Week 3 Exam

A client is admitted to the hospital with a venous stasis leg ulcer, the nurse inspects the ulcer expecting to note that:

Has a brownish or "brawny" appearance

When is the best time to take Furosemide?

In the morning

The nurse is aware that the symptoms of an impending myocardial infarction (MI) differ in women because acute chest pain is not present. Women are frequently misdiagnosed as having:

Indigestion

What are splinter hemorrhages a sign and symptom of?

Infective endocarditis

As a nurse is caring for the client immediately after insertion of a permanent demand pacemaker via the right subclavian vein, the nurse prevents dislodgment of the pacing catheter wires by implementing which intervention?

Limiting movement and abduction of the right arm

If the nurse is collecting data on a child with the diagnosis of rheumatic fever, which of the following questions would the nurse initially ask the mother of the child?

"Has the child complained of a sore throat within the past few months?"

If a home health nurse caring for a patient with infective endocarditis overhears a patient for an extraction in a month, what should the nurse ask?

"Have you contacted your physician about your dental appointment?"

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?

"I will drink hot coffee several times a day to increase the circulation and warmth in my feet."

A patient with angina pectoris is being discharged with nitroglycerin tablets. Which of the instructions does the nurse include in the teaching?

"Place one Nitroglycerine tablet under the tongue every five minutes for three doses. Go to the hospital if the pain is unrelieved."

A patient who has just begun an angiotensin converting enzyme calls the nurse and reports feeling very dizzy when standing up and asks if the medication should be discontinued, what's the best response by the nurse?

"Rise to a sitting or standing position slowly; your symptoms will resolve."

A client had abdominal aortic aneurysm graft procedure two days ago, this morning the client says I don't feel any better than I did before the surgery, the appropriate response by the nurse is:

"You are concerned that you don't feel any better after surgery?"

The client is to receive metoprolol tartrate 0.05 g po every day. Each scored tablet contains 50 mg. How many tablets would the client receive?

1

If a person has a pacemaker inserted for more than 5 years what should they avoid?

MRI's

If a patient is on warfarin, what should you teach specifically about diet?

Maintain vitamin K

The nurse assessing the cardiac monitor notes that the cardiac complexes have a P wave followed by a QRS and T wave

Normal sinus wave

A trauma patient arrives in the ER, this person is bleeding profusely, a medical alert bracelet indicates that he is on Heparin, the nurse will most likely administer which medication to counteract Heparin?

Protamine Sulfate

If you see a patient in the ER and this person appears restless, has diaphoresis, severe dyspnea, tachypnea, blood tinged frothy sputum, audible wheezing, and crackles are signs and symptoms of

Pulmonary Edema

What is a major cause of cardiac valve disease?

Rheumatic fever

How should the nurse advise the patient with an INR of 5.8?

Stop taking the anticoagulant and notify health care provider

What are some signs and symptoms of angina?

Substernal pain that radiates down the left arm

A client with hypertension has been prescribed a low sodium diet, the nurse teaching this client about foods that are allowed should plan to include which of the following in a list provided to the client?

Summer squash

A client has an Unna boot applied for treatment of a venous stasis leg ulcer. The nurse notes that the client's toes are mottled, and cool and the client verbalizes some numbness and tingling of the foot. Which interpretation should the nurse make of these findings?

The boot has been applied too tightly

A nurse is working with a client receiving an IV Heparin sodium drip, the nurse should review which of the following lab studies to determine the therapeutic effect of Heparin?

aPTT

How long do you hold insulin injection for? Even for blood thinners like Levonox or Enoxaparin to increase absorption

10 seconds

What will the nurse advise the patient to avoid the development of tolerance to nitro patches?

Allow for a daily 8- to 12-hour nitrate free period

A client seeks treatment in a doctors office for unsightly varicose veins and sclerotherapy is recommended, before leaving the exam room the client says to the nurse, "Can you tell me again how this sclerotherapy is done?" In formulating a response the nurse informs the client that sclerotherapy consists of:

An agent is injected into the vein to damage the vein wall and close the vein off."

The clinic nurse is obtaining cardiovascular data on a client, the nurse prepares to check the client's apical pulse and places the stethoscope in which position?

At the mid-clavicular line at the fifth left intercostal space

A nurse is assisting in the care of a client with MI who should reduce intake of saturated fat and cholesterol. The nurse should help the client comply with diet therapy by selecting which of the following food items?

Baked haddock/salmon, steamed broccoli, herbed rice, sliced strawberries

The physician tells the nurse that a patient is hypokalemic, has been taking a thiazide medication for treatment of his high blood pressure, the nurse should instruct him to increase his dietary intake of which of the following?

Bananas and citrus fruits

A client with MI has suspected blood clot of the leg is a candidate of altiplace, the nurse assisting in the care of the client is aware that it will be necessary to monitor for which frequent adverse effect the client receives this treatment?

Bleeding

Which nursing assessment confirms that the angiotensin II receptor blocker that a patient is taking is effective?

Blood pressure has decreased

A nurse is caring for a client on a cardiac monitor who is alone in a room at the end of the hall. The client has a short burst of Vtac followed by Vfib, which intervention should the nurse do first?

Call for help and initiate cardiopulmonary resuscitation (CPR)

The nurse making a teaching plan for a patient with Bueger's disease will teach them to:

Cessation of smoking

If a patient has been hospitalized for hypertensive episodes about 3 times in the last month while preparing the discharge teaching plan, the nurse assesses that he doesn't comply with his medication regimen, the nurse's immediate course of action would be to:

Collect more information to identify his reasons for noncompliance

A client with an abdominal aortic aneurysm is not a candidate for surgery because the aneurysm is not yet large enough, the client is fearful that the aneurysm will rupture causing death, the nurse plans to assist the client in coping with this fear by emphasizing what the client can do for self-monitoring:

Control hypertension with prescribed therapy

The nurse is providing instruction to a patient who is recently prescribed an ace inhibitor for hypertension, what is an adverse effect of this medication?

Cough

The patient is on the cardiac monitor undergoing a diagnostic procedure suddenly the health care provider says "the patient is having ventricular fibrillation". Which piece of equipment is the most vital?

Defibrillator

A client brings the following meds to the clinic for a yearly physical, the nurse realizes which medication has been prescribed to treat heart failure?

Digoxin

Which drug will you administer to a patient being admitted with severe digoxin intoxication?

Digoxin immune Fab (Digibind)

Which action will the nurse implement to decrease the risk of clot formation in an older patient on bedrest?

Encourage passive leg exercise

Activity intolerance related to generalized weakness, what intervention does the nurse plan while the patient is febrile (fever)?

Encourage rest and decrease activity

A client is admitted to hospital with possible rheumatic heart disease, the nurse collects data from the client and checks the client for which signs and symptoms?

Fever and sore throat