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A nurse is teaching a patient newly diagnosed with hypertension. Which of the following statements by the patient indicates a need for further teaching?
A. "I should reduce my salt intake."
B. "Regular exercise can help manage my blood pressure."
C. "Smoking doesn't affect my blood pressure."
D. "Taking my medications regularly is important."
C. "Smoking doesn't affect my blood pressure."
Rationale: Smoking is a known risk factor for hypertension and other cardiovascular diseases. The patient's statement shows a misconception that needs to be addressed.
A patient with heart failure asks the nurse why they feel short of breath. The nurse should explain that this is due to:
A. Decreased cardiac output leading to fluid build-up in the lungs.
B. Increased heart rate.
C. Narrowed blood vessels.
D. Elevated blood glucose levels.
Answer: A. Decreased cardiac output leading to fluid build-up in the lungs.
Rationale: In heart failure, the heart's pumping capacity is diminished. This can cause fluid to back up in the lungs, leading to symptoms of pulmonary congestion, such as shortness of breath.
A patient diagnosed with peripheral vascular disease mentions experiencing intermittent claudication. The nurse understands that this means:
A. Consistent sharp pain in the legs.
B. Itchy, red rashes on the legs.
C. Pain in the legs during exercise that relieves with rest.
D. Numbness and tingling in the toes.
Answer: C. Pain in the legs during exercise that relieves with rest.
Rationale: Intermittent claudication is a symptom of peripheral vascular disease. It refers to pain or discomfort in the legs triggered by activity and typically relieved by rest.
During a teaching session, a patient with hypertension states, "I don't need to worry about my eye health." How should the nurse respond?
A. "You're right, hypertension mainly affects the heart."
B. "Hypertension can damage the blood vessels in your eyes, leading to vision problems."
C. "Eye health is not related to hypertension."
D. "Only severe cases of hypertension can affect the eyes."
Answer: B. "Hypertension can damage the blood vessels in your eyes, leading to vision problems."
Rationale: Hypertensive retinopathy is a concern in patients with uncontrolled blood pressure. The small blood vessels in the retina can be damaged, leading to vision problems.
A family member of a patient with heart failure asks about the importance of dietary changes. Which statement by the nurse is accurate?
A. "Diet doesn't play a significant role in managing heart failure."
B. "Reducing fluid and sodium intake can help prevent fluid accumulation in the body."
C. "Your loved one should increase their salt intake to maintain electrolyte balance."
D. "It's important to increase calorie intake for energy."
Answer: B. "Reducing fluid and sodium intake can help prevent fluid accumulation in the body."
Rationale: In heart failure, dietary modifications such as limiting fluid and sodium intake can help in preventing exacerbations related to fluid overload.
A nurse is providing care to a diverse group of patients. Which patient is at the highest risk for cardiovascular disease based on ethnicity?
A. A 50-year-old Caucasian male.
B. A 52-year-old Hispanic female.
C. A 48-year-old Asian male.
D. A 49-year-old non-Hispanic African American male.
Answer: D. A 49-year-old non-Hispanic African American male.
Rationale: Based on the provided information, non-Hispanic African Americans have the highest risk of cardiovascular disease.
During an education session, a nurse stresses the importance of understanding cultural dietary preferences. This is because:
A. All ethnic foods are unhealthy.
B. Some cultural foods might be high in sodium or fats that can impact cardiovascular health.
C. People should be encouraged to adopt a Western diet for better health.
D. Cultural foods don't provide enough nutritional value.
Answer: B. Some cultural foods might be high in sodium or fats that can impact cardiovascular health.
Rationale: Different cultural diets have diverse ingredients and preparation methods. Some might be high in sodium, fats, or other components that can affect cardiovascular health. It's essential to understand and make suitable recommendations.
A nurse is working with a Hispanic patient on managing hypertension. What would be an important consideration when discussing dietary changes?
A. Instructing the patient to avoid all traditional foods.
B. Understanding and incorporating culturally preferred foods in a balanced way.
C. Recommending only American dietary guidelines.
D. Suggesting a strict vegetarian diet for best results.
Answer: B. Understanding and incorporating culturally preferred foods in a balanced way.
Rationale: Effective patient education involves understanding and respecting cultural preferences and finding a balanced approach to incorporate healthy choices.
A 60-year-old non-Hispanic African American male is diagnosed with hypertension. The nurse should:
A. Assume he's non-compliant with medications due to his ethnicity.
B. Provide education tailored to his cultural and dietary preferences.
C. Only provide standard educational materials without any customization.
D. Recommend treatments that are only specific for non-Hispanic African Americans.
Answer: B. Provide education tailored to his cultural and dietary preferences.
Rationale: Tailoring education to individual cultural and dietary preferences ensures a better understanding and adherence to management recommendations.
During a community health fair, the nurse recognizes the need for culturally tailored interventions. This is primarily to:
A. Address specific dietary habits and lifestyle factors prevalent in different cultures.
B. Promote one culture over another.
C. Force everyone to adapt to a singular dietary recommendation.
D. Avoid discussing individual differences.
Answer: A. Address specific dietary habits and lifestyle factors prevalent in different cultures.
Rationale: Culturally tailored interventions ensure that specific habits, lifestyles, and preferences are taken into account, leading to more effective education and intervention.
A patient with hypertension has been prescribed a Thiazide diuretic. Which of the following nursing interventions is most important?
A. Monitor blood sugar levels regularly.
B. Encourage increased potassium intake.
C. Promote a diet high in sodium.
D. Avoid any physical activity.
Answer: A. Monitor blood sugar levels regularly.
Rationale: Thiazide diuretics can increase blood sugar levels. Therefore, regular monitoring is crucial, especially in patients with or at risk for diabetes.
A patient recently started on an ACE inhibitor reports a persistent dry cough. The nurse's best response is:
A. "This is a common side effect. Would you like some water?"
B. "You should stop the medication immediately."
C. "This is not related to the medication."
D. "Let's discuss this with your doctor. There might be alternative medications for you."
Answer: D. "Let's discuss this with your doctor. There might be alternative medications for you."
Rationale: A persistent dry cough is a known side effect of ACE inhibitors. If it's bothersome to the patient, discussing alternative medications with the healthcare provider might be beneficial.
A patient with heart failure is on a calcium channel blocker. Which of the following is a potential side effect the nurse should educate the patient about?
A. Rapid heart rate.
B. Flushing or warmth sensation.
C. Excessive sweating.
D. Hyperactivity.
Answer: B. Flushing or warmth sensation.
Rationale: Flushing or a feeling of warmth is a common side effect of calcium channel blockers.
A nurse is caring for a patient who is on beta-blockers for hypertension. When preparing to administer the medication, the nurse should first:
A. Check the patient's blood sugar levels.
B. Monitor the patient's heart rate and blood pressure.
C. Assess for signs of hyperactivity.
D. Ensure the patient has a high-fat meal.
Answer: B. Monitor the patient's heart rate and blood pressure.
Rationale: Beta-blockers can reduce heart rate and blood pressure. It's essential to check these vitals before administration to ensure they are within safe limits.
A patient diagnosed with hypertension is prescribed Losartan, an ARB. The nurse should educate the patient to report which of the following side effects?
A. Persistent dry cough.
B. Excessive sleepiness.
C. High potassium levels.
D. Frequent urination.
Answer: C. High potassium levels.
Rationale: ARBs can cause elevated blood potassium levels, which can be harmful. Patients should be educated to report symptoms of hyperkalemia and to have regular blood tests to monitor potassium levels.
patient with suspected hypertension comes in for a checkup. Which of the following objective findings supports the diagnosis of hypertension?
A. Blood pressure reading of 115/75 mmHg.
B. Blood pressure reading of 185/100 mmHg.
C. Pulse rate of 70 beats per minute.
D. Respiratory rate of 12 breaths per minute.
Answer: B. Blood pressure reading of 185/100 mmHg.
Rationale: A blood pressure reading of 185/100 mmHg is significantly elevated and is consistent with a diagnosis of hypertension.
nurse is assessing a patient for signs of heart failure. Which of the following subjective complaints by the patient is most consistent with heart failure?
A. "I've been having constant sharp chest pains."
B. "I feel short of breath, especially when I lie down."
C. "My vision has been really blurry lately."
D. "I've lost a lot of weight unexpectedly."
Answer: B. "I feel short of breath, especially when I lie down."
Rationale: Shortness of breath, especially when lying down (orthopnea), is a common symptom of heart failure due to fluid accumulation in the lungs.
A patient diagnosed with peripheral vascular disease might exhibit which of the following objective findings?
A. Warm extremities with strong peripheral pulses.
B. Intermittent claudication.
C. Blood pressure reading of 120/80 mmHg.
D. Respiratory rate of 14 breaths per minute.
Answer: B. Intermittent claudication.
Rationale: Intermittent claudication, or pain in the legs triggered by activity and relieved by rest, is a common symptom of peripheral vascular disease.
During a physical examination, a nurse observes narrowing of retinal arterioles in a patient's eyes. This finding is most consistent with which condition?
A. Early-stage diabetes.
B. Astigmatism.
C. Hypertension.
D. Macular degeneration.
Answer: C. Hypertension.
Rationale: Narrowing of retinal arterioles is a sign of hypertensive retinopathy, indicating chronic high blood pressure.
A patient with heart failure might present with which of the following objective findings?
A. Increased urine output.
B. Dry and warm skin.
C. Peripheral edema.
D. Decreased jugular venous pressure.
Answer: C. Peripheral edema.
Rationale: Peripheral edema, or swelling in the extremities, is a common sign of heart failure due to fluid accumulation.
Which of the following is a significant risk factor for the development of hypertension?
A. Regular aerobic exercise.
B. Low-sodium diet.
C. Chronic stress.
D. Drinking green tea daily.
Answer: C. Chronic stress.
Rationale: Chronic stress is one of the underlying causes of primary hypertension.
A nurse is conducting a health history for a patient. Which of the following factors places the patient at a higher risk for developing congestive heart failure?
A. A family history of asthma.
B. The patient's use of oral contraceptives.
C. A history of prolonged, uncontrolled hypertension.
D. Regular intake of vitamin C supplements.
Answer: C. A history of prolonged, uncontrolled hypertension.
Rationale: Prolonged uncontrolled hypertension can lead to heart failure due to increased afterload and subsequent ventricular remodeling and dysfunction.
A patient asks about factors that can contribute to peripheral vascular disease. Which of the following should the nurse include in the teaching?
A. A diet high in antioxidants.
B. Wearing compression stockings daily.
C. Chronic hypertension.
D. Regular intake of omega-3 fatty acids.
Answer: C. Chronic hypertension.
Rationale: Chronic hypertension can lead to atherosclerosis and plaque formation, reducing blood flow to the extremities and causing peripheral vascular disease.
Which of the following is a potential etiological factor for the development of hypertension?
A. Chronic upregulation of the RAAS system.
B. Frequent yoga practice.
C. Consistent 8-hour sleep.
D. Regular intake of probiotics.
Answer: A. Chronic upregulation of the RAAS system.
Rationale: Chronic upregulation of the RAAS system is one of the theories behind the development of primary hypertension.
A patient with which of the following conditions is at an increased risk of developing congestive heart failure?
A. Chronic obstructive pulmonary disease (COPD).
B. History of uncontrolled diabetes.
C. Regular exercise and a balanced diet.
D. Recent recovery from a viral infection.
Answer: B. History of uncontrolled diabetes.
Rationale: Diabetes, especially when uncontrolled, can lead to various cardiovascular complications, including heart failure.
Provide education for patient and family regarding disease process for hypertension, heart failure, and peripheral vascular disease.
A patient with Peripheral Vascular Disease (PAD) complains of intermittent claudication pain when walking. Which of the following educational points should the nurse emphasize to the patient and their family regarding PAD? (Select all that apply.)
a. Elevating the affected leg can relieve pain.
b. Pain is due to reduced oxygen supply to muscles during activity.
c. The disease process involves atherosclerosis of the peripheral arteries.
d. Sores or ulcers on the feet may develop if the disease progresses.
e. Compression stockings are the primary treatment for PAD-related pain.
Answer: b, c, d Rationale: Pain during walking (intermittent claudication) in PAD is due to reduced oxygen supply to the muscles. PAD is primarily caused by atherosclerosis of the peripheral arteries. As the disease progresses, ulcers or sores may develop on the feet. Elevating the affected leg can worsen the pain in arterial diseases, and compression stockings are used for venous, not arterial, issues.
Rationale: Pain during walking (intermittent claudication) in PAD is due to reduced oxygen supply to the muscles. PAD is primarily caused by atherosclerosis of the peripheral arteries. As the disease progresses, ulcers or sores may develop on the feet. Elevating the affected leg can worsen the pain in arterial diseases, and compression stockings are used for venous, not arterial, issues.
Describe how diverse cultural, ethnic, and social backgrounds impact patient management and outcomes for cardiovascular disease.
An older adult Asian patient is diagnosed with peripheral vascular disease. Which of the following nursing interventions acknowledges the patient's cultural background and promotes effective management of the condition?
a. Limiting discussion of the disease to avoid causing the patient shame.
b. Offering plant-based meals as many Asians follow a vegetarian diet.
c. Ensuring the translation of educational materials into the patient's native language.
d. Discouraging the use of traditional herbal medications in conjunction with prescribed treatments.
Answer: c
Rationale: Ensuring that educational materials are translated into the patient's native language facilitates understanding and promotes effective management of the condition. Making assumptions about dietary preferences or discouraging the use of traditional medicines without discussion can be culturally insensitive.
Discuss the action and nursing implications of commonly used medications for patients with hypertension and heart failure.
A patient with hypertension and PAD is prescribed clopidogrel. The nurse understands that clopidogrel is primarily given to:
a. Promote vasodilation and increase peripheral blood flow.
b. Prevent platelet aggregation and decrease the risk of clot formation.
c. Reduce cholesterol levels in the blood.
d. Increase the strength and efficiency of heart contractions.
Answer: b Rationale:
Clopidogrel is an antiplatelet drug used to prevent platelet aggregation and decrease the risk of clot formation.
Describe subjective and objective findings associated with patients who are diagnosed with hypertension, heart failure, or peripheral vascular disease.
Which of the following findings would the nurse expect in a patient with advanced Peripheral Vascular Disease? (Select all that apply.)
a. Smooth, hairless legs.
b. Strong dorsalis pedis pulse.
c. Edema in the lower extremities.
d. Pain that improves with leg elevation.
e. Ulcerations on the toes.
Answer: a, e
Rationale: Advanced PAD can lead to smooth, hairless legs and ulcerations on the toes. A weakened or absent dorsalis pedis pulse, not a strong one, would be expected. Pain often worsens with leg elevation in arterial disorders. Edema is associated more with venous conditions.
Identify the etiology and risk factors for the development of hypertension, congestive heart failure, and vascular disorders.
A patient is diagnosed with PAD. Which of the following are likely etiologies and risk factors contributing to this patient's condition? (Select all that apply.)
a. Smoking.
b. Diabetes mellitus.
c. High dietary intake of antioxidants.
d. Hyperlipidemia.
e. Regular aerobic exercise.
Answer: a, b, d
Rationale: Smoking, diabetes mellitus, and hyperlipidemia are known risk factors for PAD. Regular aerobic exercise and a diet high in antioxidants are generally protective against vascular disorders.
A patient newly diagnosed with hypertension asks the nurse about the connection between hypertension and peripheral vascular disease (PAD). Which of the following responses is appropriate?
a. "Hypertension can lead to atherosclerosis, which is a primary cause of PAD."
b. "Hypertension and PAD are unrelated conditions."
c. "PAD causes hypertension by restricting blood flow to the heart."
d. "Hypertension is a side effect of the medications used to treat PAD."
Answer: a
Which of the following is a potential side effect of beta-blockers that patients with hypertension should be educated about?
a. Tinnitus.
b. Rapid weight gain.
c. Bradycardia.
d. Hyperactivity.
Answer: c
Rationale: Beta-blockers can slow heart rate, and one potential side effect is bradycardia (slow heart rate).
A nurse should instruct a patient taking loop diuretics to monitor for:
a. Increased urination.
b. Constipation.
c. Weight gain.
d. Hyperkalemia.
Answer: a
Rationale: Loop diuretics increase the excretion of water and electrolytes, leading to increased urination.
A patient with heart failure on spironolactone therapy should be cautioned about consuming foods high in:
a. Sodium.
b. Potassium.
c. Calcium.
d. Magnesium.
Answer: b
Rationale: Spironolactone is a potassium-sparing diuretic, and excessive dietary potassium intake can lead to hyperkalemia.
A nurse recognizes that ACE inhibitors are commonly prescribed in heart failure primarily to:
a. Increase urine output.
b. Decrease heart rate.
c. Dilate blood vessels.
d. Increase blood viscosity.
Answer: c
Rationale: ACE inhibitors cause vasodilation, reducing the workload on the heart and improving symptoms of heart failure.
Before initiating a patient on thiazide diuretics for hypertension, it is essential for a nurse to check:
a. Blood urea nitrogen and creatinine levels.
b. Platelet count.
c. Blood glucose levels.
d. White blood cell count.
Answer: a
Rationale: Thiazide diuretics can affect kidney function. It's essential to assess baseline renal function (using BUN and creatinine levels) before initiating therapy.
A patient with PAD is most likely to report:
a. Severe chest pain during exercise.
b. Intermittent claudication.
c. Palpitations and dizziness.
d. Shortness of breath at rest.
Answer: b
Rationale: Intermittent claudication, or pain during walking that is relieved by rest, is a hallmark symptom of PAD.
In a patient with heart failure, jugular venous distention (JVD) is an objective sign of:
a. Left ventricular failure.
b. Right ventricular failure.
c. High blood pressure.
d. Dehydration.
Answer: b
Rationale: JVD is a clinical sign of increased central venous pressure, commonly associated with right ventricular failure.
A patient diagnosed with hypertension might display:
a. Bulging neck veins.
b. No noticeable symptoms.
c. Cyanosis of the fingers.
d. Frequent nosebleeds.
Answer: b
Rationale: Hypertension is often called the "silent killer" because many individuals do not experience noticeable symptoms.
A nurse assessing a patient with PAD would expect to find:
a. Warm and red extremities.
b. Strong pedal pulses.
c. Ulceration on the lower extremities, especially the toes.
d. Pitting edema in the ankles.
Answer: c
Rationale: In PAD, due to reduced blood flow, there's an increased risk of ulceration on the lower extremities, particularly the toes.
During assessment, the absence of a dorsalis pedis pulse in a patient would indicate:
a. Normal vascular function.
b. Possible PAD.
c. Venous insufficiency.
d. Hyperlipidemia.
Answer: b
Rationale: The absence of a dorsalis pedis pulse can indicate decreased blood flow to the foot, suggesting PAD.
Which of the following is a known risk factor for the development of hypertension?
a. Low salt diet.
b. Regular aerobic exercise.
c. Chronic kidney disease.
d. Low-stress lifestyle.
Answer: c
Rationale: Chronic kidney disease is a risk factor for hypertension due to the kidney's role in blood pressure regulation.
Which condition is a direct consequence of untreated hypertension?
a. Asthma.
b. Left ventricular hypertrophy.
c. Osteoporosis.
d. Hyperthyroidism.
Answer: b
Rationale: Untreated hypertension can lead to the heart working harder to pump blood, resulting in left ventricular hypertrophy.
5.3 Obesity is a risk factor for:
a. Hypertension.
b. Peripheral neuropathy.
c. Glaucoma.
d. Osteoarthritis.
Answer: a
Rationale: Obesity increases the risk of hypertension due to increased blood volume and increased resistance in the arterioles.
A family history of early heart attacks is most closely associated with an increased risk of:
a. Rheumatoid arthritis.
b. PAD.
c. Asthma.
d. Type 2 diabetes.
Answer: b
Rationale: A family history of cardiovascular diseases, including early heart attacks, increases the risk for PAD.
A patient with a history of smoking, high cholesterol, and diabetes is at increased risk for:
a. Alzheimer's disease.
b. Glaucoma.
c. PAD.
d. Osteoporosis.
Answer: c
Rationale: Smoking, high cholesterol, and diabetes are all significant risk factors for PAD due to their contributions to atherosclerosis.
Which of the following characteristics is most commonly associated with diastolic heart failure (HFpEF)?
A. Reduced ejection fraction
B. Inability of the heart to fill with blood adequately
C. Inability of the heart to squeeze effectively
D. High afterload leading to decreased cardiac output
Answer: B
Rationale: Diastolic heart failure (HFpEF) is primarily associated with the heart's inability to fill adequately due to issues like stiffening of the heart muscle.
A patient is diagnosed with systolic heart failure (HFrEF). Which of the following would the nurse most likely expect to find?
A. Preserved ejection fraction
B. Reduced contractility of the heart muscle
C. Low afterload
D. Heart chambers filling excessively with blood
Answer: B
Rationale: Systolic heart failure (HFrEF) is characterized by a decrease in the heart muscle's ability to contract and pump blood effectively, leading to a reduced ejection fraction.
Select all the factors that can increase afterload. (SATA)
A. Aortic stenosis
B. Hypertension
C. Vasodilation
D. Mitral regurgitation
E. Vasoconstriction
Answers: A, B, E
Rationale: Afterload is the resistance the heart faces when trying to eject blood. Aortic stenosis and hypertension increase resistance, thus increasing afterload. Vasoconstriction also increases vascular resistance and afterload. Vasodilation reduces resistance, and mitral regurgitation pertains more to valvular function and preload than afterload.
Which of the following statements about preload is correct?
A. It's the resistance faced by the heart during systole.
B. It represents the volume of blood in the heart before contraction.
C. It decreases in diastolic heart failure.
D. It is the primary concern in systolic heart failure.
Answer: B
Rationale: Preload refers to the volume of blood in the heart at the end of its resting phase (before contraction).
A patient presents with symptoms of heart failure. Which of the following findings would support a diagnosis of diastolic heart failure (HFpEF)? (SATA)
A. Reduced ejection fraction
B. Stiffening of the heart muscle
C. Echo showing poor relaxation of the left ventricle
D. Weakening of the heart muscle
E. Increased preload
Answers: B, C
Rationale: Diastolic heart failure (HFpEF) is associated with stiffening of the heart muscle and issues with relaxation of the ventricles, leading to inadequate filling.
Which of the following interventions primarily targets afterload reduction?
A. Diuretics
B. ACE inhibitors
C. Beta-blockers
D. Inotropic agents
Answer: B
Rationale: ACE inhibitors are primarily used to reduce afterload by causing vasodilation, thus decreasing the resistance the heart must overcome during systole.
A nurse is educating a group of students about heart failure. Which statement by a student indicates an understanding of the difference between diastolic and systolic heart failure?
A. "In diastolic heart failure, the heart can't squeeze well, leading to reduced cardiac output."
B. "Systolic heart failure is all about problems with filling the heart with blood."
C. "Diastolic heart failure is characterized by a normal ejection fraction, but the heart doesn't fill with blood adequately."
D. "Both diastolic and systolic heart failure have reduced ejection fractions."
Answer: C
Rationale: Diastolic heart failure (HFpEF) is characterized by a normal ejection fraction but issues with the heart filling adequately due to problems like stiffening of the heart muscle.
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