PVN 131 exam1
Which health problems does the nurse identify from an older clients history that increases the client's risk factors for a brain attack ?
Transient ischemic attacks (TIAs)
The nurse concludes that the gradual occlusion of the internal or common carotid arteries, manifested by transient ischemic attacks, may occur because of what reason ?
Atherosclerosis of the vascular system
A nurse ask the client with ischemic heart disease to identify the foods that are most important to restrict. The nurse determines that the client understands the dietary instructions when the client identifies the following foods.
Avoid chicken broth enriched whole milk red meats, such as beef liver and other glandular organ meats
A nurse is teaching a client who had an MI about the prescribed 1500 calorie 2 gram sodium weight reducing diet. Which low sodium, low calorie nutrients should the nurse recommend that the client include in the diet ?
baked chicken mashed potatoes
What significant risk factors for coronary heart disease can carry a greater risk for women that for men ?
diabetes mellitus low levels of high density lipoprotein (HDL) cholesterol
A client is receiving a 2 gram sodium diet. The family asks whether they can bring snacks from home. The nurse suggests that they bring foods low in sodium such as which foods?
fresh orange wedges
What is the moat objective way that a nurse can assess the extent of edema in a client ?
weighing the patient
Which primary step should be followed by the nurse when prioritizing care for a hypertensive client?
Asses for a severe headache
How should the nurse make the bed of a client who is in the acute phase after a MI ?
Replace the top linen and only the necessary bottom linen
A nurse is assessing a client with diagnosis of early left ventricular heart failure. Specific to this type of heart failure, the nurse expects the client to make which statement?
"I have trouble breathing when I walk rapidly"
A client with a history of hypertension has a blood pressure if 180/102. When the nurse asks whether the client has been taking any medication, the client replies I took the blood pressure pills that the health care provider prescribed for a few weeks but I didn't feel any different so I decided to only take them when I feel sick. What is the best initial response by the nurse.
"it is important to take your medication daily to achieve optimal results
A client has elevated triglycerides and cholesterol. The client appears discouraged and says "well I guess id better cut out all the fat and cholesterol in my diet" What is the nurses best response?
'You need some fat to supply the necessary fatty acids, so you mainly just need to cut down on the amount of fat that you consume
Nitroglycerin tablets are prescribed for a client with the diagnosis of angina. The client asks the nurse how long it should take for the chest pain to subside after the medication is taken, What should the nurse tell the client ?
1 to 3 mins
A nurse is completing the admission assessment of a client with peripheral arterial disease. Which assessments will the nurse expect to observe?
Absence of hair on the toes Reports of pain associated with exercising
Metoprolol is prescribed for a client with hypertension. For which side effect should the nurse monitor the client?
Bradycardia
The nurse provides discharge teaching to a client with a history of angina. The nurse instructs the client to call for emergency services immediately if the clients pain exhibits which characteristics ?
Continues after rest and nitroglycerin
A nurse is assessing a middle aged female client for the presence of risk factors associated with coronary heart disease. What risk factor carries a greater risk for women that for men ?
Diabetes mellitus
Amlodipine is prescribed for a client with hypertension. Which response to the medication should the nurse instruct the client to report to the health care provider ?
Difficulty breathing
The nurse is reviewing a teaching plan for a client that has been prescribed a 2 gram sodium diet. The plan should include which foods that are low in sodium?
Fruits and juices
What should the nurse identify as the primary cause of the pain experienced by a client with a coronary occlusion ?
Heart muscle ischemia
A client experiences angina and is admitted to the telemetry unit for observation. Sublingual nitroglycerin tablets are prescribed to control periodic episodes of chest pain. What instructions should the nurse include when teaching the client about the correct use of sublingual nitroglycerine?
Hold the tablet under the tongue until it dissolves
What are clinical manifestation of MI in women ?
Indigestion Unusual fatigue sleep disturbances
A client with hypertension is scheduled for a scan and electrolyte studies. During an interview with the nurse, the client exclaims, "I don't know why I just cant get a rx for high bp pills; that probably is all it is. Im missing work by being here. Which is the best response by the nurse?
Its frustrating to miss work and not know for sure what is wrong
A client is admitted to the hospital with a long history of hypertension. The nurse should assess the client for which complication ?
Kidney failure
A nurse is assessing a client with the diagnosis of primary hypertension. What clinical finding does the nurse identify as an indicator of primary hypertension ?
Occipital headache in the morning
A nurse is caring for a client with varicose veins. Which clinical manifestation should the nurse expect with this diagnosis?
Presence of ankle edema Increased muscle fatigue Report of leg fullness and pruritus
A client who is recovering from an acute myocardial infarction reports not being happy about the lack of salt with meals. Recognizing that adhearance to a medical regimen improves understanding, the nurse explains that salt must be limited to do what?
Prevent further accumulation of fluid which increases the workload of the heart
A nurse is teaching a menu planning to a client who has a high triglyceride level. Which nutrient avoided by the client indicated that teaching about foods that are high in fat was understood ?
Red meats
A client with a history of hypertension comes to the er with double vision and a bp of 260/120. The PCP prescribes a sodium nitroprusside infusion. The nurse recalls that sodium nitroprusside decreases bp by doing what?
Relaxing arterial smooth muscles
The laboratory reports of a client with a history of congestive heart failure show a blood PH value mire than 7.45. Which type of acid base imbalance may most likely be found in the client?
Respiratory Alkalosis
To determine the status of a clients carotid pulse the nurse should palpate what ?
at the anterior neck, lateral to the trachea
A client is admitted to the hospital with chest pain and a diagnosis of MI. How does the nurse expect the client to describe the chest pain ?
Severe and intense
A woman comes to an emergency department reporting signs and symptoms determined by the health care provider to be caused by a MI. The nurse obtains a health history. Which reported symptoms does the nurse determine are specifically related to a MI in women?
Severe fatigue sense of unease
A clients monitor shows a PQRST wave for each beat and indicates a rate of 120 beats/ min. The rhythm is regular. What does the nurse conclude that the client is experiencing ?
Sinus tachycardia
A 75 year old client has a baseline blood pressure of 140/90 mm HG. The nurse obtains a sitting bp in the clients left arm and the reading is 160/100 mmHG, What action should the nurse take next?
Take the blood pressure in the right arm and then take the blood pressure in both arms while the client is standing
A client has been receiving digoxin. The client calls the clinic and complains of yellow vision. What is the nurses best response ?
The medication should be discontinued. Come to the clinic this afternoon.
A client who has MI receives a rx for a beta blocker and nitroglycerin patch. The nurse determine that the purpose of the patch is to decrease what ?
The preload of the heart, thereby reducing the cardiac workload
When auscultating a clients chest, the nurse hears swishing sounds of normal breathing, What should the nurse document ?
Vesicular breath sounds
A nurse is providing dietary instruction to a client with cardiovascular disease. Which dietary selection by the client indicates the need for further instruction ?
Whole milk with oatmeal
A clients lab report indicates the presence of hypokalemia. For which clinical manifestation associated with hypokalemia should the nurse assess the client?
anorexia leg cramps
A client is hospitalized with a severe MI and tells the nurse "My life is over, I may as well just give up" What is the best response from the nurse?
"You feel your life is over?"
The nurse recognizes what as an early finding that indicates that a client is hypertensive?
A diastolic blood pressure that remains greater that 90 mm Hg
A client is admitted to the ER with crushing chest pain. A dx of acute coronary syndrome is suspected. The nurse expects that the clients initial treatment will include which medication?
Aspirin
A client who has had an uncomplicated MI asks the nurse about the resumption of sexual activity, What parameters should the nurse consider to determine the safe resumption of sexual activity?
At least 4-6 weeks after the MI The point at which 2 flights of stairs can be climbed without dyspnea
A clients serum potassium level is below the expected range. Which clinical indicators should the nurse determine are consistent with hypokalemia ?
Decreased heart rate decreased bowel sounds
A client is admitted to the medical unit with a diagnosis of right ventricular heart failure. What is the nursing assessment that supports this medical diagnosis?
Distended jugular veins
A nurse identifies signs of electrolyte depletion in a client with heart failure who is receiving bumetanide (BUMEX) and digoxin (LANOXIN). What does the nurse determine is the cause of depletion?
Diuretic therapy
What clinical indicators are the nurse most likely to identify when taking the admission history of a client with right ventricular failure?
Edema Dyspnea
A nurse attempts to give a client with chronic arterial insufficiency of the legs the prescribed dose of aspirin (ASA). The client refuses, stating " My legs are not painful" What should the nurse do ?
Explain the reason for the medication and encourage the client to take it
Furosemide ( Lasix) has been prescribed as part of the medical regimen for a client with hypertension, and the nurse has provided related teaching. The nurse concludes that the client needs additional teaching when the client makes which statement ?
I plan to eat a food high in vitamin k every day
A client's diet is modified to eliminate foods that act as cardiac stimulants. The nurse should teach the client to avoid what foods? (Select all that apply.) 1 Iced tea 2 Red meat 3 Club soda 4 Hot cocoa 5 Chocolate pudding
Iced tea Hot cocoa Chocolate pudding
A nurse is auscultating a clients heart sounds. Which valves close when the first heart sounds are produced?
Mitral and tricuspid
A nurse is caring for a client with MI is concerned that the client may develop left ventricular failure. For which clinical manifestation should the nurse assess the client ?
Paroxysmal nocturnal dyspnea
A client who had a MI receives 15 mg of morphine sulfate for chest pain. 15 mins lasts the client complains of feeling dizzy. What action should the nurse take ?
Place the client in supine position and take the vital signs
Which modifiable risk factors for coronary artery disease (CAD) should the nurse include in a teaching session for a Native American patient?
Tobacco Hypertension Diabetes mellitus (DM)
A client with dehydration suddenly becomes diaphoretic, clammy, and pale. the clients blood pressure falls to 50/30. The nurse should place the patient in what position ?
Trendelenburg
A nurse is teaching a client about the differences between the terms saturated and unsaturated when it comes to fats. Which important factor in relation to these types of fats should the nurse include in her teaching?
density
A client with a history of heart failure is admitted to the hospital with the diagnosis of pulmonary edema. For which signs and symptoms specific to pulmonary edema should the nurse assess the client?
Crackles Coughing Orthopnea
A client with a history of heart failure and atrial fibrillation reports a 9 lb weight gain in the past 2 weeks. The nurse interprets that what is the most likely cause of this sudden weight gain ?
Fluid retention