Deck 24: Nursing Care of Patients With Occlusive Cardiovascular Disorders

Question 1

The nurse is reinforcing teaching for managing the pain of peripheral arterial disease.Which patient statement indicates correct understanding of discharge instructions?

A) "I will lie down frequently."
B) "I will use a reclining chair."
C) "I will sit with my legs down."
D) "I will do knee flexion exercises."

Answer 1

"I will sit with my legs down."

Question 2

The nurse is reinforcing the importance of leg exercises with a patient who is prescribed bedrest.Which patient statement indicates that teaching has been effective?

A) "Prepare for ambulation."
B) "Promote urinary and intestinal elimination."
C) "Prevent thrombophlebitis and blood clot formation."
D) "Decrease the likelihood of pressure ulcer formation."

Answer 2

"Prevent thrombophlebitis and blood clot formation."

Question 3

A patient is brought to the emergency room by a daughter who reports that the patient has had multiple episodes of chest pain in the past few days and has refused to seek care.The patient states,"I feel fine and the pain has only lasted for brief periods." The nurse recognizes that the patient is most likely using which coping technique?

A) Anger
B) Denial
C) Projection
D) Regression

Answer 3

Denial

Question 4

The nurse is contributing to the teaching plan for a patient who is taking nitroglycerin.Which action should be included if chest pain occurs?

A) Take 2 tablets every 3 hours for four doses until pain is relieved.
B) Take 3 tablets every 3 minutes for four doses until pain is relieved.
C) Take 1 tablet every 5 minutes for three doses until pain is relieved.
D) Take 2 tablets every 2 minutes for three doses until pain is relieved.

Question 5

The nurse has reinforced teaching about symptoms of an MI and the importance of seeking medical treatment promptly to a patient who has angina.What should the nurse explain as a common reason prompt treatment is not sought?

A) Lack of insurance
B) Denial of symptoms
C) Lack of transportation
D) Not aware of symptoms

Question 6

A patient with varicose veins asks how the condition develops.Which response by the nurse is best?

A) "Swelling of the vein is caused by bacteria."
B) "Veins spasm and twist when they get damaged."
C) "They are caused by poor function of the valves in your veins."
D) "Veins become blocked by plaque from high-fat diets over time."

Question 7

A patient who develops chest pain that radiates down the left arm has all of these measures prescribed.Which one should the nurse do first?

A) Repeat vital signs.
B) Apply oxygen at 2 L/min.
C) Administer nitroglycerin SL.
D) Obtain an electrocardiogram (ECG).

Question 8

The nurse reviews the importance of seeking medical treatment with a patient at risk for an MI.Which patient statement indicates that teaching has been effective?

A) "Angina is prevented."
B) "Risk factors are decreased."
C) "Less heart muscle is damaged."
D) "Coronary artery disease is cured."

Question 9

The nurse is caring for a patient suspected of having an MI.What laboratory tests should the nurse review to determine if this patient did experience an MI?

A) Troponin I and myoglobin
B) Bleeding time and total cholesterol
C) Urinalysis and complete blood count
D) Alkaline phosphatase and prothrombin time

Question 10

A patient who is apprehensive,gray,cold,and clammy reports pain that "is as if an elephant is standing on my chest." The nurse should recognize that these manifestations indicate which health problem?

A) Heartburn
B) Pericarditis
C) An anginal attack
D) Acute MI

Question 11

The nurse is caring for a patient recovering from an MI.In which position should the nurse place the patient to decrease preload and the heart's workload?

A) Prone
B) Supine
C) Sims' position
D) Semi-Fowler's position

Question 12

The nurse is providing discharge instructions to a patient with brown,leathery,edematous ankles and increased pain when sitting.Which patient statement indicates that teaching has been effective?

A) "I should elevate my legs on pillows."
B) "I should keep my legs lower than my heart."
C) "Elastic bandages should be wrapped from the knee down."
D) "I should increase my intake of red meat and dairy products."

Question 13

A patient has chronic peripheral arterial disease.During neurovascular checks,the nurse finds an absent left pedal pulse and a cyanotic leg.What should the nurse do?

A) Notify the registered nurse (RN) immediately.
B) Massage the patient's left foot.
C) Reassess the pulse in 30 minutes.
D) Encourage patient to flex the leg 10 times.

Question 14

A patient is recovering from a cardiac catheterization that was completed through the right femoral site.Which information is most essential for the nurse to collect immediately after the procedure?

A) Left pedal pulse
B) Right pedal pulse
C) Left brachial pulse
D) Right brachial pulse

Question 15

The nurse is assisting with admission of a patient experiencing symptoms of an acute MI.Which activity would be the highest priority for this patient?

A) Relieve pain.
B) Note emotions.
C) Limit fluid intake.
D) Support the family.

Question 16

A patient who develops chest pain says the pain is a 9 on a scale of 0 to 10.Which action should the nurse take?

A) Notify the RN.
B) Apply telemetry.
C) Administer aspirin.
D) Listen to breathing sounds.

Question 17

A patient reports acute pain and numbness in the left leg.The nurse notes the left leg is pale and cooler than the right leg.What should the nurse do?

A) Notify the RN.
B) Elevate the left leg.
C) Administer pain medication.
D) Apply an extra blanket to the left leg.

Question 18

The nurse receives a telephone call from a relative who was diagnosed with angina last year.The relative reports taking 5 nitroglycerin (NTG)tablets but still has chest pain.What would be the best advice for the nurse to give this relative?

A) "Take two more NTG tablets and lie down."
B) "I will call an ambulance and report your chest pain."
C) "Drive yourself to the emergency department immediately."
D) "Have someone drive you to the emergency department now."

Question 19

A patient with peripheral venous disease (PVD)is sitting in a chair and has edematous and purple feet.What action should the nurse to take?

A) Notify the physician.
B) Cover the patient with a blanket.
C) Place the patient's legs on a tall footstool.
D) Have the patient lie in bed with pillow under knees.

Question 20

The nurse is helping prepare a teaching plan to modify risk factors for a patient with coronary artery disease.Which risk factor should the nurse include in this patient's teaching plan?

A) Age and gender
B) Gender and ethnicity
C) Heredity and ethnicity
D) Smoking and high fat intake

Question 21

The nurse is assisting with the care of a patient with an MI.Which specialized diet should the nurse expect to be prescribed for this patient?

A) Soft diet
B) Full liquid
C) Edentulous diet
D) Clear liquid diet

Question 22

The nurse is teaching a patient about an upcoming cardiac catheterization and coronary arteriogram.What information should the nurse include in this teaching?

A) "You will be able to hear your heart beating."
B) "You will see a lot of equipment in the room."
C) "You will feel a heavy sensation throughout your body."
D) "You will not feel anything because you will be anesthetized."

Question 23

The nurse is reinforcing instructions provided to a patient to prevent the development of varicose veins.Which patient statement indicates that teaching has been effective?

A) "Sit with legs crossed."
B) "Wear support stockings."
C) "Stand for long periods of time."
D) "Sleep with the head of the bed elevated."

Question 24

The nurse is caring for a patient who is being prepared for coronary atherectomy.Which order should the nurse expect to administer?

A) Diuretic
B) Beta blocker
C) An antiplatelet
D) Calcium channel blocker

Question 25

The nurse is assisting with the care of a patient who is receiving an intravenous infusion with potassium.The nurse realizes that fluids containing potassium are administered slowly and cautiously to prevent which health problem?

A) Cardiac arrest
B) Fluid overload
C) Allergic reaction
D) Metabolic acidosis

Question 26

The nurse is collecting data from a patient who has chronic venous insufficiency of the lower extremities.Which finding should the nurse expect?

A) Leathery, brown skin
B) Diminished pedal pulse
C) Absence of pedal pulses
D) Pallor in the extremities

Question 27

The nurse is reinforcing teaching provided to a patient to decrease the risk of atherosclerosis.Which patient statement indicates that teaching on how to reduce triglycerides with lifestyle changes and prescribed medication was effective?

A) "Eat a low-protein diet, limit activity, and take niacin."
B) "Limit activity, eat a high-protein diet, and take aspirin."
C) "Eat a high-fat diet, avoid smoking, and take daily furosemide (Lasix)."
D) "Perform daily exercise, eat a low-fat diet, and take gemfibrozil (Lopid)."

Question 28

A patient recovering from an MI asks for information about the types of meat that can be eaten.What should the nurse respond to the patient?

A) "Eat small amounts of any type of meat."
B) "Eat only vegetables; you do not need to eat meat."
C) "Eat lean red meat to help increase your iron levels."
D) "Eat chicken and fish, keeping red meats to a minimum."

Question 29

The nurse is collecting data from a patient experiencing an MI.Which finding should the nurse expect?

A) Flushed face
B) Extreme thirst
C) A moist cough
D) Profuse diaphoresis

Question 30

A patient being treated for an acute MI reports severe chest pressure,"as if someone is standing on my chest." What should the nurse do first?

A) Obtain vital signs.
B) Notify the physician.
C) Administer nitroglycerin.
D) Order an electrocardiogram.

Question 31

The nurse is contributing to the teaching plan of a patient who is prescribed niacin.What specific recommendation should be included in the teaching plan?

A) Take with meals or milk to avoid gastrointestinal upset.
B) Take aspirin 30 minutes before niacin to reduce flushing.
C) Increase intake of fruits and vegetables to reduce constipation.
D) Take 30 minutes before morning and evening meals to avoid gastrointestinal upset.

Question 32

The nurse is contributing to the plan of care for a patient with varicose veins.Which position should be encouraged to reduce the patient's pain?

A) Lie prone.
B) Cross legs.
C) Elevate legs.
D) Keep legs dependent.

Question 33

The nurse is collecting data on a patient with varicose veins.What should the nurse document as a subjective finding of varicosities?

A) Ankle edema
B) Purple lesions
C) Aching of legs
D) Palpable nodules

Question 34

The nurse is reinforcing teaching provided to a patient with Raynaud's disease.Which measure should the nurse include to prevent an attack?

A) Get plenty of outdoor exercise all year.
B) Keep affected body areas covered at all times.
C) Avoid stimulation that causes vasoconstriction.
D) Take vasopressors to prevent exacerbation of symptoms.

Question 35

The nurse is reinforcing teaching provided to a patient with coronary artery disease.Which risk factor for an MI should be included in this patient's teaching plan?

A) Age
B) Stress
C) Gender
D) Ethnicity

Question 36

The nurse is reinforcing teaching provided to a patient with an aneurysm.Which patient statement indicates correct understanding of a dissecting aneurysm?

A) "An outpouching of one side of the arterial wall."
B) "A communication between an artery and a vein."
C) "A separation of the inner layer of the arterial wall."
D) "An enlargement of the entire circumference of the artery."

Question 37

A patient with a history of angina has several medications prescribed.Which medication should the nurse administer when the patient reports chest pain?

A) Nitropaste
B) Aspirin PO
C) Digoxin PO
D) Nitroglycerin SL

Question 38

A patient being treated for cardiogenic shock has an order for captopril (Capoten).Vital signs are blood pressure 120/70 mm Hg,pulse 85 beats/min,and respirations 16 breaths/min.What action should the nurse take regarding this medication?

A) Administer the dose.
B) Give the medication 1 hour later.
C) Hold the medication and notify the physician.
D) Ambulate the patient until blood pressure increases.

Question 39

The nurse is caring for a patient with an abdominal aortic aneurysm.Which statement indicates that the patient understands this condition?

A) "A blood clot in a vein."
B) "An incompetent valve in a large vein."
C) "An outpouching in the wall of an artery."
D) "A deposit of plaque in the wall of an artery."

Question 40

The nurse is collecting data on a patient with an aortic aneurysm.Which manifestation should the nurse expect to find?

A) Paralysis
B) Back pain
C) Chest pain
D) Ankle edema

Question 41

The nurse is concerned that a patient is at risk for MI because of the latest total cholesterol level.Which level did the nurse use to cause this concern?

A) 120 mg/dL
B) 138 mg/dL
C) 174 mg/dL
D) 221 mg/dL

Question 42

The physician prescribes nitroglycerin for a patient with anterior MI.The patient's vital signs are apical pulse 52 beats/min and blood pressure 80/60 mm Hg.What action should the nurse take?

A) Administer the drug as ordered.
B) Report the vital signs to the RN.
C) Recheck vital signs in 30 minutes.
D) Give medication at half the prescribed dose.

Question 43

A male patient is prescribed a long-acting nitroglycerin medication for stable angina.Which medication should the nurse remind the patient to avoid while taking the nitroglycerin?

A) Sildenafil (Viagra)
B) Warfarin (Coumadin)
C) Penicillin (Pen-V-K)
D) Hydrochlorothiazide (HCTZ)

Question 44

The nurse is reinforcing teaching provided to a patient who has been prescribed a new medication.For which medication should the patient be instructed there is the possibility of developing a cough when taking the drug?

A) Statin
B) Beta blocker
C) Calcium channel blocker
D) Angiotensin-converting enzyme inhibitor

Question 45

The nurse is contributing to a patient's teaching plan.What should be included when teaching a patient about the use of nitroglycerin? (Select all that apply.)

A) Take tablet every morning.
B) Place tablet under the tongue.
C) Rise slowly after taking tablet.
D) Sit or lie down when taking tablet.
E) Take before activity known to cause angina.
F) The patient needs a 6 month supply of the medication.

Question 46

The spouse of a patient experiencing an acute MI does not understand why the patient is receiving morphine sulfate for pain.What should the nurse explain to the patient and spouse? (Select all that apply.)

A) Decreases anxiety
B) Opens bronchioles
C) Relieves chest pain
D) Decreases preload and afterload
E) Reduces myocardial oxygen needs

Question 47

A patient is recovering from stent placement in an occluded coronary artery.Which medication should the nurse expect to be prescribed for this patient?

A) Antiplatelet
B) Beta blocker
C) ACE-Inhibitor
D) Calcium channel blocker

Question 48

A patient with chest pain is a candidate for thrombolytic therapy.How soon should this medication be provided to the patient?

A) 30 minutes
B) 120 minutes
C) 180 minutes
D) 240 minutes

Question 49

The nurse is contributing to the plan of care for a patient experiencing chest pain for 7 hours.The laboratory tests reveal elevated troponin I and myoglobin levels.What action should the nurse take when caring for this patient? (Select all that apply.)

A) Elevate head of bed.
B) Encourage ambulation
C) Provide rest in bed or chair.
D) Offer regular diet with hot tea.
E) Provide bedpan for elimination.

Question 50

A patient scheduled for a carotid endarterectomy asks what is going to happen in the procedure.What should the nurse explain to the patient?

A) "Procedures are constantly changing, so I don't know what might be planned."
B) "The procedure usually involves removing plaque from the lining of the carotid artery."
C) "An endarterectomy is usually done on major vessels of the heart to prevent the need for bypass surgery."
D) "Typically a catheter is passed through a large vessel in your groin and threaded up into your heart to allow the injection of dye."

Question 51

The nurse is caring for a patient with a cardiac history.Which actions should the nurse take when administering diltiazem (Cardizem)? (Select all that apply.)

A) Monitor for constipation.
B) Monitor for development of a round face.
C) Monitor liver and renal functions during therapy.
D) Notify physician if heart rate is less than 50 beats per minute.
E) Obtain apical pulse and blood pressure before giving medication.
F) Notify physician if blood pressure is less than 90 mm Hg systolic.

Question 52

During a home visit,the nurse is reinforcing teaching provided about nitroglycerin therapy.Which patient statement about the supply indicates that teaching has been effective?

A) "I need to replace my supply of nitroglycerin every 2 months."
B) "I need to replace my supply of nitroglycerin every 4 months."
C) "I need to replace my supply of nitroglycerin every 6 months."
D) "I need to replace my supply of nitroglycerin every 10 months."

Question 53

A patient with low back pain is returning from an abdominal computed tomography (CT)scan that revealed an aortic aneurysm.For which finding should the nurse immediately intervene?

A) Patient reports sudden severe flank pain.
B) Patient BP goes from 144/78 mm Hg to 152/80 mm Hg.
C) Patient reports a sense of abdominal fullness after eating.
D) Patient informs the nurse of a family history of hypertension.

Question 54

The nurse is participating in the preparation of a seminar on coronary heart disease for a group of community members.What should modifiable risk factors for atherosclerosis should the nurse include in this presentation? (Select all that apply.)

A) Ethnic group
B) Hypertension
C) Diabetes mellitus
D) Familial hyperlipidemia
E) Increased serum iron levels
F) Increased homocysteine levels

Question 55

A patient reports that chest pain started at 2 pm.The nurse realizes that for thrombolytic treatment to be most effective in dissolving a blood clot,it should be given by:

A) 8 pm
B) 9 pm
C) 12 midnight
D) 2 am

Question 56

The nurse determines that a patient recovering from an acute MI is experiencing activity intolerance.What findings did the nurse use to come to this conclusion? (Select all that apply.)

A) Dizziness
B) Extreme diaphoresis
C) Nausea and vomiting
D) Heart rate 140 beats per minute
E) 35 mm Hg increase in systolic blood pressure

Question 57

The nurse is reinforcing teaching provided to a patient with Buerger's disease on the most important modifiable risk factor.Which risk factor should the patient state that indicates teaching has been effective?

A) Diet
B) Smoking
C) Sedentary lifestyle
D) Exposure to cold temperature

Question 58

The nurse is caring for a patient who has long-standing asthma and stable angina.Which medication can the nurse safely provide to the patient?

A) Pindolol (Visken)
B) Nadolol (Corgard)
C) Atenolol (Tenormin)
D) Propranolol (Inderal)

Question 59

The nurse is preparing to apply a nitroglycerin patch to a patient with stable angina.What actions should the nurse take when providing this medication? (Select all that apply.)

A) Apply the new patch before breakfast.
B) Wear gloves when applying the patch.
C) Encourage rest for 1 hour after applying the new patch.
D) Remove the previous patch before applying a new one.
E) Apply the new patch 30 minutes before removing the old one.