RISKS
Which African American client is at the most risk of developing HTN?
A. Drinks 6 ounces of alcohol daily
B. Has Chronic Kidney Disease
C. Has a family history of Diabetes
D. Quit smoking 30 years ago
HAS CHRONIC KIDNEY DISEASE
A strong risk factor for HTN since the kidneys help regulate fluid status.
A client with a DVT would more likely complain of pain in the calf when doing which activity?
A. dangling the legs
B. elevating the legs
C. lying in the bed
D. walking in the halls
WALKING IN THE HALLS
Pain with movement or walking is a distinct symptom of DVT in the leg
The classification of a blood pressure reading 116/86 is:
A. Expected
B. Elevated
C. Stage I HTN
D. Stage II HTN
STAGE I HTN
Highest abnormal part of BP is the DBP which is in the 80's.
The client scheduled to take Coumadin (Warfarin) 3 mg PO for DVT has an INR of 3. The nurse knows the_____.
A. blood is clotting too fast.
B. blood is clotting slow.
C. blood is at a therapeutic level.
D. Warfarin dose needs adjusting.
BLOOD IS AT A THERAPEUTIC LEVEL
The therapeutic range for INR is 2-3
A client experiencing angina can take ____ NTG SL tablet every ____ minutes up to _____ times.
A. 1, 3, 5
B. 1, 5, 3
C. 5, 3, 1
D. 3, 5, 1
1,5,3
The right route, dose, and time
Which action made by the client would more likely decrease their risk for developing Coronary Artery Disease?
A. Checks blood pressure every 12 hrs.
B. Decreases smoking to once a day.
C. Exercises for 30 minutes twice a week.
D. Avoids eating foods with animal protein.
AVOIDS EATING ANIMAL PROTEIN
Most animal protein is high in cholesterol and fat
The nurse suspects a client may have a PE when they start coughing up what type of mucous?
A. bright red
B. jet black
C. light green
D. pale yellow
BRIGHT RED
Hemopytsis- blood from the lungs
The nurse should avoid which action if a diagnosed DVT is present in a client's leg?
A. Applying several wet, warm dressings to the legs.
B. Assisting the client out of bed to the bathroom.
C. Elevating the leg on pillows above the heart level.
D. Massaging the leg gently with moisturizing lotions.
MASSAGING THE LEG GENTLY WITH MOISTURIZING LOTIONS.
NEVER massage a client's legs due to possible presence of DVT leading to PE.
Which of the following tests of a 55-year-old women would more likely support the diagnosis of HF?
A. BNP- 99 pg/mL
B. BUN- 30 mg/dL
C. LVEF- 35%
D. HDL- 40 mg/dL
LVEF- 35%
LVEF less than 40% indicates HF
Which medication is considered "blood thinners" or anticoagulants?
A. alteplase (Activase)
B. apixaban (Eliquis)
C. naproxen (Naprosyn)
D. andexanet alfa (Andexxa)
APIXABAN (ELIQUIS)
A factor Xa inhibitor that disrupts coagulation
Which of the following food options would be the best recommendation for a client with HTN?
A. grilled ham and cheese sandwich
B. fresh salad with fried chicken strips
C. pasta with homemade tomato sauce
D. vegetable beef soup from a restaurant
PASTA WITH HOMEMADE TOMATO SAUCE
Can control the amount of sodium added
A client says he has frequent episodes of chest pain after eating large meals. What type of angina is he more likely experiencing?
A. Prinzmetal angina
B. Stable angina
C. Unstable angina
D. Variant angina
STABLE ANGINA
A predictable situation caused the pain
The nurse knows which of the following is not a typical cardiac symptom with Acute Coronary Syndrome.
A. Diaphoresis
B. Dizziness
C. Dyspnea
D. Nausea
DIZZINESS
May experience dizziness, by not typical cardiac symptoms like difficulty breathing, sweating, and nausea.
Which of the following is an incorrect step when obtaining the Ankle Brachial Index for PAD in the left leg?
A. Check the brachial artery Systolic BP in the right arm
B. Check the pedal pulse artery Systolic BP in the left leg
C. Use a stethoscope to obtain the Systolic BP readings
D. Use the highest brachial artery Systolic BP reading
USE A STETHOSCOPE TO OBTAIN THE SYSTOLIC BP READINGS
A Doppler is used to listen to the SBP
Which medication is more likely to be administered to a client with blurred vision and BP 200/102 to help lower the BP the most effectively?
A. enalapril (Vasotec) IVP
B. metoprolol (Toprol XL) PO
C. nitroglycerin SL
D. furosemide (Lasix) IVP
ENALAPRIL (VASOTEC) IVP
Hypertensive crisis is first treated with vasodilators intravenously
Which invasive procedure would put a client at the most risk for DVT?
A. Oral Surgery
B. Heart Catheterization
C. Colonoscopy
D. Cystoscopy
HEART CATHETERIZATION
Invasive procedure into a blood vessel
A client with PAD is experiencing intermittent claudication of the legs. What is the nurse's next best action?
A. Apply the SCDs to both legs
B. Elevate the client's legs
C. Encourage the client to rest
D. Obtain a STAT potassium level
ENCOURAGE CLIENT TO REST
Will help stop the cramping (intermittent claudication) by putting less demand for oxygen to the extremities.
The leg of a client with PAD will appear the color _____when elevated and ____ when in the dependent position.
A. grey/red
B. grey/white
C. red/grey
D. white/grey
GREY/RED
Dark-tone individuals will appear grey with elevation, then red when placed downward- based on the Dependent Rubor test results
The nurse knows which of the following V/Q scan results more likely indicates the client may have a Pulmonary Embolism.
A. normal ventilation with normal perfusion
B. abnormal ventilation with abnormal perfusion
C. normal ventilation with abnormal perfusion
D. abnormal ventilation with normal perfusion
NORMAL VENTILATION WITH ABNORMAL PERFUSION
There is no problem with getting oxygen into the lungs (VENTILATION), however, there is a problem with getting oxygenated blood to the tissues. (PERFUSION)
During overlap therapy for DVT, in what order are the following medications initially administered?
A. Heparin IV before Warfarin PO
B. Heparin SQ before Warfarin PO
C. Warfarin PO before Heparin IV
D. Warfarin PO before Heparin SQ
HEPARIN IV BEFORE WARFARIN PO
Once the Heparin infusion dose becomes therapeutic, it is continued and Warfarin is started.
Which of the following conditions can cause left-sided Heart Failure with systolic dysfunction? SELECT ALL THAT APPLY
A. Dilated Cardiomyopathy
B. Hypertension
C. Hypertrophic Cardiomyopathy
D. Pulmonary Hypertension
E. Restrictive Cardiomyopathy
DILATED CARDIOMYOPATHY
HYPERTENSION
Both cause a pumping problem (SYSTOLIC) from the left side of the heart
A client calls the nurse triage line to report a BP of 188/90 but denies any symptoms. Which recommendation should the nurse make? SELECT ALL THAT APPLY
A. "Call back if you develop a severe headache."
B. "Take your Nitroglycerin sublingual tablets now."
C. "Go to the nearest health care facility or ER."
D. "Recheck the BP now while lying down."
E. "You should check your BP in the morning."
GO TO THE NEAREST HEALTH CARE FACILITY OR ER
BP shows Hypertensive Crisis. The client has hypertensive urgency since no symptoms but still needs to be addressed ASAP.
A client who complains of worsening sharp, thoracic pain could more likely be experiencing which of the following conditions? SELECT ALL THAT APPLY.
A. Unstable Angina
B. Metabolic Syndrome
C. Chronic Venous Insufficiency
D. Peripheral Artery Disease
E. Pulmonary Embolism
UNSTABLE ANGINA
PULMONARY EMBOLISM
Any type of chest pain is concerning because this symptom could mean several life-threatening conditions.
DOUBLE JEOPARDY!!!
A client in a car crash could have elevated cardiac markers due to which following conditions? SELECT ALL THAT APPLY
A. headache 8 out of 10 on a numeric scale
B. injury to sternum from chest compressions
C. large open fracture to left femur and ankle
D. oxygen therapy applied via facial mask STAT
E. recent diagnosis of congested Heart Failure
INJURY TO THE STERNUM FROM CHEST COMPRESSIONS
LARGE OPEN FRACTURE TO LEFT FEMUR AND ANKLE
RECENT DIAGNOSIS OF CONGESTED HEART FAILURE
Any condition that causes damage to the heart can elevate troponin levels.
The nurse should perform which intervention for the client taking cilostazol (Pletal). SELECT ALL THAT APPLY.
A. Examine the arms and legs for large bruises
B. Monitor the complete blood count (CBC)
C. Check the bowel movements for blood
D. Obtain blood pressure measurements
E. Place client on bleeding and fall precautions
ALL THE ABOVE
The client is at risk for bleeding and should be monitored for signs and symptoms of bleeding seen in a drop in CBC (Hbg, HCT, PLT), active bleeding from or in areas of the body, and hypotension.