Deck 56: Management of Clients with Functional Cardiac Disorders

Question 1

A client is admitted to the intensive care unit with severe dyspnea, fear, noisy respirations, sweating, and tachypnea. The nurse would recognize that the client is exhibiting manifestations of

A) acute pulmonary edema.
B) acute myocardial infarction.
C) chronic congestive heart failure.
D) right ventricular failure.

Answer 1

acute pulmonary edema.

Question 2

The nurse would explain the etiology of heart failure after myocardial infarction (MI) as

A) impairment of the contractile function of the ventricle.
B) inability of the heart chambers to fill adequately.
C) increased myocardial workload.
D) increased oxygen demands of the myocardium.

Answer 2

impairment of the contractile function of the ventricle.

Question 3

The nurse would explain to a client who smokes that the nicotine in cigarette smoke increases the prevalence of CHD by

A) causing proliferation of smooth muscle cells.
B) decreasing the oxygen-carrying capacity of the blood.
C) increasing fat deposits along the intima of blood vessels.
D) increasing the heart rate and the risk of dysrhythmia.

Answer 3

increasing the heart rate and the risk of dysrhythmia.

Question 4

The nurse would advise a group of diabetic clients that primary prevention for CHD can be achieved by keeping their fasting blood sugar levels below

A) 56 mg/dl.
B) 72 mg/dl.
C) 105 mg/dl.
D) 126 mg/dl.

Question 5

The nurse would caution a client with arthritis that this chronic inflammatory disease increases the risk for CHD through the

A) amount of aspirin taken as a remedy for arthritis.
B) decreased physical activity relative to arthritic discomfort.
C) increased level of C-reactive protein.
D) increased release of histamines.

Question 6

The nurse explains that in addition to having a PTCA to clear the artery, the client will also have plaque vaporized by the use of

A) anticoagulant therapy.
B) intracoronary stent.
C) laser ablation.
D) transmyocardial revascularization.

Question 7

When the a client with left ventricular heart failure complains that she has to get up several times during the night to urinate, the nurse would explain that this bothersome event is

A) a late clinical manifestation of heart failure.
B) an indication that the right ventricle is being affected.
C) caused by an increase in blood flow to the kidneys when lying down.
D) the result of increased secretion of aldosterone at night.

Question 8

When a client with heart failure is receiving loop diuretics, the nurse would be sure to monitor serum

A) calcium levels.
B) enzyme levels.
C) potassium levels.
D) sodium levels.

Question 9

The nurse would recognize that the client at greatest risk for CHD is a

A) 35-year-old man who is 15 pounds overweight.
B) 40-year-old woman who repeatedly gains and loses 15 pounds.
C) 45-year-old man who lost 30 pounds by following a strenuous diet.
D) 50-year-old man 20 pounds overweight but a lifelong swimmer.

Question 10

When auscultating the respirations of a client in left ventricular heart failure, the nurse would most likely detect

A) crackling sounds.
B) diminished sounds.
C) grunting.
D) wheezing.

Question 11

A client with heart failure has been prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse would explain that this drug alleviates manifestations of heart failure by

A) decreasing circulating volume.
B) increasing myocardial contractility.
C) increasing vasodilation.
D) slowing atrioventricular conduction time.

Question 12

In advising a client with higher levels of high-density lipoproteins (HDLs) in proportion to low-density lipoproteins (LDLs), the nurse would suggest that the client

A) consult the physician for an anticholesterol prescription.
B) initiate a moderate exercise program.
C) is less likely to develop CHD.
D) should consider a reduced-fat diet.

Question 13

The nurse would clarify for a client that the lipoproteins representing the "good" cholesterol are the

A) HDLs.
B) LDLs.
C) VDRLs.
D) VLDLs.

Question 14

Reporting that a client's total cholesterol reading is 230, the nurse would know this result indicates a reading that is

A) low.
B) borderline high.
C) high.
D) very high.

Question 15

When the client who had a myocardial infarction develops dependent edema, the nurse would assess that this could be an early manifestation of

A) fluid deficit.
B) left ventricular failure.
C) renal failure.
D) right ventricular failure.

Question 16

The nurse would assess that the individual most at risk for death from coronary heart disease (CHD) is a

A) 30-year-old Hispanic woman.
B) 42-year-old Caucasian woman.
C) 55-year-old Asian man.
D) 62-year-old African American woman.

Question 17

When a client is admitted to the hospital with clinical manifestations of left ventricular heart failure, the nurse would question the client about

A) abdominal pain.
B) breathlessness.
C) leg swelling.
D) nausea.

Question 18

To prevent a post-procedure complication, nursing care of a client after a percutaneous transluminal coronary angioplasty (PTCA) generally would include

A) administering heparin.
B) assessing for clinical manifestations of shock.
C) forcing fluids.
D) maintaining the client flat in bed for 24 hours.

Question 19

A nurse is speaking to a group of high school girls about not smoking. The nurse would caution them that the risk of CHD in women who smoke is greater than that for nonsmoking women by

A) two times.
B) three times.
C) four times.
D) five times.

Question 20

The nurse would clarify to a client considering a MIDCABG that this procedure is less invasive and does not utilize

A) anticoagulants.
B) cardiopulmonary bypass.
C) long-term anesthesia.
D) mammary arteries.

Question 21

A client is scheduled to have CABG surgery next week. To best meet the client's need for psychosocial support, which intervention by the nurse would be best?

A) Ask the client and family to relay fears and questions.
B) Discuss the possible need for blood products during or after the operation.
C) Provide written and oral instructions along with contact phone numbers.
D) Refer the client to the preoperative educational classes at the hospital.

Question 22

A client is scheduled to have a PTCA. The nurse brings the consent forms and the client questions why he/she has to sign a consent form for possible coronary artery bypass grafting too. The nurse's response should be based on understanding that (Select all that apply)

A) a separate consent must be signed for each procedure.
B) education will only have to be done one time if the client signs both now.
C) in case of a complication, there may not be time to have a consent signed.
D) the client will be sedated during the PTCA and cannot sign another consent form.

Question 23

A client had a PTCA with stent placement. Nursing care that can be delegated to the unlicensed assistive personnel (UAP) after the procedure includes (Select all that apply)

A) assessing the distal pulses every 15-30 minutes.
B) calling for an ECG immediately if the client has angina.
C) monitoring vital signs every 15-30 minutes.
D) providing the client with plenty of fluids to drink.
E) reminding the client to remain flat in bed.

Question 24

A nurse is preparing to administer IV digoxin to an elderly client in heart failure. Which nursing action takes priority?

A) Ask the client if he/she has ever had digoxin before.
B) Assess the client's pulse rate and hold the medication if it is less than 60 beats/min.
C) Prepare the client for any side effects of the medication.
D) Provide instruction to the client on the medication's expected effects.

Question 25

A nurse is conducting worksite health education classes. The nurse informs the participants that in order to prevent heart disease, the American Heart Association recommends which amount of exercise?

A) 10-20 minutes every day.
B) 20-30 minutes three to five times a week.
C) 30-60 minutes every day.
D) 30-60 minutes on most days of the week.

Question 26

A client who is grossly overweight tells the nurse "I just can't lose a bunch of weight to prevent a disease I might not get." The best response by the nurse takes into consideration that

A) even a small weight loss is beneficial.
B) even overweight, women do not get coronary heart disease at high rates.
C) obesity is not one of the major risk factors for coronary heart disease.
D) the client really does need to lose substantial weight.

Question 27

A nurse is caring for a client in the intensive care unit who underwent a CABG earlier this morning. Which nursing diagnosis takes priority?

A) Decreased Cardiac Output
B) Impaired Gas Exchange
C) Pain
D) Risk for Hemorrhage

Question 28

A client is being discharge after successful CABG surgery. Despite the positive prognosis, the nurse cautions the client and family that

A) a heart attack could happen at any time.
B) heart disease can always return.
C) postoperative depression is common.
D) the real results of the operation are not yet known.