cardiac prep u test 3

What are the first symptoms of cardiac tamponade? Select all that apply.

shortness of breath, chest tightness, dizziness, or restlessness.

The nurse is teaching a client about chronic untreated hypertension. What complication will the nurse explain to the client?

stroke

A nurse is caring for a client who has hypertension and diabetes mellitus. The client's blood pressure this morning was 150/92 mm Hg. When the client asks the nurse what his or her blood pressure should be, what is the nurse's most appropriate response?

"Clients with diabetes should have a lower blood pressure goal. You should strive for 130/80 mm Hg."

The nurse obtains a health history from a client with a prosthetic heart valve and new symptoms of infective endocarditis. Which question by the nurse is most appropriate to ask?

"Have you been to the dentist recently?" Invasive procedures, particularly those involving mucosal surfaces (e.g., those involving manipulation of gingival tissue or periapical regions of teeth), can cause a bacteremia, which rarely lasts more than 15 minutes. However, if a client has any anatomic cardiac defects or implanted cardiac devices (e.g., prosthetic heart valve, pacemaker, implantable cardioverter defibrillator), bacteremia can cause bacterial endocarditis.

A nurse and a nursing student are performing a physical assessment of a client with pericarditis. The client has an audible pericardial friction rub on auscultation. When leaving the room, the student asks the nurse what causes the sound. The nurse's best response is which of the following?

"The pericardial surfaces lose their lubricating fluid because of inflammation and rub against each other."

Which statements are true when the nurse is measuring blood pressure (BP)? Select all that apply.

-Using a BP cuff that is too small will give a higher BP measurement. -The client's arm should be positioned at the level of the heart. -The client should sit quietly while BP is being measured.

A client has had an echocardiogram to measure ejection fracton. The nurse explains that ejection fraction is the percentage of blood the left ventricle ejects upon contraction. What is the typical percentage of blood a healthy heart ejects?

55%

Which would the nurse stress as a lifelong necessity for a client managing infective endocarditis?

Antibiotic therapy

The nurse is assessing a patient and feels a pulse with quick, sharp strokes that suddenly collapse. The nurse knows that this type of pulse is diagnostic for which disorder?

Aortic regurgitation

A nurse is caring for a client receiving warfarin therapy following a mechanical valve replacement. The client had a prothrombin time and International Normalized Ratio (INR) drawn before breakfast. The laboratory report shows the client's INR reading was 4. What is the nurse's first priority ?

Assess the client for bleeding and notify the health care provider of the results.

A client with a forceful, pounding heartbeat is diagnosed with mitral valve prolapse. Which client statement indicates to the nurse a need for additional teaching?

Caffeine is a stimulant, which can exacerbate palpitations, and should be avoided by a client with symptomatic mitral valve prolapse "I can still drink coffee and tea."

The nurse is caring for a patient diagnosed with pericarditis. What serious complication should this patient be monitored for?

Cardiac tamponade

A 46-year-old man has been diagnosed with pericarditis and has begun treatment. When assessing this patient, the nurse should prioritize assessments relevant to what complications of pericarditis? Select all that apply.

Cardiac tamponade Pericardial effusion

A nurse evaluates a client and suspects pericarditis. What indicator is considered the most characteristic symptom of pericarditis?

Chest pain

A client is admitted to the hospital with aortic stenosis. What assessment findings would indicate the development of left ventricular failure?

Dyspnea, orthopnea, pulmonary edema

A client is admitted to the hospital with possible acute pericarditis and pericardial effusion. The nurse knows to prepare the client for which diagnostic test to confirm the client's diagnosis?

Echocardiography

A patient with long-standing hypertension is admitted to the hospital with hypertensive urgency. The physician orders a chest x-ray, which reveals an enlarged heart. What diagnostic test does the nurse anticipate preparing the patient for to determine left ventricular enlargement?

Echocardiography

A client is being seen at the clinic for a routine physical when the nurse notes the client's blood pressure is 150/97. The client is considered to be a healthy, well-nourished young adult. What type of hypertension does this client have?

Essential (primary)

The staff educator is talking to a group of new emergency department nurses about hypertensive crises. The nurse educator is aware that hypertensive urgency differs from hypertensive emergency in what way?

Hypertensive emergencies are associated with evidence of target organ damage.

A nurse reviewing a client's echocardiogram report reads the following statements: "The heart muscle is asymmetrically thickened and the overall size and mass are increased, especially along the septum. The ventricular walls are thickened, reducing the size of the ventricular cavities. Several areas of the myocardium show evidence of scaring." The nurse knows these manifestations are indicative of which type of cardiomyopathy?

Hypertrophic

A client who recently had a myocardial infarction develops pericarditis and complains of chest pain rated 6 (on a scale of 0-10) with deep breathing. Which ordered pro re nata medications is most appropriate for the nurse to administer?

Ibuprofen 800 mg PO every 8 hours

What medication order would the nurse question for a patient being treated for pericarditis?

Indomethacin

A client is being seen at the clinic on a monthly basis for assessment of blood pressure. The client has been checking blood pressure at home as well and has reported a systolic pressure of 158 and a diastolic pressure of 64. What does the nurse suspect this client is experiencing?

Isolated systolic hypertension

A new client has been admitted with right-sided heart failure. When assessing this client, the nurse knows to look for which finding?

Jugular venous distention

Which is a characteristic of right-sided heart failure?

Jugular venous distention

The clinical manifestations of cardiogenic shock reflect the pathophysiology of heart failure (HF). By applying this correlation, the nurse notes that the degree of shock is proportional to which of the following?

Left ventricular function

Which feature is the hallmark of systolic heart failure?

Low ejection fraction (EF)

A nurse administers furosemide to treat a client with heart failure. Which adverse effect must the nurse watch for most carefully?

Low serum potassium level

The nurse is caring for clients on a busy cardiac unit. Following morning assessment, the nurse would notify the physician with which of the following symptoms?

Pulsus paradoxus on vital sign assessment

A patient newly diagnosed with hypertension asks the nurse what happens when uncontrolled hypertension is prolonged. The nurse explains that a patient with prolonged uncontrolled hypertension is at risk for developing what health problem?

Renal failure

type of cardiomyopathy?

Restrictive Arrhythmogenic right ventricular Hypertrophic Dilated

Which finding indicates that hypertension is progressing to target organ damage?

Retinal blood vessel damage

A nurse is conducting a heath history on a client with a primary diagnosis of mitral stenosis. Which disorder reported by the client is the most common cause of mitral stenosis?

Rheumatic endocarditis

The nurse is caring for a client who is prescribed medication for the treatment of hypertension. The nurse recognizes that which medication conserves potassium?

Spironolactone

The nurse is discussing cardiac terms with a client who was doing some reading on the Internet. What is the correct response for the nurse when the client asks what affects stroke volume?

Stroke volume is affected by temperature and heart rate.

The nurse is caring for a client with hypertension. The nurse is correct to realize that a 24-hour urine is ordered to determine if the cause of hypertension is related to the dysfunction of which of the following?

The adrenal gland

The nursing instructor is teaching a class on thrombophlebitis. What should the nurse tell the students about the inflammatory response in thrombophlebitis?

The inflammatory response is caused by accumulated waste products in the blocked vessel.

A nurse is caring for a client with pericarditis and auscultates a pericardial friction rub.What action does the nurse ask the client to do to distinguish a pericardial friction rub from a pleural friction rub?

The nurse asks the client to hold the breath during auscultation.

The nurse has attended morning report on a busy medical unit. The nurse recognizes which patient to be at greatest risk for the development of cardiogenic shock?

The patient admitted following a myocardial infarction (MI).

A patient has a diagnosis of dilated cardiomyopathy (DCM) and was admitted 24 hours ago for treatment. Which of the following principles should the nurse integrate into the planning of this patient's care?

The patient will benefit from bed rest in the short term, and activity should be introduced slowly.

The nurse understands that which of the following medications will be administered to the client for 6 to 12 weeks following prosthetic porcine valve surgery?

Warfarin

A client who had a prosthetic valve replacement was taking warfarin to reduce the risk of postoperative thrombosis. The client visited the nurse at a clinic once a week. What INR level would alert the nurse to notify the health care provider?

Warfarin patients usually have individualized target international normalized ratios (INRs) between 2 to 3.5 to maintain adequate anticoagulation. Levels below 2 to 2.5 can result in insufficient anticoagulation and levels greater than 3.5 can result in dangerous and prolonged anticoagulation.

Ascites

abnormal accumulation of fluid in the abdomen

Primary or essential hypertension accounts for about 95% of all hypertension diagnoses with an unknown etiology. Secondary hypertension accompanies specific conditions that create hypertension as a result of tissue damage. Which condition contributes to secondary hypertension?

arterial vasoconstriction

Which nursing intervention would reduce cardiac workload in a client with myocarditis?

bed rest

Warfarin (Coumadin)

blood thinner, anticoagulant

A client who is newly diagnosed with hypertension is going to be starting antihypertensive medicine. What is one of the main things the client and the client's spouse should watch for?

dizziness

heterograft (xenograft)

from another species

Direct vasodilators may cause

headache and tachycardia.

The clinical manifestations of cardiogenic shock reflect the pathophysiology of

heart failure (HF)

A blood pressure (BP) of 140/90 mm Hg is considered to be

hypertension

The nurse is caring for a client diagnosed with aortic stenosis prescribed digoxin. What clinical manifestation will be the rationale for the medication?

left ventricular dysfunction

Furosemide (Lasix)

loop diuretic

left sided heart failure signs

night with shortness of breath. Shortness of breath during exercise or when lying flat. Chronic coughing or wheezing. Difficulty concentrating Fatigue edema (ankles, legs, feet) Lack of appetite and nausea.

Which diuretic medication conserves potassium?

Amiloride. Eplerenone (Inspra) Spironolactone (Aldactone, Carospir) Triamterene (Dyrenium)

The nurse is performing a physical assessment on a patient suspected of being in heart failure. During auscultation, heart failure would be suggested by:

An S3 heart sound

The medical plan of treatment for chronic mitral regurgitation would include medications to reduce afterload, such as:

Angiotensin-converting enzyme (ACE) inhibitors.

The nurse identifies which symptom as a manifestation of right-sided heart failure (HF)?

Congestion in the peripheral tissues

A patient is undergoing a pericardiocentesis. Following withdrawal of pericardial fluid, which assessment by the nurse indicates that cardiac tamponade has been relieved?

Decrease in central venous pressure (CVP)

Which medication reverses digitalis toxicity?

Digoxin immune FAB

The nurse assessing a client with an exacerbation of heart failure identifies which symptom as a cerebrovascular manifestation of heart failure (HF)?

Dizziness

In which type of cardiomyopathy does the heart muscle actually increase in size and mass weight, especially along the septum?

Hypertrophic

Aspirin (ASA)

Non-opioid non-steroidal anti-inflammatory antipyretic Blood thinner Aspirin = binds to Cox 1/Cox 2 (stops platelet aggregation, gi upset, tinnitus, HA, sweating)

A patient comes to the walk-in clinic. While assessing the patient's vital signs, the nurse assesses the patient's blood pressure at 128/89 mm Hg. According to JNC7, how would this patient's blood pressure be classified?

Prehypertensive

Which term is refers to hypertension in which blood pressure that is controlled with therapy becomes uncontrolled (abnormally high) when the therapy is discontinued?

Rebound

A client is brought to the emergency department with reports of a bad headache and an increase in blood pressure. The blood pressure reading obtained by the nurse is 260/180 mm Hg. What is the therapeutic goal for reduction of the mean blood pressure?

Reduce the blood pressure by 20% to 25% within the first hour of treatment.

The nurse recognizes which symptom as a classic sign of cardiogenic shock?

Restlessness and confusion

A nurse is preparing a teaching plan regarding biological tissue valve replacement. What is a disadvantage of this type of valve replacement?

The valve has to be replaced frequently.

Digoxin (Lanoxin)

cardiac stimulant and diuretic

angina

chest pain/heart region caused by lack of oxygen/blood flow

A nurse caring for a client recently admitted to the ICU observes the client coughing up large amounts of pink, frothy sputum. Lung auscultation reveals course crackles to lower lobes bilaterally. Based on this assessment, the nurse recognizes this client is developing

decompensated heart failure with pulmonary edema.

allograft (homograft)

donor transfer between persons of the same species, such as human to human skin graft from another person or a cadaver

The nurse is asssessing a client with crackling breath sounds or pulmonary congestion. What is the cause of the congestion?

inadequate cardiac output

thrombophlebitis

inflammation of a vein associated with a clot formation

The nurse is caring for a patient with systolic blood pressure of 135 mm Hg. This finding would be classified as

prehypertension.

A nurse is assigned to the medical intensive care unit. The nurse ascultates a water-hammer pulse. What will the sound resemble?

quick, sharp strokes that suddenly collapse

With thiazide diuretics, monitor

serum potassium concentration.

Autograft

skin graft from a person's own body