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Nursing Care of Clients with Coronary Heart Disease
NCLEX Review

1 .       A 60-year-old male with a history of angina pectoris complains of chest pain radiating to the neck and left arm. The nurse's best initial response is which of the following? [Hint]

 
 
 
 


2 .       A nurse planning immediate postprocedure care for a client undergoing cardiac catheterization via the femoral artery would not include which of the following in the plan? [Hint]

 
 
 
 


3 .       A 46-year-old male presents to the emergency department complaining of severe chest pain and shortness of breath. The client's ECG indicates an acute myocardial infarction, and intravenous streptokinase is ordered stat. The nurse administering the streptokinase would not include which of the following in the immediate management of this client? [Hint]

 
 
 
 


4 .       A female client with acute myocardial infarction complains of severe chest pain. The nurse administers an initial intravenous dose of 6 mg morphine. 2 to 4 mg of morphine may be administered every 5 minutes until the pain is relieved. 5 minutes later, the client rates the chest pain as the same as before the administration of the first dose of morphine. The client's vital signs are stable. The nurse's next appropriate action is which of the following? [Hint]

 
 
 
 


5 .       A client in the intensive coronary care unit suddenly goes from a normal sinus rhythm with rare PVCs into sustained ventricular tachycardia. The nurse is preparing to administer lidocaine intravenously when the nurse notes the rhythm has changed to ventricular fibrillation, and no palpable or audible pulse is detected. Which of the following does the nurse immediately implement? [Hint]

 
 
 
 


6 .       A nurse in the coronary care unit responds to an alarm indicating a client is in asystole (flat line). Which of the following actions does the nurse implement immediately? [Hint]

 
 
 
 


7 .       A client is prescribed propranolol (Inderal) to help prevent angina. The nurse evaluating the client's understanding of the instructions knows further teaching is required when the client states [Hint]

 
 
 
 


8 .       A nurse, monitoring a client's cardiac rhythm, notes an atrial rate of 70, and ventricular rate of 40, both with regular rhythms. There is no relationship between P waves and QRS complexes. The nurse recognizes this rhythm as which of the following? [Hint]

 
 
 
 


9 .       A nurse performing cardiac defibrillation correctly implements the procedure when which of the following placements of the external paddles is demonstrated? [Hint]

 
 
 
 


10 .       A nurse is monitoring a client with a ventricular demand pacemaker that is set at 75. Which of the following monitor assessments indicates a complication with the pacemaker? [Hint]

 
 
 
 






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