GENERAL
NURSING
DIAGNOSTICS
MEDICATION
MISCELLANEOUS
100
The most common cause of coronary artery disease?
What is Atherosclerosis? Other causes include vasospasm of a coronary artery, myocardial trauma, structural disease, congenital anomalies, decreased oxygen supply, and increased oxygen demand.
100
A client suffering from a myocardial infarction is admitted to the cardiac unit. The nurse can best determine the efficiency of the client’s ventricular contractions by: a) Monitoring cardiac enzyme levels b) Monitoring urinary output hourly c) Assessing heart sounds frequently d) Assessing breath sounds frequently
What is B--Monitoring urinary output hourly is the best measurement tool to determine the effectiveness of the heart’s cardiac output
100
Which diagnostic tool is used to determine the location of myocardial damage for a patient with a myocardial infarction (MI)?
Electrocardiogram (ECG) because it is the quickest, most accurate and most widely used tool to determine the location of an MI
100
The primary purpose of administering aspirin as an emergency treatment for a myocardial infarction?
What is "Aspirin acts as an anti-platelet to prevent further platelet aggregation or clotting. "
100
A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. The nurse anticipates which of the following when auscultating the client's breath sounds? A) Stridor B) Crackles C) Scattered rhonchi D) Diminished breath sounds
What is B--crackles. Pulmonary edema is characterized by extreme breathlessness, dyspnea, air hunger, and the production of frothy, pink-tinged sputum. Auscultation of the lungs reveals crackles. Rhonchi and diminished breath sounds are not associated with pulmonary edema. Stridor is a crowing sound associated with laryngospasm or edema of the upper airway.
200
The purpose of a coronary angioplasty?
What is to open an occluded coronary artery?
200
Name 3 nursing interventions you would perform on a patient who is at high risk for ineffective PERIPHERAL tissue perfusion from decreased cardiac output.
What are: (Any 3 of the following) - Oxygen therapy - Regular vital signs - Head to toe, pain, GCS assessment (q4h) - Observe for cyanosis and edema - Fluid therapy - Monitor input and output - Encourage progressive physical activity
200
What is the first intervention for a client experiencing myocardial infarction (MI)? a) Administer oxygen b) Obtain an ECG c) Administer sublingual nitroglycerin d) Administer morphine for pain
What is A. Administering supplemental oxygen is always the first priority of care!
200
This classification of drugs is utilized for reperfusion therapy?
What are thrombolytic agents?
200
The client is being discharged from the hospital after being treated for infective endocarditis. The nurse provides the client with which discharge instructions? A) Take acetaminophen (Tylenol) if the chest pain worsens B) Use a firm bristle toothbrush and floss vigorously to prevent cavities C) Take antibiotics until the chest pain is fully resolved D) Notify all health care providers of the history of infective endocarditis before any invasive procedures
What is D-- The client should alert any health care provider about the history of infective endocarditis before any procedure that involves instrumentation. The provider should place the client on prophylactic antibiotics. Antibiotics should be taken for the full course of therapy. The client should notify the physician if chest pain worsens or if dyspnea or other symptoms occur. The client should use a soft toothbrush and floss carefully to avoid any trauma to the gums, which could provide a portal of entry for bacterial infection.
300
This describes the difference between stable and unstable angina?
What is : Stable angina is predictable and consistent pain that occurs with exertion. It is treated with rest. Unstable angina is not predictable and occurs more often, lasts longer, and may be associated with severe pain.
300
The nurse teaches the client that a major difference between angina pain and pain associated with MI is that angina can be relieved with rest and THIS medication.
What is Nitroglycerin
300
Which of the following diagnostic studies would most likely confirm a myocardial infarction? a) Creatinine Kinase (CK) b) Troponin and Brain Natriuretic Peptide (BNP) levels c) Serum myoglobin and Brain Natriuretic Peptide (BNP) levels d) Elevated WBC count and Hemoglobin
What is B--Troponin & BNP levels
300
This supplemental electrolyte is most frequently ordered in conjunction with furosemide (Lasix)? a) Chloride b) Potassium c) Sodium d) Digoxin
What is B) Potassium. Loop diuretics such as furosemide increase the excretion of potassium.
300
A nurse is performing an assessment on a client with a diagnosis of left-sided heart failure. Which assessment component would elicit specific information regarding the client's left-sided heart function? A) Listening to lung sounds B) Assessing for peripheral and sacral edema C) Assessing for jugular vein distention D) Monitoring for organomegaly
What is A--listen to lung sounds The client with heart failure may present with different symptoms depending on whether the right or the left side of the heart is failing. Peripheral and sacral edema, jugular vein distention, and organomegaly all are manifestations of problems with right-sided heart function. Lung sounds constitute an accurate indicator of left-sided heart function.
400
A client admitted to the hospital with CAD complains of dyspnea at rest. The nurse caring for the patient chooses which of the following as the best way to monitor respiratory status on an ongoing basis: A. Oxygen flowmeter B. Oxygen saturation monitor C. Telemetry monitor D. Apnea monitor
What is B-Oxygen saturation monitor. Dyspnea in the cardiac client often is accompanied by hypoxemia. This can be detected by an O2 sat monitor, especially if used continuously.An oxygen flowmeter is part of the setup for delivering oxygen therapy. Cardiac monitors detect dysrhythmias. An apnea monitor detects apnea episodes, such as when the client has stopped breathing briefly.
400
Dyspnea, fatigue, increased pulmonary artery pressure, and decreased cardiac output are indicative of: a) MI b) Right sided valve damage c) Left sided valve damage d) JVD
C. Left sided valve damage
400
A client is scheduled to undergo cardiac catheterization for the first time, and the nurse provides instructions to the client. Which client statement indicates a clear understanding of the instructions? A) “I will have to go to the operating room for this procedure.” B) “I probably will feel tired after the test from lying on a hard x-ray table for a few hours.” C) “It will really hurt when the catheter is first put in.” D) “I will receive general anesthesia for the procedure.”
What is Ans: B It is common for the client to feel fatigued after the cardiac catheterization procedure. Other pre-procedure teaching points include that the procedure is done in a darkened cardiac catheterization room. A local anesthetic is used, so little to no pain is experienced with catheter insertion. General anesthesia is not used. The x-ray table is hard and the procedure may take 1 to 2 hours. The client may feel various sensations with catheter passage and dye injection.
400
A patient is receiving ramipril (Altace) to help lower high blood pressure and prevent acute MI. What is the mechanism of action behind this drug?
What is an ACE Inhibitor. Ramipril blocks the conversion of Angiotensin I to II, which dilates arterial vessels, increases venous capacity, and reduces cardiac output and resistance.
400
A nurse is assessing a client with an abdominal aortic aneurysm (AAA). Which of the following assessment findings by the nurse is probably unrelated to the aneurysm? A) Pulsatile abdominal mass B) Hyperactive bowel sounds in the area C) Systolic bruit over the area of the mass D) Subjective sensation of “heart beating” in the abdomen
What is B--Hyperactive bowel sounds in the area. Not all clients with abdominal aortic aneurysm exhibit symptoms. Those who do may describe a feeling of the “heart beating” in the abdomen when supine or being able to feel the mass throbbing. A pulsatile mass may be palpated in the middle and upper abdomen. A systolic bruit may be auscultated over the mass. Hyperactive bowel sounds are not related specifically to an abdominal aortic aneurysm.
500
A nurse notes bilateral +2 edema in the lower extremities of a client with myocardial infarction who was admitted 2 days ago. The nurse would plan to do which of the following next? A) Order daily weights starting on the following morning B) Review the intake and output records for the last 2 days C) Request a sodium restriction of 1g/day from the physician D) Change the time of diuretic administration from morning to evening
What is B--Review the I & O records for the last 2 days. 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. Diuretics should be given in the morning whenever possible to avoid nocturia. Strict sodium restrictions are reserved for clients with severe symptoms
500
A client with angina complains that the pain is prolonged, severe, and occurs at the same time each day, most often at rest. How would the nurse best describe this type of anginal pain? A) Stable angina B) Variant angina C) Unstable angina D) Nonanginal pain
What is B--Variant angina, or Prinzmetal’s angina, is prolonged and severe and occurs at the same time each day, most often at rest. Stable angina is induced by exercise and relieved by rest or nitroglycerin tablets. Unstable angina occurs at lower and lower levels of activity or at rest, is less predictable, and is often a precursor of myocardial infarction.
500
Cardiac magnetic resonance imaging (MRI) is prescribed for a client. The nurse identifies that which of the following is a contraindication for performance of this diagnostic study? A) Client has a pacemaker B) Client is allergic to iodine C) Client has diabetes mellitus D) Client has a biological porcine valve
What is A: the client has a pacemaker The magnetic fields used for magnetic resonance imaging (MRI) can deactivate the pacemaker. Options 2, 3, and 4 are not contraindications for an MRI.
500
Aspirin is used for its antiplatelet activity in the treatment of ACS/MI. Name other antiplatelet medications commonly used in the treatment of these patients.
What is clopidogrel, ticagrelor, prasugrel, and persantine
500
A nurse is monitoring a client with acute pericarditis for signs of cardiac tamponade. Which assessment finding would indicate the presence of this complication? A) A pulse rate of 60 beats/min B) Flat neck veins C) Muffled or distant heart sounds D) A blood pressure (BP) of 128/82 mm Hg
What is : C--muffled or distant heart sounds Assessment findings associated with cardiac tamponade include tachycardia, distant or muffled heart sounds, jugular vein distention, and a falling blood pressure accompanied by pulsus paradoxus (a drop in inspiratory BP greater than 10 mm Hg). Bradycardia is not a sign of cardiac tamponade.
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