NUR 211 - Cardiac
A client with a history of type 2 diabetes is admitted to the hospital with chest pain. The client is
scheduled for a cardiac catheterization. Which medication would need to be withheld for 24
hours before the procedure and for 48 hours after the procedure?
1. Glipizide
2. Metformin
3. Repaglinide
4. Regular insulin - ANS Metformin - because of the injection of contrast medium during
procedure. Puts patients at risk for kidney damage/ lactic acidosis.
A client in sinus bradycardia, with a heart rate of 45 beats/minute, complains of dizziness and
has a blood pressure of 82/60 mm Hg. Which intervention should the nurse anticipate will be
prescribed?
1.Administer digoxin.
2.Defibrillate the client.
3.Continue to monitor the client.
4.Prepare for transcutaneous pacing. - ANS 4 - prepare for transcutaneous pacing. Sinus
Brady is HR <60 bpm. This rhythm becomes a concern when the patient becomes symptomatic.
Hypotension / dizziness is a sign of decreased cardiac output.
The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops
extreme dyspnea, tachycardia, and lung crackles. The nurse immediately asks another nurse to
contact the primary health care provider and prepares to implement which priority interventions?
Select all that apply:
1. Administer oxygen
2. Insert Foley catheter
3. Administer furosemide
4. Administer morphine sulfate IV
5. Transporting the client to coronary care unit
6. Placing the client in a low-Fowler's side-lying - ANS 1,2,3,4
Extreme dyspnea, tachycardia, and lung crackles in a client with HF indicate pulmonary edema,
a life threatening event. The left ventricle fails to eject sufficient blood, and pressure increases in
the lungs because of accumulation of blood.
Oxygen is supplied and patients should be in high-Fowler's to alleviate pressure. Pushing
furosemide pulls off that extra fluid. A foley is inserted to measure output accurately. IV
morphine reduces venous return, decreases anxiety, and helps with breathing. (Morphine +
Furosemide = positive inotrope)
, A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger,
and begins coughing frothy, pink-tinged sputum. Which funding would the nurse anticipate when
auscultating the client's breath sounds?
1. Stridor
2. Crackles
3. Scattered rhonchi
4. Diminished breath sounds - ANS 2 - pulmonary edema is characterized by extreme
breathlessness, dyspnea, air hunger, and production of frothy, pink-tinged sputum. Auscultation
of the lungs reveals crackles.
A client with myocardial infarction is developing cardiogenic shock. What condition should the
nurse carefully assess the client for?
1. Pulsus paradoxus
2. Ventricular dysrhythmias
3. Rising diastolic blood pressure
4. Falling central venous pressure - ANS 2 - Dysrhythmias commonly occur as a result of
decreased oxygenation and severe damage to greater than 40% of the myocardium.
Classic signs of cardiogenic shock as they relate to myocardial ischemia include low blood
pressure and tachycardia.
A client who had cardiac surgery 24 hours ago has had a urine output averaging 20mL/hr for 2
hours. The client received a single bolus of 500mL of IV fluid. Urine output for the subsequent
hour was 25mL. Daily laboratory results indicate that the blood urea nitrogen level is 45 mg/dL
(16 mmol/L) and the serum creatinine level is 2.2 mg/dL (194 mmol/L). On the basis of these
findings, the nurse would anticipate that the client is at risk for which problem?
1. Hypovolemia
2. Acute kidney injury
3. Glomerulonephritis
4. UTI - ANS 2 - AKI - The client who undergoes cardiac surgery is at risk for renal injury from
poor perfusion, hemolysis, low cardiac output, or vasopressor medication therapy.
Signs of renal injury:
Decreased urine output
Increased BUN (>20) and creatinine (>1.2)
The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes
are regular. The PR interval is 0.16 seconds, and QRS complexes measure 0.06 seconds. The
overall heart rate is 64 bpm. Which action should the nurse take?
1. Check vital signs
2. Check laboratory test results
3. Monitor for any rhythm change
4. Notify the primary health care provider - ANS 3 - normal sinus rhythm is defined as a regular
rhythm, with an overall rate of 60 to 100. PR and QRS measurements are normal: between
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