A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is scheduled for cardiac catheterization. Which medication woul... [Show More] d need to be withheld for 24 hours before the procedure and for 48 hours after the procedure?
1. Glipizide
2. Metformin
3. Repaglinide
4. Regular insulin
2. A client who had cardiac surgery 24 hours ago has had a urine output averaging 20 mL/hour for 2 hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for the subsequent hour was 25 mL. Daily laboratory results indicate that the blood urea nitrogen level is 45 mg/dL (16 mmol/L) and the serum creatinine level is 2.2 mg/dL (194 mcmol/L). On the basis of these findings, the nurse would anticipate that the client is at risk for which problem?
1. Hypovolemia
2. Acute kidney injury
3. Glomerulonephritis
4. Urinary tract infection
3. The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 seconds, and QRS complexes measure 0.06 seconds. The overall heart rate is 64 beats/minute. Which action should the nurse take?
1. Check vital signs.
2. Check laboratory test results.
3. Notify the health care provider.
4. Continue to monitor for any rhythm change.
4. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. The nurse sees no electrocardiographic complexes on the screen. Which is the priority nursing action?
1. Call a code.
2. Call the health care provider.
3. Check the client's status and lead placement.
4. Press the recorder button on the electrocardiogram console.
5. The nurse is evaluating a client's response to cardioversion. Which assessment would be the priority?
1. Blood pressure
2. Status of airway
3. Oxygen flow rate
4. Level of consciousness
6. The nurse is caring for a client who has just had implantation of an automatic internal cardioverter-defibrillator. The nurse should assess which item based on priority?
1. Anxiety level of the client and family
2. Presence of a Medic-Alert card for the client to carry
3. Knowledge of restrictions on post-discharge physical activity
4. Activation status of the device, heart rate cutoff, and number of shocks it is
programmed to deliver
7. A client's electrocardiogram strip shows atrial and ventricular rates of 110 beats/minute. The PR interval is 0.14 seconds, the QRS complex measures 0.08 seconds, and the PP and RR intervals are regular. How should the nurse correctly interpret this rhythm?
1. Sinus tachycardia
2. Sinus bradycardia
3. Sinus dysrhythmia
4. Normal sinus rhythm
8. The nurse is assessing the neurovascular status of a client who returned to the surgical nursing unit 4 hours ago after undergoing aortoiliac bypass graft. The affected leg is warm, and the nurse notes redness and edema. The pedal pulse is palpable and unchanged from admission. How should the nurse correctly interpret the client's neurovascular status?
1. The neurovascular status is normal because of increased blood flow through the leg.
2. The neurovascular status is moderately impaired, and the surgeon should be called.
3. The neurovascular status is slightly deteriorating and should be monitored for another hour.
4. The neurovascular status is adequate from an arterial approach, but venous complications are arising.
9. The nurse is evaluating the condition of a client after pericardiocentesis performed to treat cardiac tamponade. Which observation would indicate that the procedure was effective?
1. Muffled heart sounds
2. A rise in blood pressure
3. Jugular venous distention
4. Client expressions of dyspnea
10. A client with variant angina is scheduled to receive an oral calcium channel blocker twice daily. Which statement by the client indicates theneed for further teaching?
1. "I should notify my doctor if my feet or legs start to swell."
2. "My doctor told me to call his office if my pulse rate decreases below 60."
3. "Avoiding grapefruit juice will definitely be a challenge for me, since I usually drink it every morning with breakfast."
4. "My spouse told me that since I have developed this problem, we are going to stop walking in the mall every morning."
11. The nurse is monitoring a client with acute pericarditis for signs of cardiac tamponade. Which assessment finding indicates the presence of this complication?
1. Flat neck veins
2. A pulse rate of 60 beats/minute
3. Muffled or distant heart sounds
4. Wheezing on auscultation of the lungs
12. The home care nurse is providing instructions to a client with an arterial ischemic leg ulcer about home care management and self-care management. Which statement, if made by the client, indicates a need for further instruction?
1. "I need to be sure not to go barefoot around the house."
2. "If I cut my toenails, I need to be sure that I cut them straight across."
3. "It is all right to apply lanolin to my feet, but I shouldn't place it between my toes."
4. "I need to be sure that I elevate my leg above the level of my heart for at least an hour every day."
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