NUR 257 Exam 6
1. A client with a confirmed DVT is being discharged from the ED. Which client statement
indicates that the client has received proper nursing instruction and understands how to manage
this condition?
"I should try not to drink too much during the daytime."
"I should lie on my side with my knees bent when sleeping."
"I need to ice my leg every 2 hoursfor about 20 minutes."
"I need to do my leg exercises five times or more every hour."
Answer
"I need to do my leg exercises five times or more every hour."
2. A nurse is caring for a client who had an aortic balloon valvuloplasty. The nurse should
inspect the surgical insertion site closely for which complication(s)?
Bleeding and infection
Bleeding and wound dehiscence
Thrombosis and infection
Evisceration
Answer
Bleeding and infection
3. A client who recently had a myocardial infarction develops pericarditis and complains of
chest pain rated 6 (on a scale of 0-10) with deep breathing. Which ordered pro re nata
medications is most appropriate for the nurse to administer?
Morphine sulfate 6 mg IVP every 2-4 hours
Fentanyl 2 mg intravenous pyelogram (IVP) every 2-4 hours
Acetaminophen 650 mg PO every4 hours
Ibuprofen 800 mg PO every 8 hours
Answer
Ibuprofen 800 mg PO every 8 hours
4. The nurse instructs a client recovering from mechanical valve replacement surgery. Which
client statement indicates that teaching has been effective?
"I can play soccer in a week or two."
"I will not drive until informed by my health care provider."
,"I have a low risk of developing aninfection in my heart."
"I will not need to take anticoagulant medication every day."
Answer
"I will not drive until informed by my health care provider."
5. A nurse is caring for a client receiving warfarin therapy following a mechanical valve
replacement. The client had a prothrombin time and International Normalized Ratio (INR)
drawn before breakfast. The laboratory report shows the client's INR reading was 4. What is the
nurse's first priority ?
Assess the client for bleeding and notify the health care provider of the results.
Notify the next nurseon afternoon shift to hold the evening dose of warfarin.
Notify the health care provider to request an increase in the warfarin dose.
Be prepared to administer an I.M. vitamin K injection and notify the healthcare
provider of the results.
Answer
Assess the client for bleeding and notify the health care provider of the results.
6. The nurse suspects a client has developed pericarditis after a week of cold-like symptoms.
Which of the client's signs and symptoms indicate peri- carditis?
low urine output secondary to left ventricular dysfunction
fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR)
pitting edema, chestdiscomfort, and nonspecific
ST-segment elevation lethargy, anorexia, and heart failure
Answer
fever, chest discomfort, and elevated erythrocyte sedimentation rate (ESR)
7. A client is admitted to the hospital with aortic stenosis. What assessment findings would
indicate the development of left ventricular failure?
Orthopnea, nausea, pedal edema
Distended jugular veins, pedal edema, nausea
Dyspnea, orthopnea, pulmonary edema
Dyspnea, distended jugular veins, orthopnea
Answer
Dyspnea, orthopnea, pulmonary edema
,8. Which would the nurse stress as a periodic lifelong necessity for a client managing infective
endocarditis?
Exercise regimen
Antihypertensive medication
Potassium replacement
Antibiotic therapy
Answer
Antibiotic therapy
9. The nurse is caring for a client who has been diagnosed with aortic stenosis. The client is
prescribed digoxin. What is the rationale for the medication?
left ventricular dysfunction
angina
dyspnea
edema
Answer
left ventricular dysfunction
10. A client is admitted to the hospital with possible acute pericarditis and pericardial effusion.
The nurse knows to prepare the client for which diagnostic test to confirm the client's diagnosis?
Computed tomography
Echocardiography Chest x-ray
Cardiac catheterization
Answer
Echocardiography
, 11. A client comes to the clinic reporting fever, chills, and sore throat and is diagnosed with
streptococcal pharyngitis. A nurse knows that early diagnosis and effective treatment is essential
to avoid which preventable disease?
12. The nurse is educating a client about the care related to a new diagnosis of mitral valve
prolapse. What statement made by the client demonstrates understanding of the teaching?
"I will take antibiotics before getting my teeth cleaned."
"I can get my tongue pierced at a store in the shopping mall."
"I will avoid caffeine, alcohol, andsmoking."
"I can get a tattoo at a local parlor."
Answer
"I will avoid caffeine, alcohol, and smoking."
13. A nurse is caring for a client with aortic stenosis whose compensatory mechanisms of the
heart have begun to fail. The nurse will monitor the client carefully for which initial
symptoms?
Dizziness, nausea, diarrhea
Exertional dyspnea, orthopnea, pulmonary edema
Syncope, fever, vomiting
Nausea, vomiting, exertional fatigue
Answer
Exertional dyspnea, orthopnea, pulmonary edema
14. The nurse is assessing a client admitted with infective endocarditis. Which
manifestationwould the nurse expect to find?
Bruising on the palms of the hands and soles of the feet
Raised red rash on the trunk and face
Involuntary muscle movements of the extremities
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