Nokea
The nurse plans teaching for a 20-year-old newly diagnosed with hypertrophic cardiomyopathy. The client is on the college soccer team. Which information should be the nurse’s priority when teaching the client?
- A. Provide pamphlets on genetic testing to avoid passing on an inherited disease.
- B. Reinforce the need to continue exercise with soccer to strengthen the heart.
- C. Provide information about CPR to persons living with the client.
- D. Counsel on foods for consuming on a low-fat, low-cholesterol diet.
Correct Answer: C
Rationale: Because sudden cardiac death is a large risk factor for those under 30 years of age, the nurse should provide information about having others living with the client trained in CPR as a preventative measure. Genetic testing, continued strenuous exercise, and diet are less immediate priorities.
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The nurse assesses the client at a vascular clinic after being treated with pentoxifylline for 6 weeks. The nurse determines that pentoxifylline has been effective when noting that the client has which finding?
- A. A decrease in lower-extremity edema
- B. No symptoms of withdrawal after quitting smoking
- C. A venous ulcer on the ankle that has decreased in size
- D. The ability to walk a longer distance without claudication
Correct Answer: D
Rationale: Pentoxifylline (Trental) is thought to act by improving capillary blood flow and is prescribed to decrease intermittent claudication. Effects are usually seen in 2 to 4 weeks. Edema, smoking withdrawal, and venous ulcers are not treated by pentoxifylline.
The nurse is assessing the client following an inferior-septal wall MI. Which potential complication should the nurse further explore when noting that the client has JVD and ascites?
- A. Left-sided heart failure
- B. Pulmonic valve malfunction
- C. Right-sided heart failure
- D. Ruptured septum
Correct Answer: C
Rationale: Right-sided HF produces venous congestion in the systemic circulation, resulting in JVD and ascites (from vascular congestion in the GI tract). Left-sided HF causes pulmonary congestion, pulmonic valve issues cause murmurs, and a ruptured septum causes shock and murmurs, none of which match the findings.
The nurse is caring for the client who had a cardiac valve replacement. To decrease the risk of DVT and PE, which interventions should the nurse plan to include? Select all that apply.
- A. Apply a pneumatic compression device.
- B. Administer a heparin infusion intravenously.
- C. Encourage coughing and deep breathing hourly.
- D. Teach about performing isometric leg exercises.
- E. Avoid the use of graded compression elastic stockings.
Correct Answer: A;D
Rationale: The nurse should include: A) Pneumatic compression devices to mimic walking pressures; D) Isometric exercises to compress vessels and reduce DVT risk. Heparin is typically subcutaneous, coughing/deep breathing prevents pulmonary issues, and compression stockings are beneficial unless PAD is present.
The client is discovered to have a popliteal aneurysm. Because of the aneurysm, the nurse should closely monitor the client for which associated problem?
- A. Thoracic outlet syndrome
- B. Ischemia in the lower limb
- C. Pulmonary embolism
- D. Raynaud’s phenomenon
Correct Answer: B
Rationale: A popliteal aneurysm (located in the space behind the knee) may cause ischemia in the leg distal to the aneurysm due to thrombus forming inside the aneurysm and potential emboli. Other options are unrelated to popliteal aneurysms.
The client asks the nurse what can be done to alleviate the pain and discomfort associated with varicose veins. Which response by the nurse is best?
- A. “Dangle your legs off the side of the bed as often as possible to alleviate the pain.”
- B. “There isn’t much you can do about the pain except have surgery to remove the veins.”
- C. “You should wear long pants to hide bulging veins; this will help your self-confidence.”
- D. “Wear elastic stockings to promote venous return; these will also help reduce discomfort.”
Correct Answer: D
Rationale: The best response to alleviate pain and discomfort associated with varicose veins includes application of elastic stockings and elevating the lower extremities. These promote venous return. Dangling legs, surgery as the only option, or wearing long pants do not address the pain effectively.