Quiz
Chapter 29
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Questions in this quiz (40)
1The nurse notes that a patient has developed a cough productive for mucoid sputum, is short of breath, has cyanotic hands, and has noisy, moist-sounding, rapid breathing. These symptoms and signs are suggestive of what health problem?
- APericarditis
- BCardiomyopathy
- CPulmonary edema
- DRight ventricular hypertrophy
2The nurse is assessing an older adult patient with numerous health problems. What assessment datum indicates an increase in the patient’s risk for heart failure (HF)?
- AThe patient takes Lasix (furosemide) 20 mg/day.
- BThe patient’s potassium level is 4.7 mEq/L.
- CThe patient is an African American man.
- DThe patient’s age is greater than 65.
3The triage nurse in the ED is assessing a patient with chronic HF who has presented with worsening symptoms. In reviewing the patient’s medical history, what is a potential primary cause of the patient’s heart failure?
- AEndocarditis
- BPleural effusion
- CAtherosclerosis
- DAtrial-septal defect
4Which assessment would be most appropriate for a patient who is receiving a loop diuretic for HF?
- AMonitor liver function studies
- BMonitor for hypotension
- CAssess the patient’s vitamin D intake
- DAssess the patient for hyperkalemia
5The nurse is assessing a patient who is known to have right-sided HF. What assessment finding is most consistent with this patient’s diagnosis?
- APulmonary edema
- BDistended neck veins
- CDry cough
- DOrthopnea
6The nurse is caring for an adult patient with HF who is prescribed digoxin. When assessing the patient for adverse effects, the nurse should assess for which of the following signs and symptoms?
- AConfusion and bradycardia
- BUncontrolled diuresis and tachycardia
- CNumbness and tingling in the extremities
- DChest pain and shortness of breath
7A nurse in the CCU is caring for a patient with HF who has developed an intracardiac thrombus. This creates a high risk for what sequela?
- AStroke
- BMyocardial infarction (MI)
- CHemorrhage
- DPeripheral edema
8The nurse is caring for a 68-year-old patient the nurse suspects has digoxin toxicity. In addition to physical assessment, the nurse should collect what assessment datum?
- ASkin turgor
- BPotassium level
- CWhite blood cell count
- DPeripheral pulses
9The triage nurse in the ED is performing a rapid assessment of a man with complaints of severe chest pain and shortness of breath. The patient is diaphoretic, pale, and weak. When the patient collapses, what should the nurse do first?
- ACheck for a carotid pulse.
- BApply supplemental oxygen.
- CGive two full breaths.
- DGently shake and shout, “Are you OK?”
10A patient presents to the ED complaining of increasing shortness of breath. The nurse assessing the patient notes a history of left-sided HF. The patient is agitated and occasionally coughing up pink-tinged, foamy sputum. The nurse should recognize the signs and symptoms of what health problem?
- ARight-sided heart failure
- BAcute pulmonary edema
- CPneumonia
- DCardiogenic shock
11A patient admitted to the medical unit with HF is exhibiting signs and symptoms of pulmonary edema. The nurse is aware that positioning will promote circulation. How should the nurse best position the patient?
- AIn a high Fowler’s position
- BOn the left side-lying position
- CIn a flat, supine position
- DIn the Trendelenburg position
12The nurse has entered a patient’s room and found the patient unresponsive and not breathing. What is the nurse’s next appropriate action?
- APalpate the patient’s carotid pulse.
- BIlluminate the patient’s call light.
- CBegin performing chest compressions.
- DActivate the Emergency Response System (ERS).
13The nurse is providing discharge education to a patient diagnosed with HF. What should the nurse teach this patient to do to assess her fluid balance in the home setting?
- AMonitor her blood pressure daily
- BAssess her radial pulses daily
- CMonitor her weight daily
- DMonitor her bowel movements
14The nurse is caring for an 84-year-old man who has just returned from the OR after inguinal hernia repair. The OR report indicates that the patient received large volumes of IV fluids during surgery and the nurse recognizes that the patient is at risk for left-sided heart failure. What signs and symptoms would indicate left-sided heart failure?
- AJugular vein distention
- BRight upper quadrant pain
- CBibasilar fine crackles
- DDependent edema
15A patient with HF is placed on a low-sodium diet. Which statement by the patient indicates that the nurse’s nutritional teaching plan has been effective?
- A“I will have a ham and cheese sandwich for lunch.”
- B“I will have a baked potato with broiled chicken for dinner.”
- C“I will have a tossed salad with cheese and croutons for lunch.”
- D“I will have chicken noodle soup with crackers and an apple for lunch.”
16The nurse’s comprehensive assessment of a patient who has HF includes evaluation of the patient’s hepatojugular reflux. What action should the nurse perform during this assessment?
- AElevate the patient’s head to 90 degrees.
- BPress the right upper abdomen.
- CPress above the patient’s symphysis pubis.
- DLay the patient flat in bed.
17The nurse overseeing care in the ICU reviews the shift report on four patients. The nurse recognizes which patient to be at greatest risk for the development of cardiogenic shock?
- AThe patient admitted with acute renal failure
- BThe patient admitted following an MI
- CThe patient admitted with malignant hypertension
- DThe patient admitted following a stroke
18When assessing the patient with pericardial effusion, the nurse will assess for pulsus paradoxus. Pulsus paradoxus is characterized by what assessment finding?
- AA diastolic blood pressure that is lower during exhalation
- BA diastolic blood pressure that is higher during inhalation
- CA systolic blood pressure that is higher during exhalation
- DA systolic blood pressure that is lower during inhalation
19The cardiac monitor alarm alerts the critical care nurse that the patient is showing no cardiac rhythm on the monitor. The nurse’s rapid assessment suggests cardiac arrest. In providing cardiac resuscitation documentation, how will the nurse describe this initial absence of cardiac rhythm?
- APulseless electrical activity (PEA)
- BVentricular fibrillation
- CVentricular tachycardia
- DAsystole
20The nurse is reviewing a newly admitted patient’s electronic health record, which notes a history of orthopnea. What nursing action is most clearly indicated?
- ATeach the patient deep breathing and coughing exercises.
- BAdminister supplemental oxygen at all times.
- CLimit the patient’s activity level.
- DAvoid positioning the patient supine.
21The nurse is planning the care of a patient with HF. The nurse should identify what overall goals of this patient’s care?
- AImprove functional status
- BPrevent endocarditis
- CExtend survival
- DLimit physical activity
- ERelieve patient symptoms
22A patient with HF has met with his primary care provider and begun treatment with an angiotensin-converting enzyme (ACE) inhibitor. When the patient begins treatment, the nurse should prioritize what assessment?
- ABlood pressure
- BLevel of consciousness (LOC)
- CAssessment for nausea
- DOxygen saturation
23The nurse is reviewing the medication administration record of a patient diagnosed with systolic HF. What medication should the nurse anticipate administering to this patient?
- AA beta-adrenergic blocker
- BAn antiplatelet aggregator
- CA calcium channel blocker
- DA nonsteroidal anti-inflammatory drug (NSAID)
24The nurse is caring for a patient with systolic HF whose previous adverse reactions preclude the safe use of ACE inhibitors. The nurse should anticipate that the prescriber may choose what combination of drugs?
- ALoop diuretic and antiplatelet aggregator
- BLoop diuretic and calcium channel blocker
- CCombination of hydralazine and isosorbide dinitrate
- DCombination of digoxin and normal saline
25A patient with a diagnosis of HF is started on a beta-blocker. What is the nurse’s priority role during gradual increases in the patient’s dose?
- AEducating the patient that symptom relief may not occur for several weeks
- BStressing that symptom relief may take up to 4 months to occur
- CMaking adjustments to each day’s dose based on the blood pressure trends
- DEducating the patient about the potential changes in LOC that may result from the drug
26The nurse is performing a physical assessment on a patient suspected of having HF. The presence of what sound would signal the possibility of impending HF?
- AAn S3 heart sound
- BPleural friction rub
- CFaint breath sounds
- DA heart murmur
27An older adult patient with HF is being discharged home on an ACE inhibitor and a loop diuretic. The patient’s most recent vital signs prior to discharge include oxygen saturation of 93% on room air, heart rate of 81 beats per minute, and blood pressure of 94/59 mm Hg. When planning this patient’s subsequent care, what nursing diagnosis should be identified?
- ARisk for ineffective tissue perfusion related to dysrhythmia
- BRisk for fluid volume excess related to medication regimen
- CRisk for ineffective breathing pattern related to hypoxia
- DRisk for falls related to hypotension
28The nurse is performing an initial assessment of a client diagnosed with HF. The nurse also assesses the patient’s sensorium and LOC. Why is the assessment of the patient’s sensorium and LOC important in patients with HF?
- AHF ultimately affects oxygen transportation to the brain.
- BPatients with HF are susceptible to overstimulation of the sympathetic nervous system.
- CDecreased LOC causes an exacerbation of the signs and symptoms of HF.
- DThe most significant adverse effect of medications used for HF treatment is altered LOC.
29Cardiopulmonary resuscitation has been initiated on a patient who was found unresponsive. When performing chest compressions, the nurse should do which of the following?
- APerform at least 100 chest compressions per minute.
- BPause to allow a colleague to provide a breath every 10 compressions.
- CPause chest compressions to allow for vital signs monitoring every 4 to 5 minutes.
- DPerform high-quality chest compressions as rapidly as possible.
30The nurse is providing patient education prior to a patient’s discharge home after treatment for HF. The nurse gives the patient a home care checklist as part of the discharge teaching. What should be included on this checklist?
- AKnow how to recognize and prevent orthostatic hypotension.
- BWeigh yourself weekly at a consistent time of day.
- CMeasure everything you eat and drink until otherwise instructed.
- DLimit physical activity to only those tasks that are absolutely necessary.
31The nurse is educating an 80-year-old patient diagnosed with HF about his medication regimen. What should the nurse to teach this patient about the use of oral diuretics?
- AAvoid drinking fluids for 2 hours after taking the diuretic.
- BTake the diuretic in the morning to avoid interfering with sleep.
- CAvoid taking the medication within 2 hours consuming dairy products.
- DTake the diuretic only on days when experiencing shortness of breath.
32The nurse is addressing exercise and physical activity during discharge education with a patient diagnosed with HF. What should the nurse teach this patient about exercise?
- A“Do not exercise unsupervised.”
- B“Eventually aim to work up to 30 minutes of exercise each day.”
- C“Slow down if you get dizzy or short of breath.”
- D“Start your exercise program with high-impact activities.”
33The nurse is creating a care plan for a patient diagnosed with HF. When addressing the problem of anxiety, what interventions should the nurse include in the care plan? Select all that apply.
- AFacilitate the presence of friends and family whenever possible.
- BTeach the patient about the harmful effects of anxiety on cardiac function.
- CProvide supplemental oxygen, as needed.
- DProvide validation of the patient’s expressions of anxiety.
- EAdminister benzodiazepines two to three times daily.
34The critical care nurse is caring for a patient who is in cardiogenic shock. What assessments must the nurse perform on this patient? Select all that apply.
- APlatelet level
- BFluid status
- CCardiac rhythm
- DAction of medications
- ESputum volume
35A cardiovascular patient with a previous history of pulmonary embolism (PE) is experiencing a sudden onset of dyspnea, rapid breathing, and chest pain. The nurse recognizes the characteristic signs and symptoms of a PE. What is the nurse’s best action?
- ARapidly assess the patient’s cardiopulmonary status.
- BArrange for an ECG.
- CIncrease the height of the patient’s bed.
- DManage the patient’s anxiety.
36The nurse is caring for a patient who has developed obvious signs of pulmonary edema. What is the priority nursing action?
- ALay the patient flat.
- BNotify the family of the patient’s critical state.
- CStay with the patient.
- DUpdate the physician.
37A cardiac patient’s resistance to left ventricular filling has caused blood to back up into the patient’s circulatory system. What health problem is likely to result?
- AAcute pulmonary edema
- BRight-sided HF
- CRight ventricular hypertrophy
- DLeft-sided HF
38A patient who is at high risk for developing intracardiac thrombi has been placed on long-term anticoagulation. What aspect of the patient’s health history creates a heightened risk of intracardiac thrombi?
- AAtrial fibrillation
- BInfective endocarditis
- CRecurrent pneumonia
- DRecent surgery
39Diagnostic imaging reveals that the quantity of fluid in a client’s pericardial sac is dangerously increased. The nurse should collaborate with the other members of the care team to prevent the development of what complication?
- APulmonary edema
- BPericardiocentesis
- CCardiac tamponade
- DPericarditis
40The nurse is caring for a patient with severe left ventricular dysfunction who has been identified as being at risk for sudden cardiac death. What medical intervention can be performed that may extend the survival of the patient?
- AInsertion of an implantable cardioverter defibrillator
- BInsertion of an implantable pacemaker
- CAdministration of a calcium channel blocker
- DAdministration of a beta-blocker
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- Nursing (Cardiac) Quiz on Chapter 29, created by Jessica Levine on 06/10/2016.
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- Jessica Levine
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- English
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