A nurse is caring for a client who is on a continuous cardiac monitor. When evaluating the client's rhythm strip, the nurse notes that the QRS interval has increased from 0.08 second to 0.14 second. Based on this finding, the nurse should withhold continued administration of which drug?

The nurse and the student nurse are observing a cardioversion procedure completed by a physician. At which time is the nurse most correct to identify to the student when the electrical current will be initiated?

The nurse understands that asystole can be caused by several conditions. Select all that apply

An ECG has been ordered for a newly admitted client. What should the nurse do prior to electrode placement?

The nurse checks the synchronizer switch before using a defibrillator to terminate ventricular fibrillation for what important reason?

What is the treatment of choice for ventricular fibrillation?

The nurse is caring for a geriatric client. The client is ordered Lanoxin (digoxin) tablets 0.125 mg daily for cardiac dysrhythmias. Which of the following assessment considerations is essential when caring for this age-group?

The nurse suspects a client has developed pericarditis after a week of cold-like symptoms. Which of the client's signs and symptoms indicate pericarditis?

The nurse is administering an Amiodarone drip for a client that develops a ventricular dysrhythmia after having a myocardial infarction (MI). What is the best indication that the medication is having the desired effect?

Which symptom occurs in the client diagnosed with mitral regurgitation when pulmonary congestion occurs?

Which nursing intervention should a nurse perform to reduce cardiac workload in a client diagnosed with myocarditis?

Which of the following are indications of a rupturing aortic aneurysm? Select all that apply

The nurse has just admitted a 66-year old patient for cardiac surgery. The patient tells the nurse that she is afraid of dying while undergoing the surgery. The nurse should be aware that:

A critical care nurse is caring for a client with a pulmonary artery catheter in place. What does this catheter measure that is particularly important in critically ill clients?

When hemodynamic monitoring is ordered for a client, a catheter is inserted into the appropriate blood vessel or heart chamber. When assessing a client who has such a device in place, the nurse should check which of the following components? Select all that apply

What is the major clinical use of dobutamine?

A nurse is caring for a client in cardiogenic shock. Which vasopressor agents may be used in the treatment on the client? Select all that apply

A client is unstable and receiving dopamine to increase blood pressure. Which of the following are interventions that the nurse administering dopamine would employ? Select all that apply

The nurse assesses a patient in compensatory shock whose lungs have decompensated. What clinical manifestations would the nurse expect to find? Select all that apply

A client is lethargic with a systolic blood pressure of 74, heart rate of 162 bpm, and rapid, shallow respirations. Crackles are audible in the lungs. The nurse assesses frequently for which of the following? Select all that apply

A nurse is evaluating a client's drop in mean arterial pressure to 50 mmHg during progressive shock. What client assessment would follow with the drop in pressure?

A team of nurses are reviewing the similarities and differences between the different classifications of shock. Which sub-classifications of distributive shock should the nurses identify?

The seasoned nurse is instructing the new graduate on information obtained from central venous pressure and pulmonary artery pressure. Which statement, made by the seasoned nurse, reflects the most pertinent information regarding circulation?

A client at the scene of an MVA seems somewhat anxious and has clammy skin. The client's BP has dropped to 90 mm Hg. What stage of shock is the client most likely experiencing?

A critical care nurse is aware of similarities and differences between the treatments for different types of shock. What intervention is used in all types of shock?

A nurse is providing care to all of the following clients. Which client would be most at risk for septic shock?

A nurse is caring for a client in a critical care unit. With what type of shock does a client experience a pooling of blood flow to the peripheral blood vessels?

Organ failure that is associated with multiple organ dysfunction syndrome (MODS) usually begins in the

Which drug is a vasodilator used in the treatment of shock?

A client presents to the ED in shock. At what point in shock does the nurse know that metabolic acidosis is going to occur?

The ICU nurse is caring for a client with sepsis whose tissue perfusion is declining. What signs would indicate to the nurse that end-organ damage may be occurring?

The nurse is caring for a client who is receiving large volumes of crystalloid fluid to treat hypovolemic shock. In light of this intervention, for what sign or symptom should the nurse monitor?

The nurse is caring for a client in cardiogenic shock. The client weighs 90 kg. A dobutamine drip of 1 mcg/kg/min is ordered. The dobutamine is supplied in a concentration of 500 mg in 250 mL of D5W. IV infusion should be started at how many ml per hour?

The nurse obtains a blood pressure of 120/78 mmHg from a patient in hypovolemic shock. Since the blood pressure is within normal range for this patient, what stage of shock does the nurse realize this patient is experiencing?

The nurse is caring for a client with a stage IV leg ulcer. The nurse is closely monitoring the client for sepsis. What would indicate that sepsis has occurred and that the nurse should notify the physician immediately?

When caring for a client in shock, one of the major nursing goals is to reduce the risk that the client will develop complications of shock. How can the nurse best achieve this goal?

A positive inotrope:

A negative chronotrope:

A positive dromotrope:

Which of the following medications is a potassium channel blocker?

What is the therapeutic level of digoxin?

What are the signs of an overdose on a cholinergic blocker? Select all that apply

The nurse is assessing the client for possible evidence of digitalis toxicity. The nurse acknowledges that which is included in the signs/symptoms for digitalis toxicity?

The health care provider has prescribed IV norepinephrine for a patient in the ED. The nurse determines that the drug is having the desired effect when what is observed in patient assessment?

A client who is three days status post coronary artery bypass graft surgery (CABG) has gone into an atrial fibrillation (afib) rhythm. The client is started on a digoxin load to treat the afib. Which of the following nursing assessments would indicate a possible problem with the medication administration?

A nurse is caring for a client who is three days post-operative from coronary artery bypass graft (CABG) surgery. Today the client’s temporary epicardial wires will be pulled out. The nurse knows that close monitoring needs to occur in order to assess the client for signs and symptoms of cardiac tamponade. Which of the following symptoms would the nurse expect to see in cardiac tamponade?

The nurse is administering nitroglycerin intravenously to a client experiencing chest pain of an 8 on a 1 to 10 scale. What assess-ment changes would cause the nurse to decrease the infusion rate?

During the night, a client with a diagnosis of acute coronary syndrome is found to be restless and diaphoretic. What is the best nursing action?

A surgical repair is planned for a patient who has a 5.5-cm abdominal aortic aneurysm (AAA). On physical assessment of the patient, what should the nurse expect to find?

During preoperative preparation of the patient scheduled for an AAA, why should the nurse establish baseline data for the patient?

A thoracic aortic aneurysm is found when a patient has a routine chest x-ray. The nurse anticipates that additional diagnostic testing to determine the size and structure of the aneurysm will include which test?

A patient with a small AAA is not a good surgical candidate. What should the nurse teach the patient that is one of the best ways to prevent expansion of the lesion?

Which of the following shows the correct sequence of nursing interventions for a patient with new diagnosis of dissecting aortic aneurysm?

A. Administer a beta-blocker to slow heart rate.

B. Place two large bore IV catheters.

C. Transfer patient to OR.

D. Administer a large fluid bolus to prevent hypotension.

A patient comes to the emergency department with abdominal pain. Work-up reveals the presence of a rapidly enlarging abdominal aortic aneurysm. Which of the following actions should the nurse expect?

The nurse evaluates that treatment for the patient with an uncomplicated aortic dissection is successful when what happens?

Immediately following an ascending aortic aneurysm repair, what is an important finding that the nurse should report immediately to the HCP?

A patient with disseminated intravascular coagulation (DIC) is experiencing oozing from several partially healed intravenous insertion sites. The nurse plans care for this patient based on the awareness that this finding results from which coagulation problem?

DIC is a disease characterized by (select all that apply):

Which of the following may be an underlying condition that leads to DIC?

Put the options in the correct sequence for disseminated intravascular coagulation (DIC):

A. Fibrinogen converted to fibrin

B. Activation of fibrinolytic system

C. Production of intravascular thrombin

D. Uncompensated hemorrhage

E. Widespread fibrin and platelet deposition in capillaries and arterioles

F. Inhibition of normal clotting

G. Release of fibrin split proteins

Which patient manifestations confirm the development of MODS?

Which statement describing systemic inflammatory response syndrome (SIRS) and/or multiple organ dysfunction syndrome (MODS) is accurate?

What mechanism that can trigger SIRS is related to myocardial infarction or pancreatitis?

What are the criteria for SIRS? Select all that apply.

Which intervention may prevent GI bacterial and endotoxin translocation in a critically ill patient with SIRS?

The patient is admitted with an unusual infection and no other injuries. The nurse can rule out what types of mechanical tissue trauma that are also SIRS triggers? Select all that apply.

A patient with septic shock has a urine output of 20 mL/hr for the past 3 hours. The pulse rate is 120 and the central venous pressure and pulmonary artery wedge pressure are low. Which of these orders by the health care provider will the nurse question?

A patient with cardiogenic shock is cool and clammy and hemodynamic monitoring indicates a high systemic vascular resistance (SVR). Which action will the nurse anticipate taking?

What is the definition of shock?

A patient with shock of unknown etiology whose hemodynamic monitoring indicates BP 92/54, pulse 64, and an elevated pulmonary artery wedge pressure has the following collaborative interventions prescribed. Which intervention will the nurse question?

A client has been diagnosed with sepsis. The nurse will most likely find which of the following when assessing this client? Select all that apply.

Nursing intervention for a patient with septic shock is most likely to result in all of the following outcomes except:

Which signs/symptoms occur during the compensatory stage of shock? Select all that apply.

Until the physician arrives to evaluate the status of a client in the ICU, the nurse is going to begin assessing a client for shock. Which of the following would be considered traditional methods to assess this client? Select all that apply.

A client with post-myocardial infarction develops acute bacterial pericarditis. Which of the following medications would the physician most likely prescribe as the primary drug?

Because a client has mitral stenosis and is a prospective valve recipient, the nurse preoperatively assesses a client’s past compliance with medical regimens. Lack of compliance with which of the following regimens would pose the greatest health hazard to this client?

A client with acute infective endocarditis (staphylococcal organism) suddenly complains of shortness of breath and chest pain. Upon assessment, the nurse notes diminished breath sounds and hemoptysis. Based on this assessment data, the nurse suspects which of the following?

What valvular dysfunctions may be evident with an audible S3? Select all that apply.

The nurse knows it is important for which of the following patients to discuss their history with their dentist? Select all that apply.

What diagnostic criteria are used for a diagnosis of endocarditis? Select all that apply.

A 53-year-old is showing symptoms of dyspnea on exertion, angina, and exertional syncope. Which of the following do these manifestations indicate?

A client is admitted for heart valve surgery. While on the step-down unit, the client complains of chills, malaise, fatigue, and abdominal pain. Upon assessment, the nurse finds the client to be febrile at 101.5 degrees Fahrenheit, pulse 88 and regular, respirations 26 and labored. The client also has splinter hemorrhages under the nails. Which of the following diagnoses is most likely?

A patient with a history of coronary artery disease is being treated for a myocardial infarction (MI). During treatment, acute mitral valve regurgitation occurs. What is the most likely cause of the acute mitral valve dysfunction?

A 50-year-old male with history of alcohol abuse presents with complaint of worsening dyspnea. Physical examination reveals bibasilar rales, elevated jugular venous pressure, an S3 and lower extremity edema. Chest x-ray reveals pulmonary congestion and cardiomegaly. Echocardiogram shows left ventricular dilatation and an ejection fraction of 30%. Which of the following is the most likely diagnosis in this patient?

A patient with dilated cardiomyopathy phones the doctor’s office to report that in the last 3 weeks, he has gained 30 pounds and is short of breath worse when lying down. What advice should the nurse give the patient?

In which of the following types of cardiomyopathy does cardiac output remain normal?

Teaching for a patient newly diagnosed with restrictive cardiomyopathy should include what components?

If medical treatments fail, which of the following invasive procedures is necessary for treating cardiomyopathy?

If a patient with dilated cardiomyopathy has atrial fibrillation that has been unresponsive to drug therapy for several days, the nurse should anticipate that further treatment of the patient will require:

Which of the following classes of drugs is most widely used in the treatment of cardiomyopathy?

The client is at risk for heart failure symptoms because their heart doesn’t pump well. Since these symptoms have developed slowly over time, the patient should keep their appointment the next day. The nurse should closely question the patient on which medication regimen?