NSG 4100 Cardiac Problems/Heart Failure Exam Competence training check with complete Solution updated 2024/2025
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Course
NSG 4100
Institution
NSG 4100
NSG 4100 Cardiac Problems/Heart Failure Exam Competence training check with complete Solution updated 2024/2025
A client has been admitted to the intensive care unit with worsening pulmonary manifestations of heart failure. What is the nurse's best action?
a. Place the client in a high Fowler's...
NSG 4100 Cardiac Problems/Heart Failure Exam
Competence training check with complete Solution
updated 2024/2025
A client has been admitted to the intensive care unit with worsening pulmonary
manifestations of heart failure. What is the nurse's best action?
a. Place the client in a high Fowler's position.
b. Begin cardiopulmonary resuscitation (CPR).
c. Promote rest and minimize activities.
d. Administer loop diuretics as prescribed. - correct answer ANS: D
The client with worsening heart failure is most at risk for pulmonary edema as a
consequence of fluid retention. Administering diuretics will decrease the fluid overload,
thereby decreasing the incidence of pulmonary edema. High Fowler's position might
help the client breathe easier but will not solve the problem. CPR is not warranted in this
situation. Rest is important for clients with heart failure, but this is not the priority.
The rehabilitation nurse is assisting a client with heart failure to increase activity
tolerance. During ambulation of the client, identification of what symptom causes the
nurse to stop the client's activity?
a. Decrease in oxygen saturation from 98% to 95%
b. Respiratory rate change from 22 to 28 breaths/min
c. Systolic blood pressure change from 136 to 96 mm Hg
d. Increase in heart rate from 86 to 100 beats/min - correct answer ANS: C
A blood pressure change (increase or decrease) of greater than 20 mm Hg during or
after activity indicates poor cardiac tolerance of the activity. A significant decrease
(>20%) in blood pressure during or after activity is especially ominous, because it
indicates an inability of the left ventricle to maintain sufficient cardiac output.
The nurse is concerned that an older adult client with heart failure is developing
pulmonary edema. What manifestation alerts the nurse to further assess the client for
this complication?
a. Confusion
, b. Dysphagia
c. Sacral edema
d. Irregular heart rate - correct answer ANS: A
Impending pulmonary edema is characterized by a change in mental status,
disorientation, and confusion, along with dyspnea and increasing fluid levels in the
lungs. Dysphagia, sacral edema, and an irregular heart rate are not related to
pulmonary edema.
The nurse is caring for a client with mitral valve stenosis. What clinical manifestation
alerts the nurse to the possibility that the client's stenosis has progressed?
a. Oxygen saturation of 92%
b. Dyspnea on exertion
c. Muted systolic murmur
d. Upper extremity weakness - correct answer ANS: B
Dyspnea on exertion develops as the mitral valvular orifice narrows and pressure in the
lungs increases.
The nurse is caring for a client diagnosed with aortic stenosis. What assessment finding
does the nurse expect in this client?
a. Bounding arterial pulse
b. Slow, faint arterial pulse
c. Narrowed pulse pressure
d. Elevated systolic pressure - correct answer ANS: C
In aortic stenosis, the client presents with narrowed pulse pressure when blood
pressure (BP) is assessed.
A client who has had a prosthetic valve replacement asks the nurse why he must take
anticoagulants for the rest of his life. What is the nurse's best response?
a. "The prosthetic valve places you at greater risk for a heart attack."
b. "Blood clots form more easily in artificial replacement valves."
c. "The vein taken from your leg reduces circulation in the leg."
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