Deck 15: The Cardiovascular System

Question 1

An older patient complains of prolonged and severe chest pain that occurs at the same time each day during rest with no precipitating factors. How should the nurse describe this type of pain?
1) Pericarditis
2) Unstable angina
3) Coronary artery disease
4) Atypical angina (Prinzmetal's angina)

Answer 1

4

Question 2

The nurse is providing instruction to an older patient regarding a new diuretic medication. Which should be included in the teaching?
1) Patient should eat a high iron diet.
2) Patient should eat a low calcium diet.
3) Patient should eat a high sodium diet.
4) Patient should eat a high potassium diet.

Answer 2

4

Question 3

During a home visit, the nurse learns that an older patient with hypertension takes prescribed medications only when feeling tense. What instruction should the nurse provide to the patient?
1) Contact the physician for a change in blood pressure medication.
2) Continue to administer the blood pressure medication as needed.
3) Teach to take the blood pressure medication as prescribed regardless of feeling tense.
4) Instruct to take a double dose of the medication for one day then resume the normal schedule.

Answer 3

3

Question 4

An older patient is prescribed a beta blocker to treat hypertension. What effects will the nurse instruct the patient to report to the healthcare professional? Select all that apply.
1) Fatigue
2) Dry cough
3) Dry mouth
4) Cold extremities
5) Exercise intolerance

Question 5

The nurse anticipates that an older patient with right-sided heart failure would exhibit which symptoms? Select all that apply.
1) Pallor
2) Edema
3) Wheezing
4) Exertional dyspnea
5) Neck vein distention

Question 6

An older patient asks the nurse what holistic actions can be used to help lower elevated cholesterol and triglyceride levels. What information should the nurse provide to the patient? Select all that apply.
1) Increase dietary fiber.
2) Eat fatty fish twice a week.
3) Use margarine with phytosterols.
4) Increase the intake of soy products
5) Limit red meat consumption to 3 days a week.

Question 7

The nurse is assessing an older patient diagnosed with heart failure several years ago. Which would indicate the patient is in the late stage of heart failure?
1) Fatigue
2) Confusion
3) Lung congestion
4) Shortness of breath

Question 8

The nurse is providing discharge instructions for an older patient who is prescribed atorvastatin (Lipitor) for elevated cholesterol. What effects should the nurse advise the patient to report to the healthcare provider? Select all that apply.
1) Headaches
2) Stomachache
3) Shortness of breath
4) Muscle pain and weakness
5) Bruising and excessive bleeding

Question 9

An older patient with a history of atrial fibrillation has a fall at home and is diagnosed with a hemorrhagic stroke. What will the nurse assess first to help determine the cause of this patient's bleeding? Select all that apply.
1) Current INR
2) Platelet level
3) Liver function studies
4) Hemoglobin and hematocrit
5) Dose of warfarin sodium (Coumadin) taken at home

Question 10

An older patient is diagnosed with arterial peripheral vascular disease. What will the nurse assess in this patient? Select all that apply.
1) Leg ulcers
2) Pain with walking
3) 40-year history of smoking
4) Pain relieved when legs dangle
5) History of working as a computer operator

Question 11

During a blood pressure screening at a pharmacy, an older person experiences a fluttering in the chest. What should the nurse interpret this finding as being?
1) Hypothyroidism
2) Exercise intolerance
3) Nonspecific cardiac changes with aging
4) Underlying illness that requires a medical evaluation

Question 12

An older patient who is prescribed doxazosin mesylate (Cardura) has a lying blood pressure of 124/76 mm Hg and a sitting blood pressure of 100/64 mm Hg. What additional observation is needed for this patient?
1) Fall risk
2) Nausea and vomiting
3) Decreased urine output
4) Change in mental status

Question 13

The nurse is planning a presentation to a group of senior citizens on lifestyle modifications to manage high blood pressure. What major points will the nurse include in this presentation? Select all that apply.
1) Keep sodium intake to 2.4 grams per day.
2) Achieve and maintain a normal body mass index.
3) Perform aerobic activity for 30 minutes most days of the week.
4) Consumption of fruits and whole grains has little impact on blood pressure.
5) Limit daily alcohol intake to two drinks for males and one drink for females.

Question 14

An older female patient experiences fatigue and nausea, is not sleeping well, and makes a vague complaint of intermittent chest discomfort. How should the nurse interpret these symptoms?
1) Signs of anemia
2) Pancreatic disease
3) Myocardial infarction
4) Normal changes of aging

Question 15

An older patient being treated for hypertension experiences lightheadedness when getting up in the middle of the night to void and when making sudden movements. How should the nurse instruct this patient?
1) Encourage a sleeping pill to prevent nighttime waking.
2) Ensure that the side rails are upright on the bed to prevent the patient from ambulating.
3) Move slowly from a lying to a sitting position and then slowly from sitting to standing.
4) Decrease fluid intake in the evening to prevent the need to get up in the middle of the night.

Question 16

The nurse is planning care for an older patient with hypertension who recently fell in the home. Which assessment would the nurse plan for this patient?
1) Check serum sodium levels.
2) Check serum creatinine levels.
3) Check postural blood pressures.
4) Check blood pressure every 2 hours.

Question 17

The nurse is teaching an older patient with hypertension about foods on a low sodium diet. Which food choices best reflects a low sodium meal?
1) Hamburger with milkshake
2) Green salad with grilled chicken
3) Chicken noodle soup with crackers
4) Pastrami sandwich with carrot sticks

Question 18

The nurse is concerned that an older patient is at risk for developing metabolic syndrome. What manifestations would be present? Select all that apply.
1) Heart rate 88 and regular
2) Blood pressure 156/90 mm Hg
3) Respiratory rate 18 and regular
4) Waist circumference 42 inches
5) Fasting capillary blood glucose 144 mg/dL

Question 19

An older patient has an increase in pitting edema of both ankles and is experiencing breathlessness. The patient is not experiencing any pain. What action should the nurse take to help the patient at this time?
1) Allow the patient to rest.
2) Measure intake and output.
3) Measure the patient's weight.
4) Contact the physician for further evaluation and treatment.

Question 20

An older patient has a blood pressure reading of 150/88. The patient reports no other symptoms or medical history of illness. What should the nurse instruct the patient to do?
1) Have the blood pressure rechecked in a month.
2) Do nothing since this is a normal variant of aging.
3) Go to the emergency department for further evaluation and treatment.
4) Contact the primary care provider for further evaluation and treatment.

Question 21

The nurse is planning care for an older patient with heart failure who is experiencing shortness of breath. Upon assessment, the patient stated the inability to purchase medication because of financial limits. Which nursing diagnoses will be of the greatest initial importance when planning care?
1) Fluid volume excess
2) Activity intolerance related to shortness of breath
3) Powerlessness related to lack of financial resources
4) Ineffective management of therapeutic regimen related to the inability to purchase medications

Question 22

An older patient with valvular disease is scheduled for an echocardiogram. What should the nurse teach the patient about this diagnostic test?
1) Determines the risk for metabolic syndrome
2) Analyzes the reasons for high blood pressure
3) Visualizes the heart valves as they open and close
4) Measures the amount of blood flowing through arteries

Question 23

During a home visit an older patient with heart disease tells the nurse of plans to shovel the snow as soon as the visit concludes. How should the nurse instruct the patient at this time?
1) Shovel the steps only.
2) Avoid shoveling at this time.
3) Shovel for 30 minutes at a time.
4) Shovel for 10 minutes and then stop.

Question 24

An older patient diagnosed with pneumonia does not understand why the health problem occurred since respiratory problems have never been experienced. How should the nurse respond to this patient? Select all that apply.
1) Back joints are stiffer.
2) Less oxygen is used with aging.
3) Ciliary function decreases with age.
4) Retention of carbon dioxide occurs with aging.
5) Decreased immune function occurs with aging.

Question 25

The nurse is planning to assess an older patient's risk for cardiovascular disease. Which assessment question is priority?
1) "Are you short of breath at rest?"
2) "Do you sleep through the night?"
3) "Are your bowel movements regular?"
4) "Do you exercise several times a week?"