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Nurs. 401 > Cardiovascular 3 Quiz > Flashcards

Cardiovascular 3 Quiz Flashcards

0
Q

Necrosis or cell death

A

Infarction

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1
Q

Chest pain that occurs I the days or weeks before MI

A

Pre-infarction angina

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2
Q

All three layers of the heart are involved

A

Trans mural MI

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3
Q

First angina symptoms usually after exertion or other increased demands on the heart

A

New onset angina

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4
Q

Strangling of the chest

A

Angina pectoris

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5
Q

Scar tissue permanently changes the size and shape of the entire left ventricle

A

Ventricular remodeling

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6
Q

Tissue that is oxygen deprived

A

Zone of ischemia

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7
Q

Around the intial area of infarction

A

Zone of necrosis

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8
Q

Chest pain or discomfort from coronary artery spasm, typically occurs after rest

A

Variant angina

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9
Q

Tissue that is injured but not necrotic

A

Zone of injury

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10
Q

Occurs when Insufficent oxygen is supplied to meet the requirement of the myocardium

A

Ischemia

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11
Q

The nurse is interviewing a patient reporting chest discomfort that occurs with moderate to prolonged exertion. The patient describes the pain as being about the same over the past several months and going away with nitroglycerin or rest. Based on the patients description of symptoms , what does the nurse suspect in this patient ?

A
  1. Chronic stable angina

2. Coronary artery disease

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12
Q

A patient with a history of angina is admitted for surgery. The patient reports nausea, pressure in the chest raining eating till left arm, appears anxious, skin is cool and clammy, blood pressure is 150/90, pulse is 100, and respiratory rate is 32. What are the priorities of nursing care for this patient?

A
  1. Improve coronary perfusion
  2. improve coronary oxygenation
  3. relieve chest pain
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13
Q

The patient has been admitted for acute angina. Which diagnostic test identifies of the patient will benefit from further invasive management after a cute angina or an MI?

A

Cardiac catherization

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14
Q

The nurse is talking to a patient with angina about resuming sexual activity. Which statement by the patient indicates a correct understanding of the facts of angina and sexual activity?

A

I can resume sexual activity after a rest period

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15
Q

A patient with angina is prescribed nitroglycerin tablets. What information does the nurse include when teaching the patient about this drug?

A
  1. You can tell the pills are active when your tongue feels a tingling sensation
  2. keep your nitroglycerin with you at all times 3. medication can cause a temporary headache or a flushed face
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16
Q

Patient reports chest pain that is unrelieved with sublingual nitroglycerin. What drug does the nurse administers this patient next?

A

Supplemental oxygen

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17
Q

A patient is hypertensive and continues to have angina despite therapy with beta blockers. The nurse anticipates which type of drug will be prescribed for this patient?

A

Calcium channel blocker

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18
Q

The nurse has just given a patient to doses of sub lingual nitroglycerin for anginal pain. The patient’s blood pressure is typically 130/80 MMH G. Which finding wants immediate notification of the healthcare provider?

A

Systolic pressure is 90 MMH G

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19
Q

A patient is admitted for unstable angina. The patient is currently asymptomatic and all vital signs are stable. Which position does the nurse place the patient in?

A

Any place of comfort

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20
Q

Angina

A
  1. Pain is precipitated by exertion or stress
  2. Pain is relieved by nitroglycerin or rest
  3. There are few associated symptoms
    4 . Pain lasts less than 15 min
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21
Q

Myocardial infarction

A
  1. Pain occurs without cause usually in the morning
  2. Pain is relieved only by opioids
  3. Nausea, diaphoresis, fear or dyspnea may occur
  4. Pain last 30 minutes or more
  5. Pain radiates to her left arm, back, or jaw
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22
Q

True or false

Ischemia that occurs with angina is limited in duration and does not cause permanent damage of myocardial tissue

A

True

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23
Q

True or false

Studies have shown that endothelial dysfunction may be the cause of CAD in women

A

True

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24
Q

True or false

Postmenopausal women in their 70s have a higher incidence of MI then men

A

False, they have an equal incidence

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25
Q

True or false

Many patients suffering sudden cardiac arrest die before reaching the hospital due to ventricular fib

A

True

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26
Q

A patient is admitted for acute MI, but the nurse notes that the traditional manifestation of ST elevation MI is not occurring. What other evidence for acute MI does the nurse expect to find this patient?

A
  1. Positive Troponin markers

2. Non- ST elevation MI

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27
Q

People should seek treatment for symptoms of MI rather than delay because physical changes will occur approximately how many hours after an infarction?

A

6

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28
Q

The nurses caring for a patient admitted with unstable angina of an elevated lipid levels. What does the nurse include in teaching this page and about his or her elevated level levels?

A
  1. Avoid trans fatty acids
  2. Reduce intake of saturated fats
  3. Monitor the amount of cholesterol ingested staying below 200 mg a day
  4. Decrease weight
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29
Q

The nurse is auscultating the heart of a patient who had an MRI. Which finding most strongly indicates heart failure?

A

S3 gallop

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30
Q

Which diagnostic tests are used to assess myocardial damage caused by an MRI?

A

Troponin 1 isoenzyme elevation

And CK-MB isoenzyme elevation

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31
Q

A patient has heart failure related to MI. What intervention does the nurse plan for this patient’s care

A

Titrating vasoactive drugs to maintain a suffice to cardiac output

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32
Q

Which patient has the highest risk for death because of ventricular failure and dysrhythmias related to damage to left ventricle?

A

Patient with an anterior wall MI

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33
Q

A patient had an IWMI. The nurse closely monitor the patient for which dysrhythmia associated with IWMI?

A

Bradycardia and 2nd° heart block

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34
Q

The nurse is giving a Community presentation about heart disease. Because 95% of sudden cardiac arrest victims die of ventricular fib before reaching the hospital, which teaching point is the nurse emphasize?

A

Learning to operate the automatic external defibrillators or AED’s in the workplace

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35
Q

What are indicators of metabolic syndrome, which increases the risk for coronary heart disease?

A

Triglyceride level of 170 MG/DL
HDL cholesterol level 45 in a female
blood pressure of 130 86 MM HG
fasting blood sugar level of 120 mg

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36
Q

A patient has high risk for CAD. What is the goal for this patients LDL level?

A

Less than 70 mg/dl

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37
Q

The patient was trying to make dietary modifications to reduce lipid levels. The patient would like information about omega-3 fatty acid food sources. What the source is the nurse recommend?

A

Fish

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38
Q

True or false

Tobacco use especially cigarette smoking accounts for over 90% of deaths from CAD

A

False

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39
Q

True or false

A person stop smoking may decrease the risk of CAD by as much as 80% in one year

A

True

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40
Q

True or false

reducing the tar and nicotine content of the cigarette smoke reduces the risk of CAD

A

False it does not

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41
Q

True or false

less active, less fit people have a 30% to 50% greater risk of developing high blood pressure which predisposes to CAD

A

True

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42
Q

True or false

Physical activity increases collateral circulation and reduces the size of existing plaques

A

False does not increase

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43
Q

The patient comes to the walk-in clinic reporting left anterior chest discomfort with mild shortness of breath. The patient is alert, oriented, diaphoretic, and anxious. What is the primary action for the nurse?

A

Place the patient on Fowler’s position and start supplemental oxygen

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44
Q

The patient reports having chest discomfort that started during exercise the patient is currently pain-free but is concerned. What questions does the nurse asked to assess the patient’s pain episode?

A

Everything but…
How do you feel about the pain
Was the pain sharp and stabbing

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45
Q

Patient is currently pain and symptom free, but reports having in a minute episodes of chest pain over the past week. The nurse asked about which associated symptoms?

A
  1. Nausea
  2. Diaphoresis
  3. Dizziness
  4. Palpitations
  5. Shortness of breath
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46
Q

Emergency department nurse is assessing an 86-year-old patient with acute confusion, increased respiratory rate, anxiety, and chest pain. The nurse finds a respiratory rate of 36 a minute with crackles and wheezes on auscultation. How does the nurse interpret these findings?

A

Left-sided heart failure

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47
Q

The nurse is assessing a middle-age woman with diabetes who denies any history of known heart problems. However, I also Tatian of the heart the nurse here’s an S4 heart sound. The nurse alerts the physician and obtain an order for which diagnostic test?

A

ECG

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48
Q

A middle-aged African-American patient with no known medical problems has acute onset chest pain and dyspnea. In order to rule out acute MI, the nurse obtains orders for which diagnostic test?

A
  1. Myoglobin
  2. Troponin T and I
  3. Creatine kinase MB myoglobin
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49
Q

The patient had severe chest pain several hours ago but is currently pain-free and has a normal ECG. Which statement by the patient indicates a correct understanding of the significance of the ECG results?

A

ECG could be normal since I’m currently pain-free

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50
Q

Which statement about silent MIs is correct?

A

Silent MI increases the incidence of new coronary events

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51
Q

Emergency department nurse is caring for a patient with acute pain associated with MI. What are the purposes of collaborative management that address the patient’s pain?

A
  1. Prevent further damage to the cardiac muscle by decreasing myocardial oxygen demand an increasing myocardial oxygen supply
  2. Eliminate discomfort by providing pain relief modalities, decrease myocardial oxygen demand, and increased myocardial oxygen supply
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52
Q

The ED nurse caring for a patient with severe chest pain and ECG changes give supplemental oxygen to the patient is ordered. Which other medications that the nurse anticipate giving to this patient?

A
  1. IV nitroglycerin
  2. Beta blocker
  3. IV morphine
  4. Oral aspirin
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53
Q

The nurses caring for a hospitalized patient being treated initially with IV nitroglycerin. What intervention does the nurse include in this patient care?

A

Monitor blood pressure continuously

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54
Q

A patient is currently on oxygen therapy for chest pain. The pulse ox is on and signals and abrupt drop from 93 to 89%. What is the priority action for the nurse?

A

Troubleshoot the oxygen set up and the pulse oximeter sensor

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55
Q

The home health nurse received a call from a patient with CAD who reports having new onset of chest pain and shortness of breath. What does the nurse direct the patient to do?

A

Chew 325 mg of aspirin and immediately call 911 e

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56
Q

A patient is newly diagnosed with cardiovascular disease. What psychosocial reactions does the nurse assessed for?

A
  1. Fear
  2. Anxiety
  3. Anger
  4. Denial
  5. Depression
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57
Q

Which drug is given within 1 to 2 hours of an MI, if the patient is hemodynamically stable, to help the heart to perform more work without ischemia?

A

Beta adrenergic agents such as metoprolol (Lopressor)

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58
Q

Which statements are true about the use of thrombolytic agents for a patient with an acute MI?

A
  1. A patient who is received a thrombolytic agents must be continuously Monitored before and after the medication is given
  2. Thrombolytic therapy is indicated for chest pain of longer than 30 minutes duration that is unrelieved by other medications
  3. Bleeding is at risk for patients receiving thrombolytic therapy
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59
Q

The healthcare providers considering use of thrombolytic therapy for a patient. What is the criteria for this therapy?

A

Indications of transmural ischemia and injury shown by the ECG

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60
Q

The patient is being evaluated for thrombolytic therapy. What are contraindications for this procedure?

A
  1. Ischemic stroke within three months
  2. pregnancy
  3. surgery within the last 10 days
  4. intercranial hemorrhage
  5. malignant intracranial neoplasm
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61
Q

A patient has received thrombolytic therapy for treatment of acute MI. What are posted ministration possibilities for this treatment?

A
  1. Document the patient’s neurologic status 2.observe all IV sites for bleeding and patency 3.monitor clotting studies
  2. monitor hemoglobin and hematocrit
  3. test stools urine and emesis for occult blood
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62
Q

Patient is receiving beta blocker therapy for treatment of MI. What does the nurse monitor for relation to therapy?

A
  1. Hypotension
  2. Decreased level of consciousness
  3. Chest discomfort
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63
Q

A patient is being treated with medication therapy following an acute MI. The nurse questions the order for which type of drug?

A

Calcium channel blocker

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64
Q

A patient with angina is taking calcium channel blocker’s. What does the nurse monitor the patient for?

A

Hypotension

65
Q

Which diagnostic test is performed after angina or MI to determine cardiac changes that are consistent with ischemia, to evaluate medical interventions, to determine whether invasive intervention is necessary?

A

Stress test

66
Q

The nurse is monitoring a patient who had fibrinolytics and percutaneous transluminal coronary angioplasty. What is an Indication the clot has lysed and the artery reperfusion

A

Sudden onset of ventricular dysrhythmias

67
Q

A patient has had MI. The nurse anticipates which type of drug will be prescribed within 48 hours to prevent the development of heart failure?

A

ACE inhibitor

68
Q

The nurse has identified the priority problem of activity intolerance for patient had an acute MI. What is the best expected outcome for this patient?

A

Patient will walk at least 200 feet four times a day without chest discomfort or shortness of breath

69
Q

Patient is in the acute phase of cardiac rehabilitation. Which task is best to delegate to the unlicensed assistive personnel?

A

Assisted patient with ambulation to the bathroom

70
Q

The patient in the cardiac rehab facility is having difficulty coping with the changes in her health status. Which statement by the patient is the strongest indicator of ineffective coping?

A

I don’t want to go to therapy I had a bad experience yesterday with the therapist

71
Q

A post MI patient in phase 1 cardiac rehab is encouraged to perform which activity?

A

Range of motion exercises

72
Q

The nurses caring for a patient admitted for an inferior wall MI. The patient develops heart block with bradycardia because the patient’s pulse rate is low in the blood pressure is unstable, which procedure is the nearest prepared to assist with?

A

Temporary pacemaker

73
Q

The nurses contacted by the cardiac monitoring technician a says a patient is having a dysrhythmia what does the nurse do next?

A

Evaluate for chest pain or discomfort

74
Q

Nurses evaluating a patient with CAD. What is an expected patient outcome that demonstrates hemodynamic stability?

A

Blood pressure and pulse within range in adequate for metabolic demand

75
Q

The nurses assessing a patient at risk for left ventricular failure and inadequate organ perfusion. Which signs and symptoms signal decreased cardiac output?

A
  1. Change in orientation or mental status
  2. Urine output less than 1 mL per kilogram or less in 30 mL an hour
  3. Cool, clammy extremities with decreased or absent pulses
  4. Unusual fatigue
  5. Recurrent chest pain
76
Q

The nurse is reviewing medication orders for several cardiac patient there’s an order for beta adrenergic blocking agent Metropole all once a day. This drug order is most appropriate for which class of patients according to the kill a classification system?

A

Class II and III

77
Q

The nurses caring for a patient with an anterior wall MI. The patient develops tachycardia, hypertension, urine output of 10 mL an hour, cold and clammy skin with poor peripheral pulses, and agitation. What does the nurse suspect in this patient?

A

Cardiogenic shock

78
Q

The nurse is assessing a cardiac patient and finds a proximal pulse, clear lungs, and jugular vein distention that occurs when the patient is in semi Fowler’s position. What are these findings consistent with?

A

Right ventricular failure

79
Q

Intensive care nurse is monitoring a patient with a right ventricular MI. The pulmonary artery wedge pressure reading is 30 MMH G. What does the nurse do next?

A

Perform an ECG using right-sided precordial leads

80
Q

Patient continues to have chest pain despite compliance with medical therapy. The nurse teaches the patient about which diagnostic test?

A

Right sided cardiac catheterization with coronary angiogram

81
Q

Immediate reperfusion is invasive intervention that shows some promise for managing which disorder?

A

Cardiogenic shock

82
Q

A patient is scheduled to have PTCA. The nurse anticipates that an intial dose of which medication will be given before the procedure.

A

Clopidogrel (plavix)

83
Q

A patient has angina and is scheduled for PTCA. Based on outcomes of the PTCA, the nurse prepares the patient for immediate transfer to undergo which procedure

A

CABG

84
Q

The nurse is caring for a patient who had PTCA. Which symptom indicates acute closure of the vessel and therefore warrants immediate notification of the health care provider?

A

Chest pain

85
Q

Which patient may be potential candidates for CABG

A
  1. Patient with angina and greater than 50 occulsion of left main coronary artery that cannot be stented.
  2. patient with valvular disease
  3. Patient with coronary vessels unsuitable for PTCA
  4. Patient with signs of ischemia or in pending MI after angiogram or PTCA
86
Q

Patients trying to decide whether to consent to a CA BG. What information does the nurse give the patient?

A
  1. CA BG improve the quality of life for most patients
  2. Most patients are pain-free at one year after surgery
  3. Most patients remain pain-free five years after surgery, but some patients experience some pain after five years
87
Q

The patient is having an elective CA BG with a minimally invasive surgical technique. What does the nurse include in the preoperative teaching?

A

Protection and splinting of the chest incision while coughing

88
Q

A patient is having a CA BG with the traditional surgical procedure. What does the nurse include in the preoperative teaching?

A
  1. There will be a sternal incision
  2. Expect one, two, or three chest tubes
  3. And indwelling urinary catheter will be placed
  4. An endotracheal tube will prevent talking
89
Q

The intensive care nurse is caring for a patient who is just had a CA BG. The nurse notes that the patient has edema. In order to adjust fluid administration, the nurse collects which additional information and then consults the healthcare provider?

A
  1. Blood pressure
  2. PAWP
  3. Cardiac output
  4. Blood loss
  5. Urine output
90
Q

A potassium bolus of 80 mEq mix in 100 mL of IV solution at a rate of 40 and make you per hour is order for patient in the critical care unit. What does the nurse do next?

A

Give the infusion, the order exceed the recommended amount, but is within acceptable standards of practice for critical care patients

91
Q

The intensive care nurse is caring for a patient who is just had a CA BG. The patient has a systolic blood pressure of 80 MM HT. What is the primary concern related to this patient’s hypotension?

A

It may result in the collapse of the graft

92
Q

Following a CA BG, patient has a body temperature below 96.8°. What measures should be used to rewarm the patient?

A

Use lights or thermal blanket

93
Q

Intensive care nurse is caring for a patient who has just had a CA BG. What does the nurse do to assess for post operative bleeding?

A

Measured mediastinal and plural chest tube drainage at least hourly report drainage amounts over 150 mL to the surgeon

94
Q

Following a CA BG, patient in the ICU on a mechanical ventilator suddenly decompensates. The healthcare provider make the diagnosis of cardiac tamponade. The nurse prepares the patient for which emergency procedure?

A

Sternotomy

95
Q

The nurse is assessing a patient who had a CA BG. Which finding is a permanent deficit that is associated with and inoperative stroke?

A

Generalized seizure activity

96
Q

The patient reports pain after a C a BG. Which statement by the patient suggest that the pain is related to the sternotomy and not anginal in origin

A

My pain increases when I cough or take a deep breath

97
Q

A patient with a C a BG is transferred from ICU to intermediate care unit. Which activity is a nurse assist the patient with?

A

Ambulating 25 to 100 feet three times a day as tolerated

98
Q

The patient had see ABG with the radial artery uses a graph. The nurse performs which assessment specific to this patient?

A

Assesses hand color, temperature, owner and radio pulses, and capillary refill every hour initially

99
Q

A patient with a CABG has been diagnosed with mediastinitis. What information does the nurse expect to find the patient assessment documentation?

A
  1. Fever continuing beyond the first four days after CA BG
  2. Bogginess of the sternum
  3. Redness and drainage from suture site
  4. Induration or swelling at the suture site
100
Q

A patient had a CA BG with the vein graft. To help prevent collapse of the graph, what assessment is the nurse?

A

Monitor for hypotension

101
Q

The nurse is caring for a patient who had a CABG. The nurse pays close attention to which electrolyte levels for this postoperative patient?

A
  1. Potassium
  2. Calcium
  3. Magnesium
102
Q

After a CA BG a postoperative patient suddenly has a decrease in the mediastinal drainage, jugular vein distention with clear lung sounds, pulses process, and equalizing PA WP and right arterial pressure. Of what does the nurse suspect these are signs?

A

Cardiac tamponade

103
Q

The nurse coming on duty receives the change of shift report. Which patient is assessed first by the nurse?

A

Patient with anxiety, nausea, diaphoresis, and shortness of breath

104
Q

The nurses caring for a patient who had a minimally invasive direct coronary artery bypass. Which sign or symptom promotes the nurse immediately contact the healthcare provider?

A

St segment changes in the V leads

105
Q

A patient has discrete, proximal, noncalcified lesions of only one or two vessels. Which procedure is most likely to be recommended for this patient?

A

PTCA

106
Q

The nurses caring for a patient who had a PTCA. Which postoperative interventions are included in the care for this patient?

A

Everything

107
Q

Treatment of hypothermia, a common problem after CABGs surgery, with warming blankets is necessary because this condition may cause a patient be at risk for which condition?

A

Hypertension

108
Q

Which statement is true about postpericardiotony syndrome?

A

It places the patient at high risk for cardiac tamponade

109
Q

Eliminates tremors that can exist with human hands, increases the ability to reach inaccessible sites, and improves depth perception with visual acuity

A

Robotic heart surgery

110
Q

Patient has one or two very small incisions in the leg or arm

A

Endovascular vessel harvesting

111
Q

Cardiopulmonary bypass is not required

A

Minimally invasive direct coronary artery bypass

112
Q

Creates channels that will eventually allow oxygenated blood to flow during diastole from left ventricle to nurse the muscle

A

Transmyocardial laser revascularization

113
Q

Procedure in which open heart surgery is performed without the use of a heart lung bypass machine

A

Off pump coronary artery bypass

114
Q

A client who had several episodes of chest pain is scheduled for an exercise electrocardiogram. Which exclamation Chuck that arson clue and teaching the client about this procedure?

A

This is a noninvasive test to check your hearts response to physical activity

115
Q

A client is a minute with chest pain on relieved by nitroglycerin, elevated temperature, decreased blood pressure, and diaphoresis. Myocardial infarction is diagnosed. What should the nurse consider as a valid reason for one of this clients physiological responses?

A

Inflammation in the myocardium cause of the rise in the systemic body temperature

116
Q

After surgery for insertion of a coronary artery bypass graft, client about the temp of 102. What priority concern related to elevated temperatures does a nurse consider when notifying the healthcare provider about the clients temperature?

A

Fever increases the cardiac output

117
Q

During an interview the nurse discovers that the spouse of a debilitated, chronically constipated client did Julie remove stool from the clients wrecked him. What response to disimpaction is a nurse attempting to prevent by presenting other strategies to regulate the clients bowel movements?

A

Slowing of the heart

118
Q

What should the nurse identifies the primary cause of the pain experienced by client with the coronary occlusion?

A

Heart muscle ischemia

119
Q

What instructions about the use of nitroglycerin should the nurse provide to the client with angina

A

Before physical activity place one tablet under tongue, and repeat the dozen five minutes of pain recurs

120
Q

For which common complication of myocardial infarction should dinners monitor clients in the coronary care unit

A

Dsyrhytmia

121
Q

What should the nurse to decline to expect when preparing for discharge after surgery for a coronary artery bypass graft?

A

Some edema in the leg used for the donor graft is expected with activity

122
Q

A client who had a myocardial infarction is in the coronary care unit on a cardiac monitor. The nurse observes ventricular irritability on the screen. What medication to the nurse prepared with minister?

A

Amiodarone ( cordarone)

123
Q

A client is returning to the surgical unit immediately after placement of a coronary artery stent that was accomplished we access to the for moral artery. What response should the nurse consider the priority when assessing the client

A

Hematoma formation

124
Q

A client is admitted with a diagnosis of possible myocardial infarction and a series of diagnostic tests is ordered. Which blood levels of the nurse expect will increase first of this client has had a myocardial infarction

A

Troponin T

125
Q

A nurse is leading a discussion in the senior center about the risk factors for developing coronary heart disease for women versus men. What should the nurse respond when asked to identify the most significant risk factor?

A

Diabetes

126
Q

A nurse is teaching a group of clients about risk factors for heart disease. Which factors increase the clients risk for a myocardial infarction?

A
  1. Obesity

2. Hypertension

127
Q

Which signs cause the nurse to suspect cardiac tamponade after client has cardiac surgery?

A
  1. Tachycardia
  2. Increased CVP
  3. Jugular vein distention
128
Q

A nurse asked the client with ischemic heart disease to identify the foods that are most important to restrict. The nurse determines that the client understands the dietary instructions from the client identify the following foods.

A
  1. Chicken broth
  2. Enriched whole milk
  3. Red meats, beef
  4. Liver and other organs
129
Q

You’re working in the emergency department want to client arrives reporting substernal and left arm discomfort that is been going on for about three hours. Which lab test will be most useful in determining whether you should anticipate implementing the acute coronary syndrome standard protocol?

A

Troponin I level

130
Q

You were monitoring a 53-year-old client who is undergoing a treadmill stress test. Which client binding will require the most immediate action?

A

Chest pain level of three

131
Q

The healthcare provider prescribes his actions for a client who was admitted with acute substernal chest pain. Which actions are appropriate to delegate to an experienced LPN, LVN was working with you in the ED?

A
  1. Attaching cardiac monitor leads
  2. obtaining a 12 lead electrocardiogram
  3. having the client to install aspirin 162 mg
132
Q

based on the information in a clients medical record which topic we plan on including in the initial teaching plan for a client who has a new diagnosis of stage one hypertension?

A

Low-sodium foods will eating out

133
Q

You make a home visit to evaluate a hypertensive client was been taking enalapril which finding indicates that you need to contact the healthcare provider about a change in the drug therapy

A

Client coughs often during the visit

134
Q

You are the charge nurse for the coronary care step down unit. Which client is best to assign to a float RN who has come for the day from the general medical surgical unit?

A

Client recieving IV furosemide( Lasix) to treat acute left ventricular failure

135
Q

At 9 pm you admit a 63 year old with a diagnosis of acute MI. Which finding is most important to communicate to the health care provider who is considering the use of fibrinolytic therapy with tissue plasminogen activator for the client?

A

The client has had continuous chest pain since 8 am

136
Q

You are working with an experienced UAP and an LPN on the telemetry unit. A client who had an acute MI 3 days ago has a nursing diagnosis of activity intolerance related to fatigue and chest pain. Which nursing activity included in the care plan is best delegated to LPN

A

Adminstering nitroglycerin if chest discomfort occurs during client activities

137
Q

You are working in the ED Craig for a client who was just admitted with left anterior chest pain, possible ACS. What action will you take first?

A

Adminster sublingual nitroglycerin

138
Q

An 80 year old client on the coronary step down unit tells you that he does not want to take the ordered Docusate because he does not have any problems with constipation.which action is most appropriate?

A

Explain that his decreased activity level may cause constipation

139
Q

You have given morphine sulfate 4 mg IV to a client who has an acute MI. When you evaluate the clients response 5 minutes after giving the medication which finding indicates a need for immediate action?

A

Persisting chest pain at a level of 1

140
Q

You are preparing to implement teaching about a heart healthy diet and activity levels for a client who has had an MI and her husband. The client Saudi don’t see why I need any teaching. I don’t think I need to change anything right now. Which response is most appropriate.

A

Can you tell me why you don’t feel that you need to make any changes

141
Q

You are caring for a hospitalized client wih heart failure who is receiving catopril and spiral actions. Which lab values will be most important to monitor?

A

Potassium level

142
Q

The health care provider telephones you with new prescriptions for a client with unstable angina who is already taking clopidogrel. Which medication is most important to clarify further with the health care provider.

A

Omeprazole 20 mg daily

143
Q

At 10 am a hospitalize client receives a new order for transesophageal echo cardio Graffi as soon as possible what action we take first?

A

Put the client on NPO status

144
Q

You assess a client who has just returned to the recovery area after undergoing coronary arteriography. Which info is most of concern?

A

Apical pulse is 122 beats min and regular

145
Q

You’re working in an outpatient clinic where many vascular diagnostic tests are performed. Which task associated with vascular testing is most appropriate to delegate to an experienced UAP

A

Measuring ankle and brachial pressures in a client for whom the ankle brachial index is to be calculated

146
Q

While working on the cardiac step down unit you are serving as a preceptor to a new grad RN who has been in a 6 week orientation program. Which client will be best to assign to the new graduate?

A

33 year old admitted a week ago with endocarditis who will be recieving ceftriaxone 2 g IV

147
Q

Monitoring the cardiac rhythms of clients in the coronary care unit. Which client will need immediate intervention?

A

Client who is just arrived on the unit with an acute MI and have a sinus rhythm at a rate of 76 beats a minute

148
Q

Ventricular fibrillation is identified in an unresponsive if your client was just arrived in the emergency department. What action we take first?

A

Defibrillated at 22 j

149
Q

Two weeks ago a 63-year-old client with her file received a new prescription for carbon dial 3.215 mg orally. When evaluating the client in the cardiology clinic polling data. Which finding is of most concern?

A

Sinus bradycardia at a rate of 48 beats a minute

150
Q

You have just received a change of shift report about the clients on the corner step down unit. Which will only use us first?

A

45-year-old with constricted cardiomyopathy was developed acute dyspnea and agitation about one hour before the shift change

151
Q

As a charge nurse in a long-term care facility that employed RNs, LPNs, and you APs you have developed a plan for the ongoing assessment of all residents with a diagnosis of heart failure. Which activity included in the plan is most appropriate to delegate to the LPN team member?

A

Listening to lung sounds and checking for edema each week

152
Q

During a home does it to an 88-year-old client who is taking to Jackson 0.25 mg daily to treat her well you’re in atrial fab you must obtain this assessment information. Which finding is most important to communicate to the healthcare provider?

A

Vision that is becoming fuzzy

153
Q

You are ambulating a cardiac surgery client who has a telemetry cardiac monitor when another staff member tells you that the client has developed supra ventricular tachycardia at a rate of 146 bpm. In what order do you do the following action?

A
  1. Have the client sit down
  2. Adminster PRN oxygen by nasal cannula
  3. Check the clients BP
  4. Call client physician
154
Q

A client with endocarditis with vegetation on the mitral valve send the reports of your left foot pain. You know that no pulses palpable in the left foot and that it is cold and pale. Which action should you take Next?

A

Notify the clients physician about the change in status

155
Q

Resident in a long-term care facility who has venous stasis ulcers is treated with an unna boot. Which nursing activities included in the residence care is best for you to delegate to the UAP

A

Assisting the client in cleaning around the boot

156
Q

Post operative assessment of a client who is just been transferred to the post anesthesia care unit after a pair of an of Domino your dick aneurysm, you obtain these data. Which finding has those immediate implications for the clients care?

A

Arterial line indicates BP of 190/112

157
Q

You’re developing a standardize care plan for the postoperative care of a client undergoing cardiac surgery. Which nursing activities included in the care plan will need to be performed by the RN staff members?

A

Developing an individual plan for discharge teaching based on discharge medications and needed lifestyle changes

158
Q

You’re preparing to administer the following medications to a client with multiple health problems with been hospitalized with the van thrombosis. Which medication is most important to double check with another licensed nurse

A

Warfarin 2.5 mg

159
Q

Client seen in the clinic with shortness of breath and fatigue is being evaluated for possible diagnosis of heart failure. Which lab result will be most useful to monitor?

A

B type naturetic peptide

Nurs. 401 (15 decks)

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