NUR 209 Exam 2 (Cardiovascular) 102
complete solutions with rationale
NUR 209 Exam 2 (Cardiovascular) 102
complete solutions with rationale
Prep U
A nurse is assigned to care for a client with a terminal cardiovascular illness. When developing the
client's plan of care, which outcome would the nurse identify as most realistic for this client?
adaptation to living with limitations
maintenance of adequate comfort
acceptance of changes in lifestyle
recovery from the cardiovascular problem - ANSWER maintenance of adequate comfort
Rationale: The realistic outcome for a client with terminal cardiovascular disease is maintenance of
adequate comfort and acceptance of impending death.Realistic outcomes for the client with chronic
cardiovascular disease focus on helping the client to live within limitations imposed by the disease and
to improve acceptance of changes in lifestyle and self-concept. Outcomes pertinent to the client who is
admitted with an acute problem focus on recovery from the cardiovascular problem without residual
complications.
Prep U
Upon entering a client's room, the client tells the nurse, "I'm having some really strong pain in my
chest." The nurse intervenes immediately, placing the client in which position?
Sitting
,NUR 209 Exam 2 (Cardiovascular) 102
complete solutions with rationale
Standing upright
Flat with legs raised 20 to 30 degrees
Supine - ANSWER Sitting
Explanation:The nurse should make the client comfortable in a sitting position. A supine position inhibits
full chest expansion and limits gas exchange in the lung, so this position should be avoided. Since the
heart works harder in the supine position than in the upright position, the supine position is not
recommended. The hypotensive client is positioned with legs elevated 20 to 30 degrees.
Prep U
Which of the following is a noninvasive procedure assisting the nurse in cardiovascular care?
Electrocardiography
Pulmonary artery monitoring
Swan-Ganz catheterization
Cardiac output determination - ANSWER Electrocardiography
Explanation:Noninvasive heart monitoring involves electrocardiography and cardiac monitoring. Invasive
techniques, such as pulmonary artery monitoring, Swan-Ganz catheterization, cardiac output
determination, and cardiac support via an intraaortic balloon pump (IABP), typically are used by trained
critical care personnel to provide additional monitoring and support.
Prep U
, NUR 209 Exam 2 (Cardiovascular) 102
complete solutions with rationale
A nurse is teaching a client with heart disease about exercising and signs of overexertion. The nurse
determines that additional education is needed if the client states:
"I should wait at least an hour after eating before exercising."
"I need to call the doctor if it feels like my heart is racing."
"I need to start my routine with my warm-up exercises."
"I should stop exercising if my pulse is below my target zone." - ANSWER "I should stop exercising if my
pulse is below my target zone."
Explanation:For the client, the goal of the exercise program is to achieve the target heart rate. The client
should stop exercising if his pulse rate exceeds his target zone.
Prep U
A nursing instructor is developing a class presentation about reasons people with cardiovascular
problems seek medical care. Which of the following would the instructor include as the most common
reason?
Lower extremity swelling
Persistent cough
Chest pain
Hypertension - ANSWER Chest pain
complete solutions with rationale
NUR 209 Exam 2 (Cardiovascular) 102
complete solutions with rationale
Prep U
A nurse is assigned to care for a client with a terminal cardiovascular illness. When developing the
client's plan of care, which outcome would the nurse identify as most realistic for this client?
adaptation to living with limitations
maintenance of adequate comfort
acceptance of changes in lifestyle
recovery from the cardiovascular problem - ANSWER maintenance of adequate comfort
Rationale: The realistic outcome for a client with terminal cardiovascular disease is maintenance of
adequate comfort and acceptance of impending death.Realistic outcomes for the client with chronic
cardiovascular disease focus on helping the client to live within limitations imposed by the disease and
to improve acceptance of changes in lifestyle and self-concept. Outcomes pertinent to the client who is
admitted with an acute problem focus on recovery from the cardiovascular problem without residual
complications.
Prep U
Upon entering a client's room, the client tells the nurse, "I'm having some really strong pain in my
chest." The nurse intervenes immediately, placing the client in which position?
Sitting
,NUR 209 Exam 2 (Cardiovascular) 102
complete solutions with rationale
Standing upright
Flat with legs raised 20 to 30 degrees
Supine - ANSWER Sitting
Explanation:The nurse should make the client comfortable in a sitting position. A supine position inhibits
full chest expansion and limits gas exchange in the lung, so this position should be avoided. Since the
heart works harder in the supine position than in the upright position, the supine position is not
recommended. The hypotensive client is positioned with legs elevated 20 to 30 degrees.
Prep U
Which of the following is a noninvasive procedure assisting the nurse in cardiovascular care?
Electrocardiography
Pulmonary artery monitoring
Swan-Ganz catheterization
Cardiac output determination - ANSWER Electrocardiography
Explanation:Noninvasive heart monitoring involves electrocardiography and cardiac monitoring. Invasive
techniques, such as pulmonary artery monitoring, Swan-Ganz catheterization, cardiac output
determination, and cardiac support via an intraaortic balloon pump (IABP), typically are used by trained
critical care personnel to provide additional monitoring and support.
Prep U
, NUR 209 Exam 2 (Cardiovascular) 102
complete solutions with rationale
A nurse is teaching a client with heart disease about exercising and signs of overexertion. The nurse
determines that additional education is needed if the client states:
"I should wait at least an hour after eating before exercising."
"I need to call the doctor if it feels like my heart is racing."
"I need to start my routine with my warm-up exercises."
"I should stop exercising if my pulse is below my target zone." - ANSWER "I should stop exercising if my
pulse is below my target zone."
Explanation:For the client, the goal of the exercise program is to achieve the target heart rate. The client
should stop exercising if his pulse rate exceeds his target zone.
Prep U
A nursing instructor is developing a class presentation about reasons people with cardiovascular
problems seek medical care. Which of the following would the instructor include as the most common
reason?
Lower extremity swelling
Persistent cough
Chest pain
Hypertension - ANSWER Chest pain
