NUR401 Exam Questions with Answers
The nurse is providing education to help reduce cardiovascular risks for a women's book club.
Which statement made by a participant indicates a need for further teaching?
a. "We are more likely to die from cardiovascular disease than men"
b. "We need to walk or do other exercise everyday for 30 minutes"
c. "We need to stay away from people who smoke"
d. "We should take hormones for menopause to decrease the risk for heart attack" - ✔✔d. "We
should take hormones for menopause to decrease the risk for heart attack"
Rationale: meds used in hormone therapy can cause an increased incidence of MI or stroke in
women
A client is admitted to the telemetry unit after a right-sided cardiac catheterization. What is the
nurse's priority when caring for this client?
a. Assess the intensity and quality of the client's pain
b. Position the client in a sitting position to improve breathing
c. Check the client's arterial insertion site
d. Apply oxygen at 2 L/min via nasal cannula - ✔✔c. Check the client's arterial insertion site
Rationale: Pts who have had a cardiac catheterization should be restricted to short-term
bedrest, and the insertion site extremity should be kept straight. The nurse should assess the
site for bloody drainage or hematoma formation because complications with vascular closure
devices are not common but can be very serious.
A middle-aged man is admitted to the cardiac unit after reports of a severe headache and
flushing of the face. He is diagnosed with severe hypertension. The patient is alert and oriented.
BP = 192/104, HR = 88. You are the RN assigned to his care. There is an unlicensed nurse
technician working with you.
1. What assessment data will you perform upon his arrival to the unit? why?
2. The cardiologist prescribes IV fluids, hourly BP checks, BP medication, and oxygen at 2 L/min
via nasal cannula. What part of the patient's care will you delegate to the unlicensed nurse
technician? What information will you communicate upon delegation?
, 3. What interventions will you implement to ensure this patient's safety?
4. The patient's wife is very concerned about her husband returning to work as owner of a
roofing company. What education will you provide the patient and his wife at this time? With
what health care team members w - ✔✔1. Assess all VS, specifically BP, and conduct a head to
toe assessment. VS should be taken to continue observing the pt's condition (specifically HTN)
and trended to determine if treatment and interventions are working. During the physical
assessment, you will specifically need to listen to the heart for the presence or absence of
murmurs or other abnormal heart sounds and perform a basic neurological assessment to
determine the pt's baseline orientation.
2. Can delegate: hourly BP checks, with understanding that you must follow all Nurse Practice
Acts related to appropriate delegation.
Communicate: task that is to be performed and the method by which it should be (manual vs
automated). Also clarify that you need the findings reported back to you hourly.
Follow up hourly to obtain report of the vitals so you can make appropriate nursing decisions
3. Safety precautions; if need for invasive diagnostic testing, determine if there is iodine-based
contrast media allergies; report dysrhythmias immediately; continually assess pt's report of
pain, especially when pt's report is descriptive of angina or MI; teach pt safety precautions
regarding calling for assistance if pt needs to ambulate to the bathroom b/c syncope can be
related to severe HTN
4. Teach methods for decreasing cardiovascular disease risk such as control of HTN with meds,
moderate physical exercise, smoking cessation, decrease psychological stressors, and diet
modification.
Collaborate with dietician for nutrition planning, primary care provider for meds that may assist
with smoking cessation, and community support systems that may assist with psychological
stressors
A client who had open abdominal surgery 4 hours ago reports feeling weak and dizzy. The
client's current BP has decreased to 98/50 and pulse is 108. What is nurse's best action at this
time?
a. Document VS and continue to monitor the client.
b. Remind the client to stay in bed if feeling weak and dizzy.
c. Call the health care provider immediately.
d. Increase the client's IV rate to restore fluid volume. - ✔✔c. Call the health care provider
immediately.
The nurse is providing education to help reduce cardiovascular risks for a women's book club.
Which statement made by a participant indicates a need for further teaching?
a. "We are more likely to die from cardiovascular disease than men"
b. "We need to walk or do other exercise everyday for 30 minutes"
c. "We need to stay away from people who smoke"
d. "We should take hormones for menopause to decrease the risk for heart attack" - ✔✔d. "We
should take hormones for menopause to decrease the risk for heart attack"
Rationale: meds used in hormone therapy can cause an increased incidence of MI or stroke in
women
A client is admitted to the telemetry unit after a right-sided cardiac catheterization. What is the
nurse's priority when caring for this client?
a. Assess the intensity and quality of the client's pain
b. Position the client in a sitting position to improve breathing
c. Check the client's arterial insertion site
d. Apply oxygen at 2 L/min via nasal cannula - ✔✔c. Check the client's arterial insertion site
Rationale: Pts who have had a cardiac catheterization should be restricted to short-term
bedrest, and the insertion site extremity should be kept straight. The nurse should assess the
site for bloody drainage or hematoma formation because complications with vascular closure
devices are not common but can be very serious.
A middle-aged man is admitted to the cardiac unit after reports of a severe headache and
flushing of the face. He is diagnosed with severe hypertension. The patient is alert and oriented.
BP = 192/104, HR = 88. You are the RN assigned to his care. There is an unlicensed nurse
technician working with you.
1. What assessment data will you perform upon his arrival to the unit? why?
2. The cardiologist prescribes IV fluids, hourly BP checks, BP medication, and oxygen at 2 L/min
via nasal cannula. What part of the patient's care will you delegate to the unlicensed nurse
technician? What information will you communicate upon delegation?
, 3. What interventions will you implement to ensure this patient's safety?
4. The patient's wife is very concerned about her husband returning to work as owner of a
roofing company. What education will you provide the patient and his wife at this time? With
what health care team members w - ✔✔1. Assess all VS, specifically BP, and conduct a head to
toe assessment. VS should be taken to continue observing the pt's condition (specifically HTN)
and trended to determine if treatment and interventions are working. During the physical
assessment, you will specifically need to listen to the heart for the presence or absence of
murmurs or other abnormal heart sounds and perform a basic neurological assessment to
determine the pt's baseline orientation.
2. Can delegate: hourly BP checks, with understanding that you must follow all Nurse Practice
Acts related to appropriate delegation.
Communicate: task that is to be performed and the method by which it should be (manual vs
automated). Also clarify that you need the findings reported back to you hourly.
Follow up hourly to obtain report of the vitals so you can make appropriate nursing decisions
3. Safety precautions; if need for invasive diagnostic testing, determine if there is iodine-based
contrast media allergies; report dysrhythmias immediately; continually assess pt's report of
pain, especially when pt's report is descriptive of angina or MI; teach pt safety precautions
regarding calling for assistance if pt needs to ambulate to the bathroom b/c syncope can be
related to severe HTN
4. Teach methods for decreasing cardiovascular disease risk such as control of HTN with meds,
moderate physical exercise, smoking cessation, decrease psychological stressors, and diet
modification.
Collaborate with dietician for nutrition planning, primary care provider for meds that may assist
with smoking cessation, and community support systems that may assist with psychological
stressors
A client who had open abdominal surgery 4 hours ago reports feeling weak and dizzy. The
client's current BP has decreased to 98/50 and pulse is 108. What is nurse's best action at this
time?
a. Document VS and continue to monitor the client.
b. Remind the client to stay in bed if feeling weak and dizzy.
c. Call the health care provider immediately.
d. Increase the client's IV rate to restore fluid volume. - ✔✔c. Call the health care provider
immediately.
