Deck 81: Blood and Lymph Disorders

Question 1

The nurse is caring for a client who is admitted to the CICU after experiencing a myocardial infarction. The cardiologist has ordered three troponin laboratory tests over a 12- to 16-hour time frame. How soon do troponin levels rise following the onset of pain?

A) 1 to 2 hours
B) 2 to 3 hours
C) 3 to 4 hours
D) 4 to 5 hours

Answer 1

3 to 4 hours

Question 2

Tests are ordered for a client to measure the serum electrolytes potassium, sodium, and magnesium. What might an increase or decrease in the level of these electrolytes cause?

A) Cardiac tamponade
B) Cardiac dysrhythmia
C) Myocardial infarction
D) Angina

Answer 2

Cardiac dysrhythmia

Question 3

A client is scheduled for a cerebral angiogram where radiopaque dye will be utilized. What nursing intervention is essential before the client is transported for the test?

A) Ask the client if he or she is allergic to shellfish or iodine.
B) Ensure that the client has had breakfast before the procedure.
C) Ensure that the client does not void before the test.
D) Have the client on bed rest at least 2 hours before the test is performed.

Answer 3

Ask the client if he or she is allergic to shellfish or iodine.

Question 4

The femoral site was used to perform an angiocardiogram on a client with atherosclerosis. Which nursing consideration is recommended following the surgery?

A) Wake the client and ambulate 1 hour following the procedure.
B) Instruct the client to flex the legs every 20 minutes to prevent clots.
C) Check peripheral pulses distal to the site and the color and warmth of the extremity.
D) Have the client sit up in bed for up to 8 hours following surgery.

Question 5

The cardiologist orders a test for a client to diagnose heart failure and determine the heart's ejection fraction (amount of blood each ventricle ejects with every heartbeat). Which test is best for diagnosing these conditions?

A) Electrocardiogram
B) Stress test
C) Electrophysiology study
D) Echocardiogram

Question 6

The nurse is preparing a client for a cardiac catheterization to check for congenital heart defects. Which statement accurately describes a nursing consideration for this procedure?

A) State that the procedure will be painful, but pain medication will be given, as needed.
B) Warn the client that a "fluttering" may be felt in the heart as the catheter passes.
C) Tell the client that a general anesthetic will be given during the procedure.
D) Check the client's peripheral pulses every 30 minutes for an hour after the test.

Question 7

The nurse is administering nifedipine to a client diagnosed with stage II hypertension. What is the therapeutic action of this medication?

A) It inhibits stimulation of specific beta-adrenergic sites, resulting in lower heart rate and BP.
B) It causes vasodilation and lowers peripheral vascular resistance, reducing myocardial oxygen consumption.
C) It slows cardiac conduction through the AV node, which decreases heart rate, dilates peripheral arteries, and decreases peripheral vascular resistance.
D) It inhibits vasoconstriction and cardioacceleration, thus reducing peripheral resistance.

Question 8

The nurse is caring for a client who has been prescribed thrombolytic therapy. Which statement describes one of the criteria for choosing to administer this drug?

A) Ischemia of the heart persisting after administration of sublingual nitroglycerin.
B) History of chest pain within the past 24 hours.
C) Recent history of surgery, cardiopulmonary resuscitation, or CVA.
D) Recent history of bleeding abnormalities or head injury.

Question 9

The nurse reinforces for a client that the surgeon will perform a procedure that involves inserting a balloon-tipped catheter into a narrowed coronary artery to widen it. What is the term for this procedure?

A) Closed-heart surgery
B) Heart valve replacement surgery
C) Coronary artery bypass grafting
D) Percutaneous transluminal coronary angioplasty

Question 10

The nurse is preparing a client for an annuloplasty. What is the purpose of this type of surgery?

A) Improves the functioning of the chordae tendineae and papillary muscles
B) Tightens the ring of tissue around the valve
C) Repairs a floppy or prolapsed valve leaflet
D) Replaces a defective heart valve

Question 11

The nurse is providing preoperative teaching for a client who is scheduled for heart transplantation. Which are important nursing interventions to be implemented before surgery? Select all that apply.

A) Teaching deep breathing exercises
B) Providing plans for cardiac rehabilitation
C) Assessing client's nutrition and capacity for healing
D) Providing adequate tissue oxygenation
E) Monitoring and maintaining cardiac function
F) Scheduling routine tests and procedures

Question 12

What instruction should the nurse offer to help minimize a menopausal aged client's risk for developing coronary artery disease (CAD)?

A) Avoid foods rich in carbohydrates
B) Emphasize crossing legs when sitting
C) Emphasize elevating feet when sitting
D) Avoid sugary foods

Question 13

The nurse is teaching a client about abnormal conditions that may cause cardiovascular disease. Which condition occurs when the walls of the arteries thicken, harden, and lose elasticity?

A) Arteriosclerosis
B) Hypertension
C) Hypotension
D) Cardiac dysrhythmia

Question 14

The nurse is caring for a client who is diagnosed with sinus bradycardia. What are the criteria for this diagnosis?

A) Heartbeat is >100 beats per minute
B) An irregularity in the heart's ventricular rhythm
C) Heartbeat is <60 beats per minute
D) Heart beat fluctuates between 60 and 100 beats per minute

Question 15

Which client would be the best candidate for placement of a permanent electronic pacemaker?

A) A client after cardiac surgery
B) A client who has heart block
C) A client who has hypertension
D) A client who has cardiomyopathy

Question 16

The nurse is caring for a client returning to the unit after a pacemaker insertion. The nurse observes the client for signs of cardiac tamponade that must be reported at once. For which signs should the nurse look? Select all that apply.

A) Neck vein distention
B) Bradycardia
C) Muffled heart sounds
D) Crackles
E) Respiratory distress
F) Fever

Question 17

The nurse is providing teaching for a 59-year-old male client who has an implantable cardioverter-defibrillator (ICD). Which teaching point describes the correct use of the device?

A) Stand up when a shock from the ICD is felt.
B) If a shock is felt when alone, call 911 or the healthcare provider.
C) Do not to call the healthcare provider if a family member is present after a shock.
D) CPR should not be started until two shocks have been felt.

Question 18

A client with a recently implanted pacemaker reports dizziness and lightheadedness after being discharged to home. What instruction should the nurse give this client?

A) Use knee-high stockings or socks with elastic tops.
B) Move away from the source of any electrical interference.
C) Carry out active or passive range-of-motion exercises.
D) Reassure the client that this is normal in the first few days.

Question 19

The nurse is administering the cardiotonic drug, digoxin, to a client diagnosed with heart failure. Which nursing care guideline is recommended for this therapy?

A) Remember that the first administration of digoxin will be smaller than later doses.
B) Before administering digoxin, take the client's apical pulse for 30 seconds.
C) Be alert for side effects including gastrointestinal symptoms, headache, and blurred vision.
D) Be alert for tachycardia, which occurs when digoxin slows the heart too much.

Question 20

A client presents at the ER with dyspnea, dizziness, and angina. An ECG shows dysrhythmias are present and a murmur can be heard upon auscultation. These are classic symptoms of which disorder?

A) Hypertropic cardiomyopathy
B) Chronic rheumatic heart disease
C) Bacterial endocarditis
D) Angina pectoris

Question 21

The nurse is assessing a client diagnosed with chronic rheumatic heart disease. What symptom would indicate that the client's condition is severe and requires immediate attention?

A) The client's systolic blood pressure falls below 90 mm Hg.
B) The client's report of shortness of breath with exercise.
C) The client's report of a dry cough.
D) The client exhibits a low-grade fever.

Question 22

What instruction should the nurse emphasize in the teaching plan for a client diagnosed with angina?

A) Purchase a fresh supply of nitroglycerin every 6 months.
B) Reduce or avoid nicotine intake.
C) Avoid sitting for a lengthy time.
D) Avoid traveling or mild exercise.

Question 23

A client is admitted to the emergency department (ED). The preliminary assessment indicates central cerebrovascular accident (CVA) and gradual worsening of symptoms of brain ischemia. The assessment observations indicate that the client is in which stage of a CVA?

A) Transient ischemic attack
B) Stroke in evolution
C) Reversible ischemic neurologic deficit
D) Completed stroke

Question 24

A male client, aged 58 years, arrives at the community clinic reporting cramps in the calf muscles while exercising that subside with rest. During the assessment, the nurse understands that the client is a heavy smoker and observes hardened, painful areas along the course of blood vessels. The symptoms experienced by the client indicate what disorder?

A) Raynaud phenomenon
B) Varicose veins
C) Buerger disease
D) Telangiectasia

Question 25

A nurse is assessing a client diagnosed with Raynaud phenomenon. What sign or symptoms are observed in clients with Raynaud phenomenon?

A) Fingertips develop cyanosis and gangrene
B) Skin looks loose and dull
C) Appearance of dark, tortuous superficial veins
D) Cramps in the calf muscles

Question 26

A client with varicose veins has recently undergone surgery. What information should the nurse include in the discharge teaching after venous stripping?

A) Place the legs down while sitting.
B) Apply knee-high stockings.
C) Do not cross legs for more than half an hour.
D) Avoid sitting for a lengthy time.

Question 27

A client has experienced a cerebrovascular accident (CVA) that resulted in flaccid hemiplegia. Which statement characterizes this stage of paralysis?

A) Therapy and rehabilitation methods are most successful.
B) The affected side exhibits numbness and weakness.
C) The muscles are contracted and tense and movement is difficult.
D) The affected side is limp and lifeless.

Question 28

The nurse is caring for a client who is admitted to the hospital following a cerebrovascular accident (CVA). Which nursing intervention should be implemented during this acute phase of CVA?

A) Position the client on the affected side.
B) Avoid placing the unresponsive person on the back.
C) Lower the head of the bed.
D) Turn the person at least once every 4 hours.

Question 29

The nurse is administering heparin to a client who has had a cerebrovascular accident (CVA). For which complications should the nurse monitor this client?

A) Dyspnea
B) Edema
C) Nocturia
D) Hemorrhage