Cardiac Diagnostics NCLEX Questions and Answers Rated A+

Cardiac Diagnostics NCLEX Questions and Answers Rated A+ The nurse is preparing the client for a cardiac catheterization with angiography. Which teaching should the nurse give the patient prior to the test? A) "You will need to fast for about 2 hours before the test" B) "It's important for you to know that you will be lying flat on a table for about 5 hours during this process. It could be painful" C) "You may feel the need to void when the dye is injected, but this sensation should diminish in a minute" D) "If you have an allergy to shellfish we will not be able to perform this procedure" Answer: C. When the dye is injected the patient may feel a flushing sensation, the sensation to void, a feeling of the need to cough or a salty taste in the mouth. Fasting should be for 8-12 hours before the test. The procedure should take less than 2 hours. If the patient has an allergy to shellfish, an antihistamine or corticosteroid will be administered beforehand to prevent allergic reaction. The benefit of the procedure outweighs the risk. The patient with A-fib, hyperlipidemia, HTN and PAD is scheduled a cardiac cath d/t a positive exercise stress test. The patient is taking Lipitor, warfarin, and Lisinopril. The nurse knows that it is important for which of the following labs to be drawn before the procedure? A) aPTT B) Lipid Profile C) BNP D) INR Answer: D. An INR is important to draw before the procedure to understand the risk for bleeding and any potential problems that may arise during recovery. aPTT is associated with heparin use. A Lipid profile and BNP are not necessary to draw. Some other labs drawn before a cardiac cath include BUN, creatinine, CBC, and CMP to get a patient baseline. The nurse is preparing a client for a cardiac cath. The nurse knows to position the client in which position after the procedure? A) High-fowlers B) Low-fowlers C) Prone D) Sim's position Answer: B. After the procedure, the nurse will position the client in the supine or low-fowlers position with the HOB no greater than 30 degrees. The patient will remain on bedrest for 6-8 hours after the procedure with the insertion extremity straight. The client may be turned for comfort, but the insertion extremity must be kept straight. A 77 year old client is being prepared for a cardiac catheter. The client has a history of DM, HTN, and hyperlipidemia. The client's vitals are as follows before the procedure: BP 130/85, HR 101, T 100.0, RR 20, SpO2 94%. The nurse knows that the client is most at risk for which of the following complications? A) Contrast-induced Nephropathy B) Thrombus C) Hematoma D) Blood dyscrasias Answer: A. The patient is an elderly client with a history of diabetes mellitus. This puts the client at an increased risk for contrast-induced nephropathy. The client is also at risk for thrombus formation and hematoma formation, but contrast-induced nephropathy is more of a risk. Blood dyscrasias is not a common adverse reaction of this procedure The nurse is providing teaching to a client who has just finished with the cardiac cath procedure and has been cleared for discharge. Which statement, if made by the patient, indicates the need for further teaching? A) "I will contact my doctor if I see any signs of bleeding or swelling at the site" B) "Like the doctor said, I will not bend at the waist for the next day or so" C) "I will take some Tylenol for the pain when I get home" D) "I'm going to go home and get a bath so I can feel clean and fresh" Answer: D. The client should avoid tub baths until the site has healed, and should take a shower instead. The client should be told to report any bleeding, swelling, new bruising, or pain at the site or temp greater than 101. The patient should be advised against bending at the waist. Pain medication is ok to take, but the client should report any recurrence of pain at the site. Which of the following is the nurse's priority following the cardiac catheterization? A) Teaching the patient about medications to take at home B) Assessing the insertion site C) Administering Mucomyst D) Assisting the patient out of bed Answer: B. Assessing the insertion site (often the femoral artery) is important to see if any bleeding or hematoma formation has occurred. It is important to help the patient out of bed after bedrest period is over. Teaching is also important, but it is not a priority. There is no indication for Mucomyst mentioned in the question. It is only administered to those at risk for or experiencing contrast-induced nephropathy. After undergoing a cardiac catheterization, a client has a large puddle of blood under his buttocks. Which step should the nurse take first? A) Call for help B) Don gloves and assess site C) Ask the client to "lift up" D) Obtain vitals Answer: B. Observing standard precautions and assessing the site is a priority in this situation. This establishes where the blood is coming from and determines how much blood has been lost. The goal in this situation is to stop the bleeding. The nurse would call for help if the situation warranted it. After determining the extent of bleeding, vitals should be taken. The client should not be moved in case a clot has formed. Moving could disturb the clot and cause rebleeding. The nurse is administering Acetylcysteine (Mucomyst) to the patient with contrast-induced nephropathy. Which of the following should be monitored for as a side effect of this medication? Select all that apply