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Cardiac-Vascular Certification Flashcards
In an assessment for intermittent claudication, the cardiac-vascular nurse assesses the leg pain and cramping with exertion, then asks the patient: A. "Does the shortness of breath accompany the leg pain?" B. "Does this same type of pain occur without activity?" C. "Is the leg pain relieved by rest?" D. "Is the leg pain relieved with elevation?" - C. "Is the leg pain relieved by rest?" The cardiac-vascular nurse reviews risk factor reduction with a patient who is newly diagnosed with myocardial infarction. The patient states, "I don't know why you're making such a big deal about this stuff. I feel fine, and the doctor said that my heart attack was small." The nurse's most effective action is to: A. Assess the patient's perception of the event with open-ended questions B. Present research to support the need for risk factor reduction C. Reinforce patient education D. Review the laboratory values with the patient - A. Assess the patient's perception of the event with open-ended questions The cardiac-vascular nurse encourages a patient with hypertension to adopt a low-sodium diet. The American Heart Association recommends limiting this patient's sodium: A. 3,000 mg per day B. 1,500 mg per day C. 1,700 mg per day D. 2,400 mg per day - D. 2,400 mg per day A patient has been receiving heparin IV for the last three days. The patient's most current platelet count is 65,00 x 10^3/uL; the platelet count on admission was 350,000 x 1-^3/uL. The cardiac-vascular nurse contacts the physician to: A. Report that the medication level is subtherapeutic B. Report that the patient is exhibiting signs of an adverse reaction C. Request an increase in the medication infusion rate D. Request an order for platelet transfusion - B. Report that the patient is exhibiting signs of an adverse reaction A patient recently had a cardiac catheterization via right-radial approach. The patient has a compression device in place. The patient complains of numbness and pain in the right hand. The cardiac-vascular nurse notes a diminished pulse, with a cool and cyanotic hand. The nurse: A. Calls the physician
B. Performs an Allen's test C. Reduces the pressure on the puncture site D. Uses the Doppler to assess the pulse signals - C. Reduces the pressure on the puncture site A patient is admitted to the hospital for a carotid angiogram with stents placement. The patient's spouse states, "I don't know want my spouse to find out there is a risk of stroke connected with this procedure because he or she won't sign the consent form." The cardiac-vascular nurse's most appropriate action is to: A. Assess the patient's level of understanding of risks, benefits, and alternatives B. Assure the patient's spouse that the risk of stroke is minimal C. Offer the patient emotional support and reinforce the benefits of the procedure D. Perform a neurologic assessment to establish a baseline - A. Assess the patient's level of understanding of risks, benefits, and alternatives A patient who is recovering from a myocardial infarction may benefit from medication because this technique: A. Decreases sympathetic nervous system activity B. Decrease vasodilation C. Increases sympathetic nervous system activity D. Increases the release of catecholamines - A. Decreases sympathetic nervous system activity While the cardiac-vascular nurse preceptor is orientating a graduate nurse on the telemetry unit, a patient experiences cardiac arrest. Which action by the preceptor, during the emergency cardiac procedure, facilitates the graduate's nurse's competence and professional development? A. Asking the graduate nurse to review the policy and procedure for cardiac arrest A. Assigning the graduate nurse to comfort the family during the arrest C. Directing the graduate nurse to attempt IV assess D. Involving the graduate nurse in the resuscitation by assigning a basic task - D. Involving the graduate nurse in the resuscitation by assigning a basic task A patient comes to the emergency department with reports of a swollen and painful leg but denies sustaining any injury. Physical examination reveals a tense calf muscle, decreased sensation to the foot and leg, and absent pedal pulses. The cardiac-vascular nurse asks the patient when the symptoms began because: A. A compartment syndrome develops days after an arterial occlusion B. An arterial thrombus is sudden and emergency, and an embolism develops gradually C. Irreversible anoxic injury to muscles and nerves can occur in a few as four hours D. Metabolic alkalosis from muscle swelling in cardiotoxic - C. Irreversible anoxic injury to muscles and nerves can occur in a few as four hours An early predominant symptom of left ventricular failure is: A. Dyspnea
The nurse is performing a risk assessment for cardiovascular disease in a community setting. Which of the following factors would help the nurse identify the clients most at risk for experiencing a cardiac event? A. Use of tobacco in any form B. Exposure to environmental toxins C. Family history of cardiac disease D. Hypertension - A. Use of tobacco in any form The most common cause of death for patients with heart failure is: A. Sinus tachycardia B. Complete heart block C. Ventricular fibrillation D. Atrial fibrillation - C. Ventricular fibrillation You are ready to provide discharge teaching to Mr. Sams about his medications and hypertension. You know that one of the important determinants of effectiveness of patient family education is: A. Stress and his hospitalization B. Readiness to learn C. Anxious to go home D. Self-esteem - B. Readiness to learn The optimal outcome of the use of left ventricular assist devices (LVADs) for any patient with heart failure: A. Improved quality of life and increased life span B. Eventual non-assisted improvement in left ventricular dysfunction C. Improved respiratory function until death occurs D. Remodeling the left ventricles for improved cardiac output - A. Improved quality of life and increased life span The purpose of beginning cardiac rehabilitation immediately after a cardiac event is to counteract the effects of inactivity. Therefore, the optimal time to begin ambulating a stable, post cardiac surgery patient is: A. 3rd-5th postoperative day B. 1st-2nd postoperative day C. Immediately following extubation D. 6th-7th postoperative day - B. 1st-2nd postoperative day Which of the following lipid levels is raised with lipid-lowering therapy? A. Lipoprotein (a)
B. Triglycerides C. High density lipoprotein cholesterol D. Low density lipoprotein cholesterol - C. High density lipoprotein cholesterol The most important tool for assessing a patient who may have coronary artery disease is obtaining: A. An exercise stress test B. A clear, concise history C. A 12-lead ECG D. An echocardiogram - B. A clear, concise history The antiarrhythmic drug amiodarone is prescribed orally to a patient with recurrent atrial fibrillation. Major side effects of this drug include: A. Acute kidney injury and hyperkalemia B. Pulmonary fibrosis and corneal deposit C. Esophageal erosion and bleeding ulcers D. Excessive diuresis and dehydration - B. Pulmonary fibrosis and corneal deposit A nursing diagnosis/potential patient problem that would apply to the patient undergoing cardiac surgery would be: A. Potential altered family dynamics related to the patient's plan to return to work B. Potential for noncompliance related to risk factor modification C. Potential altered nutrition more than body requirements related to increased appetite D. Potential fear or anxiety related to the possibility of death during surgery - D. Potential fear or anxiety related to the possibility of death during surgery When assessing the extremities of a patient who is suspected of having peripheral arterial disease, is it likely the patient will have: A. Normal pulses and skin color B. Cramping leg pain C. Mild to severe edema D. Ulcerations at the point of injury - B. Cramping leg pain Right-sided heart failure is characterized by: A. Elevated pulmonary artery pressure B. Reduced hepatic perfusion pressure C. Increased systemic venous pressure D. Decreased systemic arterial pressure - C. Increased systemic venous pressure Echocardiography may be useful following AMI for:
B. Goals are mutually set by patient and the healthcare provider and support is provided as necessary A beta-blocking agent should be administered in the setting of: A. Complete heart block B. Atrial flutter C. Atrial fibrillation D. Sinus tachycardia - A. Complete heart block A patient who underwent a percutaneous, transluminal coronary angioplasty four weeks ago has a subsequent ejection fraction of 30%. The patient returns for a follow-up visit. Examination reveals lungs that are clear to auscultation and slight pedal edema. The patient's medications are digoxin (Lanoxin), furosemide (Lasix), enalapril maleate (Vasotec), and aspirin. The patient reports a 5-lb (2.27kg) weight gain over the past two days. The cardiac vascular nurse's initial action is to: A. Document the weight and reassess the patient at the next session B. Inquire about the patient's medication compliance C. Notify the patient's physician D. Review the patient's most recent nuclear scan - B. Inquire about the patient's medication compliance A 55-year-old patient who is diagnosed with an evolving myocardial infarction (MI) insists on going home. The cardiac-vascular nurse encourages the patient to be admitted because the greatest risk within the first 24 hours of sustaining an MI is: A. Heart failure B. Pulmonary embolism C. Ventricular aneurysm D. Ventricular fibrillation - D. Ventricular fibrillation As the cardiac-vascular nurse prepares to administer an experimental cardiac drug to a patient who is participating in a research study, the patient states that he or she no longer wants the medication. The nurse advises the patient that: A. He or she has the right to refuse the medication and withdraw from the study B. Participation in the study is critical to improving the quality of the patient outcomes C. The medication dose has been scheduled for administration D. The primary investigator will speak with the patient about his or her decision - A. He or she has the right to refuse the medication and withdraw from the study When reviewing a patient's four week diet history, the cardiac-vascular nurse identifies a pattern of high calorie intake on Monday, Wednesday, and Friday nights. The patient states that the patient's spouse recently started taking a nigh class on those evenings at a local university. The patient's diet history indicates: A. A disabling family coping behavior
B. A lack of dietary instructions C. A need for cooking classes D. An individual coping behavior - D. An individual coping behavior A contraindication to physical activity for a patient with a history of cardiac disease is: A. Diabetes B. Depression C. Unstable angina D. Chronic obstructive pulmonary disease - C. Unstable angina When assessing overall risk for cardiovascular disease, in addition to smoking, hypertension, body mass index, and diet, a contributing factor of inflammation can be measured by performing a: A. Mini mental exam B. C-reactive protein blood level C. High density lipoprotein blood level D. Graded exercise stress test - B. C-reactive protein blood level A patient reports abdominal pain, nausea, and occasional numbness in his extremities. Which of the following assessments made by the nurse will be cause of immediate contract with the healthcare provider? A. Hypoactive bowel sounds in all four quadrants B. Peripheral pulses +2 bilaterally C. Pulsatile abdominal mass D. Small inguinal hernia on left side - C. Pulsatile abdominal mass When assessing a patient with heart failure, the nurse assesses the patient's understanding of which of the following medications? A. Prophylactic antibiotics B. Angiotensin-converting enzyme (ACE) inhibitors C. Calcium channel blockers D. Nonsteroidal anti-inflammatories - B. Angiotensin-converting enzyme (ACE) inhibitors An adverse reaction to heparin administration is heparin induced thrombocytopenia (HIT). The major characteristic associated with the onset of HIT is: A. Gastrointestinal distress B. Abrupt drop in platelet count to less than 50% of baseline C. Thrombophlebitis D. Elevated activated partial thromboplastin time (aPTT) - B. Abrupt drop in platelet count to less than 50% of baseline
A patient with cardiogenic shock receives a nursing diagnosis of decreased cardiac output. With the appropriate interventions, the anticipated outcome is for the patient to achieve: A. Baseline activity level B. Baseline cardiac function C. Decrease afterload D. Reduce Anxiety - B. Baseline cardiac function Education of a patient with a lower-extremity venous ulcer would include instructions to: A. Place a pillows under the knees when lying down B. Wear constricting knee high hose C. Wash the legs and feet daily and dry well D. Shave the legs with a razor - C. Wash the legs and feet daily and dry well As often underestimated goal for cardiac rehabilitation is to address which of the following: A. Improve functional capacity B. Improve the patient's psychological well-being C. Increase the patient's sick leave from work D. Develop a regular exercise program - B. Improve the patient's psychological well-being A patient who has undergone a percutaneous coronary intervention is referred to cardiac rehabilitation. Cardiac rehabilitation focuses mainly on which of the following goals? A. Psychological adaption to role change as a result of coronary disease B. Secondary prevention of cardiac events and quality of life C. Reduction in dysrhythmias and the resulting changes in activity tolerance D. Primary prevention of cardiovascular disease by means of exercise and medication management - B. Secondary prevention of cardiac events and quality of life The goal of heparin therapy is the setting of AMI is to: A. Prevent extension of the thrombus in the coronary artery B. Inhibit platelet activation C. Avoid monitoring coagulation levels D. Raise the threshold for development of ventricular fibrillation - A. Prevent extension of the thrombus in the coronary artery A patient with a history of chronic venous obstruction often complains of: A. Thin, shiny skin B. Hair loss of the affected extremity C. Diminished sensory function D. Swelling of the lower legs - D. Swelling of the lower legs
A concern for patients with bacterial endocarditis is: A. Development of pulmonic stenosis B. Emergency surgical intervention C. Embolization of the bacterial vegetation to the periphery D. Onset of acute renal failure - C. Embolization of the bacterial vegetation to the periphery Which of the following laboratory values is considered to be a biomarker for the severity of heart failure? A. Serum potassium B. Serum creatinine C. Brain natriuretic peptide D. Serum sodium - C. Brain natriuretic peptide Excessive alcohol use while on warfarin (Coumadin) therapy leads to: A. Decreased anticoagulation effect B. Decreased international normalized ratio C. Increased anticoagulation effect D. Increased vitamin K absorption - C. Increased anticoagulation effect Following heart valve surgery, bacterial endocarditis prophylaxis would be done prior to which of the following procedures: A. Colonoscopy B. Sinus surgery C. Plastic surgery D. Dental procedures - D. Dental procedures Mr. A has a diagnosis of abdominal aortic aneurysm. At this time, treatment will be medical. The nurse understands that a priority for Mr. A will be: A. Preparing Mr. A for dialysis to correct any pending renal failure B. Restrict Mr. A's activities of daily living and low-level exercise C. Monitoring size of the aneurysm monthly with endocardiogram D. Maintaining mean blood pressure at a normal level between 70 and 100 mm Hg - D. Maintaining mean blood pressure at a normal level between 70 and 100 mm Hg The most effective strategies for self-care patient education of persons with heart failure include: A. Providing education for both the patient and family members who are involved in the care B. Providing a home care aid for assistance with activities of daily living C. Providing a call-back number for patients to access 24/7 if they have questions
The cardiac-vascular nurse reviews recommended activities with a patient who sustained a myocardial infarction. The patient states, "It doesn't really matter what I do or don't do. It will either get better or die." This statement reflects: A. Acceptance of changed health status B. An internal locus of control C. Feelings of loss of control D. Projection - C. Feelings of loss of control
