Question 1

A 77-year-old client is being treated for cardiac arrhythmia.The nurse determines that the client's cardiac output is adequate when assessment confirms which of the following? Select all that apply.

Accepted Answer

The client will maintain an adequate cardiac output, as evidenced by heart rate and rhythm within normal range, stable blood pressure, adequate peripheral pulses, mental alertness, urine output of 30 mL/hr, and clear breath sounds.

Question 2

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

Accepted Answer

The number of pacemaker cells located in the SA node decreases with age, which results in less responsiveness of the cells to adrenergic stimulation. Common aging changes that are reflected by the electrocardiogram (ECG) include a notched P wave, a prolonged PR interval, decreased amplitude of the QRS complex, and a notched or slurred T wave.

Question 3

When a nurse prepares an educational fact sheet on cardiovascular disease ( CVD ) for distribution to a senior citizens group, the lifestyle choices included are which of the following? Select all that apply.

Accepted Answer

Many forms of CVD can be accelerated by unhealthy lifestyle choices such as smoking, physical inactivity, high-risk dietary behaviors (i.e. high fat), obesity, stress, and hormonal use by women. Chronic diseases such as hypertension and diabetes mellitus also play a role in accelerating changes.

Question 4

A novice nurse requires additional education on the assessment findings reflective of arterial vascular deficiency when suggesting the condition's symptoms include:

Accepted Answer

Edema is not generally observed in cases of arterial deficiency.

Question 5

In order to evaluate an older client for possible renal failure as a result of chronic untreated hypertension, nurse prepares to:

Accepted Answer

A urinalysis will investigate for proteinuria or other signs of renal failure.

Question 6

When administering Lopressor to an older adult client with hypertension, the nurse is careful to have the client's care plan include:

Accepted Answer

Dizziness is an adverse reaction to beta-blockers such as Lopressor.

Question 7

When evaluating the effectiveness of discharge teaching for an older adult client who had a pacemaker implanted, the nurse determines the client has an appropriate understanding of the device when stating:

Accepted Answer

The radial pulse should be taken at the same time daily and recorded.

Question 8

The nurse recognizes that the symptoms that have priority for care are:

Accepted Answer

Neuropathies and changes recognition in older adults also limit the use of chest pain as a diagnostic sign for older adults. Atypical symptoms include shortness of breath, fatigue, syncope, confusion, and abdominal or back pain. Women, especially older women, may not exhibit the classic signs of CAD, and the nurse needs to be aware of this to adequately assess female clients.

Question 9

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

Accepted Answer

Skin color is not a good indicator of pallor because of varying pigmentation. Oral mucous membranes, as well as conjunctivae and nail beds, are better indicators.

Question 10

The nurse educates the obese older adult client that the single most important outcome that will affect cardiac health is:

Accepted Answer

A 10% reduction of total weight will decrease blood pressure in many overweight individuals. This factor has significance because it underscores the importance of weight reduction in the older adult population

Question 11

When preparing information concerning cardiovascular risk factors for a group of older adults, the nurse stresses that cigarette smokers are four times more likely to die of sudden cardiac death than nonsmokers because smoking:

Accepted Answer

Smoking increases platelet aggregation and causes coronary artery spasms. Nicotine increases blood pressure and cardiac demands. Carbon monoxide in tobacco smoke decreases the oxygen-carrying capacity of the blood.

Question 12

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

Accepted Answer

Individuals with valvular disease may be asymptomatic for many years, but with the deterioration of the valves and hypertrophic changes in the atria or ventricles, symptoms become evident. Exertional dyspnea is frequently the initial symptom. Other symptoms include dizziness, fatigue, weakness, and palpitations.

Question 13

The effect of aging on the cardiovascular system is evidenced when the nurse notes that an older adult performing a stress test experiences which of the following? Select all that apply.

Accepted Answer

During stress or stimulation, the heart rate increases more slowly; however, once elevated, it takes longer to return to the resting rate.

Question 14

An older adult recovering from an MI has been prescribed subcutaneous heparin but is now to receive oral warfarin (Coumadin).The nurse prepares a client teaching plan that includes information regarding which of the following? Select all that apply.

Accepted Answer

Heparin and warfarin (Coumadin) are anticoagulants used to prevent the enlargement of existing thrombi and new clot formation after MI. Therapeutic effects of heparin are monitored by partial thromboplastin times; the antidote is protamine sulfate. Warfarin is monitored by the international normalized ratio (INR); the antidote is vitamin K. Clients who initially receive heparin for anticoagulation and who need oral anticoagulation for maintenance usually take both forms of medication for 3 to 5 days to develop therapeutic blood levels. Bleeding is a complication. Clients need to be taught bleeding precautions.

Question 15

When assessing an older, female African American adult, the nurse notes that she has been a type 2 insulin-dependent diabetic 10 years.The nurse notes that the client's greatest risk for developing secondary hypertension is her:

Accepted Answer

Secondary hypertension refers to elevated blood pressure caused by underlying disease

Question 16

It is suspected that an older adult client is experiencing severe hypertension.The nurse documents symptoms that support this diagnosis when the client reports:

Accepted Answer

In severe hypertension the client may experience throbbing occipital headaches, confusion, visual loss, focal deficits, epistaxis, and coma.

Quiz 23: Cardiovascular Function