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Cardio
MedSurg Cardio
| Question | Answer |
|---|---|
| A nurse performs an apical-radial pulse evaluation, with the result of 100/88. Which value represents the pulse deficit? | 12 |
| Which of the following is increased in hypertension that in turn causes an increase in the work of the heart? | Afterload |
| Which heart sound should the nurse record as normal? | Ventricular gallop in a 20-year-old patient |
| A patient asks what a transesophageal echocardiogram (TEE) is and what it is expected to do? Which response by the nurse is accurate? | Evaluates the efficiency of the valves |
| A nurse records the finding of a normal sinus rhythm (NSR) when the P, Q, R, S, and T are all present in the electrocardiographic complex. Which additional information should the nurse document? | Rate of 82 seconds |
| Which positive outcome should the nurse anticipate that a patient taking Vasotec, an angiotensin-converting enzyme (ACE) inhibitor, should exhibit? | Decreased blood pressure |
| A 29-year-old patient is to receive cardioversion for a dysrhythmia. Which expectation should the nurse instruct the patient to anticipate? | Administration of a short-acting sedative |
| A 68-year-old patient is scheduled for open heart surgery in the morning and is crying. Which statement is the most appropriate response by the nurse? | “Tell me what concerns you the most.” |
| A nurse explains that cardiac rehabilitation lasts from the end of acute care to the return to home and beyond. Which service does this cardiac rehabilitation include? | Telemetry-monitored exercise |
| On auscultation, a nurse detects a heart murmur. Which physical information should the nurse know that a heart murmur indicates? | Valves that do not close correctly |
| A physician has ordered continuous pulse oximetry. Which information should the nurse explain to the patient about this procedure? | Measures the amount of oxygen in the blood |
| A stress test is scheduled for a 41-year-old patient. Which action should the nurse implement to prepare the patient for the examination? | Have the patient sign a consent form. |
| Which action should a nurse expect to implement when a patient returns from a cardiac catheterization? | Check the puncture site. |
| A nurse assesses an inverted T wave on the ECG of a patient who had an acute MI two days earlier. Which interpretation of this finding is correct? | Abnormal waveform |
| Laboratory tests are performed to identify damage to the heart muscle. Which test is elevated the earliest with heart damage? | Troponin |
| A patient is scheduled for a heart catheterization. Which action should the nurse implement in preparation for this examination? | Ask the patient about allergies to seafood or iodine. |
| A patient has had atropine sulfate that has been administered intravenously to treat a dysrhythmia. Which symptom should the nurse assess this patient for after administration? | Tachycardia |
| A dopamine infusion is being administered to a patient with shock. Which symptom should the nurse recognize can be caused by this medication? | Sharp spike in blood pressure |
| A patient with atrial fibrillation is prescribed amiodarone for the dysrhythmia. Which potential adverse reaction should the nurse report | Ataxia |
| A medication, simvastatin (Zocor), is administered to lower a patient’s cholesterol level. Follow-up lipid levels are reviewed by the nurse. Which level indicates the desired therapeutic range? | HDL, 42 mg/dL; LDL, 98 mg/dL |
| A diuretic medication, furosemide (Lasix), is being administered for congestive heart failure. Which assessment is not an anticipated consequence of the therapy? | Muscle weakness |
| A patient is receiving digoxin 0.25 mg/day. Which action should the nurse implement prior to administering this medication? | Hold the dose if the apical rate is 57 beats/min. |
| A 46-year-old patient is receiving propranolol (Inderal), a nonselective beta-adrenergic blocker, for a heart condition. Which patient teaching is most appropriate? | Never stop taking the drug abruptly. |
| Which assessment should be immediately addressed in a patient on lidocaine? | Increase in temperature to 102 F |
| A nurse records a “1” for the pulse quality of the pedal pulse. What interpretation is correct regarding the pulse? | Thready |
| A patient with an irregular sinoatrial (SA) node conduction has a permanent pacemaker with the code AAIOO and is now going home. The patient asks, “What happens when my real SA node fires on its own?” | Not fire |
| Which age-related change in older adults makes them susceptible to cardiovascular disease? | Stiff peripheral vessels |
| A nurse assesses a patient’s capillary refill time as less than 3 seconds. Which problem does this assessment indicate? | Tissue perfusion |
| A nurse performs Homans maneuver by flexing the knee and sharply dorsiflexing the foot. Which response indicates a positive Homans sign? | Pain in the calf area |
| Which technique should the nurse implement when performing the Allen test on a patient to evaluate the adequacy of circulation in the radial artery? | Observes whether the color is returning to the hand, which indicates perfusion |
| A nurse records that a patient has a 3+ edema to the right foot. Which measurement indicates how deep the nurse’s thumb depresses the edematous area? | To 1 inch |
| A nurse is caring for a patient who has had an angiogram. Which assessment should the nurse make a point of care to implement and document on this patient? | Peripheral pulses in the affected leg |
| A nurse is educating a patient regarding a stress test on a treadmill. Teaching includes that this test is a noninvasive procedure. Which additional information is appropriate for the nurse to include? | Is monitored continuously by blood pressure and an electrocardiogram |
| A patient inquires how something as simple as walking could help his venous vascular disorder. Which information provides the best response by the nurse when explaining the benefits of walking? | Boosts venous circulation through leg muscle activity |
| Which action is contraindicated for a patient performing Buerger-Allen exercises? | Lying on the stomach |
| A nurse is performing an intake examination on a patient with peripheral vascular disease (PVD). Which lifestyle information identified by the patient aggravates vascular disease? | Being employed as an air traffic controller |
| Vascular disease disorders often require the use of elastic stockings. Which action should the nurse implement when caring for a patient with elastic stockings? | Remove the stockings for skin inspection two times a day. |
| Which instruction is most appropriate for a patient with arterial insufficiency? | Frequently allow the legs to dangle dependently. |
| A nurse is preparing to administer low-molecular-weight heparin (LMWH). Which major advantage is related to the administration of LMWH ? | It is provided fixed doses. |
| Which statement made by a patient indicates to the nurse that a teaching plan for the use of warfarin was not effective? | “I’m drinking too much tea. My urine looks like tea.” |
| Which medication obtained in a patient’s history will lessen the effects of warfarin (Coumadin)? | Yaz (drospirenone/estradiol) as an oral contraceptive |
| A nurse uses a picture to demonstrate the conduction pathway through the chambers of the heart. Which of the following is the correct sequence of events? | The SA node fires, the atria contract, the AV node fires, conduction occurs through the bundle branches, the Purkinje fibers conduct, and then the ventricles contract. |
| Which factors affect stroke volume? (Select all that apply.) | Contractility Preload Afterload |
| Which age-related changes in the heart should a nurse take into consideration? (Select all that apply.) | Decrease in contractility Thickened valves Stiffened valves Decreased SA node cells |
| Which information explains why older persons adapt more slowly to changes in the peripheral vascular system? (Select all that apply.) | Slowing heart rate Decreasing cardiac output Stiffening of blood vessels Thickening of aorta |
| A nurse suspects a circulatory disorder in one leg. Which assessments should the nurse include when comparing both legs? (Select all that apply.) | Color Warmth Pulse quality Hair loss on extremity |
| A patient inquires if his blood pressure is normal. Which is the nurse’s most accurate response regarding the definition of normal blood pressure? | Less than 120/80 mm Hg |
| Which statement is true regarding hypertension in older adults? | It improves with treatment. |
| A patient is being evaluated every week for possible hypertension and is classified as prehypertensive. Which assessment would support this conclusion? | Blood pressure reading over 120/80 mm Hg for two consecutive visits |
| A patient with hypertension reports the symptom of headache. Which information correctly explains how headaches related to hypertension characteristically occur? | Occipital on arising |
| Which intervention does treatment for essential hypertension focus on? | Reduction of modifiable risks |
| Which focus of treatment for secondary hypertension is correct? | Specific etiologic disease |
| Which value do blood pressure readings need to exceed for a patient to be diagnosed with hypertension? | 140/90 mm Hg |
| A patient is taking hydrochlorothiazide (HydroDIURIL) for hypertension. When providing dietary teaching what should the nurse Which food item should the patient be encouraged to to increase the intake of? | Bananas |
| An obese 38-year-old African-American patient with diabetes is being evaluated for the use of propranolol (Inderal) in controlling hypertension. Which contraindication exists for the use of propranolol (Inderal) in this patient? | Diabetes |
| An 89-year-old patient is taking an antihypertensive medication. Which information should the nurse include when providing home care teaching? | Get up out of bed slowly. |
| Which physical assessment should a nurse instruct a patient who has been started on verapamil (Calan) for elevated blood pressure to monitor? | Pulse |
| A patient is prescribed an angiotensin-converting enzyme (ACE) inhibitor, enalapril (Vasotec). Which instruction is appropriate for the nurse to provide? | Return for follow-up visits. |
| An 87-year-old patient is taking furosemide (Lasix) for elevated blood pressure. Which complication should the nurse know that older patients are at risk for? | Hypokalemia |
| A nurse is providing patient education regarding a low-sodium diet. Which food item, in addition to the use of spices, should the nurse recommend to help decrease sodium in the diet? | Garlic |
| Which lifestyle change has the greatest effect on reducing hypertension? | Weight reduction |
| A nurse is educating a group of patients regarding Dietary Approaches to Stop Hypertension (DASH) diet. Which recommendation should the nurse include as a source of protein and fat? | Whole grains |
| Which antihypertensive medication is contraindicated in patients who have chronic obstructive pulmonary disease (COPD) and asthma? | Propranolol (Inderal): beta-adrenergic receptor blocker |
| A nurse is caring for a patient who is taking antihypertensive therapy. The patient reports fatigue and has a pulse of 54 beats/min. Which medication administered is most likely the cause of these symptoms? | Diltiazem (Cardizem) |
| Which information should a nurse include when developing a teaching plan for a patient with hypertension? | Encourage relaxation techniques. |
| A patient reports drowsiness after initiating atenolol (Tenormin) for the treatment of hypertension. Which response by the nurse is best when educating this patient about atenolol (Tenormin)? | Take the medication at bedtime. |
| A patient taking methyldopa (Aldomet) for hypertension reports to the emergency department with a severe headache, blurred vision, and a blood pressure reading of 200/94 mm Hg. Which complication should the nurse suspect is happening to this patient? | Abrupt cessation of medication |
| Which patient is at the highest risk for malignant hypertension? | Young African-American adults |
| A patient with hypertension comes to the emergency department and is experiencing nausea and vomiting and is restless and confused. Vital signs are assessed at blood pressure, 220/130 mm Hg; pulse, 120 beats/min; and respirations, 32 breaths/min. | Hypertension crisis from the cessation of a drug |
| Which action should be the nursing priority when caring for a patient with a hypertensive crisis? | Monitoring for seizure activity |
| Which advantages apply to hydrochlorothiazide (HydroDIURIL)? (Select all that apply.) | Is effective for African Americans Consistently controls blood pressure |
| A nurse is providing care to a patient diagnosed with essential hypertension. Which information should the nurse know is included in a first-line therapeutic approach to lowering this patient’s blood pressure? (Select all that apply.) | Smoking cessation Exercise programs Weight loss Decreased sodium intake |
| Which conditions are considered potential causes of secondary hypertension? (Select all that apply.) | Renal disease Coarctation of the aorta Increased intracranial pressure (ICP) |
| A 49-year-old patient has multiple risk factors for coronary artery disease. Which risk factor is considered modifiable? | Smoking |
| Which purpose do fibrous plaques of atherosclerosis serve when they are laid down in the vessels? | Trap to which other substances adhere |
| A patient with angina pectoris complains of chest pain at rest and needs to take three nitroglycerin (NTG) pills to relieve the pain. Of which diagnosis is this assessment a major symptom? | Unstable angina |
| Which teaching point is important for a patient with mitral stenosis? | Balance activity with oxygen supply. |
| Which information should a nurse include in a patient’s discharge instructions after an acute myocardial infarction (MI)? | Written instructions on diet and follow-up appointments |
| A patient with acute congestive heart failure has jugular vein distention, crackles bilaterally, and dyspnea. Which nursing diagnosis should have the highest priority? | Fluid volume excess |
| Which actions should a nurse implement to decrease the workload of the heart in a patient with acute congestive failure? (Select all that apply.) | Eliminate unnecessary activities. Help the patient change positions every 2 hours. Give a partial bed bath rather than full bed bath. |
| A nurse urges a 50-year-old overweight executive who had a myocardial infarction (MI) 3 months earlier to take up some conditioning exercises for 30 minutes a day. Which rationale supports this suggestion? (Select all that apply.) | Lose weight. Improve function of the left ventricle. Decrease arterial stiffening. Decrease cholesterol levels. |
| Which information should a nurse ask a patient related to past history of deep-vein thrombosis (DVT) and other vascular problems? | Recurring chest pain |
| A 69-year-old patient reports a burning, aching pain in the legs when walking to the mailbox. These symptoms are relieved with rest. Which diagnosis should the nurse suspect? | Claudication |
| A nurse records the assessment of stasis dermatitis on an intake assessment for a patient with peripheral vascular disease (PVD). Which description is the best way to document this finding? | Brownish skin discoloration on the lower legs |
| A nurse notes ulcerations on the surfaces of a patient’s toes. Which diagnosis should this assessment most likely indicate? | Arterial stasis |
| Which characteristic is indicative of a venous stasis ulcer? | Painlessness |
| A patient has returned from a vein ligation and stripping. Which instructions are appropriate for a nurse to provide? | Wear compression stockings to promote circulation. |
| An obese postsurgical patient complains of sudden discomfort in their leg. The nurse assesses the leg and finds it cold and pale with no pedal or popliteal pulse. Which diagnosis should the nurse suspect? | Arterial occlusion |
| Which postoperative sign should a nurse report immediately when caring for a patient with an endarterectomy with a synthetic graft? | Fever |
| A patient with Raynaud disease has poor tissue perfusion and is being given discharge instructions. Which instruction should the nurse include when providing this information? | Wear gloves and warm socks when outdoors. |
| Which assessment should a nurse perform on a patient after the repair of an abdominal aortic aneurysm? | Bowel sounds |
| Which patient teaching should be included for a patient with varicose veins? | Weight reduction |
| The nurse is caring for a patient diagnosed with arterial embolism. Which patient teaching information will the nurse anticipate providing to the patient? (Select all that apply.) | Protect affected limbs from pressure. Gradually increase activity as tolerated. Report any pain or numbness to health care provider. |
Created by:
DrFeelgood
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