Deck 55: Management of Clients with Structural Cardiac Disorders

Question 1

For a client waiting for a heart transplant who has been fitted with a left ventricular assist device (LVAD), the nurse would explain that the purpose of this device is to

A) electrically stimulate the left ventricle to contract.
B) extract blood from the left ventricle and propel it into the systemic circulation.
C) measure hemodynamics of cardiac output occurring because of dysrhythmias.
D) sound an alarm when the intraventricular pressure drops.

Answer 1

extract blood from the left ventricle and propel it into the systemic circulation.

Question 2

The nurse would explain to a client that the catabolism related to the hypermetabolic state caused by the client's rheumatic fever can be avoided by eating a

A) high-carbohydrate, high-protein diet.
B) high-fat, high-protein diet.
C) high-protein, low-carbohydrate diet.
D) high-protein, low-sodium diet

Answer 2

high-carbohydrate, high-protein diet.

Question 3

The change in vital signs that would most strongly suggest cardiac tamponade to the nurse is

A) bradycardia.
B) muffled heart sounds.
C) narrowing pulse pressure.
D) tachypnea.

Answer 3

narrowing pulse pressure.

Question 4

In counseling a client who is considering a heart transplant, the nurse would know the client has an accurate perception of this treatment option when the client says

A) "Less than half of those who survive a heart transplant live 10 years."
B) "People under 75 years of age may have a heart transplant."
C) "The survival rate for patients having a heart transplant is about 80%."
D) "This is an experimental treatment, but I want to take the chance."

Question 5

A client has dilated cardiomyopathy and is angry and irritable to all the nursing staff. When planning care for this client, which nursing diagnoses would be the priority to address this problem?

A) Altered Body Image
B) Hopelessness
C) Impaired Verbal Communication
D) Risk for Non-compliance

Question 6

In the discharge teaching plan of a client with chronic myocarditis, the nurse would include the suggestion that

A) family members should be screened for upper respiratory tract infection.
B) family members should learn cardiopulmonary resuscitation (CPR).
C) stairs in the home should be replaced with ramps.
D) the client should not operate a motor vehicle.

Question 7

The nurse would recognize that splinter hemorrhages in the nails, painful swollen nodules on the fingertips, and splenomegaly indicate

A) infective endocarditis.
B) mitral stenosis.
C) mitral valve prolapse.
D) pericarditis.

Question 8

The nurse would stress in a discharge teaching plan for a client recovering from endocarditis that to avoid further complication, the client should

A) become actively involved in social and community activities.
B) drink at least 1000 ml of fluid daily to ensure adequate hydration.
C) initiate a comprehensive daily exercise program.
D) notify the physician when invasive dental procedures are planned.

Question 9

The physician has expressed concern about the development of rheumatic fever in a client with a throat infection. The nurse would explain to the client that the organism causing the infection is

A) a respiratory virus.
B) beta-hemolytic streptococcus.
C) Escherichia coli.
D) Streptococcus pneumoniae.

Question 10

In caring for a client considering mechanical mitral valve replacement, the essential determination for the nurse (and physician) to make would be whether the client can or will

A) comply with the lifelong requirement for anticoagulant therapy.
B) cooperate fully and participate in a cardiac rehabilitation program.
C) experience body image problems from the sternal scar.
D) require a high level of physical energy at work.

Question 11

For a client who has undergone a tissue valve replacement, the most appropriate anticipatory guidance provided by the nurse would be

A) activity should be restricted to reduce stress on the valve.
B) follow-up is important, since most tissue valves eventually need replacement.
C) long periods of standing decreases venous return to the heart.
D) modification of lifestyle can prevent associated dysrhythmias.

Question 12

A client with mitral stenosis tells the nurse that she will not seek treatment for this disorder because she "doesn't really feel that bad." The nurse's best response would be that untreated mitral stenosis can result in

A) creation of small emboli.
B) frequent bouts of pericarditis.
C) potentially fatal myocardial infarcts.
D) pulmonary effusion.

Question 13

The nurse auscultating heart sounds notes that a client has an opening snap and a low-pitched, rumbling murmur over the apex. This assessment would indicate

A) aortic stenosis.
B) mitral stenosis.
C) pulmonic prolapse.
D) tricuspid regurgitation.

Question 14

Examining the electrocardiogram strips of a client with mitral stenosis, the nurse would recognize the characteristic dysrhythmia of

A) atrial fibrillation.
B) artial flutter.
C) sinus tachycardia.
D) ventricular tachycardia.

Question 15

To help relieve the discomfort of a client with pericarditis who is experiencing pain, the nurse would position the client

A) flat in bed.
B) in semi-Fowler's position.
C) prone.
D) sitting upright.

Question 16

When performing cardiac auscultation on a client with mitral valve prolapse, the nurse would anticipate hearing a

A) harsh, systolic murmur.
B) loud S2 heart sound.
C) midsystolic click.
D) prominent S4 heart sound.

Question 17

To encourage a client recovering from endocarditis, the nurse would stress that new guidelines for home care are less restrictive than in the past and the client no longer needs to

A) observe complete bed rest.
B) restrict the amount of activity.
C) take 2 to 5 weeks of antibiotic therapy.
D) take precautions against emboli formation.

Question 18

When a client is hospitalized with dilated cardiomyopathy, the nurse would examine the client's record for the characteristic history of

A) long-term alcohol abuse.
B) previous streptococcal infection.
C) resistant hypertension.
D) uncontrolled diabetes.

Question 19

The nurse caring for a client with acute infective endocarditis would frequently assess for

A) cardiac murmurs.
B) elevation of blood pressure.
C) pulse oximetry.
D) urine output.

Question 20

The nurse teaching a class on long-term effects of rheumatic fever would stress that the most common problem following bouts of rheumatic fever is

A) cardiac tamponade.
B) coronary artery disease.
C) pericarditis.
D) valvular disorders.

Question 21

When the client with rheumatic fever becomes irritable and impatient with the restrictions of the disease, the home health nurse would remind the client that manifestations of rheumatic fever usually abate in about

A) 3 months.
B) 6 months.
C) 9 months.
D) 1 year.