Chp37

Question 0

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?

Answer 0

Lifelong anticoagulant therapy will be needed after mechanical valve replacement.

Question 1

Afterreceivingreportonthefollowingpatients,which patient should the nurse assess first?

Answer 1

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

Question 2

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

Answer 2

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

Question 3

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

Answer 3

need for frequent laboratory blood testing.

Question 4

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

Answer 4

a new regurgitant murmur.

Question 5

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?

Answer 5

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

Question 6

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

Answer 6

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

Question 7

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)?

Answer 7

Urine output less than 30 mL/hr

Question 8

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

Answer 8

Have you had a recent sore throat?”

Question 9

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?

Answer 9

Irregular pulse

Question 10

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?

Answer 10

The patient has bilateral crackles.

Question 11

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?

Answer 11

The patient complains of chest pressure when ambulating.

Question 12

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?

Answer 12

4

Question 13

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?

Answer 13

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

Question 14

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?

Answer 14

Have you had dental work done recently?”

Question 15

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

Answer 15

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

Question 16

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

Answer 16

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

Question 17

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?

Answer 17

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

Question 18

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

Answer 18

echocardiography

Question 19

. 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?

Answer 19

Oral ibuprofen (Motrin) 600 mg

Question 20

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

Answer 20

Activity intolerance related to arthralgia

Question 21

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

Answer 21

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

Question 22

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?

Answer 22

Auscultate the heart sounds.

Question 23

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

Answer 23

shortness of breath.

Question 24

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

Answer 24

shortness of breath on exertion.

Question 25

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?

Answer 25

Teach community members to seek treatment for streptococcal pharyngitis.

Question 26

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

Answer 26

Arrange for placement of a long-term IV catheter.

Question 27

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

Answer 27

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

Question 28

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

Answer 28

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

Question 29

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?

Answer 29

Order blood cultures drawn from two sites.

Question 30

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

Answer 30

Sudden onset right flank pain

Question 31

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

Answer 31

Jugular venous distention (JVD) to jaw level

Question 32

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

Answer 32

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

Question 33

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

Answer 33

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

Question 34

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

Answer 34

promote rest to decrease myocardial oxygen demand.