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NR 324 Midterm Exam Study – ATI Test 4 Practice Assessment

1. A nurse is planning care for a client who has a suspected myocardial infarction. Which of the following should the nurse administer first?
2. While reading a client’s ECG tracing, the nurse should understand that the P wave reflects which of the following cardiac electrical activities?
3. A client comes to the emergency department via ambulance to report severe radiating chest pain and SOB. The client appears restless, frightened, and slightly cyanotic. The provider prescribes oxygen by nasal cannula at 4 L/min stat, cardiac enzyme levels, IV fluids, and a 12-lead ECG. Which of the following actions should the nurse assisting with this client client’s care first?
4. A nurse is preparing a client for an echocardiogram the following day. Which of the following instruction should the nurse include about this test?
5. A nurse is reviewing the laboratory values on a client who has HTN. Blood tests are drawn and reveal the following results. Which of the following results should the nurse identify as critical?
6. The nurse is completing a medication review of a client who has elevated cholesterol levels and takes an anticoagulant. Which of the following should the nurse report to the provider?.
7. A nurse is caring for a client who enters the emergency department complaining of severe chest pain. Which of the following interventions should the nurse implement to determine if the client is experiencing a myocardial infarction?
8. While auscultating a client’s heart sounds, the nurse hears turbulence between the S1 and S2 heart sounds. The nurse should document this finding as which of the following?
9. A nurse is reviewing the initial laboratory values for partial thromboplastin time, and prothrombin time, and thrombin time on a client who has an acute episode of disseminated intravascular coagulation (DIC). The nurse should expect the laboratory values to be
10. A nurse is reinforcing discharge teaching for a client who has received an implantable cardioverter/defribillator (ICD). Which of the following information should the nurse include?
11. A nurse is reinforcing teaching for a client who is postoperative following an insertion of a permanent pacemaker. Which of the following instructions should the nurse include? (Select all that apply.)
12. A nurse is caring for a client with a ventricular pacemaker who is on ECG monitoring. The nurse understands that the pacemaker is functioning properly when which of the following appears on the monitor strip?
13. A nurse is about to administer warfarin (Coumadin) to a client who has atrial fibrillation. When the client asks what this medication will do, which of the following is an appropriate nursing response?
14. A client is telling the nurse in the clinic that he gets a headache after he takes sublingual nitroglycerin (Nitrostat). Which of the following should the nurse remind the client to do?
15. A nurse is reinforcing teaching for a client who has a new prescription for warfarin sodium (Coumadin). Which of the following should the nurse include?
16. A nurse is caring for a client who reports an area of redness, warmth, tenderness and pain in the right calf. The nurse anticipates which of the following orders when notifying the provider of this finding?
17. A client complains of SOB and chest pain the first day following multiple long bone fractures. THe nurse would consider which of the following client complications when assessing the client?
18. A nurse is collecting data from an infant that has a coarctation of the aorta. Which of the following is a clinical manifestation?
19. When checking a client’s capillary refill, the nurse finds that the color returns to usual in 10 seconds. The nurse understands that this finding indicates which of the following?
20. Whenever a nurse is caring for clients who are receiving heparin, which of the following medications should the nruse have on hand in the event of an overdose?
21. A nurse is caring for a client who takes nitroglycerin (Nitrostat) tablet at the onset of anginal pain. AFter taking the pill, the client states that his chest pain is relieved, but then he develops a sudden pounding headache. The nurse understands that the headache is
22. A nurse is collecting data from a client who has HTN and has a prescription for propranolol (Inderal). A history of which of the following conditions should be reported to the provider?
23. A nurse is caring for a client who is admitted with a DVT of the left leg. Which of the following interventions should the nurse include in the client’s plan of care?
24. A nurse is administering monitoring medications and realizes the nifedipine (Procardia) was administered to the wrong client. Which of the following is the priority nursing action?
25. A nurse is caring for a client who is admitted to the hospital with CHF who has been taking digoxin (Lanoxin) 0.25 mg daily. The client refuses breakfast and reports nausea. Which of the following actions should the nurse perform first?
26. A nurse is reinforcing teaching regarding diet to a client after a myocardial infarction. The nurse evaluates the reinforcement as effective if the client selects which of the following options?
27. A nurse is contributing to the care plan for a client who has developed DVT. Which of the following interventions should the nurse include?
28. A nurse is helping with the admission of a client from the emergency department. The client is prescribed clopidogrel bisulfate (Plavix). Which of the following precautions should the nurse anticipate?
29. A nurse is caring for an infant who has a congenital heart defect. Which of the following is associated with increased pulmonary blood flow?
30. A nurse on a telemetry unit is caring for a client who has premature ventricular contractions (PVCs). While sitting in a chair, the client reports feeling lightheaded. If the client is having PVCs, which of the following findings should the nurse expect when auscultating the client’s apical pulse?
31. In preparation for the discharge of a client with peripheral arterial disease PAD, the nurse should reinforce which of the following instructions?
32. A nurse is talking with a client who is about to start using transdermal nitroglycerin (Nitro-Dur) to treat angina pectoris. Which of the following is an appropriate instruction for this medication therapy?
33. A nurse is caring for a client on a medical surgical unit with a DVT who has been on IV heparin for 5 days. The provider prescribes oral warfarin (Coumadin) without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following is an appropriate response by the nurse?
34. A nurse is caring for a client who just had a cardiac catheterization. The post procedure nursing care plan for this client should include which of the following nursing interventions?
35. A nurse is caring for a client who enters the emergency department complaining of chest pressure and severe epigastric distress. The physician prescribes monitoring of creatine kinase (CK) isoenzymes. The nurse should paln to monitor these levels over which of the following lengths of time?
36. A client who has angina pectoris is experiencing chest pain and has taken three nitroglycerin tablets sublingually. The client reports relief from the chest pain but now repots a headache. The nurse should explain to the clients that this symptom.
37. A nurse is reinforcing teaching with a young adult female client who has been prescribed lisinopril (Zestril). Which of the following instructions should the nurse plan to include? (Select all that apply.)
38. A nurse is reinforcing teaching with a client who was recently diagnosed with Raynaud’s phenomenon how to prevent the onset of manifestations. Which of the following statements by the client should indicate to the nurse a need for FURTHER teaching?
39. A nurse on a medical unit is caring for a client who has angina pectoris and reports chest pain with a severity of 6 on a 0 to 10 scale. The nurse administers sublingual nitroglycerin (Nitrostat). After 5 min, the client states that his chest pain is now a 2. Which of the actions should the nurse take?
40. Whenever a nurse is caring for clients who are receiving warfarin (Coumadin), which of the following medications should the nurse have on hand in the even of an overdose?
41. A nurse is caring for a client with right-sided heart failure. The nurse knows that a primary manifestation is
42. A nurse is reinforcing discharge teaching for a client who will be taking warfarin (Coumadin) at home. Which of the following statements indicates that the client understands the effects of this medication
43. A nurse is caring for a client who is to receive digoxin (Lanoxin), verapamil (Calan), and baby aspirin (ASA) at 0900. Morning vital signs reported by the AP to the nurse include, temperature 37ºC (98.6ºF), heart rate 98/min, respiratory rate 24/min, BP 98/58 mm Hg. Which of the following actions should the nurse take?
44. A nurse is caring for a client following a cardiac catheterization. Which of the following is an appropriate nursing action?
45. A client with valvular heart disease is at risk for developing left-sided heart failure. The nurse knows to monitor which of the following parameters to determine if the client has developed this disorder?
46. A nurse is collecting data from an older adult client who is receiving digoxin (Lanoxin): For HTN and Heart Failure. To evaluate the client for digoxin toxicity, the nurse should check for which of the following manifestations?
47. A client tells the nurse that he is concerned because his doctor told him he has a heart murmur. The nurse should explain to the client that a murmur
48. A client who is postoperative following surgical placement of an artificial heart valve is to be regulated on warfarin (Coumadin) prior to discharge. The nurse should use the results of which of the following diagnostic tests to monitor the effect of this therapy?
49. A nurse in a provider’s office is collecting data from a client who reports shortness of breath in the supine position and fatigue. The nurse determines that the client also has a jugular vein distention and a third heart sound (S3). Which of the following disorders should the nurse suspect?
50. A nurse is giving a presentation about caring for clients who are receiving diuretic therapy to treat heart failure. THe nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?
51. A nurse is reinforcing teaching for a client who has angina pectoris about starting therapy with nitroglycerin (Nitrostat) sublingual tablets. The nurse verifies the client’s understanding when the client states
52. A nurse is reinforcing teaching for an older adult client who has just undergone insertion of a permanent pacemaker. The nurse should emphasize that a sign of pacemaker malfunction the client should report to the provider is
53. A nurse is caring for a client who has left-sided heart failure. Which of the following findings should the nurse expect?
54. A nurse is reviewing the morning laboratory results of electrolytes of four cardiac clients who are receiving digoxin (Lanoxin). Which of the clients should the nurse identify as being at risk for developing digoxin toxicity?
55. A nurse is caring for a client who takes linsinopril (Zestril) should monitor for which of the following medication therapy? nr 324 midterm exam
56. A nurse is reading a client’s ECG tracing. There are nine QRS complexes in a 6-second interval. What is the client’s heart rate?
57. A nurse is collecting data from a client who has an acute myocardial infarction (MI). Which of the following clinical manifestations should the nurse expect to find? (Select all that apply.)
58. A nurse is talking with a client who has hypertension and stable angina pectoris and is about to start taking verapamil (Calan). The nurse should instruct the client to avoid taking this medication with
59. A nurse is talking with a client who is about to start using sublingual nitroglycerin (Nitrostat) to treat angina pectoris. The client asks the nurse how long he has to take the medication before his condition is cured. The nurse should first
60. A nurse is reading a client’s ECG tracing. Which component of the ECG should the nurse examine to determine the time it takes for ventricular depolarization and repolarization?
61. To evaluate the client following a cardiac catheterization with a left antecubital insertion site, the nurse should palpate the
62. A nurse is caring for a client with cirrhosis who has a prothrombin time of 30 seconds. Which of the following medications does the nurse anticipate the provider will prescribe?
63. A client experiencing erectile dysfunction asks the nurse about the possibility of a sildenafil (Viagra) prescription. The nurse informs the client that sildenafil is contraindicated due to the fact that the client also takes
64. A nurse is making a home visit to a client who receives diuretics daily for heart failure. Which of the following signs would the client manifest with hypokalemia?
65. A client has a new prescription for transdermal (Nitro-Dur) to treat angina pectoris. When talking with the patient about using this drug, the nurse should include which of the following instructions? (Select all that apply)
66. A nurse is assessing a client who has right ventricular failure. Which of the following findings should the nurse expect?
67. A nurse is caring for a child who has tetralogy of Fallot and notes that the child is easily fatigued. nr 324 midterm exam The nurse understands that the etiology (the cause) of the fatigue is which of the following?
68. A nurse on a medical-surgical unit is caring for a client who reports pain in the jaw, back and shoulder, SOB and nausea. Which of the following actions should the nurse perform first?
69. A nurse is reinforcing discharge teaching to a client who was prescribed verapamil (Calan) for angina. Which of the following information should the nurse include?
70. A nurse is caring for a client who is postoperative following vascular surgery. Which of the following signs should indicate to the nurse that the client has developed a thrombus?
71. A nurse is giving a presentation to a community group about preventing atherosclerosis. Which of the following should the nurse include as a modifiable risk factor for this disorder? (Select all that apply.)
72. A nurse is collecting data from an infant. Which of the following is a clinical manifestation of a large patent ductus arteriosus? nr 324 midterm exam
73. A nurse is obtaining vital signs on a client who is 3 days postoperative following a coronary artery bypass surgery (CABG), and notes that the client has in irregular radial pulse of 92/min. Which of the following actions should the nurse take first?
74. A nurse is talking with a client who is about to start taking captopril (Capoten) to treat hypertension. Which of the following instructions should the nurse include to help the client manage this medication’s adverse effects?
75. A nurse is admitting a client who has acute heart failure following an MI and is reviewing the provider’s orders. Which of the following prescriptions by the provider requires clarification?
76. Following admission, a client with a vascular occlusion of the right lower extremity calls the nurse and reports difficulty sleeping because of cold feet. Which of the following nursing actions should the nurse take to promote the client’s comfort?
77. A nurse is reinforcing teaching for a client who has a new diagnosis of angina pectoris. The nurse should remind the client of which of the following information about anginal pain?
78. A nurse is reinforcing teaching for a client who is taking warfarin (Coumadin) about monitoring its therapeutic effect. The nurse should explain that the provider will use international normalized ratio (INR) because
79. A nurse in a clinic is caring for a client who has recently begun taking warfarin (Coumadin) and the nurse is reviewing potential drug and food interaction risks. The client should be instructed to avoid which of the following?
80. A nurse is reinforcing teaching for a client discharged from the hospital after treatment for poor circulation in the lower extremities. Which of the following statements by the client indicates a need for further teaching?
81. A client who is taking medications to treat hypertension has a potassium level of 6.8 mEq/L. Besides notifying the provider, which of the following actions should the nurse take?
82. A nurse is reinforcing teaching with a client who has angina pectoris about starting therapy with nitroglycerin (Nitrostat). The nurse should remind to take the medication
83. When collecting data from a client who has atrial fibrillation, the nurse would expect his pulse to be nr 324 midterm exam
84. The nurse is caring for a client receiving nifedipine (Procardia). When the nurse checks the client’s BP prior to administering the medication, it is 98/58. Which of the following actions should the nurse take first?
85. The nurse collecting data from a client who has left-sided heart failure. Which of the following findings should the nurse expect?
86. A nurse is caring for a child with Kawasaki disease. Which of the following is the primary system involved with this diagnosis?
87. A nurse is talking with a client who is about to start taking nitroglycerin oral, sustained-released capsules (Nitro-Time). Which of the following instructions should the nurse include?
88. A nurse on a medical unit is caring for a client who has infective endocarditis. The nurse should observe this client for manifestations of a common complication of this disorder by monitoring for
89. A nurse is caring for a client who has a blood pressure of 156/98. Which of the following findings would the client manifest with Stage 1 hypertension? nr 324 midterm exam
90. A nurse is caring for a client who has thrombophlebitis and has been placed on IV heparin. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses by the nurse is appropriate?
91. A nurse is preparing to administer digoxin (Lanoxin) to a client who has heart failure. Which of the following actions is appropriate?
92. A nurse is caring for a client with infective endocarditis. Which of the following is a priority manifestation the nurse should monitor for?
93. A nurse is preparing to administer heparin intravenously to a client. Which of the following is an appropriate nursing action? nr 324 midterm exam
94. A nurse is reinforcing teaching to a group of premenopausal women about activities to reduce the risk of developing coronary artery disease. Which of the following statements by a client requires clarification?
95. A nurse is reinforcing discharge instructions for a client who developed DVT postoperatively and receives anticoagulant therapy. Which of the following instructions should the nurse include?
96. A nurse is caring for a client who is prescribed aspirin (Ecotrin) 325 mg and has a history of a previous MI. The nurse instructs the client that the aspirin is prescribed once daily due to its action as an
97. A nurse is caring for a client who receives digoxin (Lanoxin). Before administering this medicaiton, which of the following actions should the nurse take? nr 324 midterm exam
98. A nurse is assisting with the care of an older adult client who has had a cardiac catheterization. Which nursing interventions should the nurse contribute to the client’s plan of care for the next 8 hr? (Select all that apply)