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NUR 2032C CARDIOVASCULAR EXAM QUESTIONS
AND ANSWERS BEST EXAM SOLUTION
GUARANTEED SUCCESS,GRADED A+.
Cardiovascular Care of Patients with Dysrhythmias Ignatavicius: Medical-Surgical Nursing, 8th Edition A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which priority intervention should the nurse perform prior to defibrillating this client? ❖ Ensure that everyone is clear of contact with the client and the bed. After teaching a client who has an implantable cardioverter-defibrillator (ICD), a nurse assesses the client’s understanding. Which statement by the client indicates a correct understanding of the teaching? ❖ “I will avoid sources of strong electromagnetic fields.” A nurse cares for a client with atrial fibrillation who reports fatigue when completing activities of daily living. What interventions should the nurse implement to address this client’s concerns? ❖ Schedule periods of exercise and rest during the day. A nurse assists with the cardioversion of a client experiencing acute atrial fibrillation. Which action should the nurse take prior to the initiation of cardioversion?
NUR 2032C CARDIOVASCULAR EXAM QUESTIONS
AND ANSWERS BEST EXAM SOLUTION
GUARANTEED SUCCESS,GRADED A+.
❖ Turn of f oxygen therapy. A nurse prepares to discharge a client with cardiac dysrhythmia who is prescribed home health care services. Which priority information should be communicated to the home health nurse upon discharge? ❖ Medication reconciliation A nurse cares for a client who is on a cardiac monitor. The monitor displayed the rhythm shown below: Which action should the nurse take first? ❖ Assess airway, breathing, and level of consciousness. ✓ Ventricular tachycardia occurs with repetitive firing of an irritable ventricular ectopic focus, usually at a rate of 140 to 180 beats/min or more. Ventricular tachycardia is a lethal dysrhythmia. The nurse should first assess if the client is alert and breathing. Then the nurse should call a Code Blue and begin CPR. If this
NUR 2032C CARDIOVASCULAR EXAM QUESTIONS
AND ANSWERS BEST EXAM SOLUTION
GUARANTEED SUCCESS,GRADED A+.
The nurse is caring for a client on the medical-surgical unit who suddenly becomes unresponsive and has no pulse. The cardiac monitor shows the rhythm below: After calling for assistance and a defibrillator, which action should the nurse take next? ❖ Initiate cardiopulmonary resuscitation (CPR). ✓ The client’s rhythm is ventricular fibrillation. This is a lethal rhythm that is best treated with immediate defibrillation. While the nurse is waiting for the defibrillator to arrive, the nurse should start CPR. A pericardial thump is not a treatment for ventricular fibrillation. If the client does not already have an IV, other members of the team can insert one after defibrillation. The client’s code status should already be known by the nurse prior to this event. After assessing a client who is receiving an
NUR 2032C CARDIOVASCULAR EXAM QUESTIONS
AND ANSWERS BEST EXAM SOLUTION
GUARANTEED SUCCESS,GRADED A+.
amiodarone intravenous infusion for unstable ventricular tachycardia, the nurse documents the findings and compares these with the previous assessment findings: Vital Signs Nursing Assessment Time: 0800 Temperature: 98° F Heart rate: 68 beats/min Blood pressure: 135/60 mm Hg Respiratory rate: 14 breaths/min Oxygen saturation: 96% Oxygen therapy: 2 L nasal cannula Time: 1000 Temperature: 98.2° F Heart rate: 50 beats/min Blood pressure: 132/57 mm Hg Respiratory rate: 16 breaths/min Oxygen saturation: 95% Oxygen therapy: 2 L nasal
DO NO TCOP Y Respirations equal and unlabored. Client denies shortness of breath and chest pain. Client voids 420 mL of clear yellow urine. Based on the assessments, which action should the nurse take? ❖ Slow the amiodarone infusion rate. ✓ IV administration of amiodarone may cause bradycardia and atrioventricular (AV) block. The correct action for the nurse to take at this time is to slow the infusion, because the client is asymptomatic, and no evidence reveals AV block that might require pacing. Abruptly ceasing the medication could allow fatal dysrhythmias to occur. The administration of IV fluids and encouragement of coughing and deep breathing exercises are not indicated and will not increase the client’s heart rate. A nurse cares for a client with congestive heart failure who has a regular cardiac rhythm of 128 beats/min. For which physiologic alterations should the nurse assess? (Select all that apply.) ❖ Decrease in cardiac output ❖ Increase in blood pressure
DO NO TCOP Y ❖ Decrease in urine output A nurse teaches a client with a new permanent pacemaker. Which instructions should the nurse include in this client’s teaching? (Select all that apply.) ❖ “Until your incision is healed, do not submerge your pacemaker. Only take showers.” ❖ “Report any pulse rates lower than your pacemaker settings.” ❖ “Do not lift your left arm above the level of your shoulder for 8 weeks.” A nurse is teaching a client with premature ectopic beats. Which education should the nurse include in this client’s teaching? (Select all that apply.) ❖ Smoking cessation ❖ Stress reduction and management ❖ Adverse effects of medications A nurse assesses a client with tachycardia. Which clinical manifestation requires immediate intervention by the nurse? ❖ Mid-sternal chest pain A nurse teaches a client who experiences occasional premature atrial contractions (PACs) accompanied by palpitations that resolve spontaneously without treatment. Which statement should the nurse include in
DO NO TCOP Y A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to the possibility of a serious complication from this condition? ❖ Speech alterations A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication should the nurse expect to find on this client’s medication administration record to prevent a common complication of this condition? ❖ Warfarin (Coumadin) A nurse administers prescribed adenosine (Adenocard) to a client. Which response should the nurse assess for as the expected therapeutic response? ❖ Short period of asystole A telemetry nurse assesses a client with third-degree heart block who has wide QRS complexes and a heart rate of 35 beats/min on the cardiac monitor. Which assessment should the nurse complete next? ❖ Level of consciousness A nurse cares for a client with an intravenous temporary pacemaker for bradycardia. The nurse observes the presence of a pacing spike but no QRS complex on the client’s electrocardiogram. Which action should the
DO NO TCOP Y nurse take next? ❖ Assess vital signs and level of consciousness. A nurse supervises an unlicensed assistive personnel (UAP) applying electrocardiographic monitoring. Which statement should the nurse provide to the UAP related to this procedure? ❖ “Clean the skin and clip hairs if needed.” A nurse assesses a client’s electrocardiogram (ECG) and observes the reading shown below: How should the nurse document this client’s ECG strip? ❖ Sinus rhythm with premature ventricular contractions (PVCs) ✓ Sinus rhythm with PVCs has an underlying regular sinus rhythm with ventricular depolarization that sometimes precede atrial depolarization. Ventricular tachycardia and ventricular
DO NO TCOP Y : Care of Patients with Vascular Problems Ignatavicius: Medical-Surgical Nursing, 8th Edition
- A student nurse is assessing the peripheral vascular system of an older adult. What action by the student would cause the faculty member to intervene? ❖ Palpating both carotid arteries at the same time
- The nurse is reviewing the lipid panel of a male client who has atherosclerosis. Which finding is most concerning? ❖ Triglycerides: 198 mg/dL
- The nurse is evaluating a 3-day diet history with a client who has an elevated lipid panel. What meal selection indicated the client is managing this condition well with diet? ❖ Baked chicken breast, broccoli, tomatoes
- A nurse is working with a client who takes atorvastatin (Lipitor). The client’s recent laboratory results include a blood urea nitrogen (BUN) of 33 mg/dL and creatinine of 2.8 mg/dL. What action by the nurse is best?
DO NO TCOP Y ❖ Ask if the client eats grapefruit.
- A client has been diagnosed with hypertension but does not take the antihypertensive medications because of a lack of symptoms. What response by the nurse is best? ❖ “Most people with hypertension do not have symptoms.”
- A student nurse asks what “essential hypertension” is. What response by the registered nurse is best? ❖ “It is hypertension with no specific cause.”
- A nurse is interested in providing community education and screening on hypertension. In order to reach a priority population, to what target audience should the nurse provide this service? ❖ African American churches
- A client has hypertension and high-risk factors for cardiovascular disease. The client is overwhelmed with the recommended lifestyle changes. What action by the nurse is best? ❖ Assist in finding one change the client can control.
- The nurse is caring for four hypertensive clients. Which drug–laboratory value combination should the nurse report immediately to the health care provider?
DO NO TCOP Y
- An older client with peripheral vascular disease (PVD) is explaining the daily foot care regimen to the family practice clinic nurse. What statement by the client may indicate a barrier to proper foot care? ❖ “My hands shake when I try to do things requiring coordination.”
- A client is taking warfarin (Coumadin) and asks the nurse if taking St. John’s wort is acceptable. What response by the nurse is best? ❖ “No, it may interfere with the warfarin.”
- A nurse is teaching a larger female client about alcohol intake and how it affects hypertension. The client asks if drinking two beers a night is an acceptable intake. What answer by the nurse is best? ❖ “No, women should only have one beer a day as a general rule.”
- A nurse is caring for four clients. Which one should the nurse see first? ❖ Client who had a first dose of captopril (Capoten) and needs to use the bathroom
- A client had a percutaneous transluminal coronary angioplasty for peripheral arterial disease. What assessment finding by the nurse indicates a priority outcome for this client has been met? ❖ Distal pulse on affected extremity 2+/4+
DO NO TCOP Y
- A client is 4 hours postoperative after a femoropopliteal bypass. The client reports throbbing leg pain on the affected side, rated as 7/10. What action by the nurse takes priority? ❖ Assess distal pulses and skin color.
- A client had a femoropopliteal bypass graft with a synthetic graft. What action by the nurse is most important to prevent wound infection? ❖ Appropriate hand hygiene before giving care
- A client is receiving an infusion of alteplase (Activase) for an intra-arterial clot. The client begins to mumble and is disoriented. What action by the nurse takes priority? ❖ Notify the Rapid Response Team.
- A nursing student is caring for a client with an abdominal aneurysm. What action by the student requires the registered nurse to intervene? ❖ Palpates the abdomen in four quadrants
- A nurse is caring for a client with a deep vein thrombosis (DVT). What nursing assessment indicates a priority outcome has been met? ❖ Oxygen saturation of 98%
- A client has a deep vein thrombosis (DVT). What comfort measure does the nurse delegate to the
DO NO TCOP Y ❖ Measure for new compression stockings.
- A nurse wants to provide community service that helps meet the goals of Healthy People 2020 (HP2020) related to cardiovascular disease and stroke. What activity would best meet this goal? ❖ Participate in blood pressure screenings at the mall.
- A client has been diagnosed with a deep vein thrombosis and is to be discharged on warfarin (Coumadin). The client is adamant about refusing the drug because “it’s dangerous.” What action by the nurse is best? ❖ Assess the reason behind the client’s fear.
- A client with a history of heart failure and hypertension is in the clinic for a follow- up visit. The client is on lisinopril (Prinivil) and warfarin (Coumadin). The client reports new-onset cough. What action by the nurse is most appropriate? ❖ Assess the client’s lung sounds and oxygenation.
- A nurse is caring for a client with a nonhealing arterial lower leg ulcer. What action by the nurse is best? ❖ Consult with the Wound Ostomy Care Nurse.
- A client has peripheral arterial disease (PAD).
DO NO TCOP Y What statement by the client indicates misunderstanding about self-management activities? ❖ “I can use a heating pad on my legs if it’s set on low.”
- A client presents to the emergency department with a severely lacerated artery. What is the priority action for the nurse? ❖ Ensure the client has a patent airway.
- The nurse is assessing a client on admission to the hospital. The client’s leg appears as shown below: What action by the nurse is best? ❖ Assess the client’s ankle-brachial index.
- What nonpharmacologic comfort measures should the nurse include in the plan of care for a client with severe varicose veins? (Select all that apply.) ❖ Applying elastic compression stockings ❖ Elevating the legs when sitting or lying ❖ Reminding the client to do leg exercises
- A nurse is preparing a client for a femoropopliteal bypass operation. What actions does the nurse delegate to the unlicensed assistive personnel (UAP)? (Select all that apply.) ❖ Raising the siderails on the bed
