Cardiovascular

The emergency department nurse is assessing the unconscious patient following a fall from the ladder while he was doing home improvement work. Which assessment is performed first?

The nurse is the first responder to a motor vehicular accident involving the injury of a 40-year-old male. Which action is the highest priority?

As instructed by the registered nurse, the unlicensed assistive personnel (UAP) obtained vitals on a patient. The UAP obtained and charted the following vital signs monitoring results: blood pressure 90/42 mm Hg, pulse 128 bpm, oxygen saturation 86% on room air, and temperature 38.2°C. (100.8°F). The UAP left the floor for a break after charting the results, but did not tell the nurse. Thirty minutes later the patient is found unresponsive and a code blue is initiated. Who is responsible for this patient’s deterioration of condition?

Which task is most appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?

The patient with malignant hypertension has suffered from a transient ischemic attack. He asks the nurse if he can continue taking his St. John’s wort for depression. Which answer by the nurse is most appropriate?

The nurse mistakenly gives the patient with malignant hypertension the wrong dose of antihypertensive medication, and the patient complains of several hours of dizziness. Which action by the nurse is most appropriate?

Which patient is triaged as first to be treated following a hurricane?

The nurse is supervising the care of a diabetic patient with stomach cancer. After surgery, the patient is placed on total parenteral nutrition (TPN). Which information does the nurse provide the nursing student about the TPN?

To which patient does the nurse most likely anticipate administering total parenteral nutrition (TPN)?

The nurse is caring for a patient receiving total parenteral nutrition (TPN). The nurse most closely assesses for which complication in this patient? 

The nurse is most vigilant for signs of which complication in a patient receiving total parenteral nutrition (TPN)?

The patient with chronic malnourishment is started on total parenteral nutrition (TPN). The nurse is vigilant for signs of which complication?

The nurse is admitting a patient who is being transferred from a nursing home who has been bedridden for the past two months. The nurse anticipates the patient will have which electrolyte disturbances?

Which statement by the patient who has recently undergone a radical mastectomy indicates they understand teaching by the nurse?

A patient comes into the ER with HR 122 bpm, BP 110/72 mm Hg, Temp 99.4 F, and RR 22. They report a racing feeling in their heart and have also been experiencing diarrhea for the last several months. Which lab result does the nurse anticipate?

Which task is most appropriate for the registered nurse to delegate to an unlicensed assistive personnel?

Which patient must be triaged for emergency department care first?

You are taking care of a 24-year-old with chest pain. While you are assessing him he suddenly becomes limp and unresponsive. Which action does the nurse take first?

A 41-year-old male complains of sudden onset of severe chest pain and describes it as a constant tearing sensation that radiates to his lower back. The nurse is most suspicious of which condition?

The nurse suspects that a patient has Ludwig’s angina. Which action does the nurse take first?

The patient is pale and dizzy following a gunshot wound to the groin. Minimal bleeding is noted at the site. Vital signs are notable for a heart rate of 125 bpm and a blood pressure of 73/39 mm Hg. Two unsuccessful attempts have been made to establish an IV site. He loses consciousness. Which action does the nurse take next?

Which statement by the patient with systolic heart failure indicates an understanding of discharge teaching?

An 84-year-old patient being treated for a chronic obstructive pulmonary disorder (COPD) exacerbation starts to become disoriented after the evening meal and will not stay in bed. Which intervention does the nurse take first?

A cesarean section is the only safe method of delivery for the fetus when the pregnant woman has which condition? 

Which statement by the patient being prepared for a coronary angiogram indicates an understanding of the nurse’s teaching on the procedure?

A patient with severe chronic obstructive pulmonary disorder (COPD) is receiving 3 liters per minute of oxygen via nasal canal. Which oxygen saturation indicates respiratory support is adequate?

The patient is brought to the emergency room by her husband with slurred speech and facial drooping. Which question does the nurse ask first?

The patient has a mechanical mitral valve. Where does the nurse place the stethoscope bell to auscultate for valve function?

The patient is diagnosed with new, rapid atrial fibrillation and thinks the problem has been going on for two weeks. Which statement by the patient indicates an understanding of teaching about the diagnosis?

The patient is undergoing cardioversion for symptomatic atrial flutter. Which event requires immediate intervention by the nurse?

A patient presents to the ER after having impaled his hand with a nail from a pneumatic nail gun at work. His friend removed the nail at the scene. Which statement indicates the patient understands the teaching provided by the nurse?

Which statement is correct regarding arterial lines?

Which patient does the nurse assess first following shift change report?

The nurse is caring for a 62-year-old female who was recently diagnosed with glaucoma. The patient is given docusate. Which of the following is the primary reason for giving the patient a stool softener?

The 50-year-old patient receiving chemotherapy for breast cancer has developed a fungal bloodstream infection. Which intervention is the nurse’s first consideration?

Which assessment is most indicative of a pleural effusion?

The G2P1 patient who is 33 weeks pregnant is brought via ambulance to the emergency department due to significant vaginal bleeding and abdominal pain. Which action does the nurse take first?

The nurse is caring for a 48-year-old female diagnosed with acute kidney injury. Laboratory results reveal that the patient is experiencing mild hyperkalemia. Which independent nursing action is appropriate to manage the patient's hyperkalemia?

The nurse uses which technique to counsel a patient with chronic obstructive pulmonary disorder (COPD) about quitting smoking? 

The 62-year-old patient presents to the emergency department complaining of chest pain. After a battery of tests and exams, the physician tells the nurse the patient's chest pain was likely due to coronary artery spasm. The nurse prepares education for the patient about which condition? 

The nurse notes the patient being treated for chemical burns is hyperventilating. The nurse suspects which medication is the culprit of the patient's symptoms?

The nurse is caring for a 22-year-old patient who is experiencing sickle-cell crisis. Which is the priority nursing consideration?

The nurse is assigned to a 55-year-old patient with Streptococcus viridans endocarditis who is receiving penicillin and amikacin. The nurse is vigilant for which adverse effect?

The nurse is caring for a 45-year-old patient undergoing treatment with doxorubicin for small cell lung cancer. The nurse focuses education on which adverse effects? Select all that apply.

The patient is being treated with intravenous quinidine for malaria that was contracted while in Africa. Several hours after administration of the medication, the patient develops palpitations and dizziness. Electrocardiogram shows tachycardia and twisting of the QRS complexes around an isoelectric line. Which best describes the most likely etiology of this patient’s arrhythmia?

The nurse is taking care of a patient who is prescribed chloramphenicol. After three days, the patient develops fatigue and dyspnea on exertion. Physical assessment reveals tachycardia, pallor and multiple petechiae on the trunk and extremities. The nurse anticipates which laboratory result(s)?

The nurse is assigned to care for a 31-year-old male with a past medical history significant for long-standing diabetes mellitus and hypertension. Current medications are metformin, furosemide, and captopril. Laboratory tests reveal serum potassium of 3.2 mEq/L, so the patient is started on spironolactone. The nurse provides education about which side effect of therapy?

The 9-year-old patient presents to the clinic for a routine well-child visit. Which health screening does the nurse perform?

The nurse is assigned to a 32-year-old G1P0 female at 30 weeks estimated gestational age who presents with pre-eclampsia. On physical assessment, the patient’s blood pressure is 180/125 mm Hg. The patient is prescribed magnesium sulfate by the provider. Which of the following is the most indicative that magnesium sulfate has been effective?

The older adult patient is brought to the emergency department with sudden onset confusion, agitation, and hallucinations. The patient's past medical history is significant for type 2 diabetes managed with glyburide, anxiety managed with lorazepam, and insomnia managed with zolpidem. Upon assessment, the patient's heart rate and rhythm are regular, lungs are clear to auscultation, and bowel sounds are present. Vital signs are normal, with exception of a slightly elevated heart rate. Which is the most likely cause of the patient's symptoms?