nurs 370: exam 2

A client with advanced venous insufficiency is confined to bed rest following orthopedic surgery. How can the nurse best prevent skin breakdown in the client's lower extremities? A) Ensure that the patient's heels are protected and supported.

A nurse is assessing a new client who is diagnosed with peripheral artery disease. The nurse cannot feel the pulse in the client's left foot. How should the nurse proceed with assessment? D) Use Doppler ultrasound to identify the pulses.

Which classification of clients would be at greatest risk for hospital-acquired endocarditis? A. Hemodialysis clients

A client presents to the clinic reporting intermittent chest pain on exertion, which is eventually attributed to angina. The nurse should inform the client that angina is most often attributable to what cause? D. Coronary arteriosclerosis

A client is undergoing diagnostic testing for mitral stenosis. What statement by the client during the nurse's interview is most suggestive of this valvular disorder? C. "Whenever I do any form of exercise I get terribly short of breath."

A client who has recently recovered from a systemic viral infection is undergoing diagnostic testing for myocarditis. Which of the nurse's assessment findings is most consistent with myocarditis? D. Flu-like symptoms

A nurse is performing an admission assessment of a client with a diagnosis of cirrhosis. What technique should the nurse use to palpate the client's liver? D. Hold hand 90 degrees to the right side of the abdomen and push down firmly.

A client with portal hypertension has been admitted to the medical floor. The nurse should prioritize what assessments?​ C. Daily weights and abdominal girth measurement

A nurse educator is conducting an inservice for nursing students about how tobacco use impacts coronary artery disease (CAD)? What are the primary ways that tobacco use impacts CAD? Select all that apply.

A. Decreases the supply of oxygen to the myocardium B. Increases platelet adhesion C. Raises the heart rate and blood pressure E. Increases the blood carbon monoxide level

A client has developed hepatic encephalopathy secondary to cirrhosis and is receiving care on the medical unit. The client's current medication regimen includes lactulose four times daily. What desired outcome should the nurse relate to this pharmacologic intervention?​

A. Two to three soft bowel movements daily

The nurse is taking the health history of a new client who reports pain in the left lower leg and foot when walking. This pain is relieved with rest, and the nurse observes that the left lower leg is slightly edematous and is hairless. When planning this client's care, the nurse should most likely address which health problem?

B) Intermittent claudication

A nurse has written a plan of care for a client diagnosed with peripheral arterial insufficiency. One of the nursing diagnoses in the care plan is altered peripheral tissue perfusion related to compromised circulation. Which intervention is the most appropriate for this diagnosis?

B. Encourage the patient to engage in a moderate amount of exercise.

An adult client is admitted to the ED with chest pain. The client states that there was unrelieved chest pain for approximately 20 minutes before coming to the hospital. To minimize cardiac damage, the nurse should expect to administer which of the following interventions?

B. Morphine sulfate, oxygen, and bed rest

A nurse is caring for a client with a blocked bile duct from a tumor. What manifestation of obstructive jaundice should the nurse anticipate?

B. Orange and foamy urine​ / C. Increased abdominal girth

The nurse is providing an educational workshop about coronary artery disease (CAD) and its risk factors. The nurse explains to participants that CAD has many risk factors, some that can be controlled and some that cannot. Which risk factors should the nurse list that can be controlled or modified?

C. Cholesterol levels, hypertension, and smoking

A nurse in the rehabilitation unit is caring for an older adult client who is in cardiac rehabilitation following an MI. The nurse's plan of care calls for the client to walk for 10 minutes 3 times a day. The client questions the relationship between walking and heart function. How should the nurse best reply?

D) "When you walk, the muscles in your legs contract and pump the blood in your veins back toward your heart, which allows more blood to return to your heart."

The public health nurse is participating in a health fair and interviews a client with a history of hypertension, who is currently smoking one pack of cigarettes per day. The client denies any of the most common manifestations of CAD. The nurse should expect the focuses of CAD treatment to be:

D. Diet therapy and smoking cessation.

A nurse working in a long-term care facility is performing the admission assessment of a newly admitted 85-year-old resident. During inspection of the resident's feet, the nurse notes early evidence of gangrene on one of the resident's great toes. The nurse should assess for further evidence of which health problem?

D. Peripheral artery disease (PAD)

The nurse is caring for an adult client who had symptoms of unstable angina upon admission to the hospital. What nursing diagnosis underlies the discomfort associated with angina? C. Ineffective cardiopulmonary tissue perfusion related to coronary artery disease (CAD)

Family members bring a client to the ED with pale cool skin, sudden midsternal chest pain unrelieved with rest, and a history of CAD. How should the nurse best interpret these initial data? C. The symptoms indicate an acute coronary episode and should be treated as such.

A client has been admitted to the medical unit with signs and symptoms suggestive of endocarditis. The health care provider's choice of antibiotics would be primarily based on what diagnostic test? B. Blood cultures

The nurse is caring for a client with a history of endocarditis. Which topic would the nurse prioritize during health promotion education? A. Oral hygiene

C. Balancing myocardial oxygen supply with demand

The nurse is participating in the care conference for a client with acute coronary syndrome (ACS). What goal should guide the care team's selection of assessments, interventions, and treatments?

A client who has undergone liver transplantation is ready to be discharged home. Which outcome of health education should the nurse prioritize?​ C. The client will take immunosuppressive agents as required.

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