse realizes that this means that the type of pacemaker is: | Asynchronous pacing. |
| chronic heart failure | crackles |
| When caring for a chronic heart failure client with left-sided failure, the nurse would most likely hear which of the following statements from the physician after a cardiac catheterization | "Pressures in the left ventricle and atrium are increased." |
| Two signs that are indicative of heart failure are: | S3 and distended neck veins |
| When obtaining the health history of a client who is being assessed for possible congestive heart failure, it is significant when the client says: | "I have to prop myself up on three pillows to sleep at night. I cannot breathe otherwise". |
| A client is admitted with acute heart failure. The nurse realizes that acute heart failure is associated with an abrupt onset of: | Myocardial infarction (MI). |
| Blood tests are ordered for a client who is diagnosed with possible congestive heart failure (CHF). The most specific test to most accurately indicate CHF is: | Atrial natriuretic factor (ANF) |
| The nurse is caring for a client who now has invasive hemodynamic monitoring. The highest priority of care for this client is | Set alarm limits and turn monitor alarms on. |
| The client in critical care has an invasive hemodynamic pressure monitoring line. The appropriate landmark to use when calibrating and leveling hemodynamic monitoring equipment is | The right atrial position at the fourth intercostal space, midaxillary line. |
| When caring for a chronic heart failure client with left-sided failure, the nurse would most likely hear which of the following statements from the physician after a cardiac catheterization? | "Pressures in the left ventricle and atrium are increased." |
| A client is admitted with acute heart failure. The nurse realizes that acute heart failure is associated with an abrupt onset of: | MI |
| Blood tests are ordered for a client who is diagnosed with possible congestive heart failure (CHF). The most specific test to most accurately indicate CHF is: | Atrial natriuretic factor (ANF). |
| The client in critical care has an invasive hemodynamic pressure monitoring line. The appropriate landmark to use when calibrating and leveling hemodynamic monitoring equipment is: | The right atrial position at the fourth intercostal space, midaxillary line |
| The nurse is caring for an ICU client whose fluid volume status needs to be closely watched. The most likely type of monitoring that will be used is: | Central venous pressure monitoring |
| A pulmonary artery (PA) catheter is used in critical care clients who: | Require evaluation of left ventricular pressures through pulmonary artery wedge pressure readings. |
| The nurse is teaching a client who has started taking digoxin (Lanoxin) for left-sided heart failure. The highest priority information to teach is: | Check the pulse each day before taking the medication and do not take the medication if the pulse is under 60 beats per minute without talking to the physician. |
| Typical medications taken by heart failure clients include | Enalapril (Vasotec). Furosemide (Lasix). Digoxin (Lanoxin). |
| The nurse recognizes which of the following as a sign of decreased cardiac output and tissue perfusion in a client with heart failure? | Decreased mental alertness. |
| The nurse is assessing a client who arrives at the hospital with dyspnea, orthopnea, cyanosis, clammy skin, a productive cough with pink, frothy sputum, and crackles. | Pulmonary edema |
| The most important first action the nurse should initiate on a client who arrives to the hospital in pulmonary edema is: | Administer oxygen and attach a pulse oximeter. |
| Which of the following is important to keep in mind when caring for clients with possible endocarditis? | Endocarditis can be prevented in clients at risk by administering antibiotics prior to procedures. |
| Clinical signs and symptoms of pericarditis include | Pericardial friction rub. Chest pain. |
| Cardiac tamponade is treated with | Pericardiocentesis |
| What is the initial indication of valve disease | A murmur is heard during physical exam |
| A client is diagnosed with a disorder in which deoxygenated blood is having difficulty returning to the heart and lungs for reoxygenation. In which part of the peripheral vascular system is the origin of this client's disorder? | Venules |
| A client with some blood loss is maintaining a blood pressure of 100/60 mm Hg. The nurse interprets this to mean that the client's blood pressure is being maintained through the help of | Arterioles |
| A client is diagnosed with an alteration in peripheral vascular resistance. The nurse realizes that this resistance is determined by | Vessel diameter. Blood viscosity. Vessel length |
| A client's blood pressure is 128/98 mm Hg. The nurse interprets this to mean that the diastolic blood pressure reading represents: | Pressure at the peak of ventricular relaxation |
| A client is demonstrating a sign of blood pressure stabilization accompanied by a decreased urine output. The nurse explains that the body mechanism responsible for this blood pressure stabilization is | Renal conservation of sodium and water. |
| A client is being started on enalapril (Vasotec). The most common complaint from clients who routinely take this medication is | Persistent cough |
| A client is undergoing diagnostic testing to determine the cause of hypertension. Which of the following would be included if a secondary cause for this disorder is suspected? | Intravenous pyelogram |
| The nurse suspects that a client is experiencing the effects of peripheral atherosclerosis. Which of the following did the nurse most likely assess in this client | Complaints of leg pain upon rest |
| A client is having segmental pressure measurements conducted to help diagnose peripheral vascular disease. Which of the following would indicate the presence of this disorder? | Calf pressure lower than the arm |
| A client is demonstrating signs of ineffective peripheral tissue perfusion. Which of the following interventions would be appropriate for this client? | Discuss smoking cessation techniques |
| A male client is diagnosed with thromboangiitis obliterans. Appropriate teaching for this client includes: | Management depends upon the client's willingness to stop smoking. |
| A client is demonstrating signs of thrombophlebitis. With this disorder, the nurse realizes that three mechanisms occur, which include | Sluggish blood flow. Blood hypercoagulation. Vessel damage. |
| A client is seen for increasing edema in his left lower extremity and pain in the limb with ambulation. Which of the following disorders do these symptoms suggest? | Deep vein thrombosis |
| A client who is being treated for a deep vein thrombosis (DVT) complains of chest pain and shortness of breath. Which of the following should the nurse do first? | Elevate the head of the bed and begin oxygen therapy |
Created by:
kostwhit