Deck 31: Nursing Care of People With Vascular and Lymphatic Disorders

Question 1

Which of the following would be severely impaired in a patient with cardiogenic pulmonary edema?

A)Right Ventricle
B)Left Atrium
C)Left Ventricle
D)Right Atrium

Answer 1

Left Ventricle

Question 2

The elderly person has just returned home from the hospital after treatment for chronic heart failure. The person experiences a pulse rate increase from 80 beats per minute to 102 beats per minute when walking between the kitchen and the laundry to do her washing. Which of the following are appropriate nursing actions for the community nurse?

A)Encourage the person to rest for 30 minutes between each load of laundry completed.
B)Encourage the person to keep a chair near the washer/dryer unit and sit to rest until their heart rate returns to normal.
C)Suggest the person accomplish tasks like laundry early in the morning before fatigue is an issue.
D)Recommend that the person become more active in order to build stamina.

Answer 2

Encourage the person to keep a chair near the washer/dryer unit and sit to rest until their heart rate returns to normal.

Question 3

A person is admitted with acute heart failure. The nurse realises that acute heart failure is associated with an abrupt onset of which of the following?

A)Cardiomyopathy.
B)Pericarditis.
C)Hypertension.
D)Myocardial infarction (MI).

Answer 3

Myocardial infarction (MI).

Question 4

The nurse is teaching a person who has started taking digoxin (Lanoxin)for left-sided heart failure. What is the highest priority information to teach?

A)Check the pulse each day before taking the medication and do not take the medication if the pulse is under 60 beats per minute without talking to the doctor.
B)Check the pulse each day and write down the beats per minute on a notepad.
C)Foods that should be avoided while taking digoxin.
D)How to manage diarrhoea that can be associated with taking digoxin

Question 5

The nurse is assessing a person who arrives at the hospital with dyspnoea, orthopnoea, cyanosis, clammy skin, a productive cough with pink, frothy sputum and crackles. The nurse realises that the person is likely suffering from which of the following conditions?

A)Endocarditis.
B)Pulmonary oedema.
C)Myocarditis.
D)Valvular heart disease.

Question 6

Which of the following tests in most indicative of CHF in a patient who may have this diagnosis?

A)Liver function tests.
B)Serum electrolytes.
C)Blood urea nitrogen (BUN).
D)Atrial natriuretic peptide (ANP).

Question 7

Which of the following would be the preferred method of monitoring the fluid volume status of a patient in ICU?

A)Pulmonary artery pressure monitoring.
B)Central venous pressure monitoring.
C)Arterial pressure monitoring.
D)Intra-aortic balloon pump monitoring.

Question 8

Which of the following are clinical signs and symptoms of pericarditis? (Select all that apply.)

A)Pericardial friction rub.
B)Chest pain.
C)Bradycardia
D)Pulse deficit.

Question 9

In the early postoperative period a person with a transplanted heart often requires low doses of which medication to support cardiac function and circulation?

A)Dopamine.
B)Enalapril.
C)Digoxin.
D)Anginine.

Question 10

A person is commenced on an ACE inhibitor medication for heart failure. Serum levels of what substances need to be monitored for persons on an ACE inhibitor?

A)Unconjugated bilirubin.
B)Potassium.
C)Albumin.
D)Sodium.

Question 11

Which of the following would be the first intervention performed on a patient arriving to the hospital with pulmonary edema?

A)Seek an order to medicate for discomfort.
B)Insert an indwelling catheter.
C)Administer oxygen and attach a pulse oximeter.
D)Monitor the blood glucose level.

Question 12

Which of the following statements by the person is significant when obtaining the health history of a person who is being assessed for possible congestive heart failure?

A)'I am sleepy after I eat lunch each day.'
B)'I feel better with my legs down when I sit up in my favourite chair.'
C)'I break out into a cold sweat when I eat a large meal.'
D)'In order to breathe I have to prop myself up on three pillows to sleep at night.'

Question 13

When caring for a chronic heart failure person with left-sided failure, the nurse would most likely hear which of the following statements from the doctor after a cardiac catheterisation?

A)'Pressures in the left ventricle and atrium are decreased.'
B)'Pressures in the left ventricle and atrium are increased.'
C)'Pressures in the right ventricle and ventricle are decreased.'
D)'Pressures in the right ventricle and atrium match the left ventricle pressures.'

Question 14

What is the initial indication of valve disease?

A)It is discovered by accident on a routine chest x-ray.
B)A murmur is heard during physical exam.
C)An echocardiography study is done to preventatively check the valves.
D)It is discovered only through an ECG.

Question 15

Which of the following is important to keep in mind when caring for persons with possible endocarditis? The condition:

A)does not pose a high risk of damage to affected heart valves.
B)can be prevented in persons at risk by administering antibiotics prior to procedures.
C)can be treated by open heart surgery to clean the heart valves.
D)is usually unrelated to fever so medicate persons with ordered antipyretic and observe.

Question 16

What is cardiac tamponade treated with?

A)Oxygen and bed rest.
B)Pericardiocentesis.
C)Antiarrhythmic drugs and oxygen.
D)Chest x-ray and IV antibiotics.

Question 17

What is a possible manifestation of heart failure?

A)Ascites.
B)Polyuria.
C)Delayed capillary refill.
D)Bradycardia.

Question 18

What are signs indicative of heart failure?

A)S1, S2 and flat neck veins.
B)S3 and S4.
C)S5 and flat neck veins.
D)S2 is heard the loudest and followed by S1.

Question 19

Which of the following are typical heart failure medications? (Select all that apply.)

A)Frusemide (Lasix).
B)Cardiprin (Aspirin).
C)Digoxin (Lanoxin).
D)Promethazine (Phenergan).

Question 20

The nurse recognises which of the following as a sign of decreased cardiac output and tissue perfusion in a person with heart failure?

A)Impaired memory.
B)Increased urine output.
C)Joint pain.
D)Strong peripheral pulses.

Question 21

Primary cardiomyopathy is caused by which of the following?

A)Infectious disease
B)Exposure to toxins
C)Idiopathic
D)Nutritional deficiencies

Question 22

Which of the following would be considered a characteristic sign of pericarditis?

A)Pericardial friction rub
B)Low grade fever
C)Dyspnea
D)Tachycardia

Question 23

Which of the following describes the pathophysiology of the myocardial cells in a patient with myocarditis?

A)They are damaged by lack of oxygen
B)They are invaded by pathogens
C)They no longer reproduce
D)They are damaged by an inflammatory process

Question 24

As blood is flowing through the body, the mitral and triscuspid valves are fully open during which of the following?

A)Diastole
B)Systole
C)Stroke volume
D)Ejection fraction

Question 25

Which of the following would be an initial manifestation of Rheumatic Fever?

A)Involuntary muscle spasms
B)Joint pain
C)Heart murmur
D)Chest pain

Question 26

Small, purplish-red haemorrhagic spots on the trunk that manifest due to microemboli or circulating immune complexes are called:

A)Splinter haemorrhages
B)Janeway lesions
C)Petechiae
D)Roth's spots