PT 2

50問 • 1年前

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A 49-year-old patient has multiple risk factors for coronary artery disease. Which risk factor is considered modifiable?

smoking

Which purpose do fibrous plaques of atherosclerosis serve when they are laid down in the vessels?

Trap to which other substances adhere

A patient with angina pectoris complains of chest pain at rest and needs to take three nitroglycerin (NTG) pills to relieve the pain. Of which diagnosis is this assessment a major symptom?

Unstable angina

Which teaching point is important for a patient with mitral stenosis?

Balance activity with oxygen supply.

Which information should a nurse include in a patient's discharge instructions after an acute myocardial infarction (MI)?

Written instructions on diet and follow-up appointments

A patient with acute congestive heart failure has jugular vein distention, crackles bilaterally, and dyspnea. Which nursing diagnosis should have the highest priority?

Excess fluid volume

Which actions should a nurse implement to decrease the workload of the heart in a patient with acute congestive failure? (Select all that apply.)

Eliminate unnecessary activities., Help the patient change positions every 2 hours., Give a partial bed bath rather than full bed bath.

A nurse urges a 50-year-old overweight executive who had a myocardial infarction (MI) 3 months earlier to take up some conditioning exercises for 30 minutes a day. Which rationale supports this suggestion? (Select all that apply.)

Lose weight, Improve function of the left ventricle., Decrease arterial stiffening., Decrease cholesterol levels.

________ is an abnormal thickening, hardening, and loss of elasticity of arterial walls.

Arteriosclerosis

Stable angina (also called chronic stable angina) occurs most often with exercise or activity and usually subsides with _____

rest

A nurse explains that cardiac rehabilitation lasts from the end of acute care to the return to home and beyond. What does this service include

Telemetry-monitored exercise

On auscultation, a nurse detects a heart murmur. What should the nurse know that a heart murmur indicates?

Valves that do not close correctly

What is an important teaching point for a patient with mitral stenosis?

Balance activity with oxygen supply.

A physician has ordered continuous pulse oximetry. What should the nurse explain to the patient about this procedure?

Measures the amount of oxygen in the blood

A stress test is scheduled for a 41-year-old patient. What action should the nurse implement to prepare the patient for the examination?

Have the patient sign a consent form

What action should a nurse expect to implement when a patient returns from a cardiac catheterization?

Check the puncture site.

A nurse assesses an inverted T wave on the ECG of a patient who had an acute MI two days earlier. How should the nurse interpret this finding?

Abnormal wave form

A patient is scheduled for a heart catheterization. What action should the nurse implement in preparation for this examination?

Ask the patient about allergies to seafood or iodine.

A patient has had atropine sulfate that has been administered intravenously to treat a dysrhythmia. What should the nurse assess this patient for after administration?

tachycardia

A dopamine infusion is being administered to a patient with shock. For what should the nurse be alert?

Sharp spike in blood pressure

A patient with atrial fibrillation is prescribed amiodarone for the dysrhythmia. Which potential adverse reaction should the nurse report?

ataxia

What information should a nurse include in a patient's discharge instruction after an acute myocardial infarction (MI)?

Written instructions on diet and follow-up appointments

A nurse is assessing the cardiac complex above. What pattern should the nurse recognize in this rhythm strip?

NSR

A patient is receiving digoxin 0.25 mg/day. What should the nurse do prior to administering this medication?

Hold the dose if the apical rate is 57 beats/min.

A 46-year-old patient is receiving propranolol (Inderal), a nonselective beta-adrenergic blocker, for a heart condition. What patient teaching is most appropriate?

Never stop taking the drug abruptly.

How should a nurse interpret the arrhythmia in the above strip?

PVC

Which factors affect stroke volume? (Select all that apply

preload, afterload, contractility

What actions should a nurse implement to decrease the workload of the heart in a patient with acute congestive failure? (Select all that apply.)

Give a partial bed bath rather than full bed bath., Help the patient change positions every 2 hours., Eliminate unnecessary activities.

A nurse urges a 50-year-old overweight executive who had a myocardial infarction (MI) 3 months earlier to take up some conditioning exercises for 30 minutes a day. What rationale supports this suggestion? (Select all that apply.)

Lose weight., Improve function of the left ventricle., Decrease arterial stiffening., Decrease cholesterol levels.

At rest, the cardiac cells in the myocardium are electrically polarized, with the inside of the cell being more ____ than the outside of the cell.

negative

A nurse assesses a client who had a myocardial infarction and is hypotensive. Which additional assessment finding should the nurse expect

Heart rate of 120 beats/min

A nurse assesses a client after administering a prescribed beta blocker. Which assessment should the nurse expect to find?

Pulse decreased from 100 beats/min to 80 beats/min

A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as having the greatest risk for cardiovascular disease?

A 45-year-old American Indian woman with diabetes mellitus

A nurse assesses an older adult client who has multiple chronic diseases. The clients heart rate is 48 beats/min. Which action should the nurse take first?

Assess the client's medications.

An emergency room nurse obtains the health history of a client. Which statement by the client should alert the nurse to the occurrence of heart failure?

"I get short of breath when I climb stairs."

A nurse obtains the health history of a client who is newly admitted to the medical unit. Which statement by the client should alert the nurse to the presence of edema?

"My shoes fit tighter by the end of the day."

A nurse assesses an older adult client who is experiencing a myocardial infarction. Which clinical manifestation should the nurse expect?

disorientation, confusion

A nurse assesses a client 2 hours after a cardiac angiography via the left femoral artery. The nurse notes that the left pedal pulse is weak. Which action should the nurse take?

Assess the color and temperature of the left leg.

A nurse assesses a client who is recovering after a left-sided cardiac catheterization. Which assessment finding requires immediate intervention?

Slurred speech and confusion

A nurse assesses a client who is scheduled for a cardiac catheterization. Which assessment should the nurse complete prior to this procedure?

Allergies to iodine-based agents

A nurse cares for a client who is prescribed magnetic resonance imaging (MRI) of the heart. The clients health history includes a previous myocardial infarction and pacemaker implantation. Which action should the nurse take

Notify the health care provider before scheduling the MRI.

A nurse assesses a client who is recovering from a myocardial infarction. The clients pulmonary artery pressure reading is 25/12mm Hg. Which action should the nurse take first?

Compare the results with previous pulmonary artery pressure readings.

nurse cares for a client who has an 80% blockage of the right coronary artery (RCA) and is scheduled for bypass surgery. Which intervention should the nurse be prepared to implement while this client waits for surgery?

Initiation of an external pacemaker

A nurse teaches a client with diabetes mellitus and a body mass index of 42 who is at high risk for coronary artery disease. Whichstatement related to nutrition should the nurse include in this clients teaching?

"You should balance weight loss with consuming necessary nutrients."

A nurse cares for a client who has advanced cardiac disease and states, I am having trouble sleeping at night. How should the nurse respond?

"Use pillows to elevate your head and chest while you are sleeping."

A nurse cares for a client who is recovering from a myocardial infarction. The client states, I will need to stop eating so much chili to keep that indigestion pain from returning. How should the nurse respond?

What do you understand about what happened to you?"

A nurse prepares a client for coronary artery bypass graft surgery. The client states, I am afraid I might die. How should the nurse respond?

"Tell me more about your concerns about the surgery."

An emergency department nurse triages clients who present with chest discomfort. Which client should the nurse plan to assess first?

A 58-year-old male who describes his pain as intense stabbing that spreads across his chest

A nurse auscultated heart tones on an older adult client. Which action should the nurse take based on heart tones hear

Document the findings

A nurse assesses a client who has aortic regurgitation. In which location in the illustration shown below should the nurse auscultate to best hear a cardiac murmur related to aortic regurgitation?

Location A

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