Chapter 30- Management of Patients With Complications From Heart Disease

Brunner: Medical-Surgical Nursing, 10th Edition

Chapter 30: Management of Patients With Complications From Heart Disease




1. The nurse notes that a patient has developed a cough productive for mucoid sputum, is short
of breath, has cyanotic hands, and has noisy, moist sounding, and rapid breathing. These
symptoms indicate:
A) Pericarditis
B) Congestive heart failure (CHF)
C) Pulmonary edema
D) Right ventricular hypertrophy

Ans: C
Chapter: 30
Client Needs: IV-3
Cognitive Categories: Application
Concepts and Processes: Nursing Process
Difficulty: Moderate
Objective: 2
Feedback: Pulmonary congestion, peripheries becoming cyanotic and cool, fatigue, an increase
in weight, activity intolerance, and a cough productive for mucoid sputum are associated with
pulmonary edema.




2. A patient with CHF is displaying symptoms such as dry hacking cough, fatigue, and a slight
increase in today's weight. The most appropriate position for the patient to be placed in is:
A) Supine
B) Low Fowler's
C) High Fowlers with feet dangling
D) Left lateral

Ans: C
Chapter: 30
Client Needs: IV-3
Cognitive Categories: Application
Concepts and Processes: Nursing Process
Difficulty: Moderate
Objective: 1
Feedback: A dry hacking cough, fatigue, and an increase in weight are indicators of early stages
of pulmonary edema. Preventive measures should be implemented to prevent progression of
pulmonary edema, which include placing the patient in an upright position with feet and legs

,dependent.




3. Which of the predisposing factors increases the risk of CHF?
A) Lasix 20 mg/d
B) High potassium levels
C) African-American man
D) Age of 65 years or older

Ans: D
Chapter: 30
Client Needs: II-2
Cognitive Categories: Knowledge
Concepts and Processes: Nursing Process
Difficulty: Easy
Objective: 2
Feedback: The incidence of CHF increases with age.




4. Which of the following is the primary cause of heart failure?
A) Type I diabetes
B) Arteriosclerosis
C) Atherosclerosis
D) Pulmonary congestion

Ans: C
Chapter: 30
Client Needs: II-1
Cognitive Categories: Knowledge
Concepts and Processes: Nursing Process
Difficulty: Moderate
Objective: 2
Feedback: Atherosclerosis of the coronary arteries is the primary cause of CHF.




5. Mr. Black has a peripheral vessel on his right arm used for pulmonary artery
catheter monitoring. Which of the following assessments should be made to the right
hand?
A) Texture of the skin
B) Temperature of the hand
C) Pigment color of the hand

, D) Pain to the elbow

Ans: B
Chapter: 30
Client Needs: IV-3
Cognitive Categories: Application
Concepts and Processes: Nursing Process
Difficulty: Difficult
Objective: 1
Feedback: Checking the temperature of the hand is to assess circulation to the peripheries of the
arm being used for access for the pulmonary catheter.




6. What would an absence of a pulse to the right radial pulse indicate?
A) Occlusion of the vessel
B) Possible sepsis
C) Decrease tidal volume
D) Repositioning of the patient needed

Ans: A
Chapter: 30
Client Needs: IV-3
Cognitive Categories: Application
Concepts and Processes: Nursing Process
Difficulty: Moderate
Objective: 1
Feedback: Absence of the pulse to a peripheral pulse site indicates that the vessel is occluded.




7. Which of the following would be most appropriate for a patient who is receiving diuretic
therapy for cardiac failure?
A) Check laboratory results for creatinine levels.
B) Monitor for hypotension.
C) Encourage the patient to spend time outdoors to aid in vitamin D absorption.
D) Discourage use of potassium.

Ans: B
Chapter: 30
Client Needs: IV-2
Cognitive Categories: Application
Concepts and Processes: Nursing Process
Difficulty: Moderate