Question 1

A healthy postoperative patient who has been on bedrest for 3 days suddenly develops dyspnea,tachypnea,restlessness,and chest pain.The patient says,"I feel as if something is going to happen to me." What should the nurse do?

Accepted Answer

The patient likely has pulmonary emboli,which is a life-threatening condition and requires prompt medical intervention,so the physician must be notified immediately.A.B.These actions are not appropriate for the potential life-threatening condition.The physician will prescribe orders when notified.D.This would provide false reassurance which should never be done.

Question 2

The nurse is reviewing the prothrombin time (PT)value for a patient prescribed warfarin (Coumadin).The laboratory's prothrombin time range is 9 to 11 seconds.What would be the therapeutic time for the patient?

Accepted Answer

Warfarin's therapeutic range is 1.5 to 2 times the normal PT range.To monitor the patient's therapeutic PT,compare the patient's result with the therapeutic range.The therapeutic range is 13.5 to 22 seconds,so B is correct.A.The value of 12.5 seconds is sub-therapeutic.C.D.The values of 26 and 30 seconds are above therapeutic.

Question 3

A patient is diagnosed with cardiomyopathy.What should the nurse identify as a potential risk for this patient?

Accepted Answer

A consequence of all types of cardiomyopathy can be heart failure.A.B.D.Cardiomyopathy is not associated with angina,pericarditis,or myocardial infarction.

Question 4

The nurse is caring for a patient who develops a fever and reports right calf pain with a reddened and swollen calf.Which action should the nurse take?

Accepted Answer

The calf should be measured bilaterally for comparison and documented daily to note changes.A.B.C.Massaging the calf is contraindicated,and anti-embolism stockings are placed on the unaffected leg only during acute phase to prevent emboli.Warm-moist heat may be used for superficial thrombophlebitis.

Question 5

The nurse is reinforcing teaching provided to a patient with strep throat.Which statement indicates that the patient understands the complication that can occur 2 to 3 weeks after this health problem?

Accepted Answer

Rheumatic heart disease is a complication of a strep infection.A.B.C.Pericarditis,rheumatic fever,and cardiomyopathy are not complications from a strep infection.

Question 6

The nurse is collecting data on a patient recovering from a hysterectomy who is experiencing left calf tenderness.Data include the following: left calf 17.5 inches; right calf 14 inches; left thigh 32 inches; right thigh 28 inches; shiny,warm,and reddened left leg.Which actions should the nurse recommend for this patient's plan of care?

Accepted Answer

Patient has developed thrombophlebitis,and bedrest should be maintained as ordered until acute phase is resolved to prevent an emboli.B.Ambulation could lead to a pulmonary embolism and should be avoided.C.D.Anti-embolism stockings are placed on the unaffected leg only during the acute phase to prevent emboli.

Question 7

The nurse is collecting data from a patient 3 days after a motor vehicle crash in which the patient hit the steering wheel.The data reveal symptoms of pericarditis.Which finding indicates the presence of pericarditis?

Accepted Answer

A pericardial friction rub due to inflammation of pericardium is the classic sign of pericarditis.A.In pericarditis,pain occurs with inspiration.C.D.Jugular vein distention and crackles in the lung bases are manifestations of heart failure.

Question 8

The home health nurse is visiting a patient with cardiomyopathy who lives alone and is prescribed anticoagulant therapy.Which observation indicates that the patient requires more teaching?

Accepted Answer

The patient should not use a straight razor due to the risk of injury and bleeding when on anticoagulant therapy.A,C,and D are appropriate when on anticoagulant therapy to prevent injury and bleeding.

Question 9

The nurse reinforces teaching provided to a patient prescribed an anticoagulant for atrial fibrillation due to valvular disease.Which statement by the patient indicates that the teaching has been effective?

Accepted Answer

Monthly blood tests are done to monitor the effects of the anticoagulant to maintain the therapeutic range and prevent complications such as bleeding.B.Aspirin should be avoided when taking anticoagulants.C.The patient should have medical information about anticoagulant therapy available at all times.D.The patient should use a soft-bristled brush when performing mouth care to prevent gum bleeding.

Question 10

The nurse reinforces teaching provided to a patient with mitral stenosis.Which patient statement indicates that the teaching has been effective?

Accepted Answer

Mitral stenosis does not allow the left atrium to empty easily,so blood builds up in the left atrium.A.Mitral stenosis does not mean that the right side of the heart is not pumping effectively.B.There is not a backflow of blood into the lower left chamber of the heart with mitral stenosis.C.There is not a narrowing of the blood vessel that brings blood into the heart with mitral stenosis.

Question 11

A patient with mitral stenosis is prescribed a preoperative antibiotic.Which patient statement indicates an understanding for taking this medication?

Accepted Answer

Prophylactic antibiotic therapy helps prevent a bacterial infection in the heart,rheumatic fever,and subsequent rheumatic heart disease and is recommended to prevent valvular disease.A.B.D.This medication is not provided to prevent postoperative pneumonia,fever,or infection of the surgical incision.

Question 12

A patient with acute pericarditis has a nursing diagnosis of Pain related to the inflammatory process.What nursing action should the nurse recommend?

Accepted Answer

Anti-inflammatory medication as ordered reduces inflammation,which decreases pain,and should be included in the pain management plan.A.B.D.These actions will not help reduce the patient's pain.

Question 13

A patient with a history of mitral valve replacement surgery is instructed to take prophylactic antibiotics before a scheduled root canal.Which patient statement indicates to the nurse that teaching has been effective?

Accepted Answer

A fever is a manifestation of acute endocarditis.A.B.D.Dry cough,ankle edema,and weight gain are not manifestations of acute endocarditis.

Question 14

The nurse is collecting data from a patient.Which approach should the nurse use to determine the presence of a Homan's sign?

Accepted Answer

Homans' sign is performed prior to confirmation of thrombophlebitis by dorsiflexing the patient's foot sharply and asking if calf pain occurred.Pain is positive for thrombophlebitis.A.B.C.These approaches are not used to determine the presence of a Homan's sign.

Question 15

The nurse is caring for a patient with pericarditis.Which type of medication should the nurse expect to be prescribed for the patient?

Accepted Answer

Anti-inflammatory medication reduces pericardial inflammation,which decreases pain and should be included in the pain management plan.A.B.D.Beta blockers,antihypertensives,and calcium channel blockers do not treat inflammation or pain.

Question 16

The nurse is contributing to a patient's plan of care.Which positioning should the nurse recommend for a patient with a left deep vein thrombosis?

Accepted Answer

Elevating the leg above heart level for 5 to 7 days is recommended.A.The head should not be placed higher than the legs.C.D.The unaffected limb does not need to be elevated.

Question 17

A patient with a deep vein thrombosis receiving a heparin infusion and warfarin (Coumadin)therapy develops bleeding gums.What action should the nurse take?

Accepted Answer

The RN and physician should be notified so coagulation testing can be done to determine what to do with the heparin drip and warfarin,which can cause bleeding.C.Turning off the heparin infusion is not within the licensed practical nurse's (LPN's)scope of practice.B.D.Offering a saline mouth rinse or gargling with mouthwash can be done later.

Question 18

The nurse is reinforcing teaching provided to a patient with thrombophlebitis.Which diagnostic test should the nurse explain is used to confirm thrombophlebitis?

Accepted Answer

Duplex venous scanning confirms thrombophlebitis.A.B.D Chest x-ray,intravenous pyelogram,or arterial Doppler ultrasound is not used to diagnose thrombophlebitis.

Question 19

A patient with aortic stenosis is being treated for heart failure.Which medication order should the nurse question?

Accepted Answer

Medications,such as digitalis,that reduce the contractility of the heart and,subsequently,cardiac output are avoided to prevent further heart failure.A.C.D.These medications can be safely provided to the patient with aortic stenosis.

Question 20

The nurse is caring for a patient with a deep vein thrombosis who is receiving intravenous heparin.The nurse should monitor which of these laboratory tests specifically for the effects of the heparin?

Accepted Answer

Partial thromboplastin time (PTT)monitors the effects of heparin.A.C.D.These laboratory tests are not used to monitor the effectiveness of heparin.

Quiz 23: Nursing Care of Patients With Valvular, Inflammatory, and Infectious Cardiac or Venous Disorders