Med-Surg Cardiovascular HESI RN
1. A client complains of crushing chest pain that radiates to his left arm. He should be presented with
the following treatment:
1. Aspirin, oxygen, nitroglycerin, and morphine
2. Aspirin, oxygen, nitroglycerin, and codeine
3. Oxygen, nitroglycerin, meperidine,...
med surg cardiovascular hesi rn 1 a client complains of crushing chest pain that radiates to his left arm he should be presented with the following treatment 1 asp
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Med-Surg Cardiovascular HESI RN
1. A client complains of crushing chest pain that radiates to his left arm. He should be presented with
the following treatment:
1. Aspirin, oxygen, nitroglycerin, and morphine
2. Aspirin, oxygen, nitroglycerin, and codeine
3. Oxygen, nitroglycerin, meperidine, and thrombolytics
4. Aspirin, oxygen, nitroprusside, and morphine
Answer: 1. Aspirin, oxygen, nitroglycerin, and morphine
2. Which lifestyle changes should a client diagnosed with coronary artery disease consider?
1. Smoking cessation
2. Establishing a regular exercise routine
3. Weight reduction
4. All of the Above
Answer: 4. All of the Above
3. A client's cardiac monitor alarm sounds, indicating ventricular tachycardia. The nurse should:
1. perform immediate defibrillation.
2. Assess the client.
3. Call the physician.
4. Administer a precordial thump.
Answer: 2. Assess the client.
4. A complication of peripheral vascular disease may be:
1. stasis ulcer.
2. Pressure ulcer.
3. Gastric ulcer.
4. Duodenal ulcer.
,Answer: 1. stasis ulcer.
5. A key diagnostic test for heart failure is:
1. serum potassium.
2. B-type natriuretic peptide.
3. Troponin I
4. cardiac enzymes.
Answer: 2. B-type natriuretic peptide.
6. While auscultating the heart sounds of a client with mitral insufficiency, the nurse hears an extra
heart sound immediately after the S2. The nurse should document this extra heart sound as a:
1. S1.
2. S3.
3. S4.
4. mitral murmur.
Answer: 2. S3.
Rationale: An S3, is heard following an S2. This indicates that the client is experiencing heart failure and
results from increased filling pressures. An S1 is a normal heart sound made by the closing of the mitral
and tricuspid valves. An S4 is heard before S1 and is caused by resistance to ventricular filling. A murmur
of mitral insufficiency occurs during systole and is heard when there's turbulent blood flow across the
valve.
7. A nurse administers heparin to a client with deep vein thrombophlebitis. Which laboratory value
should the nurse monitor to determine the effectiveness of heparin?
1. PTT
2. HCT
3. CBC
4. PT
Answer: 1. PTT
Rationale: The therapeutic effectiveness of heparin is determined by monitoring the patient's PTT, PT,
HCT, and CBC don't monitor the therapeutic effectiveness of heparin. Monitoring the PT determines
warfarin's effectiveness.
,8. A client has just returned from cardiac catheterization. Which nursing intervention would be most
appropriate?
1. Help the client ambulate to the bathroom.
2. Restrict fluids.
3. Monitor peripheral pulses.
4. Insert an indwelling urinary catheter.
Answer. 3. Monitor peripheral pulses.
Rationale: After cardiac catheterization, monitor peripheral pulses to assess peripheral perfusion.
Helping the client ambulate to the bathroom is incorrect because the client should be on bed rest for 4
to 8 hours after the procedure to reduce the risk of bleeding at the insertion site. Restricting fluids is
incorrect because the client should be encouraged to drink fluids after the procedure, unless
contraindicated. Adequate hydration reduces the risk of nephrotoxicity that can occur with the use of
contrast dye. Although urine output is monitored following cardiac catheterization, the insertion of a
urinary catherter isn't necessary.
9. A client is in the first postoperative day after left femoropopliteal revascularization. Which position
would be most appropriate for this client?
1. On his left-sided
2. In high Fowler's position
3. On his right side
4. In a left lateral decubitus position
Answer: 3. On his right side
Rationale: Following revascularization, avoid positioning the client on the surgical side. Because this
client had left femoropoliteal revascularization, he may be positioned on the right side. Placing the client
on the left side is incorrect because this would position the client on the operative side. Positioning the
client in high Fowler's position is incorrect because the client should avoid flexion at the surgical site.
Placing the client in a left lateral decubitus position is incorrect because this would place the client on
the surgical side and cause flexion at the site.
10. A nurse is evaluating a client with left-sided heart failure. Which finding should the nurse expect to
assess?
1. Ascites
2. Dyspnea
, 3. Hepatomegaly
4. Jugular vein distention
Answer: 2. Dyspnea
Rationale: Dyspnea may occur in a client with left-sided heart failure. Ascites, hepatomegaly, and jugular
vein distention are assessment findings in right-sided heart failure.
11. A client has developed acute pulmonary edema. Which test result should the nurse expect?
1. Interstitial edema by chest X-ray
2. Metabolic alkalosis by ABG analysis
3. Bradycardia by ECG
4. Decreased PAWP by hemodynamic monitoring
Answer: 1. Interstitial edema by chest X-ray
Rationale: The chest X-ray of a client with acute pulmonary edema shows interstitial edema as a result
of the heart's failure to pump adequately. Metabolic alkalosis is incorrect because the ABG analysis of a
client in acute pulmonary edema shows respiratory alkalosis or acidosis. Bradycardia is incorrect
because the ECG would most likely indicate tachycardia. Decreased PAWP is incorrect because PAWP
rises in the client with acute pulmonary edema.
12. A nurse is performing discharge teaching for a client with PVD. The nurse should teach the client to:
1. inspect his feet weekly
2. begin a daily walking program
3. wear constrictive clothing
4. stand rather than sit when possible
Answer: 2. begin a daily walking program
Rationale: The nurse should encourage the client with PVD to follow a program of walking and other leg
exercises. Inspecting the feet weekly is incorrect because the nurse should teach the client to inspect his
feet daily. Wearing constrictive clothing is incorrect because the client should wear loose clothing that
doesn't restrict circulation. Standing when possible—rather than sitting—is incorrect because the client
should avoid standing for long periods.
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