Nokea
A patient questions 'Why all the fuss about a little high blood pressure? My father had it and he lived to be 65 years old.' The nurse bases the answer, knowing that which complication can occur due to untreated blood pressure?
- A. Chronic Obstructive Pulmonary Disease (COPD)
- B. Frequent and severe infectious disease of the lungs
- C. Increased risk of myocardial infarctions (MI) and stroke
- D. Severe corneal abrasions, requiring corneal transplants
Correct Answer: C
Rationale: Hypertension is called the 'silent killer' because a patient with elevated blood pressure does not display signs and symptoms of heart disease until damage has begun to develop. This damage increases the risks of heart disease, stroke, heart failure, or cardiovascular death.
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The nurse caring for a 92-year-old patient with pneumonia who is receiving IV carefully monitors the flow rate of the IV infusion because rapid infusion can cause which disorder?
- A. hypotension.
- B. thrombophlebitis.
- C. pulmonary emboli.
- D. heart failure.
Correct Answer: D
Rationale: Heart failure can result from rapid infusion of intravenous fluids in older adults.
The nurse is aware that the symptoms of an impending myocardial infarction (MI) differ in women because acute chest pain is not present. Women are frequently misdiagnosed as having which disorder?
- A. hepatitis A.
- B. indigestion.
- C. urinary infection.
- D. menopausal complications.
Correct Answer: B
Rationale: Indigestion, gallbladder attack, anxiety attack, and depression are frequent misdiagnoses for women having an MI.
A patient admitted to the emergency room with a possible myocardial infarction (MI) has reports back from the laboratory. Which laboratory report is specific for myocardial damage?
- A. CK-MB
- B. Elevated white count
- C. Elevated sedimentation rate
- D. Low level of sodium
Correct Answer: A
Rationale: The CK-MB is elevated when there is infarcted myocardial muscle. The elevated white count, low sodium, and ESR are nonspecific.
The nurse is reinforcing instructions on a patient who will be taking digoxin. Which sign of digoxin toxicity should the nurse include?
- A. Ringing in the ears
- B. Bradycardia
- C. Headache
- D. Visual disturbance
- E. Hematuria
- F. Anorexia
Correct Answer: B,C,D,F
Rationale: Major signs of digoxin toxicity are bradycardia (HR <60), headache, visual disturbances, anorexia, as well as fatigue and arrhythmias.
A patient is admitted from the emergency department. The emergency department health care provider notes the patient has a diagnosis of heart failure with a New York Heart Association (NYHA) classification of IV. This indicates the patient has which class of heart failure?
- A. moderate heart failure.
- B. severe heart failure.
- C. congestive heart failure.
- D. negligible heart failure.
Correct Answer: B
Rationale: Class IV: Severe; patient unable to perform any physical activity without discomfort. Angina or symptoms of cardiac inefficiency may develop at rest.