Question 1

The nurse is concerned that a patient with heart failure is decompensating.What assessment finding supports the nurse's clinical decision?

Accepted Answer

Dyspnea on exertion is a sign of decompensated heart failure, as it indicates that the heart is unable to pump enough blood to meet the body's demands.

Question 2

The nurse is preparing teaching for a patient being treated for coronary artery disease.What dietary information should the nurse emphasize?

Accepted Answer

The nurse should emphasize reducing saturated fat and sodium intake, as these measures have been proven to be effective in managing coronary artery disease. Restricting carbohydrate intake or limiting calorie intake to under 1000/day may not be necessary or realistic for all patients. Having the biggest meal of the day for lunch is not directly related to the management of coronary artery disease.

Question 3

The nurse applies oxygen two liters via nasal cannula on a patient with coronary artery disease.What should the nurse explain as being the purpose of the oxygen?

Accepted Answer

Oxygen supports myocardial oxygen demand, which is essential for patients with coronary artery disease as it helps improve oxygenation to the heart muscles, reducing the workload on the heart and decreasing the risk of complications like myocardial ischemia or infarction. Oxygen does not ensure vessel dilation, perfusion to cerebral tissues, or facilitate the metabolism of medications.

Question 4

After an assessment the nurse concludes that a patient is experiencing infective endocarditis.What finding caused the nurse to make this decision?

Accepted Answer

One of the classic signs of infective endocarditis is the development of small, painless spots on the palms or soles known as Osler's nodes. When bacteria enter the bloodstream and attach to the valves of the heart, they can cause the formation of these lesions. Friction rub, chest pain at rest, and jugular vein distention are not specific to infective endocarditis and may occur in other conditions as well.

Question 5

The nurse is caring for a patient with pericardial effusion.Which action should the nurse use to relieve shortness of breath and pain?

Accepted Answer

Elevating the head of the bed will help to relieve shortness of breath. Encouraging ambulation or placing in the left side-lying position may not be appropriate due to the patient's condition. Coaching in deep breathing and coughing may be helpful but may not provide immediate relief of symptoms.

Question 6

A patient with infective endocarditis is being started on intravenous antibiotics.What should the nurse include when teaching about this medication?

Accepted Answer

Infective endocarditis requires a prolonged course of antibiotics, typically 4-6 weeks, even after discharge from the hospital. It is important for the patient to understand the importance of completing the full course of antibiotics to prevent recurrence of the infection. Choices A and B are incorrect because changing the medication is not typical unless there is a specific reason, and the duration is longer than 7-10 days. Choice D is incorrect because antibiotics are not typically given for life unless there is a specific underlying condition that warrants it.

Question 7

The nurse is explaining the development of atherosclerosis to a patient.What should the nurse emphasize as beginning this process?

Accepted Answer

Injury to the vessel wall is the initial step in the development of atherosclerosis.

Question 8

A patient is admitted for treatment of pericarditis.For which additional health problem should the nurse expect the patient to be evaluated?

Accepted Answer

Pericarditis is inflammation of the pericardium, the sac containing the heart. If left untreated, it can lead to complications such as myocardial infarction (heart attack). Therefore, it is important for the patient to be evaluated for any signs or symptoms of myocardial infarction. Asthma, infective endocarditis, and chronic obstructive pulmonary disease are not directly related to the potential complications of pericarditis.

Question 9

During an assessment a patient describes experiencing chest pain with exercise that disappears with rest.For which health problem should the nurse plan care for this client?

Accepted Answer

The patient's chest pain with exercise and relief with rest is a typical presentation of stable angina. Variant angina, also known as Prinzmetal's angina, typically occurs at rest and is caused by spasms in the coronary arteries. Unstable angina is characterized by chest pain that occurs at rest, is more frequent or severe, and is not relieved by medication or rest.

Question 10

A patient with heart failure is prescribed an angiotensin-converting enzyme inhibitor.What should the nurse explain as being the purpose of this medication?

Accepted Answer

Angiotensin-converting enzyme inhibitors help reduce afterload by blocking the conversion of angiotensin I to angiotensin II, which causes vasoconstriction and increased blood pressure.

Question 11

The nurse is evaluating teaching provided to a patient with coronary artery disease.Which patient statement indicates that additional teaching is required?

Accepted Answer

The correct dosage of nitroglycerin is one tablet every 5 minutes for a maximum of three tablets. The patient's statement indicates they may take up to three doses within 15 minutes, which could lead to an overdose and adverse effects.

Question 12

A patient is recovering from mechanical valve replacement surgery for valvular disease.What medication teaching should medication teaching should the nurse prepare for this patient?

Accepted Answer

Patients who have undergone mechanical valve replacement surgery will require lifelong anticoagulant therapy to prevent clotting of blood around the valve. This is necessary because the mechanical valves are known to cause damage to red blood cells, leading to clot formation. The use of diuretics, antiarrhythmics, or antibiotics may be indicated depending on the patient's specific medical condition, but anticoagulant therapy is the most important medication teaching to be prepared for.

Question 13

A patient with heart failure is having a B-type natriuretic peptide (BNP)level drawn.What is the purpose of this laboratory test?

Accepted Answer

BNP levels are used to evaluate the effectiveness of medication therapy in heart failure patients, as they correlate with heart failure severity and can indicate how well the heart is responding to treatment.

Question 14

The nurse is concerned that a patient is at risk for developing infective endocarditis.What information in the patient's history caused the nurse to have this concern?

Accepted Answer

The answer of The nurse is concerned that a patient...

Question 15

The nurse is caring for a patient with infective endocarditis.For which reason would a referral to social services be needed?

Accepted Answer

A referral to social services would be needed for a patient with infective endocarditis who is using intravenous drugs as this puts them at risk for further infections and may require social support and resources for rehabilitation. The other choices do not necessarily require a referral to social services.

Question 16

A patient is demonstrating manifestations of valvular disease.Which valve should the nurse expect to be affected with this disorder?

Accepted Answer

The answer of A patient is demonstrating manifestations of valvular...

Question 17

The nurse explains about the development of tissue clumps within the innermost layer of the heart to a patient with infective endocarditis.What aspect of the disease process is the nurse describing?

Accepted Answer

The nurse is describing vegetation, which is a characteristic finding in infective endocarditis where tissue clumps develop on the innermost layer of the heart (the endocardium). Option B, oxidation, and option C, foam cells, are not directly related to infective endocarditis. Option D, fatty streaks, is a feature of atherosclerosis and not infective endocarditis.

Question 18

A patient with pericarditis asks the nurse to explain the health problem.Which phrase should the nurse use when responding to this patient?

Accepted Answer

Pericarditis is the inflammation of the tissue surrounding the heart, called the pericardium.

Question 19

After completing a physical assessment the nurse anticipates the health-care provider to prescribe diagnostic testing for valvular disease.What did the nurse assess to come to this conclusion?

Accepted Answer

Valvular disease is often characterized by abnormal heart murmurs, which can be detected during a physical assessment. The nurse would anticipate diagnostic testing to further assess and confirm the valve dysfunction. Carotid artery bruits, bounding peripheral pulses, and displaced point of maximum impulse are not specific signs indicating valvular disease.

Question 20

The nurse notes that a newly admitted patient has an elevated sedimentation rate.For which health problem should the nurse plan care for this patient?

Accepted Answer

An elevated sedimentation rate is a non-specific finding that can indicate the presence of inflammation or infection in the body. Pericarditis is an inflammatory condition involving the lining around the heart and can cause an elevated sedimentation rate. Heart failure, pericardial effusion, and coronary artery disease may or may not be associated with an elevated sedimentation rate, but pericarditis is more commonly associated with this finding.

Quiz 30: Coordinating Care for Patients With Cardiac Disorders