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Which of the following assessment findings by the nurse is probably unrelated to the AAA? a) pulsatile abdominal mass b) hyperactive bowel sounds in the area c) systolic bruit over the area of the mass d) subjective sensation of "heart beating" in the abdomen 2. A 60 year old male client comes into the emergency department with complaints of crushing substernal chest pain that radiates to his shoulder and left arm. The admitting diagnosis is acute myocardial infarction (MI). Immediate admission orders include oxygen by nasal cannula at 4 L/m, blood work, a chest radiograph, a 12-lead electrocardiogram (ECG), and a 2 mg of morphine sulfate given intravenously. The nurse should first: 3. If the client who was admitted for MI develops cardiogenic shock, which characteristic sign should the nurse expect to observe? a) oliguria b) bradycardia c) elevated blood pressure d) fever 4. The physician orders continuous intravenous nitroglycerin infusion for the client with MI. Essential nursing actions include which of the following? a) obtaining an infusion pump for the medication b) monitoring blood pressure every 4 hours c) monitoring urine output hourly d) obtaining serum potassium levels daily 5. When teaching the client with MI, the nurse explains that the pain associated with MI is caused by: a) left ventricular overload b) impending circulatory collapse c) extracellular electrolyte imbalances d) insufficient oxygen reaching the heart muscle 6. Aspirin is administered to the client experiencing an MI because of its: a) antipyretic action b) antithrombolytic action c) antiplatelet action d) analgesic action
After an MI. Which of the following is an uncontrollable risk factors that has been linked to the development of CAD? a) exercise b) obesity c) stress d) heredity 10. the hospitalized client is taught to move the legs about while resting in bed. Which of the following is an expected outcome for a client on the second day of hospitalization after an MI? The client: a) has minimal chest pain b) can identify risk factors for MI c) agrees to participate in a cardiac rehabilitation program d) can perform personal self-care activities without pain 8. The nurse's discharge teaching plan for the client with congestive heart failure would stress the significance of which of the following? a) maintaining a high-fiber diet b) walking 2 miles every day c) obtaining daily weights at the same time each day d) remaining sedentary for most of the day . Crackles heard on lung auscultation indicate which of the following? a) cyanosis b) bronchospasm c) airway narrowing d) fluid filled alveoli 11. In which of the following positions should the nurse place a client with suspected heart failure? a) semi-sitting (low-fowler's position) b) lying on the right side ( sim's position) c) sitting almost upright ( high fowler's position) d) lying on the back with the head lowered (trendelenburg position) 12. This type of exercise is recommended primarily to help: a) prepare the client for ambulation b) promote urinary and intestinal elimination c) prevent thrombophlebitis and blood clot formation d) decrease the likelihood of decubitus ulcer formation 9.7.
Essential hypertension would be diagnosed in a 40 year-old man whose blood pressure would be: a) 120/90 mmHg b) 130/85 mmHg c) 140/90 mmHg d) 160/80 mHg 14. The nurse explains to the client that this procedure is being used in this specific case to: a) open and dilate blocked coronary artery b) assess the extent of arterial blockage c) bypass obstructed vessels d) assess the functional adequacy of the valves and heart muscle 18. The primary goal for the client with Buerger's disease is to prevent a) embolus formation b) fat embolus formation c) thrombus formation d) thrombophlebitis . The most important long-term goal for a client with hypertension would be to: a) renal insufficiency and failure b) valvular heart disease c) endocarditis d) peptic ulcer disease 16. The physician refers the client with unstable angina for a cardiac catheterization. Which of the following symptoms should the nurse teach the client with unstable angina to report immediately to her physician? a) a change in the pattern of her pain b) pain during sexual activity c) pain during an argument with her husband d) pain during or after an activity such as lawn-mowing 17. The nurse understands that a priority nursing diagnosis for the client with hypertension would be: a) pain b) deficient fluid volume c) impaired skin integrity d) ineffective health maintenance 15.13.
The nurse realizes that the underlying etiology of Raynauld's disease is unknown but that is characterized by: a) episodic vasospastic disorder of the small arteries a) episodic vasospastic disorder of the small veins a) episodic vasospastic disorder of the capillaries a) episodic vasospastic disorder oof the aorta 22. Which of the following is an early sign of vasoconstriction? a) cyanosis b) gangrene c) pallor d) rubor 23. The client with Raynauld's disease complains of cold and numbness in her fingers. When helping a client change behavior it is important to know the client's: a) ability to attend support groups b) goals of the treatment c) perception of the behavior d) motivation 20. The nurse has been assigned to a client with Raynauld's disease. A client with Buerger's disease smokes two packs of cigarettes a day.19. The nurse assesses the client for effects of vasoconstriction. Which of the following clients is at risk for varicose veins? a) a client who has had a cerebral vascular accident b) a client who has had anemia c) a client who has had thrombophlebitis . Smoking cessation is critical or the client may lose the affected part. Raynauld's disease is known as arteriospastic disease and is seen most often in: a) young women b) old women c) old men d) young men 21. The nurse should instruct a client who has been diagnosed with Raynauld's disease to: a) immerse her hands in cold water during an episode b) wear light garments when the temperature gets below 50F (10C) c) wear gloves when handling ice or frozen foods d) live in cold climate 24.
Prolonged bed rest after surgery appears to promote hemostasis. particularly in th deep veins of the calves.d) a client who has had transient ischemia attack 25. The nurse realizes that a pacemaker is used in some clients to serve the function normally performed by the : . burning pain after to cold d) burning pain precipitated by cold exposure. The most likely pathologic result of such hemostasis may be thrombus formation and: a) cerebral embolism b) coronary occlusion c) pulmonary embolism d) dry gangrene of a limb 29. This would be evaluated by calculating the: a) force exerted against an arterial wall b) difference between the apical and radial rates c) difference between systolic and diastolic readings d) degree of ventricular contraction in relation to output 26. The nurse should teach the client that the stockings should be: a) alternately kept on 2 hours and off 2 hour b) Worn only at night when activity is lessened c) put on before getting out of bed in the morning d) left in place until the physician advises otherwise 30. the nurse would expect the client to demonstrate or report: a) easy fatigue of extremities. fatigue. The nurse should teach clients with peripheral vascular disease to stop smoking because nicotine: a) constricts the superficial vessels. causing a reflex constrictions of visceral vessels 27. continuous claudification b) general blanching of skin and intermittent claudification c) intermittent claudification. The nurse assesses that a client's pulse pressure is decreasing. dilating the deep vessels b) constricts the peripheral vessels and increases the force of flow c) dilates the superficial vessels but constricts the collateral circulation d) dilates the peripheral vessels. blanching of skin 28. When obtaining data from a client with thromboangitis obliterans (Burger's disease). A client is being instructed of the use of elastic stockings.
1. Chest X-ray machine b. In teaching a patient to take his own blood pressure. Which would be the best action for the nurse to implement? a. have the patient explain the importance of checking his blood pressure c. High-output electrical generators c. 1.2.3. 1 and 2 33. have the patient explain why he should learn how to take his own blood pressure 33. Metal detectors at airports 34. 2 and 4 c.a) AV node b) SA node c) bundle of his d) accelerator nerves to the heart 31. Give the client a break and then resume the exercise c. During a cardiac arrest. To prevent re-programming of an artificial cardiac pacemaker. A client with a history of chronic arterial occlusive disease complains of pain in the legs while walking. Which of the following health measures need to be carried out in the care of patients with hypertension? 1) refer to physician for proper management 2) encourage compliance to recommend schedule of blood pressure check up 3) follow-up patient to assure compliance to treatment 4) advise moderation in smoking and tobacco use a. and 4 d. a method of evaluation which could be used to measure achievement is: a. Stop the exercise and administer a narcotic . Continue the exercise b. and 3 b.2. ask the patient how would he take his blood pressure b. Microwave ovens’ d. the client should be instructed to avoid being near: a. observe the patient's ability to carry out procedure d. the nurse and the arrest team must keep in mind the: a) age of the client b) time the client is anoxic c) emergency medications available d) heart rate of the client before the arrest 32.
Lengthens the refractory phase of the cardiac cycle 40. Mild chest pain. the nurse would expect the client to describe it as: a. Tissue necrosis c. Maintain stress levels 38. A central venous pressure (CVP) reading of 3 cm H20 indicates to the nurse that the . An increased respiratory rate adds to postoperative pain 37. A squeezing chest pain. Risk factors to include in the nurse’s teaching plan are: a. radiating down to the fingers d. Pneumonia b.d. Severe. A client with congestive heart failure is placed on digoxin and asks the nurse why this is necessary. Slows and strengthens cardiac contractions d. A diet rich in saturated fats b. intense chest pain b. During the early postoperative period following open heart surgery. Regular exercise program of walking c. Reduce smoking to one-half or one pack a day d. This indicates: a. Two days following a myocardial infraction. The nurse bases the answer on the fact that digoxin: a. It is an important responsibility of the nurse to educate clients on reducing risk factors for coronary artery disease. Possible infection d. a client’s temperature is elevated. Hypoxia can stimulate dangerous dysrhythmias d. When assessing a client with a diagnosis of possible myocardial infarction for pain. Reduces edema in extracellular spaces c. A burning sensation of short duration c. Pulmonary infarction 36. Place the client on bedrest and notify the physician 35. Increases ventricular contractions b. adequate oxygenation is essential because: a. relieved by nitroglycerin 39. All clients have a chest tube in place b. Hypoxia can precipitate respiratory alkalosis c.
client is experiencing: a. Dehydration d. Pulmonary edema c. Cardiac decompression . Congestive heart failure b.
Exercise can help with weight and stress reduction... (for example...progressive exercise needs to be initiated to develop collateral circulation. walking) is suggested.blockage of myocardial blood supply causes accumulation of unoxidized metabolites that affect nerve endings and cause pain.. 29) c ... and electrical generators.....ANSWERS AND RATIONALE 33) B .. pulmonary edema and cardiac decompression.. 30) b 31) b. by altering the electrophysiologic properties of the heart.... but regular exercise is most important.. Microwave ovens will not interfere with the pacemaker.... The client should be advised to stop smoking. such as magnets..the clients needs to avoid sources of strong electromagnetic fields. 27) c . slows the heart rate (negative chronotropic effect). 24) c .... The CVP will be elevated in CHF. telecommunications transmitters. Metal detectors are safe. 38) A . 34) B .digoxin increase the strength of myocardial contractions (positive inotropic effect) and..... This strengthens and conditions the heart muscles and other muscles of the body...the body’s general inflammatory response to myocardial necrosis causes an elevation of temperature as well as leukocytosis within 24 to 48 hours.this low value reflects a drop in circulating fluid volume. 33)) c . ANSWERS: 21) a . 23) c . 25) c 26) b . since this puts him at risk for CAD.. 28) c . Pain is due to ischemic muscle and is relieved by resting...regular exercise. 36) C .. The client should be advised about how to manage stress.. 39) C . 22) c . 35) B .inadequate oxygenation can cause premature ventricular beats 37) B . 32) a .... Clients with pacemaker can have chest x-rays when necessary. 40) C ...
......... 19) c ...........12) c .. 8) c .. 2) a . 5) d 6) b . 7) d . 9) d . 15) b 16) a ......... 17) b . 10) d 11) c .................. 3) a . 13) c . 20) b ....ANSWERS: 1) b . 14) d ... 4) a .... 18) c ...