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The client is complaining of severe dizziness and drowsiness. Upon assessment, the nurse finds the client has bradycardia and a bluish discoloration of the palms and fingernails. What do these signs and symptoms indicate?
- A. Cinchonism
- B. Overdosage
- C. Hypokalemia
- D. Hypertension
Correct Answer: B
Rationale: These signs and symptoms indicate overdosage of a drug. The nurse should inform the care provider immediately if these symptoms appear. These are not the signs and symptoms of cinchonism, hypokalemia, or hypertension.
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The nursing instructor is teaching the junior nursing students about aortic regurgitation. What classification of drugs is used to sustains the client with aortic regurgitation?
- A. Antihypertensives
- B. Anticoagulants
- C. Cardiac glycosides
- D. Antiarrhythmics
Correct Answer: C
Rationale: Because aortic regurgitation is mild and only slowly progressive in most people, clients are sustained with cardiac glycosides or beta-blockers and diuretics. Antihypertensives, anticoagulants, and antiarrhythmics are not the type of drugs used to treat aortic regurgitation.
A client with aortic regurgitation is experiencing dyspnea and chest pain with activity. The nurse knows that the cause of the symptoms can be best determined by which diagnostic test?
- A. Radionuclide scan
- B. Electrocardiogram (ECG)
- C. Transesophageal echocardiogram (TEE)
- D. Magnetic resonance imaging (MRI)
Correct Answer: A
Rationale: Because the symptoms occur with activity, a radionuclide scan could compare the blood flow through the heart at rest and during activity, giving valuable information about the severity of the diseased valve. ECG, TEE, and MRI are diagnostic tests used in the diagnosis of cardiac disease but less specific for exercise evaluation.
A client with mitral stenosis develops a productive cough with pink, frothy sputum. The best interpretation made by the nurse would be to further evaluate for which complication?
- A. Pulmonary edema
- B. Congestive failure
- C. Thrombophlebitis
- D. Cardiogenic shock
Correct Answer: A
Rationale: A cough with productive, pink, frothy sputum and crackles in the bases of the lungs are signs of pulmonary congestion. Pink, frothy sputum would not be present in congestive failure, thrombophlebitis, or cardiogenic shock.
Which symptom is most important in determining the diagnosis and nursing care for a client experiencing pulmonary hypertension?
- A. Increased stroke volume
- B. Bradycardia
- C. Frothy sputum
- D. High systolic pressure
Correct Answer: C
Rationale: Tachycardia, low systolic pressure, and decreased stroke volume are symptoms associated with pulmonary hypertension. A productive cough with pink-tinged frothy sputum can indicate progression of the disorder and need for treatment.
A client who is diagnosed with aortic stenosis is scheduled for a percutaneous balloon valvuloplasty. Which statement does the nurse include when reinforcing education regarding this procedure?
- A. The balloon is placed in your heart valve and inflated.
- B. A chest incision is necessary for the scheduled procedure.
- C. You will require hospitalization for several days after the procedure.
- D. The opening from this procedure is likely to close in approximately 1 year.
Correct Answer: A
Rationale: Percutaneous balloon valvuloplasty (i.e., valvotomy) is a nonsurgical alternative for the treatment of mitral stenosis. During this procedure, a catheter with an uninflated balloon is passed through the femoral vein and threaded into the right atrium. The septum is then punctured between the right and left atria. When the catheter is in the mitral valve, it is inflated; therefore, the statement the nurse includes when reinforcing education with this client regarding this procedure is 'The balloon is placed in your heart valve and inflated.' The other statements are not appropriate for the nurse to include when reinforcing education because this procedure is nonsurgical, thus will not require a chest incision; the client is likely to be discharged the same day as the procedure, and the opening that is caused as a result of this procedure is likely to close within 6 months, not 1 year.