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B.
C.
- A nurse is establishing health promotion goals for a female client who smokes cigarettes, has hypertension, and has a BMI of 26. Which of the following goals should the nurse include?
A. The client will list foods that are high in calcium, which should be avoided. The
client will walk for 30 min 5 days a week.
C. The client will increase calorie intake by 200 cal per day. D. The client will replace cigarettes with smokeless tobacco products.
- A client who has a history of myocardial infarction (MI) is prescribed aspirin 325 mg. The nurse recognizes that the aspirin is given due to which of the following actions of the medication?
A. analgesic
B. anti-inflammatory
antiplatelet aggregate
D. antipyretic
- A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?
A. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level."
B. "A pharmacist is the person to answer that question."
"Heparin does not dissolve clots. It stops new clots from forming."
D. "The oral medication you will take after this IV will dissolve the clot."
- A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication?
A. Hyperthermia
Hypotension
C. Ototoxicity D. Muscle pain
C.
B.
- A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication?
Decreased blood pressure
B. Increase of HDL cholesterol C. Prevention of bipolar manic episodes D. Improved sexual function
- A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve. Which of the following laboratory values should the nurse monitor for a therapeutic effect of warfarin? A. Hemoglobin (Hgb) B. Prothrombin time (PT) C. Bleeding time D. Activated partial thromboplastin time (aPTT)
- While performing an admission assessment for a client, the nurse notes that the client has varicose veins with ulcerations and lower extremity edema with a report of a feeling of heaviness. Which of the following nursing diagnoses should the nurse identify as being the priority in the client's care?
Impaired tissue perfusion
B. Alteration in body image
C. Alteration in activity tolerance
D. Impaired skin integrity
- A nurse is teaching the partner of a client who had an acute m yocardial infarction (MI) about the reason blood was drawn from the client. Which of the following statements should the nurse make regarding cardiac enzymes studies?
"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.
A.
A.
D.
D. Differences in upper and lower lung sounds.
- AA nurse is preparing a community health program for adults at risk for cardiovascular disease. Which of the following should the nurse include as a modifiable risk factor? A. Diagnosis of diabetes mellitus B. Family history of cardiac disease C. Increasing age
Cigarette smoking
- AA nurse is reviewing the laboratory results for a client who has a history of atherosclerosis and notes elevated cholesterol levels. Which of the following statements by the client indicates the nurse should plan follow-up teaching on a low-cholesterol diet? A. “I flavor my meat with lemon juice.”
“I eat two eggs for breakfast each morning.”
C. “I cook my food with canola oil.” D. “I take an omega-3 supplement daily.”
- AA nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates
a need for further teaching?
"I have started taking ginger root to treat my joint stiffness."
B. "I take this medication at the same time each day."
C. "I eat a green salad every night with dinner."
D. "I had my INR checked three weeks ago."
- AA 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?
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.
B.
A.
A.
B.
D.
B.
C.
D. The QRS duration is 0.20 seconds.
- AA 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
MRI of the chest
C. Physical therapy D. Low-sodium diet
- AA nurse is providing teaching to a client about interventions to reduce the risk of developing cardiovascular disease. Which of the following statements by the client should indicate to the nurse the need for further teaching? A. "A weight loss program can decrease my LDL cholesterol level." B. "Exercising regularly will increase HDL cholesterol levels." C. "Adding foods containing omega-3 fatty acids to my diet can lower my risk."
"Increasing my intake of foods containing trans-fatty acids can lower my risk."
- AA nurse is giving a presentation to a community group about preventing atherosclerosis. Which of the following should the nurse include as a modifiable risk factor for this disorder? (Select all that apply.) A. Genetic predisposition
Hypercholesterolemia
Hypertension
D. Obesity
Smoking
- While auscultating a client's heart sounds, the nurse hears turbulence between the S1 and S2 heart sounds. The nurse should document this finding as which of the following?
A systolic murmur
B. A third heart sound (S3)
C. An expected heart sound
E.
A.
C.
Do not use salt substitutes while taking this medication.
Take the medication with food.
Count your pulse rate before taking the medication.
Expect to gain weight while taking this medication.
AA nurse on a telemetry unit is caring for a client who has unstable angina and is reporting chest pain with a severity of 6 on a 0 to 10 scale. The nurse administers 1 sublingual nitroglycerin tablet. After 5 min, the client states that his chest pain is now a severity of 2. Which of the following actions should the nurse take?
Administer another nitroglycerin tablet.
Initiate a peripheral IV.
Call the Rapid Response Team.
D. "A headache is likely due to the anxiety about the chest pain."
- AA nurse is teaching a client who has angina pectoris about starting therapy with SL nitroglycerin tablets. The nurse should include which of the following instructions regarding how to take the medication? A. "Take this medication after each meal and at bedtime." B. "Take one tablet every 15 min during an acute attack."
"Take one tablet at the first indication of chest pain."
D. "Take this medication with 8 ounces of water."
- AA nurse is caring for a client who has a cardiopulmonary arrest. The nurse anticipates the emergency response team will administer which of the following medications if the client’s restored rhythm is symptomatic bradycardia? A. Epinephrine B. Magnesium
Atropine
D. Sodium bicarbonate
- A nurse is providing teaching to a client who has hypertension and a new prescription for captopril. Which of the following instructions should the nurse provide?
C.
C.
D.
C.
D. Obtain an ECG.
29.AA nurse is providing teaching to a client who has angina pectoris and a new prescription for nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching? A. "I'll dial 911 if I still have pain after taking 3 nitroglycerin tablets 5 minutes apart." B. "I'll dial 911 if I still have pain after taking 4 nitroglycerin tablets over a 20-minute period." "I'll
dial 911 when I have pain and then take the nitroglycerin tablets."
"I'll dial 911 if 1 nitroglycerin tablet does not relieve my pain, and then take up to 2 more tablets 5 minutes apart while waiting."
30.AA nurse is admitting a client who has acute heart failure following myocardial infarction (MI). The nurse recognizes that which of the following prescriptions by the provider requires clarification? A. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain B. Laboratory testing of serum potassium upon admission
0.9% normal saline IV at 50 mL/hr continuous
D. Bumetanide 1 mg IV bolus every 12 hr
31.AA nurse is caring for a client who came to the emergency department reporting chest pain. The provider suspects a myocardial infarction. While waiting for the troponin levels report, the client asks what this blood test will show. Which of the following explanations should the nurse provide the client? A. Troponin is an enzyme that indicates damage to brain, heart, and skeletal muscle tissues. B. Troponin is a lipid whose levels reflect the risk for coronary artery disease.
Troponin is a heart muscle protein that appears in the bloodstream when there is damage to the heart.
D. Troponin is a protein that helps transport oxygen throughout the body.
- 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 in the left arm B. Brachial pulse in the right arm
Radial pulse in the left arm
C.
C.
of the catheter insertion. Which of the following complications should the nurse suspect?
Catheter occlusion
Catheter rupture
Catheter dislodgment
Catheter migration
AA nurse in the emergency department is caring for a client who reports chest pressure and shortness of breath.
Which of the following laboratory tests should the nurse anticipate the provider to prescribe?
Troponin I
Lipase
B-type natriuretic peptide (BNP)
Aspartate aminotransferase (AST)
C.
- A nurse is caring for a client who has a central venous catheter and reports hearing a gurgling sound on the side
39.AA 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 repolarization of ventricular Purkinje fibers
Atrial depolarization
D. Early ventricular repolarization
B.
40.AA 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
QT interval
C. ST segment D. QRS complex
C.
D.
B.
B.
45.AA nurse is caring for a client who reports a new onset of severe chest pain. Which of the following actions should the nurse take to determine if the client is experiencing a myocardial infarction? A. Check the client's blood pressure. B. Auscultate heart tones.
Perform a 12-lead ECG
Determine if pain radiates to the left arm.
46.AA nurse in the emergency department is caring for a client who is experiencing manifestations of a myocardial infarction (MI). Which of the following laboratory tests should the nurse expect the provider to prescribe?
Troponin
B. Creatinine kinase (CK)
C. Brain natriuretic peptide (BNP)
D. C-reactive protein
47.AA nurse in a cardiac care unit is caring for a client with acute right-sided heart failure. Which of the following findings should the nurse expect? A. Decreased brain natriuretic peptide (BNP).
Elevated central venous pressure (CVP).
C. Increased pulmonary artery wedge pressure (PAWP). D. Decreased specific gravity
48.AA nurse enters a client’s room and finds him unresponsive. After notifying the rapid response team, which of the following actions should the nurse take first? A. Attach defibrillator pads to the client.
Check for a carotid pulse.
C. Begin chest compressions. D. Deliver two breaths.
A.
C.
D.
49.AA nurse enters an adult client’s room and finds him unresponsive. After determining that the client is not breathing and does not have a pulse, which of the following actions should the nurse take first?
Summon the code team.
B. Begin chest compressions.
C. Administer rescue breathing.
D. Open the client’s airway.
50.AA nurse is teaching an older adult client who is postoperative following insertion of a permanent pacemaker. The nurse should instruct the client to notify the provider about which of the following manifestations? A. Increased urine output B. Rapid pulse
Fatigue
D. Sneezing
51.AA nurse is evaluating the central venous pressure (CVP) of a client who has sustained multiple traumas. Whichof the following interpretations of a low CVP pressure should the nurse make? A. Fluid overload B. Left ventricular failure C. Intracardiac shunt
Hypovolemia
52.AA nurse is caring for an older adult client who has left-sided heart failure. Which of the following assessment findings should the nurse expect? A. Frothy sputum B. Dependent edema C. Nocturnal polyuria D. Jugular distention
53.A A client tells the nurse that he is concerned because his provider told him he has a heart murmur. The nurse
A.
57.AA nurse in the ICU is caring for a client who has heart failure and is receiving a dobutamine drip. The nurse should identify that which of the following findings indicates that the medication is effective? A. Increased heart rate B. Increased urine output C. Decreased blood pressure D. Decreased blood glucose level
58.AA nurse in an emergency department is planning care for a client who is having an acute myocardial infarction (MI). The nurse should plan to administer which of the following medications after the initial acute phase to manage the client's pain and anxiety? A. Nitroglycerin B. Aspirin C. Oxygen D. Morphine
59.AA nurse in an urgent care center is assessing a client who reports a sudden onset of irregular palpitations, fatigue, and dizziness. The nurse finds a rapid and irregular heart rate with a significant pulse deficit. Which of the following dysrhythmias should the nurse expect to find on the ECG? A. First-degree AV block B. Atrial fibrillation C. Sinus bradycardia D. Sinus tachycardia
60.AA nurse is providing teaching for a client who has a new diagnosis of angina pectoris. The nurse should give the client which of the following information about anginal pain? A. The pain usually lasts longer than 20 min. B. The pain often radiates to the jaw or the back. C. The pain persists with rest and organic nitrates. D. Exertion and anxiety can trigger the pain.
61.AA nurse in an emergency department is caring for a client who reports substernal chest pain and dyspnea. The client is vomiting and is diaphoretic. Which of the following laboratory tests are used to diagnose a myocardial infarction? (Select all that apply.)
Troponin I
Troponin T
C. Plasma low-density lipoproteins (LDL)
D. CPK
E. Myoglobin
62.AA nurse is assessing for paradoxical blood pressure on a client who has constrictive pericarditis. Which of the following findings should the nurse expect? A. Apical pulse rate is different than the radial pulse rate B. Decrease in systolic pressure by more than 10 mm Hg during inspiration C. Increase in heart rate by 20% when moving from sitting to standing D. Drop in systolic BP by 20 mm Hg when changing positions
63.AA nurse is reinforcing teaching with a client regarding reduction of risk factors for coronary artery disease. Whichof 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."
64.AA nurse is assessing a client who has hypercholesterolemia and is receiving simvastatin. Which of the following findings should the nurse recognize as a potential adverse effect? A. Urinary retention B. Muscle weakness C. Orthostatic hypotension D. Blurred vision
A.
B.
B.
69.AA nurse is caring for a client who reports heart palpitations. An ECG confirms the client is experiencing ventricular tachycardia (VT). The nurse should anticipate the need for taking which of the following actions? A. Defibrillation
Elective cardioversion
C. CPR D. Radiofrequency catheter ablation
70.AA nurse is planning care for a client following a cardiac catheterization accessed through his femoral artery. Which of the following actions should the nurse plan to take? A. Instruct the client to perform range-of-motion exercises to his lower extremities.
Perform neurovascular checks with vital signs.
C. Ambulate the client 1 hr following the procedure. D. Restrict the client's fluid intake.
71.AA nurse is providing discharge instructions to a client following a cardiac catheterization. Which of the following information should the nurse include? A. "You can resume regular exercise as soon as tomorrow." B. "The dressing should be changed within 12 hours of the procedure." C. "You will notice a small hematoma at the incision site." D. "Pain medication will not be necessary."
72.AA nurse has received change-of-shift report on a group of clients and is preparing her assignment. Which of the following clients should the nurse assess first? A. A client who had a blood glucose reading at 0650 of 70 mg/dL after receiving 50% dextrose for a hypoglycemic episode B. A client who was admitted for chest pain and is reporting a new onset of indigestion C. A client who has pneumonia and was treated for a temperature of 38.9° C (102° F) at 0400 D. A client who has pulled out the peripheral IV catheter and is scheduled to receive a dose of famotidine at 0800
B.
73.AA nurse is preparing a client for transfer to the ICU for placement of a pulmonary artery catheter. The nurse should explain to the client that this catheter is used to monitor which of the following conditions? A. Intracranial pressure B. Spinal cord perfusion C. Renal function
Hemodynamic status D.
