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Ati lpn med surg cardiac exam
Ati lpn med surg cardiac exam
Total Questions : 35
Showing 10 questions Sign up for moreA nurse is reinforcing teaching with a client who has peripheral vascular disease (PVD). The nurse should recognize that which of the following statements by the client indicates a need for further teaching?
Explanation
A. "I will avoid crossing my legs at the knees." Crossing the legs can restrict blood flow and should be avoided in PVD.
B. "I will use a thermometer to check the temperature of my bath water." Due to reduced sensation, checking the water temperature can prevent burns.
C. "I will not go barefoot." Going barefoot increases the risk of injury or infection, especially with impaired circulation.
D. "I will wear stockings with elastic tops." Stockings with tight elastic tops can restrict blood flow, worsening symptoms in PVD.
A nurse is collecting data from a client who has atrial fibrillation. When documenting the quality of the client's pulse, which of the following terms should the nurse use?
Explanation
A. Slow: Atrial fibrillation typically leads to an irregular, often rapid pulse, not necessarily slow.
B. Irregular: Atrial fibrillation causes an irregular pulse due to uncoordinated atrial contractions.
C. Bounding: A bounding pulse is associated with conditions like high cardiac output or fluid overload, not atrial fibrillation.
D. Not palpable: The pulse in atrial fibrillation is usually palpable but irregular.
A nurse at a provider's office receives a telephone call from a client who reports nausea and has unrelieved chest pain after taking a nitroglycerin tablet 5 min ago. Which of the following is an appropriate response by the nurse?
Explanation
A. Advise the client to come into the office. The client needs immediate emergency intervention, not a routine office visit.
B. Advise the client to take an antacid. Chest pain unrelieved by nitroglycerin may indicate myocardial infarction; an antacid would not help.
C. Instruct the client to call 911. Persistent chest pain unrelieved by nitroglycerin warrants emergency attention due to potential heart attack.
D. Tell the client to take another nitroglycerin tablet in 15 min. The protocol allows taking an additional dose in 5 minutes, but emergency services should be called for unrelieved chest pain.
A nurse is reinforcing teaching to a client who has a chronic illness about the DASH diet. Which of the following meals best fits the DASH diet?
Explanation
A. Enriched cereal in whole milk. Whole milk is high in saturated fats, which the DASH diet aims to limit.
B. Turkey sandwich on whole wheat bread, green beans, and banana. This meal is balanced, low in saturated fats, high in fiber, and aligns well with the DASH diet principles. (Correct Answer)
C. Pork sausage and baked beans. Pork sausage is high in saturated fats and sodium, which should be limited in the DASH diet.
D. Hamburger, steak fries, and an orange. While the orange is DASH-friendly, the hamburger and fries are high in fats and sodium.
A nurse is collecting data on a client who has mitral valve stenosis. Which of the following findings should the nurse expect?
Explanation
A. Barrel chest. A barrel chest is commonly seen in chronic obstructive pulmonary disease (COPD) rather than mitral valve stenosis.
B. Bradycardia. Bradycardia is not typically associated with mitral valve stenosis, as symptoms often include rapid or irregular heartbeat.
C. Clubbing of the fingers. Clubbing is associated with chronic hypoxia, often due to pulmonary conditions, not specifically with mitral valve stenosis.
D. Heart murmur. Mitral valve stenosis causes turbulent blood flow through the narrowed valve, resulting in a characteristic murmur.
A nurse is collecting data for a client who experienced a myocardial infarction prior to a cardiac arrest. Which of the following laboratory tests will identify early injury to the cardiac muscle?
Explanation
A. Creatine kinase-myocardial band (CK-MB) test: While CK-MB is also a marker of myocardial injury, it is less specific than troponin and can be elevated in other conditions, such as muscle injury.
B. Troponin T test. The Troponin T test is highly specific and sensitive for myocardial injury and is considered the gold standard for diagnosing a myocardial infarction. Troponin levels rise within hours of cardiac muscle injury and remain elevated for days, providing an early and reliable indicator of cardiac muscle damage.
C. Brain natriuretic peptide (BNP) test. BNP levels are used to assess heart failure and do not indicate acute cardiac muscle injury.
D. Creatine kinase (CK) test. CK measures overall muscle injury, not specific to cardiac muscle.
A nurse is caring for a client with peripheral artery disease who has an arterial ulcer. Which of the following best describes the mechanism for developing the clinical problem?
Explanation
A. Swelling of the lower extremity can create a wound that is difficult to heal. Swelling typically relates to venous ulcers, not arterial ulcers, which are caused by reduced blood flow.
B. Decreased blood flow to the area can cause the wound and decrease the healing. Peripheral artery disease causes decreased blood flow, leading to poor oxygenation and slow healing of arterial ulcers.
C. Lower extremity compression stockings likely caused the wound to occur. Compression stockings are used in venous insufficiency and do not cause arterial ulcers.
D. Increased blood sugar associated with the condition is likely the cause of the wound not healing. While high blood sugar can impair healing, decreased blood flow is the primary cause of arterial ulcers in PAD.
A nurse is reviewing the laboratory findings of a client who experienced an acute myocardial infarction 6 days ago. Which of the following laboratory values should the nurse expect to remain elevated at this time?
Explanation
A. Creatinine phosphokinase (CPK): CPK levels peak within 24 hours after an MI and return to normal within 2-3 days.
B. Myoglobin: Myoglobin rises within hours but returns to normal within 24 hours after MI.
C. Creatinine kinase-MB (CK-MB): CK-MB peaks 12-24 hours post-MI and returns to baseline within 2-3 days.
D. Troponin T: Troponin T remains elevated for up to 10-14 days after an MI, providing long-term evidence of myocardial injury.
A nurse is reviewing the laboratory values for a client who has heart failure and is taking bumetanide. For which of the following results should the nurse notify the provider?
Explanation
A. Calcium 10 mg/dL: This calcium level is within the normal range (8.6-10.2 mg/dL) and does not require intervention.
B. Sodium 136 mEq/L: This sodium level is within the normal range (135-145 mEq/L).
C. Potassium 2.3 mEq/L: This potassium level is critically low; bumetanide is a loop diuretic that can cause hypokalemia, which can lead to dangerous cardiac dysrhythmias.
D. Magnesium 1.4 mEq/L: While slightly low, this magnesium level is only mildly decreased and not as immediately concerning as the potassium level.
A nurse is collecting data from a client who has heart failure and takes chlorothiazide sodium. Which of the following findings should the nurse identify as indicating hypokalemia?
Explanation
A. Bounding peripheral pulses: Hypokalemia typically causes weak, thready pulses rather than bounding ones.
B. Decreased deep-tendon reflexes: Hypokalemia can cause muscle weakness and decreased deep-tendon reflexes due to impaired neuromuscular function.
C. Hyperactive bowel sounds: Hypokalemia generally causes decreased or hypoactive bowel sounds due to slowed smooth muscle contraction.
D. Restlessness: Restlessness is not a typical sign of hypokalemia; hypokalemia more commonly causes weakness, lethargy, or fatigue.
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