NCLEX RN Cardiovascular Questions 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.

Click to indicate whether each clinical finding is seen in left-sided heart failure, right-sided heart failure, or both.

• A. Crackles auscultated bilaterally
• B. Bilateral lower extremity edema
• C. Paroxysmal nocturnal dyspnea
• D. Fatigue
• E. Weight gain of 4 pounds
• F. Accessory muscle use
• G. Jugular vein distension

Which of the following should the nurse do for a client reporting chest pain radiating to the arm? Select all that apply.

• A. Obtain an electrocardiogram (ECG)
• B. Prepare the client for cardioversion
• C. Establish intravenous (IV) access
• D. Insert an indwelling urinary catheter
• E. Administer prescribed nitroglycerin

The nurse is caring for a client with weak pedal pulses, absent hair on bilateral legs, and a full-thickness wound on the right lateral malleolus with defined margins, including a minimal amount of serous exudate. Which of the following interventions is contraindicated?

• A. Apply TED hose to bilateral legs
• B. Assess the need for smoking cessation
• C. Physical therapy consult
• D. Obtain Ankle-Brachial Index (ABI) with a hand-held Doppler

The home health nurse is caring for a client who experienced a myocardial infarction two weeks ago. Which of the following client statement requires immediate follow-up?

• A. I am having difficulty coping with the stress at work.
• B. I am unsure if I want to continue with cardiac rehabilitation.
• C. I have not been taking my prescribed clopidogrel because I cannot afford it.
• D. I started using nicotine patches to help me quit smoking.

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.

Select the six (6) statements that the nurse should include in the teaching plan for a client with heart failure.

• A. You should weigh yourself every morning before breakfast
• B. Report a gain of more than 2 pounds in one day.
• C. It's important to limit your fluid intake to about 3 liters per day.
• D. Try to include potassium-rich foods like bananas and oranges in your diet every day.
• E. Avoid NSAIDs like ibuprofen unless prescribed by your provider.
• F. Take frequent rest periods throughout the day and gradually increase physical activity as tolerated.
• G. Reduce your sodium intake to less than 2,000 mg per day.