WORKBOOK (CARDIO) 9.

An 85-year-old female client is brought to the emergency department due to

chest pains. She tells a nurse that the chest pain is stabbing through the chest
1. When assessing the lower extremities of a client with peripheral vascular into her back. Her blood pressure is 220/140 mm Hg. The nurse expects the
disease (PVD), the nurse notes bilateral ankle edema. This edema is primarily diagnosis to be:
caused by: a. Acute arterial occlusion
a. Increased venous pressure b. Pulmonary embolism
b. Competent venous valves c. Aortic dissection
c. Increased muscular activity d. Subclavian steal syndrome
d. Decreased blood volume
10. Which assessment findings in a patient with thoracic aneurysm suggest
2. A client who has been diagnosed with peripheral vascular disease (PVD) is occurrence of rupture? Select all that apply.
being discharged. The client needs more teaching if she states that she will: i. Severe chest pain radiating to the back
a. Avoid heating pads ii. Abdominal distention
b.Avoid crossing the legs iii. Hypotension
c. Wear leather shoes iv. Dyspnea
d. Use iodine on an injured site v. Oliguria
a. II, III, IV, V
3. The client has aching, weakness, and a cramping sensation in both of the b. I, III, IV
lower extremities while walking. To promote health and maintain the client's c. I, III, IV, V
level of activity, the nurse should suggest that the client try: d. I,II, III, IV, V
a. Riding a stationary bike
b. Skiing 11. A male client seeks care at a vascular clinic and is diagnosed with
c. Jogging Buerger’s disease (thromboangiitis obliterans). A nurse is teaching the client
d. Golfing ways to prevent progression of the disease. Which prevention measure should
be the nurse’s initial focus when teaching the client?
4. The doctor prescribed a client with pentoxifylline for his intermittent a. Abstaining from all tobacco products in all forms
claudication. To be able to determine its effectiveness, the nurse should ask if b. Avoiding exposure to cold
the client: c. Maintaining meticulous hygiene practices
a. Can wiggle the toes d. Following a low-fat diet
b. Has improved circulation in the legs
c. Is urinating more frequently 12. A nurse is completing a health history on a client admitted to a hospital with
d. Is less dizzy recurrent lower extremity cellulitis. The client tells the nurse that he has tinea
pedis. The nurse concludes that this is significant because:
5. A client who has undergone an amputation of three toes and a a. The loss of skin integrity that occurs with tinea pedis allows bacteria to
femoral-popliteal bypass asks you which leg positions can he assume while enter the tissue.
sitting. A nurse would give an incorrect answer if she suggest the patient to: b. The cellulitis is commonly caused by a fungus.
a. Flex his ankles c. The cellulitis should resolve with topical fungicide therapy.
b. Cross his legs d. The client is at risk for developing a painful neuralgia after the infection
c. Elevate his legs has resolved.
d. Extend his knees
13. The nurse has completed giving medication instructions to a client
6. A nurse admits a client with a diagnosis of severe cellulitis in his left leg. The receiving enalapril to treat hypertension. What statement made by the client is
nurse anticipates the prescribed treatment will include: an indication that he was not able to fully understand the teaching?
a. Debriding the left leg a. “Change positions slowly.”
b. Obtaining baseline coagulation laboratory tests and initiating b. “Monitor the blood pressure every week.”
anticoagulation therapy c. “Use salt moderately in cooking and on foods.”
c. Applying sequential compression devices d. “Report signs and symptoms of infection to the health care provider.”
d. Administering IV antibiotics
14. A client is taking clonidine for treatment of his hypertension. The nurse
7. A patient had a femoral-popliteal artery bypass graft surgery 48 hours ago. should teach the client about which of the following common adverse effects of
A priority nursing action at this time should be to: this drug? Select all that apply i. Hyperkalemia
a. Monitor the dorsalis pedis and posterior tibial pulses bilaterally every 4 ii. Dry mouth.
hours. iii. Pancreatitis.
b. Monitor intake and output. iv. Impotence.
c. Maintain the client at a 60-degree sitting position when resting in bed. v. Sleep disturbance
d. Report any edema that develops in the operative leg. a. II, IV, V
b. I, III, V
8. A new nurse reads the presence of lymphedema in the chart of his patient c. I, II, IV
who had undergone surgery for breast cancer. He then asks his senior nurse d. II, III, V
what lymphedema is. Which statement to the new nurse regarding
lymphedema is correct?
a. Lymphedema frequently signifies that there is a recurrence of the
malignancy.
b. Lymphedema usually resolves after the cancer treatment is completed
when collateral lymph circulation develops.
c. Lymphedema is characterized by severe swelling in the arm and hand on
the affected side.
d. Lymphedema is mainly controlled by
15. A client who has diabetes is taking metoprolol for hypertension. Which of 23. Among the following goals, which is the most important in nursing care for
the following information should the nurse include in the teaching plan? Select a client who is in shock?
all that apply. a. Manage vasoconstriction of vascular beds
i. Have a blood glucose level drawn every 6 to 12 months during therapy. b. Manage fluid overload
ii. Use an appropriate decongestant if needed. c. Manage increased cardiac output
iii. These tablets should be taken with food at the same time each day. d. Manage inadequate tissue perfusion
iv. Report any fainting spells to the health care provider
v. Do not crush or chew the tablets. 24. Which is a priority assessment for the client in shock who is receiving an IV
vi. Notify the health care provider if the pulse is 82 per minute. infusion of packed red blood cells and normal saline solution?
a. I, II, IV VI a. Fluid balance
b. I, III, IV, V b. Pain
c. II, III, IV, V, VI c. Anaphylactic reaction
d. I, II, III, IV, V d. Altered LOC

16. The nurse suspects that a client who had a myocardial infarction is
developing cardiogenic shock. The nurse should assess for which peripheral
vascular manifestation of this complication?
a. Cool, clammy skin with weak or thread pedal pulses
b. Cool, dry skin with pulsus alternans
c. Flushed, dry skin with bounding pedal pulses
d. Warm, moist skin with irregular pedal pulses
25. The patient who does not respond adequately to fluid replacement was
prescribed with Dopamine HCl via IV infusion. What would the nurse assess
the client for in determining the effectiveness of the drug?
a. Reduced preload and afterload
b. Increased renal and mesenteric blood flow
c. Increased cardiac output
d. Vasoconstriction

17. What is the mean arterial pressure (MAP) of a person with a blood 26. In caring for the client above, who is receiving dopamine for shock
pressure 130/80 mmHg? treatment, what should the nurse do?
a. 97 a. Monitory blood pressure continuously.
b. 50 b. Administer pain medication concurrently
c. 105 c. Evaluate ABGs at least every 2 hours
d. 113 d. Monitor for infection.

18. What is the normal pulse pressure? 27. Which among the following nursing interventions is the most important in
a. 80-100 mmHg preventing septic shock?
b. 30-40 mmHg a. Maintaining asepsis of indwelling urinary catheters
c. 0-5 mmHg b. Administering IV fluid replacement therapy as prescribed
d. 60-80 mmHg c. Obtaining vital signs q4h for all clients
d. Monitoring red blood cell counts for elevation
19. What is the earliest manifestation of shock?
a. Decreased oxygen saturation 28. Which of the following is an indication of a complication of septic shock?
b. Tachycardia a. Acute respiratory distress syndrome
c. Bradypnea b. Mitral valve prolapse
d. Decreased urine output c. Anaphylaxis
d. Chronic obstructive pulmonary disease
20. Milrinone is indicated in the patient experiencing hypovolemic shock. The
nurse knows that this drug acts by: 29. The nurse considers which of the following as the best indication that fluid
a. Increasing peripheral resistance while increasing venous return to the replacement for a client in hypovolemic shock is adequate?
heart a. Systolic BP > 110mmHg
b. Stimulating beta1 receptor sites on the heart and improving heart b. Diastolic BP >90 mmHg
contractility c. Urine output greater than 30mL/hr
c. Dilating coronary arteries d. RR of 20 breaths/min
d. Decreasing cardiac preload and increasing cardiac afterload
30. Which of the following indicates that a client who has had a 15% blood loss
21. A child undergoes surgical removal of a brain tumor. During the has developed hypovolemic shock?
postoperative period, the nurse is monitoring the child and notes that the child a. Unequally dilated pupils
is restless, the pulse rate is elevated, and the blood pressure has decreased b. Systolic BP 75mmHg
significantly from the baseline value. The nurse suspects that the child is in c. Pulse rate 50 bpm
shock. Which is the most appropriate nursing action? d. RR 4 cycles/min
a. Place the child in a supine position.
b. Place the child in Trendelenburg’s position. 31. Which of the following is a risk factor for hypovolemic shock?
c. Increase the flow rate of the intravenous fluids. a. Antigen-antibody reaction
d. Notify the HCP. b. Gram-negative bacteria
c. Hemorrhage
22. A patient who sustained T6 injury from a vehicular accident manifests d. Vasodilation
severe hypotension and bradycardia. What should be the initial action of the
nurse caring for the patient?
a. Insert large-bore IV catheters.
b. Prepare to administer Lasix.
c. Place the patient in Trendelenburg.
d. Notify the physician.