ATI Adult Medical-Surgical Nursing: Cardiovascular Questions And Answers

ATI Adult Medical-Surgical Nursing: Cardiovascular Questions And Answers /. A nurse is orienting a newly licensed nurse on the care of a client who is to have a line placed for hemodynamic monitoring. Which of the following statements by the newly licensed nurse indicates understanding? A. "Air should be instilled into the monitoring system prior to the procedure." B. "The client should be positioned on the left side during the procedure." C. "The transducer should be level with the second intercostal space after the line is placed." D. "A chest x-ray is needed to verify placement after the procedure." - Answer-A. Purge air from, rather than instill air into, the monitoring system. B. Place the client in the supine or Trendelenburg position. C. For hemodynamic monitoring, place the transducer level with the 4th intercostal space, which is at the base of the right atrium. D. CORRECT: Ensure that a chest x-ray is obtained to confirm proper placement of the lines following placement. /.A nurse is assessing a client who is undergoing hemodynamic monitoring. The client has a CVP of 7 mm Hg and a PAWP of 17 mm Hg. Which of the following findings should the nurse expect? (Select all that apply.) A. Poor skin turgor B. Bilateral crackles in the lungs C. Jugular vein distension D. Dry mucous membranes E. Hepatomegaly - Answer-A. The client's CVP and PAWP are above the expected reference range. Expect the client to have poor skin turgor for a decreased CVP and PAWP. B. CORRECT: Expect the client to have bilateral crackles in the lungs for an increased CVP and PAWP. C. CORRECT: Expect the client to have jugular vein distension for an increased CVP and PAWP. D. Expect the client to have dry mucous membranes for a decreased CVP and PAWP. E. CORRECT: Expect the client to have hepatomegaly for an increased CVP and PAWP. /.A nurse is teaching a client who is scheduled for coronary angiography. Which of the following statements should the nurse include? A. "You should have nothing to eat or drink for 4 hours prior to the procedure." B. "You will be given general anesthesia during the procedure." C. "You should not have this procedure done if you are allergic to eggs." D. "You will need to keep your affected leg straight following the procedure." - Answer-A. Instruct the client to remain NPO for at least 8 hr prior to the procedure to decrease the risk for aspiration while lying flat during the angiography. B. Instruct the client that they are awake and sedated during the procedure and that a local anesthetic is used at the catheter insertion site. C. Assess the client for an allergy to iodine/shellfish due to the use of contrast dye. An allergy to eggs is not a contraindication to angiography. D. CORRECT: Instruct the client of the need to remain on bed rest in the supine position with the affected leg straight for a prescribed amount of time. This positioning decreases the client's risk for bleeding and hematoma formation at the catheter insertion site. /.A nurse at a provider's office is reviewing the laboratory test results for a group of clients. The nurse should identify that which of the following results indicates the client is at risk for heart disease? (Select all that apply.) A. Cholesterol (total) 245 mg/dL B. HDL 90 mg/dL C. LDL 140 mg/dL D. Triglycerides 125 mg/dL E. Troponin I 0.02 ng/mL - Answer-A. CORRECT: A client who has a total cholesterol level greater than 200 mg/dL is at increased risk for heart disease. B. An HDL level greater than 55 mg/dL for a female client or greater than 45 mg/dL for a male client decreases the client's risk for heart disease. C. CORRECT: A client who has an LDL level greater than 130 mg/dL is at increased risk for heart disease. D. A triglyceride level between 35 and 135 mg/dL for a female client or 40 and 160 mg/dL for a male client is within the expected reference range and does not indicate an increased risk for heart disease. E. Troponin I level is monitored to detect cardiac injury due to an MI rather than to identify a client's risk for heart disease. A Troponin I level less than 0.03 ng/ mL is within the expected reference range. /.A nurse is planning care for a client who has a PICC line in the right arm. Which of the following interventions should the nurse include? (Select all that apply.) A. Use a 10 mL syringe to flush the PICC line. B. Apply gentle force if resistance is met during injection. C. Cleanse ports with alcohol for 15 seconds prior to use. D. Maintain a transparent dressing over the insertion site. E. Flush with 10 mL heparin before and after medication administration. - Answer-A. CORRECT: Use a 10 mL syringe to flush the PICC line to avoid excess pressure that could cause catheter fracture/rupture. B. Avoid the application of force if resistance is met during injection. C. CORRECT: Cleanse insertion ports with alcohol for 15 seconds and allow it to air dry prior to use. This action decreases the risk for bacterial contamination. D. CORRECT: Maintain a transparent dressing over the insertion site to decrease the risk for infection and allow for visualization. Plan to change the dressing at least every 7 days and when wet, loose, or soiled. E. Flush the PICC line with 10 mL 0.9% sodium chloride before, between, and after medications. A flush of 5 mL heparin (10 units/mL) is recommended when the PICC is not actively in use. /.A nurse on a cardiac unit is caring for a group of clients. The nurse should recognize which of the following clients as being at risk for the development of a dysrhythmia? (Select all that apply.) A. A client who has metabolic alkalosis B. A client who has a blood potassium level of 4.3 mEq/L C. A client who has an SaO2 of 96% D. A client who has COPD E. A client who underwent stent placement in a coronary artery - Answer-A. CORRECT: A client who has an acid-base imbalance such as metabolic alkalosis is at risk for a dysrhythmia. B. A blood potassium of 4.3 mEq/L is within the expected reference range and does not increase the risk of a dysrhythmia. C. SaO2 of 96% is within the expected reference range and does not increase the risk of a dysrhythmia. D. CORRECT: A client who has lung disease, such as COPD, is at risk for a dysrhythmia. E. CORRECT: A client who has cardiac disease and underwent a stent placement is at risk for a dysrhythmia. /.A nurse is reviewing the medical record of a client who is to undergo a scheduled electrical cardioversion. For which of the following findings should the nurse notify the provider? (Review the data below for additional client information.) MAR: Ferrous sulfate 200 mg PO 0800 and 2000 Diazepam 2 mg PO 0800 and 2000 Isosorbide 2.5 mg PO 4 times a day AC and HS VITAL SIGNS: 0800 T 99° F (37.2° C) Blood pressure 142/86 mm Hg Heart rate 88/min and irregular Respirations 20/min HISTORY AND PHYSICAL: Bariatric surgery 10 years ago Dyspnea with exertion for 3 years Atrial fibrillation began 3 years ago Client reports taking the following medications for the past 6 weeks: iron supplement, multivitamin, antilipemic, and nitroglycerin. A. Respiratory history B. Vital signs C. Medication history D. Medications to be administered - Answer-A. Client who have a dysrhythmia often have a history of lung disease, which can make them candidates for cardioversion. B. Client who have a dysrhythmia might have an irregular pulse, which can make them candidates for cardioversion. C. CORRECT: Because the client has a history of atrial fibrillation, it is recommended the client take anticoagulant therapy for 4 to 6 weeks prior to cardioversion to prevent clot dislodgement. The nurse should contact the provider regarding this safety concern. D. Client who have a dysrhythmia often have a history of cardiac disease and angina, which can make them candidates for cardioversion.