cardiovascular function exam with 100% correct answers 2024.

The nurse is reviewing the morning laboratory test results for a client with cardiac problems. Which finding is a priority to report to the healthcare provider? - ANSWER-K+ 3.1 mEq/L The client with a diagnosis of heart failure reports frequently awakening during the night with the need to urinate. What explanation will the nurse offer to explain the urination? - ANSWER-Edema is collected in dependent extremities during the day; at night when the client lays down, it is reabsorbed into the circulation and excreted by the kidneys. The clinic nurse caring for a client with a cardiovascular disorder is performing an assessment of the client's pulse. Which of the following steps is involved in determining the pulse deficit? - ANSWER-Count the heart rate at the apex. You are doing an admission assessment on a client who is having outpatient testing done for cardiac problems. What should you ask this client during your assessment? - ANSWER-"Have you had any episodes of dizziness or fainting?" An obese client describes symptoms of palpitations, chronic fatigue, and dyspnea on exertion to the cardiologist. Upon completing the examination, the cardiologist schedules a procedure to confirm the suspected diagnosis. What diagnostic procedure would the nurse expect to be prescribed? - ANSWER-transesophageal echocardiography The nurse auscultates the apex beat at which anatomical location? - ANSWER-fifth intercostal space, midclavicular line What does decreased pulse pressure reflect? - ANSWER-reduced stroke volume The nurse is caring for a client who is scheduled for a transesophageal echocardiogram. What nursing intervention is a priority after the procedure? - ANSWER-Keep the head of the bed elevated 45 degrees and keep NPO until return of the gag reflex. A nurse is caring for a dying client following myocardial infarction. The client is experiencing apnea with a falling blood pressure of 60 per palpation. Which documentation of pulse quality does the nurse anticipate? - ANSWER-Thready pulse The nurse is administering a beta blocker to a patient in order to decrease automaticity. Which medication will the nurse administer? - ANSWER-Metoprolol A nurse is reviewing laboratory values for a client diagnosed with hyperlipidemia 6 months ago. Which results indicate that the client has been following a therapeutic regimen? - ANSWER-High density lipoproteins (HDL) increase from 25 mg/dl to 40 mg/dl. The nurse cares for a client with clubbing of the fingers and toes. The nurse should complete which action given these findings? - ANSWER-Obtain an oxygen saturation level. The nurse is caring for a patient with a diagnosis of pericarditis. Where does the nurse understand the inflammation is located? - ANSWER-The thin fibrous sac encasing the heart The patient has a heart rate of 72 bpm with a regular rhythm. Where does the nurse determine the impulse arises from? - ANSWER-The sinoatrial node The nurse is assessing a patient who reports feeling "light-headed." When obtaining orthostatic vital signs, what does the nurse determine is a significant finding? - ANSWER-A heart rate of more than 20 bpm above the resting rate A client has undergone cardiac catheterization and will be discharged today. What information should the nurse emphasize during discharge teaching? - ANSWER-Avoid heavy lifting for the next 24 hours. The nurse is caring for an elderly client with left-sided heart failure. When auscultating lung sounds, which adventitious sound is expected? - ANSWER-crackels The nurse is performing an assessment of the patient's heart. Where would the nurse locate the apical pulse if the heart is in a normal position? - ANSWER-Left 5th intercostal space at the midclavicular line A patient tells the nurse, "I was straining to have a bowel movement and felt like I was going to faint. I took my pulse and it was so slow." What does the nurse understand occurred with this patient? - ANSWER-The patient had a vagal response. After a physical examination, the provider diagnosed a patient with a grade 4 heart murmur. When ausculatating a murmur, what does the nurse expect to hear? - ANSWER-Loud and may be associated with a thrill sound similar to (a purring cat). A nurse is performing a cardiac assessment on an elderly client. Which finding warrants further investigation? - ANSWER-Irregularly irregular heart rate You are monitoring the results of laboratory tests performed on a client admitted to the cardiac ICU with a diagnosis of myocardial infarction. Which test would you expect to show elevated levels? - ANSWER-Enzymes Within the heart, several structures and several layers all play a part in protecting the heart muscle and maintaining cardiac function. The inner layer of the heart is composed of a thin, smooth layer of cells, the folds of which form heart valves. What is the name of this layer of cardiac tissue? - ANSWER-endocardium The nurse cares for a client prescribed warfarin orally. The nurse reviews the client's prothrombin time (PT) level to evaluate the effectiveness of the medication. Which laboratory values should the nurse also evaluate? - ANSWER-international normalized ratio (INR) The client with a diagnosis of heart failure reports frequently awakening during the night with the need to urinate. What explanation will the nurse offer to explain the urination? - ANSWER-Edema is collected in dependent extremities during the day; at night when the client lays down, it is reabsorbed into the circulation and excreted by the kidneys. The clinic nurse caring for a client with a cardiovascular disorder is performing an assessment of the client's pulse. Which of the following steps is involved in determining the pulse deficit? - ANSWER-Count the heart rate at the apex. You are the clinic nurse doing assessments on your clients before they have outpatient diagnostic testing done. What would you document when assessing the client's pulse? - ANSWER-Rate, quality, and rhythm Which term describes the ability of the heart to initiate an electrical impulse? - ANSWER-automaticity The nurse is reviewing the results of the patient's echocardiogram and observes that the ejection fraction is 35%. The nurse anticipates that the patient will receive treatment for what condition? - ANSWER-Heart failure Which area of the heart that is located at the third intercostal space to the left of the sternum? - ANSWER-Erb point The nurse admits an adult female client with a medical diagnosis of "rule out MI." The client is very frightened and expresses surprise that a woman would have heart problems. What response by the nurse will be most appropriate? - ANSWER-"A woman's heart is smaller and has smaller arteries that become occluded more easily." The nurse is conducting patient teaching about cholesterol levels in the body. When discussing the patient's elevated low-density lipoprotein (LDL) and lowered high-density lipoprotein (HDL) levels, the patient shows an understanding of the significance of these levels by stating what? - ANSWER-"Increased LDL and decreased HDL increase my risk of coronary artery disease." The nurse is auscultating a client's heart sounds and notes a murmur at the left fourth intercostal space and lateral to the sternum. At which cardiac valve would the nurse document this murmur? - ANSWER-Tricuspid valve A nurse is aware that the patient's heart rate is influenced by many factors. The nurse understands that the heart rate can be decreased by: - ANSWER-Stimulation of the vagus nerve. Each chamber of the heart has a particular role in maintaining cellular oxygenation. Which chamber is responsible for pumping blood to all the cells and tissues of the body? - ANSWER-left ventricle Which area of the heart is located at the third intercostal (IC) space to the left of the sternum? - ANSWER-erb point The nurse is assessing heart sounds in a patient with heart failure. An abnormal heart sound is detected early in diastole. How would the nurse document this? - ANSWER-S3 The nurse is assessing a patient's blood pressure. What does the nurse document as the difference between the systolic and the diastolic pressure? - ANSWER-Pulse pressure The nursing instructor is teaching nursing students about myocardial contractility and ejection fractions. What diagnostic tests can determine client ejection fractions? Select all that apply. - ANSWER-Echocardiogram Cardiac catheterization Magnetic resonance imaging The nurse is auscultating a client's heart sounds and notes a murmur at the left fourth intercostal space and lateral to the sternum. At which cardiac valve would the nurse document this murmur? - ANSWER-Tricuspid valve The nursing student asks the nurse how to tell the difference between ventricular tachycardia and ventricular fibrillation on an electrocardiogram strip. What is the best response? - ANSWER-"Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes." The nurse identifies which of the following as a potential cause of premature ventricular complexes (PVCs)? - ANSWER-Hypokalemia The nurse enters the client's room and finds the client pulseless and unresponsive. What would be the treatment of choice for this client? - ANSWER-Immediate defibrillation The nurse analyzes a 6-second electrocardiogram (ECG) tracing. The P waves and QRS complexes are regular. The PR interval is 0.18 seconds long, and the QRS complexes are 0.08 seconds long. The heart rate is calculated at 70 bpm. The nurse correctly identifies this rhythm as - ANSWER-normal sinus rhythm. A nurse provides evening care for a client wearing a continuous telemetry monitor. While the nurse is giving the client a back rub, the client 's monitor alarm sounds and the nurse notes a flat line on the bedside monitor system. What is the nurse's first response? - ANSWER-Assess the client and monitor leads. The nurse knows that what PR interval presents a first-degree heart block? - ANSWER-0.24 seconds The nurse cares for a client with a dysrhythmia and understands that the P wave on an electrocardiogram (ECG) represents which phase of the cardiac cycle? - ANSWER-Atrial depolarization A nurse completes a shift assessment on a client admitted to the telemetry unit with a diagnosis of syncope. The client's heart rate is 55 bpm with a blood pressure of 90/66 mm Hg. The client is also experiencing dizziness and shortness of breath. Which medication will the nurse anticipate administering to the client based on these clinical findings? - ANSWER-Atropine The nurse is assessing vital signs in a patient with a permanent pacemaker. What should the nurse document about the pacemaker? - ANSWER-Pacer rate A client experiences a faster-than-normal heart rate when drinking more than two cups of coffee in the morning. What does the nurse identify on the electrocardigram as an indicator of sinus tachycardia? - ANSWER-heart rate of 118 bpm A nurse is performing discharge teaching with a client who has an implantable cardioverter defibrillator (ICD) placed. Which client statement indicates effective teaching? - ANSWER-"I'll keep a log of each time my ICD discharges." The nurse documents that a client is having a normal sinus rhythm. What characteristics of this rhythm has the nurse assessed? - ANSWER-The sinoatrial (SA) node initiates the impulse. A client is treated in the intensive care unit (ICU) following an acute myocardial infarction (MI). During the nursing assessment, the client reports shortness of breath and chest pain. In addition, the client's blood pressure (BP) is 100/60 mm Hg with a heart rate (HR) of 53 bpm, and the electrocardiogram (ECG) tracing shows more P waves than QRS complexes. Which action should the nurse complete first? - ANSWER-Initiate transcutaneous pacing After performing an ECG on an adult client, the nurse reports that the PR interval reflects normal sinus rhythm. What is the PR interval for a normal sinus rhythm? - ANSWER-0.12 and 0.2 seconds. The nurse is caring for a client with second-degree atrioventricular block, Type I with symptomatic bradycardia. What is the most likely medication the nurse will administer? - ANSWER-atropine sulfate The nurse is providing discharge instructions to a client after a permanent pacemaker insertion. Which safety precaution will the nurse communicate to the client? - ANSWER-Avoid undergoing magnetic resonance imaging (MRI). A client reports light-headedness, chest pain, and shortness of breath. They physician orders tests to ascertain what is causing the client's problems. Which test is used to identify cardiac rhythms? - ANSWER-electrocardiogram A client is diagnosed with a dysrhythmia at a rate slower than 60 beats/minute. What type of dysrhythmia does the client have? - ANSWER-sinus bradycardia The licensed practical nurse is monitoring the waveform pattern on the cardiac monitor ofthe client admitted following a myocardial infarction. The nurse notes that every other beat includes a premature ventricular contraction (PVC). The nurse notes which of the following in the permanent record? - ANSWER-Bigeminy A nurse provides morning care for a client in the intensive care unit (ICU). Suddenly, the bedside monitor shows ventricular fibrillation and the client becomes unresponsive. After calling for assistance, what action should the nurse take next? - ANSWER-Begin cardiopulmonary resuscitation The nursing student asks the nurse how to tell the difference between ventricular tachycardia and ventricular fibrillation on an electrocardiogram strip. What is the best response? - ANSWER-"Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes." The nurse identifies which of the following as a potential cause of premature ventricular complexes (PVCs)? - ANSWER-Hypokalemia The nurse is caring for clients on a telemetry unit. Which nursing consideration best represents concerns of altered rhythmic patterns of the heart? - ANSWER-Altered patterns frequently affect the heart's ability to pump blood effectively. Which of the following medications does the nurse anticipate administering to a client preparing for cardioversion? - ANSWER-Diazepam A patient comes to the emergency department with reports of chest pain after using cocaine. The nurse assesses the patient and obtains vital signs with results as follows: blood pressure 140/92, heart rate 128, respiratory rate 26, and an oxygen saturation of 98%. What rhythm on the monitor does the nurse anticipate viewing? - ANSWER-Sinus tachycardia The nurse knows that electrocardiogram (ECG) characteristics of atrial fibrillation include what? - ANSWER-Atrial rate of 300 to 400 A client has been living with an internal, fixed-rate pacemaker. When checking the client's readings on a cardiac monitor the nurse notices an absence of spikes. What should the nurse do? - ANSWER-Double-check the monitoring equipment. A client is unconscious on arrival to the emergency department. The nurse in the emergency department identifies that the client has a permanent pacemaker due to which characteristic? You Selected: - ANSWER-"Spike" on the rhythm strip The nurse is assessing vital signs in a patient with a permanent pacemaker. What should the nurse document about the pacemaker? - ANSWER-Pacer rate A patient is 2 days postoperative after having a permanent pacemaker inserted. The nurse observes that the patient is having continuous hiccups as the patient states, "I thought this was normal." What does the nurse understand is occurring with this patient? - ANSWER-Lead wire dislodgement