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10 Cards in this Set
- Front
- Back
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Which of the following groups is more likely to develop severe hypertension? a) African. b) American Indian (Aboriginal People). c) Asian. d) European. |
a) African. Epidemiologic and experimental research studies indicate that people of African descent are more likely to develop severe hypertension. |
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When assessing the lower extremities of a client with peripheral vascular disease (PVD), the nurse notes bilateral ankle edema. The edema is related to: a) Increased venous pressure. b) Decreased blood volume. c) Competent venous valves. d) Increase in muscular activity. |
a) Increased venous pressure. In PVD, decreased blood flow can result in increased venous pressure. The increase in venous pressure results in an increase in capillary hydrostatic pressure, which causes a net filtration of fluid out of the capillaries into the interstitial space, resulting in edema. Valves often become incompetent with PVD. Blood volume is not decreased in this condition. Decreased muscular action would contribute to the formation of edema in the lower extremities. |
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A nurse is reviewing laboratory values for a client diagnosed with hyperlipidemia 6 months ago. Which results indicate that the client has been following his therapeutic regimen? a) Low density lipoproteins (LDL) increase from 180 mg/dl (4.66 mmol/L to 190 mg/dl (4.92 mmol/L). b) High density lipoproteins (HDL) increase from 25 mg/dl (0.65 mmol/L) to 40 mg/dl (1.03 mmol/L). c) Triglycerides increase from 225 mg/dl (5.83 mmol/L) to 250 mg/dl (6.47 mmol/L). d) Total cholesterol level increases from 250 mg/dl to 275 mg/dl (6.48 mmol/L to 7.12 mmol/L). |
b) High density lipoproteins (HDL) increase from 25 mg/dl (0.65 mmol/L) to 40 mg/dl (1.03 mmol/L). The goal of treating hyperlipidemia is to decrease total cholesterol and LDL levels while increasing HDL levels. HDL levels should be greater than 35 mg/dl. This client's increased HDL levels indicate that he's followed his therapeutic regimen. Recommended total cholesterol levels are below 200 mg/dl. LDL levels should be less than 160 mg/dl, or, in clients with known coronary artery disease (CAD) or diabetes mellitus, less than 70 mg/dl. Triglyceride levels should be between 100 and 200 mg/d. |
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A physician orders digoxin for a client with heart failure. During digoxin therapy, which laboratory value may predispose the client to digoxin toxicity? a) Potassium level of 3.1 mEq/L (3.1 mmol/L) b) Calcium level of 7.5 mg/dl (0.4 mmol/L) c) Sodium level of 152 mEq/L (152 mmol/L) d) Magnesium level of 2.5 mg/dl (0.1 mmol/L) |
a) Potassium level of 3.1 mEq/L (3.1 mmol/L) Conditions that may predispose a client to digoxin toxicity include hypokalemia (evidenced by a potassium level less than 3.5 mEq/L), hypomagnesemia (evidenced by a magnesium level less than 1.5 mEq/L), hypothyroidism, hypoxemia, advanced myocardial disease, active myocardial ischemia, and altered autonomic tone. Hypermagnesemia (evidenced by a magnesium level greater than 2.5 mEq/L), hypercalcemia (evidenced by an ionized calcium level greater than 5.3 mg/dl), and hypernatremia (evidenced by a sodium level greater than 145 mEq/L) aren't associated with a risk of digoxin toxicity |
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A client is participating in a cardiac research study in which his physician is directly involved. Which statement by the client indicates a need for additional teaching about his rights as a research study participant? a) "I'll have to find a new physician if I don't complete this study." b) "I may withdraw from the study at anytime, but if I do, I won't receive the compensation I was promised." c) "My confidentiality won't be compromised by this study." d) "I understand that there may be risks associated with this study." |
a) "I'll have to find a new physician if I don't complete this study." The client stating that he will have to find a new physician if he does not participate in the study indicates a need for additional teaching. Whether the client participates in this study should not influence the relationship with his physician. The client has the right to withdraw from a study at any time without penalty. All information provided by the client is kept confidential and used only by members of the study team for scientific purposes. The client must be informed of all risks associated with study participation. |
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When helping the client who has had a cerebrovascular accident (CVA) learn self-care skills, the nurse should? a) Advise the client to ask for help when dressing. b) Encourage the client to wear clothing designed especially for people who have had a CVA. c) Teach the client to put on clothing on the affected side first. d) Dress the client, explaining each step of the process as it is completed. |
c) Teach the client to put on clothing on the affected side first. When dressing, the client will find it easier to dress if clothing is put on the affected side first. Clients who have had cerebrovascular accidents should wear normal clothing, if possible. Dressing the client does not promote self-care skills. Other people may help the client dress, but the emphasis should be on self-care. |
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A client with heart failure is receiving furosemide, 40 mg I.V. The physician orders [40 mEq (40 mmol/L)] of potassium chloride in 100 ml of dextrose 5% in water to infuse over 4 hours. The client's most recent serum potassium level is [3.0 mEq/L (3.0 mmol/L)]. At what infusion rate should the nurse set the I.V. pump? a) 10 ml/hour b) 100 ml/hour c) 50 ml/hour d) 25 ml/hour |
d) 25 ml/hour |
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In a client with chronic bronchitis, which sign would lead the nurse to suspect right-sided heart failure? a) Bilateral crackles b) Productive cough c) Leg edema d) Cyanosis of the lips |
c) Leg edema Right-sided heart failure is characterized by signs of circulatory congestion, such as leg edema, jugular vein distention, and hepatomegaly. Left-sided heart failure is characterized by circumoral cyanosis, crackles, and a productive cough. |
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A client with severe angina pectoris and ST-segment elevation on an electrocardiogram is being seen in the emergency department. In terms of diagnostic laboratory testing, it's most important for the nurse to advocate ordering a: a) liver panel. b) hemoglobin (Hb) level. c) creatine kinase level. d) troponin level. |
d) troponin level. Troponin is a myocardial cell protein that is elevated in the serum when myocardial damage has occurred during a myocardial infarction (MI). It's the best serum indicator of MI and is more indicative of cardiac damage than creatine kinase. Hb values and liver panel components aren't as useful in the diagnosis of MI as a troponin level. |
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The client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA) to treat angina. Priority goals for the client immediately after PTCA should include: a) Decreasing myocardial contractility. b) Maintaining adequate blood pressure control. c) Minimizing dyspnea. d) Preventing fluid volume deficit. |
d) Preventing fluid volume deficit. Because the contrast medium used in PTCA acts as an osmotic diuretic, the client may experience diuresis with resultant fluid volume deficit after the procedure. Additionally, potassium levels must be closely monitored because the client may develop hypokalemia due to the diuresis. Dyspnea would not be anticipated after this procedure. Maintaining adequate blood pressure control should not be a problem after the procedure. Increased myocardial contractility would be a goal, not decreased contractility. |
