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A series of nclex-style questions and answers related to cardiac disorders, covering topics such as heart failure, left ventricular failure, pulmonary artery pressure monitoring, acute pulmonary edema, pericarditis, infective endocarditis, mitral valve replacement, and hypertrophic cardiomyopathy. Each question presents a clinical scenario and multiple-choice options, followed by the correct answer and a brief explanation. This resource is valuable for nursing students preparing for the nclex exam or for those seeking to enhance their understanding of cardiac disorders.
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A patient with heart failure has an ejection fraction of 25%. What does this information indicate to the nurse about the patient's health status?
of ventricular function; CO is decreased.
A patient admitted 24 hours ago previously with heart failure has lost 1 kg of weight, has a heart rate of 88, which was 105 on admission, and now has crackles only in the bases of the lungs. How should the nurse interpret these assessment findings?
goals for care of heart failure are to slow its progression, reduce cardiac workload, improve cardiac function, and control fluid retention. A weight loss of 1 kg and crackles in the lung bases indicate control of fluid retention. A HR of 88 indicates reduced cardiac workload and improved cardiac function. The patient's condition has improved since admission. Because the patient continues to have crackles in the lungs, heart failure has not completely resolved.
A patient is diagnosed with left ventricular failure. Which findings should the nurse recognize as being consistent with this diagnosis? (Select all that apply)
In left ventricular failure, the CO falls and pressure in the pulmonary vascular system increases. Fatigue is a common early manifestation. Pulmonary congestion causes shortness of breath with minimal exertion. On auscultation of the lungs, inspiratory crackles may be heard in the lung
A patient experiencing acute pulmonary edema is prescribed morphine sulfate 2-5 mg IV as needed for pain and dyspnea. What action should the nurse take with this prescribed medication?
administered IV to relieve anxiety and improve the efficacy of breathing. It also is a vasodilator that reduces venous return and lowers left atrial pressure. The nurse should provide the medication and monitor the patient's respiratory status. The medication should not be withheld to wit for the patient's respiratory status to improve. The medication order is correct as written and does not need to be questioned. The medication is not being used to treat chest pain.
The nurse notes a grating heart sound when auscultating the apical pulse of a patient with pericarditis. What should the nurse do with this assessment data?
sound, is a characteristic sign of pericarditis so it is expected, but should be documented in the patient's record. An electrocardiogram is not needed after auscultating this sound. The patient does not need to be resuscitated.
The nurse is planning care for a patient with acute infective endocarditis. What would be an appropriate goal of nursing care for this patient?
effectively treats infective endocarditis in most cases. The goal of therapy is to eradicate the infecting organism from the blood and vegetative lesions in the heart. Since microorganisms may have a fibrin covering that protects them from antibiotic therapy, an extended course of multiple IV antibiotics is required.
The nurse is assessing heart sounds of a patient scheduled for mitral valve replacement surgery. Which sound should the nurse expect to auscultate in this patient?
The parents of a young athlete who collapsed and dies due to hypertrophic cardiomyopathy ask how it is possible that their son had no symptoms of this disorder before experiencing sudden cardiac death. How should the nurse respond to the parents?
✔✔4. In hypertrophic cardiomyopathy, manifestations may not develop l the demand for oxygen
increases, such as with athletes during activity, causing sudden death due to a ventricular dysrythmia. Hypertrophic cardiomyopathy is characterized by eased compliance of the left ventricle and hypertrophy of the ventricle muscle mass. This impairs ventricular filling, leading to small end-diastolic volumes and low cardiac output. It may be asymptomatic for many years, but symptoms typically occur when increased oxygen demand causes increased ventricular contractility. They may develop suddenly during or after physical activity; in children and young adults, sudden cardiac death may be the first sign of the disorder. This type of cardiomyopathy does not lead to ventricle rupture during exercise.