BIOLGOY 102Medical-Surgical Nursing Critical Thinking in Client Care, 4th Edition CHAPTER 31

Medical-Surgical Nursing Critical Thinking in Client Care, 4th Edition Priscilla LeMon

CHAPTER  31

1. Health counseling is being provided to a group of employees in a factory. The nurse is discussing coronary heart disease risk factors. Which of the are modifiable risk factors? Select all that apply.

a. Hypertension

b. Hormone replacement therapy

c. Heredity

d. Diabetes mellitus

2. A client is being evaluated in the office before starting a weight loss program. The program is to be initiated due to abdominal obesity, hypertension, and elevated fasting glucose. The client understands that these are qualities specific to:

a. Acute coronary syndrome.

b. Angina.

c. Metabolic syndrome.

d. Peripheral vascular disease.

3. A client has a history of myocardial infarctions. The nurse discussing discharge teaching emphasizes the need for the client to stop smoking. The client states “I have been smoking for 35 years already. It won’t make a difference now.” The best response by the nurse would be:

a. “It will reduce your risk of lung cancer.”

b. “Your risk of continued coronary heard disease will decrease by half when you stop.”

c. “It will decrease any complications you might develop.”

d. “It will enhance the effects of your medications.”

4. After being admitted to an outpatient chest pain unit, a client is told he will need further testing. Which of the following diagnostic tests would the nurse anticipate will be ordered to determine this client’s coronary heart disease status?

a. Stress electrocardiography

b. Echocardiography

c. Coronary angiography

d. Radionucleotide testing

5. Aspirin has been prescribed for a client following a myocardial infarction. Teaching about this should include:

a. Take at a different time of day than warfarin (Coumadin).

b. Report any itching after seven days of taking.

c. Do not skip any scheduled appointments to have blood drawn for labs.

d. Check with your healthcare provider before taking herbal remedies.

6. Preoperatively, a client is taught that during coronary bypass graft surgery (CABG), the cardiopulmonary bypass pump is used as a response to:

a. Cardioplegia.

b. Deep sedation.

c. Risk of bleeding.

d. Risk of clotting.

7. The nurse is assessing a client who is 6 hours postoperative from coronary artery bypass graft (CABG) surgery. The heart rate is 120, blood pressure is 90/50, urine output is decreased, chest tube output is decreased, heart sounds are muffled, and peripheral pulses are diminished. What action should be taken by the nurse first?

a. Recheck vital signs in 15 minutes.

b. Notify the physician immediately.

c. Reposition the client.

d. Increase the intravenous fluids.

8. After climbing the stairs to her office following lunch, a 33-year-old female experiences epigastric pain, nausea, and shortness of breath. She calls her healthcare provider’s office. Which response is the most appropriate for her to follow?

a. “Wait 30 minutes to see if the complaints subside.”

b. “Make an appointment to have your gallbladder evaluated.”

c. “Take an aspirin and make an appointment for tomorrow.”

d. “Have someone take you to the Emergency Department immediately.”

9. During an office visit, a 55-year-old female client asks why she has not been prescribed a daily dose of aspirin. Her 56-year-old husband has been advised by the physician to take a daily aspirin. What can the nurse explain is the most likely reason for this?

a. Aspirin is not recommended for women.

b. This must have been an oversight.

c. She has other medications that could interfere.

d. Women are not typically prescribed aspirin therapy before 65 years of age.

10. When in the cardiology office for a follow-up appointment after a myocardial infarction, the client states “My friends tell me to add more garlic to my diet and start drinking red wine each evening.” The nurse’s best response to this comment would be:

a. “I wouldn’t do that if I were you.”

b. “Discuss your idea with the physician to see what would benefit you.”

c. “You should also add ginkgo biloba for cardiovascular health.”

d. “That sounds fine. See how they work.”