NCLEX-PN
Cardiac Disorders NCLEX Questions Questions
Extract:
Question 1 of 5
When the nurse informs the client about the use of the PCA pump, which instruction is most important to include?
Correct Answer: B
Rationale: Only the client should press the PCA button to prevent overdose and ensure pain relief is patient-controlled.
Question 2 of 5
If the heart murmur is related to valve damage caused by a childhood infection, the nurse would expect the client to report having had which disease?
Correct Answer: C
Rationale: Rheumatic fever is associated with valvular damage due to streptococcal infection.
Question 3 of 5
An adult client is admitted with a diagnosis of left-sided congestive heart failure. Which assessment finding would most likely be present?
Correct Answer: B
Rationale: Dyspnea is a hallmark symptom of left-sided congestive heart failure due to pulmonary congestion. Distended neck veins, hepatomegaly, and pitting edema are more associated with right-sided heart failure.
Question 4 of 5
When the nurse is about to administer digoxin to a client, the client says, 'I think I need to see the eye doctor. Things seem to look kind of green today.' The nurse takes his vital signs, which are blood pressure = 150/94, pulse = 60 bpm, and respirations = 28. What is the most appropriate initial action for the nurse to take?
Correct Answer: B
Rationale: Visual disturbances, such as seeing a green or yellow halo, are signs of digoxin toxicity. The nurse should withhold the medication and report to the charge nurse for further evaluation.
Question 5 of 5
To provide adequate care for the client with worsening left-sided heart failure, the intensive care unit (ICU) nurse should be a full of the following on a daily basis?
Correct Answer: B,D
Rationale: Peripheral edema and weight are key indicators of fluid status in heart failure.