Cardiac PrepU
The nurse is performing health education-related lifestyle modifications for a patient who has been newly diagnosed with hypertension. As a component of these modifications, the DASH (Dietary Approaches to Stop Hypertension) eating plan has been recommended to the patient. Which of the nurse's recommendations is most congruent with this eating plan? a. "Try to buy and consume as many organic and natural foods as you can." b. "Try to replace the complex carbohydrates in your diet with protein-rich foods." c. "Try to reduce the overall amount of fat that is in your diet." d. "If you eat four of five small meals each day, you'll find that you're able to reduce your calorie intake."
"Try to reduce the overall amount of fat that is in your diet."
A client with a mechanical valve replacement asks the nurse, "Why do I have to take antibiotics before getting my teeth cleaned?" What is the nurse's best response? a. "You are at risk of developing an infection in your heart." b. "Your teeth will not bleed as much if you have antibiotics." c. "This procedure may cause your valve to malfunction." d. "Antibiotics will prevent vegetative growth on your valves."
a. "You are at risk of developing an infection in your heart."
A patient with hypertension is waking up several times a night to urinate. The nurse knows that what laboratory studies may indicate pathologic changes in the kidneys due to the hypertension? (Select all that apply.) a. Creatinine b. AST and ALT c. Urine for culture and sensitivity d. Blood urea nitrogen (BUN) e. Complete blood count (CBC)
a. Creatinine d. Blood urea nitrogen (BUN)
A client is given a prescription for metoprolol after being examined by the health care provider. What is the most important teaching for the nurse to give to the client? a. Don't suddenly stop taking the medication without calling your health care provider. b. If dizziness occurs, adjust the medication. c. Dress warmly. Blood circulation may be reduced in the extremities. d. Take the medication at the same time each day.
a. Don't suddenly stop taking the medication without calling your health care provider.
A patient who had a colon resection 3 days ago is complaining of discomfort in the left calf. How should the nurse assess Homan's sign to determine if the patient may have a thrombus formation in the leg? a. Dorsiflex the foot while the leg is elevated to check for calf pain. b. Elevate the patient's legs for 20 minutes and then lower them slowly while checking for areas of inadequate blood return. c. Extend the leg, plantar flex the foot, and check for the patency of the dorsalis pedis pulse. d. Lower the patient's legs and massage the calf muscles to note any areas of tenderness.
a. Dorsiflex the foot while the leg is elevated to check for calf pain.
A client in the ED has a 5-cm thoracic aortic aneurysm that was discovered during a routine chest x-ray. When obtaining the client's history, which symptoms will it be most important for the nurse to ask about? a. Hoarse voice and difficulty swallowing b. Back or lumbar pain c. Abdominal swelling and tenderness d. Changes in bowel and bladder habits
a. Hoarse voice and difficulty swallowing
A nurse is caring for a client after cardiac surgery. Upon assessment, the client appears restless and reports nausea and weakness. The client's ECG reveals peaked T waves. The nurse reviews the client's serum electrolytes, anticipating which abnormality? a. Hyperkalemia b. Hypercalcemia c. Hypomagnesemia d. Hyponatremia
a. Hyperkalemia
The nurse is admitting a 45-year-old man to the medical-surgical unit. The patient has a diagnosis of Buerger's disease. While the nurse is taking the patient's health history, he reveals that he smokes about 2 packs of cigarettes a day, has a history of alcohol abuse, and does not exercise. What would be the priority teaching for this patient? a. That cigarettes contain nicotine, which is a powerful vasoconstrictor and may cause or aggravate Buerger's disease b. The fact that alcohol suppresses the immune system, creates high glucose levels, and may cause Buerger's disease c. The likelihood that not exercising may cause his death in the near future without a significant change in behavior d. The lack of exercise, which is the identified cause of Buerger's disease
a. That cigarettes contain nicotine, which is a powerful vasoconstrictor and may cause or aggravate Buerger's disease
A patient has a diagnosis of dilated cardiomyopathy (DCM) and was admitted 24 hours ago for treatment. Which of the following principles should the nurse integrate into the planning of this patient's care? a. The patient will benefit from bed rest in the short term, and activity should be introduced slowly. b. Normal levels of activity should be resumed as soon as possible to reduce the risk of complications. c. The patient will benefit from early ambulation. d. The patient will need to avoid a heart rate of 75 beats per minute or more for several months.
a. The patient will benefit from bed rest in the short term, and activity should be introduced slowly.
What risk factors would cause the nurse to become concerned that the client may have atherosclerotic heart disease? Select all that apply. a. family history of eary cardiovascular events b. lowered triglyceride levels c. active lifestyle d. diabetes e. hypertension f. obesity
a. family history of eary cardiovascular events d. diabetes e. hypertension f. obesity
The nurse is teaching a client about atherosclerosis. The client asks the nurse what the substance causing atherosclerosis is made of. How does the nurse best respond? a. fatty deposits in the lumen of arteries b. cholesterol plugs in the lumen of veins c. blood clots in the arteries d. emboli in the veins
a. fatty deposits in the lumen of arteries
A patient who is postoperative day 2 following a coronary artery bypass graft (CABG) has been experiencing significant pain in the region of his sternal incision. What patient teaching should the nurse perform with this patient? a. "If possible, try to avoid coughing and breathe as shallowly as possible to relieve pressure on your incision." b. "Try to hug a folded blanket across your chest when you move or breathe deeply." c. "The less you can move, the less pain you're likely to have in the area of your incision." d. "Getting you up and mobilizing as soon as possible will help with this problem."
b. "Try to hug a folded blanket across your chest when you move or breathe deeply."
The nurse is to administer morphine sulfate to a client with chest pain. What initial nursing action is required prior to administration? a. Check the radial pulse for dysrhythmias. b. Count the respiratory rate for bradypnea. c. Measure the blood pressure for hypertension. d. Measure urinary output for dehydration.
b. Count the respiratory rate for bradypnea.
The nurse is taking a health history on a new patient. The patient reports experiencing pain in the left lower leg and foot when walking, but claims that the pain is relieved with rest. The nurse notes that the patient's left lower leg is slightly edematous and hairless. What should the nurse suspect that the patient may be experiencing? a. Coronary artery disease (CAD) b. Intermittent claudication c. Arterial embolus d. Raynaud's disease
b. Intermittent claudication
The nurse is caring for a patient who has been diagnosed with an elevated cholesterol level. The nurse is aware that plaque on the inner lumen of arteries is composed chiefly of what? a. High-density cholesterol b. Lipids and fibrous tissue c. WBCs d. Lipoproteins
b. Lipids and fibrous tissue
The triage nurse in the emergency department assesses a 66-year-old male patient who has presented to the emergency department with complaints of midsternal chest pain that has lasted for the last 5 hours. The care team suspects a myocardial infarction (MI). The nurse is aware that, because of the length of time the patient has been experiencing symptoms, the following may have happened to the myocardium: a. Can have restoration of the area of dead cells with proper treatment b. May have developed an increased area of infarction c. Has been damaged already, so immediate treatment is no longer necessary d. Will probably not have more damage than if he came in immediately
b. May have developed an increased area of infarction
A home health nurse is seeing an elderly male client for the first time. During the physical assessment of the skin on the lower legs, the nurse notes edema, brown pigmentation in the gater area, pedal pulses, and a few irregularly shaped ulcers around the ankles. From these findings, the nurse knows that the client has a problem with peripheral circulation. Which of the following does the nurse suspect? a. Arterial insufficiency b. Venous insufficiency c. Neither venous nor arterial insufficiency d. Trauma
b. Venous insufficiency
Following several months of increasing dyspnea on exertion, a 71-year-old woman has been diagnosed with mitral stenosis (MS). The woman is relieved to receive a diagnosis that explains her symptoms but does not completely understand the root of her problem. How can the nurse best explain the woman's health problem? a. "The valve between your lungs and your heart has become inelastic, so your heart can't fill up with enough blood." b. "When your heart beats, some of the blood that should go to your body is backing up into your heart because the valve leaks." c. "The valve in the left side of your heart has become stiff and narrowed, so your heart can't fill with all the blood that your body needs." d. "The left side of your heart is having trouble overcoming the resistance in your blood vessels because a valve is not sealing."
c. "The valve in the left side of your heart has become stiff and narrowed, so your heart can't fill with all the blood that your body needs."
The nurse reviews laboratory tests for cardiac biomarkers for a client suspected of suffering an MI. What is the earliest marker of an MI? a. Creatinine kinase-myocardial band (CK-MB) b. Troponin I and T c. Myoglobin d. Total creatinine kinase (CK)
c. Myoglobin
A client has a history of rheumatic fever as a child. Which instructions should be provided before the client has any dental work done? a. Avoid any kind of activities. b. Take aspirin. c. Take prophylactic antibiotics. d. Take steroids.
c. Take prophylactic antibiotics.
The nurse is teaching a client with cardiomyopathy. Which statement is a valid teaching point? a. Clients with cardiomyopathy often need to live in a skilled nursing care facility. b. Clients with cardiomyopathy have a goal to improve lung function. c. The treatments include medications, medical devices, surgery, or transplantation. d. The disease was inherited, so there are no reversal treatments.
c. The treatments include medications, medical devices, surgery, or transplantation.
One of the most common causes of mitral valve regurgitation in people living in developed countries is a. myxomatous changes. b. ischemic heart disease. c. ischemia of the left ventricle. d. rheumatic fever.
c. ischemia of the left ventricle.
A nurse working at a pediatric clinic is teaching a group of parents. A parent asks the nurse if it is okay to let the young child recover from a sore throat naturally, rather than bringing the child to the clinic for diagnosis and treatment. What is the nurse's best response? a. "It is not a good idea to give antibiotics for every sore throat that your child has because of the overuse of antibiotics." b. "It is fine to let the child recover naturally; it will save you time and money." c. "Health care providers tend to overtreat children with antibiotics so the child recovers quickly." d. "It may be streptococcal sore throat. Rheumatic heart disease can be prevented with early treatment."
d. "It may be streptococcal sore throat. Rheumatic heart disease can be prevented with early treatment."
The nurse notes that the post cardiac surgery client demonstrates low urine output (< 25 mL/hr) with high specific gravity (> 1.025). What will the nurse anticipate the health care provider will order? a. Decrease intravenous fluids b. Irrigate the urinary catheter c. Prepare the client for diaylsis d. Increase intravenous fluids
d. Increase intravenous fluids
A 61-year-old man has a longstanding history of peripheral artery disease that has progressed in recent months to acute limb ischemia (ALI). As a result, he has just undergone bilateral arterial bypass grafts and is postoperative day 1. The nurse's most recent assessment reveals that the patient's left foot is cold to touch and dusky in appearance with nonpalpable peripheral pulses. How should the nurse respond to this assessment finding? a. Place a warm compress on the patient's foot to stimulate circulation. b. Administer a dose of the patient's prescribed anticoagulant. c. Encourage the patient to perform light activity and assist with range of motion exercises. d. Report the finding to the surgeon immediately.
d. Report the finding to the surgeon immediately.
