Quiz 2

While caring for a patient with aortic stenosis, the nurse establishes a nursing diagnosis of acute pain related to decreased coronary blood flow. An appropriate intervention by the nurse is to A. Promote rest to decrease myocardial oxygen demand B. Educate the patient about the need for anticoagulant therapy C. Teach the patient to use sublingual nitroglycerin for chest pain D. Elevate the head of the bed 60 degrees to decrease venous return

A. Promote rest to decrease myocardial oxygen demand

When auscultating over the patient's abdominal aorta, the nurse hears a humming sound. The nurse documents this finding as a A. Thrill B. Bruit C. Heave D. Murmur

B. Bruit

Which information obtained by the nurse when assessing a patient admitted with a mitral valve regurgitation should be communicated to the health care provider immediately? A. The patient has 4+ peripheral edema in both legs B. The patient has crackles audible to the lung apices C. The patient has a palpable thrill over the left anterior chest D. The patient has a loud systolic murmur all across the precordium

B. The patient has crackles audible to the lung apices

Which statement made by a client who was diagnosed with mitral stenosis would alert the nurse to the possibility of heart failure? A. "I am drinking more water at night" B. "I have been awakened by the the need to urinate at night" C. "I have to stop halfway up the stairs to catch my breath" D. "I have experienced blurred vision on several occasions"

C. "I have to stop halfway up the stairs to catch my breath"

The client who has experienced blunt trauma to the chest is at risk for developing a hemothorax. Which would the nurse expect to find in a client with hemothorax? A. Thick tenacious sputum B. Muffled bilateral tactile fremitus C. Percussion dullness on affected side D. Hypertympanic sound on affected side

C. Percussion dullness on affected side

A young man is admitted to the emergency department with a stab wound to the right chest. He has moderate bleeding from the site, and his vital signs show symptoms of shock. Air can be heard entering his chest with each inspiration. To decrease the possibility of a tension pneumothorax in the patient, what should the nurse do? a. Position the patient on his injured side. b. Administer high-flow oxygen using a nonrebreathing mask. c. Cover the sucking chest wound with a petrolatum gauze dressing. d. Apply a nonporous dressing taped on three sides to the chest wound.

D. Apply a non porous dressing taped on three sides to the chest wound

When caring for a patient with mitral valve stenosis, it is most important that the nurse assess for A. Diastolic murmur B. Peripheral edema C. Right upper quadrant tenderness D. Complains of shortness of breath

D. Complains of shortness of breath

When preparing the patient with a right-sided pleural effusion for a thoracentesis, how will the nurse position the patient? A. Supine with the head of the bed elevated 45 degrees B. In the Trendelenberg position with both arms extended C. On the left side with the right arm extended above the head D. Sitting upright with the arms supported on an over bed table

D. Sitting upright with the arms supported on an over bed table

When discussing risk factor modification for a 63-year-old patient who has a 5-cm abdominal aortic aneurysm, the nurse will focus discharge teaching on which patient risk factor? a. Male gender b. Marfan syndrome c. Abdominal trauma history d. Uncontrolled hypertension

D. Uncontrolled hypertension

The nurse will plan discharge teaching about the need for prophylactic antibiotics when having dental procedures for which patient? a. Patient admitted with a large acute myocardial infarction. b. Patient being discharged after an exacerbation of heart failure. c. Patient who had a mitral valve replacement with a mechanical valve. d. Patient being treated for rheumatic fever after a streptococcal infection.

c. Patient who had a mitral valve replacement with a mechanical valve.