WorksheetsCardiovasular Thinking Questions
Total questions: 30
Worksheet time: 30mins
The nurse is assisting a client to ambulate in the hallway on the telemetry unit when the client reports mild discomfort in the left shoulder blade area. Which of the following interventions should be the priority priority nursing action?
Apply oxygen at 2L per nasal cannula
Administer sublingual nitroglycerin
Get the client back to bed
Assist client to sit in a chair
A client with left-sided heart failure is having difficulty breathing. Which of the following is the most appropriate nursing intervention?
Encourage the patient to cough & deep breathe
Assist the client to recliner to catch their breath
Place the client in high fowler's position
Administer albuterol via nebulizer
Which statement from a client with a history of heart failure is most concerning & warrants further assessment by the nurse?
"I've been wearing TED hose to help with my swollen ankles"
"My scale says I've gotten fat...I guess I need to go on a diet"
"I have to prop up with pillows at night so I can sleep"
"Doc says my cholesterol is really high & I need to eat better"
The nurse is assisting a client with heart failure to the bathroom. The client is taking is taking hydralazine and isosorbide dinitrate to alleviate edema of the feet & legs.Which of the following is a nursing priority for this client?
Carefully measure and record the urine voided.
Assist the patient to stand up slowing and gradually.
Ensure call light is within reach while in the bathroom.
Provide privacy for the patient while using the bathroom.
The nurse at a first aid station during a 5K is caring for runner who reports feeling lightheaded and dizzy. What is the priority intervention?
Provide plenty of water for the runner to drink
Assess the runner's blood pressure
Assist the runner to lie down on a cot
Determine how long runner has felt this way
A client with a prior history of blood clots reports abrupt pain in his right foot. What should the nurse do next?
Assess sensation & circulation in both feet
Elevate the right foot to improve perfusion
Administer pain meds & provide massage
Palpate for strength of all pulses in both foot
The nurse has administered a diuretic to a client in fluid volume excess with shortness of breath. The UAP reports the client has voided 876 mLs since output was recorded one hour ago. On assessment, the client reports feeling “odd”. What is the next priority intervention?
Give the next dose of diuretic
Draw a serum potassium level
Obtain an O2 saturation level
Assess the blood pressure
A client taking clopidogrel reports “weird colored, sticky stools”. What is the best response by the nurse?
This can be a side effect of clopidogrel
Can you describe what darker means?
Do you eat any foods with artificial colors?
When was your last bowel movement?
A severely dehydrated client is receiving IV normal saline when they abruptly develop shortness of breath and tachycardia. What interventions can the RN delegate to the UAP?
Apply O2 2L per nasal cannula
Assess blood pressure
Raise the head of bed
Pause the IV fluids
At 1430, the nurse notes a client’s mean arterial pressure (MAP) has consistently been under 60mmHg since noon. The nurse should anticipate what results in the next serum lab draw?
BUN & creatinine are low
Albumin is elevated
Potassium is low
ALT & AST are elevated
The nurse is providing diet discharge teaching to a client with new diagnosis of heart failure. Which of the following statements made by the client represents they understood the diet teaching?
"I should limit my sodium intake to 5-6 grams a day."
"I will be sure to incorporate canned veggies into my diet."
"I will only use whole wheat bread for my ham sandwiches."
"I should limit my consumption of Hungry Man frozen meals."
A patient is being discharged home after hospitalization of left ventricular systolic dysfunction (left heart failure). As the nurse providing discharge teaching to the patient, which statement is NOT a correct statement about this condition?
"Symptoms of left heart failure include dyspnea, cough, weight gain & difficulty breathing while supine."
"It is very important to monitor your daily weights, fluid and salt intake to detect impending complications"
" If left untreated, left-sided heart failure likely will eventually lead to right-sided heart failure."
"Left heart failure builds pressure in hepatic veins causing fluid congestion which leads to peripheral edema."
The nurse is teaching the client about lifestyle modifications to help manage the client’s hypertension. The nurse determines that teaching has been effective when the client makes which statement?
I need to get started on my meds right away.
I won’t be able to run in the next marathon.
I know I need to give up my cigarettes & alcohol.
My father had high BP, did nothing, & lived to be 90.
The client receives hydrochlorothiazide (HCTZ). He tells the nurse he is urinating a lot and questions how this drug affects his blood pressure. What is the best response by the nurse?
HCTZ enhances kidney function causing you to urinate more and that decreases your BP.
HCTZ dilates your blood vessels so you urinate more and your BP decreases.
HCTZ decreases the fluid in your bloodstream and this lowers your BP.
HCTZ increases heart rate; this pumps blood faster to your kidneys so you urinate & BP decreases.
A client with pulmonary edema has been on diuretic therapy. The client has a new order for an additional 40 mg furosemide (Lasix) and Digoxin initiation. What priority lab value should the nurse review?
Digoxin level
Creatinine level
Potassium level
Sodium level
A patient calls the urgent care clinic and reports they have taken 2 sublingual doses of Nitroglycerin as prescribed for tightness in the chest but the discomfort is not relieved. What should the nurse educate the patient to do next?
Take another dose of Nitroglycerin in 5 minutes.
Report to their primary provider’s office immediately
Lie down & rest to see to help alleviate the pain
Hang up the phone and call 911 immediately
Which patient is most at risk for developing coronary artery disease?
A 54 year old patient female who exercises 3X/week and has a history of cervical cancer.
A 49 year old female whose father died at the age of 42 from a myocardial infraction.
A 35 year old male with a BMI of 30 and reports smoking 2 packs of cigarettes a day.
A 29 year old that has type I diabetes, lupus, & drinks alcohol moderately
What is the primary reason for administering morphine to a client with an MI?
To decrease the client’s anxiety
To decrease the client’s chest pain
To decrease the client’s respiratory rate
To decrease client’s myocardial 02 demand
A client reports to the nurse recent increase in alcohol consumption, 12 pound weight gain in 2 months, occasional chest pain at rest, financial instability, noticeable elevation of BP, ankle edema, nocturia and a divorce from their spouse of 19 years. Which finding is most closely associated with an impending MI?
Weight gain & alcohol intake
Chest pain & nocturia
Divorce & finances
Ankle edema & BP
The nurse is performing a focused assessment for cardiac output. Which assessments should be included? Select all that apply.
a. Level of consciousness
b. Reports of any chest pain
c. Lung sounds
d. Presence of edema
e. Peripheral pulses
f. Urinary output
g. Skin temp
The nurse is educating a client with chronic stable angina. Which items should be included? Select all that apply.
a.Balance activity with rest periods.
b.Dress appropriately in extreme temps.
c.Wait 2 hours after eating to exercise.
d.Perform isometric exercises 3X/week
e.Avoid stimulants that increase pulse
f. Sex should be infrequent & docile
The nurse is preparing a client for a cardiac catheterization. Which interventions should be implemented?
Select all that apply.
A. Ask about allergy to shellfish.
B. Assess urinary output.
C. Teach client how to valsalva.- NO
D. Administer acetylcysteine.
E. Warn client regarding “hot shot”.
F. Educate that palpitations are normal.
G. Assess & mark baseline pulses.
A client admitted to the ED reports chest pain that started roughly 10 days ago. Which lab test will be most useful in diagnosing a possible MI?
CPK-MB
Myoglobin
Troponin
D- Dimer
A client is experiencing ventricular fibrillation (V-Fib). Place the interventions in order of priority.
A. Administer Amiodarone/Lidocaine
B. Administer Epinephrine
C. Defibrillate
D. Start CPR
The healthcare team is preparing to administer streptokinase to a client. Which interventions are appropriate? Select all that apply.
A. Administer within 12 hours or less of symptom onset
B. Monitor ABGs diligently throughout treatment
C. Obtain bleeding history & implement bleeding precautions
D. Insert a jugular line to administer the medication
E. Assess client family history for other comorbibities
Lab results for a client with heart failure reveal low hemoglobin & hematocrit. What would be the best intervention?
Administer whole blood.
Administer platelets.
Administer packed red blood cells.
Administer plasma.
The RN is preparing to administer Digoxin (Lanoxin) to a client. Assessment findings include BP146/90, P112, R22, T98.6, O2 sat 96%. The client requests hospital maintenance adjust the color on the TV. The nurse notes the color looks normal and agrees to have repair person stop by later. What is the next priority for the RN to perform?
Count the apical pulse again.
Assess for symptoms of electrolyte imbalance
Review the latest digoxin level lab results
Administer the medication
Which clients are at high risk for developing pulmonary edema? Select all that apply.
Surgical client receiving whole blood via rapid infuser
Neonate receiving IV fluids for dehydration
Geriatric client receiving LR after food poisoning
Clients with either heart or kidney disease
Which of the following patients are MOST at risk for developing heart failure? Select-all-that-apply.
A 69 year old male alcoholic recovering from a myocardial infarction.
A 55 year old female with a health history of asthma and hypoparathyroidism.
A 30 year old male with a history of endocarditis and valvular repair
A 45 year old female with lung cancer stage 2 receiving treatment
A 58 year old female with uncontrolled hypertension & influenza.-
A client on bedrest for the last 6 days is preparing to ambulate for the first time. What are the best actions for the nurse to take to avoid patient injury? Select all that apply.
A. Raise the head of the bed
B. Assess for orthostatic blood pressure
C. Utilize a gait belt when walking
D. Admin IV fluids prior to rising
E. Enlist the help of a UAP to assist
F. Medicate for pain first
