Question 1

What dietary teaching should the nurse provide to the client who has homocysteine elevation?

Accepted Answer

Homocysteine elevation is linked to deficiency in B vitamins (folate, B12, B6). Therefore, consuming a B-complex vitamin supplement daily can help to lower homocysteine levels.

Question 2

The nurse is preparing to apply sequential compression devices to a client.In which order should the nurse apply these devices?
Click and drag the options below to move them up or down.
A)Place in the dorsal recumbent or semi-Fowler's position.
B)Place a sleeve under each leg with the opening at the knee.
C)Wrap the sleeve securely around the leg,securing the Velcro tabs.
D)Turn on the control unit and adjust the alarms and pressures as needed.
E)Connect the sleeves to the control unit and adjust the pressure as needed.

Accepted Answer

A,B,C,E,D

Question 3

A client is on strict bed rest following hip surgery.What nursing intervention would support vascular health?

Accepted Answer

Alternately flexing and extending the feet several times a day promotes blood flow and prevents the development of blood clots in the lower extremities, which is a potential complication of immobility. Pillow support and knee flexion positions may be helpful for comfort and pain relief, but do not directly support vascular health. Keeping the client in a prone position for extended periods of time is generally not recommended for post-operative hip surgery clients.

Question 4

The nurse is collecting equipment to assess a client's ankle/brachial index (ABI).What equipment should be taken to the client's bedside?

Accepted Answer

To assess a client's ankle/brachial index (ABI), the nurse needs a blood pressure cuff to measure the client's blood pressure and a Doppler ultrasound device to assess the blood flow in the client's arteries. Therefore, option A is the correct choice. The stethoscope and penlight (option C) and the reflex hammer and tuning fork (option D) are unrelated and unnecessary equipment for assessing an ABI. Option B is incorrect as special equipment is needed for the assessment.

Question 5

The nurse is reviewing the laboratory results of a client who is being observed for possible myocardial infarction.Which laboratory result would be most important for the nurse to discuss with the physician?

Accepted Answer

Increased troponin levels indicate damage to cardiac muscle cells, which is a hallmark of myocardial infarction. The other options are not as directly related to cardiac damage or myocardial infarction.

Question 6

A client has a long history of hypertension and has developed heart failure.The nurse should anticipate giving medications for which purpose?

Accepted Answer

In heart failure, the heart is not able to effectively pump blood out to the body. This can often be due to increased afterload, or resistance the heart must work against to pump blood out. Medications that decrease afterload, such as ACE inhibitors or angiotensin receptor blockers (ARBs), can be used to help the heart pump more effectively and improve symptoms of heart failure. Medications to increase preload or decrease contractility would not be appropriate in this case as they would put further strain on the already weakened heart. Medications to decrease cardiac output would also not be appropriate as the goal is to improve cardiac output to better circulate blood throughout the body.

Question 7

The client has a history of recurrent transient ischemic attack (TIA).Based upon this history the nurse should be most concerned about the client's potential to develop

Accepted Answer

The client's history of recurrent TIA indicates a significant risk for developing a stroke, which is a potential complication of TIA. Renal failure and gangrene are not directly associated with TIA, and while myocardial infarction is a cardiovascular complication, stroke is a more likely outcome for a client with previous TIAs.

Question 8

A client exhibits confusion,decreased capillary refill time,low oxygen saturation readings,and decreased renal output.What NANDA nursing diagnosis problem statement should the nurse choose for this client?

Accepted Answer

The client's symptoms suggest a lack of oxygen perfusion to the tissues, potentially caused by decreased cardiac output or impaired oxygenation. However, the low oxygen saturation readings and decreased renal output point more specifically towards ineffective tissue perfusion as the primary problem. Activity intolerance and risk for injury are not the most appropriate options based on the information given.

Question 9

After a cardiac catheterization,an infant is diagnosed with a malformation of the mitral valve.The nurse will monitor the client for the development of a problem associated with the delivery of

Accepted Answer

The malformation of the mitral valve can result in a decrease in the amount of oxygenated blood being delivered to the body. The mitral valve separates the left atrium and left ventricle and allows blood to flow in only one direction, from the atrium into the ventricle. If the valve is not functioning properly, blood can leak back into the atrium, reducing the amount of oxygenated blood that is delivered to the body. This can lead to a decrease in oxygenation and perfusion to the tissues, which can result in various complications. Therefore, the nurse should monitor the client for any signs of decreased oxygenation and perfusion.

Question 10

The nurse notes a widely bizarre pattern on the client's cardiac monitor.What is the nurse's priority action?

Accepted Answer

Checking the client's pulse is the priority action to determine if the bizarre pattern on the cardiac monitor is affecting the client's hemodynamic status.

Question 11

The client is admitted with a possible deep vein thrombosis.Nursing interventions should be designed to prevent which complication?

Accepted Answer

Deep vein thrombosis (DVT) can lead to pulmonary embolism (PE), which is a serious and potentially life-threatening complication. Preventative measures such as anticoagulant therapy, compression stockings, and early ambulation can help decrease the risk of PE. Myocardial infarction (A), renal failure (B), and pneumonia (D) are not typically associated with DVT.

Question 12

The nurse is planning teaching for a client that focuses on Healthy People 2020 objectives for cardiovascular health.Which modifiable risk factors should the nurse include in this teaching?
(Select all that apply)

Accepted Answer

Age and gender are non-modifiable risk factors for cardiovascular disease, so they would not be included in teaching about modifiable risk factors. However, obesity, smoking, and hypertension are all modifiable risk factors that the client can work to improve through lifestyle changes and/or medical management. These three risk factors are also included as focus areas in the Healthy People 2020 objectives for cardiovascular health.

Question 13

The client has complaints of being tired,listless,and unable to tolerate activity at usual levels.Which laboratory value should the nurse review first while assessing this complaint?

Accepted Answer

Hemoglobin and hematocrit levels are important indicators of oxygen carrying capacity of the blood. A decrease in these levels can indicate anemia which can cause fatigue and decreased tolerance to activity. Therefore, reviewing hemoglobin and hematocrit levels first will provide important information regarding the client's complaints.

Question 14

The nurse assessing a 1-day-old infant discovers the heart rate is 140 and irregular.What action should the nurse take?

Accepted Answer

A heart rate of 140 beats per minute is within the normal range for a 1-day-old infant, and irregularities in heart rhythm are common and usually not a cause for concern in newborns. This is why it is considered a normal finding and should be documented in the infant's medical record.

Question 15

The post-myocardial infarction client asks the nurse about return to exercise.What information should the nurse give this client?

Accepted Answer

Clients who have had a myocardial infarction should avoid exercising in extreme temperatures (hot or cold) to prevent added stress on the heart. Exercise in moderate temperatures is recommended.

Question 16

The 50-year-old who is postmenopausal asks the nurse about the use of estrogen replacement therapy to protect the heart.How should the nurse respond?

Accepted Answer

The use of estrogen replacement therapy is not a straightforward decision as it is associated with possible benefits, such as protecting the heart, but also possible risks. The nurse should provide the patient with accurate information about the complexity of this therapy and encourage her to discuss her options with her healthcare provider.

Question 17

A client has a heart rate of 170 beats per minute.For what will the nurse assess next in this client?

Accepted Answer

A heart rate of 170 beats per minute is considered tachycardia, and can result in decreased cardiac output due to a shortened diastolic filling time. Therefore, the nurse should assess for signs of decreased cardiac output such as hypotension or decreased urine output. Choices A and B may occur in response to increased cardiac output, while choice C may occur in response to decreased afterload. However, none of these choices are directly related to the client's tachycardia.

Question 18

The nurse is assessing a newly admitted client for the presence of impaired peripheral arterial circulation.Which finding would be significant to this condition?

Accepted Answer

Decreased hair on the legs is a significant finding of impaired peripheral arterial circulation. This occurs due to reduced blood flow to the hair follicles, leading to decreased hair growth. It is also a common symptom of peripheral arterial disease (PAD), which is caused by atherosclerosis or hardening and narrowing of the arteries that supply blood to the legs and feet. Other common symptoms of PAD include cramping, pain, coldness, and numbness in the legs and feet, particularly during physical exertion or after periods of rest.

Question 19

The client has experienced a myocardial infarction with damage to the inferior portion of the heart.Due to this history,the nurse monitors the client for the development of rhythm disturbances that are most directly based upon which factor?

Accepted Answer

Rhythm disturbances in a client with myocardial infarction and damage to inferior portion of the heart are most directly based upon the automaticity of cardiac cells. The damaged cells may initiate electrical impulses that are different from the normal conduction pathway, leading to rhythm disturbances such as premature ventricular contractions or ventricular tachycardia. Electrolyte imbalances may contribute to these rhythm disturbances, but they are not the most direct factor. Blood sugar levels and blood flow to the liver are not directly related to rhythm disturbances.

Question 20

The nurse finds a client pulseless and breathless.The client's skin is pale and cool,but not cyanotic.Because of this finding,what should the nurse suspect?

Accepted Answer

The client's pale, cool skin suggests that cardiac arrest occurred prior to respiratory arrest. If respiratory arrest had occurred first, the skin would be cyanotic (blue) due to lack of oxygen. The nurse should immediately initiate cardiopulmonary resuscitation (CPR) and call for emergency assistance. The cause of the arrest should be determined and treated if possible.

Quiz 51: Circulation