Chp37 Flashcards

0
Q

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

Lifelong anticoagulant therapy will be needed after mechanical valve replacement.

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1
Q

Afterreceivingreportonthefollowingpatients,which patient should the nurse assess first?

A

Patient with acute aortic regurgitation whose blood pressure is 86/54 mm Hg.

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2
Q

After receiving the following information about four patients during change-of-shift report, which patient
should the nurse assess first?

A

Patient who has just returned to the unit after balloon valvuloplasty.

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3
Q

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

need for frequent laboratory blood testing.

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4
Q

During the assessment of a 25-year-old patient with infective endocarditis (IE), the nurse would expect to
find?

A

a new regurgitant murmur.

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5
Q

The nurse establishes the nursing diagnosis of ineffective health maintenance related to lack of
knowledge regarding long-term management of rheumatic fever when a 30-year-old recovering from rheumatic fever without carditis says which of the following?

A

I will be immune to further episodes of rheumatic fever after this infection.”

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6
Q

The nurse has identified a nursing diagnosis of acute pain related to inflammatory process for a patient with
acute pericarditis. The priority intervention by the nurse for this problem is to

A

place the patient in Fowler’s position, leaning forward on the overbed table.

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7
Q

The nurse identifies the nursing diagnosis of decreased cardiac output related to valvular insufficiency for the
patient with infective endocarditis (IE) based on which assessment finding(s)?

A

Urine output less than 30 mL/hr

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8
Q

The nurse is admitting a patient with possible rheumatic fever. Which question on the admission health history
will be most pertinent to ask?

A

Have you had a recent sore throat?”

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9
Q

The nurse is assessing a patient with myocarditis before administering the scheduled dose of digoxin (Lanoxin).
Which finding is most important for the nurse to communicate to the health care provider?

A

Irregular pulse

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10
Q

The nurse is caring for a 64-year-old patient admitted with mitral valve regurgitation. Which information
obtained by the nurse when assessing the patient should be communicated to the health care provider immediately?

A

The patient has bilateral crackles.

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11
Q

The nurse is caring for a 78-year-old patient with aortic stenosis. Which assessment data obtained by the nurse
would be most important to report to the health care provider?

A

The patient complains of chest pressure when ambulating.

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12
Q

The nurse is caring for a patient with mitral regurgitation. Referring to the figure below, where
should the nurse listen to best hear any murmur that the patient has?

A

4

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13
Q

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’s 29-year-old brother died from a sudden cardiac arrest

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14
Q

The nurse obtains a health history from a 65-year-old patient with a prosthetic mitral valve who has
symptoms of infective endocarditis (IE). Which question by the nurse is most appropriate?

A

Have you had dental work done recently?”

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15
Q

The nurse suspects cardiac tamponade in a patient who has acute pericarditis. To assess for the presence of pulsus paradoxus, the nurse should

A

note when Korotkoff sounds are auscultated during both inspiration and expiration.

16
Q

Thenursewillplandischargeteachingabouttheneed for prophylactic antibiotics when having dental
procedures for which patient?

A

Patient who had a mitral valve replacement with a mechanical valve.

17
Q

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

Notify the doctor about any symptoms of heart failure such as shortness of breath.

18
Q

A patient is admitted to the hospital with possible acute pericarditis. The nurse should plan to teach the patient
about the purpose of

A

echocardiography

19
Q

. 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

Oral ibuprofen (Motrin) 600 mg

20
Q

A patient with rheumatic fever has subcutaneous nodules, erythema marginatum, and polyarthritis.
Based on these findings, which nursing diagnosis would be most appropriate?

A

Activity intolerance related to arthralgia

21
Q

To assess the patient with pericarditis for evidence of a pericardial friction rub, the nurse should

A

auscultate by placing the diaphragm of the stethoscope on the lower left sternal border.

22
Q

Two days after an acute myocardial infarction (MI), a patient complains of stabbing chest pain that increases
with a deep breath. Which action will the nurse take first?

A

Auscultate the heart sounds.

23
Q

When caring for a patient with infective endocarditis of the tricuspid valve, the nurse should monitor the
patient for the development of

A

shortness of breath.

24
Q

When caring for a patient with mitral valve stenosis, it is most important that the nurse assess for

A

shortness of breath on exertion.

25
Q

When developing a community health program to decrease the incidence of rheumatic fever, which action
would be most important for the community health nurse to include?

A

Teach community members to seek treatment for streptococcal pharyngitis.

26
Q

When planning care for a patient hospitalized with a streptococcal infective endocarditis (IE), which
intervention is a priority for the nurse to include?

A

Arrange for placement of a long-term IV catheter.

27
Q

Whichactionbythenursewilldetermineifthe therapies ordered for a patient with chronic constrictive pericarditis are effective?

A

Assess for the presence of jugular venous distention (JVD).

28
Q

Which action could the nurse delegate to unlicensed assistive personnel (UAP) trained as electrocardiogram
(ECG) technicians working on the cardiac unit?

A

Check the heart monitor for changes in rhythm while a patient who had a valve replacement ambulates.

29
Q

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

Order blood cultures drawn from two sites.

30
Q

Which assessment finding in a patient who is admitted with infective endocarditis (IE) is most important to
communicate to the health care provider?

A

Sudden onset right flank pain

31
Q

Which assessment finding obtained by the nurse when assessing a patient with acute pericarditis should be
reported immediately to the health care provider?

A

Jugular venous distention (JVD) to jaw level

32
Q

Which statement by a patient with restrictive cardiomyopathy indicates that the nurse’s discharge
teaching about self-management has been most effective?

A

“I will take antibiotics when my teeth are cleaned at the dental office.”

33
Q

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

avoid use of over-the-counter (OTC) medications that contain stimulant drugs

34
Q

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.