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    Exam Review

    1. Which statements accurately describe characteristics of normal sinus rhythm (NSR)? (Select all that apply)
      (SATA)
      A)
      Heart rate 60 to 100
      B)
      One atrial contraction (P wave)
      C)
      P wave immediately after the QRS complex
      D)
      One T wave
      E)
      One ventricular contraction (QRS complex)
    2. A client is admitted for treatment of acute pericarditis. The nurse knows that which of the following possibly caused this diagnosis?
      A)
      Myocardial infarction
      B)
      Asthma
      C)
      Rheumatoid arthritis
      D)
      Chronic obstructive pulmonary disease
    3. Which factors are potential causative agents for arrhythmias? (Select all that apply)
      (SATA)
      A)
      Properly functioning sinoatrial (SA) node
      B)
      Hyperkalemia
      C)
      Excess fluid
      D)
      Infarct damage
      E)
      Valvular prolapse
    4. Which intervention would be MOST appropriate for a client with mitral valve regurgitation reporting fatigue, jugular vein distention, crackles, and dyspnea?
      A)
      Administer a diuretic to decrease pulmonary congestion.
      B)
      Increase sodium intake to improve blood volume.
      C)
      Educate the client on limiting all physical activity.
      D)
      Administer beta blockers to lower blood pressure.
    Page 1 of 13

    Exam Review

    1. While caring for a patient with an indwelling catheter, which intervention are important for the nurse to include in the plan of care? (Select all that apply)
      (SATA)
      A)
      Use a syringe to deflate the balloon before discontinuing the catheter.
      B)
      Observe tube placement and note the level of urine in the collection bag.
      C)
      Clean the meatus and catheter with soap and water.
      D)
      Avoid ambulation until the catheter is discontinued.
      E)
      Keep the drainage bag even with the level of the bed.
    2. A client is ordered to receive 2 liters of total parenteral nutrition (TPN) infused daily over 23 hours at 87 mL per hour. After shift change, the nurse discovers that the volume remaining on the bag is still over 1200 mL with only 11 hours left to infuse it. What should the nurse do?
      A)
      Infuse 10% dextrose at the same rate to prevent hypoglycemia until the next TPN solution is available
      B)
      Contact the previous nurse to determine what happened.
      C)
      Continue to infuse the TPN at 87 mL per hour.
      D)
      Increase the rate to 109 mL per hour.
      E)
      Keep the drainage bag even with the level of the bed.
    3. The high dextrose and fat content of parenteral nutrition solutions makes them an ideal culture medium for bacterial and fungal growth, and central lines provide a port of entry. Which intervention is crucial in preventing sepsis?
      A)
      Maintain sterile technique when changing tubing, dressing, or parenteral nutrition bag.
      B)
      Monitor glucose levels (blood and urine).
      C)
      Examine all tubing connection sites for their security.
      D)
      Assist patient to remain still in Trendelenburg position during catheter insertion.
    4. A prescriber has ordered propranolol for a client with recurrent ventricular tachycardia. The nurse preparing to administer this drug will be concerned about what in the client's history?
      A)
      Asthma
      B)
      Exercise-induced tachyarrhythmias
      C)
      Hypertension
      D)
      Paroxysmal atrial tachycardia associated with emotion
    Page 2 of 13

    Exam Review

    1. The nurse caring for a patient who is taking amiodarone. What side effect could this patient experience?
      A)
      Hypertension
      B)
      Corneal microdeposits
      C)
      Hyperactivity
      D)
      Sudden increase in temperature
    2. The nurse identifies which client histories below as at risk for infective endocarditis? (Select three that apply)
      (SATA)
      A)
      Post pericardiotomy syndrome
      B)
      Exacerbation of systemic lupus erythematosus
      C)
      Implanted cardiac devices (e.g., pacemaker, ICD)
      D)
      Prosthetic cardiac valves
      E)
      History of bacterial endocarditis
    3. A client with infective endocarditis is being started on intravenous antibiotics. What should the nurse include when teaching about this medication?
      A)
      “Since this infection is resilient, you might be taking antibiotics for life.”
      B)
      “The medication may be changed every few days.”
      C)
      “The typical course of this medication is 7 to 10 days.”
      D)
      “Expect to continue this medication for 2 to 6 weeks at home or at a rehab facility.”
    4. A nurse is reviewing laboratory results for a client with suspected endocarditis. Which finding would confirm the diagnosis?
      A)
      Elevated low-density lipoproteins (LDL)
      B)
      Positive blood cultures
      C)
      Elevated cardiac troponin levels
      D)
      Increased white blood cell count
    Page 3 of 13

    Exam Review

    1. A nurse is providing teaching to a client about measures to prevent urinary tract infections (UTIs). Which of the following client statements indicates a need for further teaching?
      A)
      "I will need to wipe my perineal area from back to front after urination."
      B)
      "I need to drink at least 8 cups of liquid each day."
      C)
      "I can drink cranberry juice each day."
      D)
      "I will need to empty my bladder regularly and completely."
    2. In assessing patients receiving tube feedings, the nurse must be alert for the following assessment findings? (Select all that apply)
      A)
      Amount of formula actually taken in by the client
      B)
      Change tubing and irrigation kit every 4 hours
      C)
      Check gastric residual volume before each feeding or, in the case of continuous feedings, every 4 hours
      D)
      Tube placement, head of bed elevated 30-45 degrees, and formula flow rate
      E)
      Weekly weights and clinical responses, as noted in laboratory findings
    3. Which nursing intervention is most appropriate in providing care for an adult patient with newly diagnosed adult onset polycystic kidney disease (PKD)?
      A)
      Help the client cope with the rapid progression of the disease.
      B)
      Expect the client to have polyuria and poor concentration ability of the kidneys.
      C)
      Implement appropriate measures for the client’s deafness and blindness.
      D)
      Suggest genetic counseling resources for the children of the client.
    4. Several techniques should be used to confirm proper placement of a feeding tube to prevent harm and to keep the client safe. Which of the following is recommended?
      A)
      Flush the tube with 20 to 30 mL of water
      B)
      Test for oxygen levels using capnometry
      C)
      Monitor blood urea nitrogen, serum protein, prealbumin
      D)
      Testing aspirated contents for pH
    Page 4 of 13

    Exam Review

    1. After an assessment the nurse concludes that a client is experiencing infective endocarditis. What finding is consistent with this diagnosis?
      A)
      Irregular, red or purple, painless flat macules on palms, fingers, hands, soles, and toes.
      B)
      Jugular vein distention
      C)
      Pleuritic chest pain especially when supine
      D)
      Pleural Friction rub
    2. Several mechanisms maintain the sterility of the bladder. Abnormalities or dysfunctions of these mechanisms are contributing risk factors for lower UTIs. Which are risk factors for UTIs? (Select all that apply)
      A)
      Gout
      B)
      Neurologic disorders
      C)
      Diabetes
      D)
      Male gender
      E)
      Pregnancy
    3. The nurse is concerned that a client is at risk for developing infective endocarditis. What information in the client’s recent history is a possible cause infective endocarditis?
      A)
      Recent impacted tooth extraction
      B)
      Diagnosed with benign prostatic hyperplasia
      C)
      Sister being treated for chronic renal failure
      D)
      Treatment for osteoarthritis
    4. A nurse is teaching a group of nursing students about antidysrhythmic medications. Which statement by a student indicates understanding of the teaching?
      A)
      “Antidysrhythmic drugs can cause new dysrhythmias or worsen existing ones.”
      B)
      “Use of these drugs may be necessary even if the benefits are unknown.”
      C)
      “For most antidysrhythmic drugs, there is evidence of reduced mortality.”
      D)
      “Adverse effects of these drugs are mainly noncardiac in nature.”
    Page 5 of 13

    Exam Review

    1. Signs and symptoms of cardiac tamponade may begin with the client reporting shortness of breath, chest tightness, or dizziness. Which of the symptoms below indicate severe tamponade and requires immediate emergency intervention? (Select all that apply)
      A)
      increased WBC count
      B)
      muffled heart sounds
      C)
      narrowed pulse pressure
      D)
      jugular vein distention
      E)
      pericardial friction rub
    2. The nurse is caring for two clients who recently had open heart valve replacement surgery. One received a tissue (or biologic) valve replacement and the other a mechanical valve replacement. Which information should be omitted/excluded from the teaching plan for the client with a tissue valve?
      A)
      assessment for S/S of heart failure
      B)
      cardiac rehabilitation program
      C)
      care of the incisions
      D)
      lifelong anticoagulation therapy
    3. The nurse is analyzing a patient's telemetry strip and observes this regular pattern appearance below. How should the nurse document this finding?
      A)
      Premature atrial contraction (PAC)
      B)
      Ventricular tachycardia (VT)
      C)
      Atrial flutter
      D)
      Premature ventricular contraction (PVC)
    4. A nurse is administering an enteral tube feeding to a client. Which action should the nurse take to prevent aspiration?
      A)
      Flush the tube with 30 mL of water
      B)
      Ensure the formula is at room temperature
      C)
      Place the client in the semi-Fowler's position
      D)
      Add blue food coloring to the enteral formula
    Page 6 of 13