NURS 4120 CARDIOVASCULAR LABS TESTS QUESTIONS AND ANSWERS

CARDIOVASCULAR LABS A nurse is working in the emergency department (ED) when a client arrives complaining of substernal and left arm discomfort that has been going on for about 3 hours. All of these baseline lab tests are drawn. Which of these lab values will be most useful in determining whether the nurse should anticipate implementing the acute coronary syndrome standards orders? - Troponin STRESS TEST In developing a standard teaching plan for the outpatient unit where stress testing is performed, the nurse should include information that the -Test may cause the client to experience chest pain. A client who is admitted for chest pain asks the nurse the reason for having an exercise stress test. The nurse should explain to a client that an exercise ECG is useful as one means of detecting - Coronary artery disease. CARDIAC CATHETERIZATION When preparing a patient for a cardiac catheterization, the patient states that she has allergies to seafood. Which of the following medications may give to her prior to the procedure? A. Furosemide (Lasix) B. Lorazepam (Ativan) C. Methylprednisolone (Solu-Medrol) D. Phenytoin (Dilantin) A nurse assessing a client who underwent cardiac catheterization finds the client lying flat on the bed. His temperature is 99.8° F (37.7° C). His blood pressure is 104/68 mm Hg. His pulse rate is 76 beats/minute. She detects weak pulses in the leg distal to the puncture site. Skin on the leg is cool to the touch. The puncture site is dry, but swollen. What is the most appropriate action for the nurse to take? A. Contact the physician and report her findings. B. Slow the I.V. fluid to prevent any more swelling at the puncture site. C. Encourage the client to perform isometric leg exercise to improve circulation in his legs. D. Document her findings and recheck the client in 1 hour. A nurse is performing an assessment on a client who had a cardiac catheterization three hours ago. Which of the following findings would require immediate intervention? - Catheterized extremity cold with decreased peripheral pulses. A nurse is caring for a client scheduled for a cardiac catheterization. Which of the following information would be of highest priority for the nurse to obtain before the procedure? - Allergy to Iodine or shellfish A client is scheduled for a cardiac catheterization. Which of these actions should the nurse implement? SELECT ALL THAT APPLY - Check for iodine sensitivity - Verify that written consent has been issued - Withhold food and oral fluids (8-12 Hrs) A nurse is caring for a client who has a history of coronary artery disease. That client asks the nurse how can the HCP find out the extent of the disease process. The nurse explains that the best diagnostic test to determine the location and extent of coronary artery disease would be a/an - Cardiac catheterization The RN is teamed with a LPN in caring for a group of clients on the cardiac unit. Which action by the LPN indicated the need by the RN to intervene immediately? The LPN - Assists a client to the bathroom 30 minutes after the client has returned from a cardiac catheterization. (BED REST 2-6 HOURS) A nurse is caring for a client following a percutaneous transluminal coronary angioplasty. Which of these interventions should the nurse include in the plan of care? - Encourage oral fluids for the client. A client has coronary angiography with the entrance site in the left femoral artery. Two hours after the procedure, the nurse in unable to palpate the left pedal pulse. What is the nurse’s most appropriate action at the time? - Attempt to locate pulse using a Doppler. DYSRHYTHMIAS A client’s telemetry reading shows a P-wave before each QRS complex, a regular PR interval, and the rate is 78. Which of the following actions should the nurse perform next? - Document this as normal sinus rhythm A nurse is caring for a client admitted to the telemetry unit with dysrhythmias and left ventricular failure. Which of the following is a priority assessment for the nurse? - Ausculatate breath sounds A client who has A-Fib is ambulating in the hallway on the coronary step down unit and suddenly tells the nurse, “I feel really dizzy.” After assisting the client to sit down, which of the following interventions should become a priority for the nurse? SELECT ALL THAT APPLY -Check the client’s apical heart rate. -Take the client’s blood pressure. In evaluating a client’s ECG tracing, the nurse notes three small squares between the upstroke and downstroke of the QRS complex. The nurse should record the QRS complex as - 0.12 seconds A nurse assessing an ECG rhythm strip. The p waves and QRS complexes are regular. The PR interval is 0.16 seconds and QRS complexes measure 0.06 second. The overall heart rate 64 BPM. The nurse assesses the cardiac rhythm as - Normal Sinus Rhythm A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.20 seconds, and the QRS complexes measure 0.08 seconds. The overall heart rate is 58 beats per minute. The nurse interprets the cardiac rhythm as - Sinus bradycardia During an assessment of a client, the nurse notes a heart rate of 48 beats per minute. The nurse further evaluates the client for signs and symptoms related to: - Light-headedness - Syncope - Fatigue A client with an MI has undergone ECG. What changes in the ECG tracing should the nurse expect to see in this client? - ST segment elevation, T wave inversion, abnormal Q wave After measuring 3.5 small boxes between the onset of the Q wave and the completion of the S wave, the nurse would record the QRS duration as - 0.14 second A client is wearing a continuous cardiac monitor (telemetry), which begins to sound the alarm. A nurse notes the absence of electrocardiogram complexes on the screen. The first action by the nurse would be to - Check the client status and lead placement In evaluating a client’s telemetry reading, the nurse should understand that: - “A” represents atrial depolarization, “B” represents ventricular depolarization, “C” represents ventricular repolarization. The nurse assesses the complex marked as “A” on the following 6 second strip as a -PVC (premature ventricular contraction). - Atrial Fibrillation A nurse is caring for a newly admitted client on the telemetry unit and notes the following on the monitor. The nurse correctly documents this rhythm as - Sinus tachycardia CHF When assessing a client who is diagnosed with left ventricular heart failure, the nurse interprets which of the following statements the correlate with the diagnosis. - “I cannot climb the stairs in my house without becoming SOB.” A nurse should determine that teaching regarding a 2 gram sodium diet for a client who has a history of cardiac disease, is effective if the client states, - “I can eat most foods as long as I do not add salt when cooking or at the table.” When taking a history from a client, which of these questions should the nurse ask when assessing a client for paroxysmal nocturnal dyspnea? - “Are you waking up SOB?” The nurse is assessing an older client admitted with SOB 3+ bilateral pitting edema, and crackles at bases on auscultation. Which of the following should the nurse assess first? - Blood pressure Which of the following statements is an indication that a client needs additional teaching regarding a treatment regimen for heart failure? - “I should only weigh myself once a month and watch for fluid retention.” A nurse is assessing a client with left sided heart failure and finds bilateral 2+pitting edema of the ankles. Which of the following signs or symptoms should the nurse also anticipate findings? - Jugular venous distention. A charge nurse in a long-term care facility that has RN, LPN/LVN and nursing assistant staff members has developed a plan for ongoing assessment of all residents with a diagnosis of heart failure. Which of these activities included in the plan is most appropriate to delegate to nursing assistant staff? - Weigh all residents with HF each morning. A nurse is caring for a client with an admitting diagnosis of HF. The medical record contains a notation that the client is orthopneic. The most appropriate nursing intervention to assist with this client’s problem would be to - Provide several additional pillows for sleeping. A nurse is monitoring a client with congestive heart failure. Which of the following would require further evaluation by the nurse? - Weight gain of 1.5 pounds in 24 hours. A client who experiences an MI develops left ventricular heart failure. For which sign of poor organ perfusion should the nurse monitor this client? - Urine output of 50 mL in two hours A nurse is caring for a client with congestive heart failure. A priority assessment at this time would be to - Obtain daily weights.