Module 8
A person newly diagnosed with Kawasaki disease in the acute phase will likely exhibit which clinical manifestations? Select all that apply.
- Fever - Edematous hands and feet - Bilateral conjunctivitis
The nurse knows that which statements regarding blood pressure in the black population are correct? Select all that apply.
- Hypertension is more severe among black persons compared to people from other ethnic groups. - Black clients often experience greater renal damage from hypertension. - Hypertension in black clients is often treated less aggressively.
The nurse is teaching a group of clients about hypertension. The nurse determines that teaching was effective when the clients state:
- It is the most common cardiovascular disorder. - The incidence increases with age. - The systolic pressure is ≥140 mm Hg.
A nurse is planning a community education program on lifestyle modification to manage hypertension. Which topic should be included in the teaching plan? Select all that apply.
- Limit alcohol consumption. - Reduce dietary sodium intake. - Consume a diet rich in fruits, vegetables, and low-fat dairy products. - Stop smoking.
The nurse suspects a client has stage 2 systolic hypertension. What systolic pressure would confirm the nurse's suspicion?
140 mm Hg or higher
While working triage in the emergency department, which client report should alert the nurse to imminent danger and, thus, that client should be seen first?
A client holding the abdomen and reporting a tearing and ripping feeling inside.
Which individual is likely experiencing the manifestation of acute coronary syndrome (ACS)?
A client who occasionally experiences persistent and severe chest pain when at rest
The client tells the provider he has lower back pain. Although most abdominal aneurysms are asymptomatic, the provider examines the client for which initial sign of this condition?
A pulsating mass in the abdomen
A client with a history of acute coronary syndrome asks why she needs to take aspirin 81 mg every day. The most appropriate response by the nurse would be:
"Aspirin will help prevent blood clotting."
A client has been diagnosed with chronic obstructive arterial disease. Which client statement indicates she understands how to manage this disease?
"I should have my LDL monitored."
The nurse is teaching a client with a diagnosis of hypertrophic cardiomyopathy and aortic valve stenosis. Which statement by the client shows that the client understands this condition?
"I should report episodes of dizziness or fainting."
A client has just been diagnosed with hypercholesterolemia and is asking what treatment will be needed. About which topics should the nurse educate the client? Select all that apply.
- Dietary measures to reduce LDL levels - Weight reduction if overweight - Smoking cessation
What should the nurse teach the client prior to ergometry?
"This test evaluates cardiac function."
The nursing student correctly identifies which major risk factors for coronary artery disease? Select all that apply.
- Abdominal obesity - Elevated LDL - Cigarette smoking - Diabetes - Elevated blood pressure
Which hypertensive individual is most likely to have his or her high blood pressure diagnosed as secondary rather than essential?
A 51-year-old male who has been diagnosed with glomerulonephritis
Which client is at greatest risk for orthostatic hypotension?
A 66-year-old postoperative client on bed rest
A client is transported to the emergency department in respiratory distress after eating peanuts. The following interventions are ordered by the health care provider. Which intervention should the nurse complete first?
Administer epinephrine (adrenaline).
Following several weeks of increasing fatigue and a subsequent diagnostic workup, a client has been diagnosed with mitral valve regurgitation. Failure of this heart valve would have which hemodynamic consequences?
Backflow from the left ventricle to left atrium
While examining a client, a physician finds reddish-blue, mottled areas of discoloration on the skin of the extremities (livedo reticularis). The client states she has had anorexia, weight loss, fatigue, and fever. Which diagnostic test will confirm a diagnosis?
Biopsy specimens
A pregnant female client is at risk for the development of preeclampsia-eclampsia. Select the most important data to assess.
Blood pressure 160/100 mm Hg and proteinuria during the 30th week of pregnancy
A nurse is planning a community education program on hypertension. Which parameter should be included to explain the regulation of arterial blood pressure?
Cardiac output and systemic vascular resistance
The nursing instructor is teaching her nursing students about cardiac function and different heart diseases. Which disease does she tell the students is caused by calcified scar tissue that develops between the visceral and parietal layers of the serous pericardium?
Constrictive pericarditis
When an acute MI occurs, many physiologic changes occur very rapidly. What causes the loss of contractile function of the heart within seconds of the onset of an MI?
Conversion from aerobic to anaerobic metabolism
What should the nurse teach the client with peripheral vascular disease and intermittent claudication about exercise?
Exercise can increase blood vessel growth and help to decrease symptoms.
A client with heart failure has just had an automatic defibrillator implanted. When the nurse is performing follow-up assessment the next month, which finding is most likely the result of a complication?
Fever and diaphoresis
The health care provider is discussing major risk factors for coronary artery disease (CAD) with a client. The most important information for the provider to include would be:
History of cigarette smoking and elevated blood pressure
A 17-year-old athlete died suddenly during a track meet and it was subsequently determined that he had heart disease. Which condition was the most likely cause of his heart failure?
Hypertrophic cardiomyopathy
A young college football player was bought to the emergency room after collapsing on the football field during practice. When arriving he was unconscious and his ECG was abnormal. Subsequently he died after arresting in the emergency room. What does the physician suspect is the likely cause of this?
Hypertrophic cardiomyopathy
Anaphylactic shock is the most severe form of systemic allergic reaction. Immunologically medicated substances are released into the blood, causing vasodilation and an increase in capillary permeability. What physiologic response often follows the vascular response in anaphylaxis?
Laryngeal edema
Which description sums up the basic pathophysiology of heart failure that the nurse would include when educating a client?
Low cardiac output due to reduced pumping ability
Which lipoprotein is the main carrier of cholesterol?
Low-density lipoprotein (LDL)
The nurse working in the emergency room triages a client who comes in reporting chest pain, shortness of breath, sweating and elevated anxiety. The physician suspects a myocardial infarction. The client is given a nitrate, which does nothing for his pain. Which medication should the nurse suspect the doctor will order next for the pain?
Morphine
A client with a long history of stable angina suddenly experiences substernal pain that radiates to the left arm, neck, and jaw. He describes the pain as severe and feels as if he is suffocating. He has taken nitroglycerin and not experienced any relief. The client is most likely experiencing:
Onset of STEMI
A client comes to the emergency room exhibiting signs and symptoms of right-sided heart failure. Upon X-ray it is determined that he has 250 mL of fluid in the pericardial cavity. Which disease should the nurse suspect this client is suffering?
Pericardial effusion
A client is seen in the emergency room reporting sharp chest pain that started abruptly. He says it has radiated to his neck and abdomen. He also states that it is worse when he takes a deep breath or swallows. He tells the nurse that when he sits up and leans forward the pain is better. Upon examination the nurse notes a pericardial friction rub and some EKG changes. Which disease should the nurse suspect this client to have?
Pericarditis
A 37-year-old woman is admitted to the unit with a differential diagnosis of rule out pheochromocytoma. What are the most common symptoms the nurse would expect this client to exhibit?
Periodic severe headache and marked variability in blood pressure
While lecturing on blood pressure, the nurse will emphasize that the body maintains its blood pressure by adjusting the cardiac output to compensate for changes in which physiologic process?
Peripheral vascular resistance
The nurse knows that vasopressin (antidiuretic hormone, ADH) plays which role in blood pressure control?
Promotes retention of water
The client's ultrasound shows a thrombus in the venous sinus in the soleus muscle. The nurse explains that early treatment is important to prevent:
Pulmonary embolism
Which situation related to transition from fetal-to-perinatal circulation would be most likely to necessitate medical intervention?
Pulmonary vascular resistance, related to muscle regression in the pulmonary arteries, rises over the course of the infant's first week.
A client presents to the emergency department reporting bilateral cyanosis and pallor of the fingers after being out in the cold weather for 5 minutes. The toes are of normal color. What is a potential diagnosis for this client?
Raynaud disease
The nurse should anticipate administering intravenous antibiotic therapy as a priority to a client experiencing which type of shock?
Septic shock
What is the primary cause of heart failure in infants and children?
Structural heart defects
After an acute myocardial infarction, the client undergoes a cardiac catheterization that reveals severe atherosclerosis. The practitioner reviews the labs and finds the client has no HDL. Which condition does the client exhibit?
Tangier disease
A client has been diagnosed with a dissecting aortic aneurysm. It is most important for the nurse to assess the client for:
Tearing or ripping-type pain in the chest or back
Which client is at the greatest risk of developing rheumatic heart disease?
Teenager with untreated strep throat
The nurse is preparing to auscultate a client's blood pressure. Which information obtained from the client would indicate that the nurse should wait 30 minutes prior to obtaining a reading?
The client just smoked a cigarette.
A client has just been admitted to the cardiac intensive care unit with a diagnosis of infective endocarditis. His wife appears distraught and asks the nurse what caused this to happen to her husband. What would be the nurse's best response?
The most common cause is a staph infection.
Heart failure and circulatory shock are both conditions of circulatory system failure. Which statement regarding these conditions is correct?
They have the same compensatory mechanisms.
A client comes to the emergency room with all the symptoms of a myocardial infarction. Which lab value, known to have a high specificity for myocardial tissue considered the primary biomarker test for diagnosing an MI, does the nurse suspect the physician will order?
Troponin assays
Which blood vessel layer is composed primarily of smooth muscle cells?
Tunica media
A client is told that she has cardiac valve leaflets, or cusps, that are floppy and fail to shut completely, permitting blood flow even when the valve should be completely closed. The nurse knows that this condition can lead to heart failure and is referred to as:
Valvular regurgitation
Which of the following is associated with stasis of blood, increased blood coagulability, and vessel wall injury?
Venous thrombosis
A 45-year-old client is undergoing exercise stress testing. At which point will the test be halted and not allowed to continue?
When the client experiences chest pain
Mitral valve prolapse occurs frequently in the population at large. Its treatment is aimed at relieving the symptoms and preventing complications of the disorder. Which drug is used in the treatment of mitral valve prolapse to relieve symptoms and aid in preventing complications?
beta-adrenergic blocking drugs (beta-blockers)
An older adult client has been diagnosed with chronic heart failure. He is prescribed an ACE inhibitor to treat the symptoms and improve his quality of life. This drug will alleviate the client's symptoms of heart failure by:
blocking the conversion of angiotensin I to angiotensin II.
A client with hypercholesterolemia is being treated with diet and exercise. Which assessment finding is a positive outcome of this treatment regimen?
increased high-density lipoproteins
The health care provider has determined that a client diagnosed with cardiogenic shock will now require treatment with the intra-aortic balloon pump. The expected effect of the treatment is:
decreased afterload.
An older adult client is newly diagnosed with hypertension. Which vascular changes in the aging adult can lead to hypertension?
decreased elasticity of the aorta and large arteries
A nurse is teaching a client with newly diagnosed dilated cardiomyopathy (DCM) about associated treatments. The nurse determines that the knowledge is understood when the client correctly matches which drug category to the primary action of decreasing preload by suppressing renal reabsorption of sodium and increasing salt and water excretion?
diuretics
