Exam for RN Cardiovascular NCLEX Exam Related

The following scenario applies to the next 6 items
The client is a 72-year-old male who presents to the emergency department with increasing
shortness of breath over the past two days that gets worse when he is lying flat in bed at night.
Item 1 of 6
History And Physical Nurses' Notes Flow Sheet
0700: The client is a 72-year-old male who presents to the emergency department with increasing shortness of breath over the past two days that gets worse when he is lying flat in bed at night. He states, "I feel like I can't catch my breath," and he had to sleep in a recliner. He reports a 4 lb weight gain over the last week and increasing fatigue. The client is alert and oriented but is using his accessory muscles to breathe. He reports feeling short of breath, orthopnea, and paroxysmal nocturnal dyspnea. He has bilateral pedal edema (+2), bilateral crackles heard upon auscultation, and jugular vein distention noted on his assessment. The
the client has a medical history of hypertension, coronary artery disease, and a prior myocardial infarction. He was diagnosed with heart failure with reduced ejection fraction (HFrEF) two years ago. Current home medications include lisinopril, metoprolol succinate, furosemide, and atorvastatin.

For each medication, choose the most likely option for drug classification and mechanism of action for heart failure: Spironolactone, Sacubitril/Valsartan, Dapagliflozin

• A. Spironolactone: MRA, Blocks aldosterone effects
• B. Sacubitril/Valsartan: ARNI, Blocks RAAS and neprilysin
• C. Dapagliflozin: SGLT2 inhibitor, Causes osmotic diuresis

The nurse is caring for a client who has just been diagnosed with acute pericarditis. Which of the following medications should the nurse anticipate the primary health care provider (PHCP) will prescribe?

• A. isoniazid
• B. colchicine
• C. allopurinol
• D. warfarin

The nurse assesses a client three hours following cardiac surgery. Assessment findings were a blood pressure of 88/52 mm Hg, jugular venous distention, and muffled heart sounds. The nurse anticipates that this client will need an immediate

• A. thoracentesis.
• B. pericardiocentesis.
• C. arthrocentesis.
• D. paracentesis.

The nurse is performing an assessment on a client with congestive heart failure demonstrating ineffective coping. The nurse should plan to

• A. recommend a support group.
• B. review dietary items low in sodium.
• C. review the client's vaccination status.
• D. recommend the client take St. John's Wort.

The following scenario applies to the next 1 items
The nurse in the intensive care unit (ICU) is caring for a 41-year-old male client.
Item 1 of 1
Progress Notes
1544: Received client to ICU immediately following percutaneous transluminal coronary angioplasty followed by stenting via right femoral artery. Notified primary health care provider about client status. Awaiting orders.
The nurse contacts the primary healthcare provider for admission orders

For each potential order, click to specify whether the potential order is indicated or not indicated for the client post-percutaneous transluminal coronary angioplasty.

• A. Head of the bed elevated up to 30 degrees
• B. Elevate the right leg on a pillow
• C. Continuous cardiac monitoring
• D. Serial troponin levels
• E. Keep the client NPO
• F. Obtain serum glucose levels every two hours