Deck 22: Cardiovascular and Cerebrovascular Health and Illness

Question 1

A nurse is educating a group of older adults on the impact of lifestyle changes on hypertension. The nurse includes which of the following in the education? (Select all that apply.)

A) Learning how to read and interpret food labels
B) The sodium content of commonly consumed foods
C) Techniques to incorporate more physical activity into the daily routine
D) The actions of calcium channel blocker medications on hypertension
E) The importance of adhering to pharmacological regimens for treatment of hypertension

Answer 1

Learning how to read and interpret food labels
The sodium content of commonly consumed foods
Techniques to incorporate more physical activity into the daily routine

Question 2

A homecare nurse visits an older female adult at home who has peripheral vascular disease to monitor her status. The nurse determines that the client needs additional teaching when the client states which of the following? (Select all that apply.)

A) "I need to try and elevate my legs above the level of my heart every time I sit down and all night."
B) "I really need to try and avoid sitting in one position for a long period of time."
C) "I know that I need to wear these compression stockings 24 hours a day."
D) "I will wash my feet and legs with strong antibacterial soap twice daily."
E) "I need to examine my feet daily for any cuts, sores, or openings."

Answer 2

"I know that I need to wear these compression stockings 24 hours a day."
"I will wash my feet and legs with strong antibacterial soap twice daily."

Question 3

An older adult who was diagnosed with atrial fibrillation asks a nurse, "I feel fine. I have no symptoms at all with this heart problem, yet I am now on a blood thinner medication, which I understand can by very dangerous. Is this really necessary?" The nurse formulates a response based on the understanding that:

A) Atrial fibrillation, while initially asymptomatic, will progress and become symptomatic.
B) the risk of stroke is very high for a person with atrial fibrillation.
C) untreated atrial fibrillation will likely cause a heart attack.
D) atrial fibrillation can cause coronary heart disease.

Answer 3

the risk of stroke is very high for a person with atrial fibrillation.

Question 4

An older patient with atrial fibrillation is prescribed warfarin for anticoagulation. Which of the following should the nurse include in the teaching plan? (Select all that apply.)

A) Frequent blood testing is required to assure that the level of anticoagulation is in the correct range.
B) Limit dietary intake of vitamin K.
C) Increase dietary intake of vitamin D and calcium.
D) Inform the medical provider if any antibiotics are ordered from any other provider.
E) Seek medical attention immediately if an injury is sustained.

Question 5

A nurse measures an older adult's blood pressure on the right arm and notes a reading of 150/100. The nurse waits 5 minutes and measures the blood pressure again in the right arm and obtains a reading of 152/100. What is the next action by the nurse?

A) Immediately contact the medical provider.
B) Measure the blood pressure in the left arm.
C) Measure the blood pressure in sitting and standing positions.
D) Document the findings in the medical record; elevated blood pressures are normal in older adults.

Question 6

A nurse is caring for an older hospitalized patient who recently suffered a myocardial infarction (MI). The patient asks the nurse, "I didn't even know that I had a heart attack. I did not have crushing chest pain like you see on television. Why didn't I?" The best response by the nurse is:

A) "Older patients do not feel pain in the same way that younger patients do."
B) "Oh, that is just television. Hardly anyone has crushing chest pain when he has a heart attack."
C) "Older people often do not have the typical signs and symptoms when they have a heart attack."
D) "Older people never have chest pain when they have a heart attack."

Question 7

A nurse assesses the lower extremities of an older adult and notes a small ulcer between the person's great toe and second toe. The ulcer has well-defined edges and there is no bleeding; however, there is a small amount of necrotic tissue present. This wound is most likely a(n):

A) venous ulcer.
B) arterial ulcer.
C) pressure ulcer
D) surgical wound.

Question 8

A nurse is auscultating an older patient's heart and notes a systolic murmur (heard between the S1 and S2 heart sounds. The first action by the nurse is to:

A) question the patient about the presence of the murmur.
B) note it in the chart as this is always a normal finding for an older adult.
C) contact the medical provider as this is an abnormal finding.
D) immediately implement emergency interventions.

Question 9

An older person has sudden onset of a severe headache, left-sided facial drooping, and left arm numbness. The person's daughter calls 911 and the person is transported to the emergency department. The first diagnostic test that will likely be performed is a(n):

A) electrocardiogram (ECG) to assess for atrial fibrillation
B) computed axial tomography (CAT) scan to differentiate hemorrhagic from ischemic stroke.
C) international normalized ratio to determine level of anticoagulation.
D) lumbar puncture to assess for infection.

Question 10

An older client is diagnosed with venous insufficiency of the lower extremities. The nurse expects the client to display which of the following signs and symptoms? (Select all that apply.)

A) Thin, shiny dry skin
B) Reddish brown discoloration of the skin of the legs
C) Pain when the legs are elevated
D) Varicose veins
E) Legs are cool to touch