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NSG 201H -Coordinating Care for Patients With Cardiac Disorders
NSG 201H -Coordinating Care for Patients With Cardiac Disorders
Chapter 30: Coordinating Care for Patients With Cardiac Disorders
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. 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?
| 1) | 70 years of age |
| 2) | Treatment for osteoarthritis |
| 3) | Sister being treated for chronic renal failure |
| 4) | Diagnosed with benign prostatic hyperplasia |
____ 2. A patient is admitted for treatment of pericarditis. For which additional health problem should the nurse expect the patient to be evaluated?
| 1) | Asthma |
| 2) | Myocardial infarction |
| 3) | Infective endocarditis |
| 4) | Chronic obstructive pulmonary disease |
____ 3. A patient is demonstrating manifestations of valvular disease. Which valve should the nurse expect to be affected with this disorder?
| 1) | Aortic |
| 2) | Mitral |
| 3) | Pulmonic |
| 4) | Tricuspid |
NSG 201H -Coordinating Care for Patients With Cardiac Disorders
____ 4. The nurse is explaining the development of atherosclerosis to a patient. What should the nurse emphasize as beginning this process?
| 1) | Oxidation |
| 2) | Inflammatory process |
| 3) | Injury to the vessel wall |
| 4) | Trapping of low-density lipoproteins |
____ 5. 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?
| 1) | Vegetation |
| 2) | Oxidation |
| 3) | Foam cells |
| 4) | Fatty streaks |
____ 6. A patient with pericarditis asks the nurse to explain the health problem. Which phrase should the nurse use when responding to this patient?
| 1) | Heart cell dysfunction |
| 2) | Plaque buildup in vessels |
| 3) | Infection of the innermost layer of the heart |
| 4) | Inflammation of the tissue surrounding the heart |
____ 7. 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?
| 1) | Heart murmur |
| 2) | Carotid artery bruit |
| 3) | Bounding peripheral pulses |
| 4) | Displaced point of maximum impulse |
____ 8. 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?
| 1) | Stable angina |
| 2) | Variant angina |
| 3) | Unstable angina |
| 4) | Prinzmetal’s angina |
____ 9. After an assessment the nurse concludes that a patient is experiencing infective endocarditis. What finding caused the nurse to make this decision?
| 1) | Friction rub |
| 2) | Chest pain at rest |
| 3) | Jugular vein distention |
| 4) | Painless spots on the palms and soles |
____ 10. 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?
| 1) | Pericarditis |
| 2) | Heart failure |
| 3) | Pericardial effusion |
| 4) | Coronary artery disease |
____ 11. A patient with heart failure is having a B-type natriuretic peptide (BNP) level drawn. What is the purpose of this laboratory test?
| 1) | Predict life expectancy |
| 2) | Rule out an ischemic event |
| 3) | Differentiate right from left heart failure |
| 4) | Evaluate effectiveness of medication therapy |
NSG 201H -Coordinating Care for Patients With Cardiac Disorders
____ 12. The nurse is preparing teaching for a patient being treated for coronary artery disease. What dietary information should the nurse emphasize?
| 1) | Restrict carbohydrate intake |
| 2) | Limit calorie intake to under 1000/day |
| 3) | Reduce saturated fat and sodium intake |
| 4) | Have the biggest meal of the day for lunch |
____ 13. A patient with infective endocarditis is being started on intravenous antibiotics. What should the nurse include when teaching about this medication?
| 1) | “The medication may be changed every few days.” |
| 2) | “The typical course of this medication is 7 to 10 days.” |
| 3) | “Expect to continue this medication for four to six weeks at home.” |
| 4) | “Since this infection is resilient, you might be taking antibiotics for life.” |
____ 14. 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?
| 1) | Long-term use of diuretics |
| 2) | Anticoagulant therapy for life |
| 3) | Antibiotic therapy for four to six weeks |
| 4) | Episodic use of antiarrhythmic medications |
____ 15. A patient with heart failure is prescribed an angiotensin-converting enzyme inhibitor. What should the nurse explain as being the purpose of this medication?
| 1) | Reduce afterload |
| 2) | Decrease preload |
| 3) | Increase contractility |
| 4) | Control sympathetic nervous system response to decreased cardiac output |
____ 16. 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?
| 1) | Ensures vessel dilation |
| 2) | Ensures perfusion to cerebral tissues |
| 3) | Supports myocardial oxygen demand |
| 4) | Facilitates the metabolism of medications |
____ 17. The nurse is caring for a patient with infective endocarditis. For which reason would a referral to social services be needed?
| 1) | Lives with parents |
| 2) | Uses intravenous drugs |
| 3) | Taking a leave of absence from work |
| 4) | Has two terms of college to complete |
____ 18. The nurse is caring for a patient with pericardial effusion. Which action should the nurse use to relieve shortness of breath and pain?
| 1) | Elevate the head of the bed |
| 2) | Encourage ambulation in the room |
| 3) | Place in the left side-lying position |
| 4) | Coach in deep breathing and coughing |
____ 19. The nurse is concerned that a patient with heart failure is decompensating. What assessment finding supports the nurse’s clinical decision?
| 1) | Dyspnea on exertion |
| 2) | Dry persistent cough |
| 3) | Weak peripheral pulses |
| 4) | Increased urine output |
____ 20. The nurse is evaluating teaching provided to a patient with coronary artery disease. Which patient statement indicates that additional teaching is required?
| 1) | “I will adhere to my smoking cessation plan.” |
| 2) | “I am to reduce my daily intake of saturated fat.” |
| 3) | “I can take up to three doses of nitroglycerin 15 minutes apart.” |
| 4) | “I am to follow the exercise plan for 30 minutes, five days a week.” |
____ 21. During a home visit the nurse determines that teaching provided to a patient recovering from infective endocarditis has been effective. What did the nurse observe to make this clinical determination?
| 1) | Drinking skim milk |
| 2) | Measuring radial pulse |
| 3) | Using a soft toothbrush |
| 4) | Taking anticoagulant daily |
____ 22. A patient with pericarditis is prescribed corticosteroids. What should the nurse emphasize when teaching about this medication?
| 1) | Take the medication as prescribed |
| 2) | Increase the dose if symptoms get worse |
| 3) | Reduce the frequency when symptoms subside |
| 4) | Consider taking a dose every other day to reduce side effects |
NSG 201H -Coordinating Care for Patients With Cardiac Disorders
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 23. The nurse is preparing a community program on the metrics to improve cardiovascular health. What should be included in this program? Select all that apply.
| 1) | Healthy diet |
| 2) | Alcohol intake |
| 3) | Physical activity |
| 4) | Smoking cessation |
| 5) | Lower blood pressure |
____ 24. While planning care the nurse identified interventions to reduce a patient’s risk for developing heart failure. Which assessment findings did the nurse use to make this clinical determination? Select all that apply.
| 1) | Body mass index 31.3 |
| 2) | Smokes 1/2 pack of cigarettes |
| 3) | Employed in a textile factory |
| 4) | Blood pressure 168/90 mm Hg |
| 5) | Fasting blood glucose 146 mg/dL |
____ 25. The nurse notes that a patient with heart failure has a normal ejection fraction. What should this information indicate to the nurse? Select all that apply.
| 1) | It is a common diagnosis |
| 2) | It is associated with older patients with obesity |
| 3) | It is seen in patients with diabetes mellitus and atrial fibrillation |
| 4) | It is exacerbated with invasive procedures and dental examinations |
| 5) | There is less blood in the ventricle to eject because of the impaired filling |
____ 26. A patient is experiencing manifestations of infective endocarditis. Which diagnostic tests should the nurse expect to be prescribed for this client? Select all that apply.
| 1) | Blood cultures |
| 2) | Ejection fraction |
| 3) | Electrocardiogram |
| 4) | Transthoracic echocardiogram (TTE) |
| 5) | Transesophageal echocardiogram (TEE) |
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____ 27. A patient is scheduled for an exercise stress test. For which cardiac health problems is this patient being tested? Select all that apply.
| 1) | Pericarditis |
| 2) | Heart failure |
| 3) | Valvular disease |
| 4) | Infective endocarditis |
| 5) | Coronary artery disease |
____ 28. A patient with pericarditis is being prepared for an emergency pericardiocentesis. What did the nurse most likely assess to support this immediate procedure? Select all that apply.
| 1) | Hypotension |
| 2) | Pulsus paradoxus |
| 3) | Muffled heart sounds |
| 4) | Jugular vein distention |
| 5) | Lower extremity edema |