p.1
Pulmonary Edema and Nursing Interventions
Which of the following positions would best aid breathing for a client with acute pulmonary edema?
In high Fowler’s position
p.9
Chest Trauma and Emergency Interventions
Nurse Lei caring for a client with a pneumothorax and who has had a chest tube inserted notes continues gentle bubbling in the suction control chamber. What action is appropriate?
Do nothing, because this is an expected finding
p.8
Pneumonia and Pleural Effusion
A client with pleural effusion is scheduled to have a thoracentesis. The nurse on duty will assist the client to which position during the procedure?
Lying in bed on the unaffected side with head of bed elevated about 45°.
p.6
Obstructive Respiratory Disorders
Why should a client with emphysema receive only 1 to 3 L/minute of oxygen if needed?
The client breathes only when his oxygen levels dip below a certain point.
p.11
Medications for Cardiac Performance
What should the nurse implement for a client who is starting a Schilling test?
Starting a 24- to 48-hour urine specimen collection
p.4
Coronary Artery Disease and Myocardial Infarction
What is the primary reason for administering morphine to a client with an MI?
To decrease oxygen demand on the client’s heart
p.3
Infectious Diseases of the Heart
What are the classic signs of a cardiac tamponade?
Hypotension, muffled heart sounds, increased jugular venous distension (JVD)
p.5
Coronary Artery Disease and Myocardial Infarction
Which of the following arteries primarily feeds the anterior wall of the heart?
Left anterior descending artery
p.8
Chest Trauma and Emergency Interventions
Nurse Ruth assessing a patient for tracheal displacement should know that the trachea will deviate toward the:
Contralateral side in hemothorax
p.11
Medications for Cardiac Performance
What should be the nurse’s next action for a client with a history of hypertension and indigestion, after connecting him to an ECG monitor and administering oxygen?
Start an intravenous line
p.12
Coronary Artery Disease and Myocardial Infarction
Mike, a 43-year old construction worker, has a history of hypertension. He smokes two packs of cigarettes a day, is nervous about the possibility of being unemployed, and has difficulty coping with stress. His current concern is calf pain during minimal exercise that decreased with rest. The nurse assesses Mike’s symptoms as being associated with peripheral arterial occlusive disease. The nursing diagnosis is probably:
Alteration in tissue perfusion related to compromised circulation
p.1
Heart Failure Symptoms and Management
Which of the following conditions is most closely associated with weight gain, nausea, and a decrease in urine output?
Right-sided heart failure
p.8
Chest Trauma and Emergency Interventions
After undergoing a left pneumonectomy, a female patient has a chest tube in place for drainage. When caring for this patient, the nurse must:
Encourage coughing and deep breathing
p.6
Obstructive Respiratory Disorders
What effect does exercise have on clients with asthma, chronic bronchitis, and emphysema?
It enhances cardiovascular fitness.
p.5
Obstructive Respiratory Disorders
The term “blue bloater” refers to which of the following conditions?
Chronic obstructive bronchitis
p.12
Obstructive Respiratory Disorders
With peripheral arterial insufficiency, leg pain during rest can be reduced by:
Lowering the limb so it is dependent
p.4
Coronary Artery Disease and Myocardial Infarction
Which of the following actions is the first priority of care for a client exhibiting signs and symptoms of coronary artery disease?
Enhance myocardial oxygenation
p.5
Medications for Cardiac Performance
The physician orders continuous intravenous nitroglycerin infusion for the client with MI. Essential nursing actions include which of the following?
Obtaining an infusion pump for the medication
p.9
Obstructive Respiratory Disorders
For a male client with an endotracheal (ET) tube, which nursing action is most essential?
Auscultating the lungs for bilateral breath sounds
p.3
Infectious Diseases of the Heart
The most common cause of Infective endocarditis is:
Group A B-hemolytic strep microorganism
p.9
Chest Trauma and Emergency Interventions
An initial characteristic symptom of a simple pneumothorax is:
Tachypnea and chest discomfort
p.3
Medications for Cardiac Performance
Which of the following statements indicate the patient did NOT understand your education about how to take Colchicine?
I will take my medications in the morning with grapefruit juice.
p.5
Conduction System of the Heart
The nurse coming on duty receives the report from the nurse going off duty. Which of the following clients should the on-duty nurse assess first?
A 76-year-old client who was admitted 1 hour ago with new-onset atrial fibrillation and is receiving IV diltiazem (Cardizem).
p.9
Chest Trauma and Emergency Interventions
Nurse Maureen has assisted a physician with the insertion of a chest tube. The nurse monitors the client and notes fluctuation of the fluid level in the water seal chamber after the tube is inserted. Based on this assessment, which action would be appropriate?
Continue to monitor the client
p.9
Obstructive Respiratory Disorders
A nurse is suctioning fluids from a female client through an endotracheal tube. During the suctioning procedure, the nurse notes on the monitor that the heart rate is decreasing. Which of the following is the appropriate nursing intervention?
Stop the procedure and reoxygenate the client
p.5
Coronary Artery Disease and Myocardial Infarction
Which of the following reflects the principle on which a client’s diet will most likely be based during the acute phase of MI?
Small, easily digested meals
p.6
Pneumonia and Pleural Effusion
Which measure can reduce or prevent the incidence of atelectasis in a post-operative client?
Use of an incentive spirometer.
p.11
Medications for Cardiac Performance
Which instruction about prescribed ferrous gluconate therapy should the nurse include in the teaching plan for a client with iron deficiency anemia?
Take the medication on an empty stomach.
p.8
Chest Trauma and Emergency Interventions
While helping a patient with a chest tube reposition in the bed, the chest tube becomes dislodged. What is your immediate nursing intervention?
Place a sterile dressing over the site and tape it on three sides and notify the physician.
p.6
Obstructive Respiratory Disorders
Which nursing action will facilitate obtaining a sputum specimen from a client?
Having the client take 3 deep breaths.
p.12
Pumping Mechanism of the Heart
A nurse is assessing a client with an abdominal aortic aneurysm. Which of the following assessment findings by the nurse is probably unrelated to an aneurysm?
Hyperactive bowel sounds in that area
p.2
Heart Failure Symptoms and Management
Invasive monitoring consists of:
Arterial and/or pulmonary artery catheter
p.1
Pumping Mechanism of the Heart
Complete the diagram so that it will show the correct route of blood in the heart.
Tricuspid Valve, Pulmonic Valve, Pulmonary Circulation, Mitral Valve, Aortic Valve
p.4
Coronary Artery Disease and Myocardial Infarction
Which of the following conditions is most commonly responsible for myocardial infarction?
Coronary artery thrombosis
p.8
Pneumonia and Pleural Effusion
Which of the following best describes pleural effusion?
The accumulation of fluid between the linings of the pleural space.
p.6
Obstructive Respiratory Disorders
Why is it highly recommended that clients with asthma, chronic bronchitis, and emphysema have Pneumovax and flu vaccinations?
Respiratory infections can cause severe hypoxia and possibly death in these clients.
p.11
Medications for Cardiac Performance
Which client statement indicates a need for intervention and client teaching after a resection of the terminal ileum?
“I take a vitamin B12 tablet every day.”
p.5
Obstructive Respiratory Disorders
Which of the following assessment findings would help confirm a diagnosis of asthma in a client suspected of having the disorder?
Inspiratory and expiratory wheezing
p.8
Chest Trauma and Emergency Interventions
A male patient has a sucking stab wound to the chest. Which action should the nurse take first?
Applying a dressing over the wound and taping it on three sides
p.1
Pumping Mechanism of the Heart
The nurse finds the apical pulse below the 5th intercostal space. The nurse suspects:
Left ventricular enlargement
p.1
Heart Failure Symptoms and Management
Which of the following would be a priority nursing diagnosis for the client with heart failure and pulmonary edema?
Activity intolerance related to pump failure
p.3
Infectious Diseases of the Heart
Cardiac Tamponade is described as:
Diastolic collapse of the free walls of right atrium and right ventricle
p.6
Obstructive Respiratory Disorders
What should teaching for a client with chronic obstructive pulmonary disease (COPD) include?
How to recognize the signs of an impending respiratory infection.
p.11
Medications for Cardiac Performance
What is the reason for vitamin B12 deficiency in a client with pernicious anemia?
The reason for your vitamin deficiency is an inability to absorb the vitamin because the stomach is not producing sufficient intrinsic factor.
p.8
Pneumonia and Pleural Effusion
Which statement by the patient causes you to hold the bag of Vancomycin and notify the doctor immediately?
I have this constant ringing in my ears.
p.3
Infectious Diseases of the Heart
Pericardiocentesis – everything is right, except?
The most common approach is xiphoid
p.5
Coronary Artery Disease and Myocardial Infarction
Which of the following is an expected outcome for a client on the second day of hospitalization after an MI?
Can perform personal self-care activities without pain
p.8
Chest Trauma and Emergency Interventions
A patient with a chest tube has no fluctuation of water in the water seal chamber. What could be the cause of this?
The lung may have re-expanded or there is a kink in the system.
p.4
Coronary Artery Disease and Myocardial Infarction
Which of the following conditions is the predominant cause of angina?
Inadequate oxygen supply to the myocardium
p.9
Chest Trauma and Emergency Interventions
An emergency room nurse is assessing a male client who has sustained a blunt injury to the chest wall. Which of these signs would indicate the presence of a pneumothorax in this client?
A sucking sound at the site of injury
p.7
Obstructive Respiratory Disorders
A male patient is admitted to the healthcare facility for treatment of chronic obstructive pulmonary disease. Which nursing diagnosis is most important for this patient?
Impaired gas exchange related to airflow obstruction
p.9
Obstructive Respiratory Disorders
A female patient suffers adult respiratory distress syndrome as a consequence of shock. The patient’s condition deteriorates rapidly, and endotracheal intubation and mechanical ventilation are initiated. When the high-pressure alarm on the mechanical ventilator alarm sounds, the nurse starts to check for the cause. Which condition triggers the high-pressure alarm?
Kinking of the ventilator tubing
p.3
Infectious Diseases of the Heart
Pericardiotomy is described as:
Making permanent channel between the pericardial space and chest cavity when there is recurrent pericardial effusion
p.7
Pneumonia and Pleural Effusion
You’re educating a patient with pneumonia how to deep breathe by using an incentive spirometer. Which of the following is the correct way to use this device?
The patient inhales slowly from the device until no longer able, and then holds breath for 6 seconds and exhales.
p.5
Obstructive Respiratory Disorders
A 19-year-old comes into the emergency department with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions should be taken first?
Give a bronchodilator by nebulizer
p.11
Medications for Cardiac Performance
Which factor can cause blood pressure to drop to normal levels?
Kidneys’ excretion of sodium and water
p.7
Pneumonia and Pleural Effusion
A patient was admitted to the intensive care unit 48 hours ago for treatment of a gunshot wound. The patient has recently developed a productive cough and a fever of 40°C. The patient is breathing on his own and doesn’t require mechanical ventilation. On assessment, you note coarse crackles in the right lower lobe. A chest x-ray shows infiltrates with consolidation in the right lower lobe. Based on this specific patient scenario, this is known as what type of pneumonia?
Hospital-acquired pneumonia
p.2
Conduction System of the Heart
In a normal electrocardiogram (ECG or EKG), the QRS complex results from depolarization of the ventricles.
The QRS complex results from depolarization of the ventricles.
p.10
Infectious Diseases of the Heart
Which of the following diagnostic findings are most likely for a client with aplastic anemia?
Decreased levels of white blood cells, red blood cells, and platelets.
p.6
Obstructive Respiratory Disorders
What would a nurse expect to note on assessment of a client hospitalized with acute exacerbation of COPD?
A hyperinflated chest on x-ray film.
p.11
Medications for Cardiac Performance
What is the most important long-term goal for a client with hypertension?
Make a commitment to long-term therapy
p.2
Conduction System of the Heart
Which of these statements regarding the conduction system of the heart is TRUE?
The sinoatrial (SA) node of the heart acts as the pacemaker.
p.10
Obstructive Respiratory Disorders
The following are nursing interventions to assist in the prevention of pulmonary embolism in a hospitalized patient include all except:
Encouraging the patient to dangle his or her legs over the side of the bed for 30 minutes, four times a day.
p.12
Coronary Artery Disease and Myocardial Infarction
Buerger’s disease is characterized by all of the following except:
Lipid deposits in the arteries
p.12
Coronary Artery Disease and Myocardial Infarction
A client comes to the outpatient clinic and tells the nurse that he has had legs pains that began when he walks but cease when he stops walking. Which of the following conditions would the nurse assess for?
Peripheral vascular problems in both legs
p.2
Infectious Diseases of the Heart
You are providing care to a patient with pericarditis. Which of the following is NOT a proper nursing intervention for this patient?
Place the patient in supine position to relieve pain.
p.7
Obstructive Respiratory Disorders
A nurse instructs a client to use the pursed lip method of breathing. The client asks the nurse about the purpose of this type of breathing. The nurse responds, knowing that the primary purpose of pursed lip breathing is:
Promote carbon dioxide elimination
p.12
Coronary Artery Disease and Myocardial Infarction
In preparation for the discharge of a client with arterial insufficiency and Raynaud’s disease, client teaching instructions should include:
Keeping the heat up so that the environment is warm
p.10
Infectious Diseases of the Heart
The nurse understands that the client with pernicious anemia will have which distinguishing laboratory findings?
Intrinsic factor, absent.
p.7
Obstructive Respiratory Disorders
For a patient with advanced chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange?
Using a high-flow venture mask to deliver oxygen as prescribed
p.7
Pneumonia and Pleural Effusion
You’re providing discharge teaching to a patient who was admitted for pneumonia. You are discussing measures the patient can take to prevent pneumonia. Which of the following statements by the patient indicates they did NOT understand your education material?
It is important I don’t receive the Pneumovax vaccine since I’m already immune to pneumonia.
p.2
Pulmonary Edema and Nursing Interventions
What is pulmonary edema?
Accumulation of fluid in the lungs
p.2
Infectious Diseases of the Heart
A patient is hospitalized with chronic pericarditis. On assessment, you note the patient has pitting edema in lower extremities, crackles in lungs, and dyspnea on excretion. The patient’s echocardiogram shows thickening of the pericardium. This is known as what type of pericarditis?
Constrictive pericarditis
p.10
Obstructive Respiratory Disorders
The following are diagnostic tests for a patient with pulmonary embolism except:
Pulmonary function tests.
p.10
Infectious Diseases of the Heart
The nurse would instruct the client to eat which of the following foods to obtain the best supply of vitamin B12?
Meats and dairy products.
p.10
Infectious Diseases of the Heart
The nurse devises a teaching plan for the patient with aplastic anemia. Which of the following is the most important concept to teach for health maintenance?
Avoid exposure to others with acute infection.
