NMNC 4410 EXAM #1 QUESTIONS & ANSWERS
The nurse is assessing a client newly diagnosed with Stage 1 Hypertension. Which
assessment finding should the nurse expect?
Visual disturbances
Shortness of breath
Frequent nosebleeds
Asymptomatic - Answers -Asymptomatic
Lisinopril has been recently prescribed for an anemic patient newly diagnosed with
hypertension. What should the nurse instruct the client about this medication?
Rise slowly from a reclining to a sitting position.
Discontinue the medication if nausea occurs.
Expect to note a full therapeutic effect immediately.
Take the medication with food only. - Answers -Rise slowly from a reclining to a sitting
position.
A client taking an angiotensin-converting enzyme (ACE) inhibitor to treat hypertension
calls the clinic nurse and reports that he has a dry, nonproductive cough that is very
bothersome. The nurse should respond by making which statement?
"The cough must be the start of a respiratory infection."
"When this happens typically your PCP will change your medication to an ARB".
"The medication needs to be taken with large amounts of water to prevent the cough."
"This sometimes happens, and you will need to take a cough medication with each dose
of medication." - Answers -"When this happens typically your PCP will change your
medication to an ARB".
The provider orders an antihypertensive medication for a client whose blood pressure is
205/110 mm Hg. What assessment findings does the student nurse expect for this
patient?
Select All That Apply.
Chest Pain
Diminished pulses
Pale Cool Skin
Blurred Vision
Severe Headache - Answers -Chest Pain
Blurred Vision
Severe Headache
How do anti-hypertensive medications alter cardiac output?
Increase Heart Rate
Increase Stroke Volume
Decrease Ejection Fraction
Reduce Systemic Vascular Resistance - Answers -Reduce Systemic Vascular
Resistance
,The nurse is monitoring a client for adverse effects of medications. Which findings are
characteristic of adverse effects of hydrochlorothiazide? Select all that apply.
Hypokalemia
Hypouricemia
Hyperglycemia
Sulfa allergy
Osteoporosis
Hypercalcemia - Answers -Hypokalemia
Hyperglycemia
Sulfa allergy
Hypercalcemia
A 68-yr-old male patient presents to the emergency department with a BP 210/of 118
and reports a severe headache and vomiting. You know that his BP is dangerously high
and must be lowered. - Answers -149
The nurse is assessing a client admitted to the telemetry unit from the Emergency
Department with complaints of increasing shortness of breath, and is coughing pink-
tinged frothy sputum. During the history assessment, the nurse documents a history of
left-sided heart failure. The nurse recognizes the presenting signs and symptoms of
which heart failure complication?
Acute pulmonary edema
Right-sided heart failure
Myocardial infarction
Bacterial pneumonia - Answers -Acute pulmonary edema
The nurse is caring for a hospitalized client with admitting diagnosis of right-sided heart
failure (HF). What assessment finding is most consistent with the client's diagnosis?
Distended neck veins
Pulmonary edema
Dry hacking cough
Orthopnea - Answers -Distended neck veins
The nurse is caring for a 76-year-old male who was admitted for extreme weakness,
dizziness, and orthopnea. A diagnosis of heart failure is confirmed by the cardiologist
observing JVD and reading is Echo Cardiogram. Which of the following tests was most
helpful in determining the diagnosis of heart failure?
Brain natriuretic peptide (BNP)
Renal Function Panel
12-lead EKG
Complete Metabolic Panel (CMP) - Answers -Brain natriuretic peptide (BNP)
A patient with left-sided heart failure is prescribed oxygen at 4 L/min per nasal cannula,
furosemide (Lasix), spironolactone (Aldactone), and enalapril (Vasotec). Which
,assessment should the nurse complete to best evaluate the patient's response to these
drugs?
Auscultate lung sounds.
Observe skin turgor.
Measure blood pressure.
Review intake and output. - Answers -Auscultate lung sounds.
The nurse is caring for a client who has +3 pitting edema in the legs and a potassium
level of 2.3 mEq/L. The nurse expects which of the following diuretics to be ordered?
Spironolactone (Aldactone)
Furosemide (Lasix)
Lisinopril
Hydrochorithiazide - Answers -Spironolactone (Aldactone)
A client with heart disease has developed pulmonary edema and is having difficulties
breathing. The nurse notes that the client is breathing at a rate of 28/min and has an
oxygen saturation of 90% on room air. Which best describes the first response of the
nurse?
Administer oxygen through a face mask to correct saturation levels
Gather supplies to assist with intubation
Prepare the client for a thoracentesis
Administer pain medication to slow the client's breathing - Answers -Administer oxygen
through a face mask to correct saturation levels
The nurse is monitoring a client with heart failure who takes digoxin and whose morning
lab level = 2.5. What patient presentation should the nurse assess for?
Tremors
Diarrhea
Irritability
Blurred Vision
Nausea & Vomiting
A controlled heart rate
increased urine output - Answers -Diarrhea
Blurred Vision
Nausea & Vomiting
The nurse is assessing a female patient at the neighborhood clinic. The patient reports
"feeling tired all the time." The nurse knows that fatigue may be an underlying symptom
of which condition?
Pneumonia
Peptic ulcer disease
Myocardial infarction
Ischemia - Answers -Myocardial infarction
Fatigue is an atypical symptom of myocardial infarction in women. Ischemia is
associated with pain. Pneumonia is associated with pain and shortness of breath.
Peptic ulcer disease is associated with pain and intestinal discomfort.
, The nurse is assessing the sleep patterns of a patient when the patient reports he has
trouble sleeping when lying flat. Which is the best response by the nurse?
Use pillows to prop yourself up while sleeping.
Use nasal strips to assist with breathing.
Sleep in a side-lying position.
Open a window to let fresh air into the room. - Answers -Use pillows to prop yourself up
while sleeping.
Using pillows to prop himself up during sleep allows the patient to breathe more easily
and comfortably. Nasal strips will help with breathing, but they do not always bring relief
when one is lying flat. Sleeping in a side position or opening a window does not help
one to breathe more easily when one is lying flat.
A patient is experiencing periods of confusion, and the family is concerned. The
patient's son asks the nurse for an explanation and recommendation. Which is the best
response by the nurse?
"Talk with your father about past events, and that will help with the confusion."
"Your father may be having mini-strokes; I will notify his physician."
"Your father is just confused about some things since he is in the hospital."
"The confusion will pass. Your father just has to get up and move around." - Answers -
"Your father may be having mini-strokes; I will notify his physician."
Periods of confusion may be related to mini-strokes, or transient ischemic attacks
(TIAs). Confusion during hospitalization does not occur with every patient. Talking with
the patient or thinking the confusion may pass is not a viable solution. The patient
should be assessed and the reason for the confusion identified.
A patient is questioning the nurse about circulation and perfusion. Which is the best
response by the nurse?
"Perfusion assists the cell by delivering oxygen and removing waste products."
"Perfusion assists the body by preventing clots and increasing stamina."
"Perfusion assists the heart by increasing the cardiac output."
"Perfusion assists the brain by increasing mental alertness." - Answers -"Perfusion
assists the cell by delivering oxygen and removing waste products."
Perfusion delivers much needed oxygen to the cells of the body and then helps to
remove waste products. Perfusion does not prevent clots, does not increase cardiac
output, and does not increase mental alertness.
What is the purpose of including exercise and activity in a cardiac rehabilitation
program? (Select all that apply.)
Select all that apply.
Increase blood pressure
Increase flexibility
Increase cardiac output
Increase muscle mass
Increase serum lipids
Increase blood flow through the arteries - Answers -Increase flexibility
The nurse is assessing a client newly diagnosed with Stage 1 Hypertension. Which
assessment finding should the nurse expect?
Visual disturbances
Shortness of breath
Frequent nosebleeds
Asymptomatic - Answers -Asymptomatic
Lisinopril has been recently prescribed for an anemic patient newly diagnosed with
hypertension. What should the nurse instruct the client about this medication?
Rise slowly from a reclining to a sitting position.
Discontinue the medication if nausea occurs.
Expect to note a full therapeutic effect immediately.
Take the medication with food only. - Answers -Rise slowly from a reclining to a sitting
position.
A client taking an angiotensin-converting enzyme (ACE) inhibitor to treat hypertension
calls the clinic nurse and reports that he has a dry, nonproductive cough that is very
bothersome. The nurse should respond by making which statement?
"The cough must be the start of a respiratory infection."
"When this happens typically your PCP will change your medication to an ARB".
"The medication needs to be taken with large amounts of water to prevent the cough."
"This sometimes happens, and you will need to take a cough medication with each dose
of medication." - Answers -"When this happens typically your PCP will change your
medication to an ARB".
The provider orders an antihypertensive medication for a client whose blood pressure is
205/110 mm Hg. What assessment findings does the student nurse expect for this
patient?
Select All That Apply.
Chest Pain
Diminished pulses
Pale Cool Skin
Blurred Vision
Severe Headache - Answers -Chest Pain
Blurred Vision
Severe Headache
How do anti-hypertensive medications alter cardiac output?
Increase Heart Rate
Increase Stroke Volume
Decrease Ejection Fraction
Reduce Systemic Vascular Resistance - Answers -Reduce Systemic Vascular
Resistance
,The nurse is monitoring a client for adverse effects of medications. Which findings are
characteristic of adverse effects of hydrochlorothiazide? Select all that apply.
Hypokalemia
Hypouricemia
Hyperglycemia
Sulfa allergy
Osteoporosis
Hypercalcemia - Answers -Hypokalemia
Hyperglycemia
Sulfa allergy
Hypercalcemia
A 68-yr-old male patient presents to the emergency department with a BP 210/of 118
and reports a severe headache and vomiting. You know that his BP is dangerously high
and must be lowered. - Answers -149
The nurse is assessing a client admitted to the telemetry unit from the Emergency
Department with complaints of increasing shortness of breath, and is coughing pink-
tinged frothy sputum. During the history assessment, the nurse documents a history of
left-sided heart failure. The nurse recognizes the presenting signs and symptoms of
which heart failure complication?
Acute pulmonary edema
Right-sided heart failure
Myocardial infarction
Bacterial pneumonia - Answers -Acute pulmonary edema
The nurse is caring for a hospitalized client with admitting diagnosis of right-sided heart
failure (HF). What assessment finding is most consistent with the client's diagnosis?
Distended neck veins
Pulmonary edema
Dry hacking cough
Orthopnea - Answers -Distended neck veins
The nurse is caring for a 76-year-old male who was admitted for extreme weakness,
dizziness, and orthopnea. A diagnosis of heart failure is confirmed by the cardiologist
observing JVD and reading is Echo Cardiogram. Which of the following tests was most
helpful in determining the diagnosis of heart failure?
Brain natriuretic peptide (BNP)
Renal Function Panel
12-lead EKG
Complete Metabolic Panel (CMP) - Answers -Brain natriuretic peptide (BNP)
A patient with left-sided heart failure is prescribed oxygen at 4 L/min per nasal cannula,
furosemide (Lasix), spironolactone (Aldactone), and enalapril (Vasotec). Which
,assessment should the nurse complete to best evaluate the patient's response to these
drugs?
Auscultate lung sounds.
Observe skin turgor.
Measure blood pressure.
Review intake and output. - Answers -Auscultate lung sounds.
The nurse is caring for a client who has +3 pitting edema in the legs and a potassium
level of 2.3 mEq/L. The nurse expects which of the following diuretics to be ordered?
Spironolactone (Aldactone)
Furosemide (Lasix)
Lisinopril
Hydrochorithiazide - Answers -Spironolactone (Aldactone)
A client with heart disease has developed pulmonary edema and is having difficulties
breathing. The nurse notes that the client is breathing at a rate of 28/min and has an
oxygen saturation of 90% on room air. Which best describes the first response of the
nurse?
Administer oxygen through a face mask to correct saturation levels
Gather supplies to assist with intubation
Prepare the client for a thoracentesis
Administer pain medication to slow the client's breathing - Answers -Administer oxygen
through a face mask to correct saturation levels
The nurse is monitoring a client with heart failure who takes digoxin and whose morning
lab level = 2.5. What patient presentation should the nurse assess for?
Tremors
Diarrhea
Irritability
Blurred Vision
Nausea & Vomiting
A controlled heart rate
increased urine output - Answers -Diarrhea
Blurred Vision
Nausea & Vomiting
The nurse is assessing a female patient at the neighborhood clinic. The patient reports
"feeling tired all the time." The nurse knows that fatigue may be an underlying symptom
of which condition?
Pneumonia
Peptic ulcer disease
Myocardial infarction
Ischemia - Answers -Myocardial infarction
Fatigue is an atypical symptom of myocardial infarction in women. Ischemia is
associated with pain. Pneumonia is associated with pain and shortness of breath.
Peptic ulcer disease is associated with pain and intestinal discomfort.
, The nurse is assessing the sleep patterns of a patient when the patient reports he has
trouble sleeping when lying flat. Which is the best response by the nurse?
Use pillows to prop yourself up while sleeping.
Use nasal strips to assist with breathing.
Sleep in a side-lying position.
Open a window to let fresh air into the room. - Answers -Use pillows to prop yourself up
while sleeping.
Using pillows to prop himself up during sleep allows the patient to breathe more easily
and comfortably. Nasal strips will help with breathing, but they do not always bring relief
when one is lying flat. Sleeping in a side position or opening a window does not help
one to breathe more easily when one is lying flat.
A patient is experiencing periods of confusion, and the family is concerned. The
patient's son asks the nurse for an explanation and recommendation. Which is the best
response by the nurse?
"Talk with your father about past events, and that will help with the confusion."
"Your father may be having mini-strokes; I will notify his physician."
"Your father is just confused about some things since he is in the hospital."
"The confusion will pass. Your father just has to get up and move around." - Answers -
"Your father may be having mini-strokes; I will notify his physician."
Periods of confusion may be related to mini-strokes, or transient ischemic attacks
(TIAs). Confusion during hospitalization does not occur with every patient. Talking with
the patient or thinking the confusion may pass is not a viable solution. The patient
should be assessed and the reason for the confusion identified.
A patient is questioning the nurse about circulation and perfusion. Which is the best
response by the nurse?
"Perfusion assists the cell by delivering oxygen and removing waste products."
"Perfusion assists the body by preventing clots and increasing stamina."
"Perfusion assists the heart by increasing the cardiac output."
"Perfusion assists the brain by increasing mental alertness." - Answers -"Perfusion
assists the cell by delivering oxygen and removing waste products."
Perfusion delivers much needed oxygen to the cells of the body and then helps to
remove waste products. Perfusion does not prevent clots, does not increase cardiac
output, and does not increase mental alertness.
What is the purpose of including exercise and activity in a cardiac rehabilitation
program? (Select all that apply.)
Select all that apply.
Increase blood pressure
Increase flexibility
Increase cardiac output
Increase muscle mass
Increase serum lipids
Increase blood flow through the arteries - Answers -Increase flexibility
