Exam Review
- Which two side effects are most closely associated with the use of nitroglycerin tablets? (Select all(SATA)A)that apply.)B)Erectile dysfunctionC)BackacheD)DiarrheaE)DizzinessF)Headache
- A nurse caring for a client with peripheral arterial insufficiency determined the nursing diagnosis of altered peripheral arterial insufficiency. Which intervention will be most appropriate for the client?A)Discourage walking in order to limit painB)Encourage extended periods of sitting or standingC)Elevate his legs and arms above his heart when restingD)Encourage the client to engage in moderate amount of exerciseE)Dizziness
- The LPN is caring for a client that was recently started on furosemide for dependent edema caused by right sided heart failure. Which nursing actions are appropriate to add to the plan of care for the patient?(SATA)A)Assess the patient's appetite and thirstB)Monitor magnesium levels, as orderedC)Assess the client for gastric distress including nausea, vomiting and diarrheaD)Monitor the client's potassium levels as ordered
- A client is brought to the emergency department for unrelieved chest pain for 45 minutes. ECG performed by EMS suspects a non-ST elevation myocardial infarction (NSTEMI). Which of the following interventions is most important?A)Apply oxygen, administer morphine, and place the client on bed rest with cardiac monitoring.B)Have the client chew two aspirin 325 mg each, administer oxygen and bring the crash cart to the bedside.C)Administer oxygen, give a dose of nitroglycerin sublingual, and follow with a nonsteroidal anti-inflammatory.D)Begin a heparin drip, administer oxygen, and call the lab for stat troponin levels.
Exam Review
- The nurse is performing an assessment on a client with a history of cardiovascular disease, diabetes, hypertension, and hypothyroidism. The client is experiencing exhaustion with simple activities of daily living and short ambulation, and states a 5-pound weight gain over 4 days. Assessment reveals 4+ edema to lower extremities and jugular distention. The nurse will report findings to the health care provider and anticipates which medical condition?A)Myocardial infarctionB)Left-sided heart failureC)Acute pericarditisD)Right-sided heart failure
- The telemetry monitor alarms for your client. The 6 second rhythm strip is seen here. Your first action is to:A)Give 2 rescue breathsB)Start chest compressionsC)Assess the clientD)Call a code blue/call 911
- The nurse is assessing a client with right-sided heart failure. Which of the following findings should the nurse expect? Select all that apply.(SATA)A)Distended jugular veinsB)Weight gainC)OrthopneaD)Peripheral edemaE)Crackles the lungs
- The LPN is caring for a client who was recently prescribed 20 mg of simvastatin by mouth. Which statement should the nurse include in the client's teaching session?A)"This medication should be taken before going to bed."B)"You should take these medications first thing in the morning on an empty stomach."C)"You should take this medication in the morning with your breakfast to prevent upset stomach."D)"You should take this medication with your mid-day meal with food."
Exam Review
- The nurse is caring for a client who has a fluid-volume overload related to heart failure (HF) and is admitted to the nursing unit for treatment. Vital signs are: Temperature: 98.0 oral Heart rate (HR) 88 beats/minute Respiratory rate (RR) 22 breaths/minute Oxygen saturation: 94% on room air What is the PRIORITY nursing action?A)Insert a 20-gauge peripheral IV catheterB)Administer oxygen at 2 liters per minute via nasal cannulaC)Place the client on a cardiac monitorD)Auscultate the client's breath sounds
- A client is admitted for recurrent peripheral edema. On admission the patient is AAOX3, lungs are clear to auscultations. Heart rate is 88 bmp, regular rate and rhythm. Respiratory rate is 24 breaths per minute. Abdomen is soft non-tender non-distended, last BM was yesterday and was reported by the patient to be soft, normal brown color. Patient has +2 pitting edema of the bilateral hands and bilateral ankles and feet. Blood pressure is 150/82 mmHg. Pulse ox is 88% on 3 liters of oxygen by nasal cannula. What findings in this assessment require follow-up?(SATA)A)Pulse ox of 88% on 3 1pm NCB)Lungs are clear to auscultationC)+ 2 pitting edema of the bilateral handsD)+ 2 pitting edema of the ankles and feetE)Blood pressure of 150/82F)Respiratory rate is 24G)Abdomen is soft, non-tender, non-distendedH)Client is alert and oriented x 3I)Heart rate is 88 bpm
- The nurse is caring for a client who has right-sided heart failure, and is scheduled to receive the second dose of furosemide Prior to administration of the drug, assessment of the client reveals a marked decrease from 4+ to 1+ ankle edema, neck distention is less than earlier, and the client lost 3 pounds in 24 hours. What action should the nurse take?A)Hold the furosemideB)Notify the physicianC)Give the furosemide earlyD)Give the scheduled dose
- The nurse working at a community health fair is assessing risk factors for hypertension. Which client does the nurse recognize as having the greatest risk factor?A)A 73-year-old adult client with asthma and glaucomaB)An 80-year-old client with a family history of hypertensionC)A 36-year-old client who was just diagnosed with obstructive sleep apneaD)A 45-year-old client with obesity and uncontrolled type 2 diabetes mellitus.
Exam Review
- A client is prescribed 40 mg of furosemide orally. The furosemide tablets on hand are 20 mg tablets. How many tablets will the nurse administer? (Type only the number in the box.)
- Your client: Chester Payne Age: 78 years old Past medical history. History of persistent atrial fibrillation, hypertension, hyperlipidemia and osteoarthrosis. Yesterday: Client was admitted for a diagnosis of atrial fibrillation with rapid ventricular response (RVR). Later in the day, the client's heart rhythm was converted to normal sinus rhythm using intravenous medication therapy. 0900 today: Client is sitting up in the bedside recliner. Client reports "racing heartbeat" and feeling "like I can't get a good deep breath" Upon auscultation the nurse hears an irregular heart rhythm. Assessment is as follows: Neurological: Alert and oriented x 4 Eyes, Ear, Nose, and Throat (EENT): Normocephalic, denies sore throat, denies nasal congestion, denies vision changes. No swelling or drainage visualized. Pulmonary: Reports some shortness of breath (SOB), no cough. Lungs sound clear in all fields. Cardiovascular: Irregular heart rhythm auscultated. Denies chest pain. Skin is warm and dry to the touch. Capillary refill > 3 seconds. 2+ bilateral lower extremity edema. Peripheral pulse 1+ equal bilaterally. Jugular vein distention (JVD) is noted Gastrointestinal: Abdomen rounded and firm. Reports slight nausea, bowel sounds hypoactive x 4 quadrants. Reports bowel movement prior to admission. Genitourinary: Voiding clear yellow urine without issues as per client self-report. Musculoskeletal: Full range of motion against resistance. What is the next action the nurse should take?A)Obtain manual blood pressureB)Measure airflow via incentive spirometryC)Insert indwelling urinary catheterD)Assist the patient to get dressed to work with physical therapy
- Your client: Chester Payne Age: 78 years old Past medical history. History of persistent atrial fibrillation, hypertension, hyperlipidemia and osteoarthrosis. Yesterday: Client was admitted for a diagnosis of atrial fibrillation with rapid ventricular response (RVR). Later in the day, the client's heart rhythm was converted to normal sinus rhythm using intravenous medication therapy. 0900 today: Client is sitting up in the bedside recliner. Client reports "racing heartbeat" and feeling "like I can't get a good deep breath" Upon auscultation the nurse hears an irregular heart rhythm. Assessment is as follows: Neurological: Alert and oriented x 4 Eyes, Ear, Nose, and Throat (EENT): Normocephalic, denies sore throat, denies nasal congestion, denies vision changes. No swelling or drainage visualized. Pulmonary: Reports some shortness of breath (SOB), no cough. Lungs sound clear in all fields. Cardiovascular: Irregular heart rhythm auscultated. Denies chest pain. Skin is warm and dry to the touch. Capillary refill > 3 seconds. 2+ bilateral lower extremity edema. Peripheral pulse 1+ equal bilaterally. Jugular vein distention (JVD) is noted Gastrointestinal: Abdomen rounded and firm. Reports slight nausea, bowel sounds hypoactive x 4 quadrants. Reports bowel movement prior to admission. Genitourinary: Voiding clear yellow urine without issues as per client self-report. Musculoskeletal: Full range of motion against resistance. The LPN knows the patient is likely experiencing:A)Pulmonary embolismB)GastritisC)Heart failureD)Pneumonia
- Your client: Chester Payne Age: 78 years old Past medical history. History of persistent atrial fibrillation, hypertension, hyperlipidemia and osteoarthrosis. Yesterday: Client was admitted for a diagnosis of atrial fibrillation with rapid ventricular response (RVR). Later in the day, the client's heart rhythm was converted to normal sinus rhythm using intravenous medication therapy. 0900 today: Client is sitting up in the bedside recliner. Client reports "racing heartbeat" and feeling "like I can't get a good deep breath" Upon auscultation the nurse hears an irregular heart rhythm. Assessment is as follows: Neurological: Alert and oriented x 4 Eyes, Ear, Nose, and Throat (EENT): Normocephalic, denies sore throat, denies nasal congestion, denies vision changes. No swelling or drainage visualized. Pulmonary: Reports some shortness of breath (SOB), no cough. Lungs sound clear in all fields. Cardiovascular: Irregular heart rhythm auscultated. Denies chest pain. Skin is warm and dry to the touch. Capillary refill > 3 seconds. 2+ bilateral lower extremity edema. Peripheral pulse 1+ equal bilaterally. Jugular vein distention (JVD) is noted Gastrointestinal: Abdomen rounded and firm. Reports slight nausea, bowel sounds hypoactive x 4 quadrants. Reports bowel movement prior to admission. Genitourinary: Voiding clear yellow urine without issues as per client self-report. Musculoskeletal: Full range of motion against resistance. The nurse expects the doctor to order what medication(s) for this patient?A)IV fluid bolus of normal saline at 250 ml/hourB)Furosemide and a calcium channel blockerC)Pantoprazole and digoxinD)IV potassium and antibiotics
Exam Review
- Your client: Chester Payne Age: 78 years old Past medical history. History of persistent atrial fibrillation, hypertension, hyperlipidemia and osteoarthrosis. Yesterday: Client was admitted for a diagnosis of atrial fibrillation with rapid ventricular response (RVR). Later in the day, the client's heart rhythm was converted to normal sinus rhythm using intravenous medication therapy. 0900 today: Client is sitting up in the bedside recliner. Client reports "racing heartbeat" and feeling "like I can't get a good deep breath" Upon auscultation the nurse hears an irregular heart rhythm. Assessment is as follows: Neurological: Alert and oriented x 4 Eyes, Ear, Nose, and Throat (EENT): Normocephalic, denies sore throat, denies nasal congestion, denies vision changes. No swelling or drainage visualized. Pulmonary: Reports some shortness of breath (SOB), no cough. Lungs sound clear in all fields. Cardiovascular: Irregular heart rhythm auscultated. Denies chest pain. Skin is warm and dry to the touch. Capillary refill > 3 seconds. 2+ bilateral lower extremity edema. Peripheral pulse 1+ equal bilaterally. Jugular vein distention (JVD) is noted Gastrointestinal: Abdomen rounded and firm. Reports slight nausea, bowel sounds hypoactive x 4 quadrants. Reports bowel movement prior to admission. Genitourinary: Voiding clear yellow urine without issues as per client self-report. Musculoskeletal: Full range of motion against resistance. When the nurses reassesses the patient, which finding demonstrates that the intervention was successful?A)Irregular heart beat with a rate of 86 bpmB)No edema noted in the bilateral extremitiesC)hypoactive bowel sounds in all 4 quadrantsD)Decreased urine output
- Client education about Buerger's disease should include what important life style medication?A)smoking cessation.B)reduction of alcohol intake.C)avoiding cold remedies.D)weight reduction.
- Which of the following electrocardiography (ECG) findings would require immediate intervention?A)Arterial fibrillation with a rate of 88 beats per minuteB)Ventricular fibrillationC)Sinus tachycardia with a rate of 105 beats per minuteD)Normal sinus rhythm with a rate of 72 beats per minute
- A nurse is reinforcing the education for a patient on the risks of coronary artery disease (CAD) the LPN knows that the following are modifiable risk factors: (Select all that apply.)A)Family History and GeneticsB)Poorly Controlled HypertensionC)Poorly Controlled Diabetes MellitusD)Poorly Controlled HyperlipidemiaE)Morbid obesityF)Smoking and Use of Tobacco ProductsG)AgeH)Age
Exam Review
- You are assisting a RN with discharging a patient who had a permanent pacemaker placed two days ago for sustained bradycardia. You are reinforcing the discharge teaching, what statement by the client indicates a need for further teaching?A)"I can go back to the gym and do light weight baring exercise and yoga."B)"I will report any new dizziness or lightheadedness to my health care provider."C)"I will take my pulse every day and left my health care provider if my heart rate is less than 60 beats per minute."D)"I will avoid raising my arm over my head until cleared by my health care provider."
- Before giving any medication of cardiac dysrhythmia the LPN knows that the most important assessment that must be completed prior to giving the medication is:A)Assessing the legs and feet for peripheral edemaB)Checking the results of the most recent ECGC)Listening to the apical pulse for a full minuteD)Taking the blood pressure in both arms
- The nurse correctly tells the client and family member how angioplasty with stenting is utilized to treat angina by using which explanation?A)"A tiny balloon is used to open up the blocked artery and a wire mesh stent is placed to keep the artery open."B)"The blocked artery is bypassed to an areas where there is proper blood flow for the heart muscle."C)"A tiny blade is used to cut away the plaque buildup and a stent is placed to keep the blood flowing properly."D)"The blood clot or plaque is dissolved, allowing for adequate blood flow and oxygen to flow to the heart muscle."
- A client with hypertension appears at the clinic for follow-up. The client's BP is 138/88 mm Hg. The client asks why it is important to treat hypertension. What would be the nurse's best response?A)"Hypertension is the leading cause of death for people your age"B)"Hypertension greatly increases your risk of stroke and heart disease."C)"Hypertension if unchecked increases the risk of adult-onset Type 2 diabetes."D)"Hypertension causes relaxation and dilatation of the arteries which strains the heart."