CN1 EXAM 3 REVIEW

Cardiac Output Formula

Heart Rate x Stroke Volume

1 tsp = ___ mL

5

1 Cup = __ oz

8

1 oz = ___ mL

30

1 Cup = ____ mL

240

MAP Formula

DBP x 2 + SBP

Which of the following terms describes the amount of blood the left ventricle pumps out with each heartbeat?

Stroke Volume

During which phase of the cardiac cycle does preload develop as the ventricles fill with blood?

Diastole

A nurse is explaining preload to a nursing student. Which statement best describes preload?

The amount of blood the ventricles contain before contraction

A nurse reviews a client's lab results and notes thrombocytopenia. Which finding is the client most at risk for developing?

Increased risk of bleeding

A client has leukopenia. Which complication should the nurse prioritize monitoring for?

Infection

Which laboratory pattern is consistent with pancytopenia?

Decreased red blood cells, white blood cells, and platelets

Which statement best describes the primary function of a thrombocyte?

Helping form a platelet plug to stop bleeding

A nurse explains the function of leukocytes to a client. Which statement is correct?

They help defend the body against infection.

A client has a decreased erythrocyte count. Which finding is most directly associated with this change?

Fatigue and decreased oxygen delivery

Which process occurs during fibrinolysis?

Breakdown of a clot

During a skin assessment, the nurse observes multiple tiny, flat, reddish-purple spots that do not blanch with pressure. Which term should the nurse use to document this finding?

Petechiae

A client reports calf cramping that begins after walking a short distance and resolves after resting. Which condition does this finding most strongly suggest?

Intermittent claudication

Which laboratory result best explains why a client is developing petechiae?

Decreased platelet count

A nurse is teaching a client with PAD about intermittent claudication. Which statement indicates correct understanding?

“The pain occurs when my leg muscles need more oxygen than my blood supply can provide.”

A nurse is evaluating a client for hypertension. Which finding best supports confirming the diagnosis?

Repeated elevated BP readings on separate occasions

A client is being treated for a hypertensive emergency without a special condition requiring a different target. Which approach is generally appropriate during the first hour?

Reduce systolic BP by no more than approximately 25%.

A client is admitted with a BP of 218/124 mmHg. Which finding most strongly indicates a hypertensive emergency?

Acute kidney injury with elevated BP

A client with hypertension is prescribed hydrochlorothiazide. Which effect helps lower blood pressure?

Decreased blood volume and preload

A nurse reviews the laboratory results of a client taking spironolactone. Which result is most concerning?

Potassium 6.2 mEq/L

A client taking lisinopril develops a persistent dry cough. Which medication class may the provider prescribe as an alternative?

ARBs

A nurse checks a client's vital signs before administering metoprolol. The client's HR is 54 beats/min. What should the nurse do?

Hold the dose according to the prescribed parameters and notify the provider as indicated.

Which statement by a client with hypertension indicates correct understanding of the DASH diet?

“I should choose foods rich in fruits, vegetables, and whole grains and limit sodium.”

A patient with peripheral artery disease reports foot pain that worsens when the legs are elevated and improves when the feet are placed in a dependent position. Which nursing action is most appropriate?

Allow the legs to remain in a comfortable dependent position

A patient with chronic venous insufficiency has bilateral ankle edema that worsens after standing for several hours. Which intervention should the nurse recommend when appropriate?

Elevate the legs to promote venous return.

A nurse is comparing patients with arterial insufficiency and venous insufficiency. Which statement best describes their different positioning needs?

Arterial insufficiency may improve with dependency, while venous insufficiency often improves with elevation.

A hospitalized patient develops unilateral calf swelling, warmth, and tenderness after several days of immobility. Which complication should the nurse suspect?

Deep vein thrombosis

A patient with a confirmed lower-extremity DVT suddenly develops chest pain, dyspnea, and tachycardia. Which complication should the nurse suspect?

Pulmonary embolism

A nurse assesses a patient with suspected peripheral artery disease. Which finding most strongly supports reduced arterial perfusion?

A cool foot with diminished pedal pulses

Which medication class has the pronouns -olol?

Beta Blockers

Which medication class has the pronoun "sartan"?

ARBs

Which medication class has the pronouns -prils?

ACE Inhibitors

Which medication class of CV drugs can cause hyperkalemia?

ARBs

A client states, "My BP is normal, so I am going to skip my metoprolol tonight." Which response is best?

"Stopping suddenly can cause rebound effects, so discuss a taper with your prescriber."

A client taking losartan has a potassium level of 5.9 mEq/L. Which action is most appropriate?

Assess the client and promptly report the elevated potassium level.

A nurse is assessing a client who has been taking lisinopril for 3 weeks. The client reports a new sensation of throat tightness and difficulty swallowing. Oxygen saturation is 96%, and lung sounds are clear. Which action should the nurse take first?

Withhold lisinopril and initiate an emergency response because the symptoms may indicate angioedema.

A nurse reviews the laboratory results of a client taking losartan for hypertension. The potassium level has increased from 4.2 to 5.5 mEq/L, and the creatinine has increased from 1.0 to 1.4 mg/dL. The client denies weakness or palpitations. Which action is most appropriate?

Assess the client, review the medication and laboratory trends, and promptly notify the prescriber.

A nurse is preparing to administer metoprolol. The client's HR is 64 bpm, BP is 124/76 mmHg, and the prescription states to hold the medication if HR is below 60 bpm. What should the nurse do?

Administer the medication because the BP/HR is normal.

A client with diabetes takes insulin and metoprolol. The client becomes confused and diaphoretic, and the blood glucose is 48 mg/dL. The HR is 78 bpm. Which interpretation is most accurate?

The client may have hypoglycemia without the expected S/Sx.

A client with HF and an EF of 30% is prescribed a CCB. Which concern should the nurse recognize?

CCBs may decrease HR and cause vasodilation, worsening HF symptoms

A client taking lisinopril develops a persistent dry cough. Which response by the nurse is appropriate?

Explain that a dry cough is a known adverse effect and notify the prescriber if persistent.

A nurse reviews the lipid panel of four clients. Which result falls within the desirable range for total cholesterol?

198 mg/dL

A client with atherosclerosis has an LDL level of 148 mg/dL. Which interpretation should the nurse make?

The LDL is elevated and may contribute to plaque buildup.

A nurse is teaching a client about HDL cholesterol. Which laboratory result is generally considered favorable?

63 mg/dL

A nurse reviews the lipid panel of a client with hypertension. Which triglyceride result is within the normal range?

142 mg/dL

A nurse reviews four lipid panels. Which client has all four values within the desirable ranges used in the client's chart.

Total cholesterol 185, LDL 88, HDL 64, triglycerides 145 mg/dL

A nurse is teaching a client about the difference between arteriosclerosis and atherosclerosis. Which statement best describes atherosclerosis?

Fatty plaques develop within arterial walls, narrowing the lumen and potentially triggering thrombosis.

A client with a history of CAD suddenly develops severe chest pressure. The nurse understands that a previously identified unstable atherosclerotic plaque may have ruptured. Which process most directly increases the risk of an acute myocardial infarction?

Platelets aggregate at the disrupted plaque and a thrombus forms, obstructing coronary blood flow.

A nurse assesses a client with peripheral artery disease who reports calf pain after walking approximately one block. The pain resolves within several minutes of resting. The right foot is cool to the touch, and the dorsalis pedis pulse is diminished. Which explanation best accounts for these findings?

Reduced arterial blood flow limits oxygen delivery to the leg muscles during activity, causing intermittent claudication.

During an assessment, a nurse hears a bruit over the carotid artery. Which interpretation is most appropriate?

The sound indicates turbulent blood flow and may be associated with arterial narrowing.

A client taking atorvastatin reports new severe muscle pain and weakness. The client also reports dark-colored urine. Which action should the nurse take?

Arrange prompt medical evaluation for possible serious myolysis

A client with atherosclerosis has intermittent chest discomfort during exertion that resolves with rest. The client later develops sudden chest pain at rest. Which explanation best describes why the new symptom is concerning?

A unstable plaque may rupture and form a thrombus, causing an acute reduction in coronary blood flow

A nurse reviews risk factors with a client who has a family history of premature coronary artery disease. Which factor is modifiable?

The client's cigarette smoking.

A client with heart failure develops worsening dyspnea, bilateral crackles, and pink, frothy sputum. Which condition best explains these findings?

Pulmonary edema

A nurse assesses a client with right-sided heart failure. Which group of findings would the nurse most likely expect?

Peripheral edema, jugular venous distention, and abdominal swelling.

A client with heart failure reports waking suddenly at night with severe shortness of breath after sleeping for several hours. The client states that sitting upright improves breathing. Which term best describes this symptom?

Paroxysmal nocturnal dyspnea.

A client with heart failure reports becoming short of breath while walking to the bathroom but feels better after resting. How should the nurse document this symptom?

Exertional dyspnea.

A client initially diagnosed with left-sided heart failure later develops JVD, hepatomegaly, and bilateral ankle edema. Which explanation best accounts for this change?

Pulmonary congestion has increased pressure in the right ventricle, contributing to right-sided HF.

A nurse is reviewing the hemodynamic status of a client with heart failure. Which statement best describes preload?

Ventricular filling and stretch at the end of diastole.

A client with chronic hypertension develops left ventricular hypertrophy. The nurse explains that the heart must work harder to pump blood against increased vascular resistance. Which term describes this increased workload?

Afterload, representing the resistance the ventricle must overcome to eject blood.

A client has a heart rate of 80 beats/min and a stroke volume of 50 mL/beat. What is the client's cardiac output?

4L/min.

A client with chronic HF has decreased cardiac output. Which response occurs when the renin–angiotensin–aldosterone system (RAAS) is activated?

Sodium and water retention increases blood volume and can worsen congestion.

A nurse is assessing a client who has had several episodes of vomiting and has a decreased blood pressure. Which response should the nurse expect as the body attempts to maintain blood pressure and fluid volume?

Activation of the RAAS, promoting vasoconstriction and sodium and water retention.

RAAS is activated when the kidneys detect decreased ______ or ______.

Blood flow; blood pressure

A client presents with dyspnea, crackles, and bilateral lower-extremity edema. Which BNP laboratory result would support the possibility of heart failure?

BNP 448 pg/mL

A nurse is preparing to administer digoxin to a client with heart failure. The client's apical pulse is 56 beats/min, BP is 118/71. What should the nurse do?

Hold the medication and notify the healthcare provider

ANP is primarily released by the ______, while BNP is primarily released by the ______ in response to stretching.

Atria; ventricles

A client with suspected heart failure has a BNP level of 45 pg/mL. Which interpretation is most appropriate?

The result makes acute heart failure less likely.

A nurse is teaching a client with heart failure how to monitor for fluid retention at home. Which weight change should the client report to the healthcare provider?

A gain of 2.5 lb (0.9 kg) in 24 hours.

A client has an echocardiogram showing an EF of 28%. Which interpretation is most accurate?

The left ventricle ejects 28% of its blood volume, indicating severely reduced systolic function.

A nurse reviews the echocardiogram results of four clients diagnosed with heart failure. Which client's ejection fraction indicates severely reduced systolic function?

Client D: EF of 25%

A client has decreased renal blood flow. The kidneys release renin, initiating the RAAS pathway. Which substance is converted by ACE into angiotensin II?

Angiotensin I

A client experiences significant blood loss following surgery. Which response should the nurse expect as the body attempts to maintain blood pressure?

Increased renin release, initiating a pathway that promotes vasoconstriction and fluid retention.

Renin helps convert angiotensinogen into ______, which ACE converts into ______.

Angiotensin I; angiotensin II

A client has increased RAAS activity due to decreased renal perfusion. Which effect does the nurse expect from aldosterone release?

Increased sodium and water retention with increased potassium excretion.

A client with hypertension begins lisinopril, an ACE inhibitor. Which effect should the nurse expect from this medication?

Decreased conversion of angiotensin I to angiotensin II, promoting vasodilation.

A patient with dysuria and urinary frequency develops fever, chills, and flank pain. Which complication should the nurse suspect?

Pyelonephritis involving the upper urinary tract

An older adult's urinalysis reveals bacteria, but the patient has no urinary symptoms or systemic signs of infection. Which interpretation is most appropriate?

The finding may represent asymptomatic bacteriuria and requires clinical assessment.

A nurse assesses a patient who reports leaking small amounts of urine when coughing, sneezing, or laughing. Which type of incontinence should the nurse suspect?

Stress incontinence

Which patient has the greatest number of risk factors for stress incontinence?

A patient with a history of multiple pregnancies, menopause, and obesity

A patient reports urine leakage when coughing, sneezing, and lifting groceries. Which intervention should the nurse recommend first?

Pelvic muscle exercises to strengthen support

A patient reports a sudden, intense need to urinate and frequently leaks urine before reaching the toilet. Which condition should the nurse suspect?

Urge incontinence

A patient reports a sudden, intense urge to urinate followed by leakage before reaching the bathroom. Which intervention is most appropriate?

Teach bladder training and assess possible bladder irritants.

A male patient with BPH reports frequent dribbling, a weak urinary stream, and difficulty emptying his bladder. Which type of incontinence is most likely?

Overflow incontinence

A patient with dementia has normal urinary function but frequently urinates in clothing because the patient cannot remember where the bathroom is located. Which type of incontinence is most likely?

Functional incontinence

A patient with dementia has normal bladder function but repeatedly urinates in clothing because they cannot find the bathroom. Which intervention is most appropriate?

Implement scheduled habit training and provide assistance

A patient's urinalysis shows positive leukocyte esterase and nitrites. How should the nurse interpret these results?

They support suspicion of a bacterial urinary tract infection.

A patient prescribed a new medication for urinary discomfort. After 3 days of taking it, she calls and asks why her urine has turned orange. Which medication could she be taking?

phenazopyridine

A nurse suspects that a patient is not emptying the bladder completely. Which assessment is most appropriate?

Perform a bladder scan after the patient urinates.

Which history meets the commonly used definition of recurrent urinary tract infection?

Two infections within the previous 6 months

A hospitalized patient has an indwelling urinary catheter and has successfully resolved their urinary retention. The RN then notes regular urinary frequencies when monitoring hourly output. Which action should the nurse take next?

Remove the catheter promptly according to the appropriate order or protocol.

A patient reports urine leakage when exercising and also experiences sudden urges followed by leakage. Which interpretation is most appropriate?

The patient may have mixed stress and urge incontinence

A nurse develops a care plan for a patient with urge incontinence. Which intervention is appropriate?

Implement bladder training and assess for bladder irritants

A patient taking an anticholinergic medication for urge incontinence reports difficulty urinating and a feeling of fullness. What should the nurse do?

Assess for urinary retention and notify the provider to reassess the medication

A nurse suspects overflow incontinence in a patient who reports frequent small voids. Which assessment would best help identify incomplete bladder emptying?

Measure postvoid residual urine with a bladder scan.