CHAPTER 32 quiz

Question 1

A 55-year-old man with aortic valve stenosis is being admitted for valve replacement surgery which assessment findings should the nurse expect answer systolic murmur

Answer 1

Systolic murmur

Question 2

a 74-year-old woman who has a history of heart failure and chronic obstructive lung disease which which diagnostic study with the nurse expect to be elevated if the cause of death was cardiac related

Answer 2

BNP

Question 3

The nurse is a 62-year-old woman underground radiation for breast cancer how should the nurse patient to auscultate for signs of acute pericarditis

Answer 3

Sitting and leaning forward

Question 4

Repairing to teaching group of women in the community about heart disease what should the nurse include in the teaching plan

Answer 4

Women are more likely to have non-cardiac symptoms of heart disease

Question 5

A 64-year-old patient with a history of myocardial infarction is scheduled for a transesophageal echo cardio gram to visualize a suspected clot in the left atrium what information should the nurse include when teaching the patient about this diagnostic study

Answer 5

The intravenous sedation may be administered to help the patient relax the rationale is intravenous sedation is administered to help the patient relax and ease the insertion of the tube into the esophagus

Question 6

The most tedious a 28-year-old man newly diagnosed with hypertension about lifestyle modifications to reduce his blood pressure which statement by the patient acquires intervention by the

Answer 6

I can lower my blood pressure by switching to smokeless tobacco the rationale is nicotine contained and tobacco products smoking and chew cause vasoconstriction and increase blood pressure

Question 7

The nurse supervisor is an unlicensed assistant who is taking the blood pressure of a 58-year-old female patient admitted with heart failure the patient is obese the nurse should intervene what is absurd absurd observed

Answer 7

That uap deflates the blood pressure cuff at 8 to 10 per second the rationale be deflated to her second the arm should you supported at the level of the heart but pressure minute

Question 8

44-year-old man is diagnosed with hypertension and receives a prescription for lotensin benazapril after the nurse teaches him about the medication which statement by the patient indicates his correct understanding

Answer 8

If I develop a dry cough while taking this medication I should notify my doctor

Question 9

A 67-year-old woman with a history of her disease and prior myocardial infarction emergency department with a blood pressure of 238/148 and started on IV nitroprusside(nitropress) what should the nurse deerine as an appropriate goa for the first hour oftreatment

Answer 9

mean arterial pressure no lower than 133 mmhg

Question 10

the nurse admits a 73 y/o m pt with dementia for tx of uncontrolled htn the nurse will closely monitor for hypokalemia if the pt recvs which med

Answer 10

bumetadine (bumex) a loop diuretic..hypokalemia is common a/e of this rx…the opposite affect for spironolacone and amiloride

Question 11

the rn prepared a d/c teaching plan for a 44 y/o m pt who has recently been diagnoses withcoronoary artery dz. which risk factor sbould the nurse plan to fcus on dring theteaching session

Answer 11

elevated serum levels. dislipidemia is one of the four major modfiable risk factors for coronary artery dz CAD.

Question 12

The nurse instructs a 68-year-old woman With hypercholesterolemia about lowering the nurse to turn further teaching is necessary if the patient makes makes which statement

Answer 12

I will take garlic instead of my prescription medication to reduce my cholesterol the rationale current evidence does not support using garlic in the treatment of elevated cholesterol strong evidence supports the use of omega-3 fatty acid’s duction of tryglyceride lvls

Question 13

A 52 patient has received Activase for an st elevation or STEMI to determine the effectiveness of this medication the nurse should assess the pt for the

Answer 13

presence of chest pain

Question 14

74 y/o man witha hisotry o f prostate cancer and htn is admitted to the ER with substernal chest pain which will the urse complete before administering sublingal nitroglycerin

Answer 14

obtain a 12 lead ecg

Question 15

hich patient is at greatest risk for sudden cardiac death?

Answer 15

A 52-year-old African American man with left ventricular failure

Question 16

The home care nurse visits a 73-year-old Hispanic woman with chronic heart failure. Which clinical manifestations, if assessed by the nurse, would indicate acute decompensated heart failure (pulmonary edema)?

Answer 16

evere dyspnea and blood-streaked, frothy sputum

Question 17

54-year-old male patient who had bladder surgery 2 days ago develops acute decompensated heart failure (ADHF) with severe dyspnea. Which action by the nurse would be indicated first?

Answer 17

Assist the patient to a sitting position with arms on the overbed table.

Question 18

A70-year-old woman with chronic heart failure and atrial fibrillation asks the nurse why warfarin (Coumadin) has been prescribed for her to continue at home. Which response by the nurse is accurate?

Answer 18

“The medication prevents blood clots from forming in your heart.”

Question 19

The nurse prepares to administer digoxin (Lanoxin) 0.125 mg to an 82-year-old man admitted with influenza and a history of chronic heart failure. What should the nurse assess before giving the medication?

Answer 19

Serum potassium level

Question 20

At a clinic visit, the nurse provides dietary teaching for a 56-year-old woman who was recently hospitalized with an exacerbation of chronic heart failure. The nurse determines that teaching is successful if the patient makes which statement?

Answer 20

“I will limit the amount of milk and cheese in my diet.”

Question 21

A 38-year-old teacher who reported dizziness and shortness of breath while supervising recess is admitted with a dysrhythmia. Which medication, if ordered, requires the nurse to carefully monitor the patient for asystole?

Answer 21

Adenosine (Adenocard).....Rationale
IV adenosine (Adenocard) is the first drug of choice to convert supraventricular tachycardia to a normal sinus rhythm. Adenosine is administered IV rapidly (over 1 or 2 seconds) followed by a rapid, normal saline flush. The nurse should monitor the patient's ECG continuously because a brief period of asystole after adenosine administration is common and expected. Atropine sulfate increases heart rate, whereas lanoxin and metoprolol slow the heart rate.

Question 22

he nurse is monitoring the ECGs of several patients on a cardiac telemetry unit. The patients are directly visible to the nurse, and all of the patients are observed to be sitting up and talking with visitors. Which patient’s rhythm would require the nurse to take immediate action?

Answer 22

52-year-old man with premature ventricular contractions (PVCs) at a rate of 12 per minute……

Question 23

Cardioversion is attempted for a 64-year-old man with atrial flutter and a rapid ventricular response. After the nurse delivers 50 joules by synchronized cardioversion, the patient develops ventricular fibrillation. Which action should the nurse take immediately?

Answer 23

Turn the synchronizer switch to the “off” position and recharge the device.

Question 24

The nurse performs discharge teaching for a 74-year-old woman with an implantable cardioverter-defibrillator. Which statement by the patient indicates to the nurse that further teaching is needed?

Answer 24

“I can expect redness and swelling of the incision site for a few days.”

Question 25

A 50-year-old man who develops third-degree heart block reports feeling chest pressure and shortness of breath. Which instructions should the nurse provide to the patient before initiating emergency transcutaneous pacing?

Answer 25

“The device delivers a current through your skin that can be uncomfortable.”

Question 26

The nurse performs discharge teaching for a 68-year-old man who is newly diagnosed with infective endocarditis with a history of IV substance abuse. Which statement by the patient indicates to the nurse that teaching was successful?

Answer 26

“I will inform my dentist about my hospitalization for infective endocarditis.”

Question 27

A 55-year-old female patient develops acute pericarditis after a myocardial infarction. It is most important for the nurse to assess for which clinical manifestation of a possible complication?

Answer 27

Decreased blood pressure with tachycardia