Heart Failure
Provide at least 4 examples of symptoms/assessment findings someone experiencing a CHF exacerbation may experience/have.
SOB.
DOE.
Weight gain.
Crackles in lungs.
Lower extremity edema.
Hypoxic.
Fatigue.
Activity intolerance.
According to best evidence based practice, what is the most important factor in prevention of cardiovascular disease?
A. Aggressive blood pressure control
B. Early pharmacotherapy with anti-hypertensives and statin therapy
C. Diet and lifestyle changes
D. Eliminate daily stress
C. Diet and lifestyle changes
The nurse is caring for a patient who suffered a right sided CVA. The nurse would anticipate which findings related to a right sided CVA?
A. Deficits affecting the right side.
B. The need for TPN.
C. Left sided deficits.
D. The patient complains of a headache 3/10.
C. Left sided deficits.
TRUE/FALSE
Sense of taste diminishes more than sense of smell.
False.
Sense of smell diminishes more than sense of taste
Name five risk factors that puts an older adult at risk for cardiovascular disease.
Atherosclerosis. Hyperlipidemia.
Physical inactivity. Genetics.
Obesity.
Tobacco smoking.
Diet.
Stress/depression.
HTN.
The right side of the heart pumps the blood to what part of the body?
Lungs.
The nurse has completed an assessment on a client with a decreased cardiac output. Which findings should receive highest priority?
A. BP 110/62, atrial fibrillation with HR 82, bibasilar crackles.
B. Confusion, urine output 15mL over the last 2 hours, orthopnea.
C. SpO2 92 on 2 liters nasal cannula, respirations 20, 1+ edema of lower extremities.
D. Weight gain of 1kg in 3 days, BP 130/80, mild dyspnea with exercise.
B. Confusion, urine output 15ml over the last 2 hours, orthopnea
The patient who suffered a stroke has a deficit of dysphagia. The patient is at an increased risk for developing?
A. Esophageal varices.
B. Bacterial pneumonia.
C. Aspiration pneumonia.
D. Duodenal ulcer.
B. Aspiration pneumonia
Older adults may be more willing to adjust their diet for the sake of their health?
False.
They may be more resistant to change their diet
Which heart arrhythmia is usually associated with a stroke and why?
Atrial fibrillation
Nurse is assessing a patient with systolic heart failure. Which diagnostic test will be best in diagnosing the severity of their heart failure?
A. Brain natriuretic peptide - BNP
B. CK/TROPONIN levels
C. Echocardiography
D. CBC/CMP
C. Echocardiography
The nurse is assessing clients at a health fair. Which client is at greatest risk for CAD?
A. A 32 year old female with mitral valve prolapse who quit smoking 10 years ago.
B. A 43 year old male with a family history of CAD and cholesterol level of 158.
C. A 56 year old male with an HDL of 60 who takes atorvastatin (Lipitor).
D. A 65 year old female who is obese with an LDL of 188.
D. A 65 year old with is obese with an LDL of 188.
The ED nurse is receiving report of a patient arriving to the ED in the next 5 minutes for a stroke alert. What test should the nurse anticipate the patient will require first?
A. MRI of brain.
B. CT brain.
C. NIH stroke scale.
D. GCS.
B. CT brain.
A 96 year old woman has been admitted to the hospital with a diagnosis of frailty. Which laboratory value would the nurse anticipate?
A. Elevated WBC's.
B. Low albumin.
C. Elevated serum calcium and magnesium.
D. Thrombocytopenia.
B. Low albumin
3. A patient with heart failure complains of fatigue. The nurse understands that which causes of fatigue are associated with heart failure?
A. Anemia.
B. Increased cardiac output.
C. Increased oxygen to tissues.
D. Increased perfusion to organs.
A. Anemia.
In heart failure, weakened heart muscle cannot pump effectively due to (select all that apply):
A. Mechanical abnormalities
B. Chronic HTN
C. MI
D. Cardiomyopathy
A. Mechanical abnormalities
B. Chronic HTN
C. MI
D. Cardiomyopathy
What disorders encompass metabolic disorder?
(Hint: there are 3 of them)
Lipid disorders.
Insulin resistance.
Hypertension.
The nurse is caring for a patient who suffered a CVA. Which information about the patient would require the nurse to respond immediately?
A. The patient is complaining of a headache 3/10.
B. The patient has a blood pressure of 96/58.
C. The patient is complaining of being thirsty.
d. The patient's CSF is positive for RBC's.
B. The patient has a blood pressure of 96/58
Which older adult patient is at most risk for becoming malnourished?
A. The patient with HTN taking HCTZ.
B. The patient with COPD.
C. The patient with a new set of dentures.
D. The patient who takes a daily walk around the block.
B. The patient with COPD.
5. You're educating a patient about TIA's. Select all the options that are INCORRECT about this condition:
A. TIAs are caused by a temporary decrease in blood flow to the brain.
B. TIAs produce signs and symptoms that can last for several weeks to months.
C. TIAs is a warning sign that an impending stroke may occur.
D. TIAs don't require medical treatment.
B. TIAs produce signs and symptoms that can last for several weeks to months.
D. TIAs don't require medical treatment.
What are the AHA stages of heart failure?
Stage A - at risk for HF, but without structural disease or HF symptoms.
Stage B - Structural heart disease but without signs and symptoms of heart disease.
Stage C - Structural heart disease with prior or recurrent symptoms of HF.
Stage D - Refractory HF.
Symptoms of postprandial hypotension include (select all that apply)
A. Sleepiness
B. Dizziness
C. Nausea
D. Chest pain
A. Sleepiness
C. Nausea
D. Chest pain.
The nurse is obtaining vital signs on a patient s/p right ischemic stroke on the med/surg unit. The nurse obtains a blood pressure of 178/90. Which action should the nurse take next?
A. Notify the physician of elevated blood pressure.
B. Give PRN anti-hypertensive medication.
C. Check orders and document the findings in EPIC.
D. Instruct the patient to inhale/exhale deeply to ensure relaxation.
C. Check orders and document the findings in EPIC
What should an older adult with diminished cranial nerve I (CN I) and cranial nerve II (CN II) do when dealing with food?
A. Date all leftover food in the refrigerator
B. Consume small, frequent meals
C. Make sure that food is soft and easy to chew
D. Make sure their plate is filled with vegetables and protein
A. Date all leftover food in the refrigerator
4. The nurse is assessing the adaptation of a client to changes in functional status after a stroke. Which observation indicates to the nurse that the client is adapting most successfully?
A. Gets angry with family if they interrupt a task.
B. Experiences bouts of depression and irritability.
C. Has difficulty with using modified feeding utensils.
D. Consistently uses adaptive equipment in dressing self
D. Consistently uses adaptive equipment in dressing self.