Chapter 32 DONE

15. Which interventions would the nurse expect to include in the care of a client with pulmonary edema caused by HF ? Select all that apply . A. Sodium restriction . B. Fluid restriction C. Administration of potassium supplement D. Position client in semi - Fowler or high Fowler E. Weekly weight monitoring F. Administration of loop diuretics

A. Sodium restriction . D. Position client in semi - Fowler or high Fowler F. Administration of loop diuretics

30. Which urgent intervention is required when the nurse reviews the results of diagnostic testing for a client with aortic stenosis and discovers that surface area of the valve is less than 1 cm ? A. Surgical aortic heart valve replacement B. Aortic valvuloplasty in the cardiac catheterization laboratory C. Physical therapy to create an individualized exercise program D Therapy with drugs that will increase myocardial contractility

A. Surgical aortic heart valve replacement

Which treatment best applies to care of a client newly diagnosed with infective endocarditis? A. Long-term anticoagulant therapy with IV heparin followed by oral warfarin B. Hospitalization for initial IV antibiotics, followed by continued IV antibiotics at home C. complete bedrest for the duration of the treatment with subcutaneous enoxaparin D. Administration of IV penicillin, followed by oral penicillin for 6-10 weeks

B. Hospitalization for initial IV antibiotics, followed by continued IV antibiotics at home

47. What is the definitive treatment for chronic constrictive pericarditis ? A. Pericardiocentesis B. Surgical removal of the pericardium C. Placement of a pericardial drain D. Creation of a pericardial window

B. Surgical removal of the pericardium

5 . When a client admits that he or she sometimes has trouble catching his or her breath, which question would the nurse ask to obtain information about more symptoms? A. " Do you have a history of any medical problems like high blood pressure? B. What did your health care provider tell you about your diagnosis ? " C. " What was your most strenuous activity uring the past week ? " D. " How do you feel about being told that you have heart failure ? "

C. " What was your most strenuous activity uring the past week ? "

44. Which signs or symptoms would the nurse expect when assessing a client with chronic constrictive pericarditis ? Select all that apply . A. Exertional fatigue and dyspnea B. Dependent edema C. Crackles and wheezes D. Hepatic engorgement E. Pink , frothy sputum F. Decreased appetite

A. Exertional fatigue and dyspnea B. Dependent edema D. Hepatic engorgement

26 Which findings would the nurse expect in a client with mitral valve stenosis ? Select all that apply . A. A client likely be asymptomatic. B. Classic signs include dyspnea , angina and syncope C. Rumbling apical diastolic murmur D. Syncope on exertion E Sinus tachycardia F. Right - sided heart failure with jugular ( neck ) vein distention

A. A client likely be asymptomatic. B. Classic signs include dyspnea , angina and syncope C. Rumbling apical diastolic murmur F. Right - sided heart failure with jugular ( neck ) vein distention

48. Which are potential causes of dilated cardiomyopathy ? Select all that apply . A. Alcohol abuse B. Sedentary lifestyle C. Cigarette smoking D. Infection E. Chemotherapy F. Poor nutrition

A. Alcohol abuse D. Infection E. Chemotherapy F. Poor nutrition

36 . Which complication is a client at most risk for when the nurse notes that excessive fluid was seen in the pericardial cavity on echocardiogram? A. Cardiac tamponade B. Pericardial friction rub C. Systemic emboli D. Splinter hemorrhages

A. Cardiac tamponade

24. Which key points would the nurse include when teaching a client about signs and symptoms of return or worsening of heart failure , that must be reported to the primary health care provider ? Select all that apply . A. Cold symptoms ( e.g. , cough ) lasting more than 3 to 5 days B. Rapid weight loss of 3 lb in a week C. Excessive awakening at night to urinate D. Increase in exercise tolerance lasting 2 to 3 days E. Development of dyspnea or angina at rest or worsening angina F. Increased swelling in feet , ankles , or hands

A. Cold symptoms ( e.g. , cough ) lasting more than 3 to 5 days C. Excessive awakening at night to urinate E. Development of dyspnea or angina at rest or worsening angina F. Increased swelling in feet , ankles , or hands

14. Which early symptoms indicate to the nurse that a client's HF is getting worse and pulmonary edema is developing ? Select all that apply . A. Crackles in the lung bases B. Frothy , blood - tinged sputum C. Dyspnea at rest D. Cyanosis E. Disorientation F. Level of crackles rises higher in the lungs

A. Crackles in the lung bases C. Dyspnea at rest E. Disorientation

29 . Which signs and symptoms would the nurse expect to assess when a client is diagnosed with aortic stenosis ? Select all that apply . A. Dyspnea on exertion B. Atypical chest pain C. Angina D. Hemoptysis E. Harsh , systolic crescendo - decrescendo murmur F. Orthopnea

A. Dyspnea on exertion C. Angina E. Harsh , systolic crescendo - decrescendo murmur F. Orthopnea

37. Which assessment findings would cause the nurse to suspect Cardiac tamponade in a client? Select all that apply A. Neck vein distention B. Paradoxical pulse C. Hypertension D. Muffled heart sounds E. Tachycardia F. Petechai

A. Neck vein distention B. Paradoxical pulse D. Muffled heart sounds E. Tachycardia

Which drugs would the nurse prepare to administer to a client with HF who has developed pulmonary edema ? Select all that apply A. Nitroglycerin sublingual B. Lorazepam IV C. Oxygen at 1 L / min nasal canula D. Furosemide IV E. Metoprolol IV F. Nitroglycerin IV

A. Nitroglycerin sublingual D. Furosemide IV F. Nitroglycerin IV

7 . What early sign of left ventricular failure is client most likely to report to the nurse ? A. Nocturnal coughing B. Swollen legs C. Weight gain D. Nocturia

A. Nocturnal coughing

3 . What does the nurse suspect when assessment of a client with HF reveals pulses that alternate in strength ? A. Pulsus alternans B. Pulsus paradoxus C. Orthostatic hypotension D. Angina

A. Pulsus alternans

19. Which are potential benefits of a client receiving the drug digoxin ? A. Reduced heart rate B. Increased contractility C. Venous vasodilation D. Slowed conduction through the AV node - E . Inhibition of sympathetic activity with enhanced parasympathetic activity F. Enhanced renal excretion of sodium and water

A. Reduced heart rate B. Increased contractility D. Slowed conduction through the AV node - E . Inhibition of sympathetic activity with enhanced parasympathetic activity

16. Which instruction would the nurse give the assistive personnel ( AP ) who is helping a client with HF and excessive aldosterone secretion ? A. Restrict the client's fluids to 2 L / day and keep accurate intake and output . B. Severely restrict fluids to 500 mL of fluid plus the client's urine output from the past 24 hours . C. Give the client as much water as he or she D. Frequently offer the client ice chips and wants to prevent dehydration . moistened mouth swabs and limit fluids to 1 L / day .

A. Restric the clients fluids to 2 L/day and keep accurate intake and output.

. Which assessment findings would suggest to the nurse that a client who received a heart transplant was experiencing organ rejection? A. Shortness of breath B. Hypotension C. Abdominal pain .D. Decreased activity tolerance E Fluid gain ( edema , increased weight ) F Atrial fibrillation or flutter

A. Shortness of breath B. Hypotension .D. Decreased activity tolerance E Fluid gain ( edema , increased weight ) F Atrial fibrillation or flutter

28 . Which are the characteristics that the nurse would expect when a client is diagnosed with mitral valve prolapse ( MVP ) ? Select all that apply . A. Valve leaflets enlarge and bulge up into the left atrium during systole . B. Hepatomegaly is a late sign . C. Most clients are asymptomatic and this abnormality is benign . D. Many clients have normal heart rates and blood pressures . E. Older adults have increased risk for mitral valve prolapse . F A midsystolic click and late systolic murmur is best heard at the apex of the heart .

A. Valve leaflets enlarge and bulge up into the left atrium during systole . C. Most clients are asymptomatic and this abnormality is benign . F A midsystolic click and late systolic murmur is best heard at the apex of the heart .

9. Which assessment findings would the nurse expect to find in a client with left heart failure? Select all that apply. A. Wheezes or crackles B Jugular vein distention C. S3 heart sound D. Paroxysmal nocturnal dyspnea E. Ascites F. Oliguria during the day

A. Wheezes or crackles D. Paroxysmal nocturnal dyspnea E. Ascites F. Oliguria during the day

Priority nursing actions related to caring for an older adult client with HF who is prescribed digoxin? Select all that apply? A. Monitor ECG strip for early sign of toxicity B. Ausculate the apical pulse heart rate and rhythm for one full minute before administering the drug C. Observe for signs of toxicity which are often nonspecific such as anorrexia, fatigue, blurred vision D. Report any chagnes in heart rate or rhythm to provider E. Monitor serum digoxin and potassium levels F. Check the healthcare prociders prescription for parameters to hold drug

ALL

13 . When the client asks the method of diagnosing heart failurie what teaching would the nurse provide ? A. Radionuclide studies B. Echocardiography C. Multigated acquisition ( MUGA ) scan D. Pulmonary artery catheter

B. Echocardiography

Which priority teaching would the nurse provide to a client with infective endocarditis who is scheduled for an invasive dental procedure? A. "Be sure to use you nitroglycerin whenever you experience chest pain? B " Remind your health care provider to provide you with a prescription for prophylactic antibiotics". C. " Get up slowly after taking each dose of your antihypertensive medication" D. " Your health care provider will instruct you to have blood drawn to check your anticoagulation status . "

B " Remind your health care provider to provide you with a prescription for prophylactic antibiotics".

34. Which priority information would the nurse be sure to provide for a client who is scheduled for mitral valve replacement with a xenograft valve ? A. " You will need an individualized exercise program to develop collateral circulation . " B. " Your xenograft valve will need t replaced in about 7 to 10 years . " C. " You must take and record your temperature daily and watch for signs of rejection . " D. " You will require frequent laboratory tests to monitor your coagulation status . "

B. " Your xenograft valve will need t replaced in about 7 to 10 years ."

Which statement by a client with heart failure indicates to the nurse the need for additional teaching? A. "If my heart feels like it's racing, I should call my health care provider." B. "I must weigh myself once a week and watch for sings of fluid retention" C. I'll need periods of rest and activity and I should avoid activity after meals" D. "I'll need to consider and plan my activites for the day, and rest as needed."

B. "I must weigh myself once a week and watch for sings of fluid retention"

What is the priority intervention when a client come to the emergency department with extreme anxiety, tachycardia, struggling for air, and moist cough productive of frothy and blood tinged sputum? A. Prepare for endotracheal intubation and mechanical ventilation B. Administer high-flow oxygen by face mask C. Prepare for continuous postive airway pressure ventilation D. Apply a pulse oximeter and cardiac monitor

B. Administer high-flow oxygen by face mask

50. Which criteria are appropriate for a client with dilated cardiomyopathy to become a candidate for heart transplant surgery? Select all that apply . A. Life expectancy greater than 2 years B. Age generally less than 65 years C New York Heart Association Class III or IV D. Normal or only slightly increased pulmonary vascular resistance E. Consumes less than five to six beers per day F. absence of active infection

B. Age generally less than 65 years C New York Heart Association Class III or IV D. Normal or only slightly increased pulmonary vascular resistance F. absence of active infection

38 . Which clients are at greatest risk for development of infective endocarditis ? Select all that apply . A. Clients after myocardial infarction B. Clients who are IV drug users C. Clients with poor dental health D. Clients with opioid addictions E. Clients with systemic alterations in immunity F Clients postoperative after valve replacement

B. Clients who are IV drug users C. Clients with poor dental health D. Clients with opioid addictions E. Clients with systemic alterations in immunity F Clients postoperative after valve replacement

6 . What assessment findings would the nurse expect to find in a client with right heart failure ? Select all that apply . A. Weight loss B. Dependent edema C. Neck vein distention D. Angina E. Hepatomegaly F. Weak peripheral pulses

B. Dependent edema C. Neck vein distention E. Hepatomegaly

20. When a client has an ejection fraction of less than 30 % , about which potential treatment does the nurse prepare to educate the client ? A. Heart transplant B. Implantable cardioverter / defibrillator C. Ventricular reconstructive procedure D. Implanted mechanical pump

B. Implantable cardioverter / defibrillator

31. Which type of heart valvular disease does the nurse suspect when a client's assessment reveals pitting edema ? A. Aortic valve stenosis and regurgitation B. Mitral valve stenosis and regurgitation C. Mitral valve prolapse D. Tricuspid valve prolapse

B. Mitral valve stenosis and regurgitation

39. Which findings does the nurse expect when assessing a client with infective endocarditis ? Select all that apply . A. Grating pain that is aggravated by breathing B. Osler nodes on palms of hands and soles of feet C. Splinter hemorrhages D. Janeway lesions on the hands and feet E. Anorexia and weight loss F. Pericardial friction rub

B. Osler nodes on palms of hands and soles of feet C. Splinter hemorrhages D. Janeway lesions on the hands and feet E. Anorexia and weight loss

46. Which are proposed criteria for diagnosis of a client with acute pericarditis ? Select all that apply . A. Chest pain that lasts longer than 3 months B. Pericardial chest pain C. Presence of a pericardial friction rub D. New ST elevation in all ECG leads or PR segment depression E. New or worsening pericardial effusion F. Hepatic engorgement

B. Pericardial chest pain C. Presence of a pericardial friction rub D. New ST elevation in all ECG leads or PR segment depression E. New or worsening pericardial effusion

35. Which topics would the nurse be sure to cover when providing discharge instructions for a cli ent with prosthetic valve surgery ? Select all that apply . A. Avoid heavy lifting for 3 to 6 weeks . B. Report dyspnea , syncope , dizziness , edema , and palpitations to your health care provider . C. Use an electric razor to avoid skin cuts . D. Increase your consumption of foods that are high in vitamin K. E. Notify your health provider for any bleeding or excessive bruising . F. Watch for and report any fever or drainage and redness at the surgical site .

B. Report dyspnea , syncope , dizziness , edema , and palpitations to your health care provider . C. Use an electric razor to avoid skin cuts . E. Notify your health provider for any bleeding or excessive bruising . F. Watch for and report any fever or drainage and redness at the surgical site .

17. For which finding in a client with mitral valve stenosis would the nurse immediately notify the primary health care provider because of the potential decompensation ? A. Slow , bounding peripheral pulses associated with bradycardia B. An increase and decrease in pulse rate that follows inspiration and expiration C. An irregular heart rhythm and ECG strip that indicate atrial fibrillation D. An increase in pulse rate and blood pressure after exertion

C. An irregular heart rhythm and ECG strip that indicate atrial fibrillation

33 . Which essential medications would the nurse provide teaching about postoperatively for a client who received a prosthetic valve replacement ? A. Immunosuppressants B. Antibiotics C. Anticoagulants D. Diuretics

C. Anticoagulants

8 . Based on the etiology and main cause of heart failure , the nurse knows that which client has the greatest need for health promotion measures to prevent heart failure ? A. Client with asthma B. Client with renal insufficiency C. Hypertension D. Client with Parkinson disease

C. Hypertension

18 . To improve gas exchange , how much supplemental oxygen would the nurse provide a client with HF ? A. 2 L / min by nasal canula B. 100 % by nonrebreather mask C. Within the range prescribed by the HCP to keep saturation at 90 % or more D. 50 % by endotracheal tube and mechanical ventilator

C. Within the range prescribed by the HCP to keep saturation at 90 % or more

43. What is the best method for the nurse to use when auscultating a client's pericardial friction rub with a stethoscope ? A . Place the bell just below the left clavicle . B. Place the diaphragm at the apex of the heart . C. Place the diaphragm at the left lower sternal border . D. Place the bell at several points while the client holds his or her breath .

C. Place the diaphragm at the left lower sternal border .

45. What does the nurse instruct a client with pericarditis to do to make him or her will feel more comfortable ? A. Lie down and bend the legs at the knees . B. Sit in a semi - Fowler position with pillows under each arm . C. Sit up and lean forward . D. Lie on the side in a fetal position .

C. Sit up and lean forward .

2 . When a client develops heart failure , what initial compensatory mechanism of the heart does the nurse expect to occur that will maintain cardiac output ( CO ) ? A. Parasympathetic stimulation B. Ventricular hypertrophy C. Sympathetic stimulation D. Renin - angiotensin activation system

C. Sympathetic stimulation

II . What is the most reliable method of monitoring for fluid gain or loss in a client with heart failure? A. Check for pitting edema in dependent body parts . B. Auscultate the lungs for worsening crackles or wheezes . C. Weigh the client daily at the same time and using the same scale . D. Assess the client's skin turgor and condition of mucous membranes.

C. Weigh the client daily at the same time and using the same scale .

Which statement by a client with a history of hypertension and heart problems would cause the nurse to suspect and heart problems? A" I've had a fever frequently. B. " I noticed a very fine red rash on my chest. С I get a pain in my shoulder when I cough. " D. " I've had to remove all of my rings for the past mouth,"

D. " I've had to remove all of my rings for the past mouth,"

42 What does the nurse suspect when a client describes substernal pain that radiates to the left shoulder, is grating and worsens with inspiration and coughing? A. Chronic constrictive pericarditis B. Cardiac tamponade C. Hypertrophic cardiomyopathy D. Acute pericarditis

D. Acute pericarditis

. Which type of cardiomyopathy may present with sudeen death as first symptom? A. Dilated B. Arrhythmogenic right ventricular C. Restrictive D. Hypertrophic

D. Hypertrophic

32. Which client with valvular heart disease would benefit from the nonsurgical invasive procedure balloon valvuloplasty ? A. Older adult who needs a valve replacement B. Middle - aged adult whose open - heart surgery failed C. Young adult with a genetic valve defect candidate D. Older adult who is not a surgical candidate

D. Older adult who is not a surgical candidate

When a client with heart failure walk 200 feet down the hall and develops a feeling of heaviness in the legs how does the nurse interpret this finding ? A. The client is building endurance B. The activity was appropriate C. The client could walk farther D. The activity is too stressful .

D. The activity is too stressful .

4 . When would the nurse expect the release of B type natriuretic peptide ( BNP ) for a client with heart failure ? A. When the client has an enlarged liver B. When a client's ejection fraction is lower than normal C. When a client develops ventricular hypertrophy D. When a client has fluid overload

D. When a client has fluid overload

12 Which major self - management categories will the nurse include when teaching a client, newly diagnosed with heart failure , who is about to be the discharged ? Select all that apply . A. Symptoms , what to do when they get worse B. Medications C. Activity D. Heart transplants E. Weight F. Diet

MAWDS A. Symptoms , what to do when they get worse B. Medications C. Activity E. Weight F. Diet

1 . What is the priority concept for a client who has heart failure ? A. Gas exchange B. Perfusion C. Comfort D. Infection

Perfusion B.