Cardiovascular NCLEX Questions | MI Heart Failure Nursing
Cardiovascular NCLEX Questions | MI Heart Failure Nursing
This video is about cardiovascular NCLEX questions. I will talk about MI and heart failure nursing. Be sure to watch all of my nursing school lecture videos.
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Content
0.08 -> Welcome back Lifesavers to
another NCLEX preparation video.
6.08 -> In today's video we’re going to dissect some
cardiovascular themed NCLEX style questions.
11.52 -> Hopefully this will be a reinforcement to the
content you have been learning throughout the
15.76 -> last two weeks. So without further ado let’s
go ahead and jump right into some questions.
22.88 -> Okay question 1 let’s start off with
those dreadful SATA question types:
30.4 -> An adult client is admitted to an acute care floor
with the diagnosis of heart failure. Upon further
36.24 -> work up the health care provider informs the nurse
that the client has right-sided heart failure.
41.92 -> Which symptom/symptoms does the nurse expect to
assess in this client. Select all that apply.
51.2 -> Dependent edema
53.04 -> Jugular vein distention
Weight loss
56.4 -> Crackles
Weight gain
59.52 -> So for this question we have to first re-read
the question and pick out the key words.
64.4 -> An adult admitted to an acute care floor with the
diagnosis of heart failure. BINGO there’s your
70.72 -> first key word. So now we want to start thinking
about the disease etiology of heart failure.
77.04 -> Alright let’s keep going. Upon further
workup the health care provider informs
81.36 -> the nurse that the client has right-sided
heart failure. DING DING DING, RIGHT sided
86.8 -> heart failure is your second key word because
there is a difference in clinical presentation
92.4 -> between left and right sided heart failure.
Okay we’ll keep going which signs/symptoms
99.2 -> does the nurse expect to assess in
this client. So we’re looking to assess
103.84 -> findings of RIGHT sided heart failure.
And we want to select all that apply.
108.8 -> Alright so as we read through these answers
there’s one answer we can eliminate right off
114.08 -> the bat because it’s not a sign of right sided
or left sided heart failure. The answer we can
120.64 -> eliminate first is weight loss because remember
the heart’s primary role is to pump blood which
126.8 -> is made primarily of fluid throughout the body.
If the heart is failing, it can’t adequately pump
132.96 -> that blood and fluid through the body so you start
retaining water which actually causes weight gain.
138.44 -> Okay so now that we’ve eliminated the
obviously wrong answers we have to think
144.8 -> about the difference between left and right
sided heart failure. Left sided HF results
150.64 -> from left ventricular dysfunction. This prevents
normal, forward blood flow and causes blood to
157.92 -> back up into the left atrium and pulmonary veins
whereas right sided heart failure causes a backup
164.8 -> of blood into the right atrium and impaires
venous circulation. Now let’s look at each answer.
172.4 -> Dependent edema, this means gravity related
swelling which would be a sign of poor venous
178.4 -> circulation so yes this answer is correct.
Jugular vein distention, this results from
186.16 -> increased pressure in the superior vena cava. So
where does the superior vena cava enter? It enters
192 -> into the RIGHT atrium on the RIGHT side of the
heart so if the right side of the heart is failing
197.28 -> it would make sense that you would see bulging of
the jugular vein so this answer is also correct.
204.16 -> Crackles- now crackles are adventitious lung
sounds resulting from fluid build up in the
209.36 -> lungs. So we said that left sided heart failure
prevents normal, forward blood flow causing a
215.28 -> backup of blood into the left atrium and left
PULMONARY veins. So if the pulmonary veins are
221.28 -> overloaded with fluid then you would expect to
hear crackling in the lungs. So we can conclude
227.76 -> this is a sign of left sided heart failure
therefore this is NOT the correct answer.
234.48 -> And last but not least weight gain we had already
said weight gain is a sign of both left and right
239.68 -> side heart failure due to the retention of
the fluid so yes this is the correct answer.
244.56 -> So we have 1,2, and 5 as our
correct answers for this question.
250.16 -> Let’s take a look at another SATA
question: The nurse is caring for
255.12 -> a client who is symptomatic for coronary
artery disease. Which symptom/symptoms does
260.32 -> the nurse expect to find when assessing
this client? Select all that apply.
266.64 -> Chest Pain
Arm Pain
269.2 -> Jaw Pain
270.32 -> Renal Failure
Liver Failure
274.08 -> This is a great question because we just reviewed
this information in my last common disease video
280.24 -> about coronary artery disease. So first we want
to think about the disease etiology of CAD.
291.04 -> If you remember from my common disease
video we said coronary artery disease is
295.04 -> a result of plaque build up and narrowing of
the coronary arteries which impedes that rich
300.96 -> oxygenated blood supply to the heart. So we want
to be thinking about what symptoms would a patient
306.48 -> experience if they lacked blood supply to the
heart. The correct answers here are 1, 2, and 3
313.92 -> chest pain, arm pain, and jaw pain. When there
is a lack of oxygenated blood to the heart,
319.68 -> the nerves that branch from the heart and those
coming from the arm and jaw send signals to
325.52 -> the exact same brain cells which is why patients
will experience pain that radiates from the chest
331.76 -> to the arm and jaw. These are the key signs and
symptoms of CAD and can occur after exertion,
340.16 -> emotional stress, or exposure to cold, but
can also develop when the client is at rest.
347.52 -> Renal and liver failure are not expected
symptoms with coronary artery disease.
355.76 -> Alright next question: A client calls the
nurse and states, “I think I am having bad
360.64 -> indigestion because my chest hurts.” Which
response by the nurse is most appropriate?
367.52 -> “Immediately go to the hospital.”
“Have you ever felt this way before?”
373.68 -> “What did you eat yesterday?”
“Take an antacid and see if it subsides.”
381.04 -> Okay so for this question let’s go
through and pick out the keywords here.
384.64 -> So we have a patient reporting “bad indigestion”,
key word, and chest pain, another keyword.
391.52 -> And the question is asking which response is
MOST appropriate, most appropriate is another
397.28 -> keyword because while all of these responses may
be appropriate responses we want to know which
402.48 -> response is the most appropriate. Anytime you have
a patient complaining of chest pain or a feeling
408.8 -> of indigestion you should automatically start
thinking that there may be a cardiac source to
413.92 -> the pain. So in this case the correct answer is
going to be 1, you want to instruct the patient to
421.52 -> immediately go to the hospital. The most
common symptom of a myocardial infarction
426.32 -> or heart attack is chest pain which is a result
of deprivation of oxygen rich blood to the heart.
432.64 -> The nurse would inform the client to seek
medical attention immediately because
437.84 -> if the client is in fact having a heart attack,
every second that medical attention is delayed,
443.28 -> the heart muscle becomes more and more
ischemic which means that heart muscle
447.92 -> is essentially dying. All of the other responses
are inappropriate because postponing care could
453.12 -> lead to serious complications including
death. I’ve seen many patients come into
458.56 -> my ER complaining of an acid reflux type feeling
in their chest and once I did an EKG, I could see
464.56 -> that they were having what we call a STEMI which
is an ST elevated myocardial infarction. This acid
473.04 -> reflux or indigestion feeling I have found is more
prevalent in women but it does happen in men too.
479.44 -> Next question is another select all that apply:
A client with a family history of heart disease
486.64 -> is diagnosed with coronary artery disease. The
client asks the nurse, “How might this affect my
491.84 -> future health status?” Which response/responses by
the nurse is appropriate. Select all that apply.
500.64 -> “It can lead to hypertension”
503.52 -> “It can lead to angina”
“It can lead to a myocardial infarction”
508.32 -> “It can lead to gastritis”
“It can lead to heart failure”
513.12 -> Again for this question we want to think about
the disease etiology of CAD and the symptoms or
518.96 -> comorbidities the client can experience from
it. Coronary artery disease causes decreased
524.72 -> perfusion of myocardial tissue and inadequate
myocardial oxygen supply. So knowing the etiology
531.84 -> of this disease, we can conclude that CAD can
lead to hypertension because as plaque builds
538.56 -> up and the arteries narrow the heart will have to
work harder and pump blood harder so the pressure
544.8 -> starts building up during the systole and diastole
process therefore increasing that blood pressure.
552 -> Patient’s can also experience angina
or chest pain for the same reason.
556.4 -> We know patients are also at a very high risk for
having a myocardial infarction or heart attack
562.48 -> which happens when the coronary artery becomes
completely occluded. We also know that patients
568.96 -> are at risk for heart failure because the heart
is a muscle so the more overworked that heart is,
575.36 -> the more or a chance it becomes tuckered out and
starts to fail. The only answer in this question
581.84 -> that doesn’t make sense is that CAD can lead to
gastritis. Gastritis is the inflammation in the
588.64 -> stomach lining and causes can include infection,
injury to the stomach, regular use of NSAIDs,
598.72 -> or excessive alcohol consumption. So this answer
doesn’t correlate with the etiology of CAD.
604.24 -> The correct answers here are 1, 2, 3, and 5
hypertension, angina, MI, and heart failure.
612.8 -> Lastly let’s dissect a prioritization question.
So the question is: Which nursing action is
618.8 -> priority when caring for a client exhibiting
manifestations of coronary artery disease?
625.12 -> Decrease anxiety level
Enhance myocardial oxygenation
630.08 -> Administer sublingual nitroglycerin
Educate the client about symptoms
636.8 -> For these prioritization questions, it’s important
to remember that usually all of the answers will
642.16 -> be appropriate nursing interventions. What you’re
trying to figure out is which intervention is the
648.24 -> MOST important to act on right away. For these
questions you’re going to want to think about
653.12 -> the ABCs and Maslow’s hierarchy of needs. In
my NCLEX and Chill course I do review these
660 -> concepts in great detail so make sure you check
out my course for more test taking strategies.
666 -> The abbreviated version of the ABCs is airway,
breathing, and circulation. You’ll always want
673.92 -> to prioritize your nursing interventions in this
order when caring for a client. So first you want
679.36 -> to assess for airway patency. In this question,
none of the answers indicate that there's a
685.6 -> problem with the patient's airway so we’re going
to move on to B for breathing or oxygenation
691.76 -> the two terms can be used interchangeably. So when
looking at this list of interventions, option 2 is
698.72 -> to enhance myocardial oxygenation. When following
the ABC algorithm option 2 is going to be the best
706.16 -> answer for this question. Enhancing myocardial
oxygenation is always the priority when a client
712.48 -> exhibits manifestations of cardiac compromise.
Without adequate oxygen, the myocardium suffers
720.48 -> damage. Sublingual nitroglycerin dilates the
coronary vessels to increase circulation but it’s
730.96 -> not the priority because circulation comes after
breathing when following the ABC prioritization
738.4 -> strategy. And lastly although educating
the client and decreasing anxiety are
742.96 -> important, neither are priority for
an actively compromised patient.
748.4 -> And that concludes the end of this lesson.
I hope you found this information extremely
752.88 -> valuable and it made you just a little
more confident as you prepare to take your
756.8 -> NCLEX. I want to thank you so much
life savers for tuning in today.
761.36 -> My name is Nurse Kelly Tyrrell and
I help nurses feel more confident,
765.84 -> increase their test scores, and retain
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800.4 -> And last but not least when you’re ready to
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812.64 -> so you can have that unfair advantage and
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Source: https://www.youtube.com/watch?v=-psADWDEWzA