CV (nclex, FAD, ATI) Flashcards
A nurse is preparing an automated external defibrillator (AED) for a client receiving CPR after cardiac arrest. Which of the following actions should the nurse perform first?
A. Press the analyze button on the machine
B. Stop CPR and move away from the client
C. Push the charge button to prepare to shock
D. Apply the defibrillator pads to the clients chest
D. Apply the defibrillator pads to the clients chest
A nurse is caring for a client who had a MI 5 days ago. The client has sudden onset of shortness of breath and begins coughing frothy, spine sputum. The nurse auscultation bubbly sounds on inspiration. Which of the following adventitious sounds should the nurse document ?
A.coarse crackles
B. Wheezes
C. Rhonci
D. Friction rub
A.coarse crackles
A nurse is teaching a client who has coronary artery disease about the difference between angina pectoris and MI. Which of the following should the nurse identify as indications of MI? SATA
A. Nausea and vomiting
B. Diaphoresis and dizziness
C. Chest and left arm pain that subsides with rest
D. Anxiety and feeling of doom
E. Bounding pulse and bradypnea
A. Nausea and vomiting
B. Diaphoresis and dizziness
D. Anxiety and feeling of doom
A nurse is examining the ecg of a client who has frequent premature ventricular contractions (PVC’s). Which of the following QRS changes should the nurse expect to see on the client ECG.
A. Narrower than usual QRS complexes
B. Much greater amplitude than the usual QRS complexes
C. Same polarity as the usual QRS complexes
D. Immediate resumption of usual rhythm
B. Much greater amplitude than the usual QRS complexes
A nurse is assessing a client who has heart failure and is taking daily furosemide. The clients apical pulse is weak and irregular. The nurse should identify these findings as manifestations of which of the following electrolyte imbalances?
A. Hypokalemia
B.hypophosphatemia
C. Hypercalcemia
D. Hypermagnesia
A. Hypokalemia
A nurse on a telemetry unit is caring for a client who has an irregular radial pulse. Which of the following ecg abnormalities should the nurse recognize as atrial flutter?
A. P waves occuring at 0.16 seconds before each QRS complex
B. Atrial rate of 300/min with QRS complex of 80/min
C. Ventricular rate of 82/min with an atrial rate of 80/min
D. Irregular ventricular rate of 125/min with wide QRS patterns
B. Atrial rate of 300/min with QRS complex of 80/min
A nurse is assessing a client who has fluid volume overload from a cardiovascular disorder. Which of the following manifestations should the nurse expect? SATA
A. Jugular vein distention
B. Moist crackles
C. Postural hypotension
D. Increased HR
E. Fever
A. Jugular vein distention
B. Moist crackles
D. Increased HR
A nurse is monitoring a client who had a MI. Which of the following complications should the nurse monitor for in the first 24hr.
A. Infective endocarditis
B. Pericarditis
C. Ventricular dysthymias
D. Pulmonary emboli
C. Ventricular dysthymias
A nurse is caring for an older client who had an acute MI. When assessing this client the nurse should identify that older adults are prone to complications of MI from poor tissue perfusion because of which of the following age-related factors?
A.peripheral vascular resistance increases
B. The sensitivity of BP adjusting baroreceptors increases
C. Blood is hypercoagulable and clots more quickly
D. Cardiac medications are less effective
A.peripheral vascular resistance increases
A nurse is planning who is having percutaneous transluminal coronary angioplasty (PTCA) with stents placement. Which of the following actions should the nurse anticipate in the post -procedure plan of care ?
A.instruct the client about long term cardiac conditions program
B. Administer scheduled doses of acetaminophen
C. Check for peak laboratory markers of Myocardial damage
D. Monitor for bleeding
D. Monitor for bleeding
A nurse is preparing a client for cardiac catheterization. Which of the following pieces of information should the nurse give the client before the procedure? SATA
A. “ you have to lie flat for several hours after the procedure”
B. “ you’ll receive medication to relax you before the procedure”
C. “ you’ll feel a cool sensation after the injection of the dye “
D.”you’ll have to keep your leg straight after the procedure “
E. You’ll have to limit the amount of fluid you drink for the first 24hr
A. “ you have to lie flat for several hours after the procedure”
B. “ you’ll receive medication to relax you before the procedure”
D.”you’ll have to keep your leg straight after the procedure “
A nurse is caring for a client who has an abdominal aortic aneurysm and is scheduled for surgery. The clients vital signs are BP 160/98 mug , HR 102/min, RR-22, and SPo2 95%. Which of the following actions should the nurse take?
A. Administer anti hypertensive medication for blood pressure
B.monitor to ensure the clients urinary output is 20ml/hr
C. Withhold pain medication to prepare the client for surgery
D. Take the clients vital every 2 hr
A. Administer anti hypertensive medication for blood pressure
A nurse is assessing a client who has an abdominal aortic aneurysm (AAA).which if the following findings indicates that the AAA is expanding ?
A. Increased BP and deceased Pulse
B. Jugular vein distention and peripheral edema
C. Report of sudden severe back pain
D. Report of retrosternal chest pain radiating to the left arm
C. Report of sudden severe back pain
A nurse is examining the ecg of a client who is having an acute MI, the nurse should identify that the elevated ST segments on the ecg indicate which of the following alterations?
A. Necrosis
B. Hypokalemia
C. Hypomagnesemia
D. Insufficiency
A. Necrosis
A nurse is monitoring a client for reperfusion following Thrombolytic therapy to treat acute MI. Which of the following indicators should the nurse identify to confirm reperfusion ?
A. Ventricular dysrhythmias
B. Appearance of Q waves
C. Elevated ST segments
D. Recurrence of chest pain
A. Ventricular dysrhythmias
A nurse is providing teaching about lifestyle changes to a client who experienced a MI and has a new prescription for a beta blocker. Which of the following client statements indicates an understanding of the teaching?
A. “I should eat foods that are high in saturated fats
B” before taking my medication , i will count my radial pulse rate
C. I will exercise once a week for an hour at the health club
D. I will stop taking my medication when my blood pressure is within normal range
B” before taking my medication , i will count my radial pulse rate
A nurse is preparing an in service presentation about assessing clients who are having an MI . What is the most common Assesment finding with acute MI?
A. Dyspnea
B. Pain in the shoulder and left arm
C. Substernal chest pain
D. Palpitations
C. Substernal chest pain
A nurse is providing information to a client who is scheduled for an exercise electrocardiography test. Which of the following client statement indicates an understanding of teaching?
A. I will not drink coffee 4 hr prior to my test
B. I can eat a light meal 1 hr prior to the test
C. I can have a cigarette up to 3 min prior to the test
D. I will take my heart medication not the day of the test
A. I will not drink coffee 4 hr prior to my test
A nurse is providing discharge teaching to a client who has a new permanent pacemaker. Which of the following statements by the client indicates an understanding of the teaching ?
A. “ i should check my HR at the same time each day
B. I dont have to take anti hypertensive medication now that i have a pacemaker
C. I should keep a pressure dressing over the generator until the incision is healed
D. I cannot stand in front of our new microwave when it is on
A. “ i should check my HR at the same time each day
A nurse is completing an assessment for a client who has a history of unstable angina. Which of the following findings should the nurse expect ?
A. Chest pain is relieved soon after resting
B. Nitroglycerin relives chest pain
C. Physical exertion does not precipitate chest pain
D. Chest pain lasts for longer than 15 mins
D. Chest pain lasts for longer than 15 mins
A nurse is preparing an in service presentation about the management of MI. Death following MI is often a result of which of the following complications ?
A. Cardiogenic shock
B.dysrhythmias
C. Heart failure
D. Pulmonary edema
B.dysrhythmias
A nurse is rewarming a client following a coronary artery bypass graft (CABG) surgery. For which of the following complications of the rewarming process should the nurse monitor the client?
A. Acidosis
B. Infection
C. Hypertension
D. Cardiac tamponade
A. Acidosis
A nurse is assessing a client who has left sided heart failure . Which of the following findings should the nurse expect?
A. Pitting peripheral edema
B. Crackles in the lung bases
C. Jugular vein distention
D. Hepatomegaly
B. Crackles in the lung bases
A nurse is examining the ecg of a client who has hyperkalemia. Which of the following ECG changes should the nurse expect?
A. Elevated ST segments
B. Absent P waves
C. Depressed ST segments
D. Varying PP intervals
A. Elevated ST segments
A nurse is assessing a client who is 85 years old. Which of the following findings should the nurse identify as a manifestation of MI?
A. Sudden hemptysis
B. Acute diarrhea
C. Frontal headache
D. Acute confusion
D. Acute confusion
A client who just learned that he has variant (prinzmetals) angina asks the nurse how this type of angina compares with stable angina. Which of the following replies should the nurse make?
A. Exertion often brings on pain
B. Variant angina occurs randomly at various times
C. Variant angina can cause changes on you electrocardiogram
D. Reducing your cholesterol can help you experience less pain
C. Variant angina can cause changes on you electrocardiogram
A nurse is caring for a client who has a demand pacemaker inserted with a set rate of 72/min. Which of the following findings should the nurse expect.
A. Telemetry monitoring showing QRS complexes occuring at a rate of 74/min with no pacing spikes.
B. Premature ventricular complexes at 12/min
C. Telemetry monitor showing pacing spikes with no QRS complexes
D. Hiccups
A. Telemetry monitoring showing QRS complexes occuring at a rate of 74/min with no pacing spikes.
A nurse is assessing a client who has pericarditis. Which of the following manifestations should the nurse expect?
A. Bradycardia with ST segment depression
B. Relief of chest pain with deep inspiration
C. Dyspnea with hiccups
D. Chest pain that increases when sitting upright
C. Dyspnea with hiccups
A nurse is assessing a client who had a coronary artery bypass grafts for cardiac tamponade. Which of the following actions should the nurse take?
A. Check for hypertension
B. Ascultate for loud , bounding heart sounds
C. Auscultation blood pressure for pulses paradoxus
D. Check for a pulse deficit
C. Auscultation blood pressure for pulses paradoxus
A nurse is proving care for a patient newly diagnosed with heart disease. Which dietary , activity or lifestyle modification should be included in the plan of care? SATA
A. Stopping smoking
B. Drinking lots of water
C. Limiting sedentary lifestyle
D. Eating a diet rich in red meats and protein
E. Limit alcohol intake
FA.Davis 28.4
A. Stopping smoking
C. Limiting sedentary lifestyle
E. Limit alcohol intake
What is the most likely procedure to determine the cause of severe chest pain in the patient newly admitted to the hospital ?
A. Coronary angiography
B. Nuclear stress testing
C. Right heart catheterization
D. TEE
FA . DAVIS 28.5
A. Coronary angiography
A patient with hypertension has which physical symtpom?
A. Decreased resistance, which may increase CO
B. Increased resistance, which may decrease CO
C. Increased resistance , which may increase CO
D. Deceased resistance , which may decrease CO
FA Davis 28.3
B. Increased resistance, which may decrease CO
What is an important nursing action following a cardiac catheterization intervention ?
A. Early mobilization to prevent clot formation
B. Fluid restriction to avoid fluid overload
C. Bed rest to avoid stress on cannula insertion site
D. Head bead at 30 degrees for respiratory support
FA Davis 28.6
C. Bed rest to avoid stress on cannula insertion site
What information should be included in the teaching plan for a 76 Y.O patient after a physical
A. Initiating a new strenuous exercise regimen is recommend
B. Limit physical activity and exercise
C. Report any new or excessive fatigue
D. Excessive fatigue is not usual as you age
FAdavis 28.7
C. Report any new or excessive fatigue
As the nurse , you know that the following can cause rhythm disorders? SATA
A. Exercise
B. Electrolyte imbalance
C. Myocardial hypertrophy
D. Myocardial damage
E. Eating red meat
FA Davis 29.1
B. Electrolyte imbalance
C. Myocardial hypertrophy
D. Myocardial damage
A client is admitted to the ED with chest pain that is consistent with myocardial infarction based on elevated troponin levels. Heart sounds are normal and vital signs are noted on the clients chart. The nurse should alert the health care provider because these changes are most consistent with which complication? Refer to the chart
A. Cardiogenic Shock
B. Cardiac Tamponade
C. Pulmonary Embolism
D. Dissecting thoracic aortic aneurysm
A. Cardiogenic Shock
