CHAPTER 15 The Cardiovascular System

CHAPTER 15 The Cardiovascular System

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

15.1•An 80-year-old woman arrives in the emergency department complaining of fatigue, nausea, vague complaint of intermittent chest discomfort, and not sleeping well. The nurse would interpret these findings as symptoms of

1. cardiac disease.
2. pancreatic disease.
3. normal changes of aging.
4. signs of anemia.

Answer: 1

Rationale: Many elderly women will complain of vague symptoms when having a myocardial infarction including fatigue, epigastric pain, and sleep disturbances. Pancreatic disease would present pain in the abdominal region. These symptoms are not considered normal changes of aging. Anemia would present with fatigue but not with nausea or chest discomfort.

Assessment

Physiological Integrity

Analysis

15.2•During a blood pressure screening at the local shopping center, a 78-year-old man tells the nurse he is experiencing a fluttering in his chest while doing yard work. He reports no other symptoms and the frequency is intermittent. The nurse would interpret this finding to be consistent with

1. underlying illness that requires a medical evaluation.
2. nonspecific cardiac changes with aging.
4. exercise intolerance.

Answer: 1

Rationale: New onset atrial fibrillation and other arrythmias may signal the onset of a serious underlying illness that requires further medical evaluation. Chest fluttering can be a sign of hyperthyroidism, not hypothyroidism. These symptoms are not normal cardiac changes and exercise intolerance would include symptoms of shortness of breath, which the client does not report.

Assessment

Physiological Integrity

Analysis

15.3•A 90-year-old client’s blood pressure reading is 150/88. The client reports no other symptoms or medical history of illness. The nurse would instruct the client to

1. do nothing, this is a normal variant of aging.
2. go to the emergency department for further evaluation and treatment.
3. contact the primary care provider for further evaluation and treatment.
4. have the blood pressure rechecked in a month.

Answer: 3

Rationale: Blood pressure elevation frequently occurs with aging although it is not considered a normal variant. Isolated systolic hypertension (systolic >140 mm Hg) is frequently seen in older persons. If left uncontrolled, it can lead to stroke, heart attack, and other conditions. Therefore, it warrants further evaluation. It is not a symptom of emergent nature because the diastolic is not elevated above 110 mm Hg. Waiting for 1 month to recheck the blood pressure is too long of a period of time for evaluation and treatment.

Implementation

Health Promotion and Maintenance

Application

15.4•The nurse is conducting a home care visit of an 82-year-old patient. The client’s vital signs include a blood pressure of 150/100 mm Hg. In reviewing the medication administration, the client reports that she takes the blood pressure medicine only when she feels tense and feels that the blood pressure is elevated. The nurse would instruct the patient to

1. continue to administer the blood pressure medication as needed.
2. contact the physician for an increase in blood pressure medication.
3. have the client take the blood pressure medication twice the prescribed dosage for 1 day then resume the daily schedule.
4. instruct the client to take the blood pressure medication as prescribed regardless of feeling tense.

Answer: 4

Rationale: Clients sometimes mistakenly take blood pressure medication only on an as-needed basis. This is incorrect and the client should take the medication as prescribed on a daily basis. The dosage prescribed may be appropriate if taken daily, therefore, it would not need to be increased. To advise the patient to increase the medication without a physician consultation would be out of the scope of nursing practice.

Implementation

Health Promotion and Maintenance

Application