NSU 3050 Quiz 9

The physician's order states, "Calculate the pulse pressure of the client's B/P." The blood pressure reading is as follows: systolic pressure of 146 mm Hg and a diastolic pressure of 82 mm Hg. The pulse pressure would be:

64 mm Hg

A client who has been diagnosed with mitral valve prolapse asks the nurse if there are any dietary modifications that should be incorporated into her lifestyle. The best response would be:

"Refraining from caffeine, alcohol, and cigarettes may be sufficient to control symptoms."

A client has been diagnosed with chronic obstructive arterial disease. Which client statement indicates she understands how to manage this disease?

"I should have my LDL monitored."

A monitored hospitalized client with a pulmonary embolism has been in atrial fibrillation (AF) for 4 days. The nurse observes the rhythm spontaneously convert to a normal sinus rhythm. Which form of AF is this?

Paroxysmal

The nurse determines that teaching has been effective when a client diagnosed with chronic stable angina (CSA) states:

"Angina may result from exertional activity or emotional stress and be relieved within minutes by rest or by nitroglycerin."

Which teaching point would be most appropriate for a group of older adults who are concerned about their cardiac health?

"The plaque that builds up in your heart vessels obstructs the normal flow of blood and can even break loose and lodge itself in a vessel."

A client with persistent, primary hypertension remains apathetic about high blood pressure, stating "I don't feel sick, and it doesn't seem to be causing me any problems that I can tell." How could the nurse best respond to this client's statement?

"You may not sense any problems, but hypertension increases your risk of heart disease and stroke."

Four clients were admitted to the emergency department with severe chest pain. All were given preliminary treatment with aspirin, morphine, oxygen, and nitrates and were monitored by ECG. Which client most likely experienced myocardial infarction?

An 80-year-old woman whose pain started at 6 AM shortly after awakening and was not relieved by nitrates or rest; the ECG showed ST-segment elevation with inverted T waves and abnormal Q waves; levels of cardiac markers subsequently rose

A child's history of a recurrent sore throat followed by severe knee and ankle pain has resulted in a diagnostic workup and a diagnosis of rheumatic fever. What are the treatment priorities for this child?

Antibiotics and anti-inflammatory drugs

Select the response that best describes the pressure-sensitive receptors that respond to changes in the stretch of the vessel wall.

Baroreceptors

The nursing instructor, when teaching the students about coronary artery disease (CAD), identifies which of the following as the main cause of CAD?

Atherosclerosis

Which risk factor for the development of primary hypertension is nonmodifiable?

Black ethnicity

The nurse is caring for a client who has just experienced an acute myocardial infarction. Which type of shock is this client likely to experience?

Cardiogenic

Which statement describes the greatest diagnostic limitation of an electrocardiogram (ECG)?

It documents only current cardiac function.

Which manifestation of left-sided heart failure can be diagnosed by examination of the lips and mucous membranes?

Cyanosis

The client has been diagnosed with impaired blood flow in the deep venous channels of her legs. The nurse explains that the most common cause of this condition is:

Deep vein thrombosis (DVT)

A client's electrocardiogram monitor begins to sound an alarm and shows sustained ventricular fibrillation. The client is unconscious and without a pulse. Which priority intervention should the nurse take?

Defibrillate the client

A community health nurse is conducting a seminar at a local church group on health and wellness. Which of the following does she tell the group is the leading cause of death in the United States?

Heart disease

A teenager is diagnosed with hypertension. The nurse knows that risk factors for hypertension in children and adolescents include which of these? Select all that apply.

High salt consumption, Obesity, Inactive lifestyle

Nursing students who are studying for their upcoming cardiac exam are discussing how the heart could possibly continue to beat once removed from the body. One of the students explains that this phenomenon is directly related to automaticity. What is automaticity?

Inherent spontaneous action-potential

A client is scheduled to have a Holter monitor for 48 hours to detect disturbances in conduction. Which action is important for the nurse to tell the client to ensure accuracy in correlating dysrhythmias with symptoms?

It is important to keep a diary of activities and symptoms.

On a routine physical exam visit, the physician mentions that he hears a new murmur. The client gets worried and asks, "What does this mean?" The physician responds:

One of your heart valves is not opening properly. We need to do an echocardiogram to see which valve is having problems."

The older adult client tells the health care provider about experiencing dizziness when changing from a lying to a sitting position. The provider will document which condition in the medical record?

Orthostatic Hypotension

Considering the PQRST complex of an electrocardiogram (ECG), which letter designation represents atrial depolarization?

P wave

Which goal is a priority for a nurse caring for a client diagnosed with orthostatic hypotension?

Preventing falls

A client has been diagnosed with deep vein thrombosis (DVT). The nurse is planning care and recognizes that the client is most at risk for:

Pulmonary embolism

A client has just been admitted to the cardiac intensive care unit with a diagnosis of infective endocarditis. His wife appears distraught and asks the nurse what caused this to happen to her husband. What would be the nurse's best response?

The most common cause is a staph infection.

Which dysrhythmia is considered to be the most fatal and requires immediate treatment?

Ventricular fibrillation

The nursing student has learned in his class that coronary artery disease (CAD) is heart disease caused by:

impaired coronary blood flow.

A client arrives at the emergency room with dizziness and a near syncopal episode. Vital signs include a heart rate of 46 beats/min and blood pressure of 86/50 mm Hg. The cardiac monitors show regular rhythm as above. The client states the health care provider has been running blood work to rule out hypothyroidism. Based on the rhythm, what does the nurse report the client has?

symptomatic bradyarrhythmia

A nurse is teaching a client with newly diagnosed hypertension about antihypertensive drug therapy. The nurse determines that the knowledge is understood when the client correctly describes which of the following as the mechanism of action of an angiotensin-converting enzyme (ACE) inhibitor?

Inhibits the conversion of angiotensin I to angiotensin II, decreasing angiotensin II levels and reducing its effect on vasoconstriction

A client who has suffered a myocardial infarction is being treated in the emergency room. His pain remains severe even though he was given nitrates and oxygen. The physician now orders morphine for the pain. What method should the nurse use to administer the morphine?

Intravenous

Which measure is the best modality to diagnose hypertension?

Repeated blood pressure determinations

What is the correct sequence for the generation of electrical impulses in the heart causing ventricular contraction?

SA node - AV node - bundle of His - bundle branches - Purkinje fibers

Which of the following is called the pacemaker of the heart?

Sinoatrial (SA) node

A 28-year-old marathon runner comes to the clinic to obtain a physical exam for a new job. The nurse assesses a regular pulse rate of 52 beats per minute (bpm). Which common dysrhythmia is the nurse aware this client most likely has related to maintaining a large stroke volume?

Sinus bradycardia

A client is seen in the emergency department complaining of chest discomfort, productive cough, and a fever of over 101°F (38.3°C) for 3 days. The nurse performs an electrocardiogram and observes a rate of 110 beats per minute (bpm) with a normal P wave and a PR interval of 0.12 second preceding each QRS complex. What does the nurse determine the rhythm to be?

Sinus tachycardia

A client with a known history of intravenous drug abuse has been diagnosed with infective endocarditis. Select the most likely cause of infection.

Staphylococcus aureus

A client has been diagnosed with aortic stenosis and asks the nurse what this means. The most appropriate response would be:

The valve opening is narrowed and produces increased resistance to blood flow out of the left ventricle and into the aorta.

A client with a suspected MI is brought to the emergency department by ambulance. The nurse caring for this client would expect to receive an order for which laboratory test to confirm a diagnosis of MI?

Troponin level

The nurse is teaching the client with chronic venous insufficiency. Which part of the body is particularly prone to development of stasis dermatitis?

lower leg