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WorksheetsTransition Su 22 Practice Perfusion, Clotting
Total questions: 40
Worksheet time: 21mins
The client has been taking rosuvastatin for hyperlipidemia. The client now presents with severe weakness, muscle pain, and states barely being able to move the extremities. The nurse suspects the client has which of the following?
Pruritis.
Rhabdomyolysis.
Cholelithiasis.
Cholecystitis.
A client diagnosed with hyperlipidemia is prescribed a statin. The nurse is reviewing the client's history and would notify the client's health care provider if which condition was noted in the client's history?
Asthma
Liver disease
Renal disease
Hypertension
The nurse is reviewing lab results where the client has elevated BUN and creatinine levels. The nurse would question the administration of which antihypertensive?
Amlodipine
Diltiazem
Quinapril
Nifedipine
The clinic nurse has been assigned to a 43-year-old client who is obese and loves to eat. The client has been diagnosed with hyperlipidemia and has been prescribed lovastatin. Which dietary instruction would be a priority for the nurse to discuss with the client?
Increase intake of milk and other dairy products
Increase intake of fatty acids
Decrease intake of plant stanols
Avoid drinking grapefruit juice
A client develops primary hypertension and asks the nurse, “How long will I need to receive therapy?” The nurse responds based on the understanding that therapy would be required for how long?
Lifelong
Until blood pressure is 120/80 mmHg
One year
5 years
A client, newly diagnosed with hypertension is started on captopril, an ACE inhibitor. The client should be informed of the possibility of what adverse effect?
Sedation
Persistent cough
Sweating
Hypokalemia
A 77-year-old client has newly diagnosed stage 2 hypertension. The physician has prescribed a thiazide and an angio-converting enzyme inhibitor. About what is the nurse most concerned?
Postural hypertension and resulting injury
Rebound hypertension
Sexual dysfunction
Postural hypotension and resulting injury
The nurse is preparing to administer furosemide to a client with severe heart failure. What lab study should be of most concern for this client while taking furosemide ?
BNP of 100
Sodium level of 135
Hemoglobin of 12
Potassium level of 3.1
An experienced nurse has been working with a client with heart failure. The client's lungs were clear to auscultation during the morning assessment, however, the afternoon assessment revealed bibasilar crackles and tachypnea. The nurse calls to give SBAR report to the covering healthcare provider. In the final step of the report the nurse should do which of the following?
Recommend 40 milligrams of furosemide (Lasix) be administered because the client had improvement with past administration.
Discuss the client's situation and request a chest X-ray to assess lung function.
Detail the client's past medical history and active medication orders.
Provide detailed findings of the head to toe assessment.
A client takes digoxin and furosemide for peripheral edema resulting from heart failure. Hypokalemia, caused by furosemide, has what effect on digoxin?
Increased action of digoxin
Decreased action of digoxin
Increased sodium retention
Decreased sodium retention
A client with heart failure is having a decrease in cardiac output. What indication does the nurse have that this is occurring?
Heart rate of 72 beats/minute
Respiratory rate of 20 breaths/minute
Blood pressure 80/46 mm Hg
Oxygen saturation 94%
What instruction should the nurse’s discharge teaching plan for the client with heart failure include?
maintaining a high-fiber diet
walking 2 miles (3.2 km) every day
obtaining daily weights at the same time each day
remaining sedentary for most of the day
A nurse in the emergency department is caring for a client with acute heart failure. Which laboratory value is most important for the nurse to check before administering medications to treat heart failure?
platelet count
potassium
calcium
white blood cell (WBC) count
A client arrives at the ED with an exacerbation of left-sided heart failure and complains of shortness of breath. Which of the following is the priority nursing intervention?
Administer angiotensin II receptor blockers
Assess oxygen saturation level
Administer diuretics
Administer angiotensin-converting enzyme inhibitors
Which of the following is a key diagnostic indicator of heart failure (HF)?
Brain natriuretic peptide (BNP)
Blood urea nitrogen (BUN)
Creatinine
Complete blood count (CBC)
A physician orders digoxin elixir for a client with heart failure. Immediately before administering this drug, the nurse must check the client's:
serum sodium level.
urine output.
weight.
apical pulse.
The nurse is analyzing a 6-second electrocardiogram (ECG) tracing. The P waves and QRS complexes are regular. The PR interval is 0.18 seconds long, and the QRS complexes are 0.08 seconds long. The heart rate is calculated at 70 bpm. The nurse correctly identifies this rhythm as which of the following?
Normal sinus rhythm
Sinus tachycardia
Junctional tachycardia
First-degree atrioventricular (AV) block
A parent of a child with hemophilia states that she worries whenever the child has a bump or cut. The nurse should explain that after the area is cleansed, the wound should be treated by applying which measure?
gentle pressure
warm, moist compresses
a tourniquet above the injured area
a wet-to-dry dressing
Which goal is most important when developing a long-term care plan for a child with hemophilia?
Increase the parent's and child's knowledge about hemophilia.
Prevent injury during each stage of development.
Improve the child's self-esteem during bleeding episodes.
Manage acute pain when there is bleeding into joints.
The mother tells the nurse she will be afraid to allow her child with hemophilia to participate in sports because of the danger of injury and bleeding. After explaining that physical fitness is important for children with hemophilia, which activity should the nurse suggest as ideal?
snow skiing
swimming
basketball
gymnastics
When the nurse is obtaining a health history from an older adult, which information in the history is a risk factor associated with deep vein thrombosis (DVT)?
The client walks 30 minutes every day.
The client lives alone.
The client recently had abdominal surgery.
The client wears support stockings.
A client is admitted with a diagnosis of thrombophlebitis and deep vein thrombosis of the right leg. A loading dose of heparin has been given in the emergency department, and IV heparin will be continued for the next several days. What should the nurse include in the plan of care for this client?
administering aspirin as prescribed
encouraging green leafy vegetables in the diet
monitoring the client’s prothrombin time (PT)
monitoring the client's activated partial thromboplastin time (aPTT) and International Normalized Ratio (PT/INR)
A client with deep vein thrombosis has been receiving warfarin for 2 months. The client is to go to an anticoagulant monitoring laboratory every 3 weeks. The last visit to the laboratory was 2 weeks ago. The client reports bleeding gums, increased bruising, and dark stools. What should the nurse should instruct the client to do?
Decrease the dose of the warfarin.
Return to laboratory for analysis of prothrombin time.
Decrease the amount of vitamin K in the diet.
Notify the health care provider (HCP) about the bleeding.
A client with known coronary artery disease reports intermittent chest pain, usually on exertion. The physician diagnoses angina pectoris and orders sublingual nitroglycerin to treat acute angina episodes. When teaching the client about nitroglycerin administration, which instruction should the nurse provide?
"Be sure to take safety precautions because nitroglycerin may cause dizziness when you stand up."
"Replace leftover sublingual nitroglycerin tablets every 9 months to make sure your pills are fresh."
"A burning sensation after administration indicates that the nitroglycerin tablets are potent."
"You may take a sublingual nitroglycerin tablet every 30 minutes, if needed. You may take as many as four doses."
A client complains about chest pain and heavy breathing when exercising or when stressed. Which of the following is a priority nursing intervention for the client diagnosed with coronary artery disease?
Assess chest pain and administer prescribed drugs and oxygen
Assess the blood pressure and administer aspirin
Not important to assess the client or to notify the physician
Assess the physical history of the client
In the treatment of coronary artery disease (CAD), medications are often ordered to control blood pressure in the client. Which of the following is a primary purpose of using beta-adrenergic blockers in the nursing management of CAD?
To dilate coronary arteries
To decrease workload of the heart
To decrease homocysteine levels
To prevent angiotensin II conversion
A nurse is teaching nitroglycerin to a client with hospitalized client with coronary artery disease who is being discharged. The nurse tells the client that nitroglycerin has which of the following actions?
Select all that apply.
Reduces myocardial oxygen consumption
Decreases the urge to use tobacco
Dilates blood vessels
Decreases ischemia
Relieves pain
The nurse is caring for a client in the ICU diagnosed with coronary artery disease (CAD). Which of the following assessment data indicates the client is experiencing a decrease in cardiac output?
BP 108/60 mm Hg, ascites, and crackles
Disorientation, 20 mL of urine over the last 2 hours
Reduced pulse pressure and heart murmur
Elevated jugular venous distention (JVD) and postural changes in BP
A nurse is obtaining data from an older adult client who is admitted with progressive deterioration in cognition. Which degenerative disorder does the nurse suspect the client is exhibiting?
Delirium
Dementia
Neurosis
Psychosis
When communicating with the client who is experiencing dementia and exhibiting decreased attention and increased confusion, which intervention should the nurse employ as the first step?
using gentle touch to convey empathy
rephrasing questions the client does not understand
eliminating distracting stimuli such as turning off the television
asking the client to go for a walk while talking
A nurse is working with clients with delirium on a medical unit. What is the nurse's priority concern?
safe environment
opportunity to release frustration
administering medications
providing client education
The PACU nurse is caring for an older adult who presents with clinical manifestations of delirium. Which short-term outcome would be most important for this client? The client:
experiences pain within tolerable limits.
exhibits wound healing without complications.
resumes usual urinary elimination pattern.
maintains adequate oxygenation status.
An 84-year-old client has returned from the PACU. The client is orientated to name only. The clients’ family is very upset because before having surgery the client knew the family. The client is diagnosed with delirium. What should the nurse explain to the client's family?
There is nothing to worry about.
Delirium involves a progressive decline in memory loss.
Delirium usually lasts only a short time.
Delirium is generally more prevalent in women.
A client has been diagnosed with congestive heart failure (CHF). The physician has ordered a medication to enhance contractility. The nurse would expect which medication to be ordered for the client?
Digoxin
Clopidogrel
Enoxaparin
Heparin
You are assigned to care for an 87-year-old client admitted to the medical unit for congestive heart failure. It is the fourth hospital day, and the response to treatment has been good. The client is no longer short of breath and the lung sounds are clearing. There is still a diet restriction of decreased sodium and limiting fluids to no more than 1000 mL per day. Your discharge teaching in order to promote the older client’s health will include which of the following? Select all that apply.
Gradually increase activities as tolerated.
Do not use the salt shaker at meals.
Increased stress may interfere with recovery.
Take several naps during the day.
Ronald is a 46-year-old who has developed congestive heart failure. He has to learn to adapt his diet and you are his initial counselor. Which of the following should you tell him to avoid?
Canned peas
Dried peas
Angel food cake
Ready-to-eat cereals
A client has just been diagnosed with prehypertension. What would the nurse instruct this client to do to restore his blood pressure below hypertensive levels?
Increase iodine intake.
Decrease sodium intake.
Increase fluid intake.
Avoid over-the-counter decongestants.
The nurse is caring for a client newly diagnosed with hypertension. Which of the following statements if made by the client indicates the need for further teaching?
“If I take my blood pressure and it is normal, I don’t have to take my BP pills.”
“I think I’m going to sign up for a yoga class twice a week to help reduce my stress.”
“When getting up from bed, I will sit for a short period prior to standing up.”
“I will consult a dietician to help get my weight under control.”
A nurse is assisting with checking blood pressures at a local health care fair. To which client would the nurse pay particular attention?
A 16-year-old girl
A 40-year-old African-American man
A 50-year-old Caucasian woman
An Asian adult man
A client with newly diagnosed hypertension asks what she can do to decrease the risk for related cardiovascular problems. Which of the following risk factors is not modifiable by the client?
Age
Obesity
Inactivity
Dyslipidemia
