1. During a client’s Cardiac Catheterization, a

1. During a client’s Cardiac Catheterization, a blockage of a coronary artery is found and a Percutaneous Coronary Intervention (PCI) is performed. To monitor for complications following the procedure, it is most important for the nurse to a. assess the affected leg and groin site every four hours. b. maintain the client on bedrest for only two to three hours. c. obtain a stat electrocardiogram for complaints of chest pain. d. keep the client NPO for the first three to four hours. 2. Which of the following is the best assessment to determine the effectiveness of prescribed therapies for a client with Cor Pulmonale? a. Bowel sounds b. Heart sounds c. Blood pressure d. Peripheral edema 3. The nurse should realize that the client with Right Ventricular Heart Failure may develop ascites because of a. loss of cellular makeup. b. osmosis from tissue to cells. c. increased venous pressure. d. diffusion of solutes into plasma. 4. The nurse identifies a potential complication of Pulmonary Edema for a client in acute Heart Failure. When assessing the client, the nurse will be most concerned about a. an apical pulse rate of 99 beats/min. b. an oxygen saturation of 88% on room air. c. weight gain of 1 kg (2.2 lb) over 24 hours. d. decreased hourly client urinary output 5. According to evidence-based guidelines and core measures, which of the following medications should a client be discharged on after a Myocardial Infarction? a. Loop diuretics b. Digoxin (Lanoxin) c. Beta Blockers d. Calcium channel blockers 6. The nurse obtains the following data when caring for a client who experienced an Acute Myocardial Infarction (AMI) two days previously. Which information is most important to report to the health care provider? a. The oral temperature is 100.8 deg; F (38.2 deg; C). b. The White Blood Cell (WBC) count is 12,000/ml. c. The client denies ever having a heart attack. d. The lungs have crackles audible to the midline. 7. Three days after a Myocardial Infarction, the client develops chest pain that radiates to the back and left arm that is relieved by sitting in a forward position. On auscultation of the client’s chest, the nurse would expect to hear which of the following? a. Distant heart sounds. b. S3 or S4 heart sounds. c. a pericardial friction rub. d. a loud holosystolic apical murmur. 8. A client is transferred to the step-down unit on the third day following admission for an ST-elevation myocardial infarction (STEMI). The most appropriate cardiac rehabilitation activity at this time is a. maintain complete bedrest for 24 hours. b. monitored short walks in the hallway. c. passive range of motion exercises. d. Dangling off side of bed for short periods. 9. You are responsible for developing a standardized plan for the post-operative nursing care of a client having cardiac surgery. Which nursing activity, included in the care plan, will need to be done only by a RN? a. Remove chest and leg dressings on the second post-operative day and clean the incisions with antiseptic swabs. b. Reinforce to the client the need to deep breathe and cough at least every two hours while awake. c. Provide discharge teaching based on discharge medications and needed lifestyle changes. d. Administer oral analgesic medications as needed prior to assisting client out of bed on first post operative day. 10. When evaluating the outcomes of preoperative teaching with a client scheduled for a coronary artery bypass graft (CABG) using the internal mammary artery, the nurse determines that additional teaching is needed when the client says, a. “I will have a tube in my throat helping me breath for the first 24 hours.” b. “They will circulate my blood with a machine during the surgery.” c. “I will need to take an aspirin a day after the surgery to keep the graft open.” d. “They will use an artery near my heart to bypass the area that is obstructed.” 11. A client is recovering from an uncomplicated Myocardial Infarction. Which of the following rehabilitation guidelines should be included in the teaching plan? (SELECT ALL THAT APPLY) a. Refrain from sexual activity for a minimum of 3 weeks. b. If feelings of depression persist, discuss these feelings with your physician. c. Begin an exercise program that aims for at least five 30-minute sessions per week. d. Teach the client the maximum HR that should be present at any point. e. Activity should be stopped abruptly at intervals to increase endurance.

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