Question 1

When caring for a patient with infective endocarditis of the tricuspid valve,the nurse should monitor the patient for the development of

Accepted Answer

A)  flank pain. 
B)  splenomegaly. 
C)  shortness of breath. 
D)  mental status changes.

Question 2

The nurse will plan discharge teaching about the need for prophylactic antibiotics when having dental procedures for which patient?

Accepted Answer

A)  Patient admitted with a large acute myocardial infarction. 
B)  Patient being discharged after an exacerbation of heart failure. 
C)  Patient who had a mitral valve replacement with a mechanical valve. 
D)  Patient being treated for rheumatic fever after a streptococcal infection.

Question 3

The nurse is caring for a patient with mitral regurgitation.Referring to the figure below,where should the nurse listen to best hear any murmur that the patient has?

Accepted Answer

A)  1 
B)  2 
C)  3 
D)  4

Question 4

The nurse obtains a health history from a 65-year-old patient with a prosthetic mitral valve who has symptoms of infective endocarditis (IE).Which question by the nurse is most appropriate?

Accepted Answer

A)  "Do you have a history of a heart attack?" 
B)  "Is there a family history of endocarditis?" 
C)  "Have you had any recent immunizations?" 
D)  "Have you had dental work done recently?"

Question 5

Which assessment finding in a patient who is admitted with infective endocarditis (IE)is most important to communicate to the health care provider?

Accepted Answer

A)  Generalized muscle aching 
B)  Sudden onset right flank pain 
C)  Janeway's lesions on the palms 
D)  Temperature 100.7° F (38.1° 
C)

Question 6

The nurse suspects cardiac tamponade in a patient who has acute pericarditis.To assess for the presence of pulsus paradoxus,the nurse should

Accepted Answer

A)  note when Korotkoff sounds are auscultated during both inspiration and expiration. 
B)  subtract the diastolic blood pressure (DBP) from the systolic blood pressure (SBP). 
C)  check the electrocardiogram (ECG) for variations in rate during the respiratory cycle. 
D)  listen for a pericardial friction rub that persists when the patient is instructed to stop breathing.

Question 7

While caring for a patient with aortic stenosis,the nurse identifies a nursing diagnosis of acute pain related to decreased coronary blood flow.A priority nursing intervention for this patient would be to

Accepted Answer

A)  promote rest to decrease myocardial oxygen demand. 
B)  teach the patient about the need for anticoagulant therapy. 
C)  teach the patient to use sublingual nitroglycerin for chest pain. 
D)  raise the head of the bed 60 degrees to decrease venous return.

Question 8

A 21-year-old woman is scheduled for percutaneous transluminal balloon valvuloplasty to treat mitral stenosis.Which information should the nurse include when explaining the advantages of valvuloplasty over valve replacement to the patient?

Accepted Answer

A)  Biologic valves will require immunosuppressive drugs after surgery. 
B)  Mechanical mitral valves need to be replaced sooner than biologic valves. 
C)  Lifelong anticoagulant therapy will be needed after mechanical valve replacement. 
D)  Ongoing cardiac care by a health care provider is not necessary after valvuloplasty.

Question 9

A patient admitted with acute dyspnea is newly diagnosed with dilated cardiomyopathy.Which information will the nurse plan to teach the patient about managing this disorder?

Accepted Answer

A)  A heart transplant should be scheduled as soon as possible. 
B)  Elevating the legs above the heart will help relieve dyspnea. 
C)  Careful compliance with diet and medications will prevent heart failure. 
D)  Notify the doctor about any symptoms of heart failure such as shortness of breath.

Question 10

After receiving report on the following patients,which patient should the nurse assess first?

Accepted Answer

A)  Patient with rheumatic fever who has sharp chest pain with a deep breath 
B)  Patient with acute aortic regurgitation whose blood pressure is 86/54 mm Hg 
C)  Patient with infective endocarditis who has a murmur and splinter hemorrhages 
D)  Patient with dilated cardiomyopathy who has bilateral crackles at the lung bases

Question 11

While caring for a 23-year-old patient with mitral valve prolapse (MVP)without valvular regurgitation,the nurse determines that discharge teaching has been effective when the patient states that it will be necessary to

Accepted Answer

A)  take antibiotics before any dental appointments. 
B)  limit physical activity to avoid stressing the heart. 
C)  take an aspirin a day to prevent clots from forming on the valve. 
D)  avoid use of over-the-counter (OT
C)  medications that contain stimulant drugs.

Question 12

A patient recovering from heart surgery develops pericarditis and complains of level 6 (0 to 10 scale)chest pain with deep breathing.Which ordered PRN medication will be the most appropriate for the nurse to give?

Accepted Answer

A)  Fentanyl 1 mg IV 
B)  IV morphine sulfate 4 mg 
C)  Oral ibuprofen (Motrin) 600 mg 
D)  Oral acetaminophen (Tylenol) 650 mg

Question 13

When developing a community health program to decrease the incidence of rheumatic fever,which action would be most important for the community health nurse to include?

Accepted Answer

A)  Vaccinate high-risk groups in the community with streptococcal vaccine. 
B)  Teach community members to seek treatment for streptococcal pharyngitis. 
C)  Teach about the importance of monitoring temperature when sore throats occur. 
D)  Teach about prophylactic antibiotics to those with a family history of rheumatic fever.

Question 14

Which action by the nurse will determine if the therapies ordered for a patient with chronic constrictive pericarditis are effective?

Accepted Answer

A)  Assess for the presence of a paradoxical pulse. 
B)  Monitor for changes in the patient's sedimentation rate. 
C)  Assess for the presence of jugular venous distention (JV
D) . 
D)  Check the electrocardiogram (ECG) for ST segment changes.

Question 15

When caring for a patient with mitral valve stenosis,it is most important that the nurse assess for

Accepted Answer

A)  diastolic murmur. 
B)  peripheral edema. 
C)  shortness of breath on exertion. 
D)  right upper quadrant tenderness.

Exam 37: Nursing Management: Inflammatory and Structural Heart Disorders