NCLEX Review about Cardiac Nursing (21-25)

NCLEX Review about Cardiac Nursing

21. The client with congestive heart failure develops cardiac tamponade. Which of the following signs and symptoms would the nurse assess?

a) distant or muffled heart sounds
b) hypertension
c) bradycardia
d) increased urine output

22. The nurse is giving health teachings to several clients. Which among these clients is at risk for coronary artery diseases?

a) the client who works in the department store
b) the client who smokes cigarette
c) the client who had her menarche at age 12 years old
d) the client whose serum cholesterol level is 180 mg/dL

23. Which of the following questions is most important to ask in a client with congestive heart failure who has jugular vein distention?

a) at what time do you go to sleep during the night?
b) how many pillows do you use when lying down?
c) what do you drink before going to sleep?
d) how many hours of night sleep do you have?

24. The drug of choice to control premature ventricular contractions, ventricular tachycardia, or ventricular fibrillation is

a) quinidine
b) procainamide
c) bretylium
d) lidocaine

25. Which of the following situations in a client with myocardial infarction (MI) should be given highest priority?

a) the client complains of palpitations
b) the client's BP is 170/95
c) the client has premature ventricular contractions of 4 multifocals/min
d) the client serum enzyme studies are elevated





NCLEX Review about Cardiac Nursing:
ANSWERS AND RATIONALE

21) A
- cardiac tamponade involves accumulation of fluid in the pericardial sac. It restricts ventricular filling and decreases cardiac output. It is characterized by distant, muffled sound, distended neck veins, and diminished or absent pulse (Beck's triad).

22) B
- cigarette smoking is one of the most common risks of CAD (Coronary artery disease).

23) B
- orthopnea, which is difficulty in breathing when in lying position relieved by upright position, is a sign of progressive cardiac disorder.

24) D
- lidocaine is the first line of drug to control PVC's, VT, VF. Lidocaine exerts anesthetic effect on the heart thus decreasing myocardial irritability.

25) B
- elevated BP increases afterload, and therefore increases cardiac workload. This leads to increased myocardial oxygen demand.


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