NUR 257 / NUR257 Exam 2 – Concepts of Aging and Chronic Illness in Nursing Review (Latest 2026/2027 Update) | Galen | Complete Study Guide | Verified Questions & Answers | 100% Correct Solutions | Grade A

NUR 257 / NUR257 Exam 2 – Concepts of Aging and Chronic Illness in Nursing Review (Latest 2026/2027 Update) | Galen | Complete Study Guide | Verified Questions & Answers | 100% Correct Solutions | Grade A Q: You are working on an education session for the community, what are some common risk factors for depression that you should include? Answer Chronic medical conditions Q: You are taking care of patients that have been assigned to you, which patient is exhibiting signs/symptoms of dementia? Answer A 65 year old who has trouble remembering recent events and loses her train of thought. Q: You are the nurse doing discharge teaching for a patient who has visual alterations,which statement made by the nurse requires follow up? Answer I will fill my pill organizer to keep my medications on track. Q: You are working with an elderly client and discussing proper nutrition, which recommendation made by the nurse requires follow up? Answer Cottage cheese with a large bowl of canned peaches Q: You are reviewing your patients medical records, which med offers the greatest risk for developing xerostomia (dry mouth & cracked lips)? Answer Furosemide Q: You have a patient who reports they rarely/seldomly brush their teeth, what should the nurse determine could be the possible cause of the patients poor oral hygiene? Answer Loss of manual dexterity Q: You have discussed adequate hydration with your patient, what statement made by the client requires a need for additional teaching? Answer I will drink water, tea, soda, or juice whenever i feel thirsty. Q: You are working in a long-term care facility and observe a UAP performing denture care for a client, it requires follow-up if the UAP is observed doing which of the following? Answer Brushing the client's dentures while holding them over a sink full of warm water. Q: Your patient has not had a bowel movement in 2 days, what nursing interventions are priority for this patient? Answer Asses client's normal bowel movement patterns. Q: You are caring for a patient who has a nursing diagnosis of urge incontinence related to UTIs, what statement is appropriate for the "as evidenced" portion of the nursing diagnosis? Answer Sudden leakage of urine when the client does not make it to the bathroom on time Q: You are caring for a patient who has urinary incontinence, which statement made by your patient concerns you? Answer I have never had urinary incontinence before this visit. Q: You are caring for a patient who is becoming malnourished because nothing tastes good, what could the nurse recommend for the client? Answer Take sips of water between eating different foods Q: You are taking care of a patient who complains of abdominal pain, urinary retention, & frequent small liquid stools, what should the nurse do next? Answer Assess the patient for fecal impaction. Q: You are a nurse who is caring for an older patient, you suspect they are experiencing dysphagia and/or aspiration, which of the following observations leads you to believe this? Answer Excessive throat clearing and drooling Q: You are caring for a patient who has history of dementia and is incontinent of stool because they cannot communicate their need to defecate, what is your priority? Answer Begin a prompt toileting program Q: You have a 70 year-old client with mild memory impairment related to a recent dementia diagnosis. The family is concerned about increased episodes of urinary incontinence. Which prescription ordered by the physician would you question for this patient? Answer placing an indwelling catheter. Q: A nurse is assessing a client who is at risk for dehydration, which statement made by the patient indicates further teaching is required? Answer "I stop drinking fluids in the afternoon to avoid making trips to the bathroom at night." Q: You are caring for an olde adult client who you suspect is suffering from under-nutrition. What could be the possible cause of the the under-nutrition? Answer Recovering from a recent hip replacement surgery. Q: You are caring for a patient in a nursing home who has been diagnosed with poor nutrition who has trouble taking in adequate food. All attempts to nourish this patient have not worked. What do you need to consider prior to placing a permanent feeding tube? Answer Review the patient's advance directives and determine if there are any ethical considerations Q: Using the mnemonic SAFE DRIVE, which of the following should you include? Answer Safety, record, family report, attention skills Q: You are discussing care with a family member of a patient with early-stage dementia. The family member is concerned that the patient should no longer be driving, which statement made by the nurse is appropriate? Answer You should begin having discussions now, then reevaluate the patient's driving ability every 6 months. Q: You are taking care of a patient who is having difficulty keeping their medication organized, it shows a correct understanding of active involvement if that patient states which of the following? Answer I will explain the purpose of the medications as I am placing them in a pill organizer. Q: You are caring for a patient who, due to their increasing age, they are being switched from a TCA, amitriptyline to an SSRI, which of the following side effects can be expected? Answer sexual dysfunction Q: You are working in the ED and are discharging a patient admitted for hyperthermia. What should you include in the discharge teaching for this patient? Answer Place your hands and feet in cool water Q: You have a patient who has Alzheimer's disease who is wandering the halls and claims to water the flowers. Which of the following statements are appropriate? Answer Thank you for helping me care for the flowers, it looks like some of the water has spilled. Can I help you clean it up so that you or your friends don't slip and fall? You are a home health nurse counseling the family of an 85 year-old patient about establishing rules to promote safe driving. It requires follow up by the nurse if the family identifies which of the following rules? Answer Drive below the speed limit to maintain control of the car You are teaching your patient about antipsychotics, what should you include in the teaching? Answer You are more susceptible to heart issues and stroke while taking these medications, so follow up with your doctor. You taught a patient how to use a newly prescribed inhaler, what is the best way to ensure that the patient has learned the information? Answer Observe the client using the inhaler at the correct dose You have a patient with a new prescription, what is the best way to teach the client about this medication? Answer Keep the information simple and relevant to the subject A home health nurse is caring for an older adult who asks the nurse why they are always cold, which made by the nurse response is correct? Answer You have a decreased ability to shiver You are caring for a frail, older adult in the hospital. You are concerned about preventing hypothermia. Which interventions should you implement? Answer Use warm humidified air through a mask You are a home health nurse and notice the client's home temperature is 82 degrees, the windows are closed and the client is covering up with a large blanket. You notice these factors are contributed to what? Answer Age related changes that cause issues with regulating body temperature You are a home health nurse working with a rural community. You have started seeing patients via Telehealth. What are some benefits of the client using Telehealth services? Answer Helps promote the ability to care for self and you can diagnose, monitor, and treat remotely from a provider's office. You are the nurse caring for a patient who is receiving haloperidol, which of the following is the most severe side effect you should look for? Answer Neuro malignant syndrome You have been to a conference, and you know that the complications of medications used by the elderly can have interactions with certain foods. Which of the following is a cause for concern? Answer Warfarin and vitamin C You are creating a teaching plan for a patient taking lithium, the nurse should include which of the following in the plan of care? Answer Maintain normal sodium and fluid intake in your diet You are caring for a patient who appears to have decreased cognitive functioning, which of the following actions would you take next? Answer Administering the mini mental state examination for proper screening. You are working in long-term care and notice the nurse manager is on the unit and is auditing documentation and records, why would she be auditing? Answer Review if the documentation reaches the standard of care for reimbursement purposes. You are getting ready to interview a patient and need to determine the patient's cognitive status, which of the following questions should you ask to illicit this information? Answer Are you able to drive and run errands without difficulty? You are caring for an older client who has been diagnosed with major depression and are having feelings of worthlessness, they tell you "life just isn't worth living." What is the appropriate nursing intervention? Answer Monitor the client closely one on one if possible and be prepared to help if needed. You are doing your initial assessment on an 85 year-old patient. Which of the following should the nurse use to obtain relevant information? Answer Establish rapport You are caring for an older client & want to do a quick overall assessment focusing on geriatric syndrome, which of the following would you use? Answer SPICES You are teaching a client and they have an order for a physical therapy evaluation, you are teaching them how to remain safe, which of the following statements is correct for the nurse to make? Answer You will need to have an activity planner. You are caring for an older client who drops their tray while setting the table. Another patient makes a rude comment to them. Which of the following questions by the nurse determines if the patient is depressed? Answer It's okay, it was just an accident. How does this whole incident make you feel? You are the nurse working in long-term care & you are reviewing the patient's meal consumption documented by UAP. Which of the following is documented correctly? Answer Client refused their breakfast, ate 0%, but drank 250mL of apple juice You're documenting a newly admitted patient and you are doing a full assessment. Which of the following is an appropriate statement to make in your documentation? Answer Client does not wish to be resuscitated, DNR is signed and bracelet has been placed on the patient's wrist. You are preparing to teach an elderly patient, what do you need to keep in mind when teaching the older patient population? Answer Sensory alterations occur with age You are assessing the learning needs of a client prior to teaching. Which factors from the box below should the nurse focus on? Answer Age of the patient Their understanding of their health problem Sensory acuity learning style You are caring for a newly admitted patient who has a hearing deficit. Which action should you perform as part of their care? Answer Directly face the client while speaking, with good lighting in the room if possible As a nurse, how do you establish rapport? Answer Interview, report by proxy, and assessment/observation Mini-Mental State Exam Used to screen cognitive status and monitor: Answer - orientation - short-term memory and attention - calculation ability - language - ability to correctly copy and figure (visuospatial proficiency) Fulmer SPICES Tool Used to assess geriatric syndromes: Sleep problems Problems with eating and feeding Incontinence Confusion Evidence of falls Skin breakdown Geriatric Depression Scale - used to measure mood - helpful in determining depression - it deemphasizes physical complaints, sex drive, and appetite - not for use in patients with dementia or cognitive impairment What do you, as a healthcare professional, do if a patient says, "I want to kill myself?" Report it What do you need to remember when assessing IADLs? Determine their cognitive status SAFE DRIVE Safety record Attention skills Family report Ethanol use Drugs Reaction time Intellectual impairment Vision and visuospatial function Executive functions FANCAPES Assessment Used for assessing frail and medically complex patients: Fluids: state of hydration Aeration: respiratory function Nutrition: type and amount of food consumed Communication: adequate ability to communicate his/her needs Activity: ability to meet basic needs of toileting, grooming, and meal preparation Pain: physical, psychological, or spiritual pain Elimination: difficulty with bladder or bowel elimination Socialization: ability to give and receive love and friendship How many times a year are individuals with Dementia or Alzheimer's assessed for driving? Every 6 months When is the best time to educate the patient? When the pt is at their best: not in pain, haven't just taken narcotics What is an intervention for a patient who doesn't like to eat d/t thinking the food tastes bad? Teach them to take sips of water b/t food to rinse the taste out of their mouth What are some S/S of dysphagia? Drooling, hiccups, clearing the throat What does dysphagia cause a risk for? Choking and aspiration What should you do if a patient says that they stop drinking at lunchtime to minimize trips to the bathroom at night? Educate the patient on why this is wrong. They will dehydrate, especially if the pt is taking certain medications. What should you do if a patient experiences a sudden onset of urinary incontinence? Assess for a cause because this is NOT normal Stress Incontinence Loss of small amount of urine with activities that increase intra-abdominal pressure (coughing, sneezing, exercising, lifting, bending) Urge Incontinence Loss of moderate to large amount of urine before getting to toilet, inability to suppress need to urinate (frequency and nocturia may be present) Functional Incontinence Lower urinary tract intact but individual unable to reach toilet because of environmental barriers; physical limitations; cognitive impairment; lack of assistance; difficulty managing belts and zippers or getting a dress up and undergarments down; or difficulty sitting on the toilet (may occurs w/other types of UI; more common in cognitively impaired or institutionalized pt's) Xerostomia Dry mouth As a nurse, what can you do for a patient who has xerostomia? Oral Care Does xerostomia affect the patients malnutrition status sometimes? Yes What can you encourage a patient with xerostomia to do if they have sores in their mouth? Continue drinking/hydrating If a patient was to say to you "I drank a cup of tea, soda, water, but only when I feel thirsty." Do you think they'd be at a high risk for dehydration? Yes; continue to educate the patient What symptoms would you look for in a patient who is taking Haldol? NMS- high fever, need to go to ER! If you have 6 patient's one is complaining of abdominal pain, can't void, some leakage around stool. Is this patient a priority? Yes- this patient could decline quickly! Key S/S of Fecal Impaction Urinary retention, abdominal pain, leakage of stool What medication can cause dry mouth, sexual dysfunction, or dizziness? SSRI's- educate patients on potential SE's You asked your patient what they had for dinner and they tell you they had a smoothie with yogurt, kale, spinach, bananas and strawberries. Is that consistent with MyPlate? No- missing some very important nutrients Is malnutrition a geriatric syndrome? Yes What is a post surgical patient at a high risk for? Malnutrition- need proper nutrition for healing (protein is very important) What are some reasons for a post surgical patient to be malnourished? Due to pain and pain meds, and lack of BM leaving pt feeling full What can long-term use of neuroleptic medication cause with patients? Stroke, Increased BP and other heart problems- if pt is experiencing sx's they need to call MD or go to hospital You're a nurse taking care of a patient, you go to their home, their house is 84*F and they're wrapped up in a blanket. This is common for older patients, why? Their body temperature decreases and prevents them from producing heat S/S's of Dysphagia Drooling, choking, hiccups, coughing You assess a patient after the tech fed them. You enter the room to observe and check on patient to ensure they swallowed everything and didn't aspirate. What would you look for? Pocketing For your patients that are on Coumadin (Warfarin), what could affect it? Green leafy vegetables (Vitamin K), will decrease INR and clot your blood What food interacts with Calcium Channel Blockers? Citrus can decrease the affect of the medications What food interacts with Digoxin? Fiber You are working on an education session for the community, what are some common risk factors for depression that you should include? Chronic medical conditions You are taking care of patients that have been assigned to you, which patient is exhibiting signs/symptoms of dementia? A 65 year old who has trouble remembering recent events and loses her train of thought. You are the nurse doing discharge teaching for a patient who has visual alterations,which statement made by the nurse requires follow up? I will fill my pill organizer to keep my medications on track. You are working with an elderly client and discussing proper nutrition, which recommendation made by the nurse requires follow up? Cottage cheese with a large bowl of canned peaches You are reviewing your patients medical records, which med offers the greatest risk for developing xerostomia (dry mouth & cracked lips)? Furosemide You have a patient who reports they rarely/seldomly brush their teeth, what should the nurse determine could be the possible cause of the patients poor oral hygiene? Loss of manual dexterity You have discussed adequate hydration with your patient, what statement made by the client requires a need for additional teaching? I will drink water, tea, soda, or juice whenever i feel thirsty. You are working in a long-term care facility and observe a UAP performing denture care for a client, it requires follow-up if the UAP is observed doing which of the following? Brushing the client's dentures while holding them over a sink full of warm water. Your patient has not had a bowel movement in 2 days, what nursing interventions are priority for this patient? Asses client's normal bowel movement patterns. You are caring for a patient who has a nursing diagnosis of urge incontinence related to UTIs, what statement is appropriate for the "as evidenced" portion of the nursing diagnosis? Sudden leakage of urine when the client does not make it to the bathroom on time You are caring for a patient who has urinary incontinence, which statement made by your patient concerns you? I have never had urinary incontinence before this visit. You are caring for a patient who is becoming malnourished because nothing tastes good, what could the nurse recommend for the client? Take sips of water between eating different foods You are taking care of a patient who complains of abdominal pain, urinary retention, & frequent small liquid stools, what should the nurse do next? Assess the patient for fecal impaction. You are a nurse who is caring for an older patient, you suspect they are experiencing dysphagia and/or aspiration, which of the following observations leads you to believe this? Excessive throat clearing and drooling You are caring for a patient who has history of dementia and is incontinent of stool because they cannot communicate their need to defecate, what is your priority? Begin a prompt toileting program You have a 70 year-old client with mild memory impairment related to a recent dementia diagnosis. The family is concerned about increased episodes of urinary incontinence. Which prescription ordered by the physician would you question for this patient? placing an indwelling catheter. A nurse is assessing a client who is at risk for dehydration, which statement made by the patient indicates further teaching is required? "I stop drinking fluids in the afternoon to avoid making trips to the bathroom at night." You are caring for an olde adult client who you suspect is suffering from under-nutrition. What could be the possible cause of the the under-nutrition? Recovering from a recent hip replacement surgery. You are caring for a patient in a nursing home who has been diagnosed with poor nutrition who has trouble taking in adequate food. All attempts to nourish this patient have not worked. What do you need to consider prior to placing a permanent feeding tube? Review the patient's advance directives and determine if there are any ethical considerations Using the mnemonic SAFE DRIVE, which of the following should you include? Safety, record, family report, attention skills You are discussing care with a family member of a patient with early-stage dementia. The family member is concerned that the patient should no longer be driving, which statement made by the nurse is appropriate? You should begin having discussions now, then reevaluate the patient's driving ability every 6 months. You are taking care of a patient who is having difficulty keeping their medication organized, it shows a correct understanding of active involvement if that patient states which of the following? I will explain the purpose of the medications as I am placing them in a pill organizer. You are caring for a patient who, due to their increasing age, they are being switched from a TCA, amitriptyline to an SSRI, which of the following side effects can be expected? sexual dysfunction You are working in the ED and are discharging a patient admitted for hyperthermia. What should you include in the discharge teaching for this patient? Place your hands and feet in cool water You have a patient who has Alzheimer's disease who is wandering the halls and claims to water the flowers. Which of the following statements are appropriate? Thank you for helping me care for the flowers, it looks like some of the water has spilled. Can I help you clean it up so that you or your friends don't slip and fall? You are a home health nurse counseling the family of an 85 year-old patient about establishing rules to promote safe driving. It requires follow up by the nurse if the family identifies which of the following rules? Drive below the speed limit to maintain control of the car You are teaching your patient about antipsychotics, what should you include in the teaching? You are more susceptible to heart issues and stroke while taking these medications, so follow up with your doctor. You taught a patient how to use a newly prescribed inhaler, what is the best way to ensure that the patient has learned the information? Observe the client using the inhaler at the correct dose You have a patient with a new prescription, what is the best way to teach the client about this medication? Keep the information simple and relevant to the subject A home health nurse is caring for an older adult who asks the nurse why they are always cold, which made by the nurse response is correct? You have a decreased ability to shiver You are caring for a frail, older adult in the hospital. You are concerned about preventing hypothermia. Which interventions should you implement? Use warm humidified air through a mask You are a home health nurse and notice the client's home temperature is 82 degrees, the windows are closed and the client is covering up with a large blanket. You notice these factors are contributed to what? Age related changes that cause issues with regulating body temperature You are a home health nurse working with a rural community. You have started seeing patients via Telehealth. What are some benefits of the client using Telehealth services? Helps promote the ability to care for self and you can diagnose, monitor, and treat remotely from a provider's office. You are the nurse caring for a patient who is receiving haloperidol, which of the following is the most severe side effect you should look for? Neuro malignant syndrome You have been to a conference, and you know that the complications of medications used by the elderly can have interactions with certain foods. Which of the following is a cause for concern? Warfarin and vitamin C You are creating a teaching plan for a patient taking lithium, the nurse should include which of the following in the plan of care? Maintain normal sodium and fluid intake in your diet You are caring for a patient who appears to have decreased cognitive functioning, which of the following actions would you take next? Administering the mini mental state examination for proper screening. You are working in long-term care and notice the nurse manager is on the unit and is auditing documentation and records, why would she be auditing? Review if the documentation reaches the standard of care for reimbursement purposes. You are getting ready to interview a patient and need to determine the patient's cognitive status, which of the following questions should you ask to illicit this information? Are you able to drive and run errands without difficulty? You are caring for an older client who has been diagnosed with major depression and are having feelings of worthlessness, they tell you "life just isn't worth living." What is the appropriate nursing intervention? Monitor the client closely one on one if possible and be prepared to help if needed. You are doing your initial assessment on an 85 year-old patient. Which of the following should the nurse use to obtain relevant information? Establish rapport You are caring for an older client & want to do a quick overall assessment focusing on geriatric syndrome, which of the following would you use? SPICES You are teaching a client and they have an order for a physical therapy evaluation, you are teaching them how to remain safe, which of the following statements is correct for the nurse to make? You will need to have an activity planner. You are caring for an older client who drops their tray while setting the table. Another patient makes a rude comment to them. Which of the following questions by the nurse determines if the patient is depressed? It's okay, it was just an accident. How does this whole incident make you feel? You are the nurse working in long-term care & you are reviewing the patient's meal consumption documented by UAP. Which of the following is documented correctly? Client refused their breakfast, ate 0%, but drank 250mL of apple juice You're documenting a newly admitted patient and you are doing a full assessment. Which of the following is an appropriate statement to make in your documentation? Client does not wish to be resuscitated, DNR is signed and bracelet has been placed on the patient's wrist. You are preparing to teach an elderly patient, what do you need to keep in mind when teaching the older patient population? Sensory alterations occur with age You are assessing the learning needs of a client prior to teaching. Which factors from the box below should the nurse focus on? Age of the patient Their understanding of their health problem Sensory acuity learning style You are caring for a newly admitted patient who has a hearing deficit. Which action should you perform as part of their care? Directly face the client while speaking, with good lighting in the room if possible A client with a confirmed DVT is being discharged from the ED. Which client statement indicates that the client has received proper nursing instruction and understands how to manage this condition? "I should try not to drink too much during the daytime." "I should lie on my side with my knees bent when sleeping." "I need to ice my leg every 2 hours for about 20 minutes." "I need to do my leg exercises five times or more every hour." "I need to do my leg exercises five times or more every hour." A nurse is caring for a client who had an aortic balloon valvuloplasty. The nurse should inspect the surgical insertion site closely for which complication(s)? Bleeding and infection Bleeding and wound dehiscence Thrombosis and infection Evisceration Bleeding and infection A client who recently had a myocardial infarction develops pericarditis and complains of chest pain rated 6 (on a scale of 0-10) with deep breathing. Which ordered pro re nata medications is most appropriate for the nurse to administer? Morphine sulfate 6 mg IVP every 2-4 hours Fentanyl 2 mg intravenous pyelogram (IVP) every 2-4 hours Acetaminophen 650 mg PO every 4 hours Ibuprofen 800 mg PO every 8 hours Ibuprofen 800 mg PO every 8 hours The nurse instructs a client recovering from mechanical valve replacement surgery. Which client statement indicates that teaching has been effective? "I can play soccer in a week or two." "I will not drive until informed by my health care provider." "I have a low risk of developing an infection in my heart." "I will not need to take anticoagulant medication every day." "I will not drive until informed by my health care provider." A nurse is caring for a client receiving warfarin therapy following a mechanical valve replacement. The client had a prothrombin time and International Normalized Ratio (INR) drawn before breakfast. The laboratory report shows the client's INR reading was 4. What is the nurse's first priority ? Assess the client for bleeding and notify the health care provider of the results. Notify the next nurse on afternoon shift to hold the evening dose of warfarin. Notify the health care provider to request an increase in the warfarin dose. Be prepared to administer an I.M. vitamin K injection and notify the healthcare provider of the results. Assess the client for bleeding and notify the health care provider of the results. The nurse suspects a client has developed pericarditis after a week of cold-like symptoms. Which of the client's signs and symptoms indicate pericarditis? low urine output secondary to left ventricular dysfunction fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR) pitting edema, chest discomfort, and nonspecific ST-segment elevation lethargy, anorexia, and heart failure fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR) A client is admitted to the hospital with aortic stenosis. What assessment findings would indicate the development of left ventricular failure? Orthopnea, nausea, pedal edema Distended jugular veins, pedal edema, nausea Dyspnea, orthopnea, pulmonary edema Dyspnea, distended jugular veins, orthopnea Dyspnea, orthopnea, pulmonary edema Which would the nurse stress as a periodic lifelong necessity for a client managing infective endocarditis? Exercise regimen Antihypertensive medication Potassium replacement Antibiotic therapy Antibiotic therapy The nurse is caring for a client who has been diagnosed with aortic stenosis. The client is prescribed digoxin. What is the rationale for the medication? left ventricular dysfunction angina dyspnea edema left ventricular dysfunction A client is admitted to the hospital with possible acute pericarditis and pericardial effusion. The nurse knows to prepare the client for which diagnostic test to confirm the client's diagnosis? Computed tomography Echocardiography Chest x-ray Cardiac catheterization Echocardiography A client comes to the clinic reporting fever, chills, and sore throat and is diagnosed with streptococcal pharyngitis. A nurse knows that early diagnosis and effective treatment is essential to avoid which preventable disease? Rheumatic fever Cardiomyopathy Pericarditis Mitral stenosis Rheumatic fever The nurse is educating a client about the care related to a new diagnosis of mitral valve prolapse. What statement made by the client demonstrates understanding of the teaching? "I will take antibiotics before getting my teeth cleaned." "I can get my tongue pierced at a store in the shopping mall." "I will avoid caffeine, alcohol, and smoking." "I can get a tattoo at a local parlor." "I will avoid caffeine, alcohol, and smoking." A nurse is caring for a client with aortic stenosis whose compensatory mechanisms of the heart have begun to fail. The nurse will monitor the client carefully for which initial symptoms? Dizziness, nausea, diarrhea Exertional dyspnea, orthopnea, pulmonary edema Syncope, fever, vomiting Nausea, vomiting, exertional fatigue Exertional dyspnea, orthopnea, pulmonary edema The nurse is assessing a client admitted with infective endocarditis. Which manifestation would the nurse expect to find? Bruising on the palms of the hands and soles of the feet Raised red rash on the trunk and face Involuntary muscle movements of the extremities Small painful lesions on the pads of the fingers and toes Small painful lesions on the pads of the fingers and toes During assessment of a client admitted for cardiomyopathy, the nurse notes the following symptoms: dyspnea on exertion, fatigue, fluid retention, and nausea. The initial appropriate nursing diagnosis is which of the following? Ineffective airway clearance Disturbed sensory perception Decreased cardiac output Autonomic dysreflexia Decreased cardiac output A nurse and a nursing student are performing a physical assessment of a client with pericarditis. The client has an audible pericardial friction rub on auscultation. When leaving the room, the student asks the nurse what causes the sound. The nurse's best response is which of the following? "The layers of the heart become loose from each other and rub together with each heart beat." "The lung surfaces lose their lubrication and rub against the myocardium with each heart beat." "The great vessels rub against the pericardium with each heart beat." "The pericardial surfaces lose their lubricating fluid because of inflammation and rub against each other." "The pericardial surfaces lose their lubricating fluid because of inflammation and rub against each other." The nurse determines that a patient has a characteristic symptom of pericarditis. What symptom does the nurse recognize as significant for this diagnosis? Dyspnea Fatigue lasting more than 1 month Uncontrolled restlessness Constant chest pain Constant chest pain A patient is being seen in a clinic to rule out mitral valve stenosis. Which assessment data would be most significant? The patient's has an enlarged liver and edematous abdomen. The patient reports chest pain after eating a large meal. The patient has jugular vein distention and 3+ pedal edema. The patient reports shortness of breath when walking. The patient reports shortness of breath when walking. A nurse is teaching a client about valve replacement surgery. Which statement by the client indicates an understanding of the benefit of an autograft replacement valve? "The valve is mechanical, and it will not deteriorate or need replacing." "The valve is made from a pig tissue, and I will not need to take any blood-thinning drugs when I am discharged." "The valve is from a tissue donor, and I will not need to take any blood-thinning drugs when I am discharged." "The valve is made from my own heart valve, and I will not need to take any blood-thinning drugs when I am discharged." "The valve is made from my own heart valve, and I will not need to take any blood-thinning drugs when I am discharged." The nurse is providing discharge teaching for a client with rheumatic endocarditis but no valvular dysfunction. On which nursing diagnosis should the nurse focus her teaching? Chronic pain Impaired gas exchange Risk for infection Impaired memory Risk for infection A client who had a prosthetic valve replacement was taking warfarin to reduce the risk of postoperative thrombosis. The client visited the nurse at a clinic once a week. What INR level would alert the nurse to notify the health care provider? 2.6 3.4 3.0 3.8 3.8 A client with aortic stenosis is reluctant to have valve replacement surgery. A nurse is present when the health care provider talks to the client about a treatment that is less invasive than surgery which will likely relieve some of the client's symptoms. What treatment option has been discussed? Balloon percutaneous valvuloplasty Placement of an autograft valve Antibiotic therapy Placement of a xenograft valve Balloon percutaneous valvuloplasty A client with a recent history of atrial fibrillation has been prescribed warfarin. What action will the nurse take to confirm safe dosing? Review the client's most recent warfarin blood levels. Assess the client's apical pulse. Review the client's international normalized ratio (INR). Assess the client's radial pulse. Review the client's international normalized ratio (INR). The nurse is teaching a client diagnosed with aortic stenosis appropriate strategies for attempting to relieve the symptom of angina without resorting to taking medications. What should the nurse teach the client? To eat a small meal before taking nitroglycerin To drink a glass of milk before taking nitroglycerin To rest and relax before taking nitroglycerin To engage in 15 minutes of light exercise before taking nitroglycerin To rest and relax before taking nitroglycerin A nurse plans to have an education session with a client with cardiomyopathy and the client's spouse about ways to increase activity tolerance. What instructions would the nurse provide? Gradually work up to strenuous activity. Avoid all physical and emotional stress. Alternate active periods with rest periods. Include isometric exercises in the daily routine. Alternate active periods with rest periods. A nurse is obtaining a history from a new client in the cardiovascular clinic. When investigating for childhood diseases and disorders associated with structural heart disease, which finding should the nurse consider significant? Severe staphylococcal infection Rheumatic fever Medullary sponge kidney Croup Rheumatic fever The nurse is auscultating the heart of a client diagnosed with mitral valve prolapse. Which is often the first and only manifestation of mitral valve prolapse? Syncope Dizziness Extra heart sound Fatigue Extra heart sound A nurse is caring for a young female adult client diagnosed with atrial fibrillation who has just had a mitral valve replacement. The client is being discharged with prescribed warfarin. The client mentions to the nurse that she relies on the rhythm method for birth control. What education will be a priority for the nurse to provide to this client? symptoms to report of worsening tachycardia related to atrial fibrillation foods to limit (green leafy vegetables) while taking warfarin the high risk for complications if she becomes pregnant while taking warfarin instructions for using the rhythm method the high risk for complications if she becomes pregnant while taking warfarin A nurse reviewing a client's echocardiogram report reads the following statements: "The heart muscle is asymmetrically thickened and the overall size and mass are increased, especially along the septum. The ventricular walls are thickened, reducing the size of the ventricular cavities. Several areas of the myocardium show evidence of scarring." The nurse knows these manifestations are indicative of which type of cardiomyopathy? dilated restrictive arrhythmogenic right ventricular hypertrophic hypertrophic The nurse determines that a client recently diagnosed with subacute bacterial endocarditis understands discharge teaching upon which client statement? "Can I take the antibiotics as a pill now?" "I have to call my doctor so I can get antibiotics before seeing the dentist." "I need a referral to a dietician to understand a low-sodium diet." "If I quit smoking, it will help the endocarditis." "I have to call my doctor so I can get antibiotics before seeing the dentist." A total artificial heart (TAH) is an electrically powered pump that circulates blood into the pulmonary artery and the aorta, thus replacing the functions of both the right and left ventricles. What makes it different from an LVAD? It is specifically designed for long-term use. It is designed for extremely active patients. An LVAD only supports a failing left ventricle. It never needs batteries. An LVAD only supports a failing left ventricle. A client comes into the emergency department reporting about chest pain that gets worse when taking deep breaths and lying down. After ruling out a myocardial infarction, a nurse would assess for which diagnosis? Cardiomyopathy Mitral valve stenosis Pericarditis Rheumatic fever Pericarditis The school nurse is providing care to a child with a sore throat. With any sign of throat infection, the nurse stresses which of the following? Administering antiseptic lozenges Warm, salt water gargling Fluid increase to 2500cc Obtaining a throat culture Obtaining a throat culture A nurse is admitting a client with hypertrophic cardiomyopathy (HCM). What medication order will the nurse question? spironolactone metoprolol isosorbide dinitrate enalapril isosorbide dinitrate The instructor is talking with a nursing student who is caring for a client with pericarditis. The instructor asks the student to name the main characteristic of pericarditis. What should be the student's answer? Respiratory symptoms Dyspnea Fever Precordial pain Precordial pain The nurse is caring for a patient diagnosed with pericarditis. What serious complication should this patient be monitored for? Hypertension Left ventricular hypertrophy Cardiac tamponade Decreased venous pressure Cardiac tamponade The nurse is preparing to administer warfarin to a client with a mechanical valve replacement. The client's international normalized ratio is 2.7. What action will the nurse take? Prepare to administer vitamin K. Administer the medication as ordered. Hold the medication and notify the HCP. Asses the client for abnormal bleeding. Administer the medication as ordered. A nurse is caring for a client with acute mitral regurgitation related to an acute myocardial infarction. The nurse knows to monitor the client carefully for symptoms of which initial complication or result? Cerebral vascular accident (CVA) Infarcted bowel Kidney failure Severe heart failure Severe heart failure A client who suffered blunt chest trauma in a motor vehicle accident reports chest pain during deep inspiration. On auscultation, the nurse detects a pericardial friction rub — a classic sign of acute pericarditis. To relieve this chest pain, which position should the nurse encourage the client to assume? Prone Supine Semi-Fowler's Leaning forward while sitting Leaning forward while sitting Which nursing intervention should a nurse perform to reduce cardiac workload in a client diagnosed with myocarditis? Administer supplemental oxygen. Administer a prescribed antipyretic. Elevate the client's head. Maintain the client on bed rest. Maintain the client on bed rest. Which type of graft is used when a heart valve replacement is made of tissue from an animal heart valve? Autograft Allograft Heterograft Homograft Heterograft A nurse is assessing a client with aortic stenosis. What type of murmur will the nurse expect to hear? high-pitched and blowing. low-pitched, rumbling during diastole. loud and rough during systole. low-pitched and blowing. loud and rough during systole. A client seeks medical attention for dyspnea, chest pain, syncope, fatigue, and palpitations. A thorough physical examination reveals an apical systolic thrill and heave, along with a fourth heart sound (S4) and a systolic murmur. Diagnostic tests reveal that the client has a new onset of hypertrophic cardiomyopathy (HCM). What will be included on the plan of care? beginning a weight reduction diet establishing a daily exercise program an insertion of an implantable cardiac defibrillator teaching about heart transplantation surgery an insertion of an implantable cardiac defibrillator A nurse is caring for a client newly diagnosed with mitral valve prolapse. The health care provider indicates the client has probably had this condition for years. What factor is important for the nurse to consider when teaching the client about valvular disease? "The client may have to wear antiembolism stocking to help with venous return." "The client with mitral valve prolapse probably had no health symptoms." "The client needs premium insurance to cover the cost of medications." "The client's religion may prohibit the client from seeking medical attention." "The client with mitral valve prolapse probably had no health symptoms." A client with aortic regurgitation is admitted to the hospital. Which assessment findings would indicate left ventricular failure? Orthopnea, nausea, pedal edema Dyspnea, orthopnea, paroxysmal nocturnal dyspnea (PND) Dyspnea, distended jugular veins, orthopnea Distended jugular veins, pedal edema, nausea Dyspnea, orthopnea, paroxysmal nocturnal dyspnea (PND) The nurse is reviewing the lab work of a client diagnosed with infective endocarditis. Which diagnostic study confirms the diagnosis? Serum cardiac antigens Complete blood count Positive blood culture Immunosuppressant assay Positive blood culture A young parent brings a 4-year-old child to the pediatric clinic with a mild fever and a red, spotty rash that is beginning to fade. The child's heart rate is rapid, and the rhythm is abnormal. The parent states the child has been healthy until about 3 weeks ago, when the child had a sore throat. The nurse suspects rheumatic carditis. What organism causes rheumatic carditis? Group A beta-hemolytic strep Staphylococcus aureus Epstein-Barr virus Streptococcus viridians Group A beta-hemolytic strep Which of the following clinical manifestations would the nurse expect to find in the client diagnosed with aortic regurgitation? Systolic pressure is lower in the lower extremities Decrescendo systolic murmur Visible neck vein pulsations Pulse pressure shortens Visible neck vein pulsations A nurse is assigned to the medical intensive care unit. The nurse auscultates a water-hammer pulse. What will the sound resemble? low-pitched diastolic murmur at the apex quick, sharp strokes that suddenly collapse mitral click high-pitched blowing sound at the apex quick, sharp strokes that suddenly collapse What is the most common cause of mitral stenosis? Congestive heart failure Degenerative stenosis Rheumatic endocarditis Myocardial infarction Rheumatic endocarditis The nurse is caring for a five-client assignment on a cardiac unit. In caring for which client would the nurse be most correct to assess for an effusion? A client with chest pain A client with chest trauma A client with aortic stenosis A client with mitral valve prolapse A client with chest trauma A patient has had a successful heart transplant for end-stage heart disease. What immunosuppressant will be necessary for this patient to take to prevent rejection? Nifedipine Vancomycin Cyclosporine Verapamil Cyclosporine Which mitral valve condition generally produces no symptoms? Regurgitation Stenosis Prolapse Infection Prolapse The nursing instructor is teaching a class on thrombophlebitis. What should the nurse tell the students about the inflammatory response in thrombophlebitis? The inflammatory response is caused by accumulated waste products in the blocked vessel. The inflammatory response is caused by an excess for fibrin in the blocked vessel. The inflammatory response is caused by the irritation of the clot. The inflammatory response is caused by the irritation of blood trying to flow through the vessel. The inflammatory response is caused by accumulated waste products in the blocked vessel. A client with infective endocarditis is assessed by the nurse for the presence of Janeway lesions. On inspection, the nurse recognizes these lesions by identifying which characteristic sign? Splinter hemorrhages seen under the fingernails Patterns of petechiae on the chest Erythematosus modules on the pads of the fingers Red or purple macules found on the palms of the hands Red or purple macules found on the palms of the hands A client comes into the emergency department reporting about chest pain that gets worse when taking deep breaths and lying down. After ruling out a myocardial infarction, a nurse would assess for which diagnosis? Rheumatic fever Mitral valve stenosis Pericarditis Cardiomyopathy Pericarditis A client reports headaches and "just not feeling right," which the client blames on ongoing sleep disturbances. Inspection reveals Janeway lesions on the bottoms of the client's feet. These symptoms may indicate: infective endocarditis. myocarditis. rheumatic fever. dilated cardiomyopathy. infective endocarditis. When teaching a client with rheumatic carditis and a history of recurrent rheumatic fever, which statement by the client indicates that teaching has been successful? "I may have to take prophylactic antibiotics for up to 10 years." "I will avoid any kind of activity." "I will avoid milk, yogurt, and other dairy products." "I will take a nonsteroidal anti-inflammatory medication every day." "I may have to take prophylactic antibiotics for up to 10 years." It is important for a nurse to be aware of the normal hemodynamics of blood flow to recognize and understand pathology when it occurs. The nurse should know that incomplete closure of the tricuspid valve results in a backward flow of blood from the: Right ventricle to the right atrium. Aorta to the left ventricle. Right atrium to the right ventricle. Left atrium to the left ventricle. Right ventricle to the right atrium. A patient at the clinic describes shortness of breath, periods of feeling "lightheaded," and feeling fatigued despite a full night's sleep. The nurse obtains vital signs and auscultates a systolic click. What does the nurse suspect from the assessment findings? Aortic regurgitation Mitral valve prolapse Mitral regurgitation Aortic stenosis Mitral valve prolapse A nurse is admitting a client diagnosed with infective pericarditis. What is the initial order for the nurse to implement? Provide bedrest with bathroom privileges. Schedule an echocardiogram. Obtain blood cultures times two. Administer intravenous antibiotic. Obtain blood cultures times two. A patient with pericarditis is experiencing cardiac tamponade. Which collaborative intervention should the nurse anticipate for this patient? Assess the patient's heart and lung sounds. Request STAT cardiac enzymes. Prepare for pericardiocentesis. Perform a 12-lead ECG. Prepare for pericardiocentesis. A client needs to have a cardiac valve replacement. The nurse offers client education about the procedures involved—including the benefits and risks. Which client statement indicates the need for more education? "I might lose some blood, but not likely a large quantity of it." "Since the procedure is minimally invasive, there is less surgical trauma." "Since the procedure is minimally invasive, there is less postoperative pain than with other techniques." "I'm anxious because I'll need to have cardiopulmonary bypass." "I'm anxious because I'll need to have cardiopulmonary bypass." Which action will a public health nurse include when planning ways to decrease the incidence of rheumatic fever in the community? Provide prophylactic antibiotics to individuals with a family history of rheumatic fever. Educate individuals in the community about the importance of monitoring temperature when infections occur. Encourage susceptible groups in the community to receive immunizations with streptococcal vaccine. Teach individuals in the community to seek medical treatment for streptococcal pharyngitis. Teach individuals in the community to seek medical treatment for streptococcal pharyngitis. Which type of cardiomyopathy are characterized by diastolic dysfunction caused by rigid ventricular walls that impair diastolic filling and ventricular stretch. Dilated cardiomyopathy (DCM) Arrhythmogenic right ventricular cardiomyopathy (ARVC) Hypertrophic cardiomyopathy (HCM) Restrictive cardiomyopathy (RCM) Restrictive cardiomyopathy (RCM) Which intervention should the nurse include in the plan of care for a client with valvular heart disease who is experiencing pulmonary congestion? Report a weight gain of 3 pounds in 1 week Drink at least 2 L of fluid daily and monitor urine output Take nitroglycerin if shortness of breath develops Rest and sleep in a chair or sit in bed with head elevated Rest and sleep in a chair or sit in bed with head elevated A client with aortic valve endocarditis develops dyspnea, crackles in the lungs, and restlessness. The novice nurse discusses this development with the nurse manager. What statement indicates the novice nurse is applying the assessment findings? "I placed the patient in a semi-Fowler's position and started an NPO diet." "I told the patient that this is a normal complication and to take deep breaths." "I anticipated this complication and I will call the health care provider right now." "I instructed the patient to do coughing and deep breathing and I will reassess in 30 minutes." "I anticipated this complication and I will call the health care provider right now." A nurse is caring for four clients on the cardiac unit. Which client has the greatest risk for contracting infective endocarditis? A client with hypertrophic cardiomyopathy A client with a history of repaired ventricular septal defect A client 1 day post coronary stent placement A client 4 days postoperative after mitral valve replacement A client 4 days postoperative after mitral valve replacement The nurse is caring for a client with manifestations of dilated cardiomyopathy. When planning care, which consideration would the nurse make? Assess abdominal girth daily. Assist client to bathroom every 2 hours. Instruct client to avoid strenuous activity. Place bed in a high or semi-high Fowler's position as needed. Place bed in a high or semi-high Fowler's position as needed. The nurse is admitting a client with infective endocarditis (IE). What questions will the nurse ask to explore known risk factors associated with IE? Select all that apply. Did you have a recent eye examination? Do you have any tattoos? Do you smoke marijuana? Did you have a pacemaker insertion? Are you injecting any drugs? Did you have a pacemaker insertion? Do you have any tattoos? Are you injecting any drugs? The nurse is auscultating the heart sounds of a patient with mitral stenosis. The pulse rhythm is weak and irregular. What rhythm does the nurse expect to see on the electrocardiogram (ECG)? Ventricular tachycardia Sinus dysrhythmia First-degree atrioventricular block Atrial fibrillation Atrial fibrillation The nurse is teaching a client with an atrial septal defect (ASD) about atrial fibrillation. What risk factor will the nurse include with the teaching? stroke cardiomegaly splenomegaly heart failure stroke The nurse is caring for a client with cardiogenic shock in an critical care unit and the family is asking about the intra-aortic balloon pump (IABP). What will the nurse explain is the premise of using IABP? The IABP is acting as the heart to pump blood through the body. The IABP is another machine used in the intensive care unit to keep the kidneys working. The IABP is helping to circulate oxygen to the body tissue. The IABP is reducing the workload of the heart during the shock period. The IABP is reducing the workload of the heart during the shock period. A client with systemic lupus erythematosus reports palpitations, dyspnea on exertion, and leg swelling. The client's symptoms may indicate: cardiomyopathy. thrombophlebitis. Buerger's disease. pericarditis. cardiomyopathy. Which type of cardiomyopathy is associated with syncope? Restrictive Dilated Arrhythmic Hypertrophic Hypertrophic A client is diagnosed with dilated cardiomyopathy. What is the most likely cause of the client's condition? scleroderma chronic alcohol use disorder previous myocardial infarction heredity chronic alcohol use disorder The medical plan of treatment for chronic mitral regurgitation would include medications to reduce afterload, such as: Diuretics Anticoagulants. Angiotensin-converting enzyme (ACE) inhibitors. Vasodilators. Angiotensin-converting enzyme (ACE) inhibitors. Statistics show an increase in the prevalence of infective endocarditis among older adults. Which factor places older adults at risk for developing infective endocarditis? greater incidence of a history of repaired congenital heart defects higher rate of tuberculosis increased use of prosthetic valve replacements increase in IV drug use increased use of prosthetic valve replacements The nurse is assessing a client admitted with acute left-sided infective endocarditis. What is the best diagnostic test to confirm the diagnosis? complete blood count blood cultures transesophageal echocardiogram urinalysis blood cultures A client is diagnosed with cardiomyopathy. Which symptoms that are specific to cardiomyopathy will the nurse instruct the client to report to the health care provider? Select all that apply. Weight gain of 5 lbs. (2.3 kg) in one week Swollen lymph nodes Petechiae on the roof of the mouth Persistent cough Shortness of breath at rest Persistent cough Shortness of breath at rest Weight gain of 5 lbs. (2.3 kg) in one week A client with a recent myocardial infarction was admitted to the hospital with a new diagnosis of mitral valve regurgitation. Which assessment data obtained by the nurse should be immediately communicated to the health care provider? A palpable thrill felt over the left anterior chest A loud systolic murmur all across the precordium Crackles audible throughout the lungs 4+ peripheral edema in both legs Crackles audible throughout the lungs 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? "Health care providers tend to overtreat children with antibiotics so the child recovers quickly." "It is fine to let the child recover naturally; it will save you time and money." "It is not a good idea to give antibiotics for every sore throat that your child has because of the overuse of antibiotics." "It may be streptococcal sore throat. Rheumatic heart disease can be prevented with early treatment." "It may be streptococcal sore throat. Rheumatic heart disease can be prevented with early treatment." The nurse is caring for a client diagnosed with infective endocarditis and awaiting blood culture results. The client asks, "Where did I pick up these bacteria?" The nurse is most safe to speculate which of the following? From droplets from a cough From a break in the skin From the fecal-oral route From ingestion of a food From a break in the skin A client with mitral stenosis comes to the physician's office for a routine checkup. When listening to the client's heart, the nurse expects to hear which type of murmur? Systolic, harsh, crescendo-decrescendo Pansystolic, blowing, high-pitched Diastolic, blowing, decrescendo Diastolic, rumbling, low-pitched Diastolic, rumbling, low-pitched A client with mitral stenosis is admitted to the hospital. What assessment findings would indicate right ventricular failure? Dyspnea, distended jugular veins, orthopnea Distended jugular veins, pedal edema, nausea Dyspnea, orthopnea, pulmonary edema Orthopnea, nausea, pedal edema Distended jugular veins, pedal edema, nausea While auscultating the heart of a pediatric client who is recovering from acute rheumatic fever, the nurse hears a murmur. This sound may indicate: cardiac tamponade. pericarditis. atrial gallop. valve damage. valve damage. The nurse has created a care plan for a client admitted with acute pericarditis and a nursing diagnosis of acute pain related to pericardial inflammation. What is an appropriate nursing intervention for this client? Administering around-the-clock opioids as prescribed Placing the patient in the high-Fowler's position with an over-the-bed table for the patient to lean on Positioning the patient on the right side with the head of the bed elevated 15 degrees Promoting progressive relaxation techniques with the use of slow, deep breathing Placing the patient in the high-Fowler's position with an over-the-bed table for the patient to lean on A client with infective endocarditis of a prosthetic mitral valve returns to the emergency department with a second episode of left-sided weakness and visual changes. What collaborative management will the nurse expect for this client? higher than usual antibiotic dosages administration of anticoagulants surgical valve replacement embolectomy surgical valve replacement A client is already being treated for hypertension. The doctor is concerned about the potential for heart failure, and has the client return for regular check-ups. What does hypertension have to do with heart failure? Heart failure occurs when blood pressures drops. Hypertension causes the heart's chambers to shrink. Hypertension in older males regularly leads to heart failure. Hypertension causes the heart's chambers to enlarge and weaken. Hypertension causes the heart's chambers to enlarge and weaken. A nurse is caring for a client with a cardiac disorder who is prescribed diuretics. What important factor should the nurse include in this client's teaching plan? A discussion on how to avoid direct sunlight when outdoors. A discussion of the signs and symptoms of anemia. A d