Evolve Ch. 35, 36, 38 - Cardiac
A client with peripheral arterial disease (PAD) has undergone percutaneous transluminal angioplasty (PTA) of the lower extremity. What is essential for the nurse to assess after the procedure? Ankle-brachial index Dye allergy Pedal pulses Gag reflex
Pedal pulses
A client undergoing coronary artery bypass grafting asks why the surgeon has chosen to use the internal mammary artery for the surgery. Which response by the nurse is correct? "This way you will not need to have a leg incision." "The surgeon prefers this approach because it is easier." "These arteries remain open longer." "The surgeon has chosen this approach because of your age."
"These arteries remain open longer."
The professional nurse and the nursing student are caring for a group of clients with hypertension. Which problem identified by the nursing student correctly identifies the client at risk for secondary hypertension? Psychiatric disturbance High sodium intake Physical inactivity Kidney disease
Kidney disease
A client with hypertension is started on verapamil (Calan). What teaching does the nurse provide for this client? "Consume foods high in potassium." "Monitor for irregular pulse." "Monitor for muscle cramping." "Avoid grapefruit juice."
"Avoid grapefruit juice."
The nurse is teaching a client the precautions to take while on warfarin (Coumadin) therapy. Which statement made by the client demonstrates that teaching has been effective? "I can use an electric razor or a regular razor." "Eating foods like green beans won't interfere with my Coumadin therapy." "If I notice I am bleeding a lot, I should stop taking Coumadin right away." "When taking Coumadin, I may notice some blood in my urine."
"Eating foods like green beans won't interfere with my Coumadin therapy."
Which statement by a client scheduled for a percutaneous transluminal coronary angioplasty (PTCA) indicates a need for further preoperative teaching? "I will be awake during this procedure." "I will have a balloon in my artery to widen it." "I must lie still after the procedure." "My angina will be gone for good."
"My angina will be gone for good."
A client has just undergone arterial revascularization. Which statement by the client indicates a need for further teaching related to postoperative care? "My leg might turn very white after the surgery." "I should be concerned if my foot turns blue." "I should report a fever or any drainage." "Warmness, redness, and swelling are expected."
"My leg might turn very white after the surgery."
When caring for a client with an abdominal aortic aneurysm (AAA), the nurse suspects dissection of the aneurysm when the client makes which statement? "I feel my heart beating in my abdominal area." "I just started to feel a tearing pain in my belly." "I have a headache. May I have some acetaminophen?" "I have had hoarseness for a few weeks."
"I just started to feel a tearing pain in my belly."
The nurse discusses the importance of restricting sodium in the diet for a client with heart failure. Which statement made by the client indicates that the client needs further teaching? "I should avoid eating hamburgers." "I must cut out bacon and canned foods." "I shouldn't put the salt shaker on the table anymore." "I should avoid lunchmeats but may cook my own turkey."
"I should avoid eating hamburgers."
The nurse is providing discharge teaching to a client with heart failure, focusing on when to seek medical attention. Which statement by the client indicates a correct understanding of the teaching? "I will call the provider if I have a cough lasting 3 or more days." "I will report to the provider weight loss of 2 to 3 pounds in a day." "I will try walking for 1 hour each day." "I should expect occasional chest pain."
"I will call the provider if I have a cough lasting 3 or more days."
The nurse is teaching a young female client how to prevent venous thromboembolism specific to her hospital stay after intensive orthopedic surgery. Which statement made by the client indicates the need for further teaching? "I must stop taking my birth control pills." "I should drink lots of water so I don't get dehydrated." "I should exercise my legs when I have been sitting or standing for a long time." "If I wear pantyhose, I won't have to wear the stockings the hospital gives me."
"If I wear pantyhose, I won't have to wear the stockings the hospital gives me."
A client with unstable angina has received education about acute coronary syndrome. Which statement indicates that the client has understood the teaching? "This is a big warning; I must modify my lifestyle or risk having a heart attack in the next year." "Angina is just a temporary interruption of blood flow to my heart." "I need to tell my wife I've had a heart attack." "Because this was temporary, I will not need to take any medications for my heart."
"This is a big warning; I must modify my lifestyle or risk having a heart attack in the next year."
Which teaching point does the nurse include for a client with peripheral arterial disease (PAD)? "Elevate your legs above heart level to prevent swelling." "Inspect your legs daily for brownish discoloration around the ankles." "Walk to the point of leg pain, then rest, resuming when pain stops." "Apply a heating pad to the legs if they feel cold."
"Walk to the point of leg pain, then rest, resuming when pain stops."
During discharge planning after admission for a myocardial infarction, the client says, "I won't be able to increase my activity level. I live in an apartment, and there is no place to walk." What is the nurse's best response? "You are right. Work on your diet then." "You must find someplace to walk." "Walk around the edge of your apartment complex." "Where might you be able to walk?"
"Where might you be able to walk?"
The client undergoing femoral popliteal bypass states that he is fearful he will lose the limb in the near future. Which response by the nurse is most therapeutic? "Are you afraid you will not be able to work?" "If you control your diabetes, you can avoid amputation." "Your concerns are valid; we can review some steps to limit disease progression." "What about the situation concerns you most?"
"Your concerns are valid; we can review some steps to limit disease progression."
After receiving change-of-shift report about these four clients, which client should the nurse assess first? A 46-year-old with aortic stenosis who takes digoxin (Lanoxin) and has new-onset frequent premature ventricular contractions A 55-year-old admitted with pulmonary edema who received furosemide (Lasix) and whose current O2 saturation is 94% A 68-year-old with pericarditis who is reporting sharp, stabbing chest pain when taking deep breaths A 79-year-old admitted for possible rejection of a heart transplant who has sinus tachycardia, heart rate 104 beats/min
A 46-year-old with aortic stenosis who takes digoxin (Lanoxin) and has new-onset frequent premature ventricular contractions
An LPN/LVN is scheduled to work on the inpatient "stepdown" cardiac unit. Which client does the charge nurse assign to the LPN/LVN? A 60-year-old who was admitted today for pacemaker insertion because of third-degree heart block and who is now reporting chest pain A 62-year-old who underwent open heart surgery 4 days ago for mitral valve replacement and who has a temperature of 38.2° C A 66-year-old who has a prescription for a nitroglycerin (Nitro-Dur) patch and is scheduled for discharge to a group home later today A 69-year-old who had a stent placed 2 hours ago in the left anterior descending artery and who has bursts of ventricular tachycardia
A 66-year-old who has a prescription for a nitroglycerin (Nitro-Dur) patch and is scheduled for discharge to a group home later today
Which client who has just arrived in the emergency department does the nurse classify as emergent and needing immediate medical evaluation? A 60-year-old with venous insufficiency who has new-onset right calf pain and tenderness A 64-year-old with chronic venous ulcers who has a temperature of 100.1° F (37.8° C) A 69-year-old with a 40-pack-year cigarette history who is reporting foot numbness A 70-year-old with a history of diabetes who has "tearing" back pain and is diaphoretic
A 70-year-old with a history of diabetes who has "tearing" back pain and is diaphoretic
The nurse is caring for a client with dark-colored toe ulcers and blood pressure of 190/100 mm Hg. Which nursing action does the nurse delegate to the LPN/LVN? Assess leg ulcers for evidence of infection. Administer a clonidine patch for hypertension. Obtain a request from the health care provider for a dietary consult. Develop a plan for discharge, and assess home care needs.
Administer a clonidine patch for hypertension.
The nurse is caring for a group of clients who have sustained myocardial infarction (MI). The nurse observes the client with which type of MI most carefully for the development of left ventricular heart failure? Inferior wall Anterior wall Lateral wall Posterior wall
Anterior wall
An older adult client, 4 hours after coronary artery bypass graft (CABG), has a blood pressure of 80/50 mm Hg. What action does the nurse take? No action is required; low blood pressure is normal for older adults. No action is required for postsurgical CABG clients. Assess pulmonary artery wedge pressure (PAWP). Give ordered loop diuretics.
Assess pulmonary artery wedge pressure (PAWP).
The home health nurse visits a client with heart failure who has gained 5 pounds in the past 3 days. The client states, "I feel so tired and short of breath." Which action does the nurse take first? Assess the client for peripheral edema. Auscultate the client's posterior breath sounds. Notify the health care provider about the client's weight gain. Remind the client about dietary sodium restrictions.
Auscultate the client's posterior breath sounds.
Which diagnostic test result is consistent with a diagnosis of heart failure (HF)? Serum potassium level of 3.2 mEq/L Ejection fraction of 60% B-type natriuretic peptide (BNP) of 760 ng/dL Chest x-ray report showing right middle lobe consolidation
B-type natriuretic peptide (BNP) of 760 ng/dL
For a client with an 8-cm abdominal aortic aneurysm, which problem must be addressed immediately to prevent rupture? Heart rate 52 beats/min Blood pressure 192/102 mm Hg Report of constipation Anxiety
Blood pressure 192/102 mm Hg
To validate that a client has had a myocardial infarction (MI), the nurse assesses for positive findings on which tests? Creatine kinase-MB fraction (CK-MB) and alkaline phosphatase Homocysteine and C-reactive protein Total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol CK-MB and troponin
CK-MB and troponin
Which medication, when given in heart failure, may improve morbidity and mortality? Dobutamine (Dobutrex) Carvedilol (Coreg) Digoxin (Lanoxin) Bumetanide (Bumex)
Carvedilol (Coreg)
The nurse is caring for a client with heart failure. For which symptoms does the nurse assess? (Select all that apply.) Chest discomfort or pain Tachycardia Expectorating thick, yellow sputum Sleeping on back without a pillow Fatigue
Chest discomfort or pain Tachycardia Fatigue
A client has just returned from coronary artery bypass graft surgery. For which finding does the nurse contact the surgeon? Temperature 98.2° F Chest tube drainage 175 mL last hour Serum potassium 3.9 mEq/L Incisional pain 6 on a scale of 0 to 10
Chest tube drainage 175 mL last hour
How does the nurse in the cardiac clinic recognize that the client with heart failure has demonstrated a positive outcome related to the addition of metoprolol (Lopressor) to the medication regimen? Ejection fraction is 25%. Client states that she is able to sleep on one pillow. Client was hospitalized five times last year with pulmonary edema. Client reports that she experiences palpitations.
Client states that she is able to sleep on one pillow.
While caring for a client who has received recombinant tissue plasminogen activator (t-PA) for a large deep vein thrombus, the nurse becomes most concerned when the client develops which condition? Small amount of blood at the IV insertion site Heavy menstrual bleeding +1 pitting edema of the affected extremity Client stating that the year is 1967
Client stating that the year is 1967
Which client is best to assign to an LPN/LVN working on the telemetry unit? Client with heart failure who is receiving dobutamine (Dobutrex) Client with dilated cardiomyopathy who uses oxygen for exertional dyspnea Client with pericarditis who has a paradoxical pulse and distended jugular veins Client with rheumatic fever who has a new systolic murmur
Client with dilated cardiomyopathy who uses oxygen for exertional dyspnea
The nurse in the coronary care unit is caring for a group of clients who have had myocardial infarction. Which client does the nurse see first? Client with dyspnea on exertion when ambulating to the bathroom Client with third-degree heart block on the monitor Client with normal sinus rhythm and PR interval of 0.28 second Client who refuses to take heparin or nitroglycerin
Client with third-degree heart block on the monitor
The nurse suspects that a client has developed an acute arterial occlusion of the right lower extremity based on which signs/symptoms? (Select all that apply.) Hypertension Tachycardia Bounding right pedal pulses Cold right foot Numbness and tingling of right foot Mottling of right foot and lower leg
Cold right foot Numbness and tingling of right foot Mottling of right foot and lower leg
A client who has been admitted for the third time this year for heart failure says, "This isn't worth it anymore. I just want it all to end." What is the nurse's best response? Calls the family to lift the client's spirits Considers further assessment for depression Sedates the client to decrease myocardial oxygen demand Tells the client that things will get better
Considers further assessment for depression
When administering furosemide (Lasix) to a client who does not like bananas or orange juice, the nurse recommends that the client try which intervention to maintain potassium levels? Increase red meat in the diet. Consume melons and baked potatoes. Add several portions of dairy products each day. Try replacing your usual breakfast with oatmeal or Cream of Wheat.
Consume melons and baked potatoes.
The nurse is concerned that a client who had myocardial infarction (MI) has developed cardiogenic shock. Which findings indicate shock? (Select all that apply.) Bradycardia Cool, diaphoretic skin Crackles in the lung fields Respiratory rate of 12 breaths/min Anxiety and restlessness Temperature of 100.4° F
Cool, diaphoretic skin Crackles in the lung fields Anxiety and restlessness
The client in the cardiac care unit has had a large myocardial infarction. How does the nurse recognize onset of left ventricular failure? Urine output of 1500 mL on the preceding day Crackles in the lung fields Pedal edema Expectoration of yellow sputum
Crackles in the lung fields
The nurse is teaching a group of teens about prevention of heart disease. Which point should the nurse emphasize? Reduce abdominal fat. Avoid stress. Do not smoke or chew tobacco. Avoid alcoholic beverages.
Do not smoke or chew tobacco.
The nurse is caring for a client who is being treated for hypertensive emergency. Which medication prescribed for the client should the nurse question? Enalapril (Vasotec) Sodium nitroprusside (Nipride) Dopamine (Intropin) Clevidipine (Butyrate)
Dopamine (Intropin)
Which atypical symptoms may be present in a female client experiencing myocardial infarction (MI)? (Select all that apply.) Sharp, inspiratory chest pain Dyspnea Dizziness Extreme fatigue Anorexia
Dyspnea Dizziness Extreme fatigue
After thrombolytic therapy, the nurse working in the cardiac catheterization laboratory would be alarmed to notice which sign? A 1-inch backup of blood in the IV tubing Facial drooping Partial thromboplastin time (PTT) 68 seconds Report of chest pressure during dye injection
Facial drooping
The nurse in the emergency department is caring for a client with acute heart failure who is experiencing severe dyspnea; pink, frothy sputum; and crackles throughout the lung fields. The nurse reviews the medical record, which contains the following information: Physical Assessment Findings Diagnostic Findings Provider Prescriptions Crackles in all fields S3 present Oliguria Ejection fraction 30% BNP 560 Sodium 130 mEq/L Diagnosis: heart failure Enalapril 10 mg orally daily Heparin 5000 units subcutaneously every 12 hours Furosemide 40 mg IV daily Strict I & O Which prescription does the nurse implement first? Enalapril Heparin Furosemide Intake and output (I & O)
Furosemide
The nurse in the cardiology clinic is reviewing teaching about hypertension, provided at the client's last appointment. Which actions by the client indicate that teaching has been effective? (Select all that apply.) Has maintained a low-sodium, no-added-salt diet Has lost 3 pounds since last seen in the clinic Cooks food in palm oil to save money Exercises once weekly Has cut down on caffeine
Has maintained a low-sodium, no-added-salt diet Has lost 3 pounds since last seen in the clinic Has cut down on caffeine
The nurse prepares to administer digoxin to a client with heart failure and notes the following information: Temperature: 99.8° F Pulse: 48 beats/min and irregular Respirations: 20 breaths/min Potassium level: 3.2 mEq/L What action does the nurse take? Give the digoxin; reassess the heart rate in 30 minutes. Give the digoxin; document assessment findings in the medical record. Hold the digoxin, and obtain a prescription for an additional dose of furosemide. Hold the digoxin, and obtain a prescription for a potassium supplement.
Hold the digoxin, and obtain a prescription for a potassium supplement.
The nurse is caring for an 82-year-old client admitted for exacerbation of heart failure (HF). The nurse questions the client about the use of which medication because it raises an index of suspicion as to the worsening of the client's HF? Ibuprofen (Motrin) Hydrochlorothiazide (HydroDIURIL) NPH insulin Levothyroxine (Synthroid)
Ibuprofen (Motrin)
The nurse teaches a client who has had a myocardial infarction (MI) which information regarding diet? Less than 30% of the daily caloric intake should be derived from proteins. Use canola oil rather than palm oil. Consume 10 mg of fiber daily. Work toward lowering your high-density lipoprotein (HDL) cholesterol levels.
Use canola oil rather than palm oil.
Which characteristics place women at high risk for myocardial infarction (MI)? (Select all that apply.) Premenopausal Increasing age Family history Abdominal obesity Breast cancer
Increasing age Family history Abdominal obesity
Which are risk factors that are known to contribute to atherosclerosis-related diseases? (Select all that apply.) Low-density lipoprotein cholesterol (LDL-C) of 160 mg/dL Smoking Aspirin (acetylsalicylic acid [ASA]) consumption Type 2 diabetes Vegetarian diet
Low-density lipoprotein cholesterol (LDL-C) of 160 mg/dL Smoking Type 2 diabetes
Which finding in the history of a client with an abdominal aortic aneurysm (AAA) is a risk factor for aneurysm formation? Peptic ulcer disease Deep vein thrombosis (DVT) Osteoarthritis Marfan syndrome
Marfan syndrome
The visiting nurse is seeing a client postoperative for coronary artery bypass graft. Which nursing action should be performed first? Assess coping skills. Assess for postoperative pain at the client's incision site. Monitor for dysrhythmias. Monitor mental status.
Monitor for dysrhythmias.
When planning care for a client in the emergency department, which interventions are needed in the acute phase of myocardial infarction? (Select all that apply.) Morphine sulfate Oxygen Nitroglycerin Naloxone Acetaminophen Verapamil (Calan, Isoptin)
Morphine sulfate Oxygen Nitroglycerin
Which nursing action may be delegated to a nursing assistant working on the medical unit? Determine the usual alcohol intake for a client with cardiomyopathy. I Monitor the pain level for a client with acute pericarditis. Obtain daily weights for several clients with class IV heart failure. Check for peripheral edema in a client with endocarditis.
Obtain daily weights for several clients with class IV heart failure.
A client comes to the emergency department with chest discomfort. Which action does the nurse perform first? Administers oxygen therapy Obtains the client's description of the chest discomfort Provides pain relief medication Remains calm and stays with the client
Obtains the client's description of the chest discomfort
Prompt pain management with myocardial infarction is essential for which reason? The discomfort will increase client anxiety and reduce coping. Pain relief improves oxygen supply and decreases oxygen demand. Relief of pain indicates that the MI is resolving. Pain medication should not be used until a definitive diagnosis has been established.
Pain relief improves oxygen supply and decreases oxygen demand.
Which intervention best assists the client with acute pulmonary edema in reducing anxiety and dyspnea? Monitor pulse oximetry and cardiac rate and rhythm. Reassure the client that his distress can be relieved with proper intervention. Place the client in high-Fowler's position with the legs down. Ask a family member to remain with the client.
Place the client in high-Fowler's position with the legs down.
The nurse is caring for a client in phase 1 cardiac rehabilitation. Which activity does the nurse suggest? The need to increase activities slowly at home Planning and participating in a walking program Placing a chair in the shower for independent hygiene Consultation with social worker for disability planning
Placing a chair in the shower for independent hygiene
A client is receiving unfractionated heparin (UFH) by infusion. Of which finding does the nurse notify the provider? Partial thromboplastin time (PTT) 60 seconds Platelets 32,000/mm3 White blood cells 11,000/mm3 Hemoglobin 12.2 g/dL
Platelets 32,000/mm3
The nurse is caring for a client with heart failure in the coronary care unit. The client is now exhibiting signs of air hunger and anxiety. Which nursing intervention does the nurse perform first for this client? Determines the client's physical limitations Encourages alternate rest and activity periods Monitors and documents heart rate, rhythm, and pulses Positions the client to alleviate dyspnea
Positions the client to alleviate dyspnea
A client's medical record shows these data: Physical Assessment Findings Diagnostic Findings Provider Prescriptions Crackles at bases PTT 55 seconds Lovenox 40 mg twice daily Right leg swelling POSITIVE, D-dimer Elevate right leg Right calf pain hCG negative Doppler study right leg Which finding confirms the presence of a thromboembolism? Human chorionic gonadotropin (hCG) negative Crackles at bases Positive D-dimer ( >0.5mg/L) Right leg swelling
Positive D-dimer ( >0.5mg/L)
The nurse is caring for a client with peripheral arterial disease (PAD). For which symptoms does the nurse assess? Reproducible leg pain with exercise Unilateral swelling of affected leg Decreased pain when legs are elevated Pulse oximetry reading of 90%
Reproducible leg pain with exercise
The nurse is caring for a client 36 hours after coronary artery bypass grafting, with a priority problem of intolerance for activity related to imbalance of myocardial oxygen supply and demand. Which finding causes the nurse to terminate an activity and return the client to bed? Pulse 60 beats/min and regular Urinary frequency Incisional discomfort Respiratory rate 28 breaths/min
Respiratory rate 28 breaths/min
A client with heart failure is taking furosemide (Lasix). Which finding concerns the nurse with this new prescription? Serum sodium level of 135 mEq/L Serum potassium level of 2.8 mEq/L Serum creatinine of 1.0 mg/dL Serum magnesium level of 1.9 mEq/L
Serum potassium level of 2.8 mEq/L
Which symptom reported by a client who has had a total hip replacement requires emergency action? Localized swelling of one of the lower extremities Positive Homans' sign Shortness of breath and chest pain Tenderness and redness at the IV site
Shortness of breath and chest pain
Which vascular assessment by the student nurse requires intervention by the supervising nurse? Measuring capillary refill in the fingertips Assessing pedal pulses by Doppler Measuring blood pressure in both arms Simultaneously palpating the bilateral carotids
Simultaneously palpating the bilateral carotids
The nurse caring for a client with heart failure is concerned that digoxin toxicity has developed. For which signs and symptoms of digoxin toxicity does the nurse notify the provider? (Select all that apply.) Hypokalemia Sinus bradycardia Fatigue Serum digoxin level of 1.5 Anorexia
Sinus bradycardia Fatigue Anorexia
The nurse is assessing a client with a cardiac infection. Which symptoms support the diagnosis of infective endocarditis instead of pericarditis or rheumatic carditis? Friction rub auscultated at the left lower sternal border Pain aggravated by breathing, coughing, and swallowing Splinter hemorrhages Thickening of the endocardium
Splinter hemorrhages
The nurse is assessing a client with chest pain to evaluate whether the client is suffering from angina or myocardial infarction (MI). Which symptom is indicative of an MI? Chest pain brought on by exertion or stress Substernal chest discomfort occurring at rest Substernal chest discomfort relieved by nitroglycerin or rest Substernal chest pressure relieved only by opioids
Substernal chest pressure relieved only by opioids
A client has undergone an embolectomy for acute arterial occlusion after creation of a lower arm arteriovenous fistula for dialysis. Which finding does the nurse report to the provider immediately? Swelling and tenseness in the affected area Incisional pain and tenderness at the surgical site Pink, mobile fingers An order for heparin infusion
Swelling and tenseness in the affected area
All of these client assignments have been made by the charge nurse. Which assignment is questionable? The RN with 3 years of experience caring for a client with a pulmonary embolism (PE) who is receiving heparin therapy The LPN/LVN with 5 years of experience caring for a client with leg ulcers who is awaiting nursing home placement The RN with 8 years of experience caring for a client with peripheral arterial disease (PAD) and a total cholesterol of 390 mg/dL The LPN/LVN with 20 years of experience caring for a client with a headache whose blood pressure is 210/150 mm Hg
The LPN/LVN with 20 years of experience caring for a client with a headache whose blood pressure is 210/150 mm Hg
Which sign/symptom is essential for the nurse to report to the provider when caring for a client with Raynaud's phenomenon? Nifedipine (Procardia) administration caused the blood pressure to change from 134/76 to 110/68 mm Hg. The client's extremity became white, then red temporarily. The affected extremity becomes purple and cold. The client states that the digits are painful when they are white.
The affected extremity becomes purple and cold.
The nurse is assigned to all of these clients. Which client should be assessed first? The client who had percutaneous transluminal angioplasty (PTA) of the right femoral artery 30 minutes ago The client admitted with hypertensive crisis who has a nitroprusside (Nipride) drip and blood pressure of 149/80 mm Hg The client with peripheral vascular disease who has a left leg ulcer draining purulent yellow fluid The client who had a right femoral-popliteal bypass 3 days ago and has ongoing edema of the foot
The client who had percutaneous transluminal angioplasty (PTA) of the right femoral artery 30 minutes ago
After receiving change-of-shift report in the coronary care unit, which client does the nurse assess first? The client with acute coronary syndrome who has a 3-pound weight gain and dyspnea The client with percutaneous coronary angioplasty who has a dose of heparin scheduled The client who had bradycardia after a myocardial infarction and now has a paced heart rate of 64 beats/min A client who has first-degree heart block, rate 68 beats/min, after having an inferior myocardial infarction
The client with acute coronary syndrome who has a 3-pound weight gain and dyspnea
A client admitted for heart failure has a priority problem of hypervolemia related to compromised regulatory mechanisms. Which assessment result obtained the day after admission is the best indicator that the treatment has been effective? The client has diuresis of 400 mL in 24 hours. The client's blood pressure is 122/84 mm Hg. The client has an apical pulse of 82 beats/min. The client's weight decreases by 2.5 kg
The client's weight decreases by 2.5 kg
Which nursing intervention for a client admitted today with heart failure will assist the client to conserve energy? The client ambulates around the nursing unit with a walker. The nurse monitors the client's pulse and blood pressure frequently. The nurse obtains a bedside commode before administering furosemide. The nurse returns the client to bed when he becomes tachycardic.
The nurse obtains a bedside commode before administering furosemide.
A client begins therapy with lisinopril (Prinivil, Zestril). What does the nurse consider at the start of therapy with this medication? The client's ability to understand medication teaching The risk for hypotension The potential for bradycardia Liver function tests
The risk for hypotension
The client, a college athlete who collapsed during soccer practice, has been diagnosed with hypertrophic cardiomyopathy. The client says, "This can't be. I am in great shape. I eat right and exercise." What is the nurse's best response? "How does this make you feel?" "This can be caused by taking performance-enhancing drugs." "This may be caused by a genetic trait." "Just imagine how bad it would be if you weren't in good shape."
This may be caused by a genetic trait."
The nurse is preparing to teach a client that metabolic syndrome can increase the risk for myocardial infarction (MI). Which signs of metabolic syndrome should the nurse include in the discussion? (Select all that apply.) Truncal obesity Hypercholesterolemia Elevated homocysteine levels Glucose intolerance Client taking losartan (Cozaar)
Truncal obesity Hypercholesterolemia Glucose intolerance Client taking losartan (Cozaar)
The nurse caring for a client who has had abdominal aortic aneurysm (AAA) repair would be most alarmed by which finding? Urine output of 20 mL over 2 hours Blood pressure of 106/58 mm Hg Absent bowel sounds +3 pedal pulses
Urine output of 20 mL over 2 hours
When following up in the clinic with a client with heart failure, how does the nurse recognize that the client has been compliant with fluid restrictions? Auscultation of crackles Pedal edema Weight loss of 6 pounds since the last visit Reports sucking on ice chips all day for dry mouth
Weight loss of 6 pounds since the last visit
