Perfusion

A client with a history of acute coronary syndrome asks why she needs to take aspirin 81 mg every day. The most appropriate response by the nurse would be: "Aspirin will help prevent blood clotting." "Aspirin prevents blood clotting by halting platelet production." "It will give you a steady relief of your chest pain." "Aspirin will prevent a heart attack."

"Aspirin will help prevent blood clotting." Aspirin (i.e., acetylsalicylic acid) is the preferred antiplatelet agent for preventing platelet aggregation in persons with ACS

On a routine physical exam visit, the physician mentions that he hears a new murmur. The client gets worried and asks, "What does this mean?" The physician responds: "It would be caused by stress. Let's keep our eye on it and see if it goes away with your next visit." "This could be caused by an infection. Have you been feeling well the past few weeks?" "One of your heart valves is not opening properly. We need to do an echocardiogram to see which valve is having problems." "This may make you a little more fatigued than usual. Let me know if you start getting dizzy or lightheaded."

"One of your heart valves is not opening properly. We need to do an echocardiogram to see which valve is having problems."

A client is prescribed a 12.5-mg dose of metoprolol for the treatment of high blood pressure. The nurse should administer how many 25-mg tablets? 0.5 1 2 1.25

0.5 12.5 (desired dose) ÷ 25 (available dose) = 0.5 tablets.

The nurse is performing a skin assessment on a bedbound client who was positioned in a semi-Fowler's position. The nurse notices erythema over the sacrum and repositions the patient to a left recumbent position. The nurse anticipates resolution of the erythema will occur in less than 15 minutes. 30 minutes. 45 minutes. 1 hour.

1 hour. The initial sign of pressure is erythema caused by reactive hyperemia, which normally resolves in less than 1 hour.

A person with type A blood who exhibits the D antigen would be considered to have which blood type? A+ AB- A- O+

A+ Persons who express the D antigen are designated Rh positive. This client would be considered to have A+ blood type.

Anticoagulant drugs prevent thromboembolic disorders. How does warfarin, one of the anticoagulant drugs, act on the body? Alters vitamin K, reducing its ability to participate in the coagulation of the blood Increases prothrombin Increases vitamin K-dependent factors in the liver Increases procoagulant factors

Alters vitamin K, reducing its ability to participate in the coagulation of the blood. The anticoagulant drugs warfarin and heparin are used to prevent thromboembolic disorders, such as deep vein thrombosis and pulmonary embolism. Warfarin acts by decreasing prothrombin and other procoagulant factors. It alters vitamin K in a manner that reduces its ability to participate in synthesis of the vitamin K-dependent coagulation factors in the liver.

The acute care nurse is assessing a newly admitted client's abdomen. Which finding would indicate the need to contact the health care provider? Auscultation of a bruit Auscultation of bowel sounds every 30 seconds Auscultation of gurgles and clicks Umbilicus centrally located

Auscultation of a bruit A bruit may be heard in the presence of stenosis (narrowing) or occlusion of an artery. Bruits may also be caused by abnormal dilation of a vessel.

The health care provider is reviewing the results of a client's magnetic resonance imaging (MRI). The results indicate a small spherical dilation at the circle of Willis. The provider would interpret this as: Berry aneurysm Dissecting aneurysm Saccular aneurysm Fusiform aneurysm

Berry aneurysm The description of the aneurysm describes a berry aneurysm usually found at the circle of Willis.

Which is a cardiac complication of an eating disorder? Bradycardia Hypertension Enlarged heart Thrombocytopenia

Bradycardia Cardiac complications include bradycardia, hypotension, small heart, and loss of cardiac muscle.

The public health nurse is designing a course about risk factors for various chronic illnesses. For risk factors about which chronic illness will the nurse consult the Framingham study? Cardiovascular disease Breast cancer Chronic obstructive pulmonary disease (COPD) Type 2 diabetes mellitus

Cardiovascular disease

A client has edema of the feet and ankles, along with crackles in the lower lobes and a frothy, productive cough. The nursing care plan will address implications of what medical diagnosis? Pulmonary embolism Myocardial infarction Lung cancer Congestive heart failure

Congestive heart failure A client who has edema and a cough that is productive with frothy sputum is manifesting heart failure as a result of alterations to circulation.

The heart valves control the direction of blood flow. What is the function of the pulmonic valve? Controls the direction of blood flow from the right side of the heart to the lungs Controls the direction of blood flow from the left side of the heart to the lungs Controls the direction of blood flow from the right side of the heart to the systemic circulation Controls the direction of blood flow from the left side of the heart to the systemic circulation

Controls the direction of blood flow from the right side of the heart to the lungs

When an acute MI occurs, many physiologic changes occur very rapidly. What causes the loss of contractile function of the heart within seconds of the onset of an MI? Conversion from aerobic to anaerobic metabolism Overproduction of energy capable of sustaining normal myocardial function Conversion from anaerobic to aerobic metabolism Inadequate production of glycogen with mitochondrial shrinkage

Conversion from aerobic to anaerobic metabolism

A nurse in the emergency department admits a male client who has experienced severe frostbite to his hands and toes after becoming lost on a ski hill. The nurse recognizes that which phenomena has contributed to his tissue damage? Decreased blood viscosity has resulted in interstitial bleeding. Reactive vasodilation has compromised perfusion. Autonomic nervous stimulation has resulted in injury. Decreased blood flow has induced hypoxia.

Decreased blood flow has induced hypoxia. *Damage from exposure to cold results from hypoxia, ice crystal formation, and vasoconstriction.

A nurse has applied a bandage to a client's arm from just above the wrist to just below the elbow. What finding(s) would suggest to the nurse that there are no circulatory complications? Select all that apply. Fingers with quick capillary refill Warm hand Decreased radial pulse Cyanosis No finger numbness or tingling

Fingers with quick capillary refill No finger numbness or tingling Warm hand

While assessing a newborn, the nurse notes that half the body appears red while the other half appears pale. The nurse interprets this finding as: harlequin sign. stork bites. congenital dermal melanocytosis (slate gray nevi). erythema toxic.

Harlequin sign refers to the dilation of blood vessels on only one side of the body. It gives a distinct midline demarcation, which is pale on one side and red on the opposite

A 31-year-old woman with a congenital heart defect reports episodes of lightheadedness and syncope, with occasional palpitations. A resting ECG reveals sinus bradycardia, and she is suspected to have sick sinus syndrome. Which diagnostic method is the best choice to investigate the suspicion? Signal-averaged ECG Exercise stress testing Electrophysiologic study Holter monitoring

Holter monitoring Because sick sinus syndrome frequently involves intermittent or alternating types of dysrhythmias, Holter monitoring, which can record changes in rhythm that occur over a period of up to 48 hours, is likely to provide the best picture of the spectrum of cardiac changes in any particular client.

Football fans at a college have been shocked to learn of the sudden death of a star player, an event that was attributed in the media to "an enlarged heart." Which disorder was the player's most likely cause of death? Takotsubo cardiomyopathy Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) Hypertrophic cardiomyopathy (HCM) Dilated cardiomyopathy (DCM)

Hypertrophic cardiomyopathy (HCM)

A nurse cares for a client with congestive heart failure. The nurse administers a prescribed dose of furosemide intravenously after noting an increase in dyspnea and audible wheezing. The nurse's action demonstrates which step in the nursing process? Assessment Planning Implementation Evaluation

Implementation

What does the use of cardiotonics lead to? (Select all that apply.) Improved myocardial contractility Increased myocardial efficiency Increase in blood pressure Increase in peripheral edema Improved perfusion to all body tissues

Improved myocardial contractility Increased myocardial efficiency Improved perfusion to all body tissues Cardiotonics are drugs used to increase the efficiency and improve the contraction of the heart muscle, which leads to improved blood flow (perfusion) to all tissues of the body.

A 22-year-old male is experiencing hypovolemic shock following a fight in which his carotid artery was cut with a broken bottle. What immediate treatments are most likely to benefit the man? Resolution of compensatory pulmonary edema and heart dysrhythmias. Infusion of vasodilators to foster perfusion and inotropes to improve heart contractility. Infusion of normal saline or Ringer's lactate to maintain the vascular space. Administration of oxygen and epinephrine to promote perfusion.

Infusion of normal saline or Ringer's lactate to maintain the vascular space. Maintenance of vascular volume is the primary goal in the treatment of hypovolemic shock, and can be achieved in the short term through intravenous administration of saline solution of Ringer's lactate.

Following a lengthy series of diagnostic tests, a client's chronic hip pain has been attributed to advanced osteonecrosis. What treatment is this client most likely to require? Joint replacement surgery Intravenous antibiotics Injections of corticosteroids into the synovial space Transfusion of packed red blood cells

Joint replacement surgery Advanced osteonecrosis often necessitates joint replacement surgery, because necrotic bone cannot be rehabilitated.

An 81-year-old male client who has a diagnosis of orthostatic hypotension is experiencing an episode of particularly low blood pressure. The man's body has responded by increasing levels of angiotensin II in the bloodstream, a hormone which decreases glomerular filtration rate in the kidneys and contributes to an increase in blood pressure. Which phenomena best describes what has occurred? Positive feedback Adaptation Negative feedback Homeostasis

Negative feedback This regulation and attempt to normalize blood pressure is an example of a negative feedback mechanism, in which physiologic processes result in the maintenance of homeostasis.

A client is seen in the emergency room reporting sharp chest pain that started abruptly. He says it has radiated to his neck and abdomen. He also states that it is worse when he takes a deep breath or swallows. He tells the nurse that when he sits up and leans forward the pain is better. Upon examination the nurse notes a pericardial friction rub and some EKG changes. Which disease should the nurse suspect this client to have? Myocardial infarction Abdominal aortic aneurysm Pericarditis Pneumonia

Pericarditis This client is demonstrating signs and symptoms of pericarditis, which includes a triad of chest pain, pericardial friction rub, and EKG changes.

A nurse caring for clients in a PACU assesses a client who is displaying signs and symptoms of shock. What is the priority nursing intervention for this client? Remove extra coverings on the client to keep temperature down. Place the client in a flat position with legs elevated 45 degrees. Do not administer any further medication. Place the client in the prone position.

Place the client in a flat position with legs elevated 45 degrees. Placing the client in a flat position with the legs elevated 45 degrees uses gravity to help direct blood to the vital organs.

The client explains to her new provider that she receives periodic phlebotomies to decrease her red blood cell mass. The provider believes the client may have: Polycythemia vera Sickle cell disease Beta-thalassemia Megaloblastic anemia

Polycythemia vera Primary polycythemia, or polycythemia vera, is characterized by an absolute increase in total red blood cell mass. The goal of treatment is to reduce blood viscosity.

A nurse is teaching a client the correct technique for taking an arterial pulse. The nurse explains that the pulsations are: Pressure pulses Korotkoff sounds Blood flow in the veins Turbulence of the blood flow

Pressure pulses

A client is at high risk for the development of rheumatic heart disease. The most important information for the nurse to provide would be: Prompt diagnosis and treatment of streptococcal infections Yearly electrocardiography after the age of 50 Annual blood specimen assessed for rheumatoid factor Avoiding frequent dental examinations

Prompt diagnosis and treatment of streptococcal infections Rheumatic heart disease is normally caused by streptococcal infections

Reviewing pathology for an exam on pulmonary vasculature, the nursing student states that blood enters the right side of the heart via the vena cava, then to the right atrium, right ventricle, and then which vessel carries the deoxygenated blood into the pulmonary system? Pulmonary capillaries Pulmonary artery Pulmonary vein Ductus arteriosus

Pulmonary artery Deoxygenated blood leaves the right heart through the pulmonary artery. Return of oxygenated blood to the heart occurs by way of the pulmonary vein, which empties into the left atrium.

The nurse assessing a client with scleroderma with CREST variant would include an assessment for: Raynaud's phenomenon. thrombocytopenia. leukocytosis. butterfly rash.

Raynaud's phenomenon. Raynaud's phenomenon is the characteristic symptom of CREST variant of scleroderma that is identified by the R in the CREST acronym.

The nurse takes a client's blood pressure in the primary care provider's office. The last three times the client has been in the office it has been high. What structure in the eye is this adverse effect of hypertension most likely to affect? Iris Retina Ciliary body Lens

Retina The adverse effect of hypertension most likely will affect the retina of the eye

If the parasympathetic neurotransmitter releases acetylcholine, the nurse should anticipate observing what changes in the ECG pattern? Heart rate 150 beats/minute, labeled as supraventricular tachycardia Disorganized ventricular fibrillation Complete cardiac standstill Slowing of heart rate to below 60 beats/minute

Slowing of heart rate to below 60 beats/minute Acetylcholine, the parasympathetic neurotransmitter released during vagal stimulation of the heart, slows down the heart rate by decreasing the slope of phase 4

A pregnant client at 24 weeks' gestation calls the clinic crying after a prenatal visit, where she had a pelvic exam. She states that she noticed blood on the tissue when she wiped after voiding. What initial statement by the nurse would explain this finding? The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual. She may have a bleeding disorder so she needs to come back to the clinic for blood work. It is possible she is losing her mucus plug, which can cause bloody show. Some bleeding during pregnancy is not uncommon and this finding is expected.

The cervix is very vascular during pregnancy, so spotting after a pelvic exam is not unusual.

Select the client who may be at risk for developing an increased resistance to blood flow. The client in hypovolemic shock experiencing extreme dehydration The client who is being treated for anaphylactic shock The client who is hypotensive The client who is receiving intravenous fluids at a rate of 100 mL/h

The client in hypovolemic shock experiencing extreme dehydration The blood of the client who is extremely dehydrated will be more viscous and increase resistance to flow.

A nurse is assessing the blood pressure of a client using the Korotkoff sound technique. The nurse notes that the phase I sound disappears for 2 seconds. What should the nurse document on the progress record? There is a nonauscultatory gap. There is a widening in the diameter of the artery. There is an auscultatory gap. There is an adult diastolic pressure.

There is an auscultatory gap.

A client who has bleeding tendencies has a deficiency in which vitamin? Vitamin A Vitamin B Vitamin C Vitamin K

Vitamin K Vitamin K deficiencies are manifested in two ways: an increased tendency to hemorrhage and hemorrhagic disease of the newborn, which is common in premature or anoxic newborns.

Which statement describes phase 4 of the action potential of cells in the sinoatrial (SA) node? a. A slow depolarization occurs when Na+ is transported out of the cell and K+ moves back in, resulting in resting membrane potential. b. The cells are capable of responding to a greater-than-normal stimulus before the resting membrane potential is reached. c. The fast sodium channels in the cellular membranes close, causing an abrupt decrease in intracellular positivity. d. Potassium permeability is allowing the cell membrane to remain depolarized and the Ca++ channel opens, moving Ca++ back into the cell.

a. A slow depolarization occurs when Na+ is transported out of the cell and K+ moves back in, resulting in resting membrane potential.

Which client's signs and symptoms would allow a clinician to be most justified in ruling out stroke as a cause? An adult: a. has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days. b. experienced a sudden loss of balance and slurred speech. c. has vomited and complained of a severe headache. d. states that her left arm and leg are numb and gait is consequently unsteady.

a. has had a gradual onset of weakness, headache, and visual disturbances over the last 2 days. A cardinal trait of the manifestations of stroke is that the onset is sudden, and a gradual onset of symptoms over 2 days would suggest an alternative etiology.

A client has impaired skin integrity related to compromised circulation. What should the nurse include in the teaching plan regarding nutritional considerations? adequate intake of vitamins A and C, protein, and zinc adherence to a diet that helps with weight reduction supplementation of diet with vitamins and antioxidants elimination of carbohydrates and fats from the diet

adequate intake of vitamins A and C, protein, and zinc

A client with chronic arterial occlusive disease undergoes percutaneous transluminal coronary angioplasty (PTCA) for mechanical dilation of the right femoral artery. After the procedure, the client will require long-term administration of aspirin or acetaminophen. pentoxifylline or acetaminophen. aspirin or clopidogrel. penicillin V or erythromycin.

aspirin or clopidogrel. After PTCA, the client begins long-term aspirin or clopidogrel therapy to prevent thromboembolism.

A client presents to the emergency department with a new onset of unilateral weakness and visual disturbances. The primary health care provider suspects that the client has had a cerebrovascular accident (CVA) and prescribes alteplase. What is the nurse's priority prior to administering alteplase? asking the client to state any medication allergies assessing the client for a hemorrhagic stroke seeing if the client takes a beta-adrenergic blocker or aminoglycoside antibiotics reviewing the medical record to find the client's blood type

assessing the client for a hemorrhagic stroke Administration of alteplase would exacerbate a hemorrhagic stroke by increasing bleeding. For this reason, a hemorrhagic stroke must be ruled out

A nurse is assessing an apical pulse on an older adult client who takes metoprolol daily. The nurse can anticipate that the client's medication will: decrease the blood glucose. decrease the blood volume. decrease the apical pulse. decrease the respiratory rate.

decrease the apical pulse. Metoprolol is a beta-blocker that will decrease the heart rate.

The nurse is admitting a client with a suspected diagnosis of abruptio placentae. Which assessment data would require the nurse to notify the healthcare provider immediately? Select all that apply. overt vaginal bleeding white creamy vaginal discharge a rigid abdomen gastrointestinal upset decreased blood pressure increased heart rate

decreased blood pressure. increased heart rate a rigid abdomen overt vaginal bleeding

The nurse is caring for a client with Marfan syndrome. Which assessment finding should the nurse prioritize as requiring the most emergent intervention? A sudden: drop in blood pressure from 130/90 to 95/50 mm Hg. complete loss of vision in a single eye. drop in heart rate from 80 to 60 beats per minute. onset of confusion and altered level of consciousness.

drop in blood pressure from 130/90 to 95/50 mm Hg.

A client undergoes cerebral angiography for evaluation after an intracranial computed tomography scan revealed a subarachnoid hemorrhage. Afterward, the nurse checks frequently for signs and symptoms of complications associated with this procedure. Which findings indicate spasm or occlusion of a cerebral vessel by a clot? nausea, vomiting, and profuse sweating hemiplegia, seizures, and decreased level of consciousness (LOC) difficulty breathing or swallowing tachycardia, tachypnea, and hypotension

hemiplegia, seizures, and decreased level of consciousness (LOC)

A nurse is providing discharge instructions to a client who is taking atenolol for hypertension. What aspect of this client's drug therapy may indicate a potential drug-drug interaction? tetracycline oral contraceptives ibuprofen levothyroxine

ibuprofen A decreased antihypertensive effect can occur if a beta-selective adrenergic blocking agent is used in combination with NSAIDs. If this combination is used, the client should be monitored closely and dosage adjustments made

A nurse is conducting a teaching session on complications of sickle cell anemia with the parents of an adolescent who was admitted with the disease. Which complication would be of most concern for the parents? swelling of the hands and feet petechiae leg ulcers hemangiomas

leg ulcers In sickle cell anemia, sickling of red blood cells leads to increased blood viscosity and impaired circulation. Diminished peripheral circulation makes the adolescent or adult with sickle cell anemia susceptible to chronic leg ulcers.

A client with a history of disabling claudication now is in the emergency department with a lower limb that is turning dark purple to black associated with faint Doppler pedal pulses. The client will more than likely undergo: surgery to remove the saphenous vein. percutaneous transluminal angioplasty and stent placement. injection of a potent anticoagulant into lower leg veins. whirlpool therapy with tight wrapping of lower legs immediately following.

percutaneous transluminal angioplasty and stent placement.

When lecturing about heart attacks (myocardial infarctions), the instructor will emphasize the client may present with: Select all that apply. substernal chest pain. neck pain. umbilicus pain. deep, right-sided abdominal pain. pain that radiates to the left arm.

substernal chest pain. neck pain. pain that radiates to the left arm.

A nurse assessing a client with an acute exacerbation of polycythemia vera notes coolness to the right leg and foot, pale color, and an absent right pedal pulse. Based on these findings the nurse suspects that the client has developed which complication? thrombosis in the right leg infection in the right leg compartment syndrome in the right leg edema in the right leg

thrombosis in the right leg Unregulated overproduction of the red cell mass is termed polycythemia. Thrombocytosis occurs when the bone marrow produces too many platelets and elevated viscosity contributes to a prothrombotic state, placing the client at risk for vascular occlusion.