nur 221 med surg exam Cardiac

ATI nur 221 med surg exam Cardiac

Total Questions : 53

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Question 1: View

A nurse is assessing a client who has obstructive sleep apnea. Which of the following findings should the nurse expect?

Explanation

A. Headache is correct. Clients with obstructive sleep apnea often experience morning headaches due to intermittent hypoxia and hypercapnia caused by repeated episodes of airway obstruction during sleep.
B. Hypotension is incorrect. Obstructive sleep apnea is more commonly associated with hypertension rather than hypotension due to the body's stress response to low oxygen levels.
C. Constipation is not a common symptom of obstructive sleep apnea. Gastrointestinal symptoms are not typically associated with this condition.
D. Nausea is not a characteristic finding in obstructive sleep apnea. The primary symptoms involve respiratory and neurological effects due to oxygen deprivation during sleep.


Question 2: View

A nurse in a provider's clinic is assessing a client who takes sublingual nitroglycerin for stable angina. The client reports getting a headache each time he takes the medication. Which of the following statements should the nurse make?

Explanation

A. "Try taking a mild analgesic to relieve the headache." is correct. Nitroglycerin-induced headaches are a common side effect due to vasodilation. Mild analgesics such as acetaminophen can help alleviate the discomfort.
B. Taking only one dose to reduce the risk of a headache is inappropriate. The client should follow the prescribed dosing regimen to manage angina effectively. Skipping doses may increase the risk of angina attacks.
C. Requesting a different medication is not necessary. Nitroglycerin is an effective treatment for stable angina, and headaches typically diminish over time as the body adjusts to the medication.
D. Stating that nothing can be done to relieve the headaches is incorrect. Headaches from nitroglycerin can be managed with mild analgesics or by adjusting the timing of medication administration.


Question 3: View

The nurse is caring for a diabetic client who had a Coronary Angiography two hours ago. Which of the following orders should the nurse question?

Explanation

A. Having the client lay flat for 4 hours is appropriate. After coronary angiography, bed rest is required to prevent bleeding from the arterial puncture site, especially if a femoral approach was used.
B. Monitoring the site for bleeding and hematoma formation is correct. Bleeding is a potential complication, and frequent assessment of the catheter insertion site is necessary.
C. Administering metformin should be questioned. Metformin is contraindicated within 48 hours of receiving contrast dye because of the risk of lactic acidosis, especially in clients with impaired renal function.
D. Administering aspirin is appropriate. Aspirin is commonly prescribed to prevent clot formation after a coronary procedure.


Question 4: View

A nurse is assessing a client who has right-sided heart failure. Which of the following findings should the nurse expect?

Explanation

A. Dizziness is more commonly associated with left-sided heart failure due to decreased cardiac output and reduced cerebral perfusion.
B. Crackles in the lungs occur in left-sided heart failure due to pulmonary congestion. Right-sided heart failure primarily affects systemic circulation rather than the lungs.
C. A dry hacking cough is also a symptom of left-sided heart failure, resulting from fluid backup into the lungs.
D. Hepatomegaly is correct. Right-sided heart failure leads to systemic venous congestion, which can cause liver enlargement (hepatomegaly), ascites, and peripheral edema.


Question 5: View

The nurse recognizes which of the following as a risk factor for obstructive sleep apnea?

Explanation

A. Deep vein thrombosis is not a known risk factor for obstructive sleep apnea. Sleep apnea is primarily related to airway obstruction rather than circulatory issues.
B. Being female is incorrect. Obstructive sleep apnea is more common in males than females, although postmenopausal women have an increased risk.
C. Obesity is correct. Excess weight, particularly around the neck, increases the risk of airway obstruction during sleep, making obesity a major risk factor for obstructive sleep apnea.
D. Atherosclerosis is not a direct risk factor. However, untreated obstructive sleep apnea can contribute to cardiovascular issues, including hypertension and atherosclerosis.


Question 6: View

The nurse is assessing the client diagnosed with COPD. Which of the following would require immediate attention by the nurse?

Explanation

A. Use of accessory muscles during inspiration is common in COPD as clients work harder to breathe. While this indicates respiratory distress, it is not necessarily an immediate emergency.
B. Large amounts of thick white sputum can indicate mucus production, which is common in COPD. If the sputum were yellow or green, it could suggest infection, requiring further assessment.
C. A barrel chest and clubbing are chronic changes in COPD due to prolonged air trapping and hypoxia. These findings do not require immediate intervention.
D. Oxygen flowmeter set on 8 LPM is correct. High-flow oxygen can suppress the hypoxic drive in COPD clients, leading to respiratory depression. The nurse should immediately lower the oxygen to a safer level (typically 1-3 LPM) and monitor the client’s respiratory status.


Question 7: View

The nurse is educating a client about the treatment options for a pulmonary embolism. Which of the following statements would require further teaching?

Explanation

A. Warfarin is commonly prescribed for long-term anticoagulation to prevent future clot formation. This statement is correct and does not require further teaching.
B. A Heparin infusion does not dissolve existing clots but prevents them from enlarging and new clots from forming, making this statement accurate.
C. The purpose of the Inferior Vena Cava (IVC) filter is to trap emboli from deep vein thrombosis (DVT) before they reach the lungs, not to prevent DVT formation. This statement is incorrect and requires further teaching.
D. An embolectomy is a surgical procedure to remove a pulmonary embolism, making this statement correct.


Question 8: View

A nurse is caring for a client who reports a new onset of severe chest pain. Which of the following actions should the nurse take to determine if the client is experiencing a myocardial infarction?

Explanation

A. Checking blood pressure is important but does not confirm a myocardial infarction. Hypotension or hypertension may be present, but they are not definitive diagnostic tools.
B. Auscultating heart tones can help assess for murmurs or extra sounds, but it cannot diagnose a myocardial infarction.
C. Radiating pain to the left arm is a classic symptom, but not all clients experience it, and its absence does not rule out an MI.
D. Performing a 12-lead ECG is the most important diagnostic tool for identifying myocardial infarction. It provides real-time evidence of ischemic changes, such as ST-segment elevation or depression, confirming or ruling out an MI.


Question 9: View

The emergency room nurse is assessing a client with jugular venous distention, ascites, shortness of breath, and a 3-pound weight gain in the past 24 hours. Which of the following would the nurse anticipate being ordered?

Explanation

A. A pulmonary function test is used to assess lung diseases like COPD or asthma. It is not the primary diagnostic test for fluid overload and heart failure.
B. Alpha-1 antitrypsin deficiency is associated with early-onset COPD, but it does not relate to symptoms of fluid retention and heart failure as described in the question.
C. Brain Natriuretic Peptide (BNP) is correct. BNP is released when the ventricles stretch due to fluid overload, making it a key diagnostic marker for heart failure. Elevated BNP levels indicate increased cardiac filling pressures and volume overload, which match the client’s symptoms.
D. A Doppler ultrasound is useful for detecting deep vein thrombosis (DVT) or vascular issues, but it does not assess systemic fluid retention and heart failure.


Question 10: View

The nurse is to administer heparin to a client who weighs 90 pounds. Heparin is ordered as 10,000 units/100mL. The nurse needs to administer a bolus of 40units/kg. How many units would the nurse administer? (Round to the nearest tenth)

Explanation

  • Convert pounds to kilograms:
    • Weight in kilograms = 90 pounds / 2.2 pounds/kg = 40.9090... kg. For practical purposes, we can round to 40.91kg.
  • Calculate the heparin dose:
    • The ordered bolus dose is 40 units/kg.
    • Heparin dose = 40.91 kg 40 units/kg = 1636.4 units.
  • Round to the nearest tenth:
    • The heparin dose is 1636.4 units.

= 1636.4 units


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