Question 1

An older patient is upset with a blood pressure reading of 180/78 mmHg.What response by the nurse is best?

Accepted Answer

The best response is to plan to check the blood pressure again tomorrow to see if this reading is consistent or an isolated incident. This allows for further assessment and avoids providing false reassurance or immediately jumping to medication as the solution.

Question 2

When administering metoprolol to an older adult patient with hypertension,the nurse is careful to have the patient's care plan include

Accepted Answer

Metoprolol is a medication that can cause dizziness, lightheadedness, and syncope (fainting) in older adult patients. These side effects can increase the risk of falls and injuries, so frequent assessment of the patient's balance and mobility is essential to ensure their safety. It is also important to educate the patient and their family members about the potential side effects and to encourage them to report any symptoms to the healthcare team immediately. Regular evaluation of muscle strength may not be necessary unless the patient has a specific condition that requires it, and monitoring serum potassium levels may not be directly related to the use of metoprolol. Education about thromboembolism may be important for some patients, but it is not directly related to the use of this medication for hypertension.

Question 3

An older patient in the internal medicine clinic reports usually being able to walk 1 mile without complaint.However,in the past 2 weeks,after walking just mile,the patient's legs begin to ache.The pain goes away with rest.What action by the nurse is most appropriate?

Accepted Answer

The symptoms reported by the patient suggest peripheral artery disease. Assessing pedal pulses can help to determine if there is decreased blood flow to the patient's legs, which would confirm the suspicion of peripheral artery disease. Elevating the patient's legs, taking their blood pressure, and measuring them for TED hose are not indicated based on the reported symptoms.

Question 4

The nurse educates the obese older adult patient that the single most important outcome that will affect his or her cardiac health is

Accepted Answer

Obesity is a major risk factor for the development of cardiovascular diseases, including coronary artery disease, heart failure, and stroke. Studies suggest that losing even a modest amount of weight, such as 10%, can significantly improve cardiovascular health in obese individuals. Therefore, a 10% reduction in weight is the most important outcome that will affect the patient's cardiac health. Compliance with drug therapy and adherence to a healthy diet and exercise routine are also important for overall health and disease prevention, but weight loss should be the top priority for this patient.

Question 5

An older adult recovering from a myocardial infarction (MI)has been taking subcutaneous heparin but is now to receive oral warfarin.The nurse prepares to teach the patient which topics? (Select all that apply. )

Accepted Answer

- A) It's common to administer both heparin and warfarin for a short overlap period (up to 5 days) until the warfarin reaches its therapeutic effect, as monitored by INR levels.- B) Warfarin increases bleeding risk, so using a soft bristle toothbrush can help prevent gum bleeding.- D) While transitioning from heparin to warfarin, monitoring of coagulation times is important. However, it's the prothrombin time (PT) and INR that are monitored for warfarin therapy, not partial thromboplastin times (PTT), which are used for heparin. This choice might be misleading, but understanding the intent, it's about the need for ongoing monitoring while on anticoagulation therapy.

Question 6

A patient has peripheral vascular disease.What statement by the patient indicates a need for further teaching?

Accepted Answer

Patients with peripheral vascular disease should be encouraged to engage in regular, moderate exercise as tolerated, rather than limiting their walking distances. This helps improve circulation. The other options are appropriate self-care measures for someone with this condition.

Question 7

A patient had a heart attack and the nurse identifies the diagnosis as activity intolerance.What assessment finding indicates a priority goal for this diagnosis is being met?

Accepted Answer

Oxygen saturation of 98% after using the commode indicates that the patient is maintaining adequate oxygenation with activity, which is a priority goal for someone diagnosed with activity intolerance, especially following a heart attack.

Question 8

An older patient is overwhelmed at the number of lifestyle changes needed to manage newly diagnosed cardiovascular disease.What action by the nurse will reduce this barrier to teaching?

Accepted Answer

Helping the patient choose a change and incorporating it into daily life can make the lifestyle changes more manageable and less overwhelming for the patient. This allows the patient to focus on making one change at a time and build on their successes, rather than feeling overwhelmed by a long list of changes that need to be made. Option A is also a good choice as it emphasizes the importance of making small changes over time, but it does not address the patient's feeling of overwhelm. Option B may not be helpful as the patient may already be aware that smoking is a risk factor, and simply telling them to quit without additional support or strategies may not be effective. Option D may increase fear and anxiety for the patient and is not a supportive approach to education.

Question 9

A nurse is caring for a patient taking furosemide.What assessment finding needs to be reported to the provider immediately?

Accepted Answer

A potassium level of 2.6 mEq/L is considered critically low and can lead to serious cardiac dysrhythmias. This needs to be reported immediately to the provider. The other options may require monitoring and further intervention, but they are not considered urgent.

Question 10

A novice nurse requires additional education on arterial vascular deficiency when suggesting the condition's symptoms include

Accepted Answer

Edema is typically associated with venous insufficiency, not arterial vascular deficiency. Arterial issues usually present with symptoms like ulcers, cool skin, and thickened nails due to poor blood flow.

Question 11

A 77-year-old patient is being treated for cardiac arrhythmia.The nurse determines that the patient's cardiac output is adequate with which assessments? (Select all that apply. )

Accepted Answer

The answer of A 77-year-old patient is being treated for...

Question 12

The patient is an older,female,African American adult who has a 10-year history of type 2 insulin-dependent diabetes.The nurse notes that the patient's greatest risk for developing secondary hypertension is her

Accepted Answer

The patient's greatest risk for developing secondary hypertension, given her profile, is her vascular system status. This is because long-term type 2 diabetes can lead to damage in the blood vessels, which increases the risk of hypertension.

Question 13

To evaluate an older patient for possible renal failure as a result of chronic untreated hypertension,nurse prepares to

Accepted Answer

Collecting a urine sample would be the best choice in evaluating an older patient for possible renal failure as it can help determine if there is protein or blood in the urine, which are potential indicators of kidney damage. While an ultrasound or abdominal x-ray may provide additional information about the kidneys, a urine sample is a non-invasive and more immediate way to assess kidney function. Monitoring intake and output is also important in managing kidney function, but it is not necessarily a diagnostic tool.

Question 14

An older patient is prescribed nifedipine for hypertension.What teaching topic is most important to discuss with this patient?

Accepted Answer

Nifedipine can cause orthostatic hypotension (a sudden drop in blood pressure upon standing), so it is important for the patient to change positions slowly to prevent falls or injury. While monitoring blood pressure and following a low-salt diet are also important topics for hypertension management, they are not specific to the use of nifedipine. Adding exercise to the daily routine can also be beneficial for hypertension management, but it is not the most important teaching topic for a patient newly prescribed nifedipine.

Question 15

A 76-year-old patient has been recently diagnosed with cardiac valvular disease.The nurse assesses the patient and recognizes that the medical diagnosis is supported by which finding?

Accepted Answer

Shortness of breath with activity is a common symptom of cardiac valvular disease, indicating that the heart is having difficulty pumping blood and oxygen to the body during physical exertion. Cyanotic fingertips may indicate peripheral vascular disease but not specifically cardiac valvular disease. Weight loss and angina pain are not specific to cardiac valvular disease.

Question 16

A nurse has provided discharge teaching for an older adult patient who had a pacemaker implanted.Which statement by the patient indicates appropriate understanding of the device?

Accepted Answer

Taking one's pulse each morning before consuming anything, such as coffee, is a good practice for someone with a pacemaker. It helps monitor the heart's activity and ensures the device is functioning correctly.

Question 17

A novice nurse learns that normal aging can result in changes in the ECG of a 73-year-old patient.The experienced geriatric nurse explains that these changes may include which of the following? (Select all that apply. )

Accepted Answer

The answer of A novice nurse learns that normal aging...

Question 18

The effect of aging on the cardiovascular system is evidenced by which symptoms in an older adult performing a stress test? (Select all that apply. )

Accepted Answer

The answer of The effect of aging on the cardiovascular...

Question 19

The nurse shows an understanding of how anemia symptoms present in the older population when

Accepted Answer

The answer of The nurse shows an understanding of how...

Question 20

The nurse is teaching cardiovascular risk factors to a group of older adults.The nurse stresses that cigarette smokers are four times more likely to die of sudden cardiac death than nonsmokers.What is the reason behind this statement?

Accepted Answer

Smoking increases platelet aggregation, which can lead to the formation of blood clots, increasing the risk of sudden cardiac death.

Quiz 19: Cardiovascular Function