Extract:

Question 1 of 5

A nurse in a cardiac care unit is caring for a client with acute right-sided heart failure. Which of the following findings should the nurse expect?

A. Increased pulmonary artery wedge pressure (PAWP).B. Decreased specific gravity.C. Ascending dependent edema in legs and ankles.D. Decreased brain natriuretic peptide (BNP).

Correct Answer: C

Rationale: Ascending dependent edema results from increased venous pressure and fluid retention in the lower extremities, common in right-sided heart failure due to impaired venous return and fluid overload.

Question 2 of 5

A nurse is admitting a client who has acute heart failure following a myocardial infarction (MI). The nurse recognizes that which of the following prescriptions by the provider requires clarification?

A. 0.9% normal saline IV at 50 mL/hr continuous.B. Laboratory testing of serum potassium upon admission.C. Bumetanide 1 mg IV bolus every 12 hr.D. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain.

Correct Answer: A

Rationale: Administering 0.9% normal saline IV at 50 mL/hr continuously in acute heart failure can exacerbate fluid overload, worsening symptoms like pulmonary edema.

Question 3 of 5

A nurse is evaluating a client who had a left-sided cardiac catheterization with an upper extremity insertion site. Which of the following actions should the nurse take?

A. Assess pulses in the client's affected arm.B. Keep the client NPO for at least 2 hours following the procedure.C. Apply light pressure to the insertion site.D. Encourage the client to ambulate within 30 minutes following the procedure.

Correct Answer: A

Rationale: Assessing pulses in the affected arm ensures proper blood flow and identifies potential complications like arterial occlusion following cardiac catheterization.

Question 4 of 5

Examine the attached ECG image and identify the type of arrhythmia present. The ECG shows a series of wide QRS complexes occurring at a rapid rate.

A. Supraventricular Tachycardia.B. Ventricular Tachycardia.C. Atrial Fibrillation.D. First Degree AV Block.

Correct Answer: B

Rationale: Ventricular tachycardia is characterized by a rapid rate and wide QRS complexes. This rhythm originates in the ventricles and can lead to a decrease in cardiac output and possible deterioration into ventricular fibrillation.

Question 5 of 5

A nurse is caring for a client who has peripheral arterial disease (PAD). Which of the following symptoms should the nurse expect to find in the early stage of the disease?

A. Intermittent claudication.B. Rest pain.C. Foot ulcers.D. Dependent rubor.

Correct Answer: A

Rationale: Intermittent claudication, characterized by muscle pain during exercise relieved by rest, indicates early-stage peripheral arterial disease due to decreased blood flow.