A Quiz Questions Over Hospital Client
- 1.
A client has had a recent myocardial infarction involving the left ventricle. WHich assessment finding is expected?
- A.
Faint S1 and S2 sounds on auscultation
- B.
Decreased cardiac output
- C.
Increased blood pressure
- D.
Increased strength of peripheral pulses
Correct Answer
B. Decreased cardiac outputExplanation
After a myocardial infarction involving the left ventricle, the heart's ability to pump blood effectively is compromised. This leads to a decreased cardiac output, as the damaged ventricle is unable to efficiently pump blood out to the rest of the body. This can result in symptoms such as fatigue, shortness of breath, and decreased blood pressure. Therefore, a decreased cardiac output is an expected assessment finding in this scenario.Rate this question:
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- 2.
A client with a stenotic mitral valve has presented to the clienic for further evaluation. WHich intervention is the highest priority?
- A.
Assessment of blood pressure
- B.
Assessment of heart rate
- C.
Intravenous fluids
- D.
Administration of digoxin
Correct Answer
A. Assessment of blood pressureExplanation
Assessment of blood pressure is the highest priority intervention for a client with a stenotic mitral valve. Stenotic mitral valve can lead to increased pressure in the left atrium, which can result in pulmonary congestion and increased systemic vascular resistance. Assessing the blood pressure helps in determining the severity of the condition and guiding the appropriate management. It also helps in identifying any complications such as hypertensive crisis or hypotension, which may require immediate intervention. Monitoring the blood pressure is crucial in managing the hemodynamic stability of the client and preventing further complications.Rate this question:
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- 3.
What assessment finding will the nurse expect as the client's mean arterial blood pressure decreases below 60 mm Hg?
- A.
Increased cardiac output
- B.
Hypertension
- C.
Chest Pain
- D.
Decreased heart rate
Correct Answer
C. Chest PainExplanation
As the client's mean arterial blood pressure decreases below 60 mm Hg, the nurse would expect the assessment finding of chest pain. Chest pain is a common symptom of inadequate blood supply to the heart muscle, which can occur when the mean arterial blood pressure falls to a dangerously low level. This can be a sign of myocardial ischemia or angina, indicating that the heart is not receiving enough oxygen and nutrients due to decreased blood flow. Therefore, chest pain is a significant finding that should be promptly addressed by the healthcare team.Rate this question:
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- 4.
A clients heart rate and rhythm is regular. What does the nurse assume from this finding?
- A.
The coronary arteries have no atherosclerosis
- B.
Blood pressure is stable
- C.
Conductivity of the cells in the heart is normal
- D.
Automaticity of the cells in the conduction system is normal
Correct Answer
D. Automaticity of the cells in the conduction system is normalExplanation
The nurse assumes that the automaticity of the cells in the conduction system is normal because a regular heart rate and rhythm indicate that the heart is able to generate electrical impulses at a consistent pace. This suggests that the cells in the conduction system are functioning properly and initiating the electrical signals that regulate the heart's contraction.Rate this question:
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- 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.
Sinoartial (SA) node
- B.
Bachmann's bundle
- C.
Bundle of His
- D.
Purkinji fibers
Correct Answer
A. Sinoartial (SA) nodeExplanation
The client's heart rate of 40 beats/min is lower than the normal range (60-100 beats/min) and suggests a potential alteration in the heart's electrical system. The electrophysiological study is used to evaluate the electrical activity of the heart and identify any abnormalities. The SA node is responsible for initiating the electrical impulses that regulate the heart rate. Therefore, the nurse expects that the electrophysiological study may determine an alteration in the SA node.Rate this question:
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- 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.
Increased heart rate
- B.
Vasodilation
- C.
Hypoxemia
- D.
Decreased respiratory rate
Correct Answer
A. Increased heart rateExplanation
Following a myocardial infarction, the body's baroreceptors are stimulated due to hypotension. Baroreceptors are pressure-sensitive receptors located in the walls of blood vessels and the heart. When stimulated, they send signals to the brain to increase sympathetic activity and decrease parasympathetic activity. This leads to an increase in heart rate as a compensatory response to maintain blood pressure and perfusion to vital organs. Therefore, an increased heart rate is expected as a result of baroreceptor stimulation in this scenario.Rate this question:
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- 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.
Decreased cardiac output
- B.
Increased blood pressure
- C.
Increased pulse pressure
- D.
Increased mean arterial pressure
Correct Answer
A. Decreased cardiac outputExplanation
Excessive filling of the ventricles in a client with a history of several myocardial infarctions can lead to decreased cardiac output. This is because the ventricles are not able to effectively pump blood out to the rest of the body, resulting in a reduced amount of blood being circulated. This can lead to symptoms such as fatigue, weakness, and shortness of breath.Rate this question:
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- 8.
A client's heart disease has resulted in a reduction of stroke volume. Which compensatory mechanism is expected?
- A.
Increased blood pressure
- B.
Decreased mean arterial pressure
- C.
Increased heart rate
- D.
Decreased respiratory rate
Correct Answer
C. Increased heart rateExplanation
When a client's heart disease leads to a reduction in stroke volume (the amount of blood pumped out of the heart with each beat), the body compensates by increasing the heart rate. By increasing the heart rate, the heart can pump more frequently to maintain an adequate cardiac output. This compensatory mechanism helps to ensure that enough blood is being circulated throughout the body, despite the decreased stroke volume caused by the heart disease.Rate this question:
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- 9.
The nurse has sdministered a drug that causes vasoconstriction. Which finding indicates an expected response?
- A.
Increased diastolic blood pressure
- B.
Decreased heart rate
- C.
Increased systolic blood pressure
- D.
Increased mean arterial pressure
Correct Answer
A. Increased diastolic blood pressureExplanation
When a drug causes vasoconstriction, it means that the blood vessels are narrowing, which leads to an increase in blood pressure. Diastolic blood pressure specifically measures the pressure in the arteries when the heart is at rest between beats. Therefore, an expected response to a drug that causes vasoconstriction would be an increased diastolic blood pressure.Rate this question:
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- 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.
Increased blood pressure
- B.
Increased heart rate
- C.
Increased cardiac output
- D.
Decreased heart rate
Correct Answer
D. Decreased heart rateExplanation
When the action of the sympathetic nervous system is blocked, the parasympathetic nervous system becomes dominant. The parasympathetic nervous system is responsible for slowing down the heart rate. Therefore, the nurse would expect a decreased heart rate as an assessment finding when the client is given a drug that blocks the action of the sympathetic nervous system.Rate this question:
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- 11.
Which client does the nurse determine is at high risk for cardiovascular disease?
- A.
Older audlt with asthma
- B.
Asian american woman with breast cancer
- C.
Middle aged African Man with diabetes mellitus
- D.
Postmenopausal woman on estrogen hormone replacement therapy
Correct Answer
C. Middle aged African Man with diabetes mellitusExplanation
The nurse determines that the middle-aged African man with diabetes mellitus is at high risk for cardiovascular disease. This is because diabetes is a known risk factor for cardiovascular disease, and middle age is also a risk factor. Additionally, African Americans have a higher prevalence of cardiovascular disease compared to other ethnic groups. Therefore, the combination of diabetes, middle age, and African American ethnicity puts this client at a higher risk for developing cardiovascular disease.Rate this question:
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- 12.
Which illness in a client's history would alert the nurse to the possibility of an abnormality of the heart valves?
- A.
Tuberculosis
- B.
Recurrent viral pneumonia
- C.
Rheumatic Fever
- D.
Asthma
Correct Answer
C. Rheumatic FeverExplanation
Rheumatic fever is the correct answer because it is known to cause damage to the heart valves. This condition occurs as a result of an untreated or inadequately treated streptococcal infection. The streptococcal bacteria can trigger an immune response in the body, leading to inflammation and damage to the heart valves. Therefore, a history of rheumatic fever would alert the nurse to the possibility of abnormality in the heart valves.Rate this question:
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- 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.
Document the finding as normal
- B.
Evaluate the client for pulse deficit
- C.
Assess the client's medication
- D.
Administer atropine
Correct Answer
C. Assess the client's medicationExplanation
The nurse should first assess the client's medication because certain medications can cause bradycardia, which is a heart rate less than 60 beats per minute. By assessing the client's medication, the nurse can determine if any of the medications the client is taking are known to cause bradycardia. This will help the nurse identify a potential cause for the client's low heart rate and guide further assessment and intervention.Rate this question:
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- 14.
Which cleint is most at risk for cardiovascular disease?
- A.
A woman on hormone replacement therapy
- B.
A woman who has never been pregnant
- C.
A woman with elevated HDL (high density lipoprotein) levels
- D.
A woman with abdominal obesity
Correct Answer
D. A woman with abdominal obesityExplanation
Abdominal obesity is a known risk factor for cardiovascular disease. Excess fat around the abdomen can lead to increased levels of cholesterol and triglycerides, high blood pressure, and insulin resistance. These factors contribute to the development of atherosclerosis and increase the risk of heart disease and stroke. Therefore, a woman with abdominal obesity is most at risk for cardiovascular disease compared to the other options provided.Rate this question:
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- 15.
Which client is most at risk for peripherial vascular disease
- A.
A middle aged man who smokes
- B.
A middle aged woman with a sedentary lifestyle
- C.
An older man who is moderately obese
- D.
A young adult with a famiy history of coronary artery disease
Correct Answer
A. A middle aged man who smokesExplanation
A middle aged man who smokes is most at risk for peripheral vascular disease. Smoking is a major risk factor for the development of this condition as it causes damage to the blood vessels, leading to reduced blood flow to the extremities. Additionally, the combination of middle age and smoking further increases the risk. Other factors such as sedentary lifestyle, obesity, and family history of coronary artery disease may also contribute to the development of peripheral vascular disease, but smoking is considered the most significant risk factor in this scenario.Rate this question:
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- 16.
Which client statement alerts the nurse to the occurance of heart failure?
- A.
I get short of breath when I climb stairs
- B.
I see halos floating by
- C.
I have trouble remembering things
- D.
I have lost my appetite
Correct Answer
A. I get short of breath when I climb stairsExplanation
The client statement "I get short of breath when I climb stairs" alerts the nurse to the occurrence of heart failure because shortness of breath, especially during physical exertion, is a common symptom of heart failure. This symptom occurs due to the heart's inability to pump enough blood to meet the body's demand, leading to fluid accumulation in the lungs and difficulty in breathing. Therefore, this statement indicates a possible manifestation of heart failure and should be a cause for concern.Rate this question:
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- 17.
Which statement made by a client would alert the nurse tot he presence of e dema
- A.
I wake up to go to the bathroom at night
- B.
My shoes fit tighter by the end of the day?
- C.
I seem to feel more anxious lately
- D.
I drink at least eight full glasses of water a day
Correct Answer
B. My shoes fit tighter by the end of the day?Explanation
The statement "My shoes fit tighter by the end of the day?" would alert the nurse to the presence of edema. Edema refers to the accumulation of excess fluid in the body, which can cause swelling and tightness in the feet and ankles. If the client notices that their shoes are becoming tighter as the day progresses, it may indicate fluid retention and potential edema. This symptom should be further assessed by the nurse to determine the underlying cause and provide appropriate interventions.Rate this question:
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- 18.
A client has been diagnosed as having New York Heart Association Class I functional status. What will the nurse teach the client?
- A.
You have no limitations on ordinary physical activity
- B.
The discomfort you experience may occur with ordinary physical activity
- C.
You will not be able to do more than simple activity
- D.
The discomfort you have may be present even at rest
Correct Answer
A. You have no limitations on ordinary pHysical activityExplanation
The correct answer is "you have no limitations on ordinary physical activity." This is because New York Heart Association Class I functional status indicates that the client has no limitations and can engage in normal physical activity without experiencing discomfort or symptoms.Rate this question:
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- 19.
Whihc assessment finding indicates arterial insufficiency
- A.
Dependent edema
- B.
Dependent rubor
- C.
Bluish discoloration of the toes
- D.
Clubbing of the fingers
Correct Answer
B. Dependent ruborExplanation
Dependent rubor is a clinical finding that indicates arterial insufficiency. Arterial insufficiency occurs when there is inadequate blood flow to the extremities, usually due to narrowing or blockage of the arteries. Dependent rubor refers to the redness or dusky discoloration of the affected area, typically the lower extremities, when they are in a dependent position. This occurs because of the lack of oxygenated blood reaching the area, leading to tissue hypoxia. Therefore, dependent rubor is a characteristic sign of arterial insufficiency.Rate this question:
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- 20.
The nurse deermines that the client has clubbing. Which is the best intervention?
- A.
Calling the health care provider
- B.
Assessing capillary refill
- C.
Assessing the client's pulse oxygen level
- D.
Monitoring the client's heart rate
Correct Answer
C. Assessing the client's pulse oxygen levelExplanation
Assessing the client's pulse oxygen level is the best intervention because clubbing is often associated with decreased oxygenation. By assessing the client's pulse oxygen level, the nurse can determine if there is a decrease in oxygen saturation and take appropriate actions to improve oxygenation if necessary. Calling the healthcare provider, assessing capillary refill, and monitoring the client's heart rate may also be important interventions, but assessing the client's pulse oxygen level takes priority in this situation.Rate this question:
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- 21.
The cleint's blood pressure is 134/88 mm Hg. Which is the nurses best i ntervention?
- A.
Calling the health care provider because this is severe hypertension
- B.
Reassessing the blood pressure in 1 month because this is stage 2 hypertension
- C.
Reassessing the client's blood pressure at the next yearly physical
- D.
Teaching the client lifestyle modifications to decrease the blood pressure
Correct Answer
D. Teaching the client lifestyle modifications to decrease the blood pressureExplanation
The client's blood pressure reading of 134/88 mm Hg falls within the prehypertension range, which is not considered severe hypertension. Therefore, calling the healthcare provider for this reading would not be the best intervention. Reassessing the blood pressure in 1 month or at the next yearly physical would not be necessary since the reading does not indicate stage 2 hypertension. Teaching the client lifestyle modifications to decrease blood pressure is the best intervention as it focuses on empowering the client to make necessary changes to their lifestyle, such as diet and exercise, to help lower their blood pressure.Rate this question:
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- 22.
The nurse assesses the client's cardiac status. Which finding required immediate intervention
- A.
Swishing sound heard on either side of the neck
- B.
Bounding pulses
- C.
Pulse rate of 90 beats/min
- D.
Blood pressure of 140/90 mm Hg
Correct Answer
A. Swishing sound heard on either side of the neckExplanation
A swishing sound heard on either side of the neck could indicate the presence of a carotid bruit, which is an abnormal sound caused by turbulent blood flow in the carotid arteries. This finding requires immediate intervention because it may indicate a blockage or narrowing in the carotid arteries, which can increase the risk of stroke or other cardiovascular events. The nurse should further assess the client's condition and notify the healthcare provider for further evaluation and intervention.Rate this question:
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- 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.
Pulse oximetry
- B.
Blood pressure
- C.
Respiratory rate
- D.
Neurological evaluation
Correct Answer
B. Blood pressureExplanation
The client's consistent report of feeling dizzy and lightheaded when changing positions suggests orthostatic hypotension, a drop in blood pressure when moving from lying down to sitting or standing. Assessing the client's blood pressure takes priority in this situation as it will help determine if there is a significant decrease in blood pressure when changing positions, which may require further evaluation and intervention. Pulse oximetry, respiratory rate, and neurological evaluation may also be important assessments, but they are not the priority in this case.Rate this question:
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- 24.
Which technique will the nurse use to assess the point of maximal impulse (PMI)
- A.
With the client ina supine position at a 45 degree angle, compress the upper right abdimen for 30 to 40 seconds and observe for neck vein distention
- B.
Measure the blood pressure in both upper arms. The arm with the highest pressure should be used for blood pressure measurement thereafter
- C.
Apply the bell of the stethoscope over the skin of the carotid artery while the client holds his or her breath
- D.
With the client in the supine position, inspect the chest for prominent precordial pulsations
Correct Answer
D. With the client in the supine position, inspect the chest for prominent precordial pulsationsExplanation
The nurse will use the technique of inspecting the chest for prominent precordial pulsations to assess the point of maximal impulse (PMI). This involves observing the chest for any visible pulsations, which can indicate the location of the PMI. This technique is non-invasive and does not require any additional equipment. The other options mentioned in the question are not relevant to assessing the PMI.Rate this question:
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- 25.
Which technique will the nurse use to ausculate the second heart sound?
- A.
Bell of the stethoscope at the base of the heart
- B.
Diaphragm of the stethoscope at the base of the heart
- C.
Bell of the stethoscope at the left sternal border of the heart
- D.
Diaphragm of the stethoscope at the left sternal border of the heart
Correct Answer
B. DiapHragm of the stethoscope at the base of the heartExplanation
The nurse will use the diaphragm of the stethoscope at the base of the heart to auscultate the second heart sound. The diaphragm is used to detect high-pitched sounds, such as the closure of the aortic and pulmonic valves during the second heart sound. The base of the heart is the area where these valves are best heard. The bell of the stethoscope is typically used to detect low-pitched sounds, such as the third and fourth heart sounds, which are not relevant to auscultating the second heart sound.Rate this question:
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- 26.
The nurse hears a splitting of S1 on the auscultation of a young adult child, Which is the nurse's best action?
- A.
Repeat the auscultation using the diaphragm of the stethoscope
- B.
Re3peat the auscultation with the client lying on the lift side
- C.
Notify the health care provider
- D.
Document the finding
Correct Answer
D. Document the findingExplanation
The nurse should document the finding of a splitting of S1 on auscultation. This is because splitting of S1 can be a normal variation in young adults, especially during inspiration. It is caused by a delay in closure of the mitral and tricuspid valves. Documenting the finding allows for accurate and complete documentation of the patient's assessment, which is important for continuity of care and communication with other healthcare providers. Repeating the auscultation or notifying the healthcare provider may not be necessary in this case, as it is a normal finding in young adults.Rate this question:
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- 27.
The nurse hears a splitting an atrila gallop (S4) in an older adult client. Which is the best intervention?
- A.
Admnister a diuretic
- B.
Document the finding
- C.
Decrease the intravenous flow rate
- D.
Evaluate the client's medications
Correct Answer
B. Document the findingExplanation
The best intervention in this scenario is to document the finding. Splitting of an atrial gallop (S4) is an abnormal heart sound that may indicate underlying cardiac conditions. By documenting this finding, the nurse ensures that it is properly recorded in the client's medical record, allowing other healthcare providers to be aware of the abnormality and potentially take further action if necessary. Administering a diuretic, decreasing the intravenous flow rate, or evaluating the client's medications may not be appropriate interventions based solely on the presence of a splitting S4 sound.Rate this question:
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- 28.
The cleint aske the nurse to explain about his heart murmur. WHich is the nurse's best response?
- A.
It is the rushing sound that blood makes moving through narrow places
- B.
It is the sound of the heart muscle stretching in an area of weakness
- C.
It is a term doctors use to describe how well the blood circulated in teh heart
- D.
Itr is the sound the heart makes when it has to work too hard
Correct Answer
A. It is the rushing sound that blood makes moving through narrow placesExplanation
The nurse's best response would be "It is the rushing sound that blood makes moving through narrow places." This explanation accurately describes a heart murmur as the sound of blood flowing through narrow areas in the heart. Heart murmurs are often caused by turbulent blood flow due to narrowed or leaky heart valves, which can create a rushing or whooshing sound.Rate this question:
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- 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.
Elevates the left leg and applies a sandbag to teh entrance site
- B.
Increased the flow rate of the intravenous fluids to 125 mf/hr
- C.
Assesses the color and temperature of the left leg
- D.
Documents the finding as left pedal pulse of +1/4
Correct Answer
C. Assesses the color and temperature of the left legExplanation
The nurse's first action should be to assess the color and temperature of the left leg. This is because a weak pedal pulse could indicate a decrease in blood flow to the leg, which could be a sign of a complication from the angiography procedure. Assessing the color and temperature of the leg will help the nurse determine if there is any abnormality or potential issue that needs to be addressed.Rate this question:
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- 30.
Which assessment fidnign after a left sided cardiac catheterization requires immediate intervention?
- A.
Intake less than output
- B.
Bruising at the insertion site
- C.
Weak had grasps and confusion
- D.
Discomfort in the leg
Correct Answer
C. Weak had grasps and confusionExplanation
Weak hand grasps and confusion after a left-sided cardiac catheterization indicate a potential neurological complication such as a stroke or embolism. These symptoms suggest a lack of blood flow to the brain and require immediate intervention to prevent further damage.Rate this question:
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- 31.
Which cleint assessment takes priority prior to a cardiac catheterization?
- A.
The level of anxiety
- B.
The ability to move side to side
- C.
Knowledge of the procedure
- D.
Assessment for allergies to iodine and shellfish
Correct Answer
D. Assessment for allergies to iodine and shellfishExplanation
The assessment for allergies to iodine and shellfish takes priority prior to a cardiac catheterization because iodine-based contrast dye is commonly used during the procedure. Allergic reactions to iodine and shellfish can be severe and potentially life-threatening. Therefore, it is crucial to identify any allergies beforehand to prevent adverse reactions during the catheterization. This assessment ensures the safety and well-being of the patient during the procedure.Rate this question:
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- 32.
Prior to a resting electrocardiography, which direction is the most improtant for the nurse to give the client?
- A.
You cannot eat or drink before the procedure
- B.
You must lie as still as possible during the procedure
- C.
You are likely to feel warmth as the dye enters the heart
- D.
Increase your fluid intake to at least 3 L on the day of the test
Correct Answer
B. You must lie as still as possible during the procedureExplanation
The most important direction for the nurse to give the client prior to a resting electrocardiography is to lie as still as possible during the procedure. This is because any movement during the procedure can interfere with the accuracy of the results.Rate this question:
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- 33.
PriorA nurse is monotoring a client undergoing exercise electrocardiography (stress test) which assessment finding necessitiates that the test be stopped?
- A.
The client's heart rate reaches 140 beats/min
- B.
The cleint blood pressure is 100/80
- C.
The client's respiratory rate exceeds 36 breaths/min
- D.
The client's electrocardipgram indicates significatnt ST segment dipression
Correct Answer
D. The client's electrocardipgram indicates significatnt ST segment dipressionExplanation
The correct answer is the client's electrocardiogram indicates significant ST segment depression. ST segment depression on an electrocardiogram can indicate myocardial ischemia, which means that the heart muscle is not receiving enough oxygen. This is a serious finding that necessitates stopping the stress test to prevent further harm to the client.Rate this question:
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- 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.
You will feel warmth as dye is injected
- B.
Electrophysiology is a controlled event
- C.
Keep a log of activities during the procedure
- D.
You need to lie on your left side during the procedure
Correct Answer
B. ElectropHysiology is a controlled eventExplanation
Teaching the client that electrophysiology is a controlled event is the highest priority because it helps to alleviate any anxiety or fear the client may have about the procedure. This information reassures the client that the procedure is carefully monitored and conducted by healthcare professionals, which can help to ease their concerns and promote a sense of trust and confidence in the medical team.Rate this question:
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- 35.
A client who is scheduled for a echocardiography today asks why this test is being performed. How will the nurse respond?
- A.
This procedure is the best way to assessthe structure of your heart noninvasively
- B.
This procedure is to assess for abnormal electrical impulses from the sinoatrial node
- C.
This procedure will evaluate the oxygen saturation in your blood
- D.
This is the best way to evaluate the coronary arteries for any blockages that may be present.
Correct Answer
A. This procedure is the best way to assessthe structure of your heart noninvasivelyExplanation
The nurse will respond by explaining that the echocardiography procedure is the best way to assess the structure of the client's heart noninvasively. This means that it allows the healthcare team to examine the heart's chambers, valves, and overall structure without the need for any invasive procedures or surgery. It provides valuable information about the heart's function and can help identify any abnormalities or potential issues.Rate this question:
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- 36.
For which of the following clients is magnetic resonance imaging of the heart contraindicated?
- A.
A young woman who is lactating
- B.
An older man with an implanted pacemaker
- C.
A woman who had a thallium scan yesterday
- D.
A man 10 days after a myocardial infarction
Correct Answer
B. An older man with an implanted pacemakerExplanation
Magnetic resonance imaging (MRI) uses strong magnetic fields and radio waves to create detailed images of the organs and tissues in the body. However, it is contraindicated for clients with implanted pacemakers. Pacemakers contain metal components that can be affected by the strong magnetic fields of an MRI, potentially causing malfunction or damage to the device. Therefore, it is not safe for an older man with an implanted pacemaker to undergo MRI.Rate this question:
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- 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.
Normal cardiac function at rest, but exercise induces widespread myocardial ischemia
- B.
Impaired myocardial perfusion even at rest. cleint at high risk for sudden cardiac death
- C.
Test results are inconclusive, more invasive testing needed to assess cardiac function
- D.
No myocardial scarring or impairment of myocardial perfusion at rest or after exercise
Correct Answer
D. No myocardial scarring or impairment of myocardial perfusion at rest or after exerciseExplanation
The diffuse uptake of thallium in all areas of the heart after exercise indicates that there is no myocardial scarring or impairment of myocardial perfusion at rest or after exercise. This suggests that the client has a normal cardiac function and does not have any signs of ischemia or impaired blood flow to the heart muscle.Rate this question:
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- 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.
Compares the result with previous readings
- B.
Increases the IV fluid rate because these reading are low
- C.
Immediately notifies the physician of theelevated pressures
- D.
Documents the finding and continues to monitor
Correct Answer
A. Compares the result with previous readingsExplanation
The nurse's first intervention should be to compare the result with previous readings. This is important to determine if the pulmonary artery pressure is within an acceptable range or if it has significantly increased. By comparing the current reading with previous ones, the nurse can identify any potential changes or trends that may require further intervention or medical attention. This allows for a more accurate assessment of the client's condition and helps guide the nurse's next steps in providing appropriate care.Rate this question:
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- 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.
Supine, with the head elevated to 45 degrees
- B.
Supine, with the head elevated to 30 degrees
- C.
Reverse trendelenburg position at 15 degrees
- D.
Supine, flat
Correct Answer
A. Supine, with the head elevated to 45 degreesExplanation
The nurse will place the client in a supine position with the head elevated to 45 degrees for the most accurate results when measuring the client's pulmonary artery wedge pressure (PAWP). This position helps to prevent blood from pooling in the lungs and provides optimal venous return, which allows for more accurate measurement of the pressure in the pulmonary artery.Rate this question:
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- 40.
A client's mixed venous oxygen saturation (SvO2) is 44% Which is the nurse's primary intervention?
- A.
This indicates a normal finding. No intervention is necessary
- B.
Decrease the client's oxygen percentage
- C.
Increase the client's oxygen percentage
- D.
The client has oxygen toxicity. call the health care provider
Correct Answer
C. Increase the client's oxygen percentageExplanation
A mixed venous oxygen saturation (SvO2) of 44% indicates that the client's oxygen levels are lower than normal. In order to improve oxygenation, the nurse's primary intervention would be to increase the client's oxygen percentage. This can be done by adjusting the oxygen flow rate or providing supplemental oxygen if necessary.Rate this question:
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- 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.
Furosemide (Lasix)
- B.
External pacemaker
- C.
Lidocaine
- D.
Central venous catheter
Correct Answer
B. External pacemakerExplanation
An external pacemaker is essential to have on hand because a blockage of the right coronary artery can lead to a decrease in blood flow to the heart, which can cause arrhythmias or heart rhythm disturbances. An external pacemaker can be used to regulate the heart's rhythm and prevent any life-threatening arrhythmias until the bypass surgery can be performed. Furosemide (Lasix) is a diuretic used to treat fluid retention and is not directly related to the blockage of the right coronary artery. Lidocaine is a local anesthetic and is not necessary in this situation. A central venous catheter may be used for various purposes, but it is not specifically essential for this scenario.Rate this question:
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- 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.
It will decrease my blood pressure
- B.
It will make me urinate more
- C.
I will take this medication at the first indication of chest pain
- D.
This will help prevent cardiac disease
Correct Answer
B. It will make me urinate more -
- 43.
Which client statement alerts thenurse to the possibility of cardiovascular disease (CVD)
- A.
I'm so busy at work and home; there just aren't enough hours in a day
- B.
I enjoy taking my children to there soccer games. I get to spend time with them
- C.
I hope this isnt going to take long, I have an important meeting in an hour that I can't miss
- D.
It our 25th wedding anniversary this weekend and I dont know what to get my wife
Correct Answer
C. I hope this isnt going to take long, I have an important meeting in an hour that I can't missExplanation
The client statement "I hope this isn't going to take long, I have an important meeting in an hour that I can't miss" suggests a sense of urgency and stress, which can be indicative of cardiovascular disease. Stress is a known risk factor for CVD, and the client's concern about missing an important meeting due to the duration of the activity may imply that they are experiencing symptoms or limitations related to their cardiovascular health.Rate this question:
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- 44.
What laboratory value is indicative of a myocardial infarctin
- A.
Troponin T=0.8 mg/ml
- B.
Myoglobin= 85mcg/L
- C.
CK creatine Kinase=180 units/L
- D.
HDL=60 mg/dl
Correct Answer
A. Troponin T=0.8 mg/mlExplanation
Troponin T is a laboratory value that is indicative of a myocardial infarction. Troponin T is a protein found in cardiac muscle cells, and its presence in the blood indicates damage to the heart muscle. A level of 0.8 mg/ml suggests that there has been some damage to the heart, possibly indicating a myocardial infarction. Other laboratory values such as myoglobin, CK creatine kinase, and HDL do not specifically indicate a myocardial infarction.Rate this question:
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- 45.
Which laboratory results alerts the nurse that a female client is at high risk for a cardiovascular disease?
- A.
Homocysteine = 25 mmol/dl
- B.
Highly sensiitive C reactive protein = 1mg/dl
- C.
Microalbuminuria, trace
- D.
CK-MB=1%
Correct Answer
A. Homocysteine = 25 mmol/dlExplanation
Homocysteine is an amino acid that is produced during the breakdown of proteins. High levels of homocysteine in the blood have been associated with an increased risk of cardiovascular disease. Therefore, a homocysteine level of 25 mmol/dl indicates that the female client is at high risk for cardiovascular disease.Rate this question:
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- 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.
Assessing for dysrhythmias
- B.
Measuring intake and output
- C.
Ssessing urin color and changes
- D.
Assessing pulses every 15 minutes
Correct Answer
C. Ssessing urin color and changesExplanation
The nurse can delegate the task of assessing urine color and changes to the unlicensed assistive personnel. This task does not require specialized knowledge or skills and can be easily performed by the unlicensed personnel under the supervision of the nurse. Assessing for dysrhythmias and pulses every 15 minutes requires more expertise and should be done by the nurse. Measuring intake and output may also require more knowledge and should be done by the nurse unless specifically trained and delegated to the unlicensed personnel.Rate this question:
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- 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.
Assess laboratory results
- B.
Administer aetylecysteine (Mucomyst)
- C.
Assess for allergies to iodine
- D.
Assess pulses, marking then with indelible ink
- E.
Insert a central, venous atheter
- F.
Have a client sign a consent form
- G.
Keep the client NPO
Correct Answer(s)
A. Assess laboratory results
B. Administer aetylecysteine (Mucomyst)
C. Assess for allergies to iodine
D. Assess pulses, marking then with indelible ink
E. Insert a central, venous atheter
G. Keep the client NPOExplanation
Before a cardiac catheterization procedure, the nurse would need to assess the client's laboratory results to ensure that their renal function is stable enough to undergo the procedure. Administering acetylcysteine (Mucomyst) is also important as it helps to protect the kidneys from potential damage caused by the contrast dye used during the procedure. Assessing for allergies to iodine is necessary because the contrast dye used in cardiac catheterization contains iodine. Assessing pulses and marking them with indelible ink is done to monitor for any changes or complications during the procedure. Inserting a central venous catheter may be necessary for administering medications or fluids during the procedure. Keeping the client NPO (nothing by mouth) is important to prevent aspiration during the procedure.Rate this question:
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- 48.
A female cleint is admitted to rule out ischemic heart diseas. Which symptoms are indicative of heart disease.(selecct all that apply)
- A.
Hypertension
- B.
Fatigue despite adequate rest
- C.
Indigestion
- D.
Abdominal fullness
- E.
Anxiety
- F.
Feeling of choking
- G.
Abdominal pain
Correct Answer(s)
B. Fatigue despite adequate rest
C. Indigestion
D. Abdominal fullness
E. Anxiety
F. Feeling of chokingExplanation
The symptoms of fatigue despite adequate rest, indigestion, abdominal fullness, anxiety, and feeling of choking are indicative of heart disease. Hypertension and abdominal pain are not specific symptoms of heart disease and may be caused by other conditions.Rate this question:
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- 49.
Which action will the nurse take to improve the quality of the electrocardiiographic rhythm transmission tot hemonitoring system?
- A.
Apply lotion to the client's chest before attaching the chest leads
- B.
Remove the hair from the chest area before attaching the chest leads
- C.
Instruct the client not to wear any clothing made from synthetic fabrics during the test
- D.
Apply skin protectant tot area prior to placing electrode.
Correct Answer
B. Remove the hair from the chest area before attaching the chest leadsExplanation
To improve the quality of the electrocardiographic rhythm transmission to the monitoring system, the nurse will remove the hair from the chest area before attaching the chest leads. This is because hair can interfere with the conduction of the electrical signals from the heart to the electrodes, resulting in poor signal quality and inaccurate readings. Removing the hair ensures better contact between the skin and the electrodes, allowing for more accurate transmission of the heart's electrical activity.Rate this question:
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- 50.
What will the nurse do to ensure the validity of comparison of electrocardiograms (ECGs) taken at different times?
- A.
Remove electrodes after each ECG is completed
- B.
Place new ECG chest leads on the client before each ECG is completed
- C.
Position the client supine prior to each ECG
- D.
Ensure that electrode placement is identical for each ECG
Correct Answer
D. Ensure that electrode placement is identical for each ECGExplanation
To ensure the validity of comparison of electrocardiograms (ECGs) taken at different times, the nurse needs to ensure that the electrode placement is identical for each ECG. This is important because any variation in electrode placement can lead to differences in the recorded electrical activity of the heart, making it difficult to compare the ECGs accurately. By maintaining consistent electrode placement, the nurse can ensure that any changes in the ECGs over time are due to actual changes in the client's cardiac function rather than differences in electrode positioning.Rate this question:
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Mar 21, 2023Quiz Edited by
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Mar 21, 2012Quiz Created by
Mflanagan2009