Cardiovascular Nursing Questions (26-30)
Welcome to Cardiovascular Nursing Questions. Before you begin answering the questions, you may first want to take a peek about the material that will surely help you the pass the NCLEX examination :
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26. The nurse teaches a client with thromboangitis obliterans (Buerger’s disease) about measures to control the disease process. The nurse determines that the client needs further instructions about these measures if the client states which of the following?
a) I need to stop smoking immediately
b) I need to keep my legs and arms cool
c) I will need to take nifedipine (Procardia) as directed
d) I need to watch for signs and symptoms of skin breakdown
27. The nurse notes bilateral +2 edema in the lower extremities of a client with known coronary artery disease who was admitted to the hospital 2 days ago. The nurse plans to do which of the following next after noting this finding?
a) order daily weights starting on the following morning
b) review the intake and output records for the last 2 days
c) request a sodium restriction of 1g per day from the physician
d) change the time of diuretic administration from morning to evening
28. The nurse in the emergency department is assessing a client with chest pain. Which finding helps determine that the pain is caused by myocardial infarction (MI)?
a) the client experienced no nausea or vomiting
b) the pain was described as burning and gnawing
c) the client reports that the pain began while pushing a lawnmower
d) the pain, unrelieved by nitroglycerin, was relieved with morphine sulfate
29. The nurse is assessing a client who has been hospitalized with acute pericarditis. The nurse monitors the client for cardiac tamponade, knowing that which of the following is a manifestation of this complication of pericarditis?
b) paradoxical pulse
c) bounding heart sounds
d) flattened jugular veins
30. The nurse is assisting with positioning the client for pericardiocentesis to treat cardiac tamponade. How should the nurse position the client?
a) supine with slight Trendelenberg’s position
b) lying on right side with a pillow under the head
c) lying on the left side with a pillow under the chest wall
d) supine with the head of bed elevated at a 30 to 60 degree angle
Cardiovascular Nursing Questions
Answers and Rationale
- Interventions are directed at preventing the progression of thromboangiitis obliterans and include conveying the need for immediate smoking cessation, providing medications prescribed for vasodilation, such as nifedipine (Procardia), a calcium channel blocker, or prazosin (Minipress), an a-adrenergic blocker. The client should maintain warmth to the extremities, especially by avoiding exposure to cold. The client should inspect the extremities and report signs of infection or ulceration.
- Edema is the accumulation of excess fluid in the interstitial spaces, which can be measured by intake greater than output and by a sudden increase in weight (2.2 pounds = 1 kilogram). Obtaining a weight on the following day does not provide the nurse with immediate information. In addition, the nurse would need to evaluate serial weights for comparison. Strict sodium restrictions are reserved for clients with severe symptoms. Diuretics should be administered in the morning whenever possible to avoid nocturia.
- The pain of angina may radiate to the left arm, is often precipitated by exertion or stress, has few associated symptoms, and is relieved by rest and nitroglycerin. The pain of MI may radiate to the left arm, shoulder, jaw, and neck. It typically begins spontaneously, lasts longer than 30 minutes, is frequently accompanied by associated symptoms (nausea, vomiting, dyspnea, diaphoresis, anxiety), and requires opioid analgesics for relief. A burning and gnawing pain is more likely noted in an upper gastrointestinal disorder.
- Assessment findings with cardiac tamponade include tachycardia, distant or muffled heart sounds, jugular vein distention, and a falling blood pressure (BP), accompanied by paradoxical pulse (a drop in inspiratory BP by greater than 10 mm Hg).
- The client undergoing pericardiocentesis is positioned supine with the head of the bed raised to a 30- to 60-degree angle. This places the heart in proximity to the chest wall for easier insertion of the needle into the pericardial sac. Options A, B, and C are incorrect positions.
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