NUR 2023 Cardio 1 Med Surg exam Arkansas Tech University 2022/2023

NUR 2023 Cardio 1 Med Surg exam Arkansas Tech University 2022/2023 After noting a pulse deficit when assessing a patient who has just arrived in the emergency department, the nurse will anticipate that the patient may require A) a. a 2-D echocardiogram. B) b. a cardiac catheterization. C) c. hourly blood pressure (BP) checks. D) d. electrocardiographic (ECG) monitoring. D electrocardiographic (ECG) monitoring. When reviewing the 12-lead electrocardiograph (ECG) for a healthy 86-year-old patient who is having an annual physical examination, which of the following will be of most concern to the nurse? A) a. The heart rate (HR) is 43 beats/minute. B) b. The PR interval is 0.21 seconds. C) c. There is a right bundle-branch block. D) d. The QRS duration is 0.13 seconds. A The heart rate (HR) is 43 beats/minute. During a physical examination of a patient, the nurse palpates the point of maximal impulse (PMI) in the sixth intercostal space lateral to the left midclavicular line. The most appropriate action for the nurse to take next will be to A) a. document that the PMI is in the normal anatomic location. B) b. ask the patient about risk factors for coronary artery disease. C) c. auscultate both the carotid arteries for the presence of a bruit. D) d. assess the patient for symptoms of left ventricular hypertrophy. D assess the patient for symptoms of left ventricular hypertrophy. To auscultate for S3 or S4 gallops in the mitral area, the nurse listens with the A) a. bell of the stethoscope with the patient in the left lateral position. B) b. bell of the stethoscope with the patient sitting and leaning forward. C) c. diaphragm of the stethoscope with the patient in a reclining position. D) d. diaphragm of the stethoscope with the patient lying flat on the left side. A bell of the stethoscope with the patient in the left lateral position. To determine the effects of therapy for a patient who is being treated for heart failure, which laboratory result will the nurse D B-type natriuretic peptide plan to review? A) a. Myoglobin B) b. Homocysteine (Hcy) C) c. Low-density lipoprotein (LDL) D) d. B-type natriuretic peptide (BNP) (BNP) While doing the admission assessment for a thin 72-year-old patient, the nurse observes pulsation of the abdominal aorta in the epigastric area. Which action should the nurse take? A) a. Notify the hospital rapid response team. B) b. Instruct the patient to remain on bed rest. C) c. Teach the patient about aortic aneurysms. D) d. Document the finding in the patient chart. D Document the finding in the patient chart. A patient is scheduled for a cardiac catheterization with coronary angiography. Before the test, the nurse informs the patient that A) a. electrocardiographic (ECG) monitoring will be required for 24 hours after the test. B) b. it will be important to lie completely still during the procedure. C) c. a warm feeling may be noted when the contrast dye is injected. D) d. monitored anesthesia care will be provided during the procedure. C a warm feeling may be noted when the contrast dye is injected While assessing a patient who was admitted with heart failure, the nurse notes that the patient has jugular venous distention (JVD) when lying flat in bed. Which action should the nurse take next? A) a. Use a ruler to measure the level of the JVD. B) b. Document this finding in the patient's record. C) c. Observe for JVD with the head at 30 degrees. D) d. Have the patient perform the Valsalva maneuver. C Observe for JVD with the head at 30 degrees. The nurse teaches the patient being evaluated for rhythm disturbances with a Holter monitor to A) a. exercise more than usual while the monitor is in place. B) b. remove the electrodes when taking a shower or tub bath. C) c. keep a diary of daily activities while the monitor is worn. D) d. connect the recorder to a telephone transmitter once daily. C keep a diary of daily activities while the monitor is worn. When auscultating over the patient's abdominal aorta, the nurse hears a humming sound. The nurse documents this finding as a B bruit. A) a. thrill. B) b. bruit. C) c. heave. D) d. murmur. Which action will the nurse in the hypertension clinic take in order to obtain an accurate baseline blood pressure (BP) for a new patient? A) a. Obtain a BP reading in each arm and average the results. B) b. Deflate the BP cuff at a rate of 5 to 10 mm Hg per second. C) c. Have the patient sit in a chair with the feet flat on the floor. D) d. Assist the patient to the supine position for BP measurements. C Have the patient sit in a chair with the feet flat on the floor. The nurse obtains this information from a patient with prehypertension. Which finding is most important to address with the patient? A) a. Low dietary fiber intake B) b. No regular aerobic exercise C) c. Weight 5 pounds above ideal weight D) d. Drinks wine with dinner once a week B No regular aerobic exercise After giving a patient the initial dose of oral labetalol (Normodyne) for treatment of hypertension, which action should the nurse take? A) a. Encourage oral fluids to prevent dry mouth or dehydration. B) b. Instruct the patient to ask for help if heart palpitations occur. C) c. Ask the patient to request assistance when getting out of bed. D) d. Teach the patient that headaches may occur with this medication. C Ask the patient to request assistance when getting out of bed. After the nurse teaches the patient with stage 1 hypertension about diet modifications that should be implemented, which diet choice indicates that the teaching has been effective? A) a. The patient avoids eating nuts or nut butters. B) b. The patient restricts intake of dietary protein. C) c. The patient has only one cup of coffee in the morning. D) d. The patient has a glass of low-fat milk with each meal. D. The patient has a glass of low-fat milk with each meal. A patient has just been diagnosed with hypertension and has a D. Change position slowly to new prescription for captopril (Capoten). Which information is important to include when teaching the patient? A) a. Check BP daily before taking the medication. B) b. Increase fluid intake if dryness of the mouth is a problem. C) c. Include high-potassium foods such as bananas in the diet. D) d. Change position slowly to help prevent dizziness and falls. help prevent dizziness and falls. A patient is diagnosed with hypertension and nadolol (Corgard) is prescribed. The nurse should consult with the health care provider before giving this medication upon finding a history of A) a. asthma. B) b. peptic ulcer disease. C) c. alcohol dependency. D) d. myocardial infarction (MI). A. asthma. A 52-year-old patient who has no previous history of hypertension or other health problems suddenly develops a BP of 188/106 mm Hg. After reconfirming the BP, it is appropriate for the nurse to tell the patient that A) a. a BP recheck should be scheduled in a few weeks. B) b. the dietary sodium and fat content should be decreased. C) c. there is an immediate danger of a stroke and hospitalization will be required. D) d. more diagnostic testing may be needed to determine the cause of the hypertension. D. more diagnostic testing may be needed to determine the cause of the hypertension. Which action will be included in the plan of care when the nurse is caring for a patient who is receiving sodium nitroprusside (Nipride) to treat a hypertensive emergency? A) a. Organize nursing activities so that the patient has undisturbed sleep for 6 to 8 hours at night. B) b. Assist the patient up in the chair for meals to avoid complications associated with immobility. C) c. Use an automated noninvasive blood pressure machine to obtain frequent BP measurements. D) d. Place the patient on NPO status to prevent aspiration caused by nausea and the associated vomiting. C. Use an automated noninvasive blood pressure machine to obtain frequent BP measurements. The nurse has just finished teaching a hypertensive patient about the newly prescribed quinapril (Accupril). Which patient statement indicates that more teaching is needed? A) a. "The medication may not work as well if I take any aspirin." D. "I won't worry if I have a little swelling around my lips and face." B) b. "The doctor may order a blood potassium level occasionally." C) c. "I will call the doctor if I notice that I have a frequent cough." D) d. "I won't worry if I have a little swelling around my lips and face." During change-of-shift report, the nurse obtains this information about a hypertensive patient who received the first dose of propranolol (Inderal) during the previous shift. Which information indicates that the patient needs immediate intervention? A) a. The patient's most recent BP reading is 156/94 mm Hg. B) b. The patient's pulse has dropped from 64 to 58 beats/minute. C) c. The patient has developed wheezes throughout the lung fields. D) d. The patient complains that the fingers and toes feel quite cold C The patient has developed wheezes throughout the lung fields. When developing a health teaching plan for a 60-year-old man with the following risk factors for coronary artery disease (CAD), the nurse should focus on the A) a. family history of coronary artery disease. B) b. increased risk associated with the patient's gender. C) c. high incidence of cardiovascular disease in older people. D) d. elevation of the patient's serum low density lipoprotein (LDL) level. D elevation of the patient's serum low density lipoprotein (LDL) level. To assist the patient with coronary artery disease (CAD) in making appropriate dietary changes, which of these nursing interventions will be most effective? A) a. Instruct the patient that a diet containing no saturated fat and minimal sodium will be necessary. B) b. Emphasize the increased risk for cardiac problems unless the patient makes the dietary changes. C) c. Assist the patient to modify favorite high-fat recipes by using monosaturated oils when possible. D) d. Provide the patient with a list of low-sodium, low- cholesterol foods that should be included in the diet. C Assist the patient to modify favorite high-fat recipes by using monosaturated oils when possible. Which information collected by the nurse who is admitting a patient with chest pain suggests that the pain is caused by an acute myocardial infarction (AMI)? A) a. The pain increases with deep breathing. B The pain has persisted longer than 30 minutes. B) b. The pain has persisted longer than 30 minutes. C) c. The pain worsens when the patient raises the arms. D) d. The pain is relieved after the patient takes nitroglycerin. Which information given by a patient admitted with chronic stable angina will help the nurse confirm this diagnosis? A) a. The patient rates the pain at a level 3 to 5 (0 to 10 scale). B) b. The patient states that the pain "wakes me up at night." C) c. The patient says that the frequency of the pain has increased over the last few weeks. D) d. The patient states that the pain is resolved after taking one sublingual nitroglycerin tablet. D The patient states that the pain is resolved after taking one sublingual nitroglycerin tablet. After the nurse has finished teaching a patient about use of sublingual nitroglycerin (Nitrostat), which patient statement indicates that the teaching has been effective? A) a. "I can expect indigestion as a side effect of nitroglycerin." B) b. "I can only take the nitroglycerin if I start to have chest pain." C) c. "I will call an ambulance if I still have pain 5 minutes after taking the nitroglycerin." D) d. "I will help slow down the progress of the plaque formation by taking nitroglycerin." C "I will call an ambulance if I still have pain 5 minutes after taking the nitroglycerin." Which of these statements made by a patient with coronary artery disease after the nurse has completed teaching about the therapeutic lifestyle changes (TLC) diet indicates that further teaching is needed? A) a. "I will switch from whole milk to 1% or nonfat milk." B) b. "I like fresh salmon and I will plan to eat it more often." C) c. "I will miss being able to eat peanut butter sandwiches." D) d. "I can have a cup of coffee with breakfast if I want one." C "I will miss being able to eat peanut butter sandwiches." After the nurse teaches the patient about the use of atenolol (Tenormin) in preventing anginal episodes, which statement by a patient indicates that the teaching has been effective? A) a. "It is important not to suddenly stop taking the atenolol." B) b. "Atenolol will increase the strength of my heart muscle." C) c. "I can expect to feel short of breath when taking atenolol." D) d. "Atenolol will improve the blood flow to my coronary arteries." A "It is important not to suddenly stop taking the atenolol."