Valvular problems, infective endocarditis, pericarditis, cardiomyopathy, Invasive Tx: CABG
Human valves, obtained from cadaver tissue donations are used for aortic and pulmonic valve replacement, are called homographs or__________
Allografts
6. Stroke volume plays an important part in cardiac output. Select all the factors below that influence stroke volume: A. Heart rate B. Preload C. Contractility D. Afterload E. Blood pressure
B. Preload C. Contractility D. Afterload
What valvular problem is characterized by a significantly widened pulse pressure? A. Mitral valve stenosis B .Mitral regurgitation C. Aortic regurgitation D. Aortic stenosis
C. Aortic regurgitation
5. ___________ is the amount of blood pumped by the left ventricle with each beat. A. Cardiac output B. Preload C. Afterload D. Stroke volume
D. Stroke volume
A patien has had a CABG and is being montiored in the ICU. What complications should the nurse monitor for that is associated with an alteration in preload? A. Hypertension B. Cardiac tamponade C. Elevated CVP D. Hypothermia
B. Cardiac tamponade The patient that has cardiac tamponade has a decreased blood pressure. Low preload.
17. A patient with heart failure is taking Losartan and Spironolactone. The patient is having EKG changes that presents with tall peaked T-waves and flat p-waves. Which of the following lab results confirms these findings? A. Na+ 135 B. BNP 560 C. K+ 8.0 D. K+ 1.5
C. K+ 8.0 The answer is C. Losartan and Spironolactone can both cause an increased potassium level (hyperkalemia). Losartan is an ARB and Spironolactone is a potassium-sparing diuretic. Therefore, the EKG changes are a sign of a high potassium level (normal potassium level is 3.5-5.1).
9. A patient with endocarditis has listed in their medical history "Roth Spots". You know that this is a complication of infective endocarditis and presents as? A. Non-tender spots found on the feet and hands B. Red and tender lesions found in the eyes C. Retinal hemorrhages with white centers D. Purplish spots found on the forearms and groin
C. Retinal hemorrhages with white centers The answer is C. Roth spots are found in the eyes as retinal hemorrhages with white centers.
Blood flows back from the left ventricle into the left atrium during systole is called what?
Mitral regurgitation
Which of the following is indicated for initial drug therapy in a patient newly diagnosed with uncomplicated hypertension (stage 1)? A. thiazide diuretic B. direct-acting vasodilator C. potassium- sparing diuretic D. calcium channel blocker
A. thiazide diuretic
1. True or False: The pericardium layer consists of a fibrous layer that is made up of two layers called the parietal and visceral layers. True False
False False: The pericardium layer consists of a fibrous layer and SEROUS layer that is made up of two layers called that parietal and visceral layers.
1. True or False: Endocarditis only affects the atrioventricular and semi-lunar valves in the heart. True False
False This statement is FALSE. Endocarditis can affect not only the heart valves but the interventricular septum and chordae tendineae as well.
Prevention of aortic regurgitation is primarily based on prevention or and treatment for ___ infections.
bacterial
Typical candidates for a heart transplant have severe symptoms uncontrolled by medical therapy, no other surgical options, and a prognosis of less than__________ years to live
2
2. Which of the following patients are MOST at risk for developing endocarditis? Select-all-that-apply: A. A 25 year old male who reports using intravenous drugs on a daily basis. B. A 55 year old male who is post-opt from aortic valve replacement. C. A 63 year old female who is newly diagnosed with hyperparathyroidism and is taking Aspirin. D. A 66 year old female who recently had an invasive dental procedure performed 1 month ago and is having a fever.
A. A 25 year old male who reports using intravenous drugs on a daily basis. B. A 55 year old male who is post-opt from aortic valve replacement. D. A 66 year old female who recently had an invasive dental procedure performed 1 month ago and is having a fever. Options A, B, and D are all risks for developing endocarditis. Remember that any thing that allows entry of bacteria into the system can potentially cause endocarditis. Option C is not relevant.
4. A 30 year old female is being treated for infective endocarditis with IV antibiotics. At the beginning of the hospitalization, the patient's symptoms were severe and sudden with a high fever but are now controlled. She has no significant health history other than 2 cesarean sections in the past. She is being prepped for a central line placement so she can be discharged home with home health to continue the 4 week antibiotic regime. What is type of infective endocarditis this classified as based on the information listed? A. Acute Infective Endocarditis B. Subacute Infective Endocarditis C. Non-infective Endocarditis D. Pericarditis
A. Acute Infective Endocarditis The answer is A. This is acute infective endocarditis. The key clues in this question are patient has no significant health history and signs and symptoms were sudden/severe. In subacute infective endocarditis, the patient will have a pre-existing condition that caused them to develop the IE and the symptoms are gradual and subtle.
A patient who had a CABG is exhibiting signs of cardiac failure. What nursing actions would be appropriate for this patient? Select all that apply A. Administration of furosemide B. Administration of digoxin C. Preparation of the patient for dialysis D. Administration of nitroprusside E. Administration of milrinone
A. Administration of furosemide Diuretic is appropriate B. Administration of digoxin Increases force of contraction E. Administration of milrinone
Orthostatic hypotension is a potential outcome for hypertensive drugs that places the elderly at risk for injury from falls. Instructions given to the patient to decrease this effect include which of the following? PLEASE SELECT ALL THAT APPLY A. Change position slowly when rising from bed or chair B. decrease dose until symptoms disappear C. Take the dose at bedtime D. increase fluid intake by 500mL/d
A. Change position slowly when rising from bed or chair C. Take the dose at bedtime CORRECT! Taking the dose at bedtime decreases the frequency of ambulation and the upright position. Changing position slowly decreases the occurrence of postural hypotension. A variety of lifestyle modifications to decrease the risk of falls should also be addressed by the nurse.
6. Select-all-that-apply: What are the typical signs and symptoms of infective endocarditis? A. Hyperthermia B. S4 gallop C. Enlarged Spleen D. Hyperkalemia E. Substernal pain that radiates to the back F. Heart failure G. Cardiac Murmur
A. Hyperthermia C. Enlarged Spleen F. Heart failure G. Cardiac Murmur The answer is A, C, F, and G. These are classic signs and symptoms of IE.
The nurse is for a client experiencing chronic heart failure. Which diagnostic test result require immediate follow up by the nurse? Select all that apply A. Potassium 3.3 mEq/L B. BUN 25 mg/dL C. Sodium 122 mEq/L D. Second degree heart block on ECG E. Magnesium 1.8 mEq/L F. Digoxin level 0.8 ng/ml
A. Potassium 3.3 mEq/L B. BUN 25 mg/dL C. Sodium 122 mEq/L D. Second degree heart block on ECG BUN L 7 to 20 mg/dl usually normal range Sodium Normal 135-145 Second degree heart block on ECG Dangerous heart block if second degree type 2
9. What conditions below can result in an increased cardiac afterload? Select all that apply: A. Vasoconstriction B. Aortic stenosis C. Vasodilation D. Dehydration E. Pulmonary Hypertension
A. Vasoconstriction B. Aortic stenosis E. Pulmonary Hypertension The answers are A, B, and E. Vasoconstriction increases systemic vascular resistance which will increase cardiac afterload. It will increase the pressure the ventricle must pump against to open the semilunar valves to get blood out of the heart. Aortic stenosis creates an outflow of blood obstruction for the ventricle (specifically the left ventricle) and this will increase the pressure the ventricle must pump against to get blood out through the aortic valve. Pulmonary hypertension increases pulmonary vascular resistance which will increase the pressure the right ventricle must overcome to open the pulmonic valve to get blood out of the heart....all of this increase cardiac afterload.
patient being treated with an ACE inhibitor could take which of the following drugs? PLEASE SELECT ALL THAT APPLY A. beta adrenergic blockers B. diuretics C. potassium D. calcium
A. beta adrenergic blockers B. diuretics D. calcium
The nurse is caring for a patient diagnosed with pericarditis. What serious complication should this patient be monitored for? A. cardiac tamponade B. Decreased venous pressure C. Left ventricular hypertrophy D. Hypertension
A. cardiac tamponade
"Several different groups of drugs function as antidysrhythmics. They are classified according to their mechanisms of action and effects on the conduction system, even though they differ in other respects. Some drugs have characteristics of more than one group. There are various types of antidysrhythmics: class I sodium channel blockers (quinidine, lidocaine), class II beta-adrenergic blockers (propranolol), class III potassium channel blockers (amiodarone), and class IV calcium channel blockers (diltiazem)" See pg. 528 Table 27.1 in The clinical uses of class III agents rather than class I agents is preferred for patients with heart disease because the class III agents are associated with: A. less ventricular fibrillation B. more sustained effects C. milder adverse effects D. increased mortality
A. less ventricular fibrillation
The nurse is providing discharge teaching to a client with dilated cardiomyopathy. Which statement by the client indicates the need for further education? A. "I am at risk for blood clots because I have atrial fibrillation." B. "I need to take the diuretic on the days my feet are swollen." C. " I will take the ACE inhibitor every day so my heart doesn't work as hard." D. "Going to cardiac rehabilitaion may help me manage my activities better."
B. "I need to take the diuretic on the days my feet are swollen." Meds should be taken everyday.
7. Patients with heart failure can experience episodes of exacerbation. All of the patients below have a history of heart failure. Which of the following patients are at MOST risk for heart failure exacerbation? A. A 55 year old female who limits sodium and fluid intake regularly. B. A 73 year old male who reports not taking Amiodarone for one month and is experiencing atrial fibrillation. C. A 67 year old female who is being discharged home from heart valve replacement surgery. D. A 78 year old male who has a health history of eczema and cystic fibrosis.
B. A 73 year old male who reports not taking Amiodarone for one month and is experiencing atrial fibrillation. Option B is the correct answer. Patients who are in an arrhythmia (especially a-fib) are at risk for developing heart failure because the heart is not contracting properly and blood is pooling in the chambers.
19. Select all the correct statements about the pharmacodynamics of Beta-blockers for the treatment of heart failure: A. These drugs produce a negative inotropic effect on the heart by increasing myocardial contraction. B. A side effect of these drugs include bradycardia. C. These drugs are most commonly prescribed for patients with heart failure who have COPD. D. Beta-blockers are prescribed with ACE or ARBs to treat heart failure.
B. A side effect of these drugs include bradycardia. D. Beta-blockers are prescribed with ACE or ARBs to treat heart failure.
20. You are assisting a patient up from the bed to the bathroom. The patient has swelling in the feet and legs. The patient is receiving treatment for heart failure and is taking Hydralazine and Isordil. Which of the following is a nursing priority for this patient while assisting them to the bathroom? A. Measure and record the urine voided. B. Assist the patient up slowing and gradually. C. Place the call light in the patient's reach while in the bathroom. D. Provide privacy for the patient.
B. Assist the patient up slowing and gradually. The answer is B. The best answer for this particular question is option B. All the options are important for the nurse to perform. However, Hydralazine (vasodilator) and Isordil (nitrate) can cause orthostatic hypotension. The patient should transfer slowly and gradually to decrease dizziness and the risk of falling.
8. A 74 year old female presents to the ER with complaints of dyspnea, persistent cough, and unable to sleep at night due to difficulty breathing. On assessment, you note crackles throughout the lung fields, respiratory rate of 25, and an oxygen saturation of 90% on room air. Which of the following lab results confirm your suspicions of heart failure? A. K+ 5.6 B. BNP 820 C. BUN 9 D. Troponin <0.02
B. BNP 820 The answer is option B. BNP (b-type natriuretic peptide) is a biomarker released by the ventricles when there is excessive pressure in the heart due to heart failure. <100 no failure, 100-300 present, >300 pg/mL mild, >600 pg/mL >moderate, 900 pg/mL severe
8. A patient has a blood pressure of 220/140. The physician prescribes a vasodilator. This medication will? A. Decrease the patient's blood pressure and increase cardiac afterload B. Decrease the patient's blood pressure and decrease cardiac afterload C. Decrease the patient's blood pressure and increase cardiac preload D. Increase the patient's blood pressure but decrease cardiac output.
B. Decrease the patient's blood pressure and decrease cardiac afterload The answer is B. The patient has a high systemic vascular resistance...as evidence by the patient's blood blood....there is vasoconstriction and this is resulting in the high blood pressure. Therefore, right now, the cardiac afterload is high because the ventricle must overcome this high pressure in order to pump blood out of the heart. If a vasodilator is given, it will decrease the blood pressure (hence the systemic vascular resistance) and this will decrease the cardiac afterload. The amount of the pressure the ventricle must pump against will decrease (cardiac afterload decrease) because the blood pressure will go down (hence the systemic vascular resistance).
3. Select-all-that-apply: Which of the following are NOT typical signs and symptoms of pericarditis? A. Fever B. Increased pain when leaning forward C. ST segment depression D. Pericardial friction rub E. Radiating substernal pain felt in the left shoulder F. Breathing in relieves the pain
B. Increased pain when leaning forward C. ST segment depression F. Breathing in relieves the pain The answers are B, C, and F. These are findings NOT found in pericarditis. B is wrong because leaning forward actually helps relieve pain felt in pericarditis (supine position makes it worst). C is wrong because ST segment ELEVATION is seen not depression. F is wrong because inspiration (breathing in) increases the pain felt with pericarditis.
A. It is important patients with heart failure notify their physician if they gain more than 6 pounds in a day or 10 pounds in a week. B. Patients with heart failure should receive an annual influenza vaccine and be up-to-date with the pneumonia vaccine. C. Heart failure patients should limit sodium intake to 2-3 grams per day. D. Heart failure is exacerbated by illness, too much fluid or sodium intake, and arrhythmias. E. Patients with heart failure should limit exercise because of the risks.
B. Patients with heart failure should receive an annual influenza vaccine and be up-to-date with the pneumonia vaccine. C. Heart failure patients should limit sodium intake to 2-3 grams per day. D. Heart failure is exacerbated by illness, too much fluid or sodium intake, and arrhythmias. The answers are B, C, and D. Option A is wrong because heart failure patients should notify their doctor if they gain 2-3 pounds in a day or 5 pounds in a week, and option E is wrong because exercise is important for heart failure patients to help strengthen the heart muscle...so they should exercise as tolerated.
1. Which statement below best describes the term cardiac preload? A. The pressure the ventricles stretch at the end of systole. B. The amount the ventricles stretch at the end of diastole. C. The pressure the ventricles must work against to pump blood out of the heart. D. The strength of the myocardial cells to shorten with each beat.
B. The amount the ventricles stretch at the end of diastole.
4. A patient with hypovolemic shock is given IV fluids. IV fluids will help _________ cardiac output by: A. decrease; decreasing preload B. increase, increasing preload C. increase, decreasing afterload D. decrease, increasing contractility
B. increase, increasing preload
5. You are providing discharge teaching to a patient being discharged home after hospitalization with pericarditis. The physician has ordered the patient to take Colchicine. Which of the following statements indicates the patient did NOT understand the education you provided? A. "I can take this medication with or without food." B. "I will notify the doctor immediately if I start experiencing nausea, vomiting, or stomach pain while taking this medication." C. "I like to take all my medications in the morning with grapefruit juice." D. "This medication is also used to treat patients with gout."
C. "I like to take all my medications in the morning with grapefruit juice." The answer is C. Patients should not take Colchicine with grapefruit juice because it increases the amount of Colchicine the body absorbs (causing an increased chance of Colchicine toxicity). This medication can be taken WITH or WITHOUT food.
7. You're providing discharge teaching to a patient being treated for endocarditis. Which statement by the patient demonstrated they understood your teaching about this condition? A. "I will stop taking the antibiotics once my fever is gone in order to prevent antibiotic resistance." B. "I will only wash my hands with soap and water." C. "I will inform my dentist about my history of endocarditis prior to any invasive procedures." D. "I will avoid eating fish and organ meats."
C. "I will inform my dentist about my history of endocarditis prior to any invasive procedures." The answer is C. Patients should finish all antibiotics doses and never stop taking them in the middle of treatment because this increases antibiotic resistances. Also, the patient should maintain good oral hygiene and should go to the dentist regularly for cleanings. However, it is very important the patient inform all other healthcare practitioners about their history of endocarditis because they will need prophylactic antibiotics therapy prior to any invasive procedures to prevent acquiring endocarditis again. Option D is incorrect.
2. A patient is hospitalized with chronic pericarditis. On assessment, you note the patient has pitting edema in lower extremities, crackles in lungs, and dyspnea on excretion. The patient's echocardiogram shows thickening of the pericardium. This is known as what type of pericarditis? A. Pericardial effusion B. Acute pericarditis C. Constrictive pericarditis D. Effusion-Constrictive pericarditis
C. Constrictive pericarditis The answer is C. This describes constrictive pericarditis. The key words in this question are: the patient's signs and symptoms which indicate heart failure (a common finding with patients who have constrictive pericarditis) and that the echo showed "thickening" of the pericardium.
14. A patient taking Digoxin is experiencing severe bradycardia, nausea, and vomiting. A lab draw shows that their Digoxin level is 4 ng/mL. What medication do you anticipate the physician to order for this patient? A. Narcan B. Aminophylline C. Digibind No medication because this is a normal Digoxin level.
C. Digibind The answer is C. The patient is experiencing Digoxin toxicity...therefore the physician will order the antidote for Digoxin which is Digibind.
A patient is admitted with suspected cardiomyopathy. What diagnostic test would be most helpful with the identification of this disorder? A. Serial enzyme studies B. Phonocardiagram C. Echocardiogram D. Cardiac Catherization
C. Echocardiogram The structures and the functions of the ventricles can be easily observed with an ECHO
7. Which treatments below would decrease cardiac preload? Select all that apply: A. IV fluid bolus B. Norepinephrine C. Nitroglycerin D. Furosemide
C. Nitroglycerin D. Furosemide The answers are C and D. Nitroglycerin is a vasodilator that will dilate vessels, which will decrease venous return to the heart and this will decrease preload. Furosemide is a diuretic which will remove extra fluid from the body via the kidneys. This will decrease venous return to the heart and decrease preload. An IV fluid bolus and Norepinephrine (a vasoconstrictor) will increase venous return to the heart and increase preload.
3. A patient is receiving treatment for infective endocarditis. The patient has a history of intravenous drug use and underwent mitral valve replacement a year ago. The patient is scheduled for a transesophageal echocardiogram tomorrow. On assessment, you find tender, red lesions on the patient's hands and feet. You know that this is a common finding in patients with infective endocarditis and is known as? A. Janeway Lesions B. Roth Spots D. Trousseau's Sign
C. Osler's Nodes Answer is C...Osler's Nodes. They are TENDER, red lesions on the hands and feet. Don't get this confused with Janeway Lesions which are NON-TENDER, red lesions on the PALMS of the hands and SOLES of the feet. Roth spots are retinal hemorrhages with white centers and Trousseau's Sign is found in hypocalcemia.
4. You are providing care to a patient with pericarditis. Which of the following is NOT a proper nursing intervention for this patient? A. Monitor the patient for complications of cardiac tamponade. B. Administer Ibuprofen as scheduled. C. Place the patient in supine position to relieve pain. D. Monitor the patient for pulsus paradoxus and muffled heart sounds.
C. Place the patient in supine position to relieve pain. The answer is C. Placing the patient in supine position is not a proper nursing intervention for a patient experiencing pericarditis because this increases pain. The high Fowler's position or leaning forward is the best position for a patient with pericarditis.
Mr. Conley, who is 53 yrs. old is about to be discharged from the hospital after treatment for recurrent ventricular fibrillation. To prevent break through ventricular ectopy, his prescriber orders amiodarone, 1000mg PO daily as a loading dose for 2 weeks. What patient teaching implications are important regarding this loading dose? A. Males require large dosages because of their faster metabolic rate. B. Most of the drug is destroyed in the gastrointestinal tract and thus a large dose needs to be given. C. The drug has a long serum half-life. D. A history of bentricular dysrhythmia necessitates a higher dose
C. The drug has a long serum half-life. Amiodarone is highly lipid soluble, and the drug and it's metabolites accumulate in the liver, fat, skin, and other tissues. With IV administration, the onset of action usually is within several hours. With oral administration, the onset of action may be delayed from a few days up to a week or longer. However, because of the long serum half life of amiodarone, loading doses are often given; higher loading doses can reduce the time required for therapeutic effects. Low doses (100-200 mg/d) may prevent recurrence of atrial fibrillation with less toxicity than higher doses.
5. A patient is admitted with sepsis. The patient has a temperature of 104.2 'F and is experiencing chills. On assessment, you note a mitral murmur which the patient states they've never had before, and dark, small lines on the patient's fingernails. The patient has a history of IV drug use in the past. However, the patient states they are no longer using drugs. The physician suspects possible infective endocarditis. What diagnostic test do you expect the physician to order in order to confirm the presence of infective endocarditis? A. Abdominal ultrasound B. Heart catheterization C. Transesophageal echocardiogram D. White blood cell count
C. Transesophageal echocardiogram The answer is C. Transesophageal echocardiogram (TEE) is an ultrasound performed to look at the back side of the heart and assesses the valve structure. It is a test used to diagnose vegetations found on the valves. All the other options do not confirm endocarditis.
A patient with a history of hypertension come to the emergency department with double vision and blood pressure of 240/120 mm Hg. The physician on call orders sodium nitroprusside (Nitropress) by continuous infusion, with continual blood pressure monitoring. This drug's immediate action is to lower blood pressure by which of the following mechanisms? A. increasing peripheral vascular resistance B. increasing cardiac output C. dilating venous and arterial vessels D. decreasing heart rate
C. dilating venous and arterial vessels Niroprusside is a potent vasodilator that decreases peripheral vascular resistance. The drug is given by continuous intravenous (IV) infusion and requires continuous blood pressure monitoring, most effectively by intra-arterial monitoring.
In administering a newly initiated order for captopril, an ACE inhibitor, discharge instructions should indicate that which of the following adverse effects is most common? A. constipation B. muscle weakness C. dry, nonproductive, persistent cough D. tinnitus
C. dry, nonproductive, persistent cough All ACE-inhibitors can commonly cause a nonproductive cough and a tickling in the throat. Approximately 10-20% of clients experience this minor but annoying side effect. The cough resolves when the drug is discontinued.
7. You are providing care to a patient experiencing chest pain when coughing or breathing in. The patient has pericarditis. The physician has ordered the patient to take Ibuprofen for treatment. How will you administer this medication? A. strictly without food B. with a full glass of juice C. with a full glass of water D. with or without food
C. with a full glass of water The answer is C. Ibuprofen should be taken with a full glass of water to prevent GI problems, such as ulcers or bleeding.
16. These drugs are used as first-line treatment of heart failure. They work by allowing more blood to flow to the heart which decreases the work load of the heart and allows the kidneys to secrete sodium. However, some patients can develop a nagging cough with these types of drugs. This description describes? A. Beta-blockers B. Vasodilators C. Angiotensin II receptor blockers D. Angiotensin-converting-enzyme inhibitors
D. Angiotensin-converting-enzyme inhibitors The answer is D. This is a description of ACE inhibitors (option D).
18. During your morning assessment of a patient with heart failure, the patient complains of sudden vision changes that include seeing yellowish-green halos around the lights. Which of the following medications do you suspect is causing this issue? A. Lisinopril B. Losartan C. Lasix D. Digoxin
D. Digoxin The answer is D. Yellowish-green halos/vision changes are classic signs of Digoxin toxicity.
2. Select the statement below that best describes cardiac afterload: A. It's the volume amount that fills the ventricles at the end of diastole. B. It's the volume the ventricles must work against to pump blood out of the body. C. It's the amount of blood the left ventricle pumps per beat. D. It's the pressure the ventricles must work against to open the semilunar valves so blood can be pumped out of the heart.
D. It's the pressure the ventricles must work against to open the semilunar valves so blood can be pumped out of the heart.
Ms. Ferguson, age 58, is admitted to the coronary care unit for treatment of an acute anterior myocardial infarction. That evening, she experiences frequent episodes of ventricular tachycardia. The provider tells the nurse to prepare an IV bolus dose of lidocaine. Why is lidocaine administered intravenously at this time- and not orally? A. The onset of action for oral lidocaine is greater than 8 hours B. Lidocaine is inactivated by hydrochloric acid C. Lidocaine absorption is too erratic when administered orally D. Most of an absorbed oral dose of lidocaine undergoes first-pass metabolism in the liver
D. Most of an absorbed oral dose of lidocaine undergoes first-pass metabolism in the liver
6. A patient with severe pericarditis has developed a large pericardial effusion. The patient is symptomatic. The physician orders what type of procedure to help treat this condition? A. Pericardiectomy B. Heart catheterization C. Thoracotomy D. Pericardiocentesis
D. Pericardiocentesis The answer is D. The physician will probably order a pericardiocentesis. This is a procedure to remove excessive fluid from the pericardial sac.
A patient in the ICU after cardiac surgery begins to have extremity paresthesia, peaked T waves, and mental confusion. What type of electrolyte imbalance should the nurse assess the patient for? A. Magnesium B. Sodium C. Calcium D. Potassium
D. Potassium Signs and symptoms of hyperkalemia.
8. A patient being treated for infective endocarditis is complaining of very sharp radiating abdominal pain that goes to the left shoulder and back. As the nurse familiar with complications of infective endocarditis, what do you suspect is the cause of this patient finding? A. Renal embolic event B. Pulmonary embolic event C. Central nervous system embolic event D. Splenic embolic event
D. Splenic embolic event The answer is D. These are classic signs and symptoms of a splenic embolic event. The patient with endocarditis is at risk for renal, pulmonary, central nervous system, or spleen emboli. Renal emboli would present with flank pain with pus or blood in the urine. Pulmonary emboli would present with dyspnea, chest pain, or shortness of breath, and CNS emboli would present with confusion or difficulty speaking.
Single- drug therapy with an ARB would be least effective in which of the following groups? A. people of Caucasian descent B. people of Asian descent C. people of Hispanic descent D. people of African descent
D. people of African descent CORRECT! ARBs, ACE-I, and beta blockers are less effective as monotherapy in African Americans. Overall, African Americans are more likely to have severe hypertension and require multiple drugs as a result of having low circulating renin, increased salt sensitivity, and a higher incidence of obesity.
8. On physical assessment of a patient with pericarditis, you may hear what type of heart sound? A. S3 or S4 B. mitral murmur C. pleural friction rub D. pericardial friction rub
D. pericardial friction rub The answer is D. A common sign of pericarditis is being able to auscultate a pericardial friction rub.
6. A patient has a history of heart failure. Which of the following statements by the patient indicates the patient may be experiencing heart failure exacerbation? A. "I've noticed that I've gain 6 lbs in one week." B. "While I sleep I have to prop myself up with a pillow so I can breathe." C. "I haven't noticed any swelling in my feet or hands lately." D. Options B and C are correct. E. Options A and B are correct. F. Options A, B, and C are all correct.
E. Options A and B are correct. The answer is E. Options A and B are classic signs and symptoms a patient may experience with heart failure exacerbation.
(T/F) Mitral valve prolapse is a deformity that usually produces no symptoms
True
(T/F) Often the first and only sign of mitral valve prolapse is an extra heart sound, referred to as a diastolic click
True
(T/F) The most characteristic clinical manifestation of pericarditis is a creaky or scratchy friction rub that can be clearly heard during auscultation to the left lower sternal border
True
(T/F) the pathophysiology of all cardiomyopathies is a series of events that culminates in impaired cardiac output.
True
10. True or False: Pulmonary and systemic vascular resistance both play a role with influencing cardiac afterload. True False
True The answer is True. If pulmonary vascular resistance or systemic vascular resistance is high, it will create an increased cardiac afterload. If pulmonary vascular resistance or systemic vascular resistance is low, it will create a decreased cardiac afterload.
The the most common valvuloplasty procedure is a__________
commissurotomy
The first symptom of mitral stenosis often is _____ as a result of pulmonary venous hypertension.
dyspnea on exertion
When valves do not open completely, a condition called ________________________________________ occurs, and blood flow through the valve is reduced.
stenosis
