Question 1

How should the nurse advise a patient with an international normalized ratio (INR)of 5.8?

Accepted Answer

An INR of 5.8 is significantly higher than the therapeutic range, indicating a high risk of bleeding. The nurse should advise the patient to stop taking the anticoagulant and notify their healthcare provider for further instructions.

Question 2

During a health interview by the home health nurse,which patient complaint suggests left-sided heart failure?

Accepted Answer

Left-sided heart failure often leads to pulmonary congestion and fluid buildup in the lungs, which can cause symptoms such as needing to sleep in an elevated position (to relieve shortness of breath) and experiencing a hacking cough.

Question 3

The home health nurse warns the patient who is taking warfarin (Coumadin)for anticoagulant therapy for thrombophlebitis to stop taking the herbal remedy of ginkgo because ginkgo can:

Accepted Answer

Ginkgo can increase the action of Coumadin (warfarin) by enhancing its anticoagulant effects, which can lead to an increased risk of bleeding.

Question 4

What is the patient goal of the walking exercise program designed for the rehabilitation of a post-MI patient?

Accepted Answer

Walking 2 miles in less than 60 minutes after 12 weeks is a realistic and safe goal for the rehabilitation of a post-myocardial infarction (MI) patient, focusing on improving cardiovascular health without overexertion.

Question 5

The nurse making the schedule for the daily dose of furosemide (Lasix)would schedule the administration for which of the following times?

Accepted Answer

Furosemide (Lasix) is a diuretic that increases the production of urine. Administering it in the morning prevents disruption of the patient's sleep pattern by avoiding nocturia (nighttime urination).

Question 6

What is the difference between primary and secondary hypertension?

Accepted Answer

Secondary hypertension is caused by an underlying condition, such as kidney disease, that elevates blood pressure, distinguishing it from primary hypertension, which does not have a specific cause and is more common.

Question 7

The nurse making a teaching plan for a patient with Buerger disease (thromboangiitis obliterans)will focus on the need for:

Accepted Answer

Cessation of smoking is crucial in the management of Buerger disease (thromboangiitis obliterans) because smoking is a major risk factor that can exacerbate the condition by further impairing circulation.

Question 8

The postsurgical patient has a painful and swollen right calf that appears to be larger than the calf of the left leg.What is the nurse assessing for when she flexes the patient's right leg and dorsiflexes the foot?

Accepted Answer

The nurse is assessing for a positive Homans' sign, which is indicated by pain in the calf upon dorsiflexion of the foot. This can be a sign of deep vein thrombosis (DVT), a condition that can occur post-surgery due to prolonged immobility.

Question 9

A patient admitted to the emergency room with a possible myocardial infarction (MI)has reports back from the laboratory.Which laboratory report is specific for myocardial damage?

Accepted Answer

CK-MB (Creatine Kinase-MB) is specific to myocardial damage and is used to diagnose a myocardial infarction.

Question 10

Which statement would lead the nurse to offer more instruction about taking warfarin (Coumadin)?

Accepted Answer

Warfarin (Coumadin) is an anticoagulant medication that can be affected by dietary vitamin K, which is abundant in green leafy vegetables like broccoli, spinach, and kale. Consuming large or inconsistent amounts of these foods can interfere with the medication's effectiveness, necessitating more instruction for the patient.

Question 11

The nurse caring for a 92-year-old patient with pneumonia who is receiving IV carefully monitors the flow rate of the IV infusion because rapid infusion can cause:

Accepted Answer

Rapid IV infusion, especially in elderly patients or those with compromised cardiac function, can lead to fluid overload. This increases the volume of blood that the heart must pump, potentially leading to heart failure in susceptible individuals, such as the elderly or those with pre-existing heart conditions.

Question 12

The nurse is treating a patient who had a pacemaker inserted 8 years ago for the correction of atrial fibrillation.Which diagnostic test may no longer be available to the patient because of this older model implanted device?

Accepted Answer

MRI scans are often contraindicated for patients with older pacemaker models due to the risk of interference with the device's function, which can lead to adverse outcomes. Newer pacemaker models are designed to be MRI-compatible, but an 8-year-old device may not have this feature.

Question 13

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

Accepted Answer

The answer of Which information should be taught to patients...

Question 14

The nurse caring for a patient recovering from a myocardial infarction (MI)teaches which method to avoid the Valsalva's maneuver during a bowel movement?

Accepted Answer

Mouth breathing helps to avoid the Valsalva maneuver by preventing the patient from holding their breath and straining during a bowel movement, which can increase intrathoracic pressure and affect heart function.

Question 15

The nurse would design teaching for a patient with Raynaud disease to include which of the following? (Select all that apply. )

Accepted Answer

Raynaud's disease involves reduced blood flow to extremities, often triggered by cold or stress. Using mittens (B) helps keep hands warm. Stress-reducing techniques (C) can prevent attacks. Smoking cessation (D) is crucial as smoking constricts blood vessels. Caution with cold environments like refrigerators (E) is important to prevent attacks. Heating pads (A) are not recommended due to risk of burns.

Question 16

The home health nurse caring for a patient with infective endocarditis overhears the patient making a dental appointment for an extraction next month.Which question is most important for the nurse to ask?

Accepted Answer

Patients with infective endocarditis are at risk for bacteremia with dental procedures, so it's crucial to coordinate care with their physician to ensure appropriate prophylactic antibiotics are administered to prevent exacerbation of their condition.

Question 17

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 which factor(s)?

Accepted Answer

Cocaine use is a known risk factor for cardiomyopathy in young adults due to its toxic effects on the heart muscle.

Question 18

Which assessment would lead the nurse to examine the leg closely for evidence of a stasis ulcer?

Accepted Answer

Edematous, red scaly skin on the medial surface of the leg is indicative of venous insufficiency, which can lead to stasis ulcers. This condition results from poor venous return, causing fluid to pool in the legs, leading to swelling, redness, and eventually ulceration if not properly managed.

Question 19

The nurse reminds the patient that the American Heart Association recommends a lipid study every _________ years.

Accepted Answer

The American Heart Association recommends that adults aged 20 or older who are at risk for heart disease and stroke should have a fasting lipoprotein profile (lipid study) every 4 to 6 years. This recommendation is part of a preventive healthcare measure to monitor cholesterol levels and manage the risk of cardiovascular disease.

Question 20

The patient has become very dyspneic,respirations are 32,and the pulse is 100.The patient is coughing up frothy red sputum.What should be the initial nursing intervention?

Accepted Answer

Placing the patient upright with legs in a dependent position helps to reduce pulmonary congestion by decreasing venous return to the heart, which is beneficial in managing symptoms of pulmonary edema, as indicated by coughing up frothy red sputum and dyspnea.

Quiz 48: Care of the Patient With a Cardiovascular or a Peripheral Vascular Disorder

How should the nurse advise a patient with an international normalized ratio (INR) of 5.8?

During a health interview by the home health nurse,which patient complaint suggests left-sided heart failure?

The home health nurse warns the patient who is taking warfarin (Coumadin) for anticoagulant therapy for thrombophlebitis to stop taking the herbal remedy of ginkgo because ginkgo can:

What is the patient goal of the walking exercise program designed for the rehabilitation of a post-MI patient?

The nurse making the schedule for the daily dose of furosemide (Lasix) would schedule the administration for which of the following times?

What is the difference between primary and secondary hypertension?

The nurse making a teaching plan for a patient with Buerger disease (thromboangiitis obliterans) will focus on the need for:

The postsurgical patient has a painful and swollen right calf that appears to be larger than the calf of the left leg.What is the nurse assessing for when she flexes the patient's right leg and dorsiflexes the foot?

A patient admitted to the emergency room with a possible myocardial infarction (MI) has reports back from the laboratory.Which laboratory report is specific for myocardial damage?

Which statement would lead the nurse to offer more instruction about taking warfarin (Coumadin) ?