BIOLOGY 102 Medical-Surgical Nursing Critical Thinking in Client Care, CHAPTER 32 AND 33

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

CHAPTER   32 AND 33

CHAPTER 32

1. Which of the following individuals is at the greatest risk for heart failure?

a. White male

b. African-American

c. White female

d. Asian male

2. An older adult has been diagnosed with congestive heart failure (CHF). There are many physiological findings associated with CHF. Select all that apply.

a. Weakness

b. Dependent edema

c. Respiratory crackles

d. Disorientation

3. A client diagnosed with left-sided cardiac failure would be most comfortable in which sleeping position?

a. On her side, with the head of the bed up 30 degrees

b. In a recliner with 2–3 pillows under her head

c. On her left side, with the head of the bed up 30 degrees

d. In a recliner with 2–3 pillow under her feet

4. During a hospitalization for congestive heart failure (CHF), the client awakens during the night frightened and short of breath. This client most likely is experiencing:

a. Multisystem heart failure.

b. Cardiomyopathy.

c. Paroxysmal nocturnal dyspnea.

d. High-output failure.

5. While in the office for a follow-up appointment, a client with a history of heart failure complains of a dry, persistent cough. Which of the following areas of assessment or review would provide the most information related to the cause of this?

a. Lab results

b. Medication list

c. Vital signs

d. Surgical history

6. A nurse is preparing to administer a client’s morning digoxin (Lanoxin). He assesses the apical pulse for one minute. With which value should the nurse choose not to administer the medication?

a. 72

b. 68

c. 54

d. 70

7. BiDil (hydralazine and isosorbide combination) has been prescribed for an African-American male with heart failure. An important teaching point related to this drug will be:

a. Take the drug with milk or food.

b. Obtain a home blood pressure monitor to assess for hypertension.

c. Monthly labs will need to be obtained for monitoring.

d. Impotence drugs such as Viagra (sildenafil) must be avoided.

8. A client has had a heart transplant. Nursing care will focus on monitoring for which complication in the immediate postoperative period? Select all that apply.

a. Bleeding

b. Liver failure

c. Renal failure

d. Rejection

9. Which of the following changes noted by the nurse during the morning assessment of a client hospitalized with heart failure would need to be reported to the physician?

a. Weight gain of two pounds from the previous day

b. A productive cough of pink, frothy sputum

c. Temperature of 99.9°F

d. Nausea

10. A health promotion factor that will be taught to the client with mitral valve prolapse is:

a. The need for prophylactic antibiotics prior to dental procedures.

b. Fluid restriction breakdown for each day.

c. The need for daily steroids.

d. The need for yearly cardiac catheterization.

Chapter 32

1.       The nurse is aware that which of the following represents the most common red blood cell disorder?

1. Polycythemia

2. Hemolysis

3. Anemia

4. Erythropoiesis

Cognitive Level: Comprehension

Nursing Process: Assessment

NCLEX: Physiological Integrity Reduction of Risk Potential (Laboratory Values)

2. A client has a hematocrit (Hct) of 32%. The nurse interprets this to mean:

1. The blood is very viscous.

2. Bleeding disorders are likely.

3. 32% of the blood is plasma and plasma products.

4. The client has fewer red blood cells than is normal.

3. The nurse assesses that a client’s pulse pressure is decreasing. Evaluating this would be accomplished by calculating the:

1. Difference between the apical and radial rates.

2. Degree of ventricular contraction in relation to output.

3. Force exerted against an arterial wall.

4. Difference between systolic and diastolic readings.

4. Teaching clients with peripheral vascular disease about the effects of smoking is important, since nicotine:

1. Constricts the superficial vessels while dilating the deep vessels.

2. Dilates the peripheral vessels, which causes a reflex constriction of visceral vessels.

3. Dilates the superficial vessels while constricting the collateral circulation.

4. Constricts the peripheral vessels and increases the force of flow.

5. Postoperative clients should have pedal pulses assessed by the nurse every shift. The important characteristics of pedal pulses are:

1. Contractility and rate.

2. Color of skin and rhythm.

3. Amplitude and symmetry.

4. Local temperature and visible pulsations.

6. A client with a BP of 128/84 would be classified as having:

1. Normal blood pressure.

2. Prehypertension.

3. Stage I hypertension.

4. Stage II hypertension.

7. While performing a physical assessment, the nurse hears a blowing, murmur-type sound over one of the client’s carotid arteries. What should the nurse do next?

1. Count the apical heart rate for one full minute.

2. Have another nurse to listen to validate the finding.

3. Ask the client about history of heart disease.

4. Contact the client’s health provider to report the finding.

NCLEX: Health Promotion and Maintenance

8. A client develops thrombophlebitis postoperatively. The sign that would be present to the nurse would be:

1. Intermittent claudication.

2. Severe pain with extending the extremity.

3. Localized warmth and tenderness of the extremity.

4. Pitting edema of the lower extremities.

9. A nurse would perform which of the following to detect varicose veins in a client?

1. Trendelenburg test

2. Arteriography

3. Romberg test

4. Babinski test

10. Choose the priority nursing diagnosis for a client with a platelet count of 24,000:

1. Gas Exchange, Impaired

2. Fatigue

3. Injury, Risk for

4. Infection, Risk for