Ch 28. Cardiac
The nurse is providing discharge teaching for a client with rheumatic endocarditis but
no valvular dysfunction. On which nursing diagnosis should the nurse focus her
teaching?
a. risk for infection
b. chronic pain
✅✅
c. impaired gas exchange
d. impaired memory - -a. risk for infection
A client who suffered blunt chest trauma in a motor vehicle accident complains of
chest pain, which is exacerbated by deep inspiration. On auscultation, the nurse
detects a pericardial friction rub — a classic sign of acute pericarditis. The physician
confirms acute pericarditis and begins appropriate medical intervention. To relieve
chest pain associated with pericarditis, which position should the nurse encourage
the client to assume?
a. Semi-Fowler's
b. Leaning forward while sitting
✅✅
c. Supine
d. Prone - -b. Leaning forward while sitting
Which mitral valve condition generally produces no symptoms?
a. Stenosis
b. Prolapse
✅✅
c. Regurgitation
d. Infection - -b. Prolapse
The nurse is auscultating the heart of a client diagnosed with mitral valve prolapse.
Which is often the first and only manifestation of mitral valve prolapse?
a. Fatigue
b. An extra heart sound
✅✅
c. Dizziness
d. Syncope - -b. An extra heart sound
Which term describes the splitting or separating of fused cardiac valve leaflets?
a. Annuloplasty
b. Chordoplasty
✅✅
c. Commissurotomy
d. Valvuloplasty - -c. Commissurotomy
A nurse is caring for a client with acute mitral regurgitation related to an acute
myocardial infarction. The nurse knows to monitor the client carefully for symptoms
of which initial complication or result?
a. Severe heart failure
, b. Kidney failure
✅✅
c. Cerebral vascular accident (CVA)
d. Infarcted bowel - -a. Severe heart failure
A nursing student is assigned to the medical intensive care unit for the first time. The
nurse preceptor asks the student to listen to a water-hammer pulse. The nursing
student knows that the sound will resemble which of the following?
a. Quick, sharp strokes that suddenly collapse
b. Low-pitched diastolic murmur at the apex
✅✅
c. High-pitched blowing sound at the apex
d. Mitral click - -a. Quick, sharp strokes that suddenly collapse
A patient with a history of valvular disease has just arrived in the PACU after a
percutaneous balloon valvuloplasty. Which intervention should the recovery nurse
implement?
a. Assess the patient's chest tube output.
b. Monitor the patient's chest drainage.
✅✅
c. Evaluate the patient's endotracheal lip line.
d. Keep the patient's affected leg straight. - -d. Keep the patient's affected leg
straight.
The nurse is preparing to administer warfarin (Coumadin), an oral anticoagulant, to a
patient with a mechanical valve replacement. The patient's INR is 2.7. Which action
should the nurse take?
a. Administer the medication as ordered.
b. Prepare to administer Vitamin K.
✅✅
c. Hold the medication and notify the HCP.
d. Asses the patient for abnormal bleeding. - -a. Administer the medication as
ordered.
Incomplete closure of the mitral valve results in backflow of blood from the:
a. Left ventricle to left atrium
b. Right ventricle to the right atrium
✅✅
c. Right atrium to right ventricle
d. Left atrium to left ventricle - -a. Left ventricle to left atrium
The nurse is caring for a patient diagnosed with myocarditis. The nurse must be
aware that patients with myocarditis are sensitive to which of the following
medications?
a. Digoxin
b. Lasix
✅✅
c. Penicillin
d. Corticosteroids - -a. Digoxin
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