0 [{"id":571811,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-20 20:55:36","updated_at":"2018-09-20 20:55:36","questionName":"As an initial step in treating a client with angina, the physician prescribes nitroglycerin tablets, 0.3 mg given sublingually. This drug\u2019s principal effects are produced by:","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"Nitroglycerin produces peripheral vasodilation, which reduces myocardial oxygen consumption and demand. Vasodilation in coronary arteries and collateral vessels may also increase blood flow to the ischemic areas of the heart. Nitroglycerin decreases myocardial oxygen demand. Nitroglycerin does not have an effect on pericardial spasticity or conductivity in the myocardium.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":576675,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-26 11:26:24","updated_at":"2018-09-26 11:26:24","questionName":"The type of echocardiography used to evaluate the motion of the cardiac valves and detect pericardial fluid is known as _____________ echocardiography ","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"Motion of cardiac valves and detection of pericardial fluid is done with M\u00admode echocardiography. M\u00admode echocardiography enables evaluation of anatomic relationships and the relative sizes of each. ","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":572835,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-21 21:03:14","updated_at":"2018-09-21 21:03:14","questionName":"During discharge planning after admission for a myocardial infarction, the client says, \"I won't be able to increase my activity level. I live in an apartment, and there is no place to walk.\" What is the nurse's best response?","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"This response calls for cooperation and participation from the client.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":574371,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-24 00:44:20","updated_at":"2018-09-24 00:44:20","questionName":"Which patient has the greatest risk for a pulmonary embolus related to a venous disorder?","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null},{"id":573090,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-22 06:03:22","updated_at":"2018-09-22 06:03:22","questionName":"A client with heart failure is taking furosemide (Lasix). Which finding concerns the nurse with this new prescription?","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"","question_score_id":null,"lang":"","questionAudioPath":null},{"id":573859,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-23 17:11:38","updated_at":"2018-09-23 17:11:38","questionName":"A patient is admitted for heart failure and has edema, neck vein distention, and ascites. What is the most reliable way to monitor fluid gain or loss in this patient?","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null},{"id":573091,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-22 06:04:29","updated_at":"2018-09-22 06:04:29","questionName":"A client who recently had a heart valve replacement is taking warfarin (Coumadin) as prescribed. What statement by the client indicates that the nurse will need to do additional health teaching? ","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"","question_score_id":null,"lang":"","questionAudioPath":null},{"id":571042,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-19 23:41:21","updated_at":"2018-09-19 23:41:21","questionName":"The nurse caring for four diabetic clients has all of these activities to perform. Which is appropriate to delegate to unlicensed assistive personnel (UAP)?","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"Performing bedside glucose monitoring is an activity that may be delegated because it does not require extensive clinical judgment to perform; the nurse will follow up with the results. Intravenous therapy and medication administration are not within the scope of practice for UAP. The client with blood glucose of 68 mg\/dL will need further monitoring, assessment, and intervention not within the scope of practice for UAP. The client reporting palpitations and anxiety may have hypoglycemia, requiring further intervention; this client must be assessed by licensed nursing staff.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":573858,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-23 17:11:38","updated_at":"2018-09-23 17:11:38","questionName":"The nurse is assessing a patient with left-sided heart failure. Which assessment findings does the nurse expect to see in this patient?","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null},{"id":574370,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-24 00:44:20","updated_at":"2018-09-24 00:44:20","questionName":"The nurse is assessing a patient with distended, protruding veins. In order to assess for varicose veins, what technique does the nurse use?","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":null,"question_score_id":null,"lang":null,"questionAudioPath":null},{"id":571810,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-20 20:55:36","updated_at":"2018-09-20 20:55:36","questionName":"Which of the following is not a risk factor for the development of atherosclerosis?","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"Late onset of puberty is not generally considered to be a risk factor for the development of atherosclerosis. Risk factors for atherosclerosis include family history of atherosclerosis, cigarette smoking, hypertension, high blood cholesterol level, male gender, diabetes mellitus, obesity, and physical inactivity.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":571044,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-19 23:41:21","updated_at":"2018-09-19 23:41:21","questionName":"The nurse has just received change-of-shift report on the endocrine unit. Which client does the nurse see first?","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"Because glucose levels will increase quickly in clients who use continuous insulin pumps, the nurse should assess this client and the insulin pump first to avoid diabetic ketoacidosis. Thirst is a symptom of hyperglycemia and, although important, is not a priority; the nurse could delegate a fingerstick blood glucose to unlicensed assistive personnel while assessing the client whose insulin pump is beeping. Although a blood glucose reading of 150 mg\/dL is mildly elevated, this is not an emergency. Mild hypertension is also not an emergency","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":571043,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-19 23:41:21","updated_at":"2018-09-19 23:41:21","questionName":"The nurse has just taken change-of-shift report on a group of clients on the medical-surgical unit. Which client does the nurse assess first?","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"The client taking glyburide (Diabeta) who is dizzy and sweaty has symptoms consistent with hypoglycemia and should be assessed first because this client displays the most serious adverse effect of antidiabetic medications. Although the client taking repaglinide who has nausea and back pain requires assessment, the client taking glyburide takes priority. Metformin may cause abdominal cramping and diarrhea, but the client taking it does not require immediate assessment. Ankle swelling is an expected side effect of pioglitazone.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":572834,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-21 21:03:14","updated_at":"2018-09-21 21:03:14","questionName":"An older adult client, 4 hours after coronary artery bypass graft (CABG), has a blood pressure of 80\/50 mm Hg. What action does the nurse take?","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"Decreased preload as exhibited by decreased PAWP could indicate hypovolemia secondary to hemorrhage or vasodilation; hypotension could cause the graft to collapse. Low blood pressure is not normal in older adults or postoperative clients. The cause of hypotension must be found and treated; further action is needed to determine additional interventions. Hypotension could be caused by hypovolemia; giving loop diuretics increases hypovolemia.","question_score_id":null,"lang":null,"questionAudioPath":null},{"id":576674,"quiz_id":"27637","answer_id":null,"answerType_id":"0","created_at":"2018-09-26 11:26:24","updated_at":"2018-09-26 11:26:24","questionName":"A patient received 4 mg of morphine IV and now is unresponsive\u037e his respiratory rate and depth are diminished. The antagonist for morphine is","questionTimeSeconds":"0","questionTimeMinutes":"1","questionImagePath":null,"position":null,"explanation":"The antagonist for morphine or other opioids is Narcan (naloxone). Generally, the naloxone dose is 0.4 mg IV. This dose can be repeated about every 3 to 4 minutes three times. When giving Narcan, you must always be alert for the patient to relapse once the dose wears off. Administering multiple follow\u00adup doses is not uncommon. ","question_score_id":null,"lang":null,"questionAudioPath":null}]

block

As an initial step in treating a client with angina, the physician prescribes nitroglycerin tablets, 0.3 mg given sublingually. This drug’s principal effects are produced by:

Select the correct answer(s).  

(0/0)

Explanation

Nitroglycerin produces peripheral vasodilation, which reduces myocardial oxygen consumption and demand. Vasodilation in coronary arteries and collateral vessels may also increase blood flow to the ischemic areas of the heart. Nitroglycerin decreases myocardial oxygen demand. Nitroglycerin does not have an effect on pericardial spasticity or conductivity in the myocardium.

---

Vasodilation of peripheral vasculature

Antispasmodic effects on the pericardium

Causing an increased myocardial oxygen demand

Improved conductivity in the myocardium

none

The type of echocardiography used to evaluate the motion of the cardiac valves and detect pericardial fluid is known as _____________ echocardiography

Select the correct answer(s).  

(0/0)

Explanation

Motion of cardiac valves and detection of pericardial fluid is done with M­mode echocardiography. M­mode echocardiography enables evaluation of anatomic relationships and the relative sizes of each.

---

Continuous­wave Doppler

Two­dimensional

M­mode

Contrast

none

During discharge planning after admission for a myocardial infarction, the client says, "I won't be able to increase my activity level. I live in an apartment, and there is no place to walk." What is the nurse's best response?

Select the correct answer(s).  

(0/0)

Explanation

This response calls for cooperation and participation from the client.

---

"You are right. Work on your diet then."

"You must find someplace to walk."

"Where might you be able to walk?"

"Walk around the edge of your apartment complex."

none

Which patient has the greatest risk for a pulmonary embolus related to a venous disorder?

Select the correct answer(s).  

(0/0)

---

Patient with bilateral varicose veins

Patient with phlebitis of superficial veins

Patient with venous insufficiency throughout the leg

Patient with thrombophlebitis in a deep vein of the lower extremity

none

A client with heart failure is taking furosemide (Lasix). Which finding concerns the nurse with this new prescription?

Select the correct answer(s).  

(0/0)

---

Serum potassium level of 2.8 mEq/L

Serum sodium level of 135 mEq/L

Serum creatinine of 1.0 mg/dL

Serum magnesium level of 1.9 mEq/L

none

A patient is admitted for heart failure and has edema, neck vein distention, and ascites. What is the most reliable way to monitor fluid gain or loss in this patient?

Select the correct answer(s).  

(0/0)

---

Weigh the patient daily at the same time with the same

Auscultate the lungs for crackles or wheezing

Check for pitting edema in the dependent body parts

Assess skin turgor and the condition of mucous membranes

none

A client who recently had a heart valve replacement is taking warfarin (Coumadin) as prescribed. What statement by the client indicates that the nurse will need to do additional health teaching?

Select the correct answer(s).  

(0/0)

---

"I will take my pulse every day, and call my doctor if it is below 60."

"I will take my blood pressure every day and call if it is too high or low."

"I will weigh myself every day in the morning using the same scale."

"I will eat foods that are high in vitamin K, such as kale and spinach."

none

The nurse caring for four diabetic clients has all of these activities to perform. Which is appropriate to delegate to unlicensed assistive personnel (UAP)?

Select the correct answer(s).  

(0/0)

Explanation

Performing bedside glucose monitoring is an activity that may be delegated because it does not require extensive clinical judgment to perform; the nurse will follow up with the results. Intravenous therapy and medication administration are not within the scope of practice for UAP. The client with blood glucose of 68 mg/dL will need further monitoring, assessment, and intervention not within the scope of practice for UAP. The client reporting palpitations and anxiety may have hypoglycemia, requiring further intervention; this client must be assessed by licensed nursing staff.

---

Verify the infusion rate on a continuous infusion insulin pump.

Check on a client who is reporting palpitations and anxiety

Perform hourly bedside blood glucose checks for a client with hyperglycemia.

Monitor a client with a blood glucose of 68 mg/dL for tremors and irritability.

none

The nurse is assessing a patient with left-sided heart failure. Which assessment findings does the nurse expect to see in this patient?

Select the correct answer(s).  

(0/0)

---

Wheezes or crackles

S3 heart sound

Paroxysmal nocturnal dyspnea

Oliguria during the day

Jugular venous distention

Displacement of the apical impulse to the left

none

The nurse is assessing a patient with distended, protruding veins. In order to assess for varicose veins, what technique does the nurse use?

Select the correct answer(s).  

(0/0)

---

Ask the patient to stand and observe the leg veins; then ask the patient to sit or lie down and observe the veins.

Place the patient in the Trendelenburg position and observe the distention and protruding of the veins.

Ask the patient to walk around the room and observe the veins; then have the patient rest for several minutes and reassess the veins.

Place the patient in a supine position with elevated legs; as the patient sits up, observe the veins filling from the proximal end.

none

Which of the following is not a risk factor for the development of atherosclerosis?

Select the correct answer(s).  

(0/0)

Explanation

Late onset of puberty is not generally considered to be a risk factor for the development of atherosclerosis. Risk factors for atherosclerosis include family history of atherosclerosis, cigarette smoking, hypertension, high blood cholesterol level, male gender, diabetes mellitus, obesity, and physical inactivity.

---

Elevated fasting blood glucose concentration

Total blood cholesterol level greater than 220 mg/dL

Family history of early heart attack

Late onset of puberty.

none

The nurse has just received change-of-shift report on the endocrine unit. Which client does the nurse see first?

Select the correct answer(s).  

(0/0)

Explanation

Because glucose levels will increase quickly in clients who use continuous insulin pumps, the nurse should assess this client and the insulin pump first to avoid diabetic ketoacidosis. Thirst is a symptom of hyperglycemia and, although important, is not a priority; the nurse could delegate a fingerstick blood glucose to unlicensed assistive personnel while assessing the client whose insulin pump is beeping. Although a blood glucose reading of 150 mg/dL is mildly elevated, this is not an emergency. Mild hypertension is also not an emergency

---

Newly diagnosed client with type 1 diabetes who is reporting thirst

Client with type 1 diabetes whose insulin pump is beeping "occlusion"

Client with type 2 diabetes with a blood pressure of 150/90 mm Hg

Client with type 2 diabetes who has a blood glucose of 150 mg/dL

none

The nurse has just taken change-of-shift report on a group of clients on the medical-surgical unit. Which client does the nurse assess first?

Select the correct answer(s).  

(0/0)

Explanation

The client taking glyburide (Diabeta) who is dizzy and sweaty has symptoms consistent with hypoglycemia and should be assessed first because this client displays the most serious adverse effect of antidiabetic medications. Although the client taking repaglinide who has nausea and back pain requires assessment, the client taking glyburide takes priority. Metformin may cause abdominal cramping and diarrhea, but the client taking it does not require immediate assessment. Ankle swelling is an expected side effect of pioglitazone.

---

Client taking glyburide (Diabeta) who is dizzy and sweaty

Client taking repaglinide (Prandin) who has nausea and back pain

Client taking metformin (Glucophage) who has abdominal cramps

Client taking pioglitazone (Actos) who has bilateral ankle swelling

none

An older adult client, 4 hours after coronary artery bypass graft (CABG), has a blood pressure of 80/50 mm Hg. What action does the nurse take?

Select the correct answer(s).  

(0/0)

Explanation

Decreased preload as exhibited by decreased PAWP could indicate hypovolemia secondary to hemorrhage or vasodilation; hypotension could cause the graft to collapse. Low blood pressure is not normal in older adults or postoperative clients. The cause of hypotension must be found and treated; further action is needed to determine additional interventions. Hypotension could be caused by hypovolemia; giving loop diuretics increases hypovolemia.

---

Give ordered loop diuretics.

No action is required for postsurgical CABG clients.

Assess pulmonary artery wedge pressure (PAWP).

No action is required; low blood pressure is normal for older adults.

none

A patient received 4 mg of morphine IV and now is unresponsive; his respiratory rate and depth are diminished. The antagonist for morphine is

Select the correct answer(s).  

(0/0)

Explanation

The antagonist for morphine or other opioids is Narcan (naloxone). Generally, the naloxone dose is 0.4 mg IV. This dose can be repeated about every 3 to 4 minutes three times. When giving Narcan, you must always be alert for the patient to relapse once the dose wears off. Administering multiple follow­up doses is not uncommon.

---

Epinephrine

Naloxone

Regitine

Atropine