cardiovascular - iggy study guide questions - ch. 30, 32, 33

What is the nurse's best response when a client with peripheral arterial disease asks why he or she should exercise when walking causes pain?

"Exercise can improve blood flow to your legs because small blood vessels will compensate for the blood vessels that are blocked off."

Which statement by a client with heart failure indicates to the nurse the need for additional teaching?

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

Which statement by a client to the nurse indicates an understanding of cigarette usage related to cardiovascular risks?

"I need to be completely cigarette free for at least 3 years."

Which statement by a client with a history of hypertension and heart problems would cause the nurse to suspect development of heart failure?

"I've had to remove all of my rings for the past month."

What priority teaching would the nurse provide for a client who will be discharged with a prescription for atorvastatin?

"Immediately report any muscle cramping to your primary health care provider."

Which priority teaching would the nurse provide to a client with infective endocarditis who is scheduled for an invasive dental procedure?

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

What is the best advice the nurse would give to a client with moderate-to-severe cramping sensation in their legs or buttocks associated with an activity such as walking?

"Resting or lowering the affected extremity can relieve the pain."

Which instruction would the nurse give a client who is to have an exercise electrocardiography test?

"Wear comfortable loose-fitting clothes and supportive, rubber-soled shoes."

When a client admits that he or she sometimes has trouble catching his or her breath, which question would the nurse ask to obtain more information about the client's symptoms?

"What was your most strenuous activity during the past week?"

Which priority information would the nurse be sure to provide for a client who is scheduled for mitral valve replacement with a xenograft valve?

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

What is the recommended therapeutic range for the international normalized ratio (INR) for a client receiving warfarin sodium to prevent DVT and decrease the risk for stroke?

1.5-2.0

Which factors would the nurse note as increasing the risk for atherosclerosis with an older African-American client? Select all that apply.

20-year history of type 2 diabetes Sedentary lifestyle 25 pounds overweight Grandmother died after heart attack

How many cigarette pack-years has this client smoked: Smoked half a pack a day for 6 years?

3 pack-years

What would the nurse calculate the cardiac output to be when the client's heart rate is 68 beats/min and the stroke volume is 50 mL?

3400 L/min

Which findings would the nurse expect in a client with mitral valve stenosis? Select all that apply.

A client with mild mitral valve stenosis will likely be asymptomatic. Classic signs include dyspnea, angina, and syncope. Rumbling apical diastolic murmur Right-sided heart failure with jugular (neck) vein distention

Which statements about intravascular ultrasonography (IVUS) are accurate? Select all that apply.

A flexible catheter with a miniature transducer is introduced at the distal tip to view the coronary arteries. The catheter has a transducer which emits sound waves that reflect off the plaque and the arterial wall to create an image of the blood vessel. IVUS can be used in vessels as small as 2 mm to assess the nature of plaques or vessel condition following an intervention.

Which location would the nurse expect to be the most common for a client to form an aneurysm?

Abdominal aorta

What would the nurse assess for when a client is suspected of having an abdominal aortic aneurysm? Select all that apply.

Abdominal, flank, or back pain Gnawing pain unaffected by movement Pulsation in the upper abdomen Auscultation of a bruit in the upper abdomen

Which criteria are appropriate for a client with dilated cardiomyopathy to become a candidate for heart transplant surgery? Select all that apply.

Age generally less than 65 years New York Heart Association Class III or IV Normal or only slightly increased pulmonary vascular resistance Absence of active infection

Which are potential causes of dilated cardiomyopathy? Select all that apply.

Alcohol abuse Infection Chemotherapy Poor nutrition

What is the nurse's priority action when a client with AAA suddenly exhibits decreased level of consciousness, blood pressure 82/48 mm Hg, irregular apical pulse, and perfuse diaphoresis?

Alert the Rapid Response Team.

Which drugs are useful in promoting circulation for clients with chronic peripheral arterial disease? Select all that apply.

Aspirin Pentoxifylline Clopidogrel Cilostazol

What is the nurse's best response when a client asks about the difference between arteriosclerosis and atherosclerosis?

Atherosclerosis is forming plaques in arteries but arteriosclerosis is thickening of arterial walls associated with aging.

What would the nurse teach a client with peripheral arterial disease about positioning and position changes?

Avoid crossing legs at all times.

Which are complications that the nurse would monitor for after a client receives an endovascular stent graft for emergent repair of an abdominal aortic aneurysm? Select all that apply.

Bleeding Misplacement of stent graft Peripheral embolization Endoleak Aneurysm rupture

Which piece of equipment would the nurse recommend for a client to manage hypertension at home?

Blood pressure monitoring device

Which drug would the nurse expect the primary health care provider to prescribe for a client to decrease blood pressure, decrease triglycerides, increase high-density lipoprotein cholesterol (HDL-C), and lower low-density lipoprotein cholesterol (LDL-C)?

Caduet

What is the most important teaching point for the nurse to emphasize with a client who has Buerger's disease?

Cease cigarette smoking and all exposure to tobacco to arrest the disease process.

Which method would the postanesthesia care unit (PACU) nurse use to assess the patency of the graft after a client's arterial revascularization with graft placement?

Check the affected extremity, comparing it to the unaffected, for changes in color, temperature, and pulse intensity every 15 minutes for the first hour, then hourly.

When the nurse performs blood pressure screenings, which clients would be referred for further evaluation? Select all that apply.

Client with heart disease and blood pressure 148/90 mm Hg Renal failure client with blood pressure of 180/90 mm Hg Client with muscle cramping taking a statin drug with blood pressure 124/82 mm Hg COPD client with blood pressure 158/88 mm Hg

Which clients are at increased risk for peripheral arterial disease (PAD)? Select all that apply.

Client with hypertension Client with diabetes mellitus Client who smokes cigarettes Client who is African American

For which client would the nurse question the prescription of hydrochlorothiazide?

Client with hypokalemia

CHAPTER 33

Concepts of Care for Patients with Vascular Problems

Which instructions would the nurse give a client for following dietary recommendations of the American College of Cardiology (ACC) and the American Heart Association (AHA)? Select all that apply.

Consume low-fat dairy products, poultry, and fish. Lower sodium intake to no more than 2400 mg/day. Limit intake of sweets and red meats. Eat legumes, tropical vegetable oils (e.g., canola oil), and nuts.

Which early symptoms indicate to the nurse that a client's HF is getting worse and pulmonary edema is developing? Select all that apply.

Crackles in the lung bases Dyspnea at rest Disorientation

What does the nurse suspect when assessing a client on bedrest and finding that he or she has a left calf that is swollen, warm to touch, reddened, and moderately painful?

Deep vein thrombosis

What symptom would the nurse expect on assessment of a client with inflow peripheral arterial disease?

Discomfort in the lower back, buttocks, or thighs after walking

What is the priority action for the nurse when a client is to have unfractionated heparin (UFH) discontinued and to start receiving subcutaneous low-molecular-weight heparin (LMWH)?

Discontinue the UFH at least 30 minutes before giving the first LMWH injection.

What is the nurse's best advice for a client, who is an avid golfer, but has been recently diagnosed with thoracic outlet syndrome?

Don't elevate your arms above your head.

Which essential teaching would the nurse provide for a client being discharged with chronic venous insufficiency? Select all that apply.

Elevate your legs at least 20 minutes four to five times a day. Avoid crossing legs at all times. Avoid standing still for any length of time. Avoid tight restrictive pants, girdles, or garters.

During which timeframe is it most important for the nurse to monitor a client for graft occlusion after receiving revascularization with graft placement?

First 24 hours

Which nonsurgical management techniques would the nurse expect when caring for a client with DVT? Select all that apply

Gradual increase in ambulation as tolerated by the client Elevation of legs when in bed or sitting in a chair Knee- or thigh-high compression stockings Anticoagulant drugs as prescribed

Which activity would the nurse advise during the recovery period for a client returning home after AAA repair?

Gradually increased walking

Which are conservative management measures for a client's varicose veins? Select all that apply.

Graduated compression stockings (GCSs) Exercise to increase venous return Elevating the extremities

Which findings would the nurse expect to assess when a client presents with a thoracic aortic aneurysm? Select all that apply.

Hoarseness Shortness of breath Difficulty swallowing Visible mass above the suprasternal notch

Which type of cardiomyopathy may present with sudden death as the first symptom?

Hypertrophic

Which symptoms would indicate to the nurse that a client's aneurysm had ruptured? Select all that apply.

Hypotension Diaphoresis Decreased level of consciousness Loss of pulses distal to rupture Scant urine output

Which drug would the nurse prepare to administer when a client enters the emergency department with chest pain described as a "tearing" sensation, diaphoresis, blood pressure of 200/130 mm Hg, weak pulses, and a sense of apprehension?

IV beta blocker such as esmolol

Which symptom causes most clients to seek medical attention for peripheral arterial disease (PAD)?

Intermittent claudication

What is the nurse's best explanation to a client for use of low-dose niacin to decrease LDL-C and very-low-density lipoprotein (VLDL) cholesterol levels?

It helps reduce side effects of flushing and feeling too warm.

Which statements pertaining to the use of an Unna boot for a client are accurate? Select all that apply.

It is constructed from gauze and zinc oxide. It promotes venous return and prevents stasis. It forms a sterile environment for the ulcer. The client is instructed to report any increase in pain.

Which information would the nurse be sure to include when teaching a client with peripheral arterial disease about methods to promote vasodilation? Select all that apply.

Maintain a warm environment at home. Wear socks or insulated shoes at all times. Prevent cold exposure to the affected limb. Completely abstain from smoking or chewing tobacco. Avoid emotional stress and excessive caffeine.

What is the best nonsurgical intervention for a client with a 3-cm abdominal aortic aneurysm to decrease the risk of rupture?

Maintenance of normal blood pressure and avoidance of hypertension

Which condition would the nurse suspect when a client has these findings (BP 200/130 mm Hg; sudden headache, blurred vision, and dyspnea)?

Malignant hypertension

Which instructions would the nurse give the LVN/LPN monitoring a client after cardiac catheterization by radial artery approach? Select all that apply.

Monitor the client's vital signs every 15 minutes for 1 hour. Assess the insertion site for bloody drainage or hematoma. Assess peripheral pulses and skin temperature and color with every vital sign check. Monitor intake and output. Provide oral fluids for adequate contrast excretion.

Which assessment findings would cause the nurse to suspect cardiac tamponade in a client? Select all that apply.

Neck vein distention Paradoxical pulse Muffled heart sounds Tachycardia

Which drug would the nurse expect to administer to a client with Raynaud's or Buerger's disease?

Nifedipine

Which drugs would the nurse prepare to administer to a client with HF who has developed pulmonary edema? Select all that apply.

Nitroglycerin sublingual Furosemide IV Nitroglycerin IV

Which features would the nurse recognize as indicating that a client had a venous ulcer? Select all that apply.

No claudication or rest pain Ulcer located in the ankle area Brown pigmentation Ulcer bed is pink Pulses are present

What early sign of left ventricular failure is a client most likely to report to the nurse?

Nocturnal coughing

What would be the nurse's best action when a client reports dizziness when changing position from sitting to standing and a sudden dry cough after starting a prescription of captopril?

Notify the primary health care provider immediately about these side effects.

What nursing actions are included in the routine postprocedural care for a client after percutaneous vascular intervention? Select all that apply.

Observe for bleeding at the puncture site. Perform frequent distal pulse checks on both limbs. Administer antiplatelet therapy as prescribed. Monitor for signs of shock. Check vital signs frequently as ordered.

Which are characteristics a nurse would expect in clients with Raynaud's disease? Select all that apply.

Occurs more often in young women Clients experience cold intolerance Causes red-white-blue skin color changes on exposure to cold or stress

Which client with valvular heart disease would benefit from the nonsurgical invasive procedure balloon valvuloplasty?

Older adult who is not a surgical candidate

What frequency of drug dosage therapy would the nurse advocate for an older client with hypertension who lives alone and is able to manage his or her self-care?

Once a day

Which statements about percutaneous vascular interventions are accurate? Select all that apply.

One or more arteries are dilated with a balloon catheter to open the vessel(s). Stents are often placed to ensure adequate blood flow. Some clients are occlusion free for 3 to 5 years. Clients who are candidates must have occlusions or stenoses that are accessible to the catheter.

Which statement best describes the functional capability of a client who is categorized as New York Heart Association Class II?

Ordinary physical activity results in fatigue, palpitations, dyspnea, and anginal pain.

Which findings does the nurse expect when assessing a client with infective endocarditis? Select all that apply.

Osler nodes on palms of hands and soles of feet Splinter hemorrhages Janeway lesions on the hands and feet Anorexia and weight loss

Which relatively new therapy would be tried for clients with familial hypercholesterolemia or for those who are unable to reduce LDLs with existing therapies?

PCSK9 inhibitors

Which assessment findings indicate to the nurse that a client has stage III peripheral arterial disease (PAD)? Select all that apply.

Pain is described as numbness, burning, toothache-type pain. Pain is relieved by placing the extremity in a dependent position. Pain usually occurs in the distal part of the extremity (toes, arch, forefoot, or heel). Pain while resting commonly awakens the client at night.

Which assessment data would the nurse expect for a client diagnosed with angina? Select all that apply.

Pain relieved at rest Sudden onset of pain Substernal pain that may spread across chest, back, and arms Pain that usually lasts less than 15 minutes

Which techniques would the nurse use when performing an initial cardiovascular assessment on a middle-aged client? Select all that apply.

Palpate all of the major pulse sites. Auscultate bruits in the radial and brachial arteries. Palpate and compare temperature differences in the lower extremities. Check the client for orthostatic hypotension. Perform bilateral but separate palpation on the carotid arteries.

What is the best technique for assessing a client's right lower leg for arterial insufficiency?

Palpate the peripheral arteries using a head-to-toe approach with side-to side comparison

What are the priority nursing care concepts for clients with vascular problems?

Perfusion and clotting

What would the nurse suspect when assessing a client's lower extremities and finding decreased pedal pulses, skin that is cool to touch, loss of hair, and thickened toenails?

Peripheral arterial disease

What are the purposes for a client with a venous stasis ulcer to be prescribed the topical drug Accuzyme? Select all that apply.

Promote healing Chemically debride the ulcer Eliminate necrotic tissue

Which nursing interventions promote a client's compliance with antihypertensive therapy? Select all that apply.

Provide oral and written instructions related to all prescribed medications. Stress that suddenly stopping beta blockers can cause angina or heart attack. Suggest that the client have a home scale for weight monitoring. Teach clients to report unpleasant side effects to the primary health care provider.

Acute myocardial infarction or atrial fibrillation within the previous weeks

Report these symptoms to the health care provider immediately.

What is the nurse's best interpretation when reviewing a client's abdominal CT scan and noting that there is an outpouched segment coming off the abdominal aorta?

Saccular aneurysm

Which assessment findings would suggest to the nurse that a client who received a heart transplant was experiencing organ rejection? Select all that apply

Shortness of breath Hypotension Decreased activity tolerance Fluid gain (edema, increased weight) Atrial fibrillation or flutter

For prevention of DVT, which drug would the nurse expect the health care provider to prescribe?

Subcutaneous low-molecular-weight heparin (LMWH)

What is the definitive treatment for chronic constrictive pericarditis?

Surgical removal of the pericardium

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)?

Sympathetic stimulation

Which major self-management categories will the nurse include when teaching a client, newly diagnosed with heart failure, who is about to be discharged? Select all that apply.

Symptoms, what to do when they get worse Medications Activity Weight Diet

Which action increases the effectiveness of angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) in controlling hypertension for African-American clients?

The ARB or ACEI is given with a diuretic, beta blocker, or a calcium channel blocker.

Which statements are accurate about a client's true aneurysm? Select all that apply.

The aneurysm may be described as fusiform or saccular. The aneurysm creates a permanent dilation of an artery. A congenitally weakened arterial wall may result in an aneurysm. The aneurysm section of the arterial wall is enlarged to at least twice its normal diameter.

Which control systems play an important role in maintaining a client's blood pressure? Select all that apply.

The arterial baroreceptor system Regulation of body fluid volume Vascular autoregulation The renin-angiotensin-aldosterone system

How does the nurse best interpret a client's low-density lipoprotein cholesterol (LDL-C) value which is greater than 190 mg/dL and does not respond to dietary intervention?

The client should be evaluated for secondary causes of hyperlipidemia and treated with statin therapy because of the high LDL-C level.

What drug would the nurse expect to be prescribed for a client with hypertension and for whom lifestyle modifications have failed to control blood pressure?

Thiazide diuretic

Which laboratory value test elevation does the nurse consider most significant in the diagnosis of a client's myocardial infarction (MI)?

Troponin T and I

Which actions by an older adult are likely to cause the experience of syncope? Select all that apply.

Turning the head Performing a Valsalva maneuver Shrugging the shoulders

Which diagnostic tests would the health care provider prescribe to confirm a diagnosis of abdominal aortic aneurysm (AAA) suspected in a client? Select all that apply.

Ultrasound Computed tomography scan

Which are the characteristics that the nurse would expect when a client is diagnosed with mitral valve prolapse (MVP)? Select all that apply.

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

Which statement about the peripheral vascular system is accurate?

Veins have valves that direct blood flow to the heart and prevent backflow.

Which lifestyle changes would the nurse teach a client to help control hypertension? Select all that apply.

Weight reduction if overweight or obese. Implement a healthy diet such as the DASH diet. Use relaxation techniques to decrease stress. Increase activity by use of a structured exercise program.

Which assessment factors for a 62-year-old client would the nurse recognize as modifiable risk factors for heart disease? Select all that apply.

History of smoking Obesity Sedentary lifestyle

Which treatment best applies to the care of a client newly diagnosed with infective endocarditis?

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

When a client has an ejection fraction of less than 30%, about which potential treatment does the nurse prepare to educate the client?

Implantable cardioverter/defibrillator

Which mechanisms regulate and mediate blood pressure? Select all that apply.

Kidneys Autonomic nervous system Endocrine system

Which client serum lipid tests suggest an increased risk for cardiovascular disease (CVD)? Select all that apply.

LDL 170 mg/dL Triglycerides 185 mg/dL VLDL 39 mg/dL Total cholesterol 250 mg/dL

What does the nurse suspect when a client states "I get short of breath whenever I lie down for several hours?"

Paroxysmal nocturnal dyspnea

What is the priority concept for a client who has heart failure?

Perfusion

What is the priority medical-surgical concept when the nurse is assessing a client with cardiovascular disease (CVD)?

Perfusion

Which are proposed criteria for diagnosis of a client with acute pericarditis? Select all that apply.

Pericardial chest pain Presence of a pericardial friction rub New ST elevation in all ECG leads or PR-segment depression New or worsening pericardial effusion

What is the best method for the nurse to use when auscultating a client's pericardial friction rub with a stethoscope?

Place the diaphragm at the left lower sternal border.

Which cardiovascular assessment changes would the nurse expect in an older client? Select all that apply

Presence of murmurs Atrial dysrhythmias Increased dizziness Positive orthostatic blood pressure

Which tests will the nurse teach a client are routinely done for follow-up monitoring when the client is discharged with a prescription for warfarin?

Prothrombin time (PT) and international normalized ratio (INR)

Which action does the nurse perform to prevent kidney toxicity when caring for a client after cardiac catheterization?

Provide intravenous and oral fluids for 12 to 24 hours.

What does the nurse suspect when assessment of a client with HF reveals pulses that alternate in strength?

Pulsus alternans

Which are potential benefits of a client receiving the drug digoxin?

Reduced heart rate Increased contractility Slowed conduction through the AV node Inhibition of sympathetic activity with enhanced parasympathetic activity

Which topics would the nurse be sure to cover when providing discharge instructions for a client with prosthetic valve surgery? Select all that apply

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

Which instruction would the nurse give the assistive personnel (AP) who is helping a client with HF and excessive aldosterone secretion?

Restrict the client's fluids to 2 L/day and keep accurate intake and output.

Which client has an abnormal heart sound?

S3 in a 54-year-old

What common assessment finding would the nurse expect to find in an older adult with cardiovascular disease?

S4 heart sound

What possible causes would the nurse consider when assessing a client and finding a hyperkinetic pulse? Select all that apply.

Sepsis Pain Fever Anxiety Thyrotoxicosis

What does the nurse instruct a client with pericarditis to do to make him or her will feel more comfortable?

Sit up and lean forward.

Which interventions would the nurse expect to include in the care of a client with pulmonary edema caused by HF? Select all that apply.

Sodium restriction Position client in semi-Fowler or high-Fowler Administration of loop diuretics

Which information from a client's medical history causes the nurse to check for abnormalities of the heart valves?

Streptococcal infections of the throat

For which pathophysiological conditions can a normal healthy heart adapt to maintain perfusion to the body tissues?

Stress and infection

When a client is hypovolemic, which tissue reacts and sends fewer impulses to the CNS?

Stretch receptors

Which urgent intervention is required when the nurse reviews the results of diagnostic testing for a client with aortic stenosis and discovers that the surface area of the valve is less than 1 cm?

Surgical aortic heart valve replacement

When a client with heart failure walks 200 feet down the hall and develops a feeling of heaviness in the legs, how does the nurse interpret this finding?

The activity is too stressful.

Which statements about the structure of the heart are accurate? Select all that apply.

The heart normally pumps about 5 L of blood per minute. The pericardium is a covering that protects the heart. Coronary artery blood flow occurs primarily during diastole.

What does the nurse suspect when a client who had a bruit on assessment during the previous 2 days does not have a bruit on assessment today?

The occlusion of the blood vessel is now 90%.

What is the most reliable method of monitoring for fluid gain or loss in a client with heart failure?

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

Which assessment findings would the nurse expect to find in a client with left heart failure? Select all that apply.

Wheezes or crackles S3 heart sound Paroxysmal nocturnal dyspnea Oliguria during the day

When would the nurse expect the release of B-type natriuretic peptide (BNP) for a client with heart failure?

When a client has fluid overload

To improve gas exchange, how much supplemental oxygen would the nurse provide a client with HF?

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

What is the nurse's best action when auscultating S1 for a client is difficult?

have the client lean forward or roll to his or her left side.

Which questions would the nurse ask to assess a client's nicotine dependence?

"Do you smoke even when you are ill?" "How soon after you wake up in the morning do you smoke?" "Do you wake up in the middle of the night to smoke?" "Do you find it difficult not to smoke in places where smoking is prohibited?"

Which questions would the nurse ask a client when a client is admitted reporting chest pain? Select all that apply.

"How long does the pain last and how often does it occur?" "Where does the pain occur and what does it feel like?" "Have you had other symptoms that occur with the chest pain and what are they?" "What activities were you doing when the pain occurred?" "Is this episode of chest pain different from other episodes you have had?"

What is the lowest mean arterial pressure (MAP) necessary to perfuse the major organs of the body?

60 to 70 mm Hg

What is the client's pulse pressure when the nurse finds that his or her blood pressure is 148/86 mm Hg?

62 mm Hg

What is the correct technique for the nurse to use to check a client's lower extremities using the ankle-brachial index?

A blood pressure cuff is applied to the lower extremities and the systolic pressure is measured by Doppler ultrasound at both the dorsalis pedis and posterior tibial pulses.

chapter 30

ASSESSMENT OF THE CARDIOVASCULAR SYSTEM

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?

Acute pericarditis

What action does the nurse plan to take prior to a cardiac catheterization when a client states he or she has an allergy to seafood and iodine-containing dyes?

Administer an antihistamine and / or a steroid before the test.

What is the priority intervention when a client comes to the emergency department (ED) with extreme anxiety, tachycardia, struggling for air, and a moist cough productive of frothy and blood-tinged sputum?

Administer high-flow oxygen therapy by face mask.

For which finding in a client with mitral valve stenosis would the nurse immediately notify the primary health care provider because of the potential for decompensation?

An irregular heart rhythm and ECG strip that indicate atrial fibrillation

Which essential medications would the nurse provide teaching about postoperatively for a client who received a prosthetic valve replacement?

Anticoagulants

What does the nurse suspect when assessing a client at risk for CVD who states, "my right foot turns very dark red when I sit too long and when I put my foot up, it turns pale?"

Arterial insufficiency

When the nurse assesses a client in the clinic for a physical examination and finds decreased skin temperature, what does this most likely indicate?

Arterial insufficiency

Which medications will the nurse expect the cardiologist to put on hold before an exercise stress test?

Atenolol and diltiazem

Before administering which class of drugs would the nurse always check the client's heart rate?

Beta blockers

Which exercise regimen would the nurse teach an older adult is best to meet guidelines for physical fitness to promote heart health?

Brisk walk for 20 to 30 minutes each day

Which complication is a client at most risk for when the nurse notes that excessive fluid was seen in the pericardial cavity on echocardiogram?

Cardiac tamponade

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?

Client with hypertension

Which clients are at greatest risk for development of infective endocarditis? Select all that apply.

Clients who are IV drug users Clients with poor dental health Clients with opioid addictions Clients with systemic alterations in immunity Clients postoperative after valve replacement

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.

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

CHAPTER 32

Concepts of Care for Patients with Cardiac Problems

What is the priority problem when a nurse assesses a client with CVD and notes skin that is pale, cool, and moist?

Decreased perfusion

Which statement best defines the cardiovascular concept of preload?

Degree of myocardial fiber stretch at the end of diastole and just before the heart contracts

Which is the most common and normal response by a client to a cardiovascular illness?

Denial

What assessment findings would the nurse expect to find in a client with right heart failure? Select all that apply.

Dependent edema Neck vein distention Hepatomegaly

Which statements about blood pressure are accurate? Select all that apply.

Diastolic blood pressure is primarily determined by the amount of peripheral vasoconstriction Systolic blood pressure is the amount of pressure or force generated by the left ventricle to distribute blood into the aorta with each contraction of the heart Paradoxical blood pressure is an exaggerated decrease in systolic pressure by more than 10 mm Hg during the inspiratory phase of the respiratory cycle

Which American Heart Association guidelines would the nurse teach a client to fight obesity and improve cardiovascular health? Select all that apply.

Don't consume more calories than you can use in a day Consume foods that contain vitamins, minerals, and fiber Choose foods that are healthy and low in calories Eat vegetables, fruit and whole-grain foods.

Which signs and symptoms would the nurse expect to assess when a client is diagnosed with aortic stenosis? Select all that apply.

Dyspnea on exertion Angina Harsh, systolic crescendo-decrescendo murmur Orthopnea

Which parameter indicates to the nurse that a client's exercise electrocardiogram (ECG) should be stopped?

ECG shows ST-segment depression

When the client asks the nurse about the best method of diagnosing heart failure, what teaching would the nurse provide?

Echocardiography

Which signs or symptoms would the nurse expect when assessing a client with chronic constrictive pericarditis? Select all that apply.

Exertional fatigue and dyspnea Dependent edema Hepatic engorgement

Which triad of symptoms would the nurse assess for in a woman at risk for cardiovascular disease? Select all that apply.

Feeling of abdominal fullness Chronic fatigue despite adequate rest Dyspnea or inability to catch her breath

Which techniques would the medical/surgical nurse use when inspecting a client's precordium? Select all that apply.

Look at the chest from the side, at a right angle, and downward over areas of the precordium where vibrations are visible. Note any movement over the aortic, pulmonic, and tricuspid areas. Observe for the location of the point of maximal impulse (PMI) and note any shift

What is the nurse's first action when the health care provider prescribes orthostatic blood pressure checks for a client?

Measure the blood pressure after the client has been supine for 3 minutes.

Which type of heart valvular disease does the nurse suspect when a client's assessment reveals pitting edema?

Mitral valve stenosis and regurgitation

What are the priority nursing actions related to caring for an older adult client with HF who is prescribed digoxin? Select all that apply.

Monitor the ECG strip for early signs of toxicity such as bradycardia. Auscultate the apical pulse heart rate and rhythm for a full minute before administering the drug. Observe for signs of toxicity, which are often nonspecific such as anorexia, fatigue, and blurred vision. Report any changes in heart rate or rhythm to the health care provider. Monitor serum digoxin and potassium levels. Check the health care provider's prescription for parameters to hold the drug.

Which may be causes of a client's pericardial friction rub? Select all that apply.

Myocardial infarction Cardiac tamponade Infection Inflammation Thoracotomy