While caring for a patient with aortic stenosis, the nurse identifies a nursing diagnosis of acute pain related to decreased coronary blood flow. A priority nursing intervention for this patient would be to
a. promote rest to decrease myocardial oxygen demand.
b. teach the patient about the need for anticoagulant therapy.
c. teach the patient to use sublingual nitroglycerin for chest pain.
d. raise the head of the bed 60 degrees to decrease venous return.
Question 2While caring for a 23-year-old patient with mitral valve prolapse (MVP) without valvular regurgitation, the nurse determines that discharge teaching has been effective when the patient states that it will be necessary to
a. take antibiotics before any dental appointments.
b. limit physical activity to avoid stressing the heart.
c. take an aspirin a day to prevent clots from forming on the valve.
d. avoid use of over-the-counter (OTC) medications that contain stimulant drugs.
Question 3A 21-year-old woman is scheduled for percutaneous transluminal balloon valvuloplasty to treat mitral stenosis. Which information should the nurse include when explaining the advantages of valvuloplasty over valve replacement to the patient?
a. Biologic valves will require immunosuppressive drugs after surgery.
b. Mechanical mitral valves need to be replaced sooner than biologic valves.
c. Lifelong anticoagulant therapy will be needed after mechanical valve replacement.
d. Ongoing cardiac care by a health care provider is not necessary after valvuloplasty.
Question 4When caring for a patient with mitral valve stenosis, it is most important that the nurse assess for
a. diastolic murmur.
b. peripheral edema.
c. shortness of breath on exertion.
d. right upper quadrant tenderness.
Question 5When developing a community health program to decrease the incidence of rheumatic fever, which action would be most important for the community health nurse to include?
a. Vaccinate high-risk groups in the community with streptococcal vaccine.
b. Teach community members to seek treatment for streptococcal pharyngitis.
c. Teach about the importance of monitoring temperature when sore throats occur.
d. Teach about prophylactic antibiotics to those with a family history of rheumatic fever.
Question 6The nurse establishes the nursing diagnosis of ineffective health maintenance related to lack of knowledge regarding long-term management of rheumatic fever when a 30-year-old recovering from rheumatic fever without carditis says which of the following?
a. I will need prophylactic antibiotic therapy for 5 years.
b. I will need to take aspirin or ibuprofen (Motrin) to relieve my joint pain.
c. I will call the doctor if I develop excessive fatigue or difficulty breathing.
d. I will be immune to further episodes of rheumatic fever after this infection.
Question 7A patient with rheumatic fever has subcutaneous nodules, erythema marginatum, and polyarthritis. Based on these findings, which nursing diagnosis would be most appropriate?
a. Pain related to permanent joint fixation
b. Activity intolerance related to arthralgia
c. Risk for infection related to open skin lesions
d. Risk for impaired skin integrity related to pruritus