Ree sc 1, What are non-madifiable risk factors for primary hypertension {select all * + point that eps)? @ ace d.cbesity G ccencer 2 cetniony Ge. conetic tine 2, How is seoondary hypertension differentiated from primary hypertension? O aties more getval onset then primar hyperenslen © b.dore not eave the target orgpn carnage that coc wn rary hypertension «Has a apeate cause, such a renal sease ta fen canbe tated by © Section eraurgey O Eb exsseayagereeted changes in BP regulatory mechariems in people over Syears of age 3, What isthe patient with primary hypestension tkely to repor™? * © 2.No sympteme © card peptions O c.byeones on exeion © aibicsinecs ae vertigo4, Priority Decision: A patient with stage 2 hypertension who is taking * 1 port hydroohlorothtaziee (HydreDiuril) and lisinapsilPrinivid has prazosin (Minipress) added to the medication regimen. What is most important for the nurse to teach the patient to do? © a. Weigh every morning to monitor for fukd retention O b. Change postion slowly and svold prolonged standing O elise ugaress gum or oancy ta help relieve dry mouth © 4 Take the pulse dey to note any slowing ofthe heat rate 5. A 38-year-old man is treated for hypertension with triamterene andl * pone hydrochlorethazide (Maxclde) and metaprolol(L opreaser}. Faur months after his last clinic visi, his BP returns to preveatment levels and hie admits he has not beentaking his medication requlatty. What Is the nurse's hest response to this patient? OB Tyaeys to take your mesication when you camyout another daly routine 89 youdo not forget to take it ». "You provebly would not reed to tale medlleatlone far hypertension you would © crerctse more andl stop smoking! © &Tre drugs youae tating cause seal dyetunetion In many patlnts Are you experiencing any problems inthis area?” © & "You need to remember that hypertension can be only contrelled with medication, not cured, ane! you must always take your medication.” 6. 78-year-old patient Is admitted with & BP of 180/98 mm Hy. Which age-* + pine ‘elated physical changes may contibuteto this patient's hypertension (elect all that apply)? (=. Decreased renal functlon d, Increased adrenergic receptor senlity (@ Inereased barcreceotor reflexes e. Increased collagen and stifnese of he myocarcium c. Increased peripheral vascular resistance f, Loss of elasticity in large arteries from antertosolerasis7. What shauld the nurse emphasize when teaching a patient wha Is newly. * + point prescribed clonidine (Catapres)? © a: The drug should never be stopped abruptly. O be The crug should be taken early inthe day to prevent nocturia, © @ The first dose should be taker when the patient isin bed for the night. d. Because aspitin will decrease the crug’s effectiveness, Tylenol should be used instead, 8, What is included in the carrect technique for BP measurements? ~ 1 pont © a. Always take the EP on both arms O b.Pesition the patient susine forall readings O ePlace the cuit loosely around the upper arm © Toke readings at least wo times at least 1 minute apart 9. Which manifestation is an indication that a patient is having a hypertensive emergency? O a Symptoms ata stroke with an eleveted BP O b.A systolic BP 200 mm Hg and a clastolle EP #120 mm Hg © ©.A sueden tise n BP accompanied by neurologle Imeakment © Ga severe elevation of BP that occurs over several days or weeks 10. During treatment of a patient with a BP of 222/148 mm Hg and * point confusicn, nausea, and vomiting, the nurse initiallytitrates the medications toachieve which goal? @ a Decrease the mean arterial pressure (MAP) 10 129 mm HgCee Which patents most hey to bein the ious stage of devsopment of tore otonary artery soa (CAD)? © 2#-Aee 4 omaus aareredo the coronary ay © Ace 5, pid onset of oeese win ypercholastrlenia © o-Aee22 tehened corona esl walle wth neared vessel Linen © 519, shvte owe popctaln (LL) sole pat le mosh russe cell 2.¥ha accurately descbes te pathophysiology of AD? * © Raila tl cela ofthe steamy ae osc ee tage of "oie firous plsque @ Petal atc ay ncaa y chart hat uh, hretbdeia or by tobneco use © Rill celina se stony ation nce lyfe west ‘he young pati wih CAD © fT near aerogenes popes hat het a fy day rhe ae the basic ures covers of aheroecereis. 3. Whip cotining patent store, which paint doce tno mrs ony ae set having the highest sk fr CAD? © Anite man, ge 5 nho a a emoker and ho a sect ese @ DA wie woman age 6h th 3 oF 72/00 mH ane wo ey (San hn crn age 45 wh aches kl of 240 mya AEP ot ‘sarang (© han abtee Aan Arete, age 65 nhs cholestrol tel 95 pla Sra BP of MNS4, Priority Destsion: While teaching women about the risks and incidence of * + ssst CAD, what does the nurse emphasize? © 2 Smoking is not a significant a risk factor for GAD n women as tis in men. © bomen seletestment s2cnerthan men wen te have symtoms of CAD. © Estrogen replacement iherepy in poeimengpaeel women decreases ihe ik for CAD, @ Si OAVie te leacing cave of geath in women wih a ger meray ree aie Mlthan inmen, '5, Which characteristics are associated with LDLs (select all that applyy? * + soit Oa tnereeses with exercise @ b Contains the most cholesterel [Has an aft for arterial walls 1 €.centeslnte aviey Fem errs te ver © & High terete correlate most closely wth CAD i The hignerthe level the lower te ik for OAD 66. Which sevurn lipid elevation, alang with elevated LDL, Is stiongly asedolated with CAD? O @ Apolipopreteins © Fasting riglyeertees © Total serum cholesterol O Higndtensty ineprotein HDL}7. Miyccarlal Ischemia occurs as a result of Increased axggen demand and * 0 deceased oxygen supply. What factors andisorders result in increased coeygen demand (Select al that apy)? 2 Hypovolerta and enema G » Inorensescorice woredend vith eon stenosle Gc. Nerrowes coronary eneres from sheroecleroste (4. Anaine inthe peters wth aneroeclerete coronary ereny = Left ventricular hypertrophy caused by chronic hypertension [2 1. Sympstetionersous eyetem stirulatin by drs, emetions, er exertion ©, What causes the pan that accurs with myocardial Ischewnla? * paint © a best of myocardial issue © 2» Dycinytinias cause by eller iritebiy © Lacie actd accumulation durhyg anaeroble metals Od. eleveted ressure in the venticles and pulmonary vessels 9. What tes of angina can accurin the absenoe of CAD eelect al that ppl)? 1D aster ischemia CO 2 Noctunal angina Gc. mnzmerats engine et Microvascular engine (0 e.chronis ciate angina110, Which characteristics describe unstable angina (select all that apphy?~ suit C2 tsxally preciphatei by exertion Gb Urpredictse and unvelioved by rest G ©. characterized by progreceive ceverty Oy 6. cccurs enty when the person fs recumbent C1 « tevaly occurs in responce i coronary artery spasmThe cnc 11. Which of the following is the most common symptom of myocardial —* spot infarction (ey? © a.chest pal O b.dyspnea O c.tdeme O 4.Palptetions 2. An intravancus analgesic frequently administered to ralieve chest pain * spot associated with Ml is: © 2. Meperane roche O b.Hiromomphone harocttonc © c.Merpine sultete © a.cedeine sue 8. The classic ERG changes that accur with an Ml include all of the following excopt: © ean ansert Pweve O b.An abromal @ wave O Fave invereion © 4ST segmen eleven4, Wéhich of the following statements about myocardial infarction pain is ~ | vaiit incorrect? © aris telieves by rest are acs. CO aittis-substemal in ecation. © eittis suecen in onset and prolonged in duration, © 4. ttks viselike ane adiates 1p the shoulders and arms, 5, Myocardial cell damage can be rected hy high levels af cardiac ‘enzymes. The cardiac-specific lscenzyme Is © = -Alkeline phosphatase © creatine kinase (CK ME} O 2. yoglonin © 4. Treponin 6. A patient admitted to the hospital for evaluation of chest painhhas no * | sou abnormal sum cardiac marke's 4 hows after the onset of pain, What noninvasive diagnostic test can be used to differentiate angina from other types of chest pain? O 2. 1aleaaees © 2. kreccee evess test © 2. Coronary enaiosram © 6. Transesophageal echocerdlocram7A 82:year-old man is admitted to the emaryency dapartarant with seer ~ » pore chest pain, On what basis would the nurse suspect an MI? © ate hes pale, occ. clammy skin. © bitte repsms nausee and vomiee onee at home. O ete says tei enous and has feeling of impending doom © 6.He reports ne hashed no relief te ain with rest or poston chenge. 2, Atwhat pointin the healing process ef the myceardium following an * y pore infarct does early scar tissue result in an unstable heart wall? © a.2t03days airs © bate 10 ays afer Mt © c.1010 14eaye aterm O «.veels ater i 9, To detect and treat the most common complication of Ml, what should + por the nurse do? © a.teasure hourly urine outa © b.Auscultate the crest for ereiles, © c.ttee continsous sariac monterng. O 6: Take ital egns every 2 nous forthe fret hours.10. Which treatment is used first for the patient with a confirmed MI to open * + point the blacked artery within 99 minutes of arrival to the facility? © a. Stent placement O b. Coronary artery bypass grafi (CABG) @ ©. Percutaneous coranary Intervention @CH) O 4. Trans myocarcial laser revascularization (TMR)Ree 1. Wihich statements accurately describe heart failure (select all that apply)? * prs @ ®.Acommon cause of diastole felure is lt vertouler hyperitophy. @ ®.Apamary risk factor for hear fellure Is caranary artery esease (CAD) 6, Systolic heart fatlure results in a normal left veririgular ejection fraction, O «. systole felue is enaractertzed by abnormal resistance to verculer filing. Sibipevolemia petniaes heart ele by ceereaing cor ouput ane Inereasing oxygen consumo. 2, What describes the action of the natriuretic peptides and nitric oxide in * 1 point {heir counter regulatory processes in response ta heart failure (HF)? © a.Bieretion ofpatacsium © btnoreased release of ADH © «.Vasocilation end decreased blood pressure O 4.deereasee slomenilr filtration te and edeme 8, The acronym FACES is used to help educate patients to identify powe symptoms of heart fallure. What does this aerenym mean? © a. Frequent seth leads to cough inthe eke an evelling (© bFactors of isk activity cough emotional upsets, salt intake © «Follow activity alan corrinae exercise, and know las f rolems © SFaious, imitation of ecvties, chest cengestioneough, exema,shoriness of breeth4, What is the pathophysiologic mechanism that results in the pulmonary * 1 sain: edema of left-sided heart failure? © aitncreased right ventricular preload © buincressed pulmonary hydrostatic pressure O clmpaired atvectar oxygen are cerbon eloxide exchenge © 4 Increased limphatic flow of pulmonary extravascular fluid '5, Which initial physical assessment finding would the nurse expect to he * 1 point present in a patient with acute left-sided heart failure? © «Bubbling crackles and tachycardia b, Hepatosplenomegaly and tachyones © c Peripheral edema and cool, dlaphorerie skin ¢. Frothy blooeHinged sputum and clistended juguler veins 6. A patient with chronic heart failure has avial fibrillation and a left * Toone ventricular ejection fraction (LVEF) of 18%, Ta decrease the risk of complications fram these canditions, what drug does the nurse anticipate aiving? O a.Diurettos © b- Anticoagulants O c.B-terenerale blockers © «Potassium supslements7. Which diagnostic test is most useful in differentiating dyspnea related to * 1 pairt pulmonary effects of heart failure from dyspnea related to pulmonary disease? O @.Brereise stress testing O Cardiac catheterization © ©. Biype norriretie peptide (EN) levels O 4 Peterminetion of alocd urea nitrogen ¢BUN} 8. Which medication is currently appraved only for use with African American patients for hypertension and angina? © @.Captooril (Cepoten) O b.Niraglycerin iro Bie) O e.Spironolactone (Alsactone} © .teoscrbide cintate and hycratazine iD) 9A patientis admitted to the emergency department with acute 7 paint decompensated heart failure (ADHF). Which IY medication would the nurse ‘expeot to administer first? O & bigoxin Lancair} © b-Morpnine sufate © c.Nesittide (Norrecor) © <.Bumetenide (Eumes)10. The pationt with chronic heart ng discharged with a diuretic, * 1 so: 4 cenin-angiotensin aldosterone system (RAS) inhibitor and a f-adrenergic blocker. When recelved fromm the pharmacy, which medication should net be Included for this patient? © arteseran iGozner) O hconceitol Coreg) © c.Wopamine dvrepin) © <.tiyercontoretiaaee HCTZ)(VASCULAR DISORDER) 11. When obtaining a health history fram a 72-year-old man with peripheral * + poi arterial disease (PAD) of the lower extremities, the nurse asks about a histary of related conditions, Including © a.venove thremboets O bivenous stesis ulcers. © pulmonary emoctsm, ® 4.coranary artery disease (CAD). 2. Following teaching about medications for PAD, the nurse determines that ~ 1 point additional instructicn is necessary when the patient makes which statement? © @-"Ishouled take one espitin @ dey to prevent clrting in my legs © Pe The lisinopril use for my Blood pressure may help me wall further without ain? © © tnilreed to have frequent blood tests to evaluate the effet ofthe Coumecin will be takinge © ti Pletal should help me inerease my waking distance ons help ereventclote from forming in my legs 3. Apatient with PAD has a nursing diagnosis of ineffective peripheral * 1 point tissue perfusion, Wat should be included in the teaching plan for this palient (select all that apply)? a, Keep legs and feet warm, Ob. Apply coll compresses when the legs become swollen. . Walk at least 39 minutes per day 10 the point of aiscomfor. 1 4.Use nicotine replacement therapy a8 a supstityte for smoking. . Inspect lower extremities for pulses, temperature, end any4, When teaching the patient with PAD about modifying risk factors * 1 avint associated with the condition, what should the nurse emphasize? © BAnoutation fs the ultimate outocme ithe patient des not alter lifestle behaviors. b, Modifications will reduce the risk of other atheroscleroiic conditions such as. stroke. O SRiskrecticing behaviors initiated after angioplasty can stop the progression of the disease. 6. Maintenance of notmel body weight is the most important factor in controlling arterial disease. 5, During care of the patient fallowing femoral bypass graft surgery, the * 4 port nurse immediately notifies the health care provider if the patient experiences © atever and redness at the incision site. © b. 2+ edema of the extremity and pain at the incision site. @ c.alves of palpable pulses and numbness and tingling of the feet. © increasing ankle-brachial indices and serous drainage fram the incision. 6, What are characteristic of artericspastic disease (Raynaud's * 1 point phenomenon) (select all that apply)? @, Predominant in young females b. May be aesoclated with autoimmune disorders c. Precipitated by exposure to cold, caffeine, and tabacco ¢. Involves smell cutaneous arteries of the fingers and toes: CO «. Inflammation of small and medium-sized arteries and veins @ £. Episodes involve white, blue, and red color changes of fingertips7. Which aneurysm is uniform in shape and a circurnferential dilation of the * 1 poi artery? O avFelse aneurysm O bPseuccaneurysm © e-snecular aneurysm © .Fusitarm areuyem 8. A surgical repair is planned fora patisnt who has a §.5:em abdominal * 1 pars aortic aneurysm (AAA). On physical asseesment of the patient, what should the nurse expect to find? © aHoarseness and sysphagia © bi Severe back pain with Tank ecchymosis © c.Presence ofa brult nthe pedumbilical erea © 4. Wieokness in he lower exremmles progressing o paraplegia 9. A thoracic aortic aneurysm Is found when a patient has @ routine chestxe * 1 pois ray. The nurse anticipates that additional diagnostic testing to determine the size and stucture of the aneurysm will Include which test? © eAngiogropty O buttrascnography O ckonocerdioarepry © computed tomography (7 seen10. A patient with a small AAA is nota good surgical candidate. What * 1 point should the nurse teach the patient is one of the hest ways to prevent expansion of the lesion? © a. Avold strenucus physical exertion. © b. Control hypertension with prescribed therapy. © . Comply with prescribed anticoagulant therapy. © d.Maintain e lowcalcium set to prevent calcification of the vesselRDN OD ens ee Une eA 1.4 20-year-old patient has acute infective endocarditis. While obtaining a = + point nursing history, what shauld the nurse ask the patient about (elect all that apply)? 2, Renal dialysis b.IV drug abuse Recent dental work 4, Cardiae catheterization , Recent urinary tract infection 2. Apallent has an admitting diagnosis of acute left-sided infective * point endocarditis. What is the best test to confirm this diagnosis? © 2.Blood cultures © d.complete blood count © c.cardize catheterization © «.Transecophageal echocardiogram 3. Which manifestation of infective endocarditis is a result of fragmentation ~ 5 point and micrembolization of vegetative lesians? © 2 Petechiee © Rotts spore O 2.0sler noses O 4.Splinter hemenhages4. What describes Janeway’s lesions that are manifestations of infective * 1 pain endacardi O a Hemorrhagic retinal lesions © b.Black longitudinal streaks in nail beds CO . Painful red or purple lesione on fingers or oes © 4. Flat red painless spots on the palms of hands ard soles of feet 5. The patient with acute pericarditis Is having a pericardiocentesis. Postoperatively what complication should the nurse manitar the patient for? © a.Pneumonia © b.Pneumothorax © 6. Myocardial infarction (Mb CO 4. Cerebrovascular accidem (CVA) 6. Priority Decision: A patient with acute pericarditis has a nursing * 4 point diagnosis of pain related to pericardial inflammation. What is the hest nursing intevvention for the pationt? © a. Administer opivids as prescribed on an around-the-clock schedule, © b. Promote progressive relaxation exercises with the use of deep, slow breathing. © Position the patent onthe right sie with the head ofthe bed elevated 18 degrees. @ {Postion the patient in Fowler's postion witha paced overshebed table forthe patient to lean on,7. When obtaining a nursing history for a patient with myocarditis, what —* 4 point should the nurse specifically question the patient about? © a.Prior use of digoxin for treatment of cardiac protlems @ b. Recent symatoms of a viral illness, such as fever and melaise © c.Abistory of coronary ertery disease (CAD) with or without an MI O 4.Arecent streptococcal infection requiring treatment with penicillin 8. Priarity Decision: What is the most important role of the nuree in * 1 point preventing rheumatic fever? © a. Teach patients with infective encocarditis to adhere to antibiotic prophylaxis. nts with valvular heart disease who are at risk for rheumatic fever. O ba. bentify pe © eEncovrage the use of antibiotios for reatment ofall infections involing a sore throat. @ «Promote he early ciagresis and immediate reetment cf group A streatococcal pharyngitis. 9. What manifestations most strongly support a diagnosis of acute * 1 point theumatic faver? © 2 Carditis, polyarthritis, and erythema marginatum CO »b Polyarthritis, chorea, and decreased anti-streptolysin (i siter O «a. Organic heart murmurs, fever, and elevated erythrocyte sedimentation rate (ESR) CO “Posttve Creactive protein, elevated white blood cells (WECs), and subcutaneous nodules10. A patient with rheumatic heart disease with carditis asks the nurse how =) cot Jang his activity will he restricted. What is the best answer by the nurse? O -». Full activity willbe allowed 2 socn as acute sympiams have subsided!” © b "Bes rest wil be continvec until symptoms of heart faire ere contrelled* O 6. ‘Nonstrenuous aetivities can be performed as soon 3¢ antibiotics are started? d, ‘Bed rest must be meintained until antiinflemmetory therapy hes been discontinued.” 11. The patient Is admitted past-radiation therapy with symptams af scint cardiomyopathy (CMP). Which type of CMP should the nurse suspect that the patient Is experlencing? O a itses © b Restictive O e.Tekotsubo O 4.Hyperrophic “12, What accurately describes dilated OMP (select all that apply)? ~ CO a Characictized by verircular stiffness Cb. The least common type of cardiomyopathy Fe. The hyperimamic systolic function creates a diastolic feilure @ 4. Echocardiogram reveals cercicmegaly with thin venriouler walls @ «. Often follows an infective myocarditis or exposure to toxins or drugs (titers from ehrenke heer fllure in that tere is no ventricular hypertrophy13. When planning care for the patient with hypectraphic CMR what should * + soin: the nurce include? © @. Ventriculer pacing CO b. Administration of vasodilators ©@ «. Teach the patient to avoid strenuous activity and dehydration O 4. Surgery for cardiac transolantation will need to be done soon 14, When performing discharge teaching for a patient with any type of CMP, * + soin: what should the nurse instruct the patient to do (Select all that apply)? @ 2. Eat a low-sodium diet. bb. Go to the gym every day. c. Engage in stress reduction activities. 6, Abstain from alechol and caffelne intake, €. Avoid strenuous activity and allow for perlods of rest. @ £. Suggest that caregivers leam cardiopulmonary resuscitation (CPR). 15.4 patient admitted with acute dyspnea is newly diagnosed with dilated —* 1 point cardiomyopathy. Yhich information will the nurse plan to teach the patient about managing this disorder? © «&. Aheart transplant should be scheduled 2s scon as possible, © b. Elevating the legs above the heart will help relieve dyspnea, CO «. Gareful compliance with diet anc medications will prevent heart failure. <¢. Notify the doctor about any symptoms of heart feilure such as shoriness of breath.