Nokea
A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as having the greatest risk for cardiovascular disease?
- A. An 86-year-old man with a history of asthma
- B. A 32-year-old Asian-American man with colorectal cancer
- C. A 45-year-old American Indian woman with diabetes mellitus
- D. A 53-year-old postmenopausal woman who is on hormone therapy
Correct Answer: C
Rationale: Diabetes mellitus is a significant risk factor for cardiovascular disease, and the 45-year-old American Indian woman with diabetes mellitus has the highest risk among the options provided.
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The primary care pediatric nurse practitioner is performing a well child examination on a school-age child who had complete repair of a tetralogy of Fallot (TOF) defect in infancy. What is important in this child's health maintenance regime?
- A. Cardiology clearance for sports participation
- B. Restriction of physical activity to avoid pulmonary complications
- C. Sub-acute bacterial endocarditis prophylaxis precautions
- D. Teaching about management of hypercyanotic episodes
Correct Answer: A
Rationale: Children who have had TOF repair must be cleared by cardiology before participation in sports.
The mother of a toddler reports that the child's father has just had a myocardial infarction (MI). Because of this, the nurse recommends the child have a(n):
- A. Electrocardiogram
- B. Lipid profile
- C. Echocardiogram
- D. Cardiac catheterization
Correct Answer: B
Rationale: Current recommendations are for a lipid profile in children over 2 years of age who have a family history of cardiac events or high cholesterol.
A client with unstable asthma had an emergent cardiac catheterization. Which complication should the nurse monitor for in the initial 24 hours after the procedure?
- A. Thrombus formation
- B. Infection
- C. Bronchospasm
- D. Heart failure
Correct Answer: A
Rationale: After a cardiac catheterization, the nurse must monitor for thrombus formation as it is a common complication in the first 24 hours.
Severe pulmonary valve stenosis is defined as a peak gradient of
- A. >40 mm Hg
- B. >45 mm Hg
- C. >50 mm Hg
- D. >55 mm Hg
Correct Answer: C
Rationale: Severe pulmonary valve stenosis is generally defined as a peak gradient >50 mm Hg.
The pH of urine:
- A. Is a useful indicator of the acid/base balance of blood
- B. Rises on a vegetarian diet
- C. Is determined by the concentration of ammonium
- D. Is lower than 5.5 in renal tubular acidosis
Correct Answer: A
Rationale: Urine pH reflects blood acid/base balance. A vegetarian diet typically raises urine pH, and renal tubular acidosis causes a higher pH, not lower.