Which medication, when given in heart failure, may improve morbidity and mortality? a. Dobutamine (Dobutrex) b. Carvedilol (Coreg) c. Digoxin (Lanoxin) d. Bumetanide (Bumex) Show
The health-care provider prescribes an angiotensin-converting enzyme (ACE) inhibitor for the client
diagnosed with essential hypertension. Which statement is the most appropriate rational for administering this medication? C. ACE inhibitors prevent vasoconstriction and sodium and water retention The home health nurse visits a client with heart failure who has gained 5 pounds (2.3 kg) in the past 3 days. The client states, “I feel so tired and short of breath.” Which action does the nurse take first? a. Assess the client for peripheral edema. b. Auscultate the client’s posterior breath sounds. c. Notify the health care provider about the
client’s weight gain. d. Remind the client about dietary sodium restrictions. b. Auscultate the client’s posterior breath sounds. Which diagnostic test result is consistent with a diagnosis of heart failure (HF)? a. Serum potassium level of 3.2 mEq/L (3.2 mmol/L) b. Ejection fraction of 60% c. B-type natriuretic peptide (BNP) of 760 pg/mL (760 ng/dL) d. Chest x-ray report showing right middle lobe consolidation c. B-type natriuretic peptide (BNP) of 760 pg/mL (760 ng/dL) A client begins therapy with lisinopril (Prinivil, Zestril). What does the nurse consider at the start of therapy with this medication? a. The client’s ability to understand medication teaching b. The risk for hypotension
b. The risk for hypotension The nurse is providing discharge teaching to a client with heart failure, focusing on when to seek medical attention. Which statement by the client indicates a correct understanding of the teaching? a. “I will call the provider if I have a cough lasting 3 or more days.” b. “I will report to the provider weight loss of 2 to 3 pounds (0.9 to 1.4 kg) in a day.” c. “I will try walking for 1 hour each day.” d. “I should expect occasional chest pain.” a. “I will call the provider if I have a cough lasting 3 or more days.” Which nursing intervention for a client admitted today with heart failure will assist the client to conserve energy? a. The client ambulates around the nursing unit with a walker. b. The nurse monitors the client’s pulse and blood pressure frequently. c. The nurse obtains a bedside commode before administering furosemide. d. The nurse returns the client to bed when the client becomes tachycardic. c. The nurse obtains a bedside commode before administering furosemide. How does the nurse in the cardiac clinic recognize that the client with heart failure has demonstrated a positive outcome related to the addition of metoprolol (Lopressor) to the medication regimen? a. Ejection fraction is 25%. b. Client states that she is able to sleep on one pillow. c. Client was hospitalized five times last year with pulmonary edema. d. Client reports that she experiences palpitations. b. Client states that she is able to sleep on one pillow. The nurse is caring for a client with heart failure. For which symptoms does the nurse assess? Select all that apply. a. Chest discomfort or pain b. Tachycardia c. Expectorating thick, yellow sputum d. Sleeping on back without a pillow e. Fatigue a. Chest discomfort or pain b.
Tachycardia e. Fatigue Which intervention best assists the client with acute pulmonary edema in reducing anxiety and dyspnea? a. Monitor pulse oximetry and cardiac rate and rhythm. b. Reassure the client that his distress can be relieved with proper intervention. c. Place the client in high-Fowler’s position with the legs down. d. Ask a family member to remain with the client. c. Place the client in high-Fowler’s position with the legs down. The nurse is caring for an 82-year-old client admitted for exacerbation of heart failure (HF). The nurse questions the client about the use of which medication because it raises an index of suspicion as to the worsening of the client’s HF? a. Ibuprofen (Motrin) b. Hydrochlorothiazide (HydroDIURIL) c. NPH insulin d. Levothyroxine (Synthroid) a. Ibuprofen (Motrin) The nurse is caring for a client with heart failure in the coronary care unit. The client is now exhibiting signs of air hunger and anxiety. Which nursing intervention does the nurse perform first for this client? a. Determines the client’s physical limitations b. Encourages alternate rest and activity periods c. Monitors and documents heart rate, rhythm, and pulses d. Positions the client to alleviate dyspnea d. Positions the client to alleviate dyspnea A client who has been admitted for the third time this year for heart failure says, “This isn’t worth it anymore. I just want it all to end.” What is the nurse’s best response? a. Calls the family to lift the client’s spirits b. Considers further assessment for depression c. Sedates the client to decrease myocardial oxygen demand d. Tells the client that things will get better b. Considers further assessment for depression A client with heart failure is taking furosemide (Lasix). Which finding concerns the nurse with this new prescription? a. Serum sodium level of 135 mEq/L (135 mmol/L) b. Serum potassium level of 2.8 mEq/L (2.8 mmol/L) c. Serum creatinine of 1.0 mg/dL (88.4 mcmol/L) d. Serum magnesium level of 1.9 mEq/L (0.95 mmol/L) b. Serum potassium level of 2.8 mEq/L (2.8 mmol/L) The nurse prepares to administer digoxin to a client with heart failure and notes the following information: Temperature: 99.8°F (37.7°C), Pulse: 48 beats/min and irregular, Respirations: 20 breaths/min, Potassium level: 3.2 mEq/L (3.2 mmol/L). What action does the nurse take? a. Give the digoxin; reassess the heart rate in 30 minutes. b. Give the digoxin; document assessment findings in the medical record. c. Hold the digoxin, and obtain a prescription for an additional dose of furosemide. d. Hold the digoxin, and obtain a prescription for a potassium supplement. d. Hold the digoxin, and obtain a prescription for a potassium supplement. A client admitted for heart failure has a priority problem of hypervolemia related to compromised regulatory mechanisms. Which assessment result obtained the day after admission is the best indicator that the treatment has been effective? a. The client has diuresis of 400 mL in 24 hours. b. The client’s blood pressure is 122/84 mm Hg. c. The client has an apical pulse of 82 beats/min. d. The client’s weight decreases by 2.5 kg. d. The client’s weight decreases by 2.5 kg. When following up in the clinic with a client with heart failure, how does the nurse recognize that the client has been compliant with fluid restrictions? a. Auscultation of crackles b. Pedal edema c. Weight loss of 6 pounds (2.7 kg) since the last visit d. Reports sucking on ice chips all day for dry mouth c. Weight loss of 6 pounds (2.7 kg) since the last visit After receiving change-of-shift report about these four clients, which client would the nurse assess first? a. A 46-year-old with aortic stenosis who takes digoxin (Lanoxin) and has new-onset frequent premature ventricular contractions (PVCs) b. A 55-year-old admitted with pulmonary edema who received furosemide (Lasix) and whose current O2 saturation is 94% c. A 68-year-old with pericarditis who is reporting sharp, stabbing chest pain when taking deep breaths d. A 79-year-old admitted for possible rejection of a heart transplant who has sinus tachycardia, heart rate 104 beats/min a. A 46-year-old with aortic stenosis who takes digoxin (Lanoxin) and has new-onset frequent premature ventricular contractions (PVCs) The nurse caring for a client with heart failure is concerned that digoxin toxicity has developed. For which signs and symptoms of digoxin toxicity does the nurse notify the provider? Select all that apply. a. Blurred vision b. Tachycardia c. Fatigue d. Serum digoxin level of 1.5 ng/ml (1.92 nmol/L) e. Anorexia a. Blurred vision c. Fatigue e. Anorexia The nurse discusses the importance of restricting sodium in the diet for a client with heart failure. Which statement made by the client indicates that the client needs further teaching? a. “I need to avoid eating hamburgers.” b. I must cut out bacon and canned foods.” c. “I won’t put the salt shaker on the table anymore.” d. “I need to avoid lunchmeats but may cook my own turkey.” a. “I need to avoid eating hamburgers.” A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure? a. “I have been drinking more water than usual.” b. “I am awakened by the need to urinate at night.” c. “I must stop halfway up the stairs to catch my breath.” d. “I have experienced blurred vision on several occasions.” c. “I must stop halfway up the stairs to catch my breath.” A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to the possibility of right-sided heart failure? a. “I sleep with four pillows at night.” b. “My shoes fit really tight lately.” c. “I wake up coughing every night.” d. “I have trouble catching my breath.” b. “My shoes fit really tight lately.” A nurse cares for a client with right-sided heart failure. The client asks, “Why do I need to weigh myself every day?” How should the nurse respond? a. “Weight is the best indication that you are gaining or losing fluid.” b. “Daily weights will help us make sure that you’re eating properly.” c. “The hospital requires that all inpatients be weighed daily.” d. “You need to lose weight to decrease the incidence of heart failure.” a. “Weight is the best indication that you are gaining or losing fluid.” A nurse is teaching a client with heart failure who has been prescribed enalapril (Vasotec). Which statement should the nurse include in this client’s teaching? a. “Avoid using salt substitutes.” b. “Take your medication with food.” c. “Avoid using aspirin-containing products.” d. “Check your pulse daily.” a. “Avoid using salt substitutes.” After administering newly prescribed captopril (Capoten) to a client with heart failure, the nurse implements interventions to decrease complications. Which priority intervention should the nurse implement for this client? a. Provide food to decrease nausea and aid in absorption. b. Instruct the client to ask for assistance when rising from bed. c. Collaborate with unlicensed assistive personnel to bathe the client. d. Monitor potassium levels and check for symptoms of hypokalemia. b. Instruct the client to ask for assistance when rising from bed. A nurse assesses a client after administering isosorbide mononitrate (Imdur). The client reports a headache. Which action should the nurse take? a. Initiate oxygen therapy. b. Hold the next dose of Imdur. c. Instruct the client to drink water. d. Administer PRN acetaminophen. d. Administer PRN acetaminophen. A nurse teaches a client who is prescribed digoxin (Lanoxin) therapy. Which statement should the nurse include in this client’s teaching? a. “Avoid taking aspirin or aspirin-containing products.” b. “Increase your intake of foods that are high in potassium.” c. “Hold this medication if your pulse rate is below 80 beats/min.” d. “Do not take this medication within 1 hour of taking an antacid.” d. “Do not take this medication within 1 hour of taking an antacid.” A nurse teaches a client who has a history of heart failure. Which statement should the nurse include in this client’s discharge teaching? a. “Avoid drinking more than 3 quarts of liquids each day.” b. “Eat six small meals daily instead of three larger meals.” c. “When you feel short of breath, take an additional diuretic.” d. “Weigh yourself daily while wearing the same amount of clothing.” d. “Weigh yourself daily while wearing the same amount of clothing.” A nurse admits a client who is experiencing an exacerbation of heart failure. Which action should the nurse take first? a. Assess the client’s respiratory status. b. Draw blood to assess the client’s serum electrolytes. c. Administer intravenous furosemide (Lasix). d. Ask the client about current medications. a. Assess the client’s respiratory status. After teaching a client who is recovering from a heart transplant to change positions slowly, the client asks, “Why is this important?” How should the nurse respond? a. “Rapid position changes can create shear and friction forces, which can tear out your internal vascular sutures.” b. “Your new vascular connections are more sensitive to position changes, leading to increased intravascular pressure and dizziness.” c. “Your new heart is not connected to the nervous system and is unable to respond to decreases in blood pressure caused by position changes.” d. “While your heart is recovering, blood flow is diverted away from the brain, increasing the risk for stroke when you stand up.” c. “Your new heart is not connected to the nervous system and is unable to respond to decreases in blood pressure caused by position changes.” A nurse cares for a client with end-stage heart failure who is awaiting a transplant. The client appears depressed and states, “I know a transplant is my last chance, but I don’t want to become a vegetable.” How should the nurse respond? a. “Would you like to speak with a priest or chaplain?” b. “I will arrange for a psychiatrist to speak with you.” c. “Do you want to come off the transplant list?” d. “Would you like information about advance directives?” d. “Would you like information about advance directives?” A nurse assesses a client who has a history of heart failure. Which question should the nurse ask to assess the extent of the client’s heart failure? a. “Do you have trouble breathing or chest pain?” b. “Are you able to walk upstairs without fatigue?” c. “Do you awake with breathlessness during the night?” d. “Do you have new-onset heaviness in your legs?” b. “Are you able to walk upstairs without fatigue?” A nurse cares for an older adult client with heart failure. The client states, “I don’t know what to do. I don’t want to be a burden to my daughter, but I can’t do it alone. Maybe I should die.” How should the nurse respond? a. “Would you like to talk more about this?” b. “You are lucky to have such a devoted daughter.” c. “It is normal to feel as though you are a burden.” d. “Would you like to meet with the chaplain?” a. “Would you like to talk more about this?” A nurse teaches a client with heart failure about energy conservation. Which statement should the nurse include in this client’s teaching? a. “Walk until you become short of breath, and then walk back home.” b. “Gather everything you need for a chore before you begin.” c. “Pull rather than push or carry items heavier than 5 pounds.” d. “Take a walk after dinner every day to build up your strength.” b. “Gather everything you need for a chore before you begin.” A nurse is assessing a client with left-sided heart failure. For which clinical manifestations should the nurse assess? (Select all that apply.) a. Pulmonary crackles b. Confusion, restlessness c. Pulmonary hypertension d. Dependent edema e. Cough that worsens at night a. Pulmonary crackles b. Confusion, restlessness e. Cough that worsens at night A nurse evaluates laboratory results for a client with heart failure. Which results should the nurse expect? (Select all that apply.) a. Hematocrit: 32.8% b. Serum sodium: 130 mEq/L c. Serum potassium: 4.0 mEq/L d. Serum creatinine: 1.0 mg/dL e. Proteinuria f. Microalbuminuria a. Hematocrit: 32.8% b. Serum sodium: 130 mEq/L e. Proteinuria f. Microalbuminuria After teaching a client with congestive heart failure (CHF), the nurse assesses the client’s understanding. Which client statements indicate a correct understanding of the teaching related to nutritional intake? (Select all that apply.) a. “I’ll read the nutritional labels on food items for salt content.” b. “I will drink at least 3 liters of water each day.” c. “Using salt in moderation will reduce the workload of my heart.” d. “I will eat oatmeal for breakfast instead of ham and eggs.” e. “Substituting fresh vegetables for canned ones will lower my salt intake.” a. “I’ll read the nutritional labels on food items for salt content.” d. “I will eat oatmeal for breakfast instead of ham and eggs.” e. “Substituting fresh vegetables for canned ones will lower my salt intake.” A nurse collaborates with an unlicensed assistive personnel (UAP) to provide care for a client with congestive heart failure. Which instructions should the nurse provide to the UAP when delegating care for this client? (Select all that apply.) a. “Reposition the client every 2 hours.” b. “Teach the client to perform deep-breathing exercises.” c. “Accurately record intake and output.” d. “Use the same scale to weigh the client each morning.” e. “Place the client on oxygen if the client becomes short of breath.” a. “Reposition the client every 2 hours.” c. “Accurately record intake and output.” d. “Use the same scale to weigh the client each morning.” A nurse prepares to discharge a client who has heart failure. Based on the Heart Failure Core Measure Set, which actions should the nurse complete prior to discharging this client? (Select all that apply.) a. Teach the client about dietary restrictions. b. Ensure the client is prescribed an angiotensin-converting enzyme (ACE) inhibitor. c. Encourage the client to take a baby aspirin each day. d. Confirm that an echocardiogram has been completed. e. Consult a social worker for additional resources. a. Teach the client about dietary restrictions. b. Ensure the client is prescribed an angiotensin-converting enzyme (ACE) inhibitor. d. Confirm that an echocardiogram has been completed. A nurse prepares to discharge a client who has heart failure. Which questions should the nurse ask to ensure this client’s safety prior to discharging home? (Select all that apply.) a. “Are your bedroom and bathroom on the first floor?” b. “What social support do you have at home?” c. “Will you be able to afford your oxygen therapy?” d. “What spiritual beliefs may impact your recovery?” e. “Are you able to accurately weigh yourself at home?” a. “Are your bedroom and bathroom on the first floor?” b. “What social support do you have at home?” d. “What spiritual beliefs may impact your recovery?” The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles, and the nurse suspects pulmonary edema. The nurse
immediately notifies the registered nurse and expects which interventions to be prescribed? Select all that apply. a. Administering oxygen b. Inserting a Foley catheter c. Administering furosemide (Lasix) d. Administering morphine sulfate intravenously A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. The nurse listens to breath sounds, expecting to hear which breath sounds bilaterally? A client is diagnosed with an ST-segment elevation myocardial infarction (STEMI) and is receiving tissue plasminogen activator, alteplase (Activase, tPa). Which action is a priority nursing intervention? c. monitor for signs of bleeding The nurse is monitoring a client who is taking digoxin (Lanoxin) for adverse effects. Which findings are characteristics of digoxin toxicity? SELECT ALL THAT APPLY. b. diarrhea d. blurred vision Prior to administering a
client's daily dose of digoxin, the nurse reviews the client's laboratory data and notes the following results: serum calcium, 9.8 mg/dL; serum magnesium, 1.2 mg/dL; serum potassium, 4.2 mEq/L; serum creatinine, 0.9 mg/dL. Which result should alert the nurse that the client is at risk for digoxin toxicity? A
client being treated for heart failure is administered intravenous bumetanide. Which outcome indicates the medication has achieved the expected effect? d. urine output increases from 10 mL/hour to greater than 50 mL hourly The nurse is conducting a health assessment of an older adult. The client tells the nurse about cramping leg pain that occurs when walking for 15 minutes; the pain is relieved with rest. The lower extremities are slightly cool to touch and pedal pulses are palpable +1. The nurse should instruct the client to: d. contact HCP lisinopril can lead to what electrolyte imbalance metoprolol and hydrochlorothiazide does what A client whose condition remains stable after a myocardial infarction gradually increases
activity. To determine whether the activity is appropriate for the client the nurse should assess the client for: A client is receiving spironolactone for treatment of bilateral lower extremity edema. The nurse should instruct the client to make which nutritional modification to prevent an electrolyte imbalance? c. Decrease foods high in potassium A client takes isosorbide dinitrate as an antianginal medication. Which statement indicates that the client understands the adverse effects of the drug? a. "I will need to change positions slowly so I will not get dizzy." b. "I should take my pulse before taking the medication." c. "I should take isosorbide dinitrate with food." d. "It is important that I report any swelling in my ankles." a. "I will need to change positions slowly so I will not get dizzy." A client has been taking furosemide for 2 days. The nurse should assess the client for: a) an elevated blood urea nitrogen (BUN) level. b) an elevated potassium level. c) a decreased potassium level. d) an elevated sodium level. c) a decreased potassium level. immediately following an aortobifemoral bypass graft assist pt with incentive spirometry When assessing a client with heart failure, the nurse should report which findings to the health care provider (HCP)? Select all that apply. E.) urine output 20 mL/hr F.) confusion A client with heart failure is given a prescription for torsemide. Two days after the drug therapy is started, the nurse evaluates the torsemide as effective when the client: b. weighs 7 lbs (3 kg) less than the client did 2 days ago. The provider requests the nurse start an infusion of an inotropic agent on a client. How does the nurse explain the action of these drugs to the client and spouse? a. "It constricts vessels, improving blood flow." b. "It dilates vessels, which lessens the work of the heart." c. "It increases the force of the heart's contractions." d. "It slows the heart rate down for better filling." c. "It increases the force of the heart's contractions." what is the priority problem in the pt diagnosed with CHF The client is admitted to the telemetry unit
diagnosed with acute exacerbation of congestive heart failure (CHF). Which signs/symptoms would the nurse expect to find when assessing this client? 1. Apical pulse rate of 110 and 4+ pitting edema of feet. The nurse is developing a discharge-teaching plan for the client diagnosed with congestive heart failure. Which interventions should be included in the plan? Select all that apply. 2. Teach client how to count the radial pulse when taking digoxin, a cardiac glycoside. 3. Instruct client to remove the saltshaker from the dinner table. The
nurse enters the room of the client diagnosed with congestive heart failure. The client is lying in bed gasping for breath, is cool and clammy, and has buccal cyanosis. Which intervention would the nurse implement first? 4. Assist the client to a sitting position. The nurse is assessing the client diagnosed with congestive heart failure. Which signs/symptoms would indicate that the medical treatment has been effective? 1. The client's peripheral pitting edema has gone from 3+ to 4+. 2. The client is able to take the radial pulse accurately. 3. The client is able to perform ADLs without dyspnea. 4. The client has minimal jugular vein distention. 3. The client is able to perform ADLs without dyspnea The nurse is assessing the client diagnosed with congestive heart failure. Which laboratory data would indicate that the client is in severe congestive heart failure? 1. An elevated B-type natriuretic peptide (BNP). 2. An elevated creatine kinase (CK-MB). 3. A positive D-dimer. 4. A positive ventilation/perfusion (V/Q) scan. 1. An elevated B-type natriuretic peptide (BNP). The health-care provider has ordered an angiotensin-converting enzyme (ACE) inhibitor for the client diagnosed with congestive heart failure. Which discharge instructions should the nurse include? 1. Instruct the client to take a cough suppressant if a cough develops. 2. Teach the client how to prevent orthostatic hypotension. 3. Encourage the client to eat bananas to increase potassium level. 4. Explain the importance of taking the medication with food. 2. Teach the client how to prevent orthostatic hypotension. The client diagnosed with congestive heart failure is complaining of leg cramps at night. Which nursing interventions should be implemented? 1. Check the client for peripheral edema and make sure the client takes a diuretic early in the day. 2. Monitor the client's potassium level and assess the client's intake of bananas and orange juice. 3. Determine if the client has gained weight and instruct the client to keep the legs elevated. 4. Instruct the client to ambulate frequently and perform calf-muscle stretching exercises daily. 2. Monitor the client's potassium level and assess the client's intake of bananas and orange juice. The nurse has written an outcome goal "demonstrates tolerance for increased activity" for a client diagnosed with congestive heart failure. Which intervention should the nurse implement to assist the client to achieve this outcome? 1. Measure intake and output. 2. Provide two (2)-g sodium diet. 3. Weigh client daily. 4. Plan for frequent rest periods. 4. Plan for frequent rest periods. Which cardiac enzyme would the nurse expect to elevate first in a client diagnosed with a myocardial infarction? 1. Creatine kinase (CK-MB). 2. Lactate dehydrogenase (LDH). 3. Troponin. 4. White blood cells (WBCs). Along with persistent, crushing chest pain, which signs/symptoms would make the nurse suspect that the client is experiencing a myocardial infarction? 1. Midepigastric pain and pyrosis. 2. Diaphoresis and cool clammy skin. 3. Intermittent claudication and pallor. 4. Jugular vein distention and dependent edema. 2. Diaphoresis and cool clammy skin. The nurse is caring for a client diagnosed with a myocardial infarction who is experiencing chest pain. Which interventions should the nurse implement? Select all that apply. 1. Administer morphine intramuscularly. 2. Administer an aspirin orally. 3. Apply oxygen via a nasal cannula. 4. Place the client in a supine position. 5. Administer nitroglycerin subcutaneously. 2. Administer an aspirin orally. 3. Apply oxygen via a nasal cannula. The client is one (1) day postoperative coronary artery bypass surgery. The client complains of chest pain. Which intervention should the nurse implement first? 1. Medicate the client with intravenous morphine. 2. Assess the client's chest dressing and vital signs. 3. Encourage the client to turn from side to side. 4. Check the client's telemetry monitor. 2. Assess the client's chest dressing and vital signs. The client diagnosed with a myocardial infarction is six (6) hours post-right femoral percutaneous transluminal coronary angioplasty (PTCA), also known as balloon surgery. Which assessment data would require immediate intervention by the nurse? 1. The client is keeping the affected extremity straight. 2. The pressure dressing to the right femoral area is intact. 3. The client is complaining of numbness in the right foot. 4. The client's right pedal pulse is 3+ and bounding. 3. The client is complaining of numbness in the right foot. The nurse is administering a calcium channel blocker to the client diagnosed with a myocardial infarction. Which assessment data would cause the nurse to question administering this medication? 1. The client's apical pulse is 64. 2. The client's calcium level is elevated. 3. The client's telemetry shows occasional PVCs. 4. The client's blood pressure is 90/62. 4. The client's blood pressure is 90/62. The client diagnosed with a myocardial infarction is on bedrest. The unlicensed assistive personnel (UAP) is encouraging the client to move the legs. Which action should the nurse implement? 1. Instruct the UAP to stop encouraging the leg movements. 2. Report this behavior to the charge nurse as soon as possible. 3. Praise the UAP for encouraging the client to move legs. 4. Take no action concerning the UAP's behavior. 3. Praise the UAP for encouraging the client to move legs. The client diagnosed with a myocardial infarction asks the nurse, "Why do I have to rest and take it easy? My chest doesn't hurt anymore." Which statement would be the nurse's best response? 1. "Your heart is damaged and needs about four (4) to six (6) weeks to heal." 2. "There is necrotic myocardial tissue that puts you at risk for dysrhythmias." 3. "Your doctor has ordered bedrest. Therefore, you must stay in the bed." 4. "Just because your chest doesn't hurt anymore doesn't mean you are out of danger." 1. "Your heart is damaged and needs about four (4) to six (6) weeks to heal." The client with coronary artery disease asks the nurse, "Why do I get chest pain?" Which statement would be the most appropriate response by the nurse? 1. "Chest pain is caused by decreased oxygen to the heart muscle." 2. "There is ischemia to the myocardium as a result of hypoxemia." 3. "The heart muscle is unable to pump effectively to perfuse the body." 4. "Chest pain occurs when the lungs cannot adequately oxygenate the blood." 1. "Chest pain is caused by decreased oxygen to the heart muscle." The client is scheduled for a right femoral cardiac catheterization. Which nursing intervention should the nurse implement after the procedure? 1. Perform passive range-of-motion exercises. 2. Assess the client's neurovascular status. 3. Keep the client in high Fowler's position. 4. Assess the gag reflex prior to feeding the client. 2. Assess the client's neurovascular status. Which client teaching should the nurse implement for the client diagnosed with coronary artery disease? Select all that apply. 1. Encourage a low-fat, low-cholesterol diet. 2. Instruct client to walk 30 minutes a day. 3. Decrease the salt intake to two (2) g a day. 4. Refer to counselor for stress reduction techniques. 5. Teach the client to increase fiber in the diet. 1. Encourage a low-fat, low-cholesterol diet. 2. Instruct client to walk 30 minutes a day. 4. Refer to counselor for stress reduction techniques. The nurse identifies the concept of perfusion for a client diagnosed with congestive heart failure. Which assessment data support this concept? 1. The client has a lard abdomen and a positive tympanic wave. 2. The client has paroxysmal nocturnal dyspnea. 3. The client has 2+ glucose in the urine 4. The client has a comorbid condition of MI 2. The client has paroxysmal nocturnal dyspnea. The nurse is caring for a client who suddenly complains of crushing substernal pain while ambulating in the hall. Which nursing action should the nurse implement first? 1. Call a code blue. 2. Assess the telemetry reading. 3. Take the client's apical pulse. 4. Have the client sit down. 4. Have the client sit down. The client diagnosed with an ST elevation myocardial infarction (STEMI) has developed 2+ edema bilaterally of the lower extremities and has crackles in all lung fields. Which should the nurse implement first? 1. Notify the healthcare provider. 2. Assess what the client ate at the last meal. 3. Request a STAT 12 lead echocardiogram. 4. Administer furosemide IVP. 1. Notify the healthcare provider. The home health nurse is assigned a client diagnosed with heart failure. Which should the nurse implement? Select all that apply: 1. Request a dietary consult for a sodium-restricted diet. 2. Instruct the client to elevate the feet during the day. 3. Teach the client to weigh every morning wearing the same type of clothing. 4. Assess for edema in dependent areas of the body. 5. Encourage the client to drink at least 3,000 mL of fluid per day. 6. Have the client repeat back instructions to the nurse. 1. Request a dietary consult for a sodium-restricted diet. 2. Instruct the client to elevate the feet during the day. 3. Teach the client to weigh every morning wearing the same type of clothing. 4. Assess for edema in dependent areas of the body. 6. Have the client repeat back instructions to the nurse. The client diagnosed with peripheral vascular disease is overweight, has smoked two (2) packs of cigarettes a day for 20 years, and sits behind a desk all day. What is the strongest factor in the development of atherosclerotic lesions? A. Being overweight B. Sedentary lifestyle C. High-fat, high-cholesterol diet D. Smoking cigarettes The client comes to the clinic complaining of muscle cramping and pain in both legs when walking for short periods of time. which medical term would the nurse
document in the clients record? b. intermittent claudication the nurse is teaching the client diagnosed with arterial occlusive disease. Which interventions should the nurse include in the teaching? select all that apply. a. wash legs and feet daily in warm water b. apply lotion to feet d. do not wear any type of knee stocking e. wear clean white cotton socks Which client problem would be priority in a client diagnosed with arterial occlusive disease who is admitted to the hospital with a foot ulcer. Which instruction should the nurse include when providing discharge instructions to a client diagnosed with peripheral arterial disease? instruct pt to walk daily for at least 30 minutes Which
assessment data would warrant immediate intervention in the client diagnosed with arterial occlusive disease? 3. The client has numbness and tingling. The client diagnosed with
arterial occlusive disease is one (1) day postoperative right femoral-popliteal bypass. Which intervention should the nurse implement? 4. Assess the client's leg dressing every four (4) hours. The nurse is unable to assess a pedal pulse in the client diagnosed with arterial occlusive disease. Which intervention should the nurse implement first? 1. Complete a neurovascular assessment. The wife of a client with arterial occlusive disease tells the nurse, "My husband says he is having rest pain. What does that mean?" Which statement by the nurse would be most appropriate? 2. "His legs are deprived of oxygen during periods of inactivity." The nurse is assessing the client diagnosed with long-term arterial occlusive disease. Which assessment data support the diagnosis? 1. Hairless skin on the legs. The health-care provider ordered a femoral angiogram for the client diagnosed with arterial occlusive disease. Which intervention should the nurse implement? 4. Inform the client that fluids will be increased after the procedure. Which medication should the nurse expect the health-care provider to order for a client diagnosed with arterial occlusive disease? 1. An anticoagulant medication. 2. An antihypertensive medication. 3. An antiplatelet medication. 4. A muscle relaxant. 3. An antiplatelet medication. The nurse is teaching a class on venous insufficiency. The nurse would identify which condition as the most serious complication of chronic venous insufficiency? Which assessment data would support that the client has a venous stasis ulcer? 1. A superficial pink open area on the medial part of the ankle. The nurse is caring for the client with chronic venous insufficiency. Which statement indicates the client understands the discharge teaching? 2. "I need to elevate the foot of my bed while sleeping." Which assessment data would the nurse expect to find in the
client diagnosed with chronic venous insufficiency? 4. Brown discolored skin. The nurse is admitting a client diagnosed with peripheral vascular disease. Which data support a diagnosis of venous insufficiency? B. The client has a brownish purple area on the lower legs pt has MI, which med can you anticipate the HCP to order to prevent another MI vit E and a low dose aspirin The HCP ordered an angiotensin-converting enzyme (ACE) inhibitor for the client diagnosed with a myocardial infarction. Which statement best
explains the rationale for administering this medication to this client? 1. It will help prevent the development of congestive heart failure. The client is receiving the angiotensin-converting enzyme (ACE) inhibitor enalapril (Vasotec). When would the nurse question administering this medication? 2. The client complains of a persistent irritating cough. The nurse is preparing to administer the morning dose of digoxin, a cardiac glycoside, to a client diagnosed with congestive heart failure. Which data would indicate the medication is effective? 4. The client's lungs sounds are clear bilaterally. The nursing is administering digoxin, a cardiac glycoside, to the client with congestive heart failure. Which interventions should the nurse implement? Select all that apply. 1. Check the apical heart rate for one (1) full minute. 3. Teach the client how to take his or her radial pulse. 4. Evaluate the client's serum digoxin level. The nurse is administering the loop diuretic furosemide (Lasix) to the client diagnosed with essential hypertension. Which assessment data would warrant the nurse to question administering the medication? 3. The client has tented skin turgor and dry mucous membranes. The client is diagnosed with essential hypertension and is receiving a calcium channel blocker. Which assessment data would warrant the nurse holding the client's medication? 4. The client complains of being dizzy when getting out of bed. The client is receiving thrombolytic therapy for a diagnosed myocardial infarction (MI). Which assessment data indicate the therapy is
successful? 2. The client is exhibiting reperfusion dysrhythmias. The client is receiving a loop diuretic for congestive
heart failure. Which medication would the nurse expect the client to be receiving while taking this medication? 1. A potassium supplement. What is a key diagnostic indicator of heart failure?The patient should be questioned about dyspnea, cough, nocturia, generalized fatigue and other signs and symptoms of heart failure. Dyspnea, a cardinal symptom of a failing heart, often progresses from dyspnea on exertion to orthopnea, paroxysmal nocturnal dyspnea and dyspnea on rest.
Which symptoms would indicate to the nurse that the client has heart failure?Heart failure signs and symptoms may include:. Shortness of breath with activity or when lying down.. Fatigue and weakness.. Swelling in the legs, ankles and feet.. Rapid or irregular heartbeat.. Reduced ability to exercise.. Persistent cough or wheezing with white or pink blood-tinged mucus.. Swelling of the belly area (abdomen). Which test is used for diagnosing diastolic heart failure in a patient with a history of acute dyspnea?Therefore, patients with dyspnea and suggestive abnormalities on the electrocardiogram or chest radiograph should undergo two-dimensional echocardiography with Doppler flow studies. The echocardiogram is the diagnostic standard for identifying both systolic and diastolic heart failure.
When caring for a client with heart failure which type of lung sounds would the nurse expect to hear?The appearance of pulmonary crackles (rales), defined as discontinuous, interrupted, explosive respiratory sounds during inspiration, is one of the most important signs of heart failure deterioration.
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The nurse expects an elevation in which diagnostic reading in a patient with heart failure
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