Question 1

A client, recovering from surgery to replace a calcified aortic valve with a mechanical valve, should be instructed that which of the following medications will be needed long term?&#10;A) ACE inhibitor&#10;B) Beta-blocker&#10;C) Antibiotic&#10;D) Anticoagulant&#10;

Accepted Answer

The client with a mechanical valve will need to take anticoagulants long term to prevent blood clots from forming on the valve. ACE inhibitors and beta-blockers may be prescribed for other cardiac conditions but are not specifically indicated for a mechanical valve replacement. Antibiotics may be necessary before certain dental procedures to prevent bacterial endocarditis in clients with a history of valve replacement, but are not needed long term.

Question 2

A nurse is instructing a client regarding medications and substances contraindicated for the client with heart failure. Which of the following would not be contraindicated?&#10;A) Alcohol&#10;B) Furosemide&#10;C) Metformin&#10;D) Pioglitazone&#10;

Accepted Answer

Furosemide is a loop diuretic often prescribed to manage fluid retention in clients with heart failure, making it not contraindicated but rather indicated for such conditions.

Question 3

Which of the following should the nurse instruct a client diagnosed with hypertrophic cardiomyopathy? (Select all that apply.)&#10;A) Follow recommended activity level&#10;B) Avoid all alcohol&#10;C) Take hot tub baths routinely&#10;D) Avoid overexertion&#10;E) Avoid dehydration&#10;F) Unexplained breathlessness is a common symptom&#10;

Accepted Answer

Clients with hypertrophic cardiomyopathy should follow recommended activity levels to prevent overexertion, avoid dehydration to maintain proper blood volume and circulation, and avoid overexertion to prevent exacerbating symptoms.

Question 4

In planning the care for a client diagnosed with heart failure, which of the following would be an appropriate goal?&#10;A) Reduce myocardial contractility.&#10;B) Increase cardiac workload.&#10;C) Decrease ejection fraction.&#10;D) Increase activity levels.&#10;

Accepted Answer

The appropriate goal for a client diagnosed with heart failure would be to increase activity levels as it helps to improve overall cardiovascular fitness, promote weight loss, and prevent or manage comorbidities such as hypertension and diabetes, which can exacerbate heart failure symptoms. It is important to note that reducing myocardial contractility (A) would not be appropriate as it would further decrease cardiac output and exacerbate heart failure symptoms. Similarly, increasing cardiac workload (B) would be counterproductive as it would further strain the heart and decrease cardiac function. Decreasing ejection fraction (C) would also not be an appropriate goal as it would further decrease cardiac function and exacerbate heart failure symptoms.

Question 5

The nurse determines that a client diagnosed with pericarditis is demonstrating the classic signs of the Beck triad. What are the signs of the Beck triad? (Select all that apply.)&#10;A) Fever&#10;B) Dyspnea&#10;C) Muffled heart sounds&#10;D) Elevated jugular vein pressure&#10;E) Hypotension&#10;F) Abdominal pain&#10;

Accepted Answer

The answer of The nurse determines that a client diagnosed...

Question 6

Which of the following would the nurse most likely assess in a client diagnosed with right-sided heart failure?&#10;A) Distended neck veins&#10;B) Oliguria&#10;C) Cough with frothy blood-tinged sputum&#10;D) Syncope&#10;

Accepted Answer

In right-sided heart failure, blood backs up into the veins of the body, causing fluid to accumulate in the tissues. This can lead to jugular venous distention (JVD), a visible bulging of the veins of the neck. The other options are more indicative of left-sided heart failure.

Question 7

A client diagnosed with heart failure is prescribed furosemide (Lasix). Which of the following should this client be monitored for because of this medication? (Select all that apply.)&#10;A) Dehydration&#10;B) Rebound fluid volume overload&#10;C) Hyponatremia&#10;D) Hypokalemia&#10;E) Hypernatremia&#10;F) Hyperkalemia&#10;

Accepted Answer

Furosemide is a loop diuretic that promotes the excretion of sodium, chloride, and fluid. As a result, the client is at risk for dehydration, hyponatremia (low sodium levels), and hypokalemia (low potassium levels). Rebound fluid volume overload and hypernatremia (high sodium levels) are not common side effects of this medication. Hyperkalemia is also not a common side effect, as furosemide promotes potassium excretion.

Question 8

The nurse is reviewing the medications prescribed for a client diagnosed with dilated cardiomyopathy. Which of the following medications are commonly prescribed for this disease process? (Select all that apply.)

A) ACE Inhibitor
B) Beta-blocker
C) Diuretic
D) Anticoagulant
E) Antiarrhythmic
F) Antibiotic

Accepted Answer

ACE inhibitors, beta-blockers, diuretics, and anticoagulants are commonly prescribed to manage symptoms and prevent complications in dilated cardiomyopathy. Antiarrhythmics may be used to manage arrhythmias associated with the condition. Antibiotics are not typically used unless there is an infection.

Question 9

The nurse is determining nursing diagnoses appropriate for a client demonstrating productive cough with pink frothy sputum, shortness of breath, and crackles. Which of the following nursing diagnoses is of the most importance?

A) Activity intolerance
B) Anxiety
C) Impaired gas exchange
D) Risk for ineffective respiratory function

Accepted Answer

The client's symptoms of productive cough with pink frothy sputum, shortness of breath, and crackles indicate a potential problem with gas exchange, making impaired gas exchange the most important nursing diagnosis to address. Options A, B, and D may also be appropriate but are not as urgent in this scenario.

Question 10

A client is diagnosed with heart failure. Which of the following diagnostic tests is useful to determine the degree of the failure?&#10;A) Brain natriuretic peptide level&#10;B) Blood cultures&#10;C) Sedimentation rate&#10;D) Arterial blood gas&#10;

Accepted Answer

Brain natriuretic peptide (BNP) level is a diagnostic test that can measure the level of a hormone in the blood that is released when there is stretching of the heart muscle. BNP levels are used to determine the severity of heart failure and help guide treatment decisions. Blood cultures, sedimentation rate, and arterial blood gas are not specific tests for heart failure diagnosis or severity.

Question 11

A client is scheduled for annuloplasty surgery to the aortic valve. Which of the following will most likely occur during this client's procedure?&#10;A) A catheter will be inserted through the femoral vein.&#10;B) A heart bypass machine will be used.&#10;C) Local anesthesia will be provided.&#10;D) A balloon will inflate and stretch the valve open.&#10;

Accepted Answer

The answer of A client is scheduled for annuloplasty surgery...

Question 12

The nurse suspects a client is experiencing left-sided heart failure when which of the following is assessed? (Select all that apply.)&#10;A) Decreased basilar lung sounds&#10;B) Distended neck veins&#10;C) Extra heart sounds&#10;D) Lung crackles&#10;E) Tachycardia&#10;F) Weight gain&#10;

Accepted Answer

The answer of The nurse suspects a client is experiencing...

Question 13

A client is undergoing diagnostic testing for infective endocarditis. Which of the following laboratory tests would be most useful in diagnosis?&#10;A) Basic metabolic panel&#10;B) Blood cultures&#10;C) Reticulocyte count&#10;D) Prothrombin time&#10;

Accepted Answer

The answer of A client is undergoing diagnostic testing for...

Question 14

A client tells the nurse that she had rheumatic heart disease as a child. For which of the following valvular disorders should this client be assessed?&#10;A) Mitral valve prolapse&#10;B) Mitral stenosis&#10;C) Aortic regurgitation&#10;D) Aortic stenosis&#10;

Accepted Answer

The answer of A client tells the nurse that she...

Question 15

A client diagnosed with mitral valve prolapse is experiencing palpitations. Which of the following should the nurse instruct this client?&#10;A) Avoid tobacco&#10;B) Ingest alcohol in moderation&#10;C) Avoid weight loss&#10;D) Limit caffeine intake&#10;

Accepted Answer

The answer of A client diagnosed with mitral valve prolapse...

Question 16

The nurse suspects a client's heart is failing when which of the following heart sounds is assessed? A) S₁ B) S₂ C) S₃ D) S₄

Accepted Answer

The answer of The nurse suspects a client's heart is...

Question 17

Which of the following diagnostic tests is useful to diagnose mitral valve prolapse?&#10;A) Electrocardiogram&#10;B) Echocardiogram&#10;C) Cardiac angiography&#10;D) Transesophageal echocardiography&#10;

Accepted Answer

The answer of Which of the following diagnostic tests is...

Question 18

The nurse is instructing a client diagnosed with mild heart failure on dietary modifications. Which of the following client statements indicates that the instruction has been effective?&#10;A) &#34;I will avoid green beans.&#34;&#10;B) &#34;I will avoid orange juice.&#34;&#10;C) &#34;I will avoid soy sauce.&#34;&#10;D) &#34;I will avoid apple sauce.&#34;&#10;

Accepted Answer

The answer of The nurse is instructing a client diagnosed...

Deck 25: Heart Failure and Inflammatory Dysfunction: Nursing Management