Cardiovascular NCLEX Questions and Answers Latest Update Graded A+
A client has been diagnosed with atrial fibrillation. The health care provider prescribed warfarin to be
taken on a daily basis. The nurse instructs the client to avoid using which over-the-counter medication
while taking warfarin? - Answers aspirin
Aspirin is an antiplatelet medication. The use of aspirin is contraindicated while taking warfarin because
it will potentiate the drug's effects.
The nurse has completed an assessment on a client with a decreased cardiac output. Which findings
should receive the highest priority? - Answers confusion, urine output 15 mL over the last 2 hours,
orthopnea
A low urine output and confusion are signs of decreased tissue perfusion. Orthopnea is a sign of left-
sided heart failure.
In preparing the client and the family for a postoperative stay in the intensive care unit (ICU) after open-
heart surgery, what should the nurse tell the family? - Answers The client will receive medication to
relieve pain.
Management of postoperative pain is a priority for the client after surgery, including valve replacement
surgery. The client and family should be informed that pain will be assessed by the nurse and
medications will be given to relieve the pain. The client will stay in the ICU as long as monitoring and
intensive care are needed.
The nurse is assigned to a client in the ICU. During the initial assessment, the nurse notes jugular vein
distention and recognizes that the plan of care will follow which disorder? - Answers heart failure
Elevated venous pressure, exhibited as jugular vein distention, indicates the heart's failure to pump.
The nurse is preparing the client newly diagnosed with peripheral arterial disease for discharge with the
medication atorvastatin. What laboratory work should the nurse obtain to establish a baseline before
starting the medication? - Answers creatinine level and liver function tests
Atorvastatin has serious adverse reactions of hepatotoxicity and acute renal failure, so it is
recommended that creatinine level and liver function tests be performed at baseline as a monitoring
parameter.
, An anxious client who suffered an acute myocardial infarction is transferred from the coronary care unit
to the telemetry unit. The client asks the charge nurse if they can have the same nurse care for them
every day. How should the charge nurse respond? - Answers "We will try to assign you the same nurse
as often as possible."
A client who has a history of bacterial endocarditis is scheduled to have oral surgery to remove a tooth.
What should the nurse instruct the client to do? - Answers Be sure the dentist prescribes a prophylactic
antibiotic prior to the oral surgery.
A nurse is caring for a client who had a three-vessel coronary bypass graft 4 days earlier. The client's
cholesterol profile is as follows: total cholesterol 265 mg/dl (6.845 mmol/L), low-density lipoprotein
(LDL) 139 mg/dl (3.603 mmol/L), and high-density lipoprotein (HDL) 32 mg/dl (0.829 mmol/L). The client
asks the nurse how to lower their cholesterol. The nurse should tell the client that - Answers the nurse
will ask the dietitian to talk with the client about modifying their diet.
A nurse is caring for a client receiving warfarin therapy following a mechanical valve replacement. The
nurse completed the client's prothrombin time and International Normalized Ratio (INR) at 7 a.m.
(0700), before the morning meal. The client had an INR reading of 4. The nurse's first priority should be
to - Answers assess the client for bleeding around the gums or in the stool and notify the physician of
the laboratory results and most recent administration of warfarin.
For a client taking warfarin following a valve replacement, the INR should be between 2 and 3.5. The
nurse should notify the physician of an elevated INR level and communicate assessment data regarding
possible bleeding. The nurse shouldn't administer medication such as warfarin or vitamin K without a
physician's order.
A client is taking spironolactone. Which change in the diet should the nurse teach the client to make
when taking this drug? - Answers Avoid eating foods high in potassium.
=Spironolactone is a potassium-sparing diuretic that causes excretion of sodium. When taking this drug,
it is important that the client not eat foods high in potassium to avoid elevating serum potassium levels.
=The client does not need to restrict sodium intake as the drug promotes sodium excretion.
A visiting nurse is teaching a client with heart failure about taking their medications. The client requires
six different medications that are taken at four different times per day. The client is confused about
when to take each medication. How should the nurse intervene? - Answers Teach a family member to fill
a medication compliance aid once per week so the client can independently take their medications.
The correct landmark for obtaining an apical pulse is the - Answers left fifth intercostal space,
midclavicular line.
A client has been diagnosed with atrial fibrillation. The health care provider prescribed warfarin to be
taken on a daily basis. The nurse instructs the client to avoid using which over-the-counter medication
while taking warfarin? - Answers aspirin
Aspirin is an antiplatelet medication. The use of aspirin is contraindicated while taking warfarin because
it will potentiate the drug's effects.
The nurse has completed an assessment on a client with a decreased cardiac output. Which findings
should receive the highest priority? - Answers confusion, urine output 15 mL over the last 2 hours,
orthopnea
A low urine output and confusion are signs of decreased tissue perfusion. Orthopnea is a sign of left-
sided heart failure.
In preparing the client and the family for a postoperative stay in the intensive care unit (ICU) after open-
heart surgery, what should the nurse tell the family? - Answers The client will receive medication to
relieve pain.
Management of postoperative pain is a priority for the client after surgery, including valve replacement
surgery. The client and family should be informed that pain will be assessed by the nurse and
medications will be given to relieve the pain. The client will stay in the ICU as long as monitoring and
intensive care are needed.
The nurse is assigned to a client in the ICU. During the initial assessment, the nurse notes jugular vein
distention and recognizes that the plan of care will follow which disorder? - Answers heart failure
Elevated venous pressure, exhibited as jugular vein distention, indicates the heart's failure to pump.
The nurse is preparing the client newly diagnosed with peripheral arterial disease for discharge with the
medication atorvastatin. What laboratory work should the nurse obtain to establish a baseline before
starting the medication? - Answers creatinine level and liver function tests
Atorvastatin has serious adverse reactions of hepatotoxicity and acute renal failure, so it is
recommended that creatinine level and liver function tests be performed at baseline as a monitoring
parameter.
, An anxious client who suffered an acute myocardial infarction is transferred from the coronary care unit
to the telemetry unit. The client asks the charge nurse if they can have the same nurse care for them
every day. How should the charge nurse respond? - Answers "We will try to assign you the same nurse
as often as possible."
A client who has a history of bacterial endocarditis is scheduled to have oral surgery to remove a tooth.
What should the nurse instruct the client to do? - Answers Be sure the dentist prescribes a prophylactic
antibiotic prior to the oral surgery.
A nurse is caring for a client who had a three-vessel coronary bypass graft 4 days earlier. The client's
cholesterol profile is as follows: total cholesterol 265 mg/dl (6.845 mmol/L), low-density lipoprotein
(LDL) 139 mg/dl (3.603 mmol/L), and high-density lipoprotein (HDL) 32 mg/dl (0.829 mmol/L). The client
asks the nurse how to lower their cholesterol. The nurse should tell the client that - Answers the nurse
will ask the dietitian to talk with the client about modifying their diet.
A nurse is caring for a client receiving warfarin therapy following a mechanical valve replacement. The
nurse completed the client's prothrombin time and International Normalized Ratio (INR) at 7 a.m.
(0700), before the morning meal. The client had an INR reading of 4. The nurse's first priority should be
to - Answers assess the client for bleeding around the gums or in the stool and notify the physician of
the laboratory results and most recent administration of warfarin.
For a client taking warfarin following a valve replacement, the INR should be between 2 and 3.5. The
nurse should notify the physician of an elevated INR level and communicate assessment data regarding
possible bleeding. The nurse shouldn't administer medication such as warfarin or vitamin K without a
physician's order.
A client is taking spironolactone. Which change in the diet should the nurse teach the client to make
when taking this drug? - Answers Avoid eating foods high in potassium.
=Spironolactone is a potassium-sparing diuretic that causes excretion of sodium. When taking this drug,
it is important that the client not eat foods high in potassium to avoid elevating serum potassium levels.
=The client does not need to restrict sodium intake as the drug promotes sodium excretion.
A visiting nurse is teaching a client with heart failure about taking their medications. The client requires
six different medications that are taken at four different times per day. The client is confused about
when to take each medication. How should the nurse intervene? - Answers Teach a family member to fill
a medication compliance aid once per week so the client can independently take their medications.
The correct landmark for obtaining an apical pulse is the - Answers left fifth intercostal space,
midclavicular line.
