Cardiovascular disorder exam

Mr. Henderson, a 72-year-old gentleman, has been under observation for a potential cardiac issue. He's been diagnosed with aortic stenosis. During a routine examination by the nurse in the cardiac ward, several findings are documented.
Which of the following findings in Mr. Henderson, who has aortic stenosis, will be most crucial for the nurse to report to the health care provider?

Emma, a 72-year-old woman, has just undergone a coronary artery bypass graft (CABG) procedure. After an initial recovery period in the cardiac surgical unit, she is now stable and set to be transferred to a step-down unit for continued care and monitoring.
The nursing team prepares for her transfer to ensure continuity of care and a smooth transition.
Which of the following elements are essential when transferring Emma from the cardiac surgical unit?    Select all that apply

Mr. Smith, a 57-year-old male, has been referred for an exercise stress test after reporting episodes of intermittent chest pain during physical activity.
His primary care physician wants to evaluate the nature of his chest pain and potential coronary artery blockages. Mr. Smith is anxious about the procedure, stating he doesn't know what to expect.

As a nurse preparing Mr. Smith for the exercise stress test, which of the following are essential requirements and preparations to ensure the test's safety and accuracy? Select all that apply:

You're a charge nurse in the Vascular Diagnostic Center at Riverdale Clinic.
Today is especially busy, with multiple procedures and tests scheduled, and a group of patients waiting for their appointments. One of your most experienced assistive personnel (AP), Alex, approaches you, offering assistance to ensure the efficient flow of procedures.
As a nurse, you need to delegate a task to Alex but must ensure it's both within his scope of practice and appropriate for his skill set.

Given the current patient lineup, which of these tasks associated with vascular testing would be the most appropriate to delegate to Alex?

Mr. Thompson, an 84-year-old resident of a long-term care facility, has a history of chronic venous insufficiency, resulting in the development of venous stasis ulcers on his left lower leg.
To manage this condition, his healthcare provider has ordered an Unna boot for compression and healing support.
The nursing team has been tasked with monitoring and maintaining the boot, as well as ensuring that Mr. Thompson's other health needs related to the condition are met.
With a busy shift ahead and several responsibilities to juggle, the charge nurse is considering delegating some of the tasks to the assistive personnel (AP).

From the following nursing activities related to Mr. Thompson's care, which is the most appropriate for the nurse to delegate to the AP?

A 65-year-old male, Mr. Thompson, is admitted to the emergency department following a minor car accident. While his external injuries appear minimal, he reports increasing difficulty in breathing, along with a feeling of pressure in his chest. An echocardiogram has been ordered to rule out internal cardiac injury, specifically cardiac tamponade, given his complaints.
Which of the following assessments would be indicative of cardiac tamponade in Mr. Thompson? Select all that apply

Mr. Anderson, a 62-year-old male, has been admitted to the cardiology ward for evaluation of recent episodes of dyspnea and palpitations. This morning, his cardiologist examined his recent ECG and decided to get a detailed view of the heart to rule out any structural abnormalities. 
Given the urgency of the procedure, you prioritize your nursing interventions.
Which of the following actions will you take first to prepare Mr. Anderson for the TEE?

Ms. Garcia, a 45-year-old female, is admitted to the cardiac unit after a pericardiocentesis due to cardiac tamponade. She has a history of systemic lupus erythematosus (SLE) and was recently treated for pericarditis.
The nurse is preparing to care for Ms. Garcia and administer her medications.

Which of the following actions should the nurse take to apply the principles of infection prevention during Ms. Garcia's care?

Ms. Martinez, a 58-year-old woman, is preparing for discharge after being admitted for acute exacerbation of heart failure.
She lives alone and manages her own medications and daily activities. The nurse is reviewing Ms. Martinez's discharge plan to ensure she is well-prepared for self-care at home.
Which topics will the nurse prioritize in discharge teaching for Ms. Martinez related to her heart failure? Select all that apply.

Mark, a 64-year-old retired banker, was admitted to the cardiology department complaining of exertional chest pain that subsided at rest. An angiogram revealed a significant blockage in one of his coronary arteries.
The cardiologist decided that a coronary angioplasty with stent placement femoral approach was the best course of action. The procedure was successfully performed without any complications.
As Mark is transferred to the post-procedure unit, the nursing team prepares to provide post-angioplasty care.

Which of the following are the most essential nursing actions in the immediate post-angioplasty care for Mark? Select all that apply

You're beginning your shift as the charge nurse on the coronary step-down unit at the Heart Institute. As you gather information during the handover, you're presented with a snapshot of four patients who require attention.
Each patient has unique conditions and needs, and your priority is to ensure the best possible care.
As you evaluate the information, you need to determine which patient to assess first to ensure optimal outcomes.

Which of these patients would you prioritize for assessment based on their current status and potential risk?

Mrs. Jacobs, a 58-year-old female with a history of hypertension and hyperlipidemia, was admitted to the hospital after experiencing crushing substernal chest pain radiating to her left arm and jaw.
She was diagnosed with a myocardial infarction (MI) after an elevated troponin level and ST-segment elevation on her electrocardiogram (ECG). Currently, Mrs. Jacobs reports persistent chest discomfort, rating her pain as 7 out of 10.
She describes the pain as pressure-like and states it worsens with activity.

Which of the following is the best nursing intervention to address Mrs. Jacobs' pain?

Mr. Evans, a 62-year-old male, underwent a pericardiocentesis 4 hours ago to relieve cardiac tamponade. He is now in the recovery unit and under continuous monitoring. His nurse is checking his latest lab results and monitoring for potential complications.
What should the nurse prioritize monitoring in Mr. Evans, and which intervention is most appropriate?

Mr. Johnson, a 67-year-old male with a history of coronary artery disease, is admitted to the cardiac unit for chest pain and shortness of breath. His ECG shows ST-segment elevation, and the healthcare provider orders IV nitroglycerin at 50 mcg/min.
Upon reviewing his chart, the nurse notes that Mr. Johnson is also receiving oral sildenafil .

What should the nurse do next to verify the appropriateness and accuracy of the treatment order?

Mr. Smith, a 68-year-old male, was recently diagnosed with atrial fibrillation. He has been experiencing palpitations and intermittent dizziness but does not want to rely on medications to manage his condition. The nurse is discussing non-pharmacological interventions with him.

Which non-pharmacological interventions should the nurse recommend to Mr. Smith to help manage his atrial fibrillation?

Mrs. Lee, a 52-year-old woman, is 34 weeks pregnant and has a history of cardiovascular disease. She is admitted to the obstetric unit for management of shortness of breath and fatigue.
She is receiving medication to control her heart rate, but her symptoms persist. Mrs. Lee is uncomfortable and anxious.
Which non-pharmacological comfort measures should the nurse provide to Mrs. Lee?

Ms. Mitchell, a smoker 62-year-old woman with a past medical history of hypertension, hyperuricemia,post-menopausal  and hypercholesterolemia, presents to the emergency department with a sudden onset of severe chest pain.
She describes the pain as a sharp, "tearing" sensation that started abruptly a few hours ago. The pain is primarily located in her upper chest and radiates to her upper back, between the shoulder blades.
She reports feeling short of breath and also mentions a mild headache. Ms. Mitchell has no history of similar symptoms in the past.

Given her presentation, which type of chest pain is Ms. Mitchell most likely experiencing, two(2) risk factors and two(2) initial therapeutic goals for Ms. Mitchell?

A 67-year-old retired school teacher, Anna visits her primary care physician for a routine check-up. She mentions occasional pain in her calves while walking that relieves upon resting.
Suspecting peripheral arterial disease (PAD), the physician orders an Ankle-Brachial Index (ABI) test.
The nurse prepares to perform the ABI to determine the severity of PAD.
Which of the following three actions is correct when performing the ABI on Anna?

Ana, a 29-year-old graphic designer, presents to the emergency department with a 10-day history of fever, fatigue, and shortness of breath. She recently returned from a camping trip and recalls being bitten by several ticks.
A diagnosis of acute myocarditis is suspected. As the medical team starts treatment, the nursing staff plans for important actions considering both the diagnostic and therapeutic aspects of care, with special emphasis on infection control measures to prevent further complications.

Which of the following are the most important nursing actions for a patient diagnosed with suspected acute myocarditis with a focus on infection control? Select all that apply 

David, a 59-year-old lawyer, presents to the emergency department with complaints of chest pain that started about 3 hours ago. The pain is described as a tight, squeezing sensation radiating to his left arm.
With a suspicion of an acute coronary event, the healthcare provider orders laboratory tests, including cardiac troponin T and cardiac troponin I as workup.

Which of the following statements about cardiac troponin T and cardiac troponin I are correct? Select all that apply

Ms. Parker, a 70-year-old female, has a long-standing history of heart failure and has been admitted to the hospital due to increased shortness of breath and peripheral edema. She is now stabilized and the nurse is providing discharge education.

What should the nurse emphasize in Ms. Parker’s discharge education regarding self-care at home?

Mr. Ramirez, a 62-year-old male, has been admitted with a suspected myocardial infarction.

Which of the following interventions is the priority for Mr. Ramirez?

Ms. Thompson, a 32-year-old female, is 28 weeks pregnant and has a history of mitral valve stenosis. She presents to the obstetric unit with complaints of worsening fatigue, palpitations, and mild shortness of breath.
The nurse reviews her condition and discusses ways to manage her symptoms without using medications.

What non-pharmacological interventions should the nurse suggest to help Ms. Thompson manage her cardiovascular symptoms during pregnancy?

Samuel, a 22-year-old college athlete, presents to the cardiology clinic for a routine check-up.
He has recently been experiencing episodes of dizziness after intense physical activity. He has no known heart diseases but mentions that his father was diagnosed with hypertrophic cardiomyopathy (HCM) in his early 40s.
Upon further diagnostic evaluation, Samuel is diagnosed with HCM.
Given the new diagnosis and his active lifestyle, the nursing team starts to consider the most crucial preventive actions they should teach Samuel to manage and potentially mitigate the progression or complications of HCM.

Which of the following are the most important nursing preventive actions for a patient diagnosed with hypertrophic cardiomyopathy?     Select all that apply