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NSG6420 Quiz 1
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Exam of 13 pages for the course NSG6420 at NSG6420 (NSG6420 Quiz 1)
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johnNSG6420 Quiz 1
. Question : Which of the following is the most important question to ask during
cardiovascular health history?
Student
Answer: Number of offspring
Last physical exam
Sudden death of a family member
Use of caffeine
Instructor The sudden death of a family member is an important question to ask in the health
Explanation: history because it reveals the cardiovascular disease risk of the patient. Sudden
death is usually due to an acute cardiovascular event, such as myocardial
infarction, cardiac dysrhythmia, or stroke.
Family history is particularly important for cardiac assessment because CVD, HTN,
hyperlipidemia, and other vascular diseases often have a familial association that is
not easily ameliorated by lifestyle changes. If there are deaths in the family related
to CVD, determine the age and exact cause of death, because CVD at a young age
in the immediate family carries an increased risk compared with CVD in an elderly
family member. Ask about sudden death, which might indicate a congenital disease
such as Marfan's syndrome. This is especially important to ask during pre-sports
physicals because sudden death in athletes is often related to congenital or familial
heart disease. Familial hyperlipidemia is autosomal dominant and often leads to
CAD and MI at a young age. Family history of obesity and type 2 diabetes are also
secondary risk factors for heart disease because the familial tendency for these is
strong. Ask about smoking in the house, as secondhand smoke is a risk factor for
respiratory and cardiac disease. (Goolsby 167-168)
Goolsby, Mary J., Laurie Grubbs. Advanced Assessment Interpreting Findings and
Formulating Differential Diagnoses, 3rd Edition. F.A. Davis Company, 11/2014.
VitalBook file.
Points Received: 2 of 2
Comments:
Question Question : A key symptom of ischemic heart disease is chest pain. However,
2. angina equivalents may include exertional dyspnea. Angina equivalents
are important because:
Student Answer:
Women with ischemic heart disease many times do not
present with chest pain
, john
Some patients may have no symptoms or atypical symptoms;
diagnosis may only be made at the time of an actual myocardial
infarction
Elderly patients have the most severe symptoms
A & B only
Instructor The key symptom of IHD is chest pain, but other common symptoms include
Explanation: arm pain, lower jaw pain, shortness of breath, and diaphoresis. These
symptoms are referred to as angina equivalents and can also include fatigue
or breathlessness. Some patients may have no symptoms or atypical ones so
that CAD may not be diagnosed until they experience a myocardial infarction.
(Kennedy-Malone 227)
Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced
Practice Nursing in the Care of Older Adults. F.A. Davis Company, 2014-01-
14. VitalBook file.
Points Received: 0 of 2
Comments:
Question Question : A 55-year-old post-menopausal woman with a history of hypertension
3. complains of jaw pain on heavy exertion. There were no complaints of
chest pain. Her ECG indicates normal sinus rhythm without ST
segment abnormalities. Your plan may include:
Student
Answer: Echocardiogram
Exercise stress test
Cardiac catheterization
Myocardial perfusion imaging
Instructor Once all the results of the initial laboratory and ECG testing are reviewed, a pretest
Explanation: probability of disease can be generated and additional tests can be ordered.2 The
probability of CAD can be calculated by considering the chosen noninvasive test's
sensitivity and specificity.2 Selection of the proper cardiac test (see Table 115-1) for
an individual depends on the person's risk stratification, age, and tolerable level of
activity. The most common and least invasive test for diagnosis of CAD is the stress
test, also called the exercise tolerance test (ETT) or treadmill exercise. (Buttaro
488)
Buttaro, Terry, JoAnn Trybulski, Patricia Bailey, Joanne Sandberg-Cook. Primary
Care, 4th Edition. Mosby, 2013. VitalBook file.
Points Received: 2 of 2
Comments:
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