Online Nursing Practice Test about Cardiovascular Diseases 51-55

51. A clinic nurse has provided home care instructions o the client with a history of cardiac disease who has just been told that she is pregnant. Which statement, if made by the client, indicates a need for further instructions?

a) it is best that I rest lying on my side to promote blood return to the heart
b) I need to avoid excessive weight gain to prevent increased demands on my heart
c) I need to try to avoid stressful situations because stress increases the workload of the heart
d) During the pregnancy, I need to avoid contact with other individuals as much as possible to prevent infection

52. A nurse is providing instructions to a maternity client with a history of cardiac disease regarding appropriate dietary measures. Which statement, if made by the client, indicates an understanding of the information provided by the nurse?

a) I should drink adequate fluids and increase my intake of high-fiber foods
b) I should maintain a low-calorie diet to prevent any weight gain
c) I should lower my blood volume by limiting fluids
d) I should increase my sodium intake during pregnancy

53. A clinic nurse reviews the record of a child just seen by a physician and diagnosed with suspected aortic stenosis. The nurse expects to note documentation of which clinical manifestation specifically found in this disorder?

a) pallor
b) hyperactivity
c) exercise intolerance
d) gastrointestinal disturbances

54. A nurse has provided home care instructions to the mother of a child who is being discharged following cardiac surgery. Which statement made by the mother indicates a need for further instructions?

a) a balance of rest and exercise is important
b) I can apply lotion or powder to the incision if it is itchy
c) activities in which my child could fall need to be avoided for 2 to 4 weeks
d) large crowds of people need to avoided for at least 2 weeks following surgery

55. A nurse provides home care instructions to the parents of a child with congestive heart failure (CHF) regarding the procedure for the administration of digoxin (Lanoxin). Which statement, if made by the parent, indicates the need for further instructions?

a) I will not mix the medication with food
b) If more than one dose is missed, I will call the physician
c) I will take the child's pulse before administering the medication
d) if the child vomits after medication administration, I will repeat the dose





ANSWERS AND RATIONALE

51) D
- to avoid infections, visitors with active infections should not be allowed to visit the client; otherwise, restrictions are not required. Stress causes increased heart workload, and the client should be instructed to avoid stress. Too much weight gain can place further demands on the heart. Resting should be done by lying on the side to promote blood return.

52) A
- constipation can cause the client to use Valsalva's maneuver. This maneuver can cause blood to rush to the heart and overload the cardiac system. Therefore, high-fiber foods are important. A low-calorie diet is not recommended during pregnancy and could be harmful to the fetus. Diets low in fluid can cause a decrease in blood volume, which could deprive the fetus of nutrients, so adequate fluid intake and high-fiber foods are important. Sodium should be restricted somewhat, as prescribed by the physician, because excess sodium will cause an overload to the circulating blood volume and contribute to cardiac complications.

53) C
- The child with aortic stenosis shows signs of exercise intolerance, chest pain, and dizziness when standing for long periods of time. Pallor may be noted but is not specific to this type of disorder alone. Options B and D are not related to this disorder.

54) B
- The mother should be instructed that lotions and powders should not be applied to the incision site. Lotions and powders can irritate the surrounding skin, which could lead to skin breakdown and subsequent infection of the incision site. Options A, C and D are accurate instructions regarding home care after cardiac surgery.

55) D
- The parents need to be instructed that if the child vomits after the digoxin is administered, they are not to repeat the dose. Options A, B and C are accurate instructions regarding the administration of this medication. In addition, the parents should be instructed that if a dose is missed and is not identified until 4 hours later, the dose should not be administered. 


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