Nokea
A patient has been living with dilated cardiomyopathy for several years but has experienced worsening symptoms despite aggressive medical management. The nurse should anticipate what potential treatment?
- A. Heart transplantation
- B. Balloon valvuloplasty
- C. Cardiac catheterization
- D. Stent placement
Correct Answer: A
Rationale: When heart failure progresses and medical treatment is no longer effective, surgical intervention, including heart transplantation, is considered. Valvuloplasty, stent placement, and cardiac catheterization will not address the pathophysiology of cardiomyopathy.
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A patient with mitral valve prolapse is admitted for a scheduled bronchoscopy to investigate recent hemoptysis. The physician has ordered gentamicin to be taken before the procedure. What is the rationale for this?
- A. To prevent bacterial endocarditis
- B. To prevent hospital-acquired pneumonia
- C. To minimize the need for antibiotic use during the procedure
- D. To decrease the need for surgical asepsis
Correct Answer: A
Rationale: Antibiotic prophylaxis is recommended for high-risk patients immediately before and sometimes after the following invasive procedures, such as bronchoscopy. Gentamicin would not be given to prevent pneumonia, to avoid antibiotic use during the procedure, or to decrease the need for surgical asepsis.
The nurse is caring for a patient with acute pericarditis. What nursing management should be instituted to minimize complications?
- A. The nurse keeps the patient isolated to prevent nosocomial infections.
- B. The nurse encourages coughing and deep breathing.
- C. The nurse helps the patient with activities until the pain and fever subside.
- D. The nurse encourages increased fluid intake until the infection resolves.
Correct Answer: C
Rationale: To minimize complications, the nurse helps the patient with activity restrictions until the pain and fever subside. As the patients condition improves, the nurse encourages gradual increases of activity. Actions to minimize complications of acute pericarditis do not include keeping the patient isolated. Due to pain, coughing and deep breathing are not normally encouraged. An increase in fluid intake is not always necessary.
The nurse is caring for a patient with right ventricular hypertrophy and consequently decreased right ventricular function. What valvular disorder may have contributed to this patients diagnosis?
- A. Mitral valve regurgitation
- B. Aortic stenosis
- C. Aortic regurgitation
- D. Mitral valve stenosis
Correct Answer: D
Rationale: Because no valve protects the pulmonary veins from the backward flow of blood from the atrium, the pulmonary circulation becomes congested. As a result, the right ventricle must contract against an abnormally high pulmonary arterial pressure and is subjected to excessive strain. Eventually, the right ventricle fails. None of the other listed valvular disorders has this pathophysiological effect.
The nurse is caring for a recent immigrant who has been diagnosed with mitral valve regurgitation. The nurse should know that in developing countries the most common cause of mitral valve regurgitation is what?
- A. A decrease in gamma globulins
- B. An insect bite
- C. Rheumatic heart disease and its sequelae
- D. Sepsis and its sequelae
Correct Answer: C
Rationale: The most common cause of mitral valve regurgitation in developing countries is rheumatic heart disease and its sequelae.
A community health nurse is presenting an educational event and is addressing several health problems, including rheumatic heart disease. What should the nurse describe as the most effective way to prevent rheumatic heart disease?
- A. Recognizing and promptly treating streptococcal infections
- B. Prophylactic use of calcium channel blockers in high-risk populations
- C. Adhering closely to the recommended child immunization schedule
- D. Smoking cessation
Correct Answer: A
Rationale: Group A streptococcus can cause rheumatic heart fever, resulting in rheumatic endocarditis. Being aware of signs and symptoms of streptococcal infections, identifying them quickly, and treating them promptly, are the best preventative techniques for rheumatic endocarditis. Smoking cessation, immunizations, and calcium channel blockers will not prevent rheumatic heart disease.