Alterations in Cardiac & Tissue Perfusion Final Exam | Questions and Answers

Alterations in Cardiac & Tissue Perfusion Final Exam | Questions and Answers The nurse is conducting an admission assessment on a male client. Which assessment data does the nurse identify as a risk factor for cardiovascular disease? Select all that apply. A. BMI of 26 B. BP of 120/66 mm Hg C. Triglycerides 140 mg/dl D. Moderate exercise for 20 to 30 minutes weekly E. Exposure to secondhand cigarette smoke F. History of repeated streptococcal tonsillitis G. Family history of cardiovascular disease The nurse is assessing a client with heart failure. Which assessment data are the best indicator of fluid balance? A. Blood pressure 144/79 mm Hg B. Urine output 200 mL in the last 4 hours C. Weight increase of 9 lb in the past week D. Generalized edema in the lower extremities The nurse is caring for a client immediately following a cardiac catheterization. Which assessment data require immediate nursing intervention? A. Blood pressure 146/70 mm Hg B. Hematoma developing at insertion site C. Client reports headache pain D. Client reports extreme thirst The nurse is teaching a class regarding reduction of risk factors for cardiovascular disease. Which teaching statement will the nurse include? Select all that apply. A. "If you tend to get angry easily, then your risk for heart disease is higher." B. "To reduce your overall risk, it is important to keep your BMI greater than 30." C. "Do not eat more calories on a daily basis that you are able to burn." D. "Decreasing the amount that you smoke will decrease your overall cardiovascular risk." E. "Secondhand smoke creates a significant risk to others for cardiovascular disease." F. "Exercise moderately at least 2 days per week for a total of 150 minutes." The nurse is assessing the client's heart sounds. Which instruction will the nurse provide if there is difficulty in hearing heart sounds? A. "Please roll onto your left side." B. "Lay all the way down on your back." C. "Please hold your breath while I use my stethoscope." D. "I will just take your pulse instead." A client is diagnosed with left-sided heart failure. Which client assessment findings will the nurse anticipate? Select all that apply. A. Peripheral edema B. Crackles in both lungs C. Tachycardia D. Ascites E. Tachypnea F. S3 gallop The nurse is caring for a client with heart failure who is prescribed spironolactone. Which client statement requires further nursing education? A. "I may need to take this drug every other day according to lab values." B. "I need to take potassium supplements with this medication." C. "I will try my best not to use table salt on my food." D. This medication will cause me to urinate more often." The nurse is caring for a hospitalized client with infective endocarditis who has been receiving antibiotics for 2 days. The client is now experiencing flank pain with hematuria. What complication will the nurse suspect? A. Pulmonary embolus B. Renal infarction C. Transient ischemic attack D. Splenic infarction The nurse is teaching a client with heart failure about a newly prescribed medication, ivabradine. What teaching will the nurse include? Select all that apply. A. "Visual changes with exposure to light are expected initially." B. "Be sure to take this medication with food." C. "Call your health care provider if your pulse rate is low or irregular." D. "Use caution when driving in the sunlight." E. "Check your BP regularly and notify the health care provider if elevated." The nurse is caring for a client with heart failure who is on oxygen at 2 L per nasal cannula with an oxygen saturation of 90%. The client states, "I feel short of breath." Which action will the nurse take first? A. Contact respiratory therapy. B. Increase the oxygen to 4 L. C. Place the client in a high-Fowler position. D. Draw arterial blood for arterial blood gas analysis. The nurse is admitting an 84-year-old client with heart failure to the emergency department with confusion, blurry vision, and an upset stomach. Which assessment data are most concerning? A. Digoxin therapy daily B. Daily metoprolol C. Furosemide twice daily D. Currently taking an antacid for upset stomach The nurse is caring for a diabetic client who will be discharged on hydrochlorothiazide (HCTZ). What information will the nurse include in the discharge teaching? Select all that apply. A. "This drug may cause a dry, nagging cough." B. "Take this drug with a snack, right before bed." C. "Try to increase your intake of potassium in your diet." D. "This drug can affect your glucose control." E. "Increased urination is expected with this drug. A client who is receiving heparin therapy is started on warfarin. Which nursing explanation is appropriate? A "You will need both drugs long-term to provide long-term anticoagulation. B. "Warfarin is easier on your stomach so you can take it long-term." C. "It takes several days for warfarin to begin working, so both drugs are required for a short time." D. "These drugs work the same, but one is taken by mouth, so it is easier to take at home." The nurse is teaching a client with stage hypertension. Which client statement indicates understanding of dietary modifications? A. "I will reduce my sodium intake to 2500 mg per day." B. "I will restrict my intake of daily dietary lean protein." C. "I am only going to drink one cup of coffee to start my day." D. "I will drink a glass of low-fat milk with my breakfast." The nurse is caring for a client receiving intravenous heparin for treatment of DVT who begins to begins to vomit blood. What action should the nurse be prepared to take? A. Administer vitamin K B. Stop the infusion of heparin C. Administer an antiemetic D. Insert a nasogastric tube The nurse is caring for a client with chest pain. What assessment data would cause the nurse to suspect unstable angina? Select all that apply. A. ST changes B. Troponin T 0.6 ng/mL C. Pain lasts 15 to 25 minutes D. Increased number of angina attacks E. The intensity of the chest pain has increased A 45-year-old male client having an annual physical asks the nurse about his risk for developing a myocardial infarction (MI). Which modifiable risk factors will the nurse assess to guide the client's teaching plan? Select all that apply. A. Age B. Tobacco use C. Gender D. Diet E. Family history F. Weight The nurse is providing community education regarding myocardial infarction. What teaching will the nurse include? Select all that apply. A. Denial is common reaction to chest pain. B. A myocardial infarction can occur in minutes. C. Exercise at least 20 minutes three to four times per week. D. Age is a significant risk factor in the development of CAD. E. Women are more likely to experience atypical chest pain. F. Atherosclerosis is a primary factor in the development of CAD. The nurse is preparing to discharge a client who recently experienced a STEMI. Which client statement indicates understanding of nitroglycerin use? A. "The nitroglycerin should tingle when I put it in my mouth" B. "I will keep nitroglycerin in the glove compartment of my car." C. "Since the pills are small, they won't be hard to swallow." D. "The nitroglycerin should relieve the pain immediately." Before administering which class of drugs would the nurse always check the client's heart rate? A. Beta blockers B. Diuretics C. Anticoagulants D. Nonsteroidal anti-inflammatories Which assessment factors for a 62-year-old client would the nurse recognize as modifiable risk factors for heart disease? Select all that apply. A. History of smoking B. Age C. Obesity D. Ethnic background E. Sedentary lifestyle F. Gender Which statement by a client to the nurse indicates an understanding of cigarette usage related to cardiovascular risks? A. "I don't smoke as much as I used to and I'm down to half a pack a day." B. "I need to be completely cigarette free for at least 3 years." C. "I started smoking a few years ago but I plan to quit in a year or two." D. "I smoke to relax like when I go out with friends or when I drink." How many cigarette pack-years has this client smoked: Smoked half a pack a day for 6 years? A. 2 pack-year B. 1 pack-year C. 2 pack-years D. 3 pack-years What common assessment finding would the nurse expect to find in an older adult with cardiovascular disease? A. Lower leg swelling B. Pericardial friction rub C. S4 heart sound D. Change in point of maximal impulse (PMI) location Which is the most common and normal response by a client to a cardiovascular illness? A. Denial B. Fear C. Loss of control D. Depression Which client serum lipid tests suggest an in creased risk for cardiovascular disease (CVD)? Select all that apply. A. HDL 65 mg/dL B. LDL 170 mg/dL C. Triglycerides 185 mg/dL D. Total cholesterol 175 mg/dL E. VLDL 39 mg/dL F. Total cholesterol 250 mg/dL Which laboratory value test elevation does the nurse consider most significant in the diagnosis of a client's myocardial infarction (MI)? A. Troponin T and I B. Myoglobin C. Highly sensitive C-reactive protein D. Creatinine kinase MB Which tests will the nurse teach a client are routinely done for follow-up monitoring when the client is discharged with a prescription for warfarin? A. Complete blood count and platelet count B. Partial thromboplastin time (PTT) and serum potassium C. Prothrombin time (PT) and international normalized ratio (INR) D. Serum and urine electrolyte studies What is the priority concept for a client who has heart failure? A. Gas exchange B. Perfusion C. Comfort D. Infection When a client admits that he or she sometimes has trouble catching his or her breath, which question would the nurse ask to obtain more information about the client's symptoms? A. "Do you have a history of any medical problems like high blood pressure?" B. "What did your health care provider tell you about your diagnosis?" C. "What was your most strenuous activity during the past week?" D. "How do you feel about being told that you have heart failure?" What assessment findings would the nurse expect to find in a client with right heart failure? Select all that apply. A. Weight loss B. Dependent edema C. Neck vein distention D. Angina E. Hepatomegaly F. Weak peripheral pulses Which assessment findings would the nurse expect to find in a client with left heart failure? Select all that apply. A. Wheezes or crackles B. Jugular vein distention C. S, heart sound D. Paroxysmal nocturnal dyspnea E. Ascites F. Oliguria during the day Which statement by a client with a history of hypertension and heart problems would cause the nurse to suspect development of heart failure? A. "I've had a fever frequently." B. "I noticed a very fine red rash on my chest." C. "I get a pain in my shoulder when I cough." D. "I've had to remove all of my rings for the past month." What is the most reliable method of monitoring for fluid gain or loss in a client with heart failure? A. Check for pitting edema in dependent body parts. B. Auscultate the lungs for worsening crackles or wheezes. C. Weigh the client daily at the same time and using the same scale. D. Assess the client's skin turgor and condition of mucous membranes. Which major self-management categories will the nurse include when teaching a client, newly diagnosed with heart failure, who is about to be discharged? Select all that apply. A. Symptoms, what to do when they get worse B. Medications C. Activity D. Heart transplants E. Weight F. Diet Which early symptoms indicate to the nurse that a client's HF is getting worse and pulmonary edema is developing? Select all that apply. A. Crackles in the lung bases B. Frothy, blood-tinged sputum C. Dyspnea at rest D. Cyanosis E. Disorientation F. Level of crackles rises higher in the lungs Which interventions would the nurse expect to include in the care of a client with pulmonary edema caused by HF? Select all that apply. A. Sodium restriction B. Fluid restriction C. Administration of potassium supplement D. Position client in semi-Fowler or high Fowler E. Weekly weight monitoring F. Administration of loop diuretics What are the priority nursing actions related to caring for an older adult client with HF who is prescribed digoxin? Select all that apply. A. Monitor the ECG strip for early signs of toxicity such as bradycardia. B. Auscultate the apical pulse heart rate and rhythm for a full minute before administering the drug. C. Observe for signs of toxicity, which are often nonspecific such as anorexia, fatigue, and blurred vision. D. Report any changes in heart rate or rhythm to the health care provider. E. Monitor serum digoxin and potassium levels. F. Check the health care provider's prescription for parameters to hold the drug. Which are potential benefits of a client receiving the drug digoxin? A. Reduced heart rate B. Increased contractility C. Venous vasodilation D. Slowed conduction through the AV node E. Inhibition of sympathetic activity with enhanced parasympathetic activity F. Enhanced renal excretion of sodium and water Which drugs would the nurse prepare to ad minister to a client with HF who has developed pulmonary edema? Select all that apply. A. Nitroglycerin sublingual B. Lorazepam IV C. Oxygen at 1 L/min nasal canula D. Furosemide IV E. Metoprolol IV F. Nitroglycerin IV Which statement by a client with heart failure indicates to the nurse the need for additional teaching? A. "If my heart feels like it's racing, I should call my health care provider." B. "I must weigh myself once a week and watch for signs of fluid retention." C. "I'll need periods of rest and activity and I should avoid activity after meals." D. "I'll need to consider and plan my activities for the day, and rest as needed." Which assessment findings would cause the nurse to suspect cardiac tamponade in a client? Select all that apply. A. Neck vein distention B. Paradoxical pulse C. Hypertension D. Muffled heart sounds E. Tachycardia F. Petechiae Which clients are at greatest risk for development of infective endocarditis? Select all that apply. A. Clients after myocardial infarction B. Clients who are IV drug users C. Clients with poor dental health