Chapter 08 Care of the Patient with a Cardiovascular or a Peripheral Vascular Disorder

Chapter 08  Care of the Patient with a Cardiovascular or a Peripheral Vascular Disorder

MULTIPLE CHOICE

1. Modifiable risk factors for coronary artery disease (CAD) include which group?

1. Diabetes, family history
2. Family history, smoking
3. Smoking, heredity
4. High cholesterol, obesity

ANS: D
Modifiable factors include smoking, hyperlipidemia, hypertension, diabetes mellitus, and obesity.

DIF: Cognitive Level: Comprehension REF: Page 314 OBJ: 8 TOP: Risk factors KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity

2. A 63-year-old patient with an acute myocardial infarction is on a cardiac monitor and begins to show some dysrhythmias. The physician will probably prescribe which intravenous medication?

1. Nitroglycerin
2. Digitalis
3. Lidocaine
4. Amyl nitrite

ANS: C
Management of dysrhythmias is accomplished by suppressing the impulse that triggers dysrhythmias.

DIF: Cognitive Level: Analysis REF: Pages 316-317, Table 8-1
OBJ: 11 TOP: Acute myocardial infarction
KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity

3. The nurse identifies the nursing diagnosis of Ineffective tissue perfusion related to decreased arterial blood flow for a patient with chronic arterial insufficiency. In evaluating the patient outcomes after patient teaching, which statement by the patient does the nurse recognize as indicating a need for further instruction?

1. “For about 40 minutes each day, I will walk to the point of pain, then rest, than walk again until I develop pain.”
2. “I will drink hot coffee several times a day to increase the circulation and warmth in my feet.”
3. “I will wear loose clothing that doesn’t bind across my legs or waist.”
4. “I will change my position every hour and avoid long periods of sitting with my legs

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 8-2

down.”

ANS: B
Avoiding vasoconstriction from nicotine, caffeine, and stress is an important precaution for patients with decreased arterial blood flow.

DIF: Cognitive Level: Analysis
REF: Pages 317, 367, Nursing Diagnoses boxes OBJ: 22
TOP: Arterial disorders KEY: Nursing Process Step: Evaluation MSC: NCLEX: Physiological Integrity

4. The patient has right-sided heart failure. She will probably be comfortable in which position?

1. Dorsal recumbent
2. Trendelenburg
3. Supine
4. Orthopneic

ANS: A
Restful sleep may be possible only in the sitting position or with the aid of extra pillows.

DIF: Cognitive Level: Analysis REF: Page 336 OBJ: 10 TOP: Heart failure KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity

5. A patient is admitted from the emergency department. The emergency department physician notes the patient has a diagnosis of heart failure with a New York Heart Association (NYHA) classification of IV. This indicates the patient’s condition as

1. moderate heart failure.
2. severe heart failure.
3. congestive heart failure.
4. negligible heart failure.

ANS: B
Class IV: Severe; patient unable to perform any physical activity without discomfort. Angina or symptoms of cardiac inefficiency may develop at rest.

DIF: Cognitive Level: Knowledge REF: Page 334, Box 8-3
OBJ: 11 TOP: Classification of heart failure
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity

6. A patient admitted from the emergency room with a diagnosis of heart failure and a NYHA classification of IV is requesting ambulation to the bathroom. Which nursing intervention would be appropriate for this patient?

1. Assist the patient to the bathroom.
2. Obtain a bedside commode.
3. Offer a urinal or bedpan.
4. Obtain assistance of another nurse and ambulate the patient to the bathroom.

ANS: C
Class IV: Severe: patient unable to perform any physical activity without discomfort.

Mosby items and derived items © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank 8-3

DIF: Cognitive Level: Analysis
OBJ: 11 TOP: Heart failure MSC: NCLEX: Physiological Integrity

REF: Page 334, Box 8-3
KEY: Nursing Process Step: Implementation