NUR 330 Exam 2 Sensory/Perceptual/Cardiovascular/Vascular Health/
What are the 3 hallmark symptoms of Ménière's disease? A) vertigo, tinnitus, hearing loss B) veritgo, tinnitus, hematoma C) dysphasia, vertigo, tinnitus D) hematoma, tinnitus, vertigo
A) vertigo, tinnitus, hearing loss
What should the nurse monitor when looking at myocarditis? Select all that apply A) vital signs B) heart sounds C) heart rate D) HF symptoms E) stroke symptoms
A) vital signs B) heart sounds C) heart rate D) HF symptoms
outcomes of pericarditis? (Select all that apply) A) decreased elasticity B) decrease cardiac output C) cardiac tamponade D) increased stretch of muscles
A) decreased elasticity B) decrease cardiac output C) cardiac tamponade
What needs to be resolved before bed rest can be discontinued? (Select all that apply) A) fever B) chest pain C) friction rub D) dyspnea
A) fever B) chest pain C) friction rub
What is a normal WBC count?
5000-10000
True or false: There is a 100% cure for Ménière's disease? A) true B) false
B) false
What is the major symptom of myocarditis? A) decreased bp B) decreased rr C) increased bp D) increased rr
A) decreased bp
The goal is to prevent optic nerve damage by doing what to the IOP? A) increasing it B) decreasing it C) keeping it the same
B) decreasing it
Does a negative result of blood cultures rule out endocarditis? A) yes B) no
B) no
How long is recovery for treatment of retinal detachment? A) 1-2 weeks B) 2 weeks C) 2-3 weeks D) 3-4 weeks
C) 3-4 weeks
How is endocarditis diagnoses? A) urine samples B) HR monitoring C) blood cultures D) organ sampling
C) blood cultures
Secondary represents? A) symptom B) seen by healthcare provider C) said by patient D) none of the above
A) symptom
A nurse at an Ophthalmic G clinic is providing teaching to a client who has an open angle glaucoma and a new prescription for timolol eye drops. Which of the following instruction should the nurse provide? A) the medication is to be applied when the client is expressing our pain B) the medication will be used into the client in ocular pressure return to normal C) the medication should be applied on a regular schedule for the rest of the clients life D) the medication is to be used for approximately 10 days following a gradual tapering off
C) the medication should be applied on a regular schedule for the rest of the clients life Medications prescribed for open angle glaucoma are intended to enhance adequate outflow, or decrease its production, or both. The client must continue to use the eyedrops or an on interrupted basis for life to maintain intraocular pressure at an acceptable level
What is glaucoma characterized by?
Ocular nerve damage
A nurse is caring for a client who has A pulmonary embolism and has a new prescription for enoxaparin 1.5mg/kg/dose subcutaneously every 12 hours. The client weighs 245 pounds. How many MGs should the nurse administer per dose?
167 mg Patients weight 245lb need to be found in lab/kg so divide by 2.2lb to get 11.36 rounded to 111.4 kg. Original problem called for 1.5mg to be administered every 12 hours 1.5mg x 111.4kg =167 mg per dose
What are myocarditis symptoms? (Select all that apply) A) cardiac dysfunction B) decrease bp (hypotension) C) increase rr (tachycardia) D) pulses (1+ or absent pedal pulses) E) increase cap refills F) decreased prefusion G) increase wbc from normal 5.000-10,000 H) increase sve
A) cardiac dysfunction B) decrease bp (hypotension) C) increase rr (tachycardia) D) pulses (1+ or absent pedal pulses) E) increase cap refills F) decreased prefusion G) increase wbc from normal 5.000-10,000
What are signs and symptoms of heart failure? (Select all that apply) A) heart rate B) bp C) edema D) lung counts E) breathing F) vocal sounds
A) heart rate B) bp C) edema D) lung counts E) breathing
A nurse is caring for a client who has pericarditis reports feeling a new onset of palpitations and shortness of breath. Which of the following assessment should indicate to the nurse that the client may have developed atrial fibrillation? A) different blood pressures in the upper limbs B) different apical and radial pulse is C) difference between oral and axillary temperatures D) differences in upper and lower lung sounds
B) different apical and radial pulse is Atrial fibrillation is a rapid disorganized electrical activity of the heart in which the atrium depolarizes to quickly and send erratic impulses to the ventricles. The presence of a pulse defects between the apical and radical pulses which is an indication of atrial fibrillation. The nurse should assess further by obtaining an ECG or telemetry reading
What is the #1 meticulous infection control technique? A) eating healthy B) hand hygiene C) cleaning surfaces throughly D) tracking HR
B) hand hygiene
When a shunt is placed surgically for treatment in a patient with Ménière's disease what is preserved and what is eliminated? A) thought process is preserved and syncope is eliminated B) through process is preserved and vertigo is eliminated C) hearing is preserved and syncope is eliminated D) hearing is preserved and vertigo is eliminated
D) hearing is preserved and vertigo is eliminated
A client tells the nurse that he is concerned because his provider told him he has a heart murmur due to endocarditis. The nurse should explain to the client that a murmur A) is a high pitch sound due to a narrowing valve B) an extra sound due to blood entering an inflexible chamber C) means that there is some inflammation around the heart D) indication of turbulent blood flow through a valve
D) indication of turbulent blood flow through a valve Turbulent blood flow through a valve generate a murmur, possibly due to malfunctioning valve, increased blood flow, or some type of defect in the structures of or around the heart
What can an elevated ESR indicate? A) inflammation of severe infection B) inflammation of the epicardium C) inflammation of the endocardium D) inflammation of the heart fibrins
A) inflammation of severe infection
Endocarditis is often times is missed as it what? (Select all that apply) A) influenza B) heart attack C) stroke D) PE E) HF
A) influenza C) stroke
What is the biggest problem for myocarditis? A) lose of ability for good blood flow(input and output) B) cardiac arrest C) HF D) pumping into the body
A) lose of ability for good blood flow(input and output)
If endocarditis is on the right side of the heart what will be affected by the emboli A) lungs, pulmonary circuit B) lungs, systemic circuit C) body, pulmonary circuit D) body systemic circuit
A) lungs, pulmonary circuit
What should be monitored closely for right(respiratory) sided endocarditis? (Select all that apply) A) o2 stat effort B) rr C) petechiae D) lungs pattens E) skin color and extremities F) rhythm pattens
A) o2 stat effort B) rr D) lungs pattens F) rhythm pattens
The nurse is developing a plan of care for a client who is postoperative following a pneumatic retinopexy to repair a detached retina. Which of the following intervention should the nurse include in the plan? A) position the client prone B) encourage the client to cough and deep breathe C) keep both eyes bandage D) provide a magazine for the client to read during recovery
A) position the client prone The client is positioned on the abdomen if oil or gas is placed in the eye during the surgery. The position allows the injected bubble to float into position overlying the area of detachment and provide consistent pressure to reattach the retina
When should the HOB be resided for a patient with myocarditis? (Select all that apply) A) pt becomes congested B) pt has frothy sputum C) pt request it D) none of the above
A) pt becomes congested B) pt has frothy sputum C) pt request it
What can the nurse teach to avoid increased IOP (select all that apply) A) squeezing eyes tightly B) staring with eyes open C) rolling eyes D) reading E) blinking
A) squeezing eyes tightly B) rolling eyes E) blinking
Can diuretics such as HCTZ help restore fluid balance in a patient with Ménière's disease? A) true B) false
A) true
A nurse is providing education for a client who has glaucoma. Which of the following statements should the nurse in clued in the teaching? A) without treatment glaucoma can cause blindness B) double vision is a common sign of glaucoma C) glaucoma is caused by inadequate production of fluid within the eye D) use of eyedrops will improve vision overtime
A) without treatment glaucoma can cause blindness The nurse should explain that without treatment glaucoma can result in blindness due to the irreversible damage to the retina and optic nerve
What is a normal Erytrocyte sedimentation rate (ESR) in women and men? A) women 0-29 men 0-22 B) women 0-22 men 0-29 C) women 1-22 men 1-29 D) women 1-29 men 1-22
A) women 0-29 men 0-22
A nurse is planning care for a client who has a detached retina and is pre-operative for a surgical repair. The nurse should prepare to administer which of the following medications? A)Phenylephrine B) latanoprost C) pocarpine D) timolol
A)Phenylephrine Mydriatic medications such as Phenylephrine, are used preoperatively to dilate pupils to facility inocular surgery
A nurse is assessing a client who has left-sided heart failure due to myocarditis. Which of the following findings should the nurse expect? A) jugular vein distention B) abdominal distention C) dependent edema D) hacking cough
D) hacking cough A hacking cough is a manifestation of left-sided heart failure that occurs due to pulmonary congestion
What helps to alleviate inflammation? A) ASA(asprian) B) vickadin C) NSAIDS D) steroids
D) steroids
When can pericarditis occur? (Select all that apply) A) following mi B) cardiac surgery C) viral infection D) respiratory infection or immune response E) radiation treatment F) other medication side effects G) genetics
A) following mi B) cardiac surgery C) viral infection D) respiratory infection or immune response E) radiation treatment F) other medication side effects
A nurse is caring for a client who has heart failure laded to myocarditis in prescriptions for the digoxin 125 mcg P.O. daily. Available is digoxin PO 0.25MG/tablet. How many tablet should the nurse administer per dose?
Desired 125mcg Dose available 0.25 mg 1mg/1000 mcg= xmg/125 mcg X=0.125 mg Dose available is 1 tablet 0.25mg/1 tablet=0.125mg/tablet 0.5
A nurse is caring for an older adult client who has left-sided heart failure due to myocarditis. Which of the following assessment findings should the nurse expect? A) frothy sputum B) dependent edema C) nocturnal polyuria D) jugular distention
A) frothy sputum Left sided heart failure reduces cardiac output and raises pulmonary venous pressure. Manifestations include hacking cough, frothy sputum, wheezing, fatigue and weakness
Endocarditis symptoms (select all that apply) A) fever B) cardiac dysfunction C) occurring at right or left side D) petechiae E) accelerated blood flow F) splinter hemorrhages G) Janeway lesions H) older nodes I) Roth spots
A) fever-can be masked by steroids, antibiotics or elderly age B) cardiac dysfunction-104 worsens over time or HF even tachycardia C) occurring at right or left side D) petechiae-small tiny red/purple pinpoint dots of ruptured capillaries F) splinter hemorrhages G) Janeway lesions H) older nodes I) Roth spots
Ménière's disease does what to the pressure in the ear? A) increases it B) decreased it C) stays the same
A) increases it
Diagnosis tests for pericarditis? A) ct imaging B) ekg Monitoring dysrythmia C) echocardiogram D) mri
A) ct imaging B) ekg Monitoring dysrythmia C) echocardiogram
Causes for endocarditis (select all that apply) A) IV drug users B) tattoos or body pericing a C) invasive dental procedures D) soapy fork E) nail biting F) using a toothpick
A) IV drug users- higher risk for right sided staph endocarditis B) tattoos or body pericing C) invasive dental procedures-this predisposes people to bacterial endocarditis E) nail biting F) using a toothpick
What are the two hallmark symptoms of pericarditis? Select all that apply A) JVD B) Becks triad C) hypotension D) muffled heart sounds
A) JVD (jugular vein dissension) this is a medical emergency as it leads to compression of the heart impending death C) hypotension The other answers are complications however not the main hallmark symptoms
What are the 4 major symptoms of glaucoma? A) Scotoma, loss of peripheral vision, blurred vision, difficulty adjusting to low lighting B) Scotoma, loss of peripheral vision, blurred vision, difficulty adjusting to bright rooms C) Scotoma, peripheral vision improves, blurred vision increases, difficulty adjusting to low lighting B) Scotoma, loss of peripheral vision, sees floaters, difficulty adjusting to bright rooms
A) Scotoma, loss of peripheral vision, blurred vision, difficulty adjusting to low lighting
What should a patient with Ménière's disease be mindful of? (Select all that apply) A) alcohol consumption B) calories C) limiting caffeine D) sugars E) tobacco use F) salt intake
A) alcohol consumption C) limiting caffeine E) tobacco use F) salt intake
How is the #1 goal of prevention accomplished for endocarditis? (Select all that apply) A) antibiotic use before invasive procedures B) good fetal hygiene C) using clean needles D) good hand hygiene E) eating gluten free foods F) consuming a low carb diet L
A) antibiotic use before invasive procedures B) good fetal hygiene C) using clean needles D) good hand hygiene
What are some ways to treat myocarditis? (Select all that apply) A) bed rest to decrease cardiac work load and 02 demand B) resuming normal activity as tolerated to promote circulation C) nsaids help to treat myocarditis D) beta blockers contradicts the Timolol slowing pumping
A) bed rest to decrease cardiac work load and 02 demand B) resuming normal activity as tolerated to promote circulation D) beta blockers contradicts the Timolol slowing pumping
What are some symptoms of retinal detachment? (Select all that apply) A) bright flashes of lights B) increased amounts of floaters C) nausea D) cobwebs E) shade of a curtain coming over the eye
A) bright flashes of lights B) increased amounts of floaters D) cobwebs E) shade of a curtain coming over the eye
Pericarditis symptoms Include? (Select all that apply) A) cardiac dysfunction B) cardiac friction rub C) tachycardia D) HF symptoms
A) cardiac dysfunction of it remains constant but worsens with deep breathing when laying supine or when repositioned B) cardiac friction rub scratchy at lower left eternal border holding breath C) tachycardia D) HF symptoms as it worsens
What influence does damage to the myocardium have? (Select all that apply) A) change shape of the myocardium B) separation of the muscle fibers C) blood infiltration out of the valuable space D) myocardium destruction E) blood infiltration into the vascular space
A) change shape of the myocardium B) separation of the muscle fibers C) blood infiltration out of the valuable space D) myocardium destruction
What are signs and symptoms of left sided heart failure? (Select all that apply) A) cough B) crackles C) dyspnea D) edema E) impaired oxygen exchange F) anorexia G) weakness H) weight gain I) hepatomeagly J) nausea
A) cough B) crackles C) dyspnea E) impaired oxygen exchange
How long should a patient recovering from retinal detachment wear an eyepatch? A) 12 hours after B) 24 hours after C) 2 days D) none of the above
B) 24 hours after
A nurse is assessing for paradoxical blood pressure on a client who has a constrictive pericarditis. Which of the following findings should the nurse expect? A) apical pulse rate is different than a rate of radial pulse rate B) decrease in systolic pressure more than 10 mm HG during inspiration C) increase in heart rate by 20% when moving from sitting to standing in D) a drop in systolic blood pressure by 20 MMHG when changing positions
B) decrease in systolic pressure more than 10 mm HG during inspiration The nurse should expect a client who has contract constructive pericarditis do you have a decrease in systolic blood pressure by more than 10 MMHG during inspiration, which is paradoxical blood pressure. This is also an expected finding for a client who has a pulmonary hypertension or cardiac tamponade
What happens to perfusion of the optic disc when IOP is elevated? A) increase B) decreased C) stays the same
B) decreased
A nurse is assessing a client who is ineffective endocarditis which of the following findings should the nurse as a priority to report to the provider? A) splinter hemorrhages to the nails B) dyspnea C) fever D) cluster of the petechiae in the mouth
B) dyspnea The client who has ineffective endocarditis and develops dyspnea, tachycardia, or a cough might be developing heart failure or experiencing pulmonary emboli, two complications of the infection
A nurse is caring for a client who has an ineffective endocarditis. Which of the following manifestations is a priority for the nurse to monitor? A) anorexia B) dyspnea C) fever D) malaise
B) dyspnea When using the airway, breathing, circulation ( ABC) approach to client care, the nurse determines her priority manifestation to monitor for dyspnea. This piña can be an indication of left sided heart failure, or a pulmonary in fraction due to embolization
A nurse in a cardiac care unit is caring for a client with acute right sided heart failure due to myocarditis. Which of the following findings should the nurse expect? A) decreased brain natriuretic peptide(BNP) B) elevated center venous pressure (CVP) C) increased pulmonary artery wedge pressure (PAWP) D) decreased specific gravity
B) elevated center venous pressure (CVP) CVP is a measurement of the pressure in the right atria or ventricle at the end of diastole. An elevated CVP is an indication of heart failure
Meniers disease is an abnormality or the inner ears fluid balance caused by what? A) malabsorption of endorphins B) malabsorption of endolymph C) absorption of endorphins C) none of the above
B) malabsorption of endolymph
A nurse is caring for a client in a critical care unit with pericarditis. The nurse suspects the client is developing cardiac tamponade. Which of the following assessment findings should the nurse identify as supporting this suspicion? A) sudden lethargy B) muffled heart sounds C) flat and neck veins D) bradycardia
B) muffled heart sounds Muffled heart sounds are a key indicator of cardiac tamponade because of the excess amount of fluid surrounding the heart
What does antihistamines such as mecizine help reduce in a patient with Ménière's disease? A) vomiting and syncope B) nausea and vertigo C) vomiting and vertigo D) nausea and syncope
B) nausea and vertigo
What locations of the body are best to place an ice pack to cool temps tire internally faster? A) head B) neck C) lower back D) groin E) armpits F) shoulders
B) neck D) groin E) armpits
Primary represents? A) preeclampsia B) problem C) practice D) presenting factor
B) problem
A home health nurse is assessing an older adult client in the home who has decreased vision due to a history of glaucoma. Which of the following findings should the nurse identify as a safety risk? A) electrical cords that are placed along the walls B) scattered rugs that are present in the kitchen C) handrails are present in the kitchen D) a microwave for cooking
B) scattered rugs that are present in the kitchen Scattered rugs in the kitchen are a safety hazard. The client could trip on one of the rugs and fall due to the impaired vision
What layer does retinal detachment occur at? A) subcutaneous layer B) sensory layer C) retinal layer D) sclera of the eye
B) sensory layer
What is a positive diagnosis for endocarditis based on blood cultures? A) when it reads the opposite for each of the 2 organism B) when the same organism is found in at least 2 of the sets C) when the urine comes back with one set matching correctly to results D) none of the above
B) when e same organism is found in at least 2 of the same sets
What is a normal intraocular pressure range? A) 10-20 mmHg Mercury B) 10-20 mmHg Magnesium C) 10-21 mmHg Mercury D) 10-21 mmHg Magnesium
C) 10-21 mmHg Mercury
How long are young athletes restricted from laying until the heart function is normailized? A) 1-2 months based on orders B) 3-6 months based on orders C) 6 months based on orders D) 12 moths based on orders
C) 6 months based on orders minimum time could be longer
Which medications help to alleviate pain? A) ASA(asprian) B) vickadin C) NSAIDS D) steroids
C) NSAIDS
A nurse is at an ophthalmology clinic is providing teaching to a client who has an open angle glaucoma and a new treatment regimen of Timolol and pilocarpine eye drops. Which of the following instruction should the nurse provide? A) administer the medication by touching the tip of the dropper to the square of the I B) hold pressure on the conjunctiva sac for two minutes following the application drop C) administer the medication five minutes apart D) it is not necessary to remove contact lenses before administering
C) administer the medication five minutes apart The nurse should instruct the client that, if more than one ophthalmic medication is to be administered, they should be given five minutes apart
A nurse is caring for a valvular heart disease and is at risk for developing left sided heart failure due to endocarditis. Which of the following manifestation should alert the nurse the client is developing this condition? A) anorexia B) weight gain C) breathlessness D) distended abdomen
C) breathlessness Manifestations of left-sided heart failure include crackles or wheezing and breathlessness due to pulmonary congestion
What is the greatest fear for an inflamed pericardium? A) decreased elasticity B) decrease cardiac output C) cardiac tamponade D) increased stretch of muscles
C) cardiac tamponade It restricts the hearts ability to pump and leads to decreased cardiac output and can lead to shock This is a build up of blood or other fluid in the pericardial sac that puts pressure on the heart which may prevent it from pumping effectively Becks triad is a sign of this
The nurse is administering timolol Eyedrops to a client who has glaucoma. Which of the following actions should the nurse take? A) apply pressure to the bridge of the nose after administering B) wipe the eye from the outer campus to the inner canthus before installation C) drop the prescribed amount of medication into the conjunctiva sac D) protect the distal portion of the eyedropper using clean technique
C) drop the prescribed amount of medication into the conjunctiva sac With the dominant hand resting on the clients four head, gold filled medication eyedropper or the ophthalmic solution approximately 1 to 2 cm above the conjunctiva sack. And still prescribe number of medication drops into the conjunctiva sack. After instilling the drops, ask the client to close his eyes gently. If the client is to receive more than one eye medication to the same I, we at least five minutes before administering the next medication
Endocarditis is an infection of the A) myocardium B) pericardium C) endocardium D) epicardium
C) endocardium
Myocarditis is an infection of what? A) pericardium B) epicardium C) myocardium D) endocardium
C) myocardium
Pericarditis is the inflammation of what? A) epicardium B) endocardium C) pericardium D) myocardium
C) pericardium
A nurse is completing discharge planning for a client who has bacterial endocarditis. The client will need to receive 12 weeks of anabiotic therapy. Which of the following penis assess devices should the nurse identify as an appropriate use for the client? A) short peripheral catheter B) implanted infusion port C) peripheral inserted central catheter D) arteriovenous fistula
C) peripheral inserted central catheter A peripheral inserted central catheter (PICC) line is a Venous access device commonly used when the client needs extended, but not permanent, intravenous access. The PICC line may remain in place for weeks or months. PICC lines can also be used to draw blood samples without the need for additional venous punctures
What do you need to monitor for left sided (systemic) endocarditis? A) o2 stat effort B) rr C) petechiae D) lungs pattens E) skin color and extremities F) rhythm pattens
C) petechiae E) skin color and extremities
What position should the patient remain in if retinoplexy was used during treatment for retinal detachment? A) supine B) transverse C) prone D) Fowler
C) prone
What position helps to alleviate pain? A) laying down B) prone C) sitting up and forwards D) leaning back head up
C) sitting up and forwards
How long of treatment will bacteria endocarditis require with use of IV antibiotics? A) 1-2 weeks B) 3 weeks C) 3-4 weeks D) 6 weeks
D) 6 weeks
A nurse is assessing a teenager who has heart failure following a severe endocarditis infection. Which of the following findings should the nurse expect? A) weight loss B) increased urine output C) bradycardia D) Orthopnea
D) Orthopnea A teenager who has heart failure is increased risk for Venous return to the heart and lungs, which increases pulmonary congestion. The congestion causes Orthopnea, Or difficulty breathing, while laying down. Having the teenager set up decreases venous return, as well as decrease the pressure the abdominal organs have on the diaphragm. The decrease in pressure improved breathing and oxygenation
What is the most common medication used for treating glaucoma? A) Diuretics B) Stimulants C) Antipyrine D) Timolol
D) Timolol
When are antibiotic taken upon diagnosis of endocarditis? A) before urine samples B) after urine samples C) before blood cultures D) after blood cultures
D) after blood cultures
A nurse is planning care for a client one day postoperative following a detached retina repair. Which of the following instruction should the nurse include in the plan? A) encourage coughing and deep breathing B)allow the client ambulate C) remove the eyepatch during the day D) avoid reading and writing
D) avoid reading and writing The client should avoid reading, writing, and close work with first postoperative week to decrease rapid eye movement and promote reattachment of the retina
If endocarditis is on the left side of the heart what will be affected by the emboli A) lungs, pulmonary circuit B) lungs, systemic circuit C) body, pulmonary circuit D) body systemic circuit
D) body systemic circuit
What are signs and symptoms of right sided heart failure? (Select all that apply) A) cough B) crackles C) dyspnea D) edema E) impaired oxygen exchange F) anorexia G) weakness H) weight gain I) hepatomeagly J) nausea
D) edema F) anorexia G) weakness H) weight gain I) hepatomeagly J) nausea
When auscultating the heart what will most likely be heard that worsens over time? A) s1 B) murmur C) s1-s2 lubb-dubb Dubb D) tachypnea
Murmur-swooshing sound made by turbulent blood in or near your heart
