Cardiovascular System | Myocardial Infarction And Heart Failure NCLEX Quiz 16

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  • 1/10 Questions

    The nurse coming on duty receives the report from the nurse going off duty. Which of the following clients should the on-duty nurse assess first?

    • The 58-year-old client who was admitted 2 days ago with heart failure. BP of 126/76. and a respiratory rate of 21 breaths a minute.
    • The 88-year-old client with end-stage right-sided heart failure. BP of 78/50. and a DNR order.
    • The 62-year-old client who was admitted one day ago with thrombophlebitis and receiving IV heparin.
    • A 76-year-old client who was admitted 1 hour ago with new-onset atrial fibrillation and is receiving IV diltiazem (Cardizem).
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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.

Cardiovascular System | Myocardial Infarction And Heart Failure NCLEX Quiz 16 - Quiz

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  • 2. 

    A client comes into the E.R. with acute shortness of breath and a cough that produces pink. frothy sputum. Admission assessment reveals crackles and wheezes. a BP of 85/46. a HR of 122 BPM. and a respiratory rate of 38 breaths/minute. The client’s medical history included DM. HTN. and heart failure. Which of the following disorders should the nurse suspect?

    • Pulmonary edema

    • Pneumothorax

    • Cardiac tamponade

    • Pulmonary embolus

    Correct Answer
    A. Pulmonary edema
    Explanation
    SOB. tachypnea. low BP. tachycardia. crackles. and a cough producing pink. frothy sputum are late signs of pulmonary edema.

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  • 3. 

    Which of the following terms describes the force against which the ventricle must expel blood?

    • Afterload

    • Cardiac output

    • Overload

    • Preload

    Correct Answer
    A. Afterload
    Explanation
    Afterload refers to the resistance on maintained by the aortic and pulmonic valves. the condition and tone of the aorta. and the resistance offered by the systemic and pulmonary arterioles.Option B: Cardiac output is the amount of blood expelled by the heart per minute.Option C: Overload refers to an abundance of circulating volume.Option D: Preload is the volume of blood in the ventricle at the end of diastole.

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  • 4. 

    An 18-year-old client who recently had an URI is admitted with suspected rheumatic fever. Which assessment findings confirm this diagnosis?

    • Erythema marginatum. subcutaneous nodules. and fever

    • Tachycardia. finger clubbing. and a load S3

    • Dyspnea. cough. and palpitations

    • Dyspnea. fatigue. and syncope

    Correct Answer
    A. Erythema marginatum. subcutaneous nodules. and fever
    Explanation
    Diagnosis of rheumatic fever requires that the client have either two major Jones criteria or one minor criterion plus evidence of a previous streptococcal infection. Major criteria include carditis. polyarthritis. Sydenham’s chorea. subcutaneous nodules. and erythema marginatum (transient. non pruritic macules on the trunk or inner aspects of the upper arms or thighs). Minor criteria include fever. arthralgia. elevated levels of acute phase reactants. and a prolonged PR-interval on ECG.

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  • 5. 

    A nurse is preparing for the admission of a client with heart failure who is being sent directly to the hospital from the physician’s office. The nurse would plan on having which of the following medications readily available for use?

    • Diltiazem (Cardizem)

    • Digoxin (Lanoxin)

    • Propranolol (Inderal)

    • Metoprolol (Lopressor)

    Correct Answer
    A. Digoxin (Lanoxin)
    Explanation
    Digoxin exerts a positive inotropic effect on the heart while slowing the overall rate through a variety of mechanisms. Digoxin is the medication of choice to treat heart failure.Options A. C. and D: Diltiazem (calcium channel blocker) and propranolol and metoprolol (beta blockers) have a negative inotropic effect and would worsen the failing heart.

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  • 6. 

    Acute pulmonary edema caused by heart failure is usually a result of damage to which of the following areas of the heart?

    • Left atrium

    • Right atrium

    • Left ventricle

    • Right ventricle

    Correct Answer
    A. Left ventricle
    Explanation
    The left ventricle is responsible for the majority of force for the cardiac output. If the left ventricle is damaged. the output decreases and fluid accumulates in the interstitial and alveolar spaces. causing pulmonary edema.Option A: Damage to the left atrium would contribute to heart failure but wouldn’t affect cardiac output or. therefore. the onset of pulmonary edema.Options B and D: If the right atrium and right ventricle were damaged. right-sided heart failure would result.

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  • 7. 

    A nurse is conducting a health history with a client with a primary diagnosis of heart failure. Which of the following disorders reported by the client is unlikely to play a role in exacerbating the heart failure?

    • Recent URI

    • Nutritional anemia

    • Peptic ulcer disease

    • A-Fib

    Correct Answer
    A. Peptic ulcer disease
    Explanation
    Heart failure is precipitated or exacerbated by physical or emotional stress. dysrhythmias. infections. anemia. thyroid disorders. pregnancy. Paget’s disease. nutritional deficiencies (thiamine. alcoholism). pulmonary disease. and hypervolemia.

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  • 8. 

    When developing a teaching plan for a client with endocarditis. which of the following points is most essential for the nurse to include?

    • “Report fever. anorexia. and night sweats to the physician.”

    • “Take prophylactic antibiotics after dental work and invasive procedures.”

    • “Include potassium rich foods in your diet.”

    • “Monitor your pulse regularly.”

    Correct Answer
    A. “Report fever. anorexia. and night sweats to the physician.”
    Explanation
    An essential teaching point is to report signs of relapse. such as fever. anorexia. and night sweats. to the physician.Option B: To prevent further endocarditis episodes. prophylactic antibiotics are taken before and sometimes after dental work. childbirth. or GU. GI. or gynecologic procedures.Options C and D: A potassium-rich diet and daily pulse monitoring aren’t necessary for a client with endocarditis.

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  • 9. 

    A client admitted with angina complains of severe chest pain and suddenly becomes unresponsive. After establishing unresponsiveness. which of the following actions should the nurse take first?

    • Activate the resuscitation team

    • Open the client’s airway

    • Check for breathing

    • Check for signs of circulation

    Correct Answer
    A. Activate the resuscitation team
    Explanation
    Immediately after establishing unresponsiveness. the nurse should activate the resuscitation team. The next step is to open the airway using the head-tilt. chin-lift maneuver and check for breathing (looking. listening. and feeling for no more than 10-seconds). If the client isn’t breathing. give two slow breaths using a bag mask or pocket mask. Next. check for signs of circulation by palpating the carotid pulse.

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  • 10. 

    A 55-year-old client is admitted with an acute inferior-wall myocardial infarction. During the admission interview. he says he stopped taking his metoprolol (Lopressor) 5 days ago because he was feeling better. Which of the following nursing diagnoses takes priority for this client?

    • Anxiety

    • Ineffective tissue perfusion; cardiopulmonary

    • Acute pain

    • Ineffective therapeutic regimen management

    Correct Answer
    A. Ineffective tissue perfusion; cardiopulmonary
    Explanation
    MI results from prolonged myocardial ischemia caused by reduced blood flow through the coronary arteries. Therefore. the priority nursing diagnosis for this client is Ineffective tissue perfusion (cardiopulmonary).Options A. C. and D: Anxiety. acute pain. and ineffective therapeutic regimen management are appropriate but don’t take priority.

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  • Current Version
  • Sep 29, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Sep 21, 2017
    Quiz Created by
    Santepro
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