A client's diet is modified to eliminate foods that act as cardiac stimulants.

Which foods will the nurse instruct the client to

avoid?
- Iced tea, Hot cocoa, Chocolate pudding
o Caffeine stimulates catecholamine release and acts as cardiac stimulant
 Club soda = contain sodium -> promote fluid retention; Red meat = avoid for elevated cholesterol

The nurse is planning to teach a client with heart failure about the signs and symptoms of cardiac decompensation. What
clinical manifestations should the nurse include?
- Fatigue due to low oxygen, pulmonary congestion/edema, coughing, blood tinged sputum

A client who recently had a myocardial infarction is admitted to the cardiac care unit. How can the nurse best determine
the effectiveness of the client’s ventricular contractions?
- Monitor urinary output hourly

Serum cardiac marker studies are prescribed for a client after a myocardial infarction. Which laboratory test is most
important for the nurse to monitor?
- Troponin (biomarker for MI); usually remains elevated for 2 weeks

Following a client’s cardiac catheterization (diagnostic procedure), the nurse identifies that the client’s urinary output is
three times the client’s intake amount. The client is stable otherwise. The nurse concludes that what is the cause of the
increase in the client’s urinary output?
- An expected effect of the dye used with the procedure (hypertonic + diuretic effects)

A client presenting to the emergency department with chest pain and dizziness is found to be having a myocardial
infarction and subsequently suffers cardiac arrest. The healthcare team is able to successfully resuscitate the client. Lab
work shows that the client now is acidotic. How does the nurse interpret the cause of the acidosis?
- The decreased tissue perfusion caused lactic acid production.

A nurse is working with a cardiologist for a client needing temporary pacing. Which methods are examples that the
cardiologist with the assistance of the nurse might use?
- Transcutaneous pacing, Transverse pacing, Epicardial pacing

The nurse notes asystole on the cardiac monitor. Which action should the nurse take immediately?
- Assess client’s pulse

A client is experiencing tachycardia. Which adverse hemodynamic effects will the nurse consider when planning care for
this client?
- Decreased ventricular filling time and cardiac output

A nurse is caring for a client after cardiac surgery. Which signs will cause the nurse to suspect cardiac tamponade?
- Pulsus paradoxus, Muffled heart sounds, Jugular vein distention

The nurse is assessing a client with the diagnosis of chronic heart failure. Which clinical finding should the nurse expect
the client to experience?
- Dependent edema in the evening (after the client has been standing or sitting for prolonged periods)

How should the nurse make the bed of a client who is in the acute phase after a myocardial infarction?
- Replace the top linen and only the necessary bottom linen.

A nurse is teaching a group of clients about risk factors for heart disease. Which factors will the nurse include that
increase a client's risk for a myocardial infarction (MI)?
- Obesity, Hypertension

The client is in atrial fibrillation. Which information should the nurse consider about atrial fibrillation when planning care
for this client?
- A loss of atrial kick
A nurse is providing postprocedure care to a client who had a cardiac catheterization via a brachial artery. For the first
hour after the procedure, what is the priority nursing intervention?
- Monitor vitals q 15min

In addition to atrial fibrillation, which cardiac dysrhythmia exhibited by a client does the nurse determine may be
converted to sinus rhythm by cardioversion ( It is used for atrial fibrillation, supraventricular tachycardia, and ventricular
tachycardia with a pulse when pharmaceutical preparations fail) ?
- Supraventricular tachycardia

Which client statement indicates an understanding of the nurse’s instructions concerning a Holter monitor?
- "The monitor will record any abnormal heart rhythms while I go about my usual activities."

A client is on a cardiac monitor. The monitor begins to alarm showing ventricular tachycardia. What should the nurse do
first?
- Check for a pulse

A nurse identifies premature ventricular complexes (PVCs) on a client’s cardiac monitor. What does the nurse conclude
that these complexes are a sign of?
- Cardiac irritability

What criteria should the nurse use to determine normal sinus rhythm for a client on a cardiac monitor?
- The RR intervals are relatively consistent.
- One P wave precedes each QRS complex.
- The number of complexes in a 6-second strip is multiplied by 10 to approximate the heart rate; normal sinus
rhythm is 60 to 100 beats/min. Fewer than six complexes per 6 seconds equals a heart rate less than 60 beats/min.
The QRS duration should be less than 0.12 seconds; the PR interval should be 0.12 to 0.2 second.
A client with heart failure has anxiety. Which effect of anxiety makes it particularly important for the nurse to reduce the
anxiety of this client?
- Increases the cardiac workload

A nurse is performing external cardiac compression. Which action should the nurse take?
- Interlock the fingers with the heel of one hand on the sternum and the heel of the other on top of it.

A client who has had a myocardial infarction experiences a noticeably decreased pulse pressure. What does this indicate
to the nurse?
- Decrease force of contraction

A nurse is performing cardiac compression on an adult client. How far must the nurse depress the lower sternum to
maintain circulation until a defibrillator is available?
- 2-2.5 inches (5-6.4cm)

A client is admitted to the coronary care unit with atrial fibrillation and a rapid ventricular response. The nurse prepares
for cardioversion. What nursing action is essential to prevent the potential danger of inducing ventricular fibrillation
during cardioversion?
- Synchronizer switch is in the "on" position.

A nurse discusses resumption of sexual activity with a client who is recovering from a myocardial infarction. Which
information should the nurse share with the client?
- Select familiar settings for sexual activity.
- It is generally safe to resume sexual activity 7 to 10 days after an uncomplicated MI.

A client has a mitral valve replacement, and the nurse provides health teaching to promote optimum health. Which client
statement supports the nurse's conclusion that the client needs further teaching?
- "I will start a vigorous aerobic exercise program."
Upon assessment the nurse discovers a client with heart failure has crackles in lower lung fields and dyspnea. Upon
notifying the primary healthcare provider, the provider prescribes intravenous (IV) normal saline at 200 mL/hr and
furosemide 120 mg orally stat. Which action should the nurse take next?
- Question the choice of solution, the amount to be given, and the dose of furosemide that has been prescribed.

A client with a coronary occlusion is experiencing chest pain and distress. What is the primary reason that the nurse
should administer oxygen to this client?
- Increase oxygen concentration to heart cells

A nurse reviews the plan of care for a client who is recovering from the acute phase of left ventricular failure. Which
dietary restriction will the nurse expect to be included in the plan?
- Sodium

A client is brought to the emergency department with moderate substernal chest pain radiating to the inner aspect of the
left arm, unrelieved by rest and nitroglycerin. The pain is associated with slight nausea and anxiety. Which is the priority
nursing intervention for this client?
- Provide pain medication

A nurse is caring for a client with a myocardial infarction. What is most important for the nurse to assess that has a direct
relationship to the action potential of the heart? one of the major manifestations is a decrease in the conductive energy
provided to the heart.
- Strength of contraction

A client presents to the emergency department with symptoms of acute myocardial infarction (MI). Which results will the
nurse expect to find upon assessment?
- Elevated serum troponin I

A client with a history of heart failure and hypertension is admitted with reports of syncope. Which prescribed medication
should the nurse prepare to administer based on the electrocardiogram (ECG) rhythm strip image?
Atropine
This rhythm strip reflects sinus bradycardia. Sinus bradycardia has
PQRST complexes within acceptable limits, but the rate is less than
60 beats per minute. In this strip the PR interval is 0.16, the rhythm
is regular, and the rate is 40 beats per minute. Atropine, an
anticholinergic that increases the heart rate, is administered when
the heart rate is so slow that it causes symptoms. Digoxin is a
cardiac glycoside that slows the heart rate. Enalapril is an
angiotensin-converting enzyme (ACE) inhibitor that slows the heart
rate. Metoprolol is a beta blocker that slows the heart rate.

A client is admitted with chest pain unrelieved by nitroglycerin, an elevated temperature, decreased blood pressure, and
diaphoresis. A myocardial infarction is diagnosed. Which should the nurse consider as a valid reason for one of this
client’s physiologic responses?
- Inflammation in the myocardium causes a rise in the systemic body temperature.

The nurse observes the following pattern on a client’s electrocardiogram (ECG) strip. What dysrhythmia does the nurse
identify?

- Premature ventricular complex PVC

A nurse begins to develop a plan of care with a client who has left ventricular heart failure that resulted from a myocardial
infarction (MI). Which goal is priority during the acute phase of recovery?
- Promote pain relief

The nurse is evaluating the client's cardiac rhythm and measures a PR interval of 0.08 seconds (two small boxes). How
should the nurse interpret this finding?
- Abnormally fast conduction
When the PR interval is shorter than normal, the speed of conduction is abnormally fast. The PR interval measures the
time it takes for the impulse to depolarize the atria, travel to the AV node, and dwell there briefly before entering the
bundle of His. The normal PR interval is 0.12 to 0.20 seconds, three to five small boxes wide. When the PR interval is
longer than normal, the speed of conduction is delayed in the AV node. The interval from the beginning of the P wave to
the next deflection from the baseline is called the PR interval.

The nurse notices that the client's cardiac rhythm has become irregular; QRS complexes are missing after some of the P
waves. The nurse also notes that the PR intervals become progressively longer until a P wave stands without a QRS; then
the PR interval is normal with the next beat and starts the cycle again with each successive PR interval getting longer until
there is a missing QRS. The nurse notifies the primary healthcare provider. Which rhythm does the nurse share with the
provider?
- Second degree AV block Mobitz I (Wenckebach)
Also called Mobitz I or Wenckebach heart block, second degree AV block type I is represented on the ECG as a
progressive lengthening of the PR interval until there is a P wave without a QRS complex. In first degree AV block, a P
wave precedes every QRS complex, and every P wave is followed by a QRS. Second degree AV block type II (Mobitz II)
is a more critical type of heart block that requires early recognition and intervention. There is no progressive lengthening
of the PR interval, which remains the same throughout with the exception of the dropped beat(s). Third degree block often
is called complete heart block because no atrial impulses are conducted through the AV node to the ventricles. In
complete heart block, the atria and ventricles beat independently of each other because the AV node is completely blocked
to the sinus impulse and is not conducted to the ventricles. One hallmark of third degree heart block is that the P waves
have no association with the QRS complexes and appear throughout the QRS waveform.

A nurse observes the following dysrhythmia on a client's cardiac monitor. Which rhythm does the nurse identify?
- Ventricular fibrillation

The nurse notes that the client's cardiac rhythm strips show more P waves than QRS complexes. There is no
relationship between the atria and the ventricles. How should the nurse interpret this rhythm strip?
- Third degree AV block (complete heart block)

A nurse in the coronary care unit (CCU) identifies ventricular fibrillation on a client’s cardiac monitor. What
intervention is the priority?
- Immediate defibrillation

The nurse is caring for a client who has had frequent premature ventricular complexes (PVCs) and monitors the
client closely for ventricular fibrillation. The nurse recalls that the risk for ventricular fibrillation is greatest
during which phase of the cardiac cycle?
- T wave