chapter 21 - 25 medsurg
A postoperative patient suddenly develops dyspnea, tachypnea, restlessness, and chest pain. Which complication should the nurse suspect is occurring in this patient? 1. Pulmonary edema 2. Respiratory arrest 3. Pulmonary embolus 4. 1Myocardial infarction
3. Pulmonary embolus
The nurse is planning care for a group of patients. Which individual should the nurse identify as being at the highest risk for developing hypertension? 1. A 60-year-old Japanese American man 2. A 56-year-old African American woman 3. A 45-year-old female tourist from China 4. A 51-year-old man who recently emigrated from Korea
A 56-year-old African American woman
While collecting data, a patient expectorates pink, frothy sputum. Which health problem should the nurse consider is occurring in this patient? 1. Gastritis 2. Pneumonia 3. Heart failure 4. Hepatic failure
Heart failure
The nurse is reviewing complications of hypertension with a patient. Which should the nurse include in the teaching? (Select all that apply.) 1. Heart failure 2. Liver disease 3. Hypothyroidism 4. Stroke 5. Myocardial infarction 6. Kidney Failure
Heart failure, Stroke, Myocardial infarction, Kidney Failure
The nurse is caring for a patient with stage 1 hypertension. Which medication should the nurse expect to be prescribed for this patient? 1. Verapamil (Calan) 2. Minoxidil (Loniten) 3. Diltiazem (Cardizem) 4. Hydrochlorothiazide (HydroDIURIL)
Hydrochlorothiazide (HydroDIURIL)
A patient asks the nurse what the doctor meant by the phrase, "hypertensive emergency." Which explanation should the nurse provide? 1. "It means that you've had a small stroke." 2. "It refers to an episode of very high blood pressure." 3. "It's when the heart is failing to pump blood effectively." 4. "It means the heart has become hyperactive and is beating too fast."
"It refers to an episode of very high blood pressure."
A patient is being instructed about a Holter monitor. Which statement indicates that the patient knows what to do when a symptom occurs while wearing a Holter monitor? 1. "Call an ambulance." 2. "Notify the physician." 3. "Take an apical pulse." 4. "Push the event button."
"Push the event button."
The nurse is auscultating heart sounds and notes an S4 heart sound. The nurse knows an S4 sound may be heard in a patient with which condition? 1. Hypertension 2. Crohn disease 3. Liver failure 4. Asthma
Hypertension
The nurse is reviewing the prothrombin time (PT) value for a patient prescribed warfarin (Coumadin). The laboratory's PT range is 9 to 11 seconds. What would be the therapeutic time for the patient? 1. 12.5 seconds 2. 17 seconds 3. 26 seconds 4. 30 seconds
2. 17 seconds
The nurse is reviewing care for a group of patients. Which patient with a heart valve disorder should the nurse identify as being susceptible to developing the complication of fluid volume excess? 1. A 27-year-old male on atenolol (Tenormin) 2. A 68-year-old female on digoxin (Lanoxin) 4. A 44-year-old male taking amoxicillin (Amoxil) 5. An 18-year-old female taking warfarin (Coumadin)
2. A 68-year-old female on digoxin (Lanoxin)
A patient tells the nurse he has started experiencing impotence since beginning treatment for hypertension. Which statement by the nurse is most appropriate? 1. "This is a normal side effect of the medication and you will get used to it." 2. "You should stop taking this medication immediately." 3. "I will talk to your doctor and see about referring you for sexual counseling." 4. "You can start taking sildenafil (Viagra); this should fix the problem."
"I will talk to your doctor and see about referring you for sexual counseling."
The nurse is teaching a patient with hypertension about the DASH diet. Which statement made by the patient indicates a need for further teaching? 1. "I will eat 3 ounces of baked fish for dinner." 2. "I have eaten cup of cooked beans for dinner four times this week." 3. "I ate a hamburger with a small order of fries last night." 4. "My spouse has begun to cook using only 1 teaspoon of canola oil."
"I ate a hamburger with a small order of fries last night."
The nurse is reinforcing teaching provided to a patient who has been taught ways to decrease blood pressure. Which patient statement indicates a need for further teaching? 1. "I eat fried foods three times a week." 2. "I don't add salt to my food anymore." 3. "I walk my dog for 30 minutes every day." 4. "I take high blood pressure medication daily."
"I eat fried foods three times a week."
The nurse is teaching a patient about furosemide (Lasix). Which statement made by the patient indicates an understanding of the teaching? 1. "If my blood pressure is really high, I will take a second dose." 2. "I will be sure to avoid potassium while taking this medication." 3. "I should take the medication in the morning so I am not up all night going to the bathroom." 4. "I need to be sure to take this pill without food or milk."
"I should take the medication in the morning so I am not up all night going to the bathroom."
The nurse is reinforcing teaching for a patient with hypertension. If a patient states, "I understand that if I do not eat or cook with salt, my hypertension will go away." What is the nurse's best response? 1. "Reducing salt in the diet increases blood pressure." 2. "Patients who take diuretics do not need to reduce salt intake." 3. "Excessive salt intake is responsible for most types of hypertension." 4. "Some patients' blood pressure may not respond to salt restriction alone."
"Some patients' blood pressure may not respond to salt restriction alone."
A patient will be wearing a Holter monitor for 2 days. What should the nurse instruct the patient about bathing while wearing the monitor? 1. "Take a sponge bath." 2. "You may take a tub bath." 3. "Take a shower with the monitor on." 4. "Remove the monitor before showering."
"Take a sponge bath."
A patient asks the nurse what the action of the arteries is. Which response by the nurse is most appropriate? 1. "The arteries act as valves of the heart." 2. "The arteries carry blood from capillaries to the heart." 3. "The arteries are the natural pacemaker of the heart." 4. "The arteries carry blood from the heart to capillaries."
"The arteries carry blood from the heart to capillaries."
The nurse is reinforcing teaching to a patient about to undergo angiography. Which statement made by the patient indicates a need for further teaching? 1. "I cannot have anything to eat or drink for 4 hours before the test." 2. "I will stay at the hospital after my test so the nurse can monitor the injection site." 3. "This test will assess the electrical system of my heart." 4. "I may feel a hot, burning feeling when I am injected with dye."
"This test will assess the electrical system of my heart."
A patient who has unsuccessfully implemented lifestyle modifications for high blood pressure asks what else can be done. What should the nurse respond to this patient? 1. "You should get more rest." 2. "You should decrease your exercise plan." 3. "You should consider more strenuous exercise." 4. "Your doctor may discuss medication with you."
"Your doctor may discuss medication with you."
The nurse is preparing to administer furosemide (Lasix) 20 mg intravenously to a patient with hypertension. The available dose is 40 mg/mL. How many mL will the nurse administer? Enter the numeral only.
0.5
The nurse is caring for a patient with thrombophlebitis of the left leg. Which interventions should the nurse implement? (Select all that apply.) 1. Administer acetaminophen (Tylenol) as ordered. 2. Apply ice to the affected area. 3. Encourage the patient to wear constricting clothing. 4. Apply compression stockings per order. 5. Elevate the feet above heart level.
1. Administer acetaminophen (Tylenol) as ordered. 4. Apply compression stockings per order. 5. Elevate the feet above heart level.
The nurse is caring for a patient who has aortic stenosis. During data collection, which of these manifestations should indicate to the nurse that the patient is experiencing myocardial oxygen deficiency? 1. Angina 2. Sacral edema 3. Jugular vein distention 4. Pericardial friction rub
1. Angina
The nurse is reinforcing discharge teaching to a patient with IE. Which topics will the nurse include in the teaching? (Select all that apply.) 1. Brushing teeth with a soft-bristle toothbrush 2. Avoiding biting nails 3. Avoiding applying ointment to cuts 4. Reporting fever or chills to the HCP 5. Instruction on proper handwashing
1. Brushing teeth with a soft-bristle toothbrush 2. Avoiding biting nails 4. Reporting fever or chills to the HCP 5. Instruction on proper handwashing
The nurse is caring for a patient with hypertension who is being discharged home with a prescription of propranolol (Inderal). Which topics should the nurse include in the teaching? (Select all that apply.) 1. Check the heart rate and blood pressure before taking the medication. 2. Get up slowly to avoid dizziness. 3. Keep appointments to have potassium level checked. 4. Wear sunscreen to avoid photosensitivity. 5. Talk to the doctor before the medication is stopped.
1. Check the heart rate and blood pressure before taking the medication. 2. Get up slowly to avoid dizziness. 5. Talk to the doctor before the medication is stopped.
A patient with obstructive hypertrophic cardiomyopathy is being released from the hospital and is to continue treatment with atenolol (Tenormin) and disopyramide (Norpace) at home. Which information should be included in the patient's teaching plan? (Select all that apply.) 1. Eat small meals. 2. Drink fluids to remain hydrated. 3. Plan activities in small amounts. 4. Have one alcoholic drink per day. 5. Participate in sports, such as tennis. 6. Check the pulse daily before taking medications.
1. Eat small meals. 2. Drink fluids to remain hydrated. 3. Plan activities in small amounts.
The nurse is caring for a patient with aortic regurgitation. Which clinical manifestations can the nurse expect to document? (Select all that apply.) 1. Forceful heartbeat more pronounced when laying down 2. Exertional dyspnea 3. Fatigue 4. Corrigan pulse 5. Bloody sputum 6. Petechiae
1. Forceful heartbeat more pronounced when laying down 2. Exertional 3. dyspnea 4. Fatigue
The nurse is collecting data on a patient recovering from a hysterectomy who is experiencing left calf tenderness. Data include the following: left calf 17.5 inches; right calf 14 inches; left thigh 32 inches; right thigh 28 inches; shiny, warm, and reddened left leg. Which actions should the nurse recommend for this patient's plan of care? 1. Maintain bedrest. 2. Encourage ambulation daily. 3. Place anti-embolism stocking on left leg. 4. Place anti-embolism stocking on both legs.
1. Maintain bedrest.
A patient is being admitted to the intensive care unit after cardiac surgery. Which nursing actions should the nurse include in this patient's plan of care? (Select all that apply.) 1. Note any patient shivering. 2. Assess breath sounds every shift. 3. Assist in head-to-toe data collection. 4. Place the patient in a cool environment. 5. Connect the patient to a cardiac monitor. 6. Palpate chest and neck for signs of crepitus.
1. Note any patient shivering. 2. Assess breath sounds every shift. 3. Assist in head-to-toe data collection. 5. Connect the patient to a cardiac monitor. 6. Palpate chest and neck for signs of crepitus.
A patient who has aortic stenosis develops severe dyspnea and chest pain. Which action should the nurse take? 1. Obtain vital signs. 2. Give nitroglycerin. 3. Raise the head of the bed. 4. Encourage the patient to sleep.
1. Obtain vital signs.
The nurse is caring for a patient with pericarditis who develops hypotension, confusion, tachycardia, tachypnea, and jugular venous distension. For which procedure should the nurse prepare the patient? 1. Pericardiocentesis 2. Myectomy 3. Endometrial biopsy 4. Commissurotomy
1. Pericardiocentesis
The nurse is reinforcing teaching for a patient who has had a mechanical valve replacement. What should be included regarding safety during warfarin (Coumadin) therapy? 1. Wear medial alert identification. 2. Use a straight razor when shaving. 3. Keep yearly blood test appointments. 4. Increase intake of green leafy vegetables.
1. Wear medial alert identification.
The nurse is assessing a patient who underwent valve replacement surgery. Which finding should concern the nurse the most? 1. Wet lung sounds 2. Urine output 50 mL/hr 3. Temperature of 99.1°F 4. Chest tube drainage of 100 mL/hr
1. Wet lung sounds
The infection control nurse observes a nurse on a cardiac unit. Which actions by the nurse would require intervention by the infection control nurse? (Select all that apply.) 1. Wipes stethoscope with a soft cloth before each patient use 2. Carries stethoscope in a laboratory coat pocket when not in use 3. Performs hand hygiene before and after contact with each patient 4. Leaves a thermometer in the room of a patient on contact precautions 5. Takes own stethoscope into the room of a patient on contact precautions 6. Uses a stethoscope and blood pressure cuff supplied in the patient's room
1. Wipes stethoscope with a soft cloth before each patient use 5. Uses a stethoscope and blood pressure cuff supplied in the patient's room
The nurse is preparing to administer lisinopril (Prinivil) 40 mg by mouth to a patient with hypertension. The available does is 20 mg per tablet. How many tablets will the nurse administer? Enter the numeral only
2
The nurse is measuring blood pressures during a screening clinic. Which recommended follow-up time frame should the nurse suggest to a patient for a blood pressure reading of 118/72 mm Hg? 1. 1 month 2. 2 months 3. l year 4. 2 years
2 years
The nurse is caring for a patient with infective endocarditis (IE). Which statement made by the patient leads the nurse to suspect the cause of the IE? 1. "When I was a child, I had rheumatic fever." 2. "I have not been to the dentist in 8 years." 3. "I had a myocardial infarction last year." 4. "I have to sit in one spot for a long time for my job."
2. "I have not been to the dentist in 8 years."
The nurse is teaching a patient about mitral valve prolapse and lifestyle modifications. Which statement made by the patient indicates a need for further teaching? 1. "I should cut coffee out of my diet." 2. "I need to avoid physical activity." 3. "I have been practicing yoga to reduce stress." 4. "I will need to follow a balanced diet."
2. "I need to avoid physical activity."
The nurse is caring for a group of patients. Which patient should the nurse see first? 1. A patient with IE who is receiving IV antibiotic therapy 2. A patient who underwent valve replacement surgery 4 hours ago and reports level 9 pain 3. A patient with aortic regurgitation awaiting an echocardiogram 4. A patient with myocarditis who has a 99.1°F fever
2. A patient who underwent valve replacement surgery 4 hours ago and reports level 9 pain
The nurse is caring for a group of patients. Which patient is at highest risk for developing deep vein thrombosis (DVT)? 1. A cashier 2. A truck driver 3. A nurse 4. A mail carrier
2. A truck driver
The nurse is caring for a group of patients on the cardiac unit. Which patient is at highest risk for mitral valve prolapse? 1. A 12-year-old male 2. An 18-year-old female 3. A 25-year-old male 4. A 40-year-old female
2. An 18-year-old female
The nurse is evaluating care provided to a patient with the nursing diagnosis of activity intolerance because of aortic regurgitation. Which outcome indicates that care has been effective? 1. Stated maintained bedrest to reduce fatigue 2. Engaged in desired daily and social activities 3. Completed activities of daily living with assistance 4. Reported no longer participates in gardening hobby
2. Engaged in desired daily and social activities
The nurse is monitoring a patient with aortic stenosis and notes crackles in the lungs and a cough. Which complication should the nurse suspect is occurring in this patient? 1. Pneumonia 2. Heart failure 3. Hypertension 4. Rheumatic fever
2. Heart failure
The nurse is caring for a patient with a DVT who is receiving IV heparin. The nurse should monitor which of these laboratory tests specifically for the effects of the heparin? 1. PT 2. Partial thromboplastin time (PTT) 3. Platelets 4. Bleeding time
2. Partial thromboplastin time (PTT)
The nurse is collecting data from a patient 3 days after a motor vehicle crash in which the patient hit the steering wheel. The data reveal symptoms of pericarditis. Which finding indicates the presence of pericarditis? 1. Pain on expiration 2. Pericardial friction rub 3. Jugular vein distention 4. Crackles in lung bases
2. Pericardial friction rub
The nurse is monitoring a patient with pericarditis. What health problem is this patient at risk for developing? 1. Emboli begin to form. 2. Pericardial sac fluid increases. 3. Cardiac workload increases by 15%. 4. Cardiac output decreases more than 10%.
2. Pericardial sac fluid increases.
The nurse is caring for a patient with aortic regurgitation. Which interventions should the nurse implement? 1. Encourage the patient to perform all activities of daily living at once. 2. Schedule activities with periods of rest. 3. Elevate the head of bed (HOB) to 30 degrees. 4. Apply oxygen at 2 liters/nasal cannula.
2. Schedule activities with periods of rest.
The licensed practical nurse/licensed vocational nurse (LPN/LVN) is observing the student nurse administer enoxaparin (Lovenox). Which step taken by the student requires correction by the nurse? 1. The student cleans the area with alcohol. 2. The student removes any air bubbles. 3. The student injects the medication into the subcutaneous tissue (SQ). 4. The student asks the patient to verify any allergies.
2. The student removes any air bubbles.
A patient with a history of mitral valve replacement surgery is instructed to take prophylactic antibiotics before a scheduled root canal. Which patient statement indicates to the nurse that teaching has been effective? 1. "I know I need to call my doctor if I notice a dry cough." 2. "If I notice any ankle edema, I should lower my salt intake." 3. "If I develop a fever in the next week or so, I need to call my doctor right away." 4. "Endocarditis causes rapid weight gain so I need to weigh myself every day for a full week."
3. "If I develop a fever in the next week or so, I need to call my doctor right away."
A patient with mitral stenosis is prescribed a preoperative antibiotic. Which patient statement indicates an understanding for taking this medication? 1. "To prevent postoperative pneumonia." 2. "To prevent an increase in body temperature." 3. "To prevent a bacterial infection in the heart." 4. "To prevent infection of the surgical incision."
3. "To prevent a bacterial infection in the heart."
The nurse is reviewing the medical histories for a group of patients. Which patients should receive prophylactic antibiotics to prevent infective IE? (Select all that apply.) 1. A 68-year-old with a history of atrial fibrillation scheduled for a root canal 2. A 55-year-old with a history of angina scheduled for arthroscopic knee surgery 3. A 76-year-old with a history of cardiac valve repair scheduled for a colonoscopy 4. A 71-year-old with a history of IE scheduled for a tooth extraction 5. A 69-year-old with a history of congenital heart disease who is having an abscess drained 6. A 56-year-old with a history of mitral valve prolapse scheduled for routine dental cleaning
3. A 76-year-old with a history of cardiac valve repair scheduled for a colonoscopy 4. A 71-year-old with a history of IE scheduled for a tooth extraction 5. A 69-year-old with a history of congenital heart disease who is having an abscess drained
The nurse is caring for a patient with pericarditis. Which type of medication should the nurse expect to be prescribed for the patient? 1. Beta blocker 2. Antihypertensive 3. Anti-inflammatory 4. Calcium channel blocker
3. Anti-inflammatory
The nurse is reinforcing teaching provided to a patient with thrombophlebitis. Which diagnostic test should the nurse explain is used to confirm thrombophlebitis? 1. Chest radiograph 2. IV pyelogram 3. Duplex venous scanning 4. Arterial Doppler ultrasonography
3. Duplex venous scanning
A healthy postoperative patient who has been on bedrest for 3 days suddenly develops dyspnea, tachypnea, restlessness, and chest pain. The patient says, "I feel as if something is going to happen to me." Which action should the nurse take? 1. Perform a bilateral Homans' test. 2. Give a narcotic for pain as ordered. 3. Notify the health care provider (HCP) immediately. 4. Reassure the patient that everything is fine.
3. Notify the health care provider (HCP) immediately.
The nurse is caring for a patient receiving heparin for thrombophlebitis. The nurse observes the patient has bleeding gums and black tarry stools. Which prescribed medication should the nurse plan to administer? 1. Vitamin K 2. Naloxone (Narcan) 3. Protamine sulfate 3. Flumazenil (Romazicon)
3. Protamine sulfate
The nurse is providing discharge teaching for a patient with mitral stenosis. What should the nurse include in this teaching? 1. "The medications you will be taking make your blood thicker, so you are at risk for small clots to form." 2. "It is important that you increase your fluid intake and take iron supplements so that your body can make enough blood for your heart to pump around." 3. "Your blood is rushing through your heart so fast that it may not give your heart enough oxygen and you may have something called angina, or heart pain." 4. "Because of your heart condition, the blood flow through your heart is slower and blood may tend to pool in certain areas, which might allow tiny clots to form."
4. "Because of your heart condition, the blood flow through your heart is slower and blood may tend to pool in certain areas, which might allow tiny clots to form."
The nurse is reinforcing teaching about dilated cardiomyopathy. Which statement made by the patient indicates a need for further teaching? 1. "My condition could be genetic; I should get my kids tested." 2. "I may have heart failure since I have the dilated type of cardiomyopathy." 3. "I have the more common type of cardiomyopathy." 4. "I will not have to receive treatment, since it is not useful."
4. "I will not have to receive treatment, since it is not useful."
The nurse is caring for a group of patients. Which patient is at highest risk for developing pericarditis? 1. A patient with DVT of the right leg 2. A patient with a history of rheumatic fever 3. A patient with ankylosing spondylitis 4. A patient with renal disease and systemic lupus erythematosus (SLE)
4. A patient with renal disease and systemic lupus erythematosus (SLE)
The nurse is collecting data from a patient. Which approach should the nurse use to determine the presence of a Homans' sign? 1. Observing the calf and thigh color bilaterally 2. Listening with a Doppler to posterior bilateral tibial pulses 3. Measuring the patient's calf and thigh circumference bilaterally 4. Dorsiflexing the patient's foot sharply and asking if calf pain occurs
4. Dorsiflexing the patient's foot sharply and asking if calf pain occurs
The nurse is caring for a patient who develops a fever and reports right calf pain with a reddened and swollen calf. Which action should the nurse take? 1. Massage the affected calf. 2. Place ice on the affected calf. 3. Place elastic stocking on right leg. 4. Measure bilateral calf circumference daily.
4. Measure bilateral calf circumference daily.
The nurse is caring for a patient who has possible kidney damage from high blood pressure. Which action should the nurse take? 1. Monitor glucose. 2. Encourage fluids. 3. Monitor urine color. 4. Review creatinine level.
4. Review creatinine level.
The nurse caring for patients on the cardiac unit reviews the standards related to DVT prophylaxis. Which approach should the nurse recognize as being the most effective to prevent the development of deep vein thrombosis? 1. Using bilateral thigh-high stockings throughout hospitalization 2. Using low molecular weight heparin given subcutaneously daily 3. Using bilateral leg compression devices while the patient is in bed 4. Using a combination of pharmacological and compression interventions
4. Using a combination of pharmacological and compression interventions
A patient has sustained damage to the sinoatrial (SA) node. Which heart rates indicate that the patient's atrioventricular (AV) node has taken over as the pacemaker for the heart? 1. 10 to 20 2. 20 to 35 3. 40 to 60 4. 80 to 100
40 to 60
The nurse is assessing the heart rate for a person who plays basketball and runs track. Which heart rate can the nurse expect to document? 50 beats/min 70 beats/min 90 beats/min 110 beats/min
50 beats/min
A patient has a stroke volume of 75 mL and a heart rate of 88 beats/min. What should the nurse calculate this patient's cardiac output to be?
6,600 mL/6.6 L
The nurse is teaching a group of patients about hypertension. Which patient is at highest risk for developing hypertension? 1. A 50-year-old Caucasian female who is 5 foot 6 inches and weighs 150 pounds 2. A 30-year-old Asian male who is 5 foot 5 inches and weighs 110 pounds 3. A 60-year-old African American female who is 5 foot 7 inches and weighs 275 pounds 4. A 40-year-old Hispanic female who is 5 foot 7 inches and weighs 120 pounds
A 60-year-old African American female who is 5 foot 7 inches and weighs 275 pounds
The nurse is contributing to a teaching session about hypertension. Which patient should the nurse identify as having the greatest risk for hypertension? 1. A 43-year-old married mother of three teenagers 2. A 40-year-old man whose brother has hypertension 3. A 35-year-old male construction worker who smokes 4. A 34-year-old single female who is an administrative assistant
A 40-year-old man whose brother has hypertension
The nurse is caring for a group of patients. Which patient should the nurse see first? 1. A patient who received a dose of furosemide (Lasix) and reports an increase in urine output 2. A patient receiving spironolactone (Aldactone) with a potassium level of 4.8 mEq/L 3. A patient who received a dose of Metoprolol (Lopressor) with a blood pressure of 126/74 mm Hg 4. A patient receiving atenolol (Tenormin) with a blood pressure of 188/114 mmHg
A patient receiving atenolol (Tenormin) with a blood pressure of 188/114 mmHg
The nurse is caring for a group of patients. Which patient should the nurse see first? 1. A patient with a blood pressure of 140/70 mm Hg who is asymptomatic 2. A patient with a blood pressure of 150/60 mm Hg who is anxious 3. A patient with a blood pressure of 170/80 mm Hg with a headache 4. A patient with a blood pressure of 180/120 mm Hg reporting a nosebleed
A patient with a blood pressure of 180/120 mm Hg reporting a nosebleed
The nurse is preparing to administer furosemide (Lasix) to a patient with hypertension. The nurse reviews the patient's potassium and notes a level of 4.6 mEq/L. Which action should the nurse take? 1. Notify the HCP. 2. Administer the medication as prescribed. 3. Withhold the medication. 4. Wait an hour and administer the medication.
Administer the medication as prescribed.
The nurse is planning care for patients with hypertension. Which ethnic group should the nurse understand is most sensitive to the effects of the beta blocker propranolol (Inderal)? 1. Chinese 2. Koreans 3. African Americans 4. Japanese Americans
African Americans
The nurse is caring for a group of patients. Which patient is at highest risk of death related to cardiovascular disease? 1. An African American male who smokes 2. A Caucasian female who works a high-stress job 4. A Hispanic female who exercises daily 5. An Asian male who is vegetarian
An African American male who smokes
The nurse is caring for a patient recovering from a cardiac catheterization with a right femoral artery entry site. Which action should the nurse take? 1. Ambulate every 2 hours. 2. Position knees with 40-degree bend. 3. Avoid movement of right leg as ordered. 4. Perform passive range of motion of right leg hourly.
Avoid movement of right leg as ordered.
The nurse is caring for a patient with a potassium level of 7.6 mEq/L. For which HCP- ordered test should the nurse prepare the patient? 1. Angiography 2. Electrocardiogram 3. Nuclear radioisotope imaging 4. Cardiac catheterization
Electrocardiogram
The nurse is caring for a patient recovering from a cardiac catheterization. Which action should the nurse take? 1. Force 1,000 mL of fluid per hour. 2. Keep patient NPO until gag reflex is present. 3. Encourage the patient to drink plenty of liquids. 4. Hold fluid intake for 2 hours after the procedure.
Encourage the patient to drink plenty of liquids.
The nurse instructs a patient on beverages to avoid when taking the prescribed medication warfarin (Coumadin). Which beverage should the patient state that indicates teaching has been effective? 1. Beer 2. Orange juice 3. Grapefruit juice 4. Cranberry juice
Cranberry juice
The nurse is caring for a patient with decreased arterial blood flow. Which clinical manifestations can the nurse expect to document? (Select all that apply.) 1. Decreased hair distribution 2. Varicose veins 3. Thick, brittle nails 4. Shiny skin 5. Moist skin
Decreased hair distribution
The nurse takes the BP of a patient with a result of 120/80 mm Hg. Which action should the nurse take? 1. Document the finding as normal. 2. Notify the HCP. 3. Instruct the patient to follow a salt-free diet. 4. Prepare to administer a bolus of normal saline IV.
Document the finding as normal.
The nurse becomes concerned that a male patient's blood pressure is 168/98 mm Hg after 6 months on antihypertensive medication. What question should the nurse ask after measuring this blood pressure? 1. Is the patient taking the medication? 2. What is the volume of alcohol ingested each day? 3. Which pharmacy is filling the prescribed medications? 4. How many hours of sleep does the patient receive each night?
Is the patient taking the medication?
The nurse is caring for a patient who had a cardiac catheterization using the left femoral site for entry. Which data is most important for the nurse to monitor? 1. Pupil reaction 2. Left pedal pulse 3. Orientation status 4. Right foot sensation
Left pedal pulse
The nurse is taking a medication history of a patient with a chronic cough. Which medication can the nurse suspect as contributing to the cough? 1. Chlorothiazide (Diuril) 2. Furosemide (Lasix) 3. Nadolol (Corgard) 4. Lisinopril (Zestril)
Lisinopril (Zestril)
The nurse is caring for a patient recovering from a cardiac catheterization. Which actions for site care should the nurse take? 1. Keep the site uncovered. 2. Apply an adhesive bandage to the site. 3. Maintain pressure dressing on the site. 4. Apply a gauze bandage to the puncture site.
Maintain pressure dressing on the site.
The nurse is caring for a patient who is having an exercise treadmill test. What interventions would be appropriate for the test? (Select all that apply.) 1. Remove all metal objects. 2. Monitor vital signs throughout the test. 3. Administer antianxiety medication as ordered. 4. Monitor electrocardiogram before, during, and after the test. 5. Ask the patient about allergies to dyes used in diagnostic procedures.
Monitor vital signs throughout the test.
The nurse is assessing a patient and notes a prolonged, very loud swishing sound. The nurse knows this describes which of the following? 1. Pericardial friction rub 2. Murmur 3. Ventricular gallop 4. Atrial gallop
Murmur
The nurse is reviewing laboratory values for a patient and notes a potassium level of 6.4 mEq/L. Which clinical manifestation can the nurse expect the patient to report? 1. Constipation 2. Fast heart rate 3. Muscle cramps 4. High blood pressure
Muscle cramps
The nurse knows the patient falls under which category? 1. Stage 1 hypertension 2. Elevated blood pressure 3. Normal blood pressure 4. Stage 2 hypertension
Normal blood pressure
The nurse is assessing a patient and notes that the nailbed angle exceeds 180 degrees and feels spongy when squeezed. Which intervention should the nurse implement? 1. Tell the patient he has a congenital heart defect. 2. Document the normal finding in the chart. 3. Encourage the patient to elevate his extremities. 4. Notify the HCP.
Notify the HCP.
The nurse is preparing to administer atenolol (Tenormin) to a patient with hypertension. The patient's blood pressure is 72/40 mm Hg. Which action should the nurse take? 1. Administer the medication as ordered. 2. Notify the HCP. 3. Reassess the patient's blood pressure in 8 hours. 4. Administer half of the prescribed dose.
Notify the HCP.
The nurse is assessing a patient and notices the radial pulse has fewer beats than the apical pulse. Which action should the nurse take? 1. Document the finding as normal. 2. Encourage the patient to ambulate and recheck. 3. Notify the health care provider (HCP). 4. Encourage the patient to increase fluid intake.
Notify the health care provider (HCP).
The nurse is caring for a patient with peripheral vascular disease. Which signs or symptoms should the nurse expect to observe in this patient? (Select all that apply.) 1. Pain 2. Pruritus 3. Purpura 4. Paralysis 5. Paresthesia 6. Pulselessness
Pain
The nurse is reinforcing teaching for a patient who is to wear a Holter monitor. Which of the following should the nurse include? (Select all that apply.) 1. Avoid strenuous activity. 2. Transmit data over the phone. 3. Push the event button when symptoms occur. 4. Keep an accurate diary of symptoms and activities. 5. Avoid showers or baths while wearing the monitor. 6. Take nothing by mouth for 6 hours before applying the monitor.
Push the event button when symptoms occur.
The nurse is caring for a patient in hypertensive emergency. What should the nurse expect to be the goal when treatment is provided for this patient? 1. Increase urine output. 2. Negate the impact of sodium in the body. 3. Ensure an adequate potassium blood level. 4. Reduce blood pressure by 25% in 1 hour.
Reduce blood pressure by 25% in 1 hour.
A patient on antihypertensive medication has no insurance, three children, and reports feeling great and exercising daily. What should the nurse include in this patient's teaching plan to promote compliance? 1. Encourage increased rest periods. 2. Provide names of support groups. 3. Refer the patient for financial assistance. 4. Schedule an annual physical examination.
Refer the patient for financial assistance.
A patient being treated for a severe blood loss has a BP of 90/56 mm Hg and urine output of 10 mL over the last hour. Which physiological mechanism should the nurse recall is occurring in this patient? 1. Starling's law 2. Medulla-brainstem 3. Sodium-potassium pump 4. Renin-angiotensin-aldosterone
Renin-angiotensin-aldosterone
The nurse is explaining the regulation of blood pressure (BP) to a patient newly diagnosed with hypertension. What tissues within the artery wall that helps maintain diastolic BP should the nurse identify for the patient? 1. Smooth muscle and elastic connective tissue 2. Smooth muscle and simple squamous epithelium 3. Elastic connective tissue and fibrous connective tissue 4. Fibrous connective tissue and simple squamous epithelium
Smooth muscle and elastic connective tissue
The nurse is observing a patient apply antiembolism stockings. Which action by the patient requires correction by the nurse? 1. The patient pulls the stockings up to 1 to 2 inches below the bottom of the kneecap. 2. The patient uses an assistive device in applying the stockings. 3. The patient rolls the stockings down. 4. The patient wears the stockings all day as instructed.
The patient rolls the stockings down.
The nurse is assessing a patient who has been taking prazosin (Minipress) for 3 months. Which indicates treatment is effective? 1. The patient reports a 4-pound weight loss in 3 months. 2. The patient states they work out at the gym every morning. 3. The patient tells the nurse she has been following a low-sodium diet. 4. The patient's blood pressure is 114/66 mm Hg.
The patient's blood pressure is 114/66 mm Hg.
The nurse is caring for a patient admitted with chest pain and suspected myocardial infarction (MI). Which laboratory value should the nurse expect to see an elevation? 1. Ammonia 2. Glucose 3. Amylase 4. Troponin
Troponin
The nurse notes that a patient's lower legs are brown and the feet are blue when they are in the dependent position. For which health problem should the nurse collect additional data? 1. Anemia 2. Insufficient oxygenation 3. Decreased arterial blood flow 4. Venous blood flow problems
Venous blood flow problems
The nurse is reviewing orders for a patient taking digoxin (Lanoxin). Which additional medication should the nurse question? 1. Ramipril (Altace) 2. Carvedilol (Coreg) 3. Verapamil (Calan SR) 4. Clonidine (Catapres)
Verapamil (Calan SR)
The nurse is reviewing the medication history for a patient about to undergo cardiac surgery. Which medication should the nurse report to the surgeon? 1. Furosemide (Lasix) 2. Warfarin (Coumadin) 3. Metformin (Glucophage) 4. Lisinopril (Prinivil)
Warfarin (Coumadin)