Chapter 17/18
The nurse is assessing a female patient with a family history of coronary artery disease (CAD). Which report is most concerning to the nurse?
"I stay tired all of the time, and it feels like my bra is too tight."
The nurse is caring for a patient who is scheduled to undergo a stress echocardiogram. Which statement indicates that the nurse's teaching about preparation for the test has been successful?
"I will have to move extremely quickly from the treadmill to the table."
The nurse is teaching a patient about the purpose of his telemetry. Which statement indicates that the nurse's teaching has been successful?
"The nurses will be able to monitor my heart rate and rhythm."
An 86-year-old patient asks why her ankles have a brownish discoloration and the skin looks thick. Which response best addresses the patient's concern?
"The valves in the vessels in your legs aren't working as well as they used to, which causes the discoloration and thickening of your skin."
Which blood pressure findings constitute a diagnosis of hypertension?
140/90 × 2, 2 weeks apart
When using a 0 to 4+ scale to grade pulse quality, how should the nurse record a normal volume pulse?
3+
The nurse is caring for a patient with a blood pressure of 140/90, an apical pulse of 82, and a radial pulse of 76. Which value indicates that the nurse accurately calculated the patient's pulse pressure?
50
The student nurse is planning a community group presentation on hypertension. Which group of individuals should the student identify as having the highest incidence of hypertension?
African Americans
The nurse is caring for a patient with peripheral arterial disease who complains of 3/10 pain in the lower extremities. The nurse observes a 0.5 cm × 1 cm ulcer on the left lower leg, and the lower legs are shiny and hairless bilaterally. The nurse identifies which priority problem statement/nursing diagnosis?
Altered skin integrity related to ulcers on lower extremities.
The nurse is caring for an 80-year-old long-resident in a term care facility. Which intervention(s) should the nurse plan to enhance blood flow? (Select all that apply.)
Apply light blankets over legs while sitting. Elevate legs frequently. Encourage walking. Maintain a warm environment.
Which medication is the most common and effective antiplatelet aggregation agent?
Aspirin
The patient asks if it is harmful for him to drink a glass of wine with dinner on a daily basis. Which is the nurse's best response?
"As long as it is okay with your physician, moderate alcohol intake can be beneficial to your cardiovascular health."
The nurse is caring for a patient with a history of hypertension. Which information is most important for the nurse to obtain?
"Do you use over-the-counter decongestants or diet pills?"
The nurse is caring for a patient who underwent endovenous laser treatment. Which statement indicates that the nurse's teaching about postprocedure management has been successful?
"I should walk at least an hour every day for 2 weeks."
The 65-year-old patient complains of leg pain that disappears at rest after having walked a short distance. The nurse recognizes that the patient's symptoms are consistent with which problem?
Claudication
Which disorder(s) is/are examples of congenital heart defects? (Select all that apply.)
Coarctation of the aorta Septal defects Valvular defects
The nurse is caring for a patient diagnosed with an abdominal aortic aneurysm who complains of sudden, intense abdominal pain and light-headedness. What action should the nurse take next?
Contact the physician immediately.
The nurse is caring for a 75-year-old patient with a history of diabetes and peripheral vascular disease (PVD). The nurse observes an inflamed and excoriated area on the patient's right shin. Which intervention should the nurse perform first?
Cover with clear occlusive dressing.
Which intervention(s) is/are important for a patient with venous insufficiency? (Select all that apply.)
Elevate feet to reduce edema. Apply elastic compression wraps twice daily.
Which preventative measure(s) may protect against development of cardiovascular disease? (Select all that apply.)
Exercising regularly for at least 30 minutes a day Maintaining high-density lipoprotein (HDL) greater than 50 mg/dL Refraining from smoking Obtaining and maintaining a healthy weight
Which factors may affect the volume of cardiac output? (Select all that apply.)
Heart rate c. Preload d. Contraction strength e. Afterload
The nurse is caring for a patient with a deep venous thrombosis (DVT). Which finding requires the nurse's immediate attention?
Hemoptysis
The home health nurse is caring for a patient with a blood pressure reading of 200/160. The patient denies any discomfort. The nurse should immediately contact the health care provider to report that the patient is experiencing which problem?
Hypertensive crisis
The nurse is teaching a patient who takes warfarin (Coumadin) about a coagulation monitoring device. Which blood clotting time should the device monitors?
INR
The nurse is caring for a patient who has a new prescription for a loop diuretic. Which nutritional intervention is most important for the nurse to add to the care plan?
Increase intake of bananas and potatoes.
The 85 year old patient with a newly diagnosed heart murmur expresses concern that he has never been notified of this finding before . What is most likely the cause of this patients heart murmur?
Insufficient valves
The nurse is outlining a teaching program for diabetic patients. Which teaching point about heart disease prevention should the nurse emphasize most?
Keep blood sugar below 100 mg/dL.
The nurse is caring for an older adult patient. While auscultating the patient's apical pulse, the nurse notices an irregular rhythm. The nurse suspects which causative factor for the patient's dysrhythmia?
Loss of cells in the sinoatrial (SA) nodes
The nurse is caring for a patient with peripheral vascular disease (PVD). The nurse understands that which age-related changes may cause PVD? (Select all that apply.)
Loss of elasticity in vessel walls Atherosclerotic changes in vessels Sedentary practices Weakened leg muscles
The nurse is teaching a pregnant patient who works as a cashier in a grocery store about varicose vein prevention. Which instruction is most important for the nurse to include in the teaching plan?
March in place while standing at the counter.
Which layer of the heart contains muscle fibers that contract to pump blood?
Myocardium
Which findings characterize peripheral vascular disease (PVD)? (Select all that apply.)
Narrowed arteries Obstructed veins Defective valve function Thrombophlebitis
24. Which words compose part of the "5 Ps" of arterial disease? (Select all that apply.)
Pain Paresthesia pallor
The nurse is caring for a patient with a history of peripheral arterial disease. The patient complains of significant claudication, and findings of an ankle-brachial index are abnormal. The nurse anticipates that this patient will most likely require which type of procedure?
Percutaneous transluminal angioplasty (PTA)
In a blood pressure of 120/80 what does 80 indicate
Pressure in relaxed ventricles Diastolic
The nurse is caring for a 50-year-old patient who complains of tingling in his toes. Which other assessment finding would cause the nurse to suspect arterial insufficiency?
Shiny, hairless legs
The nurse is educating an older adult patient who is taking antihypertensives with diuretics. Which information regarding safety precautions is most important for the nurse to include?
Sit on the side of the bed before standing.
Which modifiable risk factors increase a patient's risk for heart disease? (Select all that apply.)
Smoking, obesity, and sedentary lifestyle are modifiable risk factors
Which factor(s) may be useful in preventing peripheral vascular disease (PVD)? (Select all that apply.)
Stress relief Diabetes control Weight control Routine exercise Smoking cessation
Which problems are potential complications of uncontrolled hypertension? (Select all that apply.)
Stroke Kidney failure Heart attack Congestive heart failure
nurse is caring for a patient with a compression dressing. Which action indicates appropriate wound care?
The nurse places a compression dressing over the wound dressing.
The nurse is caring for a patient who just returned from a transradial heart catheterization. Which action indicates the priority care for the postprocedure period?
The nurse places the pulse oximeter on the thumb or first digit of the affected hand.
While performing a focused cardiac assessment, the nurse auscultates an abnormal swooshing sound. Which action is most appropriate to clarify the nurse's finding?
The nurse uses the bell of the stethoscope while asking the patient to lean forward.
The nurse is caring for a patient on linsinopril (Zestril) . The patient asks how the medication affects blood pressure. Which response best explains this medication effects
This medication lower blood pressure by blocking an enzyme that causes blood vessels to constrict
Which statement accurately describes the purpose of a Doppler flow study?
To visualize obstructions in leg vessels
The nurse is caring for a patient with Raynaud disease who is employed as a construction worker, has hypertension, and smokes one-half to one pack of cigarettes per day. What teaching points should the nurse include in discharge instructions? (Select all that apply.)
Wear gloves when handling cold items. Wear insulated socks when sqworking in cool weather. Attend a smoking program. Use a heating pad to stay warm.
The nurse is educating a female pt with a family history of coronary artery disease about risk factors and prevention of disease in women . Which information is most important for the nurse to include
Women should incorporate stress reduction techniques into their daily lifestyle
_________ is the acute symptom most experienced by African Americans when having a myocardial infarction (MI).
dyspnea
The nurse who uses a regular sized adult blood pressure cuff on a large adult will get a blood pressure reading that is falsely __________.
elevated/ high
The nurse is caring for a patient with a deep venous thrombosis (DVT). Which medication would likely be used for initial inpatient treatment?
heparin
The nurse assessing the heart places the stethoscope between the fifth and sixth ribs at the mid-clavicular line to hear the point of _________.
maximal impulse
The patient has been prescribed a low-sodium diet. Which food choice indicates that the patient requires additional teaching?
pickles
When the nurse uses the PQRST tool for pain assessment, the "R" prompts an inquiry about the __________ of the pain.
radiation
The patient who has a history of smoking and alcohol abuse is most likely to develop __________ hypertension.
secondary