Test 4

232 Questions  I  By Mflanagan2009

  
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1.  A client has had a recent myocardial infarction involving the left ventricle. WHich assessment finding is expected?
A.
B.
C.
D.
2.  A client with a stenotic mitral valve has presented to the clienic for further evaluation. WHich intervention is the highest priority?
A.
B.
C.
D.
3.  What assessment finding will the nurse expect as the client's mean arterial blood pressure decreases below 60 mm Hg?
A.
B.
C.
D.
4.  A clients heart rate and rhythm is regular. What does the nurse assume from this finding?
A.
B.
C.
D.
5.  The client presents with a heart rate of 40 beatsmin. The nurse expects that an electrophysiological study may determine an alteration in which structure?
A.
B.
C.
D.
6.  A client brought to the emergency room following a myocardial infarction is f ound to be hypotension. Which compensatory change is expected as a result of baroreceptor stimulation?
A.
B.
C.
D.
7.  A client with a history of having several myocardial infarctions has excessive filling of the ventricles as a result. Which physiologic response will the nurse expect to see in this client?
A.
B.
C.
D.
8.  A client's heart disease has resulted in a reduction of stroke volume. Which compensatory mechanism is expected?
A.
B.
C.
D.
9.  The nurse has sdministered a drug that causes vasoconstriction. Which finding indicates an expected response?
A.
B.
C.
D.
10.  The client is being given a drug that block the action of the sympathetic nervous system. Which assessment finding does the nurse expect
A.
B.
C.
D.
11.  Which client does the nurse determine is at high risk for cardiovascular disease?
A.
B.
C.
D.
12.  Which illness in a client's history would alert the nurse to the possibility of an abnormality of the heart valves?
A.
B.
C.
D.
13.  A nurse is performing an admission assessment on an older adult client with multiple chronic diseases. The nurse finds the heart rate to be 48 beats/min. What will the nurse do first?
A.
B.
C.
D.
14.  Which cleint is most at risk for cardiovascular disease?
A.
B.
C.
D.
15.  Which client is most at risk for peripherial vascular disease
A.
B.
C.
D.
16.  Which client statement alerts the nurse to the occurance of heart failure?
A.
B.
C.
D.
17.  Which statement made by a client would alert the nurse tot he presence of e dema
A.
B.
C.
D.
18.  A client has been diagnosed as having New York Heart Association Class I functional status. What will the nurse teach the client?
A.
B.
C.
D.
19.  Whihc assessment finding indicates arterial insufficiency
A.
B.
C.
D.
20.  The nurse deermines that the client has clubbing. Which is the best intervention?
A.
B.
C.
D.
21.  The cleint's blood pressure is 134/88 mm Hg. Which is the nurses best i ntervention?
A.
B.
C.
D.
22.  The nurse assesses the client's cardiac  status. Which finding required immediate intervention
A.
B.
C.
D.
23.  A client consistently reports feeling dizzy and lightheaded when moving from supine position to a sitting position. Which assessment takes priority at this time
A.
B.
C.
D.
24.  Which technique will the nurse use to assess the point of maximal impulse (PMI)
A.
B.
C.
D.
25.  Which technique will the nurse use to ausculate the second heart sound?
A.
B.
C.
D.
26.  The nurse hears a splitting of S1 on the auscultation of a young adult child, Which is the nurse's best action?
A.
B.
C.
D.
27.  The nurse hears a splitting an atrila gallop (S4) in an older adult client. Which is the best intervention?
A.
B.
C.
D.
28.  The cleint aske the nurse to explain about his heart murmur. WHich is the nurse's best response?
A.
B.
C.
D.
29.  A client has returned from an angiography via the left  femoral artery. two hours after the procedure. The nurse notes the left pedal pulse is weak. Which is the nurse's first action?
A.
B.
C.
D.
30.  Which assessment fidnign after a left sided cardiac catheterization requires immediate intervention?
A.
B.
C.
D.
31.  Which cleint assessment takes priority prior to a cardiac catheterization?
A.
B.
C.
D.
32.  Prior to a resting electrocardiography, which direction is the most improtant for the nurse to give the client?
A.
B.
C.
D.
33.  PriorA nurse is monotoring a client undergoing exercise electrocardiography (stress test) which assessment finding necessitiates that the test be stopped?
A.
B.
C.
D.
34.  A client who has survived a cardiac arrest is s cheduled for an electophysiology study (EPS) which is the highest priority to teach this client?
A.
B.
C.
D.
35.  A client who is scheduled for a echocardiography today asks why this test is being performed. How will the nurse respond?
A.
B.
C.
D.
36.  For which of the following clients is magnetic resonance imaging of the heart contraindicated?
A.
B.
C.
D.
37.  The result of a client who underwent myocardial nuclear perfusion imaging (MNPI) with thallium during exercises show diffuse uptake of the thallium in all areas of the heart 10 minutes after injection. What is the interpretation of this finding
A.
B.
C.
D.
38.  A nurse obtains a pulmonary artery pressure reading of 25/12 in a client recovering from a myocardial infarction. Which  is th enurse's first intervention based on these findings?
A.
B.
C.
D.
39.  A nurse is preparing to measure a client's pulmonary artery wedge pressure (PAWP). In what position will thenurse place the client for the most accurate results
A.
B.
C.
D.
40.  A client's mixed venous oxygen saturation (SvO2) is 44% Which is the nurse's primary intervention?
A.
B.
C.
D.
41.  A client's cardiac catheterization has shown an 80% blockage of the right coronary artery (RCA). While waiting for bypass surgery. What is essential to have on hand?
A.
B.
C.
D.
42.  A client post-myocardial  infarction is placed on a beta clocker. Which statemtn best indicates that the cleint understands the action of this medication.
A.
B.
C.
D.
43.  Which client statement alerts thenurse to the possibility of cardiovascular disease (CVD)
A.
B.
C.
D.
44.  What laboratory value is indicative of a myocardial infarctin
A.
B.
C.
D.
45.  Which laboratory results alerts the nurse that a female client is at high risk for a cardiovascular disease?
A.
B.
C.
D.
46.  An older adult has returned from a cardiac catherization. After the initail assessment done by the RN, which activities can the nurse delegate tot he unlicensed assisitive personal?
A.
B.
C.
D.
47.  A client with a history of renal insufficiency is scheduled for a cardiac cathererization. What will the nurse expect to do for this client precatheterization (select all that apply)
A.
B.
C.
D.
E.
F.
G.
48.  A female cleint is admitted to rule out ischemic heart diseas. Which symptoms are indicative of heart disease.(selecct all that apply)
A.
B.
C.
D.
E.
F.
G.
49.  Which action will the nurse take to improve the quality of the electrocardiiographic rhythm transmission tot hemonitoring system?
A.
B.
C.
D.
50.  What will the nurse do to ensure the validity of comparison of electrocardiograms (ECGs) taken at different times?
A.
B.
C.
D.
51.  A client's cardiac status is being observed by telemetry monitoring. A nurse observes a P wave that changes shape in lead II. What conconclusion will the nurse make from this?
A.
B.
C.
D.
52.  What does the P wave on an ECG tracing represent
A.
B.
C.
D.
53.  A nurse notes that the PE interval on a client's ECG tracing is 0.14 second. What action will the nurse take?
A.
B.
C.
D.
54.  The client has exactly 8.0 R-R intervals in 150 small blocks on the ECG paper. Based on this information, the nurse calculates the client's ventricular heart rate to be which of the following
A.
B.
C.
D.
55.  In analyzing a client's ECG tracing, the nurse observes that nor all QRS complexes are preceded by a P wave. What is the nurse's interpretation of this observation
A.
B.
C.
D.
56.  The nurse observes a prominent U wave on the clients ECG tracing. What is the nurses interpretation of this finding
A.
B.
C.
D.
57.  The cleint has a consistent and regular heart rate of 128 beats/min. Which psychologic alterations would be consistent wth this finding?
A.
B.
C.
D.
58.  The client's heart rate increases slightly during inspiration and decreases slightly  during expiration. what action will the nurse take
A.
B.
C.
D.
59.  The client with tachycardia is experiencing clinical manifestation. Which one alerts the nurse to the need for immediate intervention
A.
B.
C.
D.
60.  The client is experiencing sinus bradycardia withhyopotension and dizziness. Which will the nurse administer?
A.
B.
C.
D.
61.  The client is experiencing occasional premature atrial contraction (PAC's) accompanied by palpations. These episodes resolve spontaneously without treatment. What instruction will be included in a teaching plan for this client
A.
B.
C.
D.
62.  The clients ECG reveals tachycardia with a heart rate of 170 beats/min that was initiated after a premature atrial contraction. this rhythm resolved spontaneously withut treatment. WHat is the nurse;s interpretation of this finding>
A.
B.
C.
D.
63.  The nurse notes absent P waves and a heart rate of 200 beats/min on the client's telemetry. How does the nurse interpret these finding
A.
B.
C.
D.
64.  What will the nurse administer to a client withsustained supraventrical tachycardia?
A.
B.
C.
D.
65.  The client has a heart rate averaging 56 beats/min. The client has had no adverse symptoms associated with this bradycaredia and is not being treated for it. Which of the following activity modifications should the nurse suggest to avoid further slowing of the heart rate
A.
B.
C.
D.
66.  Which client is most at risk for atrial fibrillation
A.
B.
C.
D.
67.  Whiat physical assessment finding finding are expected in a client with atrial flutter and a rapid ventricular response?
A.
B.
C.
D.
68.  Which is a priority intervention for the client experiencing atrial fibrillation
A.
B.
C.
D.
69.  Which alteration, when manifested in a client with atrial fibrillation, should alert the nurse tot he possibility of an embolic stoke
A.
B.
C.
D.
70.  A nurse is caring for a client with a chronic atrial fibrillation who is at risk for systemic emboli. Which drug should the nurse expect to administer to prevent this complication
A.
B.
C.
D.
71.  Which dysrhythemia may develope in a client with frequent premature ventricular contractions
A.
B.
C.
D.
72.  A client ECG shows slow, irregular, wide QRS complexes and regular atrial rhythm. What is the nurse's interpretation of this observation
A.
B.
C.
D.
73.  A client;s ECG tracing shows normal sinus rhythm followed by a complexs of three PVC's with a return to normal sunus rhy thm. What is the nurse's interpretation of this finding/
A.
B.
C.
D.
74.  A client with myocardial ischemia is having freauent PVC's. Which intervetnion will the nurse administer
A.
B.
C.
D.
75.  The nurse has administered adenosine (adenocard) what is the expected therapeutic response?
A.
B.
C.
D.
76.  A clients ECG tracing shows a run of sustained ventricular tachycardia. What is the first action that the nurse will take.
A.
B.
C.
D.
77.  Which medication will the nurse administer to prevent recurrent ventricular tachycardia?
A.
B.
C.
D.
78.  A client with unstable ventricular tachycardia is receiving amiodarone hydrochloride by intravenous infusion. The nurse notes that the client's heart rate has decreased from 68 to 50 beats/min. The client is asymptomatic. What is the nurse's priority intervention
A.
B.
C.
D.
79.  The client withischemic heart disease has an ECG tracing that shows first degree heart block. What is the nurse's best action?
A.
B.
C.
D.
80.  Which assessment will  the nurse perform whenever a client has any type of dysrhthmia
A.
B.
C.
D.
81.  The physician is about to perform carotid sinus massage on a client withsupraventricular tachycardia. What equiptment or supplies will the nurse have ready for possible compplications.
A.
B.
C.
D.
82.  A nurse is caring for a client with second degree AV block type II. which is the nurse's priority intervention
A.
B.
C.
D.
83.  A client withthird degree heart block is admitted to the telemetry unit. The nurse observes wide QRS complexes, with a heart rate of 35 beats/min on the monitor. What physical assessment parameter would be importantto incorporate for this client
A.
B.
C.
D.
84.  A client with third degree AV block presents to the emergency room with a heart rate of 40 beats/min or lower is decreased cardiac output. The consequences of this dyshythmia is poor tissue perfusion to the brain and other vital organs.
A.
B.
C.
D.
85.  Which type of pacing would be most appropriate for a client with symptomatic infranodal third degree heart block
A.
B.
C.
D.
86.  A client is about to undergo noninvasive temporary pacing (NCP) which action is most appropriate for preparing this client for the procedure
A.
B.
C.
D.
87.  The nurse observes the presence of a pacind spike but no QRS on the client's ECG tracing. How will the nurse interpret this event?
A.
B.
C.
D.
88.  Which instructions will the nurse include in the teaching plan for a cient with a permenant pacemaker
A.
B.
C.
D.
89.  How will the nurse intervent for the cient with ventricular fibrillation
A.
B.
C.
D.
90.  The client with ventricular tachycardia is unresponsive and has no pulse. What will the nurse do first?
A.
B.
C.
D.
91.  A client w ith heart failure developes an increase in preload. Which mechanism contributes to this increase?
A.
B.
C.
D.
92.  A client  is admitted with early stage heart failure. Which immediate compensatory response would the nurse expect to see in this client
A.
B.
C.
D.
93.  A client is admitted with early stage heart failure, which assessment finding does the nurse expect
A.
B.
C.
D.
94.  A client with systolic dysfunciton has an ejection fraction of 38%. the nurse expects to observe which physiologiv change
A.
B.
C.
D.
95.  Which client is most at risk for developing left sided heart failure
A.
B.
C.
D.
96.  Which client statement alerts the nurse to a possible heart failure
A.
B.
C.
D.
97.  A client with a history of myocardial infarction calls the clinic report the  onset of a cough that is troublesome only at night. What direction will the nurse give to the client.
A.
B.
C.
D.
98.  Which statement made by a client would alert the nurse to possibility of right sided heart failure
A.
B.
C.
D.
99.  Which client is at highest risk for the development of high output heart failure
A.
B.
C.
D.
100.  The nurse notes that the client's apical pulse is displaced to the left. What conclusion can be drawn from the assessment?
A.
B.
C.
D.
101.  The nurse assesses a client and notes the presence of an S3 gallop. Which is the nurse's priority intervention
A.
B.
C.
D.
102.  A client asks the nurse why it is important to be wieghed every day if he or she has right sided heart failure. How will the nurse respond.
A.
B.
C.
D.
103.  A client has been admitted to the intensive care unit with worsening pulmonary manifestation of heart failure. Which primary ccollaborative intervention should the nurse perform?
A.
B.
C.
D.
104.  Whihc nurssing diagnosis would be considered a priority for the client with heart failure?
A.
B.
C.
D.
105.  The client with heart failure experiencing respiratory difficult, Which is the nurse's priority action?
A.
B.
C.
D.
106.  The client with heart failure is prescribed enalapril (Vasotec) what is the nurse's focus for teaching
A.
B.
C.
D.
107.  Which is the priority intervention for a client who has recieved the first dose of captopril (Capiten)
A.
B.
C.
D.
108.  The client with moderate heart failure is being discharged, Which is of priority to teach the client?
A.
B.
C.
D.
109.  The client who just started taking isosorbide dinitrate (Isordil) complains of a headache. What is the nurse's first action
A.
B.
C.
D.
110.  The client with heart failute has been ordered to receive a daily nitroglycerin transdermal patch. Which is the priority nursing intervention
A.
B.
C.
D.
111.  Which intervention is essential to teach the client starting on digoxin therapy
A.
B.
C.
D.
112.  A client is taking triamterene-hydrochlorothiazide (Dyazide) and furosemide (lasix) which assessment finding alers the nurse to a serious side effect
A.
B.
C.
D.
113.  A client with heart failure is going through rehabilitation to increase his or her activitgy tolerance. The nurse will stop the cilent's activity if which symptom is assessed
A.
B.
C.
D.
114.  An older adult client with heart failure has developed arterial fibrillation. what diagnositc or laboratory test would the nurse expect to be ordered
A.
B.
C.
D.
115.  Which assessment finding alerts  the nurse to the possibility of pulmonary edema in an older adult
A.
B.
C.
D.
116.  A client has been admitted to the acute care unity for an exacerbation of heart failure. which is the nurse's priority intervention?
A.
B.
C.
D.
117.  Which assessment finding supports a diagnosis of impaired tissue perfusion in teh client with heart failure
A.
B.
C.
D.
118.  Which assessment finding does the nurse  expect in a client with mitral valve prolapse
A.
B.
C.
D.
119.  Which assessment finding does the nurse expect in a client diagnosed with aortic stenosis
A.
B.
C.
D.
120.  Which assessment finding does the nurse expect in a client diagnosed with aortic stenosis
A.
B.
C.
D.
121.  Which assessment finding does the nurse expect in the client with mitral insufficiency?
A.
B.
C.
D.
122.  The client who has a prosthetic valve replacemtn asks the nurse why he must take anticoagulants for the rest of his life. How will the nurse respond?
A.
B.
C.
D.
123.  A client has jsut  undergone a balloon  valvuloplasty, For whch complication of this procedure should the nurse monitor this client
A.
B.
C.
D.
124.  A cleint is preparing to be discharged home following mitral valve replacement. Which stataemtn indicates that the client requires further education
A.
B.
C.
D.
125.  A young adult p resents with a fecer , symptoms of heart failure, and amurmur. Which additional data will the nurse obtain
A.
B.
C.
D.
126.  Whihc precautions are appropriate when providieng care to a client with infective endocarditis
A.
B.
C.
D.
127.  The home care nurse is assessing the client receiving antibiotic therapy in the home for inefective endocarditis, Which of the following clinical manifestations requires reevaluation of the treatment regimen?
A.
B.
C.
D.
128.  The nurse has difficulty hearing heart sounds in a client with pericarditis. WHich is the priority action of the nurse
A.
B.
C.
D.
129.  Which assessment finding does the nurse expect in a client with pericarditis
A.
B.
C.
D.
130.  A nurse is caring for a cleint admitted with tachycardia, a perciardial friction rub, and the development of a murmur. which finding in the client's history leads the  nurse to suspect rheumatic carditis
A.
B.
C.
D.
131.  Which instruction are essential in a teaching plan for a client with hypertrophic cardiomyopathy (HCM)
A.
B.
C.
D.
132.  The nurse cautions the client who has recieved a heart transplant to change positions slowly, Why is the instructers priority
A.
B.
C.
D.
133.  When teaching is essential for a cleint discharged after a heart transplant whi is prescribed cyclosporine (Sandimmune)
A.
B.
C.
D.
134.  A client is classified (staged) at level A heart fialure, What will the nurse teach the cleint?
A.
B.
C.
D.
135.  A client is classified (staged) at level A heart fialure, What will the nurse teach the cleint?
A.
B.
C.
D.
136.  A client with end stage heart failure is awaiting a transplant. The client appears depressed and states I know a transplant is my last chance but I dont want to become a vegetable. What is the nurse's best response
A.
B.
C.
D.
137.  Which question will best help the nurse to assess the activity lever of a client with a history of heart failure
A.
B.
C.
D.
138.  A client with heartfailure has a blood pressure of 140/60 mm Hg how will the nurse interpret this finding
A.
B.
C.
D.
139.  An older asult clientwith heart failure, "I dont know what to do. I don't want to be a burden to my daughter, but I cant do it alone/ Maybe I should die. Which is the nurse's best response
A.
B.
C.
D.
140.  An older adult client is admitted with fluid volume excess. which diagnostic or laboratory study would best assist in the diagnosis of heart failure
A.
B.
C.
D.
141.  How will the nurse position the client in severe heart failure
A.
B.
C.
D.
142.  A nurse is instructing a client with heart failure on energy conservation. WHich is the best instruction
A.
B.
C.
D.
143.  A client with heart failure is due to receive enalapril (Vasotec). the blood pressure is 98/50 mm/hg. which is the nurse's best action
A.
B.
C.
D.
144.  A client in severe heart failure is to receive nesiride (Natrecor). Which intervention is essential prior to starting this medication
A.
B.
C.
D.
145.  In Health people 2010, which is a priority of the primary nurse caring forolder adults with heart failure
A.
B.
C.
D.
146.  Which conditions are caused by left sided heart fa ilure (select all that apply)
A.
B.
C.
D.
E.
F.
G.
H.
147.  A client with arherosclerosis asks a nurse which factors are responsible for this condition. what is the nurse's best response?
A.
B.
C.
D.
148.  The nurse recognizes which client is at greatest risk for developing intimal injury leading to artherosclerosis
A.
B.
C.
D.
149.  A client with hyperlipidemia, who is being treated with dietary fat restrictions and an exercise program, asks the nurse why hi serum lipid levels are still elevated. What is the nurse's best response
A.
B.
C.
D.
150.  On auscultation of the carotoid arteries of a client with arthersclerosis, the nurse hears a swishing sound over the rish carotid, which would be the nurse;s best action?
A.
B.
C.
D.
151.  What specific instruction should the nurse give to the client with arthersclerosis who is attempting to stop cigarrette smoking with the use of a nicotine patch
A.
B.
C.
D.
152.  The client with hypercholesterolemia and artherosclerosis reports skin flushing and itching while taking nicotine acid, which is the nurse's best response
A.
B.
C.
D.
153.  The n urse incorporates which dietary teaching into the plan for a client with an LDL level of 142 mg/dl. who has been placed on a step one diet
A.
B.
C.
D.
154.  Which breakfast food recommendations are most appropriate for a client who has been placed on a low cholesterol diet
A.
B.
C.
D.
155.  In reviewing the menu selections of a client who is ordered a low cholesterol diet, the nurse questions which selection
A.
B.
C.
D.
156.  Which instruction will be given to a client who is about to begin treatment with simvastin
A.
B.
C.
D.
157.  A client diagnosed with essential hypertension asks how this type of hypertension develops. which is the nurse's best response
A.
B.
C.
D.
158.  The client has been diagnosed with Cushings syndrom. Which assessment will the nurse perform to detect vascular complications of this illness
A.
B.
C.
D.
159.  Which additional physical assessment will the nurse include in the examination of a client diagnosed with hypertension
A.
B.
C.
D.
160.  A nurse is caring for a client with newly diagnosed hypertension. Which dietary teaching will be included in the plan of care for this client
A.
B.
C.
D.
161.  A client is to begin taking hydrochlorthiazide (Microzide) for control of hypertension. which instruction will be given to this client before begining therapy
A.
B.
C.
D.
162.  Which client statement indicates a need for further teaching about hypertension therapy
A.
B.
C.
D.
163.  A client is starting Lininopril (Prinivil) therapy. The nurse will monitor for the development of which potiental side effect
A.
B.
C.
D.
164.  A nurse is about to administer the first dose of captopril (Capoten) to a client with hypertension. which is the priority nursing intervention
A.
B.
C.
D.
165.  A client with hypertension has been prescribed clonidine hydrochloride (Catapres). Which instruction will the nurse give to this client
A.
B.
C.
D.
166.  Which cleint will benefit from receiving treatment for hypertension with an angiotension ACE inhibitor and a calcium channel blocker?
A.
B.
C.
D.
167.  The nurse assesses for which client outcome as indicative of effective hy pertension management
A.
B.