A 55-year-old man with aortic valve stenosis is being admitted for valve replacement surgery. Which assessment finding should the nurse expect?
A. Pulse deficit
B. Systolic murmur
C. Distended neck veins
D. Splinter hemorrhages - B: The turbulent blood flow across a diseased valve results i...
A 55-year-old man with aortic valve stenosis is being admitted for valve replacement surgery. Which
assessment finding should the nurse expect?
A. Pulse deficit
B. Systolic murmur
C. Distended neck veins
D. Splinter hemorrhages - B: The turbulent blood flow across a diseased valve results in a murmur.
Aortic stenosis produces a systolic murmur. A pulse deficit indicates a cardiac dysrhythmia, most
commonly atrial fibrillation. Distended neck veins may be caused by right-sided heart failure. Splinter
hemorrhages occur in patients with infective endocarditis.
A 74-year-old woman who is admitted with severe dyspnea has a history of heart failure and chronic
obstructive lung disease. Which diagnostic study would the nurse expect to be elevated if the cause of
dyspnea was cardiac related?
A. Serum potassium
B. Serum homocysteine
C. High-density lipoprotein
D. b-type natriuretic peptide (BNP) - D: Elevation of b-type natriuretic peptide (BNP) indicates the
presence of heart failure. Elevations help to distinguish cardiac vs. respiratory causes of dyspnea.
Elevated potassium, homocysteine, or HDL levels may indicate increased risk for cardiovascular
disorders but do not indicate that cardiac disease is present.
A nurse is preparing to teach a group of women in a community volunteer group about heart disease.
What should the nurse include in the teaching plan?
A. Women are less likely to delay seeking treatment than men.
B. Women are more likely to have noncardiac symptoms of heart disease.
C. Women are often less ill when presenting for treatment of heart disease.
D. Women experience more symptoms of heart disease at a younger age than men. - B: Women often
have atypical angina symptoms and nonpain symptoms. Women experience the onset of heart disease
about 10 years later than men. Women are often more ill on presentation and delay longer in seeking
care than men.
, A 64-year-old patient with a history of myocardial infarction is scheduled for a transesophageal
echocardiogram to visualize a suspected clot in the left atrium. What information should the nurse
include when teaching the patient about this diagnostic study?
A. IV sedation may be administered to help the patient relax.
B. Food and fluids are restricted for 2 hours before the procedure.
C. Ambulation is restricted for up to 6 hours before the procedure.
D. Contrast medium is injected into the esophagus to enhance images. - A:IV sedation is administered
to help the patient relax and ease the insertion of the tube into the esophagus. Food and fluids are
restricted for at least 6 hours before the procedure. Smoking and exercise are restricted for 3 hours
before exercise or stress testing, but not before TEE. Contrast medium is administered IV to evaluate the
direction of blood flow if a septal defect is suspected.
The nurse teaches a 28-year-old man newly diagnosed with hypertension about lifestyle modifications
to reduce his blood pressure. Which statement by the patient requires an intervention by the nurse?
A. "I will avoid adding salt to my food during or after cooking."
B. "If I lose weight, I might not need to continue taking medications."
C. "I can lower my blood pressure by switching to smokeless tobacco."
D. "Diet changes can be as effective as taking blood pressure medications." - C: Nicotine contained in
tobacco products (smoking and chew) cause vasoconstriction and increase blood pressure. Persons with
hypertension should restrict sodium to 1500 mg/day by avoiding foods high in sodium and not adding
salt in preparation of food or at meals. Weight loss can decrease blood pressure between 5 to 20 mm
Hg. Following dietary recommendations (such as the DASH diet) lowers blood pressure, and these
decreases compare with those achieved with blood pressure-lowering medication.
The nurse supervises an unlicensed assistant personnel (UAP) who is taking the blood pressure of 58-
year-old female patient admitted with heart failure. The patient is obese. The nurse should intervene if
what is observed?
A. The UAP waits 2 minutes after position changes to take orthostatic pressures.
B. The UAP deflates the blood pressure cuff at a rate of 8 to 10 mm Hg per second.
C. The UAP takes the blood pressure with the patient's arm at the level of the heart.
D. The UAP takes a forearm blood pressure because the largest cuff will not fit the patient's upper arm. -
B: The cuff should be deflated at a rate of 2 to 3 mm Hg per second. The arm should be supported at the
level of the heart for accurate blood pressure measurements. If the maximum size blood pressure cuff
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