Unit 8 Flashcards
A patient presents to the CCU with chest pain made worse by breathing deeply or lying supine, dyspnea, malaise, fever, and elevated blood cell count. On reviewing his medical chart, the nurse observes that the patient had a myocardial infarction almost 2 months ago. What does the nurse suspect the patients condition to be?
A) Dresslers syndrome
B) Dilated cardiomyopathy
C) Hypertrophic cardiomyopathy
D) Buergers disease
a
A 20-year-old competitive swimmer was recently admitted to the CCU and diagnosed with myocarditis. The nurse is counseling the patient and her family regarding what this diagnosis means. What should the nurse mention? Select all that apply.
A) Corticosteroids are effective in changing the clinical course of this disease.
B) Immunosuppressive agents are effective in changing the clinical course of this disease.
C) Some cases of myocarditis resolve without further sequelae.
D) The patient will need to withdraw from training and competition for at least 6 months.
E) The disease is potentially lethal and often has no cure.
F) The disease may require heart transplantation.
C D E F
A patient in the CCU presents with endocarditis. This patient is 40 years old, a smoker, had rheumatic heart disease as a child, and is obese. Which characteristics of this patient are risk factors for endocarditis?
A) Age
B) Smoking status
C) History of rheumatic heart disease
D) Obesity
C
A patient in the CCU has an obstruction in his coronary arteries that is resulting in oxygen levels that are inadequate to meet the metabolic demands of his myocardial cells. He is exhibiting symptoms of left ventricular heart failure. Which disease does he most likely have?
A) Ischemic cardiomyopathy
B) Nonischemic cardiomyopathy
C) Endocarditis
D) Peripheral vascular disease
A
A patient in the CCU is experiencing a cramping pain in the buttocks whenever she stands. The nurse also observes that the patients nails on both hands are thick and her skin dry. The nurse recognizes this condition as which of the following?
A) Deep vein thrombosis
B) Abdominal aortic aneurysm
C) Peripheral arterial disease
D) Thoracic aortic aneurysm
C
A patient in the CCU has been confined to bed rest for 3 weeks. The patient is obese, is on warfarin, and has a peripherally inserted central catheter (PICC). Which of the following are causative factors for thrombophlebitis in this patient? Select all that apply.
A) Bed rest
B) Obesity
C) Presence of a PICC
D) Warfarin
E) Insulin
A C
The nurse observes a balloon-shaped outpouching on the abdomen of a cardiac patient in the CCU. The nurse recognizes this as which of the following?
A) Fusiform aneurysm
B) False aneurysm
C) Saccular aneurysm
D) Thoracic aneurysm
C
A patient in the CCU has an abdominal aortic aneurysm that is 7 cm in diameter. The nurse recognizes that which of the following is the most appropriate treatment for this patient?
A) Anticoagulant therapy
B) Heart transplant
C) Genetic screening and counseling
D) Surgical repair
D
A pregnant patient in the CCU who recently was in a motor vehicle accident suddenly complains of an intense chest pain that she describes as ripping before passing out. On auscultation, the nurse hears the murmur of aortic regurgitation. What condition does the woman most likely have?
A) Thoracic aortic aneurysm
B) Aortic dissection
C) Hypertrophic cardiomyopathy
D) Hypertensive crisis
B
. An elderly man presents to the CCU with a blood pressure reading of 190/125, severe headache, visual disturbances, and bleeding from his eyes. The nurse recognizes this condition as which of the following?
A) Pericarditis
B) Endocarditis
C) Dilated cardiomyopathy
D) Hypertensive crisis
D
The patient was admitted with an acute myocardial infarction several days ago and is now complaining of severe midsternal chest pain at rest and dyspnea. The pain is constant, more severe when the patient lies down, and unaffected by medications. What is the best nursing intervention?
A) Obtain cardiac marker blood tests to assess for reinfarction.
B) Auscultate for pericardial and pleural friction rubs.
C) Auscultate for new onset of S3 heart sound.
D) Prepare the patient for cardiac catheterization.
B
A patient has been diagnosed with pericarditis. Which assessment changes unique to pericarditis would the nurse expect to find?
A) New onset of S3 gallop
B) Severe chest pain at rest
C) Diffuse ST segment elevation on ECG
D) Prolonged, irregular PR intervals on ECG
C
A patient with mitral valve prolapse has been admitted to the CCU with probable infectious endocarditis. What physical changes unique to infectious endocarditis will the nurse be most likely to find?
A) Track marks on arms following peripheral veins
B) New onset of or change in cardiac murmur
C) Severe midsternal crushing chest pain with activity
D) Fever, tachycardia, and general malaise
B
A patient is admitted with complications and exacerbation of symptoms from dilated cardiomyopathy. Which easily treated factor might account for the change in the patients condition?
A) Viral illness before the original diagnosis
B) Acute myocardial infarction
C) Chronic alcohol abuse
D) Persistent vegetative growth on valves
C
A young adult collapses during a sporting event. Cardiopulmonary resuscitation is successful, and the patient is admitted with a diagnosis of possible hypertrophic cardiomyopathy. What nursing assessment is a priority for this patient?
A) Cardiac monitor pattern and pulse oximetry
B) Evaluation for dyspnea and heart murmur
C) Level of consciousness and mental status evaluation
D) History of recent viral illness or alcohol abuse
B
A patient is being treated for hypertrophic cardiomyopathy. During discharge teaching, what is the most important information to include?
A) Cessation of alcohol abuse will improve cardiac function.
B) Only a heart transplant is associated with increased longevity.
C) Make an appointment for genetic screening and counseling.
D) Information about anti-infective medications
C
A patient with chronic arteriosclerotic disease complains of severe pain in the calf, foot, and ankle, followed by numbness. If the patient has an embolus of the lower extremity arteries, what additional physical sign will the nurse find?
A) History of claudication
B) Black tips of toes
C) No foot pulses on affected foot
D) Bilateral cool skin on lower extremities
C
A patient is diagnosed with Buergers disease. What would be the most important teaching for this patient?
A) Information about anti-inflammatory medications
B) Importance of protecting the extremities from cold
C) Rationale for quitting smoking
D) Anticoagulant therapy precautions
C
A patient is critically ill in the CCU and is on complete bed rest. What strategy should the nurse use to prevent phlebitis leading to thromboembolism?
A) Repeated attempts to insert intravenous catheters
B) Maintain overall blood volume slightly low
C) Maintain complete bed rest
D) Passive exercises of lower extremities
D
A patient is admitted for repair of an abdominal aortic aneurysm and begins to complain of severe abdominal pain and a sense of impending doom. What assessment should the nurse perform first?
A) Blood pressure
B) Respiratory rate
C) Auscultation of heart sounds
D) Pain scale
A
A patient with a history of hypertension has been admitted for surgical repair of a thoracic aneurysm. What symptom would indicate probable acute dissection of the aneurysm?
A) Nonspecific mild chest pain
B) Absence of cardiac murmur
C) Wide mediastinum on chest x-ray
D) Equal radial pulses at normal intensity
C
A patient has been admitted with hypertensive crisis and is experiencing headache, visual disturbances, confusion, nausea, papilledema, and oliguria. The patient has been started on an intravenous vasodilator to reduce his blood pressure quickly. What is the priority nursing assessment?
A) Protection of safety with side rails and restraints
B) Continuous blood pressure monitoring by arterial catheter
C) Response to pain and nausea medications
D) Insertion of nasogastric tube to intermittent suction
B
A critical care nurse is caring for a client in a hypertensive crisis. Blood pressure is being reduced slowly. If the blood pressure is lowered too much too quickly, what is the patient is at risk for?
A) A myocardial infarction
B) A cerebral infarction
C) Renal failure
D) All of the above
C
A patient in the CCU with chronic heart failure is prescribed an ACE inhibitor. What side effects should the nurse mention to him? Select all that apply.
A) Angioderma
B) Cough
C) Rebound tachycardia
D) Hyperkalemia
E) Night sweats
F) Anxiety
A B D
A CCU nurse who works frequently with cardiac patients is putting together a teaching plan to follow when she instructs these patients on how to live with heart failure. Which points should she include in this plan? Select all that apply.
A) Discontinue medications once you are feeling better, to avoid adverse effects.
B) Take your medications about the same time every day.
C) Avoid pepper and spices.
D) Remove the saltshaker from your table.
E) The best time to weigh yourself is in the afternoon.
F) Try to perform 15 to 20 minutes of continuous activity each day.
B D F
A patient with chronic cardiac failure in the CCU is on an ACE inhibitor but still has significant pitting edema in his extremities. Which medication, in addition to the ACE inhibitor, is the physician likely to prescribe to this patient?
A) Digoxin
B) A loop diuretic
C) b-blocker
D) Calcium channel blocker
B
A patient presents to the CCU with acute, decompensated heart failure. The nurse observes that this patient has chronic obstructive pulmonary disease and hypotension. She eats a low-sodium diet and drinks alcohol excessively. Which of the following are contributing factors to this patients heart failure? Select all that apply.
A) Chronic obstructive pulmonary disease
B) Hypotension
C) Low-sodium diet
D) Excessive alcohol intake
A
A patient is in the CCU with dilated cardiomyopathy and asymptomatic right-sided chronic heart failure. What finding will the nurse most likely discover in her assessment of this patient?
A) Mitral regurgitation murmur
B) Cheyne-Stokes respiratory pattern
C) Unilateral crackles
D) Rales
A
