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Question 1 of 5.

The nurse notices a pair of nervous-acting individuals entering the emergency department. When reporting suspicious activity, the nurse should include which of the following in the report? Select all that apply.

A. Vehicle/s description.

B. Current location of parties involved.

C. Names and phone numbers of parties involved.

D. Relationship to hospitalized client.

E. Tone of voice of each party involved.

Explanation: Reporting suspicious activity should include objective details like vehicle description and current location to aid security response. Names, relationships, and tone are less critical unless directly relevant.

Question 2 of 5.

The nurse notices that a client's heart rate decreases from 63 to 50 beats per minute on the monitor. The nurse should first:

A. Administer Atropine 0.5 mg I.V. push.

B. Auscultate for abnormal heart sounds.

C. Prepare for transcutaneous pacing.

D. Take the client's blood pressure.

Explanation: A heart rate of 50 bpm may indicate bradycardia. Taking the blood pressure first assesses hemodynamic stability, guiding whether immediate intervention (e.g., atropine or pacing) is needed.

Question 3 of 5.

The nurse is assessing clients at a health fair. Which client is at greatest risk for coronary artery disease?

A. A 32-year-old female with mitral valve prolapse who quit smoking 10 years ago.

B. A 43-year-old male with a family history of CAD and cholesterol level of 158.

C. A 56-year-old male with an HDL of 60 who takes atorvastatin (Lipitor).

D. A 65-year-old female who is obese with an LDL of 188.

Explanation: Obesity and elevated LDL (188) are significant risk factors for coronary artery disease. The other clients have lower-risk profiles due to younger age, smoking cessation, or controlled lipids.

Question 4 of 5.

The physician refers the client with unstable angina for a cardiac catheterization. The nurse explains to the client that this procedure is being used in this specific case to:

A. Open and dilate blocked coronary arteries.

B. Assess the extent of arterial blockage.

C. Bypass obstructed vessels.

D. Assess the functional adequacy of the valves and heart muscle.

Explanation: Cardiac catheterization in unstable angina assesses the extent of coronary artery blockage to guide interventions like angioplasty or bypass surgery.

Question 5 of 5.

The nurse finds the apical impulse below the fifth intercostal space. The nurse suspects:

A. Left atrial enlargement.

B. Left ventricular enlargement.

C. Right atrial enlargement.

D. Right ventricular enlargement.

Explanation: An apical impulse below the fifth intercostal space suggests left ventricular enlargement, common in heart failure due to ventricular dilation.

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