Medsurg_Ch 48: Care of the Patient with a Cardiovascular or a Peripheral Vascular Disorder

45. Three kinds of blood vessels are organized for carrying blood to and from the heart: (Select all that apply.) a. Veins b. Bronchioles c. Arteries d. Capillaries

ANS: A, C, D The arteries, veins and capillaries blood vessels carry blood to and from the heart. REF: Page 1543 TOP: Function of cardiovascular system

15. What is defined as a distended dilated segment of an artery? a. Embolism b. Aneurysm c. Angina d. Adhesion

ANS: B An aneurysm is an enlarged, dilated portion of an artery. REF: Page 1595 TOP: Aneurysm

5. A patient is admitted from the emergency department. The emergency department physician notes the patient has a diagnosis of heart failure with a New York Heart Association (NYHA) classification of IV. This indicates the patient's condition as a. moderate heart failure. b. severe heart failure. c. congestive heart failure. d. negligible heart failure.

ANS: B Class IV: Severe; patient unable to perform any physical activity without discomfort. Angina or symptoms of cardiac inefficiency may develop at rest. REF: Page 1570, Box 48-3 TOP: Classification of heart failure

10. An old term defined as the condition in which the patient suffers peripheral or pulmonary congestion is called a. pneumonia. b. peripheral edema. c. pulmonary edema. d. congestive heart failure.

ANS: D Because many patients suffer pulmonary or systemic congestion with HF, the syndrome was once called congestive heart failure. REF: Page 1568 TOP: Heart failure Step: Assessment

49. B-type natriuretic peptide (BNP) is a , which is secreted by the heart in response to an expanded left .

ANS: neurohormone; ventricle B-type natriuretic peptide (BNP) is a neurohormone secreted by the heart in response to ventricular expansion. REF: Page 1547 TOP: Heart failure Step: Assessment

48. Serum cardiac markers are that indicate cardiac muscle damage after a myocardial infarction.

ANS: proteins Serum cardiac markers are certain proteins that are released into the blood in large quantities from necrotic heart muscle after a myocardial infarction. REF: Pages 1547, 1564 TOP: Myocardial infarction

11. A patient, age 34, is diagnosed with infective endocarditis. The nurse identifies the nursing diagnosis of Activity intolerance related to generalized weakness for him. Which intervention does the nurse plan while he is febrile? a. Decreased activity b. Activity as tolerated c. Monitoring vital signs during ambulation d. Allowing moderate activity if heart rate is not above 100

ANS: A During the acute phase, it is essential to maintain the patient on decreased activity and provide a calm, quiet environment. REF: Page 1579 TOP: Endocarditis Step: Planning

19. Dependent edema of the extremities, enlargement of the liver, oliguria, jugular vein distention, and abdominal distention are signs and symptoms of a. right-sided heart failure. b. left-sided heart failure. c. cardiac dysrhythmias. d. valvular heart disease.

ANS: A Inability of the right ventricle to pump blood forward into the lungs results in peripheral congestion. Edema is a sign of increased fluid in interstitial tissue and appears in dependent areas of the body such as the sacrum when supine and the feet and ankles while in an upright position. REF: Page 1570, Box 48-3 TOP: Heart failure Step: Assessment

33. A thrombectomy is done to a. prevent the flow of emboli to the lungs. b. prevent the emboli from forming. c. improve blood flow. d. limit blood flow.

ANS: A A thrombectomy or the transvenous placement of a grid or umbrella in the vena cava may be done to prevent the flow of emboli into the lungs. This inferior venacaval interruption device is called a Greenfield filter. REF: Page 1600 TOP: Thrombophlebitis

23. The patient, age 26, is hospitalized with cardiomyopathy. While obtaining a nursing history from her, the nurse recognizes that the increased incidence of cardiomyopathy in young adults who have minimal risk factors for cardiovascular disease is related to a. cocaine use. b. viral infections. c. vitamin B1 deficiencies. d. pregnancy.

ANS: A Cardiomyopathy caused by cocaine abuse is seen more frequently than ever before. Cocaine also causes high circulating levels of catecholamines, which may further damage myocardial cells, leading to ischemic or dilated cardiomyopathy. The cardiomyopathy produced is difficult to treat. Interventions deal mainly with the HF that ensues. REF: Page 1583 TOP: Cardiomyopathy

25. The nurse identifies the problem of a potential complication—pulmonary edema— for a patient in acute congestive heart failure (CHF). For which early symptom of this problem does the nurse assess? a. Pink, frothy sputum b. Lethargy and faintness c. Decreased urinary output d. Bradycardia

ANS: A Frothy sputum is produced from air mixing with the fluid in the alveoli; the sputum is blood-tinged from blood cells that have exuded into the alveoli. REF: Page 1569 TOP: Pulmonary edema

20. A patient with newly diagnosed hypertension tells the nurse he uses a lot of salt on his foods and has not been able to lose the 30 pounds that he has gained in the last 10 years. He does not understand why he has hypertension, since he is not an anxious person. Which nursing diagnosis does the nurse identify for this patient? a. Ineffective health maintenance related to the lack of knowledge of disease process and management b. Risk of noncompliance related to lifestyle patterns c. Disturbed body image related to diagnosis of hypertension d. Anxiety related to complexity of management regimen and lifestyle changes associated with hypertension

ANS: A Hypertension is a blood pressure higher than 140/90 mm Hg, which increases and individual's risk of developing cardiovascular disease. Adhering to medical therapy for control of elevated blood pressure helps to modify the individual's risk. REF: Page 1580, Box 48-4 TOP: Hypertension

27. During the nursing history and physical assessment of a patient with left-sided heart failure, which finding might the nurse expect related to the patient's diagnosis? a. Orthopnea with bubbling crackles throughout the lungs b. Anorexia with weight loss of 3 pounds in 1 week c. Increased urinary output, especially during waking hours d. Periorbital and facial edema

ANS: A Left ventricular failure; the first is the signs and symptoms of decreased cardiac output. The second is pulmonary congestion. Signs and symptoms of this condition include dyspnea, orthopnea, pulmonary crackles, hemoptysis, and cough. REF: Page 1576, Box 48-5 TOP: Heart failure Step: Planning

30. In evaluating pain for the management of myocardial infarction, the most important aspect using objective data is a. patient's vital signs during painful periods. b. dilation of the patient's pupils. c. painful expression on the patient's face. d. report of the severity of the pain.

ANS: A MI: typical vital signs reveal hypotension, pulse abnormalities such as tachycardia, a barely perceptible pulse, and early temperature elevation. Administer oxygen per protocol for 24 to 48 hours and longer if pain, hypotension, dyspnea, or dysrhythmia persist. Administer medications as prescribed: IV morphine sulfate for relief of pain and apprehension and to produce vasodilation. REF: Page 1563, Table 48-2 TOP: Myocardial infarction Step: Evaluation

34. A patient has a diagnosis of heart failure. When the nurse walks into his room, he is orthopneic. The patient is a. sitting or standing in order to breathe deeply and comfortably. b. complaining of sudden awakenings from sleep because of shortness of breath. c. complaining of pain in lower extremities. d. unable to respond to simple questions.

ANS: A Orthopnea is an abnormal condition in which a person must sit or stand in order to breathe deeply and comfortably. REF: Page 1570 TOP: Orthopnea

26. A patient has a diagnosis of heart failure. When the nurse walks into his room he is leaning over his bedside table and is short of breath. The medical term to describe his respiratory status is a. orthopnea. b. dyspnea. c. dysrhythmia. d. disorientation.

ANS: A Orthopnea is an abnormal condition in which a person must sit or stand in order to breathe deeply and comfortably. REF: Page 1604 TOP: Orthopnea

4. The patient has right-sided heart failure. She will probably be comfortable in which position? a. Dorsal recumbent b. Trendelenburg c. Supine d. Orthopneic

ANS: A Restful sleep may be possible only in the sitting position or with the aid of extra pillows. REF: Page 1572 TOP: Heart failure Step: Planning

22. A 56-year-old patient was admitted to the emergency department with a myocardial infarction. Cardiac enzymes were drawn. In a patient with a myocardial infarction, which laboratory values would be abnormal? a. Elevated levels of serum glutamic oxaloacetic transaminase (SGOT) (AST), creatine phosphokinase (CPK-MB), and lactic dehydrogenase (LDH), troponin 1 b. Decreased levels of SGOT (AST), CPK and LDH, troponin 1 c. Elevated levels of SGOT (AST), decreased levels of CPK and LDH, troponin 1 d. Decreased levels of SGOT (AST), increased levels of CPK and LDH, troponin 1

ANS: A Serum cardiac markers are certain proteins that are released into the blood in large quantities from necrotic heart muscle after a myocardial infarction. These markers, specifically cardiac serum enzymes and troponin 1, are important screening diagnostic criteria for acute MI. REF: Pages 1547, 1564 TOP: Diagnostic procedures

31. A patient with angina pectoris is being discharged with nitroglycerin tablets. Which of the instructions does the nurse include in the teaching? a. "When your chest pain begins, lie down and place one tablet under your tongue. If the pain continues, take another tablet in 5 minutes." b. "Place one tablet under your tongue. If the pain is not relieved in 15 minutes, go to the hospital." c. "Continue your activity. If the pain does not go away in 10 minutes, begin taking the nitro tablets one every 5 minutes for 15 minutes, then go lie down." d. "Place one nitro tablet under your tongue. If a burning sensation and headache occur, call your doctor immediately."

ANS: A Sit and stand slowly after taking nitroglycerin. Place nitroglycerin tablets under the tongue at the onset of anginal pain; the second tablet can be taken after 5 minutes and the third tablet after another 5 minutes if pain is unrelieved. Then, if pain is not relieved, go to the hospital. REF: Page 1562, Patient Teaching box TOP: Angina pectoris

21. A patient, age 72, was admitted to the medical unit with a diagnosis of angina pectoris. Characteristic signs and symptoms of angina pectoris include a. substernal pain that radiates down the left arm. b. epigastric pain that radiates to the jaw. c. indigestion, nausea, and eructation. d. fatigue, shortness of breath, and dyspnea.

ANS: A The pain often radiates down the left inner arm to the little finger and also upward to the shoulder and jaw. REF: Pages 1557-1558, Figure 48-11 TOP: Angina pectoris

47. Which are signs of digoxin (Lanoxin) toxicity? a. Nausea b. Bradycardia c. Headache d. Visual disturbance e. Heart rate >60 f. Gastrointestinal complaints

ANS: A, B, C, D Major signs of digoxin toxicity are nausea, bradycardia (HR <60), headache, and visual disturbances, as well as fatigue and dysrhythmias. Heart rate >60 is normal. REF: Page 1554, Table 48-1, Table 48-7 TOP: Function of cardiovascular system

42. Which statements are true? (Select all that apply) a. Anticoagulant therapy is used for DVT prevention. b. Anticoagulant therapy prevents development of new clots, embolization, and clot extension. c. Anticoagulant therapy will dissolve clots. d. Pulmonary embolus is a life-threatening complication requiring treatment with anticoagulant therapy.

ANS: A, B, D Anticoagulant therapy is used for DVT prevention and treatment. For an existing DVT, anticoagulant therapy prevents extension of the clot, development of a new clot, or embolization (embolus traveling through the blood stream). Anticoagulants do not dissolve a clot. REF: Pages 1598-1599 TOP: Thrombophlebitis

39. Modifiable risk factors for coronary artery disease include: (Select all that apply.) a. weight. b. diet. c. genetics. d. exercise.

ANS: A, B, D Maintaining proper weight, dieting, and exercise are all modifiable risk factors. However, familial tendency to develop cardiovascular disease has been documented in the literature. A family member such as a parent or sibling who has a cardiovascular problem before 50 years of age places the patient at greater risk for developing cardiovascular disease. REF: Page 1571, Box 48-8 TOP: Risk factors

44. The functions of the cardiovascular system are to: (Select all that apply.) a. deliver oxygen and nutrients to the cells. b. deliver carbon dioxide and waste products to the cells. c. remove oxygen and nutrients from the cells as waste products. d. remove carbon dioxide and waste products from the cells.

ANS: A, D The functions of the cardiovascular system are to deliver oxygen and nutrients to the cells and to remove carbon dioxide and waste products from the cells REF: Pages 1541, 1543 TOP: Function of cardiovascular system

17. A patient, age 65, has chronic angina pectoris. Her daughter had questions about the proper use of nitroglycerin for pain management. She was unsure about how many times she should take nitroglycerin for an episode of angina. The best reply the nurse could make is a. "Continue to take nitroglycerin sublingually at 5-minute intervals until the pain is relieved." b. "If the pain is not relieved after three doses of nitroglycerin at 5-minute intervals, call your physician and come to the hospital." c. "When nitroglycerin is not relieving the pain, lie down and rest." d. "Use oxygen at home to relieve pain when nitroglycerin is not successful."

ANS: B Administer prescribed nitroglycerin. Repeat every 5 minutes, three times. If pain is unrelieved, notify the physician. Nitroglycerin administered sublingually usually relieves angina symptoms but does not relieve the pain from an MI. Administering nitro more than three times will probably not relieve the pain. REF: Page 1560, Nursing Diagnoses box OBJ: 13 TOP: Angina pectoris

3. The nurse identifies the nursing diagnosis of Ineffective tissue perfusion related to decreased arterial blood flow for a patient with chronic arterial insufficiency. In evaluating the patient outcomes after patient teaching, which statement by the patient does the nurse recognize as indicating a need for further instruction? a. "For about 40 minutes each day, I will walk to the point of pain, then rest, than walk again until I develop pain." b. "I will drink hot coffee several times a day to increase the circulation and warmth in my feet." c. "I will wear loose clothing that doesn't bind across my legs or waist." d. "I will change my position every hour and avoid long periods of sitting with my legs down."

ANS: B Avoiding vasoconstriction from nicotine, caffeine, and stress is an important precaution for patients with decreased arterial blood flow. REF: Pages 1553, 1603, Nursing Diagnoses boxesOBJ: 22 TOP: Arterial disorders Step: Evaluation

7. A patient admitted from the emergency department with a diagnosis of heart failure and a NYHA classification of IV has edema in his lower extremities of +4. Which nursing intervention would aid in decreasing this edema? a. Ambulate in the hallway. b. Elevate lower extremities. c. Keep the extremities in a dependent position. d. Stand at the bedside.

ANS: B Elevate extremities when sitting or lying to promote venous return and decrease incidence of edema and venous stasis. REF: Page 1572 TOP: Peripheral edema

32. A type of medication useful for preventing venous thrombus is a. anticoagulant. b. low-molecular-weight heparin. c. intravenous thrombolytics. d. percutaneous angiography.

ANS: B Low-molecular-weight heparin (LMWH) is effective for the prevention of venous thrombosis, as well as prevention of extension or recurrence. REF: Page 1600 TOP: Medication

28. When providing discharge teaching to a patient with endocarditis regarding prevention of infections, what would the nurse stress? a. Avoid crowds. b. Take antibiotics as prescribed. c. Use only aspirin for mild pain. d. Weigh yourself daily.

ANS: B Patient teaching focuses on identifying causes, infective endocarditis precautions, dietary requirements, and gradually increasing activity levels, as well as teaching the need for prophylactic antibiotics before any invasive procedure if the patient has preexisting valvular heart disease. REF: Page 1582 TOP: Endocarditis

41. Which information should be taught to patients starting on anticoagulant therapy? (Select all that apply.) a. Increase the dose of Aspirin for better therapy. b. Take medication at the same time each day. c. Report to physician cuts that do not stop bleeding with direct pressure. d. No restrictions for food or drink. e. Report for prescribed blood tests (PTT, INR, CBC, blood sugar).

ANS: B, C Aspirin should not be used with anticoagulant therapy because it will increase bleeding. Gums, nosebleeds, excessive bruising, and cuts that do not stop bleeding with direct pressure should be reported to the physician. Alcohol and dark green and yellow vegetables should be avoided because they contain vitamin K. Normal blood tests for anticoagulant therapy are PTT, INR, and PT. REF: Pages 1594, 1600, Nursing Diagnoses box, Safety Alert! TOP: Anticoagulant therapy Step: Planning

40. Which would be included in teaching for patients with Raynaud's disease? (Select all that apply.) a. Warm hands and feet with a heating pad b. Use mittens in cold weather c. Practice stress-reducing techniques d. Complete smoking cessation e. Use caution when cleaning the refrigerator or freezer

ANS: B, C, D, E Nursing interventions include patient teaching in techniques for stress reduction, avoiding exposure to cold, and techniques for smoking cessation. REF: Page 1598, Nursing Diagnoses box TOP: Raynaud's disease

46. When assessing a patient with a myocardial infarction (MI), which is objective data? (Select all that apply.) a. Pain radiating to left arm and jaw b. Hypertension c. Vomiting d. Diaphoresis e. Nausea f. Cardiac rhythm changes

ANS: B, C, D, F Hypertension, vomiting, diaphoresis, and cardiac rhythm changes are objective data seen in patients with a myocardial infarction (MI). Pain and nausea are subjective data felt by the patient but not measurable. REF: Page 1564 TOP: Myocardial infarction

43. Which patient teaching would help to prevent venous stasis? (Select all that apply.) a. Dangle legs when sitting. b. Avoid crossing legs at the knee. c. Elevate legs when lying in bed or sitting. d. Massage extremities to help maintain blood flow. e. Wear elastic stockings when ambulating.

ANS: B, C, E Avoid prolonged sitting or standing. Avoid crossing the legs at the knee. Elevate legs when sitting. Wear elastic stockings when ambulatory. Do not massage extremities because of danger of embolization of clots (thrombus breaking off and becoming an embolus). REF: Page 1600, Nursing Diagnoses box, Table 8-12 TOP: Thrombophlebitis Step: Planning

12. A 53-year-old patient with a history of dysrhythmias is to wear a Holter monitor. The nurse should explain that Holter monitoring a. is a form of stress test. b. amplifies heart sounds. c. is a portable electrocardiographic device. d. regulates heart rate.

ANS: C A Holter monitor (a small portable recorder) is attached to the patient by one to four leads, with a 2-pound tape recorder carried on a belt or shoulder strap. REF: Page 1545 TOP: Dysrhythmias

29. A patient has been admitted after the insertion of a pacemaker because of bradycardia. She asks what third-degree heart block is, and the nurse replies a. "Coronary blood vessel occlusion causing slow contraction of the right ventricles." b. "Sclerosis of cardiac valves causing slow pulse." c. "A defect in AV junctions slows and impairs conduction of impulses from the SA node to the ventricles." d. "Increased pressure in the pulmonary vessels."

ANS: C Atrioventricular block occurs when a defect in the AV junction slows or impairs conduction of impulses from the SA node to the ventricles. REF: Page 1552 TOP: Dysrhythmias

35. Which nursing intervention reduces myocardial oxygen demand? a. Supplying a portable oxygen unit during activity b. Encouraging participation in cardiac rehabilitation program c. Elevating the head of the bed 30 to 45 degrees d. Positioning patient in supine position

ANS: C Bed rest and semi-Fowler's position reduce myocardial oxygen demands. REF: Page 1571 TOP: Myocardial infarction

6. A patient admitted from the emergency room with a diagnosis of heart failure and a NYHA classification of IV is requesting ambulation to the bathroom. Which nursing intervention would be appropriate for this patient? a. Assist the patient to the bathroom. b. Obtain a bedside commode. c. Offer a urinal or bedpan. d. Obtain assistance of another nurse and ambulate the patient to the bathroom.

ANS: C Class IV: Severe: patient unable to perform any physical activity without discomfort. REF: Page 1570, Box 48-3 TOP: Heart failure

14. The patient achieves comfort in breathing only when he assumes a sitting posture. During the charting of this position, the nurse can describe this as a. dyspnea. b. orthophrenia. c. orthopnea. d. orthuria.

ANS: C Collection of subjective data includes complaints of dyspnea and orthopnea (an abnormal condition in which a person must sit or stand in order to breathe deeply or comfortably). REF: Page 1604 TOP: Orthopnea

2. A 63-year-old patient with an acute myocardial infarction is on a cardiac monitor and begins to show some dysrhythmias. The physician will probably prescribe which intravenous medication? a. Nitroglycerin b. Digitalis c. Lidocaine d. Amyl nitrite

ANS: C Management of dysrhythmias is accomplished by suppressing the impulse that triggers dysrhythmias. REF: Pages 1552-1553, Table 48-1 TOP: Acute myocardial infarction

24. Restlessness, diaphoresis, severe dyspnea, tachypnea, hemoptysis, audible wheezing, and crackles are signs and symptoms of a. heart failure. b. respiratory failure. c. pulmonary edema. d. peripheral edema.

ANS: C Signs and symptoms of pulmonary edema are restlessness; vague uneasiness; agitation; disorientation; diaphoresis; severe dyspnea; tachypnea; tachycardia; pallor or cyanosis; cough producing large quantities of blood-tinged, frothy sputum; audible wheezing and crackles; cold extremities. REF: Page 1576, Box 48-5 TOP: Pulmonary edema

36. There is a strong relationship between Buerger's disease (thromboangiitis obliterans) and a. Alcohol b. Cocaine c. Smoking d. Obesity

ANS: C The hazards of cigarette smoking and its relationship to Buerger's disease are the primary focus of patient teaching. None of the palliative treatments are effective if the patient does not stop smoking. Nowhere are the cause and effect of smoking so dramatically seen as with Buerger's disease. REF: Pages 1596-1597 TOP: Buerger's disease

8. A patient, age 59, has Buerger's disease. The most important aspect of patient compliance in order to decrease signs and symptoms of Buerger's disease is a. a low-fat diet. b. weight loss. c. not smoking. d. keeping extremities warm.

ANS: C There is a very strong relationship between Buerger's disease and tobacco use. It is thought that the disease occurs only in smokers, and when smoking is stopped, the disease improves. None of the palliative treatments are effective if the patient does not stop smoking. REF: Page 1597 TOP: Buerger's disease Step: Evaluation

13. After an influenza-like illness, the patient complains of chills and small petechiae in his mouth and his legs. A heart murmur is detectable. These are characteristic signs of a. congestive heart failure. b. heart block. c. aortic stenosis. d. infective endocarditis.

ANS: D Collection of subjective data includes noting patient complaints of influenza-like symptoms with recurrent fever, undue fatigue, chest pain, and chills. Objective data may reveal the significant signs of petechiae in the conjunctiva and mouth. Both subjective data and objective data are indicative of infective endocarditis. REF: Page 1581 TOP: Endocarditis Step: Assessment

9. A patient has heart failure. His physician's orders include complete bed rest. The nurse knows that this order means he a. is encouraged to rest as much as possible. b. is confined to bed but may assume responsibility for all of his personal care. c. is confined to bed but is allowed to go to the bathroom as needed. d. must remain as quiet as possible, with any task requiring physical effort done for him.

ANS: D Complete bed rest: Lowering oxygen requirements of the body systems with head of the bed elevated to 45 degrees to reduce myocardial oxygen demand and decrease circulating volume returning to the heart. REF: Page 1572 TOP: Heart failure Step: Planning

38. Edema and pulmonary congestion are treated with: a. Unlimited activity, high protein diet, weights weekly b. Bed rest, normal diet, weights four times daily c. Increase in fluids, no activity restrictions d. Diuretics, restriction of sodium diet and fluid intake

ANS: D Edema and pulmonary congestion are treated with diuretics, a sodium-restricted diet, and restriction of fluid intake. Weigh the patient daily to monitor fluid retention. REF: Page 1571 TOP: Right ventricular failure Step: Planning

37. In older adults, rapid infusion of fluids can lead to a. Hypotension b. Thrombophlebitis c. Mitral insufficiency d. Heart failure

ANS: D Heart failure can result from rapid infusion of intravenous fluids in older adults. DIF: Cognitive Level: Knowledge REF: Page 1548, Life Span Considerations box, Box 8-4 TOP: Function of cardiovascular system

16. A patient is admitted with a diagnosis of possible aortic aneurysm. In assessing her, it is most important to monitor her a. temperature. b. lung sounds. c. respirations. d. blood pressure.

ANS: D Initial nursing interventions include monitoring the status of an existing aortic aneurysm. The patient should be monitored for signs of rupture of the aneurysm, such as hypotension. REF: Page 1595 TOP: Aortic aneurysm

1. Modifiable risk factors for coronary artery disease (CAD) include which group? a. Diabetes, family history b. Family history, smoking c. Smoking, heredity d. High cholesterol, obesity

ANS: D Modifiable factors include smoking, hyperlipidemia, hypertension, diabetes mellitus, and obesity. REF: Page 1550 TOP: Risk factors

18. The patient has been hospitalized for congestive heart failure (CHF) three times in the last 4 months. While preparing the discharge teaching plan, the nurse assesses that he does not comply with his medication regimen. The nurse's immediate course of action would be to a. reteach him about his medications. b. have a serious talk with him and his family about compliance. c. arrange for home visits after discharge. d. collect more information to identify his reasons for noncompliance.

ANS: D Nursing interventions include measures to prevent disease progression and complications. Reteaching about medication will not identify the cause of noncompliance. REF: Pages 1558, 1572, Box 48-9 TOP: Heart failure Step: Evaluation

50. An is an enlarged, dilated portion of an artery and may be the result of arteriosclerosis, trauma, or a congenital defect.

ANS: aneurysm REF: Page 1595 TOP: Aneurysm