MEDSURG: EXAM 2: PERFUSION: TEST 2: (CAD, INFLAMMATORY-
STRUCTURAL DISORDERS, BLOOD FLOW AND DYSRHYTHMIAS):
QUESTIONS WITH ANSWERS.
1) When caring for a patient with mitral valve stenosis, it is most important that the
nurse assess for
A) diastolic murmur.
B) peripheral edema.
C) shortness of breath on exertion.
D) right upper quadrant tenderness. -- Answer ✔✔ c. shortness of
breath on exertion.
2) A 21-year-old woman is scheduled for percutaneous transluminal balloon
valvuloplasty to treat mitral stenosis. Which information should the nurse include
when explaining the advantages of valvuloplasty over valve replacement to the
patient?
A) Biologic valves will require immunosuppressive drugs after surgery.
B) Mechanical mitral valves need to be replaced sooner than biologic
valves.
C) Lifelong anticoagulant therapy will be needed after mechanical
valve replacement.
, D) Ongoing cardiac care by a health care provider is not necessary
after valvuloplasty. -- Answer ✔✔ c. Lifelong anticoagulant therapy
will be needed after mechanical valve replacement.
3) While caring for a 23-year-old patient with mitral valve prolapse (MVP) without
valvular regurgitation, the nurse determines that discharge teaching has been
effective when the patient states that it will be necessary to
A) take antibiotics before any dental appointments.
B) limit physical activity to avoid stressing the heart.
C) take an aspirin a day to prevent clots from forming on the valve.
D) avoid use of over-the-counter (OTC) medications that contain
stimulant drugs -- Answer ✔✔ d. avoid use of over-the-counter
(OTC) medications that contain stimulant drugs
4) While caring for a patient with aortic stenosis, the nurse identifies a nursing
diagnosis of acute pain related to decreased coronary blood flow. A priority
nursing intervention for this patient would be to
A) promote rest to decrease myocardial oxygen demand.
B) teach the patient about the need for anticoagulant therapy.
C) teach the patient to use sublingual nitroglycerin for chest pain.
D) raise the head of the bed 60 degrees to decrease venous return. --
Answer ✔✔ a. promote rest to decrease myocardial oxygen
demand.
5) During discharge teaching with a 68-year-old patient who had a mitral valve
replacement with a mechanical valve, the nurse instructs the patient on the
A) use of daily aspirin for anticoagulation
B) correct method for taking the radial pulse.
C) need for frequent laboratory blood testing.
D) need to avoid any physical activity for 1 month. -- Answer ✔✔ c.
need for frequent laboratory blood testing.
6) A patient recovering from heart surgery develops pericarditis and complains of
level 6 (0 to 10 scale) chest pain with deep breathing. Which ordered PRN
medication will be the most appropriate for the nurse to give?
, A) Fentanyl 1 mg IV
B) IV morphine sulfate 4 mg
C) Oral ibuprofen (Motrin) 600 mg
D) Oral acetaminophen (Tylenol) 650 mg -- Answer ✔✔ c. Oral
ibuprofen (Motrin) 600 mg
7) When caring for a patient with infective endocarditis of the tricuspid valve, the
nurse should monitor the patient for the development of
A) flank pain.
B) splenomegaly.
C) shortness of breath.
D) mental status changes. -- Answer ✔✔ c. shortness of breath.
8) A patient admitted with acute dyspnea is newly diagnosed with dilated
cardiomyopathy. Which information will the nurse plan to teach the patient about
managing this disorder?
A) A heart transplant should be scheduled as soon as possible.
B) Elevating the legs above the heart will help relieve dyspnea.
C) Careful compliance with diet and medications will prevent heart
failure.
D) Notify the doctor about any symptoms of heart failure such as
shortness of breath. -- Answer ✔✔ d. Notify the doctor about
any symptoms of heart failure such as shortness of breath.
9) The nurse is obtaining a health history from a 24-year-old patient with
hypertrophic cardiomyopathy (HC). Which information obtained by the nurse is
most important?
A) The patient has a history of a recent upper respiratory infection.
B) The patient has a family history of coronary artery disease (CAD).
C) The patient reports using cocaine a couple of times as a teenager.
D) The patients 29-year-old brother died from a sudden cardiac
arrest. -- Answer ✔✔ d. The patients 29-year-old brother died
from a sudden cardiac arrest.
, 10) The nurse will plan discharge teaching about the need for prophylactic antibiotics
when having dental procedures for which patient?
A) Patient admitted with a large acute myocardial infarction.
B) Patient being discharged after an exacerbation of heart failure.
C) Patient who had a mitral valve replacement with a mechanical
valve.
D) Patient being treated for rheumatic fever after a streptococcal
infection -- Answer ✔✔ c. Patient who had a mitral valve
replacement with a mechanical valve.
11) Which admission order written by the health care provider for a patient admitted
with infective endocarditis (IE) and a fever would be a priority for the nurse to
implement?
A) Administer ceftriaxone (Rocephin) 1 g IV.
B) Order blood cultures drawn from two sites.
C) Give acetaminophen (Tylenol) PRN for fever.
D) Arrange for a transesophageal echocardiogram. -- Answer ✔✔ b.
Order blood cultures drawn from two sites.
12) Which assessment finding in a patient who is admitted with infective endocarditis
(IE) is most important to communicate to the health care provider?
A) Generalized muscle aching
B) Sudden onset right flank pain
C) Janeways lesions on the palms
D) Temperature 100.7 F (38.1 C) -- Answer ✔✔ b. Sudden onset
right flank pain
13) Which assessment finding obtained by the nurse when assessing a patient with
acute pericarditis should be reported immediately to the health care provider?
A) Pulsus paradoxus 8 mm Hg
B) Blood pressure (BP) of 168/94
C) Jugular venous distention (JVD) to jaw level
D) Level 6 (0 to 10 scale) chest pain with a deep breath -- Answer
✔✔ c. Jugular venous distention (JVD) to jaw level
STRUCTURAL DISORDERS, BLOOD FLOW AND DYSRHYTHMIAS):
QUESTIONS WITH ANSWERS.
1) When caring for a patient with mitral valve stenosis, it is most important that the
nurse assess for
A) diastolic murmur.
B) peripheral edema.
C) shortness of breath on exertion.
D) right upper quadrant tenderness. -- Answer ✔✔ c. shortness of
breath on exertion.
2) A 21-year-old woman is scheduled for percutaneous transluminal balloon
valvuloplasty to treat mitral stenosis. Which information should the nurse include
when explaining the advantages of valvuloplasty over valve replacement to the
patient?
A) Biologic valves will require immunosuppressive drugs after surgery.
B) Mechanical mitral valves need to be replaced sooner than biologic
valves.
C) Lifelong anticoagulant therapy will be needed after mechanical
valve replacement.
, D) Ongoing cardiac care by a health care provider is not necessary
after valvuloplasty. -- Answer ✔✔ c. Lifelong anticoagulant therapy
will be needed after mechanical valve replacement.
3) While caring for a 23-year-old patient with mitral valve prolapse (MVP) without
valvular regurgitation, the nurse determines that discharge teaching has been
effective when the patient states that it will be necessary to
A) take antibiotics before any dental appointments.
B) limit physical activity to avoid stressing the heart.
C) take an aspirin a day to prevent clots from forming on the valve.
D) avoid use of over-the-counter (OTC) medications that contain
stimulant drugs -- Answer ✔✔ d. avoid use of over-the-counter
(OTC) medications that contain stimulant drugs
4) While caring for a patient with aortic stenosis, the nurse identifies a nursing
diagnosis of acute pain related to decreased coronary blood flow. A priority
nursing intervention for this patient would be to
A) promote rest to decrease myocardial oxygen demand.
B) teach the patient about the need for anticoagulant therapy.
C) teach the patient to use sublingual nitroglycerin for chest pain.
D) raise the head of the bed 60 degrees to decrease venous return. --
Answer ✔✔ a. promote rest to decrease myocardial oxygen
demand.
5) During discharge teaching with a 68-year-old patient who had a mitral valve
replacement with a mechanical valve, the nurse instructs the patient on the
A) use of daily aspirin for anticoagulation
B) correct method for taking the radial pulse.
C) need for frequent laboratory blood testing.
D) need to avoid any physical activity for 1 month. -- Answer ✔✔ c.
need for frequent laboratory blood testing.
6) A patient recovering from heart surgery develops pericarditis and complains of
level 6 (0 to 10 scale) chest pain with deep breathing. Which ordered PRN
medication will be the most appropriate for the nurse to give?
, A) Fentanyl 1 mg IV
B) IV morphine sulfate 4 mg
C) Oral ibuprofen (Motrin) 600 mg
D) Oral acetaminophen (Tylenol) 650 mg -- Answer ✔✔ c. Oral
ibuprofen (Motrin) 600 mg
7) When caring for a patient with infective endocarditis of the tricuspid valve, the
nurse should monitor the patient for the development of
A) flank pain.
B) splenomegaly.
C) shortness of breath.
D) mental status changes. -- Answer ✔✔ c. shortness of breath.
8) A patient admitted with acute dyspnea is newly diagnosed with dilated
cardiomyopathy. Which information will the nurse plan to teach the patient about
managing this disorder?
A) A heart transplant should be scheduled as soon as possible.
B) Elevating the legs above the heart will help relieve dyspnea.
C) Careful compliance with diet and medications will prevent heart
failure.
D) Notify the doctor about any symptoms of heart failure such as
shortness of breath. -- Answer ✔✔ d. Notify the doctor about
any symptoms of heart failure such as shortness of breath.
9) The nurse is obtaining a health history from a 24-year-old patient with
hypertrophic cardiomyopathy (HC). Which information obtained by the nurse is
most important?
A) The patient has a history of a recent upper respiratory infection.
B) The patient has a family history of coronary artery disease (CAD).
C) The patient reports using cocaine a couple of times as a teenager.
D) The patients 29-year-old brother died from a sudden cardiac
arrest. -- Answer ✔✔ d. The patients 29-year-old brother died
from a sudden cardiac arrest.
, 10) The nurse will plan discharge teaching about the need for prophylactic antibiotics
when having dental procedures for which patient?
A) Patient admitted with a large acute myocardial infarction.
B) Patient being discharged after an exacerbation of heart failure.
C) Patient who had a mitral valve replacement with a mechanical
valve.
D) Patient being treated for rheumatic fever after a streptococcal
infection -- Answer ✔✔ c. Patient who had a mitral valve
replacement with a mechanical valve.
11) Which admission order written by the health care provider for a patient admitted
with infective endocarditis (IE) and a fever would be a priority for the nurse to
implement?
A) Administer ceftriaxone (Rocephin) 1 g IV.
B) Order blood cultures drawn from two sites.
C) Give acetaminophen (Tylenol) PRN for fever.
D) Arrange for a transesophageal echocardiogram. -- Answer ✔✔ b.
Order blood cultures drawn from two sites.
12) Which assessment finding in a patient who is admitted with infective endocarditis
(IE) is most important to communicate to the health care provider?
A) Generalized muscle aching
B) Sudden onset right flank pain
C) Janeways lesions on the palms
D) Temperature 100.7 F (38.1 C) -- Answer ✔✔ b. Sudden onset
right flank pain
13) Which assessment finding obtained by the nurse when assessing a patient with
acute pericarditis should be reported immediately to the health care provider?
A) Pulsus paradoxus 8 mm Hg
B) Blood pressure (BP) of 168/94
C) Jugular venous distention (JVD) to jaw level
D) Level 6 (0 to 10 scale) chest pain with a deep breath -- Answer
✔✔ c. Jugular venous distention (JVD) to jaw level
