Deck 8: Care of the Patient With a Cardiovascular or a Peripheral Vascular Disorder

Question 1

Dependent edema of the extremities, enlargement of the liver, oliguria, jugular vein distention, and abdominal distention are signs and symptoms of

A) right-sided heart failure.
B) left-sided heart failure.
C) cardiac dysrhythmias.
D) valvular heart disease.

Answer 1

right-sided heart failure.

Question 2

The patient achieves comfort in breathing only when he assumes a sitting posture. During the charting of this position, the nurse can describe this as

A) dyspnea.
B) orthophrenia.
C) orthopnea.
D) orthuria.

Answer 2

orthopnea.

Question 3

A patient is admitted with a diagnosis of possible aortic aneurysm. In assessing her, it is most important to monitor her

A) temperature.
B) lung sounds.
C) respirations.
D) blood pressure.

Answer 3

blood pressure.

Question 4

A patient has heart failure. His physician's orders include complete bed rest. The nurse knows that this order means he

A) is encouraged to rest as much as possible.
B) is confined to bed but may assume responsibility for all of his personal care.
C) is confined to bed but is allowed to go to the bathroom as needed.
D) must remain as quiet as possible, with any task requiring physical effort done for him.

Question 5

A patient, age 59, has Buerger's disease. The most important aspect of patient compliance in order to decrease signs and symptoms of Buerger's disease is

A) a low-fat diet.
B) weight loss.
C) not smoking.
D) keeping extremities warm.

Question 6

A patient, age 34, is diagnosed with infective endocarditis. The nurse identifies the nursing diagnosis of Activity intolerance related to generalized weakness for him. Which intervention does the nurse plan while he is febrile?

A) Decreased activity
B) Activity as tolerated
C) Monitoring vital signs during ambulation
D) Allowing moderate activity if heart rate is not above 100

Question 7

A 53-year-old patient with a history of dysrhythmias is to wear a Holter monitor. The nurse should explain that Holter monitoring

A) is a form of stress test.
B) amplifies heart sounds.
C) is a portable electrocardiographic device.
D) regulates heart rate.

Question 8

Modifiable risk factors for coronary artery disease (CAD) include which group?

A) Diabetes, family history
B) Family history, smoking
C) Smoking, heredity
D) High cholesterol, obesity

Question 9

A patient with newly diagnosed hypertension tells the nurse he uses a lot of salt on his foods and has not been able to lose the 30 pounds that he has gained in the last 10 years. He does not understand why he has hypertension, since he is not an anxious person. Which nursing diagnosis does the nurse identify for this patient?

A) Ineffective health maintenance related to the lack of knowledge of disease process and management
B) Risk of noncompliance related to lifestyle patterns
C) Disturbed body image related to diagnosis of hypertension
D) Anxiety related to complexity of management regimen and lifestyle changes associated with hypertension

Question 10

An old term defined as the condition in which the patient suffers peripheral or pulmonary congestion is called

A) pneumonia.
B) peripheral edema.
C) pulmonary edema.
D) congestive heart failure.

Question 11

A 63-year-old patient with an acute myocardial infarction is on a cardiac monitor and begins to show some dysrhythmias. The physician will probably prescribe which intravenous medication?

A) Nitroglycerin
B) Digitalis
C) Lidocaine
D) Amyl nitrite

Question 12

After an influenza-like illness, the patient complains of chills and small petechiae in his mouth and his legs. A heart murmur is detectable. These are characteristic signs of

A) congestive heart failure.
B) heart block.
C) aortic stenosis.
D) infective endocarditis.

Question 13

A patient admitted from the emergency department with a diagnosis of heart failure and a NYHA classification of IV has edema in his lower extremities of +4. Which nursing intervention would aid in decreasing this edema?

A) Ambulate in the hallway.
B) Elevate lower extremities.
C) Keep the extremities in a dependent position.
D) Stand at the bedside.

Question 14

The nurse identifies the nursing diagnosis of Ineffective tissue perfusion related to decreased arterial blood flow for a patient with chronic arterial insufficiency. In evaluating the patient outcomes after patient teaching, which statement by the patient does the nurse recognize as indicating a need for further instruction?

A) "For about 40 minutes each day, I will walk to the point of pain, then rest, than walk again until I develop pain."
B) "I will drink hot coffee several times a day to increase the circulation and warmth in my feet."
C) "I will wear loose clothing that doesn't bind across my legs or waist."
D) "I will change my position every hour and avoid long periods of sitting with my legs down."

Question 15

The patient has been hospitalized for congestive heart failure (CHF) three times in the last 4 months. While preparing the discharge teaching plan, the nurse assesses that he does not comply with his medication regimen. The nurse's immediate course of action would be to

A) reteach him about his medications.
B) have a serious talk with him and his family about compliance.
C) arrange for home visits after discharge.
D) collect more information to identify his reasons for noncompliance.

Question 16

A patient, age 65, has chronic angina pectoris. Her daughter had questions about the proper use of nitroglycerin for pain management. She was unsure about how many times she should take nitroglycerin for an episode of angina. The best reply the nurse could make is

A) "Continue to take nitroglycerin sublingually at 5-minute intervals until the pain is relieved."
B) "If the pain is not relieved after three doses of nitroglycerin at 5-minute intervals, call your physician and come to the hospital."
C) "When nitroglycerin is not relieving the pain, lie down and rest."
D) "Use oxygen at home to relieve pain when nitroglycerin is not successful."

Question 17

A patient is admitted from the emergency department. The emergency department physician notes the patient has a diagnosis of heart failure with a New York Heart Association (NYHA) classification of IV. This indicates the patient's condition as

A) moderate heart failure.
B) severe heart failure.
C) congestive heart failure.
D) negligible heart failure.

Question 18

What is defined as a distended dilated segment of an artery?

A) Embolism
B) Aneurysm
C) Angina
D) Adhesion

Question 19

A patient admitted from the emergency room with a diagnosis of heart failure and a NYHA classification of IV is requesting ambulation to the bathroom. Which nursing intervention would be appropriate for this patient?

A) Assist the patient to the bathroom.
B) Obtain a bedside commode.
C) Offer a urinal or bedpan.
D) Obtain assistance of another nurse and ambulate the patient to the bathroom.

Question 20

The patient has right-sided heart failure. She will probably be comfortable in which position?

A) Dorsal recumbent
B) Trendelenburg
C) Supine
D) Orthopneic

Question 21

In older adults, rapid infusion of fluids can lead to

A) Hypotension
B) Thrombophlebitis
C) Mitral insufficiency
D) Heart failure

Question 22

A patient has a diagnosis of heart failure. When the nurse walks into his room he is leaning over his bedside table and is short of breath. The medical term to describe his respiratory status is

A) orthopnea.
B) dyspnea.
C) dysrhythmia.
D) disorientation.

Question 23

In evaluating pain for the management of myocardial infarction, the most important aspect using objective data is

A) patient's vital signs during painful periods.
B) dilation of the patient's pupils.
C) painful expression on the patient's face.
D) report of the severity of the pain.

Question 24

There is a strong relationship between Buerger's disease (thromboangiitis obliterans) and

A) Alcohol
B) Cocaine
C) Smoking
D) Obesity

Question 25

A 56-year-old patient was admitted to the emergency department with a myocardial infarction. Cardiac enzymes were drawn. In a patient with a myocardial infarction, which laboratory values would be abnormal?

A) Elevated levels of serum glutamic oxaloacetic transaminase (SGOT) (AST), creatine phosphokinase (CPK-MB), and lactic dehydrogenase (LDH), troponin 1
B) Decreased levels of SGOT (AST), CPK and LDH, troponin 1
C) Elevated levels of SGOT (AST), decreased levels of CPK and LDH, troponin 1
D) Decreased levels of SGOT (AST), increased levels of CPK and LDH, troponin 1

Question 26

Restlessness, diaphoresis, severe dyspnea, tachypnea, hemoptysis, audible wheezing, and crackles are signs and symptoms of

A) heart failure.
B) respiratory failure.
C) pulmonary edema.
D) peripheral edema.

Question 27

A patient has a diagnosis of heart failure. When the nurse walks into his room, he is orthopneic. The patient is

A) sitting or standing in order to breathe deeply and comfortably.
B) complaining of sudden awakenings from sleep because of shortness of breath.
C) complaining of pain in lower extremities.
D) unable to respond to simple questions.

Question 28

The nurse identifies the problem of a potential complication-pulmonary edema-for a patient in acute congestive heart failure (CHF). For which early symptom of this problem does the nurse assess?

A) Pink, frothy sputum
B) Lethargy and faintness
C) Decreased urinary output
D) Bradycardia

Question 29

When providing discharge teaching to a patient with endocarditis regarding prevention of infections, what would the nurse stress?

A) Avoid crowds.
B) Take antibiotics as prescribed.
C) Use only aspirin for mild pain.
D) Weigh yourself daily.

Question 30

The patient, age 26, is hospitalized with cardiomyopathy. While obtaining a nursing history from her, the nurse recognizes that the increased incidence of cardiomyopathy in young adults who have minimal risk factors for cardiovascular disease is related to

A) cocaine use.
B) viral infections.
C) vitamin B1 deficiencies.
D) pregnancy.

Question 31

Which nursing intervention reduces myocardial oxygen demand?

A) Supplying a portable oxygen unit during activity
B) Encouraging participation in cardiac rehabilitation program
C) Elevating the head of the bed 30 to 45 degrees
D) Positioning patient in supine position

Question 32

Which would be included in teaching for patients with Raynaud's disease? (Select all that apply.)

A) Warm hands and feet with a heating pad
B) Use mittens in cold weather
C) Practice stress-reducing techniques
D) Complete smoking cessation
E) Use caution when cleaning the refrigerator or freezer

Question 33

A patient has been admitted after the insertion of a pacemaker because of bradycardia. She asks what third-degree heart block is, and the nurse replies

A) "Coronary blood vessel occlusion causing slow contraction of the right ventricles."
B) "Sclerosis of cardiac valves causing slow pulse."
C) "A defect in AV junctions slows and impairs conduction of impulses from the SA node to the ventricles."
D) "Increased pressure in the pulmonary vessels."

Question 34

A patient, age 72, was admitted to the medical unit with a diagnosis of angina pectoris. Characteristic signs and symptoms of angina pectoris include

A) substernal pain that radiates down the left arm.
B) epigastric pain that radiates to the jaw.
C) indigestion, nausea, and eructation.
D) fatigue, shortness of breath, and dyspnea.

Question 35

A type of medication useful for preventing venous thrombus is

A) anticoagulant.
B) low-molecular-weight heparin.
C) intravenous thrombolytics.
D) percutaneous angiography.

Question 36

During the nursing history and physical assessment of a patient with left-sided heart failure, which finding might the nurse expect related to the patient's diagnosis?

A) Orthopnea with bubbling crackles throughout the lungs
B) Anorexia with weight loss of 3 pounds in 1 week
C) Increased urinary output, especially during waking hours
D) Periorbital and facial edema

Question 37

A patient with angina pectoris is being discharged with nitroglycerin tablets. Which of the instructions does the nurse include in the teaching?

A) "When your chest pain begins, lie down and place one tablet under your tongue. If the pain continues, take another tablet in 5 minutes."
B) "Place one tablet under your tongue. If the pain is not relieved in 15 minutes, go to the hospital."
C) "Continue your activity. If the pain does not go away in 10 minutes, begin taking the nitro tablets one every 5 minutes for 15 minutes, then go lie down."
D) "Place one nitro tablet under your tongue. If a burning sensation and headache occur, call your doctor immediately."

Question 38

A thrombectomy is done to

A) prevent the flow of emboli to the lungs.
B) prevent the emboli from forming.
C) improve blood flow.
D) limit blood flow.

Question 39

Edema and pulmonary congestion are treated with:

A) Unlimited activity, high protein diet, weights weekly
B) Bed rest, normal diet, weights four times daily
C) Increase in fluids, no activity restrictions
D) Diuretics, restriction of sodium diet and fluid intake

Question 40

Modifiable risk factors for coronary artery disease include: (Select all that apply.)

A) weight.
B) diet.
C) genetics.
D) exercise.

Question 41

Which patient teaching would help to prevent venous stasis? (Select all that apply.)

A) Dangle legs when sitting.
B) Avoid crossing legs at the knee.
C) Elevate legs when lying in bed or sitting.
D) Massage extremities to help maintain blood flow.
E) Wear elastic stockings when ambulating.

Question 42

Which statements are true? (Select all that apply)

A) Anticoagulant therapy is used for DVT prevention.
B) Anticoagulant therapy prevents development of new clots, embolization, and clot extension.
C) Anticoagulant therapy will dissolve clots.
D) Pulmonary embolus is a life-threatening complication requiring treatment with anticoagulant therapy.

Question 43

Which information should be taught to patients starting on anticoagulant therapy? (Select all that apply.)

A) Increase the dose of Aspirin for better therapy.
B) Take medication at the same time each day.
C) Report to physician cuts that do not stop bleeding with direct pressure.
D) No restrictions for food or drink.
E) Report for prescribed blood tests (PTT, INR, CBC, blood sugar).

Question 44

Three kinds of blood vessels are organized for carrying blood to and from the heart: (Select all that apply.)

A) Veins
B) Bronchioles
C) Arteries
D) Capillaries

Question 45

An _____________is an enlarged, dilated portion of an artery and may be the result of arteriosclerosis, trauma, or a congenital defect.

Question 46

Which are signs of digoxin (Lanoxin) toxicity?

A) Nausea
B) Bradycardia
C) Headache
D) Visual disturbance
E) Heart rate >60
F) Gastrointestinal complaints

Question 47

When assessing a patient with a myocardial infarction (MI), which is objective data? (Select all that apply.)

A) Pain radiating to left arm and jaw
B) Hypertension
C) Vomiting
D) Diaphoresis
E) Nausea
F) Cardiac rhythm changes

Question 48

The functions of the cardiovascular system are to: (Select all that apply.)

A) deliver oxygen and nutrients to the cells.
B) deliver carbon dioxide and waste products to the cells.
C) remove oxygen and nutrients from the cells as waste products.
D) remove carbon dioxide and waste products from the cells.

Question 49

B-type natriuretic peptide (BNP) is a ___________, which is secreted by the heart in response to an expanded left ______________.

Question 50

Serum cardiac markers are __________ that indicate cardiac muscle damage after a myocardial infarction.