Term
| Nurse notes clubbing of the pt's fingers. Based on this finding, the nurse will question the pt. about which of the following disease processes? |
|
Definition
|
|
Term
| Which of the following instructions given to the pt. who is about to undergo Holter monitoring is most appropriate? |
|
Definition
| you will need to keep a diary of all your activities and symptoms |
|
|
Term
| Nurse is admitting a pt. who is scheduled to undergo a cardia catherization. Which of the following allergies is most important for the nurse to assess befoe this procedure? |
|
Definition
|
|
Term
| Nuse auscultates the BP of a 71-year-old patient admitted with pneumonia and finds it to b 160/70 mm Hg. Which of the following does the nurse consider to be an age-related change that contributes to this finding? |
|
Definition
| Loss of elasticity in arterial vessels |
|
|
Term
| Nurse teaches a pt. with hypertension that uncontrolled hypertension may damage organs in the body primarily by which of the following mechanisms? |
|
Definition
| Hypertension promotes atherosclerosis and damage to the walls of the arteries |
|
|
Term
| Teaching a pt. about dietary management of stage 1 hypertension, which of the following instructions is most appropriate? |
|
Definition
| Restrict Na+ intake to <2.4 gm/day |
|
|
Term
| Pt. admitted with poorly controlled hypertension, the nurse would understand that which of the following laboratory test results woul indicate the presence of target organ damage secondary to the primary diagnosis? |
|
Definition
Serum creatinine of 2.6 mg/dl
- normal serum creatinine level is 0.8 to 1.6 mg/dl |
|
|
Term
| Dietary instruction to a patient with hypertension, the nurse would advise the pt. to restrict intake of which of the following meats? |
|
Definition
|
|
Term
| Nurse is caring for a pt. admitted with a history of hypertension. The pt's medical hx. includes chlorothiazide daily for the past 10 years. Which of the following parameters would indicate the optimal inteded effect of this pharmacologic therapy? |
|
Definition
|
|
Term
| In reviewing medication instructions with a patient being discharged on antihypertensive medications, which of the following statements would be most appropriate for the nurse to make when discussing atenolol (Tenormin)? |
|
Definition
"Make position changes slowly, especially when going from a lying down position to a standing position."
- Atenolol is a β1-adrenergic blocker and antihypertensive agent that can cause orthostatic hypotension. For this reason, the patient should be instructed to rise slowly, especially when moving from a recumbent to a standing position. |
|
|
Term
| The nurse is caring for a patient admitted with emphysema, angina, and hypertension. Before administering the prescribed daily dose of atenolol 100 mg PO, the nurse assesses the patient carefully. Which of the following adverse effects is this patient at risk for given the patient's health history? |
|
Definition
| Bronchospasm - Atenolol is a cardioselective β1-adrenergic blocker that reduces blood pressure and could affect the β2-receptors in the lungs with larger doses or with drug accumulation. Although the risk of bronchospasm is less with cardioselective β-blockers than nonselective β-blockers, atenolol should be used cautiously in patients with COPD. |
|
|
Term
| The nurse is caring for a patient with hypertension who is scheduled to receive a dose of atenolol (Tenormin). The nurse should withhold the dose and consult the prescribing physician for which of the following vital signs taken just before administration? |
|
Definition
Pulse 48
- Because atenolol is a β1-adrenergic blocking agent, it can cause hypotension and bradycardia as adverse effects. The nurse should withhold the dose and consult with the prescriber for parameters regarding pulse rate limits. |
|
|
Term
| The community health nurse is planning health promotion teaching targeted at preventing coronary artery disease. For which of the following ethnic groups would the nurse select as the highest priority for this intervention? |
|
Definition
|
|
Term
| Which of the following individuals would the nurse identify as having the highest risk for coronary heart disease (CAD)? |
|
Definition
| A 45-year-old depressed male with a high stress job |
|
|
Term
| For which of the following antilipemic medications would the nurse question an order in a patient with cirrhosis of the liver? |
|
Definition
| atorvastatin (Lipitor) - Adverse effects of atorvastatin (Lipitor), a statin drug, include liver damage and myopathy. Liver enzymes must be monitored frequently and the medication stopped if these enzymes increase. Thus liver disease is a contraindication for this atorvastatin (Lipitor). |
|
|
Term
| After teaching a patient with chronic stable angina about nitroglycerin, the nurse recognizes the need for further teaching when the patient states: |
|
Definition
| “I can take up to five tablets every 3 minutes for relief of my chest pain.” |
|
|
Term
| When planning emergent care for a patient with a suspected myocardial infarction (MI), the nurse will anticipate administration of: |
|
Definition
| morphine, oxygen, nitroglycerin, and aspirin |
|
|
Term
| When evaluating a patient's knowledge regarding a low sodium, low fat cardiac diet, the nurse recognizes additional teaching is needed when the patient selects which of the following food choices? |
|
Definition
| Canned chicken noodle soup |
|
|
Term
| Postoperative care of a patient undergoing coronary artery bypass graft (CABG) surgery includes monitoring for which of the following common complications? |
|
Definition
|
|
Term
| The nurse is providing teaching to a patient recovering from a myocardial infarction (MI). Discussion regarding resumption of sexual activity should be: |
|
Definition
| discussed along with other physical activities |
|
|
Term
| The nurse is administering a dose of digoxin (Lanoxin) to a patient with heart failure (HF). The nurse would become concerned with the possibility of digitalis toxicity if the patient reported which of the following symptoms? |
|
Definition
|
|
Term
| The nurse is preparing to administer digoxin to a patient with HF. In preparation, lab results are reviewed with the following findings: sodium 139 mEq/L, potassium 3.0 mEq/L, chloride 103 mEq/L, and glucose 106 mg/dl. The nurse should do which of the following at this time? |
|
Definition
| Withhold the dose and report the potassium level |
|
|
Term
| The nurse is caring for a patient newly diagnosed with heart failure. The patient is to receive a first dose of digoxin (Lanoxin) 0.125 mg IV push. Available is an ampule containing 0.25 mg/ml. How many milliliters should the nurse draw up to administer the dose? |
|
Definition
|
|
Term
| The nurse is caring for a patient admitted with pulmonary edema secondary to acute decompensated heart failure. During the morning assessment, the patient complains of yellow vision. Which of the following medications would most likely be causing this clinical manifestation related to toxicity? |
|
Definition
|
|
Term
| The priority nursing assessment of a patient receiving IV nesiritide (Natrecor) to treat heart failure (HF) would be: |
|
Definition
|
|
Term
| Which of the following statements best describes the electrical activity of the heart represented by measuring the PR interval on the ECG? |
|
Definition
| The length of time for the electrical impulse to travel from the SA node to the Purkinje fibers |
|
|
Term
The nurse obtains a 6-second rhythm strip and charts the following analysis:
Atrial rate 70, regular
Ventricular rate 40, regular
No relationship between P waves and QRS complexes; atria and ventricles beating independently of each other
QRS 0.04 sec
Which of the following would be a correct interpretation of this rhythm strip? |
|
Definition
|
|
Term
| The nurse is caring for a patient who is 24 hours postpacemaker insertion. Which of the following nursing interventions is most appropriate at this time? |
|
Definition
| Assessing the incision for any redness, swelling, or discharge |
|
|
Term
| The nurse is caring for a patient whose rhythm oscillates between atrial fibrillation and sinus rhythm. The nurse will be monitoring the patient closely, knowing that the patient is at an increased risk of developing which of the following? |
|
Definition
|
|
Term
| The nurse is watching the cardiac monitor, and a patient's rhythm suddenly changes. There are no P waves; instead there are wavy lines between the QRS complexes. The QRS complexes measure 0.08 seconds (narrow), but they occur irregularly with a rate of 120 beats per minute. The nurse correctly interprets that this rhythm is which of the following? |
|
Definition
|
|
Term
| While admitting a patient with pericarditis, the nurse will assess for which of the following symptoms of a serious complication of this disorder? |
|
Definition
|
|
Term
| The nurse conducts a complete physical assessment on a patient admitted with infective endocarditis. Which of the following findings is significant? |
|
Definition
| Regurgitant murmur at the mitral valve area |
|
|
Term
| When caring for a patient with myocarditis, the nurse identifies the priority nursing diagnosis of: |
|
Definition
|
|
Term
| The nurse is caring for a patient with a diagnosis of DVT. The patient has an order to receive 30 mg enoxaparin (Lovenox). Which of the following injection sites should the nurse use to administer this medication safely? |
|
Definition
| Abdomen, anterior-lateral aspect |
|
|
Term
| The nurse is preparing to administer a scheduled dose of enoxaparin (Lovenox) 30 mg subcutaneously. The nurse should do which of the following to administer this medication correctly? |
|
Definition
| Pinch the skin between the thumb and forefinger before inserting the needle |
|
|
Term
| The nurse is admitting a 68-year-old preoperative patient with a suspected abdominal aortic aneurysm (AAA). The medication history reveals that the patient has been taking warfarin (Coumadin) on a daily basis. Based on this history and the patient's admission diagnosis, the nurse should prepare to administer which of the following medications? |
|
Definition
|
|
Term
| The nurse is caring for a patient who has been receiving warfarin (Coumadin) and digoxin (Lanoxin) as treatment for atrial fibrillation. Because the Coumadin has been discontinued before surgery, the nurse should diligently assess the patient for which complication early in the postoperative period until the medication is resumed? |
|
Definition
| Cerebral or pulmonary emboli |
|
|
Term
| The nurse is reviewing the laboratory test results for a 68-year-old patient whose warfarin (Coumadin) therapy was terminated during the preoperative period. The nurse concludes that the patient is in most stable condition for surgery after noting which of the following INR (international normalized ratio) results? |
|
Definition
| 1.0 - The therapeutic range for INR is 2.0 to 3.0 for many clinical diagnoses. The larger the number, the greater is the amount of anticoagulation. For this reason, the safest value before surgery is 1.0, meaning that the anticoagulation has been reversed. |
|
|
Term
| The nurse would determine that a postoperative patient is not receiving the beneficial effects of enoxaparin (Lovenox) after noting which of the following during a routine shift assessment? |
|
Definition
| Pain and swelling in lower extremity |
|
|
Term
| The nurse is caring for a patient with a recent history of deep vein thrombosis (DVT). The patient now needs to undergo surgery for appendicitis. The nurse is reviewing the laboratory results for this patient before administering an ordered dose of vitamin K1 (Phytonadione). The nurse determines that the medication is both safe to give and is most needed when the international normalized ratio (INR) is which of the following? |
|
Definition
|
|
Term
| A postoperative patient asks the nurse why the physician ordered daily administration of enoxaparin (Lovenox). Which of the following replies by the nurse is most appropriate? |
|
Definition
| “This medication will help prevent formation of blood clots in your legs until your level of mobility increases.” |
|
|
Term
| The nurse is caring for a preoperative patient who has an order for vitamin K1 (Phytonadione) 10 mg by subcutaneous injection. The nurse should verify that which of the following laboratory studies is abnormal before administering the dose? |
|
Definition
|
|
Term
| The nurse is caring for a newly admitted patient with vascular insufficiency. The patient has a new order for enoxaparin (Lovenox) 30 mg subcutaneously. The nurse should do which of the following to administer this medication correctly? |
|
Definition
| Leave the air bubble in the prefilled syringe |
|
|
Term
| The nurse is caring for a patient immediately following a transesophageal echocardiogram (TEE). Which of the following nursing interventions is appropriate when assessing this patient? |
|
Definition
- Assessing for return of gag reflex
- Monitoring vital signs and oxygen saturation |
|
|
Term
| When providing nutritional counseling for patients at risk for CAD, which of the following foods would the nurse encourage patients to include in their diet? |
|
Definition
- Tuna fish
- Tofu
- Walnuts |
|
|
Term
| The nurse would assess a patient with complaints of chest pain for which of the following clinical manifestations associated with a myocardial infarction (MI)? |
|
Definition
- Diaphoresis
- Nausea and vomiting
- S3 or S4 heart sounds |
|
|
Term
| A patient admitted with heart failure appears very anxious and complains of shortness of breath. Which of the following nursing actions would be appropriate to alleviate this patient's anxiety? |
|
Definition
- Administration of ordered morphine sulfate
- Instructing patient on the use of relaxation techniques
- Use a calm, reassuring approach while talking to patient |
|
|
Term
| When caring for a patient with infective endocarditis, the nurse will assess the patient for which of the following vascular manifestations? |
|
Definition
- Osler’s nodes
- Janeway’s lesions
- Splinter hemorrhages |
|
|
