NURS 401 Exam 1 Practice with Correct
Detailed Solutions Updated 2026
1
The nurse is providing education to help reduce cardiovascular risks for a women's
book club. Which statement made by a participant indicates a need for further
teaching?
a. "We are more likely to die from cardiovascular disease than men"
b. "We need to walk or do other exercise everyday for 30 minutes"
c. "We need to stay away from people who smoke"
d. "We should take hormones for menopause to decrease the risk for heart attack"
d. "We should take hormones for menopause to decrease the risk for heart attack"
Rationale: meds used in hormone therapy can cause an increased incidence of MI
or stroke in women
2
A client is admitted to the telemetry unit after a right-sided cardiac catheterization.
What is the nurse's priority when caring for this client?
a. Assess the intensity and quality of the client's pain
b. Position the client in a sitting position to improve breathing
c. Check the client's arterial insertion site
d. Apply oxygen at 2 L/min via nasal cannula
c. Check the client's arterial insertion site
Rationale: Pts who have had a cardiac catheterization should be restricted to short-
term bedrest, and the insertion site extremity should be kept straight. The nurse
should assess the site for bloody drainage or hematoma formation because
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complications with vascular closure devices are not common but can be very
serious.
3
A middle-aged man is admitted to the cardiac unit after reports of a severe
headache and flushing of the face. He is diagnosed with severe hypertension. The
patient is alert and oriented. BP = 192/104, HR = 88. You are the RN assigned to
his care. There is an unlicensed nurse technician working with you.
1. What assessment data will you perform upon his arrival to the unit? why?
2. The cardiologist prescribes IV fluids, hourly BP checks, BP medication, and
oxygen at 2 L/min via nasal cannula. What part of the patient's care will you
delegate to the unlicensed nurse technician? What information will you
communicate upon delegation?
3. What interventions will you implement to ensure this patient's safety?
4. The patient's wife is very concerned about her husband returning to work as
owner of a roofing company. What education will you provide the patient and his
wife at this time? With what health care team members w
1. Assess all VS, specifically BP, and conduct a head to toe assessment. VS should
be taken to continue observing the pt's condition (specifically HTN) and trended to
determine if treatment and interventions are working. During the physical
assessment, you will specifically need to listen to the heart for the presence or
absence of murmurs or other abnormal heart sounds and perform a basic
neurological assessment to determine the pt's baseline orientation.
2. Can delegate: hourly BP checks, with understanding that you must follow all
Nurse Practice Acts related to appropriate delegation.
Communicate: task that is to be performed and the method by which it should be
(manual vs automated). Also clarify that you need the findings reported back to
you hourly.
Follow up hourly to obtain report of the vitals so you can make appropriate nursing
decisions
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3. Safety precautions; if need for invasive diagnostic testing, determine if there is
iodine-based contrast media allergies; report dysrhythmias immediately;
continually assess pt's report of pain, especially when pt's report is descriptive of
angina or MI; teach pt safety precautions regarding calling for assistance if pt
needs to ambulate to the bathroom b/c syncope can be related to severe HTN
4. Teach methods for decreasing cardiovascular disease risk such as control of
HTN with meds, moderate physical exercise, smoking cessation, decrease
psychological stressors, and diet modification.
Collaborate with dietician for nutrition planning, primary care provider for meds
that may assist with smoking cessation, and community support systems that may
assist with psychological stressors
4
A client who had open abdominal surgery 4 hours ago reports feeling weak and
dizzy. The client's current BP has decreased to 98/50 and pulse is 108. What is
nurse's best action at this time?
a. Document VS and continue to monitor the client.
b. Remind the client to stay in bed if feeling weak and dizzy.
c. Call the health care provider immediately.
d. Increase the client's IV rate to restore fluid volume.
c. Call the health care provider immediately.
Rationale: Surgery or trauma may cause ventricular fibrillation. Symptoms include
faintness, loss of consciousness, and apnea with pulselessness; nurse should
contact health care provider immediately.
5
The health care provider prescribes warfarin (Coumadin) for a client with atrial
fibrillation. Which foods will the nurse teach the client taking this drug to avoid?
Select all that apply.
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