Chapter 48: Care of the Patient With a Cardiovascular or a Peripheral Vascular Disorder Cooper: Foundations and Adult Health Nursing, 9th Edition

The nurse is aware that which layer is the muscle layer of the heart, which is responsible for the heart’s contraction?

d. myocardium.

The nurse clarifies that which is the area of the heart that normally initiates electrical impulses?

c. sinoatrial (SA) node.

The nurse is aware that the symptoms of an impending myocardial infarction (MI) differ in women because acute chest pain is not

present. Women are frequently misdiagnosed as having which disorder?

b. indigestion.

The nurse identifies the “lub” sound of the “lub/dub” of the cardiac cycle as the sound of which event?

a. AV valves closing.

A patient is admitted from the emergency department. The emergency department health care provider notes the patient has a

diagnosis of heart failure with a New York Heart Association (NYHA) classification of IV. This indicates the patient has which

class of heart failure?

b. severe heart failure.

The nurse assesses that the home health patient has no signs or symptoms of heart failure, but does have a history of rheumatic

fever and has been recently diagnosed with diabetes mellitus. The nurse is aware that using the American College of Cardiology

and the American Heart Association (ACC/AHA) staging, this patient would be in which stage?

a. stage A.

The nurse caring for a patient recovering from a myocardial infarct who is on remote telemetry recognizes the need for added

instruction when the patient makes which statement?

b. “I always take off the telemetry device when I shower.”

The nurse assesses pitting edema that can be depressed approximately 4 mm and refills in 15 seconds. The nurse would document

this assessment as:

b. +2 edema.

What do dark or “cold” spots on a thallium scan indicate?

d. Tissue that has inadequate perfusion

The nurse recognizes the echocardiogram report that shows an ejection factor of 42% as an indication of which situation?

c. moderate heart failure.

The nurse takes into consideration that age-related changes can affect the peripheral circulation because of which factor?

a. sclerosed blood vessels.

The nurse assessing a cardiac monitor notes that the cardiac complexes each have a P wave followed by a QRS and a T. The rate is

120. The nurse recognizes this as which arrhythmia?

c. sinus tachycardia.

After an influenza-like illness, the patient reports chills and small petechiae in his mouth and his legs. A heart murmur is

detectable. These are characteristic signs of which disorder?

d. infective endocarditis.

The nurse notes a run of three ventricular contractions (PVC) that are not preceded by a P wave. This particular arrhythmia can

progress into which complication?

c. ventricular tachycardia and death.

The nurse reminds the patient who is taking warfarin for the treatment of peripheral artery disease not to eat excessive green and

yellow vegetables for which reason?

c. Vitamin K in the vegetables counteracts the anticoagulant effect

A patient with unstable angina should be provided with instructions to avoid which activity?

d. Shoveling snow

The older adult patient with angina pectoris says she is unsure how she should take nitroglycerin when she has an attack. The nurse

should reinforce which instruction?

b. “If the pain is not relieved after three doses of nitroglycerin at 5-minute intervals,

call your health care provider and come to the hospital.”

A patient questions “Why all the fuss about a little high blood pressure? My father had it and he lived to be 65 years old.” The

nurse bases the answer, knowing that which complication can occur due to untreated blood pressure?

c. Increased risk of myocardial infarctions (MI) and stroke

What is the major cause of cardiac valve disease in past years?

a. Rheumatic fever

The patient has a total cholesterol of 190 with a high-density lipid (HDL) of 110 and a low-density lipid (LDL) of 80. The nurse

reinforces which instruction?

a. Good job! Continue with your low fat diet.

A patient, age 72, was admitted to the medical unit with a diagnosis of angina pectoris. Which is a characteristic signs and

symptoms of angina pectoris?

a. substernal pain that radiates down the left arm.

A patient admitted to the emergency room with a possible myocardial infarction (MI) has reports back from the laboratory. Which

laboratory report is specific for myocardial damage?

a. CK-MB

The patient, age 26, is hospitalized with cardiomyopathy. While assisting with data collection from the patient, the nurse recognizes

that the increased incidence of cardiomyopathy in young adults who have minimal risk factors for cardiovascular disease is related

to which factor?

a. Cocaine use

The patient has become very dyspneic, respirations are 32, and the pulse is 100. The patient is coughing up frothy red sputum.

What should be the initial nursing intervention?

c. Place patient upright with legs in dependent position to reduce the symptoms of

pulmonary edema.

The nurse caring for a patient recovering from a myocardial infarction (MI) administers stool softeners for which reason?

d. Reduce the necessity to strain at the stool to lessen the effect of Valsalva’s

maneuver

The nurse reminds the patient that the American Heart Association recommends a lipid study how frequently?

d. Every 4 to 6 years

During a health interview by the home health nurse, which patient report suggests left-sided heart failure?

a. “I have to sleep in my recliner and I have this hacking cough.”

The home health nurse caring for a patient with infective endocarditis overhears the patient making a dental appointment for an

extraction next month. Which question is most important for the nurse to ask?

b. “Have you contacted your health care provider about your dental appointment?”

A 70 year female patient arrives to the emergency department, reporting nausea, vomiting, fatigue and abdominal discomfort. The health care provider requests myocardial infarction (MI) protocols to begin. For which reason is this protocol beginning?

b. Women tend to have less classic symptoms of a myocardial infarction.

What is the difference between primary and secondary hypertension?

a. Secondary hypertension is caused by another disorder like renal disease.

The nurse is treating a patient who had a pacemaker inserted 8 years ago for the correction of atrial fibrillation. Which diagnostic

test may no longer be available to the patient because of this older model implanted device?

a. MRI

Which assessment would lead the nurse to examine the leg closely for evidence of a stasis ulcer?

b. Darker, thick and toughened skin on medial surface of the leg

What is the patient goal of the walking exercise program designed for the rehabilitation of a patient who had a myocardial

infarction (MI) 3 weeks ago?

a. Walk 2 miles in less than 60 minutes after 12 weeks.

The plan of care for a patient recovering from hip surgery mentions prevention of deep vein thrombosis (DVT). Which aspect of

the plan of care addresses this concern?

c. Assisting the patient to change positions frequently

Which intervention is appropriate for a patient who is experiencing an acute attack of Raynaud’s disease?

d. Place mittens on the hands and encourage the patient to move fingers.

The nurse reinforcing a teaching plan for a patient with Buerger disease (thromboangiitis obliterans) will focus on the need for

which change?

c. cessation of smoking.

Which statement would lead the nurse to offer more instruction about taking warfarin?

b. “I try to eat more green leafy vegetables, especially broccoli, spinach, and kale.”

The nurse caring for a 92-year-old patient with pneumonia who is receiving IV carefully monitors the flow rate of the IV infusion

because rapid infusion can cause which disorder?

d. heart failure.

The nurse making the schedule for the daily dose of furosemide would schedule the administration for which of the following

times?

d. In the morning

What is the third step in the impulse pattern of conduction through the heart?

b. Atrial-ventricular (AV) node

What is the second step in the path of blood through the coronary circulation?

a. Right atrium