AH3 FINAL EXAM REVIEW MODULE 1 CARDIO
A client is in the preoperative holding area prior to an emergency coronary artery
bypass graft (CABG). The client is yelling at family members and tells the doctor to just
get this over with when asked to sign the consent form. What action by the nurse is
best?
a. Ask the family members to wait in the waiting area.
b. Inform the client that this behavior is unacceptable.
c. Stay out of the room to decrease the clients stress levels.
d. Tell the client that anxiety is common and that you can help. - Answers :d. Tell the
client that anxiety is common and that you can help.
ANS: D. Preoperative fear and anxiety are common prior to cardiac surgery, especially
in emergent situations. The client is exhibiting anxiety, and the nurse should reassure
the client that fear is common and offer to help. The other actions will not reduce the
client's anxiety. Pre-op before emergency CABG & pt is yelling. Nurse to:
2. HTN patient on enalapril x 3 weeks needs to call HCP if
a. Coughs a lot
b. Complains of occasional dizziness
c. Other choices - Answers :a. Coughs a lot
. A nurse cares for a client with atrial fibrillation who reports fatigue when completing
activities of daily living. What interventions should the nurse implement to address this
client's concerns?
a. Administer oxygen therapy at 2 liters per nasal cannula.
b. Provide the client with a sleeping pill to stimulate rest.
c. Schedule periods of exercise and rest during the day.
d. Ask unlicensed assistive personnel to help bathe the client. - Answers :c. Schedule
periods of exercise and rest during the day.
ANS: C. Clients who have atrial fibrillation are at risk for decreased cardiac output and
fatigue when completing
activities of daily living. The nurse should schedule periods of exercise and rest during
the day to decrease
fatigue. The other interventions will not assist the client with self-care activities.
Propranolol potential serious complication? - Answers :a. Complains of wheezing
Rationale: beta blockers may mess with the heart on accident if they are nonselective.
Any kind of lung problem from a heart medication is undesirable, and we should always
watch for that. See chart 34-4 on P.677
A client had an acute myocardial infarction. What assessment finding indicates to the
nurse that a significant complication has occurred?
a. Blood pressure that is 20 mm Hg below baseline
b. Oxygen saturation of 94% on room air
c. Poor peripheral pulses and cool skin
, d. Urine output of 1.2 mL/kg/hr for 4 hours - Answers :c. Poor peripheral pulses and cool
skin
ANS: C. Poor peripheral pulses and cool skin may be signs of impending cardiogenic
shock and should be reported immediately. A blood pressure drop of 20 mm Hg is not
worrisome. An oxygen saturation of 94% is just slightly below normal. A urine output of
1.2 mL/kg/hr for 4 hours is normal.
A patient with Ventricular Tachycardia has which problem as the frequently most
concerning?
a. Produces increased cardiac output leading to ischemia
b. Uncomfortable sensation of impending doom
c. Other choices - Answers :b. Uncomfortable sensation of impending doom
Rationale: there is decreased cardiac output (not increased). See Action Alert pg. 673:
For patients with sinus tachycardia, assess for fatigue, weakness, SOB, orthopnea,
↓oxygen saturation, ↑pulse rate, and ↓blood pressure. Also assess for restlessness and
anxiety from ↓cerebral perfusion and for ↓urine output from impaired renal perfusion.
The patient may also have anginal pain and palpitations. See "Tachydysrhythmias"
bullet point & chart 34-1, both on pg. 672.
Mitral stenosis patient teaching completed effectively if pt say, "___." - Answers :a. Left
atrium to the left ventricle has narrowing which leads to decreased blood
flow
A client in the cardiac stepdown unit reports severe, crushing chest pain accompanied
by
nausea and vomiting. What action by the nurse takes priority?
a. Administer an aspirin.
b. Call for an electrocardiogram (ECG).
c. Maintain airway patency.
d. Notify the provider. - Answers :c. Maintain airway patency.
ANS: C. Airway always is the priority. The other actions are important in this situation
as well, but the nurse should stay with the client and ensure the airway remains patent
(especially if vomiting occurs) while another person calls the provider (or Rapid
Response Team) and facilitates getting an ECG done. Aspirin will probably be
administered, depending on the providers prescription and the client's current
medications.
Jugular vein distention, 2+ edema in feet and ankles, crackles in lungs, swollen
hands/fingers, distended abdomen, pink sputum coughed up. What problem does pt
have?
a. Right sided HF
b. Lt sided HF
c. Class IV HF
d. Both L& R sided HF - Answers :d. Both L& R sided HF
A client is in the preoperative holding area prior to an emergency coronary artery
bypass graft (CABG). The client is yelling at family members and tells the doctor to just
get this over with when asked to sign the consent form. What action by the nurse is
best?
a. Ask the family members to wait in the waiting area.
b. Inform the client that this behavior is unacceptable.
c. Stay out of the room to decrease the clients stress levels.
d. Tell the client that anxiety is common and that you can help. - Answers :d. Tell the
client that anxiety is common and that you can help.
ANS: D. Preoperative fear and anxiety are common prior to cardiac surgery, especially
in emergent situations. The client is exhibiting anxiety, and the nurse should reassure
the client that fear is common and offer to help. The other actions will not reduce the
client's anxiety. Pre-op before emergency CABG & pt is yelling. Nurse to:
2. HTN patient on enalapril x 3 weeks needs to call HCP if
a. Coughs a lot
b. Complains of occasional dizziness
c. Other choices - Answers :a. Coughs a lot
. A nurse cares for a client with atrial fibrillation who reports fatigue when completing
activities of daily living. What interventions should the nurse implement to address this
client's concerns?
a. Administer oxygen therapy at 2 liters per nasal cannula.
b. Provide the client with a sleeping pill to stimulate rest.
c. Schedule periods of exercise and rest during the day.
d. Ask unlicensed assistive personnel to help bathe the client. - Answers :c. Schedule
periods of exercise and rest during the day.
ANS: C. Clients who have atrial fibrillation are at risk for decreased cardiac output and
fatigue when completing
activities of daily living. The nurse should schedule periods of exercise and rest during
the day to decrease
fatigue. The other interventions will not assist the client with self-care activities.
Propranolol potential serious complication? - Answers :a. Complains of wheezing
Rationale: beta blockers may mess with the heart on accident if they are nonselective.
Any kind of lung problem from a heart medication is undesirable, and we should always
watch for that. See chart 34-4 on P.677
A client had an acute myocardial infarction. What assessment finding indicates to the
nurse that a significant complication has occurred?
a. Blood pressure that is 20 mm Hg below baseline
b. Oxygen saturation of 94% on room air
c. Poor peripheral pulses and cool skin
, d. Urine output of 1.2 mL/kg/hr for 4 hours - Answers :c. Poor peripheral pulses and cool
skin
ANS: C. Poor peripheral pulses and cool skin may be signs of impending cardiogenic
shock and should be reported immediately. A blood pressure drop of 20 mm Hg is not
worrisome. An oxygen saturation of 94% is just slightly below normal. A urine output of
1.2 mL/kg/hr for 4 hours is normal.
A patient with Ventricular Tachycardia has which problem as the frequently most
concerning?
a. Produces increased cardiac output leading to ischemia
b. Uncomfortable sensation of impending doom
c. Other choices - Answers :b. Uncomfortable sensation of impending doom
Rationale: there is decreased cardiac output (not increased). See Action Alert pg. 673:
For patients with sinus tachycardia, assess for fatigue, weakness, SOB, orthopnea,
↓oxygen saturation, ↑pulse rate, and ↓blood pressure. Also assess for restlessness and
anxiety from ↓cerebral perfusion and for ↓urine output from impaired renal perfusion.
The patient may also have anginal pain and palpitations. See "Tachydysrhythmias"
bullet point & chart 34-1, both on pg. 672.
Mitral stenosis patient teaching completed effectively if pt say, "___." - Answers :a. Left
atrium to the left ventricle has narrowing which leads to decreased blood
flow
A client in the cardiac stepdown unit reports severe, crushing chest pain accompanied
by
nausea and vomiting. What action by the nurse takes priority?
a. Administer an aspirin.
b. Call for an electrocardiogram (ECG).
c. Maintain airway patency.
d. Notify the provider. - Answers :c. Maintain airway patency.
ANS: C. Airway always is the priority. The other actions are important in this situation
as well, but the nurse should stay with the client and ensure the airway remains patent
(especially if vomiting occurs) while another person calls the provider (or Rapid
Response Team) and facilitates getting an ECG done. Aspirin will probably be
administered, depending on the providers prescription and the client's current
medications.
Jugular vein distention, 2+ edema in feet and ankles, crackles in lungs, swollen
hands/fingers, distended abdomen, pink sputum coughed up. What problem does pt
have?
a. Right sided HF
b. Lt sided HF
c. Class IV HF
d. Both L& R sided HF - Answers :d. Both L& R sided HF
