Kaplan Cardio Set B

The nurse understands that intermittent claudication is:

a) found in venous insufficiency
b) pain caused by cold
c) pain caused by walking
d) found only in the elderly

(Kaplan, Cardio B 1/30)

c) intermittent claudication is pain felt in the calves when the patient walks and is seen in arterial insufficiency

(Kaplan, Cardio B 1/30)

The nurse cares for a patient admitted to the unit with a diagnosis of acute myocardial infarction. The nurse understands that a cardiac monitor is attached to this patient for which of the following reasons?

a) to monitor the patient’s condition closely without having to awaken the patient
b) to prevent another, more serious heart attack from occurring
c) to verify diagnoses of acute myocardial infarction
d) to detect any life-threatening changes in the heart rhythm

(Kaplan, Cardio B 2/30)

d) cardiac monitor displays the patient’s heart rhythm; by observing this, any abnormalities such as PVC or ventricular fibrillation can be detected

(Kaplan, Cardio B 2/30)

An older man is admitted to the hospital with a diagnosis of heart failure (HF). Which of the following findings is MOST characteristic of heart failyre?

a) pulse 110, respirations 24, blood pressure 100/60
b) pulse 100, respirations 16, blood pressure 140/90
c) pulse 150, respirations 20, blood pressure 120/80
d) pulse 100, respirations 12, blood pressure 100/70

(Kaplan, Cardio B 3/30)

a) HF is a failure of the cardiac muscle to pump sufficient blood to meet the body’s metabolic demands; can have right- or left-sided failure; characteristic signs of HF include tachycardia and increased respirations

(Kaplan, Cardio B 3/30)

The cardiac nurse instructs a patient scheduled to receive a pacemaker about how the usual cardiac conduction cycle flows. Which of the following should the nurse identify as the natural pacemaker of the heart?

a) atrioventricular (AV) node
b) Purkinje fibers
c) bundle of His
d) sinoatrial (SA) node

(Kaplan, Cardio B 4/30)

d) sinoatrial (SA) node is the pacemaker of the heart, usually initiating impulses (heartbeats) at 60-100 beats per minute (bpm); it is located in the junction of the superior vena vaca and the right atrium; it regulates heart rate, rhythm, and regularity; other components of the conduction pathway have potential to discharge impulses independently, but the SA node releases impulses more rapidly and therefore assumes control over the process

(Kaplan, Cardio B 4/30)

The nurse expects which of these laboratory test results to be elevated in a client following an acute myocardial infarction?

a) creatine kinase (CK), troponin T and I, and myoglobin
b) blood urea nitrogen (BUN), serum creatinine, and protein-bound iodine
c) aspartate aminotransferase (AST) [formerly serum glutamic-oxalaocteic transaminase (SGOT)], red blood cell count (RBC), and platelets
d) lactic dehydrogenase (LDH), thyroxine, and endorphin levels

(Kaplan, Cardio B 5/30)

a) values are increased after an MI; creatine kinase (CK-MB) is an enzyme that is cardiac specific; begins to increase in an hour and peaks in 24 hours; troponin is myocardial muscle protein released when heart muscle is damaged; any rise indicates MI; myoglobin is protein found in cardiac and skeletal muscle; normal is less than 90 micrograms/L

(Kaplan, Cardio B 5/30)

Which nursing measure would be MOST important following cardiac catheterization?

a) monitor the patient’s temperature
b) observe the patient for dysrhythmias
c) check the extremities for pulses
d) encourage coughing and deep breathing

(Kaplan, Cardio B 6/30)

c) following catheterization, trauma to the vessels used for catheterization is the major concern

(Kaplan, Cardio B 6/30)

The nurse performs a blood pressure screening at the local grocery store. The nurse knows that which of the following blood pressure readings indicates stage 1 hypertension?

a) 160/110
b) 142/88
c) 130/88
d) 126/80

(Kaplan, Cardio B 7/30)

b) systolic 140-150 mmHg or diastolic 90-99 mmHg is considered stage 1 hypertension

(Kaplan, Cardio B 7/30)

The nurse is planning discharge teaching for a patient diagnosed with peripheral vascular disease. It is MOST important for the nurse to address which of the following?

a) the patient drinks socially
b) the patient walks two miles a day
c) the patient takes vitamins daily
d) the patient smokes heavily

(Kaplan, Cardio B 8/30)

d) smoking is a predisposing factor for arterial peripheral vascular disease

(Kaplan, Cardio B 8/30)

The nurse observes a person suddenly collapse on the street. The nurse finds the person unresponsive. Which action should the nurse take FIRST?

a) check for normal breathing
b) call the emergency response number
c) deliver two rescue breaths
d) begin chest compressions

(Kaplan, Cardio B 9/30)

b) for sudden collapse, call the emergency response number and then begin CPR

(Kaplan, Cardio B 9/30)

A client receiving verapamil in the sustained-release form complains of a headache. Which information should the nurse provide the client?

a) this is an unrelated symptom and should be reported
b) this medication often causes headache
c) this medication should be stopped until the headache disappears
d) she should go immediately to the emergency room

(Kaplan, Cardio B 10/30)

b) verapamil is a calcium channel blocker that sometimes causes headache, constipation, fatigue, and dizziness; non-narcotic analgesia is often prescribed to treat the headache; this side effect seems to diminish over time

(Kaplan, Cardio B 10/30)

A client diagnosed with iron deficiency anemia receives heparin after a venous thromboembolism (VTE) is diagnosed in the left leg. Which observation MOST concerns the nurse?

a) the client passes a black stool
b) the client is pale
c) the client has a nosebleed
d) the client is confused

(Kaplan, Cardio B 11/30)

c) bleeding from any body site can indicate hemorrhage, the primary concern with anticoagulant drugs such as heparin; immediate management of the epistaxis (nosebleed) and notification of the health care provider should occur; if needed, protamine sulfate, the specific heparin antagonist, may be given

(Kaplan, Cardio B 11/30)

The nurse discovers an unconscious person in the street. The nurse notes that the person is not breathing. The nurse should take which action?

a) lift the back of the person’s neck
b) use the thumbs to move the person’s lower jaw backward
c) turn the person’s head to one side
d) tilt the person’s head back and lift the chin

(Kaplan, Cardio B 12/30)

d) by tilting the head backward and lifting the chin upward so it points straight up, the upper airway will open; this maneuver removes the tongue from obstructing the airway, a common cause of airway obstruction in unconscious people; sometimes by just performing this maneuver, the person will start breathing again

(Kaplan, Cardio B 12/30)

The nurse cares for a patient following a myocardial infarction. Which of the following information, obtained during the health history, is MOST significant when planning for the patient’s discharge?

a) the patient takes daily vitamin supplements
b) the patient has a history of pneumonia
c) the patient plays golf once a week
d) the patient has a high-stress job

(Kaplan, Cardio B 13/30)

d) high-stress job is a significant risk factor for cardiac disease

(Kaplan, Cardio B 13/30)

The health care provider prescribes hydrochlorothiazise 50mg once a day for a client. When is the BEST time for the nurse to administer this medication?

a) at 6 am
b) with breakfast
c) with dinner
d) at bedtime

(Kaplan, Cardio B 14/30)

b) hydrochlorothiazide should be taken with meals; if given with dinner, diuresis would occur while the patient was sleeping, causing interruptions in sleep

(Kaplan, Cardio B 14/30)

The nurse recognizes that the type of edema related to cardiac failure is usually

a) nonpitting
b) dependent
c) painful
d) severe

(Kaplan, Cardio B 15/30)

b) seen with right-sided heart failure and usually noted in the ankles and in the sacral region

(Kaplan, Cardio B 15/30)

The nurse educator conducts an orientation class for new graduate nurses who will be caring for cardiac patients on the medical surgical unit. The educator should remind the nurses that the QRS complex of an electrocardiogram (EKG) reflects which of the following?

a) atrial depolarization
b) ventricular depolarization
c) ventricular repolarization
d) central venous pressure

(Kaplan, Cardio B 16/30)

b) the QRS complex represents depolarization of the ventricles; occurs after the atrial depolarization, represented by the P wave, and the subsequent PR segment, which represents the length it takes for the impulse to travel through the AV node, bundle of His system and Purkinje fibers; ventricular depolarization may be conceptualized as ventricular systole

(Kaplan, Cardio B 16/30)

The nurse understands that the MOST important factor to maintain adequate circulation is

a) blood volume
b) white blood cell count
c) aerobic exercise
d) effective respiration

(Kaplan, Cardio B 17/30)

a) in order to maintain adequate circulation, an adequate transport medium to carry nutrients and gases throughout the body is needed

(Kaplan, Cardio B 17/30)

In formulating a nursing care plan for a patient following a myocardial infarction, the nurse should include which of the following goals?

a) the patient will return to the pre-illness activity.
b) the patient will achieve the optimum level of health
c) the patient will be free from pain and dysrhythmias
d) the patient will eliminate all stress from the lifestyle

(Kaplan, Cardio B 18/30)

c) this goal is realistic, achievable, and measureable

(Kaplan, Cardio B 18/30)

One week after discharge from the hospital, a client with heart failure (HF) comes to the cardiac clinic for a follow-up visit. Which of these statements, if made by the client to the nurse, indicates an improvement in the client’s condition?

a) “my clothes seem to be too tight.”
b) “i only sleep on one pillow/”
c) “i’m really worried about going back to work.”
d) “i seem to empty my bladder less often than i used to.”

(Kaplan, Cardio B 19/30)

b) a symptom of HF is orthopnea, or the inability to breathe while lying flat; the client’s statement that he only uses one pillow to sleep indicates an improvement in his respiratory function

(Kaplan, Cardio B 19/30)

The nurse understands that the purpose of a coronary artery bypass graft (CABG) is to

a) excise the vessel
b) insert the graft
c) repair the artery
d) remove the clot

(Kaplan, Cardio B 20/30)

b) in a bypass procedure, a graft is placed and anastomosed distally and proximally to bypass the obstruction

(Kaplan, Cardio B 20/30)

A patient undergoes a cardiac catheterization. Following the procedure, the nurse discovers that the patient is bleeding from the cut-down site. Which action should the nurse take FIRST?

a) take the patient’s vital signs
b) notify the physician
c) apply pressure to the site
d) reinforce the dressing over the site

(Kaplan, Cardio B 21/30)

c) the immediate priority at this time is to stop the bleeding’ after this is done, the nurse may take the patient’s vital signs, notify the physician, and reinforce the dressing over the site; after procedure, client on bedrest for 4-6 hours and the insertion site is kept straight; assess pulses, sensation, bleeding at insertion site

(Kaplan, Cardio B 21/30)

A continuous intravenous infusion of heparin is administered to a patient. It is MOST important for the nurse to have which of the following medications available?

a) digitalis
b) vitamin K
c) magnesium sulfate
d) protamine sulfate

(Kaplan, Cardio B 22/30)

d) the action of heparin is to interfere with normal blood coagulation; protamine sulfate is the antagonist to heparin and should be kept on hand at all times

(Kaplan, Cardio B 22/30)

The nurse informs a patient with angina that some common side effects of nitroglycerin include which of the following?

a) palpitations, hypertension, and tachycardia
b) flushing, bradycardia, and muscle weakness
c) dizziness, headache, and hypotension
d) flushing, vertigo, and seizures

(Kaplan, Cardio B 23/30)

c) common side effects of nitroglycerin include dizziness, headache, and hypotension; renew supply every three months, avoid alcoholic beverages, protect drug from light

(Kaplan, Cardio B 23/30)

The nurse understands that the cause of essential hypertension is

a) a high-salt diet
b) kidney disease
c) obesity
d) not known

(Kaplan, Cardio B 24/30)

d) essential (primary) hypertension accounts for 90-95% of all cases; hypertension may have no symptoms or headache, dizziness, anginal pain; treatment includes medication and lifestyle changes

(Kaplan, Cardio B 24/30)

An older client has a medical history that includes hypertension. A public health nurse visits the client regularly and on each visit records the vital signs. The nurse expects which of the following findings for this client?

a) temperature 99.5º F (37.5ºC), blood pressure 140/80, pulse 110, respirations 32
b) temperature 98.6º F (37ºC), blood pressure 120/80, pulse 78, respirations 16
c) temperature 99.9º F (37.7ºC), blood pressure 150/90, respirations 20
d) temperature 96.8º F (36ºC), blood pressure 160/92, pulse 80, respirations 24

(Kaplan, Cardio B 25/30)

d) in the elderly, body tempertaure may decrease; normal temperature for this client; blood pressure of 160/92 would be expected in a patient who has a medical history of hypertension; pulse of 80 would be normal; respirations of 24 normal

(Kaplan, Cardio B 25/30)

The nurse understands that the pain of angina is caused by which of the following?

a) insufficient oxygen in the heart muscles
b) inflammation of the pericardium
c) ineffective contractions of the heart muscles
d) severe dysrhythmias

(Kaplan, Cardio B 26/30)

a) angina pectoris is caused by ischemia of the myocardium

(Kaplan, Cardio B 26/30)

When one nurse is performing CPR on an adult, which is the CORRECT ratio of compressions to breaths?

a) 30 compressions to 2 breaths
b) 30 compressions to 1 breath
c) 15 compressions to 1 breath
d) 15 compressions to 2 breaths

(Kaplan, Cardio B 27/30)

a) compression-ventilation ratio for one or two rescuers

(Kaplan, Cardio B 27/30)

The nurse cares for a patient immediately after a femoral-to-popliteal bypass graft. The nurse is MOST concerned if which of the following is observed?

a) clammy skin
b) poor skin turgor
c) shortness of breath
d) engorged neck veins

(Kaplan, Cardio B 28/30)

a) hypovolemic shock is due to an inadequate volume of blood due to hemorrhage, severe dehydration, or burns; skin will be cold and clammy because the body redirects blood from the skin, kidneys, and GI tract to the brain and heart; urine output decreases; blood pressure will be decreased and pulse will be elevated

(Kaplan, Cardio B 28/30)

The nurse understands that the antagonist of warfarin is which medication?

a) protamine sulfate
b) calcium
c) imferon
d) vitamin K

(Kaplan, Cardio B 29/30)

d) vitamin K is a warfarin antagonist because it promotes blood clotting

(Kaplan, Cardio B 29/30)

A medical surgical unit is being converted into a cardiac unit due to increasing numbers if clients coming to the hospital with cardiac conditions. The nurse manager reviews with staff the differences between defibrillation and cardioversion. Which should the manager identify as characteristics that these two procedures have in common?

a) location where procedure is done and use of sedation
b) intended action and paddle placement
c) timing of shock delivery and voltage used
d) indication for procedure and informed consent

(Kaplan, Cardio B 30/30)

b) the intended action for both defibrillation and cardioversion is to completely depolarize all the myocardial cells at once so the sinoatrial (SA) node can reestablish its role as the pacemaker of the heart; paddle placement is the same for both procedures, with one paddle over the right sternal border and the other over the apex of the heart

(Kaplan, Cardio B 30/30)