Deck 30: Coordinating Care for Patients With Cardiac Disorders

Question 1

A patient is recovering from mechanical valve replacement surgery for valvular disease. Which statement by the patient indicates understanding of medication teaching?
1)"I will be receiving diuretics for the long term."
2)"I will need to be on anticoagulant therapy for life."
3)"I will need to take antibiotics for 4 to 6 weeks."
4)"I may need to be on antiarrhythmic medications."

Answer 1

2

Question 2

In providing care for a patient with mitral stenosis, the nurse correlates which hemodynamic parameter most directly with this disease of this valve?
1)Increased right atrial pressure
2)Increased left atrial pressure
3)Increased right ventricular pressure
4)Increased left ventricular pressure

Answer 2

2

Question 3

In a patient with coronary artery disease with elevated liver function test results, it is a priority for the nurse to follow up with the healthcare provider about which prescription?
1)Aspirin (Ecotrin)
2)Atorvastatin (Lipitor)
3)Metoprolol (Lopressor)
4)Cholestyramine (Questran)

Answer 3

2

Question 4

The nurse monitors for which diagnostic result in the patient with pericarditis?
1)Elevated sedimentation rate (ESR)
2)Elevated troponin
3)Elevated lipid panel
4)Elevated cholesterol

Question 5

The nurse monitors for which clinical manifestation in the patient diagnosed with valvular disease?
1)Heart murmur
2)Splinter hemorrhages
3)Osler's nodes
4)Displaced point of maximum impulse

Question 6

The nurse correlates which clinical manifestation to the pathophysiological process of infective endocarditis?
1)Friction rub
2)Chest pain at rest
3)Jugular vein distention
4)Painless spots on the palms and soles

Question 7

A patient is admitted for treatment of pericarditis. For which additional health problem should the nurse expect the patient to be evaluated?
1)Asthma
2)Myocardial infarction
3)Infective endocarditis
4)Chronic obstructive pulmonary disease

Question 8

The nurse is evaluating teaching provided to a patient with coronary artery disease. Which patient statement indicates that additional teaching is required?
1)"I will adhere to my smoking cessation plan."
2)"I am to reduce my daily intake of saturated fat."
3)"I can take up to three doses of nitroglycerin 15 minutes apart."
4)"I am to follow the exercise plan for 30 minutes, 5 days a week."

Question 9

The nurse is caring for a patient with pericardial effusion. Which action should the nurse use to relieve shortness of breath and pain?
1)Elevating the head of the bed
2)Having the patient lean forward
3)Placing in the left side-lying position
4)Encouraging deep breathing and coughing

Question 10

In providing care to a patient with valvular disease, the nurse recognizes which valve disorder is most prevalent? The nurse recognizes that which valve is most often affected in valvular disease?
1)Aortic stenosis
2)Mitral stenosis
3)Pulmonic regurgitation
4)Tricuspid regurgitation

Question 11

The nurse is preparing teaching for a patient being treated for coronary artery disease. What dietary information should the nurse emphasize?
1)Restrict carbohydrate intake.
2)Limit calorie intake to less than 1,000/day.
3)Reduce saturated fat and sodium intake.
4)Limit fluid intake.

Question 12

In administering oxygen 2 L via nasal cannula to a patient with coronary artery disease, what does the nurse explain as being the primary purpose of the oxygen?
1)Promotes vessel dilation
2)Prevents clot formation
3)Supports myocardial oxygen demand
4)Decreases respiratory complications

Question 13

The nurse is concerned that a patient is at risk for developing infective endocarditis. What information in the patient's history caused the nurse to have this concern?
1)70 years of age
2)History of chronic obstructive pulmonary disease
3)Retired company executive
4)Consumes a high protein diet

Question 14

A patient with infective endocarditis is being started on intravenous antibiotics. What should the nurse include when teaching about this medication?
1)"The medication may be changed every few days."
2)"The typical course of this medication is 7 to 10 days."
3)"Expect to continue this medication for 4 to 6 weeks at home."
4)"Because this infection is resilient, you might be taking antibiotics for life."

Question 15

In providing care to a patient diagnosed with atherosclerosis, the nurse correlates the initiation of this disease to which process?
1)Oxidation
2)Inflammatory process
3)Injury to the vessel wall
4)Trapping of low-density lipoproteins

Question 16

During an assessment, a patient describes experiencing chest pain with exercise that disappears with rest. The nurse correlates this finding with which health problem?
1)Stable angina
2)Variant angina
3)Unstable angina
4)Prinzmetal's angina

Question 17

A patient with heart failure is having a B-type natriuretic peptide (BNP) level drawn. The nurse correlates that the results of this diagnostic provide which data? What is the purpose of this laboratory test?
1)Measure ejection fraction
2)Rule out an ischemic event
3)Differentiate right- from left-sided heart failure
4)Measure "overstretching" of the ventricles

Question 18

In planning care for a patient with pericarditis, the nurse understands which pathophysiological process contributes to the development of this disease process?
1)Heart cell dysfunction
2)Plaque buildup in vessels
3)Infection of the innermost layer of the heart
4)Inflammation of the tissue surrounding the heart

Question 19

The nurse monitors for which clinical manifestation in a patient diagnosed with right-sided heart failure (HF)?
1)Fatigue
2)Shortness of breath
3)Crackles with auscultation
4)Edema in the lower extremities

Question 20

During a home visit the nurse determines that teaching was effective for the patient recovering from infective endocarditis. Which observation supports this evaluation?
1)Drinking skim milk
2)Measuring radial pulse
3)Using a soft toothbrush
4)Taking anticoagulant daily

Question 21

While planning care, the nurse identified interventions to reduce a patient's risk for developing heart failure. Which assessment findings did the nurse use to make this clinical determination? Select all that apply.
1)Body mass index 31.3
2)Smokes half a pack of cigarettes
3)Employed in a textile factory
4)Blood pressure 168/90 mm Hg
5)Fasting blood glucose 80 mg/dL

Question 22

The nurse monitors for which clinical manifestations in the patient suspected of having cardiac tamponade? Select all that apply.
1)Hypotension
2)Pulsus paradoxus
3)Muffled heart sounds
4)Jugular vein distention
5)Lower extremity edema

Question 23

The nurse conducts an admission assessment for a patient who presents in the emergency department (ED). Which patient statements support the healthcare provider's differential diagnosis of pericarditis? Select all that apply.
1)"I have a productive cough on most days."
2)"I have swelling in my lower legs and feet."
3)"I get short of breath when walking to my mailbox."
4)"I have chest pain that seems to radiate to my shoulder blades."
5)"I have to sleep with several pillows or I have trouble breathing."

Question 24

The nurse plans care for a patient who is admitted to the hospital for newly diagnosed left-sided heart failure. Which is the priority nursing diagnosis when planning care for this patient?
1)Activity Intolerance
2)Deficient Knowledge
3)Impaired Oxygenation
4)Impaired Tissue Perfusion

Question 25

In providing care to a patient with an acute exacerbation of heart failure, the nurse prepares to administer prescribed medication that provide which actions? Select all that apply.
1)Decrease preload
2)Increase preload
3)Decrease afterload
4)Increase afterload
5)Increase contractility

Question 26

In administering an angiotensin-converting enzyme inhibitor to a patient with heart failure, the nurse correlates its effectiveness to which mechanism of action?
1)Reduce afterload
2)Decrease preload
3)Increase contractility
4)Control sympathetic nervous system response to decreased cardiac output

Question 27

A patient is scheduled for an exercise stress test. For which cardiac health problems is this patient being tested? Select all that apply.
1)Pericarditis
2)Heart failure
3)Valvular disease
4)Infective endocarditis
5)Coronary artery disease

Question 28

The nurse notes that a patient with heart failure (HF) has a normal ejection fraction (EF). What should this information indicate to the nurse? Select all that apply.
1)It is known as HF with preserved EF.
2)It is associated with older patients with obesity.
3)It occurs in patients with diabetes mellitus and atrial fibrillation.
4)It is exacerbated with invasive procedures and dental examinations.
5)There is less blood in the ventricle to eject because of the impaired filling.

Question 29

A patient is experiencing manifestations of infective endocarditis. Which diagnostic tests are indicated for this patient? Select all that apply.
1)Blood cultures
2)Ejection fraction
3)Electrocardiogram
4)Transthoracic echocardiogram (TTE)
5)Transesophageal echocardiogram (TEE)

Question 30

The nurse is concerned that a patient with heart failure is decompensating. Which assessment finding requires an immediate intervention?
1)Dyspnea at rest
2)Dry persistent cough
3)Weak peripheral pulses
4)Jugular vein distention