Nokea
The nurse is discharging a client after a cardiac catheterization. What would the nurse include in the discharge teaching?
- A. Eat only soft foods for the next 12 hours.
- B. Report any numbness, tingling, or sharp pain in the extremity.
- C. Restrict your intake of water until the dye is out of the body.
- D. Move around whenever the client feels like getting up.
Correct Answer: B
Rationale: Instructions for the client and family include: Keep the extremity straight for several hours and avoid movement; Report any warm, wet feeling that may indicate oozing blood, numbness, tingling, or sharp pain in the extremity; Drink a large volume of fluid to relieve thirst and promote the excretion of the dye. There is no need to eat only soft foods after a cardiac catheterization.
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The nurse is caring for a client with an elevated blood pressure and no previous history of hypertension. At 0900, the blood pressure was 158/90 mm Hg. At 0930, the blood pressure is 142/82 mm Hg. The nurse is most correct when relating the fall in blood pressure to which structure?
- A. Chemoreceptors
- B. Sympathetic nerve fibers
- C. Baroreceptors
- D. Vagus nerve
Correct Answer: C
Rationale: Baroreceptors sense pressure in nerve endings in the walls of the atria and major blood vessels. The baroreceptors respond accordingly to raise or lower the pressure. Chemoreceptors are sensitive to pH, CO2, and O2 in the blood. Sympathetic nerve fibers increase the heart rate. The vagus nerve slows the heart rate.
The nurse is caring for a client with a damaged tricuspid valve. The nurse knows that the tricuspid valve is held in place by which of the following?
- A. Chordae tendineae
- B. Atrioventricular tendons
- C. Semilunar tendineae
- D. Papillary tendons
Correct Answer: A
Rationale: Attached to the mitral and tricuspid valves are cordlike structures known as chordae tendineae, which in turn attach to papillary muscles, two major muscular projections from the ventricles. Neither atrioventricular tendons, semilunar tendineae, nor papillary tendons hold the tricuspid valve in place.
The nurse is caring for a client with ECG changes consistent with a myocardial infarction. Which of the following diagnostic test does the nurse anticipate to confirm heart damage?
- A. Fluoroscopy
- B. Nuclear cardiology
- C. Serum blood work
- D. Chest radiography
Correct Answer: B
Rationale: Nuclear cardiology uses a radionuclide to detect areas of myocardial damage. Chest radiography and fluoroscopy determine the size and position of the heart and condition of the lungs. Serum blood work notes elevations in enzymes suggesting tissue damage.
The nurse is caring for a client with right-sided heart failure. When assessing the respiratory rate of this client, what is an indication that the client is having difficulty breathing?
- A. Not using the abdominal muscles during breathing
- B. Using accessory muscles during respiration
- C. Barely palpable, thready pulse volume
- D. Combination of noisy and quiet respiration
Correct Answer: B
Rationale: When assessing the respiratory rate of a client with a cardiovascular disorder, the nurse observes the character of the respirations, noting whether the client's breathing is easy, labored, or dyspneic; deep or shallow; and noisy or quiet. The use of accessory muscles such as neck or abdominal muscles during respiration is an indication that the client is having difficulty breathing. Pulse volume is described as feeling full, weak, or thready, meaning barely palpable.
When caring for a client with dysfunction in the conduction system, at which period would the nurse note that cells are resistant to stimulation?
- A. During polarization
- B. During depolarization
- C. During repolarization
- D. During the refractory period
Correct Answer: D
Rationale: The refractory period is the time when cells are resistant to electrical stimulation. Repolarization is when the ions realign themselves to wait for an electrical signal. Depolarization occurs during muscle contraction when positive ions move inside the myocardial cell membrane and negative ions move outside. Before an impulse is generated, the cells are in a polarized state.