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A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when he makes which statement? "My pants don't fit around my waist." "I sleep on three pillows each night" "My feet are bigger than normal." "I don't have the same appetite I used to."

"I sleep on three pillows each night"

A nurse is providing care for a client who has chronic venous insufficiency. The provider prescribed thigh high compression stockings. The nurse should instruct the client to do which of the following? Wear the stockings only when in bed. Massage both legs firmly with lotion prior to applying the stockings. Roll the stockings down to the knees if they will not stay up on the thigh Apply the stockings in the morning upon awakening and before getting out of bed Remove the stockings while out of bed for one hour four times a day to allow the legs to rest.

Apply the stockings in the morning upon awakening and before getting out of bed

The nurse is caring for a patient in the ED who has a B-type natriuretic peptide (BNP) level of 315 pg/mL. The nurse understands that this finding is most suggestive of which of the following? Heart failure Pulmonary edema Myocardial infarction Ventricular hypertrophy

BNP is released in response to blood volume overload or pressure overload indicative of Heart failure

A client presents to the ED reporting severe substernal chest pain radiating down his left arm. He is admitted to the coronary care unit (CCU) with a diagnosis of myocardial infarction (MI). What nursing assessment activity is a priority on admission to the CCU? Obtain information about family history of heart disease. Begin ECG monitoring. Auscultate lung fields. Determine if the client smokes.

Begin ECG monitoring.

The area of the heart that is located at the third IC space to the left of the sternum is the Erb's point pulmonic area aortic areae pigastric area

Erb's point

A nurse is providing discharge teaching for a client who has a new diagnosis of hypertension and a prescription for furosemide (Lasix) 40 mg PO daily. What time of day should the nurse encourage the client to take the medication? Immediately before dinner At bedtime Immediately after lunch Morning

Morning Lasix is a loop diuretic- makes you gotta pee

The patient with cardiac failure is taught to report which of the following symptoms to the physician or clinic immediately? Weight loss Increased appetite Ability to sleep through the night Persistent cough

Persistent cough

A client with heart failure must be monitored closely after starting diuretic therapy. The best indicator for the nurse to monitor is: weight vital signs urine specific gravity fluid intake and output

weight

A nurse is providing discharge teaching for a client who has a new diagnosis of hypertension and a prescription for spironolactone 50mg PO daily. Which of the following statements by the client indicates a need for further teaching? "I should eat a lot of bananas and potatoes." "I will report any changes in heart rate or rhythm." "I should use a salt substitute that does not contain potassium." "I will continue to take this medication even if I am feeling better."

"I should eat a lot of bananas and potatoes." a. bananas and potatoes contain potassium and could put the patient at risk for hyperkalemia •Spironolactone is a potassium sparing diuretic

A nurse is providing care for a client who has a deep-vein thrombosis (DVT) and has been taking unfractionated heparin for one week. Two days ago, the provider also prescribed warfarin (Coumadin). The client questions the nurse about receiving both heparin and warfarin at the same time. Which of the following is an appropriate response by the nurse? "I'll hold your heparin until we can clarify the order with your provider." "It takes three or four days before the effects of warfarin are achieved, then the heparin can be discontinued." "Only one of these medications is being given to treat your DVT." "Laboratory findings indicated that two anticoagulants were needed." "I will remind your provider that you are already receiving heparin."

"It takes three or four days before the effects of warfarin are achieved, then the heparin can be discontinued."

A nurse is caring for a client who is exhibiting signs and symptoms characteristic of a myocardial infarction (MI). Which statement describes priorities the nurse should establish while performing the physical assessment? HINT: unlike surgical pain. Anginal pain indicates lack of oxygen to cardiac tissues. While the patient is still complaining of pain, there is the possibility of tissue damage. Assess the client's level of pain and administer prescribed medications Ensure that the client's family is kept informed of the client's status. Prepare the client for pulmonary artery catheterization. Assess the client's level of anxiety and provide emotional support.

Assess the client's level of pain and administer prescribed medications

A nurse is caring for a client who has hypertension and is prescribed propranolol 40 mg daily. While reviewing the client's health history, which of the following findings would cause the nurse to question the prescription? Migraine headaches Angina Hypothyroidism Bronchial asthma

Bronchial asthma Metoprolol= selective blocks only beta 1 (heart) Propranolol= non selective- blocks beta 1 (heart) and beta 2 (lungs)-many adverse effects:Bronchospasm (breathing issues), hypoglycemia, peripheral vasoconstriction

A nurse is screening a client for hypertension. Which of the following actions by the client increases the risk for hypertension? Select all that apply. Drinking eight ounces of nonfat milk daily Getting a massage once a week. Consuming 36 ounces of beer daily Eating popcorn with extra butter and salt at the movie theater Walking one mile daily.

Consuming 36 ounces of beer daily Eating popcorn with extra butter and salt at the movie theater

You are caring for a client postoperatively. What nursing interventions help prevent venous stasis and other circulatory complications in a client who has undergone surgery? Place pillows under the client's knees or calves. Encourage the client to move legs frequently and do leg exercises. Place pressure on the client's lower extremities. Place the client in a side-lying position.

Encourage the client to move legs frequently and do leg exercises.

In a client with chronic bronchitis, which sign would lead the nurse to suspect right-sided heart failure? Cyanosis of the lips Productive cough Leg edema Bilateral crackles

Leg edema

A nurse in the emergency department is caring for a client with worsening heart failure. Which laboratory value is most important for the nurse to check before administering medications to treat heart failure? Potassium White blood cell count (WBC) Platelet count Calcium

Potassium

The nurse is reviewing the laboratory results for a patient having a suspected myocardial infarction (MI). What biomarkers does the nurse observe for myocardial cell damage? Select all that apply. Creatine kinase BB Alkaline phosphatase Troponin I Creatine kinase MB (CKMB)

Troponin I- if heart muscle is damaged this is released- indicative of heart attack Creatine kinase MB (CKMB)- if heart damaged, this increases in blood- indicative of heart attack

Which of the following are alterations noted in Virchow's triad? Select all that apply. Vessel wall injury Tenderness Edema Stasis of blood Altered coagulation

Vessel wall injury Stasis of blood Altered coagulation Explanation: Three factors, known as Virchow's triad, are believed to play a significant role in the development of venous thrombosis. They are stasis of blood, vessel wall injury, and altered coagulation. Edema and tenderness are clinical manifestations of venous thrombosis, but are not part of the triad.

A nurse who works in a busy emergency department provides care for numerous patients who present with complaints of chest pain. Which of the following questions is most likely to help the nurse differentiate between chest pain that is attributable to angina and chest pain due to myocardial infarction (MI)? Select all that apply a. "When was the first time that you recall having chest pain? b. "How does the pain feel when you take nitroglycerin" c. "Does resting and remaining still help your chest pain to decrease?" d. "What were doing when pain started? How long has pain lasted?"

b. "How does the pain feel when you take nitroglycerin" c. "Does resting and remaining still help your chest pain to decrease?" d. "What were doing when pain started? How long has pain lasted?"

A client who has been diagnosed with Prinzmetal's (Variant) angina will present with which symptom? prolonged chest pain that accompanies exercise chest pain that occurs at rest and usually in the middle of the night chest pain of increased frequency, severity, and duration radiating chest pain that lasts 15 minutes or less How is this treated?

chest pain that occurs at rest and usually in the middle of the night Prinzmetal's (Variant) angina is treated with calcium channel blocker. VND- Amlodipine- Vasospasms.

A nurse is caring for a client with acute pulmonary edema. To immediately promote oxygenation and relieve dyspnea, the nurse should: have the client take deep breaths and cough perform chest physiotherapy place the client in high Fowler's position administer oxygen

place the client in high Fowler's position

A client's chart indicates Virchow's triad. This client is at risk for which complication? venous stasis altered blood coagulation postphlebitic syndrome thrombophlebitis

thrombophlebitis

A nurse is teaching a client who has a new prescription for clopidogrel (Plavix) prescribed after a stent placement in the catheterization lab. Which of the following should be included in the teaching? Select all that apply. Advise the client to avoid foods containing vitamin K. Monitor for the presence of black, tarry stools Schedule a weekly Protime (PT) test. Check with health care provider before using over the counter aspirin and NSAIDS.

•Monitor for the presence of black, tarry stools •Check with health care provider before using over the counter aspirin and NSAIDS. •PT test is needed every 6 hours not every 24 A prothrombin time (PT) is a test used to help detect and diagnose a bleeding disorder or excessive clotting disorder; the international normalized ratio (INR) is calculated from a PT result and is used to monitor how well the blood-thinning medication (anticoagulant) warfarin (Coumadin®) is working to prevent blood


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