Question 1 See full question
Which statement would lead the nurse to determine that a client lacks understanding of her acute cardiac illness and the
... [Show More] ability to make changes in her lifestyle?
Question 2 See full question
What is the expected outcome of thrombolytic drug therapy for stroke?
Question 3 See full question
The client with peripheral vascular disease has been prescribed diltiazem. The nurse should determine the effectiveness of this medication by assessing the client for:
Question 4 See full question
Alteplase recombinant, or tissue plasminogen activator (t-PA), a thrombolytic enzyme, is administered during the first 6 hours after onset of myocardial infarction (MI) to:
Question 5 See full question
A nurse is caring for a client with first-degree atrioventricular (AV) block. When instructing the spouse using a diagram, identify the area in the conduction cycle where this block occurs.
Question 6 See full question
A postoperative client is receiving heparin after developing thrombophlebitis. The nurse monitors the client carefully for bleeding and other adverse effects of heparin. If the client starts to exhibit signs of excessive bleeding, the nurse should expect to administer an antidote that is specific to heparin. Which agent fits this description?
Question 7 See full question
Following a percutaneous transluminal coronary angioplasty, a client is monitored in the postprocedure unit. The client's heparin infusion was stopped 2 hours earlier. There is no evidence of bleeding or hematoma at the insertion site, and the pressure device is removed. The nurse should plan to safely remove the femoral sheath when the partial thromboplastin time (PTT) is:
Question 8 See full question
Prior to administering tissue plasminogen activator (t-PA), the nurse should assess the client for which contradiction to administering the drug?
Question 9 See full question
The nurse is concerned about the risks of hypoxemia and metabolic acidosis in a client who is in shock. What finding should the analyze for evidence of hypoxemia and metabolic acidosis in a client with shock?
Question 10 See full question
Which assessment findings would the nurse expect to find in the postoperative client experiencing fat embolism syndrome?
Question 1 See full question
A nurse is preparing to administer cardiac medications to two clients with the same last name. She checks the medication three times before entering the room to administer medications to the first client. While leaving the room, the nurse realizes she didn't check the client's identification before administering the medication. Which action should the nurse take first?
Question 2 See full question
The nurse is assessing a client with irreversible shock. The nurse should document which finding?
Question 3 See full question
The nurse instructs a client with coronary artery disease in the proper use of nitroglycerin. The client has had 2 previous episodes of coronary artery disease. At the onset of chest pain, what should the client do?
Question 4 See full question
A client with chest pain doesn't respond to nitroglycerin. When he's admitted to the emergency department, the health care team obtains an electrocardiogram and administers I.V. morphine. The physician also considers administering alteplase. This thrombolytic agent must be administered how soon after onset of myocardial infarction (MI) symptoms?
Question 5 See full question
A physician treating a client in the cardiac care unit for atrial arrhythmia orders metoprolol, 25 mg P.O. two times per day. Metoprolol inhibits the action of sympathomimetics at beta1-receptor sites. Where are these sites mainly located?
Question 6 See full question
A client with left-sided heart failure complains of increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these findings as signs and symptoms of:
Question 7 See full question
An 80-year-old client is admitted with nausea and vomiting. The client has a history of heart failure and is being treated with digoxin. The client has been nauseated for a week and began vomiting 2 days ago. Laboratory values indicate hypokalemia. Because of these clinical findings, the nurse should assess the client carefully for:
Question 8 See full question
The nurse is assisting a client with a stroke who has homonymous hemianopia. The nurse should understand that the client will:
Question 9 See full question
A client prescribed propranolol calls the clinic to report a weight gain of 3 lbs (1.36 kg) within 2 days, shortness of breath, and swollen ankles. What is the nurse’s best action?
Question 10 See full question
The nurse is preparing to administer oral digoxin to a child and notes that the child has nausea, has vomited, and has a pulse rate of 45 beats per minute. Which of the following is the appropriate nursing action?
Question 1 See full question
What is a priority nursing assessment in the first 24 hours after admission of the client with a thrombotic stroke?
Question 2 See full question
When monitoring a client who is receiving tissue plasminogen activator (t-PA), the nurse should have resuscitation equipment available because reperfusion of the cardiac tissue can result in:
Question 3 See full question
In a client with chronic bronchitis, which sign would lead the nurse to suspect right-sided heart failure?
Question 4 See full question
Which indicates hypovolemic shock in a client who has had a 15% blood loss?
Question 5 See full question
Which symptom should the nurse teach the client with unstable angina to report immediately to the health care provider (HCP)?
Question 6 See full question
The nurse is admitting an older adult to the hospital. The echocardiogram report revealed left ventricular enlargement. The nurse notes 2+ pitting edema in the ankles when getting the client into bed. Based on this finding, what should the nurse do first?
Question 7 See full question
The nurse teaches a client who has recently been diagnosed with hypertension about following a low-calorie, low-fat, low-sodium diet. Which menu selection would best meet the client's needs?
Question 8 See full question
A client has been diagnosed with Raynaud’s phenomenon on the tip of the nose and fingertips. The healthcare provider (HCP) has prescribed reserpine to determine if the client will obtain relief. The client often works outside in cold weather and also smokes two packs of cigarettes per day. Which directions should be included in the discharge plan for this client? Select all that apply.
Question 9 See full question
A client hospitalized with a myocardial infarction (MI) has a blood glucose levels ranging from 12-28 mmol/L (216-504 mg/dL) asks the nurse why the readings are so high even though there are no added sweets on the diet tray. What is the best response by the nurse?
Question 10 See full question
A client with chest pain, dyspnea, and an irregular heartbeat comes to the emergency department. An electrocardiogram shows a heart rate of 110 beats/minute (sinus tachycardia) with frequent premature ventricular contractions. Shortly after admission, the client has ventricular tachycardia and becomes unresponsive. After successful resuscitation, the client is taken to the intensive care unit (ICU). Which nursing diagnosis is the priority at this time?
Question 1 See full question
A client signed a consent form for participation in a clinical trial for implantable cardioverter-defibrillators. Which statement by the client indicates the need for further teaching before true informed consent can be obtained?
Question 2 See full question
The client asks the nurse, “Why will the health care provider not tell me exactly how much of my leg he is going to take off? Do you not think I should know that?” On which information should the nurse base the response?
Question 3 See full question
When assessing a client with left-sided heart failure, the nurse expects to note:
Question 4 See full question
A nurse is providing discharge instructions to a client with peripheral vascular disease that include stress-reduction techniques. The client asks the nurse, "Why is reducing stress so important?" What is the nurse's best response?
Question 5 See full question
A client who underwent total hip replacement exhibits a red, painful area on the calf of the affected leg. What test validates presence of thromboembolism?
Question 6 See full question
A client, hospitalized with heart failure, is receiving digoxin and furosemide intravenously and now has continuous ringing in the ears. What is the appropriate action for the nurse to take at this time?
Question 7 See full question
An older adult with a history of heart failure is admitted to the emergency department with pulmonary edema. On admission, what should the nurse assess first?
Question 8 See full question
One goal in caring for a client with arterial occlusive disease is to promote vasodilation in the affected extremity. To achieve this goal, the nurse should encourage the client to:
Question 9 See full question
When performing external chest compressions on an adult during cardiopulmonary resuscitation (CPR), the rescuer should depress the sternum:
Question 10 See full question
A nurse places electrodes on a collapsed individual who was visiting a hospitalized family member, the monitor exhibits the following. Which interventions would the nurse do first?
Question 1 See full question
A client with peripheral vascular disease has undergone a right femoral-popliteal bypass graft. The blood pressure has decreased from 124/80 mm Hg to 88/62 mm Hg. What should the nurse assess first?
Question 2 See full question
A client who has been experiencing angina has a new prescription for nitroglycerin. The nurse should instruct the client to report having which potential side effect of nitroglycerin?
Question 3 See full question
A client is receiving nitroglycerin ointment to treat angina pectoris. The nurse evaluates the therapeutic effectiveness of this drug by assessing the client's response and checking for adverse effects. Which vital sign is most likely to reflect an adverse effect of nitroglycerin?
Question 4 See full question
A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when he makes which statement?
Question 5 See full question
Metoprolol is added to the pharmacologic therapy of a woman with diabetes diagnosed with stage 2 hypertension and initially treated with furosemide and ramipril. An expected therapeutic effect is:
Question 6 See full question
A nurse is caring for a client with frequent episodes of ventricular tachycardia. The lab calls with a critically high magnesium level of 11 mg/dL on this client. What is the nurse's priority action?
Question 7 See full question
A client requested a do-not-resuscitate (DNR) order upon admission to the hospital. He now tells the nurse that he wants the medical team to do everything possible to help him get better and is concerned about the DNR order. Which response by the nurse is best?
Question 8 See full question
A nurse is caring for a client with type 2 diabetes who has had a myocardial infarction (MI) and is reporting nausea, vomiting, dyspnea, and substernal chest pain. Which of the following is the priority intervention?
Question 9 See full question
The nurse is assessing a client who has had a myocardial infarction (MI). The nurse notes the cardiac rhythm on the monitor (see the electrocardiogram strip). The nurse should:
Question 10 See full question
The nurse is caring for an elderly man who walks 2 miles every morning. The nurse notes that during his morning walk, he called his daughter and stated that he thought that he was having a heart attack. Which symptom, identified by the client, is the most common and consistent with that of a heart attack (myocardial infarction)?
Question 1 See full question
A client with end-stage heart failure is preparing for discharge. The client and his caregiver meet with the home care nurse and voice their concern that setting up a hospital bed in the bedroom
will leave him feeling isolated. Which suggestion by the home care nurse best addresses this concern?
Question 2 See full question
The nurse observes that an older female has small to moderate, distended and tortuous veins running along the inner aspect of her lower legs. The nurse should:
Question 3 See full question
Which measure should the nurse institute to help prevent complications associated with excessive calcium excretion following cardiac surgery to replace an aortic valve?
Question 4 See full question
A client has been diagnosed with peripheral arterial occlusive disease. In order to promote circulation to the extremities, the nurse should instruct the client to:
Question 5 See full question
A client with second-degree atrioventricular heart block is admitted to the coronary care unit. The nurse closely monitors the client's heart rate and rhythm. When interpreting the client's electrocardiogram (ECG) strip, the nurse knows that the QRS complex represents:
Question 6 See full question
A client who suffered blunt chest trauma in a motor vehicle accident complains of chest pain, which is exacerbated by deep inspiration. On auscultation, the nurse detects a pericardial friction rub — a classic sign of acute pericarditis. The physician confirms acute pericarditis and begins appropriate medical intervention. To relieve chest pain associated with pericarditis, which position should the nurse encourage the client to assume?
Question 7 See full question
A client with chest pain doesn't respond to nitroglycerin. When he's admitted to the emergency department, the health care team obtains an electrocardiogram and administers I.V. morphine. The physician also considers administering alteplase. This thrombolytic agent must be administered how soon after onset of myocardial infarction (MI) symptoms?
Question 8 See full question
A physician orders several drugs for a client with hemorrhagic stroke. Which drug order should the nurse question?
Question 9 See full question
A client with left-sided heart failure complains of increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these findings as signs and symptoms of:
Question 10 See full question
A nurse is caring for a client with type 2 diabetes who has had a myocardial infarction (MI) and is reporting nausea, vomiting, dyspnea, and substernal chest pain. Which of the following is the priority intervention?
Question 1 See full question
A fourth heart sound (S4) indicates a:
Question 2 See full question
The nurse instructs a client with coronary artery disease in the proper use of nitroglycerin. The client has had 2 previous episodes of coronary artery disease. At the onset of chest pain, what should the client do?
Question 3 See full question
The client has had hypertension for 20 years. The nurse should assess the client for?
Question 4 See full question
A client admitted with a massive myocardial infarction rapidly develops cardiogenic shock. Ideally, the physician would use the intra-aortic balloon pump (IABP) to support the injured myocardium. However, this client has a history of unstable angina pectoris, aortic insufficiency, hypertension, and diabetes mellitus. Which condition is a contraindication for IABP use?
Question 5 See full question
While auscultating the heart sounds of a client with heart failure, the nurse hears an extra heart sound immediately after the second heart sound (S2). The nurse should document this as:
Question 6 See full question
A nurse is performing discharge teaching with a client who has an implantable cardioverter defibrillator (ICD) placed. Which client statement indicates effective teaching?
Question 7 See full question
The nurse's unit council in the telemetry unit is responsible for performance improvement studies. What information should they gather to study whether client education about resuming sexual activity after an acute myocardial infarction (MI) is being taught?
Question 8 See full question
The nurse observes the cardiac rhythm (see above) for a client who is being admitted with a myocardial infarction. Which should the nurse do first?
Question 9 See full question
The nurse is reviewing the electrocardiogram of a client who has elevated ST segments visible in leads II, III, and aVf. Which is the nurse’s best action?
Question 10 See full question
A client arrives at the emergency department with a heart rate of 210 beats/minute and the following pattern on the cardiac monitor. The nurse is correct to alert the health care provider to the presence of which disorder?
Question 1 See full question
The correct landmark for obtaining an apical pulse is the:
Question 2 See full question
Before discharge from the hospital after a myocardial infarction, a client is taught to exercise by gradually increasing the distance walked. Which vital sign should the nurse teach the client to monitor to determine whether to increase or decrease the exercise level?
Question 3 See full question
A client with peripheral artery l disease has femoral-popliteal bypass surgery. The primary goal of the plan of care after surgery is to:
Question 4 See full question
The client who had a permanent pacemaker implanted 2 days earlier is being discharged from the hospital. The nurse knows that the client understands the discharge plan when the client:
Question 5 See full question
Which information about sublingual nitroglycerin tablets should the nurse include when instructing the
client with angina?
Question 6 See full question
On a routine visit to the physician, a client with chronic arterial occlusive disease reports that he's stopped smoking after 34 years. To relieve symptoms of intermittent claudication, a condition associated with chronic arterial occlusive disease, which additional measure should the nurse recommend?
Question 7 See full question
A client is returning from the operating room after inguinal hernia repair. The nurse notes that he has fluid volume excess from the operation and is at risk for left-sided heart failure. Which sign or symptom indicates left-sided heart failure? [Show Less]