Med surg ch.17,18,19&20
A patient who presented to the emergency room with a myocardial infarction (MI) becomes pale, diaphoretic, and hypotensive. What action should the nurse take first? a. Notify the physician immediately. b. Ensure that the patient has patent IV access. c. Request assistance from respiratory therapy. d. Inform the patient's family of the change in status.
A
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? a. "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." b. "You probably aren't getting enough iron in your diet. We should talk to your doctor about adding an iron supplement." c. "How many years have you smoked? Nicotine will cause these changes in your skin." d. "These are just normal changes seen in most older people."
A
The drug alteplase (t-PA) is given to the patient with a myocardial infarction (MI). Which statement accurately describes the purpose of this medication? a. "Alteplase (t-PA) dissolves the obstruction in the coronary artery." b. "Alteplase (t-PA) dilates vessels to relieve pain." c. "Alteplase (t-PA) strengthens cardiac contraction." d. "Alteplase (t-PA) increases cardiac output."
A
The nurse caring for a patient who requires a temporary transvenous pacemaker. Which statement indicates that the patient understands the nurse's teaching? a. "I may experience uncomfortable muscle contractions." b. "The procedure will use general anesthesia." c. "I will be given a sedative after the procedure." d. "This device may be left in place for 6 weeks."
A
The nurse is caring for a patient admitted with chest pain to rule out a myocardial infarction (MI). The nurse observes that the patient is experiencing electrocardiogram (ECG) changes and reviews new laboratory results. Which laboratory value should the nurse report immediately? a. Troponin of 2.4 mcg/L b. Potassium of 3.4 mEq/L c. Creatine phosphokinase of 134 IU/L d. Sodium of 133 mEq/L
A
The nurse is caring for a patient who underwent a transfemoral cardiac catheterization with coronary angiography earlier in the day. The patient denies pain and no longer requires bed rest. The groin is soft with no palpable hematoma. Which postprocedure care is most important for the patient at this time? a. Encourage increased fluid intake. b. Administer pain medications as ordered. c. Obtain vital signs every 15 minutes. d. Assist the patient with ambulation.
A
The nurse is caring for a patient with uncontrolled hypertension, diabetes, asthma, and gastroesophageal reflux disease (GERD). Which problem serves as a contraindication for a thrombolytic agent? a. Uncontrolled hypertension b. Diabetes c. Asthma d. GERD
A
The nurse is caring for a post-myocardial infarction (MI) patient. The patient questions the reason for a stool softener and denies constipation. Which statement indicates that the patient accurately understands the nurse's teaching? a. "Stool softeners help me keep from straining during bowel movements, which can lower my heart rate." b. "Stool softeners help me to get rid of extra wastes that can harm my heart." c. "Stool softeners help reduce swelling that can increase work on my heart." d. "Stool softeners help to reduce discomfort from gas pains."
A
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? a. Loss of cells in the sinoatrial (SA) nodes b. Increased peripheral resistance c. Hypertension d. Atherosclerosis
A
The nurse is outlining a teaching program for diabetic patients. Which teaching point about heart disease prevention should the nurse emphasize most? a. Keep blood sugar below 100 mg/dL. b. Prevent infections. c. Eat meals at regular times. d. Use sterile technique in insulin injections.
A
The nurse performs patient teaching about minimally invasive direct coronary artery bypass (MIDCAB). Which statement indicates that the patient needs further instruction? a. "It frightens me to think that my heart will be stopped for a long time during surgery." b. "This surgery bypasses my artery that is blocked, and replaces it with sections of a vein or artery taken from another part of my body." c. "This surgery will hopefully control my angina since nothing else we have tried has worked." d. "I may come out of surgery with vessels removed from my legs.
A
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? a. "As long as it is okay with your physician, moderate alcohol intake can be beneficial to your cardiovascular health." b. "Drinking wine on a daily basis may lead to you having issues with increased blood pressure." c. "You may want to be careful because drinking wine with dinner may stimulate your appetite significantly." d. "This practice may cause your triglyceride level to rise, so I would discourage it."
A
The patient with angina asks the nurse how a daily dose of 81 mg of aspirin is helpful. Which reply is best? a. Low-dose aspirin helps reduce clotting. b. Low-dose aspirin helps dilate coronary vessels. c. Low-dose aspirin helps alleviates pain associated with angina. d. Low-dose aspirin helps lower cholesterol.
A
The statement indicates that the nurse's teaching about the purpose of an implanted cardioverter-defibrillator (ICD) has been successful? a. "The ICD will detect bad rhythms and shock my heart into normal rhythm." b. "I should avoid handheld security devices at the airport." c. "I should ask my doctor how often I should have my ICD checked." d. "I should avoid working on the alternator of my boat."
A
Which disorganized ECG pattern is recognized as the most fatal of all arrhythmias? a. Ventricular fibrillation b. Premature ventricular beats c. Atrial fibrillation d. Ventricular tachycardia (VT)
A
Which layer of the heart contains muscle fibers that contract to pump blood? a. Myocardium b. Endocardium c. Epicardium d. Pericardium
A
Which factor(s) may be useful in preventing peripheral vascular disease (PVD)? (Select all that apply.) a. Stress relief b. Diabetes control c. Weight control d. Routine exercise e. Smoking cessation
A, B, C, D, E
The nurse clarifies that the MONA protocol for drug administration in the emergent stage of a myocardial infarction (MI) involves the use of which therapies? (Select all that apply.) a. Aspirin b. Morphine c. Nitrates d. Antibiotics e. Oxygen f. Anticoagulants
A, B, C, E
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.) a. Apply light blankets over legs while sitting. b. Elevate legs frequently. c. Encourage walking. d. Avoid tight compression stockings. e. Maintain a warm environment.
A, B, C, E
The nurse encourages the patient who has had a myocardial infarction (MI) to enroll in the outpatient cardiac rehabilitation in order to receive which service(s)? (Select all that apply.) a. Nutritional counseling b. Supervised progressive exercise c. Stress reduction techniques d. Sexual counseling e. Administration of cardiotonic drugs
A,B,C
The nurse instructs a patient that the pain of angina is due to ischemia of the myocardium. Which factors are causative agents for angina? (Select all that apply.) a. Exertion b. Emotional excitement c. Eating heavy meals d. Exposure to cold e. Allergic reactions
A,B,C,D
Which preventative measure(s) may protect against development of cardiovascular disease? (Select all that apply.) a. Exercising regularly for at least 30 minutes a day b. Maintaining high-density lipoprotein (HDL) greater than 50 mg/dL c. Refraining from smoking d. Obtaining and maintaining a healthy weight e. Maintaining triglycerides above 150 mg/dL
A,B,C,D
Which problems are potential complications of uncontrolled hypertension? (Select all that apply.) a. Stroke b. Kidney failure c. Heart attack d. Congestive heart failure e. Deep vein thrombosis (DVT)
A,B,C,D
Which statement(s) accurately describe(s) characteristics of normal sinus rhythm (NSR)? (Select all that apply.) a. One atrial contraction (P wave) b. One ventricular contraction (QRS complex) c. One T wave d. Heart rate 60 to 100 e. P wave immediately follows the QRS complex
A,B,C,D
The nurse is educating a patient about cardiomyopathy. The nurse includes information that which circumstance(s) may increase risk for cardiomyopathy? (Select all that apply.) a. Systemic hypertension b. Chronic excessive alcohol consumption c. Pregnancy d. Diabetes e. Systemic infection
A,B,C,E
Which factor(s) is/are potential causative agents for arrhythmias? (Select all that apply.) a. Hyperkalemia b. Valvular prolapse c. Infarct damage d. Properly functioning sinoatrial (SA) node e. Excess fluid
A,B,C,E
Which findings characterize peripheral vascular disease (PVD)? (Select all that apply.) a. Narrowed arteries b. Obstructed veins c. Involvement of all extremities d. Defective valve function e. Thrombophlebitis
A,B,D,E
Which words compose part of the "5 Ps" of arterial disease? (Select all that apply.) a. Pain b. Paresthesia c. Purulent d. Pooling e. Pallor
A,B,E
The nurse is aware that a positive diagnosis of a myocardial infarction (MI) is based on which diagnostic test finding(s)? (Select all that apply.) a. Electrocardiographic (ECG) changes in the QRS complex b. Elevation of low-density lipoprotein (LDL) c. Elevation of troponin levels d. Elevated white blood cell (WBC) count e. Elevated bilirubin levels
A,C
Which modifiable risk factors increase a patient's risk for heart disease? (Select all that apply.) a. Smoking b. Race c. Obesity d. Sedentary lifestyle e. Age
A,C,D
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.) a. Wear gloves when handling cold items. b. Drink plenty of warm beverages, such as coffee. c. Wear insulated socks when working in cool weather. d. Attend a smoking program. e. Use a heating pad to stay warm.
A,C,D,E
Which factors may affect the volume of cardiac output? (Select all that apply.) a. Heart rate b. Peripheral pulses c. Preload d. Contraction strength e. Afterload
A,C,D,E
Which herbs and supplements lower cholesterol? (Select all that apply.) a. Garlic b. Bananas c. Oatmeal d. St. John's wort e. Soy products
A,C,E
The nurse in a skilled nursing facility is caring for an 80-year-old patient who develops a productive cough with pink, frothy sputum. Which independent interventions should the nurse implement immediately? (Select all that apply.) a. Limit the patient's activity. b. Administer morphine. c. Administer lasix. d. Place the patient in high Fowler position. e. Weigh the patient daily.
A,D
How does a myocardial infarction (MI) alter the pumping efficiency of the heart? a. An MI reduces the impulse from the sinoatrial node. b. An MI causes myocardial necrosis. c. An MI shunts all myocardial blood flow to a specific cardiac region. d. An MI causes myocardial swelling and inflammation.
B
In a blood pressure of 120/80, what does the "80" indicate? a. Pulse pressure b. Pressure in the relaxed ventricles c. Relative ejection factor d. Stroke volume
B
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? a. Primary hypertension b. Hypertensive crisis c. Essential hypertension d. Secondary hypertension
B
The home health nurse is caring for a patient with congestive heart failure (CHF). Which assessment finding should the nurse report immediately to the physician? a. Moderate shortness of breath after walking down the hall b. A 3 pound weight gain over the course of a week c. Heart rate of 104 beats/min after ambulating to the bathroom d. Increase in urinary output to 50 mL in the last hour
B
The nurse caring for a patient who is taking amiodarone (Cordarone). What side effect could this patient experience? a. Sudden increase in temperature b. Hypotension c. Bradycardia d. Depressed ventilation
B
The nurse is analyzing a patient's telemetry strip and observes a sawtooth appearance with no P waves. How should the nurse document this finding? a. Premature ventricular contraction (PVC) b. Atrial flutter c. Ventricular tachycardia (VT) d. Premature atrial contraction (PAC)
B
The nurse is assessing a female patient with a family history of coronary artery disease (CAD). Which report is most concerning to the nurse? a. "I get a little short of breath after climbing the three flights of stairs to my apartment." b. "I stay tired all of the time, and it feels like my bra is too tight." c. "I awaken frequently in the night, and my husband says that I snore." d. "I notice wheezing after I dust or when I exercise."
B
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? a. Equal warmth in bilateral feet b. Shiny, hairless legs c. Thin, brittle toenails d. Pedal edema
B
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? a. Monitor the patient's blood pressure every 15 minutes. b. Contact the physician immediately. c. Notify the patient's family of the change in condition. d. Continue to assess the patient's pain.
B
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? a. Increase intake of leafy green vegetables. b. Increase intake of bananas and potatoes. c. Avoid foods like canned soups and hot dogs. d. Limit caffeine intake.
B
The nurse is caring for a patient who is taking digitalis. The patient complains of increased thirst, and the nurse observes dry mucous membranes. Which additional finding warrants the nurse's immediate attention? a. Sudden, sharp knee pain b. Blurred vision c. Epistaxis d. Chills
B
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? a. "I should wear compression stockings for 5 days." b. "I should walk at least an hour every day for 2 weeks." c. "I should massaging the legs to stimulate circulation." d. "I should notify my doctor if my foot is warm to the touch."
B
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? a. 6 b. 50 c. 82 d. 90
B
The nurse is caring for a patient with a deep venous thrombosis (DVT). Which medication would likely be used for initial inpatient treatment? a. Dabigatran (Pradaxa) b. Heparin c. Warfarin (Coumadin) d. Edoxaban (Lixiana)
B
The nurse is caring for a patient with a heart rate of 115 beats/min and complaints of shortness of breath. The nurse anticipates that these findings are most likely related which underlying problem? a. Pulmonary edema b. Decreased cardiac output c. Impending pneumonia d. Increasing anxiety
B
The nurse is caring for a patient with a history of hypertension. Which information is most important for the nurse to obtain? a. "Do you take a daily multivitamin?" b. "Do you use over-the-counter decongestants or diet pills?" c. "How often do you use laxatives?" d. "How often do you use antacids?"
B
The nurse is caring for a patient with a history of left-sided congestive heart failure (CHF). Which finding leads the nurse to suspect that the patient could be experiencing an acute exacerbation of this condition? a. The abdomen is tight and shiny. b. Wheezes are present during lung auscultation. c. The pupils react sluggishly to light. d. The heart rate is irregularly irregular.
B
The nurse is caring for a patient with agina pectoris who asks what happens to make his body experience pain. The nurse explains that pain results from which underlying causative factor? a. Congestion that backs up into the lungs b. Inadequate blood flow and poor oxygen supply c. Edema from fluid overload d. Inflammation in the vessels
B
The nurse is caring for a patient with atrial fibrillation who asks why she needs to take warfarin. Which statement best answers the patient's question? a. Warfarin increases the ejection fraction. b. Warfarin prevents clots from forming in the atria. c. Warfarin keeps the atrial fibrillation from involving the ventricles. d. Warfarin increases the cardiac output.
B
The nurse is educating a patient on a low-fat, low-cholesterol diet after a myocardial infarction (MI). Which food choice should the nurse recommend? a. "Avoid eating frozen foods." b. "Replace a serving of red meat with a serving of fish." c. "Use nondairy creamer in your decaffeinated coffee." d. "Drink a serving of grapefruit juice each day."
B
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? a. Add vitamin C to diet. b. March in place while standing at the counter. c. Avoid tight support hose. d. Wear supportive shoes.
B
The patient being evaluated for a heart transplant asks the nurse what the survival rate is. Which response is best for the nurse to make? a. "I'm not really sure. It is better if you ask your surgeon." b. "Every patient has different circumstances, but the average 5-year survival rate is 79%." c. "The survival rate is excellent. Almost all patients with a heart transplant live past 10 years." d. "There are not any really good statistics for me to give you an accurate estimate."
B
The patient has been prescribed a low-sodium diet. Which food choice indicates that the patient requires additional teaching? a. Fresh spinach b. Pickles c. Whole-grain pasta d. Grapefruit
B
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? a. Muslims b. African Americans c. Whites d. Latinos
B
Which blood pressure findings constitute a diagnosis of hypertension? a. 120/80 × 2, 2 weeks apart b. 140/90 × 2, 2 weeks apart c. 120/80 on 3 consecutive days d. 140/90 every day for a week
B
Which medication is the most common and effective antiplatelet aggregation agent? a. Warfarin b. Aspirin c. Alteplase (Activase) d. Reteplase (Retavase)
B
Which potential hazard is most important for a patient with an automatic implantable cardioverter-defibrillator (AICD) to avoid? a. Static electricity from synthetic fabric b. Airport security detection devices c. Constricting clothing and belts d. High altitudes
B
Which statement accurately describes the purpose of a Doppler flow study? a. To detect a clot in a coronary artery b. To visualize obstructions in leg vessels c. To assess efficiency of blood flow through heart chambers d. To detect a defective heart valve
B
While performing a focused cardiac assessment, the nurse auscultates an abnormal swooshing sound. Which action is most appropriate to clarify the nurse's finding? a. The nurse uses the diaphragm of the stethoscope while asking the patient to take a deep breath. b. The nurse uses the bell of the stethoscope while asking the patient to lean forward. c. The nurse asks the patient about a history of heart stents. d. The nurse asks the patient about a history of cardiac dysrhythmias.
B
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.) a. Decreasing blood viscosity b. Loss of elasticity in vessel walls c. Atherosclerotic changes in vessels d. Sedentary practices e. Weakened leg muscles
B, C, D, E
Which disorder(s) is/are examples of congenital heart defects? (Select all that apply.) a. Arteriosclerosis b. Coarctation of the aorta c. Septal defects d. Valvular defects e. Atherosclerosis
B,C,D
The nurse is caring for a 38-year-old African American patient with diabetes. The patient manages her diabetes with dietary control, takes oral contraceptives, and is a nonsmoker. Which characteristic(s) in this patient's history increase the patient's risk for coronary artery disease (CAD)? (Select all that apply.) a. Age b. Race c. Diabetes d. Nonsmoker status e. Use of oral contraceptives
B,C,E
The nurse is performing an initial assessment on a new patient with suspected right-sided heart failure. Which finding(s) is/are consistent with the patient's potential diagnosis? (Select all that apply.) a. Clammy skin b. Splenomegaly c. Abdominal distention d. Wheezing e. Dyspnea
B,C,E
Which intervention(s) is/are important for a patient with venous insufficiency? (Select all that apply.) a. Avoid swimming. b. Elevate feet to reduce edema. c. Wear tight clothing. d. Decrease fluid intake. e. Apply elastic compression wraps twice daily.
B,E
When the nurse assesses an apical pulse of 52, the nurse documents this arrhythmia as _________.
Bradycardia
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? a. Muscle spasm b. Deep venous thrombosis c. Claudication d. Angiospasm
C
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 the most likely cause of this patient's heart murmur? a. Hypertension b. Atherosclerosis c. Insufficient valves d. Weakened pacemaker
C
The nurse assesses a friction rub in a patient who is 2 days post-myocardial infarction (MI). The nurse recognizes this finding indicates which problem? a. A recurrent MI b. Pleural effusion c. Pericarditis d. Angina
C
The nurse is caring for a male patient with angina who has a new prescription for sublingual nitroglycerin. What information is most important for the nurse to include in the teaching plan? a. Nitroglycerin tablets expire 3 months after the bottle is opened. b. Take a second tablet 15 minutes after the first dose and call the physician if pain persists. c. Store nitroglycerin tablets in a cool, dark location. d. Nitroglycerin may cause an unsafe drop in heart rate when combined with certain medications for erectile dysfunction.
C
The nurse is caring for a patient on lisinopril (Zestril). The patient asks how this medication affects blood pressure. Which response best explains the medication's effects? a. "This medication blocks epinephrine and lowers the heart rate, which impacts blood pressure." b. "This medication stimulates the release of sodium and water to be excreted." c. "This medication lowers blood pressure by blocking an enzyme that causes blood vessels to constrict." d. "This medication decreases cardiac output."
C
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? a. "I should eat a full meal to give me energy to walk on the treadmill." b. "I will avoid smoking for fours before the test." c. "I will have to move extremely quickly from the treadmill to the table." d. "I should wear comfortable house shoes during the test."
C
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? a. The nurse encourages the patient to increase fluid intake. b. The nurse checks the presence and strength of pedal pulses. c. The nurse places the pulse oximeter on the thumb or first digit of the affected hand. d. The nurse places the blood pressure cuff on the arm corresponding to the affected hand.
C
The nurse is caring for a patient with a compression dressing. Which action indicates appropriate wound care? a. The nurse changes the compression dressing daily. b. The nurse uses an alcohol-based cleanser before applying the compression dressing. c. The nurse places a compression dressing over the wound dressing. d. The nurse dons a face mask before applying a compression dressing
C
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? a. Left heart catheterization b. Stress echocardiogram c. Percutaneous transluminal angioplasty (PTA) d. Nuclear medicine stress test
C
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? a. Injury related to loss of peripheral circulation. b. Acute pain related to ischemia to lower extremities. c. Altered skin integrity related to ulcers on lower extremities. d. Insufficient knowledge related to new diagnosis of hypertension
C
The nurse is caring for a patient with severe congestive heart failure (CHF) who denies pain and is fearful of taking prescribed morphine. Which explanation best works to alleviate the patient's anxiety about risk of addiction? a. "Many people with CHF use morphine for pain control." b. "We can treat your pain with aspirin or ibuprofen." c. "Morphine has properties that help relieve air hunger in CHF patients." d. "You can refuse to take it."
C
The nurse is caring for a patient with suspected right-sided heart failure. Which manifestation best supports this potential diagnosis? a. Wheezing b. Orthopnea c. Edema d. Pallor
C
The nurse is caring for a post-myocardial infarction (MI) patient who has been started on daily simvastatin (Zocor) and a low-fat diet. Which statement best indicates that the nurse's teaching has been successful? a. "I will need to have blood work every month while taking Zocor." b. "I should take my Zocor with grapefruit juice to help absorption. c. "I should call my doctor if I experience unexplained muscle pain." d. "I should take Zocor an hour before my biggest meal of the day."
C
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? a. Consider purchasing a home blood pressure monitor. b. Limit sodium intake in the diet. c. Sit on the side of the bed before standing. d. Keep an updated list of all medications
C
The nurse is teaching a patient who takes warfarin (Coumadin) about a coagulation monitoring device. Which blood clotting time should the device monitors? a. PT b. PTT c. INR d. ACT
C
The patient states that he had a cardiac catheterization 10 years ago and wonders if any of the postprocedure care has changed. Which response by the nurse is most accurate? a. "We will only roll you to the same side as the catheter insertion site." b. "You will lay flat for several hours, and we will place a sandbag over the dressing in the groin." c. "You will most likely be able to ambulate within a few hours if your doctor uses an arterial closure device at the catheter insertion site." d. "We will encourage you to flex and extend your legs when you return from the procedure to prevent a clot from forming at the insertion site."
C
When using a 0 to 4+ scale to grade pulse quality, how should the nurse record a normal volume pulse? a. 1+ b. 2+ c. 3+ d. 4+
C
Which teaching point will the nurse include when providing discharge instructions to the patient with a new permanent pacemaker? a. "You will be able to have an MRI for diagnostic purposes." b. "Avoid using microwave ovens." c. "Avoid lifting heavy objects for as long as your physician prescribes." d. "Airport screening devices may cause your pacemaker to fire incorrectly."
C
The nurse is caring for a 60-year-old African American patient with hypertension. The patient is obese and a smoker. Which modifiable risk factors place this patient at an increased risk for heart disease? (Select all that apply.) a. Age b. Race c. Hypertension d. Obesity e. Smoking
C,D,E
During the acute phase following a myocardial infarction (MI), the nurse anticipates that the patient may require a temporary pacemaker in which situation(s)? (Select all that apply.) a. The patient's heart rate remains above 120 beats/min. b. The patient experiences worsening anginal pain. c. The patient experiences complete heart block. d. The patient's systolic BP drops to 60. e. The patient's pulse rate remains below 40 beats/min.
C,E
The 60-year-old female in the post-coronary care unit confides to the nurse, "My life is over. I'll never be able to care for my family, take a vacation, or work in my garden." Which response is most supportive? a. "You are doing great! You can do all of those things in a few weeks." b. "You may have to give up some things, but there are other activities you might enjoy." c. "You are feeling a little blue today. Would you like medication to help your anxiety?" d. "You sound a little down. Tell me what you think is going to keep you from those activities; we might be able to address the problems."
D
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? a. Document the findings. b. Review the patient's diet. c. Notify the primary care provider. d. Cover with clear occlusive dressing
D
The nurse is caring for a female patient with a family history of heart disease who is undergoing a workup for cardiovascular disease. Which finding is most concerning to the nurse? a. Fainting b. Dry mouth c. Dizziness d.
D
The nurse is caring for a patient with a deep venous thrombosis (DVT). Which finding requires the nurse's immediate attention? a. Hematuria b. Decreased sensation in the affected leg c. Urine output of 35 mL in 1 hour d. Hemoptysis
D
The nurse is caring for a patient with congestive heart failure (CHF). Which intervention should the nurse include in the plan of care? a. Encourage intake of canned soups. b. Place the patient in a side-lying position to prevent venous pooling. c. Encourage large meals for increased nutritional impact. d. Alternate rest with activity.
D
The nurse is caring for several patients on a cardiac care unit. Which patient is most likely to have aortic stenosis? a. 35-year-old with a history of Raynaud disease b. 63-year-old with uncontrolled diabetes c. 73-year-old with a history of hypertension d. 86-year-old with a history of atherosclerosis
D
The nurse is educating a female patient with a family history of coronary artery disease (CAD) about risk factors and prevention of heart disease in women. Which information is most important for the nurse to include? a. Women should maintain a body mass index (BMI) of less than 28. b. Women should utilize estrogen supplementation to decrease risk of heart disease. c. Women should drink one alcoholic beverage daily. d. Women should incorporate stress reduction techniques into their daily lifestyle.
D
The nurse is explaining the difference between exertional angina and unstable angina. Which statement about unstable angina is accurate? a. Unstable angina occurs with moderate exercise. b. Unstable angina occurs when the blood pressure increases sharply. c. Unstable angina occurs when the body reacts to high stress levels. d. Unstable angina occurs unpredictably, even in sleep.
D
The nurse is teaching a patient about the purpose of his telemetry. Which statement indicates that the nurse's teaching has been successful? a. "I will need to stay in bed when the monitor is reading my heart waves." b. "This test will help determine if I have a blockage in my arteries." c. "If there is a problem with my heart valves, it will show up with telemetry." d. "The nurses will be able to monitor my heart rate and rhythm."
D
The nurse is teaching the patient with an arrhythmia. Which statement indicates that the patient requires further teaching? a. "I've cut my coffee from 10 cups to 2 cups a day." b. "I don't drink regular cola drinks anymore." c. "I have given up drinking those high-energy drinks." d. "I've switched from 5 cups of coffee to 5 cups of tea."
D
Which statement accurately explains how calcium channel blocker verapamil assists to correct an arrhythmia? a. The medication desensitizes the heart to the impulse to contract. b. The medication increases the strength of the impulse from the atrioventricular (AV) node. c. The medication alters the impulse from the sinoatrial (SA) node. d. The medication inhibits transmission of the impulse from the AV node.
D
_________ is the acute symptom most experienced by African Americans when having a myocardial infarction (MI).
Dyspnea
The nurse expresses concern to the 80-year-old resident in a long-term care facility who is attempting to jog on a treadmill. The nurse is aware that the exceptional oxygen and metabolic demands brought on by the exercise might cause ____________.
Heart failure
The patient suffering from ventricular tachydysrhythmia may benefit from _________________ when medications are not effectively treating the disorder.
Radiofrequency catheter ablation
Place the events of arterial obstruction in proper sequence. a. Platelets adhere to plaque. b. Deposits of low-density lipoproteins (LDLs) accumulate. c. Fibrous plaque is laid down in vessel. d. Streaks of fatty material are laid down in arteries. e. Platelets clump. f. Platelets calcify.
Step 1 D Step 2 B Step 3 C Step 4 A Step 5 E Step 6 F
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 uses a diagram to show how obstruction of an artery has caused an area of necrosis called a(n) _________.
infarct infarction
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 placement of the stethoscope will allow the loudest beat at the point of maximal impulse (PMI).
The nurse is aware that the patient's cardiac rehabilitation levels of physical activity are designated through ____________ units
metabolic equivalent MET
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
