To prevent clotting or blockage of a central venous catheter lumen, the nurse should administer: After the insertion of a CVAD, the distal end of the catheter sits in the: This type of CVAD does not require the use of clamps or administration of heparin: The stated first step for changing a CVAD dressing is to: When cleaning a CVAD with alcohol swabs, the nurse should avoid: When cleaning a CVAD with an antimicrobial scrub, the nurse should scrub the catheter insertion site in a circular motion for approximately: before locating the port septum of a deaccessed implanted port, the nurse should clean the site with: While flushing the accessed implanted port, the nurse should assess for: When accessing an implanted port, it should be flushed with: To maintain the patency of a PICC line that is being used intermittently, it is an important nursing intervention to flush the line with saline and heparin: The stated first step of flushing a PICC line is: After flushing a PICC line, the nurse should next: In deaccessing an implanted port, before flushing with normal saline, the nurse should: If there is blood present at the insertion site after removing the Huber needle from an implanted port, the nurse should apply a/an: when deaccessing an implanted port, the amount of heparin used for flushing should be: In PICC line assessment, coolness around the site may indicate: All of the following signs may indicate infiltration in a PICC line site, except: In regard to PICC line assessment, all of the following signs may indicate phlebitis, except: This solution can alter the result of a client's blood test: Before drawing a blood sample from the CVAD lumen, the nurse should first: If the lumen of a CVAD is not to be used after drawing blood, the nurse should: If resistance is met when flushing an implanted port, the nurse should consider all of the following interventions, except: The nurse is drawing blood from a CVAD. After putting the collection tube to the Vacutainer, the blood flow suddenly stops. The most appropriate nursing interventions for this situation should include all of the following, except: If resistance is met when trying to flush an implanted port, the nurse should document this in the client's record: All of the following findings suggest severe hyperkalemia, except: All of the following are stated goals of drug therapy for cardiopulmonary arrest, except: Cardiopulmonary arrest may result from: Normally, this type of ions moves across myocardial cell membranes in exchange for sodium and other ions: In acute renal failure, the nephrons through which excess potassium are excreted are damaged by: In acute renal failure, excitable myocardial cells can trigger: Normally, the kidneys help keep potassium at an optimal blood level, which is about: This is an antiarrhythmic drug used for treating cardiopulmonary arrest: This is a potassium-lowering drug used for treating hyperkalemia-induced cardiopulmonary arrest: Vasopressin is a type of: To avoid tissue necrosis from extravasation during epinephrine therapy for cardiopulmonary arrest, the nurse should plan to: If a central line is not available for epinephrine infusion to a cardiopulmonary arrest client, the nurse may: During immediate therapy for cardiopulmonary arrest, the nurse should administer IV epinephrine at a dose of: In a cardiopulmonary arrest client, the administration of epinephrine during immediate therapy stimulates: In the fibrillating heart of a cardiopulmonary arrest client, epinephrine may improve the: 1 receptors on smooth-muscle cell membrane]]> During epinephrine therapy for cardiopulmonary arrest, this may occur when the drug increases the client's heart rate and blood pressure: When using a central line to administer epinephrine in a cardiopulmonary arrest client, the nurse should set the IV pump to deliver: This may result when vasopressin infiltrates the soft tissues of a cardiopulmonary arrest client: During vasopressin therapy for cardiopulmonary arrest, vasoconstriction in peripheral blood vessels helps divert blood to the: During vasopressin therapy for cardiopulmonary arrest, this action promotes vasoconstriction in peripheral blood vessels: 1 receptors on smooth muscle cell membrane]]> 2 receptors on smooth muscle cell membrane]]> 3 receptors on smooth muscle cell membrane]]> 4 receptors on smooth muscle cell membrane]]> Calcium chloride is administered during immediate therapy for cardiopulmonary arrest to: 2 receptors on smooth muscle membranes]]> Normally, the minimum energy needed to depolarize myocardial cells: In a cardiopulmonary arrest client, depolarization of myocardial cells is prevented when: In acidosis, these ions move into myocardial cells in exchange for potassium ions: During immediate therapy for cardiopulmonary arrest, sodium bicarbonate lowers the potassium level by: During immediate therapy for cardiopulmonary arrest, sodium bicarbonate should be administered through a dedicated IV line at a dose of: Sodium bicarbonate should be administered if the cardiac arrest client's blood potassium level exceeds: Normally, this enzyme moves potassium and other ions into and out of cells: In a cardiopulmonary arrest client, glucose is given together with insulin to help prevent: In the pancreas of a cardiac arrest client during glucose and insulin therapy, this drives potassium into the cells: In a client with cardiopulmonary arrest, amiodarone works by: During the immediate treatment of cardiopulmonary arrest, the first dose of amiodarone should be: In a client with cardiopulmonary arrest, amiodarone reduces automaticity in the: Continuing therapy for cardiopulmonary arrest usually includes all of the following, except: If ventricular arrhythmias are likely to recur in a cardiac arrest client, the nurse should plan to administer the oral form of: This is a cat-ion exchange resin used for the continuing treatment of a cardiac arrest client: In the continuing treatment of a cardiac arrest client, a cat-ion exchange resin works by: All of the following are stated signs and symptoms of PEA and hypovolemic shock, except: All of the following are goals of drug therapy for PEA and hypovolemic shock, except: During drug therapy for PEA and hypovolemic shock, the nurse should raise the blood pressure to: All of the following actions temporarily raise a hypovolemic shock client's blood volume and blood pressure, except: The compensatory mechanisms for low blood volume begin to fail when: In a hypovolemic shock client, myocardial cells can become ischemic and may die if: This is a crystalloid solution used for the immediate treatment of PEA and hypovolemic shock: This is a vasoconstrictor and cardiac stimulant drug used in the immediate treatment of hypovolemic shock: Immediate drug therapy for PEA and hypovolemic shock usually includes all of the following, except: During immediate therapy for PEA and hypovolemic shock, the nurse should administer epinephrine by IV bolus at a dose of: During immediate therapy for PEA and hypovolemic shock, epinephrine improves coronary and cerebral blood flow by: In a client with PEA and hypovolemic shock, epinephrine promotes vasoconstriction and increased blood pressure in peripheral vascular smooth muscles by: If cardiac arrest is caused by PEA and hypovolemic shock, the code team should perform resuscitation while repeating the IV epinephrine infusion every: By replacing lost fluids and electrolytes in a PEA and hypovolemic shock client, Lactated Ringer's solution helps: During immediate therapy for PEA and hypovolemic shock, the nurse should set the infusion pump to deliver the dopamine solution at: In immediate therapy for PEA and hypovolemic shock, dopamine raises blood pressure by: In immediate therapy for PEA and hypovolemic shock, norepinephrine should be administered if: In norepinephrine therapy for PEA and hypovolemic shock, this action constricts peripheral vessels, which diverts blood and oxygen to the heart and brain: To monitor for signs of peripheral and GI ischemia during norepinephrine therapy for PEA and hypovolemic shock, the nurse should do all of the following, except: Compared to dopamine, norepinephrine is a more potent: As the condition of the PEA and hypovolemic shock client improves, the nurse should closely monitor for signs of: As the condition of the PEA and hypovolemic shock client improves, the nurse should wean the client off the vasopressor to keep his systolic pressure above: When dealing with a cardiopulmonary arrest client, the nurse should be ready to do all of the following, except: The initial phase of cardiogenic and hypovolemic shock occur when: Inadequate blood volume can result in: The compensatory phase of shock occurs when: When a cell's lactic acid level rises, its: In regard to the pathophysiology of cardiogenic shock, a cell's sodium-potassium pump can not work without this: In this phase of cardiogenic shock, cell destruction and organ dysfunction progresses despite treatment: In a client with cardiogenic shock, this soft heart sound is caused by overfilling of blood in the left ventricle: 3]]> 1]]> 2]]> 4]]> In a client with cardiogenic shock, the nurse is likely to hear this low-pitched sound just before S₁: 4]]> 2]]> When auscultating the heart of a hypovolemic shock client, the nurse is likely to hear: 4]]> Pulmonary congestion in a client with cardiogenic shock may be indicated by: In a client with cardiogenic shock, these are produced when air enters fluid-filled alveoli during inspiration: This can occur in a client with cardiogenic shock when the damaged left ventricle can not pump blood forward: In the adrenal cortex of a shock client with fluid retention, this triggers the release of aldosterone, causing sodium and water retention in the blood: In regard to fluid retention in a shock client, this prompts the conversion of angiotensinogen to angiotensin I in the blood: In a shock client, these signs may indicate reduced perfusion of the brain and periphery: In a shock client, a partial pressure of carbon dioxide below 35 millimeters of mercury most specifically indicates: This level of blood pH suggests respiratory alkalosis in a shock client: In a shock client, a partial pressure of oxygen below 80 millimeters of mercury most specifically reflects: In a cardiogenic shock client, the stimulation of myocardial cells' beta-1 adrenergic receptors most specifically increases the: In a cardiogenic shock client, this is most specifically reduced when dobutamine stimulates beta-2 adrenergic receptors in the peripheral blood vessels: In regard to nitroglycerin therapy for cardiogenic shock, the activation of guanylate cyclase increases the level of: When placing an intra-aortic balloon counter pulsation device to a cardiogenic shock client, the balloon-tipped catheter is inserted through the: In intra-aortic balloon counter pulsation therapy for cardiogenic shock, the deflation of the balloon creates a vacuum in the: During intra-aortic balloon counter pulsation therapy for cardiogenic shock, the deflation of the balloon: To restore blood volume and treat hypovolemic shock, the nurse should intervene by replacing fluids with: When restoring blood volume and treating hypovolemic shock, the nurse should expect to infuse about 300 milliliters of crystalloid solution for every: For a hypovolemic shock client, the nurse should warm the IV solution before infusion to most specifically prevent: A client recovering from hypovolemic shock should have a urine output of more than: Once a cardiogenic shock client's condition is stable, the nurse should expect to monitor vital signs and hemodynamic readings at least every: In a client recovering from hypovolemic shock, the nurse should listen for the resolution of abnormal heart and breath sounds at least: Diabetes mellitus is best characterized by: Insulin is most specifically produced by the: Glycogen is normally stored in the: Type 1 diabetes is best characterized by: Hyperglycemia can be best described as: Type 2 diabetes is best characterized by: Insulin resistance may occur when: Most specifically, obese clients are at high risk for insulin resistance because: The blood glucose level of a client with insulin resistance rises when: In the liver of a diabetic client, glucagon converts: DKA is a type of: DKA may occur in a diabetic client when: In DKA, glucose level may increase to: In DKA, the nurse may detect signs of dehydration, such as: In DKA, the nurse may see signs of electrolyte imbalances, such as: Kussmaul's respiration is characterized by: In DKA, paralytic ileus or intestinal paralysis may occur when: A diabetic client with a blood pH of less than 7.35 may have: Once DKA is confirmed, the nurse should expect to administer each liter of normal saline over: During fluid replacement in a DKA client, the nurse should recheck the client's electrolyte levels: If a DKA client's pH level falls below 7, the nurse should expect a prescription for: When the intracellular glucose level of a DKA client falls, the hormone glucagon is secreted by the: In regard to DKA, glucagon causes glycogenolysis by: During treatment for DKA, the nurse should watch for early signs of low blood glucose level or: Polydipsia can be best described as: Polyphagia can be best described as: Polyuria may occur in a diabetic client when: Most specifically, paresthesia may occur in a diabetic client if: In regard to the chronic complications of diabetes, all of the following statements about uncontrolled hyperglycemia are correct, except: These may occur in a diabetic client when hypertension, hyperlipidemia and hyperglycemia increase arterial resistance: On a fasting glucose test, a diabetic client is likely to show a level of: In a 2-hour postprandial glucose test, a diabetic client is likely to show: 200 mg/dl]]> Ketoacidosis may be present in a diabetic client if: A client with type 1 diabetes typically receives: A diabetic client should be placed on a: A balanced diet for a diabetic client typically includes all of the following, except: In a type 2 diabetic client, the conversion of fat and protein into glucose when intracellular glucose is insufficient is most specifically called: In regard to type 2 diabetes, HHNK stands for: HHNK syndrome causes: The blood glucose level of a client with HHNK syndrome may exceed: In a type 2 diabetes client, fluid and electrolyte imbalances most specifically occur when: In regard to critical care for HHNK, to prevent hypoglycemia during insulin administration, the nurse should most specifically: In a type 2 diabetes client, sulfonylureas work most specifically by: In regard to treatment for type 2 diabetes, this is an example of a biguanide: In regard to treatment for type 2 diabetes, acarbose is a/an: All of the following are stated general nursing interventions for a client recovering from DKA or HHNK syndrome, except: Before a client with type 1 or type 2 diabetes is discharged, the nurse should provide information about all of the following, except: Before a client with type 1 or type 2 diabetes is discharged, the nurse should provide information about all of the following, except: Hypertension most specifically refers to: The cause of primary hypertension is: All of the following are stated modifiable risk factors for primary hypertension, except: The arteries' resistance to blood flow is called: This statement about blood pressure is most true: Cardiac output is: In regard to the development of hypertension, the arteries dilate when catecholamines act on: 2-receptors in blood vessels]]> 1 receptors in the peripheral arteries]]> 2 receptors in the peripheral arteries]]> 1-receptors in blood vessels]]> In regard to blood pressure elevation, this most specifically occurs when hematocrit is abnormally high: In regard to the development of hypertension, ventricular contractility is increased when catecholamines stimulate: 1 receptors]]> 2 receptors]]> 1 receptors]]> 2 receptors]]> In regard to unmodifiable risk factors for primary hypertension, African-American heritage is linked to: In hypertension, this may occur when blood retains more sodium and water: Increased peripheral vascular resistance can lead to: Alcoholic drinks may raise systolic blood pressure in all of the following ways, except: Regular physical exercise may reduce the risk of developing hypertension by: A client with sodium-induced hypertension should avoid: A client with renal artery stenosis may develop secondary hypertension when slowed blood flow to the kidneys triggers the release of: Hypertension may develop in a renal artery stenosis client when angiotensin II causes: All of the following are stated common causes of secondary hypertension, except: Normally, arteries contain all of the following layers, except: In hypertension, the tunica intima's endothelial layer: All of the following organs are prone to damage from high blood pressure, except the: According to the national standards for blood pressure, normal blood pressure is best characterized by: According to the national standards for blood pressure, prehypertension is best characterized by: According to the national standards for blood pressure, stage I hypertension is best characterized by: Hypertension usually produces: Headaches in a hypertensive client are usually severe: Hypertensive crisis damages target organs and may cause emergencies, such as: In a client with hypertension, a decreased level of consciousness primarily results from: If untreated, cerebral edema can lead to: All of the following are stated symptoms of cerebral ischemia in a hypertensive client, except: Signs of irreversible retinal damage begin in: In a hypertensive client, A-V nicking may be caused by: In regard to the complications of hypertension, papilledema is the: Epistaxis may occur in a hypertensive client when: When palpated, the apical impulse is normally: In hypertension, left ventricular hypertrophy occurs when: In regard to the complications of hypertension, myocardial ischemia is commonly indicated by: In regard to the complications of hypertension, peripheral ischemia is commonly indicated by: In regard to hypertension, bruits are most specifically caused by: Dyspnea and crackles can occur when chronic, uncontrolled hypertension leads to: In a hypertensive client, crackles and dyspnea are produced most specifically when: As renal damage progresses in a hypertensive client, urine may look: In regard to the complications of hypertension, presence of these in the urine may suggest diabetes mellitus: In regard to the complications of hypertension, ultrasonography may detect: In regard to the complications of hypertension, renal angiography may detect: The stated first step in anti-hypertensive therapy is: The second step in anti-hypertensive therapy usually includes all of the following, except: If the second step in anti-hypertensive therapy does not work, the nurse should expect to: In regard to treatment for hypertension, propranolol is an example of a/an: In a hypertensive client, ACE inhibitors work by: 1 receptor sites in the arterial smooth muscle]]> In regard to treatment for hypertension, nitrates and hydralazine are examples of: When caring for a client with hypertension, the nurse should check the client's heart rate and blood pressure at least every: All of the following are points to remember when caring for a client with hypertension, except: All of the following are points to remember when caring for a client with hypertension, except: The right coronary artery has all of the following branches, except: Myocardial infarction is best described as: The right and left coronary arteries originate from the: In CAD, low-density lipoproteins and other substances form plaques in the: In CAD, this may result if the myocardial blood flow is interrupted for more than 20 minutes: In CAD, thrombi and platelet aggregation may trigger: For some clients, this may avert myocardial injury and infarction: In an MI client, these will accumulate in the blood when myocardial cells switch from aerobic to anaerobic metabolism: As oxygen deprivation persists in an MI client, the cell's mitochondria can not produce: In myocardial infarction, new, permanent scar tissue replaces necrotic tissue within: All of the following statements about myocardial infarction are true, except: In MI, cell damage in the zone of infarction denotes: Rapid, focused assessment for a client with anteroseptal myocardial infarction should include all of the following, except: The heart's wall contains all of the following layers, except: This statement about a non-Q wave MI is not true: In regard to treatment for myocardial infarction, this drug should be given intravenously to quickly relieve chest pain, reduce anxiety and decrease preload: To prevent new thrombus formation in an MI client, heparin prevents the conversion of: This is an example of beta-adrenergic blocker used in the treatment of myocardial infarction: This common complication of MI occurs when ischemic cardiac cells develop abnormal automaticity: The ability of cells to initiate cardiac impulses is most specifically called: This drug reduces automaticity and conduction in an MI client with ventricular arrhythmia: This may be detected in a client if an MI has damaged the client's SA node, AV node or bundle of His: When assessing an MI client, this may be noted if the MI has caused an AV block: This sound may be produced when MI causes the pericardium to become inflamed over the necrotic tissue: To detect signs of right ventricular infarction in a client with inferior wall MI, the nurse should perform a right-sided ECG by: In regard to the complications of inferior wall MI, cardiogenic shock may result from a decrease in all of the following, except: On a 12-lead ECG tracing, an inferior wall MI produces: If cardiogenic shock in an MI client is caused by a decreased heart rate, this drug should be administered to increase the SA node automaticity: If drug therapy is contraindicated, this may be applied to treat the cardiogenic shock of a client with an inferior wall MI: The heart's natural pacemaker is the: In a client with inferior wall MI, nausea and vomiting are common because the infarction stimulates the: In a client with inferior wall MI, this extra heart sound is most specifically caused by the right atrium's forceful contraction against the stiffened right ventricle: In regard to a client with inferior wall MI, this statement about peripheral edema is most true: The general plan of care for a client with any type of MI should include all of the following, except: On the third day after the MI, the nurse should: When an MI client is ready for discharge, the nurse should inform the client and the family about all of the following, except: This should be removed from the donor to get to the kidney: This is released if blood seeps into the wound during a kidney transplant: Uremia prevents the production of: Marfan syndrome is: A heart that is too full of blood may indicate: When all of the blood is drained out of the heart, it will: If a client has difficulty breathing, the nurse should first: Acute respiratory failure is: ARF is present when arterial blood gas analysis reveals: 2 of 50 mm Hg or less and/or a PaCO₂ of 50 mm Hg or more]]> 2 of 50 mm Hg or more and/or a PaCO₂ of 50 mm Hg or more ]]> 2 of 50 mm Hg or less and/or a PaCO₂ of 50 mm Hg or less]]> 2 of 50 mm Hg or more and/or a PaCO₂ of 50 mm Hg or less]]> Myasthenia gravis is: Muscle weakness in a client with myasthenia gravis may be caused by: Myasthenic crisis may impair ventilation when it affects: These may help diagnose acute respiratory failure in a client with myasthenic crisis: An Allen's test should be performed prior to drawing blood from this artery: An Allen's test assesses: Prior to radial artery puncture for ABG analysis, the nurse should first do all of the following, except: After a radial artery puncture, the nurse should apply firm pressure on the puncture site for: After a radial artery puncture, when bleeding from the puncture site has stopped, the nurse should: Types of acute respiratory failure include all of the following, except: An increased PaCO₂ in the arterial blood most specifically indicates: Alveolar hypoventilation due to ventilatory failure may result in: 2 and a decreased PaO₂]]> 2 and PaO₂]]> 2 and PaO₂]]> 2 and an increased PaO₂]]> All of the following factors place COPD clients at high risk of developing acute respiratory failure, except: These may develop in a COPD client with under-ventilated lung areas: COPD, together with pneumonia, may lead to ARF when: 2 reaches >60 mm Hg and PaCO₂ reaches <45 mm Hg]]> Prior to the ET intubation of a client with ARF, the nurse should do all of the following, except: The cricoid cartilage is best described as the: Proper ET tube placement in an ARF client may be verified by: An ARF client receiving PEEP should be assessed for all of the following at regular intervals, except: If PEEP causes decreased venous return to an ARF client, the nurse should expect an order for: In an ARF client, positive end-expiratory pressure most specifically increases: