4801 Adaptive Quizzing Review (Cardiac)
Prep Exam And All Correct Answers.
A nurse is conducting a health class for adolescents. What modifiable risk factor, most closely associated
with the development of coronary heart disease (CHD) in both men and women, should the nurse
discuss? - Answer Cigarette smoking.
Nicotine in cigarette smoke constricts blood vessels, including coronary arteries, which contributes to the
occurrence of angina and CHD. Opioid use is not a risk factor for CHD. Judicious alcohol intake may
promote relaxation, decreasing stress and limiting the development of CHD. Inactivity, not moderate
exercise, is a risk factor for CHD. Exercise decreases hypertension, blood clotting, and heart rate. Exercise
also increases metabolism, the plasma level of high-density lipoprotein cholesterol, and cardiac capillary
blood flow.
A nurse is caring for a client with heart failure. The healthcare provider prescribes a 2-gram sodium diet.
What should the nurse include when explaining how a low-salt diet helps achieve a therapeutic
outcome? - Answer Allows excess tissue fluid to be excreted
A decreased concentration of extracellular sodium causes a decrease in the release of antidiuretic
hormone (ADH); this leads to increased excretion of urine. Sodium restriction does not control the
volume of food intake; weight is controlled by a low-calorie diet, exercise (if permitted), and prevention
of fluid retention. The resulting elimination of excess fluid reduces the workload of the heart but does
not improve contractility. Potassium is retained inefficiently by the body; an adequate intake of
potassium is needed.
A nurse is teaching a group of clients about risk factors for heart disease. Which factors will the nurse
include that increase a client's risk for a myocardial infarction (MI)? - Answer Obesity; Hypertension.
Obesity increases cardiac workload associated with vascular changes that lead to ischemia, which causes
an MI. Hypertension damages blood vessels and increases peripheral resistance and cardiac workload,
which may lead to an MI. Increased levels of low-density lipoprotein (LDL), not HDL, increase the risk for
heart disease. Diabetes mellitus, not insipidus, is a risk factor for an MI. The risk is higher for African
Americans.
,The nurse is conducting a nutrition class for a group of clients with heart failure (HF). Which information
is most important for the nurse to share with the class? - Answer Choosing fresh or frozen vegetables
instead of canned ones.
The key principle to teach HF clients is the importance of decreasing sodium in their diet and which
foods contain sodium. If sodium is decreased, water retention will decrease also. Fresh or frozen
vegetables have less sodium than canned ones. If the client is on a low-sodium diet and receiving
diuretics but continues to be fluid overloaded, then fluid restriction may be instituted. A low caloric diet
is not indicated for all HF clients. Some are very thin because of various factors, including the work of
breathing and rapid heart rate. A low cholesterol diet is important for clients with coronary artery
disease and for the American population in general but is not specifically related to HF.
A client has surgery to replace a prolapsed mitral valve. What should the nurse teach the client? -
Answer The signs and symptoms of heart failure.
The teaching plan for this client should focus on the possibility of heart failure. Clients with a failed valve
are prone to heart failure; report any signs of dyspnea, syncope, dizziness, edema, and palpitations.
Infective endocarditis, not pericarditis, may occur. Endocarditis is an infection of the endothelial surface
of the heart and valves. Pericarditis is an inflammation of the pericardium, the membranous sac
enveloping the heart. There is no evidence of pathology of other valves. There is no schedule that valves
will be replaced every six months.
The client is admitted with sinus tachycardia. To treat the dysrhythmia, the nurse will look for potential
causes. Which causes will the nurse look for in this client? - Answer Anxiety; Caffeine; Exercise; Anemia.
A client with mild chronic heart failure is to be discharged with prescriptions for daily oral doses of an
antidysrhythmic, potassium chloride 40 mEq, docusate sodium 100 mg, and furosemide 40 mg twice a
day. The client reports having no family members who can help after discharge. What should the nurse
help this client identify? - Answer Support systems that can assist the client at home
The rehabilitative phase requires a balance between activity and rest; supportive individuals are needed
to perform more strenuous household tasks and to provide emotional support. A client with mild heart
failure does not need inpatient care. A support system should be identified before considering
community agencies. More information is needed before encouraging the development of relationships
with neighbors.
, A thallium scan is prescribed for a client with a history of chest pain. Which information should the nurse
include when explaining the purpose of the test to the client? - Answer It assesses myocardial ischemia
and perfusion.
Thallium imaging is used to assess myocardial scarring and perfusion; necrotic or scar tissue does not
extract the thallium isotope. The scan monitors action of the heart valves available from an
echocardiogram or, if indicated, from a cardiac catheterization with an angiography. Visualization of the
ventricular systole and diastole are determined by cardiac angiography. Identifying the adequacy of
electrical conductivity is determined by an electrocardiogram (ECG).
Upon assessment the nurse discovers a client with heart failure has crackles in lower lung fields and
dyspnea. Upon notifying the primary healthcare provider, the provider prescribes intravenous (IV)
normal saline at 200 mL/hr and furosemide 120 mg orally stat. Which action should the nurse take next?
- Answer Question the choice of solution, the amount to be given, and the dose of furosemide that has
been prescribed.
The choice of normal saline at 200 mL/hr should be questioned for using saline, which is inclined to
retain fluid, and the amount, which would be too much for most older adult persons' cardiac status to
tolerate. This client is in heart failure as evidenced by crackles and dyspnea, and pulmonary edema is
occurring. Using an infusion pump to infuse solution assures the prescribed amount is infused but does
not address that this is too much. Giving a higher dose needs to be questioned, and the nurse can refuse
to follow prescriptions that are outside of standards. Giving a medication without understanding normal
range and information violates standards. In addition, older adult clients do not metabolize medication
as efficiently as younger clients.
A client with a history of heart failure on daily weights has a 2-pound (0.9 kilogram) weight gain and
pitting edema in lower extremities bilaterally. Which action should the nurse take next? - Answer
Perform a head-to-toe assessment, including vital signs.
Performing a head-to-toe assessment, including vital signs, would indicate symptoms, such as jugular
distention with right-sided heart failure, or pulmonary issues (crackles) associated with left-sided heart
failure. Checking the record for code status is not a priority and should have been established and known
on an elderly client. Increasing intake will make the problem of fluid retention worse. Continuing to
monitor daily weights without an assessment may miss worsening symptoms.
A client hospitalized for heart failure is receiving digoxin and will continue taking the drug after
discharge. What should be included in the plan of care for the next few days? - Answer Teaching the
client how to count the pulse.
