MEDICAL SURGICAL NURSING - CARDIOVASCULAR
DISORDERS
The nurse is preparing the client newly diagnosed with peripheral arterial disease for
discharge with the medication atorvastatin. What laboratory work should the nurse
obtain to establish a baseline before starting the medication?
creatinine level and liver function tests
white blood cell count and blood sugar
hemoglobin and hematocrit levels
platelet count and urinalysis - Answers- creatinine level and liver function tests
The nurse caring for a client on the cardiac unit notices that the client's cardiac monitor
shows ventricular fibrillation. What is the priority action by the nurse?
administration of digoxin
insertion of an I.V. line
immediate defibrillation
scheduling a pacemaker insertion - Answers- immediate defibrillation
Metoprolol is added to the pharmacologic therapy of a diabetic female diagnosed with
stage 2 hypertension who has been initially treated with furosemide and ramipril. The
nurse should evaluate the client for which expected therapeutic effect?
decrease in heart rate.
lessening of fatigue.
improvement in blood sugar levels.
increase in urine output. - Answers- decrease in heart rate.
A client prescribed propranolol calls the clinic to report a weight gain of 3 lb (1.36 kg)
within 2 days, shortness of breath, and swollen ankles. What is the nurse's best action?
Assess the client's dietary intake for the past 24 hours.
Have the client come to the clinic in order to assess the lungs.
Review medication administration with the client.
Assess the client's knowledge of expected effects of the drug. - Answers- Have the
client come to the clinic in order to assess the lungs.
The nurse is admitting an older adult to the hospital. The echocardiogram report
revealed left ventricular enlargement. The nurse notes 2+ pitting edema in the ankles
when getting the client into bed. Based on this finding, what should the nurse do first?
Assess respiratory status.
Draw blood for laboratory studies.
Insert a Foley catheter.
,Weigh the client. - Answers- Assess respiratory status.
A client is admitted with shortness of breath, a brain natriuretic peptide (BNP) level of
615 pg/mL, and pedal edema. Which actions should the nurse take next? Select all that
apply.
Initiate I.V. diuretic therapy.
Give oxygen by mask.
Raise the feet on pillows.
Schedule an exercise stress test.
Increase dietary calcium. - Answers- Initiate I.V. diuretic therapy.
Give oxygen by mask.
A client has been prescribed hydrochlorothiazide to treat heart failure. What adverse
effect should the nurse instruct the client to report to the health care provider?
urinary retention
muscle weakness
confusion
diaphoresis - Answers- muscle weakness
What is a priority nursing assessment in the first 24 hours after admission of the client
with a thrombotic stroke?
cholesterol level
pupil size and pupillary response
bowel sounds
echocardiogram - Answers- pupil size and pupillary response
A visitor to the hospital has a cardiac arrest. When determining to use an automated
external defibrillator (AED), the nurse should consider that AEDs are used in cardiac
arrest in which circumstances?
early defibrillation in cases of atrial fibrillation
cardioversion in cases of atrial fibrillation
pacemaker placement
early defibrillation in cases of ventricular fibrillation - Answers- early defibrillation in
cases of ventricular fibrillation
The nurse is preparing to administer 0.1 mg of digoxin intravenously. Digoxin comes in
a concentration of 0.5 mg/2 ml. How many milliliters should the nurse administer?
Record your answer using one decimal place. - Answers- 0.4 mL
A nurse is evaluating a client who had a myocardial infarction (MI) 7 days earlier. Which
outcome indicates that the client is responding favorably to therapy?
, The client exhibits a heart rate within normal limits.
The client requests information regarding smoking cessation.
The client is able to verbalize the action of all prescribed medications.
The client demonstrates ability to tolerate more activity without chest pain. - Answers-
The client demonstrates ability to tolerate more activity without chest pain.
A client with second-degree atrioventricular heart block is admitted to the coronary care
unit. The nurse closely monitors the client's heart rate and rhythm. When interpreting
the client's electrocardiogram (ECG) strip, the nurse knows that the QRS complex
represents
atrial repolarization.
ventricular repolarization.
atrial depolarization.
ventricular depolarization. - Answers- ventricular repolarization.
A client arrives in the emergency department with an ischemic stroke. What should the
nurse do before the client receives tissue plasminogen activator (t-PA)?
Ask what medications the client is taking.
Complete a history and health assessment.
Identify the time of onset of the stroke.
Determine if the client is scheduled for any surgical procedures. - Answers- Identify the
time of onset of the stroke.
The nurse has completed an assessment on a client with a decreased cardiac output.
Which findings should receive the highest priority?
blood pressure 110/62 mm Hg, atrial fibrillation with heart rate 82, bilateral basilar
crackles
confusion, urine output 15 mL over the last 2 hours, orthopnea
SpO2 92% on 2 L nasal cannula, respirations 20 breaths/min, 1+ edema of lower
extremities
weight gain of 1 kg in 3 days, blood pressure 130/80 mm Hg, mild dyspnea with
exercise - Answers- confusion, urine output 15 mL over the last 2 hours, orthopnea
A nurse is teaching a client about maintaining a healthy heart. The nurse should include
which point in teaching?
Smoke in moderation.
Use alcohol in moderation.
Consume a diet high in saturated fats and low in cholesterol.
Exercise one or two times per week. - Answers- Use alcohol in moderation.
The nurse on the previous night shift documented that the lungs of a client with lung
cancer were CTA (clear to auscultation) in all fields. While doing the shift assessment,
DISORDERS
The nurse is preparing the client newly diagnosed with peripheral arterial disease for
discharge with the medication atorvastatin. What laboratory work should the nurse
obtain to establish a baseline before starting the medication?
creatinine level and liver function tests
white blood cell count and blood sugar
hemoglobin and hematocrit levels
platelet count and urinalysis - Answers- creatinine level and liver function tests
The nurse caring for a client on the cardiac unit notices that the client's cardiac monitor
shows ventricular fibrillation. What is the priority action by the nurse?
administration of digoxin
insertion of an I.V. line
immediate defibrillation
scheduling a pacemaker insertion - Answers- immediate defibrillation
Metoprolol is added to the pharmacologic therapy of a diabetic female diagnosed with
stage 2 hypertension who has been initially treated with furosemide and ramipril. The
nurse should evaluate the client for which expected therapeutic effect?
decrease in heart rate.
lessening of fatigue.
improvement in blood sugar levels.
increase in urine output. - Answers- decrease in heart rate.
A client prescribed propranolol calls the clinic to report a weight gain of 3 lb (1.36 kg)
within 2 days, shortness of breath, and swollen ankles. What is the nurse's best action?
Assess the client's dietary intake for the past 24 hours.
Have the client come to the clinic in order to assess the lungs.
Review medication administration with the client.
Assess the client's knowledge of expected effects of the drug. - Answers- Have the
client come to the clinic in order to assess the lungs.
The nurse is admitting an older adult to the hospital. The echocardiogram report
revealed left ventricular enlargement. The nurse notes 2+ pitting edema in the ankles
when getting the client into bed. Based on this finding, what should the nurse do first?
Assess respiratory status.
Draw blood for laboratory studies.
Insert a Foley catheter.
,Weigh the client. - Answers- Assess respiratory status.
A client is admitted with shortness of breath, a brain natriuretic peptide (BNP) level of
615 pg/mL, and pedal edema. Which actions should the nurse take next? Select all that
apply.
Initiate I.V. diuretic therapy.
Give oxygen by mask.
Raise the feet on pillows.
Schedule an exercise stress test.
Increase dietary calcium. - Answers- Initiate I.V. diuretic therapy.
Give oxygen by mask.
A client has been prescribed hydrochlorothiazide to treat heart failure. What adverse
effect should the nurse instruct the client to report to the health care provider?
urinary retention
muscle weakness
confusion
diaphoresis - Answers- muscle weakness
What is a priority nursing assessment in the first 24 hours after admission of the client
with a thrombotic stroke?
cholesterol level
pupil size and pupillary response
bowel sounds
echocardiogram - Answers- pupil size and pupillary response
A visitor to the hospital has a cardiac arrest. When determining to use an automated
external defibrillator (AED), the nurse should consider that AEDs are used in cardiac
arrest in which circumstances?
early defibrillation in cases of atrial fibrillation
cardioversion in cases of atrial fibrillation
pacemaker placement
early defibrillation in cases of ventricular fibrillation - Answers- early defibrillation in
cases of ventricular fibrillation
The nurse is preparing to administer 0.1 mg of digoxin intravenously. Digoxin comes in
a concentration of 0.5 mg/2 ml. How many milliliters should the nurse administer?
Record your answer using one decimal place. - Answers- 0.4 mL
A nurse is evaluating a client who had a myocardial infarction (MI) 7 days earlier. Which
outcome indicates that the client is responding favorably to therapy?
, The client exhibits a heart rate within normal limits.
The client requests information regarding smoking cessation.
The client is able to verbalize the action of all prescribed medications.
The client demonstrates ability to tolerate more activity without chest pain. - Answers-
The client demonstrates ability to tolerate more activity without chest pain.
A client with second-degree atrioventricular heart block is admitted to the coronary care
unit. The nurse closely monitors the client's heart rate and rhythm. When interpreting
the client's electrocardiogram (ECG) strip, the nurse knows that the QRS complex
represents
atrial repolarization.
ventricular repolarization.
atrial depolarization.
ventricular depolarization. - Answers- ventricular repolarization.
A client arrives in the emergency department with an ischemic stroke. What should the
nurse do before the client receives tissue plasminogen activator (t-PA)?
Ask what medications the client is taking.
Complete a history and health assessment.
Identify the time of onset of the stroke.
Determine if the client is scheduled for any surgical procedures. - Answers- Identify the
time of onset of the stroke.
The nurse has completed an assessment on a client with a decreased cardiac output.
Which findings should receive the highest priority?
blood pressure 110/62 mm Hg, atrial fibrillation with heart rate 82, bilateral basilar
crackles
confusion, urine output 15 mL over the last 2 hours, orthopnea
SpO2 92% on 2 L nasal cannula, respirations 20 breaths/min, 1+ edema of lower
extremities
weight gain of 1 kg in 3 days, blood pressure 130/80 mm Hg, mild dyspnea with
exercise - Answers- confusion, urine output 15 mL over the last 2 hours, orthopnea
A nurse is teaching a client about maintaining a healthy heart. The nurse should include
which point in teaching?
Smoke in moderation.
Use alcohol in moderation.
Consume a diet high in saturated fats and low in cholesterol.
Exercise one or two times per week. - Answers- Use alcohol in moderation.
The nurse on the previous night shift documented that the lungs of a client with lung
cancer were CTA (clear to auscultation) in all fields. While doing the shift assessment,
