Abrums Quiz 2

A client is experience muscle tremors and premature atrial contractions. Which electrolyte imbalance does the nurse suspect?

Hypomagnesia Magnesium is required for conduction of nerve impulses and contraction of muscle in skeletal and cardiac cells. A serum magnesium less than 1.5 mEq/L can cause muscle tremors and premature atrial and ventricular beats. Potassium helps with conduction of nerve impulses and contraction of muscle in the cardiac cycle. Sodium assists in regulating osmotic pressure, water balance, and electrolytes. Chloride helps to maintain osmotic pressure and water balance, similar to sodium and is not relevant to muscle tremors nor premature atrial contractions.

An adult client recently diagnosed with hypertension has begun combination therapy. Which client statement would suggest a need for additional health education?

"I'll only need to take these drugs on days when my blood pressure is particularly high."

Antianginal drugs are most often used to manage what conditions? (Select all that apply.)

Severe angina Severe hypertension Serious cardiac dysrhythmias

Sympathetic stimulation of the heart causes:

an increased rate and force of myocardial contraction.

A nurse is completing an admission assessment. During a 24-hour diet recall, the client reports eating spinach, asparagus, and green beans for lunch and dinner. Which vitamin is the client most likely consuming?

vit k

A client is hospitalized for heart failure and is being treated with a beta blocker. What client teaching should the nurse include about side effects? Select all that apply.

"You may feel light-headed and dizzy when you stand up, so ask for assistance prior to getting out of bed." "Your heart rate will decrease so, your blood pressure could become low, too. Notify the nurse if you feel like you are lightheaded."

The nurse is aware that heart failure may result from what problems? (Select all that apply.)

-Impaired myocardial contraction during systole -Impaired relaxation and filling of ventricles during diastole -A combination of systolic and diastolic dysfunction -Cardiomyopathy Heart failure may result from impaired myocardial contraction during systole (systolic dysfunction), impaired relaxation and filling of ventricles during diastole (diastolic dysfunction), or a combination of systolic and diastolic dysfunction. Cardiomyopathy (weakened and enlarged heart muscle) also increases the risk for the development of heart failure.

Before discharge from the cardiac step-down (status post-MI), a client questions the prescription for beta-blockers. What should the client be told about the purpose for taking beta-blockers? (Select all that apply.)

Decrease mortality rates over several years. Protect the heart from reinfarction.

A client diagnosed with heart failure has been prescribed digoxin. The nurse is aware that caution is required if the client exhibits which electrolyte imbalance? Select all that apply.

Hypokalemia Hypermagnesemia Hypercalcemia Hypokalemia, hypermagnesemia, and hypercalcemia increase the risk of dysrhythmia in clients taking digoxin.

After receiving the results of an echocardiogram, a client has many questions regarding the results and their impact on the client's lifestyle. The client is a 57-year-old Hispanic man with a 10-year history of hypertension. The client would like to know what effect hypertension has on the heart. What is the nurse's best reply?

Myocardium hypertrophy As a result of increased cardiac workload from cardiac wall sclerosis, the myocardium hypertrophies as a compensatory mechanism and heart failure eventually occurs.

When preparing a plan of care for a client in hypovolemic shock, which partial nursing diagnosis might be relevant to the patient's condition?

Ineffective Tissue Perfusion

After teaching a group of nursing students about antianginal agents, the instructor determines that the teaching was successful when the students identify which mechanisms of calcium channel blockers? Select all that apply.

Slow the conduction velocity of the cardiac impulse. Depress myocardial contractility. Dilate coronary arteries and arterioles.

Which single class drug is known to be most effective in reducing the major types of dyslipidemia?

Statins

Most acute CNS responses are caused by fast-acting neurotransmitters, which include:

acetylcholine, dopamine, norepinephrine, and serotonin. Neurons expressing certain types of neurotransmitters sometimes form distinct and fast-acting systems, where activation of the system affects large volumes of the brain. The major neurotransmitter systems for acute CNS responses are the noradrenaline (norepinephrine) system, the dopamine system, the serotonin system, and the cholinergic system. A synapse is cholinergic if it uses acetylcholine as its neurotransmitter.

Which classes of medications are currently used as first-line treatments for heart failure? Select all that apply.

angiotensin-converting enzyme inhibitors (ACEIS) beta blockers loop diuretics ACEIs, beta blockers, and loop diuretics are currently first-line treatments for heart failure. Cardiotonic drugs are used to treat heart failure if other treatments fail to improve client status and to treat atrial fibrillation. Angiotensin II receptor blockers (ARBs) decrease blood pressure, thus decreasing the workload of the heart.

A nurse administers calcium IV slowly based on the understanding that rapid IV administration of calcium can lead to which adverse effects?

hypotension Rapid IV administration of calcium can lead to bradycardia, hypotension, vasodilation, cardiac arrhythmias, and cardiac arrest. Tachycardia can be seen with electrolyte replacement of sodium chloride in the form of Slo-Salt. Hypomagnesemia or hyponatremia can result in tachycardia. Administration of calcium IV can lead to vasodilation, not constriction. Infusions of vesicants or vasoconstrictive solutions can cause vasoconstriction as in the treatment of shock and other emergencies. The administration of insulin can cause hypoglycemia.

Which of the following is a correct route of administration for potassium?

oral Potassium may be administered through the oral route. Potassium is never administered by IV push or intramuscularly to avoid replacing potassium too quickly. Potassium is not administered subcutaneously.

A client is taking atorvastatin calcium to reduce serum cholesterol. Which aspect of client teaching is most important?

Call the health care provider if muscle pain develops. Clients should be advised to notify their health care provider if unexplained muscle pain or tenderness occurs. The client should avoid saturated fats when taking statins but should not entirely eliminate fats from the diet. The client should not decrease the dose of statins without the health care provider's knowledge. The client should not increase the intake of eggs due to the increase in cholesterol.

What cardiac risk factors are related to metabolic syndrome? (Select all that apply.)

Central adiposity Elevated triglycerides Reduced high density lipoprotein cholesterol Elevated fasting blood glucose Metabolic syndrome is a group of cardiovascular risk factors that are linked with obesity and include elevated waist circumference (central adiposity), elevated triglycerides, reduced high density lipoprotein cholesterol, elevated blood pressure, and elevated fasting glucose.

An elderly client with dyslipidemia has had fenofibrate added to the existing medication regimen. In addition to having the lipid profile drawn on a regular basis, the nurse should educate the client about the need for what ongoing laboratory testing during therapy?

Liver panel Because of the risk for hepatotoxicity, clients taking fenofibrate require serial testing of liver enzyme levels. There is no specific need for follow-up with CBCs, coagulation tests, or reticulocyte counts.

What will occur when oxygen is administered to a client in heart failure? (Select all that apply.)

Relieve dyspnea Reduce the work of breathing Decrease constriction of pulmonary blood vessels Improve oxygen delivery Administer oxygen, if needed, to relieve dyspnea, improve oxygen delivery, reduce the work of breathing, and decrease constriction of pulmonary blood vessels (which is a compensatory measure in clients with hypoxemia).

Increases in neurohormonal activity cause which of the following to occur in clients with heart failure? Select all that apply:

Remodeling of the cardiac muscle cells Hypertrophy of the heart Increased need for oxygen Cardiac necrosis Increased catecholamines lead to increases in neurohormonal activity that cause remodeling of the cardiac muscle cells, leading to hypertrophy of the heart, increased need for oxygen, and cardiac necrosis, which worsen the heart failur

The nurse is caring for a client diagnosed with coronary artery disease and a history of angina receiving the medication nitroglycerin ointment 2%, 2 inches every 8 hours. The nurse should perform which assessment(s) for safe administration of the nitroglycerin? Select all that apply.

Remove previous nitroglycerin ointment and applicator paper and fold in half before disposing in trash. Do not massage area of nitroglycerin ointment, and secure the applicator paper with tape with date, time, initials. Wear gloves when removing old application and applying new application to prevent the development of headache.

The electrical impulses flow in the following manner:

Sinoatrial node, the atrioventricular node, bundle of His, right and left bundle branches, and Purkinje fibers.

A nurse is caring for a patient who is having a sympathetic response. A sympathetic response involves:

an increase in blood pressure, bronchi dilation, and decreased bowel sounds