Iggy 10th Edition: Chapter 32: Concepts of Care for Patients With Cardiac Problems
A nurse prepares to discharge a client who has heart failure. Which questions would the nurse ask to ensure this client's safety prior to discharging home? (Select all that apply.) A. "Are your bedroom and bathroom on the first floor?" B. "What social support do you have at home?" C. "Will you be able to afford your oxygen therapy?" D. "What spiritual beliefs may impact your recovery?" E. "Are you able to accurately weigh yourself at home?"
A. "Are your bedroom and bathroom on the first floor?" B. "What social support do you have at home?" D. "What spiritual beliefs may impact your recovery?"
A nurse is teaching a client with heart failure who has been prescribed enalapril. Which statement would the nurse include in this client's teaching? A. "Avoid using salt substitutes." B. "Take your medication with food." C. "Avoid using aspirin-containing products. D. "Check your pulse daily.'
A. "Avoid using salt substitutes."
A nurse cares for an older adult client with heart failure. The client states, "I don't know what to do. I don't want to be a burden to my daughter, but I can't do it alone. Maybe I should die What is the best response by the nurse? A. "I can stay if you would you like to talk more about this.' B. "You are lucky to have such a devoted daughter." C. "It is normal to feel as though you are a burden. D. "Would vou like to meet with the chanlain?"
A. "I can stay if you would you like to talk more about this.'
After teaching a client with congestive heart failure (CHF), the nurse assesses the client's understanding. Which client statements indicate a correct understanding of the teaching related to nutritional intake? (Select all that apply.) A. "I'll read the nutritional labels on food items for salt content." B. "I will drink at least 3 L of water each day. C. "Using salt in moderation will reduce the workload of my heart.' D. "I will eat oatmeal for breakfast instead of ham and eggs." E. "Substituting fresh vegetables for canned ones will lower my salt intake." F. "Salt substitutes are a good way to cut down on sodium in my diet.
A. "I'll read the nutritional labels on food items for salt content." D. "I will eat oatmeal for breakfast instead of ham and eggs." E. "Substituting fresh vegetables for canned ones will lower my salt intake."
A nurse collaborates with assistive personnel (AP) to provide care for a client with congestive heart failure. Which instructions would the nurse provide to the AP when delegating care for this client? (Select all that apply.) A. "Reposition the client every 2 hours" B. "Teach the client to perform deep-breathing exercises." C. "Accurately record intake and output.?" D. "Use the same scale to weigh the client each morning." E. "Place the client on oxygen if the client becomes short of breath."
A. "Reposition the client every 2 hours" C. "Accurately record intake and output.?" D. "Use the same scale to weigh the client each morning."
A nurse cares for a client with right-sided heart failure. The client asks, "Why do I need to weigh myself every day?" How would the nurse respond? A. "Weight is the best indication that you are gaining or losing fluid." B. "Daily weights will help us make sure that you're eating properly.' C. "The hospital requires that all clients be weighed daily.' C. "You need to lose weight to decrease the incidence of heart failure."
A. "Weight is the best indication that you are gaining or losing fluid."
A nurse assesses clients on a cardiac unit. Which client would the nurse 1dentity as being al greatest risk for the development of left-sided heart failure? A. A 36-year-old woman with aortic stenosis B. A 42-year-old man with pulmonary hypertension C. A 59-year-old woman who smokes cigarettes daily D. A 70-year-old man who had a cerebral vascular accident
A. A 36-year-old woman with aortic stenosis
A nurse assesses Clients on a cardiac unit. Which clients would the nurse dentitV as al greatest risk for the development of acute pericarditis? (Select all that apply.) A. A 36-year-old woman with systemic lupus erythematosus (SLE) B. A 42-year-old man recovering from coronary artery bypass graft surgery C. A Sy-year-old woman recovering from a hysterectomy D. An 80-year-old man with a bacterial infection of the respiratory tract E. An 88-year-old woman with a stage III sacral ulcer
A. A 36-year-old woman with systemic lupus erythematosus (SLE) B. A 42-year-old man recovering from coronary artery bypass graft surgery D. An 80-year-old man with a bacterial infection of the respiratory tract
A nurse is caring for a client who was admitted with hypertrophic cardiomyopathy (HCM). What interprofessional care does the nurse anticipate providing? (Select all that apply.) A. Administering beta blockers B. Administering high-dose furosemide C. Preparing for a cardiac catheterization D. Loading the client on digitalis E. Instructing the client to avoid strenuous exercise F. Teaching the client how to use the CardioMEMSTM
A. Administering beta blockers C. Preparing for a cardiac catheterization E. Instructing the client to avoid strenuous exercise
While assessing a client on a cardiac unit, a nurse identifies the presence of an S3 gallop. What action would the nurse take next? A. Assess for symptoms of left-sided heart failure. B. Document this as a normal finding. C. Call the primary health care provider immediately. D. Transfer the client to the intensive care unit
A. Assess for symptoms of left-sided heart failure.
A nurse admits a client who is experiencing an exacerbation of heart failure. What action would the nurse take first? A. Assess the client's respiratory status. B. Draw blood to assess the client's serum electrolytes. C. Administer intravenous furosemide D. ASk the client about current medications.
A. Assess the client's respiratory status.
A nurse evaluates laboratory results for a client with heart failure. Which results would the nurse expect? (Select all that apply.) A. Hematocrit: 32.8% B. Serum sodium: 130 mEg/L (130 mmol/L) C. Serum potassium: 4.0 mEq/L (4.0 mmol/L) D. Serum creatinine: 1.0 mg/dL (88.4 mcmol/L) E. Proteinuria F. Microalbuminuria
A. Hematocrit: 32.8% B. Serum sodium: 130 mEg/L (130 mmol/L) E. Proteinuria F. Microalbuminuria
A nurse is assessing a client with left-sided heart failure. For which clinical manifestations would the nurse assess? (Select all that apply.) A. Pulmonary crackles B. Contusion C. Pulmonary hypertension D. Dependent edema E. Cough that worsens at night F. Jugular venous distention
A. Pulmonary crackles B. Contusion E. Cough that worsens at night
A nurse assesses a client who is recovering from a heart transplant. Which assessment findings would alert the nurse to the possibility apply.) A. Shortness of breath B. Abdominal bloating C. New-onset bradycardia D. Increased ejection fraction E. Hypertension F. Fatigue
A. Shortness of breath B. Abdominal bloating C. New-onset bradycardia F. Fatigue
A nurse cares for a client with infective endocarditis. Which intection control precautions would the nurse use? A. Standard Precautions B. Bleeding Precautions C. Reverse 180 ation D. Contact isolation
A. Standard Precautions
A nurse assesses a client who has a historv of heart failure. Which auestion would the nurse ask to assess the extent of the client's heart failure? A. "Do you have trouble breathing or chest pain?" B. "Are you still able to walk upstairs without fatigue?" C. "Do you awake with breathlessness during the night?" D. "Do you have new-onset heaviness in your legs?'
B. "Are you still able to walk upstairs without fatigue?"
A nurse is providing discharge teaching to a client recovering from a heart transplant. Which statement would the nurse include? A. "Use a soft-bristled toothbrush and avoid flossing." B. "Avoid large crowds and people who are sick." C. "Change positions slowly to avoid hypotension." D. "Check your heart rate before taking the medication."
B. "Avoid large crowds and people who are sick."
A nurse teaches a client with heart failure about energy conservation. Which statement would the nurse include in this client's teaching? A. "Walk until you become short of breath, and then walk back home." B. "Begin walking 200 feet a day three times a week." C. "Do not lift heavy weights for 6 months." D. "Eat plenty of protein to build your strength."
B. "Begin walking 200 feet a day three times a week."
A nurse cares for a client recovering from prosthetic valve replacement surgery. The client asks,' "Why will I need to take anticoagulants for the rest of my life?" What is the best response by the nurse? A. "The prosthetic valve places you at greater risk for a heart attack." B. "Blood clots form more easily in artificial replacement valves." C. "The vein taken from your leg reduces circulation in the leg. D. "The surgery left a lot of small clots in your heart and lungs.
B. "Blood clots form more easily in artificial replacement valves."
After teaching a client who is being discharged home after mitral valve replacement surgery, the nurse assesses the client s understanding. Which client statement indicates a need for additional teaching? A. "I'll be able to carry heavy loads after 6 months of rest. B. "I will have my teeth cleaned by my dentist in 2 weeks. C. "I must avoid eating foods high in vitamin K, like spinach. D. "I must use an electric razor instead of a straight razor to shave.'
B. "I will have my teeth cleaned by my dentist in 2 weeks.
A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to the possibility of right-sided heart failure? A. "I sleep with four pillows at night. B. "My shoes fit really tight lately?' C. "I wake up coughing every night." D. "I have trouble catching my breath.
B. "My shoes fit really tight lately?"
A nurse assesses a client who has mitral valve regurgitation. For which cardiac dysrhythmia would the nurse assess? A. Preventricular contractions B. Atrial fibrillation C. Symptomatic bradycardia D. Sinus tachycardia
B. Atrial fibrillation
A nurse assesses a client with mitral valve stenosis. What clinical sign or symptom would alert the nurse to the possibility that the client's stenosis has progressed? A. Oxygen saturation of 92% B. Dyspnea on exertion C. Muted systolic murmur D. Upper extremity weakness
B. Dyspnea on exertion
A nurse prepares to discharge a client who has heart failure. Based on national quality measures, what actions would the nurse complete prior to discharging this client? (Select all that apply.) A. Teach the client about energy conservation techniques. B. Ensure that the client is prescribed a beta blocker. C. Document a discussion about advanced directives. D. Confirm that a post discharge nurse visit has been scheduled. E. Consult a social worker for additional resources. F. Care transition record transmitted to next level of care within 7 days of discharge
B. Ensure that the client is prescribed a beta blocker. C. Document a discussion about advanced directives. D. Confirm that a post discharge nurse visit has been scheduled. F. Care transition record transmitted to next level of care within 7 days of discharge
A nurse assesses a client with pericarditis. Which assessment finding would the nurse expect to find? A. Heart rate that speeds up and slows down. B. Friction rub at the left lower sternal border. C. Presence of a regular gallop rhythm. D. Coarse crackles in bilateral lung bases.
B. Friction rub at the left lower sternal border.
After administering the first dose of captopril to a client with heart failure, the nurse implements interventions to decrease complications. Which intervention is most important for the nurse to implement? A. Provide food to decrease nausea and and in absorption. B. Instruct the client to ask for assistance when rising from bed. C. Collaborate with assistive personnel to bathe the client. D. Monitor potassium levels and check for symptoms of hypokalemia.
B. Instruct the client to ask for assistance when rising from bed.
A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure? A. "I have been drinking more water than usual." B. "I am awakened by the need to urinate at night." C. "I must stop halfway up the stairs to catch my breath." D. "I have experienced blurred vision on several occasions.
C. "I must stop halfway up the stairs to catch my breath."
After teaching a client who is recovering from a heart transplant to change positions slowly, the client asks, "Why is this important?" How would the nurse respond? A. "Rapid position changes can create shear and friction forces, which can tear out your internal vascular sutures" B. "Your new vascular connections are more sensitive to position changes, leading to increased intravascular pressure and dizziness." C. "Your new heart is not connected to the nervous system and is unable to respond to decreases in blood pressure caused by position changes." While your heart is recovering, D. "blood flow is diverted away from the brain increasing the risk for stroke when you stand up."
C. "Your new heart is not connected to the nervous system and is unable to respond to decreases in blood pressure caused by position changes."
A nurse teaches a client Who 1s prescribed digoxin therapy. Which statement would the nurse include in this client's teaching? A. "Avoid taking aspirin or aspirin-containing products." B. "Increase your intake of foods that are high in potassium." C. "Hold this medication if your pulse rate is below 80 beats/min." D. "Do not take this medication within 1 hour of taking an antacid."
D. "Do not take this medication within 1 hour of taking an antacid."
A nurse teaches a client who has a history of heart failure. Which statement would the nurse include in this client's discharge teaching? A. "Avoid drinking more than 3 quarts (3 L) of liquids each day." B. "Eat six small meals daily instead of three larger meals." C. "When you feel short of breath, take an additional diuretic." D. "Weigh yourself daily while wearing the same amount of clothing."
D. "Weigh yourself daily while wearing the same amount of clothing."
A nurse cares for a client with end-stage heart tallure who 15 awaiting a transplant. The client appears depressed and states, "I know a transplant is mv last chance. but I don't want to become a vegetable." How would the nurse respond? A. "Would you like to speak with a priest or chaplain?" B. "I will arrange for a psychiatrist to speak with you." C. "Do you want to come off the transplant list?" D. "Would you like information about advance directives?"
D. "Would you like information about advance directives?"
A nurse assesses a client after administering the first dose of a nitrate. The client reports a headache. What action would the nurse take? A. Initiate oxygen therapy. B. Hold the next dose. C. Instruct the client to drink water. D. Administer PRN acetaminophen.
D. Administer PRN acetaminophen.
A nurse is caring for a client with acute pericarditis who reports substernal precordial pain that radiates to the left side of the neck. Which nonpharmacologic comfort measure would the nurse implement? A. Apply an ice pack to the client's chest. B. Provide a neck rub, especially on the left side. C. Allow the client to lie in bed with the lights down. D. Sit the client up with a pillow to lean forward on.
D. Sit the client up with a pillow to lean forward on.
