MS2.CardiacValve.EndChptQuestions.ch23

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pcp
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185895
Filename:
MS2.CardiacValve.EndChptQuestions.ch23
Updated:
2012-12-02 11:10:10
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CARDIAC VALVE ANNULOPLASTY BETA HEMOLYTIC STREPTOCCI TAMPONADE CARDIOMEGALY CARDIOMYOPATHY CHOREA COMMISSUROTOMY DRESSLERS SYNDROME EMBOLI ENDOCARDITIS INR MURMU MYECTOMY MYOCARDITIS PERICARDIAL PERICARDITIS PETECHIAE RHEUMATIC STENOSIS THROMBOPHLEBITIS VALVOTOMY VALVULOPLASTY
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MS2 CARDIA VALVE DISORDERS CH 23
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  1. Which of the following symptoms would the nurse identify as a priority to report for a patient with aortic stenosis?

    A. Angina.
    B. Headache.
    C. Weight loss.
    D. Peripheral edema.
    A. Angina.

    Angina indicates cardiac ischemia and requires prompt intervention.
    (this multiple choice question has been scrambled)
  2. The nurse is evaluating patient teaching for mitral valve prolapse. The patient shows understanding of the prognosis of MVP by stating which of the following?

    A. The prognosis is poor.
    B. There are often no symptoms.
    C. Heart failure often occurs.
    D. Symptoms quickly progress.
    B. There are often no symptoms.

    Symptoms are often not present in MVP.
    (this multiple choice question has been scrambled)
  3. The nurse is evaluating patient preoperative teaching for a commissurotomy. The patient shows understanding of the purpose of this procedure by stating which of the following?

    A. A biological valve is inserted to replace a valve.
    B. The valve flaps are repaired or reconstructed.
    C. Fused valve flaps are separated to enlarge the valve opening.
    D. A mechanical valve is inserted to replace a valve.
    C. Fused valve flaps are separated to enlarge the valve opening.

    In commissurotomy, the valve flaps that have adhered to each other and closed the opening between them, known as the commissure, are separated to enlarge the valve opening.
    (this multiple choice question has been scrambled)
  4. The nurse is planning care for a patient having a cardiac vavle replacement. With which type of valve will the patient beĀ on anticoagulant therapy to prevent thrombus formation?

    A. Mechanical valve.
    B. Porcine valve.
    C. Allograft valve.
    D. Bovine valve.
    A. Mechanical valve.

    Mechanical valve requires lifelong anticoagulants to prevent emboli, unlike biological valves, which are less likely to create emboli.
    (this multiple choice question has been scrambled)
  5. The nurse evaluates the patient as understanding how to prevent rheumatic fever if the patient states that rheumatic fever can be prevented by treating streptococcal infections with which of the following?

    A. Cortisone.
    B. Penicillin.
    C. Prednisone.
    D. Cyclosporine.
    B. Penicillin.

    Streptococcal infection is a bacterial infection treated with the anticacterial agent penicillin.
    (this multiple choice question has been scrambled)
  6. The nurse is planning care for a patient with cardiomyopathy. For which of the following complications of cardiomyopathy should the nurse collect data?

    A. Heart failure.
    B. Pulmonary embolism.
    C. Thrombophlebitis.
    D. Rheumatic fever.
    A. Heart failure.

    Heart failure is a complication of cardiomyopathy.
    (this multiple choice question has been scrambled)
  7. Which of the following signs and symptoms indicate to the nurse the presence of a deep venous thrombus in the patient's leg? (select all that apply).

    A. Calf swelling.
    B. Crackles.
    C. Jugular venous distention.
    D. Positive Homan's sign.
    E. Warmth.
    F. Redness.
    • A. Calf swelling.
    • D. Positive Homan's sign.
    • E. Warmth.
    • F. Redness.

    These indicate blood clot. Selections b and c are seen with heart failure.
  8. The nurse is to give warfarin (Coumadin). Which of the following lab tests should the nurse review before giving the medication?

    A. International Normalized Ratio.
    B. Partial thromboplastin time.
    C. Bleeding time.
    D. Plasma fibrinogen level.
    A. International Normalized Ratio.

    INR - prothrombin time is monitored during warfarin (Coumadin) therapy.
    (this multiple choice question has been scrambled)
  9. Which of the following does the nurse understand occurs in aortic stenosis?

    A. Blood backflows into the left atrium.
    B. Aortic valve does not close tightly.
    C. Emptying of blood from left ventricle is impaired.
    D. Emptying of the left atrium is impaired.
    C. Emptying of blood from left ventricle is impaired.

    Impaired emptying of blood from the left ventricle occurs because the blood cannot easily leave the left ventricle through the narrowed aortic valve.
    (this multiple choice question has been scrambled)
  10. The nurse understands that which of the following occurs in mitral regurgitation?

    A. Backflow of blood into the left atrium.
    B. Backflow of blood into the right atrium.
    C. Impaired emptying of the left ventricle.
    D. Impaired emptying of the right ventricle.
    A. Backflow of blood into the left atrium.

    Backflow of blood into the left atrium occurs through the mitral valve, which does not close tightly.
    (this multiple choice question has been scrambled)
  11. Which of the following compensatory mechanisms does the nurse understand occurs with ventricular valve disorders?

    A. Systolic hypertension.
    B. Ventricular hypertrophy.
    C. Decreased atrial kick.
    D. Atrial hypertrophy.
    B. Ventricular hypertrophy.

    Ventricular hypertrophy occurs to help maintain cardiac output.
    (this multiple choice question has been scrambled)
  12. Which of the following does the nurse understand causes fatique in patients with chronic aortic stenosis?

    A. Increased coronary artery blood flow.
    B. Decreased pulmonary blood flow.
    C. Left ventricular failure.
    D. Atrial fibrilation.
    C. Left ventricular failure.

    Left ventricular failure results in decreased cardiac output, which reduces O2 to the tissues and causes fatigue.
    (this multiple choice question has been scrambled)
  13. Which of the following diagnostic tests does the nurse understand measures the pressures in the cardiac chambers?

    A. ECG.
    B. Echocardiogram.
    C. Cardiac catheterization.
    D. Exercise stress test.
    C. Cardiac catheterization.

    Cardiac catheterization measures chamber pressures.
    (this multiple choice question has been scrambled)
  14. Which of the following does the nurse understand usually precedes rheumatic fever?

    A. A staphylococcal infection.
    B. A fungal infection.
    C. A viral infection.
    D. A beta-hemolytic streptococcal infection.
    D. A beta-hemolytic streptococcal infection.

    Beta-hemolytic streptococcal is a bacterial infection that can precede rheumatic fever.
    (this multiple choice question has been scrambled)
  15. Which of the following is the most common symptoms of pericarditis?

    A. Calf pain.
    B. Dyspnea.
    C. Intermittent claudication.
    D. Chest pain.
    D. Chest pain.

    Chest pain is the most common symptom, especially with deep inspiration.
    (this multiple choice question has been scrambled)
  16. Which of the following should the nurse include in the POC as a patient outcome for Deficient Knowledge r/t mitral stenosis?

    A. Normal changes in vital signs with less fatigue during self-care.
    B. Clear breath sounds, no edema or weight gain.
    C. States fear is reduced.
    D. Verbalizes knowledge of disorder.
    D. Verbalizes knowledge of disorder.

    The patient's goal would be to be able to verbalize knowledge of disorder.
    (this multiple choice question has been scrambled)
  17. Which of the following medications does the nurse anticipate that the patient will be given to prevent complications associated with decreased cardiac output? (select all that apply).

    A. Furosemide (Lasix).
    B. Cephalein (Keflex).
    C. Penicillin (Bicillin).
    D. Warfarin (Coumadin).
    E. rPA (Retavase).
    F. Fondaparinux (Arixtra).
    • A. Furosemide (Lasix).
    • E. rPA (Retavase).

    Furosemide helps prevent pulmonary edema, a complication of decreased cardiac output and heart failure, and a potassium supplement is needed with furosemide, a potassium-wasting diuretic. (b,c,d,f) are not related to decreased cardiac output.
  18. The nurse is caring for a patient, age 70, who has a nursing dx of Deficient Knowledge r/t furosemide administration. Which of the following interventions is essential to include when planning a teaching session?

    A. Assess patient's learning priorities.
    B. Tell patient what to learn firtst about furosemide.
    C. Give patient a written test at the end of the teaching session.
    D. Assess patient's dietary intake of potassium.
    A. Assess patient's learning priorities.

    Determining the patient's learning priorities helps ensure that the patient is motivated to learn because the patient's needs and not the nurse's needs are being met.
    (this multiple choice question has been scrambled)
  19. A patient is 65, is being discharged after a mechanical valve replacement for aortic stenosis. Which of the following should be taught regarding warfarin (Coumadin) therapy?

    A. Keep yearly blood test appointments.
    B. Wear Medic Alert identification.
    C. Use a straight razor when shaving.
    D. Increase intake of green leafy vegetables.
    B. Wear Medic Alert identification.

    Wearing a Medic Alert is essential in case of a bleeding problem or loss of consciousness.
    (this multiple choice question has been scrambled)
  20. The nurse is teaching a patient with heart failure how to avoid activity that results in Valsalva's maneuver. Which of the following statements by the patient indicates to the nurse that the teaching has been effective?

    A. I will breathe normally when moving.
    B. I will use a straw to drink oral fluids.
    C. I will take fewer but deeper breaths.
    D. I will clench my teeth when moving.
    A. I will breathe normally when moving.

    If the patient understands to breathe normally when moving, Valsalva's maneuver will not occur.
    (this multiple choice question has been scrambled)
  21. The nurse is planning care for a patient with chronic mitral regurgitation. Which of the following assessments would be the highest priority?

    A. Heart tones.
    B. Cardiac rhythm.
    C. Lung sounds.
    D. Peripheral edema.
    C. Lung sounds.

    Dyspnea and coughing are indicators of heart failure because of fluid congestion in the lungs, so you would listen to lung sounds to see if crackles are present.
    (this multiple choice question has been scrambled)
  22. A patient with endocarditis is undergoing surgery and is recommended to have to take prophylactic antibiotics to prevent which of the following?

    A. Infective endocarditis
    B. Vegetative emboli.
    C. Inflammation.
    D. Peritonitis.
    A. Infective endocarditis

    To prevent endocarditis from recurring because of increased risk from previous heart damage.
    (this multiple choice question has been scrambled)
  23. A patient has a positive Homan's sign. Which of the following does the nurse understand explains why ambulation and performing the Homans' sign is now contraindicated?

    A. They can cause patient pain.
    B. They may cause a clot to form.
    C. They can cause calf swelling.
    D. They can cause an emboli.
    D. They can cause an emboli.

    They can cause the clot to dislodge and become an embolus.
    (this multiple choice question has been scrambled)
  24. A patient develops a postoperative deep venous thrombosis and is starting on intravenous heparin. Which of the following laboratory tests is monitored during the heparin therapy?

    A. Plasma fibrinogen.
    B. Prothrombin time (PT).
    C. Partial thromboplastin time (PTT).
    D. International normalized ratio (INR).
    C. Partial thromboplastin time (PTT).

    PTT is monitored for heparin.
    (this multiple choice question has been scrambled)
  25. The nurse is caring for a patient on warfarin (Coumadin) with an elevated INR. Which of the following would be ordered as the antidote for warfarin?

    A. Vitamin B12.
    B. Vitamin K.
    C. Calcium chloride.
    D. Protamine sulfate.
    B. Vitamin K.

    Vitamin K is the antidote for warfarin. Protamine sulfate is the antidote for heparin.
    (this multiple choice question has been scrambled)
  26. Which of the following is a desired outcome for the nursing diagnosis of Acute Pain for a patient with acute thrombophlebitis?

    A. Is able to participate in desired activities.
    B. Reports ability to ambulate without pain.
    C. States pain is satisfactorily relieved.
    D. States anxiety is decreased.
    C. States pain is satisfactorily relieved.
    (this multiple choice question has been scrambled)
  27. A patient visits the doctor for a severe sore throat and fever. As the nurse plans the patient's care, which of the following diagnostic tests is obtained to prevent cardiac complications?

    A. Throat culture.
    B. Erythrocyte sedimentation rate.
    C. White blood cell count.
    D. Chest x-ray examination.
    A. Throat culture.

    A throat culture must be done to rule out a streptococcal infection, which can lead to complications.
    (this multiple choice question has been scrambled)
  28. The nurse is reviewing the daily INR and PT levels for a patient who had a mechanical valve replacement. The INR is 3.7 and the PT level is 29. Which of the following actions should the nurse take?

    A. Inform physician now.
    B. Give warfarin (Coumadin) now.
    C. Give the next dose of warfarin (Coumadin).
    D. Hold the next dose of warfarin (Coumadin).
    A. Inform physician now.

    The physician should be informed and the next dose of warfarin withheld because INR and PT monitor Coumadin effects and they are over the high end of therapeutic range.
    (this multiple choice question has been scrambled)
  29. A patient who had a hysterectomy 2 days ago, reports tenderness in her left calf. The nursing assessment reveals the following: L-calf 17.5", R-calf 14", L-thigh 32", R-thigh 28", and a shiny, warm, and reddened left leg. Which intervention is priority? (select all that apply).

    A. Maintain bedrest.
    B. Encourage ambulation TID.
    C. Encourage bilateral leg exercises.
    D. Apply bilateral antiemolism stockings.
    E. Apply right antiembolism stocking.
    F. Apply warm moist heat as ordered.
    • A. Maintain bedrest.
    • E. Apply right antiembolism stocking.
    • F. Apply warm moist heat as ordered.

    Bedrest is essential to prevent emboli development. It is OK to apply stocking to nonaffected leg to prevent venous stasis. Heat provides pain relief and increases circulation.
  30. Which of the following findings should be reported to the physician for a patient receiving warfarin therapy?

    A. PTT 28 (normal 30 to 45 seconds).
    B. PT 20 (normal 9 to 12 seconds).
    C. INR 4 (normal 2 to 3 seconds).
    D. Bleeding time 3 (normal 2 to 5 seconds).
    C. INR 4 (normal 2 to 3 seconds).

    INR is above therapuetic range and must be reported to physician.
    (this multiple choice question has been scrambled)
  31. A patient who has end-stage dilated cardiomyopathy come to the ER with dyspnea. The patient reports waking with a feeling of suffocation, which was frightening. Which of the following responses by the nurse is most appropriate?

    A. Reclining decreases the heart's ability to pump blood.
    B. Reclining increases fluid returning to the heart, which builds up fluid in the lungs.
    C. You must have been dreaming.
    D. Sleeping increases heart rate, which increases the body's need for O2.
    B. Reclining increases fluid returning to the heart, which builds up fluid in the lungs.

    The patient is experiencing paroxysmal nocturnal dyspnea, which occurs from increased fluid returning to the heart from reclining; the fluid then builds up in the lungs.
    (this multiple choice question has been scrambled)
  32. Which of the following assessments of a patient would indicate a side effect of digoin (Lanoxin) is occuring that requires follow-up?

    A. Constipation.
    B. Anorexia.
    C. Skin flushing.
    D. Hypertension.
    B. Anorexia.

    Anorexia is a side effect of digoxin, the rest are incorrect.
    (this multiple choice question has been scrambled)
  33. The physician writes a "now" order for codeine 45mg IM for a patient with thrombophlebitis. The nurse has on hand codein 60mg/2mL. Which of the following doses should be given?

    A. 1.75 mL.
    B. 1.45 mL.
    C. 1.50 mL.
    D. 2.15 mL.
    C. 1.50 mL.

    45/60 x 2 = 1.50
    (this multiple choice question has been scrambled)
  34. A patient, age 46, is admitted for observation with a chest contusion after hitting the steering wheel in an auto accident. Which of the following findings would be the highest priority?

    A. Bronchovesicular sounds heard over the major airways.
    B. Patient reports chest soreness and tenderness.
    C. Pericardial rub heard on ausculation.
    D. Sternal buising noted.
    C. Pericardial rub heard on ausculation.

    Pericardial friction rub indicates inflamed pericardial tissue and would be the highest priority for this patient.
    (this multiple choice question has been scrambled)

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