NCLEX 10000 CARDIOVASCULAR

NCLEX 10000 CARDIOVASCULAR

MULTIPLE EXAM RATED A

An 80-year-old client is admitted with nausea and vomiting. The client has a history of heart failure and is being treated with digoxin. The client has been nauseated for a week and began vomiting 2 days ago. Laboratory values indicate hypokalemia. Because of these clinical findings, the nurse should assess the client carefully for: Answer - digoxin toxicity

A client is admitted to the hospital through the emergency department with chest pain.Which intervention is the priority? Answer -assessing troponin 1 levels

A client is receiving nitroglycerin ointment to treat angina pectoris. The nurse evaluates the therapeutic effectiveness of this drug by assessing the client's response and checking for adverse effects. Which vital sign is most likely to reflect an adverse effect of nitroglycerin? Answer -blood pressure 84/52 mm Hg

An older adult takes two 81-mg aspirin tablets daily to prevent a heart attack. The client reports having a constant "ringing" in both ears. How should the nurse respond to the client's comment? Answer -explain to the client that the "ringing" may be related to the aspirin

A client who has been experiencing angina has a new prescription for nitroglycerin. The nurse should instruct the client to report having which potential side effect of nitroglycerin? Answer -headache

The nurse is taking a nursing history from a client prior to surgery. Which information in the client's history would have a significant impact on the client's recovery postoperatively? The client: Answer -has smoked 1 pack of cigarettes a day for 12 years

A client has been diagnosed with atrial fibrillation. The health care provider (HCP) prescribed warfarin to be taken on a daily basis. The nurse instructs the client to avoid using which over-the-counter medication while taking warfarin? Answer -aspirin

A 68-year-old client on day 2 after hip surgery has no cardiac history but reports having chest heaviness. The nurse should first: Answer -inquire about the onset, duration, severity, and precipitating factors of the heaviness

What is a priority nursing assessment in the first 24 hours after admission of the client with a thrombotic stroke? Answer -pupil size and pupillary response

What mechanical device increases coronary perfusion and cardiac output and decreases myocardial workload and oxygen consumption in a client with cardiogenic shock? Answer -intra-aortic balloon pump

A client with a history of coronary artery disease (CAD) has been diagnosed with peripheral arterial disease. The health care provider (HCP) started the client on pentoxifylline once daily. Approximately 1 hour after receiving the initial dose of pentoxifylline, the client reports having chest pain. The nurse should first: Answer - inform the HCP

A nurse is caring for a client with type 2 diabetes who has had a myocardial infarction (MI) and is reporting nausea, vomiting, dyspnea, and substernal chest pain. Which of the following is the priority intervention? Answer -control the pain and support breathing and oxygenation

Which information about sublingual nitroglycerin tablets should the nurse include when instructing the client with angina? Answer -store the tablets in a tight, light-resistant container.

A client with left-sided heart failure complains of increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these

findings as signs and symptoms of: Answer -acute pulmonary edema

Which symptom should the nurse teach the client with unstable angina to report immediately to the health care provider (HCP)? Answer -a change in the pattern of the chest pain

A nurse is evaluating a client who had a myocardial infarction (MI) 7 days earlier. Which outcome indicates that the client is responding favorably to therapy? Answer -the client demonstrates ability to tolerate more activity without chest pain

Which food should the nurse teach a client with heart failure to limit when following a 2- gram sodium diet? Answer -canned tomato juice

The nurse is assessing a cliet who has a history of peripheral vascular disease. The nurse observes that the left great toe is black. The discoloration is likely a result of: Answer -gangrene

A physician admits a client to the health care facility for treatment of an abdominal aortic aneurysm. When planning this client's care, which goal should the nurse keep in mind as she formulates interventions? Answer -stabilizing heart rate and blood pressure and easing anxiety

What is the expected outcome of thrombolytic drug therapy for stroke? Answer - dissolved emboli

A client is receiving pentoxifylline for intermittent claudication. The nurse should determine the effectiveness of the drug by asking if the client: Answer -has less pain in the legs

A client is taking spironolactone to control her hypertension. Her serum potassium level is [6 mEq/L (56mmol/L)]. For this client, the nurse's priority should be to assess her: Answer -ECG results

A client is discharged after an aortic aneurysm repair with a synthetic graft to replace part of the aorta. The nurse should instruct the client to notify the health care provider

(HCP) before having: Answer -major dental work

A nurse is caring for a client who had a three-vessel coronary bypass graft 4 days earlier. His cholesterol profile is as follows: total cholesterol 265 mg/dl (6.845 mmol/L), low-density lipoprotein (LDL) 139 mg/dl (3.603 mmol/L), and high-density lipoprotein (HDL) 32 mg/dl (0.829 mmol/L). The client asks the nurse how to lower his cholesterol.The nurse should tell the client that: Answer -shell ask the dietitian to talk with him about modifying his diet

A client is in hypovolemic shock. In which position should the nurse place the client?Answer -supine with the legs elevated 15 degrees

A client with peripheral vascular disease has undergone a right femoral-popliteal bypass graft. The blood pressure has decreased from 124/80 mm Hg to 88/62 mm Hg. What should the nurse assess first? Answer -pedal pulses

A client has a history of heart failure and has been prescribed furosemide, digoxin, and potassium chloride. The client has nausea, blurred vision, headache, and weakness.The nurse notes that the client is confused. The telemetry strip shows first-degree atrioventricular block. The nurse should assess the client for signs of Answer - digoxin toxicity

A visiting nurse is teaching a client with heart failure about taking his medications. The client requires six different medications that are taken at four different times per day.The client is confused about when to take each medication. How should the nurse intervene? Answer -teach a family member to fill a medication compliance aid once per week

The nurse is preparing to defibrillate a client on a cardiac monitor who is in ventricular fibrillation (see photo). What should the nurse do? Answer -after pressing the change button and calling all clear push the shock button

A client has acute arterial occlusion. The health care provider (HCP) has prescribed IV heparin. Before starting the medication, the nurse should Answer -review the blood coagulation lab values

The client has had a myocardial infarction, and the nurse has instructed the client to prevent Valsalva's maneuver. The nurse determines the client is following the instructions when the client: Answer -avoids holding the breath during activity

The nurse is assessing a client admitted with a myocardial infarction with the following assessment: dyspnea, heart rate of 140 bpm, and crackles in the posterior chest. The nurse would interpret these findings as which of the following? Answer - development of congestive heart failure

The nurse teaches a client who has recently been diagnosed with hypertension about following a low-calorie, low-fat, low-sodium diet. Which menu selection would best meet the client's needs? Answer -baked chicken, and apple, and a slice of white bread

As an initial step in treating a client with angina, the health care provider (HCP) prescribes nitroglycerin tablets, 0.3 mg given sublingually. This drug's principal effects are produced by Answer -vasodilation of peripheral vasculature

A client with heart failure is receiving furosemide, 40 mg I.V. The physician orders [40 mEq (40 mmol/L)] of potassium chloride in 100 ml of dextrose 5% in water to infuse over 4 hours. The client's most recent serum potassium level is [3.0 mEq/L (3.0 mmol/L)]. At what infusion rate should the nurse set the I.V. pump? Answer -25 ml/hr

A client with migraine headaches and a history of angina asks the nurse why the physician does not prescribe one of the newer medications for migraine, such as sumatriptan. The nurse responds that Answer -sumatriptan is contraindicated in clients with angina

The nurse is caring for a client who has been diagnosed with deep vein thrombosis.When assessing the client's vital signs, the nurse notes an apical pulse of 150 bpm, a respiratory rate of 46 breaths/minute, and blood pressure of 100/60 mm Hg. The client appears anxious and restless. What should be the nurse's first course of action?Answer -notify the health care provider

A client with known coronary artery disease reports intermittent chest pain, usually on exertion. The physician diagnoses angina pectoris and orders sublingual nitroglycerin to treat acute angina episodes. When teaching the client about nitroglycerin administration, which instruction should the nurse provide? Answer -be sure to take after precautions because nitro may cause dizziness when you stand up

A nurse is instructing a client about using antiembolism stockings. Antiembolism stockings help prevent deep vein thrombosis (DVT) by: Answer -forcing blood into the deep venous system