After noting a pulse deficit when assessing a patient who has just arrived in the emergency department, the nurse will anticipate that the patient may require A) a. a 2-D echocardiogram.
B) b. a cardiac catheterization.
C) c. hourly blood pressure (BP) checks.
D) d. electrocardiographic (ECG) monitoring.
| D electrocardiographic (ECG) monitoring.
| When reviewing the 12-lead electrocardiograph (ECG) for a healthy 86-year-old patient who is having an annual physical examination, which of the following will be of most concern to the nurse? A) a. The heart rate (HR) is 43 beats/minute.
B) b. The PR interval is 0.21 seconds.
C) c. There is a right bundle-branch block.
D) d. The QRS duration is 0.13 seconds.
| A The heart rate (HR) is 43 beats/minute.
| During a physical examination of a patient, the nurse palpates the point of maximal impulse (PMI) in the sixth intercostal space lateral to the left midclavicular line. The most appropriate action for the nurse to take next will be to A) a. document that the PMI is in the normal anatomic location. B) b. ask the patient about risk factors for coronary artery disease. C) c. auscultate both the carotid arteries for the presence of a bruit. D) d. assess the patient for symptoms of left ventricular hypertrophy.
| D assess the patient for symptoms of left ventricular hypertrophy.
| To auscultate for S3 or S4 gallops in the mitral area, the nurse listens with the A) a. bell of the stethoscope with the patient in the left lateral position. B) b. bell of the stethoscope with the patient sitting and leaning forward. C) c. diaphragm of the stethoscope with the patient in a reclining position. D) d. diaphragm of the stethoscope with the patient lying flat on the left side.
| A bell of the stethoscope with the patient in the left lateral position.
| To determine the effects of therapy for a patient who is being treated for heart failure, which laboratory result will the nurse plan to review? A) a. Myoglobin
B) b. Homocysteine (Hcy)
C) c. Low-density lipoprotein (LDL)
D) d. B-type natriuretic peptide (BNP)
| D B-type natriuretic peptide (BNP)
| While doing the admission assessment for a thin 72-year-old patient, the nurse observes pulsation of the abdominal aorta in the epigastric area. Which action should the nurse take? A) a. Notify the hospital rapid response team.
B) b. Instruct the patient to remain on bed rest.
C) c. Teach the patient about aortic aneurysms.
D) d. Document the finding in the patient chart.
| D Document the finding in the patient chart.
| A patient is scheduled for a cardiac catheterization with coronary angiography. Before the test, the nurse informs the patient that A) a. electrocardiographic (ECG) monitoring will be required for 24 hours after the test. B) b. it will be important to lie completely still during the procedure. C) c. a warm feeling may be noted when the contrast dye is injected. D) d. monitored anesthesia care will be provided during the procedure.
| C a warm feeling may be noted when the contrast dye is injected
| While assessing a patient who was admitted with heart failure, the nurse notes that the patient has jugular venous distention (JVD) when lying flat in bed. Which action should the nurse take next? A) a. Use a ruler to measure the level of the JVD.
B) b. Document this finding in the patient's record.
C) c. Observe for JVD with the head at 30 degrees.
D) d. Have the patient perform the Valsalva maneuver.
| C Observe for JVD with the head at 30 degrees.
| The nurse teaches the patient being evaluated for rhythm disturbances with a Holter monitor to A) a. exercise more than usual while the monitor is in place. B) b. remove the electrodes when taking a shower or tub bath. C) c. keep a diary of daily activities while the monitor is worn. D) d. connect the recorder to a telephone transmitter once daily.
| C keep a diary of daily activities while the monitor is worn.
| When auscultating over the patient's abdominal aorta, the...
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