Cardiovascular Disorders Exam 3
A client is admitted to the hospital displaying sinus bradycardia, nausea, anorexia, and blurred vision. What should the nurse suspect this client to be experiencing?
digoxin toxicity
When caring for a child diagnosed with a ventricular septal defect, how would the nurse describe this condition when talking with the parents?
failure of a septum to develop completely between the ventricles
The nurse is instructing a client about the use of antiembolism stockings. Antiembolism stockings help prevent deep vein thrombosis (DVT) by:
forcing blood into the deep venous system.
A nurse is caring for a hypertensive client who has been placed on a low-sodium diet. Which menu selection demonstrates the client's understanding of this diet?
fresh green beans and chicken salad
When gathering data from a client admitted with hypertension, the nurse should expect the client to report which symptom?
headache
Before discharge, which instruction should the nurse give to a client receiving digoxin?
"Call the physician if your heart rate goes above 120 beats/minute."
When obtaining data from a child with suspected Kawasaki disease, which symptom is common?
"strawberry tongue"
A client who is being treated for unilateral lower extremity deep vein thrombophlebitis is being discharged. Which statement made by the client indicates to the nurse that additional discharge education is needed?
"Tight compression hose rolled down behind the knee won't fall down and improves the circulation in my legs."
At a staff meeting, a nurse-manager states that the unit performance improvement committee will perform a concurrent audit of the documentation of all coronary artery bypass clients' clinical pathways weekly for 4 weeks. A nurse asks why this is necessary. Which response is the best explanation of the audit's purpose?
"Audits are an evaluation tool used to improve compliance with hospital policy and standards."
The nurse is reinforcing teaching with a client who has a new order for the medication enoxaparin. The nurse determines the client needs further instruction when the client makes which statement?
"I need to have my partial prothrombin time (aPTT) monitored everyday while on enoxaparin."
Propranolol has been prescribed for a teen who has been diagnosed with hypertension. When discussing the medication with the teen, which statement indicates the need for further instruction?
"I should take this medication daily on an empty stomach."
The parents of a 3-year-old with a congenital heart disease report during a checkup that they are concerned about giving a flu vaccine to their child. Which statement is appropriate for inclusion in the nurse's response?
"The flu vaccine is both safe and recommended to children who have chronic illness such as heart disease."
A client with a history of hypertension had a total hip replacement. The health care provider prescribes hydrochlorothiazide 35 mg oral solution by mouth once per day. The label on the solution reads hydrochlorothiazide 50 mg/5 mL. To administer the correct dose, how many milliliters should the nurse pour? Record your answer using one decimal place.
3.5
A client admitted to the hospital for an abdominal aneurysm repair tells a nurse that he has an advance directive. What action should the nurse take?
Ask the client for a copy of the advance directive to place on his chart.
A nurse has administered enalapril to a client. What intervention should the nurse perform to accurately determine the effectiveness of this drug?
Check blood pressure 1 hour after administration.
A client is evaluated for hypertension. The physician prescribes atenolol, 50 mg by mouth daily. Atenolol should have which therapeutic effect on the client?
Decreased cardiac output and systolic and diastolic blood pressure
A client is recovering from coronary artery bypass graft (CABG) surgery. Which nursing diagnosis takes highest priority at this time?
Decreased cardiac output related to depressed myocardial function, deficient fluid volume, or impaired electrical conduction
A client diagnosed with acute arterial occlusive disease is scheduled to undergo an atherectomy. What is the priority nursing intervention for this client immediately after the procedure?
Closely monitor catheter site for bleeding.
For a client with cardiomyopathy, the highest priority nursing diagnosis is:
Decreased cardiac output related to reduced myocardial contractility.
The nurse is caring for a client who has been receiving anticoagulant therapy for deep vein thrombosis (DVT). Before discharge, which activities does the nurse reinforce for the client to continue at home? Select all that apply.
Dorsiflex both feet when reclining. Increase walking. Elevate affected leg when reclining.
A client taking a new prescription for propranolol calls the clinic to report a weight gain of 3 lb (1.36 kg) within 2 days, shortness of breath, and swollen ankles. What is the nurse's best action?
Due to fluid accumulation, have the client assessed for worsening heart failure by the health
A client taking a new prescription for propranolol calls the clinic to report a weight gain of 3 lb (1.36 kg) within 2 days, shortness of breath, and swollen ankles. What is the nurse's best action?
Due to fluid accumulation, have the client assessed for worsening heart failure by the health care provider.
A white male, age 43, is admitted to an acute care facility with a tentative diagnosis of infective endocarditis. His medical history reveals diabetes mellitus, hypertension, and pernicious anemia; he underwent an appendectomy 20 years ago and an aortic valve replacement 2 years ago. Which history finding is a major risk factor for infective endocarditis?
History of aortic valve replacement
Which statement by the client best indicates an understanding on how to prevent complications while taking warfarin?
I should use a soft toothbrush
A nurse is attempting to administer lisinopril to a client. The client refuses to take the pill, stating that in the past he developed a rash as an allergic reaction to the medication. Which of the following is the best response by the nurse?
I will call the physician with this information
A nurse is reinforcing education for a client with a family history of atherosclerosis. To decrease the risk of atherosclerosis, what should the nurse encourage the client to do?
Increase activity level
A client experiences orthostatic hypotension while receiving furosemide to treat hypertension. How should the nurse intervene?
Instruct the client to flex the calf muscles and then sit up for several minutes before standing.
The nurse is discussing bacterial/infective endocarditis with the parent of a teen who has been diagnosed with the disorder. Which statement about bacterial/infective endocarditis indicates an understanding of the condition?
It is an infection of the valves and inner lining of the heart.
The nurse is caring for a child with heart failure. What should the nurse recognize when monitoring administration of oxygen to avoid complications?
Oxygen decreases the work of breathing.
A nurse is monitoring a client who has just returned from a cardiac catheterization. Which is an appropriate nursing intervention?
Palpate the peripheral pulses.
An average-weight client reports of generalized steady abdominal pain. The nurse should suspect an abdominal aortic aneurysm, if the abdominal pain is accompanied by which finding?
Pulsating mass in the periumbilical area
A client is admitted to the health care facility for treatment of an abdominal aortic aneurysm. When planning this client's care, the nurse formulates interventions with which goal in mind? You Selected:
Stabilizing the heart rate and blood pressure and easing anxiety
A child returns to the unit after a cardiac catheterization. The nurse should reinforce education for the child and parents on which point regarding mobility?
The child will be maintained on bed rest with the affected extremity immobilized.
After abdominal surgery, which factor would predispose a client to deep vein thrombosis?
The client will be immobile during and shortly after surgery.
The nurse is reinforcing discharge instructions for a client with varicose veins. Which statement by the client indicates a need for further instruction?
Wearing tight clothes won't affect me.
The nurse has reinforced education about angina to a client who has pain from angina. Which statement made by the client indicates a need for further teaching? You Selected:
angina pain can be relieved by nitroglycerin
A client has a blockage in the proximal portion of a coronary artery. After learning about treatment options, the client decides to undergo percutaneous transluminal coronary angioplasty (PTCA). During this procedure, the nurse expects which medication to be administered to the client?
anticoagulant
The nurse correctly instructs a client with peripheral vascular disease that stress-reduction techniques:
are helpful because stress stimulates the release of vasoconstricting catecholamines.
A nurse receives a report on a client who has been diagnosed with an abdominal aortic aneurysm (AAA). The nurse would expect the client to have which underlying disease?
atherosclerosis
The licensed practical nurse discovers a client with a pulse rate of 40 beats/minute. His blood pressure is 80/50 mm Hg and he reports dizziness. Which medication would the registered nurse use to treat the client's bradycardia?
atropine
Which precaution should a nurse take when caring for a client with a myocardial infarction (MI) who has received a thrombolytic agent?
avoid puncture wounds
A client is receiving nitroglycerin ointment to treat angina pectoris. The nurse evaluates the therapeutic effectiveness of this drug by assessing the client's response and checking for adverse effects. Which vital sign is most likely to reflect an adverse effect of nitroglycerin?
blood pressure
Which factor is an important part of observing a child with a possible cardiac anomaly?
blood pressure in all 4 extremities
Which potential side effects should the nurse include when assisting in discharge teaching of a male client who was started on atenolol?
causes and treatments for erectile dysfunction
A child with tetralogy of Fallot has clubbing of the fingers and toes. The nurse understands that this finding is related to which condition?
chronic hypoxia
The nurse is monitoring laboratory studies for a client who had a myocardial infarction. Which test will the nurse monitor that is most indicative of cardiac damage?
creatine kinase isoenzymes (CK-MB)
The nurse cares for a client on the first postoperative day after repair of an abdominal aortic aneurysm. Which finding requires additional collaboration with the RN?
decreased urine output
A nurse obtaining data from a client observes jugular vein distention (JVD). Which condition does the nurse suspect this client to have?
heart failure
A client is placed on a medication to stimulate the sympathetic nervous system. Which response should the nurse expect from this medication?
heart rate increase from 60 to 80 bpm
A client is placed on a medication to stimulate the sympathetic nervous system. Which response should the nurse expect from this medication?
heart rate increase from 60 to 88 beats/minute
Which of the following complications is most common after an abdominal aortic aneurysm resection?
hemorrhage and shock
A nurse is reinforcing education for a client with a family history of atherosclerosis. To decrease the risk of atherosclerosis, what should the nurse encourage the client to do?
increase activity level
Before administering digoxin to a client, a nurse reviews information about the drug. She learns that after digoxin is metabolized, the body eliminates remaining digoxin as unchanged drug by way of the:
kidneys
A hospitalized client experiences digoxin-induced premature ventricular contractions (PVCs). Which type of effect do such contractions represent?
latrogenic
A client who had an anterior wall myocardial infarction (MI) would have a greater risk for exhibiting crackles in the lungs related to which disorder?
left-sided heart failure
The nurse is teaching a client who receives nitrates for the relief of chest pain. Which of the following instructions should the nurse emphasize?
lie down 5 to 10 minutes after taking the drug
The nurse administers furosemide to treat a client with heart failure. Which adverse effect must the nurse watch for most carefully?
low serum potassium level
A client comes to the emergency department reporting chest pain. Upon further evaluation, the nurse suspects unstable angina. Which disease process should the nurse reinforce teaching this client about because it is directly related to unstable angina?
myocardial infarction
A client comes to the emergency department reporting chest pain. Upon further evaluation, the nurse suspects unstable angina. Which disease process should the nurse reinforce teaching this client about because it is directly related to unstable angina?
myocardial infarction (MI)
An increase in the creatine kinase-MB isoenzyme (CK-MB) can be caused by:
myocardial necrosis
A client has been hospitalized with a diagnosis of acute arterial occlusive disease. After surgery, the health care provider orders heparin IV therapy for the client. What test does the nurse need to monitor for this client while on heparin?
partial thromboplastin time (PTT)
The nurse advises a client recovering from a myocardial infarction to decrease fat and sodium intake. Which foods should the nurse instruct the client to avoid? Select all that apply.
pepperoni pizza, bacon, cheese, soft drinks
A client is receiving captopril for heart failure. Which finding indicates that the medication isn't producing the desired treatment outcome and requires the nurse to notify the health care provider?
peripherial edema
The nurse is caring for a client with acute pulmonary edema. To immediately promote oxygenation and relieve dyspnea, the nurse should:
place the client in high Fowler's position
A nursing student is observed by the instructor obtaining a blood pressure reading. The instructor immediately intervenes when the student:
places the stethoscope over the brachiocephalic artery.
A client is admitted to the cardiac unit with a diagnosis of heart failure. The health care provider prescribes furosemide and digoxin to manage the condition. Which laboratory value should be monitored during hospitalization?
potassium
An older adult client with heart failure and 2+ pitting edema is prescribed furosemide. Due to the effects of furosemide, which supplemental medication would the nurse expect to see ordered for this client?
potassium
A client who has a deep vein thrombosis (DVT) reports dyspnea and chest pain and has diminished breath sounds. Which condition does the nurse prepare treatment for?
pulmonary embolism
The nurse is caring for a child with symptomatic aortic stenosis. Which instruction should be provided to the child and parents.
restrict exercise
The nurse is obtaining data from a new client in the cardiovascular clinic. When asking about childhood diseases and disorders associated with structural heart disease, the nurse should consider which finding significant?
rheumatic fever
The nurse is caring for a client with peripheral vascular disease who is scheduled for a venogram. The client reports allergy to several food items. The nurse should be most concerned about allergy to which food?
shellfish
The clinic nurse is reinforcing teaching about symptoms of cardiovascular disease (CVD) with the client. What are common symptoms associated with cardiovascular disease?
shortness of breath, chest discomfort/pain, palpitations
The clinic nurse is reinforcing teaching about symptoms of cardiovascular disease (CVD) with the client. What are common symptoms associated with cardiovascular disease?
shortness of breathe, chest discomfort/pain, palpitations
The nurse is performing an electrocardiogram (ECG) for a client with chest pain. To achieve the best results, in which position will the nurse place the client?
supine
When assisting with an electrocardiogram (ECG), the nurse would expect to place the client in which position?
supine
A nurse is caring for a client diagnosed with myocardial infarction (MI) who is prescribed a nitrate. What does the nurse identify as the purpose of giving a nitrate to this client?
to dilate coronary arteries
A client with severe angina and electrocardiogram changes is seen in the emergency department. In terms of serum testing, the nurse can expect which laboratory test to be ordered?
troponin
A client comes to the emergency department reporting visual changes and a severe headache. The nurse measures the client's blood pressure at 210/120 mm Hg. However, the client denies having hypertension or any other disorder. After diagnosing malignant hypertension, a life-threatening disorder, the physician initiates emergency intervention. What is the most common cause of malignant hypertension?
untreated hypertension
A client has sudden cardiac death. Which arrhythmia commonly associated with sudden cardiac death does the nurse suspect this client may have experienced?
ventricular fibrillation
The nurse suspects that a 68-year-old client has digoxin toxicity. The nurse should assess for:
vision changes
The nurse is caring for a client with heart failure who is receiving furosemide daily. What action should the nurse instruct the client to perform?
weigh self daily
A client comes to the emergency department with symptoms of a myocardial infarction (MI). The health care provider prescribes reteplase. The nurse is aware that this medication will be most effective when given at which time?
within 1 to 3 hours of onset of symptoms
A client with chest pain doesn't respond to nitroglycerin. On admission to the emergency department, the health care team obtains an electrocardiogram and administers I.V. morphine. The physician also considers administering alteplase. This thrombolytic agent must be administered how soon after onset of myocardial infarction (MI) symptoms?
within 3 to 6 hours
