Deck 20: Care of Patients With Cardiac Disorders

Question 1

The patient with severe congestive heart failure (CHF)does not want to take the morphine ordered,stating that he is not in pain and he is fearful of becoming addicted.The nurse can allay anxiety by explaining that the morphine:

A)is given to many people with CHF.
B)can be omitted and relief can be obtained with NSAIDs.
C)is used to relieve anxiety and air hunger.
D)is the only drug that can be used for CHF patients.

Answer 1

is used to relieve anxiety and air hunger.

Question 2

The nurse caring for a patient who is taking amiodarone (Cordarone)will plan to assess the vital signs carefully for which common side effect?

A)Sudden increase in temperature
B)Hypotension
C)Bradycardia
D)Depressed ventilation

Answer 2

Hypotension

Question 3

The nurse is caring for several patients on a cardiac care unit.The nurse is aware that the patient who is most likely to have the disorder of aortic stenosis is which patient?

A)35 year old with a history of mitral valve prolapsed
B)63 year old with uncontrolled diabetes
C)73 year old with a history of hypertension
D)86 year old with a history of atherosclerosis

Answer 3

86 year old with a history of atherosclerosis

Question 4

Of all the assessments the nurse has made on the new patient,those that may indicate heart failure are: (Select all that apply.)

A)flushed skin.
B)jugular distention.
C)weight gain but eating very little.
D)diminished pedal pulses.
E)wearing loose house shoes rather than street shoes.

Question 5

The nurse recognizes the disorganized ECG pattern of the most fatal of all arrhythmias as:

A)ventricular fibrillation.
B)premature ventricular beats.
C)atrial fibrillation.
D)ventricular tachycardia.

Question 6

The home health nurse is assessing the home-bound patient with heart failure.Which assessment finding is of most concern to the nurse?

A)The patient complains of moderate shortness of breath after walking 1 mile on the treadmill.
B)The nurse notes a 3-lb weight gain over the course of a week.
C)The patient reports an increase of heart rate of 10 beats per minute after vacuuming the floor.
D)The patient reports an increase in urinary output.

Question 7

If there are several tiny spikes in place of P waves on the ECG,the nurse recognizes the arrhythmia as:

A)premature ventricular contraction (PVC).
B)atrial flutter/fibrillation.
C)ventricular tachycardia (VT).
D)premature atrial contraction (PAC).

Question 8

The nurse evaluates the need for further instruction on reduction of caffeine when the patient who has an arrhythmia says:

A)"I've cut my coffee from 10 cups to 2 cups a day."
B)"I don't drink regular cola drinks anymore."
C)"I have given up drinking those high-energy drinks."
D)"I've switched from 5 cups of coffee to 5 cups of tea."

Question 9

The nurse explains that the calcium channel blocker verapamil assists to correct an arrhythmia by:

A)"numbing" the heart to the impulse to contract.
B)increasing the strength of the impulse from the atrioventricular (AV) node.
C)altering the impulse from the sinoatrial (SA) node.
D)inhibiting transmission of the impulse from the AV node.

Question 10

The nurse caring for a patient with congestive heart failure (CHF)will include which intervention in the plan of care?

A)Perform all care at one time to allow more time to rest.
B)Keep the patient as flat as possible to prevent venous pooling.
C)Encourage eating large meals at regular times.
D)Alternate rest with activity.

Question 11

The nurse will instruct a patient with an automatic implantable cardioverter-defibrillator (AICD)to avoid:

A)static electricity from synthetic fabric.
B)airport security detection devices.
C)constricting clothing and belts.
D)high altitudes.

Question 12

The nurse anticipates that,on auscultation of the chest of an older adult with left-sided congestive heart failure (CHF),the major adventitious sound will be:

A)wheezing.
B)crackles.
C)rhonchi.
D)friction rub.

Question 13

The patient with tachycardia who has a heart rate of 115 complains of shortness of breath.The nurse interprets this complaint as being related to which problem?

A)Pulmonary edema
B)Drop in cardiac output
C)Impending pneumonia
D)Increasing anxiety

Question 14

The patient who is taking digitalis for his heart condition becomes extremely dehydrated and has scant urine output.The nurse will assess regularly for the complaint of:

A)left arm pain.
B)blurred vision.
C)itching.
D)increasing edema.

Question 15

The nurse would anticipate that the patient with right-sided heart failure would exhibit:

A)wheezing.
B)orthopnea.
C)edema.
D)pallor.

Question 16

The nurse explains to the patient that the implanted cardioverter-defibrillator (ICD)will:

A)shock the arrhythmias into sinus rhythm.
B)enhance the heart pumping action.
C)stimulate an extra beat if the heart rate drops.
D)control the rate of the heart at a the present level.

Question 17

The nurse caring for a patient with a temporary transvenous pacemaker will include which intervention?

A)Informing the patient that they may experience uncomfortable muscle contractions as current passes through the chest
B)Leaving the wires exposed for easy assessment
C)Using an electric razor with caution
D)Leaving the controls of the bed in easy reach

Question 18

The patient with atrial fibrillation asks why she needs to take warfarin.The most informative response by the nurse is that warfarin will:

A)thin the blood to increase the ejection fraction.
B)prevent clots from forming in the atria.
C)block the arrhythmia from involving the ventricles.
D)increase the cardiac output.

Question 19

The nurse reminds the 60-year-old moderately obese African American hypertensive diabetic male who smokes that he can modify his risk for heart disease by: (Select all that apply.)

A)smoking cessation.
B)controlling diabetes.
C)exercising regularly.
D)reducing blood pressure.
E)reducing weight.
F)None of the above.

Question 20

Which teaching point will the nurse include when providing discharge instructions to the patient with a new permanent pacemaker?

A)"You will be able to have an MRI for diagnostic purposes."
B)"Avoid using microwave ovens."
C)"Avoid lifting heavy objects for as long as your physician prescribes."
D)"Airport screening devices may cause your pacemaker to fire incorrectly."

Question 21

The nurse points out the characteristics of normal sinus rhythm (NSR),which are: (Select all that apply.)

A)one atrial contraction (P wave).
B)one ventricular contraction (QRS complex).
C)one T wave.
D)heart rate 60 to 100.
E)P wave following the QRS complex.

Question 22

When the nurse assesses an apical pulse of 52,the finding of this arrhythmia is known as _________.

Question 23

The nurse expresses concern to the 80-year-old resident in a long-term care facility who is attempting to jog on a treadmill.The nurse is aware that the exceptional oxygen and metabolic demands brought on by the exercise might cause ____________.

Question 24

The independent interventions the nurse may employ when the 80-year-old patient in the long-term health care facility develops acute pulmonary edema are to: (Select all that apply.)

A)give oxygen at 2 L/min.
B)give morphine to relieve respiratory distress.
C)give diuretics to relieve excess fluid.
D)position in high Fowler's position.
E)apply compression stockings.

Question 25

The patient suffering from ventricular tachydysrhythmia may benefit from _________________ when medications are not effectively treating the disorder.

Question 26

The nurse is aware that certain risk factors increase the chance of a person developing cardiomyopathy.Which of the circumstances increase the risk for cardiomyopathy? (Select all that apply.)

A)Systemic hypertension
B)Chronic excessive alcohol consumption
C)Pregnancy
D)Diabetes
E)Systemic infection

Question 27

The nurse is aware that some arrhythmias may be the result of: (Select all that apply.)

A)hyperkalemia.
B)valvular prolapse.
C)infarct damage.
D)defective sinoatrial node.
E)excess fluid.
F)None of the above.