NUR 417 Exam 1 | Nursing Practice Questions & Verified Answers
An older adult patient who has just arrived in the 3. Electrocardiographic monitoring
emergency department has a pulse deficit of 46 beats.
Which intervention would the nurse anticipate for this Pulse deficit is a difference between simultaneously obtained apical and radial
patient? pulses. It indicates that there may be a cardiac dysrhythmia that would best be
detected with ECG monitoring. Frequent BP monitoring, cardiac catheterization, and
1. Cardiac catheterization emergent cardioversion are used for diagnosis and/or treatment of cardiovascular
2. Hourly blood pressure checks disorders but would not be as helpful in determining the immediate reason for the
3. Electrocardiographic monitoring pulse deficit.
4. Emergent synchronized cardioversion
How would the nurse listen to auscultate for S3 or S4 2. Use the bell of the stethoscope with the patient in the left lateral position.
gallops in the mitral area?
Gallop rhythms generate low-pitched sounds and are most easily heard with the bell
1. Use the diaphragm of the stethoscope with the patient of the stethoscope. Sounds associated with the mitral valve are accentuated by
lying flat. turning the patient to the left side, which brings the heart closer to the chest wall.
2. Use the bell of the stethoscope with the patient in the The diaphragm of the stethoscope is best to use for the higher pitched sounds such
left lateral position. as S1 and S2.
3. Use the diaphragm of the stethoscope with the patient in
a supine position.
4. Use the bell of the stethoscope with the patient sitting
and leaning forward.
A patient is being treated for heart failure. Which laboratory 4. B-type natriuretic peptide (BNP)
test result will the nurse review to determine the effects of
the treatment? Levels of BNP are a marker for heart failure. The other laboratory results would
assess for myocardial infarction (troponin) or the risk for coronary artery disease
1. Troponin (Hcy and LDL).
2. Homocysteine (Hcy)
3. Low-density lipoprotein (LDL)
4. B-type natriuretic peptide (BNP)
A patient is scheduled for a cardiac catheterization with 2. A flushed feeling is common when the contrast dye is injected.
coronary angiography. What information would the nurse
provide before the procedure? A sensation of warmth or flushing is common when the contrast material is injected,
which can be anxiety producing unless it has been discussed with the patient. The
1. It will be important not to move at all during the patient may receive a sedative drug before the procedure but monitored anesthesia
procedure. care is not used. Arterial pressure monitoring is not routinely used after the
2. A flushed feeling is common when the contrast dye is procedure to monitor blood pressure. The patient is not immobile during cardiac
injected. catheterization and may be asked to cough or take deep breaths.
3. Monitored anesthesia care will be provided during the
procedure.
4. Arterial pressure monitoring will be needed for 24 hours
after the test.
A patient will be evaluated for rhythm disturbances with a 4. Keep a diary of daily activities while the monitor is worn.
Holter monitor. Which instruction would the nurse provide?
The patient is taught to keep a diary describing daily activities while Holter
1. Connect the recorder to a computer once daily. monitoring is being accomplished to help correlate any rhythm disturbances with
2. Exercise more than usual while the monitor is in place. patient activities. Patients are taught that they should not take a shower or bath
3. Remove the electrodes when taking a shower or tub during Holter monitoring and that they should continue with their usual daily
bath. activities. The recorder stores the information about the patient's rhythm until the
4. Keep a diary of daily activities while the monitor is worn. end of the testing, when it is removed and the data are analyzed.
How would the nurse document a loud humming sound 2. Bruit
auscultated over the patient's abdominal aorta?
A bruit is the sound created by turbulent blood flow in an artery. Auscultating a bruit
1. Thrill in an artery is not normal and indicates pathology. Thrills are palpable vibrations felt
2. Bruit when there is turbulent blood flow through the heart or in a blood vessel. A murmur
3. Murmur is the sound caused by turbulent blood flow through the heart.
4. Normal finding
, NUR 417 Exam 1 | Nursing Practice Questions & Verified Answers
The standard policy on the cardiac unit states, "Notify the 1. Postoperative patient with a BP of 116/42 mm Hg.
health care provider for mean arterial pressure (MAP) less
than 70 mm Hg." Which patient's status would the nurse The mean arterial pressure (MAP) is calculated using the formula MAP = (systolic
report to the health care provider? BP + 2 diastolic BP)/3. The MAP for the postoperative patient is 67. The MAP in the
other three patients is higher than 70 mm Hg.
1. Postoperative patient with a BP of 116/42 mm Hg.
2. Newly admitted patient with a BP of 150/87 mm Hg.
3. Patient with left ventricular failure who has a BP of
110/70 mm Hg.
4. Patient with a myocardial infarction who has a BP of
140/86 mm Hg.
The nurse is admitting a patient for a cardiac 2. The patient is allergic to contrast dye.
catheterization and coronary angiogram. Which
information is important for the nurse to communicate to Patients who have allergies to contrast dye will require treatment with medications,
the health care provider before the test? such as corticosteroids and antihistamines before the angiogram. The other
information may be communicated to the health care provider but will not require a
1. The patient's pedal pulses are +1. change in the usual pre-cardiac catheterization orders or medications.
2. The patient is allergic to contrast dye.
3. The patient had a heart attack 1 year ago.
4. The patient has not eaten anything today.
The nurse is reviewing the laboratory results for newly 1. High troponin I level
admitted patients on the cardiovascular unit. Which
laboratory result is most important to communicate rapidly The elevation in troponin I indicates that the patient has had an acute myocardial
to the health care provider? infarction. Further assessment and interventions are indicated. The other laboratory
results indicate increased risk for coronary artery disease but are not associated
1. High troponin I level with acute cardiac problems that need immediate intervention.
2. Increased triglyceride level
3. Very low homocysteine level
4. Elevated C-reactive protein level
Which hemodynamic parameter most directly reflects the 2. Systemic vascular resistance (SVR)
effectiveness of drugs given to reduce a patient's left
ventricular afterload? SVR reflects the resistance to left ventricular ejection, or afterload. Other
parameters may be monitored but do not reflect left-sided afterload as directly.
1. Cardiac output (CO)
2. Systemic vascular resistance (SVR)
3. Pulmonary vascular resistance (PVR)
4. Pulmonary artery wedge pressure (PAWP)
After surgery, a patient's central venous pressure (CVP) 2. Increase the IV fluid infusion per protocol.
monitor indicates low pressures. Which action would the
nurse take? A low CVP indicates decreased preload from hypovolemia and a need for an
increase in the infusion rate. Diuretic administration will contribute to hypovolemia
1. Administer IV diuretic medications. and elevation of the head or increasing vasodilators may decrease cerebral
2. Increase the IV fluid infusion per protocol. perfusion.
3. Increase the infusion rate of IV vasodilators.
4. Elevate the head of the patient's bed to 45 degrees.
Which parameter will the nurse use to evaluate changes in 3. Pulmonary vascular resistance (PVR)
a patient's right ventricular afterload?
PVR is a measure of right ventricular afterload, which is elevated in conditions such
1. Central venous pressure (CVP) as pulmonary hypertension The other parameters do not directly assess for right
2. Systemic vascular resistance (SVR) ventricular afterload.
3. Pulmonary vascular resistance (PVR)
4. Pulmonary artery wedge pressure (PAWP)
A patient requires arterial pressure monitoring. Which 2. Position the zero-reference stopcock line level with the phlebostatic axis.
action would the nurse plan to take?
For accurate measurement of pressures, the zero-reference level would be at the
1. Balance and calibrate the monitoring equipment every 2 phlebostatic axis. There is no need to rebalance and recalibrate monitoring
hours. equipment every 2 hours. Accurate hemodynamic readings are possible with the
2. Position the zero-reference stopcock line level with the patient's head raised to 45 degrees or in the prone position. Alarms should be
phlebostatic axis. activated; if the pressure in the line falls (e.g., when the line is disconnected), the
3. Disconnect the low pressure alarm to avoid disturbing low-pressure alarm sounds immediately and notifies staff to promptly correct the
the patient's sleep. problem.
4. Ensure that the patient is supine with the head of the
bed flat for all readings.
An older adult patient who has just arrived in the 3. Electrocardiographic monitoring
emergency department has a pulse deficit of 46 beats.
Which intervention would the nurse anticipate for this Pulse deficit is a difference between simultaneously obtained apical and radial
patient? pulses. It indicates that there may be a cardiac dysrhythmia that would best be
detected with ECG monitoring. Frequent BP monitoring, cardiac catheterization, and
1. Cardiac catheterization emergent cardioversion are used for diagnosis and/or treatment of cardiovascular
2. Hourly blood pressure checks disorders but would not be as helpful in determining the immediate reason for the
3. Electrocardiographic monitoring pulse deficit.
4. Emergent synchronized cardioversion
How would the nurse listen to auscultate for S3 or S4 2. Use the bell of the stethoscope with the patient in the left lateral position.
gallops in the mitral area?
Gallop rhythms generate low-pitched sounds and are most easily heard with the bell
1. Use the diaphragm of the stethoscope with the patient of the stethoscope. Sounds associated with the mitral valve are accentuated by
lying flat. turning the patient to the left side, which brings the heart closer to the chest wall.
2. Use the bell of the stethoscope with the patient in the The diaphragm of the stethoscope is best to use for the higher pitched sounds such
left lateral position. as S1 and S2.
3. Use the diaphragm of the stethoscope with the patient in
a supine position.
4. Use the bell of the stethoscope with the patient sitting
and leaning forward.
A patient is being treated for heart failure. Which laboratory 4. B-type natriuretic peptide (BNP)
test result will the nurse review to determine the effects of
the treatment? Levels of BNP are a marker for heart failure. The other laboratory results would
assess for myocardial infarction (troponin) or the risk for coronary artery disease
1. Troponin (Hcy and LDL).
2. Homocysteine (Hcy)
3. Low-density lipoprotein (LDL)
4. B-type natriuretic peptide (BNP)
A patient is scheduled for a cardiac catheterization with 2. A flushed feeling is common when the contrast dye is injected.
coronary angiography. What information would the nurse
provide before the procedure? A sensation of warmth or flushing is common when the contrast material is injected,
which can be anxiety producing unless it has been discussed with the patient. The
1. It will be important not to move at all during the patient may receive a sedative drug before the procedure but monitored anesthesia
procedure. care is not used. Arterial pressure monitoring is not routinely used after the
2. A flushed feeling is common when the contrast dye is procedure to monitor blood pressure. The patient is not immobile during cardiac
injected. catheterization and may be asked to cough or take deep breaths.
3. Monitored anesthesia care will be provided during the
procedure.
4. Arterial pressure monitoring will be needed for 24 hours
after the test.
A patient will be evaluated for rhythm disturbances with a 4. Keep a diary of daily activities while the monitor is worn.
Holter monitor. Which instruction would the nurse provide?
The patient is taught to keep a diary describing daily activities while Holter
1. Connect the recorder to a computer once daily. monitoring is being accomplished to help correlate any rhythm disturbances with
2. Exercise more than usual while the monitor is in place. patient activities. Patients are taught that they should not take a shower or bath
3. Remove the electrodes when taking a shower or tub during Holter monitoring and that they should continue with their usual daily
bath. activities. The recorder stores the information about the patient's rhythm until the
4. Keep a diary of daily activities while the monitor is worn. end of the testing, when it is removed and the data are analyzed.
How would the nurse document a loud humming sound 2. Bruit
auscultated over the patient's abdominal aorta?
A bruit is the sound created by turbulent blood flow in an artery. Auscultating a bruit
1. Thrill in an artery is not normal and indicates pathology. Thrills are palpable vibrations felt
2. Bruit when there is turbulent blood flow through the heart or in a blood vessel. A murmur
3. Murmur is the sound caused by turbulent blood flow through the heart.
4. Normal finding
, NUR 417 Exam 1 | Nursing Practice Questions & Verified Answers
The standard policy on the cardiac unit states, "Notify the 1. Postoperative patient with a BP of 116/42 mm Hg.
health care provider for mean arterial pressure (MAP) less
than 70 mm Hg." Which patient's status would the nurse The mean arterial pressure (MAP) is calculated using the formula MAP = (systolic
report to the health care provider? BP + 2 diastolic BP)/3. The MAP for the postoperative patient is 67. The MAP in the
other three patients is higher than 70 mm Hg.
1. Postoperative patient with a BP of 116/42 mm Hg.
2. Newly admitted patient with a BP of 150/87 mm Hg.
3. Patient with left ventricular failure who has a BP of
110/70 mm Hg.
4. Patient with a myocardial infarction who has a BP of
140/86 mm Hg.
The nurse is admitting a patient for a cardiac 2. The patient is allergic to contrast dye.
catheterization and coronary angiogram. Which
information is important for the nurse to communicate to Patients who have allergies to contrast dye will require treatment with medications,
the health care provider before the test? such as corticosteroids and antihistamines before the angiogram. The other
information may be communicated to the health care provider but will not require a
1. The patient's pedal pulses are +1. change in the usual pre-cardiac catheterization orders or medications.
2. The patient is allergic to contrast dye.
3. The patient had a heart attack 1 year ago.
4. The patient has not eaten anything today.
The nurse is reviewing the laboratory results for newly 1. High troponin I level
admitted patients on the cardiovascular unit. Which
laboratory result is most important to communicate rapidly The elevation in troponin I indicates that the patient has had an acute myocardial
to the health care provider? infarction. Further assessment and interventions are indicated. The other laboratory
results indicate increased risk for coronary artery disease but are not associated
1. High troponin I level with acute cardiac problems that need immediate intervention.
2. Increased triglyceride level
3. Very low homocysteine level
4. Elevated C-reactive protein level
Which hemodynamic parameter most directly reflects the 2. Systemic vascular resistance (SVR)
effectiveness of drugs given to reduce a patient's left
ventricular afterload? SVR reflects the resistance to left ventricular ejection, or afterload. Other
parameters may be monitored but do not reflect left-sided afterload as directly.
1. Cardiac output (CO)
2. Systemic vascular resistance (SVR)
3. Pulmonary vascular resistance (PVR)
4. Pulmonary artery wedge pressure (PAWP)
After surgery, a patient's central venous pressure (CVP) 2. Increase the IV fluid infusion per protocol.
monitor indicates low pressures. Which action would the
nurse take? A low CVP indicates decreased preload from hypovolemia and a need for an
increase in the infusion rate. Diuretic administration will contribute to hypovolemia
1. Administer IV diuretic medications. and elevation of the head or increasing vasodilators may decrease cerebral
2. Increase the IV fluid infusion per protocol. perfusion.
3. Increase the infusion rate of IV vasodilators.
4. Elevate the head of the patient's bed to 45 degrees.
Which parameter will the nurse use to evaluate changes in 3. Pulmonary vascular resistance (PVR)
a patient's right ventricular afterload?
PVR is a measure of right ventricular afterload, which is elevated in conditions such
1. Central venous pressure (CVP) as pulmonary hypertension The other parameters do not directly assess for right
2. Systemic vascular resistance (SVR) ventricular afterload.
3. Pulmonary vascular resistance (PVR)
4. Pulmonary artery wedge pressure (PAWP)
A patient requires arterial pressure monitoring. Which 2. Position the zero-reference stopcock line level with the phlebostatic axis.
action would the nurse plan to take?
For accurate measurement of pressures, the zero-reference level would be at the
1. Balance and calibrate the monitoring equipment every 2 phlebostatic axis. There is no need to rebalance and recalibrate monitoring
hours. equipment every 2 hours. Accurate hemodynamic readings are possible with the
2. Position the zero-reference stopcock line level with the patient's head raised to 45 degrees or in the prone position. Alarms should be
phlebostatic axis. activated; if the pressure in the line falls (e.g., when the line is disconnected), the
3. Disconnect the low pressure alarm to avoid disturbing low-pressure alarm sounds immediately and notifies staff to promptly correct the
the patient's sleep. problem.
4. Ensure that the patient is supine with the head of the
bed flat for all readings.
