Question 1

A patient who was admitted in hypertensive crisis in now normotensive.The nurse notes the patient's output from the indwelling urinary catheter has been 15 mL over the last hour and was 20 mL the previous hour.What nursing intervention is necessary?

A)Assess the patient for development of stroke findings.
B)Discuss these findings with the primary care provider.
C)Increase the patient's intravenous fluid rate.
D)Irrigate the patient's indwelling urinary catheter.

Accepted Answer

Discussing these findings with the primary care provider is necessary because the patient's urinary output is significantly low (less than 30 mL/hour for 2 hours), which could indicate acute kidney injury or another serious complication related to the hypertensive crisis or its treatment. It's important for the healthcare team to evaluate the cause and decide on the appropriate intervention.

Question 2

A patient's blood pressure is measured as 138/88 mm Hg in the right arm.The nurse will anticipate which action as a result of this finding?&#10;A)Initiation of therapy with a thiazide diuretic&#10;B)Repeating the measurement in the left arm&#10;C)Diagnosis of prehypertension will be made&#10;D)Instructing the patient to follow the DASH (dietary approaches to stop hypertension)diet&#10;

Accepted Answer

The nurse should repeat the blood pressure measurement in the left arm to confirm the reading and rule out any potential for a difference in blood pressure measurements between the arms, which could indicate an underlying health issue. The other options may be considered depending on further assessment and evaluation, but repeating the measurement in the left arm is the most immediate action needed.

Question 3

The nurse is collecting the health history of a patient hospitalized for possible infective endocarditis.Which findings would the nurse evaluate as supporting this presumptive diagnosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The patient reports having rheumatic heart disease as a child.
B)The patient has asthma.
C)The patient had a routine screening colonoscopy 1 month ago.
D)The patient is maintained on hemodialysis.
E)The patient has developed osteoarthritis over the last 2 years.

The patient reports having rheumatic heart disease as a child.
The patient had a routine screening colonoscopy 1 month ago.
The patient is maintained on hemodialysis.

Accepted Answer

A) Rheumatic heart disease can cause damage to the heart valves, making them more susceptible to infection, including infective endocarditis.C) Procedures like colonoscopies can introduce bacteria into the bloodstream, potentially leading to infective endocarditis, especially in individuals with pre-existing heart conditions.D) Patients on hemodialysis have an increased risk of infective endocarditis due to the frequent use of central lines or vascular access, which can serve as entry points for bacteria.

Question 4

A patient is diagnosed with an acute myocardial infarction and ruptured papillary muscle.Which action is the highest priority for the nurse to complete?&#10;A)Obtain an electrocardiogram.&#10;B)Measure the patient's cardiac output.&#10;C)Assess the patient's neurological status.&#10;D)Assess respiratory status.&#10;

Accepted Answer

Assessing respiratory status is the highest priority in a patient with a ruptured papillary muscle following an acute myocardial infarction because this condition can lead to acute mitral valve regurgitation, causing pulmonary edema and compromising respiratory function.

Question 5

A patient is admitted for treatment of heart failure.The nurse would attribute which patient complaint to this diagnosis?&#10;A)&#34;I often have headaches early in the morning.&#34;&#10;B)&#34;I have some numbness in my feet.&#34;&#10;C)&#34;I wake up a lot at night.&#34;&#10;D)&#34;I find I bruise more easily now.&#34;&#10;

Accepted Answer

Waking up frequently at night is a common symptom of heart failure, as the body may have difficulty breathing and fluid may accumulate in the lungs when lying down. Headaches, numbness in the feet, and easy bruising are not specific to heart failure and can be caused by a variety of factors.

Question 6

A patient is prescribed Carvedilol for hypertension.Which medication education should the nurse provide?&#10;A)&#34;Let me know if this medication causes you to have a headache.&#34;&#10;B)&#34;This medication's main side effect is dizziness,so be careful when you first sit up.&#34;&#10;C)&#34;Some people get a mild skin rash for a few days after starting this therapy.&#34;&#10;D)&#34;You should avoid eating foods high in vitamin K while on this medication.&#34;&#10;

Accepted Answer

Carvedilol can cause dizziness, especially when first starting the medication, so it is important for the nurse to educate the patient to be careful when getting up or sitting down. The other options are not the main side effects or concerns with this medication.

Question 7

A patient diagnosed with heart failure makes the following comments.Which statement requires additional assessment by the nurse?&#10;A)&#34;I still sleep better in a recliner.&#34;&#10;B)&#34;I do pretty well as long as I don't try to do too much at one time.&#34;&#10;C)&#34;My heart rate runs around 60 to 64 most of the time.&#34;&#10;D)&#34;I've gained 4 pounds since yesterday.&#34;&#10;

Accepted Answer

A sudden weight gain of 4 pounds could indicate fluid retention, a common symptom of heart failure. This statement requires further assessment by the nurse to determine if there have been any changes in the patient's diet, medication regimen, or activity level that could account for the weight gain.

Question 8

It is suspected that a patient has an aortic aneurysm that may be dissecting or rupturing.Which assessment finding would the nurse evaluate as suggesting the aneurysm is in the thoracic region?&#10;A)The patient has severe pain.&#10;B)The patient becomes rapidly hypotensive.&#10;C)Syncope occurs.&#10;D)The blood pressure reading is different from arm to arm.&#10;

Accepted Answer

If the aneurysm is in the thoracic region, there may be a difference in blood pressure readings from arm to arm due to compressed or occluded vessels. Severe pain may be present regardless of the location of the aneurysm. Rapidly hypotensive state and syncope are indications of rupture and may suggest either thoracic or abdominal aneurysm.

Question 9

A patient admitted in hypertensive crisis is being cared for by a newly licensed nurse and his preceptor.The preceptor would consider which information when explaining the potential etiology of this crisis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)How well has the patient's hypertension been controlled in the past?
B)How old is the patient?
C)Has the patient been following the prescribed therapy?
D)What therapy was the patient prescribed?
E)How long has the patient been hypertensive?

Accepted Answer

These factors can all contribute to a hypertensive crisis and should be considered when explaining the potential etiology to the patient.

Question 10

A nurse has completed instruction regarding the DASH (dietary approaches to stop hypertension)eating plan for a patient with hypertension.Which patient statements would indicate additional education is required? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)"I will take walks several times a week."
B)"I can drink a glass of wine weekly."
C)"I will avoid dairy products."
D)"I will avoid changing my intake of green leafy vegetables until my medication is stabilized."
E)"I will limit my intake of sodium and potassium."

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Accepted Answer

C) The DASH diet actually encourages the consumption of low-fat dairy products as they are high in calcium and protein, which can help lower blood pressure.D) The DASH diet recommends increasing the intake of fruits and vegetables, including green leafy vegetables, as they are rich in minerals, fiber, and other nutrients that can help reduce blood pressure.E) While the DASH diet recommends limiting sodium intake, it encourages the consumption of potassium, as potassium can help lower blood pressure. Limiting both sodium and potassium is not in line with the DASH diet recommendations.

Question 11

The nurse has completed discharge teaching with a patient who had a mechanical valve replacement.Which patient behavior would the nurse evaluate as indicating additional teaching is necessary?&#10;A)The patient asks his wife to purchase a blood pressure monitor from their pharmacy.&#10;B)The patient tells the nurse of his plans to visit Rome next year.&#10;C)The patient orders a pasta salad with broiled salmon for lunch.&#10;D)The patient makes plans to stay with his daughter in her three-story condominium for a few weeks after discharge.&#10;

Accepted Answer

The answer of The nurse has completed discharge teaching with...

Question 12

A patient has been diagnosed with dilated cardiomyopathy.The nurse would provide which instruction?&#10;A)&#34;It will be necessary for you to rest more and to limit exercise.&#34;&#10;B)&#34;In some cases,this condition is treated with a surgical procedure to place a dual-chamber pacemaker.&#34;&#10;C)&#34;You will need to take calcium channel blockers exactly as prescribed for the rest of your life.&#34;&#10;D)&#34;A common treatment for your condition is the implantation of a cardioverter-defibrillator.&#34;&#10;

Accepted Answer

The answer of A patient has been diagnosed with dilated...

Question 13

A patient has been diagnosed with an abdominal aortic aneurysm (AAA)that is not large enough to be treated surgically.What is the most important teaching for the nurse to provide this patient on discharge?

A)Information about smoking cessation
B)Information on how to monitor radial pulses
C)Need for frequent blood pressure measurements in both arms
D)Need to eat a very low-fat diet

Accepted Answer

The answer of A patient has been diagnosed with an...

Question 14

When conducting a health history on a patient with aortic valve stenosis,which question would be most important for the nurse to ask?&#10;A)&#34;Do you have a family history of coronary artery disease?&#34;&#10;B)&#34;Do any of your family members have valvular problems?&#34;&#10;C)&#34;Have you ever been diagnosed with rheumatic fever?&#34;&#10;D)&#34;Have you ever been diagnosed with high blood pressure?&#34;&#10;

Accepted Answer

The answer of When conducting a health history on a...

Question 15

Which clinical manifestation would the nurse evaluate as most significant in a patient with mitral valve stenosis?&#10;A)Edema of the lower extremities&#10;B)A heart rate of 110 beats per minute&#10;C)Altered deep tendon reflexes&#10;D)Bounding peripheral pulse&#10;

Accepted Answer

The answer of Which clinical manifestation would the nurse evaluate...

Question 16

A patient was sent to a rural emergency department after screening by the occupational health nurse revealed a blood pressure of 185/115 mm Hg.The patient reports feeling "fine" and denies associated symptoms.The nurse would anticipate which interventions for this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Administration of oral antihypertensive medications
B)Admission to the hospital for monitoring
C)Teaching the patient how to monitor blood pressure at home
D)IV administration of antihypertensive medications
E)Transfer to an intensive care unit in a larger hospital

Accepted Answer

The answer of A patient was sent to a rural...

Question 17

A patient with heart failure tells the nurse that she is "allergic" to angiotensin-converting enzyme (ACE)inhibitors because they make her cough "all of the time." What does this information suggest to the nurse?

A)The patient should not take an angiotensin receptor blocker because of the ACE inhibitor allergy.
B)The patient's asthma has been exacerbated by the use of ACE inhibitors.
C)The patient experienced a side effect of the ACE inhibitor,which is a cough.
D)The patient's cough is due to long-standing heart failure.

Accepted Answer

The answer of A patient with heart failure tells the...

Question 18

A patient is admitted for a severe headache and is found to have a blood pressure of 185/115 mm Hg.The nurse would prepare to manage administration of which drug most likely to be prescribed?&#10;A)Clonodine&#10;B)Oral furosemide&#10;C)Nitroprusside&#10;D)Captopril&#10;

Accepted Answer

The answer of A patient is admitted for a severe...

Question 19

A patient is diagnosed with rupture of an aortic aneurysm and surgery is imminent.What interventions would the nurse anticipate prior to surgery? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Starting intravenous lines for fluid resuscitation
B)Administration of blood
C)Administration of IV narcotic for pain
D)Preparation for endotracheal intubation
E)Administration of anticoagulants to prevent clots in the prosthesis

Accepted Answer

The answer of A patient is diagnosed with rupture of...

Question 20

A patient with a history of mitral valve stenosis is placed on a cardiac monitor.Which arrhythmia would the nurse anticipate since it is a common rhythm for patients with this history?&#10;A)Ventricular tachycardia&#10;B)Third-degree heart block&#10;C)Junctional rhythm&#10;D)Atrial fibrillation&#10;

Accepted Answer

The answer of A patient with a history of mitral...

Deck 14: Alterations in Cardiac Function