RN Targeted Medical Surgical- CARDIOVASCULAR Questions Answered Correctly Latest Update

RN Targeted Medical Surgical- CARDIOVASCULAR Questions Answered Correctly Latest Update A nurse caring for a client who has a history of angina and is scheduled for exercise electrocardiography at 1100. Which of the following statements by the client requires the nurse to contact the provider for possible rescheduling? - "I'm still hungry after the bowl of cereal I ate at 7 a.m." - "I didn't take my heart pills this morning because the doctor told me not to." - "I have had chest pain a couple of times since I saw my doctor in the office last week." - "I smoked a cigarette this morning to calm my nerves about having this procedure." - Answers - "I smoked a cigarette this morning to calm my nerves about having this procedure." Rationale: Smoking prior to this test can change the outcome and places the client at additional risk. The procedure should be rescheduled if the client has smoked before the test. RATIONALES: "I'm still hungry after the bowl of cereal I ate at 7 a.m.": - It is not necessary for the client to be NPO prior to this procedure. "I didn't take my heart pills this morning because the doctor told me not to." - The provider might withhold cardiovascular medications prior to this procedure to effectively monitor cardiovascular response to stress. "I have had chest pain a couple of times since I saw my doctor in the office last week." - Episodes of chest pain are not a contraindication to this test. A nurse is providing discharge teaching to a client who has heart failure. The nurse should instruct the client to report which of the following findings immediately to the provider? - Weight gain of 0.9 kg (2 lb) in 24 hr - Increase of 10 mmHg in systolic blood pressure - Dyspnea with exertion - Dizziness when rising quickly - Answers - Weight gain of 0.9 kg (2 lb) in 24 hr Rationale: When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is a weight gain of 0.5 to 0.9 kg (1.1 to 2 lb) in 1 day. The weight gain is an indication of fluid retention resulting from worsening heart failure. The client should report this finding immediately. RATIONALES: Increase of 10 mmHg in systolic blood pressure -An increase of 10 mmHg in systolic blood pressure is a nonurgent finding. Although the client should report the increase in blood pressure, there is another finding the client should report immediately. Dyspnea with exertion - Dyspnea with exertion is a nonurgent finding that is expected for a client who has heart failure. Although the client should report it, there is another finding the client should report immediately. Dizziness when rising quickly - Dizziness when rising quickly is a nonurgent finding that is expected for a client who is taking medications to treat heart failure. Although the client should report it, there is another finding the client should report immediately. A nurse is assessing a client who has a history of deep-vein thrombosis and is receiving warfarin. Which of the following findings should indicate to the nurse that the medication is effective? - Hemoglobin 14 g/dL - Minimal bruising of extremities - Decreased blood pressure - INR 2.0 - Answers - INR 2.0 Rationale: The nurse should identify that an INR of 2.0 is within the desired reference range of 2.0 to 3.0 for a client who has deep-vein thrombosis and is receiving warfarin to reduce the risk of new clot formation and a stroke. RATIONALES: Hemoglobin 14 g/dL - The nurse should recognize that a hemoglobin level of 14 g/dL is within the expected reference range. However, this is not evidence of effective warfarin therapy. Minimal bruising of extremities - The nurse should recognize that minimal bruising or no bruising is desired. However, this is not evidence of effective warfarin therapy. Decreased blood pressure - The nurse should recognize that decreased blood pressure is a manifestation of bleeding, which is an adverse effect of warfarin. A nurse is reviewing the ECG rhythm strip of a client who is receiving telemetry. Which of the following areas of the strip should the nurse examine to observe for atrial depolarization? - A (P wave) - B (QRS complex) - C (T wave) - Answers - A (P wave) Rationale: The nurse should examine this area, the P wave, of the rhythm strip to evaluate for atrial depolarization RATIONALES: B (QRS complex) - The nurse should examine this area, the QRS complex, of the rhythm strip to evaluate for ventricular depolarization. C (T wave) - The nurse should examine this area, the T wave, of the rhythm strip to evaluate for ventricular repolarization. A nurse is caring for a client who is receiving heparin therapy and develops hematuria. Which of the following actions should the nurse take if the client's aPTT is 96 seconds? - Increase the heparin infusion flow rate by 2 ml/hr - Continue to monitor the heparin infusion as prescribed - Request a prothrombin time (PT) - Stop the heparin infusion - Answers - Stop the heparin infusion Rationale: The nurse should identify that the client's aPTT is above the critical value and the client is displaying manifestations of bleeding. Therefore, the nurse should discontinue the heparin infusion immediately and notify the provider to reduce the risk of client injury.