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NURSING 404 - NCLEX Cardiovascular System | Questions with Answers (100% correct)., Exams of Nursing

Pace UniversityNursing

NURSING 404 - NCLEX Cardiovascular System | Questions with Answers (100% correct).

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NURSING 404 – NCLEX Cardiovascular System Questions with
Answers
1. A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is scheduled for cardiac
catheterization. Which medication would need to be withheld for 24 hours before the procedure and for 48 hours
after the procedure?
1. Glipizide
2. Metformin
3. Repaglinide
4. Regular insulin
2. A client who had cardiac surgery 24 hours ago has had a urine output averaging 20 mL/hour for 2 hours. The
client received a single bolus of 500 mL of intravenous fluid. Urine output for the subsequent hour was 25 mL.
Daily laboratory results indicate that the blood urea nitrogen level is 45 mg/dL (16 mmol/L) and the serum
creatinine level is 2.2 mg/dL (194 mcmol/L). On the basis of these findings, the nurse would anticipate that the
client is at risk for which problem?
1. Hypovolemia
2. Acute kidney injury
3. Glomerulonephritis
4. Urinary tract infection
3. The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR
interval is 0.16 seconds, and QRS complexes measure 0.06 seconds. The overall heart rate is 64 beats/minute.
Which action should the nurse take?
1. Check vital signs.
2. Check laboratory test results.
3. Notify the health care provider.
4. Continue to monitor for any rhythm change.
4. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. The nurse sees no
electrocardiographic complexes on the screen. Which is the priority nursing action?
1. Call a code.
2. Call the health care provider.
3. Check the client's status and lead placement.
4. Press the recorder button on the electrocardiogram console.
5. The nurse is evaluating a client's response to cardioversion. Which assessment would be the priority?
1. Blood pressure
2. Status of airway
3. Oxygen flow rate
4. Level of consciousness
6. The nurse is caring for a client who has just had implantation of an automatic internal cardioverter-defibrillator.
The nurse should assess which item based on priority?
1. Anxiety level of the client and family
2. Presence of a Medic-Alert card for the client to carry
3. Knowledge of restrictions on post-discharge physical activity
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Download NURSING 404 - NCLEX Cardiovascular System | Questions with Answers (100% correct). and more Exams Nursing in PDF only on Docsity!

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

  1. A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is scheduled for cardiac catheterization. Which medication would need to be withheld for 24 hours before the procedure and for 48 hours after the procedure?
  2. Glipizide
  3. Metformin
  4. Repaglinide
  5. Regular insulin
  6. A client who had cardiac surgery 24 hours ago has had a urine output averaging 20 mL/hour for 2 hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for the subsequent hour was 25 mL. Daily laboratory results indicate that the blood urea nitrogen level is 45 mg/dL (16 mmol/L) and the serum creatinine level is 2.2 mg/dL (194 mcmol/L). On the basis of these findings, the nurse would anticipate that the client is at risk for which problem?
  7. Hypovolemia
  8. Acute kidney injury
  9. Glomerulonephritis
  10. Urinary tract infection
  11. The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 seconds, and QRS complexes measure 0.06 seconds. The overall heart rate is 64 beats/minute. Which action should the nurse take?
  12. Check vital signs.
  13. Check laboratory test results.
  14. Notify the health care provider.
  15. Continue to monitor for any rhythm change.
  16. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. The nurse sees no electrocardiographic complexes on the screen. Which is the priority nursing action?
  17. Call a code.
  18. Call the health care provider.
  19. Check the client's status and lead placement.
  20. Press the recorder button on the electrocardiogram console. 5. The nurse is evaluating a client's response to cardioversion. Which assessment would be the priority?
  21. Blood pressure
  22. Status of airway
  23. Oxygen flow rate
  24. Level of consciousness
  25. The nurse is caring for a client who has just had implantation of an automatic internal cardioverter-defibrillator. The nurse should assess which item based on priority?
  26. Anxiety level of the client and family
  27. Presence of a Medic-Alert card for the client to carry
  28. Knowledge of restrictions on post-discharge physical activity

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

  1. Activation status of the device, heart rate cutoff, and number of shocks it is

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

  1. The home care nurse is providing instructions to a client with an arterial ischemic leg ulcer about home care management and self-care management. Which statement, if made by the client, indicates a need for further instruction?
  2. "I need to be sure not to go barefoot around the house."
  3. "If I cut my toenails, I need to be sure that I cut them straight across."
  4. "It is all right to apply lanolin to my feet, but I shouldn't place it between my toes."
  5. "I need to be sure that I elevate my leg above the level of my heart for at least an hour every day."
  6. The nurse is providing instructions to a client with a diagnosis of hypertension regarding high-sodium items to be avoided. The nurse instructs the client to avoid consuming which item?
  7. Bananas
  8. Broccoli
  9. Antacids
  10. Cantaloupe
  11. The nurse is preparing discharge instructions for a client with Raynaud's disease. The nurse should plan to provide which instruction to the client?
  12. Use nail polish to protect the nail beds from injury.
  13. Wear gloves for all activities involving the use of both hands.
  14. Stop smoking because it causes cutaneous blood vessel spasm.
  15. Always wear warm clothing, even in warm climates, to prevent vasoconstriction.
  16. The nurse is developing a plan of care for a client with varicose veins in whom skin breakdown occurred over the varicosities as a result of secondary infection. Which is a priority intervention?
  17. Keep the legs aligned with the heart.
  18. Elevate the legs higher than the heart.
  19. Clean the skin with alcohol every hour.
  20. Position the client onto the side during every shift. Rationale: In the client with a venous disorder, the legs are elevated above the level of the heart to assist with the return of venous blood to the heart. Alcohol is very irritating and drying to tissues and should not be used in areas of skin breakdown. Option 4 specifies infrequent care intervals, so it is not the priority intervention.
  21. The nurse in the medical unit is reviewing the laboratory test results for a client who has been transferred from the intensive care unit (ICU). The nurse notes that a cardiac troponin T assay was performed while the client was in the ICU. The nurse determines that this test was performed to assist in diagnosing which condition?
  22. Heart failure
  23. Atrial fibrillation
  24. Myocardial infarction
  25. Ventricular tachycardia
  26. The nurse is caring for a client with cardiac disease who has been placed on a cardiac monitor. The nurse notes that the client has developed atrial fibrillation and has a rapid ventricular rate of 150 beats/minute. The nurse should next assess the client for which finding?

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

  1. Hypotension

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

  1. The nurse is developing a plan of care for a client who will be admitted to the hospital with a diagnosis of deep vein thrombosis (DVT) of the right leg. The nurse develops the plan, expecting that the health care provider (HCP) will most likely prescribe which option?
  2. Maintain activity level as prescribed.
  3. Maintain the affected leg in a dependent position.
  4. Administer an opioid analgesic every 4 hours around the clock.
  5. Apply cool packs to the affected leg for 20 minutes every 4 hours.
  6. A client with a diagnosis of varicose veins is scheduled for treatment by sclerotherapy and is receiving education about the procedure from the nurse. Which statement by the client indicates that the teaching has been effective?
  7. "It involves tying off the veins so that circulation is redirected in another area."
  8. "It involves surgically removing the varicosity, so anesthesia will be required."
  9. "It involves tying off the veins to prevent sluggishness of blood from occurring."
  10. "It involves injecting an agent into the vein to damage the vein wall and close it off."
  11. A client calls the nurse at the clinic and reports that ever since the vein ligation and stripping procedure was performed, she has been experiencing a sensation as though the affected leg is falling asleep. The nurse should make which response to the client?
  12. "Apply warm packs to the leg."
  13. "Keep the leg elevated as much as possible."
  14. "Your health care provider needs to be contacted to report this problem."
  15. "This normally occurs after surgery and will subside when the edema goes down."
  16. The registered nurse (RN) is educating a new RN about the use of oxygen for clients with angina pectoris. Which statement by the new nurse indicates that the teaching has been effective?
  17. "Oxygen has a calming effect."
  18. "Oxygen will prevent the development of any thrombus."
  19. "The pain of angina pectoris occurs because of a decreased oxygen supply to heart cells."
  20. "Oxygen dilates the blood vessels so that they can supply more nutrients to the heart muscle.

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

  1. A client with a diagnosis of angina pectoris is hospitalized for an angioplasty. The client returns to the nursing unit after the procedure, and the nurse provides instructions to the client regarding home care measures. Which statement, if made by the client, indicates an understanding of the instructions?
  2. "I need to cut down on cigarette smoking."
  3. "I am so relieved that my heart is repaired."
  4. "I need to adhere to my dietary restrictions."
  5. "I am so relieved that I can eat anything I want to now."
  6. The nurse is caring for a client with a diagnosis of myocardial infarction (MI) and is assisting the client in completing the diet menu. Which beverage should the nurse instruct the client to select from the menu?
  7. Tea
  8. Cola
  9. Coffee
  10. Raspberry juice
  11. The nurse is performing an admission assessment on a client with a diagnosis of angina pectoris who takes nitroglycerin for chest pain at home. During the assessment the client complains of chest pain. The nurse should immediately ask the client which question?
  12. "Where is the pain located?"
  13. "Are you having any nausea?"
  14. "Are you allergic to any medications?"
  15. "Do you have your nitroglycerin with you?"
  16. The nurse has provided dietary instructions to a client with coronary artery disease. Which statement by the client indicates an understanding of the dietary instructions?
  17. "I'll need to become a strict vegetarian."
  18. "I should use polyunsaturated oils in my diet."
  19. "I need to substitute eggs and whole milk for meat."
  20. "I should eliminate all cholesterol and fat from my diet."
  21. A client is admitted to the visiting nurse service for assessment and follow-up after being discharged from the hospital with new-onset heart failure (HF). The nurse teaches the client about the dietary restrictions required with HF. Which statement by the client indicates that further teaching is needed?
  22. "I'm not supposed to eat cold cuts."

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

  1. A client has been experiencing difficulty with completion of daily activities because of underlying cardiovascular disease, as evidenced by exertional fatigue and increased blood pressure. Which observation by the nurse best indicates client progress in meeting goals for this problem?
  2. Ambulates 10 feet (3 meters) farther each day
  3. Verbalizes the benefits of increasing activity
  4. Chooses a healthy diet that meets caloric needs
  5. Sleeps without awakening throughout the night
  6. The health care provider (HCP) has written a prescription for a client to have an echocardiogram. Which action should the nurse take to prepare the client for the procedure?
  7. Questions the client about allergies to iodine or shellfish
  8. Has the client sign an informed consent form for an invasive procedure
  9. Tells the client that the procedure is painless and takes 30 to 60 minutes
  10. Keeps the client on nothing by mouth (NPO) status for 2 hours before the procedure
  11. A client with coronary artery disease is scheduled to have a diagnostic exercise stress test. Which instruction should the nurse plan to provide to the client about this procedure?
  12. Eat breakfast just before the procedure.
  13. Wear firm, rigid shoes, such as work boots.
  14. Wear loose clothing with a shirt that buttons in front.
  15. Avoid cigarettes for 30 minutes before the procedure.
  16. A client is scheduled for a cardiac catheterization to diagnose the extent of coronary artery disease. The nurse places highest priority on telling the client to report which sensation during the procedure?
  17. Chest pain
  18. Urge to cough
  19. Warm, flushed feeling
  20. Pressure at the insertion site
  21. A client recovering from pulmonary edema is preparing for discharge. What should the nurse plan to teach the client to do to manage or prevent recurrent symptoms after discharge?
  22. Weigh self on a daily basis.

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

  1. Sleep with the head of the bed flat.
  2. Take a double dose of the diuretic if peripheral edema is noted.
  3. Withhold prescribed digoxin if slight respiratory distress occurs.
    1. A client is scheduled to undergo cardiac catheterization for the first time, and the nurse provides instructions to the client. Which client statement indicates an understanding of the instructions?
  4. "It will really hurt when the catheter is first put in."
  5. "I will receive general anesthesia for the procedure."
  6. "I will have to go to the operating room for this procedure."
  7. "I probably will feel tired after the test from lying on a hard x-ray table for a few hours." Rationale: It is common for the client to feel fatigued after the cardiac catheterization procedure. A local anesthetic is used, so little to no pain is experienced with catheter insertion. General anesthesia is not used. Other pre-procedure teaching points include the fact that the procedure is done in a darkened cardiac catheterization room. The x-ray table is hard and may be tilted periodically, and the procedure may take 1 to 2 hours. The client may feel various sensations with catheter passage and dye injection.
  8. A client admitted to the hospital with coronary artery disease complains of dyspnea at rest. The nurse caring for the client uses which item as the best means to monitor respiratory status on an ongoing basis?
  9. Apnea monitor
  10. Oxygen flowmeter
  11. Telemetry cardiac monitor
  12. Oxygen saturation monitor
    1. The nurse is listening to a lecture about angina. Which statement by the nurse indicates that the teaching has been effective?
  13. "Stable angina is chronic."
  14. "Variant angina is caused by emotional stress."
  15. "Unstable angina is not a life-threatening condition."
  16. "Intractable angina rarely limits the client's lifestyle." Rationale: Stable angina is triggered by a predictable amount of effort or emotion and is a chronic condition. Variant angina is triggered by coronary artery spasm; the attacks are of longer duration than in classic angina and tend to occur early in the day and at rest. Unstable angina is triggered by an unpredictable amount of exertion or emotion and may occur at night; the attacks increase in number, duration, and severity over time. Intractable angina is chronic and incapacitating and is refractory to medical therapy.

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

  1. Strict bed rest for 24 hours after transfer
  2. Bathroom privileges and self-care activities
  3. Unsupervised hallway ambulation for distances up to 200 feet (60 meters)
    1. A client with no history of heart disease has experienced acute myocardial infarction and has been given thrombolytic therapy with tissue plasminogen activator. What assessment finding should the nurse identify as an indicator that the client is experiencing complications of this therapy?
  4. Tarry stools
  5. Nausea and vomiting
  6. Orange-colored urine
  7. Decreased urine output Rationale: Thrombolytic agents are used to dissolve existing thrombi, and the nurse should monitor the client for obvious or occult signs of bleeding. This includes assessment for obvious bleeding within the gastrointestinal (GI) tract, urinary system, and skin. It also includes Hema-test testing of secretions for occult blood. The correct option is the only one that indicates the presence of blood.
  8. The nurse is discussing smoking cessation with a client diagnosed with coronary artery disease (CAD). Which statement should the nurse make to try to motivate the client to quit smoking?
  9. "None of the cardiovascular effects are reversible, but quitting might prevent lung cancer."
  10. "Because most of the damage has already been done, it will be all right to cut down a little at a time."
  11. "If you totally quit smoking right now, you can cut your cardiovascular risk to zero within a year."
  12. "If you quit now, your risk of cardiovascular disease will decrease to that of a nonsmoker in 3 to 4 years."
  13. A client has experienced an episode of pulmonary edema. The nurse determines that the client's respiratory status is improving after this episode if which breath sounds are noted?
  14. Rhonchi
  15. Wheezes
  16. Crackles in the bases
  17. Crackles throughout the lung fields Rationale: Pulmonary edema is characterized by extreme breathlessness, dyspnea, air hunger, and the production of frothy, pink- tinged sputum. As the client's condition improves, the amount of fluid in the alveoli decreases, which may be detected by

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

crackles in the bases. (Clear lung sounds indicate full resolution of the episode.) Rhonchi and wheezes are not associated with pulmonary edema. Auscultation of the lungs reveals crackles throughout the lung fields.

  1. A hospitalized client has been diagnosed with heart failure as a complication of hypertension. In explaining the disease process to the client, the nurse identifies which chamber of the heart as primarily responsible for the symptoms?
  2. Left atrium
  3. Right atrium
  4. Left ventricle
  5. Right ventricle Rationale: Hypertension increases the workload of the left ventricle because the ventricle has to pump the stroke volume against increased resistance (afterload) in the major blood vessels. Over time this causes the left ventricle to fail, leading to signs and symptoms of heart failure. The remaining options are not the chambers that are primarily responsible for this disease process, although these chambers may be affected as the disease becomes more chronic.
  6. The nurse has just completed education on myocardial infarction (MI) to a group of new nurses. Which statement made by one of the nurses indicates that the teaching has been effective?
  7. "Chest pain is caused by tissue hypoxia in the myocardium."
  8. "Chest pain is caused by tissue hypoxia in the vessels of the heart."
  9. "Chest pain is caused by tissue hypoxia in the parietal pericardium."
  10. "Chest pain is caused by tissue hypoxia in the visceral pericardium."
  11. The registered nurse (RN) is educating a new nurse on mitral stenosis. Which statement by the new nurse indicates that the teaching has been effective?
  12. "Left ventricle to aorta narrowing will impede flow of blood."
  13. "Left atrium to left ventricle narrowing will impede flow of blood."
  14. "Right atrium to right ventricle narrowing will impede flow of blood."
  15. "Right ventricle to pulmonary artery narrowing will impede flow of blood." Rationale: The mitral valve separates the left atrium from the left ventricle.
  16. The registered nurse (RN) is educating a new nurse about aortic regurgitation. Which statement by the new nurse indicates that the teaching has been effective?
  17. "Failure of the aortic valve to close completely allows blood to flow retrograde through the aorta to the left ventricle."

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

through the left ventricle to the left atrium."

  1. "Failure of the aortic valve to close completely allows blood to flow retrograde through the right ventricle to the right atrium."
  2. "Failure of the aortic valve to close completely allows blood to flow retrograde through the pulmonary artery to the right ventricle." Rationale: The aortic valve separates the aorta from the left ventricle.
  3. The nurse educator is teaching the new registered nurse (RN) how to care for clients with a decrease in blood pressure. Which statement by the new RN indicates the need for further instruction?
  4. "Decreased contractility occurs."
  5. "Decreased heart rate is not a side effect."
  6. "Decreased myocardial blood flow is not a concern."
  7. "Increased resistance to electrical stimulation often occurs." Rationale: The primary effect of a decrease in blood pressure is reduced blood flow to the myocardium. This in turn decreases oxygenation of the cardiac tissue. Cardiac tissue is likely to become more excitable or irritable in the presence of hypoxia. Correspondingly, the heart rate is likely to increase, not decrease, in response to this change. The effects of tissue ischemia lead to decreased contractility over time.
  8. The nurse educator is lecturing new registered nurses (RNs) about serum calcium levels. Which statement by one of the new RNs indicates that teaching has been effective?
  9. "Calcium has no effect on the risk for stroke."
  10. "Low calcium levels can lead to cardiac arrest."
  11. "Low calcium levels cause high blood pressure."
  12. "Calcium has no effect on urinary stone formation."
    1. The nurse is reinforcing instructions to a hospitalized client with heart block about the fundamental concepts regarding the cardiac rhythm. The nurse explains to the client that the normal site in the heart responsible for initiating electrical impulses is which site?
  13. Bundle of His
  14. Purkinje fibers
  15. Sinoatrial (SA) node
  16. Atrioventricular (AV) node

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

  1. A nursing instructor asks a nursing student to describe the structure and function of the coronary arteries. Which response by the student indicates a need for further teaching on the anatomy and physiology of the heart?
  2. "The coronary arteries branch from the aorta."
  3. "The coronary arteries supply the heart muscle with blood."
  4. "The left coronary artery provides blood for the left atrium and the left ventricle."
  5. "The left coronary artery supplies the right atrium and right ventricle with blood."
  6. The registered nurse (RN) is orienting a new RN assigned to the care of a client with a cardiac disorder and is told that the client has an alteration in cardiac output. After educating the new RN about cardiac output, which statement made by the new RN indicates the need for further instruction?
  7. "A cardiac output of 2 L/min is normal."
  8. "A cardiac output of 4 L/min is normal."
  9. "A cardiac output of 6 L/min is normal."
  10. "A cardiac output of 7 L/min is normal." Rationale: The cardiac cycle consists of contraction and relaxation of the heart muscle. In adults, the cardiac output ranges from 4 to 7 L/min. Therefore, option 1 identifies a low cardiac output.
  11. The new registered nurse (RN) is orienting on the cardiac unit. Which statement by the new RN indicates an understanding of an early indication of fluid volume deficit due to blood loss?
  12. "Pulse rate will increase."
  13. "Blood pressure will decrease."
  14. "Edema will be present in the legs."
  15. "Crackles in the lungs will be present."
  16. A client who has been exercising in a gymnasium stops to measure his pulse and places his fingers over both carotid arteries simultaneously. The nurse exercising nearby is correct when cautioning the client to check the pulse on only one side, primarily for which reason?
  17. It is unnecessary to use both hands.
  18. The client could occlude the trachea.
  19. The heart rate and blood pressure could drop.
  20. Feeling dual pulsations may lead to an incorrect measurement.

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

The LAD bifurcates from the left main coronary artery to supply the anterior wall of the left ventricle and a few other

NURSING 404 – NCLEX Cardiovascular System Questions with

Answers

structures. The circumflex coronary artery bifurcates from the left coronary artery and supplies the left atrium and the lateral wall of the left ventricle. The RCA supplies the right side of the heart, including the right atrium and right ventricle. The PDA supplies the posterior wall of the heart.

  1. A new registered nurse (RN) is assigned to the care of a client hospitalized with a diagnosis of hypothermia. After consulting with an experienced RN, which statement by the new RN indicates understanding of likely assessment findings for this client?
  2. Increased heart rate and increased blood pressure
  3. Increased heart rate and decreased blood pressure
  4. Decreased heart rate and increased blood pressure
  5. Decreased heart rate and decreased blood pressure Rationale: Hypothermia decreases the heart rate and the blood pressure because the metabolic needs of the body are reduced in this condition. With fewer metabolic needs, the workload of the heart decreases, resulting in decreased heart rate and blood pressure.
  6. A client who has had a myocardial infarction asks the nurse why she should not bear down or strain to ensure having a bowel movement. The nurse provides education to the client based on which physiological concept?
  7. Vagus nerve stimulation causes a decrease in heart rate and cardiac contractility.
  8. Vagus nerve stimulation causes an increase in heart rate and cardiac contractility.
  9. Sympathetic nerve stimulation causes a decrease in heart rate and cardiac contractility.
  10. Sympathetic nerve stimulation causes an increase in heart rate and cardiac contractility.
  11. A client with iron deficiency anemia complains of feeling fatigued almost all of the time. The nurse should respond with which statement?
  12. "The work of breathing is increased when the client is anemic."
  13. "Blood flows more slowly when the hemoglobin or hematocrit is low."
  14. "The body has to work harder to fight infection in the presence of anemia."
  15. "Adequate amounts of hemoglobin are needed to carry oxygen for tissue metabolism."
  16. Which laboratory test results may be associated with peaked or tall, tented T waves on a client's electrocardiogram (ECG)?
  17. Chloride level of 98 mEq/L (98 mmol/L)