A client admitted to the hospital with coronary artery disease complains of dyspnea at rest

Doctors usually classify patients' heart failure according to the severity of their symptoms. The table below describes the most commonly used classification system, the New York Heart Association (NYHA) Functional Classification1. It places patients in one of four categories based on how much they are limited during physical activity.

For Example:

• A patient with minimal or no symptoms but a large pressure gradient across the aortic valve or severe obstruction of the left main coronary artery is classified:
  • Function Capacity I, Objective Assessment D

• A patient with severe anginal syndrome but angiographically normal coronary arteries is classified:
  • Functional Capacity IV, Objective Assessment A

1 Adapted from Dolgin M, Association NYH, Fox AC, Gorlin R, Levin RI, New York Heart Association. Criteria Committee. Nomenclature and criteria for diagnosis of diseases of the heart and great vessels. 9th ed. Boston, MA: Lippincott Williams and Wilkins; March 1, 1994.

Original source: Criteria Committee, New York Heart Association, Inc. Diseases of the Heart and Blood Vessels. Nomenclature and Criteria for diagnosis, 6th edition Boston, Little, Brown and Co. 1964, p 114.

Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff.

Cardiovascular NCLEX Questions

1.A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is

scheduled for cardiac catheterization. Which medication would need to be withheld for 24 hours

before the procedure and for 48 hours after the procedure?

1. Regular insulin

2. Glipizide (Glucotrol)

3. Repaglinide (Prandin)

4. Metformin (Glucophage)

4. Metformin (Glucophage)

2.The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are

regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart

rate is 64 beats/minute. Which would be a correct interpretation based on these characteristics?

1. Sinus bradycardia

2. Sick sinus syndrome

3. Normal sinus rhythm

4. First-degree heart block

3. Normal sinus rhythm

3.A client is wearing a continuous cardiac monitor, which begins to sound its alarm. A nurse sees no

electrocardiographic complexes on the screen. Which is the priority action of the nurse?

1. Call a code.

2. Call the health care provider.

3. Check the client's status and lead placement.

4. Press the recorder button on the electrocardiogram console.

3. Check the client's status and lead placement.

4.A client is having frequent premature ventricular contractions. The nurse should place priority on

assessment of which item?

1. Sensation of palpitations

2. Causative factors, such as caffeine

3. Precipitating factors, such as infection

4. Blood pressure and oxygen saturation

4. Blood pressure and oxygen saturation

5.The nurse is evaluating a client's response to cardioversion. Which observation would be of highest

priority to the nurse?

1. Blood pressure

2. Status of airway

3. Oxygen flow rate

4. Level of consciousness

2. Status of airway

6.The nurse is caring for a client who has just had implantation of an automatic internal cardioverter-

defibrillator. The nurse immediately would assess which item based on priority?

1. Anxiety level of the client and family

2. Presence of a Medic-Alert card for the client to carry

3. Knowledge of restrictions of postdischarge physical activity

4. Activation status of the device, heart rate cutoff, and number of shocks it is programmed to

deliver

What position is preparing a client for a Pericardiocentesis?

Which diagnostic study is usually performed to confirm the diagnosis of heart failure?

Which of the following tests is used most often to diagnose angina?

Which feature is the hallmark of systolic heart failure?