Question 1

A patient with mitral stenosis is prescribed a preoperative antibiotic.Which patient statement indicates an understanding for taking this medication?

Accepted Answer

A)  "To prevent postoperative pneumonia." 
B)  "To prevent an increase in body temperature." 
C)  "To prevent a bacterial infection in the heart." 
D)  "To prevent infection of the surgical incision."

Question 2

A patient is scheduled for cardiac surgery for placement of a mechanical valve.Which patient statement indicates correct understanding of characteristics of mechanical valves used for cardiac valve replacement? (Select all that apply.)

Accepted Answer

A)  "They are durable." 
B)  "They require donors." 
C)  "They create turbulent blood flow." 
D)  "They can be placed during balloon angioplasty." 
E)  "They do not require lifelong anticoagulant therapy."
F) "They may be preferred if anticoagulation is a concern."

Question 3

The nurse is caring for a patient with pericarditis.Which type of medication should the nurse expect to be prescribed for the patient?

Accepted Answer

A)  Beta blocker 
B)  Antihypertensive 
C)  Anti-inflammatory 
D)  Calcium channel blocker

Question 4

The nurse is reviewing the prothrombin time (PT)value for a patient prescribed warfarin (Coumadin).The laboratory's prothrombin time range is 9 to 11 seconds.What would be the therapeutic time for the patient?

Accepted Answer

A)  12.5 seconds 
B)  17 seconds 
C)  26 seconds 
D)  30 seconds

Question 5

The nurse is collecting data from a patient.Which approach should the nurse use to determine the presence of a Homan's sign?

Accepted Answer

A)  Observing the calf and thigh color bilaterally 
B)  Listening with a Doppler to posterior bilateral tibial pulses 
C)  Measuring the patient's calf and thigh circumference bilaterally 
D)  Dorsiflexing the patient's foot sharply and asking if calf pain occurs

Question 6

A patient with chronic mitral regurgitation states,"I am always so tired." Which factor should the nurse identify as contributing to this patient's fatigue?

Accepted Answer

A)  Coughing 
B)  Heart murmur 
C)  Pulmonary congestion 
D)  Decreased cardiac output

Question 7

The home health nurse is visiting a patient with cardiomyopathy who lives alone and is prescribed anticoagulant therapy.Which observation indicates that the patient requires more teaching?

Accepted Answer

A)  The patient is wearing elastic stockings and slippers. 
B)  The patient has a straight razor on the bathroom sink. 
C)  The patient has a soft-bristle toothbrush in the bathroom. 
D)  The patient has a bottle of acetaminophen on the counter.

Question 8

The nurse is evaluating care provided to a patient with the nursing diagnosis of activity intolerance because of aortic regurgitation.Which outcome indicates that care has been effective?

Accepted Answer

A)  Stated maintained bedrest to reduce fatigue 
B)  Engaged in desired daily and social activities 
C)  Completed activities of daily living with assistance 
D)  Reported no longer participates in gardening hobby

Question 9

A patient with aortic stenosis is being treated for heart failure.Which medication order should the nurse question?

Accepted Answer

A)  Heparin 
B)  Digoxin (Lanoxin) 
C)  Bumetanide (Bumex) 
D)  Warfarin (Coumadin)

Question 10

The nurse is reinforcing teaching provided to a patient with thrombophlebitis.Which diagnostic test should the nurse explain is used to confirm thrombophlebitis?

Accepted Answer

A)  Chest radiograph 
B)  Intravenous pyelogram 
C)  Duplex venous scanning 
D)  Arterial Doppler ultrasonography

Question 11

The nurse is contributing to a patient's plan of care.Which statement is a desired outcome for the nursing diagnosis of Deficient Knowledge related to a new medical diagnosis of mitral valve prolapse?

Accepted Answer

A)  Exhibits less fatigue during self-care 
B)  Clear breathing sounds, no edema or weight gain 
C)  States ability to comply with therapeutic regimen 
D)  Verbalizes definition of disorder and manifestations

Question 12

A patient recovering from cardiac surgery complains of discomfort when turning and moving in bed.What should the nurse encourage the patient perform when making position changes?

Accepted Answer

A)  Hold the breath 
B)  Splint with a pillow 
C)  Bend the knees to the chest 
D)  Lift the head off of the bed

Question 13

A postoperative patient suddenly develops dyspnea,tachypnea,restlessness,and chest pain.Which complication should the nurse suspect is occurring in this patient?

Accepted Answer

A)  Pulmonary edema 
B)  Respiratory arrest 
C)  Pulmonary embolus 
D)  Myocardial infarction

Question 14

The nurse caring for patients on the cardiac unit reviews the standards related to deep vein thrombosis prophylaxis.Which approach should the nurse recognize as being the most effective to prevent the development of deep vein thrombosis?

Accepted Answer

A)  Using bilateral thigh-high stockings throughout hospitalization 
B)  Using low molecular weight heparin given subcutaneously daily 
C)  Using bilateral leg compression devices while the patient is in bed 
D)  Using a combination of pharmacological and compression interventions

Question 15

A patient with a deep vein thrombosis receiving a heparin infusion and warfarin (Coumadin)therapy develops bleeding gums.What action should the nurse take?

Accepted Answer

A)  Notify the registered nurse. 
B)  Offer the patient a saline mouth rinse. 
C)  Turn off the heparin infusion immediately. 
D)  Tell the patient to gargle with mouthwash.

Question 16

A patient recovering from valve replacement surgery has a low cardiac output.Which laboratory tests should the nurse identify as a possible cause for this patient's problem? (Select all that apply.)

Accepted Answer

A)  Low serum sodium level 
B)  Low serum calcium level 
C)  Low serum magnesium level 
D)  Elevated serum glucose level 
E)  Elevated serum potassium level

Question 17

The nurse suspects that a patient recovering from valve replacement surgery is experiencing an infection.Which findings did the nurse use to come to this conclusion? (Select all that apply.)

Accepted Answer

A)  Cloudy urine 
B)  Lung crackles 
C)  Incisional pain 
D)  Elevated temperature 
E)  Yellow-green sputum

Question 18

The nurse is reinforcing discharge instructions to a patient who has a mitral valve prolapse.What information should be included?

Accepted Answer

A)  "Begin a home aerobic exercise program." 
B)  "Perform hourly leg exercises if lying down." 
C)  "Deep breathe and cough hourly when awake." 
D)  "You may have a possible need for prophylactic anticoagulants."

Question 19

A healthy postoperative patient who has been on bedrest for 3 days suddenly develops dyspnea,tachypnea,restlessness,and chest pain.The patient says,"I feel as if something is going to happen to me." What should the nurse do?

Accepted Answer

A)  Perform a bilateral Homans' test. 
B)  Give a narcotic for pain as ordered. 
C)  Ensure physician is notified immediately. 
D)  Reassure the patient that everything is fine.

Question 20

The nurse is caring for a patient who has a valvular problem.The patient states the doctor is ordering something that measures the pressures in the patient's heart.Which diagnostic test should the nurse anticipate scheduling for the patient?

Accepted Answer

A)  Echocardiogram 
B)  Chest radiograph 
C)  Electrocardiogram 
D)  Cardiac catheterization

Exam 23: Nursing Care of Patients With Valvular, Inflammatory, and Infectious Cardiac or Venous Disorders