NSG 202 Exam 4 Questions & Answers (Multiple Choice, Graded A)

1. A client with a history of a-fib is prescribed Digoxin (Lanoxin) 0.125 mg daily. The nurse needs to determine the amount to be administered per peg tube. 2. How many mL will be administered? 3. The nurse is assess ...

1. A client with a history of a-fib is prescribed Digoxin (Lanoxin) 0.125 mg daily. The nurse needs to determine the amount to be administered per peg tube. 2. How many mL will be administered? 3. The nurse is assessing a client admitted to the cardiac unit. Which assessment findings are a priority for the nurse to report to the healthcare provider? 4. When titrating IV nitroglycerin for a client with a myocardial infarction (MI), which action will the nurse take to evaluate the effectiveness of the drug? 5. Which nursing action can the registered nurse (RN) delegate to experienced unlicensed assistive personnel (UAP) working as telemetry technicians on the cardiac unit? 6. The nurse is caring for four clients on a cardiac unit. Which of the following therapeutic nursing interventions is a priority? 7. A nurse on the cardiac care unit is monitoring telemetry. The following appears on the cardiac monitor. Which of the following medications may be used to treat this dysrhythmia? (Select all that apply). 8. After reviewing information shown in the accompanying figure from the medical records of a 43-year-old, which risk factor modification for coronary artery disease should the nurse include in client teaching? 9. A client is ordered Simvastatin (Zocor) for the management of dyslipidemia. The client is instructed by the nurse to have which serum level monitored by the health care provider while on this drug? 10. A nurse is assessing clients on a medical-surgical unit. Which client should the nurse identify as being at greatest risk for atrial fibrillation? 11. A nurse teaches a client with a new permanent pacemaker. Which instructions should the nurse include in this client's teaching? (Select all that apply) 12. The client is newly prescribed apixaban (Eliquis) for treatment of atrial fibrillation. The nurse evaluates teaching was effective when the client states which one of the following? 13. A 74 y/o client with recurring stable angina is experiencing chest pain while out for a walk. What action should he take first? 14. A client is admitted for management of atrial fibrillation with a rapid ventricular response. The client is being treated with amiodarone (Pacerone) and heparin infusion. The nurse obtains the following assessment data: The client with heart failure has been prescribed intravenous Nitroglycerin and Furosemide (Lasix) for pulmonary edema. Which is a priority nursing intervention? 15. Which nursing intervention will be the most effective when assisting the client of Middle Eastern descent with coronary artery disease (CAD) to make appropriate dietary changes? 16. Diltiazem (Cardizem) is ordered for a client with newly diagnosed Prinzmetal's (variant) angina. When teaching the client, the nurse will include which information about diltiazem? 17. After receiving change of shift report about the following four clients, which client should the nurse assess first? 18. After assessing a client who is receiving amiodarone (Cordarone) intravenous infusion for unstable ventricular tachycardia, the nurse documents the findings and compares these with the previous assessment findings. Based on the assessments, which action should the nurse take? 19. Which nursing action is essential for the client experiencing severe pitting edema secondary to heart failure? 20. When admitting a client with a non-ST segment elevation myocardial infarction (NSTEMI) to the intensive care unit, which nursing intervention takes priority? 21. A nurse is evaluating a client's response to cardioversion. Which of the following observations would be of highest priority to the nurse? 22. A client is admitted to the hospital with heart failure. The client complains for shortness of breath and the nurse notes the heart rate has increased from 86 bpm to 110 bpm. The nurse also notes the respiratory effort increases with position changes. Which condition is this client experiencing? 23. A 68 y/o female who presents with complaints of indigestion and nausea is concerning for which of the following diseases? (Select all that apply) 24. You are preparing to administer nitroglycerin sublingual to a 58 y/o male client with unstable angina. He complains of 7/10 chest pain. BP is 95/64, HR 89, and SPO2 (cut out of pic). Which of the following actions should you take next? 25. A client has recently started on digoxin (Lanoxin) in addition to furosemide (Lasix) and captopril (Capoten) for the management of heart failure. Which assessment finding by the home health nurse is a priority to communicate to the health care provider? 26. Which information about a client who has been receiving thrombolytic therapy for an acute myocardial infarction (AMI) is most important for the nurse to communicate to the health care provider? 27. Interpret the following rhythm. 28. The nurse is caring for a client on a telemetry unit. The nurse interprets the rhythm strip below from the nursing station monitor. What is the nurse's priority action? 29. A nurse is preparing to defibrillate a client in ventricular fibrillation. After placing the paddles on the client's chest and before discharging them, which of the following should be done? 30. Interpret the following rhythm. 31. A client of Asian descent is admitted with uncontrolled hypertension, congestive heart failure (CHF) and coronary artery disease (CAD). Which outcome indicates that the client's cultural needs have been addressed? 32. The nurse is admitting a client to the medical surgical unit for a heart failure exacerbation. Which statement by the client alerts the nurse that the client is not complying with the healthcare provider's treatment regime? 33. A client is discharged home following a myocardial infarction (MI). You are visiting her as a home health care nurse. Which of the following statements should be included for client teaching? (Select all that apply) 34. When caring for a client who has just arrived on the telemetry unit after having catheterization, which nursing intervention should the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)? 35. A 19 y/o student comes to the student health care center at the end of the semester complaining that "My heart is skipping beats." An electrocardiogram (ECG) shows occasional unifocal premature ventricular contractions (PVCs). What action should the nurse take next? 36. Which is a priority intervention for the client experiencing atrial fibrillation (Afib)? 37. A client is involved in an auto accident with blunt abdominal trauma. His history includes atrial fib treated with Coumadin, renal insufficiency, and HTN. A foley catheter is inserted with bright red return. What lab results should be reviewed immediately? (Select all that apply) 38. A client had a non-ST segment elevation myocardial infarction (NSTEMI) 3 days ago. Which nursing intervention included in the plan of care is most appropriate for the RN to delegate to an experienced licensed practical/vocational nurse (LPN/LVN)? 39. After receiving change-of-shift report on four clients admitted to a heart failure unit, which client should the nurse assess first? 40. Which assessment finding in a client admitted with acute decompensated heart failure (ADHF) requires the most immediate action by the nurse? 41. Which electrocardiographic (ECG) change is most important for the nurse to report to the health care provider when caring for a client with chest pain? 42. Which finding should alert the nurse to monitor the newly diagnosed client with heart failure more closely? 43. The client is admitted with a fever and rapid heart rate. The client's temp is 103F (39.4C). The nurse places the client on a cardiac monitor and finds the client's atrial and ventricular rates are above 105 bpm. P waves are clearly seen and QRS complexes are normal in appearance. The rhythm is regular, and blood pressure is normal. The nurse should focus on providing care for which of the following? 44. A nurse assesses a client's electrocardiogram (ECG) and observes the reading shown below. How should the nurse document this client's ECG strip? 45. A client is in sinus bradycardia with a heart rate of 45 bpm, complains of dizziness, and has a blood pressure of 82/60 mm Hg. Which of the following should the nurse anticipate will be prescribed? 46. The client is being treated with atenolol (Tenormin). The nurse notes that the client has been experiencing sinus bradycardia (HR 48). What is the highest priority nursing intervention? 47. A client who has recently started taking pravastatin (Pravachol) and niacin reports several symptoms to the nurse. Which information is most important to communicate to the health care provider? 48. A client is receiving an infusion of tissue plasminogen activator (t-PA). The nurse assesses the client to be disoriented to person, place, and time. What action by the nurse is best? 49. A client presents with pulmonary edema characterized by tachycardia, hypertension, and cough with frothy sputum. What initial treatments are most common? 50. A client is starting captopril (Capoten) therapy. The nurse will monitor for the development of which potential side effect? (Select all that apply). 51. A client experiences chest pain and bradycardia during a cardiac catheterization. The nurse has which drugs available? 52. Your client is a 55 y/o female admitted with a history of a MI, valvular disorder, and heart failure. The client presents with weight gain, ascites, heart rate of 104/min, crackles, and complaints of fatigue and gastrointestinal symptoms. Which of the following conditions are most likely developing? (Select all that apply) 53. When admitting a client with atrial fibrillation with rapid ventricular response (RVR) to the intensive care unit, which action should the nurse perform first? 54. A client has a history of heart failure and has been taking all of the following medications: Furosemide (Lasix), Digoxin (Lanoxin), and potassium. The client complains of nausea, blurred vision, headache and weakness. The client is confused. The nurse should suspect which of the following diagnosis? 55. The client has been admitted with acute coronary syndrome (ACS). The nurse evaluates the labs. Which of the following labs requires immediate action? (Table 31-6 in the Lewis book should help with this) 56. A client has returned from an angiography via the left femoral artery. Two hours after the procedure, the client complains of numbness and tingling. Which is the nurse's first action? 57. Three days after experiencing a myocardial infarction (MI), a client who is scheduled for discharge asks for assistance with hygiene activities, saying. "I am too nervous about my heart to be alone while I get washed up." Based on this information, which nursing diagnosis is appropriate? 58. Which of the following people are most likely to experience an episode of angina? 59. Interpret the following rhythm 60. A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure? 61. A client with a history of chronic heart failure is admitted to the emergency department with severe dyspnea and a dry, hacking cough. Which action should the nurse do first? 62. A client is admitted for heart failure exacerbation. The nurse is reviewing the electronic health records and notes the following: How should the nurse interpret this data? 63. A client who is recovering from an acute myocardial infarction (AMI) asks the nurse about resuming sexual intercourse. Which response by the nurse is best? 64. A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which priority intervention should the nurse perform prior to defibrillating this client? 65. A client has an order for nifedipine (Procardia) and furosemide (Lasix). On admission the BP was 150/80, HR 95, RR 22/min. Current vital signs are BP 100/60, HR 64, RR 20. Which action is most appropriate for the nurse to take? 66. Two days following insertion of a pacemaker, the client calls the cardiac nurse practitioner, stating that he "just doesn't feel right." What question does the nurse ask to assess pacer functioning? 67. After receiving change-of-shift report about the following four clients on the cardiac care unit, which client should the nurse assess first? 68. A client with a pulmonary history is being treated for atrial fibrillation with a rapid ventricular response with metoprolol (Toprol X). The nurse assesses the client and notes the following: Apical HR 62 bpm, BP 118/68. Breath sounds reveal high pitched wheezing in bilateral anterior and posterior chest. What is the highest priority nursing intervention? 69. Which organs are most adversely affected when heart failure occurs? 70. A client with severe HF is ordered dobutamine at 2.5 mcg/kg/min. The client's weight is 90.5 kg. How many mg/hr should the client receive? (Round to the nearest tenth. Only round at the end of the problem) 71. When teaching the client with newly diagnosed heart failure about a 2000-mg sodium diet, the nurse explains that which of the following foods should be restricted? 72. A client who is receiving dobutamine for the treatment of acute decompensated heart failure (ADHF) has the following nursing interventions included in the plan of care. Which action will be most appropriate for the registered nurse (RN) to delegate to an experienced licensed practical/vocational nurse (LPN/LVN)? 73. Clients scheduled for angiography must be asked which question?