Perfusion quiz
The nurse is volunteering at a community blood pressure screening. A client, never diagnosed with hypertension, presents with a blood pressure of 158/90 mm Hg. Which assessment question(s) is appropriate for the nurse to ask? Select all that apply. "Do you have a friend accompanying you?" "Have you recently drunk a caffeinated beverage?" "Did you have a beer after work?" "Are you married and with children?" "Do you smoke?"
"Have you recently drunk a caffeinated beverage?" "Do you smoke?"
A 66-year-old client presents to the emergency department reporting severe headache and mild nausea for the past 6 hours. Upon assessment, the client's BP is 210/120 mm Hg. The client has a history of hypertension and takes 1.0 mg clonidine twice daily. Which question is most important for the nurse to ask the client next? "Are you having chest pain or shortness of breath?" "Do you have a dry mouth or nasal congestion?" "Have you taken your prescribed clonidine today?" "Did you take any medication for your headache?"
"Have you taken your prescribed clonidine today?"
A nurse is reviewing self-care measures for a client with peripheral vascular disease. Which statement indicates proper self-care measures? "I walk only to the mailbox in my bare feet." "I have my wife look at the soles of my feet each day." "I like to soak my feet in the hot tub every day." "I stopped smoking and use only chewing tobacco."
"I have my wife look at the soles of my feet each day."
A client admitted to the medical-surgical unit with a venous thromboembolism (VTE) is started on enoxaparin and warfarin. The client asks the nurse why two medications are needed. Which response by the nurse is accurate? "Enoxaparin will dissolve the clot, and warfarin will prevent any more clots from occurring." "Because of the potential for a pulmonary embolism, it is important for you to take at least two anticoagulants." "Administration of two anticoagulants decreases the risk of recurrent venous thrombosis." "The enoxaparin will work immediately, but the warfarin takes several days to achieve its full effect."
"The enoxaparin will work immediately, but the warfarin takes several days to achieve its full effect."
A 55-year-old male client newly diagnosed with hypertension returns to the physician's office for a routine follow-up appointment after several months of treatment with metoprolol. During the initial assessment, the nurse records the client's blood pressure (BP) as 180/90 mm Hg. The client states that the medication is not taken as prescribed. Which is the best response by the nurse? "It is very important for you to take your medication as prescribed, or you could experience a stroke." "The medication you were prescribed may cause sexual dysfunction; are you experiencing this side effect?" "Your hypertension must be treated with medications; you need to take your metoprolol every day." "Be certain to discuss your noncompliance with your medication regimen with the physician."
"The medication you were prescribed may cause sexual dysfunction; are you experiencing this side effect?" Metoprolol is a beta-blocker. All clients should be informed that beta-blockers might cause sexual dysfunction and that other medications are available if problems with sexual function occur. The other statements, although true, are not therapeutic and would not elicit the reason why the client was not taking the medication as prescribed.
During a routine physical examination, the nurse assesses a blood pressure reading of 150/90 mm Hg. The patient's blood work indicates several abnormal results. The health care provider informs the nurse that he suspects that the patient has metabolic syndrome. The nurse knows that this diagnosis is associated with three classic signs/symptoms. Select all that apply. Dyslipidemia and/or abdominal obesity Insulin resistance A blood pressure reading greater than 130/85 mm Hg Increased blood urea nitrogen and serum creatinine levels
A blood pressure reading greater than 130/85 mm Hg Dyslipidemia and/or abdominal obesity Insulin resistance
Hypertension is defined as "sustained elevations in systolic or diastolic blood pressures that exceed prehypertension levels." What are some of the consequences of hypertension that make it such a health menace in the United States? cardiac failure cerebrovascular accident All options are correct. renal disease
All options are correct.
Which term refers to chest pain brought on by physical or emotional stress and relieved by rest or medication? Atheroma Atherosclerosis Ischemia Angina pectoris
Angina pectoris
The nurse understands it is important to promote adequate tissue perfusion following cardiac surgery. Which measures should the nurse complete to prevent the development of deep venous thrombosis (DVT) and possible pulmonary embolism (PE)? Select all that apply. Initiate passive exercises. Apply antiembolism stockings. Encourage the client to cross their legs. Avoid elevating the knees on the bed. Place pillows in the popliteal space.
Apply antiembolism stockings. Avoid elevating the knees on the bed. Initiate passive exercises.
A nurse is preparing a client for cardiac catheterization. The nurse knows that which nursing intervention must be provided when the client returns to the room after the procedure? Restrict fluids for 6 hours after the procedure. Inform the client that he or she may experience numbness or pain in the leg. Withhold analgesics for at least 6 hours after the procedure. Assess the puncture site frequently for hematoma formation or bleeding.
Assess the puncture site frequently for hematoma formation or bleeding.
A patient has returned to the nursing unit after having a percutaneous coronary intervention (PCI) in the hospital's cardiac catheterization laboratory. The nurse who is providing care for this patient should prioritize what assessment? Assessing the patient for signs and symptoms of hemorrhage Assessing the patient's capillary refill time and peripheral pulses Assessing the patient for signs and symptoms of acute renal failure Assessing the patient for signs and symptoms of infection
Assessing the patient for signs and symptoms of hemorrhage
The nurse is caring for a client diagnosed with unstable angina who is receiving IV heparin. The client requires bleeding precautions. Bleeding precautions include which measure? Avoid continuous BP monitoring Avoid the use of nail clippers Use an electric toothbrush Avoid subcutaneous injections
Avoid continuous BP monitoring
The nurse is providing education about angina pectoris to a hospitalized client who is about to be discharged. What instruction does the nurse include about managing this condition? Select all that apply. Carry nitroglycerin at all times. Avoid all physical activity. Stop smoking. Balance rest with activity. Follow a diet high in saturated fats.
Balance rest with activity. Stop smoking. Carry nitroglycerin at all times.
The nurse is providing education about the nutrient content of the Therapeutic Lifestyle Changes (TLC) diet to a community group. What information will the nurse provide? Select all that apply. Dietary fiber should be 20 to 30 grams per day. Cholesterol should be less than 1 gram per day. Carbohydrates should make up 50% to 60% of the total calories. Protein should make up approximately 15% of total calories. Total fat should make up only 5% of the total calories.
Carbohydrates should make up 50% to 60% of the total calories. Dietary fiber should be 20 to 30 grams per day. Protein should make up approximately 15% of total calories.
Which of the following is accurate regarding the effects of nicotine and tobacco smoke on the body? Select all that apply. Decreases blood viscosity Impairs transport and cellular use of oxygen Increases blood viscosity Reduces circulation to the extremities Causes vasospasm
Causes vasospasm Reduces circulation to the extremities Impairs transport and cellular use of oxygen Increases blood viscosity
A client is being scheduled for a stress test. The client is unable to exercise during the test. The nurse would include information about which medication used for pharmacologic stress testing? Lanoxin Cardiolite Dipyridamole Thallium 201
Dipyridamole
Choose the statements that correctly match the hypertensive medication with its side effect. Select all that apply. With thiazide diuretics, monitor serum potassium concentration. Direct vasodilators may cause headache and tachycardia. Cough is a common side effect of adrenergic inhibitors. Beta-blockers may cause sedation. With ACE inhibitors, assess for bradycardia.
Direct vasodilators may cause headache and tachycardia. With thiazide diuretics, monitor serum potassium concentration. Thiazide diuretics may deplete potassium; many clients will need potassium supplementation. Direct vasodilators may cause headache and increased heart rate. Adrenergic inhibitors can cause sedation and fatigue. Beta-blockers may induce decreased heart rate; pulse rate should be assessed before administration. Angiotensin-converting enzyme inhibitors can induce a mild to severe dry cough.
The nurse is admitting a 32-year-old woman to the presurgical unit. The nurse learns during the admission assessment that the client takes oral contraceptives. The nurse's postoperative plan of care should include what intervention? Dependent positioning of the client's extremities when at rest Doppler ultrasound of peripheral circulation twice daily Cessation of the oral contraceptives until 3 weeks postoperative Early ambulation and leg exercises
Early ambulation and leg exercises
How should the nurse best position a patient who has leg ulcers that are venous in origin? Keep the patient's knees bent to 45-degree angle and supported with pillows. Elevate the patient's lower extremities. Keep the patient's legs flat and straight. Dangle the patient's legs over the side of the bed.
Elevate the patient's lower extremities.
A client has been scheduled for cardiovascular computed tomography (CT) with contrast. To prepare the client for this test, what action should the nurse perform? Limit the client's activity for 2 hours before the test. Keep the client NPO for at least 6 hours prior to the test. Establish peripheral IV access. Teach the client to perform incentive spirometry.
Establish peripheral IV access.
The nurse is caring for a client at risk for thrombosis. What is an appropriate nursing action when evaluating this client? Examine the client's mental and emotional status. Examine for pain around the shoulder and neck region. Examine the legs for color, capillary refill time, and tissue integrity. Examine the extremities for skin lesions.
Examine the legs for color, capillary refill time, and tissue integrity.
A nurse is teaching about risk factors that increase the probability of heart disease to a community group. Which risk factors will the nurse include in the discussion? Select all that apply. Family history of coronary heart disease Body mass index (BMI) of 23 African-American descent Age greater than 45 years for men Elevated C-reactive protein
Family history of coronary heart disease Age greater than 45 years for men African-American descent Elevated C-reactive protein
A client with hypertension has been able to maintain a blood pressure of 130/70 mm Hg for 1 year while reducing dietary sodium and taking hydrochlorothiazide (HCTZ) and atenolol. What treatment plan will the nurse educate the client about?
Gradual reducing the HCTZ and the atenolol and continuing to reduce sodium intake
A nurse teaches a client with angina pectoris that he or she needs to take up to three sublingual nitroglycerin tablets at 5-minute intervals and immediately notify the health care provider if chest pain doesn't subside within 15 minutes. What symptoms may the client experience after taking the nitroglycerin? Nausea, vomiting, depression, fatigue, and impotence. Sedation, nausea, vomiting, constipation, and respiratory depression. Flushing, dizziness, headache, and pedal edema. Headache, hypotension, dizziness, and flushing.
Headache, hypotension, dizziness, and flushing.
Which is a modifiable risk factor for coronary artery disease (CAD)? Increasing age Male gender Hyperlipidemia Family history
Hyperlipidemia
A client with venous insufficiency is instructed to exercise, apply elastic stockings, and elevate the extremities. Which is the primary benefit for this nursing management regime? Improve arterial flow Increase venous congestion Improve venous return Strengthen venous valves
Improve venous return
A client diagnosed with hypertension informs the nurse that they are not taking prescribed antihypertensive medications due to an absence of symptoms. What is the most appropriate response by the nurse? Inform the client that this is why hypertension is known as "the silent killer." Suggest that the client try an herbal supplement instead. Inform the client there should be no problems as long as she a low sodium diet is maintained. Inform the client that remaining unmedicated is all right in conjunction with routine follow-up.
Inform the client that this is why hypertension is known as "the silent killer."
Which term refers to a muscular, cramp-like pain in the extremities consistently reproduced with the same degree of exercise and relieved by rest? Ischemia Intermittent claudication Aneurysm Bruit
Intermittent claudication
A home health nurse is teaching a client with peripheral arterial disease ways to improve circulation to the lower extremities. The nurse encourages which of the following in teaching? Keeping the legs in a neutral or dependent position Application of ace wraps from the toe to below the knees Elevation of the legs above the heart Use of antiembolic stockings
Keeping the legs in a neutral or dependent position
The nurse has been asked to teach a patient how to self-administer nitroglycerin. The nurse should instruct the patient to do which of the following? Select all of the teaching points that apply. Keep the tablets at home on the kitchen counter or bedside table so they can be reached quickly. Put some of the tablets in a small metal or plastic pillbox that can be easily carried at all times and be accessible quickly, when needed. Let the tablet dissolve in the mouth and keep the tongue still. The tablet can be crushed between the teeth but not swallowed. Call emergency services if, after taking three tablets (one every 5 minutes), pain persists. Renew the supply every 6 months. Take the tablet in anticipation of any activity that can produce pain.
Let the tablet dissolve in the mouth and keep the tongue still. The tablet can be crushed between the teeth but not swallowed. Renew the supply every 6 months. Take the tablet in anticipation of any activity that can produce pain. Call emergency services if, after taking three tablets (one every 5 minutes), pain
A client has just received a diagnosis of hypertension after the completion of diagnostics. What can the client do to decrease the consequences of hypertension? Select all that apply. Get plenty of rest. Lose weight. Use smokeless tobacco. Manage stress effectively.
Lose weight. Manage stress effectively.
Which assessments should a nurse perform when caring for a client following a cardiac catheterization? Select all that apply. Palpate the pulse in different locations. Inspect the color in every extremity. Monitor BP and pulse frequently. Palpate the insertion site for tenderness. Inspect pressure dressing for signs of bleeding.
Monitor BP and pulse frequently. Inspect pressure dressing for signs of bleeding. Palpate the pulse in different locations.
Severe chest pain is reported by a client during an acute myocardial infarction. Which of the following is the most appropriate drug for the nurse to administer? Morphine sulfate (Morphine) Isosorbide mononitrate (Isordil) Meperidine hydrochloride (Demerol) Nitroglycerin transdermal patch
Morphine sulfate (Morphine)
A nurse is assessing a client's right lower leg, which is wrapped with an elastic bandage. Which signs and symptoms suggest circulatory impairment? Swelling, warm skin temperature, and drainage Redness, cool skin temperature, and swelling Numbness, cool skin temperature, and pallor Numbness, warm skin temperature, and redness
Numbness, cool skin temperature, and pallor
Which medication is an antidote to heparin? Clopidogrel Aspirin Protamine sulfate Alteplase
Protamine sulfate
A 35-year-old client has been diagnosed with hypertension. The client is a stock broker, smokes daily, and has diabetes. During a follow-up appointment, the client states that regular visits to the doctor just to check blood pressure (BP) are cumbersome and time consuming. As the nurse, which aspect of client teaching would you recommend? Purchasing a self-monitoring BP cuff Discussing methods for stress reduction Advising smoking cessation Administering glycemic control
Purchasing a self-monitoring BP cuff
Which term is refers to hypertension in which blood pressure that is controlled with therapy becomes uncontrolled (abnormally high) when the therapy is discontinued? Primary Essential Rebound Secondary
Rebound
An older African American client is found to have a blood pressure of 150/90 mm Hg during a work-site health screening. What should the nurse do? Recommend the client have blood pressure rechecked within 2 weeks. Consider this to be a normal finding for the client's age and race. Recommend the client have blood pressure rechecked in 1 year. Recommend the client see a health care provider immediately for further evaluation.
Recommend the client have blood pressure rechecked within 2 weeks.
When assessing a client with cellulitis of the right leg, which finding should the nurse expect to observe? Painful skin that is swollen and pale in color Small, localized blackened area of skin Cold, red skin Red, swollen skin with inflammation spreading to surrounding tissues
Red, swollen skin with inflammation spreading to surrounding tissues
When caring for a client with essential hypertension what instruction should the nurse provide to the client to normalize blood pressure? Increase iodine intake. Reduce sodium intake. Avoid intake of low-fat diet. Increase intake of fluids.
Reduce sodium intake.
A client with primary hypertension reports dizziness with ambulation when taking the prescribed alpha-adrenergic blocker. When teaching this client, what should the nurse emphasize? Taking medication first thing in the morning Stopping medication if dizziness persists Increasing fluids to maintain BP Rising slowly from a lying or sitting position
Rising slowly from a lying or sitting position
A client reports recent onset of chest pain that occurs sporadically with exertion. The client also has fatigue and mild ankle swelling, which is most pronounced at the end of the day. The nurse suspects a cardiovascular disorder. What other client report increases the likelihood of a cardiovascular disorder? Lower substernal abdominal pain Shortness of breath Insomnia Irritability
Shortness of breath
The nurse is educating the patient about administering nitroglycerin prior to discharge from the hospital. What information should the nurse include in the instructions? Take a nitroglycerin and if the pain is not relieved, drive to the nearest emergency department. Take a nitroglycerin and repeat every 5 minutes if the pain is not relieved until a total of 3 are taken. If pain is not relieved, activate the emergency medical system. Take 2 nitroglycerines and if the pain is not relieved, go to the emergency department. Take 2 nitroglycerines every 10 minutes until a total of 6 pills are taken. If pain is not relieved, activate the emergency medical system.
Take a nitroglycerin and repeat every 5 minutes if the pain is not relieved until a total of 3 are taken. If pain is not relieved, activate the emergency medical system.
Following abdominal surgery, which factor predisposes a client to deep vein thrombosis? The client is 5' 9" tall and weighs 128 lb (58 kg). The client usually walks 3 miles a day. The client will be immobile during and shortly after surgery. The client has been pregnant four times.
The client will be immobile during and shortly after surgery.
The nurse observes a certified nursing assistant (CNA) obtaining a blood pressure reading with a cuff that is too small for the patient. The nurse informs the CNA that using a cuff that is too small can affect the reading results in what way? It will be significantly different with each reading. It will give an accurate reading. The results will be falsely elevated. The results will be falsely decreased.
The results will be falsely elevated.
The nurse is providing care for a client who has just been diagnosed with peripheral arterial occlusive disease (PAD). What assessment finding is most consistent with this diagnosis? Unequal peripheral pulses between extremities Visible clubbing of the fingers and toes Numbness and tingling in the distal extremities Reddened extremities with muscle atrophy
Unequal peripheral pulses between extremities
The nurse teaches the client with peripheral vascular disease (PVD) to refrain from smoking because nicotine slows the heart rate. causes diuresis. causes vasospasm. depresses the cough reflex.
causes vasospasm.
The nurse cares for a client in the ICU diagnosed with coronary artery disease (CAD). Which assessment data indicates the client is experiencing a decrease in cardiac output? elevated jugular venous distention and postural changes in BP BP 108/60 mm Hg, ascites, and crackles reduced pulse pressure and heart murmur disorientation, 20 mL of urine over the last 2 hours
disorientation, 20 mL of urine over the last 2 hours
A client with a history of hypertension is receiving client education about structures that regulate arterial pressure. Which structure is a component of that process? parasympathetic nervous system kidneys limbic system lungs
kidneys
A client describes chest pain as sharp, substernal, of intermittent duration, and radiating to the arms and back. The client says the pain increases with inspiration and swallowing and is alleviated when sitting upright. What does the nurse suspect the client may be experiencing? angina pectoris panic attack pericarditis dissecting aorta
pericarditis
