Question 1

A patient with endocarditis develops sudden leg pain with pallor, tingling, and a loss of peripheral pulses. What should be the initial nursing intervention?

Accepted Answer

Sudden leg pain with pallor, tingling, and a loss of peripheral pulses may indicate acute arterial occlusion, which is a medical emergency. The nurse should immediately notify the physician about these findings.

Question 2

A nurse caring for a patient with coronary artery disease CAD) hears a murmur during auscultation of the heart. The nurse suspects which complication of CAD?

Accepted Answer

A murmur heard during auscultation of the heart may indicate valvular heart disease, which is a complication of CAD. This is because decreased blood flow to the heart can cause damage to the heart valves, leading to valvular disease. Pericarditis and cardiac tamponade may present with other symptoms such as chest pain and shortness of breath. Heart failure may also be a complication of CAD, but the presence of a murmur would not necessarily indicate this.

Question 3

A patient being admitted for valvular annuloplasty says, "I still don't understand why I need my valve replaced now. I've had this floppy valve for years." How should the nurse respond? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

A,E

Question 4

A patient with mitral regurgitation is instructed to report to the health care provider if it becomes too difficult to perform activities of daily living. What is the nurse's rationale for providing this instruction?

Accepted Answer

Mitral regurgitation can lead to progressive deterioration of cardiac function, which can result in activity intolerance. This may indicate that the patient is no longer compensating effectively and may require valve replacement. Prompt recognition of this deterioration is important for timely intervention and to prevent further complications.

Question 5

The nurse is admitting a patient with a sudden onset of dyspnea and a blowing high-pitched murmur. The nurse is most concerned about which condition?

Accepted Answer

A sudden onset of dyspnea and a blowing high-pitched murmur are indicative of acute mitral valve regurgitation. This condition can lead to rapid heart failure and is considered a medical emergency, thus requiring immediate attention.

Question 6

The nurse implements the following measures for a patient with rheumatic fever: turn, cough, deep breathe, elevate head of bed, instruct on use of incentive spirometry. On which parameters would the nurse assess the effectiveness of the nursing interventions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse implements the following measures for...

Question 7

The nurse caring for patients on a cardiac unit should plan to see which assigned patient first?

Accepted Answer

A patient with bacterial endocarditis reporting dyspnea and chest pain could be experiencing a worsening of their condition or complications such as heart failure or embolic phenomena, which requires immediate assessment and intervention.

Question 8

Diagnostic testing reveals that an adult patient has a stenotic mitral valve. How would the nurse explain this diagnosis to the patient?

Accepted Answer

Stenotic means narrowed or constricted, indicating that the mitral valve is not opening well enough.

Question 9

Which information should the nurse consider when planning care for patients at risk for endocarditis?

Accepted Answer

Endocarditis can be prevented in patients at risk by administering antibiotics prior to procedures. This is known as antibiotic prophylaxis and it is recommended for certain high-risk procedures such as dental extractions or surgeries involving the respiratory or gastrointestinal tract. The other options are incorrect - endocarditis can cause significant damage to the heart valves, treatment for endocarditis does not always require open heart surgery, and fever is a common symptom of endocarditis.

Question 10

Pain is associated with inflammatory heart disease. What interventions should be included in an effective management plan to keep the patient pain-free? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Instructing the patient to inform the nurse if pain is not relieved and providing a supportive environment in which the patient is able to express his or her pain level are both essential interventions in managing pain associated with inflammatory heart disease. Having the family manage the patient's pain is not recommended as it is the responsibility of healthcare professionals to assess and manage pain effectively. Medicating the patient only when the pain is severe is not recommended as proactive pain management is essential to prevent exacerbations of pain. Instructing the patient that there is a risk of addiction and overdose is not appropriate as it may cause fear and anxiety and may make patients reluctant to take their medication.

Question 11

Cardiac tamponade is suspected in a patient diagnosed with pericarditis. What assessment data would assist the nurse in determining the presence of this complication?

Accepted Answer

Changes in systolic blood pressure during inspiration, known as pulsus paradoxus, are a key indicator of cardiac tamponade. This condition involves a significant drop in systolic blood pressure during inspiration, which is a hallmark sign of this complication in patients with pericarditis.

Question 12

The nurse has provided discharge education for a patient who had valve replacement surgery and is on warfarin. Which statement by the patient would indicate understanding of the nurse's instruction?

Accepted Answer

The patient needs to report any signs of bleeding or bruising, which are potential side effects of warfarin therapy. Aspirin and NSAIDs can increase the risk of bleeding and should be avoided. Red meat does not have a significant effect on warfarin therapy, but large amounts of green leafy vegetables should be eaten in moderation to avoid interfering with the medication's effectiveness.

Question 13

The nurse, caring for a patient diagnosed with cardiac tamponade, prepares to participate in which initial treatment?

Accepted Answer

The initial treatment for cardiac tamponade involves emergency drainage of the pericardial sac through pericardiocentesis. This is done to relieve pressure on the heart and prevent further damage. Antidysrhythmic drugs and oxygen may be given after pericardiocentesis depending on the patient's condition, but they are not the initial treatment. Oxygen and rest may help relieve symptoms in some cases, but they do not address the underlying cause of cardiac tamponade. Antibiotics are not used to treat cardiac tamponade, as it is not an infectious condition.

Question 14

A nurse is caring for a patient diagnosed with pericarditis. Due to this patient's risk for cardiac tamponade, the nurse is vigilant about assessing for which findings? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Pericarditis can lead to the accumulation of fluid in the pericardial sac, which can cause cardiac tamponade. Signs of cardiac tamponade include difficulty auscultating heart sounds, decreased systolic blood pressure, and visible distention of jugular veins. A palpable lift at the third intercostal space just left of the midclavicular line is not typically associated with cardiac tamponade. Headache is also not a common finding in patients with pericarditis or cardiac tamponade.

Question 15

Following valve replacement surgery, the patient is instructed to notify the health care provider if fever, increased heart rate, fatigue, malaise, anorexia, weight loss, headache, chills, and/or night sweats occur. What is the nurse's rationale for this instruction?

Accepted Answer

These findings are manifestations of infective endocarditis, a serious infection that can occur after valve replacement surgery. It is important to promptly identify and treat this infection to prevent further complications.

Question 16

A patient is being discharged from the health care facility following surgical replacement of a mitral valve with a mechanical valve. The patient asks the nurse how much longer he will need to take warfarin Coumadin). What is the nurse's best response?

Accepted Answer

Patients with mechanical heart valves are at an increased risk of blood clots, and warfarin (Coumadin) is a blood-thinning medication that can help reduce this risk. Patients with mechanical valves need to take warfarin for the rest of their lives to prevent blood clots from forming around the valve.

Question 17

Home care teaching is being completed by the nurse for a patient recovering from rheumatic fever. Which statement by the patient would indicate that the teaching has been effective?

Accepted Answer

This statement shows that the patient understands the importance of informing healthcare providers about their prior diagnosis of rheumatic fever, as it can affect treatment plans and medication choices.

Question 18

The nurse is providing discharge instructions to a patient diagnosed with severe aortic stenosis. What should the nurse teach the patient about returning to activity? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse is providing discharge instructions to...

Question 19

A patient is admitted with acute pericarditis. When auscultating heart sounds, the nurse should ask the patient to assume which position?

Accepted Answer

The patient should assume a sitting position and lean forward to auscultate heart sounds because this position can help alleviate the pain associated with acute pericarditis and may also increase the intensity of pericardial friction rubs. Lying supine, sitting upright, or lying on the left side may not provide optimal positioning for detecting heart sounds in a patient with acute pericarditis.

Question 20

Which assessment findings would increase the nurse's suspicion that a patient may have pericarditis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

Accepted Answer

Pericardial friction rub and chest pain are both classic findings in pericarditis. Abdominal discomfort and nausea, bradycardia, and distended neck veins are not typically associated with pericarditis.

Quiz 33: Caring for the Patient With Cardiac Inflammatory Disorders