med surg ch 21-23

A client with hypertension presents to the clinic with a blood pressure reading of 218/112. Which question is most important for the nurse to ask?

"Have you been taking your blood pressure medications?"

The nurse is teaching a client about enoxaparin. Which statement made by the client indicates the need for further teaching?

"I need to get the air bubble out of the syringe."

The nurse is providing teaching to a client with strep throat about preventing rheumatic fever. Which statement made by the client indicates an understanding of the teaching?

"I will be given penicillin to treat the strep throat."

The nurse is providing teaching for a client with thrombophlebitis. Which of the following statements made by the client indicates an understanding of the teaching?

"I will elevate my legs to promote circulation and reduce edema."

The nurse is caring for a client with suspected cardiomyopathy. Which statement made by the client requires correction by the nurse?

"Restrictive cardiomyopathy is the most common type."

The nurse is teaching a postoperative client how to apply antiembolism stockings. Which statement made by the client indicates a need for further teaching?

"The top of the stocking need to be 2 inches over the kneecap."

The nurse is answering questions for a client about to undergo angiography. Which statement made by the client indicates an understanding of the procedure?

"This test will inject dye into my vessels and see if I have a clot somewhere."

The nurse is caring for a client with mitral regurgitation. The client asks the nurse what this means. Which response by the nurse is best?

"Your mitral valve leaflets do not close all the way. This allows backflow of blood into the left atrium every time the left ventricle contracts."

The nurse is preparing to administer heparin sodium 5,000 units. Available is heparin sodium 10,000 units/mL. How many milliliters will the nurse administer? Enter the numeral only.

0.5ml

The nurse is preparing to administer enoxaparin to a client who weighs 60 kg. The ordered dose is 1 mg/kg every 12 hr. The available dose is enoxaparin 60 mg/0.6 mL. How many milliliters will the nurse administer? Enter the numeral only.

0.6 ml

The nurse is providing teaching regarding healthy food choices to a client with hypertension. Which food choice indicates that the client understood the teaching?

1 small apple with 1 cup of raw leafy vegetables and 1 ½ ounce of cheese

The nurse is assessing the pulse of a client. The pulse disappears when slight pressure is applied and returns when the pressure is removed. This describes a pulse of what quality?

1+

The nurse is assessing a client's blood pressure (BP). Which finding would the nurse document as normal?

110/70

The nurse is administering furosemide 40 mg by mouth to a client with hypertension. Available is furosemide 20 mg tablets. How many tablets will the nurse administer? Enter the numeral only.

2

The health-care provider suspects a client has hypertension. The nurse should anticipate preparing the client for which of the following?

24-hour ambulatory blood pressure (BP) monitoring

The nurse is assessing the resting heart rate of a marathon runner. Which heart rate is an expected finding in this client?

50 beats/minute

The nurse is caring for a group of clients. Which client is at highest risk for mitral valve prolapse (MVP)?

A 20-year-old female client

The nurse is caring for a group of clients. Which client is at highest risk for developing hypertension?

A 56-year-old African-American female who is 5'4" and weighs 260 pounds.

The nurse is caring for a group of clients. Which client does the nurse identify as a high risk for developing dilated cardiomyopathy?

A client who recently received chemotherapy

The nurse is caring for a group of clients. Which client should the nurse see first?

A client who underwent valve replacement surgery 2 hr ago who is reporting pain

The nurse is caring for a group of clients. Which client should the nurse see first?

A client with a blood pressure of 180/90 who reports chest pain

The nurse is caring for a group of clients. Which client should the nurse see first?

A client with a manual blood pressure of 224/114

The nurse is caring for a group of clients. Which client should the nurse see first?

A client with deep vein thrombosis (DVT) who reports dyspnea

The nurse is caring for a group of clients. Which client does the nurse identify as high risk for developing infective endocarditis (IE)? Select all that apply.

A client with human immunodeficiency virus (HIV) A client who reports using intravenous (IV) drugs A client with gingival gum disease A client with an artificial heart valve

The nurse is caring for a client on warfarin. A normal prothrombin time (PT) range is 9 to 12 seconds. Calculate the therapeutic range. Enter the numeral only.

A normal therapeutic range is 9 to 12 seconds. Warfarin's therapeutic range is 1.5 to 2 times the normal PT range. Multiply 9 by 1.5 to equal 13.5 for the low end of the range. Multiple 12 by 2 to equals 24 for the high end of the range.

The nurse is caring for a client who reports pink and frothy sputum. The nurse suspects this client may have a diagnosis of which condition?

Acute heart failure

The nurse is calculating intake for a client with hypertension. The client has consumed three servings of grape juice with 240 mL volume in each container, 110 mL of diet soda, and 1 L of water. Calculate the client's total intake. Enter the numeral only.

Add 240 x 3, 110, and 1000 mL to produce a sum of 1,830mL

The nurse is caring for a client receiving tissue plasminogen activator (tPA). Which of the following orders should the nurse question?

Administer acetylsalicylic acid (aspirin) as ordered.

The nurse is caring for a client with myocarditis. Which of the following interventions should the nurse implement?

Administer lisinopril as ordered

The nurse is caring for a client with thrombophlebitis. Which of the following interventions should the nurse implement?

Administer nonsteroidal anti-inflammatory drugs (NSAIDS) as ordered.

Which of the following is a nonmodifiable risk factor for heart disease?

Age

The nurse is preparing a client for a cardiac catheterization. Which of the following is the most important piece of data to know prior to the procedure?

Allergies to iodine, shellfish, or contrast dye

The nurse is caring for a client taking digoxin. Which medication in the client's orders should the nurse question?

Amlodipine

The nurse is caring for a client with mitral valve prolapse (MVP). Which of the following clinical manifestations can the nurse expect to find? Select all that apply.

Anxiety Dyspnea Murmur Fatigue

The nurse is caring for a client with a deep vein thrombosis (DVT). Which interventions should the nurse implement? Select all that apply.

Apply compression stockings. Instruct the client to quit smoking. Administer warfarin as ordered.

The nurse is caring for a client with mild mitral regurgitation. Which clinical manifestations can the nurse expect to find?

Asymptomatic

The nurse is caring for a client with hypertension. Which clinical manifestations should the nurse expect the client to exhibit? Select all that

Asymptomatic Headache Bloody nose Shortness of breath

A client returns to the clinic for a follow-up after being treated for hypertension for 4 months. Which assessment data indicates that the medication has been effective?

Blood pressure is 116/70

A client presents to the emergency department with chest pain. Which blood study is most important to monitor to rule out a myocardial infarction (MI)?

Cardiac troponin

Which answer describes the role of arteries?

Carry blood from the heart to capillaries

The nurse is caring for a client with pericarditis. Which clinical manifestation can the nurse expect to find?

Chest pain radiating to the clavicle

The nurse is caring for a client who underwent valve replacement surgery 1 hr ago. Which of the following interventions should the nurse implement?

Communicate using simple terms and closed-ended questions

The nurse is assessing the temperature of a client's lower extremities and notes that one leg is cool to the touch. Which of these answers describes the meaning of a cool extremity?

Decreased arterial blood flow

Which internal factor may contribute to hypertension?

Decreased elasticity of blood vessels

The nurse is caring for a client with suspected orthostatic hypotension. Which factors place this client at risk? Select all that apply.

Diuretics Analgesics Pain

The nurse is assessing a client with a suspected deep vein thrombosis (DVT) of the left leg. Which clinical manifestations can the nurse expect to find? Select all that apply.

Edema Pain Venous distention

A client presents to the clinic with chest pain. For which test should the nurse prepare the client first?

Electrocardiogram (ECG)

The nurse is teaching a group of clients about preventing infective endocarditis (IE). Which of the following should the nurse include in the teaching?

Emphasize importance of regular dental care.

The nurse is caring for a client with orthostatic hypotension. Which intervention should the nurse implement to promote safety?

Encourage the client to ask for assistance prior to getting out of bed

The nurse is caring for a client with aortic stenosis. Which of the following interventions should the nurse implement?

Encourage the client to use the call light when getting up.

The nurse is caring for a client with aortic regurgitation. Which of the following clinical manifestations should the nurse expect to find?

Forceful heartbeat when lying down

The nurse is preparing to administer propranolol to a client with hypertension. The nurse obtains a blood pressure reading of 76/42. Which action should the nurse take?

Hold the medication and notify the health-care provider (HCP)

The nurse is providing teaching regarding the DASH diet for a client diagnosed with hypertension. Which statement made by the client indicates a need for further education?

I can eat foods high in sodium as long as I drink plenty of water."

The nurse is providing preoperative teaching to a client about to undergo cardiac surgery. Which of the following statements made by the client indicates a need for further education?

I should avoid coughing and deep breathing so my incision does not reopen.

The nurse is providing teaching for a client with mitral valve prolapse. Which of the following statements made by the client indicates an understanding of the teaching?

I should follow a healthy diet."

Hypertension can lead to which change in the heart?

Increase in size of left ventricle

The nurse is teaching a group of clients about risk factors for pericarditis. Which of the following should the nurse include in the teaching? Select all that apply.

Infections Medications Systemic lupus erythematosus (SLE)

A client with a diagnosis of hypertension who has been taking medication reports a dry cough. Which medication can the nurse expect to find in the client's medication history?

Lisinopril

The nurse is caring for a client receiving anticoagulant therapy for a deep vein thrombosis (DVT) of the left leg. How will the nurse know that therapy has been effective?

Measurement of the effected calf has shown a decrease in size.

The nurse is caring for a client with exacerbation of asthma and hypertension. Which medication order should the nurse question?

Metoprolol

Which of the following are valves of the heart? Select all that apply.

Mitral Tricuspid Pulmonic Aortic

The nurse is caring for a client who underwent a cardiac catheterization. Which of the following interventions should the nurse implement? Select all that apply.

Monitor vital signs Monitor peripheral pulses Keep the client on bed rest as ordered Monitor the puncture site

The nurse is auscultating a client's heart sounds and notes a prolonged, faint swishing sound. The nurse suspects the client may be exhibiting which abnormality?

Murmur

The nurse is monitoring a client's pulse and notes there are fewer radial beats than apical beats. Which action by the nurse is best?

Notify the health-care provider

The nurse is caring for a client with pericarditis. Which of the following is a clinical manifestation the nurse can expect to find?

Pericardial friction rub

The nurse is caring for a client with pericarditis who develops cardiac tamponade. For which treatment should the nurse prepare the client?

Pericardiocentesis

The nurse is caring for a client with infective endocarditis (IE). Which clinical manifestations can the nurse expect to find? Select all that apply.

Petechiae Aching muscles Fever

The nurse is caring for a client with myocarditis. Which of the following is an early clinical manifestation of this condition?

Pharyngitis

The nurse is reviewing lab values for a client taking furosemide. Which of these lab values would concern the nurse the most?

Potassium 2.5 mEq/L

The nurse is caring for a client receiving heparin sodium who begins bleeding. Which medication is an antidote to heparin?

Protamine sulfate

The nurse is assessing a client who reports chest pain along with pain in the shoulder. Which term describes this pain?

Radiate

Where does pulmonary circulation begin?

Right ventricle

Which part of the heart pumps deoxygenated blood toward the lungs?

Right ventricle

The first heart sound heard at the beginning of systole when the tricuspid and mitral valves close is known as which sound?

S1

The nurse is caring for a client with aortic regurgitation. Which of the following interventions should the nurse implement?

Schedule periods of rest between activities.

The nurse obtains a blood pressure (BP) reading of 134/86. According to the blood pressure categories, this client's blood pressure is in which category?

Stage I Hypertension

The nurse is caring for a client with hypertension. The client is at risk for which of the following? Select all that apply.

Stroke Heart failure Pulmonary edema

The nurse is caring for a client receiving furosemide. The nurse should provide the following education to the client:

Take the medication in the morning

The nurse is taking a medication history of a client about to undergo cardiovascular surgery. Which medication reported by the client would require the nurse to notify the surgeon?

Warfarin

The nurse is providing teaching for a client being discharged home with metoprolol. Which of the following is most important for the nurse to include in the teaching? Select all that apply.

Weigh yourself weekly Sit up slowly from a lying position Notify the health-care provider if dizziness occurs

The nurse is caring for group of clients. Which client is at highest risk for developing deep vein thrombosis (DVT)?

a truck driver

Where does systemic circulation begin?

left ventricle

The nurse is caring for a client with cardiomyopathy. The client suddenly develops orthopnea, extreme fatigue, and chest pain. Which action should the nurse take first?

notify HCP

The nurse is reviewing the prothrombin time (PT) of a client receiving warfarin. The PT is 64 seconds. Which action should the nurse take first?

notify HCP

What is the term for a normal heartbeat?

sinus rhythm

Rheumatic fever is a rare complication of which condition?

strep throat

The nurse is caring for a client receiving warfarin who begins to bleed. Which medication is the antidote for warfarin?

vitamin k

The nurse is assessing a client with aortic stenosis. Which of the following should concern the nurse the most?

wet lung sounds