Cardiovascular System | Coronary Artery Disease & Hypertension NCLEX Quiz 3

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Cardiovascular System | Coronary Artery Disease & Hypertension NCLEX Quiz 3 - Quiz

All questions are shown, but the results will only be given after you’ve finished the quiz. You are given 1 minute per question, a total of 10 minutes in this quiz.


Questions and Answers
  • 1. 

    A client is scheduled for a cardiac catheterization using a radiopaque dye. Which of the following assessments is most critical before the procedure?

    • A.

      Intake and output

    • B.

      Baseline peripheral pulse rates

    • C.

      Height and weight

    • D.

      Allergy to iodine or shellfish

    Correct Answer
    D. Allergy to iodine or shellfish
    Explanation
    This procedure requires an informed consent because it involves injection of a radiopaque dye into the blood vessel. The risk of allergic reaction and possible anaphylaxis is serious and must be assessed before the procedure.

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  • 2. 

    A client with no history of cardiovascular disease comes into the ambulatory clinic with flu-like symptoms. The client suddenly complains of chest pain. Which of the following questions would best help a nurse to discriminate pain caused by a non-cardiac problem?

    • A.

      “Have you ever had this pain before?”

    • B.

      “Can you describe the pain to me?”

    • C.

      “Does the pain get worse when you breathe in?”

    • D.

      “Can you rate the pain on a scale of 1-10. with ten (10) being the worst?”

    Correct Answer
    C. “Does the pain get worse when you breathe in?”
    Explanation
    Chest pain is assessed by using the standard pain assessment parameters.Options 1. 2. and 4 may or may not help discriminate the origin of pain. Pain of pleuropulmonary origin usually worsens on inspiration.

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  • 3. 

    A client with myocardial infarction has been transferred from a coronary care unit to a general medical unit with cardiac monitoring via telemetry. A nurse plans to allow for which of the following client activities?

    • A.

      Strict bed rest for 24 hours after transfer

    • B.

      Bathroom privileges and self-care activities

    • C.

      Unsupervised hallway ambulation with distances under 200 feet

    • D.

      Ad lib activities because the client is monitored.

    Correct Answer
    B. Bathroom privileges and self-care activities
    Explanation
    On transfer from the CCU. the client is allowed self-care activities and bathroom privileges. Supervised ambulation for brief distances are encouraged. with distances gradually increased (50. 100. 200 feet).

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  • 4. 

    A nurse notes 2+ bilateral edema in the lower extremities of a client with myocardial infarction who was admitted two (2) days ago. The nurse would plan to do which of the following next?

    • A.

      Review the intake and output records for the last two (2) days

    • B.

      Change the time of diuretic administration from morning to evening

    • C.

      Request a sodium restriction of one (1) g/day from the physician.

    • D.

      Order daily weight starting the following morning.

    Correct Answer
    A. Review the intake and output records for the last two (2) days
    Explanation
    Edema. the accumulation of excess fluid in the interstitial spaces. can be measured by intake greater than output and by a sudden increase in weight.Option B: Diuretics should be given in the morning whenever possible to avoid nocturia.Option C: Strict sodium restrictions are reserved for clients with severe symptoms.

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  • 5. 

    A client is wearing a continuous cardiac monitor. which begins to sound its alarm. A nurse sees no electrocardiogram complexes on the screen. The first action of the nurse is to:

    • A.

      Check the client status and lead placement

    • B.

      Press the recorder button on the electrocardiogram console.

    • C.

      Call the physician

    • D.

      Call a code blue

    Correct Answer
    A. Check the client status and lead placement
    Explanation
    Sudden loss of electrocardiogram complexes indicates ventricular asystole or possible electrode displacement. Accurate assessment of the client and equipment is necessary to determine the cause and identify the appropriate intervention.

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  • 6. 

    A nurse is assessing the blood pressure of a client diagnosed with primary hypertension. The nurse ensures accurate measurement by avoiding which of the following?

    • A.

      Seating the client with arm bared. supported. and at heart level.

    • B.

      Measuring the blood pressure after the client has been seated quietly for 5 minutes.

    • C.

      Using a cuff with a rubber bladder that encircles at least 80% of the limb.

    • D.

      Taking a blood pressure within 15 minutes after nicotine or caffeine ingestion.

    Correct Answer
    D. Taking a blood pressure within 15 minutes after nicotine or caffeine ingestion.
    Explanation
    BP should be taken with the client seated with the arm bared. positioned with support and at heart level. The client should sit with the legs on the floor. feet uncrossed. and not speak during the recording. The client should not have smoked tobacco or taken in caffeine in the 30 minutes preceding the measurement.Option B: The client should rest quietly for 5 minutes before the reading is taken.Option C: The cuff bladder should encircle at least 80% of the limb being measured. Gauges other than a mercury sphygmomanometer should be calibrated every six (6) months to ensure accuracy.

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  • 7. 

    IV heparin therapy is ordered for a client. While implementing this order. a nurse ensures that which of the following medications is available on the nursing unit?

    • A.

      Vitamin K

    • B.

      Aminocaproic acid

    • C.

      Potassium chloride

    • D.

      Protamine sulfate

    Correct Answer
    D. Protamine sulfate
    Explanation
    The antidote to heparin is protamine sulfate and should be readily available for use if excessive bleeding or hemorrhage should occur.Option A: Vitamin K is an antidote for warfarin.

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  • 8. 

    A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin (Coumadin). The client’s prothrombin time is 20 seconds. with a control of 11 seconds. The nurse assesses that this result is:

    • A.

      The same as the client’s own baseline level

    • B.

      Lower than the needed therapeutic level

    • C.

      Within the therapeutic range

    • D.

      Higher than the therapeutic range

    Correct Answer
    C. Within the therapeutic range
    Explanation
    The therapeutic range for prothrombin time is 1.5 to 2 times the control for clients at risk for thrombus. Based on the client’s control value. the therapeutic range for this individual would be 16.5 to 22 seconds. Therefore the result is within the therapeutic range.

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  • 9. 

    A client who has been receiving heparin therapy also is started on warfarin. The client asks a nurse why both medications are being administered. In formulating a response. the nurse incorporates the understanding that warfarin:

    • A.

      Stimulates the breakdown of specific clotting factors by the liver. and it takes two (2)- three (3) days for this to exert an anticoagulant effect.

    • B.

      Inhibits synthesis of specific clotting factors in the liver. and it takes 3-4 days for this medication to exert an anticoagulant effect.

    • C.

      Stimulates production of the body’s own thrombolytic substances. but it takes 2-4 days for this to begin.

    • D.

      Has the same mechanism of action as Heparin. and the crossover time is needed for the serum level of warfarin to be therapeutic.

    Correct Answer
    B. Inhibits synthesis of specific clotting factors in the liver. and it takes 3-4 days for this medication to exert an anticoagulant effect.
    Explanation
    Warfarin works in the liver and inhibits synthesis of four vitamin K-dependent clotting factors (X. IX. VII. and II). but it takes 3 to 4 days before the therapeutic effect of warfarin is exhibited.

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  • 10. 

    A 60-year-old male client comes into the emergency department with complaints of crushing chest pain that radiates to his shoulder and left arm. The admitting diagnosis is acute myocardial infarction. Immediate admission orders include oxygen by NC at 4L/minute. blood work. chest x-ray. an ECG. and two (2) mg of morphine given intravenously. The nurse should first:

    • A.

      Administer the morphine

    • B.

      Obtain a 12-lead ECG

    • C.

      Obtain the lab work

    • D.

      Order the chest x-ray

    Correct Answer
    A. Administer the morphine
    Explanation
    Although obtaining the ECG. chest x-ray. and blood work are all important. the nurse’s priority action would be to relieve the crushing chest pain.

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