Question 1

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

Accepted Answer

Inability of the right ventricle to pump blood forward into the lungs results in peripheral congestion. Edema is a sign of increased fluid in interstitial tissue and appears in dependent areas of the body such as the sacrum when supine and the feet and ankles while in an upright position.

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

Accepted Answer

Collection of subjective data includes complaints of dyspnea and orthopnea (an abnormal condition in which a person must sit or stand in order to breathe deeply or comfortably).

Question 3

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

Accepted Answer

Initial nursing interventions include monitoring the status of an existing aortic aneurysm. The patient should be monitored for signs of rupture of the aneurysm, such as hypotension.

Question 4

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

Accepted Answer

Complete bed rest: Lowering oxygen requirements of the body systems with head of the bed elevated to 45 degrees to reduce myocardial oxygen demand and decrease circulating volume returning to the heart.

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

Accepted Answer

There is a very strong relationship between Buerger's disease and tobacco use. It is thought that the disease occurs only in smokers, and when smoking is stopped, the disease improves. None of the palliative treatments are effective if the patient does not stop smoking.

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?

Accepted Answer

During the acute phase, it is essential to maintain the patient on decreased activity and provide a calm, quiet environment.

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

Accepted Answer

A Holter monitor (a small portable recorder) is attached to the patient by one to four leads, with a 2-pound tape recorder carried on a belt or shoulder strap.

Question 8

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

Accepted Answer

Modifiable factors include smoking, hyperlipidemia, hypertension, diabetes mellitus, and 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?

Accepted Answer

Hypertension is a blood pressure higher than 140/90 mm Hg, which increases and individual's risk of developing cardiovascular disease. Adhering to medical therapy for control of elevated blood pressure helps to modify the individual's risk.

Question 10

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

Accepted Answer

Because many patients suffer pulmonary or systemic congestion with HF, the syndrome was once called 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?

Accepted Answer

Management of dysrhythmias is accomplished by suppressing the impulse that triggers dysrhythmias.

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

Accepted Answer

Collection of subjective data includes noting patient complaints of influenza-like symptoms with recurrent fever, undue fatigue, chest pain, and chills. Objective data may reveal the significant signs of petechiae in the conjunctiva and mouth. Both subjective data and objective data are indicative of 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?

Accepted Answer

Elevate extremities when sitting or lying to promote venous return and decrease incidence of edema and venous stasis.

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?

Accepted Answer

Avoiding vasoconstriction from nicotine, caffeine, and stress is an important precaution for patients with decreased arterial blood flow.

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

Accepted Answer

Nursing interventions include measures to prevent disease progression and complications. Reteaching about medication will not identify the cause of 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

Accepted Answer

Administer prescribed nitroglycerin. Repeat every 5 minutes, three times. If pain is unrelieved, notify the physician. Nitroglycerin administered sublingually usually relieves angina symptoms but does not relieve the pain from an MI. Administering nitro more than three times will probably not relieve the pain.

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

Accepted Answer

Class IV: Severe; patient unable to perform any physical activity without discomfort. Angina or symptoms of cardiac inefficiency may develop at rest.

Question 18

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

Accepted Answer

An aneurysm is an enlarged, dilated portion of an artery.

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?

Accepted Answer

Class IV: Severe: patient unable to perform any physical activity without discomfort.

Question 20

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

Accepted Answer

Restful sleep may be possible only in the sitting position or with the aid of extra pillows.

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