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    Exam Review

    1. A client is ordered to receive amiodarone 0.5 mg/min. The supply on hand is 1 g/500 mL of NS. Calculate the flow rate of the intravenous medication _________mL/hr. Round answer to the nearest whole number. Enter numeric answer only.
      Correct Answer:15 15 mL/hr
    2. A client is receiving an infusion of alteplase for treatment of an anterior-septal myocardial infarction. The nurse assesses the client and finds them to be disoriented to person, place, and time. What action by the nurse is best?
      A)
      Obtain a STAT electrocardiogram (EKG).
      B)
      Call the primary health care provider immediately.
      C)
      Prepare the client for percutaneous cardiac intervention (PCI).
      D)
      Obtain STAT cardiac enzymes.
    3. A client with acute coronary syndrome is receiving a continuous heparin infusion. The client is to receive 18 units/kg/hour. The client weighs 181.4 pounds. Based on the heparin concentration on the label, the nurse will set the infusion pump to deliver _______ mL/hr. Round to the nearest tenths place. Record numerical answers only.
      Correct Answer:29.7 mL/hr
    4. A nurse is caring for a client with cardiomyopathy and is receiving a dobutamine drip. Which assessment finding indicates that the medication is effectively working?
      A)
      Increased respiratory rate.
      B)
      Decreased blood pressure.
      C)
      Increased urine output.
      D)
      Decreased blood glucose.
    Page 1 of 10

    Exam Review

    1. A nurse assesses a client with mitral valve stenosis. What clinical sign or symptom would alert the nurse to the possibility that the client's stenosis has progressed?
      A)
      Muted systolic murmur.
      B)
      Dyspnea on exertion.
      C)
      Upper extremity weakness.
      D)
      Oxygen saturation of 93%.
    2. A client who is scheduled for a coronary arteriogram is admitted to the hospital on the day of the procedure. Which information is most important for the nurse to communicate to the provider before the procedure?
      A)
      Client took metformin 500 mg by mouth this morning.
      B)
      Sinus bradycardia with a rate of 56 on the monitor.
      C)
      Client reports chest pain that occurred yesterday.
      D)
      Blood glucose level 144mg/dL.
    3. A nurse prepares a client for an emergent aortic aneurysm open repair. The client states, "I am afraid I might die." What is the nurse's best response?
      A)
      Tell me more about your concerns about the surgery.
      B)
      Would you like to speak with a chaplain prior to surgery?
      C)
      What support systems do you have to assist you?
      D)
      This is a routine surgery and the risk of death is very low.
    4. The nurse is assessing a client who received a heart transplant 6 months ago for cardiomyopathy. What assessment finding would lead the nurse to suspect the transplant is being rejected?
      A)
      EKG showing sinus tachycardia, rate 112.
      B)
      Blood pressure 154/90.
      C)
      White Blood Cell count 11,000.
      D)
      Ejection fraction of 20%.
    Page 2 of 10

    Exam Review

    1. The nurse is caring for a client with pericarditis. What heart sounds does the nurse expect to hear during the physical assessment?
      A)
      Pericardial friction rub.
      B)
      Mitral murmur.
      C)
      Pleural friction rub.
      D)
      S3 or S4.
    2. A nurse is caring for a client who was admitted with hypertrophic cardiomyopathy (HCM). What order does the nurse anticipate providing?
      A)
      Prepare for transcutaneous pacing.
      B)
      Instructing the client to start an aerobic exercise plan.
      C)
      Instruct the client to perform a Valsalva maneuver.
      D)
      Preparing for a cardiac catheterization.
    3. The client is exhibiting sinus bradycardia, is complaining of syncope and weakness, and has the following vital signs. Which treatment would the nurse anticipate being implemented?
      A)
      Prepare for transcutaneous pacing.
      B)
      Administer an antiarrhythmic medication.
      C)
      Prepare for synchronized cardioversion.
      D)
      Administer a thrombolytic medication.
    4. A nurse is caring for a client following a cardiac catheterization that was inserted through the femoral artery. While turning the client, the nurse discovers ecchymosis underneath the clients lower back. Which priority action would the nurse initiate?
      A)
      Obtain a STAT electrocardiogram.
      B)
      Remove the closure device and assess the incision.
      C)
      Reposition the client to semi-fowlers.
      D)
      Apply manual pressure over the closure device.
    Page 3 of 10

    Exam Review

    1. A client has intra-arterial blood pressure monitoring after a myocardial infarction. The nurse notes that the client's heart rate has increased from 88 to 110 beats/min, and the blood pressure dropped from 120/82 to 100/60 mm Hg. What action by the nurse is most appropriate?
      A)
      Allow the client to rest quietly.
      B)
      Document the findings in the chart.
      C)
      Assess the client for bleeding.
      D)
      Medicate the client for pain.
    2. A nurse in an urgent care center is assessing a client who reports a sudden onset of irregular palpitations, fatigue, and dizziness. The nurse assesses a rapid and irregular heart rate with a significant pulse deficit. Which dysrhythmia does the nurse expect to find on the cardiac monitor?
      A)
      Ventricular tachycardia
      B)
      Atrial fibrillation
      C)
      Sinus bradycardia
      D)
      First-degree atrioventricular block
    3. A client presents to the emergency department with an acute ST elevation myocardial infarction (STEMI) at 1500. The facility has 24-hour catheterization laboratory abilities. To improve client outcomes, by what time would the client have a percutaneous coronary intervention performed?
      A)
      1630.
      B)
      160.
      C)
      1700.
      D)
      1530
    4. A client is admitted with infective endocarditis. Which findings during the nursing assessment support this diagnosis? Select all that apply.
      A)
      Skin petechiae.
      B)
      Friction rub heart sounds.
      C)
      Hypothermia.
      D)
      Fever.
      E)
      New onset murmur.
      F)
      Splinter hemorrhages on fingernails.
    Page 4 of 10

    Exam Review

    1. Which client has the least risk for developing endocarditis?
      A)
      A 57-year-old with a mechanical mitral valve in need of a tooth extraction.
      B)
      A 19-year-old college student presents with a sore throat and fever.
      C)
      A 77-year-old with a history of angina and new onset of chest pain.
      D)
      A 35-year-old who reports using intravenous drugs on a daily basis.
    2. A nurse is caring for a client who returned from the catheterization laboratory (cath lab) to recover on the cardiac intermediate care unit status post radial approach transcatheter aortic valve replacement (TAVR). Which intervention would the nurse include in the client's care?
      A)
      Perform range of motion (ROM) exercises.
      B)
      Assess the insertion site.
      C)
      Maintain NPO status for 2-6 hours.
      D)
      Log roll the client to use the bedpan.
    3. A client's abdominal aortic aneurysm (AAA) has ruptured. Which intervention is the highest priority for the nurse?
      A)
      Inserting an indwelling urinary catheter for strict intake and output.
      B)
      Instruct the client not to strain when having a bowel movement.
      C)
      Obtaining a STAT electrocardiogram (EKG).
      D)
      Ensure the client has a large bore peripheral intravenous catheter.
    4. A client is suspected to have a thoracic aortic aneurysm (TAA). What does the nurse assess for?
      A)
      Hoarseness and difficulty swallowing.
      B)
      Bruit and thrill in upper abdomen.
      C)
      Disruption of bowel patterns.
      D)
      Abdominal, flank, or back pain.
    Page 5 of 10

    Exam Review

    1. The nurse is caring for clients on a cardiac unit. Which client would the nurse assess first?
      A)
      The client diagnosed with endocarditis who has a temperature of 100°F.
      B)
      The client diagnosed with cardiomyopathy who has bilateral 4+ peripheral edema.
      C)
      The client diagnosed with aortic valve stenosis who has weakness.
      D)
      The client diagnosed with angina who is reporting chest pain.
    2. A client reports having crushing chest pain that radiates to the jaw. The nurse obtains a 12-lead EKG. Which finding confirms the client had myocardial infarction?
      A)
      ST segment depression.
      B)
      Wide QRS complex.
      C)
      Absent P wave.
      D)
      Peaked T wave.
    3. Which explanation would the nurse give to the spouse of a client who had coronary artery bypass graft (CABG) surgery when asked why there is a dressing on the client's left leg?
      A)
      A vein in the leg was used to bypass the coronary artery.
      B)
      A filter is inserted in the leg to prevent embolization.
      C)
      The arteries in the extremities are examined during surgery.
      D)
      This is the access site for the heart-lung machine.
    4. A nurse is caring for a client with the six second telemetry strip below. The nurse anticipates the emergency response team will administer which medication?
      A)
      Atropine.
      B)
      Magnesium.
      C)
      Adenosine.
      D)
      Epinephrine.
    Page 6 of 10